bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF SCIENCE ACTIVITIES ON PRE-SCHOOLERS' CREATIVE THINKING: AN EXPERIMENTAL STUDY
Authors:   PhD Scholar, Department of Education, The University of Lahore, Lahore, Iqbal Humaira , Habib Musarrat ,   Assistant Professor, Department of Education, The University of Lahore, Lahore, Saeed Muhammad ,   Professor, Department of Education, The University of Lahore, Lahore
Published: January 2023

The current experimental study aimed to investigate the effect of science activities on pre-schoolers' creative thinking. The researchers used one-group pretest-posttest designs in the present investigation. It was a 16 weeks experimental study in which pre-schoolers were taught using science activities based on an activity-based teaching method. From the 24 study participants, the data was collected using the Torrance Creative Thinking Test (TCTT) before providing intervention (pre-test) and after completing the treatment (post-test). Data were analysed using the paired sample t-test at the alpha level of .05. The findings of the study revealed that results in the post-test were significantly higher than the pre-test for TCTT fluency, originality, elaboration, the abstractness of labels, premature closure, overall figure, overall creative strength, and overall creative thinking. Based on the study findings, the researcher recommended that pre-school teachers develop and use science activities to enhance the creative thinking of the pre-schoolers. Keywords. Creative thinking, science activities, fluency, Torrance creative thinking test
Byzantine monodic singing from the Romanian space versus polyphonic religious singing: divergences and convergences
Authors: GALAICU Violina
Published: January 2023

Among the agents of the infiltration of polyphony in native religious singing are the reforming current, coming from the West through Transylvania, as well as the act of uniting with Rome a part of Transylvanian Romanians (1701). Catholic choral pieces are insinuated in Psalter manuscripts, including the curious phenomenon of the transposition of polyphonic religious singing into the Byzantine semiographic system. The two components — monodic and polyphonic — are also meet in Moldova. In 1782 during the abbotship of Paisie Velicikovski, a choir of Russian monks was established, who practiced harmonic singing (along with native monks who, traditionally, sang monodically) at Neamts Monastery. In the first half of the 19th century, the contacts of psalter music with polyphonic religious music intensified. The presence of choral singing was signaled in several cultural centers in the researched area (Arad, Bucharest, Iasi). As time goes on, psalter singing is competing more and more dangerously with harmonic singing, things being pushed to a fierce confrontation between the two currents. The saving solution for keeping the balance between continuity and renewal is seen by the bishop Melchizedek of Roman.
Observations of foreign travelers — narrative sources about the phenomenon of music in Moldovan culture (XVIII century)
Authors: GHILAŞ Victor
Published: January 2023

Th e present paper is designed with the intention of capitalizing on the narrative praxis of foreign travelers, which partially outlines the image of music from the culture of Moldova, resulting from their stay on the territory of the country. Starting from the researched historical sources, the content, presented in chronological order, highlights and analyzes the points of view of the travelers from outside, whose reflections and comments facilitate the penetration into the realities of court music and fiddle music, often considered “minor forms” of manifestation of the sound art, to which local research has often paid less attention. Captured from the perspective of the non-professional traveller, the described information reveals the circumstances, in which the services of music are appealed to and the share of the phenomenon in official events. At the same time, the syntheses undertaken shed light on the exaggerations and (or) subjectivisms expressed in the interpretations and opinions of foreign visitors. Nevertheless, the travel notes have the role of contributing to broadening the horizon of national music in the historical period under research.
Serghei Cretu and neo-traditional music: the path of creation in the Soviet period
Authors: CHISELIȚĂ Vasile
Published: January 2023

Th e study „Sergei Cretu and neo-traditional music: the creative path in the Soviet period” sketches a brief portrait of the artist, highlighting the important biographical data on specialized studies, the context of professional evolution in the Soviet period of the 1960s-1980s, marked by the so-called „new wave of folklore”. Special emphasis is placed on the reflection of his activity as a dulcimer player, arranger and composer in the Popular Stage Orchestra and in the „Folclor” Orchestra of the Moldovan Republican Television and Radio Broadcasting Company. The main compartments and aesthetic directions in the his interpretive and compositional creation, the structure of the genres and styles, including the place, the sources and the social motivations of the works of Soviet ideological inspiration and instrumentalization are also highlighted. The study capitalizes on documents, data and information from the Archive of the „Teleradio-Moldova” Company, materials from the press of the time, audio and video sources as well as a series of concepts from modern specialty literature, able to promote the interpretation and analysis of cultural facts.
The culturally distinct musical discourses in the new compositional schools of the late XIX century — beginning of the XX century
Authors: BARBAS Valeria
Published: January 2023

In this article is analyzed the correlation of the concepts of music and identity is analyzed, in which music lends itself as one of the key elements of identity, because it offers a perception of the self, but also of the collective. The concept of musical identity was the main focus in the creation of new national musical schools (Eastern Europe). Musical compositional creation that tended to embody tradition has served as a powerful cultural resource for nationalism since the 19th century. Th e compositional vector was directed, on the one hand, to get out of the crisis of the romantic music trend, and on the other hand, to strengthen the new national schools in the states of Eastern Europe, where the academic musical culture was at a relatively young stage. In the post-romantic crisis, the appeal to formulas of folklore origin brought a new breath, diversifying the musical language and the means of expression, in order to affirm musical cultures (Poland, Hungary, Czech Republic, Bulgaria, Romania), etc. The new states, previously under the influence of the great empires, distanced themselves somewhat from Western musical culture, a fact that allowed, on the one hand, the creation of national schools and the preservation of traditions in the conditions of essential changes in European, pan-European and world composition.
Moldovan-Ukrainian musical relations in the context of the cultural polylogue of the “Ukrainian Musical Encyclopedia”
Authors: СИКОРСКАЯ Ирина
Published: January 2023

Th e article presents the concept of the study of Ukrainian-foreign musical relations in the “Ukrainian Music Encyclopedia”, which is published by the Musicology and Ethnomusicology Department of the M. Rylsky Instiitute, on the example of Moldovan-Ukrainian musical connections. The directions, on which facts were systematized, are investigated. One of the components of the rich and long-lasting Moldovan-Ukrainian musical relationship is composer creativity, aimed at enriching both our cultures. It should be emphasized that the creative relations of figures of both cultures at all times were exclusively friendly and based on partnership. Of course, the creative dialogue of artists — both direct and indirect — began long before its formalizing in 1937 by launching the branch of the Union of Moldovan Composers within the Odessa organization of the Union of Composers of Ukraine. In the last century, the relations were concentrated mainly on the educational and pedagogical sphere and connected with the names of S. Vorobkevych, G. Muzychenko (Muzychescu), and M. Kazanli. One of the aspects of mediated creative dialogue is the appeal to Ukrainian composers concerning the Moldovan theme. In the XIX century, it was manifested in Th e Memoirs of the land of Moldova, op. 85, J. Rukgaber, 48 folk Romanian songs by K. Mikuli. The same aspect is deepened by an appeal to national poetry, for instance, in the romances by S. Vorobkevych, E. Mandychevsky, based on the poems of V. Alecsandri, A. Vlahutse, M. Eminescu, G. Cosbuc, etc
Intermediate ways of creating theatricality in artistic discourse
Authors: GHILAȘ Ana
Published: January 2023

Th e article addresses the issue of theatricality, especially the way of creating this cultural phenomenon in the dramaturgical text and in the narrative artistic text. Theatricality understood as a cultural and aesthetic aspect is combined in some types of speeches with theatricality in life, especially in prose. If in the dramaturgical text its structure (dialogue — stage directions) constitutes a first element of theatricality, then the theatrical techniques from the show (ad spectatores, the monologue, the actor’s corporeality, etc.) are elements that can also be found in the narrative literary text in the form of authoriality, of various forms of psychology, etc. In this context, an important role in the creation of theatricality is played by intermediality as the interaction of codes specific to certain artistic or non-artistic discourses. We investigate the relationship between theatricality and intermediality from a theoretical and methodological point of view, with some examples from artistic texts or performances.
Th e performances of the Moldovan Academic Musical Dramatic State Th eater “A.S. Pushkin” in the 1970s
Authors: COROLIOVA Elfrida
Published: January 2023

Th e present article analyses the performances of the Moldovan Academic Musical Dramatic State Theater „A.S. Pushkin” staged in the 1970s, in which cultural and civic identities were manifested, and namely: Egor Bulâciov and others by M. Gorki, Th e tiger and the hyena by S. Petőfi , Th e armored train 14-69 by Vs. Ivanov, Romeo and Juliet by W. Shakespeare, On the Night of a Moon Eclipse by M. Karim, The Inspector General by N. Gogol, Beyond the Green Door by R. Ibraghimbekov, Th e Blue Deer by A Kolomieț, An interview in Buenos Aires by H. Borovik, Servant to two masters by C. Goldoni, As long as we are going live by O. Iosseliani, The Prize by A. Ghelman, Night Asylum by M. Gorki, Solo for the clock by O. Zagradnic, the trilogy Th e Paths, A boat in the forest and Th e Dogs by N. Haitov, The Lark by J. Anouilh. The article also examines the shows marked by cultural, national and civic identities, among them: Love is not a bad counsel by A. Marinat, Th e Birds of our youth by I. Druță, Two girls and a nanny by V. Alecsandri, The Leader by D. Matcovschi, Childhood Memories and Harap Alb (Once upon a time…) by I. Creangă, Father by D. Matcovschi.
Methodical aspects of the (H)ostropat dance as an indispensible part in the repertoire of dance groups from the Republic of Moldova
Authors: TALPĂ Svetlana
Published: January 2023

Th e study addresses a wide range of interpretations of (H)ostropat dance from the repertoire of dance groups in the Republic of Moldova in the XXI century. (H)ostropat — represents a ceremonial dance that accompanies various ritual acts in the traditional wedding, being an expression of a specific language of communication that determined the very aesthetics of the dance, its forms of expression, stylistic norms of the repertoire, etc. The (H)ostropat dance, being part of the value system of popular culture, with some aspects of ritual and entertainment, highlights the importance of professional choreographic practice and the role of dance groups in cultural institutions of traditional amateur artistic activity. Th e author focuses her attention on the configuration of the methodological apparatus of researching the repertoire of dance groups as a paradigm of a new stylistic direction and cultural identity in the realm of contemporary choreographic art. It is found that the tendencies of simplifying the ritual structure of the wedding and of compressing the temporal and spatial framework, the modernization of the ceremonial conception and the flow of new dances, created by professional artists or adapted from the repertoire of folk, neo-traditional and national dances in the region, have essentially marked the structure of the repertoire of the traditional dance groups.
Art and culture — the screen of the people’s spiritual being
Authors: OLĂRESCU Dumitru
Published: January 2023

For centuries, art and culture have established themselves as fundamental forms of activity, through which man manifests his visions of the world. Having the man and his creation at their center, they also defi ne the human way of existence, becoming the symbol of man’s creative force. Th at is why they are always in the center of attention of scientists, people of art and culture, including filmmakers, who have released an indefinite number of films on this theme on the world’s screens. One of them is the filmmaker Vlad Druc, for whom art and culture are his favorite themes. His films can serve as argument: Arta, Maria Codreanu, Ion Creangă, Ploi de dor, Firul viu, Goblen, Tata, Meșterul anonym, …și neobosite mâinile tale, Vai, sărmana turturică, Obsesie, Aria, etc. On the basis of the feature film Timp de a trăi (Time to Live), we will try to highlight the spectrum of interests of the director Vlad Druc in the fi eld of art and culture, the visions and the ways of expression through the cinematographic language of the invaluable matter subjected to cinematic investigations in order to elucidate his identity paradigm.
The image of the forest in the national artistic creation
Authors: TIPA Violeta
Published: January 2023

Th e image of the forest or of the woods is deeply implanted in the spiritual life, becoming for centuries a maternal symbol of our people. We fi nd it in popular creation (doinas, ballads, tales). In most folk tales, the main characters, on their way to becoming, wander through a thick and dark forest, as the forest itself is the destination point, where the dramatic denouement, an unpredictable meeting or a love idyll will take place. We also fi nd this space of transformations in the creation of our poets and writers (Mihai Eminescu, Vasile Alecsandri, Grigore Vieru, Ion Druță, etc.), in some tales, cult fairy tales, including those of the classic Ion Creangă. We will elucidate this space, represented in various interpretations of the Crengian tales: „Capra cu trei iezi”(Goat with three kids) in the fi lm Mama (1976, directed by Elisabeta Bostan); „Povestea lui Harap Alb”(Th e Story of Harap Alb) in De-ași fi Harap Alb (If I were Harap Alb) (1965), „Povestea porcului” (Th e story of the pig) in “Povestea dragostei”(Love story) (1977), “Fata babei și fata moșneagului” (Th e grandmother’s girl and the old man’s girl) in Maria-Mirabela (1981) — all directed by the Romanian Ion Popescu- Gopo, Dănilă Prepeleac (1996, directed by Tudor Tătaru) etc., fi lms where the forest is the main space for the unfolding of actions/events in the evolution of the dramaturgy, but also the spiritual modifi cation of the character.
Electronic Health Records From The Perspective Of Nurses
Authors: ATAK Gülşah , DOĞAN Pınar , BAYER Sinem , EYÜBOĞLU Özge , KURT Asiye , YAZICI Ebrar
Published: January 2023

Since the time of Florence Nightingale, the founder of modern nursing, data obtained by nurses in relation to patient diagnosis have become the most important source in planning care. These data have now been transferred to electronic media. Electronic health records have increased the quality and safety of care, as well as helping establish accessible and holistic health records. In this process, while nurses try to rapidly adapt to the electronic health record system, they also experience work stress due to the difficult workflow and time pressure. However, in the current period of rapid digitalization, nurse informaticsts, with their increased skills and observation of user experiences, can be the key health personnel for every institution to develop and improve electronic health records.
Neurotrophic Factors as Antiapoptotic Agents – A Review
Authors: Bharti Abhishek , Mittal Payal , Singh Bora Kundan
Published: January 2023

Neurotrophic elements are the development factors which are engaged with the neuronal endurance and recovery of neurons. It is finished by forestalling the customized cell passing apoptosis. Development factors are the gathering of proteins which invigorate the development of explicit tissues. They are communicated in different organic entities including people. These developmental factors do a significant job by controlling assortment of cell cycles like expansion, separation and development. This survey will examine about apoptosis and the different Neurotrophic components which are associated with neuronal endurance and recovery of neurones including GDNF, Neuropoietic cytokines, nerve development factors, cerebrum inferred neurotrophic factors (BDNF) and job of BDNF in antiapoptotic and cell endurance.
Preventive Cardiology: Ayurveda View
Authors: Dinkarro Shekhar Abhijit , H Yeola Gunvant , Kulkarni Prasad N , Khade Prashant , Gaikwad Pranesh
Published: January 2023

Cardiovascular diseases are one of the leading causes of morbidity and mortality all over the world than any other aliment. The global burden of this disease is gradually increased and it’s about 25% out of the total deaths (2.3 million). The Global Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Ayurveda, the art of living and the science of life is serving the man kind since antiquity. However Ayurveda extends itself to accommodate prevention and cure of the diseases which are the major impediments to health, wellbeing and long life. Ayurveda has real strength in promotive and preventive health care through Ahara-Vihara.In view of the increasing evidence of cardiac disorders in the present times this aspect assumes added importance. The present article undertakes to discuss this point in detail, based on Ayurvedic concepts as well as for primary and secondary prevention, rehabilitation and adjunct therapy complementary to conventional treatment for current knowledge.
A review on antitumor action of amygdalin on various types of cancers
Authors: Ramachandran Vadivelan , Rapindra Hosalli Kirankumar , Vijayakumar Inbakumar , Mani Lalithkumar , Tiwari Ruchi , Tiwari Gaurav
Published: January 2023

Cancer can be described as the abnormal cell division which is uncontrolled and involves the destruction of neighbour cells and tissues. This condition is significantly holds up a fact that 18 million fresh cases were detected during 2018 and the prevalence rate of cancer within 0 to 74 years is 20.2%. WHO stated that 9.6 million deaths worldwide occur by this disease. A complete cure for cancer has not been found yet but in recent years researches are made in the development of site-specific drugs with low cytotoxic effect with high specificity. However, amygdalin which belongs to the nitroside group has a standout feature for the presence of cyanide in it, this cyanide involves in the decomposition of carcinogenic substances and ultimately leads to the blocking of the nutrient source to the tumor cells which inhibits further growth of cancer cells leading to the cancer cell apoptosis. Amygdalin is extensively used in various diseases such as bronchitis, nausea, leprosy, asthma, etc but recently the antitumor property was evident in a large number of in-vitro studies in various types of cancer such as breast, renal, bladder, cervical, prostate by inhibiting the growth of tumor cells, apoptosis, and reducing metastasis of tumor cells. During this review, we look upon the role of amygdalin in a range of diseases and mainly focused on the treatment of various types of cancers.
Analysis of Bonjor Sugar Business Feasibility Study in Karyamukti Village (Case Study on Mr. Lukman’s MSMEs)
Authors: Lutfiyya Bella , Akhirson Armaini
Published: January 2023

Bonjor Sugar is one of the typical preparations from the Gunung Padang Cultural Heritage Site in Karyamukti Village, one of the managers of the Bonjor Sugar Business is Mr. Lukman. As a business that has been running for a long time, Mr. Lukman's business did not test the feasibility of the business he was running. There are several problems related to accessibility, technology, and limited knowledge of human resources. The purpose of this analysis is to test the feasibility of Mr. Lukman's Bonjor Sugar Business. This research uses a mixed or combination research method where data is obtained based on the results of interviews and observations. The results obtained are that there are several aspects that have not been fulfilled. Of the 7 aspects analyzed, only financial, economic and social aspects, as well as environmental aspects are considered feasible.
Understanding Business Marketing Strategy and Its Influence on Consumer Behavior: A Qualitative Analysis
Authors: Yunus Riza M
Published: January 2023

The activity carried out by consumers every day is shopping. This activity is very important because it affects everyday life. In carrying out shopping activities, many decisions are made by the consumer. Understanding the consumer decision process is very important for marketers to create the right marketing strategy. This research will be carried out to look at the relationship that occurs between consumer behavior and its influence on changes in marketing strategy in Indonesia. This research will be carried out using a qualitative approach. The data used in this research comes from the results of previous research or studies that still have relevance to this research. This study found that when consumers feel a product has successfully met their needs, they will feel satisfied in consuming the product. Marketing strategy is determined by its interaction with consumer decisions. Then a good marketing strategy is to provide products that can meet the needs of consumers.
The Effects of Audit Firm Size, Audit Tenure, and Audit Rotation on Audit Quality
Authors: Salman Kautsar Riza , Setyaningrum Bety
Published: January 2023

This study examines the effect of audit firm size, audit period, and audit rotation on audit quality. The data come from annual reports of infrastructure, utilities and transportation companies listed on the Indonesia Stock Exchange (IDX) from 2016 to 2020. The sampling method used is purposive sampling. A sample of 267 companies was obtained based on the purposive sampling method. The analysis technique used is logistic regression analysis with SPSS software. This study's results confirm agency theory's role in explaining the relationship between parties with different interests. The research findings reveal that the role of audit professional services performed by audit firms can minimize agency problems that arise. Empirically, study findings show that the size of an audit firm and its audit period positively affect audit quality. Conversely, audit rotation does not affect audit quality. The study results provide a practical contribution so that non-big-4 audit firms can improve audit quality as big-4. Audit firms should also pay attention to sufficient audit tenure, short enough or too long, to produce good audit quality.
Corporate Policy Strategy Based on Comparison of Financial Performance Due to the Impact of the Covid-19 Pandemic
Authors: Andriani Wiwik , Ananto Rangga Putra , Aprila Dandi , Fitri Wina Nofrima
Published: January 2023

The analysis carried out to see how far a company has carried out by using the rules of financial implementation correctly and adequately is called financial performance. There are 5 (five) ratios used in assessing a company's financial performance, including liquidity ratios, leverage ratios, activity ratios, profitability ratios, and market value ratios. This study aims to determine policy strategies based on the results of comparative tests of the financial performance of companies in the technology and infrastructure sector before and during the 2018-2021 Covid-19 pandemic. This study uses secondary data. The sampling technique used was the purposive sampling method. This study used the normality test and paired difference test. The results of this study indicate that the financial performance of technology companies during the Covid-19 pandemic obtained significant results for all variables. In contrast, for the variables in the infrastructure sector companies, only one variable was significant. Based on the comparative test results, a policy strategy is needed to overcome problems related to financial performance experienced by infrastructure and technology companies listed on the Indonesia Stock Exchange. Through the eight determined policy strategies, it is expected to be able to make the company survive and choose the proper steps in developing its business.
Restaurant Accounting System Studies in Indonesia 2021-2022: A Systematic Literature Review
Authors: Mussa Nelcie , Yuliana Yuliana , Ismiyar Ika , Tjahjadi Effendi , Munandar Agus
Published: January 2023

The purpose of this study is to determine whether the design of an accounting system in a restaurant or franchise business can provide benefits in realizing the creation of accounting reporting that has a positive impact on management. In this study, the application of accounting system design using accounting information system applications was taken from the results of research conducted by previous researchers on restaurants and franchise businesses. The study was conducted based on the literature review of the ten previous studies by making a summary of the results and conclusions. Some of the criteria used in selecting articles to be material in this study are as follows: the method used, trends and topics in related research, factors that influence financial reporting and the next best method used in writing financial reports.The design of an accounting information system using a PHP program and a MySQL database can help companies make financial accounting reports which include the calculation of profit and loss from restaurant companies. PHP applications and MySQL databases used by restaurant companies must comply with applicable accounting standards. Technical competence of employees needs to be given support from the top management of the company to receive special training in the use of financial accounting programs, so that the performance of accounting information systems can be measured for success. The involvement of users of the financial accounting information system program in the company has a positive impact on the performance of the financial accounting system.
Utilization of Information and Communication Technology in the Tax Administration System to Increase Taxpayer Compliance
Authors: Djafri Intan Arsitia , Damawati Intan , Suharto Suharto , Satwika I Gusti Agung Raka Putra , Rahmatullah Rahmatullah
Published: January 2023

Adaptation to changes based on information and communication technology (ICT) causes obstacles and community preparedness for the 5.0 age, also known as society 5.0. This necessitates the digital revolution of all disciplines, including taxation. Government efforts to promote taxpayer compliance include creating a contemporary tax administration system encompassing organizational structure, business processes, information and communication technology, human resource management, and applying good governance. In addition to the tax administration system, taxpayer knowledge also influences the level of taxpayer compliance. This study's objective is to investigate the use of ICT in a modern tax administration system to enhance taxpayer compliance. The main theory in this research is positive accounting theory which was developed by Watt & Zimmerman in 1986. This study employs a qualitative approach and descriptive methodologies. This study demonstrates that the incorporation of ICT is a component of the modernization of the tax administration system. Application of the e-tax system, which comprises E-Registration, E-SPT, E-Filing, E-Payment, Blockchain, Artificial Intelligence (AI), Chatbots, and Biometric Identification, can constitute the use of ICT in the tax administration system. Ease of service, particularly in filling out SPT electronically, or e-SPT, is the method for boosting taxpayer compliance with the modernization of the tax administration system utilizing ICT.
Utilizing 10kHz Stimulation to Salvage a Failed Low Frequency Spinal Cord Stimulation Trial
Authors: Hasoon Jamal , Robinson Christopher , Urits Ivan , Viswanath Omar , Kaye Alan D.
Published: January 2023

Spinal cord stimulation (SCS) is a viable treatment option for chronic pain. One of the primary indications for SCS implantation is persistent pain after spinal surgery. Studies have demonstrated that these patients have a better response to SCS over conservative management or repeat surgery. Traditional SCS therapy uses parasthesias to overlap a patient’s pain pattern and provide relief, though some patients find this uncomfortable. To avoid the use of paresthesias, a 10kHz waveform can be utilized to provide a subthreshold level of high frequency stimulation to provide superior pain relief without paresthesias. Additionally, 10kHz stimulation may be used to salvage therapy when other

forms of SCS have failed. Here, we present a case in which a patient was switched from traditional SCS to 10kHz in the middle of a SCS trial with lead placement revision to salvage SCS therapy.
Suvorexant, a Novel Dual Orexin Receptor Antagonist, for the Management of Insomnia
Authors: Han Andrew H. , Burroughs Caroline R. , Falgoust Evan P. , Hasoon Jamal , Hunt Grace , Kakazu Juyeon , Lee Tim , Kaye Adam M. , Kaye Alan D. , Ganti Latha
Published: January 2023

Purpose of Review

The present investigation is a comprehensive review regarding the use of Suvorexant for insomnia treatment. It covers the background, pathophysiology, and significance of addressing insomnia, the pharmaceutical details of Suvorexant, and its safety, efficacy, and implications in treating insomnia. We further discuss Suvorexant’s role in targeting insomnia with other comorbidities.

Recent Findings

Insomnia refers to poor quality and/or quantity of sleep. While there are many existing treatments such as benzodiazepines, melatonin agonists, TCAs, and atypical antipsychotics used to target various receptors involved in normal induction and maintenance of sleep, Suvorexant is an antagonist that specifically targets orexin receptors. Recent clinical studies suggest that Suvorexant is both clinically safe and effective. Quantity and quality of sleep are measured in various ways, yet the consensus points towards Suvorexant’s effectiveness in improving sleep time, onset, latency, and quality compared to placebo. In addition to helping improve isolated insomnia, Suvorexant helps improve sleep in patients that have other comorbidities such as obstructive sleep apnea, Alzheimer’s disease, dementia, acute stroke, and delirium. While Suvorexant is safe, there are still adverse effects associated with the drug that needs to be considered. The most common adverse effects include dizziness, somnolence, headaches, and cognitive impairment.

Insomnia is a major public health concern that affects many people worldwide and has been linked to many adverse health outcomes. While there are existing treatments that target different receptors and pathways of normal sleep induction and maintenance, Suvorexant is a novel drug that targets dual orexin receptors. Its safety and efficacy, mechanism of action, pharmacokinetic parameters, and relative lack of rebound and withdrawal effects render suvorexant a reliable choice for the treatment of insomnia.
Inotersen to Treat Polyneuropathy Associated with Hereditary Transthyretin (hATTR) Amyloidosis
Authors: Robinson Christopher , Pham Cynthia , Zamarripa Alec M. , Dugay Chase S. , Lee Christopher A. , Berger Amnon A. , Landman Avi , Cornett Elyse M. , Kassem Hisham , Kaye Alan D. , Urits Ivan , Viswanath Omar , Ganti Latha
Published: January 2023

Background

Amyloidosis is a group of diseases with the common pathophysiology of protein misfolding and aberrant deposition in tissue. There are both acquired and hereditary forms of this disease, and this review focuses on the latter hereditary transthyretin-mediated (hATTR). hATTR affects about 50,000 individuals globally and mostly appears as one of three syndromes - cardiac, polyneuropathy, and oculoleptomeningeal. Polyneuropathy is the most common form, and there is usually some overlap in individual patients.

Results

Recently, novel therapeutic options emerged in the form of groundbreaking drugs, Patisiran and Inotersen, small interfering RNA molecules that target TTR and reduce the production of this protein. By targeting TTR mRNA transcripts, Inotersen decreases protein translation and production, reducing the deposition of misfolded proteins. It was shown to be both effective and safe for use and specifically formulated to concentrate in the liver – where protein production takes place.

Conclusion

hATTR is a rare, progressive, and debilitating disease. Its most common presentation is that of polyneuropathy, and it carries a very poor prognosis and a natural history conveying a median survival of < 12 years. Novel therapeutic options are groundbreaking by providing disease-modifying specific, targeted therapies against TTR production and deposition. The use of RNA interference (RNAi) opens the door to the treatment of hereditary diseases by targeting them at the genetic level.
The influence of health education on the prevention of diabetic ulcuses in type 2 diabetes mellitus patients
Authors: Desanti Agustina Enggalita  , Fahrun Nur Rosyid
Published: January 2023

Background: Diabetes mellitus is a relative or absolute decrease in insulin production that can cause direct or long-term metabolic disorders. The complications are microanglopathies and macroanglopathies. Diabetic ulcer is one of the side effects. Numerous studies have shown that health education can stop diabetic ulcers from progressing. Methods: This research is a quasi-experimental study with two group pretest-posttest with control design. Respondents were type 2 diabetes mellitus at the Gatak Health Center. The number of respondents consisted of 78 respondents who were divided into 2 groups. In this study there were 78 respondents with type 2 diabetes mellitus who participated, and divided into two groups, namely the intervention group (n = 39) who were given health education about diabetic ulcer prevention and the control group (n = 39) who were not given health education about diabetic ulcer prevention. Data from the results of this study were obtained from filling out questionnaires that had been tested for validity and reliability and analyzed using the Paired Sample t-test and Independent Sample t-test. Data were processed using SPSS. Results: The test results showed that there was a significant difference between the intervention group and the control group in preventing diabetic ulcers with a P=0.000. Conclusion: Data from the results of this study were obtained from filling out questionnaires that had been tested for validity and reliability and analyzed using the Paired Sample t-test and Independent Sample t-test. Data were processed using SPSS. Results: The test results showed that there was a significant difference between the intervention group and the control group in the prevention of diabetic ulcers with a value of P = 0.000. Conclusion: Data from the results of this study were obtained from filling out questionnaires that had been tested for validity and reliability and analyzed using the Paired Sample t-test and Independent Sample t-test. Data were processed using SPSS. Results: The test results showed that there was a significant difference between the intervention group and the control group in preventing diabetic ulcers with a P=0.000. Conclusion: Providing health education to people with type 2 diabetes mellitus in the prevention of diabetic ulcers that there is a significant influence in preventing the occurrence of diabetic ulcers.
Prevalence of Non-Carious Cervical Lesions in Individuals who Undergo Orthodontic Surgery: A Cross-Sectional Study
Authors: Tahir Muhammad , Maqbool Ali , Baloch Sanam , . Amrita , . Piryanka , Anique Muhammad
Published: January 2023

Objective: To examine the dispersal of NCCLs (non-carious cervical lesions) by tooth type. This research also aims to explore NCCLs’ prevalence in those patients who go through orthodontic surgery and the possible factors linked with it. Study design: A cross-sectional study Place and Duration: This study was conducted at Pakistan Medical Center Hyderabad from August 2021 to August 2022. Methodology: Overall, 162 individuals were involved in this research. Data from the patients were collected before and after the orthodontic surgery. The data include age, gender, number of sessions activated, facial pattern, retreatment, compensatory treatment, and angle’s malocclusion. Lateral intraoral pictures of every patient were taken from the left, right, and front. These pictures were clicked to see whether NCCLs are present or absent in every tooth and to evaluate the dispersal of non-carious cervical lesions in the teeth of every individual. To evaluate the relationship between each variable and NCCLs, Poisson regression analysis (multivariate and bivariate) with robust variance was used. The confidence interval was at 95% and significant p-value was less than 0.05. Results: The prevalence of NCCLs before orthodontic surgery was 23.01% and the prevalence of non-carious cervical lesions after orthodontic surgery was 31.09%. The most affected teeth were premolars along with incisors, first molars, and canines. It was found after the statistical analysis that the factor that affected the prevalence ratio was age. If orthodontic surgery was performed in adulthood, NCCLs were more prevalent. Conclusion: It was concluded that the most affected teeth by NCCLs were premolars. Moreover, age seems to influence the increasing prevalence of non-carious cervical lesions in those participants who go through orthodontic surgery in their adulthood. Keywords: premolars, non-carious cervical lesions, teeth, orthodontic surgery
The Outcome of Titanium Elastic Nail in Pediatric Femoral Diaphyseal Fracture in a Tertiary Care Hospital
Authors: Tayyab Affan , Jan Babar , Kumar Dileep , Ahmed Faheem , Gul Shakeel , Iqbal Malik Naveed
Published: January 2023

Objective: To determine the outcome of titanium elastic nail in pediatric femoral Diaphyseal fracture in a tertiary care hospital. Study Design: A longitudinal study Place and Duration: The Department of Orthopedics, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi from 5th January 2022 to 4th July 2022. Methodology: A total of 126 Patients with femoral shaft fractures who were hospitalized were included. Through a little incision, an intramedullary nail was pushed into the canal. Union and callus formation were monitored with serial radiographs, and weight bearing was gradually increased based on fracture healing. The chi-square test and stratification were utilized to attain this result. A significance level of 0.05 was used. Results: There were 76.2% male and 23.8% female. The mean nail diameter, radiological union, limb length discrepancy and angulation were 3.31±0.32mm, 8.71±1.44weeks, 1.09± 0.81cm and 5.43±2.63° respectively. The mean follow-up was 4.30±1.06 months. The pain was observed in 15.1% of children while in 66.7% of cases no complications were observed. A total of 66.7% of cases were found with excellent, 18.3% with good and 15.1% with poor outcome. Conclusion: Titanium elastic nails have a high probability of good and excellent outcomes in children and it is a simple, minimally invasive implant technique. Keywords: Outcome, Titanium Elastic Nail, Pediatrics, Femoral Diaphyseal Fracture.
Advantages of Stretching Before Surgery on the Functionality of the Shoulder after the Surgery in Patients Undergoing Mastectomy
Authors: Chandio Muhammad Mubashir Ahmed , Owais Muhammad Abid , Ahmed Masood , Shah Syed Moin Islam , Unar Rafia , Khan Ramsha
Published: January 2023

Objective: To analyse the effects of stretching the muscles of the shoulder before surgery on the functionality of the shoulder after the surgery of mastectomy Study design: An analytical cross-sectional study Place and Duration: This study was conducted at Bibi Asifa Bhutto Dental College SMBB Medical University CMC Teaching Hospital Larkana from January 2022 to June 2022. Methodology: All the patients included in the study had mastectomy. The participants were randomized to control groups and treatment groups. The participants in the treatment group were gone through static stretching with a range of motion. The control group did not undergo any stretching preoperatively and was given standard postoperative care. The Numeric Pain Rating Scale (NPRS), Groningen Activity Restriction Scale (GARS), and Universal Goniometer (UG) were used for the collection of the data on the first and third postoperative days. The data was analyzed in the IBM SPSS version 26. Results: A total of 20 patients were included in the study. Overall10 patients were allocated to the treatment group and 10 were allocated to the control group. The mean age of the patients was 47±11.86 years. A significant difference in the functionality, range of motion, pain, and Groningen Activity Restriction Scale scores for daily activities was seen in the treatment group (p<0.05)compared to the control group (p>0.05). However, the difference was not significant in external rotation and Groningen Activity Restriction Scale scores (p>0.05). Conclusion: Shoulder stretching before surgery is not only safe, but it is also effective in the reduction of functional restriction and pain after the mastectomy surgery. Keywords: Shoulder stretching, Pre-operative stretching, Mastectomy, Post-op shoulder function
Perianal Abscess Cavity Packing Versus No Packing A Randomized Control Trial
Authors: Rai Lajpat , Ghufran Muhammad Ali , Samo Khursheed Ahmed , Mangi Munawar Hussain , Babar Jahanzaib , Saeed Summaya
Published: January 2023

Objective: To compare the outcome of perianal abscess cavity packing versus no packing following I&D. The primary objective is to compare postoperative pain. The secondary outcomes were the number of follow-up visits, fistula formation, wound healing time and abscess recurrence. Methods: A randomized clinical trial was conducted at Dr Ruth K. M. Pfau Civil Hospital Karachi from March 2020 to July 2021. Results: 70 participants' data were analyzed, 35 in the packing group (control) and 35 in the no packing group (intervention). The preoperative and postoperative pain scores at 48 hours are stastatistically not significant. The mean postoperative pain score showed a significant difference at two weeks, showing that the group receiving no packing experienced less intense pain. The mean wound healing time was 44.09 days in the packing group and 26.91 days in no packing group (p=0.001). The occurrence of fistula in ano was 2.8% in the packing group and 5.7% in no packing group (p=0.55). Abscess recurrence was 14.2% in the packing group, while 0% in no packing group (p=0.02). Conclusion: This study revealed that the no-packing technique is superior in decreasing postoperative pain and patient satisfaction. Keywords: Perianal Abscess, Randomized trials, No packing, Packing, Anorectal disease
Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu
Authors: Khalid Alma , Aman Suhail , Jhatial Irfan , Talreja Washdev , Hussain Wajid , Wadho Sasui
Published: January 2023

Background: According to standard guideline for breastfeeding, t is mandatory to practice exclusive breastfeeding during the first six months of a baby's life to provide the finest physiological support for all neonates. In Pakistan there is visible underuse of exclusive breastfeeding among lactating mothers. This study aims to assess the variables affecting the non-compliance to exclusive breastfeeding among mothers at a district hospital in Pakistan. Materials and methods: A descriptive cross sectional study design was conducted to in Pediatric OPD at the district hospital Dadu from January to June 2022, breast feeding mothers were the study population, Using a total population sampling method, 224 breastfeeding mothers were interviewed regarding their practice towards exclusive breast feeding. Chi square test of association was used to evaluate the association of variables. Results: We observed that only 29. 5% mothers practiced exclusive breast feeding. All the mothers in the study had a breastfeeding child. Most of the mothers in this study were aged between 20 to 40 years (62%). Nearly 2/3rd of the mothers in the study had no formal education, only 5.8% mothers had higher secondary education. More than 1/5th of the mothers had more than 5 children. The most common reason for non-compliance with the exclusive breastfeeding was the use of formula milk by the mothers followed by insufficient breast milk Conclusion: Inclination to use formula milk, insufficient breast milk, early weaning and lack of the education among mothers were most common causes of non-compliance towards exclusive breastfeeding. Maternal education level was significantly associated with exclusive breastfeeding. Mass level health education for maternal and child health are recommended. Keywords Breast feeding, Exclusive breastfeeding, Neonate, Maternal factors,
Efficacy and Safety of Percutaneous Cystolithalopexy in Children Under 5 Years of Age
Authors: Ahmad Tariq , Khan Farman Ullah , Ali Sajjad , Ammar Muhammad Asif
Published: January 2023

Objectives: To assess the efficacy and safety of percutaneous cystolithalopexy in children under 5 years of age Study design: Retrospective study Place: Department of Paediatric Urology Institute of Kidney Diseases Hayat Abad Peshawar Methodology: Retrospective descriptive study was conducted in Institute of kidney diseases Peshawar between Jan 2020 and January 2022. After applying the inclusion and exclusion criteria all patients in the mentioned period were include in his study. Results were inferred as frequency and percentages. Results: Without observing any difference for age and gender 100% clearance was achieved in all patients with the most prominent complication being supra pubic catheter leakage which was treated conservatively. Conclusions: Percutaneous cystolithalopexy is safe and efficient for the management of bladder stone under 5 years Keywords: Bladder Calculi, Percutaneous Cystolithalopexy, Urolithiasis, Lithiasis