bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the English language teaching in bilingual private primary schools in Benin: Case of Abomey-Calavi region
Authors: EGOUNLETI Marius Pédro , HINDEME Sèna Orlando Ulrich , TOBOULA Coffi Martinien ZOUNHIN
Published: November 2024

This study examines English language teaching practices in bilingual private primary schools in the Abomey-Calavi region of Benin. The aim is to identify the challenges teachers face in teaching English and to propose solutions to overcome them. A mixed-methods approach was used, combining three hundred (300) students’ survey data with ten (10) English teachers’ semi-structured interview data and classroom observation. Thematic analysis was used for qualitative data and descriptive statistics for the survey results. The results show several challenges: limited English exposure, bad teaching strategies and lack of resources. The study concludes that teacher training, resource availability and student engagement are key to effective English teaching in bilingual schools. The practical implication of this study is that policymakers and educators should focus on teacher development and better teaching materials to improve outcomes in a bilingual context.
Development technology of helium neon laser power supply
Authors: Abdulrahman Hayder J. , Najimaldeen Sarah. Z.
Published: November 2024

The Helium-Neon (HeNe) laser is one of the most commonly used gas lasers in many spectroscopic applications. It is a visible laser with a typical wavelength of 632.8 nm. The best part is, due to its low cost and simplicity, it is popular among hobbyists as well. The output power of a practical HeNe laser tube is usually less than 1mW. In order to operate the HeNe laser, it requires a few kilovolts of direct current (DC). The necessary high voltage DC is generated by a HeNe laser power supply. A typical HeNe laser power supply is a complex, high voltage circuit which is designed to provide the gas discharge current, as well as to maintain the helium and neon mixture within the laser tube at an optimal pressure and temperature. There are many existing laser power supply designs. Therefore, the objective of this design project, "Development of Helium Neon Laser Power Supply" is to design and construct a HeNe laser power supply which is low cost, efficient, light in weight and most importantly, to develop a high voltage DC power supply circuit which can be used to power the HeNe laser. Through this design project, a comprehensive and systematic study from the analysis of the existed laser power supply designs to the performance testing of the developed HeNe laser power supply has been carried out. The use of organic electro-optic material for electro- optical applications was suggested many years ago. Many devices have been developed since then, but some of them have been examined for their electro- optic response. Due to the many and important uses of radioactive isotopes in medical and industrial applications, it became necessary to evolve materials that are used in protection. [1] [2] [3] [4] [5].
Artificial intelligence in digital marketing automation: Enhancing personalization, predictive analytics, and ethical integration
Authors: Islam Md Ahadul , Fakir Shafiqul Islam , Masud Seaam Bin , Hossen Md. Deluar , Islam Md Tariqul , Siddiky Md Rafiuddin
Published: November 2024

Artificial Intelligence (AI) is revolutionizing digital marketing automation by enhancing efficiency, personalization, and predictive capabilities. This study examines the role of AI in transforming marketing practices, focusing on its applications, benefits, ethical considerations, and future directions. By leveraging AI tools such as predictive analytics, NLP, and chatbots, businesses can achieve improved customer segmentation, content personalization, and campaign optimization in marketing strategies. Secondary data from journals, articles, and conference papers were synthesized to provide insights into AI's impact on digital marketing automation. A systematic literature review utilizing the PRISMA methodology initially identified 2,850 records from database searches. Following the removal of duplicates and non-relevant studies, 1,035 records were screened for eligibility based on defined criteria, resulting in the inclusion of 150 relevant studies and 25 high-quality reports for detailed analysis. This robust approach ensured the inclusion of high-quality research, minimizing biases. The findings reveal that AI enhances digital marketing by streamlining processes, automating repetitive tasks, and delivering hyper-personalized customer experiences. Predictive analytics helps anticipate consumer behavior, while chatbots improve real-time customer engagement. However, challenges such as data privacy, algorithmic bias, and the high costs of AI adoption persist. AI adoption allows businesses to make data-driven decisions, improve customer retention, and maximize return on investment. Ethical AI practices, such as transparency and algorithm fairness, are essential for maintaining consumer trust. The study primarily focuses on existing literature, with limited empirical validation. Future research should explore long-term effects of AI-driven marketing on consumer behavior and investigate its integration with emerging technologies like the Internet of Things (IoT) and blockchain. Additionally, tailored AI solutions for SMEs and under-researched areas, such as B2B marketing, are critical for inclusive growth.
Study of isotherm, thermodynamic characteristics and sorption mechanism of toluene adsorption on zeolite CsZSM-5 by adsorption-calorimetric method
Authors: Bakhronov Khayot , Ergashev Oybek , Оchilov Gʻolibjon , Ganiev Abror , Akhmedova Nodira , Ochilova Ozoda
Published: December 2024

This paper presents experimental results of isotherm and basic (H, F and S) thermodynamic characteristics of toluene adsorption in CsZSM-5 zeolite. A system consisting of a universal high-vacuum adsorption unit and a Tiana-Calvet type differential microcalorimeter DAC-1-1A coupled to it was used to measure the adsorption isotherm and differential heats of adsorption, giving directly quantitative and qualitative characteristics of the nature and forces of adsorption interaction between adsorbent and adsorbate. A correlation between adsorption-energy characteristics was found and the molecular mechanism of toluene adsorption in CsZSM-5 zeolite throughout the filling region was revealed. Toluene adsorbed in CsZSM-5 zeolite is located in the first coordination sphere with Cs+ cation, forming two-dimensional complexes. It was found that the charge density of cesium cation significantly affects the molecular mechanism, adsorption energetics and the number of adsorbed toluene molecules. It was determined that the average molar entropy of toluene adsorption in CsZSM-5 zeolite is equal to -73 J/molK indicating that the mobility of toluene molecules in CsZSM-5 zeolite is lower than the liquid phase and close to the mobility of the solid phase, indicating a strong inhibition of the mobility of toluene molecules both on cesium cations and without cationic parts of the zeolite, i.e. where there are no cesium cations. This work shows how calorimetric data can be used to complement crystal structure results and to detect subtle adsorbent/adsorbate interactions at the molecular level.
Deciphering why petrol stations have become hot spots for crime in South Africa
Authors: Nyahunda Louis , Rakubu Kholofelo Anna
Published: December 2024

In the ever-evolving landscape of criminal activity, petrol stations in South Africa have emerged as a prime target for malicious actors, capturing the attention of law enforcement agencies, researchers and various authorities. The rise in criminal activities at petrol stations in South Africa has become a mounting concern, with researchers and law enforcement agencies striving to understand the root causes and devise sustainable ways to curtail the scourge. This study explores the underlying factors that have contributed to the surge in criminal incidents at these perceived safe havens, delving into the empirical drivers of this alarming trend. The study employed a qualitative research approach which operated within the exploratory research design. A purposive sampling technique was utilised to select 10 petrol stations around Gauteng province. In this view, petrol attendants, petrol station owners and members of the security patrols participated in the study. A total of 30 participants gave their insights to the study. The findings revealed that petrol stations have become hunting grounds because of the availability of an assortment of items. Furthermore, the study established that the flourishing of crime syndicates, the environmental design of most petrol stations, limited to no periodic police patrols and outdated security systems are contributing factors to this conundrum.  This paper posits that the transformation of petrol stations into preferred hunting grounds for criminals in South Africa is a multifaceted phenomenon, shaped by the interplay of a lack of technological advancements to combat crime, pitfalls in the broader security landscape in the country and lack of pragmatism in implementing the Crime Prevention through Environmental Design strategy.
Leveraging data quality analytics for enhanced loan application and performance insights: A comprehensive approach
Authors: Karamani Brunela , Shehu Bojken
Published: December 2024

The objective of this research is to discover the ways in which the banking sector can use data quality analytics to improve the processing of applications for loans and gain better insights into their performance. We use SQL, Power BI, and Python to examine how these decisions can be improved, how customer experiences can be made better and more compliant, and how we can use good data analytics to ensure that proper regulatory guidelines are followed. To do this, we employ a quasi-mixed method that solves the "what" question with descriptive and inferential statistics, the "how" question with good data visualization, and the "why" question using advanced analytics. The data we use encompass over 300K records of loan performance and over 150K entries of loan applications from the years 2020–2022. Data cleaning, transformation, analysis, and visualization are done using SQL, Python, and Power BI to derive actionable insights. The analytics side of data quality is examined in this study with a view to understanding its impact on the loan application process and the performance of the business. The analytics have shown that the quality of data and the insight which can be gained from it has a material effect on the aforementioned processes and performance. The study shows how sophisticated analysis can be applied in the actual operations of a banking institution. It underscores the value of solid customer and loan data for making high-level decisions within the bank.
The grandparent scam: A systems perspective case study on elder fraud and the concept of human layering
Authors: Espinoza Michelle
Published: November 2024

In April 2024, an 81-year-old Ohio man was charged with murder, assault, and kidnapping. The man believed that he was protecting his family from scammers threatening harm. What he did not realize was that the 61-year-old Uber driver he killed, was also a victim of the same scammers. This qualitative case study examines some common variants of the Grandparent Scam from a systems perspective and how weaponization of conscience is used in these scams. Additionally, this study examines the parallels between layering in money laundering and human layering in the execution of these scams. By examining the underlying dynamics and principles that enable these scams to succeed, law enforcement, regulatory agencies, and organizations can direct efforts to curtailing scammers’ success.
Reviewer acknowledgements for International Journal of Marketing Studies, Vol. 16, No. 2
Authors: Sun Alyssa
Published: November 2024

Reviewer acknowledgements for International Journal of Marketing Studies, Vol. 16, No. 2, 2024.
MBTI personality type and financial behavioral bias
Authors: Effendi Kharisya Ayu , Amalia Shendy
Published: November 2024

Studies on behavioral financial theory found that the individual investment decision process involves many behavioral biases. This behavioral bias can cause investors to deviate from rational decision-making. The purpose of this study is to see whether there is an influence of gender factors on financial behavioral biases in this study, namely overconfidence bias, herding, and regret aversion. Then this study also aims to see whether MBTI personality types influence financial behavioral biases in this study, namely overconfidence bias, herding, and regret aversion. This study aims to identify the relationship between gender variables, MBTI personality assessments, and financial behavioral biases in investors in Indonesia. To conduct this study, a structured questionnaire was given to 230 respondents at the researcher.populix.co.id as the primary data collection page that includes questions related to gender variables, overconfidence bias, herding bias, regret aversion bias, and MBTI personality assessment. Of the 230 respondents, 182 respondents were accepted and met the analysis requirements. The findings obtained were that the gender factor that had a significant effect on this study was only on overconfidence bias while herding and regret aversion did not have a significant effect. Then the MBTI personality type significantly influenced the three financial behavior biases.
SKIN ANTISEPSIS PRACTICES FOR CENTRAL NEURAXIAL BLOCKADE
Authors: Nisar Abdullah , Rehman Azhar , Siddiqui Ali Sarfraz
Published: November 2024

Background: Skin antisepsis is essential before the central neuraxial blockade. Various antiseptic solutions are in clinical use, like povidone-iodine, alcohol, or chlorhexidine. This study was conducted to assess current practices for skin antisepsis before central neuraxial blockade and observe the compliance of anaesthesiologists with international standards in Teaching Hospitals in Karachi, Pakistan. Methods: A cross-sectional study was conducted on all anaesthesia faculty members, working in Teaching Hospitals in Karachi from March to May 2022. Demographic data included institutional setup and current position at the institution. The type of solution used for skin anti-sepsis for the central neuraxial blockade, method of application, and subsequent practices of anti-sepsis were asked. Recommendations for the skin anti-antisepsis and the reason for opting for their choice of solution and practices were also assessed. Stratification analysis was then performed to observe the effect modifiers of study variables. Results: Data from seventy faculty members were analyzed. Povidone-Iodine was the most frequent solution used for skin antisepsis. Alcohol-based Chlorhexidine 2% and 0.5% were the alternative choices. The application method prevalent was Sponge/swab with Gallipot (94.3%). Major reasons to opt for their choice of solution were personal preference, cost-effectiveness, and availability of the solution in their Institute. Fifty percent of physicians considered Chlorhexidine 2% as the recommended solution for central neuraxial procedures. Regarding sterility, over ninety percent adhered to the recommended practices. Conclusion: Povidone-Iodine is currently the most frequent solution used for skin antisepsis before central neuraxial blockade by anaesthesiologists. The recommended solution (Chlorhexidine) was not in clinical practice due to personal preference, cost-effectiveness, or unavailability.
SUPERIOR MESENTERIC ARTERY SYNDROME COUPLED WITH RENAL NUTCRACKER SYNDROME
Authors: Sana Sharafat Ali  , Waqar Shazad Hussain , Sajid Ali Shah  , Isbah Rashid  , Fatima Shahzad
Published: November 2024

An acute vascular angle between the superior mesenteric artery and the Aorta may compress the third part of the duodenum (SMA Syndrome) and the Left Renal Vein (Renal Nutcracker Syndrome). Usually, patients are young females with a lean stature. Symptoms of outlet obstruction and pelvic congestion syndrome may be present. Our patient presented with bilious vomiting and unintentional weight loss for the last 6-8 months. On further inquiry, she had dysmenorrhea and left flank pain associated with microscopic haematuria. Duodenojejunostomy with Left Renal Vein (LRV) re-positioning was performed. She recovered uneventfully and has improved intake with mild or no pain troubling her at 6 weeks of surgery.
EXPLORING THE PERCEPTIONS OF UNDERGRADUATE MEDICAL STUDENTS AND FACULTY REGARDING THEIR ENGAGEMENT IN INTEGRATED CURRICULUM DEVELOPMENT IN AZAD JAMMU & KASHMIR MEDICAL COLLEGE MUZAFFARABAD.
Authors: Muhammad Ijaz  , Jamil Brekhna , Nowshad Asim  , Ayaz Ul Haq  , Yasir Khan  , Samreen Riaz
Published: November 2024

Background: The development of a medical curriculum is a multi-layered and complicated process, demanding teamwork among diverse stakeholders, including undergraduate medical students and faculty members. This study investigates the underexplored realm of stakeholder perceptions, specifically those of undergraduate medical students and faculty, regarding their engagement in the intricate process of medical curriculum development
ADMISSION WITH ACUTE ABDOMEN: PRESENTATION, CONDITIONS IDENTIFIED AND MANAGEMENT OUTCOMES
Authors: Farzana Sabir  , Shafaq Hanif  , Fakhra Gardezi  , Mohsina Saeed  , Rashida Bibi  , Sajjad Haider
Published: November 2024

Background: Acute abdomen is one of the few conditions that require immediate surgical intervention most of the time. However, not all cases of acute abdomen need surgery. The objective was to determine the various presentations of acute abdomen and their management outcome in patients presenting with acute abdomen to AIMS, Muzaffarabad, Azad Jammu and Kashmir, Pakistan.  Methods: This prospective cohort study included individuals aged 18 and above who presented with abdominal pain lasting at least eight hours. Patients with trauma-induced abdominal pain were excluded. Consecutive non-probability sampling facilitated participant recruitment. Results: The majority (54%) were young, and males outnumbered females (62.61% and 37.39% respectively. Most patients presented within 8 hours of pain onset, diabetes and hypertension were the commonest comorbid. Mild pain was most common at presentation. In descending order, acute Appendicitis, acute cholecystitis, acute pancreatitis, intestinal obstruction, Peritonitis, UTIs, and gynaecological & obstetric conditions were the frequent reasons for abdominal pain. Conclusion: Recognizing the patterns of conditions that present as acute abdomen is essential for healthcare planners to develop effective treatment protocols, as incorrect management can lead to significant consequences.
EFFICACY OF ORAL VORICONAZOLE VERSUS ORAL ITRACONAZOLE, IN THE TREATMENT OF DERMATOPHYTE INFECTIONS
Authors: Ali Maira , Najia Ahmed  , Seemab Khan  , Afshan kiran
Published: November 2024

Background: Dermatophyte infections are common in tropical areas with a humid climate. In recent times, it is getting extremely challenging to treat these infections because of resistance that has occurred to the conventional antifungals, which is attributed to changes in the fungal strains. Keeping in view this issue, more advanced drugs have come into being. Voriconazole is a potential such drug with promising results. Methods: A total of 76 patients participated in the study, they were divided into two groups, with 38 participants in each group. Group A was treated with voriconazole and group B was treated with itraconazole, for 2 weeks in patients who achieved a complete response, and 4 weeks for patients who achieved a partial response. Baseline complete blood count, Liver function tests, renal function tests, blood sugar levels, and KOH microscopy was done for every patient, and was repeated after completion of treatment. Clinical response was assessed on the basis of clearance of the lesion and negativity on KOH microscopy. Results: After completion of treatment with voriconazole, 32 (84.2)% of the patients achieved a complete clearance of the lesion, while 6(15.8%) of the participants achieved partial response to the treatment. Among the patients who received oral itraconazole,6 (15.7%) showed a complete response ,16 (42.1%) participants achieved a partial cure, while 16 (42.2%) patients did not show any improvement after the treatment. Conclusion: It is safe to conclude, that voriconazole shows better efficacy and results in treating resistant dermatophyte infections.
VENOUS THROMBOEMBOLISM RISK ASSESSMENT IN HOSPITALISED PATIENTS IN A TERTIARY CARE HOSPITAL IN PAKISTAN
Authors: Ajwad Farogh  , Noman Ullah Wazir  , Saima Mumtaz  , Farzana Salman  , Ahsan Arif  , Anam Umair
Published: November 2024

Background: Venous thromboembolism (VTE) ranks as the third most common cause of vascular death following myocardial infarction and stroke. VTE is a prevalent illness, particularly in the elderly, and is linked to a high recurrence rate, substantial healthcare costs, and reduced survival rates. The Objective of the study was to investigate the impact of using the VTE risk assessment (VTE-RA) tool and thromboprophylaxis (TP) on all adult patients hospitalized. Methods: This study was conducted at a single centre using a prospective cross-sectional design to compare data before and after an intervention at a tertiary referral hospital in Pakistan from May 2019 to February 2020. All adult inpatients over the age of 18 were eligible for inclusion. Results: A total of 1,200 patients were screened in the study. The majority of these patients were medical 701(58.42%) and 499(41.58%) were surgical. The mean age of patients was 59.02±1.40 years. The male patients were 690(57.55%) as compared with females were 510 (42.5%). The average stay in hospital was 8.01±1.11 days. At that time, there was no official RA instrument implemented. Researchers documented any written proof of RA in patients' medical records as "RA completed." 190(15.83%) out of all charts evaluated had a recorded VTE risk assessment. TP was prescribed to 450(37.5%) patients, which accounts for of the total. Risk factors for VTE in high-risk patients. Conclusion: VTE risk assessment, prescribing adequate thromboprophylaxis, and integrating it into practice is challenging. The majority of hospitalized patients investigated were at a high risk of having venous thromboembolism (VTE). The most prevalent risk factor for developing VTE is old age, however, only few hospitalized patients were actually given thromboprophylaxis.
EFFECTIVENESS OF MANUAL THERAPY, PHYSICAL THERAPY IN CONJUNCTION WITH PATIENT EDUCATION FOR TEMPOROMANDIBULAR DISORDERS: A RANDOMIZED CONTROLLED STUDY.
Authors: Saeed Ullah Shah  , Sana Shakil Khan  , Sadia Moin  , Shumaila Younus  , Hina Jabeen  , Kanwal safeer
Published: November 2024

Background: Temporomandibular joint (TMJ) disorders represent a significant health concern affecting a substantial portion of the population worldwide. The management of TMJ disorders often involves a multifaceted approach including physiotherapy techniques, manual exercise interventions, patient education, and medication therapy. Objective: The purpose of this research is to examine the Effectiveness of manual therapy, and physical therapy in conjunction with patient education for temporomandibular disorders. Methods: 40 patients with TMDS were randomized into two groups: one for home physical therapy and the other for manual therapy plus physical therapy. Patient education and counseling were done in both groups. the patient had assessments both before and after. Results: The study made a comparison of two groups: one received physical therapy only (n=20) and the other group received a combination of physical and manual therapy (n=20). There were no significant differences between the two groups in terms of age, gender distribution, or the affected side of the face (p>0.05). Conclusion: For TMJ issues, physical therapy patient education is a useful therapeutic method. Moreover, combining these modalities with manual therapy improves results beyond what would be achieved with just these modalities alone.
OPTIMIZING POSTOPERATIVE OUTCOMES: ASSESSING THE EFFECT OF ENHANCED RECOVERY AFTER SURGERY PROTOCOLS IN GENERAL SURGICAL PATIENTS
Authors: Atif Iqbal  , Hamid ur Rehman  , Ibrar Ahmad  , Sauda Bibi  , Haseena Safdar  , Liaqat Ali  , Qazi Mohammad Hameed
Published: November 2024

Background: Enhanced Recovery After Surgery (ERAS) protocols were progressively implemented to advance postoperative results in various surgical specialties. However, their effectiveness in general surgical patients remains underexplored. This study intended to assess impact of ERAS protocols on postoperative results in general surgical patients at Jinnah International Hospital Abbottabad (JIHA). Methods: A retrospective cohort study was conducted at Jinnah International Hospital Abbottabad from May 2023 to April 2024. A total of 120 general surgical patients who underwent procedures under ERAS protocols were related with a historical control group who received conventional perioperative care. Data on perioperative variables, postoperative complications, length of hospital stay, and readmission rates were collected and analyzed. Results: Implementation of ERAS protocols resulted in significantly decreased postoperative complications (p < 0.05), shorter length of hospital stay (p < 0.001), and lower readmission rates (p < 0.01) compared to conventional perioperative care. Patients in the ERAS group experienced improved recovery trajectories and enhanced overall postoperative outcomes. Conclusion: The results of the study demonstrate beneficial impact of implementing ERAS protocols in general surgical patients at Jinnah International Hospital Abbottabad. Adoption of ERAS protocols can lead to enhanced postoperative recovery, reduced complications, and shorter hospital stays, ultimately optimizing patient outcomes.
OUTCOME OF PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION (STEMI) BASED ON ADMISSION SERUM POTASSIUM LEVEL
Authors: Qayyum Malik Sidra , Fatima Qayyum  , Masud Akhtar Malik  , Hamza Javed  , Ayub Khan
Published: November 2024

Background: Potassium levels play a significant role in cardiovascular patients, with hypokalemia and hyperkalemia having profound effects on the mortality rate. The aim of this study was to investigate the correlation of admission serum potassium levels and in-hospital mortality in patients suffering from acute ST-elevation myocardial infarction (STEMI). Methods: The study was conducted in the Department of Cardiology, Ayub Teaching Hospital Abbottabad, and involved 225 patients with STEMI who underwent thrombolysis with streptokinase. The serum potassium levels of patients were recorded at the time of admission, and its correlation was observed with the short-term outcomes, i.e., discharge to home versus those who did not survive during the hospital stay of 72 hrs. Results: The mean level of serum potassium at admission was 4.2 mmol/dL and 74.2% patients were discharged alive. T test indicated that a higher risk of death was associated with old age. No significant association between gender, serum potassium levels, systolic blood pressure, heart rate, and outcomes was seen. Logistic regression analysis further showed that age had a significant association with the outcome of death.  Conclusion: In our study, age had a significant impact on predicting the mortality of patients with STEMI and whereas the serum potassium levels at the time of admission did not exhibit any significant predictive value. Further research is needed to elucidate the complex interplay of various factors in predicting mortality, to improve the management practices of AMI.
IRISIN AS A NOVEL DIAGNOSTIC BIOMARKER FOR INFLAMMATORY DISEASES: A REVIEW
Authors: Rana Sadia , Abdul Wahab Norsila , Wan Nazatul Shima Shahidan  , Atif Saira , Fahim Ayesha
Published: November 2024

Background: Inflammatory biomarkers are molecules that can offer vital information on the intricate chain of happenings and molecular processes underpinning the pathophysiology of any inflammatory disease. They can be measured in various biological samples such as blood, urine, or saliva, and are used as indicators of the presence and severity of inflammation. Measuring salivary inflammatory biomarkers is a non-invasive and relatively easy way to monitor inflammation, and it has been shown to be a useful tool in the diagnosis and management of various oral and systemic inflammatory diseases. Irisin is a novel anti-inflammatory protein and its implication and diagnostic role in inflammation have been widely studied; however, not much have been studied in oral inflammation per se. Irisin is predominantly downregulated in several inflammatory conditions, including obesity, type 2 diabetes, periodontitis, and cardiovascular diseases. This suggests that irisin may be involved in the inflammatory process, but more research is needed, especially of salivary irisin to understand its precise role. Overall, the role of irisin as an inflammatory biomarker is still an area of active research, and more studies are needed to determine its diagnostic and therapeutic potential. This review highlights the diagnostic and therapeutic potential of irisin in various systemic and oral inflammatory conditions.
FREQUENCY OF NO-REFLOW IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION AND THE IMPACT OF INTRACORONARY ADRENALINE AND TIROFIBAN ON TIMI FLOW
Authors: Ullah Ikram , Hamidullah  , Farooq Ahmad  , Sajjad Khan  , Hafiz Adil Bilal  , Samiurehman
Published: November 2024

Background: Coronary interventions, including percutaneous coronary intervention (PCI), have significantly improved management of coronary artery disease by restoration of coronary blood flow to myocardium. However, despite of so many advancements in PCI procedural techniques, there is still a significant and challenging complication known as the "no-reflow" phenomenon exists which worstly effect the PPCI outcome. Methods: It was Cross sectional study conducted at Department of Cardiology, Lady Reading Hospital Peshawar. Study was conducted from 1/1/2023 to 30/6/2023 for six months. All patients who developed no reflow were subjected to intracoronary Tirofiban. Those who do not responded to Tirofiban were given intracoronary adrenalin and effect was noted. Data were analyzed using SPSS Version 23.0. Mean and standard deviation were calculated for quantitative variables like age. Frequencies and percentages were calculated for categorical variables like gender. The p-value less than 0.05 was considered significant. Results: Among 151 participants, 18% experienced the no-reflow phenomenon. Intracoronary adrenaline and Tirofiban individually showed a significant positive impact on TIMI flow. It was found that 40% patients with no reflow responded to Tirofiban administration. Remaining patients with no reflow were subjected to intracoronary adrenalin therapy and 74% of these patients had improved TIMI flow. It was also found that combine effect of Tirofiban and adrenalin was found in 84% of patients. Conclusion: No reflow phenomenon is common finding in Primary PCI and can be effectively managed by Tirofiban and intracoronary adrenalin administration in most cases.
IMMUNOHISTOCHEMICAL EXPRESSION OF PD-L1 IN NON-SMALL CELL LUNG CARCINOMA
Authors: Khan Muhammad Umair , Hafeez ud Din  , Wajahat Ahmed Khan
Published: November 2024

Background: Lung cancer is a leading cause of death related to cancer worldwide, surpassing the number of deaths caused by breast, colon and prostate cancers. Objective of the study was to determine the frequency immunohistochemical expression of PD-L1 in non-small cell lung carcinoma (NSCLC). It was a descriptive cross-sectional study, carried out at the Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2020 to July 2021. Methods: We inducted total of 145 diagnosed cases of NSCLC irrespective of age, gender, histological grade and stage of carcinoma. Immunohistochemical staining of PD-L1 was done using Leica kit. Patients with no expression for PD-L1 were considered negative, whereas immunohistochemical expression of ‰¥1% is considered positive. PD-L1 statuses of all patients was determined. The data was analyzed by using SPSS version 25. Results: In our study age ranges from 31 to 85 years with mean age of 64.20±10.90 years. Out of the 145 patients, 126 (86.90%) were male and 19 (13.10%) were females. 108 (74.50%) were squamous cell carcinoma and 37 (25.50%) were adenocarcinoma. Most of them were histological grade II, 88 (60.70%), followed by grade I in 26 (17.9%). Immunohistochemical expression of PD-Ll in NSCLC was found in 35 (24.13%) patients. Of all the positive cases, PD-L1 expression was slightly higher in adenocarcinoma 27.02% as compared to squamous cell carcinoma 23.14%. Conclusion: PD-L1 expression is associated with increased aggressiveness, enhanced tumor progression and shorter survival in patients of NSCLC. This study concluded that frequency of positive immunohistochemical expression of PD-L1 in NSCLC is though low, yet significant in adenocarcinoma as compared to squamous cell carcinoma.
VERSATILITY OF TENSOR FASCIA LATA FLAP FOR RECONSTRUCTION OF GROIN DEFECTS
Authors: Anwar Saira , Waqas Sami  , Faisal Akhlaq Ali Khan  , Sumaira Sattar  , Saba Kiran  , Sindhu Khan
Published: November 2024

Background: The evolution of reconstructive surgery techniques has significantly improved the management of soft tissue defects across various anatomical regions. In 1972, McGregor et al. devised a pivotal method for generating a flap to cover hand defects. The benefits of this technique, which include a larger skin surface without the need for microsurgery and yielding an easily concealed donor site scar, quickly became a cornerstone in the field, evidencing its widespread acceptance and application. Objective was to compare outcomes such as wound infection, skin flap necrosis and hospital stay between primary closure and tensor fascia lata flap for the reconstruction of groin defects among patients presenting at tertiary care hospital, Karachi, Pakistan. Methods: It was a prospective observational study carried out at the Department of plastic surgery, Dow University of Health Sciences, Civil hospital, Karachi, Pakistan from 23rd August 2023 to 25th January 2024. Patients who had groin defects after trauma or excision of lymph node of age 20-80 years of either gender were included and divided into two groups. Group A (n=30) had patients who had primary wound closure, while Group B (n=30) had patients who underwent a tensor fascia lata flap procedure for wounds coverage. Both groups were compared in terms of wound infection, skin flap necrosis, and hospital stay following surgery after 4 weeks. Data was analyzed using SPSS version 23. Results: The overall average age of participants in the study was 35.7±11.18 years. Of 73.3% participants were male and 26.7% were female. Group B (TFL flap reconstruction) demonstrated significantly lower rates of wound infection (p=0.001) and skin flap necrosis (p=0.001) compared to Group A (primary closure). Additionally, the average hospital stay was significantly shorter for Group B than Group A (p=0.001). Conclusion: TFL flap reconstruction for groin defects significantly reduces postoperative complications, including wound infection and skin flap necrosis, and shortens hospital stays compared to primary closure.
HYPERCHOLESTEROLEMIA AS A CAUSATIVE RISK FACTOR FOR NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD)
Authors: Abbasi Sarwat , Saadia Sadiq  , Nadia Haleem  , Salma Shazia  , Sara Jadoon  , Muhammad Israr
Published: November 2024

Background: Increased serum Cholesterol level is a known risk factor for cardiovascular diseases. Derangements in serum Cholesterol levels will affect normal hepatic Cholesterol homeostasis resulting in hypercholesterolemia. Non-Alcoholic fatty liver disease (NAFLD) initially asymptomatic but can lead to cirrhosis and hepatocellular carcinoma from mild steatosis to non-alcoholic steatohepatitis. The objective of this study is to find out hypercholesterolemia as a causative risk factor in NAFLD patients. This will help to prevent the development and progression of the disease.
MODES OF DELIVERY IN SECOND PREGNANCY IN WOMEN WHO HAD ELECTIVE CAESAREAN SECTION FOR BREECH PRESENTATION IN FIRST PREGNANCY
Authors: Rabail Azeem  , Shabana Kokeb  , Kausar Inayat  , Nargis Danish  , Talat Nelofer  , Sadaf Saifullah
Published: November 2024

Background: The optimal management of breech presentation remains a debate among obstetricians worldwide. The Term Breech Trial (2000) highlighted elective caesarean section as a preferable method over vaginal delivery for breech presentations. This study investigates delivery modes in women who had an elective caesarean section for breech presentation in their first pregnancy. Objective was to evaluate delivery outcomes in the second pregnancy of women who had an elective caesarean section for breech presentation in their first pregnancy. Methods: A cross-sectional study was conducted at Jinnah International Hospital Abbottabad from October 10, 2018, to April 10, 2019. Data was collected from 321 women who had an elective caesarean section for breech presentation during their first pregnancy. The study used per-abdominal examination and obstetrical ultrasound to assess foetal presentation and recorded the mode of delivery in the second pregnancy. Results: Participants' ages ranged from 18 to 49 years, with a mean age of 28.87±4.07 years. The average interval between deliveries was 1.92±0.92 years, labour duration averaged 5.56±2.41 hours, and foetal head engagement averaged 2.92±1.35. Of the participants, 18.7% achieved a vaginal delivery, while 81.3% had a repeat caesarean section. Reasons for repeat caesarean included recurrent breech presentation in 44.9% and foetal distress in 32.4%. Conclusion: Approximately 18.7% of women who had an elective caesarean section for breech presentation in their first pregnancy achieved vaginal delivery in their second pregnancy, whereas the majority underwent another elective caesarean section.
ASSESSMENT OF POSTOPERATIVE ANALGESIC EFFECT OF RECTUS SHEATH BLOCK IN GYNECOLOGICAL LAPROSCOPIC SURGERY
Authors: Sobia Irum  , Samina Saleem  , Alia Bano  , Sadia Irum  , Kaneez Fatima
Published: November 2024

Background: Gynecological laparoscopic surgery is a minimally invasive surgical technique that can cause pain and discomfort in the postoperative period. To manage this pain, various analgesic techniques have been employed, including rectus sheath block (RSB). Bupivacaine is a long-acting local anesthetic that has been used in bilateral rectus sheath block (BRSB) for postoperative pain relief after laparoscopic surgery. The objective of this study is to assess the impact of bupivacaine's bilateral rectus sheath block (BRSB) on post-laparoscopic pain relief with its intraperitoneal (IP) administration. Methods: This prospective randomized, double-blind, clinical trial was done at the department of obstetrics and gynaecology Patel hospital Karachi, from September 2022 to February 2023. All the adult female patients aged 18 years or older undergoing elective gynecological laparoscopic surgery and willing to receive RSB as a postoperative analgesic technique were included. After taking informed consent, the patients were randomly allocated into two groups. In group I, BRSB was performed with 25 mg of bupivacaine and in group II was given 25 mg of bupivacaine intraperitoneal. Postoperative pain was assessed by visual analog pain score (VAS) at 1st, 6th, 10the and 24the hours postoperatively. All the information was collected via study proformas. Results: The study comprises 60 patients who underwent gynecological laparoscopic surgeries, with group I having a mean age of 38.10+11.19 years and an average BMI of 27.07+5.15 kg/m2, and group II having a mean age of 41.36+11.18 years and an average BMI of 27.51+4.22 kg/m2. Average (VAS) was significantly lower in group I compared to group II at 1st, 6th, 10th, and 24th hour, with a statistically significant p-value of 0.001. The average duration of surgery was not statistically significant in both groups, as an average duration in group I was 32.14+12.20 minutes and in group II was 31.0+19.21 minutes. Conclusion:  The use of bupivacaine in a bilateral rectus sheath block (BRSB) with was observed to be more effective for post-laparoscopic pain relief compared to 25 mg of bupivacaine intraperitoneal administration.
ASSOCIATION OF CONSANGUINITY WITH RECURRENT FOETAL LOSS
Authors: Irshad Romana , Muhammad Adnan Rashid  , FAROOQ Abeera
Published: November 2024

Background: Approximately 25% of all recognized pregnancies result in foetal loss. Women who will experience two consecutive foetal loss is less than 5%, while loss of three or more consecutive pregnancies in the first trimester, termed as Recurrent foetal loss (RFL), occurs in 1% of all pregnancies. RFL is often associated with cousin marriages. Keeping in view the social and psychological burden associated with RFL, it deems necessary to conduct further studies, to clear this ambiguity about the adverse effect of consanguinity on the foetal loss. The study was done with the objective to ascertain association of consanguinity with recurrent foetal loss. Methods: A total of 432 individual were recruited in this case control study (216 each in case and control groups) and was conducted at the Armed Forces Institute of Pathology (AFIP) Rawalpindi. The Cases consist of women having recurrent foetal loss while controls were women who do not experience recurrent foetal loss. Results: The Cases had mean parity level of 5.13 while controls 4.02. The difference in parity level of both cases and controls was statistically significant. The mean live births for all the participants were 2.35±1.915 ranging from 0-7. The cases had 0.72 mean live births while controls had 3.98 mean live births. The cases and controls were compared for consanguinity, i.e., if they had a blood relationship with their husbands. 67 (31.01%) of the cases had consanguinity while 62 (28.70%) of the controls had consanguinity. There was no statistically significant difference among cases and controls in terms of consanguinity. Conclusion: Although our study does not show any significant harmful effect of consanguinity on foetal outcome, however more in-depth research is required to look for genetic loci which are contributing to the causation of RFL, especially those inherited recessively, since homozygosity is increased in consanguinity.
INFLAMMATORY BOWEL DISEASE AND ASSOCIATED SKIN MANIFESTATIONS
Authors: Usman Ghani  , Mahwish Ahmed  , Athar NAyeem  , Zunaira Qayyum
Published: November 2024

Background: Inflammatory bowel disease (IBD) is a group of chronic inflammatory conditions of the gastrointestinal tract. Skin manifestations are frequently found with IBD yet they are not completely comprehended regarding how common they are and whether they reflect the seriousness of disease. Objective was to determine the prevalence, type and treatment of skin recall manifestations among a cohort of patients with CD and ulcerative colitis (UC). Methods: A total of 250 IBD patients (140 CD and 110 UC) were enrolled in the study. Demographics of patients, disease duration, skin morphology were enrolled. We evaluated the frequency of skin manifestations, their association with disease activity, and course in response to therapy. Results: Skin manifestations appeared in 31.2% of patients, and were more prevalent in CD (35%) compared to UC (26%) (p=0.04). The most common skin manifestations were erythema nodosum (11.2%), pyoderma gangrenosum (5.6%), and perianal skin tags (8%). Active disease demonstrated a significant association with skin manifestations (45% active disease vs 18% remission, p<0.001). Patients receiving anti-TNF therapy had fewer new skin manifestations (20%) when compared to patients receiving conventional therapy (36%) (p=0.03), however 5% of patients receiving biologic therapy reported developing paradoxical skin reactions. Management of skin manifestations consisted mainly of systemic corticosteroid therapy, which was effective in 80% of cases, while 10% of patients with more severe perianal disease underwent surgical intervention to treat their skin manifestations. Conclusion: Skin manifestations appear to be common in patients with IBD, and a significant difference was observed between patients with CD and UC. The disease activity showed a strong association with the occurrence of skin manifestations. Anti-TNF therapy is likely to be associated with less frequent new skin manifestation, however it remains substantive that patients with biologic therapy can have paradoxical skin reactions.
Antimycotic Properties of Potentials Botanical Crude Extracts and Bio-Control Agent against Fusarium Wilt of Chili caused by Fusarium oxysporum f.sp. capsici
Authors: Hussain Shahid , Aslam Muhammad Naeem , Mehmood Basharat , Zafar Lubna , Shafiqe Saima , Qureshi Farhan F. , Khan Yasar S. , Ayub Muhammad , Mushtaq Saqlain
Published: November 2024

Fusarium wilt is a devastating disease of Chili in Pakistan and its management is very difficult. Therefore the studies were conducted in in-vitro conditions. Mmycelium appeared were yellow, reddish-brown or blue-black in color. Macro conidia short, straight, or 40-75 x 25.5-5 micron and long 5-8 septate. Micro conidia consist of 1-3 septate, with a short beak and 22-48 x 3.4 microns. The results showed that the disease is present in high frequency throughout the districts surveyed. The maximum disease incidence was recorded in Hyderabad (55%) whereas; the incidence of the disease from the Tando Allahyar district was recorded up to (35%). The used botanical extracts showed high variation in reducing the colony growth of the fungus. All the botanical extracts significantly reduced the mycelial growth of Fusarium oxysporum. Eucalyptus leaves was found most effective in reducing the colony growth of the fungus at their highest dose (6.33 mm), Aloe suppress the fungal mycelial growth (21.00 mm). Whereas the Mari gold reduce the fungal growth (25.33 mm) and Mint leaves (26.33 mm). All the botanical extracts at their respective doses significantly retarded the growth of fungus as compared to control (82.00 mm). Trichoderma spp. as bio control agent was tested in-vitro condition against Fusarium oxysporum and significantly reduced the mycelial growth of Fusarium oxysporum. Trichoderma spp. reduces the activity of the Fusarium oxysporum (10.00 mm) as compared to control (82.00 mm). Based on the in-vitro result Eucalyptus leaves extract can be effectively used for field experiment. These studies will be helpful for researchers and growers.