bluuebunny/crossref_metadata_2025 huggingface dataset:
PARTISIPASI MASYARAKAT DALAM PEMULIHAN PARIWISATA PADA ERA NEW NORMAL DI KSPN BEDUGUL
Authors: Ariasri Nyoman Reni , Susianti Hartanti Woro
Published: March 2022

The research aims to investigate community participation in KSPN Bedugul towards tourism recovery efforts. Data was collected by observation, survey and interview using questionnaires and interview guides. The sampling technique used was purposive and snow ball sampling and the data obtained were analyzed using quantitative descriptive analysis techniques and the typology theory of community participation in tourism from Pretty were referred to. The results showed that the overall community participation in the recovery of tourism in the New Normal era at KSPN Bedugul, appears very small (below 50%). Based on the seven levels of participation typology, the level of participation in the Bedugul community from the lowest can be seen as follows: manipulative participation with average value of 0.556 or 27.8%; passive participation (0.546 or 27.3%); participation by consultation (0.563 or 28.1%); participation for material incentives (0.82 or 41%); functional participation (0.293 or 14.6%); interactive participation (0.156 or 7.8%); self-mobilization and connectedness (0.9 or 45%). It is recommended that stakeholders involve the community in tourism recovery efforts, as well as the re-establishment of organizations such as Pokdarwis. It is also necessary to increase public awareness of the meaning of tourism for improving their standard of living.
PERILAKU KEUANGAN WIRAUSAHA PADA INDUSTRI PARIWISATA: STUDI KOMPARATIF GENERASI X, Y DAN Z
Authors: Rukmiyati Ni Made
Published: March 2022

This study aims to determine the differences in financial behavior among generations X, Y, and Z. This study uses the Kruskal-Wallis test to examine differences in financial behavior. Based on the results of the Kruskall-Wallis test, it is concluded that there are differences in financial management between Generations X, Y, and Z, with a Chi-Square value of 12,579 and an Asympt. Sig. of 0.002 < (0.05). Generation differences will also lead to differences in information in each generation that can affect financial behavior. This study supports the Theory of Planned Behavior, which states that humans behave in a conscious way by considering relevant information.
STRATEGI PENGEMBANGAN PENGOLAHAN KOPI ARABIKA SEBAGAI DAYA TARIK WISATA GASTRONOMI DI DESA CATUR, KINTAMANI, BALI
Authors: Hendrayana I Made
Published: March 2022

Catur Village is a center for Kintamani Arabica Coffee production, the distribution of the coffee products has been carried out throughout Bali to foreign countries such as Japan, Europe, America, and Australia with the brand "Kopi Catur Arabika Kintamani". As a tourist village, Catur needs to have a strong tourist attraction to attract tourist visits. The study of the development of the Kintamani Arabica Catur Coffee processing attraction as a gastronomic tourist attraction is the right step to create a strong story or story in the minds of tourists. The purpose of this study was to determine the development strategy of coffee processing as a gastronomic tourist attraction. The research method used is qualitative using SWOT analysis. The results show that there are 13 strategy formulations that can be used in the development of coffee processing as a gastronomic tourist attraction, of these 13 strategies there are 11 strategies that have been realized, but the realization must be further optimized.
IKATAN MAHASISWA MUHAMMADIYAH SEBAGAI LABORATORIUM AKADEMISI ISLAM BERAHLAK MULIA
Authors: Asman Asman
Published: March 2022

Penelitian bertujuan untuk menganalisis sekaligus memberikan afirmasi bahwa organisasi kemahasiswaan khususnya IMM selama ini telah menisbahkan gerakannya dalam pembentukan akademisi Islam yang berahklak mulia, melalui laboratorium IMM. Penelitian ini merupakan penelitian, studi pustaka dengan pendekatan kualitatif. Data yang dikumpulkan bersumber dari buku-buku terkait penelitian, serta beberapa jurnal ilmiah yang menjadi penunjang dari penelitian ini. Yang berkaitan dengan IMM sebagai laboratorium akademisi Islam yang berahklak mulia. Penelitian ini berkesimpulan bahwa, IMM sebagai laboratorium akademisi Islam dengan melakukan pembinaan baik dalam kegiatan jenjang pekaderan secara formal maupun non formal dan sesudah pelasanaan pekaderan masih membina kader-kader IMM dalam bentuk follow up kegiatan IMM. Selain itu, IMM sebagai pergerakan Mahasiswa Islam menekankan nilai-nilai Islam terinternalisasi terhdapa seluruh kegiatan IMM.
Factors Associated with the Incidence of Anemia in Pregnant Women at the Sambau Nongsa Community Health Center Batam in 2021
Authors: Sinaga Suharni Pintamas
Published: March 2022

Anemia in pregnancy is the condition of the mother with hemoglobin levels below 11 g/dL in the 1st and 3rd trimesters <10.5 g/dL in the 2nd trimester, this limit value and the difference with the condition of non-pregnant women is due to hemodilution, especially in the 2nd trimester. Aims to determine the relationship between age, gestational age, parity and KEK status with the incidence of anemia in pregnant women at the Sambau Nongsa Community Health Center Batam in 2021. This study used a cross-sectional design. The population in this study were all pregnant women who visited the Sambau Nongsa Community Health Center Batam 267 people and a sample of 82 people. Data analysis using Chi square test. The results showed that there was a relationship between age (p=0.043), gestational age (p=0.037), parity (p=0.035) and KEK status (p=0.000) with the incidence of anemia in pregnant women at the Sambau Nongsa Community Health Center Batam in 2021. It is recommended that every mother pregnant women are advised to frequent antenatal care (ANC) visits and seek information about the dangers of pregnancy, considering the incidence of anemia can occur in pregnancy and to prevent pregnant women should consume iron (Fe) tablets during pregnancy regularly and consume healthy and nutritious foods.

Keywords: Age, Gestational Age, Parity, KEK Status, Anemia, Pregnant Women.
Post-Acute COVID-19 Syndrome after a Critical COVID-19: A Case Report
Authors: Apsari Dewi Ni Putu Rani , Gde Upeksha Anak Agung
Published: March 2022

Introduction: The COVID-19 pandemic has caused many impacts in health, economic and social aspect worldwide. Infection of SARS-CoV-2 affects many organ systems. Post-COVID-19 syndrome is a condition when some of those infected with SARS-CoV-2 are complaining symptoms that persist for weeks to months even the PCR was negative.
Case Illustrations: We present a case of post-acute COVID-19 syndrome in a 59 years old man with persistent respiratory symptoms for 3 months since the onset of a critical COVID-19. He was admitted to the hospital with critical COVID-19 which he received treatment for COVID-19 according to protocol and mechanical ventilation via tracheostomy in intensive care unit (ICU). In the post-acute COVID-19 conditions, he complained of persistent fatigue, shortness of breath, cough, limited walking activity and palpitations.
Discussion: In most cases of asymptomatic, mild and moderate COVID-19 symptoms, patients usually resolve without complications. However, in cases with severe symptoms, systemic hyperinflammation of the immune system occurs due to activation of the SARS-CoV-2 virus which causes various complications in several organs. The management of patients with post-COVID-19 syndrome is determined based on clinical assessment of the patient, radiological examination, and laboratory and pulmonary function tests if possible. Patients with radiological abnormalities without clinical symptoms, evaluation is carried out 8 to 12 weeks after therapy and can be earlier if patients have any complains. Meanwhile patients with clinical symptoms with or without radiological abnormalities, need to evaluate after 4 weeks to see if there is any improvements. In addition to symptomatic treatment, oxygen therapy, rehabilitation, psychotherapy and nutritional therapy can also be given in patients with post-COVID-19 syndrome.
Conclusion: Post-COVID-19 syndrome is a condition that affected almost all of the organ system in the body. The most common symptoms are persistent fatigue, shortness of breath, cough, myalgia, malaise and headache. This condition impact both physical and mental health that persists for weeks or months after being infected with SARS-CoV-2. Patient with post-COVID-19 syndrome should be prioritized due to their impact on the global health burden. Those who diagnosed with post-COVID-19 syndrome also needed psychological and emotional support to deal with persistent symptoms caused by post-COVID-19 condition so the survivors can return to living their lives as before.

Keywords: Post-COVID-19 Syndrome, Long COVID, Post-Acute COVID-19 Syndrome, Critical COVID.
Pre-Experimental Study to Assess the Knowledge Regarding Intramuscular (IM) Injection among Undergraduate Students in SRM College of Nursing, Kattankulathur, Tamil Nadu, India
Authors: Bhusal Pampha , Kanniammal C. , Malarvizhi P.
Published: March 2022

Background of the Study: Intramuscular injection is a method of administering medications deep into the muscle tissues so that they can be absorbed quickly into the body. Generally, the intramuscular injection is used to administer vaccines and drugs.
Aim: The aims of the study was to assess the pretest posttest level of knowledge regarding intramuscular injections and to determine the association between the levels of knowledge regarding intramuscular injection with their selected demographic variables.
Methodology: A pre-experimental research design (one group pre-test and post-test design) was applied for this study, which included Fifty-five nursing students. Purposive sampling technique was used for the sample selection. The data was collected through virtual mode using demographic variables as well as a structured knowledge questionnaire. Descriptive, inferential statistics were used to analyze the data.
Results: Majority of the nursing students had moderately adequate knowledge 31(56.4%), 16(29.1%) had inadequate knowledge and 8(14.5%) had adequate knowledge on pre-test. There was a significant improvement in post-test knowledge score of nursing students regarding IM injections (M=10.89 SD=4.508) compared to the pre-test scores (M=14.42 SD=3.720) with the ‘t’ value of p < 0.01.
Conclusion: The present study reveals that more practical exposure is necessary so that they can gain more knowledge regarding intramuscular injections. They are the future nurses who will do medication to the patient.

Keywords: Knowledge, Intramuscular injections, Nursing students.
Use of Katlu, a Traditional Food for Lactating Mothers: A Study of Three Generations of Gujarati Women
Authors: Raval Neeta , Goyal Aditi , Udipi Shobha A.
Published: March 2022

Background & Aim - ‘Katlu’ or ‘Battrisu’ is a traditional Gujrati preparation consisting of 32 herbs and is given to lactating mothers. With globalization and exposure to varied cuisines, diet patterns in urban areas in India have changed considerably. Therefore, this study was undertaken to determine whether consumption of ‘katlu’ and knowledge about it, has changed over three generations.
Methodology - Practices related to ‘katlu’ consumption were examined across three generations within the same family; lactating mothers (n = 79), their mothers/ mothers-in-law (n = 77), and their grandmothers/ grandmothers-in-law (n = 57). Participants were recruited by snowball sampling from three cities – Mumbai, Maharashtra state, and Junagadh and Ahmedabad in Gujarat State.
Results - More than half of participants from all three generations were aware of ‘katlu’ and knew how it is prepared. Among the participants, 98.2% of new mothers and all participants from the two older generations had a favourable opinion about ‘katlu’. Percent participants who consumed ‘katlu’ were slightly higher among grandmothers (70.9%) as compared to 64.9% mothers/ mothers-in-law and 65.8% new mothers.
Conclusion - These results suggest a declining trend for consumption. There is a need for further research into the medicinal benefits of ‘katlu’ and other such herbal preparations and to bring this knowledge to consumers and create public awareness about their benefits.

Keywords: katlu, battrisu, lactation, galactagogues, polyherbal formulation, traditional food.
Severity and Impact of rest leg Syndrome on Sleep and its Causative Factors in Pregnant Females of Lahore
Authors: Sagheer Basita , Zahid Ambreen , Mubeen Iqra , Jafar Mahwish , Amin Fatima , Ali Muhammad
Published: March 2022

Background: Restless legs syndrome is a common musculoskeletal problem which is mostly ignored, undiagnosed and poorly treated, in which individuals complains of dull pain deep in the legs which is frequently felt during inactivity compelling individual to move his leg. The symptoms of rest leg syndrome are mostly severe at night which ultimately causes the sleep disturbance in affected individuals. Objectives: The purpose of the study was to find out the severity and impact of Rest leg syndrome on sleep and its causative factors in pregnant females of Lahore. Methodology: This observational cross study was conducted at University of Lahore from 15 December to 29 December 2015 after the approval of synopsis and data was collected from services hospital, Jinnah Hospital and Sir Ganga ram Hospital, Lahore. By using convenient random sampling technique 384 patients were included the study during 16 weeks. Pregnant females with age between 20- 30 year were included in the study. Subjects with age above 30 presented with Pre-eclampsia, Diabetes, High risk pregnancy, Trauma, Tumor were excluded from the study. Results: Prevalence of leg cramps during pregnancy was found to be 63% it was seen that most of the female experiencing leg cramps were pregnant third time, and 50.8% had bilateral leg cramps, in 54.8% pain was non-radiating and for majority it was of moderate intensity. It was reported by 38.1% of participants that sleep is disturbed due to leg cramps. Conclusion: This study shows leg cramps are common during pregnancy and may be unilateral or bilateral. Results shows high prevalence of leg cramps in pregnant ladies. Furthermore Intensity of leg cramps was moderate for majority of participants. Keywords: Inactivity, leg cramps, leg pain, Pregnancy, Restless leg syndrome, Sleep disturbance
Comparison of Disease Progression in Patients with Osteoarthritis of Knee Treated with Versus without Intraarticular Injection of Corticosteroids
Authors: Rehman Saif ur , Afzal Tanveer , Iqbal Safdar , Haq Abrar-Ul- , Abidin Muhammad Zain-Ul- , Aslam Farhan
Published: March 2022

Objectives: To compare the frequency of disease progression in patients with osteoarthritis of knee treated with versus without intra-articular injection of corticosteroids. Design: The present study was a randomized single-blind controlled trial. Study Settings: The current study was conducted at Department of Orthopedic Surgery at Sir Ganga Ram Hospital Lahore over 1 year from May 2020 to April 2021. Study Procedure: The present study was conducted over 186 patients of both genders aged between 40-70 years presenting in outpatient department of orthopedic surgery with osteoarthritis of knee joint. The sampled patients were randomly allotted into two treatment arms. Patients from Group-A received intraarticular injection of steroids in addition to conservative management while those in Group-B were taken as controls and were managed conservatively without intraarticular injection of steroids. Outcome variable was frequency of disease progression over KL grading which was noted and compared between the groups. An informed on paper consent was obtained from every participant. Results: The mean age of the patients was 52.5±8.7 years. There was a female predominance with a male to female ratio of 1:1.7. The mean BMI of these patients was 28.3±3.6 Kg/m2 and 60 (32.3%) patients were obese. 103 (55.4%) patients had grade 2 while 83 (44.6%) patients had grade 3 osteoarthritis. Disease progression was noted in 30 (16.1%) patients after 6 months follow-up. The frequency of disease progression was significantly higher in patients receiving intra-articular injection of corticosteroids as compared to controls (26.9% vs. 5.4%; p-value<0.001). When stratified, comparable difference was observed across various subgroups of patients based on patient’s age, gender, BMI and baseline Kellgren-Lawrence Grade. Conclusion: In the present study intraarticular injection of steroids was found to be associated with articular cartilage damage evident from increased frequency of disease progression following intraarticular injection as compared to controls which advocates that intraarticular injection of steroids should be avoided in the management of osteoarthritis and should be reserved only for patients with advanced disease and who are already planned for joint replacement. Keywords: Osteoarthritis, Intraarticular Steroids, Chondrotoxicity
The Effect of Mobilization Combined with Soft Tissue Massage Versus Soft Tissue Massage Alone on Migraine Intensity
Authors: Zahid Ambreen , Sagheer Basita , Mubeen Iqra , Mutasansar Alishba , Amin Fatima
Published: March 2022

Background: Mobilization methods have shown optimistic results for the treatment of migraine, however previous studies also show unavailability of control group, or subjected to deficient methodological quality. Aim: To differentiate the effects of cervical mobilization coupled with massage versus massage only on, headache frequency, intensity and disability in patients with migraine. Methodology: A Randomized, single-blinded, controlled clinical trial was conducted in Izmir Medicare center. Subjects with migraine headache were selected and were divided into two groups: 1) Mobilization and massage (case) 2) Massage only (control). Four sessions of treatment was given in four weeks. Headache disability inventory (HDI) was evaluated before at baseline and after completion of treatment sessions. Results: Study shows that cervical mobilization is effective treatment for migraine .according to result analysis both groups shows high improvement in score of HDI before and after treatment. Additionally, if compare with control group patient that receive additional treatment shows no significant results in reduction of migraine frequency among all data points. Conclusion: This study shows positive results of treatment for migraine. Both interventions massage alone and massage with cervical mobilization showed positive results for migraine. Furthermore massage with mobilization shows more effective and positive results than alone massage on the four sub-components of HDI. Keywords: Headache, Cervicogenic headache, head disability index (HDI)
Clinical Features and Histological Features of Relapsed Patients of Ulcerative Colitis
Authors: Khan Momina Jehangir , Rehman Amman ur , Sahrish Fariha , Mukhtar Rabia , Ilyas Anum , Aamir Zain
Published: March 2022

Introduction: Ulcerative colitis is a chronic inflammatory disease of indefinite etiology having relapsing and remitting course. Assessing inflammatory activity via different scoring systems along with clinical correlation plays an important role in the diagnosis and surveillance of ulcerative colitis patients. Histopathological findings should be correlated with the clinical, endoscopic and radiological findings to exclude other causes with similar symptomatology, hence improving the management of patients with UC. Aims and objective: To determine the clinical features and histological features in relapsed patients of ulcerative colitis. Place and duration of study: Department of Pathology, Histopathology section, Sheikh Zayed hospital Lahore, from 25th February, 2016 to 25th February, 2017. Materials and methods: One hundred and ninety cases underwent endoscopic colonic biopsies from the three sites proximal colon, distal colon and rectum. Results: Out of one hundred ninety patients majority patients presented with vague abdominal pain 105(55.3%) followed by bleeding per rectum 74(38.9%). Most commonly seen histological feature is cryptitis 189(99.5%) succeeding chronic inflammation 188 (98.9%). Conclusion: Relapsed patients predominantly presents with vague abdominal pain. Cryptitis is most commonly seen histological feature in relapsed patients of ulcerative colitis. Keywords: Inflammatory bowel disease, Ulcerative colitis , Crohn’s disease
Frequency of Hypocalcaemia after Thyroid Surgery
Authors: Ahmed Shabbir , Shafi Asim , Malik Rab Nawaz , Tahir Umair , Ghulam Bushra , Saleem Farah
Published: March 2022

Aim: to investigate the frequency of postoperative hypocalcaemia undergoing thyroid surgery. Study design: Cross sectional study Place and duration: Study was conducted at Endocrinology department of general surgery, Bakhtawar Amin Medical and Dental College, Multan, from January 2021 to January 2022. Methodology: Study was conducted on total 115 patients who were admitted for thyroid surgery. Main variables of study were demographics, preoperative diagnosis, calcium level after surgery at 1st, 2nd and 5th day. SPSS version 23 was used for data analysis, test of significant were applied and p value ≤ 0.05 was taken as significant. Results: One hundred and fifteen patients were analyzed in our study, with mean age 38.99±4.63 years. There were 54.8% males and 45.2% females. Total thyroidectomy underwent in 46.1% patients and completion thyroidectomy underwent in 53.9% patients. Furthermore, 84.3% developed malignant and 15.7% developed benign. Hypocalcaemia developed in 9.6% patients. Among these, 54.5% malignant and 36.4% benign and only 9.1% developed permanent hypocalcaemia. On the second day of operation, 7.8% patients developed transient hypocalcaemia. While, on the fifth day of operation, 4.3% patients developed transient hypocalcaemia.2.6% patients required calcium and vitamin D supplements. Conclusion: Following thyroid surgery hypocalcaemia is a major concern that can be prevented by adopting meticulous operative technique and preserving vascularity of parathyroid glands. Continuous monitoring of serum calcium level in postoperative period and early management in cases of hypocalcaemia can significantly reduce the associated morbidity. Keywords: Hypocalcaemia, Frequency, Thyroid surgery, Postoperative period
The Frequency of the Modifiable Risk Factors in Young Versus Old Patients of Acute ST Elevation Myocardial Infarction
Authors: Javaid Imran , Rashid Munir Ahmed , Ramzan Muhammad
Published: March 2022

Objective: To investigate the frequency of modifiable risk factors of ST elevation myocardial infarction (STEMI) in young and old patients. Study design: Cross sectional observational study Place and duration: Study was conducted at cardiology department of DG Khan Medical College & DHQ Teaching Hospital, DG Khan, from 1st July 2020 to 30th June 2021. in one year duration. Methodology: Data was collected from consecutive 120 patients admitted in ward with diagnosis of STEMI. Patient differentiated on the bases of their age ≤ 40 years and above 40 years. Patient's complete demographic data was recorded and blood samples were taken for serum cholesterol, HDL level, LDL level and triglycerides. SPSS version 23 was used for data analysis and mean (SD) were calculated for numerical data. Frequency (percentages) was calculated for categorical data. Results: Age was stratified with respect to risk factors and it was seen that history of HTN, history of diabetes mellitus, family history of CD, smoking, elevated cholesterol, elevated triglyceride, decreased HDL and elevated LDL were highly associated except gender. These risk factors were more common in >40 years of age. Conclusion: Modifiable risk factors like cholesterol level, smoking, hypertension have high prevalence in ST elevation myocardial patients. Along with all modifiable risk factors old age increase the chances of STEMI. Keywords: STEMI, Modifiable risk factors, cardiac diseases, elevated cholesterol
To Asses Factors Influencing and Practice of Early Initiation of Breast Feeding
Authors: Rasul Noreen , Afzal Sidra , Ijaz Sara
Published: March 2022

Introduction: Early initiation of breast feeding that is breast feed given within first hour of birth prevents newborn from hypothermia, hypoglycemia and infections. It increases bonding with mother and promotes exclusive breast feeding. Objectives: To assess the factors influencing the mothers for early initiation of breast feeding and how much mothers practice it. Material and Methods: It was a retrospective study conducted at Pak Red Crescent Medical and Dental College, Dina Nath. The study was in form of questionnaire interview taken from delivered women including caesarean section and spontaneous vaginal delivery 293 and 57 women from out-patient department. Total number of women were 350. Duration of study was six months from 1 July 2021 to 31 December 2021. The influencing factors of early initiation of breast feeding and practice of giving milk within an hour after birth was assessed. Results: In our study percentage of early initiation of breast feeding was 13.4%. Maximum age for breast feeding was between 25 to 35 years that is 48.5% and regarding parity maximum in Para2 to 3 had 40%. The women who were willing for breastfeeding within first hour of birth had family support 26.2%, support by doctors or nurses 16.5% and 2% got counselling in antenatal period. Regarding factors that decrease EIBF, 53.4% women failed to initiate breast fed in first hour after birth due to pain, caesarean section under general anesthesia3.1%, discomfort due to episiotomy 6.2% and 10.5% babies were referred to neonatal unit immediately after birth due to danger signs. Conclusion: Counselling of mothers in antenatal period, improving counselling skills of health providers and strengthening community based support are likely to improve early initiation of breast feeding. Keywords: NICU neonatal intensive care unit, WHO World Health Organization EIBF early initiation of breast feeding
Comparison of Hysterosalpingographic findings in patients with Primary and Secondary Subfertility
Authors: Karim Sajilah , Bashir Sadia , Bibi Amna , Riaz Madeeha , Faiz Sadia , Shafi Asim , Khakwani Ayesha Khan
Published: March 2022

Hysterosalpingography is a commonly used imaging modality to assess the pathology of uterine cavity and fallopian tubes of patient with infertility. Hysterosalpingography has an established role in the assessment of tubal factor in patients with subfertility. Objective: To compare hysterosalpingographic findings in patients of primary and secondary subfertility. Materials and methods: A prospective study spanning six months duration was carried out in radiology department of private clinic in Multan. A total of 602 patient both primary and secondary subfertility were included in the study. Clinical notes and x-ray findings were analyzed for demographic data such as age and duration of subfertility and tubal and uterine abnormalities. Results: Out of 602 patient 66.8% had primary subfertility and 33.2% were in the secondary subfertility group. Tubal blockage was most common abnormalities in both groups i.e. 21.1% of patients with primary subfertility and 27.5% with secondary subfertility had tubal blockage. Key words: Subfertlity, hysterosalpingography, tubal blockage
Frequency of Molar Pregnancy in Abortion Cases Diagnosed by Histopathology Specimens at Nishtar Medical University Hospital, Multan Pakistan
Authors: Shafi Shazia , Perveen Shahida , Qureshi Asim Iqbal , Munir Ayesha , Qureshi Hina Zahra , Gul Pari Iman
Published: March 2022

Objective: To determine the frequency of molar pregnancy in abortion cases diagnosed by histopathology specimens. Study Design: A cross-sectional study. Place and Duration of the Study: Department of Obstetrics & Gynecology, Nishtar Medical University Hospital, Multan from March 2020 to November 2020. Material and Methods: A total of 243 pregnant women with singleton pregnancy aged 18 to 40 years with gestational age below 22 weeks presenting with abortion and admitted to labor ward of Nishtar Medical University Hospital, Multan were included. Both suction and sharp curettage specimens were obtained and submitted to the institutional pathology department for histopathological examination. Presence of molar pregnancy was noted. Results: In a total of 243 women, mean age of the women was 29.6±4.5 years while 112(46.1%) women were aged between 26 to 30 years. Mean gestational age was 16.9±3.4 weeks whereas 39(16.0%) women were in their 1st trimester of pregnancy and 204(84.0%) in 2nd trimester of pregnancy. A total of 142(58.4%) women belonged to rural areas of residence. There were 58 (23.9%) women who were illiterate. Molar pregnancy was noted in 5(2.1%) patients, out of which, there were 2 cases of complete mole and 3 cases of partial mole. Conclusion: Frequency of molar pregnancy in this study was 2.1% including 2 cases of complete and 3 cases of partial mole. Keywords: Hydatidiform mole, gestational trophoblastic disease, molar pregnancy
Functional Outcome of Posterior Transpedicular Screw Fixation among Patients Presenting with Spinal Tuberculosis
Authors: Anwer Muhammad Sohaib , Jalal Malik Liaqat Ali , Farooq Muhammad Shaukat , Shareef Rizwan , Waqas Muhammad Ali , Ali M.
Published: March 2022

Material and Methods; A series of descriptive case was completed at Neurosurgery Department Nishtar Hospital Multan. The time period for this study was from November 2014- September 2016. After registering the patients, under the supervision of an expert neurosurgeon results of all the clinical examinations, and medical history were recorded. The medical record reported forty-one consecutive patients were treated with one-stage posterior debridement, transpedicular fixation suffering from monosegmental lumbar spinal tuberculosis, between December 2014-August 2016, were prospectively analyzed. Results; Forty one patients were observed for this procedure 25 (61%) were male patients and 16 (39%) of the patients were female with their mean age was 29.58 years ±2 years. The average time between follow-ups was 13.6 ±2.7 months. The average pain score preoperatively was 9.2 ± 2.13 on the VAS scale and postoperatively was 2.5 ± 1.32. This decrease in back pain was statistically significant (0.05142, P > 0.05) and Complication rate was 7.31 % in these patients Conclusion; Our results support one stage posterior fixation procedure with pedicle screw in adults with lumbar spinal tuberculosis as it is safe, effective and yields desired functional outcome. Keywords; Spinal Tuberculosis, Transpedicular screw fixation, posterior debridement.
Prevalence of Vitamin D Deficiency in Pregnant Ladies
Authors: Saqib Shazia , Umer Sabeena , Bano Nosheen , Anwar Zubda , Liaqat Jawairiah , Khanam Saadia
Published: March 2022

Objective: To find out the prevalence of vitamin D deficiency (VDD) in pregnant ladies. Study Design: A cross-sectional study. Place and Duration of the Study: Department of Obstetrics & Gynecology, Sialkot Medical College, Sialkot Pakistan from 1st July 2021 to 30th December 2021. Methodology: We included a total of 165 pregnant women aged 18 to 40 years having singleton pregnancy with gestational age below 16 weeks. Three cc blood samples were taken during routine antenatal investigation from all pregnant ladies. The serum vitamin D was asked from the institutional laboratory. Prevalence of VDD, insufficiency and sufficiency were calculated. Results: In a total of 165 pregnant ladies, mean age was noted to be 30.2+5.5 years. There were 90 (54.5%) women who were living in rural areas. Sunlight exposure was less than 1 hour in 104 (63.0%) pregnant ladies. Ninety four (57.0%) women belonged to low socio-economic status. Evaluation of Vitamin D status revealed that 87 (52.7%) women had VDD, 52 (31.5%) vitamin D insufficiency while 26 (15.8%) had normal vitamin D levels. Sunlight exposure < 1 hour (p=0.0001) and low socio-economic status (p=0.0001) were noted to have significantly association with VDD. Conclusion: Among pregnancy ladies, prevalence of VDD was very high. Poor sunlight exposure and low socio-economic status were revealed to have significant association with VDD. Keywords: Pregnant, singleton, sunlight exposure, Vitamin D
Effect of hydrocortisone on outcome of septic shock patients. A prospective observational study in a tertiary care ICU.
Authors: Rauf-ul-Hassan Muahmmad , Aslam Seemal , Waseem Muhammad , Bashir Imran , Naz Shafia , Iqbal Ahtesham
Published: March 2022

Introduction: Sepsis and septic shock have 10% and 40% mortality in ICU respectively. Early recognition and prompt management of septic shock in ICU can reduce mortality. Further, some studies have suggested that hydrocortisone can impact outcome of septic shock significantly. Methodology: We designed prospective observational study to evaluate the effect of hydrocortisone in septic shock patients. Septic shock was defined according to definition proposed by international consensus definition of septic shock 2016. We excluded those who were less than 18 years and receiving steroids for some other indication at the time of admission to ICU. Primary outcome was to determine mortality in ICU. Secondary outcome was to evaluate length of stay, vasopressor days, vasopressor free days and dose of norepinephrine. Results: We studied 208 cases of septic shock. Median age was 61 years. Out of 208 participants, 106 received hydrocortisone. Out of 102 cases who did not receive hydrocortisone, 56.7% died and 42.3% survived (p=<0.001). There was no effect of hydrocortisone on length of stay, vasopressor days, vasopressor free days (OR: 0.7,0.3,1.1), (p=0.98,0.92,0.93) respectively. Conclusion: We concluded that hydrocortisone reduces mortality in septic shock patients in ICU. Keywords: Sepsis, hypotension, hypovolemia, septic shock
Risk factors for development of covid associated pulmonary aspergillosis in ICU population. An observational study from a large tertiary care hospital
Authors: Iqbla Ahtesham , Hassan Muahmmad Rauf-ul- , Waseem Muhammad , Ashraf Muhammad Zubair , Abaid Tehreem , Saleem Anam
Published: March 2022

Background: Covid associated pulmonary aspergillosis is a serious life-threatening infection which is increasingly being identified in severe covid pneumonia. There are multiple factors which predispose to this infection, still lot of research is needed to explore more about this infection Objective: Our aim of study was to find out risk factors associated with development of CAPA in severe covid pneumonia. Materials and methods: We prospectively enrolled 698 cases of severe covid pneumonia and aimed to identify risk factors associated with development of CAPA. We included only those who were PCR confirmed cases severe covid pneumonia requiring ICU admission with at least 48 hours of ICU stay. Infectious disease experts decided candidacy of Tocilizumab. CAPA cases were diagnosed according to ISHAM criteria for diagnosis of CAPA. Results: Out of 678 participants, 17.4% developed CAPA. Out of 17.4% cases of CAPA, 83.9% did not survive. Median ICU stay was 10 days. NUTRIC score and ICU days were identified as statistically significant risk factors for CAPA (OR: 2.1,1.2 p= 0.006, <0.001). Median NUTRIC score was 3. Tocilizumab prevents development of CAPA (OR: 0.09, p=< 0.001). Conclusion: We concluded that NUTRIC score and ICU days are predisposing factors for CAPA in severe covid pneumonia. Tocilizumab has role in reducing CAPA infection in severe covid pneumonia. Keywords: Pneumonia, CAPA, aspergillus, mortality
Efficacy of Oral Voriconazole in the Treatment of Dermatophyte Infections (Tinea Corporis and Cruris)
Authors: Shahzad Muhammad Khurram , Hassan Tahir , Tahir Raheel , Jawaid Kalsoom , Khan Muhammad Farooq , Naveed Muhammad Abdullah
Published: March 2022

Objective: To determine the efficacy of oral voriconazole in the treatment of dermatophyte infections (tinea corporis and cruris) Methodology: A total of 200 patients of both sex with age group 18-60 year having dermatophyte infection of body and groin were enrolled in this study. Each patient was given oral voriconazole 200 mg twice a day (tablet vorif 200 mg) for two weeks. Follow up was done at end of 2nd, 4th and 12 weeks. Efficacy was assessed clinically in the form of complete healing of lesion leaving behind post inflammatory pigmentation or normal skin. Study duration was 3 months. Patients were assessed for any possible side effects at each appointment. All of the patients were truly monitored and checked for their compliance to drug. The data was recorded on preformed Proforma for each patient. Results: Out of 200 cases, 133 were new, 42 were relapsing and 25 were resistant cases. Total efficacy was noted in 164 patients (82%) of all study cases. Male and female showed efficacy in 81% and 82% of cases respectively (Table 1). Patients belonging to age group 18-40 year showed 86 % efficacy and patients belonging to age group 41-60 year showed 76% efficacy (Table 2). From all new, relapsing and resistant study cases, 90 %, 71% and 58% showed efficacy to treatment respectively (Table 3). Conclusion: In our population oral voriconazole is efficacious in the treatment of tinea corporis and cruris. Keywords: Dermatophytes, Efficacy, Voriconazole
Transfusion transmissible infections in blood donors presenting at department of hematology, Jinnah Hospital, Lahore
Authors: Ahmad Rabia , , Ch. Sidra Sonia , Rehan Ali
Published: March 2022

Objective: To determine the frequency of transfusion transmissible infections in blood donors presenting at department of hematology, Jinnah Hospital, Lahore. Material and methods: This cross sectional study was conducted at Department of Hematology, Jinnah Hospital, Lahore from March 2021 to September 2021. Total 190 blood donors presenting at Blood Bank having age 17-65 years both male and female were recruited. Transfusion transmissible infections in blood donors were studied. Results: Age range in this study was from 17 to 65 years with mean age of 39.59 ± 9.04 years. Majority of the blood donors 124 (65.26%) were between 17 to 40 years of age. Out of the 190 blood donors, 140 (73.68%) were male and 50 (26.32%) were females with male to female ratio of 2.8:1. In this study, I have found the hepatitis B in 08 (4.21%), hepatitis C in 17 (8.95%), HIV in 01 (0.53%) and syphilis in 04 (2.11%) blood donors. Conclusion: This study concluded that prevalence of HCV, HBV, HIV and Syphilis in blood donors was 8.95%, 4.21%, 0.53% and 2.11% respectively. Keywords: blood donors, hepatitis B, syphilis.
Frequency of Retinopathy in Premature Infants in a Tertiary Care Hospital
Authors: Qureshi Aamer Naseer , Riaz Lubna , Nazeer Shahid , Fatima Sehar , Javed Maria , Aamer Mahnoor
Published: March 2022

Background: Retinopathy of prematurity is one of the important problems faced by neonates causing lifelong morbidity. It can be prevented by early detection and prompt treatment. Objective: To determine the frequency of retinopathy in premature infants in a Tertiary Care Hospital. Methodology: A three-centered cross-sectional study was conducted in tertiary care hospitals of Lahore. All neonates after taking informed consent form guardians were enrolled in the study according to selection criteria. All cases were screened for retinopathy of prematurity at four weeks of age for the first time and later followed up at 4 to 6 weeks interval according to disease stage on slit lamp by consultant ophthalmologist. The premature infants were diagnosed as retinopathy of prematurity based on the operational definition. Results: The mean age was 15.80±5.57 hours, mean gestational age of positive cases was 30.46±1.40 weeks and mean birth weight of positive cases was 1528.2.36±201.47 g. There were 15 (14%) cases who had retinopathy of prematurity while 96 (86%) cases had normal eyes. Among them 11 (73%) cases were of stage 1, 3 (20%) cases of stage 3 and 1(7%) case of stage 4 retinopathy of prematurity. Conclusions: In our study, retinopathy is observed in 14% of the premature infants. Keywords: Preterm birth, Gestational age, Complication, Retinopathy of prematurity
Frequency of Sleep Pattern Abnormalities among End Stage Renal Disease Patients on Maintenance Hemodialysis
Authors: Azam Aftab , Anwar Shahid , Akram Mateen , Ahmad Sajad , Usman Hafiz Tahir , Anwar Zahid
Published: March 2022

Background: End-stage renal disease patients getting hemodialysis (HD) frequently report sleep problems. There are various sorts of sleep disorders, generally classified into different categories depending upon initiation of sleep, duration, and continuity of sleep, calmness during sleep, respiration pattern during sleep, and daytime alertness. Sleep abnormalities have a significant and well-documented effect on daily routine activities thereby reducing the quality of life. Objective: To determine the frequency of sleep pattern abnormalities in patients with chronic kidney disease on maintenance hemodialysis. Study Design: Cross-sectional study Place and Duration of Study: Department of Nephrology, Sir Ganga Ram Hospital, Lahore from 24th January 2019 to 24th July 2019. Methodology: Ninety one cases ages between 14-70 years of either gender, having ESRD, and are on maintenance HD for at least 3 months were included. All those patients who were having HD for acute kidney injury were excluded. Sleeping disorders were evaluated using Pittsburgh Sleep Quality Index by a single interviewer. Results: Fifty five (60.4%) were males and 36 (39.6%) were females. The mean age was 51.1±12.1 years, mean BMI was 25.1±5.2, and mean duration of dialysis was 5.1±2.8 years, 74(81.3%) patients had sleep disorders. Among patients having sleep disorders, 38(41.8%) had Insomnia, Narcolepsy in 41(51.6%), Sleep Apnoea Syndrome in 38(41.8%), restless leg syndrome in 35(38.5%) and parasomnia in 17(18.7%) patients. Conclusion: Sleep disorders are common in regular hemodialysis patients affecting 81.3% of individuals. Key words: Chronic kidney disease, Haemodialysis, Sleep disorders
Frequency of Dyslipidemia among End-Stage Renal Disease Patients on Thrice Weekly Maintenance Hemodialysis
Authors: Fatima Arooj , Anwar Shahid , Awan Abad-ur-Rehman , Ahmad Sajad , Usman Hafiz Tahir , Anwar Zahid
Published: March 2022

Background: Serum lipid abnormalities are strongly related to cardiovascular as well as all-cause mortality. The most common dyslipidemia among dialysis patients is low HDL followed by hypertriglyceridemia. Total cholesterol and LDL levels are normal. Dyslipidaemia in end-stage renal disease is multifactorial in addition to abnormalities in lipid metabolism, malnutrition, inflammation, low albumin, and inadequate hemodialysis also contribute to premature atherosclerosis. That’s why treatment of dyslipidemia in hemodialysis patients should be individualized. Objective: To determine the frequency of dyslipidemia among patients of end-stage renal disease on thrice-weekly hemodialysis. Study Design: Cross-sectional study Place and Duration of Study: Dialysis Unit, Department of Nephrology Sir Ganga Ram Hospital, Lahore from 1s9th March 2021, to 18th September 2021 Methodology: Seventy two patients having maintenance HD at our center were enrolled. The data included the patient's name, age, gender, duration of maintenance hemodialysis, BMI, HTN, DM, IHD, and smoking status. Fasting lipid samples of patients were collected in serum vials and samples were analyzed in the major laboratory for any lipid abnormality. Results: Forty four (61.1%) patients have dyslipidemia among which 27 (61.4%) were males and 17 (38.6%) were females. The mean age was 47.5±11.5 years. The most common lipid abnormality in our patients was low HDL levels i.e., 56.8% followed by hypertriglyceridemia 6.9%. Total cholesterol and LDL levels are normal in 98% and 100% respectively. Conclusion: The frequency of dyslipidemia among patients of thrice-weekly maintenance hemodialysis is 61.1%. Low HDL is the most common lipid abnormality followed by hypertriglyceridemia 56.8% and 6.9% respectively. Key words: Dyslipidemia, End-stage renal disease (ESRD), Hemodialysis
Knowledge and Practices of General Public in Context to Canine Rabies
Authors: Irum Shazia , Qayyum Aamir , Javed Maryam , . Abdullah
Published: March 2022

Objective: To estimate knowledge and practices of general public in context to canine rabies. Study Design: Retrospective study. Place and Duration of Study: Department of Nephrology, Mayo Hospital, Lahore 1st January 2020 to 30th June 2020. Methodology: Based on variance in topography and high animal acquaintance, the area was divided into four cardinal points and 50 respondents were taken from each area. A well-structured questionnaire was designed for entering the required information in form of open ended questions regarding their knowledge and general practices. All the responses were categorized and further decoded for extracting related information. Results: There were 127 male and 73 female respondents. The mean age was 29.3±3.5 years with 52% within the age group of 26-35 years. Only 44% respondents were known about clinical symptoms of rabies. Almost half of the respondents had their pets vaccinated while other half did not vaccinate their pet/pets against rabies. Conclusion: More awareness program should be conducted for increasing knowledge of general public against rabies disease. Key words: Knowledge, General public, Canine rabies
Functional Outcomes of Non-operative Treatment in Proximal Humeral Fracture of Adults
Authors: Shahani Mehtab Ali
Published: March 2022

Background: The functional outcomes after non-operative treatment of proximal humeral fractures in adults required detailed understanding for improved health outcomes. Objective: To identify the functional outcomes of non-operative treatment in proximal humeral fracture of adults. Study Design: Prospective cohort study Place and Duration of Study: Department of Orthopaedic, KMC Civil Hospital, Khairpur Mirs from 1st October 2020 to 30th September 2021. Methodology: Fifty patients with proximal humeral fracture >45 years were treated with non-operative treatment protocol including 1 year follow-up. Patient’s radiological imaging was continued till one year and they were given a sling to wear for three week’s time. The treatment primary functional outcomes were assessed by Oxford Shoulder Score and EuroQol-5 Dimensions-3 Levels, while secondary functional outcomes were assessed by visual analog scale and university of California Los-Angeles scoring method. Results: Mean age was 65.6±4.2 years with females as 74% and 26% males. Improvement in OSS was up to 48 points. One-year scores for OSS were mean 33.1 with 95% confidence of interval while it was 0.59 for EQ-5D-3L. Mean VAS pain score was 32.1 with 59.2 as VAS satisfaction score and UCLA activity score as 20.4. Conclusion: Non-operative treatment for proximal humeral fracture in adults’ results in significant changes in shoulder-specific as well as improved health outcomes after one year. Key words: Proximal humeral fractures, Non-operative, Bone health