bluuebunny/crossref_metadata_2025 huggingface dataset:
Tooth Size and Arch Widths in Crowded Class I Malocclusion
Authors: Warda Arif Khan  , Syed Shah Faisal  , Syed Sheeraz Hussain
Published: February 2023

Objective: To examine the extent to which maxillary arch width and tooth size contributes to dental crowding.

Methods: A cross-sectional study was conducted for six months after approval of synopsis  by  ERC  of KMDC with 96 patients at department of orthodontics, Karachi Medical and Dental College, Karachi, Paki- stan. Patients with age 13-21 years with maligned teeth, over-crowding, presence of all fully erupted per- manent teeth and all angle classes were included, whereas patients with history of orthodontic treatment, presence of fractured restorations/crowns with tooth anomalies such as number, size, form and position as confirmed on clinical examination and craniofacial anomalies/syndromes were excluded. Maxillary crowding was calculated as the millimetre difference between arch perimeter and the sum of tooth widths of both second premolars. Arch perimeter was measured from the mesial aspect of the permanent first    molar to its antimere with a brass wire. Intermolar arch width was calculated as distance from the central  fossa of permanent maxillary first molar to its antimere. Data was analysed using SPSS 23.0. Prior to  analysis assumptions were tested; an independent sample t-test was used to compare differences  in  crowded maxillary arch widths and spearman correlation was used to determine relationship between variables.

Results: Significant differences were obtained in anterior (t(63) = -2.547, p=0.047) and posterior tooth size (t(63)= -2.218,  p=0.030) in patients with mild, moderate and severe maxillary crowded arches and an in-verse weak correlation was obtained against maxillary crowding and maxillary arch widths (r=-0.054) and maxillary crowding and anterior tooth (r= -0.201) and posterior tooth size (r= -0.353).

Conclusion: An inverse significant relation was found between crowding and tooth sizes & significantly different tooth sizes were observed in patients with mild, moderate and severe maxillary crowding.
Congenital Anomaly of Gall Bladder Assessed Through Magnetic Resonance Cholangiography in Relation to Its Clinical Relevance
Authors: Ishaque Imran , Fatima Urooj , Siddiqui Naveed Ali , Baig Nadeem , Illyas Amber , Gohar Naheed
Published: February 2023

AbstractObjective: The overall incidence of Phrygian cap is about 04%. It is an anomaly of gall bladder found congenitally. It can be a misguided pathological diagnosis often seen mimicking a liver mass on imaging of the hepatobiliary tree. Although Phrygian cap is a congenital anomaly, it does not show any pathological significance, In light of this condition, the purpose of this research was to find out the congenital anomalies of the gallbladder through magnetic resonance cholangiopancreatography (MRCP) along with its clinical significance.Methods: A total of 377 patients were selected with a number of 192 females and 185 males, with ages ranging from 16-90 years, with a mean age of 48 years, who had undergone MRCP for diagnosed stone in gallbladder or bile duct on a clinical basis, carcinoma of pancreas and inflammatory changes of pancreatic and/or bile ducts. The patient's imaging was done using a 1.5-T superconductive magnet which was four-channel phase-arrayed body coil and breath-holding technique was utilized, using multi-sliced T2-weighting half-Fourier acquisition single-shot turbo spin-echo (HASTE), MIP reconstruction, and also single-shot T2-weighted turbo-spin-echo sequence rapid acquisition with relaxation enhancement (RARE) having a varying thickness of slices.Results: The MRCP imaging results demonstrated extra hepatic biliary tract anomalies in 94 out of the 377 patients which represented a frequency of 24.93%. However, a Phrygian cap was found to be present in 6 patients with a frequency of 1.6% with 4 females and 2 males.Conclusion: From the results that we achieved, it was made quite apparent that congenital anomalies can be classified as a complex spectrum of variations that have a propensity to occur on a regular basis, emphasizing their value for attention in clinical as well as surgical settings along with the need to be readily identifiable with MRCP.
Prevalence and Management of Tooth Plaque Among University Students
Authors: Sadeeqa Saleha , Yousaf Saba , Nawaz Iram , Imtiaz Aiman , Kulb Amna , Zafar Zabeen
Published: February 2023

AbstractDental plaque is a biofilm of microbes which has a cross-linkage with the host tissues. The study objective was to assess the prevalence and management of dental plaque among university students. An observational study was conducted from July-2018 to September-2018, at different departments of Punjab University and Lahore College for Women University, Lahore, Pakistan. A total of 300 students with tooth plaque and age between 18-25 years were included in the study. The results showed that tooth plaque was more prevalent between 24-25 years of age. A significant association was found between the following: 'importance of oral hygiene' and gender( p=0.025) and economic status (p=0.001), 'yellowing of teeth' and age (p=0.001) and economic status (p=0.001), 'inherent characteristics' and economic status (p=0.01), 'brushing daily' and age (p=0.015) and economic status (p=0.003), 'type of toothpaste used' with gender (p=0.001) & economic status (p=0.016) and finally between 'visits to dentist' and age (p=0.03) & economic status (p=0.005). Tooth plaque was more prevalent in people with low economic status.
Evaluation and Comparison of Lipid Profile in Pregnancy and Preeclampsia
Authors: Ahmed Jan Naseema , Mahmood Raana , Wasi Nosheen , Ahmad Jan Naila , Anjum Nargis , Salahuddin Huma
Published: February 2023

Objective: The objective of the study is to evaluate and compare the lipid profile in normotensive pregnancy and in pre-eclamptic pregnant women.Methods: The study was a case-control study, conducted from January 2018 to June 2018. The sample size was 90. Participants were recruited after fulfilling the selection criteria out of which, 45 were normal pregnant females and 45 were pregnant females with Preeclampsia (PE). Participants were placed in two groups namely A and B. Group A were 45 healthy pregnant females and group B were 45 preeclamptic pregnant women. The biophysical parameters included age, weight, height and BMI. Blood pressure was recorded through standard protocols. Blood was taken for lipid profile which includes Cholesterol, Triglyceride and HDL-C, measured through enzymatic colourimetric (CHOD-PAP) method, Glycerol-3-Phosphate Oxidase Phenol Aminophenanzone (GPO-PAP) method and Cholesterol Oxidase-Phenol Aminophenazone (CHOD-PAP) method respectively, however; LDL-cholesterol was calculated through Friedewald's formula. Urinary protein was measured through URS Strips through semi-automated analyser CYBOW reader 300. Data were statistically analysed through IBMSPSS software version 20 with the help of one-way analysis of variance (ANOVA) analysis, Tukey'sHSD test, independent sample t-test and Pearson correlation analysis by considering p-values 0.05 as a significant.Results: The results of the study revealed a significant rise in the lipid profile of pregnant women with preeclampsia than in normotensive pregnant women including cholesterol, Triglyceride, HDL-C and LDL-C.Conclusion: The study concluded that dyslipidaemia or hyperlipidaemia in early pregnancy could be one of the reasons for developing preeclampsia in late pregnancy and the risk of being hypertensive in advanced age.
The Role Of IGF-I in Females Selected for Assisted Reproductive Technique (Art)
Authors: Salahuddin Huma , Anjum Nargis , Rehman Rehana , Rehman Sadia , Kumar Winay , Jan Naseema Ahmed
Published: February 2023

Objective: To assess the role of Insulin growth factor-I (IGF-I) in females selected for assisted reproductive technique (ART).Methods: In this cross-sectional study 133 infertile females were recruited for Intracytoplasmic sperm injection (ICSI). The antral follicle count (AFC), pre-ovulatory follicle count (PFC), total doses of follicle stimulating hormone (FSH) were estimated. IGF was measured. Successful pregnancy conception afterICSI was confirmed by an intrauterine gestational sac with cardiac activity after embryo transfer. Receiver Operating Curve (ROC) analysis was also done to find out the area under the curve for clinically pregnant samples using IGF-I. Binary logistic regression analysis was done to estimate the odds ratio with 95% confidence interval for clinical pregnancy using IGF-I; all p-values less than 0.05 were considered significant.Results: Study results revealed that IGF-I gave positive association with clinical pregnancy outcome, and is a more reliable predictor of clinical pregnancy. IGF-I gives 39.8% positive correlation with number of oocytes fertilized. These correlations were statistically significant with p-values less than 0.05. Area under the curve for clinical pregnancy using IGF-I, was 72.4% which reveals the importance of IGF-1 in predicting the outcome of ART.Conclusion: Based on the results of the present study we came to the conclusion that IGF-I is a better and cheaper option and an important tool in the field of infertility.
Replacement of congenitally missing maxillary lateral incisor with ipsilateral canine: A case report
Authors: Alnazeh Abdullah
Published: February 2023

Abstract

Congenital missing lateral incisor of maxilla is a common tooth anomaly. Its replacement can have many options. The choice ought to be understandable for patients or guardians hence effectively address the patient's issues. Regardless of canine replacement, solitary inserts, tooth-supported prosthesis are techniques for patients with missing maxillary missing lateral incisors, although numerous confront are engaged with acquiring and holding ideal outcomes.

In this case, report a case of 16 year old boy was discussed which has the diagnosis of Class II division 1 with missing upper laterals and anterior open bite. Plan was  to perform space closure by canine lateralization and retraction of upper anterior to reduce the overjet followed by extraction of lower 5s to alleviate anterior crowding, correct molar relationship, maintain lower anterior teeth position, finishing, and alignment followed by retention.
Opinion of Parents Regarding Conjugate Typhoid Vaccine
Authors: M.Hanif Memon  , Farhan Saeed  , Muhammad Iqbal  , Muhammad Athar Khan  , Saboohi Erum Saboohi , Fatima Siraj  , Fatima Siraj
Published: February 2023

Abstract

Objective : To study the opinion of parents regarding conjugate typhoid vaccine .

Method : 400 parents bringing their kids for vaccination were enrolled for the study at the vaccination clinic of The Karachi Adventist Hospital .A cross sectional survey was done from 18th November  to 30th November 2019. All parents attending the vaccination clinic of the hospital with their children during the study period; and who met inclusion criteria were consecutively enrolled. A structured self -administered questionnaire was used to collect information from the parents.Parents whose infants are aged between 9 months to 15 years and mothers whose informed consent were obtained are included in the study.  Data was analyzed using SPSS version 21.The Level of significance was set at P = 0.05 and 95% confidence interval reported where indicated.

Result :Opinion of parents regarding new conjugate typhoid vaccine correlated positively with parental age and educational level. Our data showed that majority of the respondents knew the typhoid illness though 75.8% had heard of new conjugate typhoid vaccine . A small percentage believed certain myths and feared its side effects to their child/children . After effective cousnselling and health education , 95.3% agreed for the given vaccination .

Conclusion : Our study showed encouraging opinion of majority of parents regarding new conjugate typhoid vaccine .Few parents  have certain misconcepts and vague beliefs which were efficiently resolved by effective counselling regarding health education .

 

Key Words: Parents,vaccination ,children,new conjugate vaccine
Treatment with Twin-block appliance followed by fixed appliance therapy in a growing Class II Class II Div 1 patient – A case report
Authors: Alsharani Yahya
Published: February 2023

Intraoral examination revealed poor oral hygiene He was in late mixed dentition. He had Class II Div I malocclusion with excessive overjet

Overjet 9mm ,Overbite: 8mm which is represent 100% of lower incisors overlapped by upper incisors ,Mandibular to maxillary midline is deviated to the left by 2 mm. left Molars: full unit Class II , Canines: N.A Right Molars: 3/4 unit Class II , Mild crowdng upper : - 5 mm and lower : - 6 mm ,overlapped upper central incisors ,Proclined upper incisors .There was no transverse discrepancy . However, during TMJ evaluation, he did not report any muscle pain, joint pain, or other symptoms typically associated with temporomandibular disease.
Pictorial Quiz
Authors: Majeed Sobia , Jamaluddin Muhammad
Published: February 2023

A 12 year old female child came with c/o swelling at outer canthus of right eye, for 10 years. It does not cause her pain, no discharge and its size remained same.O/e: swelling is around 1 x 1.5cm, non-tender, round, smooth, margin yield to the pressure and do not slip away, not attached to skin or underlying tissues, cough impulse negative, fluctuation positive but translucency negative. Following is the picture.
Changes in Hematological Parameters of Sprague Dawley Rats with Use of Cyclosporine and Nigella Sativa
Authors: Yonus Nadia , Basharat Ali Asma , Sajjad Shaikh , Mukhtar Sahrish , Rasheed Aaqiba , Kazmi Tayyaba
Published: February 2023

Objective: The objective of this study was to observe the signs of Cyclosporine toxicity and to analyze the ameliorative effects of Nigella Sativa (NS or Kalonji) on body weight and haematological parameters.Methods: This study was conducted in the Department of Anatomy, Baqai Medical University of Karachi during the month of February 2017. Thirty healthy male Sprague Dawley rats were selected from the Animal House of the university. After acclimatization, the animals were randomly divided into three groups, with 10 rats in each Group. Group A was the control group and received no intervention. Group B received treatment of oral Cyclosporine (15 mg/kg/day) in a single daily dose and Group C was given Cyclosporine (15 mg/kg/day) with Nigella Sativa seeds (450 mg/kg) as a protective agent. The bodyweight of rats in each group was measured at the start of the study period. The treatment was given for the duration of 21 days, after which the body weight was measured again. The rats were anaesthetized and blood was collected through cardiac puncture. Blood analysis for haemoglobin percentage, total leucocyte count and differential leucocyte count was done using haematology analyzer. Manual differential leucocyte was also done after staining the blood smear with Leishman's stain.Results: Final body weight of rats in Cyclosporine treated Group B was decreased significantly p<0.001 in comparison to control Group A and increased significantly p=0.001 in Nigella Sativa and Cyclosporine protected Group C. Blood parameters showed decreased mean haemoglobin p=0.03, decreased mean total leucocyte count p=0.003, increased mean neutrophil count p=0.27 and decreased mean lymphocyte count p=0.27 in Cyclosporine treated Group B while the mean values of these haematological parameters improved in Nigella Sativa protected Group C.Conclusion: The present study demonstrated that Cyclosporine caused a decrease in animal weight and toxic changes in haematological parameters while Nigella Sativa was helpful in ameliorating them
To evaluate the dimensions of each lobe and total volume of thyroid gland by ultrasonography among pregnant and non pregnant women in local population, Karachi.
Authors: Ahmed Hira , Ahmed Shazia , Rahim Anila , Perveen Khalida , Saeed Talat , Ainuddin Jahan Ara
Published: February 2023

To evaluate the dimensions of each lobe and total volume of thyroid gland

by ultrasonography among pregnant and non pregnant women in

local population, Karachi.

 

 

Abstract:

Background: Pregnancy has an anatomical and physiological influence on the thyroid gland and it’s function. It is good to know the normal changes that occur during pregnancy. The size and volume of this gland is increased through the pregnancy and becomes visible due to iodine deficiency (ID) that can lead to goiter or may develop hypothyroidism. Objective of the study were to evaluate dimensions of both lobes and calculation of thyroid volume by using ultrasonography (USG) and to compare these parameters between pregnant and non pregnant in Karachi, Pakistan.

Methodology: It was a clinical cross sectional study that was conducted at Gynae OPD and Radiology Department, Ojha campus, Dow university of health sciences (DUHS), Karachi from October 2016 to December 2018 through consecutive sampling. The study volunteers of reproductive age (14-45 years) were included and divided into two groups (pregnant and non-pregnant women). The dimensions of each lobe and calculation of thyroid volume were taken into the account through their standard protocol after following inclusion and exclusion criteria.

Results: The comparisons were made on thyroid gland dimensions, ultrasound outcomes of right and left lobe length, width, depth and volume of thyroid gland. In pregnant women, right lobe length was 2.91±1.05, width was 1.54±0.41 and depth was 2.31±1.41 whereas in non pregnant women mean right lobe length was 2.50±0.97, width was 1.34±0.51 and depth was 1.68±0.98. The mean difference was considered statistically significant in pregnant women with p-value (< 0.01). In pregnant women thyroid volume was 7.02±3.21 whereas in non pregnant, it was   5.58±2.41 which was significantly increased in pregnant women with p-value (< 0.01).

Conclusion: Therefore our study concludes that, in our population at least half of the apparently healthy pregnant females do have some degree of iodine deficiency. The volume of the gland is increased during pregnancy, suggesting iodine deficiency.

 

Key Words: Pregnant women, non pregnant women, dimensions of thyroid gland and

                      volume of thyroid gland.
Knowledge, Attitude & Practices of Surgeons in the time of COVID-19
Authors: Jalil Amir , Kanwal Rahila , Idrees Zeeshan , Mehmood Khan Kashif , Naseem Muhammad , Safi Kamal Muhammad
Published: February 2023

Objective: The objective of the study was to determine the knowledge, attitude and practices of surgical interns, residents and surgeons in the time of COVID-19.Methods: A cross-sectional study was conducted on surgical interns, trainees, registrar and consultants working in public and private sector tertiary care hospitals of Karachi. The non-Convenience sampling technique is used. A total of 184 patients were included. The study was performed on assessing patients' demographics, basic knowledge and awareness of COVID 19 and individuals' practices toward COVID 19 in their professional routines. Data were stored and analyzed using IBMSPSS version 23.0. Pearson Chi Square test was used to test the association outcomes, awareness and attitude items on COVID-19 between private and public sector hospitals. P-values less than 0.05 were considered statistically significantResults: The study comprised a total of 184 participants. Mostly from public 115(63%) rest 69(37%) belonged private sector hospitals. Most respondents 122(66.3%) were aware of COVID 19 incubation, symptoms and the detection of patients at risk and modalities of transmission in operating rooms.Results showed among public vs Private sector hospitals (81.7% / 68.1%) were treating corona virus, there were (35.7% / 46.3%) screening and admitted the cases, (56.5% / 62.4) tentative numbers of COVID-19 cases reported range from 0-25, (40.9%/ 11.6%) surgeons were assigned additional duties for COVID -19 by hospital management found statistically significant with "p<0.01".Conclusion: It is concluded after this study that the surgeons in Pakistan are well aware of the situation, have adequate knowledge of the risk factors and symptoms of COVID-19. But statistically, probably because of limited resources and workload, there is a substantial gap in practices between public and private sector surgeons. There is also a dire need to develop local guidelines related to preventive measures in our health care systems according to our demands and supply.
Prevalence of Risk Factors for Thyroid Hormone Imbalance
Authors: Sadeeqa Saleha , Zaka Amna , Arif Iram , Nasir Maham Saba , Zakreya Pakiza Bint , Amin Fatima
Published: February 2023

This study was aimed to assess the frequency of thyroid hormone imbalance risk factors. A cross-sectional survey was conducted using the convenience sampling technique, from July-2018 to September-2018 in different cities of Punjab, Pakistan. A total of 150 patients, having thyroid hormone imbalance with or without any comorbidity were included and the subjects having normal thyroid levels were excluded. Thyroid hormone imbalance was more frequent in females having 40-60 years of age. Gender was significantly associated with 'pregnancy or delivery in last six months' (p=0.029) and iodine deficiency (p=0.036). Marital status was significantly associated with 'symptoms observed' (p=0.009), 'radioactive iodine exposure' (p=0.001), 'autoimmune disease' (p=0.050), 'smoking' (p=0.014) and 'stress' (p=0.040). Family income was significantly associated with 'family history of disease' (p=0.039) and 'iodine deficiency' (p=0.049). Residential area was significantly associated with 'autoimmune disease' (p=0.050), 'smoking' (p=0.036) and 'stress' (p=0.029). Use of iodized salt and stress were prevalent risk factors and disease was common among females, especially age group 40-60 years.
Pictorial Quiz
Authors: Iqbal Fatima , Jamaluddin Muhammad
Published: February 2023

My patient 30 years of age G3P2 with 30 weeks of gestational amenorrhea came with complain of abdominal distension, relative constipation and multiple episodes of vomitings for 3 days. She had history of eating hairs for 3 years. On examination, abdomen was distended and tense overall. Gutsounds inaudible. Digital rectal examination was unremarkable. X-ray Erect abdomen showed multiple air fluid levels. Attached below is the picture of operative finding.
Adverse Effects of HMG CoA Reductase Inhibitor and Garlic on Renal Function in Patients with Diabetic Dyslipidemia
Authors: Siddiqui Naveed Ali , Ishaque Imran , Rahat Yousra , Akhtar Naheed , Tehreem Umaya , Javed Rafia , Ali Rayyan
Published: February 2023

Objectives: To analyze the adverse effects of HMG CoA reductase inhibitor (statin) and garlic (Allium sativum) on renal function in diabetic dyslipidemic patients.Methods: This clinical trial was conducted at Surgeon Munawar Memorial Hospital, Karachi from 1st March 2019 to 30th August 2019. Total of 60 patients of 30-70 years of age with abnormal lipid profile were enrolled for this study after a written consent. The study was conducted to assess the side effects of statin (20 mg/day) and garlic (300 mg/day) in diabetic dyslipidemia patients. The study period consisted of six months. Blood pressure, body weight and height of subjects were assessed. The patient answered the questionnaire on health complaints, smoking, social role, drug usage, family history and dietary pattern. The initial inclusion criteria of the patient were 1) Age between 30-70 years old of either sex, 2) Patients with diabetic dyslipidemia. The exclusion criteria were 1) Pregnancy or lactation, 2) Patients with liver diseases, 3) Patients with renal diseases. Detailed medical history and physical examination of all patients were carried out.Results: This study included 60 patients with an abnormal lipid profile of age 30-70 years. Internationalstatin product (20 mg/day) and local garlic product (300 mg/day) for 08 weeks were used for oral administration in patients. Urea and creatinine levels in the serum of diabetic dyslipidemic patients were measured before and after treatment with an international statin (20 mg/day) and a local garlic product (300 mg/day).

Conclusion: According to the findings of this study, statins increase the serum level of urea and creatinine while garlic has no effect on urea and creatinine serum level.
Comparison Of Outcome Between Simple Polypectomy Versus Endoscopic Sinus Surgery
Authors: Kumar Amrat , Waheed Abdul , Mahar Ghulam Shabbir , Mahmood Zafar , Hussain Junaid , Wasee Nosheen , Anwar Adnan
Published: February 2023

Objective: Nasal polyps are smooth, soft tissue, pale or yellow shining bulges that can block nasal cavity, sinuses and brings persistent state of rhino sinusitis influencing quality of life. The objective of this study was to compare outcomes of simple intranasal polypectomy versus Endoscopic sinus surgery after removing nasal polyps.

Methodology: This comparative cross-sectional study was conducted at Department of ENT in Civil Hospital, Hyderabad from April 2020 to June 2020. After ethical approval, 60 adult patients of either gender ranging from 14 to 40 years, with Sino nasal Polyposis were randomly selected. The collected data was analyzed using SPSS version 17. Categorical variables like all complications were presented as frequency and percentage.

Result: Out of 60 patients, 37(61.6%) males and 23 (38.4%) female, and mean age 28.87 ± 7.69 years, the post-operative complications like bleeding was observed in 6.7%, crusting 10%, Synechiae formation 10% of patients after 6 weeks, recurrence in 13.3% after 3 months, while intraorbital complications i.e. orbital swelling in 13.3% patients following simple intranasal polypectomy. In contrast, bleeding 10%, crusting 16.7% with orbital swelling 3.3% was reported up to 2 weeks following surgery. Synechiae formation 16.7% up to 3 months was observed following Endoscopic sinus surgery.

Conclusion: Post-operative complications of endoscopic sinus surgery have been quite lesser as compared to simple nasal polypectomy along with low recurrence rate. Fortunately, intra cranial complications were not observed, only intra orbital swelling was seen in both types of surgeries.
Association between Functional Status of Patients and Cognitive Impairment in End Stage Renal Disease
Authors: Arman Asma , Yaseen Mahjabeen , Ansari Tahir , Billia Natasha , Butt Mehwish Arif
Published: February 2023

ABSTRACT

Objective: The increased incidence of diabetes, hypertension in third world countries has lead to an increase in end stage renal disease which in turn escalates the burden of dialysis on patients and caregivers. Dialysis is associated with many serious physical and mental disturbances. The aim of this study is to highlight the importance of screening for cognitive impairment and depression in End stage renal disease because cognitive impairment can impair the activities of daily living and overall quality of life.  

Methods: 150 patients were included in a study after fulfilling the inclusion and exclusion criteria. They were screened for cognitive impairment by using the Montreal cognitive assessment scale, for depression by using Hospital Anxiety and Depression scale and Barthels index for assessment of activities of daily living. 

Results: Of 150 patients most were males (56%) and females were (44%) out of which 36.67% males and 32.67% of females were cognitively impaired. Most patients were hypertensive and unemployed.  There was no significant social demographic association observed for cognitive impairment. The patients with cognitive impairment need assistance in feeding, bathing and mobility as compared to patients with no cognitive impairment.  

Conclusion: Our study revealed that cognitive impairment is present in patients and it is related with activities of daily living. The presence of depressive symptoms and anxiety is also affecting activities of daily living difficulty in ambulatory hemodialysis patients. Patients especially need help in climbing stairs and minor help in transferring, occasional bladder help, minor help in feeding and minor help during walk. 

Key words: Cognitive impairment, End stage renal disease, Dialysis, Activities of daily living.
Effect on Cardiovascular System by Hyperbaric Bupivacaine and Isobaric Ropivacaine Given By Sub-Arachnoid Block in Planned Lower Extremity Surgery
Authors: Pasha Muhammad Naeem , Naeem Pasha Sheeza , Naeem Ayeza , Haque Syed Hurul
Published: February 2023

Objectives: Efficacy of two local anesthetic drugs such as Ropivacaine and Bupivacaine were compared when they were administered intrathecally during elective lower limb surgery. Furthermore, the side effects of both drugs were also studied in the similar research.

Methods: The study was done double-blinded, un-biased and a randomized control trial. Cardiovascular system parameters such as average heart rate and average systolic blood pressure were monitored after medication given. Decreased BP, nausea, vomiting, shivering and headache were the parameters used to assess the side effects on the patients receiving both the drugs.

Results: Action of these two drugs on cardiovascular system parameters were monitored and there was no valuable dissimilarity seen. No statistical significance was found in the duration of nausea, vomiting and headache. None of the patients reported bradycardia or backache. However, shivering was observed in the patients that were administered Bupivacaine as compared to Ropivacaine.

Conclusion: Ropivacaine is a better drug of choice as compared to Bupivacaine while considering the hemodynamic parameters as well as the different post-operative symptoms.

Clinical Trial Number: Reference number: 0031/14 (Authenticated by Ethical and Scientific Review Committee, Karachi Medical and Dental College)
Clinical Features, Laboratory Characteristics, and Outcome of Patients Admitted With COVID-19 Infection; A Single-Center Experience
Authors: Mehboob Saima , Banori Syed Hamid Hussein , Ullah Zahir
Published: February 2023

Objective: To determine the clinical features, laboratory variants, and outcome of patients with Corona virus Dis- ease-2019 (COVID-19) infection.

Methods: A descriptive, single-center case series was conducted between October to December 2020. It included patients diagnosed with COVID-19 infection via Polymerase Chain Reaction (PCR). Patients were recruited through non-probability convenience-based sampling. After history and detailed examination of the patients, their demographic and clinical characteristics, including complete blood count (CBC), renal & electrolytes profile, inflammatory markers like C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimers were recorded using a structured questionnaire. Patients were managed according to the severity of the disease and disease progression was monitored regularly. Treatment offered to these patients was based on their presentation and severity of the disease.

Results:  Out of 1092 patients, 77% were males. Most of them were diabetic (71.0%) and aged between 51-70 years (58.97%). Furthermore, 1051 of the total enrolled cases were symptomatic and had shortness of breath (94.32%), dry cough (91.20%), anorexia (91.20%), fatigue (90.65%), and etc. Among the laboratory parameters, raised C-reactive protein (CRP) was found in 96.24% of patients while leukocyte count, Alkaline phosphatase (ALP), D-dimers, ferritin and lactate dehydrogenase (LDH) levels were elevated in 89.37%, 71.61%, 68.77%, 56.86%, and 44.04% respectively. Hyponatremia was also observed in 53.75% patients. Most patients (32.60%) had oxygen saturation between 80 to 89%, while it was   80% among 20.42% patients. Moreover, 31.05% patients were categorized as having mild disease, 23.68% had moderate severity, and 24.84% had severe disease on the basis of clinical criteria. About 20.42% were critical and had respiratory failure. The recovery rate was high (96.0%), and the mortality rate was only 4.0%.

Conclusion: We observed dynamic changes in the clinical and laboratory features of the COVID-19 patient’s ad- mitted at District Health Quarter in Charsada, highlighting the significance of each of these parameters for individual patient’s recovery and survival.
Frequency of Orthopedic Trauma in Patients Attending Khalifa Gul Nawaz Teaching Hospital: A Retrospective Analysis
Authors: Khan Alamzeb , Ahmed Israr , Sher Gul
Published: February 2023

Objective: The present study aimed to assess the frequency of orthopedic trauma injuries in patients admitted to the Orthopedic Department at Khalifa Gul Nawaz Teaching Hospital in Bannu.

Methodology: This retrospective snapshot study was conducted at the Orthopaedic & Traumatology Department of K.G.N. Hospital in Bannu, KPK. Data were extracted from hospital records of 380 patients admitted for emergency orthopedic surgery due to fractures, lacerations, and/or fractures with lacerations. The frequency and etiologies of orthopedic diagnoses were recorded. 

Results: Out of the 380 cases admitted during the study, the majority were males (76.05%). Furthermore, these orthopedic trauma injuries were more common in individuals aged 21 to 50 years (66.83%) than the other age groups. Road Traffic Accidents (RTA) were the major etiological factor (49.21%), followed by falls from height (31.84%). Upper limb fractures were diagnosed in 46.27% of patients, and 53.63% had lower limb fractures. Isolated radius (14.47%) and femoral fractures (23.94%) were the most frequent diagnosis.

Conclusion: The present study provides a brief overview of the major etiologies and diagnoses for orthopedic emergencies. It is essential to identify the risk factors and strategize a prevention plan that should be the priority of the healthcare system to avoid morbidities and mortalities associated with orthopedic traumas.
Frequency of Self-Medication and Its Associated Factors among Outpatients
Authors: Hyder Naqvi Syed Muhammad Zulfiqar , Ahmed Jafry Syed Imtiaz
Published: February 2023

Objectives: To assess the frequency of self-medication and its associated factors among outpatients.

Methods: A cross-sectional study was conducted at the outpatient department of Fatima Hospital, Baqai Medical University, from May 2019 to September 2019. After checking eligibility, a total of 360 outpatients were included in the study using the convenience sampling technique. Being aged 18 years or above and belonging to either gender were the study's inclusion criteria, whereas refusal to give verbal informed consent was the exclusion criterion of the study. The data was collected by interviewing the study participants using a structured questionnaire. Statistical package for social sciences version 21 was used for data analysis, while inferential analysis was performed using univariate and multivariable binary logistic regression.

Results: The study results showed that 118 (32.8%) of the participants were suffering from a chronic illness, 240 (66.7%) of them kept medicines at their houses, 235 (65.3%) of them self-medicated, whereas the mean duration of their self-medication was found to be 9.90 ± 8.51 years. Moreover, age, educational status, employment status, and keeping medicines at the house were significantly associated with self-medication of the participants were those who were aged 50 years or above (AOR,7.83; 95% CI,2.27-27.04; p=0.001), able to read and write (AOR, 4.36; 95% CI, 1.58-11.98; p=0.004) and kept medicines at the house (AOR, 46.35; 95% CI, 20.07-107.06; p<0.001) had significantly higher odds of self-medication than those who were aged up to 30 years, were illiterate or did not keep medicines at house respectively whereas those who were employed/self-employed (AOR, 0.30; 95% CI, 0.10-0.88; p=0.028) had significantly lower odds of self- medication than those who were unemployed.

Conclusion: Almost two-thirds of the participants were found to be self-medicating. Moreover, age, educational status, employment status, and keeping medicines at the house were significantly associated with the self-medication of the respondents.
A Prognostic Model for Predicting Liver Cancer Patients Based On Immune Checkpoint Gene-Related Basement Membrane Genes, And Analyzing Immunity and Potential Drug Candidates
Authors: Chen Yiyang , Gong Yiju , Ou Xi
Published: February 2023

Abstract:

Objective: Hepatocellular carcinoma is one of the most common malignant tumors in the world. The expression of immune checkpoint genes in tumor cells prevents the immune system from eliminating tumors. Basement membrane-related genes are genes that are closely related to human diseases obtained in the latest research.

Methods: First, basement membrane-related genes were extracted from immune checkpoint genes, and a prognosis model of immune checkpoint-related basement membrane genes was constructed. C-index curves and ROC were drawn by survival analysis, progression-free survival analysis, and independent prognostic analysis. Curves, principal component analysis, and validation of the clinical grouping model were performed to verify its accuracy, enrichment analysis, immune analysis, and tumor mutation burden survival analysis were performed to further explore the potential functions of the model, and finally, potential drugs targeting the model were discussed.

Results: A prognostic model for predicting the survival time of liver cancer patients was constructed, and the predictive ability of the model was verified. GO and KEGG enrichment analysis revealed differences in the functions and pathways of differential genes. Four differentially expressed immune functions were found. The top 4 genes mutated in the high and low risk groups were compared. Twenty-five drugs with significant differences in drug sensitivity between high- and low-risk groups were explored.

Conclusion: The risk-prognostic model based on the association of basement membrane genes and immune checkpoint genes in this study may be promising for clinical prediction of prognosis and immunotherapy response in patients with liver cancer.
Hegel on International Recognition
Authors: Giladi Tal Meir ,   Philosophy Documentation Center
Published: February 2023

Scholars have recently argued that Hegel posited international recognition as a necessary feature of international relations. My main effort in this article is to disprove this point. Specifically, I show that since Hegel rejected the notion of an international legal system, he must hold that international recognition depends on the arbitrary will of individual states. To pinpoint Hegel’s position, I offer a close reading of Hegel’s intricate formulations from the final paragraphs of the Philosophy of Right—formulations that are easy to quote out of context just as they are transparent when considered in due context.
EFFICACY OF A MUSIC-BASED INTERVENTION ON ENHANCEMENT OF TREATMENT MOTIVATION AMONG CLIENTS WITH SUBSTANCE USE DISORDERS IN RESIDENTIAL TREATMENT IN KENYA
Authors: Chege Antony , Kathungu Beatrice , Karega Muchiri
Published: February 2023

Abstract

Although evidence suggests music-based interventions (MBI) may help enhance treatment motivation, their efficacy was generally untested among the Kenyan population. This motivated the current study to test the efficacy of an MBI on treatment motivation of clients with substance use disorder (SUD) in a selected treatment center. Subjects were 40 clients in a residential treatment facility with two branches. A quasi-experiment, nonequivalent control group pre-test post-test design was used. The treatment group, with 20 clients in branch A, received MBI in addition to treatment as usual (TAU) while the control, comprising 20 clients in branch B, only received the TAU in the same period. A TM test using the TCU/SRF Treatment Motivation scale was administered to both groups before and after the four weeks of MBI on the treatment group. Findings showed that the treatment group had significantly higher levels of treatment motivation at post-test compared to the control group after controlling for various covariates, suggesting that MBI may have contributed to the increased TM in the treatment group. This implies that MBI may be a promising intervention in enhancing treatment motivation among clients with SUD in treatment settings in Kenya.
VYANZO VYA MISIMU KWA WANAFUNZI KATIKA KISWAHILI
Authors: Adolph Editha
Published: February 2023

Makala hii inachunguza vyanzo vya misimu kwa wanafunzi katika Kiswahili. Mtafiti ametumia mbinu za hojaji, usaili na uchambuzi wa matini. Mtafiti aligawa hojaji 15 kwa wanachuo 15 wa Chuo Kikuu cha Dar es Salaam. Chuo hiki kinapatikana katika Wilaya ya Ubungo mkoani Dar es Salaam nchini Tanzania. Aidha, mtafiti alisoma nyaraka zinazohusiana na mada husika kama vile: majarida na tasinifu. Makala hii imeongozwa na Nadharia ya Uchanganuzi wa Kimaeneo ya Fishman (1972). Data ya makala hii imechambuliwa kwa kutumia mkabala wa maelezo. Matokeo ya makala hii yamebainisha kuwa wanachuo wa Chuo Kikuu cha Dar es Salaam pamoja na kutumia msamiati sanifu pia hutumia misimu kutoka katika nyanja tofautitofauti katika mawasiliano yao ya kila siku. Mtafiti amechunguza misimu inayotokana na uwanja wa sanaa, siasa na michezo. Makala hii ni muhimu kwa wanaisimu kwani inabainisha misimu mbalimbali inayotumiwa na wanachuo wa chuo husika. Pia misimu tofautitofauti inayohusiana na nyanja za utani, soka na sanaa. Hii itatoa msukumo kwa wasanifishaji wa lugha ya Kiswahili kusanifisha misimu husika. Makala inapendekeza kuwa watafiti wa lugha wachunguze misimu inayotokana na mitandao ya kijamii, aina mbalimbali za misimu, misimu inayotumika katika maeneo mbalimbali kama vile shuleni, vijiweni, hospitalini na maofini.
A Syntactic Analysis of Raising Structures in Kĩmũthambĩ
Authors: Kaburo Diana
Published: February 2023

This paper provides a syntactic analysis of noun phrase movement in raising predicates in Kĩmũthambĩ, a Bantu language, spoken in Kenya. Kĩmũthambĩ belongs to the larger Kikuyu-Kamba group (E50) and is classified as E531 Mwimbi-Muthambi by Eberhard et al. (2022). The study is guided by the Minimalist Program developed by Chomsky (1995). This theory recognizes that there is always a trigger movement which is the need to check features at an appropriate landing site. The paper demonstrates that Raising in Kĩmũthambĩ is triggered by the need to check case features. Since raising verbs cannot assign case to a NP, the NP must move to a position in a sentence where it can be assigned case. This according to Carnie (2007) is due to the fact that the NP and the case assigner must be local in such a way that it must be the specifier or the complement of the case assigner, in order to check the feature of case. Case therefore becomes a mandatory trigger for movement of NPs that are not in positions that can be assigned case as in the case of raising predicates. The paper also demonstrates that unlike in English where raising occurs on non-finite clauses only, Kĩmũthambĩ allows raising of subjects out finite clauses a situation referred to as hyper-raising. This study contributes to the study of Kĩmũthambĩ, a language that has had little research attention. It also contributes to the body of knowledge on raising structures in Bantu languages.
IMAGE REPAIR DISCOURSE OF KENYA POLICE FACING A SCANDAL
Authors: Sifuna Tom
Published: February 2023

The present study aims to analyze image repair strategies employed in press releases issued by the Kenya police. The main aim of the study was to analyze the linguistic resources of image repair strategies in press releases issued by the Kenya police.  This study took the reporting periods from 30th March 2008 until 30th May 2012. Seven press releases were selected for analysis: Torture in Turkana, Mount Elgon operation saves lives, Criminal acts attributed to Mungiki, Human Rights Watch Report, brief on the explosion at Kampala coach offices, Allegations on the conspiracy of silence, and a Report on Post-Election Violence. Three major linguistic strategies are adopted: denial, reducing the offensiveness of the event, and corrective action. For this study, the linguistic resources used were the use of active, and passive voice and the use of modal auxiliaries verbs constructions.
Vowel Hiatus in Lubukusu Revisited: A Positional Faithfulness Reanalysis
Authors: Nandelenga Henry
Published: February 2023

Previous phonological studies have indicated that a sequence of dissimilar hetero-syllabic/morphemic vowels are dispreferred across languages because it creates vowel hiatus. As a result, it may engender multiple repair mechanisms. However, the repair mechanisms do not apply liberally; they may be resisted in certain positions when segmental deletion or featural change fail to take place. Segments in phonetically and psycholinguistically privileged positions invariably resist such repair strategies that may be quite regular in the grammar of the language. In this study, a reanalysis of data from Lubukusu language (Bantu, Kenya) shows that a Positional Faithfulness (PF) account within an Optimality Theory (OT) framework may be felicitous in explaining both the initiation and resistance to the said repair processes. The findings indicate that the positional faithfulness of the vowel in question may determine whether it is deleted or which features may be changed based on a single constraint hierarchy in an optimal grammar of the language. Preservation of lexical contrast in positions that are critical in language processing is accounted for through positional sensitive constraint domination.
STRATEGIES FOR RE-SHAPING INITIAL TEACHER EDUCATION TO STEER HOLISTIC AND SUSTAINABLE EDUCATION IN AFRICA
Authors: Zigama Jean Claude , Somba Anthony M
Published: February 2023

Education is the only institution through which society can attain its ideals and aspirations. For this to happen, teachers play a pivotal role in translating the ideals into mini activities that are meant to transform individuals’ learners into useful competent citizens. This is the main reason that Teacher education as a special programme of education, has undergone tremendous transformations over few decades ago in Africa and the world. These transformations, however, have not been accompanied by concrete actions to adapt Teacher Education to the different dynamisms the African society is traversing. This paper aims at examining the effectiveness of practices being used in current initial teacher education in sub-Saharan Africa. The focus of the paper is based on three paramount questions: 1. What are the current practices versus new requirements in initial teacher education of the Twenty-First Century (21st C) in the context of Africa? 2. How best can teachers be prepared to meet the needs and aspirations of African societies and the world in the Twenty-First Century and beyond? 3. What are the challenges militating against quality teacher education in Africa? The first question seeks answers on who should be the teachers in the 21st Century classroom in Africa. The second question focuses on who and how such a teacher can be prepared. The third attempts to identify challenges that potentially threatens the attainment of an effective and efficient initial teacher education. The information generated from these questions will not only help in shedding light on some wrongdoings surrounding initial teacher education, but also unlock the door to more modern and ultra-modern practices that can make Africa produce useful, competent, and exportable teachers.
Suicide disguised as homicide: A case report of yellow oleander poisoning
Authors:   Professor and Head, Department of Forensic medicine & Toxicology, Sri Devaraj Urs Medical College., P Srinivasa Reddy , M G Raj Kumar
Published: February 2023

Yellow oleander is an ornamental cardiotoxic plant found in tropical and subtropical areas of the World. Its toxicity is related to the content of cardio active glycosides, mainly oleandrin1. A 38-year-old fe-male was brought to to R.L Jalappa hospital, Mortuary, Kolar with history of consumption of unknown com-pound and succumbed to death at her residence. Initially deceased husband was suspected for committing homicide but after meticulous autopsy and FSL report it was found to be a case of yellow oleander poison-ing. This case report wherein the victim succumbed to instantaneous death following consumption of yel-low oleander. Key words: Yellow oleander, cardiotoxicity, oleandrin, homicide, & suicide