bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated mental healthcare and vocational rehabilitation for people on sick leave with stress-related disorders: 24-month follow-up of the randomized IBBIS trial
Authors: Hoff Andreas , Poulsen Rie Mandrup , Fisker Jonas Peter , Hjorthøj Carsten , Nordentoft Merete , Bojesen Anders Bo , Eplov Lene Falgaard
Published: March 2023

OBJECTIVES: Integrating vocational rehabilitation and mental healthcare has shown effects on vocational outcomes during sick leave with common mental disorders. In a previous paper, we showed that a Danish integrated healthcare and vocational rehabilitation intervention (INT) had a surprisingly negative impact on vocational outcomes compared to service as usual (SAU) at 6- and 12-month follow-up. That was also the case with a mental healthcare intervention (MHC) tested in the same study. This article reports the 24-month follow-up results of that same study.

METHOD: A randomized, parallel-group, three-arm, multi-centre superiority trial was conducted to test the effectiveness of INT and MHC compared to SAU.

RESULTS: In total, 631 persons were randomized. Contrary to our hypothesis, SAU showed faster return to work than both INT [hazard rate (HR) 1.39, P=0.0027] and MHC (HR 1.30, P=0.013) at 24-month follow-up. Overall, no differences were observed regarding mental health and functional level. Compared to SAU, we observed some health benefits of MHC, but not INT, at 6-month follow-up but not thereafter, and lower rates of employment at all follow-ups. Since implementation problems might explain the results of INT, we cannot conclude that INT is no better that SAU. The MHC intervention was implemented with good fidelity and did not improve return to work.

CONCLUSION: This trial does not support the hypothesis that INT lead to faster return to work. However, implementation failure may explain the negative results.
Hasil Belajar Matematika Melalui Model PJBL dalam Blended Learning Ditinjau dari Tingkat Integritas Akademik
Authors: Aranggani Dresthya , Prihatnani Erlina
Published: March 2023

Integrity is honest, fair behavior and shows consistency between words and actions. In the field of education, the term academic integrity is known. Academic integrity is behavior that is in accordance with the norms of truth in the academic context. there are five aspects in academic integrity, namely honesty, trust, fairness, respect, and responsibility. Academic integrity is very important to have so that a person behaves ethically in the learning process. a decrease in academic integrity has the potential to affect students' professional lives when working later. Lack of integrity in academics in a person can be influenced by several factors, both internal and external. The internal factor causing the lack of integrity is academic anxiety. This happens because of the worries that arise over failure in the exam, so students do various ways to get good test scores. the purpose of this study is to determine with the application of the PjBL learning model, whether there are significant differences in learning outcomes between students with high, medium and low integrity. The project given in the application of the PjBL model is expected to provide a different, fun, meaningful and challenging learning experience for students. The method used in this research is through cluster random sampling technique. The application of PjBL in blended learning with a project-shaped evaluation model produces the same learning outcomes for the three integrity groups. With the highest average learning outcomes coming from the medium integrity group followed by the high integrity group and the lowest average coming from the low integrity group.
A Study of Dalit Feminism in Bama's Sangati
Authors: Chetna Gorasya
Published: March 2023

Patriarchy is considered to be a big rival of women literature. In association with this, exploitation or oppression of weaker by stronger is nothing new. Feminism or feminist aspect deals with society in general and woman in particular. ‘The Woman’ and ‘The Dalit’ are marginalized, hegemonized and downgraded. This paper examines the varied underlined, invisible ways of sufferings embedded in the lives of the Dalit community, particularly women and their lived experiences portrayed in Bama’s Sangati. It also discusses how Dalit women are constantly exploited by the powerful caste- Hindus and experiences faced by the two protagonists: Mariamma and Maikkanni in the novel. In the light of this background the paper delineates how Bama analyzed and characterized many individual stories in Dalit life.
Chasing the Shadows: A study of The Half Mother
Authors: Maryah Charoo
Published: March 2023

The three decade old armed conflict in Kashmir has claimed thousands of lives, left hundreds homeless and rendered numerous youth missing. The vacillation of the Kashmir issue has raised a furore and frenzy among the people and it has been registered and documented in various literary and non-literary genres. The narratives about the state of conflict and its impact on the populace are tendentious, written from extrinsic and probative positions that fall in the ambit of mainstream narratives. Lately, the indigenous writers from Kashmir have registered the grim accounts of the impact of insurgency and militancy in the state and the unabated military action. The native writers have a firsthand account of the events of the turmoil. One such writer Shahnaz Bashir’s The Half Mother is a doleful story of Haleema, the protagonist who is an epitome of valiance and courage. It is a woeful tale of a grief stricken mother who loses her only son to the enforced disappearance at the hands of the armed forces In this paper, I aim to highlight the importance of the native Kashmiri writers in bringing out the honest and truthful accounts of the impact of militancy on the contemporary Kashmiri literature.
Un'anca molto raffreddata
Authors: Carraro carolina
Published: March 2023

The case of a 3-year-old girl presenting with right hip pain and persisting limp is described. The diagnosis of adrenal neuroblastoma with femoral metastasis was finally made.
Association of Low Ferritin Level of new Born with Iron Deficiency Anemia in Mothers
Authors: Zahoor Saiqa , Latif Aqsa , Khan Hammad , Khalid Maida , Kanwal Bukhari Syeda Zainab , Ambreen Shazia
Published: March 2023

Background: Iron deficiency and iron-deficiency anemia (IDA) affect around 2 billion individuals all over the globe. IDA is a problem for pregnant women in developing countries. Objective: To assess the association of low ferritin level of new born with iron Deficiency Anemia in Mothers Methodology: The current descriptive study was carried out at the Hematology Department, Hayatabad Medical Complex, Peshawar from January 2022 to July 2022. All the data including age, gender and lab parameters was documented in a proforma designed for this research. IBM SPSS version 23 was employed for analysis of data. Results: In the current research, totally 150 antenatal mothers having hemoglobin ≤10.5gm/dl were enrolled. The mean age of our study participants was 26 years with standard deviation of ±1.56. Among pregnant women with iron deficiency, the overall frequency of low ferritin level was 90 (60%). In distribution of women based on severity of low ferritin levels amongst 90 women, 41 (45.56%) women were observed with mild low ferritin levels, 43 (47.78%) women were observed with moderate low ferritin levels while 6 (6.66%) women were observed with severe low ferritin levels. Conclusion: In the present research, it was shown that there was a high frequency of low ferritin levels in newborns amongst women with iron deficiency anemia during pregnancy. Based on our findings we concludes that low ferritin level of newborns is strongly associated with the with iron Deficiency Anemia in Mothers. Keywords: Iron Deficiency Anemia; Ferritin levels; Pregnancy
Prevalence of Celiac Disease Amongst Patients with Chronic Diarrhea: A Cross Sectional Study
Authors: Shah Naseeb Ur Rehman , Khan Samiullah , Khan Muhammad Omar , Alam Mohsin Ul , Khan Radhia , Razaq Adan , Razaq Abdul
Published: March 2023

Background: An autoimmune disease called celiac disease (CD) causes intolerance of gluten in genetically predisposed individuals. Celiac disease may exhibit a variety of clinical signs, making it difficult to diagnose based purely on symptoms. Objective: To find out the prevalence of celiac disease amongst chronic diarrhea patients Methodology: The current study was cross sectional carried out at the department of Medicine, Khalifa Gul Nawaz Teaching Hospital, Bannu Medical College Bannu from August 2022 to January 2023. All the laboratory examination like blood smear, stool routine examination serum calcium and serum albumin was done. The serological tests for celiac disease like IgA anti TTG and IgG anti TTG was also determined. All the data was documented in a proforma designed for this study. All the data collected was analyzed by employing IBM SPSS version 23. Results: Amongst total 140 patients, the male patients in our study were 67 (47.86%) whereas female patients were 73 (52.14%). The mean age (SD) in the current research was 34 (7.12) years. The overall celiac disease prevalence amongst chronic diarrhea patients was 18 (12.86%). Conclusion: Our study concludes that the prevalence of celiac disease amongst chronic diarrhea patients is very high. Keywords: Prevalence; celiac disease; chronic diarrhea
Frequency of Cesarean Section in Patients Presenting with Non-Reactive Cardiotocography (CTG)
Authors: Unar Asma , Zaheen Aneela , Jatoi Shazia Ahmed , . Maria, , . Zakia , Irum Fozia , Aamir Kiran , Naz Aasma
Published: March 2023

Objective: Aim To determine frequency of cesarean section in patients presenting with non-reactive cardiotocography. Study Design: Descriptive study Place and Duration: Obstetrics and Gynaecology Unit-II at Peoples University Hospital Nawabshah. Feb 2021-August 2021 Methods: This study included 156 women had age 20-45 years admitted to the labour room through OPD and ER with uterine contractions. Antepartum and intrapartum CTG revealed abnormal results. Physical examination and CTG determined delivery mode. SPSS v25.0 examined and entered data. Chi-square was used post-stratification. Significant p-values were <0.05. Results: There were 82(52.6%) patients were in 18-30 years age group and 74(47.4%) were in 31-40 years age group. According to gestational age distribution, 86(55.1%) were from 37-38 weeks gestational age group and 70(44.9%) from 39-40 weeks gestational age group. Majority of the patients 97(62.2%) had rural residence and 59(37.8%) from urban area. Among all 11(7.1%) were obese and 19 (12.2%) had anemia. We found that 58(37.2%) cases had low income, while 42(26.9%) and 56(35.9%) had middle income and high income respectively. Frequency of C-section was found in 72(46.2%). Conclusion: Due to the high false positive rate of cardiotocography monitoring in labor, women are more likely to have a caesarean section. Other tests, such as fetal scalp electode and fetal pH, should be done to diagnose fetal distress before having one. Keywords: C-section, Non-reactive cardiotocography, Anemia, Obesity
To Determine the Effect of Prothrombin Time (PT), Activated Partial Thrombopalstin Time (APTT), and International Normalized Ratio (INR) Levels on Gender and Age
Authors: Sultana Aysha , Hussain Fida , Asif Razia , Bhutto Amanullah , . Shabnam , Ali Azhar , Aamir Kiran , Ramzan Aamir
Published: March 2023

Background: Hepatic function, coagulation disorders, and the risk of postoperative bleeding can all be detected with PT assay. When it comes to measuring "extrinsic route" coagulation factors, the PT is the most commonly used test. It is possible to check for a lack of intrinsic or common route factors by measuring the duration to trigger partial thromboplastin (aPTT). A solution to the problem of inconsistent PT measurements among laboratories was the creation of the International Normalized Ratio (INR). Laboratory-specific reference intervals can have a significant impact on the quality of patient treatment by influencing clinical decision-making. Objective: The purpose of this study is to determine if gender and age affect PT, International normalised ratio (INR), and aPTT levels in people without known liver disease or anticoagulant therapy. Method: Between July and December of 2021, patients without a past history of bleeding were admitted to the LUMHS Hyderabad civil hospital for minor surgical procedures (inguinal/umbilical hernia repair, caesarean section, rectal polyp excision, and diagnostic cystoscopy). There were 2274 patients in all, with 766 males and 1508 females. According to their chronological age, patients were separated into three groups. The study sampled 268 men and 22 women aged 0-14, 222 men and 1335 women aged 15-50, and 151 women and 276 men in the third age range (over the age of 50 year). Systemex CA-500 auto analyzer was used to conduct the analyses. Results: Males and females have considerably different PT and INR values. Men and women between the ages of 15 and 50 were more likely to have increased PT, INR, and aPTT readings than those between the ages of 0 and 14. Males and females between the ages of zero and fourteen had the lowest aPTT levels. Between the ages of 15 and 50, women and men had higher PT, INR, and aPTT values than women and men over 50. PT, INR, and aPTT reference values based on a 95% confidence interval for men and women, as well as sexes and ages. Conclusion: In this arena, a dearth of study has established that gender and age have little effect on PT, INR, and aPTT levels. Gender and age disparities in clinically used reference ranges for PT, INR, and aPTT must be taken into account. Keywords: Prothrombin Time, INR, APTT, Outcomes
Frequency of Portal Vein Dilatation in Chronic Liver Diseased Patients through Ultrasound
Authors: Ahmed Maneeza , Khan Sahar , Ullah Habib , Ullah Atiq , Zaman Aqal , Ullah Rizwan
Published: March 2023

Background: Cirrhosis is one of the chronic liver disease in which the liver cells get fibrose and healthy tissues converted into scar tissues. The scar tissues compress the sinusoidal space in which portal vein drains, this causes pressure in portal vein and due to the backflow of blood the portal vein dilates. Portal vein dilatation in chronic liver disease patients leads to various complications. The objective of this study was to find out the frequency of portal vein dilatation in chronic liver disease patients and correlate it with age, gender, smoking, spleen size and ascites. Methods: This cross-sectional study, which involves the convenient sampling techniquewas conducted at Shangla hospital Swat conducted in 2022 with sample size of 171 patients from World Health Organization calculator, out of 171 , 2 patients did not give response, so we included 169 patients.. confidence level taken is 95%. The level of significance is 5% and Prevalence is 20%. Data was collected through a standard and validated questionnaire which included three portions. 1st portion of questionnaire contained written informed consent. 2nd portion contained demographic profile of the patient. 3rdportion of questionnaire contained all the sonographic findings. Data were analyzed through SPSS version 22. Correlation, spearman and pearson tests were applied. Result: There were total of 169 patients consisted of 102 males and 67 females. Out of 169 patients 53 were having normal portal vein diameter and 116 were having portal vein dilatation. Portal vein diameter is not affected by gender. Age and smoking are associative factors of portal vein dilatation. Ascites occurs in chronic liver disease patients due to dilated portal vein. Portal vein dilatation does not affect spleen size. Early detection of liver diseases and diagnosis of focal and diffuse parenchymal disease can be made possible with ultrasound because its first line of investigation, its efficiency is 95%, its noninvasive, easily available in the backward areas and various factors such as liver size, shape changes, liver markings, echogenicity, nodular pattern, portal vein diameter, inferior vena cava irregularity and spleen size can all be timely detected with ultrasound and life can be saved. Conclusion: It is concluded in this study that portal vein dilatation increases with age and is more common in middle aged people, gender and spleen size does not show any relation with portal vein dilatation. Ascites increases with portal vein dilatation and smoking is also an associative factor for portal vein dilatation in chronic liver disease patients. Keywords: Chronic liver disease, ultrasonography, portal vein dilatation, portal hypertension, cirrhosis, parenchymal disease.
Compare the Role of 5% Phenol in Almond Oil and Injection Sodium Tetradecyl Sulfate in the Treatment of Rectal Prolapse
Authors: Iqbal Javed , Kamal Arshad , Kumar Suresh , Chaudhry Abid Rafiq
Published: March 2023

Objective: To compare the role of 5% Phenol in Almond oil and Injection Sodium Tetradecyl Sulfate in the treatment of rectal prolapse. Methods and material: This study was conducted at Pediatric Surgery Department, Mayo Hospital Lahore. A total of 100 patients were included in the study and randomly divided into 2 groups. In Group-A patients were given 5% Phenol in Almond Oil and in Group-B patients were given Sodium Tetradecyl Sulfate. Patients were followed up at 1st post operative day and at 1st post operative month to see recurrence or any other complications (bleeding, perirectal inflammation, urinary retention, ischiorectal abscess, and necrosis of the rectal mucosa) in cases in both treatment groups. Results: In Group-A mean age was 5.63±3.34 years and in Group-B mean age of children was 7.16±2.80 years. In Group-A 46 and in Group-B 39 children were included.. There was significant association between treatment groups and outcome on 1st postoperative day reduction (P < 0.05). In Group-A 5 and in Group-B 1 child had bleeding PR after postoperative day. No statistically significant association was present between treatment groups and bleeding PR after POD (P > 0.05). In Group-A 49 and in Group-B 44 children had achieved reduction when observed at one month follow up time period. In Group-A reduction was achieved in greater number of patients as compared to that of Group-B patients (P < 0.05). Practical implication: Current study will bring a revolution in the awareness of community amoung rectal prolapse problem and treating it successfully with the knowledge provided with the current literature. The role of 5% Phenol in Almond oil and Injection Sodium Tetradecyl Sulfate is well shown which proven to be a good treatement in Rectal prolapse. Conclusion: We conclude that 5% Phenol almond oil is more effective than Sodium Tetradecyl Sulfate in treating rectal prolepses. i.e., after the one-month follow-up, the post-operative decrease was 98% vs. 88 percent. Keywords: Rectal submucosa, ischiorectal abscess, ulceration, polyps, inflammation, idiopathic rectal prolapse,Etiology.
Megrment the Level of SDF1-Α in the Serum of Patients with Urinary Tract Infection and Patients with Vaginal Infection
Authors: Ali Ahmed Abbas , Ibrahim Hayder Hamzah
Published: March 2023

Urinary tract infection, Bacterial vaginosis as one of the global threats affecting millions of women and causing some time deaths around the world. Objective: This study aims to assess levels of SDF1 and IgA in patients with Urinary tract infection, Bacterial vaginosis, and people enjoying good health as a control group. Methods: Collecting medical information from (180) participants in the Imam Al-Sadiq General Teaching Hospital in Iraq-Babylon, the Gynecology Consultant, according to specific criteria, the subjects were divided into three groups: the control group, the patients (UTI, BV), while the demographic study included age, education, Jobs, and living Laboratory results, signs and symptoms, SDF1-α and IgA levels were assessed by the enzyme-linked immunosorbent assay (ELISA) technique. Results: The results revealed that there were significant variations in SDF1 and IgA between the UTI group, BV group, and control groups. SDF1 level with the UTI group was (1.206522 ±.0927277 pg/ml) and for patients with BV was(1.213735 ±.0661389 pg/ml) whereas the control group appear was (1.130013±.0496400 pg/ml), IgA level in the UTI patients was (64.252983 ± 7.5946759pg/ml) and patients with BV was (60.441928±6.1457661pg/ml) whereas the control group appears was (48.011745 ±4.7938613 pg/ml) Conclusion: They can be considered good indicators to give knowledge about the diagnosis of urinary tract infection and bacterial vaginosis, and help doctors to give appropriate medications. Keywords: Urinary tract infection, bacterial vaginosis, stromal cell-derived factor 1-alpha, Immunoglobulin A.
Comparison of Outcome in Unilateral and Bilateral Sphinctorotomy in Patients of Haemorrhoidectomy
Authors: Rehman Ayesha , Rana Rabail , Liaquat Kamran , Tahir Farheen
Published: March 2023

The anal canal is the site of the dilated veins known as haemorrhoids. They're essential for achieving and maintaining complete continence. In the anal canal, they can be either internal or external. Haemorrhoids can cause pain, pruritis, mucous discharge, mucosal prolapse, bleeding (which is often painless), and brilliant red haemorrhage. 2 There are four different types of haemorrhoids, ranging from first degree (just bleeding) to fourth degree (prolapse and stay reduced on reduction) (permanently prolapsed).3 Even though every case of haemorrhoids bleeds, there are different categories based on how far the haemorrhoids have prolapsed. Only when things get complicated do you see any signs. 4 Objective and Methodology: This research aims to compare the rates of pain experienced by patients after undergoing haemorrhoidectomy, lateral internal sphincterotomy, and bilateral internal sphincterotomy. A Randomized Controlled Trial (RCT) study design was used for this investigation. The investigation took place at the Surgery Department of Allied Hospital in Faisalabad (March to September 2021). In all, 140 patients aged 25-65 with severe haemorrhoids (grades III and IV) were chosen. Any neurological deficiency or chronic pain syndrome, renal disease, or bleeding disorders, as well as patients with recurring haemorrhoids or other anorectal pathology (fistula in ano, anal fissures, etc.), were not included in the study. Hemorrhoidectomy with bilateral internal sphincterotomy (Group BL) and hemorrhoidectomy with lateral internal sphincterotomy (Group UL) were performed on patients. After 24 postoperative hours, all patients were evaluated for postoperative pain. Results: Patients in Group BL had a mean age of 45.36 10.33 years, whereas those in Group UL had a mean age of 43.94 10.22 years. A whopping 76 (54.29%) of the patients fell within the 25-45-year-old age range. The ratio of male to female patients was 2.1:1, with 95 males (67.86%) and 45 females (32.14%) in a total of 140 patients. Pain was experienced by 4 (5.71%) of my patients following haemorrhoidectomy with bilateral internal sphincterotomy and by 25 (35.71%) of my patients following haemorrhoidectomy with lateral internal sphincterotomy (p 0.0001). Conclusion: Patients undergoing hemorrhoidectomy were less likely to experience postoperative pain if bilateral internal sphincterotomy was performed. Keywords: Haemorrhoids, internal sphincterotomy, post-operative pain.
Factors Causing Lack of Interest in Clinical Research Among Postgraduate Trainees at Peoples University of Medical & Health Sciences for Women, Shaheed Benazir Abad. A Mixed Method Study
Authors: Tabassum Rafia
Published: March 2023

Background: Conduct of clinical research requires time, resources, dedication, enthusiasm, willingness, knowledge, training of research methodology, and practical skills. Postgraduate medical students show lack of interest towards clinical research attributed to a diverse group of causes. Objectives: The objective of current mixed method study was to evaluate factors contributing to lack of interest in clinical research among PG trainees at PUMHSW SBA. Study Design: This is a Mixed Method Study. Place and Duration of Study: This study was conducted at Peoples University of medical & health sciences for women Shaheed Benazir Abad Sind (PUMHSW - a public sector medical university) from September to November 2022. Methodology: After taking approval from the Institutional Ethical review committee and obtaining written informed consent from the 50 participants selected by purposeful sampling. Two focus group discussions (FGD) were arranged, which were recorded and transcribed. Thematic content analysis of these transcripts was carried out. In the subsequent phase the predesigned validated questionnaire was used and analyzed using descriptive statistics. Results: A total of 92% (46/50) responded, of those 21 were females. The knowledge regarding research and its methodology was 89-93%. Eighty-nine percent strongly agreed to include research in the curriculum and believed that it would facilitate better patient outcome and clinical practice (89.1%). All respondents opined that faculty and mentors play a crucial role in the conduct of research. Factor hindering interest in research were lack of previous exposure to research (54.3%), lack of research curriculum (45.7%), deficient statistical support (43.5%), disinterested faculty (30.4%), lack of time due to heavy ward duties (39.1%), and family commitments (37%). Practical Implication: Conduct of clinical research requires time, resources, dedication, enthusiasm, willingness, knowledge, training of research methodology, and practical skills. Current study will provide help to the new researchers to solve their research hazards for new and innovative developments. Conclusion: Majority of the participants had some knowledge about research and its positive impacts on clinical practice. Factors identified to cause lack of interest included lack of research curriculum, statistical support, time, previous knowledge, financial and family issues. Keywords: Clinical research, factors, lack of interest, attitude, post graduate trainees.
Effect of Combined Oral Contrraceptive Pills on Serum Total Cholesterol and Body Mass Index in Females of Reproductive Age Group
Authors: Faryal Uzma , Jadoon Madeeha , Shoukat Sofia , Ahmad Angbeen , Rashid Shazia , Shaheen Rifat
Published: March 2023

Objective: to find out the effect of combined oral pills on serum total cholesterol as well as Body mass Index (BMI) in two groups: females who were not using any method of hormonal contraceptives (controls) and the subjects using combined oral contraceptive pills in their reproductive age (15-49yrs) Material and Methods: This study was created and executed for this goal at Hazara University in Mansehra. Two groups of 200 married, fertile women who were not pregnant or nursing were created: Group 1 consisted of controls (females who did not use any hormonal contraception), and Group 2 consisted of participants taking combination oral tablets (COCs). The laboratory derived variables studied was serum total cholesterol. BMI was calculated. It was decided to use a 5% level of significance (p0.05). With the help of Pearson's correlation coefficient r, the relation was established. Results: Serum total cholesterol showed a statistically significant difference. BMI and serum TC did not statistically associate with one another. BMI and serum total cholesterol were positively connected in group 1 and negatively correlated in group 2, respectively. Conclusion: This study facilitated to find out a simple and save method for an efficient and reliable mode of hormonal contraception for practice by general population Keywords: Hormonal contraception, combined oral pills, serum total cholesterol
Correlation Between Pre-Operative Vitamin D Deficiency and Incidence of Hypocalcemia Following Total Thyroidectomy in Hyperthyroid Patients
Authors: Naz Gul , Rizwan Muhammad , Rasheed Zahid , Ali Imran , Mirza Natasha Kanwal , Jameel Muhamamd Khurram , Hameed Fawad
Published: March 2023

Objective: This study was designed to determine whether or not "hypocalcemia following complete thyroidectomy in hyperthyroid patients was associated with preoperative vitamin D insufficiency." Methodology: This research was carried out in the West Surgical Ward of Mayo Hospital in Lahore, Pakistan. Total 60 patients were included in the study. Patients were divided in two groups i.e. Vit-D deficient group “with vitamin D deficiency” and Vit-D sufficient group “without vitamin D deficiency”. All the patients underwent total thyroidectomy preserving parathyroid glands performed by the same team of surgeons. Patients were assessed for signs and symptoms of hypocalcemia. Serum calcium was measured at day of surgery, post-operative day-1 and at the end of 2 weeks on follow up after surgery. Results: The mean of age in the Vit-D deficient group was 38.87±9.31 and in Vit-D sufficient group was 37.70±8.56. Majority of patients in the Vit-D deficient group were females (70.0%). In Vit-D deficient group, 13(43.3%) had hypocalcemia, while 5(16.7%) in Vit-D sufficient group (p-value 0.024). Conclusion: Pre-operative VDD “vitamin D deficiency” is linked with postoperative hypocalcemia increased occurrence after total thyroidectomy. There is a “positive correlation of preoperative vitamin D deficiency on postoperative hypocalcaemia after total thyroidectomy in patients of hyperthyroidism”. Keywords: Hyperthyroid, Total Thyroidectomy, Hypocalcemia, Vitamin D deficiency
Evaluation of Radon Concentrations in some Samples of Dwellings of Lung Cancer Patients and Healthy Using CR-39 in Iraq
Authors: Kadhim Haneen Waheed , Hady Heiyam Najy
Published: March 2023

Lung cancer is considered a disease that is completely happened by smoking; therefore, it is preventable perfectly. Yet, a small percentage of cases is there, possibly as many as 5 to 15%, in which there are other reasons. The risk factors acknowledged for the other groups comprise passive smoking, family history of cancer, occupational expo sure to certain chemicals and ionizing radiation, and diet. Moreover, a fifty samples from the dwelling of lung cancer patients were compared with twenty healthy volunteers. The study aims at identifying the dangers of radon gas in the dwelling of infected patients and the control group, clarifying how it contributes to increasing the risk of lung cancer. To achieve the aim of the study, the researcher used nuclear track detectors CR-39 , baguettes and TASLIMAGE System . Keywords: Lung cancer, CR-39 Detector, Radon gas for dwellings, Iraq.
Comparison Between Prophylactic use of Atropine and Glycopyrolate in Prevention of Spinal Induced Hypotension in Patients Undergoing C-Section
Authors: Khalid Laila , Aziz Khawar , Qayoom Aqil , Sirajuddin Muhammad , Asghar Ali , Tahir Ayesha
Published: March 2023

Objective: The purpose of this study is to compare the efficacy of atropine and glycopyrrolate in reducing the risk of hypotension caused by spinal anesthesia in patients undergoing caesarean sections. Methods: After ethical approval from institution review board, this randomized control was carried out at Liaqat national hospital and medical college. 332 pregnant women in a row who had chosen to have a caesarean section were enlisted through non-probability consecutive sampling technique. Subjects were randomly assigned to one of two groups of 166 using computer-generated randomization tables. Group A Patients received intravenous atropine in dose of 0.01mg/kg before inducing spinal anesthesia. Group B Patients received intravenous glycopyrrolate in dose of 0.01mg/kg before inducing spinal anesthesia. Pre-surgical, operational, and post-operative treatment for all patients was adhered to the same established protocols. Results: The mean age of the participants in both study groups were 26.28±4.03 and 26.07±3.78 years. The mean weight of the participants in both study groups were 75.24±7.6 and 74.17±7.54 Kg. The mean gestation age of the participants in both study groups were 38.82±1.17 and 38.70±1.19 months. The heart rate (HR) 15-minutes after the administration of atropine in group A was 94.89±11.8, and in Group B after administration of glycopyrrolate was 98.18±11.5. A significant difference (P=0.045) in the mean HR of the participants in both study groups was observed. The Mean Arterial Pressure (MAP) 15-minutes after the administration of atropine in group A was 76.63±7.9, and in Group B after administration of glycopyrrolate was 79.6±10.5. A significant difference (P=0. 0.029) in the mean MAP of the participants in both study groups was observed. Conclusion: Glycopylorate, atropine, spinal anesthesia, hypotension, heart rate
The Effect of Single Dose Dexamethasone on Postoperative Pain and Post Operative Nausea Vomiting in Patients Undergoing Breast Surgery Under General Anaesthesia
Authors: Khalid Laila , Aziz Khawar , Qayoom Aqil , Sirajuddin Muhammad , Asghar Ali , Tahir Ayesha
Published: March 2023

Objective: The primary purpose of this study is to assess the efficacy of intravenous dexamethasone in preventing postoperative nausea and vomiting in patients who have had breast surgery under general anesthesia. Methods: After ethical approval from institution review board, this randomized control was carried out at Liaqat national hospital and medical college. Seventy-four patients who completed the study's criteria and provided written informed permission were enrolled in a random order. Patients were recruited and then randomly assigned through balloting without replacement to one of two groups: (A) dexamethasone (n = 37) or (B) placebo (n = 37). After general anesthesia, patients in Group received 0.1mg/kg of dexamethasone intravenously at the same time. Patients in Group B received a placebo (2 ml of normal saline 0.9% at the same time following general anesthesia). Mean arterial blood pressure (MAP), heart rate (HR), respiration rate (RR), and the intensity of pain and vomiting was measured at 0 (in the operating room), 30, 60, and 120 minutes, and 4-, 6-, 12-, and 24-hours following surgery. Results: The mean age of the participants in both study groups were 48.56±15.25 and 50.4±16.8 years. The mean anesthesia time of the participants in both study groups were 114±9.6 and 122.7±8.7 minutes. The mean surgery time of the participants in both study groups were 88.2±2.1 and 96.1±3.72 minutes. No significant difference in the heart rate (HR) was observed in both study groups at any time interval. A significant difference in the heart rate was observed in both study groups at 6-, 12-, and 24-hours’ time interval. A significant difference in the heart rate was observed in both study groups at 0 and 30 minutes, 1-,2-,4-, 6-, 12-, and 24-hours’ time interval. Conclusion: There were no notable changes in vital signs associated with the use of intravenous dexamethasone for the treatment of postoperative pain, the need for rescue analgesia on postoperative day 1, or the occurrence of postoperative nausea and vomiting. Keywords: Visual analog score, nausea, vomiting, pain, dexamethasone
Efficacy of Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine Alone in Lower Segment Caesarian Section Patients
Authors: Tahir Ayesha , Aziz Khawar , Iftikhar Arif , Sirajuddin Muhammad , Asghar Ali , Khalid Laila
Published: March 2023

Objective: This research aims to compare the effectiveness of intrathecal bupivacaine combined with dexmedetomidine to bupivacaine alone in patients having caesarian procedures. Methods: This randomized, controlled study was conducted at in operation theatre in Liaquat national hospital, with the agreement of the hospital's institutional review board. There were 272 patients total, and they were split evenly in two groups of 136 using non-probability consecutive sampling technique. Group A: Patients received subarachnoid block (2 ml of 0.5 % hyperbaric bupivacaine and 10 micrograms of normal saline). Group B: Patients received subarachnoid block (2 ml of 0.5 % hyperbaric bupivacaine and 10 micrograms of dexmedetomidine at L3-L4 or L4-L5 inter-vertebral space). Before the induction of anaesthesia, the patient's systolic blood pressure (BP), diastolic blood pressure (BP), mean arterial pressure (MAP), heart rate (HR), and peripheral capillary oxygen saturation (SPO2) will be monitored Results: The mean age of the participants in both study groups were 27.14±5.3 and 25.9±3.65 years. A significant difference in the mean systolic blood pressure of the participants in both groups as observed at 15-, 45- and 60-minutes interval (p=0.000). The mean time interval from blocks to shivering occurrence in the participants in both study groups were 57.08±3.8 and 81.03±2.8minutes. A significant difference (P=0.000) in the mean time interval from blocks to shivering occurrence in the participants in both study groups was observed. 49% participants in the groups experienced shivering while 24% in group B. Conclusion: From our findings, we infer that adding 10µg of dexmedetomidine to strong bupivacaine in SA may reduce the frequency and severity of shivering without causing any serious side effects.
Prevalance of Burnout Syndrome Among Anaesthesia Residents in Tertiary Care Hospitals of Karachi
Authors: Tahir Ayesha , Aziz Khawar , Iftikhar Arif , Sirajuddin Muhammad , Asghar Ali , Khalid Laila
Published: March 2023

Objective: The purpose of this study is to assess the incidence of burnout syndrome among Karachi's anesthesiology residents in teaching hospitals. Methods: This cross-sectional research was undertaken at tertiary care hospitals of Karachi. Ethical committee permission, authorization from institutions, and agreement from residents were all required before data collection from 144 anesthesiology residents could begin. Participants were recruited from both public and private healthcare facilities. The demographic data from a questionnaire was used to determine the prevalence of the burnout syndrome, which is defined by feelings of emotional tiredness, depersonalization, and decreased personal accomplishment. SPSS was used to generate descriptive statistics. Results: The mean working hours of the participants in government and private hospitals were 64.21±12.40 and 90.24±25.01 hours. A significant difference (p=0.000) in the mean working hours of the participants were observed in participants at government and private hospitals. Emotional exhaustion score of the participants in government and private hospitals were 15.72±11.56 and 22.69±11.20. A significant difference (p=0.002) in the mean emotional exhaustion score of the participants were observed in participants at government and private hospitals. Depersonalization score of the participants in government and private hospitals were 8.79±6.71 and 12.82±7.59. A significant difference (p=0.004) in the mean depersonalization score of the participants were observed in participants at government and private hospitals. Reduced personal achievement score of the participants in government and private hospitals were 12.97±11.96 and 19±12.65. A significant difference (p=0.002) in the mean reduced personal achievement score of the participants were observed in participants at government and private hospitals. Conclusion: We observed the variation in burnout of private hospital versus government hospital. Residents working in private hospital work for extensive hours as compared to government hospital residents. There is an extensive need of comprehensive support groups, humane number of working hours, improved de-stressing activities for mental health of resident physicians and enhance their productivity. Keywords: Burnout, emotional exhaustion, depersonalization, Reduced personal achievement
Factors Linked with Prognosis in Epithelial Ovarian Cancer: A Study From Lahore, Pakistan
Authors: Hussain Rizwana , Khaliq Saba
Published: March 2023

Background: Current study compared prognosis variables in epithelial ovarian cancer regarding survival and expired status with follow up of 30-36 months. The variables analyzed for prognosis were age, BMI, marital status, FIGO stage, Type of tumor and parity. Identifying the factors affecting prognosis give insight of disease variation among ethnicities. Objective: It was assumed that certain factors are linked with prognosis of ovarian cancer. Therefore, the factors like age (premenopausal and postmenopausal), BMI normal (25-29) and non-normal (>30), marital status (Married and unmarried), FIGO (I-IV) stage of tumor, tumor type (Malignant and borderline) and parity status (nuliparous, primiparous, multiparous) were analyzed. Study Design: This is a Retrospective Study. Place and Duration: Current study is a part of PhD research work and the period of this research was from July 2018 to July 2019. All the subjects of study were followed back after 30–36-month interval gap (2021-2022) from sample collection date to follow up date, and survival status was investigated. Methodology: This study was conducted on 70 diagnosed epithelial ovarian cancer who were recruited for PhD research project. After the completion of study the participants were followed up after gap of (average) 30-36 months from sample collection time. Data was fetched telephonically from alive patients themselves while from first degree relatives of those who were found expired when traced. Results: This study reported non-significant impact of Age (Premenopausal, postmenopausal), BMI, tumor Type, marital status and Parity on prognosis of ovarian cancer. However, this study reported significant association of FIGO stage of tumor with prognosis of survival with p=0.016. Practical Implication: The second most frequent gynecological cancer is ovarian cancer, which has a 40% to 45% 5-year survival rate. Based on prognostic criteria, this ratio ranges from 15% to 95%.1 Prognosis is influenced by a wide range of clinical, pathological, and biological aspects. In this study, prognostic variables for advanced epithelial ovarian cancer were evaluated. Factors linked with prognosis of ovarian cancer are shown which will spread awareness in the community regarding Ovarian Cancer and bring some change in the community. Conclusion: Therefore, it was concluded that BMI, Stage of tumor, Type and Parity impose impact on life of women being diagnosed with ovarian cancer. Keywords: Ovarian cancer, prognosis, FIGO, parity, BMI, Chemotherapy, EOC, Premenopausal
Risk of Retinopathy of Prematurity Among Preterm with Neonatal Sepsis in a Tertiary Care Hospital a Prospective Study
Authors: Afzal Amir , Omer Riffat , Kumar Manjoor , Naveed Khani Muhammad
Published: March 2023

Objective: To determine the risk of retinopathy of prematurity (ROP) among preterm with and without sepsis admitted in a neonatal intensive care unit of a tertiary care hospital of Karachi, Pakistan. Methodology: In this prospective cross-sectional study conducted at Aga Khan University Hospital from October 2021 to March 2022. All the preterm born at gestation <32 weeks with birth weight of <1.5kg and were <28 days old of either gender was included. Examination for ROP was performed. Information about maternal and neonatal confirmed sepsis, risk factors predisposing to sepsis, ROP status were noted. Babies were followed in the outpatient clinics. The first examination was performed at 28th days and was subsequently followed at one or two week’s interval as per the Ophthalmologist. Results: Of 125 neonates, the mean age was 4.34 ±0.79 weeks. There were 72 (57.6%) males and 53 (42.4%) females. Stage 0 and 1 were most common stages reported as 49 (39.2%) and 55 (44%) neonates respectively. Zone 1 disease was observed in 15 (12.0%) whereas ROP plus disease in 7 (5.6%) neonates. Neonates with ROP stage <2 had significant association with maternal risk factors for sepsis (p-value 0.026), neonatal risk factors for sepsis (p-value 0.047), and neonatal culture proven sepsis (p-value 0.010). Similarly, zone 1 disease had a significant association with presence of maternal risk factors for sepsis (p-value 0.033), neonatal risk factors for sepsis (p-value 0.045), and antibiotics taken >48 hours (p-value 0.027). Conclusion: A considerably higher risk of ROP was observed among hospitalized neonates with neonatal sepsis. Keywords: Neonates, sepsis, retinopathy of prematurity, Preterm
Emotional Regulation, Self-Compassion, Medication Adherence and Quality of Life in Dermatologic Patients
Authors: Amjad Anum , Batool Iffat , Akhtar Nasreen , Khan Muhammad Zohaib , Tariq Shah Rukh
Published: March 2023

Aim: To investigate the relationship between emotional regulation, self-compassion, medication adherence, and quality of life in dermatologic patients. Method: The sample consisted of 150 young adults (males=51 (34%) and females=99 (66%)). The quantitative data was gathered via self-reported questionnaires including Emotion Regulation Questionnaire1, Neff’s Self-Compassion Scale (Short-Form)2, Medication Adherence Rating Scale3, Quality of Life Scale4, and a demographic information form. Results: Significant positive associations were explored among emotional regulation, self-compassion, and quality of life. In contrast, negative significant associations were found between self-compassion, medication adherence, and quality of life. The multiple regression analysis suggested a positive regression coefficient of self-compassion and a negative regression coefficient of medication adherence on the quality of life in dermatologic patients with a 41% variation. The results of the independent sample t-test specified non-significant gender differences in terms of emotional regulation, self-compassion, medication adherence, and quality of life in dermatologic patients. However, the significant difference was explored in the marital status (unmarried and married) in terms of i.e.,self-compassion, medication adherence, and quality of life. Conclusion and Implications: The study’s findings have contributed to the gap of literature in the domains of psychology, dermatology, and clinical studies in Pakistan. The result of the study would be helpful for psychologists and dermatologists to make plans for enhancing emotional regulation, self-compassion, medication adherence, and quality of life in dermatologic patients. Keywords: Emotional Regulation, Self-Compassion, Medication Adherence, Quality of Life, and Dermatologic Patients.
Clinical and Radiologic Spectrum of Odontogenic Keratocyst: Descriptive Study
Authors: Khan Naveed , Rehman Abdur , . Alamgir , Jadoon Zainab , Naeem Shagufta , Naz Shabana
Published: March 2023

Background: Odontogenic keratocyst is relatively common developmental odontogenic lesion occurring with a frequency of approximately 10-14% of all jaw cyst. Aim: To find the clinic-radiologic pattern of odontogenic keratocyst cases. Study design: Descriptive cross sectional. Methodology: Present study was conducted at Pathology and diagnostic Medicine, Khyber Medical University Peshawar in which 83 patients were enrolled. An OPG x-ray was done for all the patients to see the nature of the lesion. Surgical specimens were stored in formalin solution. After gross examination, they were evaluated histopathologically for diagnosis of Odontogenic keratocyst according to WHO criteria2. Data was collected through performa by non-probability convenient sampling following ethical approval. Data was evaluated by using SPSS version 23. Quantitative data was presented as mean ± SD. Categorical data was presented by frequency and percentage. Chi square was applied with p-value <0.05 as significant. Results: Almost 55.4% were male patients. Almost 45.8% patients were in the 4th decade of their life. The mandible was the most common site of involvement accounting for 68.7%. An impacted tooth was associated in 26.5% of cases. Conclusion: It was concluded that OKC involved mandible while occurring in 4th decade of life among males commonly. There was an association with an impacted tooth, therefore to rule out the presence of odontogenic keratocyst, all impacted teeth should be assessed. Key words: Impacted Tooth, Multilocular, Odontogenic Keratocyst and Satellite Cyst.