bluuebunny/crossref_metadata_2025 huggingface dataset:
Variability of anatomical features of frontal sinuses among the male ethnic groups residing in Karachi.
Authors: Javaid Quratulain , Usmani Ambreen
Published: July 2020

Objectives: To determine anatomical variability in morphometry of frontal air sinuses in male ethnic groups residing in Karachi. Study Design: Cross sectional descriptive study. Setting: Radiology Department of Jinnah Postgraduate Medical Center. Period: Nov 2018 to April 2019. Material & Methods: In total, the research subjects were 108. They were divided into four ethnic sub groups. Each ethnic subgroup had 27 members. The study subjects were in between 20 to 50 years of age with the mean age of 35.14 ± 8.68 years. Before the enrolment of the participants in the research, informed consent was taken. The methodology incorporated was X-ray radiography. The view for radiology was Water’s view. Area, height and width of both right and left frontal sinuses were measured by the help of Radiant DICOM digital software. A questionnaire was designed to record the demographic data. The parameters of area, height and width of the sinuses were noted in the proforma. The data was analyzed by the help of SPSS version 23.0. Results: The ethnic sub groups were compared by the application of One Way ANOVA. The comparison of the four ethnic groups showed high variability in terms of area, height and width of the right frontal air sinuses (p=0.000). Significant variations were also recorded for these parameters on the left side (p=0.000). Conclusion: The height width and area show pattern of anatomical variability in the right and left frontal air sinuses among the ethnic groups of males living in Karachi.
Natural variations in the appearance and the positions of the mental foramen in a selected population of Karachi (Pakistan).
Authors: Fatima Sara , Baig Arfa , Ali Aeman
Published: July 2020

Objectives: The purpose of this study is to evaluate the most common appearance, horizontal and vertical positions of the mental foramen (MF), using the panoramic radiographs in a selected population of Karachi (Pakistan). As this is relevant to consider prior to plan any maxillofacial surgical procedures in order to avoid nerve injuries. Study Design: Cross-sectional study. Setting: Radiology Department of the Dr. Ishrat ul Ebad khan institute of oral health sciences (Dow University of Health Sciences). Period: 25th September to 5th November 2018. Material & Methods: Total 500 panoramic images were assessed. The study was divided in to the two group i.e. male and female adult patients in which the appearance, anterior-posterior positions and the superior-inferior positions of the MF was analyzed on the panoramic radiographs. Results: Total 500 OPG were accessed, the age ranges between 12 years to 73 years, 229 were male, 271 were females, and majority of MF were separated type (n=341, 68.2%) on right side and (n=373, 74.6%) on left side. And the most common superio-inferior position of the MF on both sides were position 2 (below the level of apices of 1st and 2nd premolar) on right side (n=387, 77.4%) and on left side (n=376, 75.2%), and the most common anterio-posterior position of the MF on both the right and left side is position 4 ( M.F lies in the line of 2nd premolars), on right side (n=269, 53.8%) and on left side (n=255, 51%). Conclusion: In this study the “separated type” was the most common type of appearance in both genders and the most frequent superio-inferior position of the MF is below the level of apices of 1st and 2nd premolar on both right and left sides. And the most common anterior-posterior position is within the line of longitudinal axis of 2nd premolar on both sides.
Early outcome of total correction in adult tetralogy of fallot patients.
Authors: Khalid Zaigham Rasool , Mughal Abdul Razzaq , Siddiqui Muhamamd Mujtaba Ali , Haq Riaz ul
Published: July 2020

Objectives: To detect the early outcome of total correction of Tetralogy of Fallot (TOF) in adult patients of age 16 years or above. Study Design: Retrospective descriptive case series. Setting: Paediatric Cardiac Surgery Department of Faisalabad Institute of Cardiology, Faisalabad. Period: October 2016 to June 2019. Material & Methods: All consecutive patients of age 16 years or above who underwent total correction for TOF during study period were included. Surgical procedure and early outcome measures were recorded and analyzed. Results: Sixty nine patients underwent total correction for TOF during the study period. Majority of patients (n=55, 79.7%) were between16 to 25years of age. Male dominated the study population (56.5%, n=39) with male to female ratio 1.3: 1. Nine patients (13%) had coiling of MAPCA before surgery while prior palliation with Blalock Taussig shunt (BT Shunt) was seen in 5.8 % patients (n=4). All patients were operated with trans-atrial trans-pulmonary approach (n=69, 100%). Pulmonary artery was augmented with pericardial patch in 22 cases (32%) while left pulmonary artery (LPA) augmentation was done in two patients. Pulmonary valve annulus divided in 22 % of patients (n=15), RVOT was reconstructed with trans-annular pericardial patch in 10.1% patients (n=7) while Pulmonary valve was replaced with tissue valve in 7 patients (10.1%). In one patient RV to PA continuity was established with contegra. Post operatively Inotropic support was given for initial 39 ±45 hours, mean ICU stay was 39±75 hours, mean chest drainage 1086±741 ml and mean requirement for blood transfusion was 2.2 ±2.4 units. As regard early complications, six patients had tiny to small residual VSD (8.7%) while no patient developed complete heart block. Two patients had neurological damage (2.9%), one patient developed renal failure (1.45%) while chest reopening was done in two patients due to postoperative bleeding and/ or tamponade (2.9%). There was death of two patients (2.9%), one had renal failure due to low cardiac output (LCOS) and the other had stroke. Conclusion: The early outcome of complete repair of TOF in patients 16 years and above is good with a negligible mortality and limited number of complications.
Comparison of magnesium sulphate as an adjuvant to lignocaine with lignocaine alone in intravenous regional anaesthesia for upper limb surgery in improving tourniquet pain.
Authors: Ali Syed Mehmood , Bokhari Sadaf , Shuja Hajra
Published: July 2020

Objectives: To compare mean time to the first analgesic requirement with the Magnesium sulfate with lignocaine and lignocaine alone under intravenous regional anaesthesia for upper limb surgery. Study Design: Randomized Controlled Trial. Setting: Operative Rooms of Shaikh Zayed Hospital, Lahore. Period: October 2, 2018 to April 2, 2019. Material & Methods: For the analysis, a total of 150 (75 subjects per group) were selected that fulfilled the inclusion criteria. Those subjects were allocated by the use of the tables to two separate anesthetic regimes. Lignocaine plus magnesium sulphate was given to experimental group (M) as an adjunct and control group (L) was given simple IVRA with lignocaine. Mean Atrial Pressure, Heart Rate, and SpO2 were tracked every 2 minutes after start of anesthesia before and after use of the tourniquet. All the patients will be counseled to report if they experience tourniquet pain. When patients complained of tourniquet pain it was assessed on VAS of l-10 and patient was given analgesia if pain >3 on VAS. The data were collected and analyzed in SPSS v25.0. The median time for analgesics was used in both groups for the analysis of the independent t-test. A p-value of 0.05 was estimated significant. Results: 150 patients were enrolled. Mean time to first analgesic requirement is greater with the Magnesium sulfate with lignocaine and lignocaine alone in patients undergoing upper limb surgery under intravenous regional anaesthesia 51.9±4.2 minutes vs. 32.1±4.4 minutes (p=0.000). Conclusion: The findings indicate that the tourniquet pain is reduced by adding magnesium sulphate as an adjuvant to lignocaine.
Diagnostic accuracy of Yale observational scale in bacteremia in infants and children.
Authors: Javed Motia , Siddiqui Mehboob Alam , Anjum Zahid Mahmood , Bajwa Fazal Elahi , Ayesha Hina
Published: July 2020

Bacteremia is the presence of viable bacteria in the circulating blood. Bacteremia is diagnosed by blood culture. Yale Observation Scale (YOS) is a scale consisting of six observational items originally and is validated in young febrile children to detect serious illness. If YOS found to be highly accurate, it will help us to design a protocol for early screening and diagnosis of bacteremia in infants so that patient’s morbidity and mortality can be minimized by early treatment. Objectives: To determine the diagnostic accuracy of Yale Observation Scale (YOS) for diagnosing bacteremia, taking blood culture as gold standard. Study Design: Cross-Sectional Validation study. Setting: Department of Pediatrics, D.H.Q Hospital, Faisalabad. Period: 26th May, 2016 to 25th November, 2016. Material & Methods: One hundred and five patients suffering from fever>38 0C, having age from 3-36 months were included in the study. Patients already taking antibiotics, immune compromised, patients with signs and symptoms of malaria or viral infections were excluded. YOS was calculated and blood culture was performed in all patients to diagnose bacteremia. Results: Out of 105 patients, mean age was 12.9±8.24 months. There were 55(52.4%) male and 50(47.6%) female patients. Sensitivity of YOS in diagnosing bacteremia was 90.63%, specificity 79.45%, PPV 65.91%, NPV 95.08% and diagnostic accuracy was 82.86%. Conclusion: YOS can be used as a key diagnostic tool in detecting bacteremia. So, by using this tool many cases in the rural areas can be diagnosed and managed early.
Comparison of phenobarbital and sodium valproate for the treatment of status epilepticus in children.
Authors: Jamali Ameer , Ali Waqas , Rehman Fazal Ur
Published: July 2020

Objectives: Seizure is considered to be one of the commonest emergency involving more than half of the admissions in Pediatric Neurology wards. It has been well documented that proper management not only improves the prognosis but also decrease complications in these children. This study was planned to compare phenobarbital against sodium valproate for the treatment of status epilepticus (SE) in children. Study Design: Randomized clinical trial. Setting: Emergency Department of Pediatrics Medicine, the Baqai University and Medical College, Karachi. Period: 15th July 2018 to 31st December 2018. Material & Methods: A total of 100 children (50 in each group) with seizure lasting longer than 5 minutes, aged 6 months to 12 years, did not respond to diazepam (0.2mg/kg)  within five minutes, were enroll. Randomization was done using lottery system where Group A was nominated who used sodium valproate and Group B, phenobarbital. Good response was labeled if a child’s seizure was controlled within 20 minutes of treatment. Results: Out of total of 100 children included in the present study, there were 60 (60.0%) male and 40 (40.0%) female. Mean age of the children was 5.4 years with standard deviation of 2.2 years. As far as type of seizures are concerned, there were 43 (43.0%) children presented with febrile convulsions (FC) while 57 (57.0%) with SE.  Overall, positive response was noted in 69 (69.0%) children. Response in between both the groups turned out to be of statistical significance as more children, 40 (80.0%) showed positive response in Group B in comparison to 29 (58.0%) in Group A (p value = 0.017). Amongst children with positive response, the difference between both the study groups was significant in relation to seizure types as 75.9% of children with SE showed positive response with sodium valproate while 52.5% children with FC showed positive response in Group B (p value=0.018). Conclusion: Overall, both study drugs showed good positive response but phenobarbital when compared to sodium valproate is a better choice for controlling seizure in pediatric population. Sodium valproate showed greater effectiveness when used in children with SE while phenobarbital was comparatively more effective in febrile convulsion.
Enhancement of students learning outcome by supplementing Self-directed learning with video clipping.
Authors: Sadiq Noman , Ali Shazia
Published: July 2020

Objectives: Self-directed learning is an active learning strategy in which students are accountable for their own learning by taking initiative. It has been supplemented with other instructional strategies like interactive lecturing, in order to enhance student’s learning. The current study was carried out to determine the effect of supplementing self-directed learning with video clipping on students learning outcome. Study Design: Randomized Control study. Setting: Islamic International Medical College. Period: For one day at 16th September 2016. Material & Methods: This study was conducted among seventy six students of Islamic International Medical College. Students participated in a quiz competition whose syllabus of content and suggested reading materials were communicated to the students three week prior to the competition date. The registered students were than randomly divided into two Groups each comprising of 38 students. Self-directed learning of one group was supplemented with a video while the other group did not watch the video. Learning outcome of both groups was assessed by an MCQ exam. Results: The overall score of Self-directed learning group supplemented with a video was 65.17(7.68) while the score of self-directed learning group was 59.54 (8.54). A significant difference were found among the score of both groups (p = .042). Conclusion: Self-directed learning when supplemented with the instructional strategy of video clipping leads to the improvement in the learning outcome of the students.
Association of hypovitaminosis D with poor glycemic control and obesity in type II diabetes mellitus.
Authors: Khan Tahir Ullah , Arshad Rozina , Khan Zohaib Ahmad
Published: July 2020

Objectives: To determine the association of low serum vitamin D levels with poor glycemic control and obesity in type 2 diabetic patients. Study Design: Descriptive Cross Sectional study. Setting: Sakina Institute of Diabetes and Endocrine Research Centre (SIDER), Shalamar Hospital Lahore. Period: 1st June to 31th august 2017. Material & Methods: After applying strict exclusion criteria, about 450 patients with known type II diabetes were enrolled in the present study and their HBA1C and fasting vitamin D levels were measured. Patients were divided into two groups, group 1 with poor glycemic control (HBA1C>8%) and group 2 with good glycemic control (HBA1C <8%). Results: After performing extensive matching in both groups, it was found that vitamin D levels in group 1 with poor glycemic control were significantly low as compared to group 2 with good glycemic control (p value <0.001). Furthermore, approximately 87% of patients with BMI >23 were having suboptimal Vitamin D levels (p value <0.005). Conclusions: Low serum vitamin D is associated with poor glycemic control in type 2 diabetics and vitamin d supplementation could possibly play a role in improving glycemic control in these patients. Furthermore, hypovitaminosis D is also associated with obesity.
Xanthogranulomatous pyelonephritis: Presentation and surgical complications.
Authors: - Salahuddin , Khan Masha , Anwar Muhammad , Nawaz Ali , Shoaib Muhammad , Samad Abdul ` , Nawaz Haq , Zarkoon Yaqoob , Khan Saadat
Published: July 2020

To review & evaluate the clinical presentation & surgical complications of Xanthogranulomatous Pyelonephritis (XGP). Objectives: XGP is usually considered as an uncommon destructive chronic inflammatory disease of the kidney. The disease is usually diagnosed only on postoperative histopathological reports of the surgically excised tissues and has given less emphasis on preoperative diagnosis. We retrospectively reviewed biopsy proven diagnosed cases of XGP over the past 7 years, with a specific emphasis on preoperative clinical presentation of the patients, to help improve the preoperative diagnosis of XGP. Study Design: Case Series study. Setting: Department of Urology Sandeman Provincial Teaching Hospital Quetta. Period: 7 years July, 2011 to June, 2018. Material & Methods: We retrospectively reviewed all biopsy proven cases of XGP who underwent surgery in the department of Urology of a tertiary care hospital from July, 2011 to June, 2018 regarding clinical characteristics, laboratory & radiological finding, interoperate & postoperative complications. Results: There were 42 patients of XGP. The mean age was 49.8+-16.04 years. Male & female percentage was 40.50 & 59.50 respectively. Majority (88.1%) of patients were of low socio-economic status. The most common presentation was flank pain in 100% patients. Fever & dysuria in 64.28%, anorexia in 85.71% and weight loss in 83.33%. In laboratory findings, pyuria was present 88.09%, anemia in 71.42%, azotemia & abnormal liver enzymes in 14.29% each. The most common associated conditions were renal calculi in 83.33% and diabetes in 47.61%. The commonest organism isolated on culture was E-Coli in 35.48%. Intra-operatively excessive bleeding occurred in 3(7.14%), including one with tear of inferior vena cava. Two patients suffered colonic injury & another one pleural injury. Postoperatively the common complications were, wound infections in 8(19.04%) patients & Incisional hernia in 2(4.76%) patients. Conclusion: Urolithiasis and urinary tract infection are two well known risk factors for the development of XPN. Our experience in the present series, demonstrates that low socioeconomic status could be another risk factor for XPN. Early diagnosis and proper treatment of urolithiasis & urinary tract infection is important to prevent their complications including XGP.
Study of insulin to glucagon ratio and its correlation with thyroid hormones in streptozotocin induced type 2 diabetes.
Authors: Arshad Sidra , Mehmood Muhammad Sajid , Siddique Lubna , Parveen Shahida , Rasul Amina , Ayaz Hira
Published: July 2020

A number of endocrine hormones play a significant role in glycemic control of the body. Insulin and glucagon are two contrasting hormones which work in close association to maintain a normal fuel balance. Thyroid hormones also have a key role in regulating blood glucose levels. Several studies have suggested that type 2 diabetes mellitus (T2DM) have increased incidence of thyroid abnormalities. Objectives: To determine correlation between insulin to glucagon ratio and thyroid hormones levels in the two groups. Study Design: Randomized Control Trial. Settings: Physiology Department of Army Medical College, Rawalpindi and National Institute of Health (NIH), Islamabad. Period: 6 months (from 1st January 2017 to 30th June 2017). Material & Methods: A sample of sixty apparently healthy Sprague Dawley rats was selected randomly. It was divided into two groups i.e control and diabetic. It was ensured that all the rats were euglycemic and euthyroid at the start of the study by investigating serum thyroid stimulating hormone (TSH) and serum glucose levels. The control group was given with normal pellet diet whereas, STZ induced rats were fed on high fat diet while. The control group were injected with saline injection intraperitoneally after 2 weeks, while low dose of streptozotocin was injected to diabetic rats. The induction of diabetes mellitus was affirmed by checking plasma glucose levels and homeostatic model for insulin resistance (HOMA-IR). The specific diet was continued for another five weeks in both the groups. The terminal sample was investigated for plasma glucose using glucose oxidase method and serum insulin, TSH, T3 and T4 levels using ELISA technique. Results: The serum insulin and glucose levels were elevated in diabetic group as compared to the control group. HOMA-IR was also raised significantly in the diabetic group. The serum TSH and T4 levels were considerably higher (p˂0.001) while serum T3 was comparable in both the groups. There was no correlation between Insulin to Glucagon Ratio and TSH, T3 and T4 both in control and diabetic groups. Conclusion: Serum glucose, serum insulin and HOMA-IR were raised in the diabetic group. Serum TSH and T4 levels were also increased while no change in serum T3 levels. IGR and thyroid hormones were not correlated in either group.
Gastroesophageal reflux disease: Treatment options are beyond the proton pump inhibitors.
Authors: Bhutto Abdul Rabb , Abbasi Amanullah , Chandio Sultan Ahmed , Lolai Aftab Ahmed , Arsalan Muhammad
Published: July 2020

Objectives: To observe the effects of different combinations of medicines in GERD patients by using FSSG score. Study Design: Observational Study. Setting: Al-Tibri Medical College Hospital, Isra University Karachi Campus Karachi. Period: June 2017 to December 2017. Material & Methods: The study was conducted on GERD patients at Tertiary Care Hospital of Karachi. Adult patients from male and female gender with clinical symptoms suggestive of GERD were included. During clinical history taking patients were interviewed to respond symptoms frequency of FSSG questionnaire score from 0 to 4 on each question. All 154 eligible patients enrolled in the study and divided into three groups Group I (PPI alone), Group II (PPI with prokinetic) and Group III (PPI, prokinetic and SSRI). After 2 weeks of treatment, FSSG score of every participant was calculated. Results: Results of 134 patients 72 (53.3%) males and 63 (46.7%) females were analyzed. The cumulative mean age was 37.12±8.221 (range 16 – 60) years. The patients were grouped by single blind randomization method, each group I and group II consisted of 45 subjects and 44 patients were enrolled in group III. The mean FSSG score prior to treatment and after treatment was 21.194±4.786 and 14.962±3.696 respectively, hence, the gradient of pre-treatment and post-treatment was 6.231±4.601. The three groups shown significant improvement in FSSG score after treatment but the group III had shown highest improvement in mean FSSG score of 7.522±3.592, followed by group II with 7.2889±3.805and group I had shown the lowest improvement of 3.911±5.346 but statistical analysis revealed these improvements within each group as insignificant while turned to be significant when groups were analyzed with each other. (p 0.003). Conclusion: The results of this study suggests that PPIs alone have good therapeutic role but as dysmotility aspect of GERD and psychological comorbidity is very common in those patients and is likely to play an important role in response, or failure of response, to proton pump inhibitor treatment. Hence, addition of prokinetic and anxiolytics can augment the response rate.
Comparison of postoperative complications after impacted mandibular third molar extraction with conventional suturing versus tube drainage.
Authors: Rajper Wajid Ali , Channar Kashif Ali , Larik Munawar Din , Majeedano Sajid Ali , Soomro Aftab Ahmed , Hussain Asfar
Published: July 2020

Objectives: To determine the effectiveness of tube drain compared with conventional suturing on postoperative complications after extraction of impacted mandibular third molars. Study Design: Cross Sectional study (Comparative). Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, LUMHS Jamshoro/Hyderabad. Period: Six months duration from 12-11-2015 to 13-05-2016. Material & Methods: All the patient age from 18 to 45 years irrespective of gender, having mesioangular impacted mandibular third molar were included in the study. Patients were divided into two groups, Group-A and group-B. The severity of pain was recorded by using Visual Analog Scale from 0 no pain to 10 worst pain, degree of swelling was measured by facial size through Amin and Laskin criteria and mouth opening was measured by interincisal distance through ruler. All data was recorded on the 3rd and 7th day by the clinician. Results: Mean age of group A was 31.22+7.21 years, and mean age of group B was 28.34+5.33 years. Male were found slightly more as compared to female. On 3rd day the post-operative pain assessment was almost equal in both groups p-value 0.06 and assessment of post-operative swelling on 3rd day was found with insignificant difference p-value 0.22. Assessment of pain on 7th post-operative day was that the severe pain was found significantly reduced in group B as compared to group A p-value 0.01, swelling was significantly reduced in group B p-value 0.04. While mouth opening was also found significantly more in group B as compared to group A p-value 0.022. Conclusion: After removal of impacted mandibular third molars, incorporating tube drain is very effective as compared to conventional suturing in reducing the facial swelling, trismus and postoperative pain.
Frequency of dyslipidemia in patients with type ii diabetes mellitus presenting in DHQ Teaching Hospital, Sahiwal.
Authors: Humayun Abbas , Ahmad Khalil , Diwan Rana Aamir , Malook Muhammad Saiful
Published: July 2020

Dyslipidemia is major risk factor for cardiovascular disease in diabetes mellitus (DM). Early detection and treatment of dyslipidemia in type 2 DM can prevent the risk for atherosclerosis. Objectives: To determine the frequency of dyslipidemia in patients with type 2 diabetes mellitus presenting in DHQ Teaching Hospital, Sahiwal for routine check-up. Study Design: Cross Sectional, Observational, Descriptive study. Setting: Medical Unit 1, DHQ Teaching Hospital, Sahiwal, Pakistan. Period: 05-05-2018 to 05-11-2018. Material & Methods: Total 180 patients fulfilling selection criteria were enrolled in the study. Blood samples were obtained and sent to the Pathology Laboratory of the hospital for assessment of lipid profile. Reports were assessed and if cholesterol>200mg/dl and triglyceride>150mg/dl, then dyslipidemia was labeled. All this information was recorded on pro-formas. Results: In this study dyslipidemia was diagnosed in 81(45%) patients. Frequency of dyslipidemia was higher in age group 51-60 years (44.4%) as well as among female patients (56.8%). Overweight patients and patients with normal BMI had the highest frequency of dyslipidemia. Conclusion: the results of this study showed high frequency of dyslipidemia among type II diabetic patients. Type II diabetes is very much common in our population so there is a need to design screening programs in which blood lipid levels screening should be monitored on regular intervals to rule out dyslipidemia timely and for effective and proper management with statin therapy.
A rare case of spontaneous scrotal enterocutaneous fistula as a complication of incarcerated inguinal hernia with review of literature.
Authors: Asghar Mohammad Sohail , Kaleem Ahmad , Rijal Sushil
Published: July 2020

Inguinal hernias are one of the most common problems presenting in both adult and pediatric surgical departments. Normally hernia is easy to diagnose and manage. On the other hand if its presence is ignored and surgery is delayed, hernia related morbidity can increase significantly. In developing countries, these complications are seen more often as there is more ignorance, illiteracy, lack of health facilities. We present a rare case of entero cutaneous fistula in scrotum due to a complete indirect inguinal hernia incarceration. There have been very few such cases that have been like this and reported so far.
Rate of influenza vaccination among patients of rheumatoid arthritis receiving immunosuppressive drugs in Islamabad.
Authors: Naseem Sajid , Zahoor Ambreen , Choudhary Zaidan Idrees , Sana Ahmad Bilal
Published: July 2020

Objectives: Patients of rheumatoid arthritis (RA) receiving immunosuppressive drugs have an increased risk of infections such as influenza and are more likely to develop serious complications. WHO and other leading international health organizations recommend influenza vaccination as the most effective preventive strategy in these patients. The aim of our study was to assess the rates of influenza vaccinations in patients of rheumatoid arthritis receiving immunosuppressive drugs in a tertiary care hospital in Islamabad. Study Design: Cross-sectional study. Setting: Medical outpatient unit of the HBS General Hospital, Islamabad. Period: From October 2018 to January 2019. Material & Methods: Included 108 patients of rheumatoid arthritis selected through nonprobability purposive sampling and Patients with at least one year history of Rheumatoid arthritis currently receiving immunosuppressive therapy were included in the study. Socio-demographic details and vaccination history was collected on a pre-designed performa. Data was analyzed using SPSS version 23. Chi square test was applied to ascertain association. Results: Out of the total 108 patients, 80 were females and 28 were males. Average duration of RA among the study sample was 4.6 years. 34% of the patients reported having co-morbid medical condition(s). Only 3% of the patients had received influenza vaccination. 22% of the patients reported severe influenza infection during the preceding season. Lack of awareness about the importance of vaccination was the main reason for low vaccination rate. Conclusion: The rates of influenza vaccination in patients of rheumatoid arthritis receiving immunosuppressive drugs are extremely low in Islamabad. There is an urgent need to raise awareness on this issue among the patients as well as physicians.
Frequency of male factor and abnormalities of semen analysis in infertile couple.
Authors: Fayyaz Asiya , Tabassum Shagufta , Qadir Saima Yasmin
Published: July 2020

Infertility is global health issue. Male factor contribute to infertility in more than half of sub fertile couples. Their diagnosis is easy by simple test of husband semen analysis. This study has been designed to know the contribution of male factor and frequency of abnormalities of semen in infertile couple. Objectives: To determine the frequency of male factor in infertile couple and to evaluate the different abnormalities in semen. Study Design: Descriptive study. Setting: Department of Obstetrics and Gynecology in Nishtar Hospital Multan. Period: From January 2019 to June 2019. Material & Methods: Study started after taking approval from hospital ethical committee. Study included 200 subfertile couples after informed consent attending the outpatient department. The partner of female attending the fertility clinic between ages 20-40 were selected. History taken from female partner regarding age, duration of subfertility, type of subfertility any drug intake and medical illness of male. Result: Among 200 couples 64(32%) had abnormal semen parameters.24 had oligospermia. Eight had azoospermia and 60 had asthenospermia. 20 patients had teratospermia. Conclusion: Male factor is significant contributor of infertility therefore awareness is needed in order to engage more males partner in evaluation and management of infertility.
Effect of endurance exercise on oxidative stress marker malondialdehyde in type 2 diabetic mice.
Authors: Akram Sana , Tabssum Maimona , Rao Maryam , Qureshi Hamid Javaid
Published: July 2020

Diabetes is associated with oxidative stress and has a significant role in the pathophysiology of the disease and its complications. Exercise training is a powerful therapeutic approach in diabetes and has protective effects against the progress of its complications. Objectives: The aim of this study was to investigate the effect of an endurance exercise program on the oxidative stress marker malondialdehyde (MDA) in high fat diet-low dose streptozotocin induced type 2 diabetic mouse model. Study Design: Randomized Control trial. Setting: Department of Physiology, Akhtar Saeed Medical and Dental College, Lahore. Period: August 2017 to August 2018. Material & Methods: 60 male albino mice were fed a high fat diet containing 60% kCal as fat for 4 weeks. This was followed by intra peritoneal injection of 40mg/kg body weight streptozotocin, given on three consecutive days. Mice with fasting blood glucose more than 250mg/dl after a week were considered diabetic. Half the mice underwent an exercise program which comprised of a 20 minute swimming session per day, with a 6% body weight load attached to the tail of mice, 3 days a week, for 4 weeks. The level of MDA was estimated in both groups using TBARs method. Results: Mean malondialdehyde level was significantly (p˂0.05) reduced in diabetic mice that underwent endurance exercise training. Conclusion: This study highlights the important role of endurance exercise in reducing oxidative stress in diabetes.
Factors associated with compliance to antihypertensive therapy in patients visiting Tertiary Care Hospital.
Authors: Qasim Afzal , Qureshi Muhammad Inam , Kumar Darshan , Kashif Syed Muhammad
Published: July 2020

Objectives: The objective of this study is to factors associated with compliance to antihypertensive therapy in patients visiting tertiary care hospital. Study Design: Cross-Sectional study. Setting: (Dow Institute of Cardiology) Cardiology Department, Dow OJHA Campus and Karachi Institute of Heart Diseases (KIHD), Karachi. Period: July, 2019 to Dec, 2019. Material & Method: Over a period of 6 months participants were evaluated for their compliance to therapy. Data was collected using a questionnaire which consisted of sociodemographic profile, type of treatment regimen, compliance to medication and lifestyle changes. Compliance of all participants was calculated and factors associated with low compliance were pointed out. Data was analyzed using SPSS version 20. Results: A total of 271 patients visiting the hospital’s outpatient department matched the inclusion criteria of this study. Among them there were 69.3% (n=188) were males and 30.6% (n=83) females. Around 83% patients were married, while the rest were unmarried or divorced. Patients in our study had age range of 38-84 years with mean age of 49.5 + 11.7 years. Approximately 52.7% (n=143) patients were addicted to smoking, 15.4% (n=42) patients were addicted to alcohol. Our study showed that 47.6% (n=129) hypertensive patients were highly compliant to treatment, whereas 20.6% (n=56) were moderately compliant and 31.7% (n=86) patients were not compliant to the treatment. Only 39.4% of the patients were carrying out lifestyle modifications along with antihypertensive treatment. Conclusion: Compliance to antihypertensive therapy is of prime importance to decrease morbidity and mortality as complication to hypertension. Factors associated with non-compliance to antihypertensive therapy should be studied and possible interventions should be taken to increase adherence.
Antistreptolysin O titer and C-reactive protein levels in pediatric patients of acute rheumatic fever.
Authors: Zainab Sana , Saleem Nida , Manzoor Adil , Khaliq Saba , Wasim Anum , Khaliq Shakila , Shehzad Farhana
Published: July 2020

Objectives: To determine serum levels of antistreptolysin O titre (ASOT) and C-reactive protein (CRP) and their association with clinical manifestations of Acute rheumatic fever (ARF). Study Design: Descriptive study. Setting: Department of Diagnostic Immunology and Serology, Children’s Hospital and Institute of Child Health, Lahore. Period: Jan 2015 to Jan 2016. Material & Methods: Fifty clinically confirmed patients of ARF were included in this descriptive study. The samples were taken from Children hospital and Institute of child health Lahore after written informed consent. The sampling technique was convenient sampling. Results: Out of 50 enrolled patients, males were 32(64%) and women 18(36%). Only 5(10%) patients had normal ASOT levels, 20(40%) patients were with borderline ASOT, and 25(50%) patients had titres above 200 IU/ml. There was no significant association of ASOT with gender, age and arthralgia with p-value = 0.060, 0.875 and 0.473, respectively. However, a significant association was found in ASOT with carditis and C-reactive protein (p-value = 0.028 and 0.014, respectively). Only 3 (6%) patients had CRP levels below 6mg/l, whereas 43 (86%) patients were with CRP levels above 6. Only 4(8%) patients had borderline value of CRP titer. There was no significant association between C-reactive protein with gender, age and arthralgia (p-value = 0.148, 0.184 and 0.574, respectively). Moreover, there was a significant association between C-reactive protein with carditis and AOST (p-value = 0.020 and 0.014, respectively). Conclusion: ASOT and CRP are important laboratory parameters reflecting undergoing infection (mainly caused by Streptococcus pyogenes A) and inflammation in patients of ARF. Rising levels of ASOT and CRP in ARF patients might be used as an indicator of involvement of heart tissues and therefore can be used to monitor transition of rheumatic carditis into Rheumatic heart disease.
Tastemakers, ‘Foreign Merchants’ and the Making of the V&A’s Islamic Art Collection.
Authors: Wharton Alyson
Published: July 2020

The relationship of the V&A with three dealers, Krikor Minassian, Hagop Kevorkian and Dikran Kelekian, proffering goods from the Ottoman Empire they had recently fled, provides an interesting case study for viewing asymmetries of power in the 20th-century art world. Referred to by museum staff as ‘foreign merchants’, these dealers went out of their way to prove themselves as collectors. Museum staff continued to view them with suspicion and condescension into the 1930s and even 1950s. Keepers and Directors voiced the opposition of institutional values to the trade, but, after the death of Kelekian in 1951, they showed themselves to be motivated by financial gain. These relations draw attention to the ways in which the museum attempted to demonstrate its hegemony over ‘others’, beyond better-studied colonial relationships. The difference in dealings of these Armenians with American and British institutions indicates at the unusual role of the V&A and its preoccupation with social control.
“Deterritorializing the Canadian Museum for Human Rights”
Authors: Muller Adam
Published: July 2020

This article explains the value of assemblage theory to making sense of a museum like the Canadian Museum for Human Rights (CMHR), which has struggled with the formidable challenge of comparatively representing human rights in controversial cultural and historical contexts. I argue that “assemblage thinking” permits us to appreciate more richly the way in which the expressive power of the CMHR arises from the dynamic interaction/intersection of overlapping clusters of objects, spaces, ideologies, memories, feelings, structures, histories, and experiences.  Understood as “assemblages,” these clusters in important (but not all) ways lie beyond the scope of formal agency such as that exercised by curators and museum administrators. Accordingly, we must understand museums generally, and the CMHR particularly, as fundamentally unable guarantee the integrity and perdurability of their/its own structures and meanings, and recognize these meanings (and a museum’s identity) as irreducibly open-ended and provisional.
From takeover to debacle: An analysis of the Nympghate network using Twitter data
Authors: Arias Maria Paula
Published: July 2020

On January 26, 2018 the painting Hylas and the Nymphs was temporarily removed from the Manchester Art Gallery’s walls and taken underground to its store. The removal was part of a ‘takeover’ event that questioned the relationships between historic works of art and contemporary social-cultural contexts. The following days saw a barrage of online comments accusing the Gallery of censorship, of ‘feminism gone mad’, and of inadequacy. In this article I use Twitter data and Actor Network Theory to explore how a community and a narrative took shape around the takeover. The analysis shows how this Nymphgate network was influenced by a series of human and non-human actors, as well as by Twitter’s technological affordances. This study is part of a larger project, as such it leads to question the potential effects of this mediatized debacle to the Gallery’s organizational strategy — including the roles of, and relationships between, decision-makers, social media, and visitors within it.
The Potency of Design in Holocaust Exhibitions. A Case Study of The Imperial War Museum’s Holocaust Exhibition (2000)
Authors: Popescu Diana I.
Published: July 2020

Holocaust exhibitions are known for their unique iconography, often constructed by means of exhibition design. This article focuses on how visitors construct meaning based on display choices made by exhibitions designers. It presents insights from an audience research study which was conducted with young visitors of The Holocaust Exhibition at the Imperial War Museum in London. It addresses how design choices impact on the visitor’s engagement and understanding of the Holocaust Exhibition. By drawing on visitor comments, this article shows that design plays a significant role in shaping visitors’ understanding of the Holocaust, as well as their level of engagement, focus and emotional response. It further makes several practical suggestions, informed by visitor feedback, regarding the development of new Holocaust exhibition designs.
At Large in the Empire of Things: The Museum of Sundry Objects
Authors: Bodinger de Uriarte John
Published: July 2020

AbstractThe Museum of Sundry Objects, located in Sólgarður, about 25 kilometers north of Akureyri, offers a site to think carefully about a number of key elements of museum practice, including the logic of collection, the practice of object “array,” and the role of the museum “heroic” object. Where the heroic object directs one to move from the individual to the imagined array, the array opens a different set of possibilities for recognizing the singularity of objects. In addition, a close examination of the Sundry suggests that “the museum” may simply be one stage of many in the ongoing life of the object, an extended liminal phase that offers a number of opportunities for the re-enlivening of the objects, a different set of steps on the path of the inbetween.
Social Justice Education and the Role of Museums
Authors: Levin Amy
Published: July 2020

Review of three books:Gonzales, Elena, Exhibitions for Social Justice. Abingdon, Oxon.: Routledge, 2020, hardback £120, paperback £34.99, ebook £31.49, 194 pp. Kostache, Irina D., and Clare Kunny, eds. Academics, Artists, and Museums: 21st-Century Partnerships. Abingdon, Oxon.: Routledge, 2019, hardback £120, paperback £36.99, ebook £40.49, 204 pp. Quinn, Therese, about Museums, Culture, and Justice to Explore in Your Classroom, New York: Teachers College Press, 2020, hardback $75, paperback $24.95, ebook $19.96, 95 pp. [Amazon UK £81.95, £27.50, £18.68]
The Perceptions of Primary School Teachers of Online Learning during the COVID-19 Pandemic Period: A Case Study in Indonesia
Authors: Rasmitadila Rasmitadila , Aliyyah Rusi Rusmiati , Rachmadtullah Reza , Samsudin Achmad , Syaodih Ernawulan , Nurtanto Muhammad , Tambunan Anna Riana Suryanti
Published: July 2020

This study explores the perceptions of primary school teachers of online learning in a program developed in Indonesia called School from Home during the COVID-19 Pandemic. Data were collected through surveys and semi-structured interviews with 67 class teachers in primary schools. Data analysis used thematic analysis of qualitative data. The analysis results found four main themes, namely, instructional strategies, challenges, support, and motivation of teachers. This research contributes to the literature of online collaborative learning between teachers, parents, and schools that impact student success. Broadly, the success of online learning in Indonesia during the COVID-19 Pandemic was determined by the readiness of technology in line with the national humanist curriculum, support and collaboration from all stakeholders, including government, schools, teachers, parents and the community.
Associations between body mass index and breast cancer markers
Authors: Saha Ishita , Singh Poonam , Medda Sunit Kumar , Das Rabindra Nath
Published: July 2020

Body mass index (BMI) and breast cancer biomarkers such as resistin, leptin adiponectin, monocyte chemoattractant protein-1 (MCP-1) and homeostasis model assessment of insulin resistance (HOMA-IR) are highly associated with each other. The report has focused the inter-relationship between BMI and breast cancer biomarkers based on probabilistic modeling. It has been shown that mean BMI is positively associated with leptin (P<0.0001) and MCP-1 (P=0.0002), while it is negatively associated with adiponectin (P=0.0003), HOMA-IR (P<0.0001), and it is higher for healthy women (P=0.0116) than breast cancer women. In addition, variance of BMI is negatively associated with resistin (P=0.1450). On the other hand, mean MCP-1 is positively associated with BMI (P<0.0001). Mean resistin is positively associated with the interaction effect of BMI and leptin (BMI*Leptin) (P=0.0415), while its variance is positively associated with BMI (P=0.0942), and it is negatively associated with BMI*Adiponectin (P=0.1518). Leptin is positively associated with BMI (P<0.0001). Also adiponectin is negatively associated with BMI (P<0.0001), BMI*Leptin (P=0.1729), while it is positively associated with Age*BMI (P=0.0017) and BMI*Resistin (P=0.0615). It can be concluded that BMI and breast cancer biomarkers are strongly associated with each other. Care should be taken on BMI for breast cancer women.
Application of AI technology in tumor medical imaging
Authors: Li Tong
Published: July 2020

Abstract: Artificial intelligence AI has many algorithms, , there are many applications in central nervous system tumors, lung cancer, breast cancer, prostate cancer, orthopaedic tumors, etc., with the norms and support of national policies,AI technology in tumor medical imaging will be ushed broadly .
Study on Microstructure and Properties of Pure Ti flat Wire
Authors: Wang Bojian , Ge Xiaochen , Liu Qiang
Published: July 2020

The titanium round wires could be prepared to the high precision flat wireswith the sizes of 0.63mm×5.03mm by nine-pass cold continuous rollingprocess.Mechanical property and metallograph analysis were used to analyze the possibilities of preparing flat wire. Results show that the grain keptequiaxed grain in the rolling processes,and a large number of dislocationand a small amount of twin existed in the microstructure of final rollingflat wire.During the whole rolling processes, when the accumulated rollingdeformation degree was at low degree, the deformation of titanium wascontrolled under the mutual control of dislocation slip and twinning. Whenthe accumulated rolling deformation degree was at high degree, the deformation of titanium was controlled by the dislocation slip.
List of Men of the Erechtheis Tribe Killed in Battle
Authors: Zaccarini Matteo
Published: July 2020

This Athenian casualty list of the Erechtheis tribe, c. 460-459 BCE, is an important source for our understanding of the Athenian military effort in the Eastern Mediterranean in the central decades of the 5th century. While it can be safely dated and contextualized on the basis of Thucydides, the inscription highlights the selective and biased narrative provided by the literary sources. Furthermore, along with other similar documents, this list provides valuable information on the rationale and aims of the public celebration of the war dead in Athens, on the identity of the civic body, and on the inclusion of various social classes in the celebration of the polis.
Votive Dedication from the Heraion of Argos
Authors: Giovagnorio Francesca
Published: July 2020

The stele was found in the sanctuary of Hera in Argos. It is characterised by a triangular pediment and, in the lower part, by a donative that had to fit into a rectangular depression, clearly visible in the stone. The content of the text consists of a list of four Ieromnemones, one for each tribe (which is carefully mentioned after each individual name), and of the specification of the cultic destination of the dedication, to Hera Argeia. The inscription has a primary historical importance, first of all because it is one of the oldest inscriptions from the sanctuary of Hera in Argos and, secondly, because it is one of the first texts to mention the fourth tribe of the Hyrnathioi.