bluuebunny/crossref_metadata_2025 huggingface dataset:
РОЗВИТОК ПІДПРИЄМНИЦТВА В УМОВАХ ЗАВЕРШЕННЯ АДМІНІСТРАТИВНО-ТЕРИТОРІАЛЬНОЇ ТА ЗЕМЕЛЬНОЇ РЕФОРМ: СТАЛІСТЬ СІЛЬСЬКИХ ТЕРИТОРІЙ ТА ІНВЕСТИЦІЙНА КОНКУРЕНТОСПРОМОЖНІСТЬ
Authors: Гаража Олена , Шиян Дмитро , Чернега Інна , Петренко Олександр
Published: May 2022

Проаналізовано особливості розвитку підприємництва в умовах завершення адміністративно-територіальної та земельної реформ. Продемонстровано, що підприємництво є необхідною умовою економічного розвитку територіальних громад, які утворилися в результаті проведення адміністративно-територіальної реформи в контексті ринкового реформування національної економіки, яке передбачає реалізацію державної політики, формуючи новий формат взаємовідносин між публічною владою і бізнесом, урегульовує економічні процеси у приватному секторі економіки, прискорює економічне зростання, підвищує якість надання державних послуг. Виявлено пріоритетні напрями вдосконалення цього процесу. Хоча адміністративно-територіальна реформа в Україні перебуває на завершальній стадії, зроблено висновок про її неефективність, що призводить до низької ефективності функціонування і розвитку бізнес-середовища та підприємництва малого і середнього бізнесу, які є основними джерелами наповнення місцевих бюджетів на основі чинної податкової системи. Було зазначено, що розвиток підприємництва в Україні повинен мати свою стратегію впровадження, яка може визначати головні аспекти, розкривати актуальну проблематику і надавати варіанти рішень цих гострих питань. Ключовими положеннями подібної стратегії стануть: інституціональне бізнес-середовище, покращення якості дорадництва, налагодження комунікаційних каналів та тісних взаємовідносин між місцевою владою і населенням, удосконалення механізмів розвитку кооперації та кластерів, розроблення рекомендаційних бізнес-пакетів для потенційних підприємців, проведення аналізу ресурсного потенціалу сільської території, розроблення інструментів державної підтримки малого і середнього бізнесу, формування доступних і відкритих геоінформаційних систем з розвитку підприємництва, удосконалення моделей державно-приватного партнерства для розвитку територій громад, організація дистанційного навчання зацікавлених жителів для ефективного ведення власної справи з урахуванням змін клімату, стимулювання місцевих органів влади до нарощування власного бюджетного потенціалу, прозорість і доступність до інформації з упровадження окремих видів підприємницької діяльності на території громади, розкриття ресурсного забезпечення та інвестиційної привабливості території
FINANCIAL AND ECONOMIC SUPPORT OF THE FUNCTIONING OF ENTERPRISES OF THE MATERIAL SPHERE OF PRODUCTION : A PRACTICAL DIMENSION
Authors: Perevozova Iryna , Mykhailyshyn Lilya , Morozova Olena , Gordeyeva Ylena , Liubar Ruslan , Shapoval Olena
Published: May 2022

There are enterprises of different types of economic activity at the market, which should be classified into tangible and intangible enterprises. The first group includes enterprises in industry, agriculture, forestry and fisheries and construction. The second group consists of companies engaged in trade and providing various services to market participants. In general, 128.9 thousand enterprises operated at the market at the beginning of 2021. With a share of 35.5% of the total number of enterprises, they produced products worth UAH 3.9 trillion, which is almost a third of the market. We consider the financial support of the material sphere enterprise through the prism of planning the needs of production in financial resources directed to its resource provision. If the company lacks its own financial resources, it is forced to look for external sources to cover costs. An important role is played by the imbalance in revenue and expenditure growth, which amounted to -6.4%, the growth of receivables (in industry and construction). The reduction of enterprises' own cash by this amount is caused by a constant increase in energy tariffs, a decrease in the purchasing power of the population, an increase in tax pressure, and other factors. The management of enterprises compensates the shortage of financial resources by attracting bank loans and borrowings (long-term and short-term), issues of shares and bonds. Thus, long-term liabilities and collateral increased (+ 23.2%), especially due to an increase in bond issues (4.8 times). At the same time, the amount of funds raised from the placement of shares decreased significantly (almost 6 times)against the background of uncertainty and instability of the stock market. Even in the conditions of economic instability in 2020, enterprises make capital investments in tangible and intangible assets, although to a much lesser extent than in 2016 (almost a quarter less). The financial results of enterprises are the lowest in 2016-2020, especially in industry and construction, where there is a loss of 43.1%. The situation that arises requires a detailed in-depth study and the formation of appropriate recommendations for enterprises, depending on the type of economic activity.
STRATEGIC DIRECTIONS OF MARKETING COMMUNICATIONS OF AGRO-INDUSTRIAL ENTERPRISES IN UKRAINE
Authors: Kuzyk Oleg
Published: May 2022

The use of various tools of marketing communications and a strategic approach to developing communication campaigns are nowadays of particular importance. The processes of differentiation and positioning, being an integral part of any business, become complete only if consumers are made aware of the unique qualities and differences of the product, compared to alternative offers, through the marketing communication tools. Most of the Ukrainian agro-industrial companies should refer to the experience of leading Ukrainian and foreign companies, which, thanks to effective communication strategies, have successfully explained the differences and position of their products to the target audience and markets and achieved significant success.
In marketing communication campaigns, especially in foreign markets, it is advisable to refer to the image of Ukraine as a well-known agricultural producer and the heritage, being an important component of modern agribusiness. Today, the issues regarding the truthfulness of messages of agricultural companies are associated with the compliance with standards and food safety regulations, which is a concern of national governments and international organizations. Therefore, communication campaigns of the Ukrainian companies should be simple and distinguishable, and convey the main ideas of differentiation and positioning of a product or enterprise itself short and clear. The limited and selective perception of modern consumers, who are overloaded with the vast amount of information, should also be taken into account.
BANKING PROJECT FINANCING OF PUBLIC-PRIVATE PARTNERSHIP AND ITS ROLE IN ENSURING PUBLIC WELFARE
Authors: Shuliuk Bohdana , Horyn Volodymyr
Published: May 2022

The article reveals the peculiarities of the use of bank project financing in the field of PPP. It is substantiated that the peculiarity of the application of  PPP project financing is the creation of a special project company, which is responsible for mobilizing financial resources for project implementation; the presence of a hierarchy of investment; more objective assessment of the borrower's solvency and reliability and evaluation of the project itself in terms of its efficiency, security and risk; significant transaction costs to settle the interests of all members of the partnership.

It is proved that in modern conditions the role of project bank lending in the sources of project financing is growing rapidly, and the role of banks in this process is much wider than in traditional forms of lending. They not only provide financial support for the project, but also become direct participants in the implementation of the PPP project, performing management, settlement, consulting, guarantee and other functions. Given the specifics of PPP projects (large scale, long implementation time, cost), the participation of commercial banks in their financing is complicated. International development banks and international financial institutions play a leading role in the formation of project financing in the field of PPP, and the syndicated lending mechanism is also used in foreign practice. However, in Ukraine, bank project financing is practically underdeveloped, which is due to its institutional and legal irregularities. The use of syndicated lending mechanisms in Ukraine is unique, as well as the financing of PPP projects through credit and export agencies. PPP project financing with the support of international financial institutions, in particular the EBRD, has been the most developed, concentrating in such areas as infrastructure development, energy reform, and construction. In this regard, the problems of economic, legal and managerial nature, which hinder the development of bank project financing in the field of PPP in Ukraine in modern conditions, are outlined.
Perception of Undergraduate Dental Students about Use of Smartphones in Dentistry: An Efficient Teaching-Learning Tool During Covid – 19 Pandemic
Authors: Chahande Dr. Jaishree , Deshmukh Dr. Saee
Published: May 2022

Health care has transformed intensely with the Digital Era. Smartphone is one of the digital tools which change the traditional way of teaching-learning nowadays. There is the widespread use of Smartphones as a part of the ‘Learning Management System’ in dental healthcare. Amid the COVID-19 pandemic, regular classroom and clinical educational activities for dental students were almost disturbed globally. ‘WHO Guidelines’, appeal to everyone to stop the spread of pandemic by maintaining social distancing. As per the Government and University guidelines, colleges must continue education through an online platform so that students should not be deprived of education. As this current situation is unpredictable, Smartphones are routinely used by many students to continue digital education. Therefore the perception of students on the usage of Smartphones as an easily available efficient teaching-learning tool in dentistry is the need of the hour. So, the aim of the study was to assess the perception of undergraduate dental students about the use of Smartphones in dentistry as an efficient teaching-learning tool during COVID – 19 pandemic. A cross-sectional study was carried out at VSPM Dental College and Research Centre, Nagpur. Pre-validated questionnaires were provided to the dental undergraduate students containing 14 closed-ended questions and one open-ended question among approximately 500 students through Google Form. 99% of students used smartphones for e-learning. Smartphones are convenient and easily accessible devices during this pandemic situation to continue teaching and learning. Smartphones in dentistry are really an efficient digital teaching-learning tool during COVID – 19 pandemic situations.
Right To Privacy: A Comparative Study
Authors: Nirala Dr. Surendra Kumar
Published: May 2022

The term ‘Privacy’ is derived from the Latin word ‘Privatus’ which means separated from the rest. Though it is a variable concept and varies with cultural or social context, but actually it means, the right to be left alone. The need for Privacy is to create a balance between individual and social interests, which is equally applicable to past, present and future society. In this sense, the necessity of Privacy was found in the dawn of human civilization. The idea of Privacy is as old as Biblical periods. Also, the growth and expansion of Privacy varied according to the variation in different stages of human civilization. Hence, the description of origin and history of Right to Privacy should proceed from the ancient period to the modern period. In fact, the idea of Privacy was originated in the animal society and gradually it has been incorporated into the human society. The idea of Privacy, which was originated in the animal society, has been adopted in the primitive human society, where the traces of it were first found. According to different Anthropological studies, the idea of Privacy varied in respect of different primitive societies. With the evolution of primitive society to ancient society and then gradually to modern society, the idea of Privacy has been developed to get its present shape. The root of Privacy and its protection is embedded in the history of human civilization, which is characterized specially by transformation of primitive society into modern society. The social transformation has increased both the physical and psychological opportunities for Privacy and also proved to be fruitful for conversion of these opportunities into choices of values in the context of socio-political reality. Social transformation is the responsible factor for changing nature of Privacy as well as the changing character of Privacy violations from primitive societies to modern societies
Striking The Withdrawal Benefit Off The Social Security Statutes And Its Remedies In Social Security Industry Of Tanzania
Authors: Issah Jackson Masoud
Published: May 2022

The withdrawal benefit is one of the social security benefits that were payable in the Tanzanian social security scheme before the 2018 amendment. The recent amendment in social security law of the country. It is the benefit peculiar to other common benefits in the world of social security which stood the legal statutes of the country for a quite long period of time in the state history. Despite its black knowledge in international law perspectives, in practical aspect, this benefit served a lot to the employees especially those employed on non-pensionable employment schemes, before its recent removal from the social security laws of Tanzania. This is because, payments of small salaries; un-secured employment tenure and limited chance of securing a new job after a loss of one’s employment; are some of the serious challenges relating to private sector employment to which most of the employees belong in Tanzania. The withdrawal benefit in that special purpose, therefore, remedied the employment uncertainty and contingency in Tanzania before its burn. Despite the reflective value of the withdrawal benefit in the social security legal context of Tanzania, the same benefit has been removed from the laws of the state via the recently enacted law, which is the Public Service Social Security Fund Act, 2018. The academic call that is behind this paper, therefore, is an examination of the social security purpose and functions saved by the withdrawal benefit; its justification in the social security industry and its replacement that has been brought by its complementary legislative initiatives in the Tanzanian social security industry.
Mullā Jīwan’s Methodology in His Qurʾān Commentary Al-Tafsīrāt Al-Aḥmadiyyah
Authors: Uddin Kamil Zia
Published: May 2022

This article outlines the Ḥanafī subcontinent contribution to the field of tafsīr. It provides a synopsis of Ḥanafī books on the genre of aḥkām al-Qurʾān (legal verses of the Qurʾān). Aḥmad b. Abū Sa‘īd al-Junfūrī (d. 1717), more commonly known as Mullā Jīwan, was an Indian jurist and celebrated teacher of the Mughal Emperor Alamgir (d. 1707). Given he was a teacher of a Mughal emperor, his writings potentially had the capability to practice and influence fiqh at state level. In his introduction, Mullā Jīwan states three types of derivations from the selected āyāt: juristic rulings (aḥkām fiqhiyyah), Islamic jurisprudence (uṣūl al-fiqh) and issues of creed (masāʾil al-‘ʿaqīdah al-sunniyyah). I use examples of āyāt for each derivation to highlight and identify the manhaj (methodology) of his tafsīr. Other sciences are mentioned in his tafsīr—like naḥw (grammar) or taṣawwuf (Sufism)—but they are not the salient objectives mentioned in his introduction nor are they as common as the abovementioned points. Mullā Jīwan is most known for his commentary on Abū al-Barakāt al-Nasafī’s (d. 1311) text on jurisprudence, al-Manār, titled Nūr al-anwār sharḥ al-manār (Light of Lights, commentary on the Enlighted). Prior to writing that commentary, Mullā Jīwan wrote a juristic exegesis of the Qurʾān titled al-Tafsīrāt al-Aḥmadiyyah fī bayān al-āyāt al-sharʿiyyah (Aḥmad’s Exegeses in Explaining Legal verses). It was the first complete juristic exegesis written in the subcontinent. In this tafsīr, he presents each masʾalah (case study) based on the Ḥanafī/Māturīdī school of thought.
Protection of Traditional Knowledge and its Resulting Innovation
Authors: Mejía-Trejo Juan
Published: May 2022

This document aims to propose a reflection on how important it is for emerging countries to protect their traditional knowledge and the potential it has to generate resulting innovation. This is based on defining what traditional knowledge is, the scope and limitations of the practice by the countries that recognize it, and its relationship with the concepts of the 2018 Oslo Manual (OECD, 2018) on innovation. It is concluded that there is still work to be done since there are persistent problems such as the lack of schemes: regulatory protection, rapprochement of cultural and/or traditional issues as well as marketing, among others, for emerging countries, which, if achieved, will allow them to reflect it in the improvement of their economies.
Regional Wealth with Biodiversity and Socioeconomic Marginality
Authors: Vázquez-Elorza Ariel
Published: May 2022

Purpose. Mexico is a country with a richness in biodiversity and a high level of Natural Capital throughout the territory; however, the highest concentration is distributed in regions where a population with high levels of marginalization and socioeconomic poverty lives.

Methodhology. The characteristics of genetic resources and their sustainable use in conservation require the establishment of cross-cutting strategies in the design and implementation of comprehensive public policies focused on society and the diversity of territories and social needs.

Findings and originality. This reality highlights the relevance of identifying the main elements that characterize the Natural Capital in the environments, mainly in the South Pacific region due to its social and cultural importance. The originality of this document is the analysis of the socioeconomic and marginalization conditions of the population with the most incredible wealth in biodiversity and establish strategies that facilitate the conservation of genetic resources in tune with sustainable social and economic growth in the medium and long term.
Valuando la Evaluación: Protocolos Comunitarios Bioculturales, Innovación de Negocios Circulares Inclusivos y Prospectivos en México
Authors: Mejía-Trejo Juan , Aguilar-Navarro Carlos Omar
Published: May 2022

Propósito. Se hace una aproximación teórico-argumentativa, sobre la importancia de anexar en los protocolos comunitarios bioculturales (PCB), la realización de innovación de negocios circulares e inclusivos (iNCI) en México.
Metodología. Se revisa literatura sobre los PCB, con métodos de evaluación de recursos biológicos o de conocimiento tradicional a proteger incluyendo métodos de evaluación de impacto social para diseñar e implementar la iNCI basados en emprendimientos de base tecnológica o startups de impacto social (SIS). La prospectiva estratégica es resaltada como generadora de escenarios de negocios para llevarlos a cabo.
Hallazgos. Propuesta de modelo concepual funcional PCB-iNCI a través de una SIS.
Originalidad. La posibilidad tanto de atraer inversionistas a la comunidad y viceversa para logro de beneficios mutuos.
Piggybacking access: providing library access to the College of Intensive Care Medicine
Authors: Prentice John
Published: May 2022

In late 2019, the Australian and New Zealand College of Anaesthetists library began supplying library services to the College of Intensive Care Medicine. It did this by “piggybacking” the new service on the back of its existing library service. This model is presented as a way of providing library services to smaller institutions that would not normally be in a position to manage their own library service.
ALIA advocacy events and the conundrum presented for Health and Special Libraries
Authors: Pitman Michelle
Published: May 2022

the generalized thematic thrust of ALIA events messaging may get lost in translation for the Specialist Librarian. Unless one has time and capacity to exert some imagination, these marketing opportunities and their themes will often mean little to our unique cohorts.
From library to knowledge centre: evolving a responsive hospital library service for Far North Queensland health services
Authors: Marconi Juliet
Published: May 2022

Juliet Marconi reflects on her time in the hospital and health service library serving Cairns and Far North Queensland.
Libraries in the digital age
Authors: Kluwer Wolters
Published: May 2022

Editor’s note: Health Libraries Australia receives sponsorship from vendors for various activities it undertakes, including JoHILA. Sponsorship helps to offset the sundry costs associated with hosting and maintaining the journal. In this and future issues opportunity will be made available for the sponsor to share with the readership information that may be of interest or relevance. As with conference presentations and the like this content is provided independently by the sponsor and Health Libraries Australia is not endorsing any particular company or product. Also, please note for this article comments from me are featured. These comments were made in response to a generic question about the balance between print and digital tools in health libraries, and were offered independent of my JoHILA role. They do not represent an endorsement of particular companies or products.
A personal reflection: the first four months of the CHQ Library
Authors: Jensen Fiona
Published: May 2022

In September 2021 I started a new job with the Children’s Health Queensland Hospital and Health Service (CHQ) in Queensland. CHQ was established in 2012 and had never had a library. As I was to find out, my new manager had been pushing for a library/librarian for some time, and eventually obtained approval for a 0.4 position with the title “Librarian and Research Metrics Manager”.
Don Keast chats with Jocelyn Morris
Authors: Keast Don , Morris Jocelyn
Published: May 2022

Don Keast recently retired after a long career in health libraries, most recently at the George Hatch Medical Library, Dubbo Health Service. He sat down for a chat with Jocelyn Morris, formerly Charles Sturt University campus librarian at Dubbo.
Increased Psychological Disorders among Pediatric Population during Covid
Authors: AlQaatri Hamda Ahmed J H
Published: May 2022

A review of the literature on psychological disorders aming the pediatric population during the Covid 19 pandemic. Key words: Covid 19, psychological disorders, paediatric population
School Teachers’ Knowledge and Attitude toward School Students with Epilepsy
Authors: AlSugair Rawan S. , Alyabis Mohrah A. , Algadi Marwa A. , Attieh Asmaa I. , Juha Labani A , Alawa Rama G. , Alghannam Sarah G. , Alsaadoon Noora Z. , Elsayed Nervana A. , Alfadeel Mona A.
Published: May 2022

Background: Epilepsy is a chronic disorder of the central nervous system that affects people of all ages worldwide. Objectives: to measure schoolteacher’s perception of epilepsy in school children in Riyadh, Saudi Arabia in 2018. Methods: an observational, descriptive, cross-sectional study was done and data was collected by online and manual survey from (476) teachers chosen by quota sampling technique. The data was analyzed by using SPSS. Scale of level of knowledge in Table 1. Results: Most of the teachers had moderate and good knowledge (81%); females had better knowledge (85%); teachers with higher educational level had better knowledge (92%) and teachers with more years of experience had better knowledge (83%). Most of the teachers feel sympathy toward students with epilepsy (67%). Most of the teachers had moderate and good attitude (84%). Those who were 40 years or above had a better attitude (88%). About half the teachers knew about epilepsy from their friends (45%). Most of the teachers had poor practice (85%). Conclusion: Our study revealed that the majority of the teachers had moderate and good knowledge and attitude while only a few teachers had moderate and good practice. Teachers’ age and years of experience are shown to be factors in acquiring knowledge. It was found that teachers’ age has a significant effect on their attitude and teachers with higher educational level had better attitude. Teachers’ gender and educational level appeared to have a significant effect on their knowledge. Key words: Teachers, Knowledge, Attitude, Students, Epilepsy, Saudi Arabia
Proton Pump Inhibitors Awareness among Physicians and Pharmacists in Primary Healthcare Centres in Abha, Saudi Arabia
Authors: Alasmari Ibrahim Hasan , AL Saleh Majed Mohammed , Alahmari Majed Ali , Asiri Sawsan Mohammad , Asiri Aljawhara Yahya
Published: May 2022

Background: Proton pump inhibitors (PPIs) effectively suppress acid secretion and play an important role in peptic ulcer disease and gastroesophageal reflux disease. Physicians and pharmacists’ awareness and perception toward PPIs have a crucial role in regulating the use of PPI and preventing any adverse event, drug-drug interaction, or inappropriate use PPIs. Aim: The current study aims to assess proton pump inhibitors awareness level among physicians and pharmacists and its detriments in PHCCs, Aseer region, Saudi Arabia. Methods: An analytical cross-sectional study was applied to answer the main research question. The study targeted all physicians and pharmacists in primary healthcare centres in Abha who will be accessible during the study period from 23 May to 27 July. Data were collected from eligible participants using pre-structured online questionnaire. The questionnaire was developed by the researchers based on intensive literature review and expert’s consultation. The questionnaire covered participants’ personal data including age and gender, job title, and awareness items regarding PPI types, uses, side effects, and types. Results: A total of 178 participants completed the study questionnaire. 97 (54.5%) participants were pharmacists, 45 (25.3%) were clinical pharmacists, and 36 (20.2%) were physicians. Participants ages ranged from 20-40 years with mean age of 25.4 ± 9.7 years. 78.7% of the participants reported that PPIs are the 1st line pharmacological treatment for peptic ulcer which was insignificantly higher among clinical pharmacists (84.4%; P=.077). Omeprazole as the most prescribed PPI was known by 75.8% of the participants. As for Long-term use of PPI adverse reactions, 22.5% reported osteoporosis, 20.2% selected vitamin B12 deficiency, 2.2% reported pneumonia, while 55.1% selected all options, especially pharmacists and clinical pharmacists (60.8% and 60%, respectively; P=.017). Conclusion and Recommendations: In conclusion, the current study showed that medical staff in the primary healthcare centres had moderately low knowledge regarding PPI and its indications. The lowest awareness was mainly among physicians relative to pharmacists especially clinical pharmacists. Key words: Proton pump inhibitors, awareness, practice, medical staff, pharmacist, physician, knowledge
Awareness and Knowledge about Childhood Autism among Family Medicine Residents in Al Madinah Region in Saudi Arabia, 2020
Authors: Masarit Ahmad Mohamme , Alhafithi Maher , Alsanna Haytham , Almaghaslah Sokinh
Published: May 2022

Background: Autism spectrum disorder (ASD) refers to a range of conditions characterized by some degree of impaired social behavior, communication and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively. Objective: To assess knowledge of Family Medicine residents in Al Madinah Region regarding childhood autism. Methods: This cross-sectional study was conducted to assess knowledge of 103 family medicine residents about childhood autism in Al Madinah Region, Saudi Arabia. A structured self-administered web-based Healthcare Workers (KCAHW) Questionnaire was used to assess knowledge of childhood autism among participant residents. Results: Residents’ total score (Mean±SD) was 13.18±2.80 (out of 19, 69.4%). The highest attained mean scores were for the first and second domains (6.36±1.64, 79.5% and 0.78±0.42, 78%, respectively), while the lowest was for the fourth domain (2.62±1.10, out of 6, 43.7%). Highest mean knowledge scores among participants were among those aged 35-39 years (13.33±0.58). However, knowledge scores did not differ significantly according to residents’ age groups. Male residents had significantly lower knowledge scores than females (12.56±2.53 and 14.21±2.95, respectively, p=0.003). Mean knowledge scores were highest among R4 residents (13.66±2.91). However, knowledge scores did not differ significantly according to residents’ training levels. Participants in Yanbu Residency Program had significantly lower mean knowledge scores than those in AL Madinah (12.26±2.70 and 13.45±2.79, respectively). However, knowledge scores did not differ significantly according to residency programs. Mean knowledge scores about autism did not differ significantly according to attending workshops or conferences about autism. Conclusion: Knowledge of family medicine residents regarding childhood autism is suboptimal. Correlates of KCA may help in selection of healthcare workers who would best provide health education and management for caregivers of children with autism. It is important to update the knowledge gaps of healthcare workers who have limited knowledge regarding childhood autism and to train them to be able to provide healthcare service that would ensure early diagnosis and interventions for management of autism. Key words: Autism spectrum disorder, children, Family Medicine, Knowledge, Saudi Arabia.
Prevalence of overt and subclinical hypothyroidism during pregnancy in antenatal care - cross-sectional study, Jeddah, Saudi Arabia
Authors: Zahrani Lubna M. , Abdulhaq Mada I. , Shams Taghreed M. , Farahat Fayssal M.
Published: May 2022

Objective • To estimate the prevalence of subclinical and overt hypothyroidism in antenatal care clinics • To evaluate the performance of targeted screening approach based on the risk stratification as recommended by the U.S. Preventive Service Task Force (USPSTF) and adopted by the American Thyroid Association (ATA) Method: This was a multicenter, cross-sectional study conducted in 386 pregnant women attending routine antenatal visits at 4 antenatal clinics from September 2019 to August 2020. All participants underwent clinical and thyroid function test (TFT) including TSH and T4 levels. Based on risk factor assessment, participants were categorized into low-risk versus high-risk patients. The performance of targeted screening was assessed by comparing the two categories regarding the prevalence of subclinical and overt hypothyroidism and calculating the associated sensitivity, specificity and accuracy. Result: Overall, the prevalence of dysthyroidism was 11.7% (95% CI=8.6-15.3%) with 10.4% subclinical hypothyroidism and 1.3% overt hypothyroidism cases. No difference in the prevalence of dysthyroidism was found between low-risk and high-risk patients. The performance of the risk stratification-based screening approach in detecting subclinical or overt hypothyroidism showed sensitivity (73.3% and 86.7%), specificity (30.2% and 13.2%), and accuracy (35.2% and 21.8%), using the USPSTF alone and combined with the ATA criteria, respectively. Conclusion: The application of the targeted screening for subclinical and overt hypothyroidism using the USPSTF and ATA criteria performed poorly in the studied population. Thus, universal screening appears to be a better option. Key words: Hypothyroidism, Overt, Pregnancy, Screening, Subclinical, Targeted, Universal, U.S. Preventive Service Task Force;
Prevalence of iron supplementation among pregnant woman in Taif, Saudi Arabia: a cross sectional study
Authors: Ali Amena , Aladwani Setah J. , AlotibiIbtihal Awatef M. , Althumali M. , Alafghani Marwah O. , Alzahrani Mona S.
Published: May 2022

Background: Deficiencies in iron during pregnancy may negatively impact the health of the mother, the pregnancy, as well as fetal development. Aim: Several studies evidenced that there is poor compliance with prenatal iron supplements during the antenatal period. More studies are needed to assess the prevalence, compliance and influencing factors of iron supplement among pregnant women. Methods: A cross-sectional study was carried out to assess the iron supplementation practice and influencing factors among pregnant woman in different hospitals of Taif city, Saudi Arabia. Results: The prevalence of iron supplements use during pregnancy among the study participants was 99.6%. There was no significant association between the age, weight and number of pregnancies (p value >0.05). There was significant association in status of previous pregnancy (p value = 0.014). Women with healthy previous pregnancies appeared to consume iron supplement more than women with problems in their previous pregnancies. Pregnant women aged between 30-44 years were more likely to be adherent to iron supplement (30%). Mothers who had University education were more likely to be adherent to iron supplement than others (35%). Conclusion: There is a need to encourage pregnant women to visit early for antenatal care. Iron and folic acid supplements, dietary intake preferences, diagnosis and continuous follow up of pregnant women are approaches to reduce anemia during pregnancy in Taif region. The purpose of this study was to enhance the public awareness about iron supplements during pregnancy. Key words: Iron supplements; anemia; pregnant women; prevalence.
Clinical Audit Report on Adherence to Imaging Guidelines for Patients with Acute Low Back Pain in Airport Health Centre
Authors: Al-shamery Hanan , Abouamer Wesam , Sulaiman Neelufur
Published: May 2022

It is estimated that up to 84 percent of adults have low back pain at some time in their lives [1,2]. The vast majority of patients seen in primary care (>85 percent) will have nonspecific low back pain, meaning that the patient has back pain in the absence of a specific underlying condition that can be reliably identified [3-4]. For most of these individuals, episodes of back pain are self-limited. Patients who continue to have back pain beyond the acute period (four weeks) have subacute back pain (lasting between 4 and 12 weeks), and some may go on to develop chronic back pain (lasting >12 weeks) [5]. Patients who don’t improve on pharmacotherapy should be reassessed and must not be given imaging within 6 weeks from the onset of symptoms. However, acute low back pain will go on to develop chronic low back pain if not addressed. It is observed from practice that most of the physicians did follow the guidelines while treating the patients with acute low back pain, although, sometimes they advised imaging within 6 weeks of symptoms. The Audit was conducted through a retrospective review of health records of a randomly selected 66 patients with acute low back pain, seen at the Airport Health Center during the months from 1st January 2021 till 31st March 2021. Audit criteria is derived from PHCC Clinical Practice Guideline for the Management of Low Back Pain in Adults. Audit findings of the total sample of 66 patients showed 95% compliance with the recommended practice on imaging requirement for patients with acute Low Back Pain and didn’t do imaging at the first visit. Conclusion: Audit concluded with the recommendation on achieving 100% level of compliance in practice and to sustain the practice. Key words: clinical audit, low back pain, imaging
A case of Erythroderma following Terbinafine therapy
Authors: Ali Rahma Yusuf , Ali Fatima
Published: May 2022

Background: The onset of cutaneous lupus erythematosus may be associated with the administration of a variety of drugs. Terbinafine, an oral antifungal agent, which rarely causes cutaneous eruptions, has been implicated as the cause or exacerbation of cutaneous lupus erythematosus in several patients. Case: A 52-year-old female patient had received oral terbinafine for onychomycosis. The patient had a family history of lupus, but no personal history. Six weeks after initiating treatment with terbinafine the patient developed cutaneous lupus which was diagnosed clinically and by histology. She developed an erythrodermic rash. Immunological studies showed elevated titres of anti-nuclear antibodies. Following discontinuation of terbinafine therapy and under the treatment of systemic and topical steroids, a slow resolution of the eruption was noted over several weeks. Conclusions: This report, along with previous cases described, suggests the association between terbinafine therapy and the onset or exacerbation of SLE often occurring in a patient with history of systemic lupus erythematosus or SLE. Key words: SLE, erythroderma, drug reactions
Rare presentation of lower limb weakness, a case report
Authors: khmour Hamzeh Yousef , el Nour Salma , Elmahdi Mansour
Published: May 2022

SUMMARY This is a 53 year old male, who was previously healthy, and who presented to a primary care physician, complaining of from chronic back pain. He was seen multiple times with the same problem, which was treated as Myalgia with pain killers only. After a proper approach and investigation he was found to have ALS Amyotrophic lateral sclerosis. BACKGROUND: Lower limb weakness is a common problem in the primary care setting, with a multiple differential diagnosis. It is defined as loss of muscle strength[1]. The physician should firstly isolate and be sure that the complaint of patient is weakness of the muscle , mainly by investigating other causes that may mimic and overlap with the presentation; the famous and most common cause being fatigue[2]. History and physical examination in addition to investigation will assure that the physician will reach the proper diagnosis and management plan but before that knowing the mechanisms of weakness is the corner stone in approach[3,5], which includes[3,4]: Upper motor neurons, Lower motor neurons, Neuromuscular junction, Muscle. In the primary care setting and because of patient flow, usually common is common, which is exactly what happened to the patient, as he visited the center multiple time because of weakness and mild pain which did not attract the attention of the treating physicians to more serious and complicated disease[6,7]. Amyotrophic lateral sclerosis (ALS), commonly called Lou Gehrig’s disease, is a progressive neurodegenerative disease affecting both upper and lower motor neurons. ALS is a condition characterized by weakness, muscle wasting, fasciculations and increased reflexes[1,2]. The annual incidence rate is one to three cases per 100,000. The disease is mostly diagnosed in middle age and affects more men than women [5]. Over a period of months or years, patients with ALS develop severe, progressive muscular weakness and other symptoms caused by loss of function in both upper and lower motor neurons. Mainly it presents with 2 major categories of symptoms: Upper motor neuron, Lower motor neuron [2]. In the patient’s case it was mainly lower motor neuron symptoms without any symptoms of upper motor which makes the presentation unique and confusing with other differential diagnoses. ALS has a bad prognosis and limited options of treatment. Respiratory failure limits survival to 2-5 years after disease onset. RILUZOLE is the only drug that can affect prognosis [1,7,8,9]. Being rare, difficult to treat and with a bad prognosis, makes us want to share this case with our colleagues as the learning opportunity in this case makes it a valuable one for a case report. Key words: lower limb weakness, case report
Contrast-Induced Nephropathy among adults after administration of intravenous material in the Emergency department at King Abdul-Aziz university hospital
Authors: Alsaiari Afaf , Alsaedi Samiyah , Alzahran Esraa , Kutbi Latifah , Alsahafi Bothainah Abed A , alharbi Ghoson ghonem , Abdelsalam Mostafa , Bakhsh Abdullah
Published: May 2022

Background: Contrast-induced nephropathy (CIN) is known as the third most common cause of iatrogenic acute kidney injury after severe hypotension and surgery. Objectives: to assess the risk and estimate the incidence of contrast-induced nephropathy in low-risk patients. Methods: A retrospective study was done in King Abdul-Aziz University hospital (KAUH), Jeddah, Saudi Arabia. Data about adult patients who underwent CT was collected from electronic records of the Emergency Department. Patients were divided into two groups with and without injections of IV contrast, evenly. Data about patients’ demographics, diagnosis, chronic comorbidity, nephrotoxic medication, and serum creatinine were collected. Results: No significant difference was found in the pre-contrast serum creatinine in both groups, while eGFR was significantly higher among those receiving contrast media. Serum creatinine after 48 hours showed a significantly lower level while eGFR was significantly higher among those receiving contrast media. Before and 48 hours after the radiology,significant improvement was found between serum creatinine and eGFR levels among all patients, while the eGFR showed significant improvement among patients who received contrast media. About 26% of patients showed rising serum creatinine; of them and 10.5% of them matched the KDIGO guidelines for the diagnosis of acute kidney injury. Patients with worsening kidney function were older, diabetics and hypertensives. Age was the most independentpredictor for worsening of kidney function.. Conclusion: In the current clinical setting, the administration of contrast media is not associated with an increased incidence of acute kidney injury. Key words: Nephropathy, Contrast, Emergency, Induced, Risk
Early-onset CTCL, localized and unilateral – case review
Authors: Elghblawi Ebtisam
Published: May 2022

A 39-year-old man attended with an itchy single rounded red non-scaly skin lesion, with slightly raised edge, on his left leg that was unresponsive to topical steroids for the past two-weeks (figure-1). Apart from that, he had no other complaint. He was fit and well. Examination showed a unilateral localised red slightly-scaly, non-blanchable skin plaque on his lower left leg. Other skin parts were not affected. Physical examination was otherwise unremarkable without any detectable lymhadenopathies. Based on the clinical examination I could not align this skin lesion to any other dermatological disease. However; I agreed with the patient to take a punch biopsy from the skin lesion that he had presented with, in order to find out the actual pathology. The histology reading showed perivascular and periadnexal lymphocytic infiltration in the dermis. Some lymphoid cells were larger and neomorphic. There was no exocytosis. Histopathlogy with immune histochemical profile showed CD-3 positive and CD-20 negative. The report concluded by the histopatholgist that the immunohistochemical profile is consistent with T-cell proliferation and the picture suggests cutaneous T-cell lymphoma. This diagnosis should not be missed. When the condition at its earlier stage, usually it shows erythematous patches with fine scales, however, when it starts to infiltrate, it can involve blood, lymph nodes and many viscera ultimately. It is abnormal lymphocytes proliferation and mostly males predominan with an incidence of 1 per 100,000 per year.
Study of the clinical features of vitiligo among Yemeni patients in Aden
Authors: Saleh Asia Hassan Abdulla , Al-Zou Amer Bin
Published: May 2022

Objective: The objective of the study was to evaluate the different clinical features of vitiligo diseases and to assess the comorbidity disorders in Aden. Patients and method: This was a retrospective descriptive study, in which we reviewed the medical records of all patients with vitiligo attending two private clinics in Aden during the period January 2019 to December 2020. Results: The study patients were (33.5%) males and (66.5%) females (male : female 1: 2). The mean age of the study patients was 23.6 ± 12.9 years and the age ranged between 2 and 65 years. Nearly half (49.7%) of patients were aged 20 years old and a positive family history of vitiligo was found in 28.6%. Vulgaris is the predominant vitiligo type (57.8%) followed by acrofacial type (13.0%). Extremities involvement were higher in females than males (17.4%) and (9.9%), respectively. Face with extremities involvement and trunk with extremities involvement in female patients seemed to be similar with (9.9). Significant differences were found between vitiligo involvement types and the sex of patients, (p < 0.05). In the age group 20 years old we found (28%) vulgaris type of vitiligo followed by acrofacial (7.4%). Vitiligo onset on extremities represented the highest site involvement (27.3%). Twelve (7.4%) of the patients had associated diseases distributed as follows: diabetes mellitus (4.3%) followed by thyroid diseases (1.9%) and atopic disorders (1.2%). The associated diseases occurred among the age group 20 years old and the age group 21 – 40 years old; (p = 0.043). Conclusion: Vitiligo disease is more common in females and the most common form was vitiligo vulgaris. A third of patients had a positive family history of vitiligo and the most sites involved were extremities. Key words: clinical futures, vitiligo, Yemeni patients, Aden
Children’s vision health during the COVID-19 pandemic
Authors: Timorkhan Moustafa Abdalhade , Ibraheem Mouazzar yusuf Thani
Published: May 2022

During the peak months of the COVID-19 pandemic, several countries elected to close schools and adapted to online learning. The aim of the article is to review the impact of lockdown measures instituted during the COVID-19 pandemic on children’s vision health and to make recommendations for mitigating potential visual impairment. Methods: We reviewed studies focused on digital device usage, near work, and outdoor time in relation to myopia onset and progression in children during the COVID-19 pandemic. Studies focused on the relation between screen time, asthenopia and dry eyes in children during COVID-19. Results: Increased digital screen time, near work and limited outdoor activities were found to be associated with the onset and progression of myopia during the COVID-19 pandemic period. Screen time was positively associated with asthenopia and dry eye in children during COVID-19. Conclusion: The COVID-19 pandemic has led to dramatic changes in many aspects of daily life. Online learning has become the mainstream public learning mode during the pandemic. Several studies indicate accelerated myopic progression during the COVID-19 pandemic in children and the increase has been found to be related to excessive use of digital screen devices and the decrease of outdoor activities duration. Also prolonged screen time, and online-course time can significantly increase asthenopia and dry eye risk. Several studies have recommended to decrease screen time and to increase outdoor activities. Key words: Myopia progression, digital screen time, near work, outdoor activity time, asthenopia and dry eye