bluuebunny/crossref_metadata_2025 huggingface dataset:
LEADERSHIP ROLE IN DECISION MAKING AND TEAM BUILDING IN SCHOOL
Authors: Baharun Hasan , Rozi Fathor , Baihaki Muhammad Ali Fadar
Published: May 2022

This paper describes the role of leadership in decision-making and team-building at SMP Nurul Jadid Paiton Probolinggo. This research uses a qualitative approach with a case study type, in which the data is collected through interviews, observation, and documentation. The data analysis used is data reduction, presenting the data and concluding it. The study results indicate that the leader's role in making decisions at the institution is as an entrepreneur, as a deterrent to distractions, as a resource divider, as a negotiator. At the same time, the role of leadership in building teamwork is showing his side, building an atmosphere or climate of mutual trust, respecting the ideas proposed by subordinates, prioritizing the comfort of his subordinates, taking into account the job satisfaction factors of subordinates, acknowledging the status of members of the organization appropriately and professionally, trying to sticking to commitments, views that teamwork is the best effort.
OBSTACLES OF IMPLEMENTING STRATEGIC PLANNING FROM SECONDARY SCHOOL PRINCIPALS’ PERSPECTIVES IN KHARTOUM STATE
Authors: Al-Zubair Bannaga Taha , El-khder El-Zain El-Khalefa
Published: May 2022

This study aimed at identifying the main obstacles that face the implementation of strategic planning from secondary school principals’ perspectives in Khartoum State. To meet the study purpose, the descriptive research method was used. The study population consists of all secondary school principals in Omdurman locality amount 220. Out of the study population, 110 principals were selected through a random sample technique. The data were collected using a designed a questionnaire by the researchers. To analyse the collected data, the researchers used the Chi2 test through the Statistical Package of Social Sciences (SPSS). The school principals face difficulties in analysing the points of strength, weakness opportunities, and threats of their schools as they lack the basic scientific foundations and knowledge of strategic planning. The school principals encounter difficulties and problems when they try introduce the strategic planning of their schools because they lack the basic required skills and competencies regarding the implementation of strategic planning processes.  The study recommended that the principals’ skills should be developed to meet the strategic planning requirements. Besides, more attention needs to be given to the obstacles that hinder the implementation of strategic planning processes in the future studies
FINANCING MANAGEMENT OF MIDDLE EDUCATION ASSISTANCE FUNDS DURING THE PANDEMIC
Authors: Mulyati Sri , Safitri Sundaniawati
Published: May 2022

This study aimed to explore funding management of School Operational Assistance Funds (Indonesian term: Bantuan Operasional Sekolah) during COVID-19 Pandemic at Al-Muhajirin Islamic Junior High School, Gunungsindur, Bogor. This study employed a descriptive qualitative approach by utilizing interviews, documentation, and observation to collect the data. The data analysis process involved a series of procedures from data collection, data reduction, data presentation, data verification to conclusions. The results showed that the fund management at Al-Muhajirin Islamic Junior High School was actualised into planning, implementing, and supervising stages. Planning includes the activities of formulating a draft budget. The implementation stage was through socialization and distribution of funds. The supervision stage involves all school parties, both internal and external. Fund reporting is carried out via offline and online pathway every semester.
LIMITED FACE-TO-FACE LEARNING MANAGEMENT DURING THE COVID-19 PANDEMIC
Authors: Paramita Ainun Amaliya , Setiawan Farid , Palupi Retno , Anam Rijal Khoirul
Published: May 2022

This study aims to understand the management of learning in schools at SD Negeri Caturtunggal 3, Depok, Sleman, Yogyakarta Special Region, during the Limited Face-to-Face Learning (PTMT) was carried out during the Covid-19 pandemic. The method used in this research is qualitative. The results showed that the limited face-to-face learning carried out after the previous learning was done online, there were several obstacles that the students strongly dominated at the beginning of the learning implementation. Limited face-to-face learning has obstacles. Namely, many students are confused when invited to icebreaking. Students are still adjusting to the learning, and the reality of student understanding seen from the assessment during online learning and then implemented in a limited manner is very different. Although at the beginning of the implementation of limited face-to-face learning, there were still obstacles, SD Negeri Caturtunggal 3 was able to prepare and develop sound strategies to manage limited face-to-face learning to anticipate unwanted things.
LEARNING MANAGEMENT SYSTEM AS COVID 19 RISK MITIGATION
Authors: Wafa Ali , Muhammad Muhammad , Shofia Shofia
Published: May 2022

This study aims to analyze the learning management system as a risk mitigation for Covid 19 at an early childhood education institution in Probolinggo Regency. The research method used is a qualitative case study type. In order to get an overview of the Learning Management System Learning as Covid Risk Mitigation in early childhood, the researchers mingled directly in the implementation of learning and made observations and documented learning activities at the institution. Interviews were conducted with principals and teachers. The results of the study indicate that teacher innovation using a learning management system is carried out through; parental involvement, use of online media, selection of materials, assessment, and follow-up. This study implies that teachers must have innovation and creativity in managing their learning according to the targets they have set to generate total motivation and intelligence of students.
GIRLS' EDUCATION POLICY IN SUDAN: CHALLENGES AND PROSPECTS
Authors: Onia Saifaldin Idris
Published: May 2022

Girls' education in the 21st Century, is not only a women's issue it is a development issue. Girls' education is `positively correlated with increased economic productivity, more robust labor markets, higher earnings, and improved societal health and well-being. Nevertheless, Sudan has witnessed low development of girls' education because of the country's traditions. Parents tended to look upon girls' education with suspicion, if not fear, that it would corrupt the morals of their daughters. Moreover, preference was given to sons, who, by education, could advance in society to the pride and profit of their family. Therefore, this study aimed to assess girls' education policy in Sudan. In doing so, this study followed a descriptive qualitative approach to the type of library research in which the data collection technique was carried out based on literature data. The study confirmed that there are several barriers to girls' education in Sudan including economic factors (i.e. cost of educational materials, girls are needed at home to contribute to the household economy), cultural factors (early marriages, tradition, and customs), and school factors (motivation as the lack of female role models). The researcher suggests that the authorities should enforce laws against the marriage of young girls. In addition, schools should be built in such a way that they are close to villages, allowing girls to attend. Furthermore, the nomads should be given lectures to be aware of the necessity of girls' education
Students of Higher Education Institutions (HEIs) and Information and Communication Technologies (ICTs): Viability of Digital Media Literacy in Pakistan
Authors: Shah Mudassar Hussain , Saima Kausar  , Maryam Waqas
Published: May 2022

Information and Communication Technologies (ICTs) have changed the dynamics of higher education institutions (HEIs) worldwide. The dependency of students on ICTs increased significantly and it considered requisite for modern higher education. Adverse impacts of ICTs studied by scholars on students of higher education that reflect ICTs are influencing social interaction pattern, cognition, academics and bring addiction. However, little work is done in HEIs to create curricula of digital media literacy which may reflect the demography of students and direct training and utility of ICTs that may mitigate adverse effect. This article argues that how students of HEIs use ICTs and what are the plausible actors that can contribute in the digital media literacy in Pakistan. For this purpose, a structured questionnaire is designed to collect the data from 640 respondents of two major public sector universities of Pakistan i.e. University of Sargodha and Bahauddin Zakariya University Multan through online survey on google form by distributing it to various online WhatsApp groups by convenience sampling technique. Actor Network Theory (ANT) is the conceptual framework of this study.  The findings of the study reveal that significant respondents spent their large amount of time on ICTs for pleasure instead of necessity drive. However, findings reflect that ICTs are using by youth for various purposes that are education, political and religious information, and entertainment. Moreover, the significant respondents use ICTs for connect themselves with Internet, gaming consoles, movies, audio/video players and sharing of documents. The gender is also significant factor that contributes in the utility of ICTs. This article argues on digital media curriculum development in the universities of Pakistan..
A wave-breaking model for the Depth-Semi-Averaged equations: some preliminary results
Authors: Antuono Matteo
Published: May 2022

A novel model for the description of the wave breaking process and the subsequent generation and

evolution of the vorticity is defined for a particular non-hydrostatic scheme, namely the Depth-SemiAveraged model of Antuono et al. [1]. Such a model is based on the use of mollified differential operators

inside the vorticity equation, following an approach which is similar in spirit to that used in the context of

the Smoothed Particle Hydrodynamics. The breaking conditions and the expression for the vorticity

injection at the free surface are adapted from the work of Veeramony [2] and Veeramony and Svendsen [3]

while a proper closure for the turbulent cinematic viscosity is proposed.

Some preliminary test cases are shown by using the experimental data from Lucarelli et al. [4] for a spilling

breaking event. These suggest that the proposed model is accurate and reliable and that it is suited for the

description of the main features of the wave breaking at spatial and time scales typical of the coastal

models.

The proposed work is developed in collaboration with the Università Politecnica delle Marche (UNIVPM) in

the context of the project entitled “FUNdamentals of BREAKing wave-induced boundary dynamics”

(FUNBREAK), funded by the Italian Ministry MIUR with grant number 20172B7MY9_003.
Interaction between wave-induced nearbed vortex structures and cohesionless sediments: numerical results
Authors: Blondeaux Paolo
Published: May 2022

In the framework of the research project “FUNdamentals of BREAKing wave-induced boundary dynamics” (FUNBREAK) and of the ONR Global research project aw. nr. N62909-17-1-2144, we performed and analysed direct numerical simulations of the turbulent oscillatory flow generated close to the bottom by the propagation of surface waves. The bottom was composed of cohesionless spherical particles which are free to move when dragged by the surrounding fluid. The hydrodynamic stress over the surface of each sediment grain was explicitly computed by means of the immersed boundary approach. Hence, the force and torque acting on the sediment grains were readily evaluated. Numerical simulations were made for a range of flow Reynolds numbers and sediment particle dimensions that are typical of shallow coastal areas. An example of the results is given in the figure where the instantaneous position of the sediment grains is plotted along with the turbulent vortex structures generated by the interaction of the turbulent eddies with the spherical particles. The results were used to develop and test physically based models for bedload transport and reference bed concentration of suspended sediment in oscillatory flow.
Shear-instability in Internal Kelvin waves
Authors: Stastna Marek
Published: May 2022

Internal waves in the ocean and their laboratory analogues are known to break down via a variety of mechanisms.

In this talk I will focus on Direct Numerical Simulations of mode-2 internal waves generated from a lock-release

on a laboratory scale. This well-understood process of generation allows us to control the size and shape of

the wave formed, for example through a judicious choice of density stratification. In the absence of rotation

the internal waves generated, primarily induces stream wise and vertical currents, with span wise currents being

the product of small scale three-dimensionalization. When rotation is present, the process of geostrophic adjustment

leads to a complex pattern of wave-induced currents oriented in all three coordinate directions. I will demonstrate

that this leads to shear instabilities that are trapped near one of the tank walls, it also leads to smaller scale

shear instabilities with a stream wise oriented vorticity axis (to our knowledge the first documented case of

such instabilities). I will discuss the breakdown into turbulence of these instabilities and the possibilities and

challenges of scale up of these simulations to the field scale.
Maps of phenomena for breaking waves in deep, intermediate, and shallow waters
Authors: Desmons Florian
Published: May 2022

Numerous numerical simulations were performed to investigate the phenomena occurring when waves

break [1]. The Notus CFD code was used to solve the Navier-Stokes equations in the finite volume

framework. The breaking event was inspected on a 2D periodic first order stokes waves over a flat

bottom at different depths : shallow, intermediate and deep. The wavelength of the initial wave is varying

from 5 cm to 35 cm. The observation of the breaking type (Parasitic Capillary Waves, Spilling Breaker

and Plunging Breaker) of each simulation has permitted to generate three mapping of the phenomena

occurring during the breaking process following the wavelength and the wave steepness.

Firstly, we aim at presenting and discussing the mapping generated for the three different water depths.

Then, an investigation of the vorticities created during the first steps of the breaking event will be presented. This investigation has permitted to observe three sub-categories, which has not been described

in the literature, to the best of our knowledge : the spilling breaker with single vortex, with dipoles and

the plunging breaker without roller. The characteristics of these sub-categories will be presented and

explained thanks to the surface motion and the vorticities generated. The figure 1 is a representation of

the vorticity field obtained during the spilling breaker with dipoles.

Acknowledgements: This study has been carried out with financial support from the French State, managed by the French National Research Agency (ANR) in the frame of the ”Investments for the future”

Programme IdEx Bordeaux - SysNum (ANR-10-IDEX-03-02).
Internal breaking wave: from the dead water effect to complex structures
Authors: Fourdrinoy Johan
Published: May 2022

A movement of a ship in a density stratified environment generates different internal waves

systems. These waves cause boat’s slowdowns, known as dead-water. In wide channel experiments, the

boat’ speed oscillates when passing a dispersive undulating depression. With strong lateral confinement

(narrow channel), the amplitude of the waves increases, and the boat can even come to a stop. When the

waves’ cambers become too high, breaking-waves appear at the stern.

The study of this phenomenon has led us to revisit an old experiment of Scott Russell. The

Scottish engineer studied the formation and propagation of dispersive waves when an object is removed

from a laterally confined open channel with a shallow layer of water. The “vacuum” created by the mass

removal generates a linear dispersive free surface deformation with a front of negative polarity followed

by a wave train. If we extend this configuration to a two-layers stratification, we can observe a linear

dispersive wave with negative polarity à la Scott Russell, propagating along the interface.

During an initial disturbance of high amplitude many other structures appear. The wave front

will first break, generating a mixing zone. Within this area, baroclinic modes can appear as a wave

response to vertical displacements. Finally, if the amplitude of the initial impulse is even stronger, a

hydraulic response appears. Indeed, a BOLUS, or breaking wave 2-mode, (an ovoid coherent mass of

recirculating mixed fluids immerged in a surrounding medium/a of different density/ies) propagating

along a pycnocline. These different hydraulic or wave structures have been observed experimentally by

a subpixel detection method allowing spatiotemporal monitoring of structures of very low amplitudes.
High-fidelity observations and modeling of wave breaking dissipation and bubble plumes
Authors: Derakhti Morteza
Published: May 2022

Combining high-fidelity numerical modeling and field observations,

we examine wave-breaking-induced energy dissipation and bubble plumes

over a wide range of sea state conditions, including storms with sustained

winds up to 22 m/s and significant wave heights up to 10 m. We use

a polydisperse two-fluid LES/VOF model (Derakhti Kirby, 2014) to

simulate bubble entrainment and turbulent bubbly flow in short-crested

deep water wave breaking events. Bubble contributions to dissipation and

momentum transfer between the water and air phases are considered. Using the numerical model results, we examine the statistical characteristics

of wave breaking and associated turbulent dissipation rates in a field of

intermittent events. We show that convergence of statistics occurs for

signals that have minimum length of approximately 1000–3000 wave periods with randomly spaced observations in time and space relative to 3D

breaking events. We further show important effects of obscuration of velocity measurements due to entrained bubbles on the estimated turbulent

dissipation rates. Observations are recently collected in the North Pacific

Ocean and include arrays of surface following SWIFT buoys as well as

shipboard winds and optical video systems. Two types of SWIFT buoys

are concurrently used with uplooking and downlooking Acoustic Doppler

Current Profilers to measure turbulence and image bubble plumes with

echograms in a wave-following reference frame. This vertical reference is

used throughout the analysis, with important distinctions from the more

common mean-sea-level reference frame. Combining the data from both

types of SWIFT buoys, we obtain turbulence dissipation rate profiles that

extend from sea surface to 3 m depth. The echograms extend to 30 m

depth range and indicate bubble plumes reach more than 10 m beneath

the surface, with residence time of several wave periods. The volume of

bubble plumes is estimated by combining active whitecap coverage and

plume depth measurements. Dependencies of the observations on wave

age, bulk and spectral steepness, and wind accelerations are explored.

Finally, we show that bubble plume statistics are closely linked to wave

breaking dissipation, such that one may scale the other.
On the breaking inception of unsteady water wave packets evolving in the presence of constant vorticity
Authors: Banner Michael Leslie
Published: May 2022

The recent numerical study of Barthelemy et al. (J. Fluid Mech., vol. 841, 2018, pp. 463–488) investigated

the local properties of two-dimensional (2-D) and three-dimensional (3-D) nonlinear unsteady gravity

wave packets in deep and uniform intermediate depth water. Their study focused on the breaking inception

transition zone separating maximum recurrence and marginal breaking, and reported that a suitably

normalized energy flux localized at the steepest crest in the packet provides a robust breaking threshold parameter.

Our present study uses the fully nonlinear boundary integral element method solver developed by

Touboul Kharif (Nat. Haz., vol. 84, issue 2, 2016, pp. 585–598) to investigate breaking inception of

2-D deep water nonlinear water wave packets propagating in the presence of a background current that

varies linearly with depth. We seek to validate whether the proposed generic breaking inception threshold

holds for the case of constant background vorticity. Results are presented for different

packet bandwidths and background vorticity levels.
Depth-limited wave breaking dissipation in a potential flow code
Authors: Mohanlal Sunil
Published: May 2022

Simulation of waves beyond the breaking point in a fully non-linear potential flow model (e.g.

Raoult et al. [1]) is considered with a semi-empirical dissipation term that requires correctly

determining the breaking onset and estimating the energy dissipation rate. A kinematic breaking

criterion, similar to those found recently to be practical for arbitrary water depth (e.g. Derakthi

et al. [2]), is applied here. The criterion is based on 푈/퐶, the ratio of the free surface water

velocity to the wave phase speed. To estimate the wave breaking strength in shallow water,

previous work by Svendsen et al. [3] that continues to be used and developed (e.g. Grilli et

al. [4]), has shown that a hydraulic jump model can provide a reliable approach for spilling

shallow water breakers. Alternatively, Derakthi et al. [5] proposed a parameterization for the

breaking strength in deep and intermediate water depending on the rate of change of 푈/퐶. Here,

a range of depth-limited wave breaking cases for regular and irregular waves are considered and

validated with experimental measurements, and values for the rate of change of 푈/퐶 and the

breaking strength are calculated for shallow water cases. Current work includes exploring if

and how these different parameterizations may be combined to develop a unified approach to be

applied in fully nonlinear potential flow models.
Burgers-like wave turbulence in the surf zone
Authors: Bonneton Philippe
Published: May 2022

Ocean wave fields are made of a large number of waves that are mutually interacting in a random way. It is

an important example of wave turbulence (Nazarenko, 2011). Significant achievements for modelling wave

turbulence in deep water have been made since the pioneer work of Hasselman (1962). Under the hypotheses

of weak nonlinearities and strong dispersion Hasselman derived a kinetic equation for the wave action, which is

the basis of current operational wave forecasting models. A remarkable property of Hasselmann kinetic equation

is that it possesses a stationary analytical solution that corresponds to a constant flux of energy from high to

small wave numbers(Zakharov and Filonenko, 1966). The solution corresponds, in the frequency wave spectrum,

to a power law of the form of ω-4 (ω the pulsation), that is in agreement with field observations.

In shallow waters, the weak wave turbulence approach is no longer valid because, as the waves propagate

shoreward, the nonlinearities increase and the dispersive effects decrease. In the inner surf zone, waves are

strongly nonlinear and almost non-dispersive. The interacting random waves become phase-locked and generate

sawtooth waves. These coherent structures result from the competition between nonlinear and dissipative

processes.

During this talk, I will analysed wave dynamics in the inner surf zone. First, I will show that this dynamics has

strong similarities with Burgers-like turbulence (Saffman 1968). Then I will present the derivation of a theoretical

power spectral density law which describes wave energy from the inertial range to the dissipative range (see

figure below). Finally, we will discuss about the implications of this work for predicting energy dissipation and

turbulent eddy viscosity in the inner surf zone.
On the stability of the laminar boundary layer beneath a Stokes wave
Authors: Fedele Francesco
Published: May 2022

The linear stability of the laminar boundary layer flow of a Stokes wave in deep waters is

investigated by means of a 'momentary' criterion of instability for unsteady flows. In the

parameter range investigated, it is found that the flow is stable to 2-D perturbations. The least

stable eigenmode of the resulting Orr-Sommerfield spectrum attains its maximum beneath

the boundary layer of the Stokes wave. Moreover, an analysis of the associated

pseudospectrum indicates that the laminar flow when modified by imperfections is unstable

due to the non-normality of the Orr-Sommerfeld operator, and the unstable pseudoeigenmodes tend to peak within the boundary layer. The laminar flow of the Stokes wave is

also stable to 3-D streamwise-independent perturbations. Instability is observed for the

laminar flow with imperfections. The associated unstable pseudo-eigenmodes are streamwise

vortical rolls similar to Langmuir cells. The laminar boundary layer flow of a Stokes wave

appears to be stable to infinitesimal perturbations, but it may likely be unstable to finite

perturbations, as in Poiseuille pipe flows. The present results are supportive of the recent

experimental evidence of spontaneous occurrence of turbulence beneath unforced nonbreaking surface waves.
UNTUNG ATAU RUGI SAMA SAJA, KOK!
Authors: Sri W. Andi
Published: May 2022

Kegiatan ekonomi (muamalah) merupakan bagian dari ibadah. Transaksi ekonomi dilakukan tidak hanya mencapai tujuan duniawi semata, namun lebih diarahkan atas pencapaian yang lebih tinggi, yaitu kesadaran religiositas. Perspektif yang ditawarkan melebihi sekedar upaya melihat keuntungan sebagai stimulus bersyukur atau kerugian sebagai cara bersabar, namun buku ini mengarahkan pada kekuatan dua perkara besar yang dijadikan pijakan kesadaran baru muncul. Kesadaran bahwa untung atau rugi itu tidak memiliki perbedaan dan justru keduanya berdampak kebaikan-kebaikan lain. Pijakan kesadaran baru tersebut dilandasi al Qur’an dan hadist
Kuasa Akuntan Publik dan Eksistensi Laporan Audit Simbolik (Bourdieusian Perspective)
Authors: Ahmad Kurniawan F.
Published: May 2022

pemberian kuasa oleh negara tidak cukup menjamin AP memiliki kuasa di dalam arenanya sendiri. Oleh karena itu perlu kebijakan mengatur arena audit yang tujuannya menciptakan keseimbangan subjektif dan objektif di dalam arena audit. Keterbatasan studi ini hanya mengangkat perspektif dari Akuntan Publik yang dipilih oleh penulis sehingga tidak bisa dilakukan generisasi. Peneliti tidak melakukan proses triagulasi dengan penerbit laporan keuangan, pengguna laporan audit independen dan regulator. Dengan demikian, penelitian ini memiliki keterbatasan dalam mengungkapkan realitas yang tidak dijamah oleh peneliti. Peneliti merekomendasikan keterbatasan penelitian ini bisa dikembangkan dalam perspektif yang lebih luas untuk dikaji atau diteliti lebih lanjut.
Chester Himes and the Popular Novel: A Voice for Existential Blackness
Authors: Duran Jane
Published: May 2022

The work of Chester Himes, as exemplified by Real Cool Killers, is examined for its attention to social issues. It is concluded, as Polito has contended, that Himes is gifted at portraying an inner-city world and its problems. In a sense, Himes’s work also speaks to the post-World War II existential issues that drive some of the writing of Richard Wright.
Colonial Legacies and African Reparations: What Ubuntu Implies in Terms of the Duties of Europeans
Authors: Cordeiro-Rodrigues Luis
Published: May 2022

The current COVID-19 pandemic is likely to have a strong negative impact on African countries. This is due to the fact that poverty has reduced the ability of these countries to implement health measures that are necessary to address the pandemic. In this article, I contend that colonialism has a role to play in this reduced ability to respond to the current crisis. Hence I argue that Ubuntu ethics imposes responsibility on European governments to aid Africans during this period.
Frequency of Hepatic Encephalopathy (HE) among Hepatitis Patients at Mardan Medical Complex, Mardan
Authors: Bilal Muhammad , Ali Sajid , Mohammad Sajjad , Ahmad Mushtaq , Ullah Aman , Shuaib Syed Luqman
Published: May 2022

Introduction: Hepatic encephalopathy (HE) represents severe neuropsychiatric condition of acute and chronic liver disease. Approximately 70% HE found in patients already suffering from liver cirrhosis. The aim of this study was to find the risk factors for developing Hepatic Encephalopathy in patients suffering from Chronic liver disease. Materials and Methods: This descriptive study was conducted in Mardan medical complex in four months duration. Data was collected from one hundred patients using non-probability sampling technique. All the data were analyzed through statistical software, JMP, 10.0 SAS, USA. Results: This study reports the frequency of HE among 100 hepatitis patients with mean age 55±9years. Out of these patients, 58% were males and 42% females. In our study, infection was the main precipitating factor found in most of the patients examined, followed by spontaneous bacterial peritonitis (20% patients), constipation (18% patients), GI bleeding (13% patients), and electrolyte imbalance such as hypokelmia (6% patients) and hypernatremia (3% patients). Conclusion: It is concluded that HE is more common in male patients than female. The risk of HE can be minimized by providing good hygienic conditions and germs free food in hospital. Keywords: Hepatic encephalopathy, Hepatitis, Cirrhosis, Chronic liver diseases
A Comparative Study on Caudal Bupivacaine with and without Tramadol for Analgesia Postoperatively in Paediatric Inguino Scrotal Surgeries
Authors: Ashfaq Shumaila , Asghar Faheem , Channa Aftab Ahmad , Saqib Muhammad , Ahmad Nisar , . Shahjehan
Published: May 2022

Objective: The objective of this analysis was to govern the analgesic effect of tramadol with caudal bupivacaine in children enduring inguinal-scrotal surgery postoperatively. Study design: A Quasi experimental study. Methods: In this comparative and double-blind study, 120 children undergoing inguinal scrotal surgery were involved in the analysis. They were 2-12 years old. The inclusion standards were children from ASA I and II. The two identical groups were formed. After initiation of general anesthesia, group A patients (n = 60) 0.25% bupivacaine 0.75 ml / kg was administered and tramadol 1 mg / kg with 0.25% bupivacaine 0.75 ml / kg were administered in B group (n = 60). Postoperative pain was evaluated with a visual analogue pain score in 6-7 years of age children and with behavioural reflexion in pre-speech children. Using a 4-point sedation scale; Sedation was assessed; heart rate, mean arterial pressure, arterial oxygen saturation and respiration rate. The sedation and pain were documented at consistent duration up to 24 hours after surgery immediately after recovery from anesthesia. If the pain score was higher than 4, paracetamol (20 mg / kg) was administered rectally. Results: Addition of intravenous bupivacaine and tramadol suggestively have longer postoperative analgesia (10.1 ± 2.1 hours) in group B, while the mean duration of analgesia (2.90 ± 0.79 hours) in group A, where bupivacaine alone was, provided. No significant changes were observed in blood pressure, O2 saturation and heart rate between groups. Apart from vomiting and nausea, no side effects like retention of urine, depression and pruritus were observed. Conclusion: In children undergoing inguinal scrotal surgery, caudal bupivacaine and tramadol have more lasting and better postoperative analgesia than bupivacaine alone. Keywords: Postoperative analgesia, tramadol, Caudal and bupivacaine.
Frequency of Pulmonary Hypertension in Patients with Chronic Kidney Disease Undergoing Hemodialysis
Authors: Shamim Javeria , Zahra Fatima , Munir Amna , Zuhra Fatima , Haider Syed Aftab
Published: May 2022

Objective: To determine the frequency of pulmonary arterial hypertension (PAH) in patients with chronic kidney disease (SKD) undergoing hemodialysis. Materials and Methods: A total number of 80 patients of age 16-75 years, either gender presenting with CKD undergoing hemodialysis were included. This study was conducted in the department of nephrology of Nishtar Hospital Multan from June-2021 to February 2022. The patients underwent echocardiography. If there was pulmonary artery systolic pressure >35 mm Hg, then pulmonary hypertension was labeled. Results: Mean age of patients was 48.67±11.71 years. Mean BMI patients was 24.79±3.25 kg/m2. There were 57 (76.00%) males and 18 (24.00%) female patients. 31 (38.8%) out of 80 patients were smokers, diabetes was found in 35 (43.8%) patients. Hypertension was found in 53 (66.3%) patients. Mean pulmonary artery systolic pressure were 29.47±9.16 mmHg. PAH was found in 15 (18.75%) patients. Conclusion: PAH is a common disorder in patients of CKD undergoing maintenance hemodialysis and more than 18% of CKD patients undergoing maintenance HD had PAH. Keywords: Pulmonary hypertension, chronic kidney disease, hemodialysis.
Effect of Impacted Mandibular Third Molar on Development of Distal Caries of Second Molars
Authors: Iqbal Faiqa , Zia Khadija , Sajid Ramsha , Khan Amna Nauman , Rabbani Sarah , Khan Nauman Rauf
Published: May 2022

Objectives: The aim of this study was to evaluate the incidence of caries on distal aspect of mandibular second molars due to impacted third molars. Methodology: Radiographs were obtained for the patients with clinical evidence of impacted 3rd molar. Dental records including number of impacted third molars, pathological conditions and complaints of caries, pericoronitis and recurrent pain were taken. Data of patients with visible distal caries to second molars in the absence of third molar was also recorded entered into specially formulated Performa. Results: A total of 151 participants shared their data for research purpose. According to Winter’s classification, 42.4% and 41.7% impactions were mesioangular and vertical 3rd molars respectively. According to Pell and Gregory classification more than half (55%) of the impacted 3rd molars were in Class I relationship to the ramus whereas 51% of impacted 3rd molars were at the depth of level A. Conclusion: Caries of second more is more common if the impacted third molar tooth is mesioangulated, having class I relationship with respect to ramus. Keywords: second molar, distal caries, impacted third molar
To Access the Clinical Outcomes at Three Months amongst Patients Presenting with Acute De-Compensated Heart Failure
Authors: Memon Shahid Hussain , Ahmed Iftikhar , Arbab Irfan Ali , Butt Muhammad Hassan , Shaikh Javed Khurshed , , Raza Syed Ahsan
Published: May 2022

Aim: To determine the 3-month clinical outcome in patients with acute decompensated heart failure (ADHF). Study Design: A cross-sectional descriptive study. Place and Duration: This study was conducted at Cardiology department of Liaquat University of Medical and Health Sciences Jamshoro for six-months duration from July 2021 to December 2021. Methodology: Patients with acute de-compensated heart failure (ADHF) were involved and followed for the consequences in the form of worsening functional class, re-admission and mortality. The exercise test was performed according to the modified Bruce protocol on treadmill, with incessant on-line respiratory gas. The slope of the association between CO2 production (VCO) ventilation (VE) was evaluated by computer graphical analysis (VE / VCO2 slope). Results: 79(54.1%) of 146 patients were male. Patients' age ranged from 15 to 85 years, and the mean age was 52.10 ± 19.54 years. The patients were alienated into four age groups. Overall, 94(64.4%) of patients showed adverse clinical outcomes at three months of follow-up. Overall readmission rates were 16.7% higher in patients 51-70 years of age. Deterioration in the functional class occurred in 32.9%, less frequently in 14.6% of patients in 71-85 years of age. Mortality was found in 16.4% of patients and 37.5% of patients aged 71-90 years in the three-month follow-up. Conclusions: During the three-month follow-up period, readmissions for acute decompensated heart failure were significantly higher at a younger age, while functional class deterioration and mortality were higher at an older age. Keywords: Rehospitalization, Acute decompensated heart failure, Mortality and Functional class.
Frequency of Hydrocephalus in Patients with Spontaneous Intracerebral Hemorrhage (ICH) at Chandka Medical College Hospital Larkana
Authors: Shaikh Sana Ghous , Shaikh Abu Bakar , Shaikh Nagina , Siddiqui Alam Ibrahim , Ali Aijaz , Irshad Mohsin
Published: May 2022

Background: The small rupture of vessels damaged due to HTN (Hypertension) or amyloid angiopathy is the causative agent of ICH (Intracerebral Hemorrhage). There is strong association of Spontaneous ICH with high rate of morbidity as well as in hospital mortality. Other important factors include altered conscious level, hematoma volume, midline shift, intraventricular extension, high blood pressure and renal dysfunction. Objective: The rationale of this research study was to find out the rate of occurrence of hydrocephalus among patients who suffered from spontaneous ICH and to observe the in-hospital outcome for these patients having hydrocephalus. Methodology: The design of this study was descriptive, cross-sectional study. Patients of spontaneous ICH admitted to the Neurology Department CMC Hospital, Larkana were the samples of this study and the duration of this study was from June 2021 to November 2021. Total 87 patients were the participants of this research study. Hypertension was confirmed through clinical record or two readings ten minutes apart. Diabetes was diagnosed through clinical record or through HbA1C. CT scan brain was done. The diagnosis of spontaneous ICH was carried out on the basis of the clinical and radiological criteria and admitted for further diagnosis of hydrocephalus and in-hospital outcome. We calculate the descriptive statistics. We performed the stratification with the utilization of Chi square test considering the P-value of ≤ 0.050 as much significant. Results: Total 59.80% male and 40.20% female patients were the subjects of this research work. Mean age and BMI was 35.63±10.13 years and 26.69±7.92 kg/m2 respectively. The frequency of hydrocephalus with spontaneous intra-cerebral hemorrhage (ICH) was found in 58.60% patients and their in-hospital mortality was recorded in 49.40% cases. Conclusion: A significant number (58.60%) of patients of ICH were having hydrocephalus and it has a strong association with the high rate of mortality 49.40%. Keywords: Hydrocephalus, Spontaneous ICH, In-Hospital Outcome
Diagnostic Accuracy of CT-Scan Chest in Distinguishing Ground-Glass Opacities from Covid-19 Causes and Other Causes of Ground-Glass Opacities
Authors: Khattak Nadia , Samawat Najm us , Rehman Hafeez ur , Akram Muhammad Nauman , Memon Jawad Ali , Chaudhry Abid Rafiq
Published: May 2022

Introduction: Evaluation of the effectiveness of diagnostic computed tomography of the chest in differentiating between coronavirus 2019 (COVID-19) ground glass opacities and other reasons of ground glass opacities (GGO) not related to COVID-19. Place and Duration: In the department of Radiology, Miangul Abdul Haq Jahenzeb Kidney Hospital Swat for six-months duration from March 2021 to August 2021. Methods: 90 total covid-19 confirmed patients by RT-PCR having GGO (53 males and 37 females, with 47.20 ± 15.10 years mean age) and 110 patients (63 males and 47 males) who were confirmed GGO on chest CT but not due to Covid-19 were selected for the study. The experienced radiologists studied all chest CT scans after removing all descriptive information from the images. They tested negative or positive for COVID-19 and noted other features of CT of the lungs, including laterality, distribution pattern and lobe involvement. The laboratory results and clinical data were documented. Results: This study consisted of 90 COVID19 patients and 100 non-COVID-19 with ground glass opacities on CT chest. In terms of age; no statistically significant alteration was noted amid the 2 groups (p-value = 0.129). Non-COVID-19 cases with GGO; 6 patients have atypical bacterial pneumonia, 42 patients have GGO after viral pneumonia, 14 patients have interstitial pneumonia, 5 patients have PJP, eosinophilic pneumonia in 3 patients, 9 patients have hypersensitivity pneumonia, 6 patients have drug-induced lung injury, 5 patients have pulmonary alveolar hemorrhage and pulmonary edema in 11 patients (cardiogenic and noncardiogenic). Conclusion: Chest CT is rational for distinguishing ground glass opacities form COVID-19 and non-COVID-19 reasons, with less specificity for distinguishing COVID-19 from viral pneumonia and intermediate specificity for distinguishing COVID-19 from other reasons of ground glass opacities. Keywords: SARS-COV2, COVID-19, Diagnosis, Computed tomography and ground glass opacities.
Comparison of Effectiveness of Induction of Labour between Misoprostol Per Oral and Per Vaginal
Authors: Gul Sara , Ali Tabassum , Bashir Amber , Ali Asma , Bibi Maryam , Asghar Asia
Published: May 2022

Introduction: Oral misoprostol as a labor inducing agent (IOL) is quickly attaining popularity under resource constraints due to its cheapness, stability at room temperature, and logistically easier administration in comparison to oxytocin and dinoprostone. We purpose to inspect the effectiveness and safety of a regimen of oral misoprostol in in the Gynae/Obs unit at Rehman Medical Institute, Peshawar Pakistan. Material and Methods: This was Randomized Controlled Trial conducted at department of Gynecology & Obstetrics, Rehman Medical Institute, Hayatabad, Peshawar, from December, 2016 to May, 2017.In this study a total of 200 (100 in each group) patients were observed. After the drug administration, per vaginal examination was done at 4 hourly intervals to see for labor induction/pains. Data was collected by means of proforma. Results: In this study, the mean age was 31.2 with SD ± 3.51 in group B and the mean age was 32.80 with SD ± 4.02 in Group A. Oral route (Misoprostol, 50μg) (Group A) was operative in 80% patients and was not effective in 20% patients. While Vaginal route (Misoprostol, 25μg) (Group B) was effective in 88% patients and was not effective in 12% patients. Conclusion: The oral misoprostol IOL regimen designated in this analysis is effective, safe and logistically practicable to direct with limited resources. Keywords: Vaginal misoprostol, oral misoprostol, induction of labour.
Socio-Cultural Factors Affecting Livelihood of Staff Nurses in Lahore, Punjab Pakistan
Authors: Nafees Muhammad , Naz Madiha , Anjum Faiza , Mehdi Muntazir , Abbas Safder , Iqbal Aamir
Published: May 2022

Introduction: The working women in under-developing nations face multiple issues due to their conservative socio-cultural setup. It not only affects the status of women but also hinders regional socio-economic development. Despite being significant contributors to healthcare, nurses are not treated well in society and also at their workplace. The maltreatment adversely affects their livelihood which ultimately affects the efficiency of healthcare. Objectives: Major objective of the study was to examine the socio-cultural factors affecting the livelihood of staff nurses, and to suggest suitable policy measures to address the issue. Material and methods: Using a qualitative research approach, this study was conducted in Lahore, the capital of Punjab province, Pakistan. Through multistage sampling, one hundred and fifty staff nurses were conveniently interviewed for data collection using a well structure Interview Schedule. The data collection tool was designed according to the Sustainable Livelihood Framework of DFID. The data were analyzed using descriptive statistics, and multivariate linear regression analysis using Statistical Package for Social Sciences (SPSS) version 21. Results: The irritating behavior of the patients, coworkers, and relatives, inability to attend social gatherings and harassment were negatively associated with the livelihood of the respondents. Conclusion: The socio-cultural factors had a negative impact on the livelihood of staff nurses. There is a dire need to make policies to change the attitude of the people towards this profession. Keywords: Staff Nurses, Socio-cultural factors, livelihood, Lahore
Relationship of Oral Pathologies Associated with Second Molars to the Patterns of Adjacent Impacted Third Molar
Authors: Butt Hira , Jabbar Maria , Shumyle Dur e , Moeen Zahra , Liaqat Samra , Irum Fareeha , Khan Nauman Rauf
Published: May 2022

Objective: To assess the relationship of oral pathologies associated with second molars to the patterns of adjacent impacted third molar. Methodology: A cross sectional descriptive study was conducted on 385 Orthopantomograms (OPG) of patients. The study was conducted in the Institute of Dentistry, CMH Lahore Medical College, Lahore, Sharif Medical and Dental College (SMDC) and Services Institute of Medical Sciences (SIMS) over a period of three months from December 2020 to February 2021. The Pell and Gregory classification was used for depth of third molar impaction and ramus relationship of mandibular third molars. Winter`s classification was used for classifying the angle of impaction. Results: The association between presence of caries (p=≤0.001) and external resorption (p=≤0.001) in second mandibular molar with depth of impaction of adjacent an impacted third molar, ramus relationship of third molar with presence of external root resorption in second molar (p=≤0.001) and presence of caries (p=0.005), periapical radiolucencies (p=0.009) and external root resorption (p=≤0.001) in second molar with the angle of impacted third molar were significant. The association of presence of caries, pericoronal, periapical radiolucencies and external root resorption in the maxillary second molars with the depth and angle of adjacent impacted third molars was not significant. Conclusion: The carious lesions were the highest where the third molar had class A depth of impaction while the maximum external resorption was seen where the third molar had class C depth of impaction. Second mandibular molars adjacent to impacted third molars in class 2 ramus relationship had the most external root resorption. It was seen that second molars adjacent to the impacted third molars with mesioangular impactions had the highest percentage of caries and periapical radiolucencies while those adjacent to third molars with horizontal angle of impaction showed the maximum external root resorption. Keywords: Second molars, impacted third molars, pericoronal radiolucency, periapical radiolucency, external root resorption, caries