bluuebunny/crossref_metadata_2025 huggingface dataset:
Electric Vehicles in Indonesia: Public Policy, Impact, and Challenges
Authors: Pambudi Ilham , Juwono Vishnu
Published: November 2023

Indonesia's population is still growing, and the demand for energy for transport to sustain community mobility grows yearly. On the other hand, environmental challenges and green energy policies have become critical issues in today's countries, including Indonesia, and are the key subjects in sustainable development. So far, Indonesian transportation has relied on fossil-fuel vehicles. Fossil fuel vehicles negatively influence the environment due to exhaust gas emission pollution and an economic burden on the State Budget due to the substantial energy subsidies that the government must pay each year. Electric vehicles can suit people's mobility demands while remaining environmentally beneficial due to their lack of pollutants and exhaust emissions. The Indonesian government has devised different regulations to stimulate the usage of electric vehicles to support the three key programs in the National Medium-Term Development Plan For 2020-2024. This study will go through electric car policy issues, including the consequences of the policy's implementation in Indonesia. The literature review strategy is used in this study. The author thoroughly evaluated prior studies on electric vehicles in the literature. The research findings reveal that the electric car policy impacts direct and indirect expenses, but the government will have difficulty assessing the program's indirect advantages. As a result, the author suggests that the government take immediate steps to anticipate various negative impacts that may arise so that they do not become problems in the future and do not become barriers to achieving the goals of Indonesia's battery-based electric vehicle program
Adolescents’ and Families’ Needs to Prevent Repeated Adolescent Pregnancy: A Qualitative Study
Authors: Tumchuea Siriwan , Kongvattananon Puangpaka , Hsu Yu-Yun Alice
Published: November 2023

Repeated adolescent pregnancy affects maternal and child health and the family. This issue has become more prevalent in Thailand and requires strategies to address this. mHealth, an emerging tool in the digital era, has been highlighted to lead to better healthcare outcomes. This qualitative descriptive study explored end-users’ needs in decision-making for choosing contraception via mHealth to prevent repeated adolescent pregnancy. Purposive sampling was undertaken with the snowball technique to select 31 key informants: ten adolescent mothers, ten of their family members, and 11 healthcare providers. Data were collected by conducting semi-structured, in-depth interviews at hospitals, homes and healthcare workplaces and were analyzed using content analysis, the trustworthiness of the data employed with data triangulation, member checking, and peer debriefing. Three main themes emerged from the findings: 1) The meaning of repeated pregnancy in adolescence involved being considered a trite event, a bullied girl, a burden and stress; 2) Motivating repeated pregnancy involved a lack of contraceptive knowledge, knowing methods and lack of awareness, knowing how to use but not using it, intending use and failing to use it; 3) The needs for repeated adolescents’ pregnancy prevention were easily accessible knowledge, having a trusted person, social support, and adolescent-friendly healthcare services. Knowledge about adolescents and their family needs to prevent repeated pregnancy is necessary for developing mHealth and valuable guidelines to improve contraceptive services to prevent repeated adolescent pregnancy.
Enhancing Maternal Self-efficacy in Caring for Preterm Infants with Ventilator through a Telehealth Program: A Randomized Controlled Trial
Authors: Kongsaenkaew Kritsana , Rungamornarat Somsiri , Payakkaraung Sudaporn
Published: November 2023

Telehealth is increasingly important in nursing, encouraging mothers of preterm infants with ventilators to have confidence in their infant care. This study investigated the impact of a telehealth program on maternal self-efficacy in caring for preterm infants with ventilators in the early postpartum period. We employed a randomized controlled trial using the block allocation method, enrolled 42 mothers of preterm infants receiving ventilators and randomly assigned 21 in the experiment group and 21 in the control group. The experimental group received asynchronous and synchronous telehealth programs for six days to enhance their self-efficacy. Data were obtained using the demographic data questionnaire and the maternal self-efficacy questionnaire. Data were analyzed using the Chi-square test, Fisher’s Exact test, Mann–Whitney U test, independent t-test, and paired t-test.
After completing the program, the experimental group had a significantly higher mean score of maternal perceived self-efficacy than the control group, and this was significantly higher than before the trial. A telehealth program is effective for mothers with preterm infants with ventilators. Nurses should allow the mothers to practice care activities with infants at least once before discharge and when they arrive home and provide health information via telehealth. These can enhance maternal self-efficacy in caring for premature infants with ventilators in the first week of life. However, further testing of the program in other settings is needed before widespread implementation.
IMPACT OF WORK-RELATED STRESS ON EMPLOYEES PERFORMANCE IN THE KENYA DISCIPLINED SERVICES
Authors: MUCHIRI (PhD) DR. CHEGE THENYA
Published: November 2023

The employees in the disciplined services are exposed to the stress outside the range of usual human experience. The operational duties of their work, by their nature, may at any time place the employees at high stress levels. In addition to the operational stressors inherent in disciplined services work especially the police, numerous studies have shown that factors related to organizational structure and climate can be an even greater source of stress for the disciplined officer. In the disciplined services, officers and staff are bound by strict difficulties in managing their occupational role. Without effective stress identification mechanisms as well as stress management programs, stress can have detrimental impact on staff and organizations performance. The purpose for this paper therefore was to evaluate the impact of work-related stress on employee’s performance in the Kenya disciplined services. Kenya Disciplined services staff at NYS Nairobi stations were surveyed to identify their perceived job stressors and measure degree of impact of job related stress and organizations performance. The result was used to design effective strategies for reducing job stress that in turn result in improved job performance among these staff. A  Sample size of 111 employees from a population of 557 was drawn for the study. Structured questionnaires were administered and data analysis done with the help of statistical package for Social Scientists (SPSS). The study findings indicated that 50.5% of staff were exposed to stress arising from excessive work pressure also recorded negative concentration of work; 2.97% of staff who suffered stress triggered by frequent abuse by supervisors had their concentration of work impaired. Also 58.1% of staff who are exposed to frequent run-ins with supervisors experienced impaired creativity. Adequate job control enhanced work creativity as posited by 59.2% of participating NYS staff. Findings also supported that staff exposure to sexual harassment in the office impacted negatively on creativity. It was therefore, recommended that there was a need for NYS to realign its vision, mission and long-term objective for the challenges of becoming a premier disciplined Service will be reflected on the quality of service delivery. Achieving these organization performance indicators calls for among others a stress free working environment among staff and a comprehensive stress policy to monitor, manage and prevent work stress.
AN EXAMINATION OF THE EFFECTS OF CYBER SECURITY IN ENHANCING PERFORMANCE OF THE PUBLIC SECTOR INSTITUTIONS
Authors: TOO WILLIAM KIPLIMO , MUTUKU MORRISON
Published: November 2023

The anticipated outcomes of this study was to gain a deeper understanding of the current state of cyber security adoption by the public sector institutions, especially in Kenya. The study reviewed on different literature on the status of cyber security adoption in regard to the enhancement on the performance of these institutions, identified challenges that the institutions faced in adopting and implementing such cyber security technologies, and the strategies needed to improve on cyber security applications. The review also pointed out cyber security measures that can lead to improved service delivery, increased operational efficiency, and more secure digital environment for the country's citizens. Thus, by identifying the challenges and barriers faced by these institutions, the study could help inform policy and decision-making processes, guiding future investments in cyber security and other related technologies. Further, the findings of this research could contribute to the enhancement of cyber security measures and their implementation in Kenya's public sector institutions. This, in turn, could lead to improved service delivery, increased operational efficiency, and a more secure digital environment for the country's citizens. By identifying the challenges and barriers faced by these institutions, the study could also help inform policy and decision-making processes, guiding future investments in cyber security technologies.
Evolution of perceptions of motivational climates in youth soccer development and a comparison of opinions between families and players
Authors: Sarmiento Espiau Alberto , Murillo Lorente Víctor , De Tremps Vicente Jesús , Álvarez Medina Javier
Published: November 2023

Motivation is one of the general variables with the greatest influence on behaviour, making it essential to understand the perspectives of various stakeholders as well as the theories that examine it. Furthermore, it stands as one of the primary causes of dropout in adolescent sports participation. The primary objective of this research is to ascertain the assessment of the motivational climate from both players and families in youth football development categories. Specific objectives include validating whether the adaptation of the SMS and AGSYS questionnaires yields congruent results, comparing the perspectives of families and players regarding the motivational climate, and finally, examining the opinions and evolution of the motivational climate among players across different age categories. The sample consisted of 143 individuals from the top-tier teams in youth development stages at the Cuarte Sports Club (Zaragoza, Spain). Descriptive and inferential statistics were employed using the SPSS 22.0 statistical software. The findings indicate that the adaptation of both questionnaires does not measure the same constructs, significant differences exist in the opinions of families and players, and lastly, cadet-level players demonstrate distinct opinions in comparison to other age categories.
Comparison of Prophylactic Use of Intravenous N Acetylcysteine v/s Amiodarone in Preventing Post Operative Artrial Fibrillation after Coronary Artery Bypass Graft
Authors: Muhammad Ramzan  , Muhammad Kashif Javed  , Jehan Zab  , Muhammad Shoaib Abid  , Hamza Ghafor  , Abu Bakar Ali Saad
Published: November 2023

Objective: compare the effectiveness of intravenous N-acetylcysteine and amiodarone in prevention of pos operative atrial fibrillation.
Study Design: Randomized control trial
Place and duration: study was conducted cardiac surgery department of Choudhary Pervaiz Elahi Institute of Cardiology, Multan from December 2017 to December 2018 in one year duration.
Methodology: study was conducted on 130 patients. Patients were divided into two equal groups by lottery method. Study was started after permission from academic affairs committee written informed consent from the patients. Non probability consecutive sampling was used Study variables are age, gender, duration of ICU stay and mortality. An outcome variable was post operative atrial fibrillation. Data was computed on software SPSS version 23 and analyzed for all possible variables. P value ?0.05 was taken as significant.
Results: POAF of amiodarone and NAC group was noted as 26.2% and 13.8%, respectively. The difference was statistically insignificant (0.079). Mortality of amiodarone and NAC groups was occurred as 7.7% and 4.6%, respectively. The difference was statistically insignificant (0.465).
Conclusion: intravenous N-acetylcysteine is more effective in prevention of post operative atrial fibrillation as compared intravenous amiodarone but post operative stay is prolonged in patients of NAC.
Frequency of Pulmonary Tuberculosis in Patients with Cutaneous Diseases taking Oral Steroid Therapy
Authors: Muhammad Zulqarnain Haider Khan  , Muhammad Shahid Nawaz Khan  , Farah Sattar  , Shamshad Akram  , Muhammad Farooq Khan  , Asma Bano
Published: November 2023

Objective: to investigate the frequency of pulmonary tuberculosis in patients of cutaneous diseases requiring high dose steroids therapy.
Study Design: Cross sectional study Place and duration: Dermatology department of Nishtar Hospital Multan in one year duration from 2nd March 2018 to 2nd March 2019.
Methodology: Sixty patients currently diagnosed with skin manifestations and taking high dose steroids were screened for pulmonary tuberculosis. Patients were screened at 6 weeks, 3 months and 6 months. Chest radiograph, sputum smear for acid fast bacilli and sputum culture were performed at every visit. SPSS version 23 was used for analysis of data and test of significance.
Results: Sputum smear at 6 weeks, 3 months and 6 months was observed as 1.6%, 3.3% and 6.6%, respectively. Sputum culture at 6 weeks, 3 months and 6 months was observed as 11.6%, 13.3% and 10%, respectively. X-Ray at 6 weeks, 3 months and 6 months was observed as 1.6%, 0% and 0%, respectively.
Conclusion: Patients with cutaneous diseases taking systemic steroids should screen for pulmonary diseases at intervals because they can develop pulmonary tuberculosis.
Prevalence of Noise Induced Hearing Loss Among the Workers of Metallurgical Factory; A study Conducted at Nishtar Hospital Multan
Authors: Muhammad Sharif Shahid  , Muhammad Hassan Nisar  , Sanaullah Bhatti  , Salman Ali  , Muhammad Shakaib Faiz  , M. Ashfaq Siddiqui
Published: November 2023

Objective: To evaluate the prevalence of nose induced hearing loss in the industrial workers and its association with age, gender and duration of exposure. Study design: A cross sectional study.
Place and duration of study: ENT department of Nishtar Hospital Multan from July 1st 2018 to June 30th 2019.
Methodology: Age, gender, duration of exposure, overtime workers and presence of NIHL was noted for 316 workers. Three age groups were made i.e. <30 years, 30-40 years and >40 years. Duration of exposure was categorized as <5 years, 5-15 years, and >15 years. Overtime workers were classified as those who worked for >8hours daily. Workers having NIHL were compared in both genders, age groups, exposure duration groups and according to daily duration of work. Number and percentages were calculated. Results were significant if p ?0.05.
Results: At the time of study, 67 (21%) had developed noise induced hearing loss. Considering exposure duration of workers to noise, 12% with <5years of exposure; 28.8% with 5-15years of exposure; and 28.7% with >15years of exposure developed NIHL (p=0.001). Frequency of NIHL was 38.4% in overtime workers as compared to 16% among regular workers (p<0.001).
Conclusion: The prevalence of NIHL is very high among the workers who are constantly exposed to noise and it rises with the prolongation of total exposure time as well as daily exposure time.
Challenges Faced by Health Professionals at the Beginning of Research in Pakistan
Authors: Khan Imran , Yazdani Sahar , Yaseen Anum
Published: November 2023

Objective: The present research paper is purely focused on the niche segment of the academic consideration in terms of the research projects and studies observed by the health professionals of Pakistan. The researcher of the paper has not only outlined the challenges and the problems of the medical research but also looked out to provide the solutions to overcome those challenges.
Method: The paper has implicated quantitative research method in terms of collecting the primary data by closes ended questionnaire for the sample of about 200 respondents.
Results: Nonetheless, the study has concluded on the direct relationship with that of the findings by statistical means and interpreted the intra connected dots of the research questions with that of the key consideration.
Conclusion: based on the observations done, it can be concluded that researchers who want to increase their number of papers often face issues in handling the respondents and producing quality content.
Management of Unstable Tibial Shaft Fracture with Titanium Elastic Nails in Children: Unstable Tibial Shaft Fracture
Authors: Ali Muhammad
Published: November 2023

Objectives: to evaluate radiological and functional outcomes of Titanium elastic nails (TEN) in pediatric patients with tibial shaft fractures. Methods: Study wasprospective design. A total number of forty patients were treated who were presented with tibial shaft fracture. Patients were treated with TEN. In every patient antegrade nailing was performed by inserting a TEN in the medial side of metaphysic and another TEN in the lateral side of the proximal metaphysis. Main outcomes were leg length inequality, union, malunion and complications. SPSS version 23 was used for data analysis. Result: Functional result (Flynn Criteria) was excellent in 38.5% patients and satisfactory was in 61.5% patients. Patients were treated with TEN. In every patient antegrade nailing was performed by inserting a TEN in the medial side of metaphysic and another TEN in the lateral side of the proximal metaphysis. Main outcomes were leg length inequality, union, malunion and complications. SPSS version 23 was used for data analysis. Result: Functional result (Flynn Criteria) was excellent in 38.5% patients and satisfactory was in 61.5% patients. Conclusion: Unstable pediatric tibial shaft fractures can be treated ideally through intramedullary fixation technique withtitanium elastic nailing even untreated cases of conservative management and those cannot be reduces due to presence of open wound or edema.
Cardiovascular Disease and its Risk Factors: Frequency in Patients with Chronic Obstructive Pulmonary Disease (COPD)
Authors: Waseem Riaz Muhammad , Azam Mushtaq Muhammad , Imran Sharif Muhammad , Waqas Afzal Muhammad , Ali Naqvi Syed Sarmad
Published: November 2023

Chronic obstructive pulmonary disease (COPD) is one of the respiratory conditions which is indicated by persistent airflow obstruction. It is linked with various different comorbidities. Ischemic heart disease (IHD) is reported to be the most recurring in patients with COPD. Its impact in context of patient's exercise capacity, health status and manifestation of symptoms is poorly understood. The objective of my study is to ascertain the frequency of ischemic heart disease in patients with chronic obstructive pulmonary disease and to evaluate current magnitude of the problem in our local population. It a cross sectional study conducted in Department of Pulmonology, Nishtar Hospital Multan. Patients with COPD (as defined in Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria 2021) with duration of more than 3 months were taken in the study. Of these 212 study cases, 127 (59.9 %) were male patients while 85 (40.1 %) were female patients. Mean age of our study cases was 56.75 ± 6.78 years. Diabetes was present in 57 (26.9 %), Dyslipidemia in 43 (20.3%), hypertension in 98 (46.2%) our patients and 29 (13.7 %) were obese. Smoking was noted in 100 (47.2 %). Ischemic Heart disease was present in 57 (26.9%) of our study cases. High frequency of ischemic heart disease was noted in patients with chronic pulmonary obstructive disease in our study. Ischemic Heart Disease was significantly linked with male gender, increasing age, diabetes, hypertension, obesity, and family history for IHD and dyslipidemia.
Evaluation and surgical outcome of Adrenal Incidentalomas: Surgical Outcome of Adrenal Incidentalomas
Authors: Ali Mazhar , Biyabani Syed Raziuddin , Cowasji Zain , Aziz Wajahat
Published: November 2023

Objective: To observe the presentation, radiological and endocrine evaluation, and management of incidentally discovered adrenal masses at our institution.
Study Design: Retrospective
Place and duration:  Study was conducted at Agha Khan University Hospital Karachi from July 1988 and December 2011.
Methodology:  Case records of patients undergoing adrenalectomy from July 1988 to December 2011 were reviewed. Patients with known or suspected adrenal disease prior to imaging were excluded. The clinical presentation, demographic data, preoperative workup and preoperative clinical diagnosis was reviewed and compared with the final histopathological diagnosis.  
Results: Out of 56 patients undergoing adrenalectomy, 23 had an adrenal incidentalomas (AI) which includes 14 males and 9 females. The mean age was 40 (± 14) years. Mean size of the adrenal mass was 6 (± 6) cm.  Incidenataloma was detected on ultrasound in 12 patients, CT scan in 10 patients, and MRI in 1 patient. Twenty patients (87 %,) underwent biochemical evaluation, including urinary Vanillylmandelic acid (VMA) level in 15, serum cortisol in 10 and aldosterone level in 7. 
Conclusion: Complete metabolic workup in essential in all patients with incidentally detected adrenal mass. Although malignancy is a valid concern in >4cm adrenal mass, the possibility of subclinical functioning adrenal adenoma or pheochromocytoma should not be ignored.
Comparison of Accuracy of Frameless Stereotactic System (Neuronavigation) Against Frame Based Stereotaxy in Deep Seated Lesion of Brain
Authors: Shareef Rizwan , Ahmad Shakeel
Published: November 2023

Objective: The determination of accuracy of frameless stereotactic system against frame based stereotaxy in deep seated lesion of brain.
Study Type: randomized controlled trial.
Study Place and Duration: Department of Neurosurgery, Nishtar Hospital Multan from June 2019 to June 2020.
Material and methods: A total of 124 patients were included in the study after informed consent and eligible in accord to the inclusion and exclusion criteria. Total participants were 124 (randomized) and were divided into two randomized groups; frame-based stereotaxy group (FB) and stereotaxy group (SG) including 62 patients in each group. The angular deviation and target distance between actual and planned trajectory were the primary outcomes in this study. Independent samples were tested through 2-tailed t-tests for statistical testing. Mann-Whitney U test was performed for non-normally distributed data while for comparison of categorical variables Chi-square or Fisher tests were performed. P-value was 0.05 as a level off statistical significance. SPSS version 23 was used for statistical computations.
Results: Trajectory length and distance were 42.32±10.38 mm and 2.43±1.02 mm in FB group, while 43.45±11.65 mm and 2.59±1.06 mm in VG group, and there was no statistically significant difference in these two parameters (p value 0.570 and 0.390, respectively). Trajectory deviation was 1.85±1.28 degree in FB group and 2.63±158 degree in VG group, and the difference was statistically significant (p=0.003). Table-II.
Conclusion: Patients in which brain biopsy was done, the Varioguide system can be compared to the gold standard frame-based stereotaxy on the basis of means of trajectory accuracy, complications rate and diagnostic yield.
Frequency of anemia in patients with pulmonary TB presenting at Nishtar Hospital Multan
Authors: Shahzad Alam khan  , Ramzan Faisal , Noshad javed  , Hamad Arshad  , Sadam Hussain  , Muhammad Usman Zaffar
Published: November 2023

Objective: The present study aimed to determine the frequency of anemia in patients with pulmonary TB presenting at Nishtar Hospital Multan and its classification as per the severity and morphological characteristics.

Methods: This retrospective cross-sectional study was conducted at Nishtar Hospital Multan.  A total of 109 TB patients were enrolled and underwent physical and systemic examination. Blood samples were collected to estimate complete blood counts (CBC), liver and renal function tests (LFT; RFT), serum albumin, and C - reactive protein (CRP) levels. Abdominal ultrasound was performed when suspected of any organomegaly. Hemoglobin was estimated using an automated analyzer (SYSMEX-SP100) and repeated manually among doubted cases. Before inclusion, written informed consent was obtained from all patients before inclusion, and the collected data was analyzed using SPSS version 22.0.

Results: The female majority (54%) in the studied sample, with a mean age of 38 ± 15.3 years, and most belonged to low socioeconomic status (80%). Moreover, 43% were from Multan, 30% from D.G. Khan, and the remaining were from Khanewal, Layyah, and Vehari districts. Anemia was found in 82.56% of the enrolled TB patients. Most patients were moderately weak (Hb < 10 g/dl > 7 g/dl), and microcytic anemia was found in more than 80% of the anemic patients. CRP level was raised in 70% of these patients, and there was hypoalbuminemia in 80%. Furthermore, females were more anemic than males.

Conclusion: In our study, anemia was prevalent in TB patients, specifically microcytic anemia. Hence, TB patients must be monitored for dietary deficiencies and inflammatory modulators to avoid such complications
Comparison of the outcome of 0.02% mitomycine C versus limbal conjunctival autograft after primary pterygium excision.
Authors: Akram Syed Nishat , Muhammad Ajmal Chaudhary  , Muhammad Ajmal  , Nesr Farooq
Published: November 2023

Objective: is to compare the outcomes of mitomycin 0.02% intra-operatively and limbal conjunctival autograft after excision of primary pterygium.
Methodology: Randomized controlled trial (RCT) was conducted at Opthalmology department Shalamar medical and Dental College, Lahore from October 2021 to September 2022 in duration of 1 year. A total of 62 patients enrolled in study. Patients were divided into two groups MMC and LCAG. Main variables of study were laterality of pterygium, size of pterygium cross limbus, preoperative and post operative BCVA and proportion of pterygium recurrence in both groups. SPSS version 24 was used for data analysis.
Results: Laterality were right for 48.4% patients in Group MMC and 58.1% for Group LCAG, (p=0.445). The average Size of pterygium cross limbus, Preoperative and postoperative BCVA of both the groups were almost equal, (p>0.050). The recurrences at 3, 6 & 9 months and after 1 year in Group MMC was 12.9%, 6.5%, 16.1%, 9.7%, 45.2% which is greater than Group LCAG 9.7%, 9.7%, 3.2%, 6.5%, 29% respectively, but the difference was statistically insignificant, (p=0.526).
Conclusion: Limbal conjunctival autograft is more successful in prevention of recurrence after excision of primary pterygium as compare intraoperative application of mitomycin-c. But simple excision and LCAG or MMC both are acceptable in terms of minor difference in recurrence rate, surgeon’s skill and preferences of local practice are main risk factors.
Trend and Reasons of Women Towards the Choice for Place of Delivery: Evidence from Mics 2017-18 Punjab, Pakistan
Authors: Zeeshan Muhammad , Isaac Shahzad  , Shazia Hayat
Published: November 2023

Objective: To assess the attitudes and reasons of women towards the choice for place of delivery as per the data from the Multiple Indicators Cluster Survey (MICS) 2017-18, Punjab, Pakistan.
Material and methods: Observational Study conducted at 36 districts of the Punjab, 2017-18A total of 53,840 households were drawn as the sample size from 2,692 sample clusters, out of which 1,893 were rural clusters and 799 were urban clusters. From 53,840 households, 52,765 households occupied and 51,660 were successfully interviewed. Therefore, the response rate was 97.9%. According to survey results, 79,510 women had been eligible for interview of age group 15-49 years. Out of which 74,010 women were interview successfully with the response rate 93.1%. Further, out of these 74,010 women, there were 26,980 women who had ever or currently married, and out of these women 15,656 women gave birth in the last two years. In our study, we considered the place of delivery as an outcome variable and wanted to identify the associated socio-demographic and socioeconomic characteristics that were expected to be responsible for shifting the trend from the public to the private sector for delivery. To check the association and for statistical testing of hypothesis, Chi-square test for association was applied. We also applied multinomial logistic regression to identify the predictors for the place of delivery by using SPSS. P-value ?0.05 was considered as significant.
Results: Majority of the women (43.5%) delivered their babies in the private sector while (29.7%) of women delivered their babies in public sector hospitals, and (26.4%) women prefered home delivery. In the comparison of area of residence, urban women compared to rural women were more likely to choose public sector hospitals for their deliveries OR=1.02 (0.94-1.09) 95% CI, p=0.000, for home deliveries OR=1.293 (1.154-1.45) 95% CI, p=0.000 and for other OR=2.341 (1.196-4.582)95% CI, p=0.013. In the comparison of regions of Punjab, the women of South and Central Punjab were more likely to choose private sector hospitals for delivery, OR=1/0.535=1.87 (0.478-0.600)95% CI, p=0.000 and OR=1/0.624=1.61 (0.564-0.690)95% CI, p=0.000, respectively. The women who get antenatal care had 2.84 times more chances, as compared to the women who did not get antenatal care visits, to deliver in the private sector OR=0.353 (0.213-0.538)95% CI, p=0.000. About the model fitting, chi-square value=3527.06, Cox & Snell=0.202 and p=0.000 suggested that the predictors in the model had a significant effect.
Conclusion: Overall women prefer to undergo childbirth process in private sector hospital while women of urban area prefer public sector hospital. It may be related to facilities present in private sector hospitals or it may due to the fact that public healthcare facilities are not accessible to everybody especially in rural areas. In modern era, still many women prefer home delivery.
Pattern of Factors Associated with Obesity in Young Adults of Ischemic Heart Disease
Authors: Tariq Abbas  , Badar  , Zarlish Qazi Muhammad , Momin Rasheed  , Kashif Ali Hashmi  , Hira
Published: November 2023

Abstract:
Objectives:    The objective of studying the pattern of factors associated with obesity in young adults with ischemic heart disease is to identify the various factors that contribute to the development of obesity in young adults that leads to ischemic heart disease in the population. By understanding the associated factors, healthcare providers can develop effective strategies for preventing and treating obesity in young adults with ischemic heart disease, which may ultimately help reduce their risk of heart disease and improve their overall health outcomes.
Methodology: To better understand the pattern of risk factors responsible for obesity in young adults, we have conducted a cross-sectional in outpatient department (OPD) of Ch. Pervaiz Elahi Institute of Cardiology Multan. A non-purposive sampling technique was used. We have measured height, weight, body mass index BMI and collected data about their lifestyle, hypertension, diabetes and smoking status. 
Results: Out of 458 patients, after dichotomizing the BMI variable into >30 BMI as obese and <30 as non-obese, we studied the incidence of obese patients overall and the presence of different risk factors in the obese population. In the obese group, the significant risk factor in our sample population had either a sedentary lifestyle comprising 19.2% or Hypertension (19.6%).
Conclusions: It has been concluded from the study that sedentary lifestyle is the most common risk factors in obesity among young adults. The incidence of hypertension in young adults is also significant.
Comparison of Nebulized vs Systemic Corticosteroids for Management of Children Presenting with Acute Exacerbation of Asthma
Authors: Zaffar MUhammad Usman , Waqas Ahmad  , Nadeem Iqbal
Published: November 2023

Objective: is to compare the effectiveness of nebulized and systemic corticosteroids for management of acute exacerbation of asthma in children.

Methodology: This randomized control trial was conducted at emergency department of Agha Khan University Hospital, Karachi in 6 months duration from 1st July 2021 to 30th December 2021. A total of 90 patients were emrolled in study and divided into two groups I and II. In group I nebulized corticosteroids were administered and in group II systemic corticosteroids were administered. Final outcomes were assessed after 2 weeks post treatment follow up.

Results: Comparison of disease reduction (pre-treatment) of both the groups was shown in table II. Oscillometric Resistances at 1st day, 7th day and 14th day were almost equal in both the groups, (p>0.010). The mean length of stay of group I and group II was 1.75±0.56 days and 3.62±1.44 days, respectively, (p<0.001). most of the patients of group I were satisfied as compare to group II, 42 (93.3%) and 34 (75.6%), respectively, (<0.001).

Conclusion: Use of nebulized steroids and systemic steroids can both be effective in the treatment of acute exacerbation of asthma, but their specific roles and benefits may vary depending on the individual patient's condition and the severity of the exacerbation. Specific outcomes of hospital stay and severity of disease are much better in inhaled steroids as compare to systemic steroids.
Influence of Timing of Surgery on Surgical Outcomes of Elderly Hip Fractures
Authors: Ahmad Umair , Muhammad Naqash Khan  , Gauhar Nawaz Khan  , Hassan Raza Khosa  , Syed Zohaib Haider  , Shahid Javed
Published: November 2023

Objective: To determine the effect of timing of surgery on surgical outcomes of hip fractures in elderly patients.
Methods: This Cross Sectional study including 150 elderly patients who presented in Indus RTEH campus Muzaffargarh and underwent surgical management for hip fractures was conducted from 1st  January-2021 to 30th Dec-2022. The patients were labeled to have early surgery if they underwent surgery within 24 hours of surgery and delayed surgery if they underwent surgery after 24 hours of fracture. Details regarding surgical procedure, duration of surgery and intraoperative blood loss was determined for each patient. The patients were followed for 30 days after surgery. Occurrence of pressure sores, cardiovascular events, implant complications was determined. 30-day operative mortality was also noted.
Results: Mean age of patients was 72.8±7.9 years in early and 74.3±8.2 years in delayed group. Majority patients were females with frequency of 70.6% (53) in early and 76% (57) in delayed group (p-value 0.67). Bed sores occurred in 1 (1.3%) patient in early group and in 5 (6.7%) patients in delayed group with p-value 0.09. UTI occurred in 4 (5.3%) patients in early group versus in 9 (12.0%) patients in delayed group (p-value 0.14). Length of stay was significantly prolonged in delayed group; 7.5±2.3 days versus 6.1±1.8 days in early group, p-value 0.001. 30 days mortality rate was 7 (9.3%) in early group versus 9 (12.0%) in delayed group, p-value 0.59.
Conclusion: Early surgical intervention in elderly patients with hip fractures is beneficial as it significantly lower the risk of post-operative complications and results in early discharge of patient from the hospital.
Relationship Between Social Media Use and Professional Identity Development Among Undergraduate Nursing Students
Authors: Hafsa bibi  , Victoria Samar  , Syed Azmat Hussain shah  , Irum Qureshi  , Sabiha Sarwar  , Farzana Parveen
Published: November 2023

Objective: To assess the relationship between social media usage by undergraduate nursing students and the development of their professional identity.

Methodology: Cross-sectional study was conducted at people’s Nursing School, LUMHS, Jamshoro during the period of May 15,2023 to June 10,2023. A questionnaire was adopted form Muna Alharbi et.al, study conducted at Saudi Arabia, was distributed to 162 students to collect data. Descriptive analysis, including frequencies, percentages, and medians, was performed, along with non-parametric tests to examine relationships in the questions.

Results: Out of 162 participants, the majority had high or very high professional identity levels (48.8% and 37.0% respectively). Those who used social media for education had higher professional identity scores (p = 0.001), and participants with more years of study also had higher scores (p = 0.028). Hours of social media use (3 to 5.5 hours) were significantly related to professional identity scores (p=0.029).

Conclusions: Social media has a positive impact on the development of professional identity among undergraduate nursing students. However, nursing education has been slow to integrate social media into curricula. Students need guidance on using social media for professional growth.
Frequency of intraoperative hypotension after the induction of anesthesia in hypertensive patients with preoperative angiotensin converting enzyme inhibitors
Authors: Shuja Syed Zaidan , Lubna Naz  , Atique ur Rehman orakzai  , Muhammad Fahad Farooq  , Maqsood Ahmed Siddiqui  , Jawad Hameed
Published: November 2023

Objective: is to evaluate the intraoperative hypotension after anesthesia induction in controlled hypertensive patients who have been taking ACE inhibitors preoperatively.

Methodology: Prospective study conducted at department of anesthesia and ICU Jinnah Postgraduate Medical Institute, Karachi, Pakistan from 1st march 2021 to 28th February 2022. Before the surgery, the patient's mean arterial pressure and blood pressure (systolic, diastolic) were recorded in the preoperative holding area. During the surgery, the primary anesthesia team maintained an intraoperative monitoring chart. After the surgery, patient was shifted to recovery room, patient was monitored for blood pressure, for at least 10 minutes after the shifting from operation theater.

Results: There were 73.1% males and 26.9% females, 57.7% patients had hypotension. The mean age, BMI and duration of anesthesia of the patients was 54.07±6.85 years, 26.52±4.45 kg/m2 and 82.19±3.16 minutes, respectively. There were 74.7% patients had hypotension and on antihypertensive drugs other than ACE inhibitor and hypotension was occurred in 74.5% of patients who are using ACE inhibitors as antihypertensive drugs (p>0.050).

Conclusion: Higher incidence of intraoperative hypotension in patients with controlled hypertension who are taking ACE (Angiotensin-Converting Enzyme) inhibitors. So, controlled hypertension with ACE inhibitors is a significant risk factor for intraoperative hypotension.

Keywords: Intraoperative hypotension, ACE inhibiotrs, Hypertensive, Anesthesia, Antihypertensive
Etik utifrån ett samiskt perspektiv i mötet med film och fotograf
Authors: Kuoljok Kajsa
Published: November 2023

Based on older films and photographs, this article discusses archival material with a Sámi presence. The aim is to highlight thoughts and experiences of research and documentation in various forms from a Sámi perspective and to link it with thoughts about ethics. The approach to older Sámi archival material is not static but changing, and during the 21st century a more conscious approach to ethical issues concerning indigenous peoples has emerged. In all forms of work with the collection of research material, we have two dimensions of ethics to deal with; what the national legislation regulates as well as a personal and practical ethics that arise in the meeting between man and material or between people. In this article, personal stories and experiences from the knowledge holders form an empirical basis for the discussion. Their counterstories contribute alternative stories to the stories presented through the eyes and voice of the majority population in the form of film and photography. Today, the older generations are important mediators of Sámi culture and history to a younger generation. Through their personal stories, they contribute knowledge that is otherwise impossible to reach. Although it is their stories that constitute the empirical material in the article, I bring in my own reflections and thoughts. Here, my own Sámi affiliation and background have been a central part in the mutual exchange of knowledge.
Mungigan i Sverige
Authors: Wikström af Edholm Klas
Published: November 2023

An overall view of the history of the Jew’s harp in Sweden has been lacking up to the 2020s. Previous research has mainly been focussed upon the Medieval period, but less upon the Post-Medieval use of the instrument. I will therefore give an up to date and summarising picture of this subject here, also reviewing literary references and characterisations of the instrument. The other main focus of this article is the ideo-historical perception of the instrument. Besides being a common instrument in (folk)music, a change in the perception of the instrument developed during the middle of the nineteenth century, where the instrument was in addition being perceived as primitive and used as a childrens’ toy. The jew’s harp had a revival in the 1960s in Sweden (and Norway). In contrast to the Norwegian development were the primary perception of the instrument in Sweden over time established as a “folksy”, “Medieval”, and ridiculous instrument. This idea of the jew’s harp seems to be generally accepted today, as the instrument from time to time appears in public media or popular culture with this characterisation. In addition, a new kind of spirituality has during recent years been connected to the jew’s harp, providing the instrument a new ritual (and commercial) use.
Recensioner
Authors: Kuusela Tommy , Lövkrona Inger , Gustavsson Anders , Jönsson Håkan , Ternhag Gunnar , Svensson Birgitta , Sandgren Patrik , Steinrud Marie
Published: November 2023

Recensioner av

Tora Wall: Folktrons väsen. Encyklopedi

Folktro. En besjälad värld. Huvudredaktörer Kurt Almqvist och Lotta Gröning

Kågeträskdagboken. En västerbottnisk dagbok 1891–1901 med kommentarer. Volym 2. Ann-CatrineEdlund (huvudredaktör), Lars-Erik Edlund & Ulf Lundström under medverkan av Birgitta Bjurman

Ulrica Söderlind: Cajsa Wargs kokkonst. Fyra gastronomer, mat, dryck och tillagning under svenskt 1700- tal

Gustaf Ankarcrona och bilden av Dalarna som svenskt ideal. Johan Knutsson (red.)

Manligt mode. En okänd historia. Ingrid Giertz-Mårtenson (red.)

Leif Runefelt: Några ögonblicks förundran. Marknaden för ambulerande underhållning i Sverige 1760–1880

Margareta Petersson: Kärlek, kvinnoroller och koloniala drömmar. Familjen Stephens livsöden på och bortom Huseby bruk
PERKEMBANGAN JIWA BERAGAMA PADA ANAK USIA 10-12 TAHUN
Authors: Sembiring Rizki khairunisa , Lubis Ramadan , Sihotang Ayu Saniah , Ahunaya Dea , Octarina Hani , Anggraini Nia , Wulandari Yesi
Published: November 2023

Perkembangan anak merupakan proses pertumbuhan yang melibatkan perubahan fisik, kognitif, dan sosial sejak ia lahir hingga dewasa. Perkembangan jiwa keagamaan pada masa anak-anak sampai dewasa melalui berbagai tahapan, dimana tahapan tersebut akan berbeda-beda setiap umurnya. Penelitian ini bertujuan untuk mengetahui proses perkembangan jiwa beragama pada anak 10-12 tahun. Tulisan ini menggunakan metode penelitian kualitatif dengan jenis penelitian studi pustaka. Metode ini bersifat deskriptif analitik yang menggambarkan peristiwa-peristiwa dengan data berupa observasi, wawancara, analisis, dan dokumentasi. Hasil penelitian menunjukkan bahwa perkembangan jiwa keagamaan pada anak usia 10-12 tahun sangat dipengaruhi oleh faktor lingkungan, pendidikan, dan pengalaman yang dilaluinya.
YEREL FOLKLOR DERLEMELERİNDE OKULLARIN ROLÜ: KASTAMONU LİSESİ ÖRNEĞİ
Authors: SERHOŞOĞLU Kamil
Published: November 2023

Türkiye’de folklor, tanımlayıcı ve tarifleyici mahiyetteki ilk yazıların yayımlanması ile birlikte bir bilim dalı olarak kabul edilmiş; Türk Ocakları, Halkevleri ve bazı derneklerin faaliyetleri sonrası üniversitelerde folklor eğitimi başlamıştır. Bunun yanında üniversiteler dışında folklor çalışmaları yapan bazı eğitim- öğretim kurumları bulunmaktadır. Bunlardan biri de Kastamonu Lisesidir. 1885 yılında dönemin Kastamonu Valisi Abdurrahman Paşa tarafından “Kastamonu Mekteb-i İdadî Mülkisi” adıyla açılan günümüzdeki adıyla Abdurrahmanpaşa Lisesi, Anadolu’da idadî seviyesinde açılan ilk resmî devlet lisesi olma özelliği taşımaktadır. Okulun adı 1912 yılında “Kastamonu Mekteb-i Sultanisi”, 1923 yılında “Kastamonu Lisesi”, 1963 yılında ise kurucusuna ithafen “Abdurrahmanpaşa Lisesi” olarak değiştirilmiştir. 1930 yılında karma eğitime geçen okul, eğitim tarihinde Anadolu’nun seçkin okulları arasında yer almıştır. Lisenin mezun ettiği isimler arasında birçok üst düzey kamu görevlisi, yazar, şair ve bilim insanı bulunmaktadır. Okuldaki folklor çalışmaları, bünyesinde kurulan “Hars Derneği” eliyle yürütülmüştür. Öğrenciler yaz tatillerinde okul idaresi ve öğretmenlerin isteği üzerine genellikle halk edebiyatı alanında derlemeler yapmış; “Hars Derneği” incelemesi sonrası yayımlamaya değer bulunanlar 1931-1936 ders yılları arasında, otuz bir sayı çıkarılan “Kastamonu Lise Mecmuası” adlı okul dergisinde yayımlanmıştır. Bununla birlikte yazıların bir araya getirildiği, “Kastamonu Vilayet Matbaası”nda, 1933 yılında basılan Derlediklerimiz, Mâni, Koşma, Bozlak, Oyun ve Âdetler adlı kitap okulun folklor derlemelerinin göstergesi olarak önemli bir yerde durmaktadır. Bu makalede, sözü edilen süreli yayın ve kitaptaki yazılardan yola çıkılarak Kastamonu Lisesi’nin yerel folklor derlemelerindeki rolü ele alınmıştır. Sonuç olarak yazıların Kastamonu ve civar illerin folklor çalışmaları tarihinin bilinmesi ve yöre folkloru hakkında yazılı kaynakların az olduğu 1930’lu yılları yansıtması bakımından önemli bir işlev üstlendiği görülmüştür.
SOME OF THE POSSIBLE MISCONCEPTIONS REGARDING HUMAN RIGHTS
Authors: Krivokapić Boris
Published: November 2023

The paper presents a review of human rights in the past with the aim of pointing out common misconceptions and prejudices. The author tries to prove with arguments that: 1) it is not true that human rights did not exist in the past; 2) human rights have not developed constantly and uniformly; 3) human rights did not appear and develop only in Western Europe, in order to spread from there to the whole world; 4) the homeland of human rights is everywhere; 5) developed countries i.e. political, economic and other powers have never really been real champions of human rights. His conclusion is that the acquis of human rights has always existed more or less developed, and that human rights will always exist, in one form or another, while at the same time there has also always been and will be their denial and violation. The question of the degree of their development, protection and respect is always a problem in itself and can be answered only on the occasion of a specific case, after a thorough study of not only legal regulations but also the practice of the respective society.