bluuebunny/crossref_metadata_2025 huggingface dataset:
AVALIAÇÃO E QUIMIOPROFILAXIA DE CONTATOS DE PACIENTES DIAGNOSTICADOS COM HANSENÍASE EM PETROLINA-PE
Authors: BARBOSA Danila dos Santos , SILVA Flávia Freire Ramos da , SILVA David Souza , FREITAS Francisco Araújo , PINHEIRO Ingrid Geovanna Bezerra , PEIXOTO Marlene Leandro dos Santos , ANDRADE Thaise Vieira de , ARAUJO Andrea Maia Fernandes de , IGNOTTI Eliane , ALBUQUERQUE Magnilde Alves Cavalcante de
Published: February 2021

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EPISÓDIOS REACIONAIS HANSÊNICOS E FATORES ASSOCIADOS
Authors: RAPOSO Marcos Túlio , POLON FILHO Kélcio Oliveira de , REIS Martha Cerqueira , CAMINHA Ana Virgínia de Queiroz
Published: February 2021

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SITUAÇÃO DOS CASOS NOTIFICADOS EM UM CENTRO NACIONAL DE REFERÊNCIA PARA HANSENIASE NO BRASIL ENTRE 2013 A 2018: DEFINIÇÃO DEINSUFICIÊNCIA, FALÊNCIA DE TRATAMENTO E RECIDIVA
Authors: GOULART Isabela Maria Bernardes , SANTOS Diogo Fernandes dos , ANTUNES Douglas Eulalio , GONÇALVES Maria Aparecida , COSTA Adeilson Vieira da , SABINO Elaine Fávaro Pípi , GOULART Luiz Ricardo
Published: February 2021

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CORRELAÇÃO ENTRE A ENDEMICIDADE E CONTATO EM HANSENÍASE NAS ALTERAÇÕES MORFOLÓGICAS DOS NERVOS PERIFÉRICOS DEFINIDAS POR ULTRASSOM
Authors: VOLTAN Glauber
Published: February 2021

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Efectividad de las técnicas de manejo conductual en odontopediatría. Revisión sistemática
Authors: Ortega Miriam , Tapia Calderón María Tatiana , Cedillo Mora Gabriela Estefanía , Ramos Montiel Ronald Roossevelt , Navas Perozo Rita Mireya
Published: February 2021

Objetivo: efectuar una revisión sistemática sobre la  efectividad de las técnicas  de manejo de la conducta  en niños sistémicamente sanos,  en la  consulta  de Odontopediatría. Métodos: Investigación descriptiva, retrospectiva, de estudios observacionales y  ensayos clínicos aleatorios controlados que evaluaron  la efectividad de las técnicas en niños y adolescentes de 03 a 18 años de edad. Resultados: criterios de inclusión artículos en inglés y español, publicados desde 2014 al 2019. El análisis de la calidad metodológica de los estudios se realizó mediante la guía Strobe y CASPe. Se identificaron términos de búsqueda en inglés en el  tesauro MeSH en la base de datos Pub­M/Medline, Scopus /Elsevier, español, se utilizaron descriptores de las Ciencias de la Salud (DeCS/BIREME) en la base de datos SciELO.org Redalyc.org,  Latindex,  Dialnet y  google académico. Hubo homogeneidad en los estudios respecto a la selección de escalas para medir ansiedad y miedo en los niños al recibir tratamiento preventivo, curativo o restaurador. Los estudios evaluaron mayoritariamente técnicas de distracción aplicadas con recursos audiovisuales para determinar efectividad sobre el comportamiento de los niños en el consultorio odontológico. También reportaron disminución de la ansiedad y miedo, después de la aplicación de técnicas de distracción, e informaron que hubo cambios de conducta de pacientes ansiosos y negativos a pacientes positivos y colaboradores. Conclusiones: estudios mostraron una insuficiente calidad en sus diseños, lo que no permitió emitir juicios respecto a la contundencia y solidez de la  evidencia sobre la efectividad de las técnicas aplicadas.

Palabras clave: DeCS: efectividad, técnicas, conducta, niños, odontopediatria
IMPACTOS DE UM PROGRAMA DE GINASTICA LABORAL NA QUALIDADE DE VIDA DE TRABALHADORES DO SETOR ADMINISTRATIVO DE UMA EMPRESA DE BELO HORIZONTE/MG
Authors: Sousa Adriana Alves de , Pessoa Cristiane Guimarães , Metzker Carlos Alexandre Batista
Published: February 2021

A prevenção de doenças ocupacionais é crescente nas empresas, considerando a necessidade atual pela alta incidência registrada, além dos afastamentos do trabalho, absenteísmo e até mesmo os riscos de invalidez permanente de trabalhadores, situações que impactam diretamente na produtividade e desempenho nas organizações. Nesse sentido, foi objetivo deste estudo avaliar a percepção da qualidade de vida de funcionários de uma empresa privada, antes e após implantação de um programa de Ginástica Laboral (GL) de relaxamento. Para tanto, foi realizado um estudo de campo descritivo e quantitativo, em que oito participantes foram submetidos a um programa de GL durante seis semanas, cinco vezes por semana. O questionário SF-36 foi aplicado pré e pós implantação do programa de GL com a intenção de avaliar a percepção da qualidade de vida dos participantes. Os resultados apontaram que dos ítens avaliados pelo SF-36 destacaram-se a melhora da dor, dos aspectos emocionais e da percepção da saúde. Ao final do estudo pode-se concluir que a GL foi benéfica na qualidade de vida dos profissionais avaliados. Sugere-se novos estudos que utilizem frequência das atividades, número de repetições e tipo de GL diferentes das aplicadas nesse estudo a fim de que se possa verificar resultados da GL em outros cenários.
DESAFIOS DOS ENFERMEIROS FRENTE AOS PACIENTES COM INDICAÇÃO DE CUIDADOS PALIATIVOS
Authors: Torres Cristina Medianeira Gomes , Nunes Simone Dos Santos , Piovesan-Rosanelli Cleci Lourdes Schmidt , Conterato Denise Miranda , Dias Caren Franciele Coelho
Published: February 2021

Introdução: Os cuidados paliativos consistem em toda abordagem que visa maior qualidade de vida e alívio do sofrimento em indivíduos acometidos por doença sem possibilidade de cura. Esta modalidade terapêutica é regida de princípios psicossociais e espirituais, sendo extensivo aos seus familiares, inclusive no enfrentamento do luto. Objetivo: identificar na literatura científica os desafios dos enfermeiros frente ao paciente com indicação de cuidados paliativos. Método: Estudo narrativo com abordagem qualitativa, que foi realizada a partir de abril de 2019 na biblioteca virtual de saúde utilizando as palavras-chave "Enfermagem" or "Enfermeiros", and "Cuidados Paliativos" and "Terminalidade", obtendo um total de 314 artigos. Após os filtros realizados foram selecionados 31 artigos, sendo exclusos os duplicados e que não respondiam a questão da pesquisa, dos quais restaram 6 para a elaboração do estudo. Resultados: Foram encontradas duas categorias: Impotência dos Enfermeiros frente à finitude de vida; Limitação na Formação Acadêmica. Discussão: O estudo contribuiu para verificar que os desafios dos enfermeiros frente aos pacientes com indicação de cuidados paliativos estão todos voltados ao modelo de formação acadêmica vigente, fazendo-se necessário uma mudança na grade curricular das instituições de ensino. Conclusão: Neste sentido, faz-se necessário inserir disciplinas que abordem a tanatologia e as questões de espiritualidade, além de reforçar os princípios dos cuidados paliativos a fim de proporcionar maior suporte aos enfermeiros e menor vulnerabilidade diante dos pacientes com indicação dessa modalidade terapêutica.
An Unusual Lacrimal Gland Mass
Authors: Singh Manpreet , Kaur Savleen , Gupta Pankaj , Zadeng Zoramthara , Vasishta Rakesh
Published: February 2021

Aim and objective

The present report describes an atypical presentation of a lacrimal gland mass in a young male patient. Symptomatology favored a benign mass that was proven to be malignant on histopathology.

Background

Adenoid cystic carcinoma is the most common epithelial malignancy of the lacrimal gland. The usual presentation of adenoid cystic carcinoma is in either sex at about an average 40 years of age with range from 6 to 79 years. The patient usually complains of a superotemporal orbital mass with rapid progression usually within a year. Uncommonly, these masses may present with longer history as is described in present case report.

Case description

A 17-year-old male patient of Indian origin presented with a mass in the superotemporal part of the right orbit for the last 5 years and 6 months. A firm and smooth orbital mass, approximately 20 mm × 15 mm, was present in superotemporal orbit that was nontender and nonpulsatile. A clinical diagnosis of lacrimal gland pleomorphic adenoma was strongly suggested by the clinical as well as radiological features. The orbital mass was excised en bloc by a right transseptal anterior orbitotomy. Histopathological examination of the excised mass revealed features characteristic of lacrimal gland adenoid cystic carcinoma.

Conclusion

Lacrimal gland adenoid cystic carcinoma can simulate pleomorphic adenoma and can present with history over 5 years. Hence, it should always be kept as a clinical possibility in patients with the painless superotemporal orbital mass and early excision of such orbital masses for appropriate diagnosis and management is vital.

Clinical significance

The duration of 5½ years at presentation in well-localized lacrimal gland adenoid cystic carcinoma is the longest period ever reported. The present article recommends keeping the differential diagnosis of adenoid cystic carcinoma in all patients with the clinically benign superotemporal orbital mass.

How to cite this article

Gupta P, Kaur S, Zadeng Z, et al. An Unusual Lacrimal Gland Mass. Clin Rhinol An Int J 2019;12(2 and 3):49–51.
A (des)construção do corpo em Quarto de despejo
Authors: Bezerra Renan da Silva , Volker Camila Bylaardt
Published: February 2021

Neste artigo objetivamos contribuir com o rol de pesquisas em Carolina Maria de Jesus, figura importante na literatura brasileira contemporânea, e tecer algumas reflexões em torno da noção de desconstrução do corpo, na obra Quarto de despejo: diário de uma favelada (2014), mediante o lugar de fala de Carolina de Jesus, que recria o ambiente insalubre em que viveu e projeta as diversas vozes do constructo da favela.
O entretenimento como arte séria: a revista MAD e a crítica ao consumismo
Authors: Lagerlöf Michel , Ribeiro Gilvan Procópio
Published: February 2021

O presente artigo estabelece relações entre a revista MAD, revista de humor norte-americana, e a hibridização entre a arte leve e a arte séria, segundo o pensamento de Andreas Huyssen. As duas esferas da arte serão problematizadas a partir da atualidade do conceito de indústria cultural e seu conjunto de ideais. Na sequência, abordaremos as características gerais da revista em busca de uma síntese com as ideias apresentadas. Por fim, tratar-se-á do tema do consumismo, que atravessa por diversas vezes a publicação, como uma forma de engajamento crítico, que é um atributo da arte séria, em reação aos mecanismos de dominação de uma sociedade baseada na cultura do consumo.
Pharmacognostic Investigation of Leaves and Bark of Cochlospermum Religiosum Linn
Authors:   CRPS, Nanded Pharmacy College, Nanded, Maharashtra, India., Ramling G Patrakar , Omprakash G Bhusnure ,   Channabasweshwar Pharmacy College, Latur, Maharashtra, India.
Published: February 2021

Cochlospermum religiosum (Linn.) Alston. (Bixaceae) otherwise known as Yellow silk cotton tree.Traditionally, the plant is used in the treatment of cough, asthma, jaundice, tuberculosis, inflammation, gonorrhea, fever and dysentery. In the present studymicromorphological investigations and the physicochemical analysis of Cochlospermum religiosumleaves and stem bark were carried out.The macromorphological examination indicated simple, palmately lobed, alternate distichous leaves possessing the prominent parallel venation, acute apices and crenate margin. Similarly, smooth, fibrous, ash coloured bark containing an orange-coloured gummy exudate observed. The microscopy of leaves presented a dorsiventral lamina, long filamentous unicellular uniseriate covering trichomes, anomocytic stomata, annulated lignified xylem vessel, mucilaginous brown matter, starch grains and prisms of calcium oxalate whereas the microscopic examination of the bark indicated lignified cork cells, thick-walled lignified sclereids, bundles of lignified fibres, rounded starch grains, elongated cellulosic medullary rays, tetragonal and rosette crystals of calcium oxalate. Thequalitative analysis of inorganic elementsexhibited the presence of aluminium, sodium, calcium, chlorides and ironin leaves and the bark ofCochlospermum religiosum.The present investigation on pharmacognostic characters and analytical standards of Cochlospermum religiosumwill provide a diagnostic tool in the authentication and the assessment of its quality.
SPECTRUM OF OPTIC NEUROPATHIES PRESENTING IN NEUROOPHTHALMOLOGY CLINIC AT AFIO
Authors: Ijaz Umer , Habib Asad , Rathore Hassan Sajjad , Sarwar Khan Muhammad Imran
Published: February 2021

Objective: To study the spectrum of optic neuropathies in patient’s presenting at AFIO Rawalpindi.

Study Design: Descriptive study/retrospective study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2017 to Dec 2017.

Methodology: Retrospective analysis of hospital record of patients coming to neuro-ophthalmic clinic of ArmedForces Institute of Ophthalmology (AFIO), Rawalpindi, from Jan to Dec 2017 was done. Only patients with clearfinal diagnosis of neurophthalmic disease were included. Those with vague diagnosis were excluded. Data wasentered in SPSS version 22 and grouped into variables before analysis. Chi-square test was used for statisticalanalysis. The p<0.05 was considered significant.

Results: Forty-five patients were included in study including 33 (73.3%) males and 12 (26.6%) females. Mean age of patients was 41.64 ± 17.74 years. Patients were grouped into ischemic optic neuropathy 20%, toxic optic neuropathies 20%, compressive optic neuropathies 17.7%, inflammatory optic neuropathies 11%, neuroretinitis 6.7%, hereditary optic neuropathies 6.7%, multiple sclerosis (MS) related 4.4%, neuromylitis optics spectrum (NMO-SD) related 4.4%, traumatic optic neuropathies 4.4% and nutritional optic neuropathies 4.4%. Deficiency of vitamin B12 and vitamin D was strongly associated with nutritional optic neuropathies while raised TLC was most common association with inflammatory optic neuropathies (57.14%) and of neuroretinitis (66%). Anti-tuberculosis drugs were most common cause of toxic optic neuropathies (88.88%). Chi square test was used for statistical analysis and p<0.05 was considered significant.

Conclusion: Ischemic optic neuropathy is the most common presentation in our population according to ourstudy. However...........
EFFECT OF SUBCUTANEOUS RECOMBINANT HUMAN ERYTHROPOIETIN ON BLOOD PRESSURE IN PRE-DIALYSIS CHRONIC KIDNEY DISEASE (CKD) PATIENTS
Authors: Hussain Muhammad Sajid , Raza Qasim , Omer Aamir Muhammad , Murtaza Nadia , Naureen Sadia , Razzaq Mehwish
Published: February 2021

Objective: To determine the effect of subcutaneous recombinant human erythropoietin on blood pressure in predialysis chronic kidney disease (CKD) patients.

Study Design: Case-series descriptive study.

Place and Duration of Study: Combined Military Hospital Peshawar, from Mar 2016 to Sep 2016.

Methodology: A total of 100 cases were enrolled. Inclusion criteria was patients of 18 to 60 years of both gender & estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2 having Hb <10g/dL and pre-dialysis while Exclusion Criteria was pregnancy or lactation, BP more than 140/90 mmHg, patients on Haemodialysis and worsening renal function. Baseline BP, body weight and eGFR of anaemic chronic kidney disease patients were recorded prior to EPO Alpha therapy. Erythropoiesis-stimulating agents (ESAs) i.e. EPO Alpha (50-100 Units/kg thrice or once weekly) was administered subcutaneously. Subsequent blood pressure, body weight and eGFR monitoring was done after 2 and 4 weeks post EPO Alpha injection.

Results: Mean age range was 46.71 years with range of 20-60 years, 73 (73%) were male while 27 (27%) werefemales. Mean ± SD for other quantitative variables like eGFR was 23.12 ± 5.28, Hb levels (g/dL) was 8.62 ± 0.85,Weight (kg) was 56.66 ± 6.62 and duration of CKD was 9.87 ± 4.02. Frequency of Hypertension (post EPO) was 2(2%) and p-value was 0.453.

Conclusion: We concluded that the frequency of hypertension in pre-dialysis patients with chronic kidney disease (CKD) receiving recombinant human erythropoietin (rhEPo) subcutaneously (SC) in low doses, is very low, so rhEPo can be used subcutaneously......................
COMPARISON OF SOLIFENACIN VERSUS COMBINATION OF SOLIFENACIN AND TAMSULOSIN IN IMPROVING UNILATERAL DOUBLE-J STENT RELATED LOWER URINARY TRACT SYMPTOMS - A PROSPECTIVE RANDOMIZED CONTROL TRIAL
Authors: Sajid Muhammad Tanveer , Rehman Sami Ur , Akmal Muhammad , Ahmad Hussain , Mirza Zahoor Iqbal , Mahmood Arshad
Published: February 2021

Objective: To compare Solifenacin versus solifenacin plus tamsulosin in terms of international prostate symptom score (IPSS) for lower urinary tract symptoms (LUTS) in patients with unilateral double-J (DJ) ureteric stents.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2018 to Feb 2019.

Methodology: A total of two hundred (n=200) patients of either gender aged 20-50 years, who underwentunilateral DJ stenting for different endourological procedures, were enrolled after satisfying inclusion/exclusioncriteria and then randomly allocated to group A (Solifenacin 5mg once daily (OD) ± placebo for 2 weeks) or group B (Solifenacin 5mg OD ± Tamsulosin 0.4 mg OD for 2 weeks) respectively. Baseline (1st post-operative day) and Post 02 weeks treatment IPSS was recorded and analyzed.

Results: Mean age of presentation in group A and group B was 41.11 ± 6.45 vs 39.86 ± 5.34 years with p-value 0.14. Majority of patients in both groups were male (34% female in group A while 31% in group B, difference being statistically insignificant p 0.65). Baseline IPSS in group A and group B was 10.33 ± 2.72 vs 10.46 ± 3.12 with pvalue 0.76 (statistically insignificant) while post 02 weeks treatment IPSS in group A and B was 9.20 ± 2.67 vs 7.88 ± 2.63 respectively with p-value <0.001, the difference being statistically significant.

Conclusions: Current study revealed significant advantage of combination therapy (solifenacin ± tamsulosin)compared with solifenacin monotherapy in lowering LUTS based on IPSS in patients having unilateral......
CLINICAL EFFICACY OF RECOMBINANT FACTOR VIII FC FUSION PROTEIN IN HAEMOPHILIA A PATIENT RECEIVING ON DEMAND TREATMENT ONLY
Authors: Zahir Saima , Zafar Tahira , Hussain Altaf , Malik Hamid Saeed , Ahmed Pervez , Khan Saleem Ahmed
Published: February 2021

Objective: To evaluate the efficacy of recombinant factor VIII FC fusion protein in haemophilia A patientreceiving on demand treatment only.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology and PakistanHemophilia Welfare Society, Rawalpindi, from Jun to Dec 2017.

Methodology: Eighty-nine male patients of Hemophilia A already receiving recombinant factor VIII (20-30 Units/kg) on demand, with no history of inhibitors were included in study. Patients were divided as per age into paediatric and adult group and also on the basis of their basal factor VIII levels into severe, moderate and mild groups. Same patients were switched to recombinant factor VIII FC fusion protein (20-30 Units/kg) and its efficacy was measured and compared with recombinant Factor VIII in terms of dose requirement, injections, bleeds in six month period, presence of inhibitors and side effects.

Results: Eighty nine male patients were studied. There was significant reduction in dose from median value of5750 units for group I to 4000 units for group II. Number of bleed in six month period were reduced from 5.3 ingroup I to 4.5 in group II. Number of injections were reduced on average to 1-2 injection per bleed in group II. No inhibitors were detected in group II.

Conclusion: rFVIII Fc fusion protein has prolong activity and results in reduction of total dose, number of bleed,dose per bleed and has reduced antigenecity.
FREQUENCY OF HYPERURICEMIA IN HYPERTENSIVE PATIENTS AND ITS ASSOCIATION WITH AGE OF PATIENT
Authors: Shah Syed Saif Ul Hassan , Iqbal Usman , Ahmad Ejaz
Published: February 2021

Objective: To determine the frequency of hyperuricemia in hypertensive patients and its association with the age of patients.

Study Design: Cross sectional analytical study.

Place and Duration of Study: Combined Military Hospital Abbottabad, from Sep 2016 to Feb 2017.

Methodology: All patients of 18-70 years of age with either gender presenting in and out patient departmentswith hypertension were enrolled. Serum uric acid was measured. Analysis of serum uric was done with SelectraXL chemical analyzer having normal references range of 2.52-6.97 mg/dl for males and 1.51-6.0 mg/dl forfemales. Reports were verified by Pathologist.

Results: A total of 137 patients were selected for the study. Mean age of the patients was 56.09 ± 09.36 years.There were 76 (55.50%) patients with >55 years of age while 61 (44.50%) patients were presented with ≤55 years of the patients. Male preponderance was higher 83 (61%) as compared to females 54 (39%). Mean weight, height and Body Mass Index of the patients was 67.99 ± 6.91 kilograms, 1.63 ± 0.08 meters and 25.32 ± 2.15 kg/m2 respectively. Mean systolic blood pressure of the patients was 166.71 ± 13.67 mmHg. Mean Diastolic blood pressure was 100.15 ± 8.84 mmHg. Mean serum uric acid level was 6.96 ± 0.82 mg/dl. Frequency of hyperuricemia was found in 102 (74.45%) while normouricemia in 35 (25.55%) patients.

Conclusion: Frequency of hyperuricemia was found higher in hypertensive patients and it was not associatedwith the age of patients.
ASSESSMENT OF CLINICAL EFFICACY OF COOLING GEL PATCH
Authors: Hussain `Muhammad , Asim Muhammad , Atif Muhammad , Anjum Naveed
Published: February 2021

Objective: To determine the efficacy of cooling gel patch in various clinical indications and comparison of cooling gel patch with water spray and cold sponging in fever and heat exhaustion.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Garrison Medical Centre Okara Cantt, from Sep to Dec 2018.

Methodology: A total of 48 male patients, age ranges from 20-40 years were assessed with different clinical indications of cooling gel patch. Patients with fever, heat exhaustion, headache, muscle cramps and toothache were included in this study and patients with acute illness other than fever were excluded. A control group of 20individuals was also analyzed against fever and heat exhaustion in which water spray and cold sponging wasused. Frequency and percentages of each indication were calculated and chi square test was applied.

Results: Total of 48 individuals living in plain terrain with various clinical indications of cooling gel patch wereassessed. Cooling Gel Patch was tested on 16 sportsmen with heat exhaustion out of which 2 (12.5%) individualhad minimal effect whereas control group of 10 showed good response in 8 (80%) sportsmen with water sprayand cold sponging with p-value .000578. Six patients with headache and 4 individuals with toothache reportedno reduction in symptoms. Two out of 6 patients with muscle cramps reported mild relief in symptoms. Sixteenpatients reported with high grade fever and out of these, 12 (75%) individuals showed no reduction in temperature after 4 hours of application......
QUANTIFICATION OF RETINAL NERVE FIBER LAYER FOR EARLY DETECTION OF ANTERIOR VISUAL PATHWAY LESIONS
Authors: Malik Noureen , Masud Hannan , Awan Muhammad Manzoor
Published: February 2021

Objective: To assess the role of quantification of retinal nerve fiber layer for early detection of anterior visualpathway lesions.

Study Design: Case-control study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan to Jul 2019.

Methodology: A total of 100 cases of anterior visual pathway lesions of varying clinical presentations wereincluded in the study. There were 100 matched controls who were selected from the community without anyophthalmological abnormality using non-probability consecutive sampling technique. Retinal nerve fiber layer(RNFL) thickness was measured with the help of optical coherence tomography in both the cases and controls.Mean retinal nerve fiber layer values were compared in both the groups. Student’s t-test was applied to look forany significant difference between the two groups.

Results: Mean age of the patients was 39.14 ± 3.925 years while mean age of the controls was 39.23 ± 2.415 years. Mean retinal nerve fiber layer thickness in the case group was 72.21 ± 9.615 µm while on the control group was 101.34 ± 9.615 µm. A statistically significant difference was observed between cases and controls in terms of mean retinal nerve fiber layer thickness (p<0.001). Subjects with retinal nerve fiber layer thickness <85 µm were more likely to exhibit anterior visual pathway lesions (OR= 15.915 [6.278-40.346]; 95% CI, p<0.001).

Conclusion: Decreased retinal nerve fiber layer thickness can serve as a predictor for anterior visual pathwaylesions. Optical coherence tomography should be incorporated for routine screening of high-risk cases in order.........
D-1 / PD-L1 EXPRESSION IN INVASIVE BREAST CARCINOMA / CANCER
Authors: Salim Sammeen , Asif Muhammad , Ahmed Rabia , Khadim Muhammad Tahir
Published: February 2021

Objective: To investigate the immunohistochemical expression of PD-1 and PD-L1 in breast cancer cases and itscorrelation with clinicopathological factors.

Study Design: Cross sectional study.

Place and Duration of Study: Histopathology department, Armed Forces Institute of Pathology Rawalpindi, form Jan to Jun 2019.

Methodology: Sixty five cases of breast cancer were retrieved. Clinicopathological parameters like age, gender,tumor grade and receptor status were noted. Immunohistochemistry for PD-1 and PD-L1 was applied. The datawas entered and statistical analysis was done using SPSS version 21. The associations between variables werefound using the Fisher exact test.

Results: Sixty five cases of breast cancer were investigated from tumour registry. The sample included femalepatients, having mean age of 50.86 ± 11.1 Years. Invasive mammary (ductal) carcinoma, NST was the most prevalent subtype 60 (92.3%) and most tumors were grade I/II 53(82%). PD-1 expression was seen in TIL’s 31 (48%) and PD-L1 expression was observed in tumour cells 30 (46%). Expression of PD-1/PD-L1 expression was more common in premenopausal age group and grade I/II tumors. Among molecular subtypes, PD-L1 expression was detected in 11 (52%) TNBC, 5 (71%) in HR-/HER2+ and 12 (32)% in HR + HER2 - and PD-1 expression was observed in 13 (62%) TNBC, 5 (71%) in HR-/HER2+ and 13 (35%) in HR+ HER2-.

Conclusion: A large proportion of breast cancer cases show expression of PD-1 / PD-L1. Anti PD-1 and PD-L1therapy may benefit these patients.
HIGH ALTITUDE AND VENOUS THROMBOSIS: FREQUENCY AND RISK FACTORS
Authors: Choudry Qamar Un-Nisa , Iftikhar Raheel , Qadir Manzur , Satti Tariq Mehmood , Omair Ghassan , Mehmood Syed Kamran
Published: February 2021

Objective: To determine the effect of high altitude on frequency and risk factors of venous thrombosis inindividuals ascending to high altitude

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Armed Forces Bone Marrow Transplant Centre, Combined Military HospitalSkardu, from Apr 2015 to Aug 2018.

Methodology: High Altitude was taken as height equal to or more than 8000 feet. Polycythemia as hemoglobin>16.5 g/dl OR hematocrit >49%. Medical records of all patients evacuated from high altitude through CombinedMilitary Hospital Skardu were analyzed retrospectively. A proforma was designed to include necessary variables.

Results: We evaluated medical records of 539 individuals and found frequency of 86 (15.9%) for venous thromboembolism (VTE) at high altitude. Cerebral venous sinus thrombosis (CVST) was most common thrombotic complication seen in 39 patients (46%). Majority of thrombotic episodes occurred at >18000 feet (likelihood ratio (LR) 5.99, p-value 0.009). Majority of thrombotic episodes 34 (39%) occurred within first 45 days of ascent to high altitude. Thrombosis was linked to smoking 47 (55%) (likelihood ratio 21.3 and p-value <0.001) and use of melted snow as a source of drinking water 56 (65%) (likelihood ratio 57.6 and p-value <0.001).

Conclusion: This study showed a very high frequency of thrombotic complications at high altitude. There isa need for a robust prospective study covering epidemiology, clinical information and diagnostics in order todevelop appropriate standard operating procedures and guidelines for prevention of thrombosis at HA
OPEN PARTIAL NEPHRECTOMY FOR SMALL RENAL TUMOURS: TECHNICAL AND ONCOLOGICAL OUTCOMES
Authors: Zia Qamar , Sajjad Mudassar , Akmal Muhammad , Kiyani Faran , Nawaz Muhammad , Razzaq Sohail
Published: February 2021

Objective: To assess the safety and oncological outcomes of Open Partial Nephrectomy in management of small renal tumours.

Study Design: Case series.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2015 to Dec 2018.

Methodology: We prospectively studied 61 patients with renal tumours either observed on computerized tomography (CT) scan or magnetic resonance imaging (MRI) having size ≤7cm and underwent open partial nephrectomy. The collected data included demographics, dimension of tumour, indication for surgery, cold ischemia time, hospital stay, complications and histopathological finding including involvement of margins. Patients were followed up for atleast 2 years.

Results: Among 61, 39 patients were male and 22 females. The age of patients ranged from 20-72 years. Mean cold ischaemia time was 24.7 ± 6.37 minutes. Except for 2 patients with Von Hippel–Lindau (VHL) disease, all other patients had solitary renal growth. Nine (14.75%) patients had solitary kidney. The mean of maximum dimension of tumours was 3.84 ± 1.38 cm and mean hospital stay was 3.18 ± 2.19 days. Histopathological results showed 34 tumours to be conventional renal cell carcinoma (RCC) (55.73%) followed by 12 papillary renal cell carcinoma (19.67%). Two (3.27%) patients had positive surgical margin who were operated for >5 cm tumours and later managed expectantly. Twenty one patients had Grade I and II complications while 2 patients were stented post operatively for urine leak. At 2 years follow up there was no recurrence of tumour in any of the patient operated.

Conclusion: Open ..........
THE ATTITUDES OF MEDICAL STUDENTS TOWARDS CLINICAL RELEVANCE OF HISTOLOGY
Authors: Waseem Naureen , Rasheed Aaqiba , Gill Maria , Asad Ayesha , Shamim Muhammad Omar , Waseem Fatima
Published: February 2021

Objective of Study:

The objective of this study is to have an insight on student’s attitudes regarding histology’s clinical relevance in public and private sector medical college.

Methodology: A cross sectional survey for attitude analysis towards histology’s clinical importance was carried out among 200 third year medical students from private and public sector medical college. Thurdstone and Chave attitude analysis questionnaire was employed to find the attitude score.

Results: Students of both public and private sector medical college show scepticism towards the clinical importance of histology. There was no marked difference in the attitudes of students of public and private sector medical college. Most data remained on the borderline of the attitude scale employed.

Conclusion: This study provided useful information for the teachers that students do not appreciate the clinical importance of histology much. Teachers need to devise strategies and to work on the students helping them comprehend the importance of histology.
ORAL HYGIENE PRACTICES OF FIRST AND FINAL YEAR DENTAL STUDENTS AT FOUNDATION UNIVERSITY: A COMPARATIVE STUDY
Authors: Ahsin Emaan , Ahsin Sadia
Published: February 2021

Objective: To compare personal oral hygiene practices between first and final year dental students of Foundation University College of Dentistry (FUCD).

Study Design: Cross sectional study.

Place and Duration of Study: Foundation University College of Dentistry, Islamabad, from Mar to May 2019.

Methodology: A pre-structured questionnaire was distributed to students of first and final year BDS classes with questions related to seven basic oral hygiene practices. These included frequency of teeth cleaning, time spent in cleaning teeth, tools used for cleaning teeth, frequency of changing toothbrushes, use of secondary plaque control methods, whether or not students cleaned their tongue, and how often they visited a dentist.

Results: Only 2 out of 7 practices, (i.e. more frequency of brushing, 45/52 (86.5% in final year vs 25/47 (53.1% infirst year and usage of floss 22/52 (42.3%) in final year vs 9/47 (19.1%) in first year) were found to be significantly better in final year students when compared to first year BDS students with a p-value of 0.012 and 0.04 respectively. The remaining differences did not reach statistical significance.

Conclusion: When compared with first year BDS students, only 2 out of 7recommended oral hygiene practiceswere found to be better in final year students. Therefore, there is a need for greater emphasis on oral hygienepractices at undergraduate educational years.
MALARIAL PARASITE SCREENING OF TROOPS RETURNING FROM UN MISSION TO PAKISTAN
Authors: Khan Muhammad Qaiser Alam , Shaheen Nasira , Khan Romesa Qaiser
Published: February 2021

Objective: To establish efficacy of malaria prevention programs by screening troops returning from UN peacekeeping services in high risk areas in Africa for malarial parasites.

Study Design: Cross sectional study.

Place and Duration of Study: Combined Military Hospital, Kharian, from Jan 2017 to Jan 2019.

Methodology: In this cross sectional study, individuals of regiments returning to Pakistan from high risk areasin Africa were screened for malarial parasites. A total of 1632 samples were analyzed during this time frame.Informed consent was taken at the individual and institutional level. Blood samples obtained from each participant were tested by both immuno-chromatographic techniques and peripheral blood films.

Results: Total 1632 individuals were screened for malarial parasites. Peripheral blood slides were negative in allindividuals except one. Immuno-chromatographic techniques for detection of malarial parasites were positive in 17 individuals for Plasmodium falciparum antigen. Only one individual had both Plasmodium vivax and Plasmodium falciparum positivity via both methods. All of them were asymptomatic at the time of screening, had a past history of high grade fever treated with anti-malarial drugs and were admitted for observation and follow up.

Conclusion: Despite the high prevalence of malaria in Africa, the current prevention protocols prove to be highly efficacious in protecting UN peace-keeping forces from infection and lowering mortality rates.
MALIGNANCY IN MULTINODULAR GOITER-POST THYROIDECTOMY: A PROSPECTIVE STUDY
Authors: Naeem Fizza , Raza Sayed Nusrat , Khan Taimoor Ashraf
Published: February 2021

Objective: To find out the frequency and types of malignancy in patients treated surgically for nontoxicmultinodular goiter and its correlation in different age groups and gender.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of ENT, Combined Military Hospital Rawalpindi, from Dec 2018 toDec 2019.

Methodology: A total of 116 patients operated for nontoxic multinodular goiter were included in the study.Demographic details along with pre-op Ultrasonography findings, Fine Needle Aspiration Cytology, thyroidfunction test results and post-op histopathological reports of the thyroid specimen were entered on pre-designed proforma. Results were analyzed using the Statistical Package for Social Sciences (SPSS) Version 22.

Results: Age ranges from 19 to 70 years (mean 43.51 years). Out of 116 cases operated for multinodular goiter,37 (31.8%) had malignant thyroid lesions (13 males, 24 females). Papillary carcinoma of the thyroid (45.9%) wasthe commonest malignancy followed by a follicular variant of papillary carcinoma (24.3%). The most common age group with malignancies was 49-58 years.

Conclusion: Malignant Thyroid cancers showed a female preponderance and were most common in age group49-58 years. Papillary carcinoma of thyroid was the commonest tumor. Radical thyroid surgery is a recommended surgical management option for nontoxic Multinodular goiter.
COMPARATIVE STUDY OF EFFECTIVENESS OF VENLAFAXINE, DULOXETINE AND SERTRALINE IN MANAGEMENT OF DIABETIC SENSORY NEUROPATHY
Authors: Shaukat Nabila , Nisar Shazia , Sajid Usman , Jan Osman Ali , Mahmood Amjad , Zahid Huma
Published: February 2021

Objective: To compare efficacy of 3 commonly prescribed anti-depressants from classes’ selective serotoninreuptake inhibitor and serotonin-nor epinephrine reuptake inhibitors i.e. Venlafaxine, Duloxetine and Sertralinein the management of diabetic sensory neuropathy in subjects with type 2 diabetes mellitus.

Study Design: Comparative, prospective study.

Place and Duration of Study: Combined Military Hospital Jhelum, Mar 2018 to Jul 2018.

Methodology: This study included 94 patients with metabolically stable type 2 Diabetes Mellitus with diabeticsensory neuropathy. Patients were randomly assigned into 3 treatment group, treatment group 1 (n1=29) receiving Venlafaxine 37.5mg × BD, treatment group 2 (n2=33) receiving duloxetine 30mg × BD and treatment group 3 (n3=25) receiving Sertraline 50mg × OD, each group being treated for 6 weeks, with optional dose titration fortnightly. The efficacy measure was done by revised Neuropathy Disability Score (NDS), measured at baseline and at the end of treatment period i.e. 6 weeks. The primary outcome of this study was “functional outcome” assessed by Disability Neuropathy scale (DNS) and overall improvement and adverse events were measured as secondary outcome measures.

Results: There was significant improvement in Neuropathy Disability scale (DNS) at the end of treatment periodin all treatment groups from their baseline score, with comparable efficacy among all drug groups i.e. p-valuebetween venlafaxine and duloxetine, venlafaxine and sertraline were non-significant i.e. p>0.05 except betweenDuloxetine and Sertraline group where there was significant difference in efficacy (p<0.05). Good, moderate andmild improvement in symptoms was noticed in all study groups.

Conclusion: Non-tricyclic Anti-depressants i.e. Venlafaxine..........
FREQUENCY OF HEPATITIS B AND C IN PATIENTS UNDERGOING CATARACT SURGERY IN A TERTIARY CARE EYE HOSPITAL
Authors: Khan Summaya , Rafique Aisha , Khizer Muhammad Azeem , Zafar Omar
Published: February 2021

Objective: To assess frequency of Hepatitis B and C infection in patients undergoing cataract surgery.

Study Design: Cross sectional study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2018 to Jan 2020.

Methodology: Pre operatively patients were subjected to detail ocular examination for cataract evaluation.Patient under 20 years of age, complicated cataract, uveitis, retinal detachment, previous history of ocular surgery or neurosurgery, treatment with systemic medication causing ocular side effects were excluded from study. Preoperatively hepatitis B and C screening was performed for all enrolled patients. The findings were recorded on data sheets and analyzed through statistical software system (SPSS) version 20.

Results: Out of 4671 patients, 35 (0.74%) were positive for hepatitis B surface antigen (HBsAg) and 146 (3.1%)were positive for hepatitis C antibody (HCVAb). Eight (22.8%) females and 27 (77.17%) males were positive forHBsAg. Fifty seven (39.04%) females and 88 (60.96%) males were found to be HCVAb positive. It clearly showshigher prevalence of hepatitis in males. Twenty three (65%) of patient with hepatitis B virus and 80 (54.8%) ofpatients with hepatitis C virus had nuclear sclerosis cataract as compared to 51% of non-infected patients.

Conclusion: Screening of hepatitis B and C is mandatory in order to prevent health care associated hepatitisinfection. There has been a role of inflammation due to hepatitis in development of cataract. Further studies may elaborate it vividly.
COLLUM’S ANGLE AND CROWN ROOT ANGLE OF MAXILLARY INCISORS IN DIFFERENT MALOCCLUSIONS
Authors: Panezai Saadia , Mengal Nasrullah , Ahmed Sadia Nisar
Published: February 2021

Objective: To determine Collum angle and crown to root angle of maxillary central incisor in different skeletalmalocclusion.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Orthondontics department, Bolan Medical College, Civil Sandman Hospital,Quetta, from Jun to Dec 2018.

Methodology: Data sample consisted of 140 lateral cephalograms. Sample consisted of 74 female cephalograms and 66 male cephalograms. The mean age of sampled subjects ranged between 21.62 ± 5.96 years. The Colum angle of the maxillary central incisors in each group was measured. SPSS version 21 was used to enter and process data. Comparison between Class II division 1 and division 2 collum angles was made by applying student t-test.

Results: The average value for Collum angle in class II division 1 sample was 4.38 ± 3.08 with minimum being 0and maximum 15 degree. The average values for Class II division 2 was 10.52 ± 4.37 with minimum 30 and amaximum 23 degree.

Conclusion: Maxillary central incisors in all malocclusions had significantly different mean Collum angles fromzero. Paired sample t-test comparison showed that the Collum angle for maxillary central was much higher inClass II division 2.
NÂNG CAO HIỆU QUẢ CÔNG TÁC QUẢN LÝ HỌC SINH SINH VIÊN Ở TRƯỜNG ĐẠI HỌC TÂN TRÀO TRONG GIAI ĐOẠN HIỆN NAY
Authors: Lê Thị Thu Hà
Published: February 2021

Công tác học sinh sinh viên được xác định là một trong những nhiệm vụ trọng tâm, chủ yếu góp phần quan trọng vào việc nâng cao chất lượng đào tạo nguồn nhân lực ở các trường Đại học hiện nay. Ý thức được điều đó, trong những năm qua, trường Đại học Tân Trào đã không ngừng đổi mới nội dung, hình thức tổ chức công tác quản lý học sinh sinh viên. Những kết quả đạt được trong công tác quản lý học sinh sinh viên của trường Đại học Tân Trào đã góp phần không nhỏ vào việc thực hiện sứ mạng đào tạo nguồn nhân lực chất lượng cao phục vụ sự phát triển kinh tế - xã hội của tỉnh Tuyên Quang và các tỉnh lân cận trong khu vực.
Adolescentes do ensino fundamental de uma escola pública do DF: avaliação do consumo alimentar dos escolares do período integral
Authors: Fernandes Polyana Veloso de Oliveira , Haack Adriana , Kanno Patrícia
Published: February 2021

Introdução: a escola é um local importante para aplicar estratégias de intervenção em adolescentes sobre hábitos alimentares saudáveis. Objetivo: Avaliar o consumo alimentar e o perfil socioeconômico de alunos do período integral de uma escola pública.Métodos: Estudo transversal descritivo realizado com 22 alunos, de 10 a 12 anos, de ambos os sexos. Foi utilizado questionário para identificar o perfil socioeconômico e para o consumo alimentar, o Recordatório de 24 h (R24) /Questionário de Frequência Alimentar (QFA), e uma escala hedônica verbal para aceitabilidade ou negação do cardápio. Resultados e Discussão: Ao se analisar o Valor Energético Total (VET), o resultado foi de um consumo alimentar inadequado para faixa etária, porém quando observadas em % de adequação dos macronu-trientes foram adequados. Em relação à ingestão dos macronutrientes em gramas e porcentagens, para o consumo entre o domicílio e a escola, o carboidrato e a proteína apresentaram diferença estatisticamente significativa, onde a ingestão na instituição escolar foi maior do que em seus domicílios. Para a ingestão dos lipídios não houve diferença significativa. Os alimentos mais consumidos diariamente são os doces e hortaliças, as frutas, os refrigerantes e os salgados de pacote duas ou mais vezes por semana e os fast foods uma vez por semana. Os estudantes em vulnerabilidade econômica recebem uma quantidade de alimentos maior do que é oferecido no domicílio o que pode contribuir para a qualidade da dieta. Conclusão: Políticas públicas para escolares e educação alimentar devem ser estimuladas na comunidade.
Perfil de Estudos da Rede Brasileira de Avaliação de Tecnologia em Saúde (Rebrats) de 2004 a 2015
Authors: Elias Flávia Tavares Silva , Morais Rafael Dias Gomes de , Silva Erica Tatiane da , Pereira Daniella Cristina Rodrigues
Published: February 2021

Introdução: A Rede Brasileira de Avaliação de Tecnologia em Saúde (Rebrats) atua na produção e disseminação de estudos para analisar eficácia, segurança, efetividade e custo‑efetividade de tecnologias em saúde. Objetivo: Traçar o perfil dos estudos concluídos pelos membros da rede no período de 2004 a 2015. Método: Realizou‑se estudo descritivo, com base no banco de dados do sistema de informação da REBRATS. As seguintes variáveis foram investigadas: ano e tipo de estudos, agravos para os quais as tecnologias estavam direcionadas, natureza e aplicação da tecnologia estudada. Resultados: Foram identificados 346 estudos concluídos no período em análise, sendo 131 pareceres técnico‑científico (PTC), 118 revisões sistemáticas, 31 avaliações econômicas em saúde, 19 estudos de gestão de tecnologias em saúde e 47 outros tipos de estudos em ATS. Destacaram‑se os estudos cuja classificação por agravo referia neoplasias medicamentos como natureza da tecnologia, tecnologias aplicadas ao tratamento e diagnóstico e investigação da eficácia e segurança. Conclusão: Houve ênfase em estudos que utilizam metodologias de síntese de evidências sobre eficácia e segurança de tecnologias médicas, como o PTC. As avaliações econômicas são delineamentos mais complexos, e estavam presente em menor número. Os agravos e tecnologias estudados acompanharam a transição epidemiológica e demográfica do Brasil, com foco predominante no tratamento e diagnóstico de doenças crônicas na população.
Vigilância da Leishmaniose Visceral no Distrito Federal: aspectos organizacionais, situação epidemiológica e medidas intersetoriais
Authors: Silva Gisele de Jesus , Da Silva Erica Tatiane , De Toledo Costa Gabriela Rodrigues , Dos Santos Isabele Barbieri
Published: February 2021

Introdução: A leishmaniose canina coexiste com a doença humana e costuma precedê‑la, sendo os cães o principal reservatório doméstico. São escassos os estudos sobre a vigilância e epidemiologia das Leishmanioses no Brasil, inclusive no Distrito Federal (DF).Objetivo: Descrever a vigilância da Leishmaniose Visceral no DF, quanto ao arranjo organizacional, situação epidemiológica e medidas intersetoriais para prevenção e controle da doença.Métodos: Estudo descritivo utilizando dados dos sites oficiais do Ministério da Saúde e da Secretaria de Estado e Saúde do DF, complementados por consulta à Diretoria de Vigilância Ambiental. Foram investigados os marcos históricos, a estrutura e as ações desenvolvidas, além da distribuição dos casos de Leishmaniose Visceral humana (LVH) e canina (LVC) por ano e região administrativa.Resultados: O histórico da evolução da vigilância da leishmaniose no DF e seu arranjo organizacional atual evidenciam a contínua ampliação e fortalecimento deste sistema. No período de 2004 a 2015, foram registrados 321 casos confirmados de LVH, dos quais 4,8% evoluíram para óbito, além de 6.608 casos de LVC. O aumento do número de casos de LVC precedeu o aumento de número de casos de LVH. Para enfrentamento desta zoonose, foram desenvolvidas e fortalecidas ações intersetoriais entre Diretoria de Vigilância Epidemiológica, Diretoria de Vigilância Ambiental em Saúde e o Laboratório Central do DF.Conclusão: Faz‑se necessária uma avaliação contínua da estrutura e capacidade de resposta do sistema territorial de vigilância da LVC, como componente fundamental da política nacional de saúde pública de combate às leishmanioses.