bluuebunny/crossref_metadata_2025 huggingface dataset:
Penetrating Injury to the Floor of Mouth in a Child
Authors: Dash Manas R , Mallick Sworupa Nanda , Mishra K Rajinder , Panigrahi Pranay
Published: February 2022

Penetrating injuries of the oro-maxillofacial region are not only rare but difficult to manage in the pediatric age group. We report a case of a six-year-old girl who was injured with a penetrating reinforcing bar (rebar) in the floor of the mouth, where both ends of the rebar protruded out. The girl fell off a partially constructed terrace and was hanging with the rebar in her neck for hours. On examination, the vital structures of the neck were not involved. The child was taken for surgery after stabilization, abiding by COVID protocols. The rebar was removed under ketamine sedation with repair of the injury in the floor of her mouth. The postoperative period was uneventful and the child was discharged on the fifth postoperative day. Managing this pediatric trauma emergency was challenging in terms of imaging, securing an airway, and assuring parents about the choices for intervention during lockdown.
Mild Cognitive Impairment and its Lifestyle-Related Risk Factors in the Elderly
Authors: Saikia Anku Moni , Rajendran Vinoth
Published: February 2022

Context:

Alzheimer's dementia (AD), an irreversible condition is an important cause of disability in old age. Mild cognitive impairment (MCI) is an intermediate state between normal cognition and dementia. Amnestic MCI (aMCI) is the precursor of AD. Identification of modifiable lifestyle risk factors help in the prevention of aMCI, and thereby in the prevention of AD.

Aim:

The purpose of this study was to determine the prevalence of aMCI and different lifestyle factors associated with types of MCI.

Methods:

This cross-sectional study was conducted amongst the elderly (≥60 years). A sample of 576 persons was selected using a multistage sampling technique. Vernacular adaptation of Hindi Mini-Mental State Examination tool was used to screen dementia and MCI. Geriatric Depression Scale-15 was used for screening depression. Data were collected using a pre-designed and pretested schedule and SPSS was used for data entry and analysis.

Results:

The prevalence of MCI was found to be 22.4% among the elderly. Out of all MCI cases, the prevalence of aMCI was 38.8% in this study. The lack of social and leisure engagement was found to be significantly associated with the type of MCI.

Conclusion:

The comparatively higher prevalence of aMCI is just the tip of the iceberg. Lack of social and leisure engagement is a highly predictive risk factor.
Evaluation of Human Epidermal Growth Factor Receptor 2 Expression in Colorectal Cancer and its Correlation with Clinicopathological Variables
Authors: Ahuja Sana , Arora Vinod Kumar
Published: February 2022

Context:

Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Overexpression of human epidermal growth factor receptor 2 (HER2) in breast and gastric cancer is associated with poor prognosis. However, in colorectal cancer, there are no specific guidelines for immunohistochemical interpretation of HER2. Furthermore, there are conflicting reports regarding correlation of clinicopathological parameters with HER2 expression.

Aim:

The present study was conducted to determine the frequency of HER2 expression in colorectal cancer and its correlation with clinicopathological variables, if any.

Methods:

Resection specimens for colorectal cancer over a 2-year period were included in this retrospective study. HER2 immunostaining was done using a monoclonal antibody followed by evaluation of pattern and intensity of staining along with correlation of cells with membranous positivity. Clinicopathological parameters such as age, gender, tumor location, histological subtype of tumor along with tumor stage and grade were analyzed using Fisher's exact test for significance.

Results:

Of the 50 cases analyzed, 70%, 28%, and 2% were conventional, mucinous, and signet cell ring adenocarcinomas, respectively. The majority were moderately differentiated (56%) and most of the cases presented at Stage III. Weak-to-moderate cytoplasmic positivity was seen in 18% cases, while one case each (2%) showed combined cytoplasmic-membranous and complete membranous positivity, respectively. No significant correlation could be established between HER2 immunostaining and histological subtype or tumor stage/grade.

Conclusions:

Colorectal cancer demonstrates a very low membranous positivity to HER2 immunostaining. HER2 expression in colorectal cancer has no correlation with clinicopathological variables such as tumor grade, stage, and histological subtype. HER2 does not appear to have any prognostic role to play in colorectal cancer in the context of Indian population.
Physiotherapy for Simple Mastectomy Following Phyllodes Tumor
Authors: Alvi Zoha Badiuzzama , Shukla Manish Prannath , Mishra Abhishek Satyadeo
Published: February 2022

Phyllodes tumors are relatively rare breast tumors. Management of these tumors with surgical resection may cause postoperative complications. The purpose of this case study was to define the role of early postoperative physiotherapy in a patient with phyllodes tumor of the breast following simple mastectomy. A 50-year-old woman was brought to the outpatient department following a 1-year history of the lump in the right breast, worsening gradually in the preceding 2 months, and subsequently diagnosed to be a phyllodes tumor. She was treated with simple mastectomy followed by a drain insertion. Postoperatively, she presented with reduced chest expansion and functional mobility and postural impairments. Treatment protocol was set and follow-up was made on the 8th postoperative day. We conclude that early physiotherapy intervention can help in improving the functional mobility and preventing further postoperative complications.
Audit of Blood Utilization in a Tertiary Care Hospital
Authors: Chakravarty-Vartak Urmi , Neelakantan Amrita , Vartak Shailesh , Shewale Rohini
Published: February 2022

Context:

Blood transfusion plays a vital role in saving lives. However, owing to its many side effects, it should be used judiciously.

Aim:

The aims of this study were: audit of blood utilization in our tertiary care set up, formulation of a maximum surgical blood ordering schedule (MSBOS) for procedures where a complete cross-match appears mandatory, and improvement in the efficiency of blood utilization in trauma care.

Methods:

All patients admitted to Lokmanya Tilak Municipal Medical College and General Hospital during the study period for whom cross-match requests were sent to blood bank were included in this study. They were divided into groups according to the departments under which they were admitted. Data were analyzed and cross-match to transfusion ratio (C/T ratio), transfusion index, and transfusion probability (%T) were calculated. C/T ratio was used as an index of the efficacy of blood ordering practice, and a ratio of >2.5 was considered an indication of the excess cross match.

Results:

The maximum C/T ratio of 34.11 was noted in the Department of Cardiology. Only three departments (Artificial Kidney Dialysis, Pediatrics, and Medical Intensive Care Unit) showed effective utilization of blood. Minimum C/T ratio of 1.34 observed in the Department of Artificial Kidney Dialysis.

Conclusion:

We found gross over-ordering of blood by different departments. Hence we propose the formulation of a blood ordering schedule. We drafted a MSBOS which provides guidelines for frequently performed elective surgical procedures by recommending the maximum number of units of blood to be cross-matched preoperatively, implementation of which will result in more efficient use of blood.
Epidemiological Study of Vitamin D Deficiency among Libyan Patients
Authors: Atia Ahmed , Arhoma Sundes
Published: February 2022

Background:

Vitamin D deficiency (VDD) is not only common globally but is more rampant in Libya. Assessment and management of it can help prevent many other conditions and serious diseases.

Objective:

This stuay aimed to study the prevalence of VDD among patients attending private clinics in Zawia city of Libya.

Methods:

A Cross-sectional study was carried out among 71 apparently healthy patients from different private clinics laboratory, Zawia city, Libya. After obtaining informed consent and confirming the willingness of the patients to give the blood samples, the data were recorded in the pre-designed, pre-tested, and semi-structured study questionnaire. Variables such as age and sex were recorded. Vitamin D status was ascertained for all included participants in the present study.

Results:

Female participants were more than male participants in the present study (63.4% vs. 36.6%). Majority (45.1%) belonged to the age group of 41–64 years followed by 1–18 years of age (39.4%). The mean value of Vitamin D among females (19.8 ± 2 nmol/L) was significantly lower when compared to males (25.7 ± 3 nmol/L). The mean value of Vitamin D was significantly lower in the age group of 41–64 years and more than 64 years of age compared to 1–40 years of age (P < 0.05).

Conclusion:

The prevalence of VDD was more in females compared to males. The values decreased with increasing age.
Efficacy of ultrasound guided quadratus lumborum plane-1 block for post operative analgesia at iliac / hypogastric donor sites in patients undergoing reconstructive surgery with graft harvest from dermatomal area t7 - l1
Authors: Srivatsav A. Muralikrishna , Boopathi V. , Sankuru Divya , Sasidharan Shibu , Manalikuzhiyil Babitha , Dhillon Harpreet Singh
Published: February 2022

Background:

Ultrasound-guided quadratus lumborum plane-1 (QLP-1) block involves placement of local anesthetic lateral to the quadratus lumborum muscle. It provides better and long-lasting analgesia than transverse abdominis plane block due to the spread of local anesthetic more posteriorly along the thoracolumbar fascial plane, thus involving the L1 dermatomal area.

Objectives:

We conducted a study to evaluate the efficacy of ultrasound-guided QLP-1 block for postoperative analgesia at iliac/hypogastric donor sites in patients undergoing reconstructive surgery with graft harvest from dermatomal area T7-L1.

Materials and Methods:

After obtaining approval from the ethical committee, a randomized controlled trial was conducted from February 2018 to November 2018. Eighty patients were randomly allocated into two equal groups, Group A (QLP-1 block) and Group B (control, without any block, and only iv analgesics) based on computer-generated random number techniques. Twenty ml of local anesthetic mixture containing 0.5% bupivacaine and 2% lignocaine with adrenaline and 4 mg of dexamethasone was for QLP-1 block in Group A. Aim was to assess pain scores every second hourly up to 24 h and secondary objective was the requirement of rescue analgesia. SPSS version 19 was used to derive statistical results. The unpaired t-test is used for quantitative analysis.

Results:

The numerical pain score (NPS) was significantly low in Group A compared to Group B between 6th and 12th h after the block (P < 0.001). The mean time at which first rescue analgesia had to be given was significantly later in group A (15.55 h) compared to Group B (6.25 h). The requirement of double rescue analgesia in the first 24 h after the block was higher in Group B (100%) compared to Group A (0%).

Conclusion:

Ultrasound-guided QLP-1 block is safe, hemodynamically stable, and provided superior analgesia at iliac/hypogastric donor sites compared to control group in patients undergoing reconstructive surgery with graft harvest from dermatomal area T7-L1. The number of rescue analgesics required in the QLP-1 group is less compared to the control group.
“Dolce far niente” and mindfulness
Authors: Dhillon Harpreet Singh , Sasidharan Shibu , Dhillon Gurpreet Kaur , Manalikuzhiyil Babitha
Published: February 2022

In this fast-paced stressful life, can the art of doing nothing be the key to psychological well-being? In this review article, we have proposed and reviewed that how can you make your idle moments and acts of daily living pleasurable when combined with the principles of Mindfulness. The neurobiological basis for the same has also been explored, which however warrants rigorous research in future. The potential benefits of mindfulness-based interventions on various psychiatric and physical disorders have been discussed. The need for standardized, longitudinal studies with a specific type of mindfulness-based interventions has been impressed upon to draw definite conclusions.
Evaluation of autologus platelet-rich plasma versus silver nitrate in the treatment of cervical erosion
Authors: Aitah Naglaa F.H.A. , Hamouda Mahmoud S.L. , Ahmed Amira Y. , Elsokary Amal A.E.
Published: February 2022

Background

Cervical erosion is identified by the existence of columnar cells on the ectocervix rather than on the squamous epithelium. Adolescent age, pregnancy, and hormonal contraception are all causes of erosion. Some doctors think erosion is a typical asymptomatic variation, while others believe it is caused by persistent cervicitis. Metaplastic columnar epithelium may cause a variety of symptoms such as vaginal discharge, leukorrhea, postcoital bleeding, pelvic discomfort, and dyspareunia. Laser ablation, microwave ablation, platelet-rich plasma (PRP) injections, herbal treatments, and cryosurgery have all been reported as therapeutic options.

Aim

Evaluating the therapeutic effect of applying an autologous PRP in cervical erosion versus chemical cautery with silver nitrate.

Patients and methods

Randomized controlled clinical study on 100 patients at the outpatient clinic of the Obstetrics and Gynecology Department, Faculty of Medicine, Tanta University Hospitals. A total of 50 patients was assigned as the PRP group), the study group, while the other was the silver nitrate group. Follow-up visits occurred on the 1st, 2nd, 4th, 6th, 8th, 10tht, and 12th week posttreatment for the lesion size changes, symptom relief, postprocedure discomfort, pain, and long-term complications.

Results

PRP and silver nitrate are now being used to treat symptomatic patients with cervical erosion. Because it resulted in a faster tissue healing time and fewer complications, autologous PRP has the potential to replace alternative unpleasant treatment options such as cautery, with promising results for inflamed and injured cervical tissue with erosion repair.

Conclusion

PRP shows no immunogenic difficulty or ethical matters as autologous. It stops damage to the cervix and hence prevention from cervical cancer.
Incidence of vaginal delivery and its outcome in Tanta University Hospital
Authors: Abd Elwhab Elshair Rabab E. , El Halwagy Ahmed El Sayed , Kabbash Ibrahim A.F. , Elkholi Gamal El Deen Yousef
Published: February 2022

Background

In developing countries, women are unwilling to accept cesarean delivery due to their old-style principles and sociocultural customs. Those women are frequently sent to hospitals with life-threatening problems and in these circumstances the cesarean section (CS) is done as an emergency operation.

Aim

We aimed to determine the incidence of vaginal delivery and its outcome in Tanta University Hospital.

Patients and methods

This prospective cohort study was conducted at Obstetrics and Gynecology Department, Tanta University Hospital during the period from August 2018 to January 2019. All women in labor during the period of the study were the target population of the study.

Results

Prevalence of normal vaginal delivery (NVD) was found to be 59.3% of all deliveries in our study. No significant difference was found between NVD and CS as regards neonatal outcome. Postpartum hemorrhage was the most common complication after NVD representing 5.5% of all cases. NVD were found to decrease with increased age of women, number of gravida, parity of studied women, and with increased abortions. It was found to increase with increased gestational age.

Conclusion

The prevalence of NVD at Tanta University Hospitals was 59.3% compared with 40.7% for cesareans and the outcome of delivery did not differ between NVD and CS.
Evaluation of ocular surface status in patients with glaucoma treated with preservative or preservative-free prostaglandin analogs
Authors: Khedr Amira M. , Eid Tarek E. , Elsaka Ayman M. , Elmaria Ahmed F.
Published: February 2022

Background

Glaucoma is one of the eye diseases that require chronic treatment. Prostaglandin derivatives are popular for treating glaucoma. Most prostaglandin drops contain benzalkonium, which contains the contraceptive pill.

Aim

Comparing the ocular surface changes in patients with primary open-angle glaucoma treated with preservative-free versus preserved prostaglandin analogs (PGAs).

Patients and methods

This prospective study was carried out on 40 eyes of 40 patients with newly diagnosed primary open-angle glaucoma and randomly divided into two groups that received PGAs: group A (20 eyes) received preserved PGA (latanoprost 0.005%), and group B (20 eyes) received preservative-free PGA (tafluprost 0.0015%). After 3 months of treatment, the ocular surface status in every patient was evaluated by Schirmer 1 test, tear film break-up time, fluorescein corneal staining, impression cytology, and Ocular Surface Disease Index questionnaire.

Results

Schirmer 1 test showed that 90% of patients in group B had normal values compared with 40% in group A (P=0.008). Tear film break-up time showed that 90% of patients in group B had normal values compared with 35% in group A (P=0.004). Regarding fluorescein corneal staining, 100% of the patients in group B had normal values compared with 60% in group A (P=0.007). Impression cytology grading was significantly better in group B (P<0.001). According to the Ocular Surface Disease Index score, patients on tafluprost treatment reported better drug tolerability (P=0.041).

Conclusion

Patients with glaucoma treated with preservative-free PGA have fewer ocular surface adverse effects, which may increase the tolerability of topical glaucoma medications.
Role of multislice computed tomography in evaluation of thoracic complications in patients with chronic renal failure
Authors: Elsayed Mahmoud M.S. , El Hafez Zayton Hossam A. , Hantera Mohamed S. , Elshaarawy Fatma A.
Published: February 2022

Background

The incidence of chronic renal failure (CRF) is increasing worldwide. With the expanded use of hemodialysis treatment and extended life of patients with chronic renal failure, large numbers of thoracic complication of CRF patients are being increased. The radiological findings of the thoracic complications in patients with CRF are multiple.

Aim

To study the role of multislice computed tomography (MSCT) in the evaluation of thoracic complications in patients with CRF.

Patients and methods

A total of 30 patients with CRF who presented with chest diseases were included in this study (13 females and 17 males). All patients underwent detailed history taking, clinical examination, laboratory studies, and MSCT examination.

Results

Pleural effusion was the most common complication found in 19 (63.3%) patients, pulmonary infection was the second most common complication detected in 16 (53.3%) patients, followed by mediastinal lymphadenopathy presented in six (20%) patients, pulmonary nodules presented in six (20%) patients, pericardial effusion presented in four (13.3%) patients, pulmonary thromboembolism, hydropneumothorax, vascular calcification, and pleural thickening presented in three (10%) patients each, then, cardiomegaly presented in two (6.7%) patients, and finally, lung cancer presented in one (3.3%) patient.

Conclusion

MSCT was effective to illuminate a wide spectrum of thoracic complications in symptomatic patients with CRF and was the most sensitive imaging modality for detection of these complications.
Antioxidant effects of gum arabic on gentamycin-induced hepatotoxicity in rats
Authors: Hassanien Mohammed A.
Published: February 2022

Background

Gum arabic (GA) is an exudate obtained from Acacia senegal and A. seyal, and it contains a large amount of nonviscous soluble fiber. Experimental studies revealed its strong antioxidant properties. Gentamycin-induced hepatotoxicity has been reported in experimental animals. Gentamycin induces hepatoxicity mainly by generating free radicals and enhancing oxidative stress.

Aim

This study aimed to investigate the involvement of oxidative stress and the alteration of the oxidant–antioxidant balance in gentamycin-induced hepatotoxicity. In addition, this study explored the possible protection that can be afforded by GA, given its antioxidant potential.

Materials and methods

Forty adult male Albino rats’ weighing was used in this study. The animals were randomly divided into four groups. Group I served as control, which received normal mouse diet. Group II orally received GA through a gastric feeding tube for 8 days. Group III received a daily intraperitoneal injection of gentamycin. Group IV received gentamycin intraperitoneally plus orally for 8 days.

Results

The results of this study revealed significant elevation of serum alanine transaminase, hepatic malondialdehyde level, glutathione peroxidase, and glutathione S-transferase activities and reduction of hepatic Reduced Glutathione (GSH) and glutathione reductase activities in gentamycin-treated animals. Administration of GA with gentamycin intake restored the altered parameters to their normal values, whereas hepatic glutathione peroxidase and glutathione S-transferase activities were enhanced further.

Conclusion

This study demonstrated the antioxidant effect of GA and its protective role against gentamycin-induced hepatocyte injury. More studies are warranted to further reveal the underlying mechanisms of the antioxidant properties of GA, especially at the structural and molecular levels.
Assessment of diaphragmatic excursion-time index as a predictor of successful weaning from mechanical ventilation
Authors: Mashal Aya E. , Abd Elhafez Ahmed A. , Elbaradey Ghada F. , El Keblawy Amira M.
Published: February 2022

Background and aim

Timing is essential for real weaning from mechanical ventilation as unfavorable weaning may provoke extended cardiovascular, respiratory-pressing factor, carbon dioxide retention, and hypoxemia. The mark of the current examination was to review the accuracy of diaphragmatic excursion-time index assessed by ultrasound as a predictor of successful weaning from mechanical ventilation.

Patients and methods

This is a prospective cohort study. It was done in the University Hospitals during the period from October 2019 to March 2020.

Results

This study was done on 36 patients over 18 years of age precisely ventilated for over 48 h legible for the beginning of weaning from mechanical ventilation. After endorsement of Institutional Ethical Committee, a written informed consent was obtained from every tolerant's family member. Patients were arbitrarily assigned into two equivalent groups: group 1: successful weaning thought about when supported spontaneous breathing without invasive or noninvasive mechanical support for over 48 h following extubation and group 2: failed weaning when the patient needs reintubation, noninvasive ventilation, or required tracheostomy within 48 h after extubation.

Conclusions

Ultrasound-guided diaphragmatic excursion-time index measured either at the beginning of spontaneous breathing trial or before extubation was the stronger predictor of successful weaning from mechanical ventilation compared with diaphragmatic excursion, rapid shallow breathing index, and negative inspiratory pressure.
Outcomes of anterior-wedge resection of the middle turbinate in functional endoscopic sinus surgery
Authors: Elbasty Hazem A. , Elsheikh Mohamed N. , Hagras Mahmoud A. , Tomoum Mohamed O.
Published: February 2022

Background

Chronic rhinosinusitis is a common condition that affects the quality of life of patients. Patients may require sinus surgery in case of failure of medical treatment. One of the important decisions to be made during sinus surgery is middle-turbinate (MT) management.

Aim

The objective of this study was to evaluate the outcomes of the anterior-wedge excision of the MT in sinus surgery regarding accessibility to the sinuses both intraoperatively and postoperatively and the quality-of-life changes at least 6 months after surgery.

Patients and methods

This is a prospective, cohort-controlled study. Fifty patients were enrolled into two groups: group A consisted of 25 patients who had anterior-wedge resection of the MT and group B consisted of 25 patients in whom the MT was preserved during sinus surgery for management of chronic rhinosinusitis.

Results

Anterior-wedge resection of the MT was found to improve access to middle meatus during surgery and postoperative care. There was a significant enhancement of SNOT-22 total score and all its subscale scores.

Conclusion

Anterior-wedge MT resection is a promising procedure during sinus surgery. It can be a helpful auxiliary procedure to enhance surgical accessibility, facilitate postoperative follow-up and debridement, and reduce the risk of synechiae formation between the MT and lateral nasal wall. This may be associated with improvement of the disease-related quality of life after sinus surgery.
Evaluation of the diagnostic yield of ultrasound in the management of appendicitis
Authors: Chiegwu Hyacienth Uche , Ugwuanyi Daniel C. , Udoh Benjamin E. , Chianumba Francis S.
Published: February 2022

Introduction:

In most complaints of right lower abdominal pains appendicitis is suspected. Appendicitis often creates the most common abdominal surgical emergency. Ultrasound and computed tomography are often the imaging modalities used to confirm the clinical diagnosis of appendicitis. The aim of this study was to evaluate the accuracy of ultrasound in the diagnosis of appendicitis in a tertiary hospital in South Eastern, Nigeria.

Materials and Methods:

A retrospective study design was adopted to study 152 records of patients aged 1–65 years who had ultrasound scans for clinical suspicion of appendicitis at a tertiary hospital in Anambra State, South Eastern Nigeria from 2016 to 2018. Patients' age, gender, and provisional diagnosis were obtained from the patients' request forms. Ultrasound results were obtained from the radiology department and the histology reports from the histology unit of the hospital. The Statistical Package for the Social Sciences, SPSS, version 22.0. was used for data analysis.

Results:

Of the 152 cases, ultrasound was positive in 115, while histology confirmed 136 positives. Ultrasound, therefore, had a sensitivity, specificity, and accuracy of 84.56%, 100%, and 86.18%, respectively. The positive predictive value and negative predictive values were 100% and 43.24%, respectively. The study showed a higher incidence of appendicitis among females (n = 84) than males (n = 52), (ratio 1:1.6). Age groups 10–19 and 20–29 years were the most affected. Accuracy was 91.94% (in males) and 82.22% (in females). The most common ultrasound features include enlarged appendix (>9 mm, 100%), rebound tenderness to probe (92%), and fluid-filled appendix (88%).

Conclusions:

Ultrasound has high sensitivity, specificity, and accuracy for the diagnosis of appendicitis.
Opportunistic use of “follow-up” chest and abdominal computed tomography in the assessment of bone mineral density of breast cancer patients in a resource-poor nation
Authors: Mensah Yaw Boateng , Edusa Clement , Nsaful Josephine , Mensah Naa Adjeley , Badu-Peprah Augustina , Gbadamosi Hafisatu , Appau Andrea , Amankwa Adu Tutu
Published: February 2022

Background:

Breast cancer patients experience bone loss from treatment-induced menopause, as well as from the direct effect of cancer. The use of computed tomography (CT) attenuation values of the lumbar spine to estimate bone mineral density has been validated by several studies.

Materials and Methods:

This was a retrospective study conducted at Sweden Ghana Medical Centre and Korle Bu Teaching Hospital between June 2016 and August 2019. Measurement of Hounsfield unit (HU) of lumbar vertebrae was achieved by drawing an elliptical region of interest (ROI) on an axial image of the vertebra about 2–3 mm from the spinal cortical bone. The mean HU of the ROI was measured on bone window for each of the vertebral bodies, and the values were documented and analyzed.

Results:

The mean bone densities of the vertebrae were generally higher for the noncancer patients compared to the breast cancer patients for all the age groups. The measured bone densities showed a normal distribution curve. The range of bone density for osteopenia and osteoporosis was between 174.4 and 236.4 HU and <174.4 HU, respectively. A Pearson's correlation analysis between patient age and bone density for both groups showed a negative statistically significant relationship.

Conclusion:

Using CT attenuation values of lumbar vertebra to estimate bone density established that the bone densities follow a normal distribution, the mean bone density for breast cancer patients were slightly lower than for noncancer patients, and age correlated better with lumbar bone density in noncancer patients than in breast cancer patients.
From ancient Greek medicine to EP³OS
Authors: Prokopakis E.P. , Hellings P.W. , Velegrakis G.A. , Kawauchi H.
Published: February 2022

The manuscripts of eminent Byzantine physicians from the 4th to the 14th century contain extensive information on various otorhinolaryngological issues. In their work, the early knowledge of rhinological disease from definition and symptoms to conservative treatment and surgical intervention is intriguing. Most of this meticulous knowledge was developed through time, beginning mainly from Hippocrates and the Hellenistic period. Thereafter, medicine developed through Roman and Byzantium times to finally influence European medicine and later the rest of the Western world. History of medicine reflects the history of mankind itself, and otorhinolaryngology follows closely this path. Our goal is to slim down and illuminate the most challenging of the vast amount of information on rhinological issues contained in the original Greek text of Hippocrates, and mainly in the hagiographical texts of Byzantine medical writers. In particular, we focus on rhinological diseases from antiquity till the time being, following the journey of evolution of topical and nebulizer therapy for sinonasal inflammatory diseases in Greece, from "milothris" to modern nasal sprays, leading to an understanding of the philosophy of our predecessors and the roots of modern rhinology.
Design Optimization of the Bolted Connection Loaded Parallel to the Timber Grain for Masonry Building Retrofits
Authors: Karim Abdul Razak Abdul , Quenneville Pierre , Sadon Norazzlina M.
Published: February 2022

The experimental results of timber bolted connection tests for the purpose of optimizing the use of current design standard are presented. The test was conducted to investigate the structural performance of bolted connections loaded parallel to the timber grain. Both ductile and brittle failure modes were investigated to identify the governing parameters that affect the types of failures. The Meraka hardwood was chosen because it was found to be commonly used in the construction of the structural components of floor and roof diaphragms in Malaysia unreinforced masonry (URM) buildings. From this study, a wood database can be established for assisting the design engineers in developing the retrofitting technique of the building, especially the timber diaphragm joint part of the wall-diaphragm connections. Eighteen characteristics of steel-wood-steel (SWS) with a single row bolted joints were tested in tension, whereas ten specimens were prepared for each connection group. From the results obtained, it can be observed that the current timber design code is far too conservative compared to the optimized design proposed in this paper.
Ergot sclerotia and ergot alkaloids occurrence in wheat and rye grains produced in Croatia
Authors: Pleadin Jelka , Zadravec Manuela , Vasilj Višnja , Petrović Danijela , Cvetnić Luka , Škrivanko Mario , Kudumija Nina
Published: February 2022

Ergot alkaloids (EAs) are mycotoxins produced by several species of fungi of the genus Claviceps, among which Claviceps purpurea is the most widespread in Europe. This species has been found in many economically important cereal grains, such as rye, wheat, triticale, barley, millet and oats. The distribution of EAs contamination has a sporadic incidence with many factors involved in its occurrence, greatly varying between fungal strains, geographic regions, host plants and regional/local weather conditions, at the same time emphasizing that cool, damp weather favours ergot by enhancing the germination of sclerotia. The aim of this study was to investigate the occurrence of ergot sclerotia and EAs in wheat and rye grain samples (n = 64) taken during the year 2021 from Croatian cereal producers located in the Central and Eastern parts of Croatia. In two of the rye samples the presence of ergot sclerotia was detected in the amount of 259 mg/kg and 536 mg/kg, whereas none of the wheat samples tested positive for ergot sclerotia. A higher contamination with EAs was determined in the rye samples (18% contaminated, max 167.4 µg/kg), while a lower frequency of contamination, with only one positive sample (1.9 %), was determined in wheat (68.5 µg/kg). The results pointed to a low-level of EAs contamination of wheat and rye cultivated by Croatian producers during the whole investigative period. However, although a low percentage of the positive tested rye samples with EAs was determined, the content of ergot sclerotia in two of the samples was higher than is allowed by legislation for foodstuffs. Because the levels of these mycotoxins and ergot sclerotia content can vary depending on a number of factors, further research of them is required over a longer period of time and under different cereal cultivation and processing conditions.
Day Care Centers for Children in Karachi City A Mapping Study
Authors: Ishrat Sumera , Rauf Samina
Published: February 2022

Many parents send their pre-school aged children to daycare services. Generally, children spend their time in daycare from the age of 3 months to 5 years. Various daycare centers are operating in Karachi. This researcher is exploratory and was focused on gathering information about the care quality standards of daycare centers. Different factors, which include institution type, operational timings, building structure and capacity, financial sources, workforce competency, service delivery mechanism (use of equipment), the behavior of staff, amenities available, hygiene management, and perception of daycare service providers have been analyzed in this research.
A Study of Relations between Mughal India and the Ottoman Empire 1556-1748
Authors: Hameed Umer , Hameed Usman , Umer Saima
Published: February 2022

In India, relationship with Ottoman was not found until the foundation of the Mughal empire in the early sixteenth century that India was able to break this self-imposed isolation from the outside world. Several factors were responsible for this momentous development. The present study is, therefore, a pioneering effort. It seeks to fill a gap in the Indian and Ottoman historical literature. Two fundamental questions guide this study. First, what factors determined Mughal policy towards the Ottoman empire? Was it guided by the interests of the Mughal state? Or was it governed by the whims, passions, and prejudices of the Mughal Emperors? Second, did Mughal relations with the Safavids, the Uzbeks, and the Sharifs of Mecca have any bearing on Mughal-Ottoman relations? The present study discussed the three major aspects. The first aspect is the Mughal empire's political and diplomatic relations with Istanbul from its beginning in 1556 to Emperor Shahjahan's deposition in 1658. The second aspect relates to the story of the Mughal-Ottoman relations from the accession of Aurangzeb in 1658 to the death of Muhammad Shah in 1748. The third aspect includes Mughal relations with the Sharifs of Mecca.
The Human Rights Violation A Study of the Indigenous People of Biafra Agitation (IPOB)
Authors: Kevin Ifeanyi
Published: February 2022

The proliferation of ‘violent-oriented' ethnic organizations and agitation groups operating in Nigeria, is a result of the inability of the Nigerian state to resolve the questions of citizenship, resource control, federalism and political representation. This, of course, is an expression of sub-nationalism and irredentism, hence posing a threat to the survival of the fragile democracy and nation-building in the country. No doubt, the Igbo people who bore the brunt of the Nigerian Civil War has been relegated to the background and are being treated as a minority group in the country, even though they are one of the three major ethnic groups in the country. Another problem is the fact that they have been used as scape goats in any political crises in Nigeria. They have been extra-judicially killed and their property wantonly destroyed. All these infringed on their fundamental human rights. These are the factors that have fuelled the recurrent agitation and demand by the Indigenous People of Biafra (IPOB) for a separate state was their rights can be protected. This study, therefore, concludes that the development of Nigeria will remain a mirage, and Nigeria, making a positive impact in international politics, a white goose chase, should the country fail to tackle her internal political problems.
Issues and Perceptions of Farmers/Herders Conflicts in Central Nigeria
Authors: Tari Vahyala Adamu
Published: February 2022

Farmers/herders conflict is not new in Nigeria. The need to put more emphasis on Central Nigeria particularly Benue, Plateau and Nasarawa States was born out of the persistent conflicts arising from and complicated by farmer-herder vested interest. Currently, the subject matter is under-exploited and under-researched. Existing extant studies in that regard tend to have focused on farmer-herder conflicts without comprehensively emphasizing the philosophy and ideology operating by the two parties in fueling the conflicts. The study adopts community case study approach. Three states were purposefully selected, namely Benue, Plateau and Nasarawa, these states were highly affected by the conflict in recent years. Two local governments were randomly selected from each state. individuals were selected for Key Informant Interview (KII), FGD and Study Chart from All Farmers Association of Nigeria (AFAiencN), Miyetti Allah Cattle Breeders Association of Nigeria (MACBAN), Community Security Architecture Dialogue (CSAD). Participation was voluntary, therefore, those who were readily available were used. 30 KII, 17 FGDs and 10 SCs were carried out across the targeted communities. Findings show that issues and perceptions of farmers/herders’ conflict in Central Nigeria includes: divergent of perception in the process of survival; land grabbing and unending tension; water scarcity and insufficient pasturelands; underage and children herding and profiling/stereotyping. This calls for an urgent need for government at all levels including Non-Governmental Organizations (NGOs) to create effective awareness, promote peace building and other measures to curtail the existing conflict.
Status of Maharaja of Manipur in British India Empire and Current Social Status Among Peers
Authors: Khumancha Oinam Ghanashyam , Teresa Oinam
Published: February 2022

Many writers claim that kingdom of Manipur with varieties of its, name, is a continuous institution from by-gone many millennia. Now many wishful thinkers claim, Meitei Tribe should not be Scheduled Tribe list of India, any more due to adoption of Hindu and glorious history of kinghood. This paper will try to examine the status of Maharaja of Manipur within the British India Empire and current Social status among peers to verify the merit of those wishful thinkers.
Political and Social Struggle of Ghazi-e-Millat Sardar Muhammad Ibrahim Khan Freedom of Kashmir
Authors: Jahangir Amar , Jamshad Unsa , Khawaja Anbrin
Published: February 2022

Although a few research studies are available on the Kashmir, Sardar Muhammad Ibrahim Khan, Freedom Movement of Kashmir and the establishment of Azad Kashmir Government. In this paper, an attempt has made to study and analyze the role of Sardar Muhammad Ibrahim Khan in the Freedom Movement of Kashmir, especially in the Establishment of Azad Kashmir Government. Sardar Muhammad Ibrahim Khan led the country during an era when the entire subcontinent was enslave by the British Empire. He has emerged as a national leader who has brought the nation together. On 19 July 1947, he passed a resolution of Accession with Pakistan. Because of his political and social struggle on 24 October 1947 a massive area became independent and announce the revolutionary government of Azad Kashmir.
Study on Stipend Program and Girls’ Education in Public Schools of Sindh
Authors: Unar Muhammad Safar , Zarif Tayyaba , Nisa Aziz Un
Published: February 2022

Women empowerment through education process is the key element for the national development by providing basic resources & facilities. Every country has taken systemic initiatives for the development of girls’ education at all levels, to empower women, Pakistan has also started number of motivational steps for girls’ education especially in Sindh. Consequently government of Sindh has taken numerous initiatives to promote girls’ education, in this connection girls’ stipend program started was from 2001 for girls’ students studying from VI to X level in public schools of Sindh. Keeping in view, the primary purpose of this study was to know the effectiveness of girls’ stipend program in public schools of Sindh on the enrollment , attendance of girls , encouragement of parents’ motivational & interest level of parents’ towards continuity of education process as per the perception of head teachers . Current study was descriptive in nature and quantitative by method. Population of this study was all head teachers of elementary, middle and secondary schools of Sindh. Targeted population of this study was all head teachers of elementary, middle and secondary schools of district Shaheed Benazir Abad. Seventy percent head teachers of elementary, middle and secondary schools was selected by convenient random sampling from the targeted population of the study. Questionnaire with five points Likert scale was developed for exploring the perception of head teachers’ about effectiveness of girls’ stipend program. Data was analyzed by the help of percentage. Findings of this study identified that girls’ stipend program proved as motivational factor for the enrolment, attendance, continuity and encouragement of parents and for girls who were studying in 6th to10th classes in public schools.
Knowledge, Attitude and Practices About Hiv/Aids Among Fsws (Female Sex Workers): A Case Study of Karachi
Authors: Mamdani Kaneez Fatima , Madani Munazza , Siddiqui Naila Usman
Published: February 2022

The present research was conducted on female sex workers (FSWs) to study the knowledge Attitude and Practices towards HIV/AIDS. Females are more vulnerable to HIV/AIDS as compared to males in Pakistan. The FSWs are on high risk due to the high-risk practices in their profession. Female sex workers are the major drivers of HIV/AIDS into general population. This is the group, which is ignored due to the social taboo, and stigma attached to their profession that in turn gave boom to these females and now they have become dangerous segment of the society. Present study was conducted on Napier Road, Karachi which is the oldest brothel area of Pakistan established during the rule of British. The data was collected from 180 FSWs through questionnaires. The findings showed that these females didn’t use preventive measures against HIV/AIDS. Stigma, fear, threat and cultural constraint were some of the factors which have made them more vulnerable to HIV/AIDS. It was concluded that females in brothels were vulnerable to HIV/AIDS mainly due to their lifestyle, ignorance, use of drugs and little power to negotiate about the use of condoms, the safest form of prevention of STD’s and HIV/AIDS. HIV prevalence is low in Pakistan even in this high risk group. It is suggested that the government should immediately launch security, educational and health services programs specifically for commercial sex workers in order to minimise the risks before it expounds and becomes epidemic.
Evaluating the outcomes of four-year B. Ed program: A case study of Graduates of Public Sector University
Authors: Siddiqua Naila , Parveen Nighat , Khan Muhammad Zakria
Published: February 2022

The purpose of the study was to evaluate the outcomes of four year B. Ed program with respect to the objectives set by NACTE for teacher education program. It was a dire need of the society to produce competent and skilled teacher to build up a world class education system that are sincere and dedicated to their profession. NACTE has been developed as an autonomous body to ensure the quality of education. A descriptive case study was designed to collect data qualitatively through interview protocol. Questions were designed on the basis of subsidiary objectives related to international standard for teachers, modified and skillful curriculum and practicality of content through practicum. Data was collected from twenty passed out graduates selected by snow ball sampling technique and analyzed by thematic approach. Findings indicate that despite little weaknesses most of the objectives of NACTE and USAID program have been achieved. The participants expressed their views that after completing this four year B. Ed program they are able to know the use of different teaching strategies and skills which are required for an internationally licensed teacher. It was recommended that content courses should be revised to meet the new challenges and assistance should be taken from the concerned department to improve the concept of the student for related subjects.
Teachers Morale: Satisfaction and Annoyance Among the Teachers Working at Secondary Level in Private Sector of Karachi
Authors: Siddiqua Naila , Asim Muhammad , Jawaid Maria
Published: February 2022

This study investigated the teachers’ morale in an outlook of satisfaction and annoyance among the teachers working at secondary schools in private sector of Karachi. Literature reported the paramount position of teachers in society was an effecting factor which was related to their job satisfaction and motivation to sustain in teaching profession. Teachers’ productivity was the result of job satisfaction and motivation. This research addressed the factors associating teachers’ job satisfaction and annoyance in the context secondary schools of Karachi. Qualitative research paradigm used to explore the perception of secondary teachers in Karachi. Semi-structured interview protocol was used to record the opinion of secondary teachers about the factors of annoyance and job satisfaction. A total sample of 12 teachers was chosen as the participants by using Purposive sampling. Data was analyzed through thematic analysis. The findings obtained from the qualitative data proved Maslow’s theory of need in job satisfaction and annoyance. Findings also reported the themes including social benefits, meaningfulness of job and self-esteem was validated by the researcher as a factor for teachers’ morale. This research implies better remuneration for the teachers and healthy working environment for more conductive learning and healthier development of students.