bluuebunny/crossref_metadata_2025 huggingface dataset:
On the transcendence and immanence of God
Authors: Nestler Michael
Published: December 2021

Transcendence and immanence are two terms used two differentiate two realities, one of transcending worldly experience and the other of an inner-worldly experience. In scholastic theology (kalām), a respective distinction is being made regarding the image of God, whereby transcendence (tanzīh) is set against anthropomorphism (tašbīh) to solve the problem of how to deal with Quranic expressions that attribute human - formal or essential - characteristics to God. Also, in mysticism, the notion of transcendence and immanence of God plays a central role, for instance, in the teachings of Ibn al-Arabi. He mainly discusses this distinction in the chapter of Noah in Fuṣūṣ al-ḥikam (»The Bezels of Wisdom«), regarding knowledge of God. He rejects a pure theology of transcendence as it describes only a part of the divine reality. However, he points out that even though His immanent reality can be experienced, it is not comprehensible, because it is unlimited. Both realities interlock through the idea of the Oneness of Being or Unity of Existence (waḥdat al-wuğūd), because ›in reality‹ they are nothing else than God. Ibn al-ʿArabī illustrates this ontological dependency by the example of Noah’s legend, by showing that the prophet supported the belief of the absolute transcendence of God, which was unacceptable for his people, not because they negated God’s existence, but because they had an immanent image of God. Accordingly, Ibn al-Arabi interprets the divine punishment, instead of misfortune, as immersing in the sea of knowledge of God. In this way the soul becomes a place of manifestation or a mirror of the divine reality.
Generosity in Arabic culture
Authors: Khalfallah Khouloud
Published: December 2021

In his »Essai sur le don« (»The Gift«) the sociologist Marcel Mauss studied the ritual of gift exchange that, in various ancient societies, was characterized by exaggeration, but also by its consideration as not only a material giving, but also as a spiritual one. Was the exaggeration of giving regarded as a kind of heroism in the old Arab society, the question arises, if this was at the same time a spiritual giving of himself. To answer this question an anecdote about the poetess al-Khansāʾ (who lived at the time of the prophet Muhammad) is analyzed, whereby it becomes apparent that the ritual of giving exchange had something to do with poetry or magic, and therefore possessed a dimension of spirituality. Though the exaggerated gift represents a pre-Islamic ›virtue‹, this ritual has survived in Arabic countries, even in modern times. Therefore, it seemed only natural to conduct an interview about this topic as a kind of ethnographic fieldwork. As it turned out, the old Arab ideal did undeniably survive, while at the same time it now interferes with a rational discourse that makes heroic exaggeration appear ›unreasonable‹.
Thinking about boundaries and self-knowledge
Authors: Esfahani Mahdi
Published: December 2021

What are conditions of possibility of thinking about boundaries? When we are speaking of boundaries, it means that we know both side of them, without such a presupposition we can’t know boundaries and can’t speak meaningfully about them. This ›knowledge of both sides‹ is the most important epistemological condition of possibility of thinking about boundaries. This article tries to analyze this epistemological Condition and its anthropological (or ontological) conditions; it tries to explain the role of human existence and its specialties in this context and through it, attempt to disclose key function of thinking about boundaries for self-knowledge which is core of Socrates definition of philosophy.
YOUNG AND LATE ONSET DEMENTIA: HOW DO THEY DIFFER IN TERMS OF DOMAINS OF AWARENESS?
Authors: Baptista Maria Alice , Kimura Nathália , Lacerda Isabel , Silva Felipe , Dourado Marcia Cristina
Published: December 2021

Background: Young onset dementia (YOD) is a diagnosis given when the neurocognitive process sets in before 65 years age. The YOD dementia process poses specific challenges related to financial issues, work and social demands, marriage, and parenthood, including losses and shifting roles, care responsibilities, as well as prospects for the future. Those challenges might account for the difference in awareness between YOD and late onset dementia (LOD). Awareness can be defined as the recognition of changes caused by deficits related to the disease process, which may include the ability to recognize a specific deficit, the emotional response to the difficulties presented and the ability to understand the impact of the disease in activities of daily living Objectives: This study is designed to investigate differences in awareness of cognitive functioning and health condition, functional activity impairments, emotional state, and social functioning and relationships among people with young onset (YOD) and late onset dementia (LOD); and examine associations between awareness and its domains with cognition, functionality, neuropsychiatric symptoms, social and emotional functioning and quality of life (QoL) in both groups. Methods: This is a cross-sectional design study. A group of 136 people with dementia and their respective caregivers (YOD = 50 and LOD = 86) were consecutively selected from an Alzheimer’s disease outpatient unit in Rio de Janeiro, Brazil. We assessed awareness of disease, dementia severity, cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and quality of life. Results: People with YOD were more aware of disease (total score), more aware of their cognitive functioning and health condition and of their functional activity impairments than people with LOD, even if this group was more severely cognitive impaired and had a worse level of functionality than LOD group. Besides, people with YOD had more neuropsychiatric symptoms than people with LOD. Multivariate linear regressions showed that functionality has a wide relationship to awareness for people with YOD. While neuropsychiatric symptoms and quality of life has a greater relation to awareness for people with LOD. Conclusions Different clinical variables are associated to different domains in YOD and LOD groups, reinforcing the heterogeneity of awareness in dementia.
THE ACCURACY OF TRANSCRANIAL SONOGRAPHY ON ALZHEIMER’S DISEASE DIAGNOSIS
Authors: Santos Roberto , Fernandes Rita
Published: December 2021

Background: The diagnosis of Alzheimer’s disease (AD) is clinical, combining neurological examination, neuropsychological tests and neuroimaging. One of the anatomical features of AD is medial temporal lobe (MTL) atrophy graduated by magnetic resonance imaging (MRI) with accuracy to discriminate between healthy controls, mild neurocognitive disorder (MCI) or dementia, but it has its limitations. Transcranial sonography (TCS) demonstrated good accuracy to display changes in echogenicity or size of intracranial structures. Objective: The objective of this study is to evaluate TCS diagnostic accuracy in AD. Methods: Prospective cross-sectional case-control study. Patients in the outpatient unit of a University Hospital with >2 y AD diagnosis and controls. TCS performed with a 2-4MHz sector probe to study lateral temporal lobe (A), MTL height (B) and width (C), ambiens cistern width (D) and choroidal cistern height (E). Results: TCCS exams were performed. 2 individuals had no bone window (1 control, 1 AD). 15 healthy controls and 4 DA patients showed significantly different B/E measurements (3.17+0,47 cm2 vs 2.23+0.22 cm2; p=0,0001). Conclusions: Our preliminary results indicate that our measurements are in agreement with those found in the literature. The present results indicate the reproducibility of the technique in our Hospital and encourages us to expand the number of participants.
THE EFFECTS ON COGNITIVE RESERVE (CR) GENERATED BY EXERCISE IN ALZHEIMER’S DISEASE: A SYSTEMATIC REVIEW
Authors: Lima Rian , Silva Carlos , Santos João , Pinheiro Letícia
Published: December 2021

Background: Cognitive reserve (CR) is a concept that describes a large amount of neural changes, which come from habits, like physical activity. CR protects the brain against the development and evolution of dementia. The possible mechanisms of these changes still remain unknown, and this lack of knowledge distorts the elaboration of practices capable of amplifying this protection. Objectives: To analyze the data about how physical activity can reverberate on the nervous system, relating the effects of exercise and development of AD. Methods: Search in the Pubmed database using descriptors: “Physical activity” OR “Exercise” AND “Cognitive reserve” AND “Alzheimer”. All articles that include any physiological correlation between exercise and CR were analysed. Results: Sedentaries people had greater β-amyloid loads in the brain and lower levels of it in the cerebrospinal fluid. Furthermore, habitual physical activity may improve serum level of brain derived neurotrophic factor, a protein which is capable of enhancing synaptic plasticity and leads to the formation of new neurons in the dentate gyrus of the hippocampus. The studies also showed that aerobics exercises have a greater effect on CR, mainly if they are done in a regular form. Conclusion: Habitual physical activity can impact AD by helping the effectiveness of the treatment and delaying it´s evolution.
FEASIBILITY OF USING TELEMEDICINE FOR LANGUAGE ASSESSMENT
Authors: Silagi Marcela , Freitas Maria , Almeida Isabel , Pisetta Paola , Beber Bárbara , Oliveira Maira , Brucki Sonia
Published: December 2021

Background: The international literature has shown viability in the use of telemedicine for language assessment in individuals with dementia. However, no studies were found on language testing via the Internet in Brazil. Objectives: To verify the feasibility of using telemedicine for language assessment, by comparing the performance of healthy adults in face-to-face and online assessments, and to verify the influence of age and education in the evaluation types. Methods: The sample consisted of 15 cognitively healthy subjects, aged between 57-70 years (M=63.2; SD=4.6) and education between 8-22 years (M=14.7; SD=4.3). The Western Aphasia Battery-Revised (WAB-R) was used for language assessment, with subtests for spontaneous speech, auditory verbal comprehension, repetition, naming, reading, and writing. Subjects were randomly evaluated in person and online. Results: No differences were found in WAB-R scores obtained in a face-to-face versus online environment. There was a negative correlation between the Aphasia Coefficient score and age (rs=-0.814; p=0.013) and a positive correlation for education (rs=0.736; p=0.037) in the online assessment. Conclusions: The use of telemedicine for language assessment proved to be feasible for cognitively healthy adults, despite the influence of age and education. Future research is needed to analyze the feasibility of this mode of evaluation in subjects with cognitive impairments.
CONECTOME COMPARISON IN MILD COGNITIVE IMPAIRMENT: AD CONTINUUM X SNAP
Authors: Lourenço Rafael , Balthazar Marcio
Published: December 2021

Background: Studies on functional magnetic resonance imaging of prodromal Alzheimer´s disease can help understanding on how it affects the brain. Objective: We seek for potential differences in brain resting state functional connectivity (FC) of subjects with Mild cognitive impairment with biomarkers: Alzheimer’s disease continuum (MCI-DA) and Suspected non-Alzheimer pathology (MCI-SNAP). Methods: MCI and controls were defined by the Clinical Dementia Rating, neuropsychological measures and cerebrospinal fluid data, resulting in 32 MCI-DA, 25 MCI-SNAP and 35 controls. An analysis ROI-to-ROI was performed inter and intra-networks involving the default mode (DMN), salience (SN), visuospatial (VN) and executive networks. FC was estimated by Pearson’s correlation coefficients converted into Z-Scores. Groups were compared by T tests. Alpha was set to 0.05, FDR correction. Results: Between MCI-DA and controls, intra-network decrease of FC in the SN and inter-network between SN and VN was observed. There was maintenance of the anti-correlation between DMN and VN, which may indicate an indirect dysfunction of the DMN. Between MCI-SNAP and controls, there was an increase in FC between one ROI of DMN and one ROI of VN. Conclusion: MCI-AD showed marked differences in FC compared to MCI-SNAP, mainly in salience network and indirectly in DMN. MCI-SNAP showed milder impairment in resting state networks.
CAN EPWORTH SLEEPINESS SCALE BE A PREDICTOR OF COGNITIVE DEFICT IN A COGNITIVE SCREENING TEST IN A COHORT OF ELDERLY FREE OF CLINICALLY MANIFEST VASCULAR BRAIN DISEASE
Authors: Carvalho Marta de , Trindade Maria Cecília , Freitas Wladimir , Sposito Andrei
Published: December 2021

Background: The Obstructive Sleep Apnea Syndrome (OSAS) is highly prevalent among the elderly and relevant due to its cognitive impact. Objective: To evaluate an association between cognitive impairment (CI) and the presence of OSAS as assessed by the Mini Mental (MM) scale and the Ephorth Sleepiness Scale (ESS) in a population of octogens free from overt cerebral vascular disease (CVD). Methods: 137 individuals were selected. The study was approved by the ethics committee. Categorical variables were evaluated as percentages, continuous variables with normal distribution as mean ± SD and non-parametric variables as median. The subjects were not categorized into the presence or absence of CI according to the score on the MM scale according to education. In a multivariate binary logistic regression model with dependent variable CI, independent variables were incorporated according to the clinic and whether they were associated with CI in the bivariate models. All independent variables were defined in the model. Results: There was an association between high probability of OSAS by ESS and CI by MM. X2(1) = 5.34 p = 0.021. Conclusions: There was an association between high scores on the ESS and the presence of CI at the MM, even compatible for age, BMI, gender, coronary calcification, blood pressure.
Tendência temporal da incidência de hepatite B em Mato Grosso, Amazônia Legal, 2010-2019
Authors: Souza Tony José de , Assis Júlia Maria Vicente de , Pires Jussara Conceição Santos , Lima Solange da Silva
Published: December 2021

Introdução: Estima-se que mais de 2 bilhões de pessoas possuam evidência sorológica de infecção presente ou passada pelo vírus da hepatite B no mundo. Em 2020 foram registrados 13.971 casos novos de hepatite B no Brasil, correspondendo à incidência de 6,6 casos a cada 100.000 habitantes. Objetivo: Analisar a tendência temporal da taxa de incidência de hepatite B na população adulta (15 anos a 59 anos) residente em Mato Grosso, Amazônia Legal, 2010-2019. Métodos: Estudo ecológico, do tipo série temporal, pautado em dados secundários do Censo Demográfico de 2010 do Instituto Brasileiro de Geografia e Estatística e do Sistema de Informação de Agravos de Notificação. A população do estudo foi composta da taxa de incidência de hepatite B registrada na população adulta residente em Mato Grosso, 2010 a 2019. Os dados do estudo foram coletados em etapa única, no período de 17 e 18 de janeiro de 2021, por meio de acesso ao sítio do Departamento de Informática do Sistema Único de Saúde e Instituto Brasileiro de Geografia e Estatística. A estimativa da taxa de incidência de hepatite B foi realizada por meio de estatística descritiva, na qual TIHB = total de casos novos de hepatite B registrados em adultos/população adulta residente em Mato Grosso no periodo do estudo X 100.000 habitantes. Para realização do estudo, obedeceu-se aos dispositivos contidos na Resolução nº 466/2012 do Conselho Nacional de Saúde. Resultados: No período do estudo foram registrados 8.481 casos de hepatite B em Mato Grosso, e a incidência registrada em 2010 era de 29,42/100.000 habitantes, decrescendo para 26,23/100.000 habiantes em 2015 e 18,68/100.000 habitantes em 2019. Conclusão: Os achados evidenciam tendência decrescente da incidência de hepatite B na população adulta de Mato Grosso, porém as taxas registradas no estado foram superiores às registradas no Brasil no período de 2010 a 2019.
Boas práticas de saúde dando sentido à representação social da qualidade de vida de pessoas vivendo com vírus da imunodeficiência humana
Authors: Oliveira Júnior Reynaldo de Jesus , Marques Sérgio Correa , Oliveira Denize Cristina de , Cecílio Hellen Pollyana Mantello , Spindola Thelma , Hipólito Rodrigo Leite
Published: December 2021

Introdução: Os avanços observados no tratamento das pessoas vivendo com vírus da imunodeficiência humana promoveram mudanças na vida desse grupo, influenciando a qualidade de vida. Objetivo: Compreender a representação social da qualidade de vida de pessoas que vivem com vírus da imunodeficiência humana em municípios de pequeno porte da região Médio Paraíba/Rio de Janeiro. Métodos: Estudo descritivo, apoiado na Teoria do Núcleo Central das representações sociais. Participaram 80 pessoas vivendo com vírus da imunodeficiência humana assistidas nos ambulatórios de atendimento às pessoas com vírus da imunodeficiência humana/aids no âmbito dos programas municipais de infecções sexualmente transmissíveis/aids e hepatites. Os dados foram coletados por questionário sociodemográfico e pela técnica da associação livre de palavras para o termo “qualidade de vida”. Os dados sociodemográficos foram organizados no software Excel. O conjunto das evocações livres foi organizado e submetido à análise prototípica com o software denominado EVOC. Resultados: O grupo foi constituído predominantemente de homens (57,5%), com idade inferior a 40 anos (56,3%) e renda inferior a dois salários mínimos (71,25%), e 96,25% utilizavam terapia antirretroviral. A análise prototípica evidenciou que os conteúdos evocados mais frequentes foram boa alimentação, saúde e estado psicológico (núcleo central), lazer, atividade física e família. A análise evidencia que a representação social da qualidade de vida está assentada em dimensões que envolvem atenção ao corpo, à mente, à saúde, aos aspectos relacionais e aos determinantes sociais (moradia e condições financeiras). Essas dimensões denotam cuidados em saúde, como medidas de promoção a saúde, assim como alguns condicionantes em saúde que proporcionam apoio social e segurança que conduzem a um viver com qualidade, apesar das questões que são impostas pelo viver com o vírus da imunodeficiência humana. Conclusão: A representação social do grupo está assentada no apoio social e nas práticas de promoção da saúde que contribuem para a boa qualidade de vida, na medida em que proporcionam saúde física e mental.
Avaliação da oferta de serviços na rede de atenção às hepatites virais no estado de Mato Grosso
Authors: Gleriano Josué Souza , Almeida Elton Carlos de , Ferreira Janise Braga Barros , Chaves Lucieli Dias Pedreschi
Published: December 2021

Introdução: A organização do sistema de saúde em rede de atenção favorece o acesso à saúde. Objetivo: Analisar a distribuição de serviços de saúde de atenção às hepatites virais segundo as regiões de saúde do estado de Mato Grosso, Brasil. Métodos: Pesquisa avaliativa (Certificado de Apresentação de Apreciação Ética: 01481918.0.0000.5393) considerando serviços de atenção à saúde do Cadastro Nacional de Estabelecimentos de Saúde com análise por meio do georreferenciamento. Resultados: São 26 serviços ambulatoriais para atenção às hepatites virais, sendo 10 (38,7%) Centros de Testagem e Aconselhamento/sistematização da assistência de enfermagem, 7 (26,9%) sistematização da assistência de enfermagem, 6 (19,2%) Centros de Testagem e Aconselhamento, 1 (3,8%) Centro Estadual Regional de Média e Alta Complexidade, 1 (3,8%) Ambulatório Prisional, 1 (3,8%) Unidade Saúde da Família, 1 (3,8%) hospital. O Centro Estadual Regional de Média e Alta Complexidade está localizado na região da Baixada Cuiabana, sendo referência de atenção para os municípios que não possuem serviços nas regiões de saúde. A maior oferta e heterogeneidade de serviços está na região sul-mato-grossense. São 119 serviços que ofertam teste rápido com maior concentração na região Garças Araguaia e Baixada Cuiabana. A coleta de carga viral acontece em 19 serviços, com maior concentração na região da Baixada Cuiabana e do Norte Mato-Grossense; cinco regiões não ofertam coleta, e a leitura ocorre em apenas dois serviços. Para a coleta de amostra de genotipagem, há maior oferta na região da Baixada Cuiabana e Teles Pires, porém sete regiões de saúde não oferecem essa coleta. O tratamento está disponível em 15 serviços, no entanto cinco regiões de saúde não o ofertam. Conclusão: A distribuição dos serviços por regiões de saúde não garante o acesso universal e equitativo. Os resultados apresentam aspectos especialmente territorializados, com indicação de locais prioritários para investimento na atenção às hepatites virais. É necessário um conjunto de arranjos institucionais para articular um pacto capaz de adequar a oferta de serviços à organização dos marcos da regionalização.
Serological profile of HBV infection among young adults assisted at a Counseling and Testing Centre in the southwest of Goiás
Authors: Sousa Adriany Brito , Oliveira Cristhiane Campos Marques de , Cardoso Nicole Nogueira , Dias Luis Regagnan , Carmo Carolina Barbosa Carvalho do , Langkamer Marcos Filipe Bueno , Mariz Fabiana Nunes de Carvalho , Araújo Carla Nunes de
Published: December 2021

Introduction: Young people often present risky sexual behavior and are more exposed to hepatitis B virus (HBV) infection. Objective: The aim of this study was to describe the sexual behavior and HBV serological profile in the young population attended at a Counseling and Testing Centre (CTC) in the southwest of Goiás. Methods: Quantitative cross-sectional study with descriptive and retrospective analysis conducted at the CTC of Rio Verde. Data from young adults (18-29 years) attended in 2018 were examined to determine the seroprevalence and sexual behavior of HBV. Results: The sample consisted of 1,455 individuals, with 1,423 nonreactive for HBV (HBsAg and total anti-HBc negative), 2 with serological scar (total anti-HBc and anti-HBs positive), and 8 reagents (HBsAg and total anti-HBc positive). Of these, 63% (5) were males and 38% (3) females, with an average age of 24.6 years, 75% (6) were single, and a mean education of 4.25 years. The average number of sexual partnerships in the past 12 months was 2.71. Notably, 25% (2) had previous sexually transmitted infection (STI) and 75% (6) reported drug use, with alcohol being the most frequent. Regarding the use of condoms with fixed partnership, 57% (4) men did not use them. As reason for not wearing a condom, 71% (5) of them claimed trust in the sexual partnership. With casual partners, 14% (1) did not use condoms, 14% (1) justified their nonuse by trust, and 14% (1) were under the effect of drugs/alcohol. Conclusion: The prevalence of HBV in young adults who attended the CTC in 2018 was 0.55% with HBsAg and total anti-HBc positive and 0.14% with total anti-HBc and anti-HBs positive. Among those infected, most were single men, brown, with low education, and reported alcohol consumption and inconsistent use of condoms in sexual intercourse for both fixed and casual partnerships. These data reinforce the need for STI preventive strategies in this population.
Pattern of Psychiatric Morbidities and Sociodemographic Profiles of Patients Attending Out-Patient Department (OPD) at Iftikhar Psychiatric Hospital, Peshawar
Authors: Khan Ghaazaan , Ullah Shafi
Published: December 2021

Background: Psychiatric disorders are the major causes of disability worldwide. Due to cultural differences, the patterns of mental disorders vary globally and there is need to study the patterns of psychiatric disorders in our region. Aims and Objectives: The aim of this study is to know the pattern of various psychiatric morbidities as well as socio demographic characteristics of patients attending out-patient department (OPD) at Iftikhar Psychiatric Hospital, Peshawar. Materials and Methods: This descriptive study was conducted at Iftikhar Psychiatric Hospital, Peshawar from 1st June 2020 to 31st January 2021. During this period, a total of 150 patients were recruited through non-probability consecutive sampling technique. Data was collected for variables like gender, age, marital status, urban/rural background, employment status and psychiatric diagnosis. For the variables of continuous type like age, mean and standard deviation were calculated. Diagnosis was made using ICD-10 diagnostic classification system. All the variables were presented as frequencies and %ages. Data was analyzed using SPSS software version 20. Conclusion: Male predominance was observed in the study. Maximum numbers of psychiatric patients were in the age range from 18-40 years. Majority of the study participants were married, employed and belonged to urban background Regarding psychiatric morbidities, the most common were neurotic, stress related and somatoform disorders (38%) followed by mood disorders (28.66 %)., schizophrenia and other psychotic disorders (17.33%) and substance misuse disorders (10%). Keywords: ICD-10; Psychiatric morbidity; out-patient department
Prevalence of Psychiatric Disorders in Burn Patients in a Tertiary Care Hospital
Authors: Khan Imran , Khan Taimur , Asif Shakil , Ali Kazmi Syed Azhar , Ullah Subhan , Shoaib Irfan Muhammad
Published: December 2021

Background and Aim: Burn injuries patients generally suffer from various psychological and mental disorders especially in lower socio-economic groups. It can adversely affect their wellbeing and health. Proper consultation and clinical diagnosis need to be carried out on burns injuries patients from the early critical phase to rehabilitation phase recovery. The current study's aim was to determine the prevalence of psychiatric disorders in burn patients in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 82 attempted burn suicides, adult patients in Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from June 2020 to December 2020. All the patients admitted with suicides burns were of either gender and had ages above 15 years. The convenience technique was used for sampling. The patients’ demographic details such as psychiatric illness, self-immolation act motivation, burn injury depth, burn total body surface area, inhalation injury, hospitalization duration, and mortality was recorded on pre-designed proforma. Data analysis was carried out with SPSS version 20. Results: The mean age of all 82 patients was 28.9±5.2 with an age range of 14 to 55 years. Of the total, 66 (80.5%) were female while 16 (19.5%) were male. In this study, the most frequent suicidal attempt was made by the marital conflicted patients 50 (61%) followed by love affair failure 8 (9.7%). An overall mean of 53.6±19.6 was observed for total body surface area affected with a range of 15-100%. The hospital duration mean was 8.2±5.9 with a range of 1-38 days. Young, married, and rural area illiterate housewives were the most common self-inflicted/suicide burn injuries. The prime cause of such injuries was getting married. The mortality rate was found at 82.3%. Conclusion: Our study concluded that patient’s well-being and mental health could be severely affected by burn injuries. Prevalent depression was noted among severe burn injuries patients. Depression related to deformity could be prevented with early grafting, wound management, proper splinting, coping ability, intense physiotherapy, and long-term rehabilitation. Keywords: Burn; Depressed mood, Psychiatric morbidity, Posttraumatic stress disorder
An Emerging Marker Predicting The Severity of Covid-19: Neutrophil-Lymphocyte Count Ratio
Authors: Hassan Ali , Ali Zulfiqar , Iftikhar Hina , Graded Azhar , Haider Zulfiqar , Rehman Habib ur
Published: December 2021

Objective: To assess the efficacy of neutrophil-lymphocyte count ratio in predicting the severity of covid-19 Materials and Methods: The patients with positive results for COVID-19 were shifted to COVID ITC, CMH, Multan. The clinical histories of confirmed patients of COVID-19 during February 2020 to May 2021 were reviewed. The patients were divided into 4 classes, mild, common, severe, and fatal, according to guidelines of COVID-19 i.e., trial version 7. Data was collected regarding age, sex, smoking history, temperature, epidemiological history, clinical symptoms, and laboratory findings of all included patients including NLCR. Results: The mean NLCR of Mild and Severe Group was 2.77±1.23 and 20.31±4.45, respectively, (p=0.000). (Table. II). The area under the curves of NLCR was larger than neut, suggesting the optimal performance of NLCR with cut-off value 5.89. The sensitivity and specificity of NLCR was 85% and 95%, respectively. (Table. III). Conclusion: It can be concluded that an increase in NLCR levels can indicate that the covid-19 disease is moving towards exacerbation. NLCR can be recommended as a novel and highly sensitive and specific indicator for severity prediction in Covid-19 patients. Keywords: Emerging, Marker, Severity, Covid-19, Neutrophils, Lymphocytes, Ratio
Study of Levels of Plasma Fibrinogen and its Association with Disease Severity in Patients with Chronic Obstructive Pulmonary Disease
Authors: Masood Ayesha , Amin Maria , Qasim Fizza , H. Sharfi Masroor
Published: December 2021

COPD has been recognized as a component of the systemic inflammatory syndrome. A commonly used indicator of the severity and progression of the disease in COPD is expiratory volume per second (FEV1). However, it is weakly associated with symptoms and administration difficulties in elderly patients. Therefore, there is a need for other markers that are better and easy to apply to sick and elderly patients. Plasma fibrinogen can be used as a marker of disease severity. Aim: To estimate the plasma fibrinogen level in patients with COPD and Relationship of levels of plasma fibrinogen with the severity of chronic obstructive pulmonary disease using the BODE classification and GOLD staging. Place and Duration: In the Medicine Unit-II of Jinnah Hospital Lahore for one-year duration from August 2020 to August 2021. Methods: In this cross-sectional study, 110 COPD patients were assessed by measuring plasma fibrinogen correlated with disease severity using the GOLD scale, BODE index and the 6-minute walk test. Results: Plasma fibrinogen is present in all COPD patients. A significant correlation was observed between the BODE index (r = 0.69, p <0.001), gold grading (r = 0.95, p <0.001) and plasma fibrinogen levels. Most of the 110 subjects (34.5%) were Grade II, then Grade III 30.9%, 18.1% Grade IV and 14.5% Grade I. In our study, it was found that the average level of fibrinogen increased with the increase in the GOLD stage, which was statistically significant, and the p value was 0.01. Conclusions: Plasma fibrinogen levels are significantly higher in COPD and can be used as a marker correlating with disease severity in COPD. Keywords: COPD; plasma fibrinogen; GOLDEN stage; BODE index.
Achillea Fragrantissima Ethanolic Extract Exerts Hypocholesterolemia and Hepatic Antioxidant Effects in High Fat-Cholesterol Diet: An Experimental Study
Authors: Saaty Afnan H.
Published: December 2021

Background: Hypercholesterolemia and oxidative stress consider the main causes for atherosclerotic cardiovascular diseases, that are one of the major non-communicable diseases responsible for more than a third of deaths in Saudi Arabia. Cholesterol-lowering medications as Atorvastatin® (ATOR) are linked to a variety of side effects. Achillea fragarntissima (AF) is a valuable medicinal plant in Saudi Arabia with potent antioxidant activity. Aim: The current study was performed to determine the efficacy of AF in the treatment of hypercholesterolemia through the antioxidant metabolic pathway. Methodology: Dried aerial parts of AF were extracted by ethanol (70%). Induction of hypercholesterolemia in rats was induced through feeding a high fat-cholesterol diet (HFCD) for 8 weeks. Rats were assigned to two main groups; control group (Cont, n=10) rats fed a standard diet, and hypercholesterolemic group (HFCD) (n=40) rats fed HFCD. The HFCD group was further assigned after measured lipid profile to confirm the induction of hypercholesterolemia to HFCD; HFCD+AF (hypercholesterolemic rats treated orally with 500 mg/kg AF); HFCD+ ATOR (hypercholesterolemic rats treated orally with 20 mg/kg ATOR, as a reference drug); and HFCD+AF+ATOR (hypercholesterolemic rats treated orally with AF+ ATOR). Different treatments were ingested to rats for 4 weeks. Results: The results revealed that the HFCD group showed significant hyperlipidemia (elevation of serum TC, TG, LDL-C, and VLDL-C levels concurrent with a reduction in serum HDL-C level); significant disturbance in liver functions (elevation in serum ALT, AST, and ALP enzymes activities); and significant oxidative stress (elevation in hepatic MDA level with a reduction in hepatic SOD activity) compared with the Cont group. Besides, hepatic central vein section showed deposition of large lipid within hepatocytes and abundant focal cell necrosis. Oral treatment with AF, ATOR, and the mixture of the drug and AF produced significant hypocholesterolemia, antioxidant, and improved liver function enzymes, with normalized hepatic central vein tissue compared with the HFCD group. The mixture of AF+ATOR had a superior effect than either treatment alone. Conclusion: In hypercholesterolemic rats, AF may be used to prevent atherosclerosis through improving lipid profile levels, protecting against hepatic oxidative stress, and ameliorating hepatic functions. Thus highlighting its valuable effects in the treatment of atherosclerotic cardiovascular diseases. Keywords: Achillea fragarntissima, lipid profile, hepatic oxidative stress, hepatic function, hypercholesterolemia.
Depression and Anxiety among patients suffering from mild to moderate Covid-19 Disease
Authors: Ali Shah Syed Asim , Zubair Usama Bin , Nadeem Muhammad , Faheem Qasim Muhammad , Azhar Ali Syed , Yasmeen Riffat
Published: December 2021

Aim: To look for the presence of depression and anxiety among patients suffering from mild to moderate COVID-19 disease. Methodology: This cross sectional study was conducted at Department of Medicine, Pakistan Ordinance Factory (POF) Hospital Wah Cantt from 1st April 2020 to 30th September 2020. Patients presenting to Pakistan Ordinance Factory (POF) Hospital Wah Cantt with relevant symptoms and tested positive on polymerase chain reaction for COVID-19 were included in the study. Hospital anxiety and depression scale (HADS) was administered to look for the presence and severity of anxiety and depression among the study participants. Results: Total 101 patients were included in the study, 76.2% were male while 23.8% were female. Mean age of the patients was 53.50 ±13.281years.Out of 101 patients, 33.7% did not show any sign of anxiety and 42.6% showed borderline anxiety while 23.8% had confirmed anxiety. Depression was not found in 72.3%, borderline depressive symptoms were present in 25.7%, while 2% had confirmed depression. Conclusion: Depression and anxiety were common findings among patients admitted in hospital with COVID 19. Anxiety was more common than depression in these patients. Borderline anxiety and depression were found in most of the patients which may need formal psychiatric consultation for exact diagnosis. Keywords: Anxiety; covid-19; depression, Pakistan
COVID-19 Infection among the Health Care Staff at Frontier Medical and Dental College and Hospital
Authors: Rashid Sadia , Sadaqat Saveela , Iqbal Muhammad Adnan , Ahmad Shakeel , Rizwan Muhammad , Ghafoor Ch Muhammad Aamir
Published: December 2021

Background: First case of pandemic COVID-19 was diagnosed in December 2019 in China from where it spread throughout the world. In Pakistan, first case was diagnosed in February 2020 which resulted in a complete and several smart national lockdowns. National Command and Operation Center (NCOC) and Ministry of Health published guidelines for patient’s treatments during pandemic which includes: 1) providing only emergency Treatments 2) Patient’s pre-admittance Questioning, 3) Increasing intervals between appointment, 4) prevent crowding in waiting rooms, 5) Wearing masks at all times. 6) Wearing PPE. Methods: Data from all clinical departments of Frontier Medical and Dental College and Hospital Abbottabad was collected between March and December 2020 which included Number of; 1) Patients treated 2) Medical Staff 3) patients with positive COVID-19 reports 4) healthcare workers suffering from COVID-19. And 6) Post treatment Virus Infected patients. Results: 291 health care staff including 135 medical and dental doctors, 4 dental hygienists, 82 paramedics and 70 Administrative staff worked during the study period and 3280 procedures were performed. Out of these, thirty-eight (38) staff members treated 190 verified COVID-19 patients. During the study period 6 dentists (2.06%) and 9 (3.09%) medical doctors, 2 (0.7%) assistants and 3 (1.03%) admin staff were tested positive for the virus. Conclusion: Present study highlights the importance of education and stickiness to the infection control guidelines thus minimizing the risk of transmission of corona virus among the Healthcare professionals in hospitals. Keywords: COVID-19; Infection control, PPE, NCOC
Comparison of Impairment of PFT due to Plain Vs Pegylated Interferon Therapy in pts With Ch. Hepatitis C Virus Infection
Authors: Sohail Umer , Shah Zahid Hussain , Zaidi Sohaib Haider , Ashfaq Umair , Kazmi Salman
Published: December 2021

Aim: To compare Impairment of pulmonary function tests due to plain versus pegylated interferon therapy in the diagnosed cases of chronic Hepatitis C Methodology: In this comparative study, 71 patients fulfilling inclusion criteria were randomly included in each group. Study consisted; Group 1 (Control Group): Pulmonary Function Tests performed before and after the completion of 24 weeks of treatment with Plain/conventional Interferons and ribavirin. Group 2 (experimental Group): PFTs performed before and after the completion of 24 weeks treatment with Pegylated Interferon Therapy and ribavirin. Referred patients of both groups underwent spirometry (PFTs) at baseline and at the end of 6 months Results: Mean value observed for age was 49.86, for height 1.592 meters, for weight 62.6 kg and for BMI 24.9. Before and after therapy mean for FEV1 was 90.19 and 67.71 and it was 91.34 and 67.83 for FVC respectively. N=71 patients were enrolled in both groups. Male gender showed high prevalence 70%. Group-1 (46 vs 25) & group-2 (45 vs 26) male to female ratio seen. Adult age group hold bulk of disease (30 - 40 years of age). Patients preferred winter season for treatment (Sep to Nov). Low viral load and genotype 3a were common findings (82% and 35%). Constitutional symptoms improved after therapy (86 to 44%) as a whole. Individually, anorexia, body aches, lethargy and fever were like this (39 vs 19%, 66 vs 28%, 54 vs 30%, 19 vs 11%) pre and post therapy. Cough and dyspnea reported in 7% and 20% respectively. Conclusion: According to the present study, treatment with pegylated interferon and ribavirin is associated with impairment of pulmonary function tests similarly as treatment with plain interferon and ribavirin. Long Half-life of pegylated interferon cause more impairment in lung functions as indicated by limited available literature (Foster GR et al). Keywords: Chronic hepatitis C, Pulmonary function tests, plain/Conventional interferon therapy, Pegylated interferon therapy.
Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Knee Joint Using Hamstring Autograft
Authors: Bilal Muhammad , Ijaz Bhatti Muhammad , Shakeel Basit Muhammad , Naqvi Qasim Raza , Hashmi Gull Mahnoor , Afaq Muhammad
Published: December 2021

One of the most common injuries during sports is anterior cruciate ligament (ACL) injury. A number of surgical and rehabilitation techniques have been developed. ACL reconstruction is mainstay of treatment. Objective: In this study we are evaluating the outcome of ACL surgery. Design & Setting: Retrospective study Methodology: Data collection of all cases that underwent primary arthroscopic anterior cruciate ligament reconstruction performed. All patients were operated with same surgical technique using quadrupled hamstring autograft. Results: There was an overall male predominance (95.3%). Medical meniscal injury was found in 05 (24%) patients. Lateral Meniscus injury was found in 04(19%) patients. Adjustable length CSF device was used in 12 (57%) patients and fixed-loop CSF device in 9 (43%) patients. Conclusion: At two years, outcome of ACL reconstruction performed by one surgeon using same surgical technique with adjustable CSF device and absorbable tibial screw granted satisfactory clinical results in all patients. Rehabilitation played an important role in return to activities of daily living in all patients at final follow up. Keywords: Anterior Cruciate Ligament, Arthroscopy, Rehabilitation
Controlling Hyperglycaemia Diabetes Mellitus Type-II: Bromocriptine Alone or in Combination with Metformin
Authors: Mastoor Khadija , Khan Faisal Idrees , Imran Iram , Errum Anila , Sharif Sadia , Naveed Amir
Published: December 2021

Background: Diabetes Mellitus is one of the leading cause of morbidity and mortality globally. According to WHO there is a steady increase in the number of diabetic patients annually. Maintenance of good glycaemic control in type 2 diabetic patients typically becomes progressively more difficult as the duration of disease lengthens due to decline in the capacity of the pancreatic beta cells for glucose stimulated insulin release, in the presence of insulin resistance. This study is conducted to observe the effect of metformin and bromocriptine individually and sub-therapeutic doses of these drugs when used as a combination therapy. Objective: The objective of this study is to primarily investigate and then compare the antihyperglycemic effects of bromocriptine with metformin, also to see the combined effect of sub therapeutic doses of both these drugs. Methodology: Random allotment of 24 albino male rats was done in four groups. Group 1 was kept as control. Alloxan monohydrate was given to group 2, 3 and 4 and diabetes was induced. Group 2 and 3 were treated with metformin (1.5mg/kg body weight) and bromocriptine (3 mg/kg body weight) respectively while group 4 was treated with sub therapeutic doses of metformin (1 mg/kg body weight) and bromocriptine (1.5 mg/kg body weight)both. Serum glucose levels were estimated at 1, 10, 20 and 30 days. Results: Results showed that metformin reduces blood glucose level significantly where as bromocriptine also showed reduction of blood glucose level but not as significantly as metformin. However, the combination of metformin and bromocriptine showed much reduction in blood glucose level than metformin and bromocriptine used alone. Conclusion: Bromocriptine and metformin when combined ameliorated blood guclose efficiently than given alone Keywords: Diabetes mellitus, bromocriptine, metformin
Lawrence Syndrome “acquired generalized lipodystrohy” with type 1 diabetes mellitus in 7 years boy of Bahawalpur
Authors: Akram Sumera
Published: December 2021

Lipodystrophy syndromes are rare disorders characterized by either generalized or partial lack of adipose tissue. They are congenital or acquired. These syndromes are associated with various metabolic and harmonal disorders leading to severe comorbidities including hypertriglyceridemia, diabetes mellitus, acanthosis nigricans, xanthomas, polycystic ovarian syndrome (POS) and non-alcoholic fatty liver disease. Keywords: Lawrence syndrome, lipodystrophy, diabetes mellitus
Covid-19 y trabajadoras de salud en Venezuela desde el enfoque de género.
Authors: Alcántara Gustavo
Published: December 2021

El propósito del presente artículo es analizar algunas repercusiones en mujeres en general y, particularmente, mujeres trabajadoras del sector salud en Venezuela a raíz de la pandemia por Covid-19, desde una perspectiva sociopolítica del enfoque de género. La investigación fue de tipo analítica y documental. El concepto de género se entiende como las diferencias y desigualdades entre hombres y mujeres creadas y reproducidas en y por la sociedad, a través de las interacciones sociales que continuamente van construyendo la cotidianidad y moldeando las diversas instituciones sociales que, a su vez, estructuran y constriñen la acción social del individuo o el grupo determinado. Se observó que muchos de los avances conseguidos en el mundo y en Venezuela, en materia de protección y bienestar de las mujeres, se han visto quebrantados por el coronavirus. En conclusión, la pandemia ha creado un contexto que agudiza las vulnerabilidades de las mujeres en general, pues los riesgos van más allá de enfermar o morir por Covid-19. Son más vulnerables las trabajadoras sanitarias porque el sector salud está feminizado. Es la sociedad con sus complejos entramados la que se ha encargado de estructurar instituciones que colocan a las mujeres en situaciones que demandan mayores responsabilidades en tiempos de pandemia. Los derechos de la mujer y las políticas públicas que como país seamos capaces de crear e implementar para protegerlas en medio de la pandemia, son la base para superar la crisis y edificar una mejor sociedad.
La obra por encargo como caso de excepción a la excepción del principio de formalidad escrita prevista en el ecosistema de presunciones legales de la Ley Sobre el Derecho de Autor.
Authors: D’Jesús Antonio
Published: December 2021

La Ley sobre Derecho de Autor establece, en el ecosistema de presunciones legales, la excepción al principio de formalidad escrita para la transferencia del derecho patrimonial y el ejercicio lícito del derecho moral de autor, en este último caso cuando sea necesario para la explotación normal de la obra, sin embargo, esta excepción no aplica a las obras creadas por encargo en virtud de su propia naturaleza, siendo obligatorio, a los fines del ejercicio del derecho de autor por parte del comitente o persona que encarga la obra, establecer en contrato escrito las condiciones del encargo y las características de la obra encargada.
Los derechos de propiedad intelectual y el acceso a los medicamentos para enfrentar a la COVID-19.
Authors: Astudillo Francisco
Published: December 2021

La pandemia llamada COVID-19 generada por el coronavirus SARS-CoV-2 y la necesidad de la humanidad de acceder a medicamentos para su prevención, diagnóstico, tratamiento y cura ha traído nuevamente a la palestra a los derechos de propiedad intelectual y concretamente al sistema de patentes de invención, por cuanto los titulares de los derechos que estas confieren sobre los medicamentos, permiten oponerse a quienes pretendan producirlos y comercializarlos sin su autorización. La producción de medicamentos es motivada en gran parte por el sistema de patentes, por cuanto esa posibilidad real de exclusión de otras personas por un lapso previsto en las leyes, incentiva sin dudas las inversiones necesarias para lograrlos. Los mencionados derechos en caso alguno son absolutos y esa relatividad se manifiesta en las limitaciones para su ejercicio y flexibilidades para su aplicación, previstas en leyes y convenios internacionales como el Acuerdo sobre los Derechos de Propiedad Intelectual relacionados con el Comercio, conocido bajo los acrónimos ADPIC o TRIPS, este último en el idioma inglés. Este artículo analiza cómo los medicamentos inherentes a la COVID-19 ayudan a enfrentarla en las diferentes áreas del ejercicio de la medicina; también los nuevos usos de medicamentos conocidos para enfrentar a la COVID-19, la división de medicamentos en originales y genéricos, el acceso a los fármacos patentados a través de las flexibilidades del sistema, como son las licencias obligatorias y otras iniciativas voluntarias; para finalizar considerando la propuesta del Secretario General de las Naciones Unidas, en el sentido de tratar la eventual vacuna como un “bien público global” para su acceso por toda la población mundial y los problemas inherentes a su producción y distribución.