bluuebunny/crossref_metadata_2025 huggingface dataset:
THE EUROPEAN UNION MIGRATION POLICY IN TERMS OF COVID-19 PANDEMIC
Authors:   Lomonosov Moscow State University, Fomenko Maxim V. , Kriuchkova Anfisa E. ,   Lomonosov Moscow State University
Published: September 2021

The article is devoted to the impact of the epidemiological situation in the countries of the European Union in connection with the coronavirus COVID-19 pandemic on the migration policy of the integration association. Based on the analysis of documents and statistical materials, the author identified the key factors that determine the transformation of European migration policy at the present stage. In addition to that the author put forward the idea of the EU maintaining the course for the implementation of a set of measures taken in this area before the beginning of the pandemic. The article analyzes some of the consequences of the migration crisis of 2015-2016. Some documents adopted in the EU during and after the migration crisis are cited. A critical understanding of the "open door policy" is given. After the outbreak of the COVID-19 pandemic, the EU countries faced a new challenge. The global lockdown put tens of thousands of migrants in a vulnerable position in EU countries awaiting status. Despite the fact that the primary tasks of accommodating and helping migrants at the beginning of the pandemic were solved, it is worth noting that the European Union did not show proper coordination of actions. For example, a comprehensive approach to the formation of a unified migration policy has not yet been developed.
ESCALATION OF THE CONFLICT BETWEEN IMMIGRANTS AND THE HOST SOCIETY IN GERMANY DURING THE COVID-19 PANDEMIC
Authors:   Saint Petersburg State University, Korotkova Elizaveta V.
Published: September 2021

The article examines the features of the interaction of immigrants and the host society of Germany in a historical retrospective. Particular attention is paid to the formation of the modern migration crisis, which arose as a result of the massive resettlement of immigrants from Africa and the Middle East in 2014-2016. Mass migration during this period gave rise to new and exacerbated previous conflicts between immigrants and the local population in Germany. As a result, in the FRG the problem of conflict not only does not lose its relevance, but also prioritizes new dimensions, complicating the processes of integration of immigrants into the host society. The COVID-19 pandemic has become a new conflict factor that has exacerbated the situation between immigrants and the local population in Germany. Particular attention is paid to the change in the political landscape of Germany under the influence of the migration crisis and the use of migration rhetoric by political parties. The article examines the influence of the largest migration communities on the territory of the Federal Republic of Germany on the change in the composition of the parliament, the change in the popularity of various parties, and the change in public opinion. The reasons for the growing popularity of the right-wing party "Alternative for Germany" are analyzed. The problems of integration of immigrants into the host society of Germany are also highlighted, including in the context of the coronavirus pandemic. The religious aspect of interaction between immigrants and the local population in Germany is also considered as a significant moment of integration.
Growing mathematical learners
Authors: Ingram Naomi
Published: September 2021

Results in the International Trends in Mathematics and Sciences Study, and the National Monitoring Study of Student Achievement, have meant there has been recent focus on mathematics education in New Zealand. As with previous iterations of assessment result reports, the quality of teachers, teaching, teacher education, professional learning, mathematics programmes and curriculum have been questioned by the media. It seems that change in mathematics education in New Zealand may, once again, be imminent. In this paper, there is a plea that any change needs to retain what is positive about mathematics education in New Zealand. Teachers need to be supported to grow their own mathematics content knowledge and pedagogical content knowledge so they can make autonomous and sound decisions for their own students’ needs, while retaining the ethic of care they already foster in their classrooms. Support needs to be in the form of rich, centrally managed yet locally adapted, non-divisive resources and professional learning.

 

Furthermore, any change to mathematics education in New Zealand needs to be centred around students and teachers engaging in authentic mathematics practice. A challenging task approach is described that supports this practice, which has been successfully trialled with New Zealand teachers. In this approach, content is not pre-taught. Rather, teachers support the students to solve challenging tasks by moving through the phases of Launch, Explore, Summarise, and Reflect.
Scam design: the anatomy of online products & services scams
Authors:   , Estrella Rosanina
Published: September 2021

Netsafe New Zealand’s (2018) quarterly reports indicate that millions of dollars are lost through online products and services scams in New Zealand through social media and online platforms every year. In 2018 alone, there were over 10,740 total scams, with the highest reported fraud type being products and services. However, despite regular media attention and community conversation on the problem, why is the number of everyday users who fall for the same online traps continuously increasing? From fake competitions to counterfeit online goods retailers, it is shown that many users are quick to believe these impersonated companies are real, only to publicly vocalise their distress once they have succumbed to a scam.

This study provides insights into the overarching processes of how online products and services scams are constructed and implemented within social media and websites. Specifically, this study explores the mechanics, tools, techniques and frameworks that make up the basis of how online products and services scams work. Through these investigations, this study will develop a unique framework that captures the overarching process of how online products and services scams function from start to end. By creating 2 small design experiments, this new framework is further demonstrated within the context of coronavirus (COVID-19) pandemic online scams by deconstructing then reconstructing both commonly encountered and potential COVID-19 New Zealand specific scams that have appeared between March - June 2020.
Scam design: the anatomy of online products & services
Authors:   , Estrella Rosanina
Published: September 2021

Netsafe New Zealand’s (2018) quarterly reports indicate that millions of dollars are lost through online products and services scams in New Zealand through social media and online platforms every year. In 2018 alone, there were over 10,740 total scams, with the highest reported fraud type being products and services. However, despite regular media attention and community conversation on the problem, why is the number of everyday users who fall for the same online traps continuously increasing? From fake competitions to counterfeit online goods retailers, it is shown that many users are quick to believe these impersonated companies are real, only to publicly vocalise their distress once they have succumbed to a scam.

This study provides insights into the overarching processes of how online products and services scams are constructed and implemented within social media and websites. Specifically, this study explores the mechanics, tools, techniques and frameworks that make up the basis of how online products and services scams work. Through these investigations, this study will develop a unique framework that captures the overarching process of how online products and services scams function from start to end. By creating 2 small design experiments, this new framework is further demonstrated within the context of coronavirus (COVID-19) pandemic online scams by deconstructing then reconstructing both commonly encountered and potential COVID-19 New Zealand specific scams that have appeared between March - June 2020.
Movement Through the Marginalised: An Urban Landscape Investigation
Authors:   , Bensemann Freddie
Published: September 2021

In Western democratic society, urban public space has always been dominated by theMainstream user. The Marginalised, to being periodically shifted from one area to another through prevailing processes that gentrify and regulate space. These habitual processes directly and indirectly manage civic space eroding particular character evolved fromMarginalised occupation and expression, and in doing so, urban space caters to the needs and wants of the Mainstream.

This project investigates such a situation yet with such habits reversed. Through the landscape design of urban space the project asks can we design urban space to accommodate thesocio-spatial needs of the Marginalised whilst at the same time, support Mainstream users?

The investigation situates its research in Te Aro Park, a public urban space in Wellington Cityoccupied predominantly by the Marginalised. From the homeless to the eccentric, the drugaddict to the gang member, the space is often a considered a black spot avoided oruncomfortably and rapidly moved through by the Mainstream user. With a social hierarchy that has been flipped on its head the space exudes the diverse nature of Wellington with murals and public artwork that represent the Marginalised groups including local Iwi.

This project aims to use landscape architecture design to critically assess, seek and developpotentials for harmony of urban spaces exhibiting spatial and social conflicts betweenMarginalised and Mainstream citizens. It is an attempt through landscape architecture technique, to destabilize the binary between Mainstream and marginal, and therefore engender conditions for truly diverse urban spaces. In doing so the research discovers how designers can approach public space design problems while opposing the forces of displacement. The researchadditionally contributes an understanding of the underpinnings of trying to introduce new actors without displacement of the existing and more vulnerable actors.
House as Autobiography: An Architectural (Mis)Translation of My Kitchen
Authors:   , Rea Emma
Published: September 2021

This research unravels and reconstructs the all-enveloping, surreal-slowness of my kitchen during Level-4 lockdown; through the intimate familiarity of the line, and the tactility of paper. In a time and place defined by the assimilation of our public and private lives, physical boundaries that ordinarily served to separate and structure, were dissolved. Within this physically smaller world, the kitchen felt relatively larger.

Architecture and the kitchen (and equally, food and cooking) have long since existed within one another, both physically (in space) and etymologically. Isodore de Seville postulated that architecture first emerged in the dining hall, where the first building was made for eating. Equally, cooking and eating rely on a more-or-less solid and spatial framework.

Within the “pseudo-fastness” of the architectural industry, drawing is a comparatively slow and contemplative practice, cultivating an attention to detail, and embodying the capacity to enhance social and historic values. Equally, the generative capacity of drawing makes it uniquely capable of creating something new, from something else.

Just as lockdown was a recluse from the pace of everyday life, drawing is a recluse from the pace of normative architectural practice. The outcome of the research is a series of autobiographic houses, equally symptoms of the introspective experience of lockdown, and the introspective practice of drawing.

By exploiting the subtle parallels that transcend architectural practice, language, and the kitchen (and cooking); this research makes a sensitive proposition for a design practice deeply implicated by the composition of temporal and spatial conditions from which it is conceived.
House as Autobiography: An Architectural Mis(Translation) of My Kitchen
Authors:   , Rea Emma
Published: September 2021

This research unravels and reconstructs the all-enveloping, surreal-slowness of my kitchen during Level-4 lockdown; through the intimate familiarity of the line, and the tactility of paper. In a time and place defined by the assimilation of our public and private lives, physical boundaries that ordinarily served to separate and structure, were dissolved. Within this physically smaller world, the kitchen felt relatively larger.

Architecture and the kitchen (and equally, food and cooking) have long since existed within one another, both physically (in space) and etymologically. Isodore de Seville postulated that architecture first emerged in the dining hall, where the first building was made for eating. Equally, cooking and eating rely on a more-or-less solid and spatial framework.

Within the “pseudo-fastness” of the architectural industry, drawing is a comparatively slow and contemplative practice, cultivating an attention to detail, and embodying the capacity to enhance social and historic values. Equally, the generative capacity of drawing makes it uniquely capable of creating something new, from something else.

Just as lockdown was a recluse from the pace of everyday life, drawing is a recluse from the pace of normative architectural practice. The outcome of the research is a series of autobiographic houses, equally symptoms of the introspective experience of lockdown, and the introspective practice of drawing.

By exploiting the subtle parallels that transcend architectural practice, language, and the kitchen (and cooking); this research makes a sensitive proposition for a design practice deeply implicated by the composition of temporal and spatial conditions from which it is conceived.
PARAMTR - Enhanced generative design tools for prefabricating large-scale residential developments
Authors:   , Joe Joshua
Published: September 2021

Designers are encountering greater issues with residential projects, which are increasing in complexity, scale, and performance requirements. Despite significant advancements in technology and the AEC industry, large-scale residential developments are still designed and built at scale as if they were singular projects. Variable and increased construction time, cost, and material waste at scale are all issues with existing design and construction methodologies for construction at scale. Prefabrication and generative design tools have the potential to significantly reduce these issues.

This paper investigates how collaborative, human-generative design tools can optimise building performance and make prefabricated housing at scale feasible, whilst still encouraging design variance. In this context, collaborative human-generative tools refer to a partially algorithmic design tool that facilitates an open-box approach to design. Using a mixture of research-based design and design-based research, a new tool (PARAMTR) was created to improve feasibility whilst reducing time, complexity, and cost of designing and building residential projects using prefabrication at scale.

The research demonstrates eight unique designs produced using the new human-generative tool. Despite their individuality, these designs have 8-10 times fewer unique components when compared to existing residential projects. Designs produced using PARAMTR could reduce construction/design time by up to 50%, reduce construction costs by up to 26% and share no design commonality, enabling unique designs across an entire development. This research paper could therefore fundamentally change how the AEC industry builds at scale, using algorithms and human-generative design tools.
زانژکۆی هەڵەبجە
Authors: Hama Amin Qadir Sherko
Published: September 2021

ملخص البحث

بحث اللغوي من الاقسام الادب الفولكلورية قليل جدا ، من هذا الزاوية البحث يحمل العنوان ( المثل روءية النحوية و البراغماتية) حسب المنهج التحليلي ،يتكون البحث من الفصلين مع اهم النتائج و في النهاية المصادر و المراجع التي استفدنا منها. الفصل الاول: في هذا الفصل بحثنا التعريف المثل او الحكمة واهم خصائصها وتميزها من الاقسام الادب الفولكلورية اخرى، ثم شرح الحكمة وفق الشكل و المضمون ،واهم معاير تحديد المثل او الحكمة. الفصل الثاني: خصص هذا الفصل للجانب العملي لكن في البداية عرفنا العلامات التداولية مع اهم خصائصهما و التحليل بعض الحكمة في اللغة الكردية من حيث البونية النحوية و العلامات التداولية  (الضمائر ،علامات المكان و الزمان مع العلامات الاجتماعية ) وفي النهاية البحث عرضنا اهم النتائج مع القاءمة المصادر و المراجع و ملخص البحث بالغتين العربية و الانكليزية .
Contribuições do uso dos dispositivos móveis para a abordagem de conteúdos matemáticos no Ensino Médio
Authors: Ferreira Neuber Silva , Rocha Marcos Dias da , Araújo Junior Carlos Fernando
Published: September 2021

Neste artigo apresentamos parte de uma pesquisa que teve o intuito de identificar as contribuições do uso de dispositivos móveis (smartphones) para o estudo de conteúdos matemáticos e para a promoção de ações de motivação na disciplina. Os participantes da pesquisa foram os alunos de duas turmas de Matemática do primeiro ano do Ensino Médio em um Instituto Federal. Para atingir o objetivo, os pesquisadores buscaram desenvolver, aplicar e investigar uma proposta de ensino tendo como suporte teórico os trabalhos e textos publicados sobre o uso de dispositivos móveis na concepção do Mobile Learning. A metodologia de pesquisa foi a Design Based Research. As estratégias de aprendizagem móvel desenvolvidas foram esquematizadas de forma a alcançar os objetivos e resultados almejados. Os resultados mostram que a utilização do smartphone e seus aplicativos possibilitou incrementar a formação dos estudantes, contribuindo para o entendimento dos conteúdos e para a promoção de motivação e engajamento dos alunos na disciplina.
GENDER STUDIES. THEORY, SCIENTIFIC SCHOOLS, PRACTICE IN THE SOCIAL SCIENCES AND HUMANITIES
Authors:   Russian State University for the Humanities, Milovanova Marina Yu.
Published: September 2021

The article analyzes results of the international scientific and practical conference “Gender Studies. Theory, Scientific schools, Practice” (Moscow, March 4–5, 2021). The geography of the representation of the conference participants showed the relevance of the stated topic in Russian and foreign humanities, and the range of researchers in the humanities – sociologists, historians, cultural scientists, political scientists, psychologists, anthropologists – expressed multi-disciplinarity in the study of gender issues. It presents an analysis of current trends in the gender relations and gender discourse in the political, social, economic and cultural spheres in the context of the formation of a new gender order. Moreover it accumulates the scientific ideas, approaches and new research technologies and adduces the practice of implementing their results. The conference was timed to coincide with the 110th anniversary of the celebration of International Women’s Day–March 8 as a day of solidarity of women in the struggle for their rights.
FEMINIZATION OF THE RUSSIAN CITY. FICTION OR TENDENCY?
Authors:   Volgograd State University, Dulina Nadezhda V. , Anufrieva Evgeniya V. ,   Volgograd State Technical University
Published: September 2021

In order to study the feminization process of the Russian city, the article compares statistical data on a number of indicators for 2015 and 2019–2020. In the course of the analysis an asymmetry in the urban population is revealed: (there are more women than men). It is shown how the ratio of women to men in employment has changed during the study period. As well the article defines those areas in which women lead. The authors outline a range of works studying the feminization phenomenon in social processes, including the feminization of the city. The results of the work made it possible to conclude that the feminization of the Russian city is one of the processes in the space of a today Russian city that have a positive dynamics
CONGENITAL ADRENAL HYPERPLASIA;
Authors: QURESHI SAIMA , KHALIQ SHAHIDA , ROOHI MAHNAAZ
Published: September 2021

Congenital Adrenal Hyperplasia is the most common cause of female intersex and is an autosomalrecessive disorder resulting in enzyme deficiency 21-hydroxylase. The case series describes three such cases thatare investigated and managed at Independent University Hospital Faisalabad.
SUPERIOR VENA CAVA OBSTRUCTION;
Authors: SULTAN ILTIFAT
Published: September 2021

Idiopathic mediastinal fibrosis is a disease of unknown etiology. The causeis probably an abnormal fibro-proliferative response within the mediastinum. It can result in clinical syndromes due toinvasion and compression of mediastinal structures.A case of young male with idiopathic mediastinal fibrosis and superior vena caval obstruction is described.
HEAD INJURY;
Authors: CHEEMA MUHAMMAD RAFIQUE , ASHRAF MUHAMMAD
Published: September 2021

. Back Ground: Abnormal coagulation and fibrinolysis is a complication observed in individuals having traumatic brain injury.Objectives: To evaluate the incidence of this complication. Design: Retrospective and comparative study. Setting: Lahore general HospitalLahore. Period: From 1995 to 2000. Materials & Methods: One hundred adults, both male and female, having traumatic brain injury, admittedin Lahore general Hospital Lahore were subjected to estimation of prothrombin time, activated partial thromboplastin time and fibrin degradationproducts 48 hours after injury. Results: Fifty control and thirty three patients with severe head injury were studied. Prothrombin time in 17patients was prolonged. Which was statistically significant. APTT was prolonged in four cases when compared with normal. FDP were increasedin 51% cases. This elevation was again significant statistically. Conclusion: Significant changes in prothrombin time and fibrin degradationproducts were observed after 48 hours of brain injury.
PROSTHETIC JOINT INFECTION DUE TO HAEMOPHILUS APHROPHILUS
Authors: CHESTERFIELD HELEN , ASSARIAN ABDOLALI , PALLETT ANN , Latham Jeremy
Published: September 2021

A case of prosthetic joint infection due to Haemophilus aphrophilus is presented. A 76-year-old woman, with a long historyof pain in her left hip and raised inflammatory markers, underwent prosthetic joint excision. Six samples of pus and tissue were taken from thejoint and Haemophilus aphrophilus was cultured from 3 of these specimens. We review the clinical and microbiological findings. Treatment withciprofloxacin after removal of the prosthesis resulted in clinical improvement.
SPONTANEOUS RUPTURE OF AMYLOID SPLEEN
Authors: DIGHE SHWETAL , ZAIDI A. , FARHAT SAMI
Published: September 2021

.Primary systemic amyloidosis (AL) is characterized by the overproduction of immunoglobulin light chain proteins by amonoclonal, terminally differentiated B-lymphocyte or plasma cell clone. The free immunoglobulin light chains are deposited in an abnormalconformation as amyloid in a variety of organs in the body (1). Splenic involvement is seen in 4 -13% of cases, however amyloidosis causingspontaneous rupture is very rare with only 31 cases reported so far. We report a case of 60-year old, suffering from Primary AL amyloidosisand multiple myeloma involving the liver, spleen and GI tract, who suddenly collapsed and developed rapid abdominal distension. CT scansuggested rupture of the spleen. She underwent emergency Splenectomy and had an uneventful recovery. It has been suggested that thedeposition of amyloid in the basement membrane of the vascular endothelium leads to increased gap between junctions and leading to vascularfragility and propensity to rupture. The amyloid can also lead to defective interaction with platelets and predispose to spontaneous haemorrhage.Conclusion: Thus in a case of occult haemorrhage with Amyloidosis, diagnosis of rupture of spleen should be considered and CT scan shouldbe performed if the patient is haemodynamically stable. Splenectomy is the ideal treatment for ruptured spleen.
CONJUNCTIVAL SQUAMOUS CELL CARCINOMA;
Authors: CHAUDHRY MUHAMMAD MUMTAZ , ALTAF SHEHRYAR
Published: September 2021

Objectives: To evaluate 20 patients with squamous cell carcinoma of the conjunctiva. To determine the clinical andpathological characteristics. Design Retrospective study. Setting: POF hospital & EDO eye hospital Wah.Cantt Period: From June 200 toJuly 2006. Methods: The patients presenting with squamous cell carcinoma of the conjunctiva were retrospectively evaluated. Results: Patientswere usually male (80%), elderly (75% >60 years of age), with most lesions (90%) occurring at the limbus. Two patients (10%) sufferedrecurrence of the squamous cell of the conjunctiva within 2 to 4 months of resection. Corneal invasion was noted in two patients (!0%) whilethere was intraocular and orbital invasion in two patients (10%). One patient (5%) required enucleation and one patient (5%) requiredexenteration. In situ carcinoma was noted in 18 patients (90%). Conclusions: Squamous cell carcinoma of the conjunctiva occurs in the sunexposed area of the conjuntiva at the limbus in the elderly men. Recurrence was noted in the younger patients and with larger lesions.Enucleation and exenteration is required in a small number of cases.
TREATMENT OF ACUTE LUMBAGO
Authors: KHAN TAHIR AHMAD , AHMAD ASHER , HAIDER IRFAN ZAFAR
Published: September 2021

Objective: To determine whether concomitant use of vitamins B1, B6, B12 along with low dose of diclofenac sodium causesquicker pain relief in patients of acute lumbago compared with diclofenac sodium alone. Design: A randomized clinical trial. Setting: SurgicalDepartment of C M H Attock. Period: From September 2004 to August 2005 Patients & Methods: A total of 50 patients were selected forthe study. The patients complaints were of acute lumbago of less than 3 days duration with severe impairments of movements. The age groupof patients was between 20 and 65 years. The patients were randomly assigned into two groups. Group I was prescribed tablet diclofenacsodium 25mg along with vitamin B-complex containing combination of 100mg thiamine nitrate (B1), 100mg pyridoxine hydrochloride (B6), and200mcg cyanocobalmine (B12) three times a day. Group II patients were prescribed 25mg of tablet diclofenac sodium alone. Improvement inthe intensity of pain at rest and during movements (as assessed by the patients) was noted in accordance to visual analogue scale 1 to 10.The effectiveness of diclofenac sodium in combination with vitamin-B complex with diclofenac sodium alone was judged on the basis of extentof pain relief after 7 days of treatment. Results: A total of 25 patients were treated with combination of diclofenac sodium & vitamin-B complex(Group I) and 25 were treated with diclofenac sodium alone (Group II). As far as the extent of pain relief in first 7 days is considered, 22 patients(88%) belonging to group I and 10 patients (12%) belonging to group II had an excellent pain relief and were able to carry on with their normalroutine activities. Remaining 3 patients in group I were completely relieved of pain in next 3 days while 15 patients in group II had to completeanother 10 days for complete cure. To test the statistical significance of the result chi-square test was applied and the result showed thatpatients of Group I responded significantly well to the treatment as compared to those in Group II. Conclusion: Using the parameters of painrelief and movements of vertebral column, the combination of diclofenac sodium & vitamin-B complex was found to be more effective modeof treatment as the duration of treatment and the dosage of diclofenac sodium was less and also relief of pain was more rapid.
ABDOMINAL VERSUS VAGINAL HYSTERECTOMY;
Authors: IKRAM MUHAMMAD , SAEED ZOONA , SAEED ROOHI , Saeed Uhammad
Published: September 2021

Objective: To evaluate abdominal versus vaginal hysterectomy in relation to operative and post operative complications.Design: Single centre cross sectional study. Place and duration: The Department of Obstetric and Gynaecology, Shaikh Zayed post graduateMedical institute and Hospital, Lahore from 1 November 2005 to 31 October 2006. Subject and methods: All the patients with benign st stindications for hysterectomy (abdominal and vaginal) were included except patients with serious / complicated medical disease. Relativeinformations were filled in a Performa and informations were taken from case records. Results: This audit report included 200 women. 23.3%patients of vaginal hysterectomy were in the age group of 40-45 years while 35.7%patients of abdominal hysterectomy were in the age of 51-55years. Main indication for abdominal hysterectomy (85.5%) was fibroid uterus while for vaginal hysterectomy (66.6%) was Uterovaginal prolapse.Most common immediate post operative complication in abdominal and vaginal hysterectomy was fever in 42.8% and 20.0% respectively.Intraoperative visceral injuries were done in 4 patients in abdominal hysterectomy while no injury was done in vaginal hysterectomy. 44(80%)patients of vaginal hysterectomy were discharged with in 7 days of hospitalization while 64 (44%) patients of abdominal hysterectomy weredischarged with in 7 days of hospitalization. Conclusion: Hysterectomy either abdominal or vaginal is very safe and there were no lethalcomplication except few minor complications and also there was no mortality.
ESOPHAGEAL VARICES:
Authors: ATIF MOAZZAM ALI , AHMAD IRFAN
Published: September 2021

. Objectives To document the frequency of esophageal varices and their importance in a tertiary care hospital of SouthernPunjab. Design: Observational. Setting: Endoscopy unit of Sheikh Zayed Medical College/Hospital. Period: From Nov 2005 to May 2007.Materials & Methods The data of 500 patients who underwent upper GI endoscopy was analyzed. Demographic features, reasons for referraland endoscopic diagnoses were noted. Results: Among 500 patients, 57% were referred due to upper GI bleeding, 9% due to dysphagia, 8%due to persistent vomiting and 7% due to dyspeptic symptoms. Common endoscopic diagnoses were esophageal varices (44%). Conclusion:Major Endoscopic finding in our study was esophageal varices. Gastric or duodenal ulcers, congestive gastropathy, obstructive lesions ofesophagus and stomach were the next most common observations.
PUERPERAL BREAST ABSCESSES
Authors: SALEEM SAIRA , FAROOQ TARIQ , KHAN NAEEMULLAH , Shafiq Muhammad , Azeem Muhammad , Dab Riaz Hussain
Published: September 2021

. Objectives: The aim of this study was to compare the management of puerperal breast abscess by ultrasound guidedpercutaneous drainage v/s incision and drainage with special attention to resolution time and complications. Setting: Allied Hospital Faisalabad.Period: Jan 2005- June 2007. Patients and Methods: 60 patients with puerperal breast abscess were studied. Patients were divided into twogroups randomly after informed consent. In Group A; patients were treated with percutaneous drainage under local anesthesia while GroupB patients were treated by conventional incision and drainage, and results were compared with reference to resolution time and complicationsrate using student’s t-test. Results: By percutaneous method abscess healed in 5-8 days time. Recurrent abscess was found in one case (3%),milk fistula formation in one case (3%) and no residual abscess was found. There was no scar formation, induration or distortion of the breastparenchyma. Breast-feeding was interrupted in four patients (13%) only due to milk fistula (one case), recurrent abscess (one case) andpatient’s own preference (two cases). On the other hand by conventional method healing took 15-25 days with pain and discomfort of dailydressings, scarring and cessation of breast feeding in most of the cases. Conclusion: Percutaneous ultrasound guided placement of suctiondrainage catheter in puerperal breast abscess for 5-8 days is less invasive, high resolution rate, scarless, low complication rate and preservesthe function of breast-feeding as compared to conventional incision and drainage.
CHRONIC DIARRHEA;
Authors: DIN RAFI UD , ZAKARIA MANZAR , ABID BUTT MUJEEB-UR-REHMAN
Published: September 2021

Objective: To determine the frequency of large bowel causes of chronic diarrhea in adult Pakistani patients. StudyDesign: Cross sectional study. Setting: Medical unit 1 at Combined Military Hospital Lahore, Pakistan. Duration: Six months (from 01-11-2007 to 30-4-2008). Subjects and Methods: Fifty adult patients with chronic diarrhea, irrespective of their gender were selected by nonprobability convenient sampling. Patients already diagnosed with diseases known to cause diarrhea and those with toxic mega colon wereexcluded from the study. All patients were subjected to fiberoptic colonoscopy and findings were recorded. Biopsies were taken fromsuspected lesions or from normal looking mucosa. Diagnosis was made with colonoscopic and histopathologic findings. Results: Thirty two(64%) patients had abnormal findings visible on colonoscopy. Histopathology was normal in 18 (36%). Twenty (40%) patients hadulcerative colitis, seventeen (34%) had IBS, five (10%) had CA colon and three (6%) patients had crohn’s disease. Other diagnosesincluded non specific colitis, tubulovillous adenoma and infection. Twenty three out of 24 patients (95%) who had blood in stools had avisible abnormality on colonoscopy whereas colonoscopy was positive in only 33% of patients who did not have blood in stools.Conclusion: Most causes of large gut chronic diarrhea can be identified by colonoscopy and biopsy. Colonoscopy has a very high yield inchronic diarrhea and should be recommended for its work up. Its yield is even higher in patients with bloody diarrhea.
FAT EMBOLISM AND FAT EMBOLISM SYNDROME;
Authors: LATIF ANSAR , BASHIR ANILA , , AURANGZEB , Ghani Umar
Published: September 2021

Fat Embolism and the associated Fat Embolism Syndrome is a serious and potentially life threatening condition. It tends tooccur usually after fractures or intramedullary instrumentation of long bones. Non-traumatic conditions such as Diabetes Mellitus severe Burns,SLE, sickle cell disease and Pancreatitis can also lead to Fat Embolic syndrome. Young adults are commonly affected. Presentation consistsof an asymptomatic interval followed by pulmonary and neurological manifestations combined with petechial haemorrhages. The diagnosislargely depends on high index of suspicion and exclusion of other conditions. Treatment of this condition remains supportive. Mortalityassociated with this condition is significant, ranging from 10-20% .
TB-DOTS PROGRAM;
Authors: SULEHR MUHAMMAD ANWAR , `ALI AYUB
Published: September 2021

Objectives: To assess the performance of Lady Health Workers (LHWs) in collection, storage & distribution of drugs andevaluate their effectiveness regarding TB suspect identification, referral, directly observing the intake of medicine, default identification andhealth education in TB-DOTS program. Design: A cross-sectional study. Setting: In district Toba Tek Singh. Period: From January to Sep2006. Materials & Methods: One hundred and Two LHWs were selected randomly and interviewed using a structured pre-tested questionnaire.Results: Among 102 LHWs, 76.5% were trained in TB-DOTS. Sixty four (62.7%) had qualification matric and above. Collection of the drugswas being performed properly by 87.3%, while 83.4% were storing the anti-TB drugs at proper places. Anti-TB drugs were being distributedto patients daily by 95.1%. Under the direct supervision of LHWs 69.6% of TB patients had completed treatment. In the areas of 58.8% LHWs,TB patients were declared cured after 8 months treatment. Defaulted TB cases were present, in the areas of 19.6% LHWs, while 12.8% of theLHWs had relapsed TB cases in their areas. Most of the LHWs (85.3%) had proper record of medicine and of the patients (84.3%). Conclusion:The experienced and TB-DOTS trained LHWs of urban areas, in the age group of 41-50 years had overall good performance. The LHWs havingqualification matric and above had better performance than the LHWs having middle qualification. TB-DOTS program in district Toba Tek Singhwas working successfully and it should be continued with some improvements and innovations.
CHRONIC ANAL FISSURE
Authors: ZEESHAN SAQIB , CHUGHTAI JEHAN ZEB
Published: September 2021

. Topical application of glyceryl trinitrate (GTN) ointment heals anal fissures, providing an alternative to the traditional first linetreatment of surgical sphincterotomy. Setting: Tathlith General Hospital Saudi Arabia. Period: January 2001 – April 2003. Objective: Todetermine the effectiveness and safety of topical 0.5% glyceryl trinitrate (GTN) in the management of chronic anal fissure. Patients & methods:Individual Patients were randomized to receive 0.5%GTN paste or placebo three times per day for six weeks in addition to oral senna and/orlactulose. Patients took laxatives alone for further 6 weeks. Patients were followed every week for six weeks and then fortnightly for anothersix weeks to assess pain scores and were given advice. Results: Fifty patients were recruited in this study and 44 patients completed the trial(23 in the GTN group and 21 in the placebo group), patients who could not complete the study were excluded. At 6 weeks, 74% of patients hadno pain in the GTN group as compared to the 29% in the placebo group. In 26% of cases treatment was unsuccessful. At three month followup there was no early recurrence. The prevalence of headaches was 65% in GTN group ( reported by 15 patients) and 24% in placebo group(reported by 5 patients). Mean pain scores were lower in the GTN group as compared to the placebo group. Conclusions: The use of 0.5%GTN induces healing of chronic anal fissures and may by used as a first line of treatment in patients with chronic anal fissure. Successfultreatment may come at the expense of a high incidence of headaches.
PILONIDAL SINUS
Authors: MALIK GULZAR AHMAD , CHOUDHARY TARIQ HUSSAN , WAHAB ABDUL
Published: September 2021

O b j e c t i v e s : To study the prevalence of pilonidal sinus and compare the outcome of the excision and primary closure withlay open surgical procedures. D e s i g n : Prospective randomized comparative study. Setting: Department of surgery, Bahawal VictoriaHospital Bahawalpur. P e r i o d : From 1s t December 2002 to 30th November 2007.Materials a n d M e t h o d s : A total of 40 patients with pilonidalsinus were randomized into two groups. Group I underwent excision and primary closure while Group II underwent excision and lay openprocedure. Results: Patients of Group I & II had comparable mean operation time of 42.7 minutes. Group I patients had a shorter meanhospital stay of 4.87 days, earlier return to light work after 13.21 days, less treatment expenses and low rate of postoperative complicationsand good patient satisfaction. C o n c l u s i o n : We conclude that primary closure after excision of pilonidal sinus is superior surgical procedurethan excision and laying it open
BICYCLE PASSENGER INJURIES IN CHILDREN
Authors: MIRZA TAHIR IQBAL , MALIK FAKHAR ILYAS
Published: September 2021

O b j e c t i v e ; To find out types of traumatic injuries in bicycle passenger children. S e t t i n g : At PAC hospital Kamra. P e r i o d :From October 2005 to October 2007. Patients & M e t h o d s : The children between the ages of 03 to 10 years were included in this study.They were divided into two groups. First group(Gp-l) sustained injuries due to ankle or foot entrapment in rear running wheel while thesecond group(Gp-ll) sustained injuries due to fall of bicycle, while child sitting alone either at front bar or rear luggage carrier unattended.R e s u l t s : Gp-I sustained mostly frictional injuries ranging from simple abrasion to deep lacerated wounds of lower leg, ankle and foot. Whilein Gp-ll severe injuries like fractures of upper and lower limbs, visceral abdominal injuries and head injuries were observed. C o n c l u s i o n :Bicycle passenger injuries are common injuries of the children in less developed countries. These injuries range from simple "road rash' toserious head injuries.
PAROTID SWELLING IN CHILDREN
Authors: SHEIKH ABID HAMEED , HAQ EHSAN UL , ANJUM MUHAMMAD ZULFIQAR , Ahmad Gulzar
Published: September 2021

Objective: To describe the clinical and pathological presentation as well as treatment options of parotid swelling inchildren. D e s i g n : Descriptive case series study. S e t t i n g : Department of Paediatric Surgery Bahawal Victoria Hospital Bahawalpur. Period:From Nov2005 to Jul2007. Material a n d m e t h o d : All patients of either sex below the age of 13 years presenting with parotid swelling wereincluded in the study. Clinical presentations, preoperative investigations, operative procedures, histopathology reports, postoperativecomplications and further management (radiotherapy &chemotherapy) were recorded. Results: Twelve patients presented with parotidswelling. Commonest presentation was a lump over the parotid region (100%) & pain (25%). Majority of tumours were benign (50%).Vascular lesions outnumbered solid tumours. 4 patients (33.33%) had haemangioma 1 patient (8.33%) had cystic hygroma, one patienteach of pleomorphic adenoma, mucoepidermoid carcinoma and Adenocarcinoma. C o n c l u s i o n : Salivary gland lesions are most likelyinflammatory in origin. Vascular tumours are common benign tumours than epithelial tumours in children. Superficial parotidectomy is theoperation for benign tumours and total conservative parotidectomy for malignant tumours.
CENTRAL VENOUS PRESSURE LINE
Authors: AKBAR SAYED ALI , AHMAD NAZIR , ALI JOHAR , Qasim Mohammad
Published: September 2021

Objective: To study the frequency of complications of central venous pressure line. S t u d y d e s i g n . Descriptiveobservational study. S e t t i n g : This study was carried out in surgical ward and intensive care unit of Fauji Foundation hospital Rawalpindiand Frontier Medical College Abbottabad. P e r i o d : From 2003-2007. M e t h o d s a n d Materials: One hundred consecutive surgical patientsneeding central venous line insertion above 14 years of age were included in the study. Patients under 14 years of age, with central venousline in situ at the time of admission, with thoracic trauma, chronic obstructive pulmonary disease, burns involving upper chest and neck areas,cardiovascular disease and bleeding disorders were excluded from this study. R e s u l t s : 100 cases were included in the study with the rangeof age between 16-82 years. There were 76% female and 24% male. Out of these 100 cases 40 were suffering from malignancy, 20 weresuffering from intestinal obstruction, 10 were with peritonitis and 30 cases were having miscellaneous disorders. Rate of complications ofcentral venous line was 30% in this study. Rate of infection was 20%, rate of misplacement of catheter was 8% and rate of pneumothoraxwas 2% C o n c l u s i o n : infection is the most common complication of the central venous line insertion followed by misplacement of catheterand pneumothorax, so it is important to take specific measures to minimize these complications
DIABETIC FOOT ULCERS
Authors: KHOHARO HAJI KHAN , ANSARI SHUAIB , QURESHI FATIMA
Published: September 2021

(SUMMARY) Aim: To determine common pathogens isolated in diabetic foot ulcers & in vitro antimicrobial activity. Setting:Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical & Health Sciences Jamshoro. Period: 1s t November2007 to 30th June 2008. Research Methodology: Pus samples for bacterial culture were collected from 60 patients admitted with diabeticfoot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommendedby the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organismsto metronidazole and amoxicillin/clavulanate. A vancomycin screen agar (6 Lig/ml) was used to detect vancomycin intermediate isolatesof Staphylococci. Results: Clinical grading and bacteriological study of 60 patients revealed, 44 (73.33%) patients had gram-negativeorganisms, & Pseudomonas aeruginosa was the most common. While 16 (26.66%) patients had gram-positive organisms & Staphylococciwas the most common organism. Infection with anaerobes was observed in one patient (1.66%). Both gram-positive and -negative organismswere seen in 8 (13.33%). Pseudomonas aeruginosa & S.aureus exhibited a high frequency of resistance to the antibiotics tested. All theisolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Conclusions: Pseudomonas aeruginosa,Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infectionsin this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin,levofloxacin, amikacin and vancomycin.
TUBERCULOSIS
Authors: ANJUM AFTAB , DAUD SEEMA , MUKHTAR FATIMA
Published: September 2021

Objective:Toassesstheawarenessaboutspread and control of Tuberculosis amongst people presenting at GhurkiTrustHospital, Lahore. Design:Across-sectional survey. Place of study: Lahore Medical and Dental College (LMDC), Lahore, Period: FromNovember and December 2006. M e t h o d o l o g y : Across-sectional survey was conducted among people presenting at Ghurki Trust Hospital,Lahore, between November and December 2006. A structured questionnaire was used to collect the data. Descriptive statistics weredetermined in terms of percentages. Results: In the present study, 82% respondents did not know the correct mode of transmission oftuberculosis. Correct modes of transmission including coughing, sneezing, spitting and breathing air were mentioned only by 18%. Alargeproportion of respondents (76%) knew that tuberculosis presents as cough lasting more than three (3) weeks and having prolonged fever(68%). Fifty percent of respondents said that government health facilities are the best places for the treatment of TB. Twenty three percent(23%) of respondent mentioned use of medicine as a method of management and t reatment. Improving sanitation and nutrition wasmentioned to prevent and control TB by respondents in almost equal percentage {20% & 18%). Conclusion: Poor knowledge andmisconceptions concerning tuberculosis are rampant in Pakistani patients. Poor knowledge of TB patients concerning their disease maycontribute to the high burden of TB disease in the country.
TUBERCULOUS PATIENTS
Authors: SULTAN ILTIFAT , AKHTAR JAVED , SADIQ MUHAMMAD , Jaleel Rashid
Published: September 2021

Objective: To evaluate Demographic Data of tuberculous patients in Faisalabad catchments areas. Setting: RehmatWard at Divisional Head Quarter Hospital Faisalabad a teaching Pulmonary Unit of Punjab Medical College Faisalabad. Period: 131 Jan 2006to 30th June 2006.
LIPID PROFILE
Authors: H AQ QAMAR-UL-
Published: September 2021

Objective: To assess the lipid profile among adult males belonging to high socioeconomic status and to probe the dietaryhabits playing a key role as causative factors in multiple complicated and grievous health hazards e.g. hyperlipidemia, hypertension, diabetesand ischemic heart diseases, which can be managed by just controlling diet and regular exercise. S t u d y D e s i g n : Cross sectionalobservational study. P e r i o d : From March 2003 to September 2003. S u b j e c t & Setting: In this study, research was conducted for 150respondents of age 20-50 belonging to high socioeconomic status in three posh areas of Faisalabad city, by using simple random samplingtechnique and SPSS was used for statistical analysis. Results: It was concluded that lipid profile including LDL, HDL, TG and TC had asignificant relationship with high socio-economic status adult males and recommendations were designed to avoid the problems related withhyperlipidemia in the said class.