bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of continuous cold flow and compression device and traditional icing regimen and no icing following anterior cruciate ligament reconstruction: a pilot study
Authors: Butt Umerr , Iqbal Javed , Shah Imran Ali , Khan Zainab Aqeel , Vuletic Filip , Mohsin Areeb
Published: December 2023

The aim of this study was to investigate the effectiveness of continuous cold flow and compression device as against traditional icing regimen and without icing after anterior cruciate ligament (ACL) reconstruction. All patients undergoing ACL reconstruction from June 2021 to August 2021 were enrolled in this study. Patients were randomly allocated to three groups: A control group (n=10) with no ice regimen post-operatively, a second control group (n=10) with ice bag, and a third group (n=10) with continuous cold flow and compression device (physiolab). All patients who had isolated ACL tear evident on magnetic resonance imaging were included. Pain intensity, limb girth, Oxford Knee Score, and 12-item survey form were measured pre- and post-operatively. Significant difference was noted between pain scores in all groups at two- and six-week follow-ups with p-value of 0.004 and 0.01.
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Should probiotics be administered as an adjunctive treatment along with antidepressants for major depressive disorder?
Authors: Haiqa Zulfiqar  , Aslam Uzma
Published: December 2023

Madam,
Major depressive disorder (MDD) is a significant factor in global disability rates and contributes significantly to the overall disease burden worldwide. According to estimates, approximately 3.8% of the global population is impacted, with a prevalence of 5.0% among adults and 5.7% among adults aged 60 years and above [1]. It is also the leading cause of suicide among individuals. While the administration of antidepressants is the widely known and successful treatment for this mental disorder, recent research and accumulating evidence have demonstrated that probiotics also function effectively in controlling anxiety and depression.
Probiotics that provide psychological benefits are now referred to as psychobiotics. Psychobiotics are defined as live organisms that, when consumed in sufficient quantities, produce unexpected health benefits in individuals with psychiatric disorders [2]. Around 30% of patients with major depressive disorder (MDD) do not respond to traditional antidepressant medications targeting monoamine pathways, indicating the involvement of other biological mechanisms in the development of MDD [3]. One particularly promising hypothesis regarding the pathogenesis of MDD is the dysfunction of the gut-brain axis (GBA), with the gut microbiota playing a crucial role [4]. Numerous studies have investigated the impact of probiotics on stress resilience. The recent meta-analysis discovered a significant finding: when probiotics were combined with antidepressants, they showed a remarkable reduction in depressive symptoms. However, when used alone, probiotics exhibited a less impact on alleviating depressive symptoms. This highlights the crucial role of combining probiotics with standard treatments for a more substantial effect on managing depression [5].
These impressive results elucidate the advantages of administering probiotic strains in individuals suffering from mental health disorders, specifically MDD, by effectively addressing the imbalance within the gut-brain axis (GBA) and suppressing stress-induced activation of biological pathways involved in psychological disturbances. Recurrent evidence has proven that gut microbiota play a significant role in neuronal homeostasis and any imbalance may contribute as a factor in the underlying mechanism of the pathogenesis of MDD.
Henceforth, further research should be encouraged in order to develop promising microbiome-based therapeutics for MDD, and physicians should consider administering probiotics as an adjunctive treatment for depression alongside antidepressants. Moreover, the importance of probiotics should be thoroughly studied, and medical doctors should raise awareness of the significance of the gut-brain axis and associated biological pathways, which play a major role in an individual's mental health.
Tunneled dialysis catheter utilization and patency: a retrospective-prospective study from a tertiary care hospital in Karachi Pakistan
Authors: Tahir Misbah , Ali Muhammad , Siddiqui Danial Khalid , Durrani Noureen , Iqbal Jawaid , Mustafa Khalid
Published: December 2023

Objective: To assess the patency of tunnel dialysis catheters and their results in patients in a tertiary care setting.
Method: The retrospective-prospective, observational study was conducted at the Department of Interventional Radiology, Liaquat National Hospital, Karachi, from September 2021 to February 2022, and comprised records of patients who underwent tunnel dialysis catheters placement from July 2019 to December 2020. Data regarding age, gender, residence, comorbidity, catheter placement site, use of antibiotics before catheter insertion, reasons for catheter removal, and total catheter days was retrieved from the medical record. Data was analysed using STATA 14.
Results: Of the 134 patients, 74(56.9%) were males and 56(43.1) were females. The overall median age was 65 years (interquartile range: 56.75-70.25 years). Catheters were electively removed in 97(72.4%) patients, while in 19(14.2%), 16(11.9%) and 2(1.5%) cases, catheters were removed due to infections, blockage and physical damage, respectively. Mortality due to catheter-related complications was not found. Incidence per 10,000 catheter days of overall infection, bacteraemia and other infections during one year was 8.4, 5.3 and 3.1, respectively. Overall infection-free survival rate was seen for 19 patients (survival rate=67.6%). Survival rate from catheter removal was seen in 36 patients (survival rate=53.2%).
Conclusion: When all precautions were followed to circumvent catheter-related issues, tunnel dialysis catheters were found to be a viable option for haemodialysis until permanent access for dialysis is gained or a kidney transplant is performed.
Key Words: Tunnel dialysis catheter, End-stage kidney disease, Chronic kidney disease, Interventional radiology.
Covid19 pandemic impacted ianternet use and anxiety among general public during covid19 pandemic in Pakistan
Authors: Maryam Pyar Ali Lakhdir  , Khan Malik Muhammad Hamza , Fauzia Basaria Hasnani  , Ghazal Peerwani  , Muhammad Talha Nawaz  , Ayesha Nasir Hameed  , Meher Angez  , Apsara Ali Nathwani  , Syed Iqbal Azam
Published: December 2023

Objective: To determine the association between internet use and anxiety among people during the coronavirus disease-2019 pandemic.
Method: The cross-sectional study was conducted across Pakistan from January 14 to February 21, 2021, which was the active phase of the coronavirus disease-2019 pandemic in Pakistan. The participants were aged at least 13 years having internet access regardless of gender or their location across Pakistan. The anonymous web-based survey was conducted using a questionnaire generated on Google Forms and disseminated through various social media platforms and WhatsApp groups. Anxiety symptoms were screened using the Depression, Anxiety and Stress Scale-21, while the Young Internet Addiction Test was used to evaluate symptoms of internet addiction. Data was analysed using STATA 16.
Results: Of the 1,145 subjects, 686(60%) were females and 459(40%) were males. A total of 257(22.5%) participants were found to have extremely severe anxiety and internet usage pattern was significantly associated with the level of anxiety (p<0.05). Age, gender, social class and marital status were not significantly different (p>0.05), while family income and area of living were significantly different (p<0.05) in terms of anxity levels. . The odd of addictive internet use was 10.2 (95% confidence interval: 5.7-18.5) times greater in extreme anxiety individuals compared to individuals having no anxiety after controlling for other sociodemographic, health-related, behavioral and environmental factors during the pandemic.
Conclusion: A significant association of anxiety was found with internet addiction during the coronavirus disease-2019 pandemic.
Key Words: Internet addiction, Anxiety, Pandemic, COVID-19, Low-income countries.
Ripple effects of COVID-19 lockdown pertaining to clinical skills among undergraduate medical students of Karachi
Authors: Asma Shaikh  , Mawara Amin  , Azhar Uddin  , Mahrukh Khan  , Muhammad Ammad Hussain  , Ubaid Ahmed Khan
Published: December 2023

Objective: To determine the outcomes of coronavirus disease-2019 lockdown pertaining to clinical skills among undergraduate medical students.
Method: The cross-sectional questionnaire-based study was conducted after approval from the Jinnah Sindh Medical University, Karachi, at 6 public and private medical education institutions in Karachi from July 3 to August 3, 2021, and comprised undergraduate students from the 3rd, 4th and final academic years. Data was collected using a pre-designed questionnaire. Data was analysed using SPSS 20.
Results: Of the 383 subjects, 260(67.9%) were females and 123(32.1%) were males. The overall age range was 20-25 years. There were 145(37.9%) students from the 3rd year, 154(40.2%) from 4th and 84(21.9%) from the final year. Among them, 251(84.2%) accepted having decreased efficiency in clinical skills because they were not being able to train in person, 157(41%) claimed that certain topics related to clinical study were given in exams even though they were not taught, and 164(72.6%) faced difficulty in exams related to clinical skills.
Conclusion: Coronavirus disease-2019 caused disruption in routine life, and medical education was not an exception. E-learning modality was found to be insufficient, and patient exposure elevates confidence, eliminates hesitation, and improves clinical skills.
Key Words: COVID-19, Clinical skills, Undergraduate medical students.
Comparison of intravenous ibuprofen and paracetamol for peri-operative analgesia in paediatric day care tonsillectomy: research article
Authors: Zaheer Amna , Majeed Kaukab , Sharif Asjad , Bashir Saima , Khan Adeela , Niwaz Azhar
Published: December 2023

Objective: To determine the effectiveness of intravenous ibuprofen and acetaminophen as perioperative analgesics in paediatric patients undergoing day-care tonsillectomy with general anaesthesia.
Method: The quasi-experimental study was conducted at the Anaesthesia Department of Pak Emirates Military Hospital, Rawalpindi, Pakistan, from July 2021 to June 2022, and comprised paediatric patients aged 5-12 years undergoing day-care tonsillectomy with general anaesthesia. The subjects were divided into two equal groups. Patients in Group I received intravenous ibuprofen 7mg/kg and patients in Group P received intravenous paracetamol 10mg/kg immediately after induction of anaesthesia. All patients received standard general anaesthesia with endotracheal intubation. The primary outcome measured was revised faces pain score immediately after recovery and at the time of discharge 6 hours later. Adverse events were also noted. Data was analysed using SPSS 26.
Results: Of the 100 patients, there were 50(50%) in Group I; 21(42%) boys and 29(58%) girls with mean age 7.82±1.903 years. The remaining 50(50%) subjects were in Group P; 25(50%) boys and 25(50%) girls with mean age 7.68±1.812 years. At baseline, 44(88%) patients in Group I and 42(84%) in Group P reported no pain, while 6(12%) and 8(16%) patients in the two groups, respectively, reported pain (p=0.56). At discharge, 35(70%) patients in Group I and 18(36%) in Group P reported no pain (p<0.001). Adverse events were not significantly different between the groups (p>0.05).
Conclusion: Intravenous ibuprofen was found to be a superior pain-killer than intravenous paracetamol for peri-operative care of paediatric patients in day-care tonsillectomy.
Key Words: Acetaminophen, Analgesia, Ibuprofen, Paracetamol, Revised faces pain score, FPS-R.
Serum resistin and lipid profile in primigravida females with and without preeclampsia: an analytical cross-sectional study
Authors: Rana Mehwish , Cheema Mohsin Ali , Khan Rida Ajmal , Kanwal Asia , Rana Arshia Mobeen , Khalid Parvez Lone
Published: December 2023

Objective: To measure and compare the serum levels of resistin and lipid profile parameters in primigravida females with and without preeclampsia.
Method: The analytical cross-sectional study was conducted at the Department of Physiology and Cell Biology, University of Health Sciences, Lahore, Pakistan, from 2018 to 2020, and comprised primigravida females having gestational age 30-36 weeks. Those with preeclampsia constituted group 1, while normotensive females constituted group 2. All the participants were subjected to detailed history and general physical examination. Serum resistin levels were measured by enzyme-linked immunosorbent assay, and lipid profile parameters were measured using the colorimetric method. Data was analysed using SPSS 20.
Results: Of the 80 women, 40(50percent) were in group 1 with mean age 23.07±2.10 years and mean gestation age 33.45±2.30 weeks. There were 40(50percent) women in group 2 with mean age 23.02±2.11 years and mean gestational age 34.45±1.75 weeks. Mean serum resistin was significantly higher in group 1 compared to group 2 (p 0.02). Mean levels of lipid parameters were significantly different between the groups (p 0.05).
Conclusion: Preeclampsia was found to be associated with higher levels of resistin and lipid parameters compared to normal pregnancy.
Keywords: Pre-eclampsia, Resistin, Hypertension, Pregnancy outcome, Primigravida.
Flood and Dengue: Increased risk of Gestational Pestilences
Authors: Rizwan Amna , Tariq Moeez , Imran Maryum
Published: December 2023

Madam Editor,
Dengue fever is an acute viral disease caused by an RNA (Ribonucleic Acid) virus transmitted by Aedes mosquitoes. Symptoms can range from asymptomatic fever to life-threatening complications such as haemorrhagic fever and shock (1). Dengue fever is recognized by the (WHO (World Health Organization)) World Health Organization as a serious global public health threat in tropical and subtropical countries. Dengue-endemic regions are home to 2.5 billion people, and 400 million infections occur each year, with mortality rates exceeding 20% in some areas (2). Extremely heavy rains have lately devastated Pakistan, with its most populous metropolis of Karachi witnessing the worst floods in a century. Flooding and inadequate water sanitation have increased the risk of dengue, malaria, and other water-borne disease outbreaks. Determining whether dengue infection during pregnancy is associated with adverse effects on the fetus is important, given that women of reproductive age in dengue-endemic areas are at risk of contracting the disease.
Studies have suggested an association between maternal infection during pregnancy and preterm birth, low birth weight, small gestational age births, stillbirth, and miscarriage (3, 4). According to Pouliot SH, et al., high rates of cesarean deliveries (44%) and pre-eclampsia (12%) occurred in women who had dengue infection during pregnancy (5). Even though there are several variants of dengue infection, the study found that the proportion of DENV-4 in pregnant women was higher than in non-pregnant women (6), the reason for which is still unclear.
The gestational period involves various anatomical and physiological changes in the female body, such as increased capillary permeability, hemodilution, leukocytosis, thrombocytopenia, etc., which may complicate the assessment of the clinical manifestation of dengue due to opposing effects on the body, such as the contradicting leucocyte concentration, as pregnancy causes leukocytosis, whereas dengue causes leukopenia (6).
Though the exact mechanism of the effect of maternal dengue on the fetus is yet to be determined, recent studies have put forward two mechanisms for fetal and neonatal morbidity caused by maternal dengue infection. The first theory is that dengue infection causes hemodynamic changes during pregnancy that could affect the placenta and cause fetal hypoxia, In contrast, the second theory states that dengue infection affects the fetus directly (7).
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Correlation of lymphocyte subsets and inflammatory biomarkers with disease severity in COVID-19 patients
Authors: Abbas Khawar , Musharraf Wajiha , Zafar Mirza Naqi , Lal Jawahar , Dodani Sunil , Rizvi Syed Adibul Hassan
Published: December 2023

Objective: To determine the correlation of lymphocyte subsets and soluble serum inflammatory biomarkers with disease severity in coronavirus disease-2019 infection.
Method: The retrospective study was conducted at the Department of Immunology, Sindh Institute of Urology and Transplantation (SIUI), Karachi, Pakistan from September 1 to November 30, 2021, and comprised data of patients admitted from June to July 2021 who tested positive for coronavirus disease-2019 on the basis of reverse transcription-polymerase chain reaction of nasopharyngeal swab specimens. The patients were categorised into severe group A and non-severe group B. Initial investigations included complete blood count, neutrophil-to-lymphocytes ratio, C-reactive protein, D-Dimers and serum ferritin levels. Lymphocyte subsets included cluster of differentiation-3+, cluster of differentiation-4+/ cluster of differentiation-3+, cluster of differentiation-8+ T lymphocytes, cluster of differentiation-19+B lymphocytes, cluster of differentiation-16+ cluster of differentiation-56+ Natural Killer cells and serum cytokine levels of interleukin-2, interleukin-4, interleukin-6, interleukin-10, tumour necrosis factor-alpha and interferon gamma. They were correlated with disease severity. Data was analysed using SPSS 20.
Results: Of the 54 patients., 33(61.1%) were males and 21(38.9%) were females. There were 29(53.70%) patients in group A with median age 52 years (interquartile range: 43.5-65 years), and 25(46.29%) in group B with median age 50 years (interquartile range: 36.5-59 years) (p=0.241). Disease was significantly more severe in male patients compared to female (p=0.002). In group A, cluster of differentiation-3+ T cells were reduced in 21(72.4%) patients, cluster of differentiation-8+ T cells in 16(55.2%), cluster of differentiation-4+ T cells in 23(79.3%) and cluster of differentiation-19+ B cells in 8(27.6%). In group B, cluster of differentiation-3+ T cells were reduced in 10(40%) subjects, cluster of differentiation-8+ T cells in 7(28%), cluster of differentiation-4+ T cells in 12(48%) and cluster of differentiation-19+ B cells in 4(16%) patients. Serum cytokine levels were not significantly different between the groups (p>0.05). In group A, 7(24.13%) patients died, and in such cases, the neutrophil-to-lymphocytes ratio was significantly higher (p=0.037).
Conclusion: Pro-inflammatory markers and cytokine levels increased, while lymphocyte subsets decreased with increasing severity of the disease.
Key Words: COVID-19, C-reactive protein, Ferritin, Lymphocyte subsets, Interleukin-6.
Complications related to unwitnessed magnet ingestion in paediatrics: case report
Authors: Suresh Kumar  , Ghani Amarah
Published: December 2023

Foreign body ingestion is one of the most common problems among children. There is a great tendency among children between the age of six months to six years to place objects, such as coins, fish bone, pins, button batteries, magnets and other household items, in their mouth and often swallow them. Magnet ingestion is not uncommon. Hazardous effects can occur owing to the fact that these are usually unwitnessed leading to disparity in history and delayed presentation. Nowadays these magnets are made of Neodymium which is a strong element and can be moulded into various shapes and sizes, making them more attractive to children. Single magnet ingestion may pass without complication, but multiple ingested magnets pose risk of severe complications such as obstruction, inter bowel fistulae, and perforation often requiring urgent intervention3.
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Preference of the patient’s family for family-centred care in a paediatric hospital
Authors: Tauseef Usman , Anjum Misbah , Khoso Zubair Ahmed , Ahmed Syed Habib , Noor Noshaba , Jalil Muniba
Published: December 2023

Objective: To explore the dimensions of family-centred care preferred by families of paediatric inpatients in a public healthcare setting.
Method: The qualitative study was conducted at the National Institute of Child Health, Karachi, from October 2021 to August 2022, and comprised family members of the hospitalised children. Data was collected through three focus group discussions that were guided by a semi-structured questionnaire. Using the five-step Fereday and Muir-Cochrane guidelines, data was coded and subjected to thematic analysis.
Results: Of the 21 subjects, 13(62%) were males and 8(38%) were females. The overall mean age was 32.24±7.58 years (range: 18-50 years). In terms of relationship with the patient, 9(43%) were fathers and 6(28.6%) were mothers. Each focus group discussion had 7(33.3%) subjects. Thematic analysis showed that the participants perceived family-centred care positively. Eight categories emerged depicting family perception and experience of family-centred care in a tertiary-care setting.
Conclusion: The participants perceived family-centred care respectful and empathic towards patients' families, making them integral care team members.
Key Words: Delivery of health care, Paediatrics, Personal satisfaction, Parents, Family, Patient-centred care.
Heterologous Covid-19 vaccines intervention effect on reactogenicity
Authors: Najeeb Wajeha , Waheed Palvasha , Khadim Rehana
Published: December 2023

To determine the change in the occurrence of short-term vaccine reactions on the use of heterologous Covid-19 booster, a single centre short-term study of two months duration was conducted. It was designed as an interventional study with registered clinical trial number # SLCTR/2022/008. It was conducted on medical students and faculty of a National university of medical sciences, Rawalpindi affiliated public sector medical college. A total of 348 individuals were administered with Ad5-nCoV vaccine and 101 with mRNA-1273 vaccine. They all had been previously vaccinated with two doses of BBIBP-CorV. BBIBP-CorV reactogenicity was considered a control group. Vaccine reactions, including pain and redness at the injection site, fever, no observed reactions at all, myalgia, feeling cold, dizziness, paraesthesia in the arm, light-headedness, had a significant change in their frequencies in comparison to homologous vaccine (BBIBP-CorV) reactogenicity.
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Effect of constraint-induced 12movement therapy in reducing severity of mirror movements in children with unilateral spastic cerebral palsy
Authors: Shahid Javeria , Hussain Mir Arif , Khan Huma
Published: December 2023

To determine the effect of constraint-induced movement therapy (CIMT) in improving hand function and reduction in severity of mirror movements in children with spastic cerebral palsy who have mirror movement disorder. Spastic hemiplegic CP children of either gender, aged six to 16 years, with mirror movements of grade 1 and 2 who were able to make a gross grip, were included in this single arm feasibility study. CIMT was provided as an intervention to these children for six hours per day for 10 consecutive week days. Woods and Teuber criteria was applied for the assessment of mirror movements. Pre- and post-intervention assessment results showed that there was improvement in the unimanual and bimanual hand function in CP-affected children (p 0.05) and reduction in the severity of mirror movements (p 0.05). Constraint-induced movement therapy improved hand function and reduced the severity of mirror movements in children with unilateral spastic cerebral palsy.
Comparison of muscle energy technique and facet joint mobilisation in the patient with chronic neck pain: A randomized controlled trial
Authors: Huma Tabassum  , Mariam Misbah , Gondal Kirran Sikandar
Published: December 2023

Objective: To compare the effects of muscle energy techniques, facet joint mobilisation and conventional physical therapy on pain, disability, cervical lordosis and range of motion in patients with chronic neck pain.
Method: The parallel-design randomised controlled trial was conducted at the Physical Therapy and Rehabilitation Department of the Heavy Industries Taxila Hospital, Taxila Cantt, Pakistan, from December 2020 to May 2021, and comprised patients of either gender aged 35-50 years who had chronic neck pain, recurrent neck pain, and cervical spine curve. The participants were randomised into muscle energy techniques group A, facet joint mobilisation group B and conventional physical therapy group C. The outcome measures were cervical lordosis, pain intensity, neck disability index and cervical range of motions. Data was analysed using SPSS 21.
Results: Of the 115 patients initially assessed, 105(91.3%) were included; 67(63.8%) females and 38(36.2%) males. There were 35(33.3%) subjects in group A with mean age 40.09± 4.29 years, 35(33.3%) in group B with mean age 40.14±4.57 years and 35(33.3%) in group C with men age 39.26±5.19 years. There were no significant differences among the groups at baseline in terms of mean age, weight, height, body mass index, neck disability index, cervical lordosis and range of motion (p>0.05). Of the total, 6(5.7%) were lost to follow-up and the study was completed by 99(94.3%) subjects. Outcome variables in group A were superior to those in groups B and C with respect to flexion, rotation and side-bending (p<0.05). There was no significant difference between groups A and B related to numeric pain rating scale and neck disability index (p>0.05).
Conclusion: Muscle energy techniques and facet joint mobilisation showed significant improvement in neck pain, disability and cervical range of motions compared to conventional physical therapy. Muscle energy techniques and facet joint mobilisation produced similar outcomes with respect to pain intensity and functional disability.
Clinical Trial Number: The study was prospectively registered with clinicaltrials.gov (NCT05040477).
Key Words: Cervical lordosis, Facet joint, Mobilisation, Muscle energy techniques, Neck pain.
Association of methylenetetrahydrofolate reductase gene variant C677T and folate levels in non-syndromic cleft lip/palate among Sindhi, Pakistani population
Authors: Effendi Sadia , Memon Samreen , Khidri Feriha Fatima , Waryah Ali Muhammad
Published: December 2023

The objectives of this study were to determine the association of methylenetetrahydrofolate reductase (MTHFR) gene variant C677T with non-syndromic cleft lip/palate (NSCLP) in Pakistani population and compare the maternal serum folic acid levels in NSCLP-affected and healthy group. A comparative cross sectional study was conducted between 2017 and 2019 at Liaquat University of Medical and Health Sciences, Jamshoro. Sixty mother-infant dyads were recruited (n = 120), including NSCLP-affected and healthy infants along with their mothers. The MTHFR C677T variant exhibited significant association with NSCLP in dominant and over-dominant models. No differences in maternal serum folic acid levels were observed between both the groups; however, the folic acid intake during pre-conception period was associated with decreased risk for NSCLP. Our study suggested that MTHFR 677 CT genotype was related with decreased risk for NSCLP in Sindhi, Pakistani, population. Pre-conception folic acid may decrease the risk for oral clefts.
Endometriosis presenting as relapsing haemorrhagic ascites in a South Asian woman: a case report
Authors: Ahmed Ushna , Chughtai Novera
Published: December 2023

Endometriosis presenting as ascites is a rare entity, and is more so in women of Asian ethnicity. Less than a hundred cases have been reported worldwide. Majority of patients present with abdominal distension and pain, draining massive blood stained serosanguineous fluid. This hinders future fertility prospects of these women. Ovarian suppression has been employed as a successful treatment, followed by definitive surgical treatment, such as bilateral salpingo-oophorectomy, to end the possibility of recurrences, which are otherwise always possible. We present the case of a woman of reproductive age, seeking fertility treatment, who had a more subtle presentation of moderate, but relapsing ascites of unknown origin in the past two years.  Diagnostic laparoscopy and histopathology of the peritoneal deposits suggested endometriosis. Her ovarian function was suppressed, and she is currently underway of assisted reproduction for achieving a pregnancy.
Keywords: Endometriosis, ascites, ovarian suppression.
SERM Therapy for patients of breast cancer and otherwise
Authors: Sikandar Eman , Javid Arysha , Ahmed Minahel
Published: December 2023

Madam,
In Pakistan, the most frequently diagnosed cancer among females is breast cancer, where every year at least 90,000 women suffer from the disease [1]. This incidence is 2.5 times higher than that of Pakistan’s neighbouring countries and the highest in Asia[1]. The current treatments for breast cancer in the country are all invasive forms of therapy and include radiation therapy, chemotherapy, lymph node removal, and mastectomy. This letter aims to draw attention to a newer form of treatment for breast cancer known as selective estrogen receptor modulators (SERMs).
Selective estrogen receptor modulators (SERMs) are synthetic molecules that provide a non-invasive therapy for breast cancer patients. Recent studies have proposed that the specificity of SERM’s mechanism of action and antiviral properties yield fruitful outcomes in treating covid-positive breast cancer patients [2], giving SERMs a significant advantage over former treatments such as radiation therapy or chemotherapy which reduce the body’s ability to fight infections. SERMs block the effects of estrogen on breast tissue, preventing cancer cells from dividing. They also act as an adjuvant in breast cancer therapy [3], suppressing secondary tumor formation. A recent study published in the Journal of Clinical Oncology showed significant benefits from two years of tamoxifen therapy in estrogen receptor- positive premenopausal patients of breast cancer [4].  On various other tissues, they act as estrogen, allowing for their use alongside other treatments for postmenopausal women to prevent bone loss and osteoporosis [3].
Despite SERM ‘s wide range of benefits in patients with breast cancer, it is not a fully recognized form of treatment for this population in Pakistan. Such hormonal therapy is only offered by a handful of high-end private-sector hospitals. This is attributed to a lack of research in this area due to various socio-economic factors. A limited choice of treatment for women with breast cancer in Pakistan results from fear of stigmatization and feminine sensitivity [5]. Attention should be brought to alternative therapies for breast cancer treatment to improve prognosis and help patients make the best possible shared decision-making choices.
Hadis Şerhlerinde Şair Katkısı: Mütenebbî Örneği
Authors: ALKAN Ahmet , ARSLAN Adnan
Published: December 2023

Arapların kültür tarihinde edebiyatın özellikle de şiirin kuşkusuz büyük bir yeri olmuştur. Cahiliye döneminde Arap şairi; kabile mensuplarının kah-ramanlıklarını destanlaştırmak, vefat edenlerinin isimlerini ölümsüzleştirmek, hasım kabile ve kişileri hicvederek bir nevi psikolojik üstünlük sağlamak gibi pek çok kritik işlev üstlenmekteydi. Şiir Arapların kültürel kodlarına sirayet ettiği için İslamiyet’ten sonra da şiir hayatın her alanında varlığını sürdürmüştür. Bunun bir tezahürü olarak, ilerleyen yıllarda teşekkül eden İslami disiplinlerde şiirlerden azami düzeyde istifade edilmiştir. Arap şiiri sadece sarf, nahiv gibi dilbilimsel çalışmalarda değil tefsir, hadis ve kıraat gibi İslami ilimlerin de başvuru kaynaklarından biri olmuştur. Istılahta istişhâd olarak terimleşen şiirden delil getirme ameliyesinin tatbiki hadis şerhlerinde de görülmektedir. Şârihler, hadislerde geçen kimi garîb lafızların manasını şiirde ararken bazen de hadisin manasına tam mutabık düşen birkaç beyte yer verirdi. Bu çalışmada Peygamber (s.a.s.) ile muhaddislerin şiire karşı tutumu ve hadis şerhinde şiirin rolüne dair bilgiler verilmiştir. Ayrıca, hadis şerhlerinde şiirlerine sıklıkla atıfta bulunulduğu görülen Abbâsî şairi Mütenebbî (ö. 354/965) şiirlerinin hadis şerh kaynaklarında nasıl ele alındığı incelenmiştir. Böylece araştırma sonuçlarının Arap dili ve belâgatı ile hadis alanı araştırmacılarına veri sağlayacağı öngörülmüştür.
natureza agápica da conduta pragmática
Authors: Baggio Renan Henrique
Published: December 2023

Buscamos compreender neste trabalho o papel do pragmatismo de Peirce enquanto face ética da investigação científica e como instanciação da lei evolucionária do amor criativo, ou Agapismo. Em meio ao cenário informacional contemporâneo no qual as redes se tornam plataformas para a transmissão de crenças por contágio, a desconfiança no método científico se intensifica e promove atitudes negacionistas, bem como o consequente desprezo pela alteridade dos fatos. Nesse contexto, é possível questionar: o método científico está sujeito à dinâmica comunicacional de nosso tempo? Isto é, seus produtos serão, de algum modo, influenciados pela desinformação? Como suporte teórico à análise deste cenário, convocamos o princípio evolutivo agápico defendido por Peirce em seu ensaio Evolutionary love, segundo o qual todo o cosmo evolui, em busca da harmonia como ideal aglutinador. Tal princípio evolutivo, enquanto uma lei geral, apresenta-se por meio de sua instanciação que julgamos estar configurada na conduta pragmática. Sob o ponto de vista do pragmatismo, na medida em que toma a alteridade da realidade como guia corretivo de conduta, o curso da história deverá, malgrado a custos conflitivos altos e de seu próprio retardamento, desmobilizar o desprezo pela ciência e uso irresponsável das plataformas comunicacionais, fazendo com que as novidades resultantes de nosso tempo sejam incorporadas cada vez mais na estrutura de nossos hábitos ao mesmo tempo em que promovem mudanças em nós.
Medical activity of middle-aged Russians in the «pre-pandemic» and «pandemic» periods
Authors: Gordeeva Svetlana S. , Sharypova Sofia Yu.
Published: December 2023

Introduction. Solving the health saving problem of middle-aged people in a risk social context is impossible without increasing the level of their medical activity, as well as forming a value attitude to health.
Material and methods. The study was conducted on the data of the Russian Longitudinal Monitoring Survey of the National Research University “Higher School of Economics” for 2018–2021. The analysis of statistical data was carried out using the methods of descriptive statistics and correlation analysis, the calculation of the odds ratio and cluster analysis were carried out.
Results. Middle-aged Russians are characterized by a low level of medical activity, which is due to their health status. Gender has an impact on the indicators of medical activity: men demonstrate a lower level of medical activity, despite low health indicators. In modern conditions, models of medical activity are varied: from passive practices without prevention to highly active practices combined with preventive examinations. An “inconsistent” model of medical activity with a predominance of self-treatment practices without preventive motives for visiting a doctor is the most common pattern during the COVID-19 pandemic.
Limitations. When studying the medical activity of middle-aged Russians in the “pre-pandemic” and “pandemic” periods, 17,631 questionnaires were evaluated during 2018–2021, which is sufficient to achieve the set goal. This study has limitations related to the survey period: data is not available after 2021, but the COVID-19 pandemic has officially ended in May 2023.
Conclusion. Insufficient medical activity of the middle age group of the population, especially during crises (including during the pandemic), presents itself as a risk factor for health loss, reduces the ability of institutional medicine to diagnose diseases at an early stage. The predominance of attitudes towards maintaining employment and income among middle-aged people, as well as an independent search for information on the Internet to resolve health issues, increases commitment to self-treatment practices.
Occupational risk of developing chronic non-communicable diseases in bearing production workers
Authors: Novikova Tamara A. , Bezrukova Galina A. , Kochetova Natalya А. , Migacheva Anna G. , Aleshinа Yulia A. , Raikova Svetlana V.
Published: December 2023

Introduction. Prevention of chronic non-communicable diseases, maintaining health and prolonging the occupational longevity of the working population is the most important strategic direction of the state policy of the Russian Federation in the field of public health
The purpose. Stratification of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings for the subsequent development of specialized targeted programs for the prevention of health disorders.
Material and methods. An assessment of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings is given on the basis of complex studies of production factors, primary and general chronic morbidity using the methodology for assessing occupational health risk.
Results. It has been established that the development of chronic non-infectious diseases in bearing production workers is determined by a complex of harmful (classes 3.2–3.4) factors of the working environment of various nature, which form an occupational health risk in categories from medium to very high. In the structure of the general chronic non-infectious morbidity of workers, diseases of the eye and its adnexa (24.4%), diseases of the musculoskeletal system and connective tissue (20.7%), diseases of the circulatory system (19.32%) and diseases of the endocrine system had the highest prevalence in systems of eating disorders and metabolic disorders — 15.1%. A causal relationship of varying severity with the work of the most common nosological forms of chronic was revealed as arterial hypertension (RR = 1.425; EF = 29.837%; C = 1.044–1.945), obesity (RR = 1.731; EF = 42.24%; CI = 1.219–2.459), presbyopia (RR = 2.443; EF = 59.071%; CI = 1.549–3.855), indicating their occupational conditioning.
Limitations. The limitation of the study was the assessment of the occupational risk of developing chronic non-communicable diseases in one occupational cohort of workers.
Conclusion. The development of specialized programs for the prevention of chronic non-communicable diseases among workers should include the study of causal aspects of health disorders and the rationale for measures to minimize the impact of occupational risk factors for occupationally determined pathology.
Features of professional hearing loss with combined exposure to noise and vibration
Authors: Sukhova Anna V. , Preobrazhenskaya Elena A.
Published: December 2023

For most modern industries, there is characteristic the simultaneous impact of noise with other factors aggravating its effect.
The purpose of the study is to determine the features of occupational hearing loss in the combined effects
of noise and vibration.
Materials and methods. A comparative assessment of the level of occupational risk and audiometric indicators was carried out in three groups of employees: 1st group (210 people) — is exposed to noise, 2nd group
(170 people) — to noise and local vibration, 3rd group (200 people) — to noise and general vibration.
Results. In group 1 workers exposed to isolated noise, occupational hearing loss was diagnosed significantly less frequently compared to group 2 and 3 including workers exposed to combined noise and vibration
(7% vs. 14 and 13%, respectively, p < 0.05). Combined exposure to noise and vibration increases the risk of occupational hearing loss by 1.82–1.85 times (RR = 1.82–1.85; EF = 45–46%). Audiological features
of the lesion of the auditory analyzer have been revealed depending on the presence and nature of the affecting vibration, manifested by changes in hearing thresholds in certain frequency spectra and their combination. According to the data of speech audiometry, a violation of speech intelligibility with the presence of speech-tonal dissociation was revealed in workers of groups 2 and 3, indicating violations in the central department
of the auditory analyzer.
Limitations of the study. The study is limited to the study of the features of occupational hearing loss in the combined effects of noise and vibration in mining workers according to audiometric indicators.
Conclusion. The conducted studies have shown the need to develop individual programs for the preservation of hearing, taking into account the degree of risk and the identified features of the formation of occupational hearing loss. The topic of research on the effects of noise and vibration on hearing loss requires in-depth research, taking into account the intensity and duration of vibration exposure, the type of vibration generating equipment.
Social media interaction of publications in the field of general surgery: A comparative analysis of the twitter performances of Q1 medical journals with their impact factor
Authors: ERTENLİCE Alparslan
Published: December 2023

Background: It is a well-known fact that social media has the power to reach a great number of audiences through robust information, interaction, and communication. Twitter is also known to be one of the strongest social media tools, which is especially known for its high volume of information sharing. In this study it is aimed to analyse the relationship between the impact factor (IF) of Quartiles1(Q1) journals in the field of General Surgery and their performances on Twitter.
Methods: Surgical Q1 journals have been listed. While creating the list, journals without a Twitter account have been excluded from the study. The IF of the journals has been compared with their total shares, comments, likes, retweets, total views, followers, and total shares for all time between June 1st, 2023, and November 30th, 2023.
Results: Results indicated moderate positive correlations between IF and engagement metrics like shares, comments, likes, and retweets, with follower count and total shares showing stronger statistically significant correlation.
Conclusion: No comparative relationship or correlation is found between the parameters of the last six months and the IF. Only, a correlation has been observed with the total number of views within the last six months. A correlation is noted between the number of followers and the total number of shares for all time. These results are attributed to the fact that journals with a high IF are established and respected and lead to these outcomes even if they share at similar rates as other journals.
ANALISIS KORELASI KEMAMPUAN LITERASI SAINS DENGAN KEMAMPUAN MEMECAHKAN PERMASALAHAN KONSEP ENERGI TERBARUKAN PADA MAHASISWA PENDIDIKAN FISIKA
Authors: Anggraeni Sisilia Nur Hikmah , Sholehatennafiah Vivi , Purwanti Nurul Yunda Nanik , Pujiningtyas Emma Berliana , Mahartika Dina , Sudarti Sudarti , Subiki Subiki
Published: December 2023

Literasi sains kemampuan menggunakan pengetahuan sains untuk mengidentifikasi pertanyaan, memperoleh pengetahuan baru, menjelaskan fenomena ilmiah dengan menyimpulkan berdasarkan bukti-bukti ilmiah. Penelitian ini bertujuan untuk mengetahui kemampuan literasi sains dan kemampuan memecahkan permasalahan sains mahasiswa Pendidikan fisika pada konsep energi terbarukan. Metode penelitian yang digunakan adalah metode analisis korelasi menggunakan kuisioner berupa google form yang disana nantinya akan mengetahui hubungan kedua variabel yang dibuktikan dengan aplikasi SPSS dan penelitian secara deskriptif. Hasil penelitian menunjukkan bahwa bahwa antara kemampuan literasi sains (X) terhadap kemampuan memecahkan masalah (Y) terdapat hubungan yang positif dengan tingkat korelasi sempurna. Hal tersebut tampak pada nilai koefisien korelasi Pearson di atas adalah 0,847 dimana nilai korelasinya bernilai positif sehingga hubungan antara Literasi Sains terhadap Kemampuan Memecahkan Masalah tentang Energi Terbarukan. Temuan hasil penelitian ini dapat digunakan untuk mengukur dan mengevaluasi sejauh mana literasi sains tentang energi terbarukan yang sudah diterapkan oleh mahasiswa pendidikan Fisika.
PENUNDAAN PEMILU 2024: QUO VADIS HAK KONSTITUSIONAL RAKYAT DALAM DEMOKRASI INDONESIA
Authors: Liunda Sheren Agapena Hosaya , Hutabarat Ela Suryani , Rasji Rasji
Published: December 2023

Pada Tahun 2024 seluruh wilayah indonesia akan melaksanakan pemilu. Pemilu termasuk salah satu kewajiban yang akan dijalankan oleh seluruh rakyat indonesia akan dijalankan setiap 5 tahun sekali. Pada Tahun 2024 ada wacana mengenai adanya penundaan pemilu di indonesia yang akan ditunda dengan alasan - alasan yang masih kurang jelas, jika dalam Hal penundaan pemilu terjadi, penundaan pemilu pada tahun 2024 akan mengalami kontra terhadap masyarakat indonesia karena sudah melanggar peraturan undang - undang yang mengatur tentang pemilu No 7 Tahun 2017 dan tidak sesuai dengan hak demokrasi di indonesia untuk Pemilu. Dalam hal ini ,bahwa berita mengenai isu penundaan pemilu tahun 2024  jika secara positif dan terus mengarah terhadap penundaan pemilu yang cenderung dari sisi pemerintah, pengamat politik dan lembaga yang berwenang  terhadap usulan penundaan pemilu. jika dalam pelaksanaan penundaan pemilu Tahun 2024 , terjadinya penundaan pemilu Tahun 2024 maka penundaan pemilu di indonesia akan dijalankan menjadi 2 cara yakni secara konstitusional dan secara non - konstitusional. Dalam hal diatas jika terjadinya penundaan pemilu di wilayah indonesia yang berpendapat terhadap hak demokrasi konstitusional, perlu adanya formulasi normal dalam menjalankan penundaan pemilu secara konstitusi agar tidak bertentangan dengan asas demokrasi yang ada di wilayah indonesia.Kata kunci: Pemilu, Wilayah, Konstitusional, Nonkonstutional, Undang-Undang.
TRANSFORMASI HUKUM E-COMMERCE DI INDONESIA: ANALISIS DAN SOLUSI PERMASALAHAN
Authors: Purba Bonaraja , N Hasyim , Hutasoit Hosiana Febby Yolanda Putri , Sinaga Hana Ema Nuela , Adriansyah Teguh , Simangunsong Yuni Sari
Published: December 2023

E-commerce mengalami pertumbuhan yang signifikan dalam beberapa tahun terakhir dan telah menjadi bagian penting dari perekonomian Indonesia. Namun, dengan pertumbuhan ini muncul sejumlah masalah hukum yang perlu ditangani. E-commerce memiliki beberapa permasalahan hukum yang mempengaruhi legalitas transaksi, keaslian data, tanda tangan digital, keamanan informasi dan privasi. Penelitian ini bertujuan untuk mengatasi masalah e commerce melalui landasan hukum untuk menjamin keuntungan dan kepastian hukum. Penelitian ini menggunakan pendekatan deskriptif untuk menganalisis situasi hukum e-commerce di Indonesia. Data dikumpulkan dengan menggunakan survei literatur, analisis dokumen, dan kuesioner jika diperlukan. Analisis deskriptif dilakukan untuk mengidentifikasi permasalahan hukum yang ada pada e-commerce di Indonesia dan hasilnya digunakan sebagai dasar usulan solusi. Oleh karena itu, penelitian ini memberikan pemahaman mendalam tentang transformasi hukum e-commerce di Indonesia dan menawarkan solusi untuk mengatasi permasalahan yang ada. Penelitian ini menyimpulkan bahwa dalam memecahkan masalah ini memerlukan penciptaan dasar hukum yang menguntungkan, memastikan kepastian hukum, dan mengembangkan program dukungan teknis yang aman dan efisien.Kata kunci: Regulasi Bisnis, Permasalahan E-Commerce, Solusi Hukum