bluuebunny/crossref_metadata_2025 huggingface dataset:
Memupuk Kemahiran Pemikiran Sejarah dalam Pengajaran Sejarah
Authors: Lee Bih Ni  , Hassan Nurul Asyikin
Published: May 2023

Kertas kerja ini membincangkan pemupukan kemahiran pemikiran Sejarah dalam pengajaran Sejarah. Mata pelajaran Sejarah Kurikulum Sejarah Sekolah Rendah (KSSR) mula diperkenalkan sebagai mata pelajaran di peringkat rendah pada tahun 2013. Mata pelajaran Sejarah Kurikulum Sejarah Sekolah Rendah (KSSR) mula diperkenalkan sebagai mata pelajaran di peringkat rendah pada tahun 2013 untuk Tahap 2 bermula Tahun 4 dan merupakan mata pelajaran teras yang wajib dipelajari. Ini bertujuan untuk menyemai kefahaman pelajar terhadap mata pelajaran Sejarah pada peringkat awal agar pelajar memperoleh dan menguasai ilmu dan kemahiran Sejarah. Kaedah penyelidikan ialah gabungan komponen atau elemen untuk membentuk satu keseluruhan yang bersambung. Dapatan kajian menunjukkan bahawa sebelum Kurikulum Baru Sekolah Rendah (KBSR) yang diperkenalkan pada tahun 1983, mata pelajaran Sejarah dahulunya dikenali sebagai Tawarikh telah diajar di sekolah rendah kepada murid Darjah 4, Darjah 5 dan Darjah 6. Dalam KBSR, unsur sejarah dimasukkan dalam mata pelajaran Kajian Tempatan yang dipelajari di Tahap 2 bagi Tahun 4, Tahun 5 dan Tahun 6. Kementerian Pendidikan Malaysia (KPM) menggariskan Kurikulum Standard Sekolah Rendah (KSSR) digubal berdasarkan prinsip Rukun Negara, Falsafah Pendidikan Kebangsaan (FPK) dan tunjang KSSR iaitu i) komunikasi; ii) Perkembangan Fizikal & Estetik; iii) Kemanusiaan; iv) Kemahiran Peribadi; v) Sains dan Teknologi dan vi) Kerohanian, sikap dan nilai. Mata pelajaran Sejarah KSSR juga digubal berdasarkan prinsip yang sama dengan menekankan domain kognitif, berkesan dan psikomotor serta menerapkan nilai tambah alaf baru seperti kemahiran berfikir, kemahiran teknologi maklumat dan komunikasi, kemahiran pelbagai kecerdasan, pengajian masa depan dan pembelajaran sepanjang hayat .
„Sie brauchen nicht viel. Nur das Richtige.“
Authors: Röhl Thomas
Published: May 2023

Steigende Energiepreise, Rohstoffknappheit und Versorgungsengpässe belasten zunehmend Unternehmen. Daher stellt Robatech auf der interpack 2023 GreenSaver vor. Mit diesem Service kann das Einsparpotenzial im industriellen Heißleimauftrag ermittelt werden.
Maschinenbau in guter Position vor der Interpack 2023
Authors: Laux Matthias
Published: May 2023

Der deutsche Verpackungsmaschinenbau befindet sich im Vorfeld der Interpack in guter Verfassung: Der Produktionswert stieg 2022 trotz der schwierigen Rahmenbedingungen geprägt durch anhaltende Lieferengpässe und Verunsicherungen in Europa in Folge des Ukrainekrieges auf 7,3 Milliarden Euro.
Für die sichere Reise rund um den Globus
Authors: Röhl Thomas
Published: May 2023

Von den weltweit produzierten Waren geht ein großer Teil in den Export. Alle diese Güter legen oft weite Wege zurück und müssen für ihre Reise sicher verpackt werden. Daher sind die Anforderungen an Industrieverpackungen für den Land-, Luft- und Seeweg hoch.
Harter Edeka-Kurs sorgt für Gegenwind
Authors: Biehl Bernd , Schulz Hans-Jürgen , Hebben Miriam , Stockburger Manfred , Brändlein Philip , Sachsenröder Delphine
Published: May 2023

Die Geschäftsbeziehung zwischen Edeka und vielen Top-Lieferanten ist zerrüttet. Der Druck auf den Einkauf steigt, denn in den Märkten fehlt Ware im Jahreseinkaufswert von bis zu 3 Mrd. Euro.
Spargel- und Erdbeerbauern bangen um ihre Existenz
Authors: Krönert Alrun
Published: May 2023

Diese Spargel- und Erdbeersaison wird nach dem desaströsen Vorjahr zum Seismometer für heimische Anbieter. Zwar bekunden Händler wie Aldi Süd Unterstützung. Wenn sich die Rahmenbedingungen für die Produktion aber nicht ändern, sehen sich Erzeuger gezwungen aufzugeben.
Deutsche Umwelthilfe prangert Lidl-Kampagne an
Authors: Wenzel Horst
Published: May 2023

An der Lidl-Kampagne für das Recycling von PET-Flaschen mit Testimonial Günther Jauch kommt man derzeit kaum vorbei. Der Deutschen Umwelthilfe ist der Werbeaktion allerdings ein Dorn im Auge.
Özdemir verteidigt Werbeverbote bei Verbandstag
Authors: Deglow Hans-Jürgen
Published: May 2023

Trotz alles bisherigen Auseinandersetzungen zeichnet sich zwischen Industrie und Minister eine vorsichtige Annäherung an. Beide Seiten betonen Dialogbereitschaft.
Mitten im Kiez
Authors: Himberg Mathias
Published: May 2023

Die Rewe-Kaufmänner Sulaf und Soran Ahmed haben sich im Berliner Stadtteil Schöneberg eine Stellung erarbeitet, die ihnen so leicht keiner streitig machen kann. Durch persönliche Beziehungen, soziales Engagement und freundliche Mitarbeiter haben sie sich fest mit ihrem Viertel verbunden. Mathias Himberg
Reinheit hat ihren Preis
Authors: Hubert Wolfgang
Published: May 2023

Trotz allgemeiner Kaufzurückhaltung setzen Bio-Anbieter auf ein Gewürz-Reinheitsgebot ohne Füllstoffe. Würzmischungen für neue Käufergruppen beleben auch hier die Nachfrage. Wolfgang Hubert
Messe bietet Gelegenheit zum Netzwerken
Authors: Fries Tanja
Published: May 2023

Die ISM bleibt ein Anlass zur Vernetzung: Der Verband Sweets Global Network sowie die Kölner Messe schufen auch diesmal den Rahmen für den Austausch.
EU visiert grüne Zeitenwende im Packaging an
Authors: Flanderka Fritz
Published: May 2023

Der Brüsseler Gesetzgeber will der verpackenden Wirtschaft deutliche Fortschritte in puncto Materialeffizienz sowie mehr, besseres und leichteres Recycling abverlangen. Vorankommen sollen auch der Einsatz zurückgewonnener Rohstoffe und die Installation weiterer Mehrwegsysteme.
Technik-Schau öffnet ihre Tore
Authors: Wenzel Horst
Published: May 2023

Nach pandemiebedingt sechsjähriger Pause führt die Düsseldorfer Interpack der FMCG-Industrie und dem Handel wieder ein Panorama von Verpackungs- und Prozesstechnik vor Augen, das international seinesgleichen sucht.
LSI profitiert von Lust auf Veggie
Authors: Schindler Barbara
Published: May 2023

LSI ist in der von Handelsmarken geprägten Kategorie der Meat-Snacks mit 18 Prozent Marktanteil führender Markenhersteller. Vor allem die Veggie-Range legt zu.
Agrarexporte steigen auf Rekordwert
Authors: Schindler Barbara
Published: May 2023

Das deutliche wertmäßige Plus beim Export von Agrarerzeugnissen aus den Niederlanden gibt angesichts gestiegener Kosten nur wenig Grund zur Freude. Die Lage bleibt herausfordernd.
TPC weist Weg nach Deutschland
Authors: Schindler Barbara
Published: May 2023

The Protein Community unterstützt Produzenten pflanzlicher Alternativen beim Markteintritt mit Wissen und Kontakten.
Growers United kennt Wünsche der Shopper
Authors: Schindler Barbara
Published: May 2023

Mit den Ergebnissen der eigenen Marktforschung und Verbraucheranalysen optimiert die Genossenschaft Growers United Sortiment und Kategorie bei ihren Kunden im LEH.
Wassernetzwerke im Gleichgewicht
Authors: Indlekofer Rebecca
Published: May 2023

Wassernetzwerke müssen im Zuge zunehmender Urbanisierung und hinsichtlich der Auswirkungen des Klimawandels gestärkt werden. Ein effektives Druckmanagement ist dafür unerlässlich. Druckregelventile aus modernen Materialien, mit simpler Konstruktion und digitaler Funktionalität sind die Antwort.
Paradigma infrage gestellt
Authors: Graeber Daniel
Published: May 2023

Flache Seen können zwei alternative stabile Zustände annehmen – das besagt eine Theorie zum ökologischen Gleichgewicht in der Binnengewässerkunde. Dieses Paradigma stellt nun eine im Fachjournal Nature Communications erschienene Studie infrage, die das Helmholtz-Zentrum für Umweltforschung und die Universität Aarhus durchführten.
Nachhaltigkeit treibt Verpackungsentwicklung voran
Authors: Frutig Markus
Published: May 2023

Nachhaltigkeit, Recycling und der Trend zu faserbasierten Packstoffen prägen die Branche auch im Verpackungsjahr 2023. Darüber hinaus standen regulatorische Anforderungen wie die geplante Revision der Verpackungsrahmenverordnung in der EU im Fokus der fünften SVI-Jahrestagung, die am 28. März mit rund 90 Teilnehmenden in Zürich stattfand. Teil 1 von 2.
EU tritt die Bremse
Authors: Mönch Axel
Published: May 2023

Brüssel. Die ukrainischen Landwirte können ihre zum Teil verminten Felder nur unter großen Schwierigkeiten bestellen. Ob sich das Ernten lohnt, hängt in der Luft. Die EU schränkt ihre Einfuhren von Getreide und Ölsaaten aus der Ukraine ein.
Die stille Kündigung
Authors: Brust Martin
Published: May 2023

In den letzten Monaten hat der Begriff „Quiet Quitting“ eine steile Karriere in Suchmaschinen hingelegt. Wie ernst muss man diesen Hype nehmen?
Benzodiazepines
Authors: Kuebler Kim
Published: May 2023

Take a crash course in use, misuse, complications, and withdrawal.
Nurses on the go
Authors: Moore Elizabeth
Published: May 2023

Pursuing passions leads to personal fulfillment.
Relato de campo: Tamandaré entre o social e o ambiental
Authors: Freitas Carlos José , Rocha Gerlane Gomes
Published: May 2023

O presente trabalho objetiva relatar de forma crítica uma aula de campo interdisciplinar ocorrida entre os dias 11 e 13 de abril de 2022, com destino ao município de Tamandaré (PE).  Essa aula foi ofertada para o curso de Licenciatura em Geografia da Universidade Federal de Pernambuco e buscou analisar aspectos sociais, naturais, econômicos e culturais de Tamandaré, por meio de excursões didáticas e atividades direcionadas. Com a finalidade de relatar a experiência vivenciada nesta aula de  campo, inicialmente buscamos trazer uma breve apresentação sobre a importância e estrutura dessa metodologia e posteriormente relatamos as atividades feitas no período do campo a partir de anotações e observações pessoais. O convívio com a prática em campo proporcionou aos alunos um processo de conexão com o município Tamandaré e os espaços e ecossistemas visitados. Com isso, discernimos sobre a produção e reprodução do espaço geográfico e a inter-relação de  processos naturais e sociais nessa dinâmica. Os saberes tradicionais foram essenciais nesse processo, evidenciando a necessidade da atuação da academia para além dos muros das universidades.
The influence of demographic factors and culture on the risk management practices of SMEs in Zimbabwe
Authors:   , Mauchi Fungai Ngoma
Published: May 2023

Organisations are confronted with risks that negatively affect their performance. Risk management practices focus on detecting, calculating and evaluating threats to reduce material, reputation, opportunity and other costs. While business frameworks play a significant role in accomplishing impactful and profitable innovations, various studies point to the lack of a comprehensive SME risk management framework. This study sought to identify the level of SME risk management practices; determine their perception of the relevance of risk management in their businesses; and ascertain the influence of demographic factors and culture on Small and Medium Enterprises’ (SMEs) risk management practices in Zimbabwe. Furthermore, the study aimed to develop a risk management framework that ensures SME survival. The adoption of a risk management framework is hoped to guide effective SME risk management. A mixed-method research design was used, with a target population of 35 700 SMEs from Harare and Mashonaland Central provinces. Cluster and simple random sampling methods were used to select a sample of 276 SMEs. Data was collected using a structured questionnaire and semi-structured interviews. Quantitative Data was analysed using the Spearman rho test, descriptive statistical analysis, frequency analysis as well as correlations, inferential statistical analysis, T-tests and regression analysis whilst qualitative data was analysed using thematic analysis. Findings showed that risk management practices in SMEs were low, reflecting a negative perception of its relevance in business success. Age, gender, race and marital status, as well as educational and income levels, influenced the adoption of risk management practices by SMEs in Zimbabwe, whilst family size did not. Social complexity, fate control and religiosity were found to also influence SME risk management practices, whilst social cynicism and reward for application had no impact. The study recommended the adoption of a risk management framework for SMEs, SME capacity building through education and access to information, networking, the transformation of SME business principles and SME policy reform
An Activity for Design Skill Labs: Activity Planning Processes and Pre-Service Chemistry Teachers' Views
Authors: YALÇIN ÇELİK Ayşe
Published: May 2023

The traditional roles of schools are inadequate to prepare students for the change. Thus, Design Skill Labs (DSLs) have been established in Turkey to provide opportunities for students at all levels of education to discover and develop their talents. Nevertheless, the activities currently available in DSLs are not yet sufficient or diverse enough. The aim of this study is to exemplify the process of developing an activity that can be implemented in DSLs and to obtain the opinions of pre-service teachers about them. Two out of six pre-service chemistry teachers planned the activity, and six pre-service teachers are participated in the study. The participants were senior pre-service chemistry teachers from a state university in Ankara. The data collected from the case study were analyzed using content analysis. According to the research findings, DSLs activities differ from other activities carried out in schools in terms of student and teacher roles, learning environment, research problem, and process. Moreover, DSLs activities contribute to students' skill acquisition, personality development, learning, socialization, and mental development.
Correlation Between Environmental Health and Stunting of Children Under Five Years Old in Puskesmas Balowerti Kediri City
Authors: Dwiretnoastuti Annisa , Umijati Sri , Irawan Roedi , Dewanti Linda
Published: May 2023

Introduction: Stunting prevalence in Indonesia is very high. Puskesmas Balowerti has the highest stunting prevalence in Kediri City, one of the focus locations. A healthy environment is one of the key interventions to reduce stunting. Method: This study uses a cross-sectional study with 110 samples, mothers and their children under five years old, who live in the area of the Puskesmas Baloweti, which fulfills inclusion and exclusion criteria. The independent variables are environmental health, and the dependent variable is stunting. The data collection method was conducted by using a questionnaire and height/length measurement, then analyzed using the Spearman Rank Correlation test. Result: There are 89 normal children (80.9%), 15 stunted children (13.6%), and 4 severely stunted children (3.6%). There are 87 children with inappropriate defecation behaviour (79.1%), 82 children with appropriate water sources (74.5%), 93 children with appropriate waste disposal (84.5%), 108 children with appropriate liquid disposal (98.2%), and 93 children’s families with appropriate handwashing behaviour (84.5%). The Spearman Rank Correlation test showed no correlation (p>0,05) between environmental health and stunting of children under five years old in Puskesmas Balowerti, Kediri city (p=0,073). Conclusion: This research concludes that there is no correlation between environmental health and stunting because the data of this research are less varied. Further research needs to be done with a larger sample and more varied data.
Pseudo Random Numbers Generated By Using Mixture Of Modular Function And Tent Map
Authors: Jr. Epimaco A. Cabanlit, , Vinson-Unggol Mary Ann M.
Published: May 2023

In this paper, we develop an algorithm in generating random numbers from the mixture of the modular function and the tent map. Results show that there are more random numbers generated from the mixture compared to the random numbers generated purely from the modular function and the tent map. Moreover, majority of the distributions of the generated random numbers for the mod100 are uniform. However, the distributions of the generated random numbers for the mod1000 are not uniform. Lastly, the sequences of random numbers generated for divisor of mod100 and mod1000 behave to be random.
The Relationship Between Nutritional Knowledge and Support Family with Dietary Complience in Chronic Renal Failure Patients at Suyudi General Hospital in Indonesia : Research
Authors: Fitmawati Khozatin Zuni , Rosyidah Diyah Agustina Ainur , Hartanto Dedy
Published: May 2023

Introduction: Dietary compliance is the level of willingness of patients to carry out a diet following the dietary arrangements recommended by nutritionists in acordance with established rules. The purpose of this study was to determine the correlationbetween knowledge of nutrition and family support with dietary adherence to hemodialysis patients in suyudi general hospital, Lamongan. Methods: The method of this research was observational analytic with Cross Sectional approach. The sample of 54 hemodialysis patients were taken using purposive sampling. The data on nutrition knowledge and family support were obtained through interviews. The analysis of data used Rank Spearman. Result: The result showed that the correlation between nutritional knowledge with dietary compliance obtained p = 0,479, the correlation family support with dietary compliance obtained p value 0,175. Conclusion: there is no correlation between knowledge of nutrition and family support with dietary compliance to hemodialysis patients in Suyudi General Hospital.
Reduction of Active and Reactive Power Losses on Transmission Lines using SSSC
Authors: Uzor J. C. , Oyiogu D. C. , Ikaraoha C.O.
Published: May 2023

This paper discusses a comprehensive study on reduction of power (active and reactive) losses in transmission lines using a second generation FACTS device, Static Synchronons Series Compensator (SSSC). Modern restructured power systems sometimes operate with heavily loaded lines resulting in power losses and higher voltage deviations, which may lead to mal-operation of power system and eventual collapse of the system. This is mainly due to continuous and uncertain growth in demand for electrical power. The paper presents a methodology to solve the problem of power losses in the Nigerian 28 – bus power system by incorporating Static Synchronons Series Compensator in the network using Newton-Rahson power flow algorithm. Simulation of power flow solution without and with the FACTS device was done using a Matlab software. The results showed that the maximum power (active and reactive) loss in the system without SSSC occurred in the transmission line connecting bus 17 (Jebba) to bus 23(Shiroro) and a 19.32% loss reduction was obtained on the line after the incorporation of the SSSC FACTS device giving a power saving of 80.68%. The total system active and reactive power losses before the application of SSSC was 205.183MW and 1594.683MVAR respectively. However, when the FACTS device was applied at the weak buses the total system active and reactive power losses reduced to 144.571MW and 1136.863MVAR respectively giving a percentage loss reduction in active and reactive power of 29.54% and 28.71% respectively resulting in a power saving of 70.46% and 71.29%. Hence, more power was available in the network when compared to the base case due to the installation of SSSC. Also an improvement in the voltage magnitude at the weak buses and other buses were noticed as they were all maintained at 1.0 PU.
Islamic Banks: Analysis Of The Rules Of Fiqh On The Fatwa Of The National Sharia Board-Indonesian Ulama Council
Authors: Yusuf Mahmud , Hasanudin Hasanudin , Azhari Fathurrahman , Abduh Muhammad Rahmani , Farhanah Sri Ana
Published: May 2023

Both directly and indirectly, Sharia banking regulations in Indonesia are heavily influenced by the Fatwa of the National Sharia Council-Indonesian Ulema Council. In its fatwas, the National Sharia Council-Indonesian Ulema Council cites many fiqh principles as one of its legal foundations which shows that fiqh rules occupy a crucial position in the fatwas issued by the National Sharia Council-Indonesian Ulema Council. But unfortunately, research and scientific studies related to fiqh principles are currently still relatively few and receive less attention from academics. Therefore, this study aims to find out how fiqh principles are used in the National Sharia Council-Indonesian Ulema Council fatwas related to sharia banking to fill the void in scientific studies and attract scientific interest in this field. This research is normative legal research/legal research. The data used in this study were obtained from the Sharia Banking Fatwa Association compiled by the National Sharia Council-Indonesian Ulema Council. The data is then analyzed using a qualitative content analysis technique, which analyzes the contents of various texts and then systematically transforms them into a very organized and concise main summary. The results of this study indicate that from 2000 to 2018, the National Sharia Council-Indonesian Ulema Council issued 90 fatwas related to Islamic banking. Of the 90 fatwas, 87 fatwas used fiqh principles as one of their legal foundations. Overall, the fiqh principles used in the National Sharia Council-Indonesian Ulema Council Fatwa regarding Islamic banking total 39 principles with a frequency of use of 266 times. Where the rule "Basically, all forms of muamalah may be carried out unless there is an argument that forbids it" is the rule most often used with a frequency of use of 85 times and Fatwa 118/DSN-MUI/II/2018 concerning Guidelines for Guaranteeing Deposits for Customers of Sharia Banks is a fatwa that the most use of fiqh rules is as many as 11 rules. Then, the generalization of the 39 fiqh principles used in the National Sharia Council-Indonesian Ulema Council Fatwa regarding sharia banking has at least produced several theories, namely the theory of origin law, the theory of maslahat, the customary theory, the Khilafah theory, the wasilah theory, the promise theory, the majority theory, and several another theory. In addition, the National Sharia Council-Indonesian Ulema Council fatwas related to sharia banking has also made a positive contribution to the development of sharia banking in Indonesia. Finally, for future researchers, we provide suggestions in the form of future research related to the principles of fiqh and the National Sharia Council-Indonesian Ulema Council Fatwa.
Evaluation of Cognitive Functions in Type 2 Diabetes Mellitus Patients Attending Diabetic Clinic of Tertiary Care Hospital in India
Authors: Kumar Rajan , Mahesh Chinnanagammagari , Mullur Lata
Published: May 2023

Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide and has become a significant public health problem. Diabetes can lead to many secondary complications affecting multiple organs in the body. There is an association between diabetes mellitus and cognitive impairment, rapid decline in cognitive function, and dementia.

The purpose of this study was to determine the effect of diabetes on cognitive functions of male and female patients and to assess whether cognitive functions of diabetic patients differentially vary between male and female patients.

Methods: 94 [Male (n=52) and female (n=42)] patients suffering from diabetes for more than five years attending diabetes clinic were selected for study and subjected to blood sugar tests and various cognitive function tests like MMSC, CDT, TRIAL A&B, WMS 1&2 tests.

Results: The results from the tests showed significant alteration in the cognitive function of both male and female patients although patients are on treatment for diabetes.

Conclusion: The elucidation of the mechanism of T2DM-associated cognitive dysfunction and dementia may lead to the development of therapeutics for this specific condition as well as for dementia.

Key Words: T2DM,  Cognitive function tests, Cognitive dysfunctions,
Diagnosis of Papulonecrotic Tuberculid with Chronic Kidney Disease- A Rare Case Report.
Authors: Adeel Muhammad , Haider Syed Nayab
Published: May 2023

A 56-year old male with pulmonary tuberculosis and non-compliant to anti-tuberculosis therapy presented with multiple skin eruptions over the shins and hands for 2 months. Clinical features and skin biopsy were indicative of Papulonecrotic  tuberculid, hence, he was put on renal adjusted ATT due to his worsening serum creatinine.
Impact of Bad Air Quality on the Morphology of Lungs - A Radiological Cross-Sectional Study Conducted at a Tertiary Care Hospital in Lahore.
Authors: Haider Syed Nayab , Iqbal Muhammad Wasif
Published: May 2023

Objective: To radiologically examine the impact of bad air quality on the x-ray findings of patients visiting a tertiary care hospital in Lahore. Material and Methods: This cross-sectional study was conducted in the outpatient department of CPTH, Lahore, from 1st of Oct. to 1st of Dec. 2021. A total of 40 patients from age groups between 21 – 60 years and from both genders, who presented with respiratory symptoms, were included in the study for their x-ray findings. As this was a radiological study, there was only one clinical parameter taken into consideration and that was x-ray chest. The patients enrolled in the study were divided into 4 groups, based on the severity of symptoms and findings on x-rays. Only non-smokers were included in the study. Results: Out of 40 patients, 18 showed no changes on x-ray chest, 12 showed minor appearance of unilateral peri bronchiolar shadows, 6 showed a more prominent appearance of peribronchiolar shadows bilaterally whereas 4 showed bilateral signs of lung fibrosis. Conclusion: Exposure to smog filled air can be linked to accelerated development of lung damage, even among people who have never smoked.
Pollution; an Aftermath of Urbanization
Authors: Saleemi Munir Akhtar
Published: May 2023

Human living, activity, refuse and waste burden the environment. The modern life has changed quantum of many aspects of human living. The present day living is attended  with provision and consumption of water, electicity and fuel for cooking. The mobility from one place to another is mechanised. The modes of transport vary in different parts of country. At individual level motor cycle and cars are used. The public transport in shape of modified chingchi rickshaw, taxi and bus are available in Pakistan, which add tremendously to air pollution.

 

Author Biography

Professor Dr Munir Akhtar Saleemi

Head of Department of Community Medicine and Research,

University College of Medicine, Lahore, Pakistan
Clinical Presentation and Outcome of Fibrous Dysplasia in Patients attending Sahiwal Teaching Hospital, Punjab.
Authors: Lail Raees Abbas , Majeed Amir
Published: May 2023

Objective: To study the clinical presentation, management and outcome of Fibrous Dysplasia in patients admitted in Neurosurgery Department of Sahiwal Teaching Hospital, Punjab.

Methods: This retrospective descriptive observational study was conducted in the months of January-June, 2021 on 20 patients with histologically confirmed Fibrous Dysplasia whose records were obtained from the hospital laboratory data base admitted between January 2017 to January 2021. The age of the patients, gender, socioeconomic status and length of stay of patients was also recorded. Clinical presentation and exact location on x-rays of the lesion, surgical intervention and clinical outcome were tabulated.

Results: This condition was common in the age range of 25-50 years, affected both genders equally, was more prevalent in low socioeconomic group and prolonged the length of stay of patients to 3-4 weeks. It was observed from the radiographs of the patients that ethmoid bone was most commonly eroded (75%) followed by sphenoid (60%) and frontal bone (25%), 2 cases involved the maxillary bone (10%) and in one case it infiltrated the zygomatic bone (5%). The most common presenting features included visual deterioration and proptosis. Surgical intervention ranged from biopsy and conservative treatment to craniotomy and resection. There was no mortality recorded.

Conclusion: Patients with fibrous dysplasia most commonly present with visual deterioration. Although it is a benign disease, but surgical intervention is required for cosmetic purposes.

Keywords: Fibrous dysplasia, computed tomography (CT), magnetic resonance imaging (MRI).
Frequency of the Palmaris Longus muscle in the Population of Islamabad, Pakistan
Authors: Zahra Tatheer , Sumra Safura Awais , Shafi Saeed , Amjad Areeba , Khan Nisma , Saif Ayesha , Khakwani Namira Khan
Published: May 2023

Abstract

Background: The Palmaris Longus is a variable muscle with differing frequencies of presence in different ethnicities, populations and regions. Our study is a cross-sectional study measuring the frequency of the muscle in our sample size in Islamabad. Our aim is to determine the frequency of the palmaris longus muscle in the population of Islamabad, Pakistan. Absence of the palmaris longus does not result in any functional disability. Our objective is to improve our knowledge and spread awareness of the variability of the palmaris longus muscle and its use as a graft tissue at other sites of injury. 

Methodology: The presence of the palmaris longus was determined using 4 tests involving various hand movements. Observation of the tendon of the palmaris longus at the wrist confirmed its presence. A sample of 389 participants from the residents of Islamabad was picked randomly. This study was conducted in 2019 at Shifa College of Medicine (Shifa Tameer e Millat University). 

Results: Absence of palmaris longus in males and females was 4.7% and 6% respectively. Bilateral absence was seen only in 1% of the study population. Unilateral absence in the right and left hands were seen to be 1.3% and 3.3% respectively. In ambidextrous persons, palmaris longus was present in both hands. In right and left-handed persons, 4.80% and 19.2% of the study population exhibited palmaris longus absence, correspondingly.

Conclusion: Overall, the palmaris longus was absent in 5.7% of the entire sample. Further studies can be conducted to establish a relationship between the presence of the palmaris longus muscle and different determinants such as ethnicity and hand dominance etc
Hematological and Inflammatory Parameters in Hookah Smokers and Nonsmokers: A Cross-sectional Study.
Authors: Latif Sidra , Saeed Muniza
Published: May 2023

Objective: To observe the effects of hookah smoking on hematological and inflammatory parameters in chronic hookah smokers.

Methods: A cross sectional observational study was conducted in the setting of Post Graduate Medical Institute, Lahore from March to September, 2021, on 30 male chronic hookah smokers, who had been smoking hookah for more than 5 years, in the age range of 30-60 years and a comparison of their hematological parameters was done with 30 subjects of the same age group and ethnic background with no history of hookah smoking. Fresh blood samples from antecubital vein were collected and tested for hemoglobin (Hb) content, red blood cells (RBC) count, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), platelet count, neutrophil count, lymphocyte count and neutrophil lymphocyte ratio (NLR). An automatic hematological analyzer was used to get results. High sensitivity CRP (hs-CRP) was measured using Elisa kit.  Data was analyzed using SPSS 21.

Results: A statistically significant difference was found in Hb, PCV, MCV, MCH, MCHC, platelets, MPV (p ˂ 0.05). Inflammatory markers such as hs-CRP (p = 0.05), NLR (p = 0.03) were significantly higher in hookah smokers as compared to non-smoker.

Conclusion: Hookah smokers have altered hematological and inflammatory parameters and are at higher risk of developing atherosclerosis, cardiovascular and pulmonary diseases associated with these alterations.
Comparison between Escitalopram and Pregabalin for Generalized Anxiety Disorder Treatment
Authors: Zafar Muhammad Shoaib , Idrees Chaudhary Nazish
Published: May 2023

Objective: To facilitate the emerging need for investigating the efficacy of escitalopram compared to pregabalin for treating generalized anxiety disorders.

Methods: This quasi-experimental study with pre and post-test design was carried out for twelve weeks in the year 2019 between January to June where 90 patients visiting Mayo Hospital in Lahore, within the age range of 18 to 60 years were divided into 2 equal groups by purposive sampling. The 20 mg dose of escitalopram per day was given to the participants of group A while a dose of 150-200mg per day of pregabalin was given to group B and the level of anxiety before and after the experiment was measured by Hamilton Anxiety Baseline. A record of all clinical signs and symptoms was also maintained throughout the time of medication. After 12 weeks, follow-up data was taken from the patients and the scores were compared with the baseline.

Results: Efficacy, defined as ≥2% reduction in the scores of anxiety among the participants after 12 weeks was significantly higher in Escitalopram group A than in Pregabalin group B: (92.8% vs. 82.5%) with p-value= 0.003. Gastrointestinal symptoms were seen in 11.9% of patients in Group A and 27.5% of patients in Group B. In Group A 14.2% of patients reported headaches, as compared to 22.5% of patients in Group B. Sleep disturbances, were reported by 10% of patients in Group A and 15% of patients in Group B. Sweating was seen by 19% of patients in Group A and 50% patients in Group B. Urinary symptoms were experienced by 4.7% patients in Group A and 7.5% patients in Group B.

Conclusion: Escitalopram is a better option and efficacious for the Pakistani population in treating psychological issues including depression, bipolar and other affective disorders despite the minor side effects compared to Pregabalin.
Medical Students’ Perception about the Impact of Teachers’ Attitude on their Academic Performance and Character Building.
Authors: Saif Marwa , Saif Safa , Shahid Noor , Anwar Aiza , Kazmi Tahseen
Published: May 2023

Introduction: To observe the student’s perception about teacher’s attitude and its impact on academic performance and character building of the student.

Methodology: A descriptive cross-sectional study using a random sampling technique was conducted among students from all the years of MBBS of Central Park Medical College, CMH Lahore Medical College & Institute of Dentistry, and Allama Iqbal Medical College in July- August 2021.The minimum sample size calculated from Raosoft sample size calculator was 314. The questionnaire consisted of questions sorted as students’ insight regarding teachers’ attitude and impact of that attitude on academics and on character building. Factor analysis and chi-square method was used to interpret the results.

Results: Two hundred eleven female and one hundred three male students filled in the questionnaire. Approximately 74% of the students mentioned that negative attitude of the teacher decreased their academic performance and had a negative influence on their character building.

Conclusion: There is a positive correlation between the attitude of a teacher and academic achievement of students as well as their character building. Positive attitude leads to higher achievement of the students whereas negative attitude deteriorates their progress and demotivates them.
Pengaruh Penerapan 5 R ( Ringkas, Rapi, Resik, Rawat, Rajin ) Terhadap Perencanaan Logistik Alat Kesehatan Di RSU Muhammadiyah Sumatera Utara Tahun 2019
Authors: Yunita Sukma , Irawati Vera
Published: May 2023

Ketidaktersediaan alat kesehatan dipengaruhi manajemen logistik meliputi proses perencanaan, pengadaan, penerimaan, penyimpanan, pendistribusian serta pengendalian alat. 5R adalah salah satu metode untuk meningkatan efisiensi, produktifitas, dan keselamatan kerja. Tujuan Penelitian mengetahui untuk mengetahui bagaimana “pengaruh penerapan 5R terhadap perencanaan logistik alat kesehatan di RSU Muhammadiyah tahun 2019. Jenis penelitian ini adalah pre-Ekperiment Design, dengan one group pretes–posttes dengan jumlah sampel 9 responden. Tehnik pengambilan sampel yaitu teknik Purposive sampling Instrumen penelitian menggunakan lembar konsoner dan observasi. Analisa bivariat dengan uji Wilcoxon signed rank test. Hasil penelitian menunjukan pada sebelum diberikan metode 5R didapatkan perencanaan logistik yang kurang baik sebanyak 9 responden dan setelah dilakuakn metode 5R perencanaan logistik yang cukup baik sebanyak 9 responden didapatkan nilai signifikan P= 0,003 sehingga ada pengaruh penerapan metode 5R. Kesimpulan didapatkan ada perbedan perencanaan logistik sebelum dan sesudah diterapkan 5R, diharapkan kepala ruangan dari setiap ruangan melakukan briefing dan controlling alat kesehatan secara rutin.
Kesehatan Mental Pasien Diabetes Melitus di Puskesmas Langsa Baro
Authors: Ningsih Nurhayati , Thahura Farahdiba
Published: May 2023

Diabetes Melitus (DM) menjadi masalah kesehatan global karena prevalensinya terus meningkat sehingga membutuhkan upaya pencegahan. DM merupakan kelompok penyakit metabolik ditandai dengan hiperglikemia sebagai akibat dari defek sekresi insulin, kerja insulin atau kedua. Prevalensi diabetes mellitus saat ini meningkat tidak hanya di Indonesia tetapi juga di Dunia. Penelitian ini bertujuan untuk mengidentifikasi kesehatan mental pada pasien diabetes melitus di Puskesmas Langsa Baro. Desain penelitian analytic yang bersifat cross sectional. Jumlah sampel dalam penelitian ini sebanyak 170 pasien yang terdiagnosa Diabetes Melitus dengan teknik Accidental Sampling. Pengumpulan data menggunakan kuesioner Sosio demografi, insomnia Screening Questionnaire (ISQ) dan Depression, Anxiety, and Stress Scale 42 (DASS 42). Analisis Data menggunakan Kendall tau C. Hasil penelitian ini menyimpulkan bahwa hubungan antara sosio demografi seperti; Usia, tingkat pendidikan, Tipe Diabetes Melitus, dan gangguan tidur insomnia terhadap DASS-42. Saran: Peneliti menyarankan kepada instansi kesehatan agar mengidentifikasi kesehatan mental penderita Diabetes Melitus agar menjadi lebih produktif, baik secara promotif hingga rehabilitative. Meningkatkan kebijakan-kebijakan yang lebih spesifik dalam rangka meningkatkan derajat kesehatan pasien diabetes mellitus dengan meningkatkan pemberian informasi dan edukasi untuk meminimalkan stres dan meningkatkan kualitas tidur pada pasien diabetes melitus.
Pengaruh Metode Kangaroo Mother Care Terhadap Perubahan Tanda-Tanda Vital Pada Bayi Berat Badan Lahir Rendah(BBLR) di Rumah Sakit Sawit Indah Perbaungan
Authors: Matondang Elsa Rizky Safitri , Munir Chairul
Published: May 2023

Metode Kanguru adalah metode perawatan dini dengan sentuhan kulit antara ibu dan bayi baru lahir dalam posisi seperti kanguru. Dengan metode ini mampu memenuhi kebutuhan dasar bayi baru lahir prematur dengan menyediakan situasi dan kondisi yang mirip dengan rahim ibu. Tujuan penelitian ini untuk mengetahui pengaruh metode Kangaroo Mother Care terhadap perubahan tanda-tanda vital pada bayi berat badan lahir rendah. Jenis penelitian ini adalah eksperimen yang bersifat quasi eksperiment (eksperimen semu) dengan model rancangan one group pretest postest dimana Lokasi penelitian dilaksanakan di Ruang Perinatologi Rumah Sakit Sawit Indah Perbaungan. Adapun populasi dari penelitian ini BBLR di Rumah Sakit Sawit Indah Perbaungan dengan jumlah 10 orang pada bulan November dengan jumlah sampel yang dibuka 10 orang menggunakan teknik total sampling. Hasil Uji statistik didapatkan nilai p= 0,002 (α=0,05) yang berarti ada pengaruh metode Kangaroo Mother Care terhadap perubahan tanda-tanda vital pada bayi berat badan lahir rendah (BBLR). Hasil interval dapat dipercaya bahwa 95% percaya perbedaan suhu tubuh sebelum dan sebelum dilakukan metode Kangaroo Mother Care adalah 1.090C.
Pengaruh Pemberian Rendam Kaki Air Hangat Campuran Garam Terhadap Penurunan Tekanan Darah Penderita Hipertensi Di Desa Alus-Alus Kecamatan Teupah Selatan Kabupaten Simeulue
Authors: Pakpahan Jun Edy Samosir , Putra Adil
Published: May 2023

Hipertensi adalah peningkatan tekanan darah lebih dari 140/90 mmHg secara kronis. Hipertensi telah menjadi kasus kesehatan di Indonesia yang sering di temukan di pelayanan kesehatan. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian rendam kaki air hangat campuran garam terhadap penurunan tekanan darah penderita hipertensi. Metode penelitian ini menggunakan metode penelitian kuantitatif  dengan jenis Pre-Eksperimental dimana lokasi penelitian ini dilakukan di Desa Alus-Alus Kabupaten Simeuleu dengan sampel berjumlah 34 orang dan dianalisa mengguankan tekhnik uji Paired T-Test. Hasil uji analisis t-test berpasangan menunjukkan bahwa perbedaan rata-rata TD diastolic sebelum intervensi (pretest) dengan TD diastolik setelah pemberian rendam kaki air hangat dengan campuran garam pengobatan kedua sebesar 8,16 mmHg (SD= 3,11). Hasil uji statistik juga menunjukkan nilai t hitung sebesar 2,59 dengan p value 0,000 sehingga dapat diinterpretasikan bahwa terdapat perbedaan yang signifikan antara pretest dengan posttest 2 dan kunci ada pengaruh setelah pemberian rendam kaki air hangat dengan campuran garam terhadap TD diastolik pada penderita 48 hipertensi pada pengobatan kedua.
Evaluasi Desain Fisik Instalasi Laboratorium Terhadap Kepuasan Petugas Laboratorium di RSU. Mitra Medika Tanjung Mulia
Authors: Martina Dewi , Fitriani Arifah Devi , Yuniati Yuniati
Published: May 2023

Berdasarkan survei awal yang dilakukan di RSU. Mitra Medika Tanjung Mulia, di dapatkan bahwa desain fisik instalasi laboratorium tidak lengkap sesuai standar PERMENKES. Hal ini menyebabkan staf laboratorium sering mengalami kendala saat memanggil nama pasien atau keluarga pasien di ruang tunggu. Kendala lainnya tidak adanya ruang administrasi menyebabkan yang tidak berkepentingan masuk ke ruang pemeriksaan. Pengambilan sampel urin pasien juga dilakukan di kamar mandi lantai dua dan lokasi laboratorium yang tidak strategis menuju instalasi gawat darurat.Jenis penelitian ini adalah metode kualitatif dengan pendekatan deskriptif. Pengumpulan data ini dilakukan dengan wawancara semi terstruktur yang menggunakan pertanyaan terbuka. Penelitian dilakukan di RSU. Mitra Medika Tanjung Mulia pada instalasi laboratorium. Sumber informasi penelitian ini 6 orang informan, yaitu 1 orang kepala instalasi laboratorium, 1 orang kepala ruangan, 3 orang analis pelaksana dan 1 orang staf administrasi.Berdasarkan hasil penelitian yaitu lokasi laboratorium, desain tata ruang laboratorium, luas ruang laboratorium dan pemanfaatan ruang laboratorium belum memenuhi syarat standar.Kesimpulan penelitian lokasi laboratorium belum memiliki akses yang mudah ke instalasi gawat darurat karena berada diantara ruang tunggu rumah sakit. Pada desain tata ruang tidak terdapat ruang administrasi, BDRS, penyimpanan reagensia, ruang kepala instalasi, ruang petugas dan kamar mandi pasien. Luas ruangan yang didapat tidak sesuai standar PERMENKES
Impacts of maritime shipping on air pollution along the U.S. East Coast
Authors: Golbazi Maryam , Archer Cristina
Published: May 2023

Abstract. Air pollution is considered a leading threat to human health in the United States (U.S.) and worldwide. An important source of air pollution in coastal areas is the globally increasing maritime shipping traffic. In this study, we take a high-resolution modeling approach to investigate the impacts of ship emissions on concentrations of various atmospheric pollutants, under the meteorological conditions and emissions of the year 2018. We utilize the Comprehensive Air Quality Model with extensions (CAMx) to simulate transport, diffusion, and chemical reactions, and the Weather Research and Forecasting (WRF) model to provide the meteorological inputs. We focus on four criteria pollutants – fine particulate matter with a diameter smaller than 2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) – as well as nitrogen oxide (NO), and we calculate their concentrations in the presence and absence of the ship emissions along the U.S. East Coast, particularly in the proximity of major ports. We find that ship emissions increase the PM2.5 concentrations over the ocean and sparse areas inland. The 98-th percentile of the 24-hour average PM2.5 concentrations (the "design value'' used by the U.S. Environmental Protection Agency) increased by up to 3.2 μm m−3 in some coastal areas. In addition, ships contribute significantly to SO2 concentrations, up to 95 % over the Atlantic and up to 90 % over land in coastal states, which represents a ~45 ppb increase in the SO2 design values in some states. The 98-th percentile of the hourly NO2 concentrations also increased by up to 15 ppb at the major ports and along the shore. In addition, we find that the impact of shipping emissions on O3 concentrations is not uniform, meaning that ships affect ozone pollution in both positive and negative ways. Over the ocean, O3 concentrations were significantly higher in the presence of ships, but in major coastal cities, O3 concentrations decreased in the presence of ships. Our simulation results show that ships emit significant amounts of fresh NO in the atmosphere, which then helps scavenge O3 in VOC-limited areas, such as major ports. By contrast, over the ocean (NOx-limited regime), enhanced NOx (NO2 + NO) concentrations due to ships contribute to the formation of O3 and therefore enhance O3 concentrations. Overall, due to the dominant southwesterly wind direction in the region, the impacts of ships on air pollutants mainly remain offshore. However, in coastal states near major ports, the impacts are significantly important.
Mobile Air Quality Monitoring and Comparison to Fixed Monitoring Sites for Quality Assurance
Authors: Whitehill Andrew R. , Lunden Melissa , LaFranchi Brian , Kaushik Surender , Solomon Paul A.
Published: May 2023

Abstract. Air pollution monitoring using mobile ground-based measurement platforms can provide high quality spatiotemporal air pollution information. As mobile air quality monitoring campaigns extend to entire fleets of vehicles and embrace lower cost air quality sensors, it is important to address the quality assurance needs for validating these measurements. We explore collocation-based evaluation of air quality instruments in a mobile platform against fixed regulatory sites, both when the mobile platform is parked at the fixed regulatory site and when moving at distances of meters to kilometers from the site. We demonstrate agreement within 4 ppbv (for NO2 and O3 + NO2) to 10 ppbv (for NO) when using a running median of 40 hourly differences between the moving mobile platform measurements and stationary site measurements. The comparability is strong when only measurements from residential roads are used but are only slightly diminished when all roads except highways are included in the analysis. We present a method for assessing mobile measurements of ozone (O3), nitrogen dioxide (NO2), and odd oxygen (OX = O3 + NO2) on an ongoing basis through comparisons with fixed regulatory sites.