bluuebunny/crossref_metadata_2025 huggingface dataset:
Conversaciones con Thomas A. Lee Whiting
Authors: Esponda Jimenno Víctor Manuel , Lee Whiting Thomas Arvol
Published: September 2021

Hablar de Thomas Arvol Lee Whiting es por demás un tema interesante e importante para el pasado, el presente y el futuro de nuestra sociedad intelectual y académica. Lo es también para las generaciones estudiosas de ahora y del mañana. Es una referencia obligada de primera mano si se trata de conocer la historia y cultura chiapanecas, particularmente de las sociedades arcaicas. Áreas del conocimiento que han sido abundantemente estudiadas, y explicadas con estilo propio, lejos de la ortodoxia académica y didáctica que tanto aburre, por el arqueólogo y académico, pero sobre todo por el amoroso de Chiapas que es el Maestro Lee Whiting.
Trabajo y más trabajo... No puedo dejarnos morir de hambre. Región Centro
Authors: Arellano Nucamendi Mauricio , Álvarez Hernández Blanca Luz
Published: September 2021

El libro hace referencia a la incertidumbre cotidiana que viven las mujeres para resolver la sostenibilidad familiar, pero también a su movilidad y a los esfuerzos que realizan ante la falta de trabajos asalariados y las dificultades de los hombres para obtener ingresos.
Jirones en el camino: pueblos indígenas y extractivismo minero en América Latina
Authors: Martínez Espinoza Manuel Ignacio
Published: September 2021

Jirones en el camino aborda con perspectiva regional las dinámicas y los conflictos de los derechos de los pueblos indígenas en el contexto de un fenómeno cada vez más apremiante en América Latina: el extractivismo minero.
Simbolismos y realidades. Las mujeres y la tierra en Chiapas
Authors: Olivera Bustamante Mercedes
Published: September 2021

Este libro es resultado de una estrecha colaboración entre el Grupo Tierra del CESMECA, el Centro de Derechos de la Mujer de Chiapas y el Movimiento en Defensa de la Tierra, el Territorio y por el Derecho de las Mujeres a Decidir; también constituye una experiencia de trabajo colectivo que articula a la sociedad y la academia para evidenciar la situación de las mujeres rurales, en el campo y la ciudad, derivada de los cambios ocasionados por las dinámicas neoliberales y neoextractivistas de las políticas oficiales en el estado. Se abordan las respuestas organizadas de las mujeres relacionadas con la tenencia, uso y usufructo de la tierra, así como su derecho al territorio. Hacemos énfasis en la propuesta de tenencia familiar de la tierra, una importante herramienta de lucha con y desde las mujeres contra el despojo patriarcal y capitalista de la tierra/territorio en los ejidos y comunidades; los antecedentes, el devenir de la propuesta en sí y su discusión con las mujeres interesadas en ella son abordadas en estas páginas.
Mujeres y varones en búsqueda de cambio. El malestar como vía
Authors: Cantoral Cantoral Guadalupe
Published: September 2021

El malestar, concepto eje del estudio, propuesta de la psicóloga social argentina Mabel Burin, es la herramienta que permite a Guadalupe Cantoral abordar qué sucede con las mujeres y los varones de San Cristóbal de Las Casas, Chiapas, ante los cambios en su vida familiar y laboral. La autora trabaja este concepto desde la perspectiva de las identidades de género a partir de lo que llama “las normatividades de género” —que están presentes en las identidades y prácticas sociales de las mujeres y varones—, para encontrar las tensiones que se crean desde las contradicciones entre el considerado “deber ser” como mujer o como hombre. Identificando el malestar y siguiendo sus huellas, la autora quiere encontrar qué tanto esta sensación lleva a las personas a encontrar rutas que abren caminos para la construcción de ideas distintas acerca del ser mujeres y hombres.
Gestar, parir y resistir. Ejercicios de autonomía y ciudadanía en un poblado alteño de Chiapas
Authors: Íñiguez Hernández Lilia Elena
Published: September 2021

Este libro tiene como principal objetivo dar cuenta de las dinámicas presentes en la experiencia de la atención biomédica de salud materna de las mujeres de Cruztón, Chiapas, para lo que se analizó la existencia o no de violencia obstétrica y se observó el impacto que tuvo en la posibilidad para las mujeres de ejercer de manera autónoma sus derechos a la salud reproductiva, sin perder de vista la coexistencia de distintos modelos de atención de salud, como el brindado por las parteras indígenas, y las implicaciones que esto tiene en las posibilidades de construcción de ciudadanía de las mujeres.
Intervención recreativa para la motricidad en personas autistas
Authors: Gutiérrez Haro Adrián , Ávila Zúñiga Abril , Romero Cota María Dolores , Palacios Solano Paloma Noheli
Published: September 2021

El autismo es un trastorno (también conocido como espectro) en el desarrollo neurológico que se presenta a edad temprana con algunas dificultades de aprendizaje vocales, motrices y sociales. En este caso, el “paciente” tiene comportamientos rutinarios, movimientos repetitivos, deficiencia vocal, motriz y poco social, permite el contacto físico y sus canales de aprendizaje son visual auditivo. Se hizo una valoración motriz antes de empezar dicho programa, observando que su lateralidad estaba mal afirmada. En las escalas de competencia motriz, solo uno de tres ítems estaba más elevado debido a su rutina, su edad motriz básica se asemeja a un individuo de entre cinco y nueve años de edad y sus evaluaciones de los patrones no rebasaban el estado inicial más que solo dos casos, el de atrapar y de la carrera. Después de cinco meses trabajando su lateralidad, se definió como lado dominante, derecha. Dos de las escalas con déficit se elevaron en la competencia motriz y la otra se mantuvo estable, su edad motora básica término entre ocho y nueve años de edad y sus evaluaciones de los patrones quedaron entre elemental y maduro.
Beneficios de la actividad física para mantener la capacidad funcional de los adultos mayores. Artículo de Revisión.
Authors: DUQUE FERNANDEZ LEONOR MARIANA , DUQUE FERNANDEZ LEONOR MARIANA
Published: September 2021

Introducción. Un programa de actividad física diversa sobre la condición física-funcional del adulto mayor repercutirá favorablemente en su calidad de vida.Objetivo: Analizar por medio de una revisión sistemática la relación entre la actividad física y la capacidad funcional en adultos mayores.Método: Se realizó una búsqueda electrónica en las siguientes bases de datos: Scopus, Scientific Electronic Library Online (Scielo), Web of Science (WOS) y PEDro, además se utilizó el motor de búsqueda Google Académico. En la búsqueda se emplearon las palabras clave functional capacity, physical  activity, elderly, actividad física, envejecimiento, capacidad funcional, adulto mayor, programas de actividad física, en artículos publicados entre el 2008 y 2018, escritos en español o inglés.Resultados: Se encontraron 5198 estudios, de los cuales se seleccionaron 51 estudios y todos ellos cumplieron con los criterios de inclusión. Con los artículos identificados, se procedió a revisar sus títulos, se eliminaron las dúplicas y se examinaron los ejes de estudio, con particular atención a la metodología propuesta, los resultados y la discusión. De los 51 artículos seleccionados se encuentra una gran prevalencia de estudios que reportan que el envejecimiento asociado a una buena ejecución de actividad física brinda beneficios en la capacidad funcional en el adulto mayor a través de diversos programas realizados.Discusión: La actividad física en los adultos mayores debe ser considerada como una de las principales estrategias de mantenimiento de la capacidad funcional, promoción de la salud y prevención de la enfermedad.Palabras clave: functional capacity, physical activity, elderly actividad física, capacidad funcional.
Activación de vías redox en respuesta a cargas únicas de ejercicio
Authors: Alvarado Espinoza Brenda Linda , Carrasco-Legleu Claudia Esther , González Rodríguez Everardo , Reza López Sandra Alicia
Published: September 2021

La actividad física insuficiente se asocia con el desarrollo de enfermedades crónicas no transmisibles. Promover la práctica de ejercicio se vuelve una estrategia importante para contribuir en su prevención y tratamiento.  Las reacciones redox se presentan como parte de la respuesta metabólica al ejercicio. Se desarrolló una revisión sistemática en seis bases de datos con el objetivo de identificar estudios que reportaran  biomarcadores redox asociadas con el ejercicio. Se localizaron nueve publicaciones de los últimos 10 años, en idioma inglés, que cumplían con los criterios de elegibilidad (estudios originales,  en humanos, que incluyeran mecanismos/biomarcadores redox). La mayoría de los biomarcadores reportados fueron proteínas y ARNm, analizados en sangre y músculo. Los cambios en dichos marcadores se observaron mayormente dentro de las tres primeras horas después de cargas únicas de ejercicio físico. Individuos con actividad sedentaria, obesidad o de edad mayor a los 50 años, mostraron mayores niveles de productos de oxidación después de la carga de ejercicio que sujetos entrenados, activos o de menor edad. Los estudios sugieren que en sujetos entrenados se requiere valorar los cambios en biomarcadores redox mínimo a las 3 horas post-carga para detectar diferencias en las respuestas, las cuales son mayores  después de  cargas de duración larga e intensa. El estudio de cambios en biomarcadores redox ante ejercicio físico contribuye a  una mayor comprensión de la respuesta fisiológica generada. Esto  sería de utilidad para ajustar el entrenamiento para promover los beneficios del ejercicio y prevenir el potencial daño de un estrés oxidativo crónico.
El Clima organizacional en tiempos de COVID-19
Authors: Moguel-Torres Karina Denisse , Enriquez-Del Castillo Liliana Aracely , Álvarez Mendoza Gustavo , Cossio Ponce De León Mariana , Hernández Gutiérrez Perla Zukey
Published: September 2021

Objetivo: analizar el clima organizacional en tiempos de COVID-19 del equipo femenil de futbol profesional Ciudad Juárez, Chih. Método: estudio de tipo observacional-descriptivo, se aplicó a 27 jugadoras y 3 personas del cuerpo técnico, el instrumento aplicado contiene 53 items, distribuidos en 9 dimensiones en escala de Likert con cuatro opciones de respuesta, durante abril y mayo de 2020, se utilizó el whatsapp, formularios de google y el correo electrónico. Resultados: muestran que el clima organizacional del equipo femenil de futbol profesional están de acuerdo en la escala de estructura, responsabilidad y riesgo por encima del 52 %. No obstante, existen diferencias significativas en la percepción de las dimensiones; recompensa, calor, apoyo, desempeño, conflicto e identidad ya que la opción de respuesta en desacuerdo fue contante con el 35 % en las seis escalas. Discusión: la percepción en desacuerdo en la escala de recompensa, relaciones, apoyo, desempeño conflicto e identidad pudo deberse a la clara diferencia entre los objetivos de los empleados y los de la organización, es decir, es débil trascendencia de la misión y visión. Del mismo modo, ésta no hace participes a los empleados de su plan general o la comparte, ni recibe información que permita hacer crecer a la organización. Conclusión: cuando las jugadoras se sienten involucradas en la organización, reflejan un buen desempeño dentro y fuera del terreno de juego. Es importante fortalecer que los líderes de la organización  unifiquen objetivos personales con los del equipo y realicen mejoras en las seis áreas de oportunidad mencionadas.
Habilidades motrices en preescolares, comparación por género
Authors: Laguna Celia Azaneth , Jiménez Lira Carolina , Benavides Pando Elia Verónica , Blanco Vega Humberto , Ornelas Contreras Martha
Published: September 2021

Objetivo: Comparar las habilidades motrices en niños de 3 a 6 años de acuerdo al género, inscritos en centros educativos de nivel preescolar del Municipio de Parral, Chihuahua. Método: Se realizó un estudio descriptivo transversal con una población de 94 sujetos con un rango de 3 a 6 años, pertenecientes a centros educativos del municipio de Parral, Chihuahua. Se evaluó la habilidad motriz fina y gruesa mediante el Inventario de Desarrollo Battelle Segunda Edición BDI-2. Resultados: El análisis descriptivo de frecuencia reveló que la mayoría se encuentran dentro del perfil promedio, con un 65.9 % (niñas) y un 59.3% (niños) en motricidad gruesa; en el caso de la motricidad fina se muestra 41.5% (niñas) y un 38.9% (niños). Conclusiones: La mayoría de los niños y niñas se encuentran dentro del promedio, cabe resaltar que el desempeño de las ultimas está por encima de los primeros.
SERUM HOMOCYSTEINE;
Authors: HASHMI SYED FASIH AHMED , DASTI MASHOOQ ALI , JAFFERY MUKHTIAR HUSSAIN , Shah Syed Zulfiquar Ali
Published: September 2021

objective: To evaluate the serum homocysteine level in patients with hypertension at Liaquat University HospitalHyderabad. Patients and methods: This six months study was conducted at Liaquat University Hospital Hyderabad. All the hypertensivepatients for ≥ 01 years duration, of ≥ 35 years of age and either gender visited at the cardiac logy OPD or admitted incardiac ward were registered and evaluated for their homocysteine level. The normal plasma homocysteine level isbetween 5 to <15 μmol/L. The results of plasma homocysteine level were interpreted as normal, moderate,intermediate and severe according to the reference range (moderate = 15 to 30 μmol/L; intermediate = 30 to 100μmol/L; severe = >100 μmol/L). The frequency and percentage was calculated for hyperhomocysteinemia in hypertensivepatients. The chi-square and independent t-test was applied between categorical variables at 95% confidence interval and the p-value ≤0.05 was considered as statistically significant. Results: Total 120 hypertensive patients were registered for study. Of these 86(71.7%)were males and 34 (28.3%) were female. Regarding plasma homocysteine level, hyperhomocysteinemia was observed in 99(83%)hypertensive patients, of which 75(75.8%) were males and 24(24.2%) were females while the 21(17.5%) subjects hadnormohomocysteinemia [p=0.04]. According to the categorical classification of plasma homocysteine level, the moderate wasidentified in 58(48%), intermediate in 19 (16%) and severe in 22 (18%) [p = 0.04]. The mean systolic and diastolic blood pressure inoverall population was 160 ± 26 and 90 ± 16 [p=0.02] respectively. The mean ± SD for plasma homocysteine level in overallpopulation was 72.83 ± 12.61 whereas the mean ±SD of patients with normal, moderate, intermediate and severe plasmahomocysteine level was 7.1 ± 1.8, 21±2.7, 60±12.4 and 116 ±7.3 respectively. Conclusion: It is observed that serum homocysteineappears to be raised in patients with hypertension. The hyperhomocysteinemia may be involved in the induction and sustaining of
OVARIAN CANCER;
Authors: SHAIKH NASEER AHMED , SAMO RUKHSANA PARVEEN , MEMON M. QASIM
Published: September 2021

Object: 1). To analyze of serum tumor marker CA-125 in patients with ovarian malignant tumors. 2). To correlate betweenthe serum levels of tumor marker with histological types of ovarian malignant tumors. Study Design: Institution based descriptive andprospective study. Place & Duration: Department of Pathology, Liaquat University of Medical & Health Sciences, Jamshoro from January2009 to June 2011. Material & Methods: One hundred cases, diagnosed as ovarian malignant tumor on H&E staining were selected forstudy & measure serum CA-125 preoperatively and postoperatively in each case. Results: Out of 100 cases diagnosed as on H&E stainwere 33 serous cystadenocarcinoma, 24 mucinous adenocarcinoma, 10 germ cell tumors and 08 sex-cord stromal tumors. On serumanalysis increased level of CA-125 was seen preoperatively in 33/33 cases of serous cystadenocarcinoma and 24/29 cases of mucinousadenocarcinoma. Serum tumor marker value was declined following appropriate therapy of the tumors. Conclusions: Serum tumormarkers CA-125 is useful and important for the detection of ovarian tumors. It is most significant for serous cystadenocarcinoma. It mayalso help in prognosis and specific treatment of ovarian malignancies relating to histological type.
COLORECTAL CARCINOMA
Authors: RANA HAMAD , MAHMOOD SHAHID , SHAHID SOSAN , Munir Muhammad , Bukhari Mulazam Hussain
Published: September 2021

Introduction: Prognosis is excellent in colonic carcinoma in case of well differentiated growth. All efforts must be done todiagnose the malignancy at an earlier stage for a better outcome specially if it is well differentiated growth. Objectives: To compare thedifferent modes of presentation of carcinoma of large bowel in a tertiary care hospital and their association with pathological findings.Material & Methods: It is a cross sectional retrospective study. Patients with histological proof of carcinoma were included in the study.Data over the period of two year was collected and analyzed. Results: This study included one hundred patients. Mean age was 49.56years and 56 % of the patients were males. 40 % of the patients present between the ages of 40 to 60 years. Mean time of start ofsymptoms and the time of presentation in the hospital was 6.5 months ranges from 1 to 24 months. 76 % of the patients had history ofaltered bowel habits and 60% had anorexia and weight loss. 41.66% of patients had well differentiated growth while 37.55% of patientshad moderately differentiated adenocarcinoma. Conclusions: Majority of the patients with colonic carcinoma had well or moderatelydifferentiated growth. If they are diagnosed and properly treated at an early stage, outcome is good.
PAINLESS MYOCARDIAL INFARCTION;
Authors: TASEER IJAZ-UL-HAQUE , KHAN SHAHZAD ALAM , NAZIR MUHAMMAD IMRAN , Safdar Sohail
Published: September 2021

Objective: To determine the frequency of painless MI in patients with acute coronary syndrome. Study design: Descriptivecross-sectional study. Setting and duration: This study was conducted at cardiology unit Nishtar Hospital Multan and Chaudhry PervezElahi Institute of Cardiology Multan. The study duration was 1 year starting from July 2011 to June 2012. Materials and Methods: Thisdescriptive study included 331 patients of AMI of either sex and age which were admitted at “Cardiology unit Nishtar Hospital Multan andChaudhry Pervez Elahi Institute of Cardiology Multan” using non-probability convenience sampling technique. Informed verbal consentwas taken from each patient for participation. Results: Out of these 331 patients 308 (93.1%) patients reported chest pain as thepresenting complaint. Remaining 23(6.9%) presented with clinical feature other than chest pain. Of these 23 patients who presentedwithout chest, minimum age was 30 years while maximum was 90 years with mean age 54.82 ± 12.28 years. Patients with painless AMIpresented with variety of symptoms. Most common symptoms seen in patients of AMI without chest pain were generalized weakness andcold sweats. Out of 23 patients with painless AMI, 15(65.22%) patients were male and 08(34.8%) were female. Diabetes mellitus waspresent as co-morbid condition in 16(69.56%) while 7(30.44%) patients were non diabetic. Hypertension was present in 8(34.78%)patients with painless AMI. Conclusions: Painless AMI or atypical presentation of AMI is seen in substantial proportion of ischemic heartdisease patients. Absence of chest pain in AMI patients may misguide the doctors and diverts his attention towards other diagnosis whichcan lead to considerable delay in the essential therapies required in the management of AMI. It definitely affects morbidity and mortality ofemergency department. Health care professionals particularly those working in emergency set up must keep in mind that absence ofchest pain in suspected cases of ischemic heart disease does not necessarily rule out AMI. Features of AMI other than chest pain shouldalso be kept in mind while dealing with a suspected case of ischemic heart disease. Further research work on painless AMI andpresentation of AMI other than chest pain is needed.
INTRAMEDULLARY NAILING;
Authors: SHUAIB MOHAMMAD , KK GHULAM MUATAFA , AHMED NAVEED , Ishtiyaque Mohammed
Published: September 2021

Objective: Gunshot comminuted fractures of femoral shaft are complicated fractures to treat in orthopedic practice,resulting in prolonged morbidity and extensive disability. Intramedullary interlocking nail is a well-established operative procedure for themanagement of this entity. The objective of this study is to find out the healing of gunshot comminuted fracture of shaft of femur treated byinterlocking nails. Methodology: This study was conducted at Civil Hospital Karachi during July 2009 to December 2009.Forty threepatients sustaining gunshot comminuted fracture of shaft of femur were selected. All patients then underwent fracture stabilization bylocking intramedullary nail. The main outcome measure was fracture healing (i.e. callus formation) on X-ray at six months of follow-up.The SPSS version 13 was applied to the data. Results: Majority of the patients (46.5%) were between 18-30 years of age group with meanage of 36.05(+12.53) years. Males were affected more than females with male to female ratio being 4.3:1. Healing (i.e. callus formation)was achieved in 39(90.7%) patients radiographically at the end of six-months. Conclusions: Intramedullary interlocking nail is safe andeffective procedure in the management of gunshot comminuted fractures of femur shaft as it is associated with good healing.
WHEAT PILL (ALUMINUM PHOSPHIDE) POISONING”;
Authors: GHAZI, MUHAMMAD A.
Published: September 2021

Purpose: The number of deaths due to wheat pill poisoning is enormous and despite aggressive management only a fewpatients survive the fatal effects of the wheat pill poison. Despite the growing number of patients appearing in the emergency departmentswith this easily available poison in the market, very little effort has been put forth to study the subject scientifically and to prevent theongoing loss of precious lives. This is a narrative review of the wheat pill poisoning, highlighting the important steps in diagnosis andmanagement. Methods: Data sources include Pubmed, Scopus, Medline (1996 to date), Cochrane library and Google scholar. Weincluded all clinical trials, systematic reviews and ongoing cohort studies. Conclusions: Wheat pill (Aluminum Phosphide) poisoning is alethal toxin and its effective treatment requires prompt diagnosis and early, time-efficient management. Early transfer to a healthcarefacility, good resuscitation, diagnosis, monitoring, gastric lavage and supportive therapy are the hallmarks of management and may resultin improved outcomes. The governmental and legislative authorities must take appropriate steps towards limiting its availability at thegrass-roots level. Aluminum Phosphide poisoning must be a part of the medical students’ curriculum and long-term, well-designedcomprehensive research studies are required to discover new modalities of treatment.
DOWN’S SYNDROME;
Authors: AHMAD SHAKIL , SARWAR IMRAN , SAJID NISAR KHAN
Published: September 2021

Objective: To evaluate the various types of congenital heart defects and to determine their frequency in children withDown’s syndrome. Study Design: Descriptive study. Place and duration of study: Department of Pediatrics, Independent UniversityHospital Faisal Abad Pakistan, from January 2010 to December 2012. Methodology: 93 children between the ages of day 1 to 12 years,diagnosed clinically as Down’s syndrome based on its characteristic phenotypic appearance, were included in the study. A detailedhistory, physical examination and evaluation of cardiovascular status (including Chest x-ray, Electrocardiogram and Echocardiography)were performed in each Down’s syndrome case. Variables of interest included age, sex, maternal age at birth and type and frequency ofcongenital heart disease. Results: Congenital heart disease was present in 48 (51.62%) children out of 93 children with Down’ssyndrome. Congenital cardiac defects in order of predominant type and their frequency included Ventricular septal defect (29, 60.4%),Atrioventricular septal defect (14, 29.1%), Atrial septal defect (2, 4.1%), Patent ductus arteriosis (2, 4.1%) and Tetralogy of Fallots (1,2%). 68 (73.2%) Down’s syndrome children (n=93) presented during their first year of life with mean age of 7±4 months. Malepredominance was observed in both with and without congenital heart disease Down’s syndrome children (male: female 1.7:1 and 2.5:1respectively). Mean maternal age at birth was 27±2 years. Conclusions: Congenital heart disease (CHD) is frequently associated withDown’s syndrome (DS). Ventricular septal defects and atrioventricular septal defects are the most common forms of CHDs in DS childrenof our region. Their earlier presentation (in infancy) and significant contribution to the morbidity and mortality of DS children warrantsearly diagnosis of DS and mandatory screening of all DS children for associated CHDs.
NON OPERATIVE TREATMENT
Authors: Alam Waqar , Shah Faaiz Ali , Jan Roohullah , Rehman Riaz-Ur-
Published: September 2021

Background: Pediatric forearm fractures result in substantial morbidity andcosts. Despite the success of public health efforts in the prevention of other injuries, the incidenceof pediatric forearm fractures is increasing. Most forearm fractures occurred during the springseason. Objective of the study is to determine the functional outcome of conservatively treatedradius ulna fractures in Children. Design: Descriptive study. Setting: Department of Orthopedicsand Traumatology, Khyber Teaching Hospital Peshawar. Period: March 2009 to April 2010.Methodology: Total 236 children with radius ulna fractures were manipulated and above elbowplaster Cast applied for 6-8 weeks and reviewed every second week. After plaster cast removalPronation and supination measured with goniometer and fortnightly thereafter for 6 weeks.Results: All the fractures united. Normal range of pronation and supination at the end of followsup period was in 182(80.53%) children. Loss of pronation and supination of average 10 degreeswere in 9(3.98%) patients. Patients having displacement of the fracture and opted for surgerywere 35(15.46%). Conclusions: Closed reduction of diaphyseal fractures in children results innormal pronation and Supination in majority of the patients.
TRACHEOSTOMY
Authors: Mahmood Ghazi , Sadiq Muhammad , Manzoor Saima
Published: September 2021

Objective: This study involves the review of management of patients whorequired temporary airway support and were treated either with tracheostomy or endotrachealintubatione in ear, nose, throat. Department and intensive care unit of Multan Medical & DentalCollege Ibne Sina Hospital Multan. Another important aspect of the study is to compare theresults of tracheostomy with endotracheal intubation . Study Design: Retrospective anddescriptive. Place and Duration of Study: Multan Medical and Dental College Ibnae e SinaHospital Multan. From 2012 to 2013. Patients and Method: Twenty consecutive patients whohad operation of tracheostomy whether emergency or elective, and were admitted in ENTward of Ibne Sina Hospital Multan and twenty patients were intubated with endotracheal tube inthe intensive care unit of the hospital. Results: The main indications of tracheotomy were upperair way obstruction (80)% and mechanical respiratory insufficiency (20)%. Indications ofendotracheal intubation were mechanical respiratory failure(80)% and ventilatory insufficiencydue to retention of secretions (20)%. Tracheostomy is better choice in prolonged air way controlmore than three 3 weeks. But endotracheal intubation is found to be better choice in early andquick management of short term airway control up to 3 weeks.
ASCORBIC ACID
Authors: Tassaduq Iram , Rashid Saadia , Amber Sunya , Saga Zarmina , Jaffri Samina Anjum
Published: September 2021

Objective: Rifampicin continues to be an effective drug for treatment oftuberculosis. A variety of drug reactions have been reported of which hepatotoxicity is wellknown. This study was conducted to investigate the effects of ascorbic acid as dietarysupplementation in case of Rifampicin induced hepatotoxicity. Data source: Animal house NIH(National Institute of Health). Study design: Randomized control trial. Materials and Methods:Thirty adult BALB/c mice weighing 30-60 grams were taken. They were kept under standardlaboratory conditions. Mice were randomized and divided into three groups A, B and C eachcontaining 10 mice. Group A was given Rifampicin 100 mg/kg body weight, group B wasadministered Rifampicin 100 mg/kg body weight along with ascorbic acid 500 mg/kg bodyweight orally and group C was given regular NIH lab diet for six weeks. Result: Liver specimens ofanimals given rifampicin showed formation of necrotic foci. Simultaneous administration ofascorbic acid significantly reduced histological changes induced by Rifampicin. Conclusions:Ascorbic acid has protective role against hepatotoxic effect of Rifampicin used in chemotherapyof tuberculosis in animal models.
WARFARIN VS ASPIRIN;
Authors: Ahmad Farooq , Farooq Fahad , Farooq Faizan , Farooq Faiq
Published: September 2021

Objectives: to determine the patient compliance with the use of blood thinners.Design: Randomized controlled trial comparing the use of warfarin and aspirin. Setting: Farooqteaching hospital Lahore, Fatima Memorial Teaching Hospital, Lahore and Allied teachinghospital Faisalabad. Period: October 2012 to March 2013. Results: Warfarin is a better drug interms of patient compliance as compared to aspirin. Conclusion: Warfarin is actively used incardiovascular problems and is well tolerated by the patients as compared to aspirin which is alsowidely used but the incidence of adverse affects limits its use.
TRAUMATIC EXTRADURAL HEMATOMA
Authors: Iftikhar ul Haq Mian
Published: September 2021

Objectives: To determine the frequency, clinical presentation and outcome ofextradural hematoma in patients with head injury. Study Design: Cross sectional descriptivest study. Setting: Neurosurgery department of Hayatabad Medical Complex, Peshawar. Period: 1st January 2011 to 1 July 2012. Patients and methods: All patients of head injury, from all ages andboth genders were included. Patients in whom EDH caused by bleeding disorders or vascularmalformations of the dura mater and post surgical EDHs were excluded from the study. CT scanbrain was done for all patients to confirm their diagnosis. The information regarding patientdemographical details, clinical presentation and site and size of hematoma was documented inpatient's Performa. The data was analyzed by SPSS version 16. Results: A total of 331 patientswith head injuries were included in the study. Out of 331 patients, there were 221(66.76%) malesand 110(33.23%) females. Majority of patients 90(27.2%) were in the age range of 21-30 years.EDH was found in 29(8.76%) patients. The commonest location of extradural hematoma wastemporo-parietal region i.e 3.93%. One patient had left side weakness postoperatively andtwo(6.89%) died. Conclusions: The outcome of operated extradural hematoma patients wasgood in those patients having higher GCS score
DRUG-DRUG INTERACTIONS;
Authors: Iqbal Syed Talat , Batool Zainab , Amir Haseeba , Mansoor Tamkenat
Published: September 2021

Introduction: This research paper is based on a study conducted on the in-doorpatients at a teaching hospital in Gujrat, Pakistan, in order to check for the frequency with whichPenicillins, Quinolones and Cephalosporins are being used together and in combinations withother drugs and the drug-drug interactions that occur due to these combinations and theirimpacts on the patients. Objectives: (1) To check the frequency with which Penicillins,Quinolone and Cephalosporins are being used in different combinations in patients. (2) Todetermine their drug-drug interactions. (3) Impact on patients due to these interactions. (4)Reasons for prescription of mismatched combinations by clinicians. Study Design: 270 randomprescriptions were collected from different wards of DHQ hospital, Gujrat. These prescriptionswere then analyzed for drug interactions among the above mentioned group of drugs, with thehelp of soft ware program named The Medical Letter Adverse Drug Interaction Program. Setting:Aziz Bhatti Shaheed Hospital (DHQ), Gujrat , Pakistan. Period: Prescriptions were collected overthe period of 3 months. Conclusions: Prescribing antibiotics for different indications in indoorpatients is unavoidable. However, it is the duty of the clinician to monitor the patient when he isusing two or more drugs together. This study recommends the use of drug-drug interactiondetecting software in hospitals, so that, the level of patients’ safety may be enhanced.
ROLE OF ERCP;
Authors: Khan Jahangir Sarwar , Hamdani Syed Usman , Zareen Abeera
Published: September 2021

Objective: To determine the efficacy of ERCP in acute severe biliary pancreatitis inrelation to rate of complications and hospital stay. Patients and Methods: 30 patents wereincluded in the study, divided into ERCP group & Non ERCP group. The study was conducted atSurgical Unit-I, Holy Family Hospital Rawalpindi from July 2009 to April 2011. ERCP Groupcomprised of 11 patients and non ERCP Group 19 patients. All patients having severe acutebiliary pancreatitis raised alkaline phosphatase and common bile duct diameter >8mm wereincluded in the study. Results: In ERCP Group, there were 3 males and 4 females with mean age42.77 ± 14 years. In non ERCP group there were 17 males and 2 females with mean age 46.76 ±13 years. ERCP was done within 3 day in 8 patients and within 7 day in 5 patients in ERCP group.The rate of complications in both groups was insignificant (P= .92). The length of hospital stayalso does not differ significantly between two groups (P=.874). Conclusions: In our set up therewas no significant difference in outcome in ERCP and non-ERCP group of severe acutepancreatitis. However, in ERCP group intervention was mostly performed after 72hrs.
DENGUE FEVER;
Authors: Shaikh Khalida , Memon Khalida Naz , Sarah Bibi , Akhtar Rasheed , Memon Manzoor , Memon Saeeda
Published: September 2021

Background: Dengue fever & its complications have become a nightmare forcommon people in Asian countries including Pakistan. Besides environmental factorsresponsible for its transmission, there are many host factors too involved in its rapid spread.Objective: To assess risk factors for dengue fever among patients reporting at Liaquat UniversityHospital (LUH) Hyderabad. Study Design, Setting & Study duration: Descriptive crosssectional study was conducted at LUH, Hyderabad for six months i.e. from 15th May 2013 to 15thNovember 2013. Methods: 481 patients were registered through convenient sampling afterinformed verbal consent. Patients’ demographic features, clinical presentations & laboratoryreports were collected on a preformed proforma. Results: The reporting rate for dengue feverwas 18.5% & the mean age of presentation was 28.5 ± 3.5 years. Males were in majority (72.55%)3 & the average days of admission were 4.5 days; low platelets count (< 50,000/mm ) wasrecorded in 72% of cases; however 11.64% patients presented with hemorrhagic tendency. Agewas strongly associated with thrombocytopenia (p=0.04) & with occurrence of hemorrhage(p=0.03) in both genders; this association was more evident among males (p=0.01). Howeveramong uncomplicated cases no association was evident between gender & length of stay in(p=0.35). Conclusions: The alarmingly higher reporting rate of dengue fever necessitatescontextual preventive interventions. As younger age & male gender are the major risk factors forthis disease; therefore age-specific & gender-specific preventive strategies against this diseaseare recommended.
LAPAROSCOPIC SURGERY;
Authors: Ghani Umar Fayyaz , Khan Faran , Zaid Ameer Yasser , Afridi Khan Dost
Published: September 2021

Objective: To observe the rate of complications during elective laparoscopiccholecystectomies. Design and study duration: It was a prospective study and was carried outfrom July 2011 to June 2012. Setting: The study was conducted at PAF Hospital Islamabad.Patients: 105 patients with gall stone disease who underwent elective laparoscopiccholecystectomy. Material and Methods: 105 patients ranging in age from 23yrs to 81yrs wereoperated. 12 were males and 93 were females. History, clinical examination and ultrasonographywere used to diagnose the presence of gall stones. Patients with acute symptoms were excludedfrom the study. Results: The main complications encountered were iatrogenic perforation of thegall bladder (8), haemorrhage (7), post-operative bile leakage (4), and large gut injury (1).Conversion to open surgery was done in three cases due to difficulty in identifying anatomy and incase of large gut injury. There was one death. Conclusions: Laparoscopic cholecystectomy (LC)has become the preferred method of treatment in surgery for gall stone disease. A soundknowledge of the complications and their management makes this a safe procedure.
INDUCTION OF LABOUR;
Authors: Sajjad Rabia , Ansari Asma , Snover Ayesha
Published: September 2021

Objective: The aim of this study to justify induction of labour at 40 weeks of pregnancy in our population. Design: Quasi experimental study. Place and duration: Combined Military hospital Attock, Obstetric and Gynaecology Department from 1.6.2011 to 1.2.2012. Material and method: 100 patients were selected from outpatient department, and divided into two groups, group A, with 50 patients at 40 weeks and group B with 50 patients at 41 weeks. Booked or unbooked patients with singleton pregnancy with cephalic presentation, were selected by non propability consecutive sampling technique. Pregnancy with previous scar, medical disorder, polyhydramnios, multiple fetal and uterine abnormality and intrauterine death, placenta previa, were ruled out excluded from study. Postdate pregnancy was confirmed clinically by last menstrual period and early dating ultrasound. Patients were clinically followed for fundal height, presentations and FHR. Bishop scoring was done and patients were induced mechanically with cervical foley and vaginal pessary PGE2 according to bishop score. Amniotomy was done at bishop score more than 7. Labour was monitored with full protocol. Same procedure was repeated for group B of 50 patients who were selected according to criteria, for induction of labour at 40 weeks of pregnancy. Maternal and fetal outcome was analysed in term of mode of delivery and APGAR score respectively. Results: Out of 100 patients, 50 patients with age 20 to 35 year, presenting at 40 weeks were included in group A. Spontaneous vaginal delivery was seen in 30 patients (60%), 4 by vaccum(8%), 3 by forcep delivery (6%), 13 patients ended up into emergency LSCS (26%). In group B of 50 women, planned for induction at 41 weeks, emergency cesareans were 23 (46%). MAS was in 9(18%) babies as compared to 2% in group A and, Fetal distress (type 2 dips) were found in 3(6%) cases. Neonatal outcome was assessed with help of APGAR score. Babies delivered with good APGAR were 47 in group A, as compared to 41 in group B. Rate of vaginal delivery was high in group A (74%) induced at 40 weeks. Results were analysed by using SPSS 10 and p-value was found to 0.024. No difference was found in the incidence of fetal outcome with APGAR SCORE 10, and fewer babies were with poor APGAR SCORE and p=0.051. Conclusions: Induction at 40 weeks may reduce perinatal mortality and incidence of MAS. It does not increase risk of caesarean section when compared with induction at or beyond 41 weeks.
MID TRIMESTER TERMINATION;
Authors: Niaz Ghazala , Ali Rubina , Shaheen Shazia
Published: September 2021

Objective: The objective of study was to compare the efficacy of extra amniotic prostaglandin F2 alpha and vaginal misoprostol for termination of 2nd trimester pregnancy. Study design: It was quasi experimental study. Place and duration of study: The study was conducted at Gynae Unit II, DHQ Hospital affiliated with Punjab Medical College, Faisalabad for a period of one year from July 2012 to June 2013. Material and methods: This study included 100 patients who presented with congenitally anomalous foetus or IUD during 2nd trimester for termination of pregnancy. Outcome was evaluated by percentage of successful cases for TOP and induction to delivery interval. Result: As regards the efficacy of misoprostol, success rate for termination of pregnancy was 86% and mean induction to delivery interval was 13.16±1.987 hours. Regarding PGF2 alpha success rate for TOP was 88% and mean induction to delivery interval was 16.07±3.202 hours. Conclusions: Misoprostol is comparable in its efficacy to PGF2 alpha for mid trimester termination and can be used as a cheaper alternative.
CEREBRAL PALSY;
Authors: Mansha Naeem Mohammad , Anwar Sumair , Afridi Itaat Ullah Khan , Maqbool Shazia
Published: September 2021

Background: Cerebral Palsy is a disorder of movement and postural balance due to insult to the brain. The injury to the developing brain may be prenatal, natal or postnatal. The diagnosis is clinical mainly. The spastic Cerebral Palsy is classified into monoplegic, hemiplegic, diplegic, and quadriplegic types. There is a difference in the frequency of these types of Cerebral Palsy in different studies. The patterns of various forms of Cerebral Palsy emerge gradually with a delay in developmental milestones. A spectrum of associated developmental disabilities has been found to be common in these children. Management is through a multi-disciplinary approach. Objectives: To find out the frequency of different types of Cerebral Palsy and degree of associated developmental delay. Methodology: A cross sectional study was carried out for a period of six months (October 1, 2006 to March 31, 2007) at The Children’s Hospital & Institute of Child Health Lahore. 100 Cases diagnosed as Cerebral Palsy on clinical basis were assessed for the type of cerebral palsy and the degree of associated developmental delay. Results: Out of the total 100 patients 54% had quadriplegia, 32% had diplegia, 10% had himiplegia and 4% had monoplegia. The total fifty-four cases of quadriplegic cerebral palsy 54 had developmental delay and amongst them 4 (7%) had mild delay, 16 (30%) had moderate delay while 34 (63%) had severe delay. Amongst the total forty-six other three types of cerebral palsy 12 (26%) had mild delay, 6 (13%) had moderate delay and 28 (61%) had severe delay. The P-value was >0.05. Conclusions: Quadriplegic is the commonest type of CP, associated with the factors (peri-natal more than socio-demographic) and had significant effect on the developmental parameters.
WOMEN REPRODUCTIVE HEALTH SECURITY;
Authors: Asghar Kanwal , Maan Ashfaq Ahmad , Ch Khalid Mahmood , Anjum Farkhanda , Ashraf Ijaz , Saghir Aqeela , Khan M. Athar Javed
Published: September 2021

Around the world, the right to health and especially reproductive health right are far from a reality for many women. Reproductive health is of growing concern today. Reproductive health therefore implies that people are able to have a satisfying and safe sexual life and that they have the capability to reproduce and the freedom to decide if, when and how after to do so. Reproduction is a dual commitment but so after in much of the world, it is seen as wholly the women’s responsibility. There are four major problems commonly encountered by women in family planning and contraceptive use: accessibility to family planning information and services, quality of services, gender responsibilities and spousal communication. These problems become major obstacles preventing women from regularity fertility or exercising the reproductive rights. The importance of good health and education to women’s well being and that of her family and society cannot be overstated. Spousal Communication is crucial step toward increasing women’s participation in improving their health rights. Therefore the study was conducted to investigate the perception of married women about the role of spousal communication in establishing reproductive health security. For this purpose 200 married women of age group 15-45 with having at least one living child were selected through multistage sampling technique from urban areas of district Faisalabad. The study explored in bi-variate analysis that those women who were educated, younger and had a high economic status had a perception that the spousal communication plays a significant role in the development of women’s attitude towards their reproductive health security.
FERTILITY LEVELS IN RELATION TO EDUCATION IN PAKISTAN
Authors: Chaudhry Abid Ghafoor , Gul Asha , Khan Shaheer Ellahi , Khan Nida , Khan Maha
Published: September 2021

The objective of this study was to examine the effect of education on fertility levels in Pakistan using data for 4125 females aged 15-49 years from the Pakistan Social and Living Standards Measurement Survey (PSLM) 2007-08 both at the aggregate and disaggregate level. The methodology of this study uses Poisson regression, the estimated results of which verify that education (measured by the highest class passed) has a negative and statistically significant impact on fertility levels, but this relation does not hold true for all levels of education. While higher secondary and higher education are significant across all specifications in the aggregate analysis, the impact of matriculation on fertility levels is mixed. Although, similar results are obtained from the disaggregate analysis, an interesting conclusion is that no level of education comes out to
MAJOR DEGREE PLACENTA PRAEVIA;
Authors: Azhar Tasneem , Bano Sadia , Awais Nadia
Published: September 2021

Introduction: Placenta praevia is a major cause of maternal & fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. Objectives: I). To Find out major risk factors and maternal complications in major degree placenta praevia. II). Know perinatal outcome in major degree placenta praevia. Study Design & Techniques: It is a descriptive study. Patients were selected by simple random sampling techniques. Settings: The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Subjects & Method: Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. Results: In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Conclusions: Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born.