bluuebunny/crossref_metadata_2025 huggingface dataset:
Parties of Order Right and Left
Authors: Clover Joshua
Published: December 2022

“Parties of Order Right and Left” takes the right-authoritarian turn (particularly in Central Europe) as an opportunity to reflect on the left-authoritarian turn elsewhere in Europe and “the West” more broadly. The talk pays special attention to the shared faith in policy imposition as the necessary and sufficient mechanism to address social volatility, notably the volatility both expressed and borne by surplus populations and climate refugees. The presupposition of policy solutions even in times of social catastrophe is traced through two parallel texts, Andreas Malm’s How to Blow Up a Pipeline and Kim Stanley Robinson’s Ministry for the Future, and their shared theory of political violence as policy weapon. It concludes with a discussion regarding the nationalist implications of policy solutions more broadly and the historically specific demand for internationalism against border regimes in present conditions.
Author(s): Joshua Clover
Title (English): Parties of Order Right and Left
Journal Reference: Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022).
Publisher: Institute of Social Sciences and Humanities - Skopje
Page Range: 28-38
Page Count: 10
Citation (English): Joshua Clover, "Parties of Order Right and Left,” Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022): 28-38.
Author Biography
Joshua Clover, University of California Davis
Joshua Clover is the author of seven books, including Roadrunner (Duke, 2021) as well as Riot.Strike.Riot: the New Era of Uprisings, a political economy of social movements, with recent editions in Italian, French, German, Turkish, and Swedish. He is a currently professor of English and Comparative Literature at University of California Davis as well as Affiliated Professor of Literature and Modern Culture at University of Copenhagen.
The Swerve and Ancient Materialism
Authors: Nail Thomas , Kolozova Kamelia
Published: December 2022

Author(s): Thomas Nail and Katerina Kolozova
Title (English): The Swerve and Ancient Materialism
Journal Reference: Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022).
Publisher: Institute of Social Sciences and Humanities - Skopje
Page Range: 58-71
Page Count: 13
Citation (English): Thomas Nail and Katerina Kolozova, “The Swerve and Ancient Materialism,” Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022): 58-71.
 
Author(s) Biography
Thomas Nail, University of Denver
Thomas Nail is a Distinguished Scholar and Professor of Philosophy at the University of Denver and author of numerous books, including The Figure of the Migrant, Theory of the Border, Marx in Motion, Theory of the Image, Theory of the Object, Theory of the Earth, Lucretius I, II, III, Returning to Revolution, and Being and Motion. His research focuses on the philosophy of movement.
Katerina Kolozova, Institute of Social Sciences and Humanities, Skopje
Dr. Katerina Kolozova is Executive Director, senior researcher and full professor at the Institute of Social Sciences and Humanities, Skopje, and a professor of political philosophy at FMK-Belgrade. She has published many influential articles in a number of international journals, as well as several books. These include: Capitalism’s Holocaust of Animals: A Non-Marxist Critique of Capital, Philosophy and Patriarchy (Bloomsbury Academic), as well as Cut of the Real: Subjectivity in Poststructuralist Philosophy (Columbia University Press).
Рез на полот (во Лакановска смисла)
Authors: Жупанчич Аленка
Published: December 2022

Овој разговор ќе се обиде да ја истражи природата на поделбата или резот што е имплицитен, исто така етимолошки, во терминот „пол“. Тој ќе се обиде да развие концепт на поделба што не имплицира некаква предегзистентна целина, туку постои како ентитет сам за себе, втемелен во своја сопствена реалност. Што доколку поделбата имплицирана во „полот“ не е едноставно таа помеѓу два пола (или повеќе), туку нешто што го означува немирот на самата сексуалност? Како ова може да се поврзи со современата феминистичка борба и каков вид концепт на универзалноста тоа би подразбирало?
Author(s): Аленка Жупанчич 
Title (Macedonian): Рез на полот (во Лакановска смисла)
Journal Reference: Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022).
Publisher: Institute of Social Sciences and Humanities - Skopje
Page Range: 136-146
Page Count: 10
Citation (Macedonian): Аленка Жупанчич, "Рез на полот (во Лакановска смисла),” Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022): 136-146.
Author Biography
Аленка Жупанчич
Аленка Зупанчич е словенечка филозофка и општествена теоретичарка. Таа работи како истражувачки советник на Институтот за филозофија, научно-истражувачки центар на Словенечката академија на науките. Таа исто така е професор на Европската постдипломска школа Graduate School во Швајцарија. Позната по нејзината работа на пресекот на филозофијата и психоанализата, таа е авторка на бројни статии и книги, вклучувајќи ги: „Етиката на реалното: Кант и Лакан“, „Најкратката сенка: Ничеовата филозофија на двојното“, „Зошто психоанализа: три интервенции“, „Чудниот внатре: за комедијата“, а нејзино најново дело е „Што е полот?“
Од социјално дистанцирање до општествена трансформација
Authors: Тејлор Блер
Published: December 2022

Author(s): Блер Тејлор
Title (Macedonian): Од социјално дистанцирање до општествена трансформација
Journal Reference: Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022).
Publisher: Institute of Social Sciences and Humanities - Skopje
Page Range: 160-172
Page Count: 12
Citation (Macedonian): Блер Тејлор, "Од социјално дистанцирање до општествена трансформација,” Identities: Journal for Politics, Gender and Culture, Vol. 19, No. 1-2 (2022): 160-172.
Penerapan Model Pembelajaran Kooperatif Tipe Jigsaw Untuk Meningkatkan Hasil Belajar Matematika Materi Kaidah Pencacahan Bagi Siswa Kelas XII IPA 2 SMAN 1 Nunukan Selatan Tahun Pelajaran 2021/2022
Authors: Sulastri Sulastri
Published: December 2022

This classroom action research aims to 1) Describe the process of learning mathematics material on enumeration rules for students of class XII IPA 2 SMAN 1 Nunukan Selatan by using the application of jigsaw type cooperative learning. 2) Describe the increase in learning outcomes of mathematics material on enumeration rules for students of class XII IPA 2 SMAN 1 Nunukan Selatan with the application of jigsaw cooperative learning. This study uses the classroom action research phase which includes planning, action, observation, and reflection which is carried out in two cycles. Data collection techniques in this study were through observation of the learning process and tests. Data analysis was carried out by processing data from observations of the learning process and learning outcomes data in a qualitative and quantitative descriptive way. The results of the research show that the learning process is getting better. Successively obtained an average learning process in Cycle I of 64.31%, and Cycle II of 79.99%. In terms of learning outcomes, the number of students who achieved a passing score in Cycle I was 50% and in Cycle II was 94%. In general, it can be concluded that up to Cycle II there was an increase in the process and results of students' mathematics learning in the enumeration rule material through jigsaw cooperative learning.
Frequency And Significance of Electrocardiographic Changes in Beta Thalassemia Major Patients
Authors: Hamid Naila , Shafique Muhammad Faisal , Zaman Qamar -uz- , Niaz Hafsa
Published: December 2022

Objective: To find out the electrocardiographic changes among beta thalassemia major patients as the marker of cardiac complications at later stages of life.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Pediatrics and Neonatology, Pak Emirates Military Hospital Rawalpindi from Jul 2018 to Dec 2018.

Methodology: One hundred and thirty patients of age 5-20 years with beta thalassemia major were included in the study. Patients were attending the thalassemia centre regularly.

Results: Out of total 130 patients, 70 (53.84%) were males and 60 (46.15%) were females. Out of 81 (56.92%) patients showed at least one electrocardiographic change while 49 (37.69%) patients showed normal electrocardiography. Remarkable electrocardiographic changes were sinus tachycardia, arrhythmias, T-wave inversions, long QTc interval and sinus bradycardia. There was statistically significant association in the increased serum ferritin levels, electrocardiographic changes, number of blood transfusions and occurrence of ECG changes (p<0.05).

Conclusion: Regular electrocardiographic monitoring has significant role in cardiac evaluation of beta thalassemia major patients as an indicator of evolving cardiac complications that can arise from iron overload secondary to multiple blood transfusions.
Pattern of Cervical Lymph Node Metastasis in Squamous Cell Carcinoma of Buccal Mucosa and Its Correlation for Optimal Neck Management
Authors: Raza Syeda Hala , Ahmed Sufyan , Tahir Muhammad
Published: December 2022

Objective: To document cervical node metastasis in oral squamous cell carcinoma (OSCC) of buccal mucosa and analyze the oncological necessity of most suitable neck dissection, in population of a tertiary care hospital.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Maxillofacial department, Abbasi Shaheed Hospital, Karachi Pakistan, from Jul 2018 to Jul 2020.

Methodology: It was a study of 110 histopathologically proven patients of Oral Squamous Cell Carcinoma of buccal mucosa. Non-probability sampling technique was used and sample size was calculated with help of WHO software using 8% prevalence of cervical metastasis in oral squamous cell carcinoma of buccal mucosa, 95% confidence interval, 7% margin of error. Patients aged 18-75 years, either gender, resectable tumor with or without lymph node involvement were included. Patients treated previously, with distant metastasis, unfit for general anesthesia and not willing to give consent were excluded. Tumor resection with selective neck dissection was done by one experienced surgeon and specimens were sent to same laboratory for histopathology. Data was collected on a proforma and analyzed using SPSS version 26.

Result: Out of 110 patients 93 (84.5%) were male and 17 (15.5%) were female. Mean age was 43 years ± 12.75. Occurrence of occult metastasis was 41.8%. According to histopathologically positive metastatic node, highest incidence was in level I 21 (19.1%) followed by levels I, II, III 12 (10.9%) and levels I-II 7 (6.4%), while positive levels I, II, III, IV were seen in only 2 (1.8%) cases.

Conclusion: Oral Squamous Cell Carcinoma.............
Effectiveness of An Oral Health Care Workshop in Primary School Teachers of Barakahu; A Pilot Study
Authors: Qazi Sheze Haroon , Mumtaz Rubina , Masoud Saba , Tassaduq Rabia
Published: December 2022

Objective: To assess the effectiveness of an oral health care workshop in enhancing the knowledge of primary school teachers

Study design: Quasi-experimental study.

Place and Duration of Study: Primary schools of Barakahu, from Feb to Jun 2019.

Methodology: This pilot study was carried out among who attended a training workshop on oral health at various primary schools of Barakahu. Training methods included didactic lectures, demonstrations and audio-visual aids. Scores were graded pre and post workshop as poor, fair and good knowledge. Evaluation was done to assess the effectiveness of the training.

Results: Out of 40 participants, 78% had good pre-training knowledge as compared to 83% after the training. As our data was not normally distributed therefore, we applied, Wilcoxon signed ranks test to check the change in the questionnaire scores (pre- and post-workshop). Among the 40 participants, 30 had a higher score post-workshop, while 7 had the same score and 3 participants had the lower score (p-value <0.001).

Conclusion: The study concluded that a training workshop was an effective tool for improving the knowledge of primary school teachers regarding oral health.
Role of Oral Steroids in The Treatment of Carpal Tunnel Syndrome
Authors: Ahmad Zaheer , Aslam Muhammad Adnan , Hasan Arsilan
Published: December 2022

Objective: To compare the efficacy of oral steroids and intracarpal steroids in treating carpal tunnel syndrome.

Study Design: Quasi-experimental study.

Place and Duration of Study: Neurology department, Allied Hospital, Faisalabad Pakistan, from Jul to Dec 2020.

Methodology: Patients of either gender, >18 years of age having carpal tunnel syndrome were included and divided into two groups. The oral steroids group received 20mg Prednisone tablets for two weeks and 2cc 0.9% Saline injection locally in the carpal tunnel on the affected hand by a neurologist. Intracarpal steroids group received 40mg Methylprednisolone locally in the carpal tunnel on the affected hand and placebo tablets for two weeks. Global symptom score was calculated at baseline and four weeks of treatment. Nerve conduction studies were conducted at baseline and four weeks of treatment.

Result: A total of 106 patients were included in the study. There was a statistically significant improvement in the oral steroids group and intracarpal steroids group at four weeks follow up in mean sensory conduction velocity, mean global symptom score, mean motor conduction velocity and mean sensory latency (p<0.05). There was no statistically significant difference in the efficacy of oral Prednisone and intracarpal Methyl prednisone in the groups (p-value 0.579).

Conclusion: Oral steroids and intracarpal steroids are effective as conservative treatment of carpal tunnel syndrome in decreasing symptoms on global symptom score (GSS) and improving the nerve conduction parameters of carpal tunnel syndrome.
Outcomes of Neonates Born To Mothers Who Were COVID-19 Positive; An Observational Study from Pakistan
Authors: Ahmad Zeeshan , Khushdil Arshad , Waqar Talal , Ahmed Madiha , Haque Khalid N , Sultana Rashida , Sughra Umme e , Farooq Shoaib , Malik Qudrat Ullah
Published: December 2022

Objective: To assess outcomes of neonates born to mothers who were COVID-19 positive.

Study Design: Prospective observational study.

Place and Duration of Study: Secondary and Tertiary Care Hospitals of the Armed Forces, Pakistan, from Apr to Aug 2020.

Methodology: We studied 106 pregnant women who tested positive for SARS-CoV-2. Stable asymptomatic newborn babies were kept in SARS-CoV-2 specified incubators, at specially designated areas for observation. Nasopharyngeal swabs were taken at first 24 hours and if negative, babies were handed over to clinically stable mothers who were educated regarding use of facemasks and proper hand washing. Neonates who tested positive for SARS-CoV-2 were evaluated for SARS-CoV-2 again at 48 hours and then every 48-72 hours, until found to be negative.

Results: Total 106 women were found to be SARS-CoV-2 positive during the study period. All the women delivered singleton babies. Of the 106 babies, 5 (4.71%) were found to be positive for SARS-CoV-2 at 24 hours and only 1 (0.94%) baby was found to be positive at 48 hours and then tested negative at 7th day.

Conclusion: Babies born to SARS-CoV-2 mothers were mostly asymptomatic and there was no increased risk of morbidity or mortality to the neonates suffering from the infection.
Efficacy of Alpha Keto-Analogues in The Management of Chronic Kidney Disease
Authors: Umar Saba , Sabir Sohail , Altaf Ashfaq , Raja Khalid Mahmood , Siddiqi Fuad Ahmed , Saleem Salman , Azam Malik Nadeem , Sabir Haroon
Published: December 2022

Objective: To determine the efficacy of alpha keto-analogues in the management of chronic kidney disease at a tertiary care hospital.

Study Design: Quasi-experimental study.

Place and Duration of Study: Nephrology Department, Armed Forces Institute of Urology, Rawalpindi from Jul to Dec 2020.

Methodology: A total of 300 patients of chronic kidney disease stage 3 and 4, not dependent on hemodialysis were included in the study. They were divided into two groups with matched age, gender and duration of chronic kidney disease. Group-I received the routine treatment of chronic kidney disease with low protein diet while group-II received alpha keto-analogue in standard dose in addition to routine treatment of chronic kidney disease with low protein diet. Estimated glomerular filtration rate was assessed at the baseline and after six months.

Results: Out of 300 patients 151 (50.3%) were males while 149 (49.7%) were female patients. 110 (36.7%) patients had stage-3 disease while 190 (63.3%) had stage-4 chronic kidney disease. Mean difference of eGFR in group-I was 3.17 ± 3.19 mL/min/ 1.73m2 while mean difference of eGFR in group-II was 1.16 ± 1.52 mL/min/1.73m2 (p-value<0.001).

Conclusion: Alpha keto-analogues emerged as an efficacious short-term option in reducing the progression of chronic kidney disease in our study. Use of this option in addition to routine treatment and low protein diet was related to significant improvement in renal functions.
Vitamin D Status in Acute Ischemic Stroke: Relation To Initial Severity and Short-Term Outcome
Authors: Sarwar Natasha , Raja Khalid Mehmood , Uruj Sana , Khan Sarah , Hussain Amina
Published: December 2022

Objective: To assess the vitamin D levels among patients presenting with acute ischemic stroke and relationship of these levels with short-term outcome and the severity of stroke.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi Pakistan, from Dec 2019 to Feb 2021.

Methodology: A total of 300 patients with ischemic stroke diagnosed by the consultant medical specialist or neurologist on the basis of clinical and neuro-radiological findings were included in this study. Serum Vitamin D levels were assessed along with other baseline investigations among the study participants. Severity of stroke was assessed via National Institutes of Health Stroke scale and short-term outcome was assessed by modified Rankin scale.

Results: Out of 300 patients of acute ischemic stroke, 183 (62.3%) were males while 117 (37.3%) were females. 151 (50.3%) of the patients had Vitamin D levels within range while 149 (49.7%) had deficient vitamin levels. On National Institutes of Health Stroke scale, 163 (54.3%) had mild, 87 (29%) had mild to moderately severe, 33 (11%) had severe and 17 (5.7%) had very severe symptoms. Statistical analysis revealed that short-term outcome and stroke severity had a statistically significant relationship (p-value <0.05) with Vitamin D deficiency among patients suffering from acute ischemic stroke.

Conclusion: Almost half of the patients presenting with acute ischemic stroke had vitamin D deficiency in our study. Those having vitamin D deficiency had more chances of having severe form of ischemic stroke and poor short-term outcome.
Epidemiology of SARS-CoV-2 with Implications of Reinfection Update After 01 Year of Ongoing Pandemic: Cross Sectional Study From Tertiary Care Hospital From Southern Region of Pakistan
Authors: Ahmed Abeera , Sana Fatima , Yasir M. , Jamal Hamid , Yousaf Shagufta , Khan Aysha
Published: December 2022

Objective: To share the epidemiological, clinical and laboratory -based evidence of severe acute respiratory syndrome Corona Virus-2 with focus on the cases of re-infection; an update after one year of the ongoing pandemic.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Pathology, in collaboration with Department of Medicine, Combined Military Hospital, Malir, from Mar 2020 to Feb 2021.

Methodology: Total 5190 nasopharyngeal swabs were collected and transported to the laboratory in viral transport media for severe acute respiratory syndrome Corona Virus-2, from all symptomatic patients with a history of exposure/traveling from endemic areas and those requiring admission in hospital and were screened for COVID-19 as per hospital standing protocols.

Results: 561(10.8%) patients were PCR positive for severe acute respiratory syndrome Corona Virus-2. The mean age of patients was 39.45±31.9 years and a majority of patients were males 426 (76%). The most common symptoms were fever and dry cough followed by myalgia and shortness of breath. 37 (9%) patients died due to the severity of the illness. Total 6 (1.46%) cases of laboratory-confirmed reinfection of severe acute respiratory syndrome Corona Virus-2 were reported. 2(33%) cases of reinfection were observed in health care workers, mortality was seen in a single patient associated with old age and comorbidities.

Conclusion: In our study, the severity of the disease was directly related to the age of patients and underlying comorbidities. Reinfection was associated with increased viral load and exposure to the infected environment.
Evaluating Prediction Score For Success of Trial of Labor After Cesarean (TOLAC)
Authors: Baqai Shehla , Afroze Sadaf
Published: December 2022

Objective: To determine the success rate for trial of labor after cesarean section in women with good prediction score.

Study Design: Cross sectional (analytical) study.

Place and Duration of Study: Department of Obstetrics and Gynecology, PEMH Rawalpindi, from Dec 2017 to Jun 2018.

Methodology: A total of 141 women with previous delivery by caesarean section, planned for trial of labor with good prediction score of ≥8 were included in the study. All patients were then allowed to labor spontaneously. Data was collected for success rate after trial of labor

Results: Age range in this study was from 18-35 years with mean age of 29.234 ± 2.13 years, mean gestational age 38.531 ± 0.99 weeks, mean weight 63.290 ± 9.97 Kg, mean height 1.532 ± 0.08 meter and mean BMI was 27.097 ± 4.59 Kg/m2. Success rate was seen in 86.5% patients.

Conclusion: In conclusion, a prediction model was proposed that can provide useful insights to envisage VBAC success rate for the pregnant women having history of caesarean delivery at the time of admission.
INTER-OBSERVER VARIABILITY IN GLEASON SCORING SYSTEM F0R HISTOLOGICAL GRADING OF ADENOCARCINOMA PROSTATE
Authors: Ahsan Farah , Khan Ahmed Ahson , Asif Muhammad , Aslam Maria , Hamayun Saba , Din Hafeez Ud
Published: December 2022

ABSTRACT

Objective: To evaluate the reproducibility of the Gleason scoring system and to compare its inter-observer variability for histological grading of prostatic adenocarcinoma.

Study Design: Prospective double-blind study.

Place and Duration of Study: Histopathology department of Armed Forces Institute of Pathology (Jan-Jul 2020).

Methodology: A total of 128 pathology slides of prostate biopsies from patients with prostate cancer were re-evaluated. The International Society of Urological Pathology 2005 modified Gleason grading system with Epstein’s modification was used. Two pathologists, blinded to each other and to the initial pathology report, performed the pathological evaluation. To determine inter-observer concordance, the kappa coefficient test was used.

Results: Concordance rates between the two observers for Gleason pattern sums were 67% (Ꝁ=0.556, 95% CI 0.40-0.59), respectively. Best concordance was at Gleason sum 7 (n=30/128).

Conclusion: The agreement between observers on the Gleason sum was moderate. It can be greatly reduced if better trained uropathologists employ the Gleason scoring system resulting in less variability and more conformity.
Comparison of Hand Grip Strength Among Chefs and Non-Chefs
Authors: Mazhar Fatima , Amjad Fareeha , Ahmad Ashfaq
Published: December 2022

Objective: To compare the handgrip strength among chefs and non–chefs.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Different restaurants and hotels of Lahore, from Apr to Sep 2018.

Methodology: Thirty-one chefs and 31 non-chefs (waiters and managers) were included in the study. We used a standard method for measuring the handgrip strength of the dominant and non-dominant hand. Handgrip strength was measured with the help of an electronic hand dynamometer (Model EH101).

Results: The mean handgrip strength of the dominant hand of the chefs was 39.90 ± 8.50 kg, with the range 22.76 kg-55.30 kg, whereas among non-chefs, the mean handgrip strength of the dominant hand was 38.54 ± 7.85 kg, with the range 21.06 kg52.86 kg. The mean handgrip strength of the non-dominant hand of the chefs was 38.36 ± 7.97 kg, with the range 24.20 kg-56.66kg, whereas, among non-chefs, the mean handgrip strength of non-dominant hand was 37.15 ± 7.26 kg, with the range 23.03kg-51.60 kg.

Conclusion: Handgrip strength of chefs and non-chefs was the same in the dominant and non-dominant hands. There was no significant statistical difference in the handgrip strength among chefs and non-chefs.
Determination of Medians of Biochemical Serum Markers in First Trimester of Healthy Pregnant Women in Tertiary Care Setup
Authors: Kanwal Shamsa , Asif Naveed , Baqai Shehla , Ijaz Aamir , Bahadur Kulsoom , Nida Sumbal
Published: December 2022

Objective: To determine medians of pregnancy-associated plasma protein-A (PAPP-A) and free β subunit of Human Chorionic Gonadotropin (hCG-β) in the first trimester of healthy pregnant women visiting tertiary care hospital.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) from May 2018 to May 2019.

Methodology: Healthy pregnant women with a singleton pregnancy reported for an antenatal checkup in Obstetric OPD, Pak Emirates Military Hospital (PEMH) and Combined Military Hospital (CMH) Rawalpindi were included in the study. PAPP-A level was determined by enzyme-linked immunosorbent assay (ELISA) method using PR 4100 Microplate Reader®, and serum hCG-β were analysed on random access IMMULITE 2000®.

Results: A total of 135 pregnant women were enrolled in the current study. The mean age of subjects was 27.66 ± 4.24 years, mean maternal weight was 59.91 ± 8.87 kgs and mean gestational age was 10.37 ± 1.16 weeks. Median value of PAPP-A was 1289.43 mIU/L (range: 510.8-5965.99) and hCGβ was 120985 mIU/ml (range: 23592-290000).

Conclusion: Median values of PAPP-A and HCGβ can be used to calculate (Multiple of Medians) MoM during the first trimester in tertiary care setup.
Mandibular Premolar Macrodontia And Its Association With Bilateral Posterior Crossbite; A Case Report
Authors: Hamid Fatima , Bangash Azhar Ali , Khan Mehwish , Tariq Sana
Published: December 2022

Macrodontia presents various complications such as arch length discrepancies, unstable occlusion and esthetic issues.Complex treatment planning and a multidisciplinary approach are required in treating these patients. We have presented two cases of bilateral mandibular second premolar macrodontia associated with a bilateral crossbite.
Ineffective Transition of Patients During Shift Handover Process of Nurses in Private Sector Tertiary Care Hospital of Peshawar, Pakistan
Authors: Khan Asghar , Ali Sardar , Bhatti Joius , Hayat Nasar
Published: December 2022

Objective: To explore the factors hindering the shift handover process of nurses and the types of training in a private tertiary care hospital of Peshawar, Pakistan.

Study Design: Cross-sectional study.

Place and Duration of Study: Northwest General Hospital, Peshawar Pakistan, from Nov 2016 to Aug 2018.

Methodology: The sample population comprised 112 registered nurses with at least one year of experience. A structured questionnaire was used for data collection.

Results: Of the participants, 6 (54.5%) were males, and 51 (45.5%) were females. The mean age of the participants was 27.86 ± 4.57 years. The most prominent alarming factor was messy record 100 (89.3%). 94 (83.9%) participants described interruption by parents' relatives, 97 (86.6%) participants identified staff shortage, difficulty in recognizing essential information was described by 92 (82.1%) study participants and long-working hours was identified by 89 (79.5%) participants. No significant association was found between gender and the working environmental factors.

Conclusion: There are multiple factors that affect the process of shift handover. The health care organizations must ensure proper training of the nursing staff and provide an appropriate environment during shift handover to maintain patient safety.
Success Rate Comparison of Nasolacrimal Duct Probing with and without Assistance of Nasal Endoscope in Congenital Nasolacrimal Duct Obstruction
Authors: Hussain Irshad , Khan Shafaq Pervez , Alam Masood , Abbas Asim , Khan Faisal Aziz
Published: December 2022

Objective: To compare the success rate of nasal endoscopic assisted probing and simple probing in congenital nasolacrimal duct obstruction.

Study Design: Quasi-experimental study.

Place and Duration of Study: Eye department, Combined Military Hospital, Malir Cantt, Karachi, from Feb 2018 to Jun 2019.

Methodology: A total of 100 children were randomly divided into two groups. Each child in both groups underwent probing of the nasolacrimal duct. In one group, simple probing was performed, and patency was confirmed with metal on metal touch. In the second group, a nasal endoscope was employed to visualize probe passage through the opening of the nasolacrimal duct in the inferior meatus. In fracture of the inferior turbinate was performed in every case when a nasal endoscope was utilized. In the simple probing group, in fracture was performed if the inferior meatus was narrow. The rate of epiphora resolution was recorded in both groups at 1-month postoperatively.

Results: The success rate of epiphora resolution was 96% (48 out of 50) in the nasal endoscopic assisted probing-group and 82% (41 out of 50) in the simple probing-group (p=0.02). The simple probing-group had a 40% (20 out of 50) significant nasal bleed, and in the nasal endoscopic-group, the significant nasal bleed was 20% (10 out of 50) (p=0.02).

Conclusion: Nasal endoscopic assisted probing of the nasolacrimal duct has a higher success rate than simple probing in congenital nasolacrimal duct obstruction.
Awareness of Medical Professionals about Common Disinfectants in a Tertiary Care Hospital Against Corona Virus
Authors: Fahim Qanita , Shah Bukhari Karamat Hussain , Khattak Abdul Katif , Uddin Nasir , Sattar Nadia , Malik Nasir Javed
Published: December 2022

Objective: To assess the working knowledge of health care workers (HCW) regarding the appropriate use of disinfectants against Coronavirus in hospital care settings using a questionnaire.

Study Design: Cross-sectional study.

Place and Duration of Study: Combined Military Hospital Lahore, Pakistan, from Apr 2020.

Methodology: Two hundred health care workers were consecutively selected and divided into two groups, irrespective of gender. Each participant had to fill a structured proforma containing twenty-five close-ended questions.

Result: Group-1 participants were 126 (63%) and group 2 participants were 74 (37%). 117 (92.8%) group-1 participants were 20–30 years of age and degree holders while 40 (54%) group-2 participants were 31-40 years old and diploma holders. Significant awareness (p<0.001) regarding disinfectants was observed in group-1 (102 81%); all the degree holders were well aware of disinfectants and required less training. In contrast, in group-2, 44 (59%) were fully aware of disinfectants; the rest did not qualify and needed proper training. Participants with a good educational status and work experience of >10 years were the high achievers in both groups.

Conclusion: This study revealed that majority of the participants knew about the correct usage of disinfectants and they were fully prepared to handle the ongoing pandemic. Another finding was that awareness was directly related to relevant education, prolonged work experience and age
Association of Fear of Childbirth with the Preference for Cesarean Section; A Cross Sectional Study
Authors: Ansari Asma , Irum Samina
Published: December 2022

Objective: To determine the fear of childbirth (FOC) amongst pregnant women and its association with preference for cesarean section.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Obstetrics and Gynecology Pak Emirates Military Hospital, Rawalpindi from Jan 2018 to Jun 2018.

Methodology: Demographic and reproductive data of the patients including mode of delivery, was noted. The intensity of fear of childbirth was measured by Wijma delivery expectancy/experience questionnaire (W-DEQ), and a score was allotted. The total sum of scoring ranged from 0 to 165. A score of >85-99 indicated an intense fear of childbirth, and ≥100 indicated very intense fear. The frequency of requests for cesarean section in women suffering from fear of childbirth was calculated.

Results: A total of 335 patients were included. The mean age was 28.74 ± 3.58 years, and the mean gestational age was 39.50 ± 1.43 weeks. The mean W-DEQ score was 94.59 ± 9.86. The fear of childbirth calculated by W-DEQ in the third trimester of pregnancy showed no fear in 233 (69.55%) participants, intense fear in 42 (12.54%) and very intense fear in 60 (17.91%) women. The requests for cesarean section in women suffering from intense fear were made by 5 (11.90%) women and in women suffering from very intense fear of childbirth was 19 (31.67%) (p-value <0.001).

Conclusion: This study concluded that the intensity of fear of childbirth calculated by W-DEQ amongst pregnant women in the third trimester of pregnancy was relatively high, with a much higher rate ...
Periodontal and Gingival Health of Pregnant Women in Comparison to Non-Pregnant Women
Authors: Butt Hira , Khan Nauman , Tahir Fizza , Piracha Maila Habib
Published: December 2022

Objective: To assess pregnant women's periodontal and gingival health compared to non-pregnant women.

Study Design: Cross-sectional comparative study.

Place and Duration of the Study: Department of Gynecology, Sharif Medical and Dental College, and Raiwind Polyclinic Lahore (Outreach program of the Sharif Medical and Dental College, from Mar 2019 to Aug 2019.

Methodology: The periodontal and gingival health of 44 pregnant and 52 non-pregnant females was evaluated using the community periodontal index of treatment needs and gingival index.

Results: A total of 44 pregnant and 52 non-pregnant were evaluated. The periodontal health and pregnancy status were significantly associated (p=0.008). The periodontal health and the trimester of pregnancy were not significantly associated (p=0.787). There was no significant association between the gingival health of the females with the status of pregnancy (p=0.773). Maximum calculus deposition in the oral cavity of pregnant women was during the third trimester (36.4%).

Conclusion: The pregnant females had a higher percentage of bleeding gums, while calculus deposition was higher in non-pregnant females. Pregnant females had more periodontal pockets of 4-5 mm, while pocket depths of 6mm or more were seen in non-pregnant females only.
Relation of Days on Ventilatory Support to Total Days of Illness in COVID-19 Patients
Authors: Ameer Khalid , Khan Burki Ahmed Mujadid , Khan Rao Ali Shan , Ghani Usman , Yaqub Khan Muhammad , Butt Nabeel Tahir
Published: December 2022

Objective: To determine the relation between days on ventilatory support and overall mortality to total days of pre- ventilator illness in COVID-19 patients.

Study Design: Cross-sectional study.

Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi Pakistan, from Mar to Aug 2020.

Methodology: A total of 140 admitted patients within the prescribed time frame were observed in the established COVIDIntensive Care Units of Pak Emirates Military Hospital, Rawalpindi. The criteria for inclusion in the study were patients of any age and gender on ventilatory support with a confirmatory diagnosis of SARS-CoV-2 both by RT-PCR, and radiological evidence on HRCT Chest.

Results: The mean age of patients was 59.39 ± 13.517 years. Patients who presented with a confirmed diagnosis of COVID-19 and more than ten days of illness with respiratory compromise had a higher occurrence to be placed on mechanical ventilation. There was a strong linear and positive correlation between the total days of illness on presentation and the total days on ventilatory support (p-value <0.01). This linear relationship consequently translated into overall mortality of 78.6% with a 21.4% survival rate.

Conclusion: To conclude, the total days of illness in critical COVID-19 patients had a linear relationship to days on ventilatory support and overall mortality.
EVALUATION OF PATIENT SATISFACTION LEVEL WITH DIFFERENT OUTPATIENT DEPARTMENT SERVICES: A SITUATIONAL ANALYSIS IN A TERTIARY CARE HOSPITAL
Authors: Qureshi Farhan Muhammad , Bari Samira Faiz , Siddiqui Hamid Jamal , Tahir Muhammad , Khalid Kanwal , Rizwan Saba
Published: December 2022

Objective: To evaluate satisfaction of outpatients with respect to administrative services and the level of satisfaction towards the various facilities available in an outpatient department of a tertiary care hospital.

Study Design: Hospital based transverse situational analysis.

Place and Duration of Study: Combined Military Hospital, Malir Cantt, from Nov 2018 to Dec 2019.

Methodology: Data was collected from 756 participants, using an “Outpatient Feedback Form” to evaluate the satisfaction level of patients. Nonprobability, convenient sampling technique was used to select study participants. Data was analyzed in Statistical Package of Social Sciences, version 22.

Result: The patient satisfaction was present in 388 (51%) followed by 235 (31%) participants graded the Outpatient department facilities (OPD) as excellent and good respectively. However, only 16 (3%) were disgruntled with the present OPD administrative and medical service of the hospital.

Conclusion: Overall the study showed a good satisfaction level of patients with OPD services received from the hospital. Hospital administration has managed to deliver excellent quality services towards betterment in every discipline and created an example for other hospitals to become an effective part of the healthcare delivery system.
How Strongly the Body Mass Index (BMI) Is Associated with Inter Arm Blood Pressure Difference
Authors: Alam Muhammad Absar , Rehman Anam , Manzoor Javaria , Zafar Zafar Ali , Jawed Shireen , Altaf Benash
Published: December 2022

Objectives: To explore the association between the body mass index (BMI) and inter arm difference (IAD) blood pressure and to understand how these factors influence blood pressure.

Study Design: Cross-sectional study.

Place and Duration of Study: Aziz Fatimah Medical and Dental College Faisalabad Pakistan, from Nov to Dec 2020.

Methodology: Total 100 healthy medical students aged 19-21 years were included in the study. Height in meters and weight in kilograms were documented by stadiometer (ZT-100). BMI was assessed by Quetelet's index (BMI=weight in Kg/height in m2). Blood pressure was recorded simultaneously in both arms by the auscultatory method. Inter arm difference in blood pressure was estimated by calculating differences in diastolic and systolic pressures between the right and left arm.

Results: Mean age of the participants was 19.83 ± 1.23 years. Significant difference was noted in systolic and diastolic interarm blood pressure among obese and non-obese groups (p-values <0.001). BMI was positively associated with diastolic and systolic inter-arm blood pressure (p-values <0.001).

Conclusion: Body mass index is positively associated with inter arm difference in blood pressure, and both positively impact the blood pressure.
Histo-Pathological Findings of Critical COVID-19 Pneumonia: A Case Series
Authors: Shehzad Farrukh , Naseem Arshad , Din Hafeez Ud , Sajjad Kaswar , Khan Asad Zaman , Zafar Bushra
Published: December 2022

Objective: To study the histo-pathological findings in lung biopsies of critical COVID-19 cases.

Study Design: Case series.

Place and Duration of Study: Pakistan Emirates Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2020.

Methodology: Deceased patients who remained on ventilatory support with a confirmatory diagnosis of SARS-CoV-2 both by PCR and radiological evidence on HRCT and clinically established severity of disease as per CALL scoring were included in the study. Written informed consent for lung biopsy was taken from the deceased's next of kin

Result: Mean age of the study group was 67.20 ± 6.01 years. The patients had a mean high resolution computed tomography score of 36.73 ± 1.59, and the mean CALL score was 12.73 ± 0.691 on admission. The average time after intensive care unit admission to intubation was 1.23 ± 0.50 days. Histopathological examination of the lung biopsy showed 27 (87.1%) patients had the exudative stage of adult respiratory distress syndrome while three (9.7%) patients had a proliferative stage of adult respiratory distress syndrome.

Conclusion: Histopathological findings of an exudative stage of adult respiratory distress syndrome in the lung biopsies of critical COVID-19 showed no significant difference with typical adult respiratory distress syndrome and are correlated with very high mortality rates in critical COVID-19.
Assessment of Microsatellite Instability in Endometrioid Carcinoma by Immunohistochemistry At Armed Forces Institute of Pathology, Rawalpindi
Authors: Arif Ayesha , Akhtar Farhan , Ahsan Ahmed , Din Hafeez Ud , Ahmed Rabia , Ahmed Aminah
Published: December 2022

Objective: To assess microsatellite instability in endometrioid carcinoma by immunohistochemistry expression of MLH1, PMS2, MSH2 and MSH6.

Study design: Case series.

Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from Jun to Dec 2018.

Methodology: Thirty-two cases of endometrioid carcinoma were included in the study. Patient age and menopausal status were recorded. The grade of the tumour was ascertained by microscopic examination. Immunohistochemistry for MLH1, PMS2, MSH2 and MSH6 assessed microsatellite instability.

Results: In our study, eight females (25%) had premenopausal status while 24 (75%) had postmenopausal status. Out of 32 cases, 25 (78.1%) females had grade-I tumours, 4 (12.5%) had grade-II tumours, and 3 (9.45%) had grade-III endometrioid carcinoma. MMR status was proficient in 8 cases (25%) while deficient in 24 cases (75%). Among the 24 cases of MMR deficient endometrioid carcinoma, loss of expression of MLH1 was most frequent n=15 (62.5%), followed by PMS2 n=14 (58.3%) MSH2 n=7 (29.2%). MSH6 was retained in all cases. The most common pattern was a combined loss of MLH1/PMS2 in 12 cases (50%).

Conclusion: As depicted by the high percentage of MMR deficient tumours, microsatellite instability is observed in many endometrioid carcinomas. Patients suffering from endometrioid carcinoma should be screened for Lynch syndrome by testing for MMR status.
Burden of Vitamin D Deficiency in Patients of Chronic Liver Disease
Authors: Manzoor Waqas , Khalid Muhammad Tanveer , Karim Shahid , Kalwar Hamid Ali , Mujtaba Ghulam , Faryal Asheen
Published: December 2022

Objective: To determine the frequency of vitamin D deficiency in chronic liver disease patients.

Study design: Cross-sectional study.

Place and Duration of Study: Gastroenterology Department, Liaquat National Hospital and Medical College, Karachi Pakistan, from Jan to Dec 2020.

Methodology: Patients between the age of 18 to 50 years, of either gender, already diagnosed case of chronic liver diseases for 6 months and had sun exposure of at least 15 minutes twice weekly were included in this study. History was taken after taking informed written consent, the clinical assessment was done, and blood samples were sent for serum vitamin D levels to determine the results.

Results: The study included 177 patients with chronic liver disease. One hundred eleven patients (62.7%) were males and 66 patients (37.3%) were females, with the mean age of 45.0 ± 6.306 years. Vitamin D deficiency was observed in 100 patients (56.5%).

Conclusion: The frequency of vitamin D deficiency was quite high. It increases with age and body mass index and is predominant in the male gender, while no association was noted with sun exposure time.
Sweeping of Membranes for Induction of Labour in Low Risk Term Pregnancy
Authors: Pirzada Hina , Shabir Rabia , Ehsan Ambreen , Tahir Noreen , Saifuddin Zainab , Fatima Ambreen
Published: December 2022

Objective: To determine the frequency of spontaneous labour in the swept and non-swept groups.

Study Design: Quasi-experimental study.

Study and Duration of Study: Department of Gynaecology and Obstetrics, Sheikh Khalifa bin Zayed Hospital, SKBZ Hosp/AK CMH Muzaffarabad, from Nov 2019 to Apr 2020.

Methodology: Patients were randomly divided into two groups (with lottery method). Group-A underwent a sweeping membrane while group-B was the control group. Spontaneous labour and other outcomes were observed in both groups.

Results: A total of 250 women were included in the study. There were 125 women in each group. The mean age of women was 23.4 ± 1.3 years in swept-group and 24.5 ± 1.7years in the non-swept group. The swept-group showed a high frequency of spontaneous labour compared to the non-swept group (24.8% vs 15.2%, p=0.01). Swept-group showed less postpartum haemorrhage (p=0.001), pain (p=0.001), pre-labour membrane rupture (p=0.03) and admission to neonatal intensive care unit (p=0.01).

Conclusion: Sweeping of the membrane is a safe and beneficial procedure for labour induction among low-risk term pregnant women. It is an effective procedure preventing women from reducing the incidence of post-term pregnancy with minimum complications.
In-Vitro Antimicrobial Drug Susceptibility Pattern of Methicillin Resistant Staphylococcus Aureus (MRSA)
Authors: Mubariz Rabia , Yasmin Shahina , Taj Shazia , Butt Tariq , Ellahi Ayesha , Mussarat Uzma
Published: December 2022

Objective: To determine the in-vitro antimicrobial susceptibility pattern of Methicillin-resistant Staphylococcus aureus (MRSA) isolates using an automated VITEK-2 compact system.

Study Design: Cross-sectional study.

Place and Duration of Study: Pakistan Railway Hospital (PRH) Rawalpindi collaborates with the Armed Forces Institute of Pathology (AFIP) Rawalpindi, from Sep 2018 to Aug 2019.

Methodology: 100 MRSA samples were isolated from tissue, pus, urine, blood, high vaginal swabs (HVS) and ear swabs using standard microbiological techniques. MRSA isolates' antimicrobial susceptibility pattern was made using an automated VITEK-2 compact system.

Results: Among 100 MRSA isolates, 63% were obtained from pus and 17% from tissue, respectively. MRSA isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Susceptibility to other drugs has shown wide variation, i.e., Tigecycline 97%, Rifampicin 95%, Clindamycin 86%, Tetracycline 79%, and Cotrimoxazole 78%. The minimum inhibitory concentration (MICs) of Vancomycin and Linezolid against MRSA isolates revealed that 41% had 0.5 µg/ml, 46% had one µg/ml, and 13% had two µg/ml for Vancomycin. Whereas for Linezolid, 38 isolates had MIC 1 µg/ml, then 62 isolates had MIC 2 µg/ml.

Conclusion: All the isolates showed 100% sensitivity to Vancomycin, Teicoplanin and Linezolid. Moreover, being less costly, Clindamycin, Tetracycline and Cotrimoxazole are good oral choices for empirical therapy against minor MRSA infections.
EAR PIERCING: A GATEWAY TO TETANUS
Authors: Mumtaz Hassan , Zaman Nahdia , Zafar Anam , Saeed Tariq , Ahmad Shahzaib
Published: December 2022

Tetanus is initiated by the release of neurotoxins. The progressive paralysis of several muscles is due to contamination of the wound by the toxin. The case under discussion was about a patient with the tetanus infection after ear piercing due to unsterilized instruments and lack of awareness of complications. Due to the late presentation to the hospital, leading to a delay in treatment, the child could not survive. Physicians need to have a vigilant eye to have a high suspicion for tetanus at a very early stage and immediate initiation of advanced critical care, which can favour lifesaving interventions. Prophylactic tetanus toxoid should be administered before any body piercing