bluuebunny/crossref_metadata_2025 huggingface dataset:
MACHINE LEARNING APPLICATIONS IN MEDICAL DIAGNOSIS : A REVIEW
Authors:   Department of Computer Science Institute of Technology and Management, Gwalior, India, Joshi Neelam , Joshi Krishna Kumar , Mishra Manuj , Chaoudhari Ravi Ray
Published: September 2022

Artificial Intelligence and Machine Learning are the two important techniques in the current era, playing important role in almost each and every field of our daily life. These techniques are preferred because of their accuracy and predictability. Nowadays, Machine Learning is getting importance in Medical fields also. Due to the result accuracy, Machine Learning Techniques are used in even critical medical diagnosis application. These techniques are used in prediction of various types of cancers such as brain cancer, Lung cancer, Breast cancer, in Brain MRI, in CT scan and various critical diagnoses. In this paper a review is provided on the applications of Machine Learning techniques in various medical diagnosis applications. As a future work, we will implement some approach for medical diagnosis using ML Techniques.
PENERAPAN PERMAINAN TEMBAK IKAN UNTUK MENINGKATKAN HASIL BELAJAR GERAK DASAR MELEMPAR PADA SISWA KELAS II SD
Authors: CAHYONO IRWAN BUDI
Published: September 2022

This study aims to determine the application of the game "Shoot Fish" in improving learning outcomes of basic throwing motions. This research is a classroom action research. The survey was conducted in two cycles. Each cycle consists of two meetings covering the stages of planning, implementing actions, observing and reflecting. The research subjects were second grade students of SDN 013 Tana Tidung, totaling 20 students. Sources of data used are observations, tests, and student learning outcomes documents. For data analysis using quantitative descriptive analysis techniques. The results showed that the results of learning the basic throwing motion of second grade students of SDN 013 Tana Tidung increased after the application of the Fish Shoot game method. These results are indicated by an increase in student learning outcomes in each cycle. The improvement of student learning outcomes is seen from two aspects, namely based on students' cognitive and psychomotor. Students' cognitive learning outcomes have increased as indicated by the increase in the average value of 73,00 in the first cycle and increased to 87.00 in the second cycle and being able to pass the KKM value 75.
ABSTRAKPenelitian ini bertujuan untuk mengetahui penerapan permainan “Tembak Ikan” dalam peningkatan hasil belajar gerak dasar melempar. Penelitian ini merupakan penelitian tindakan kelas. Survei dilakukan dalam dua siklus. Setiap siklus terdiri dari dua pertemuan meliputi tahap perencanaan, pelaksanaan tindakan, observasi dan refleksi. Subjek penelitian adalah siswa kelas II SDN 013 Tana Tidung yang berjumlah 20 siswa. Sumber data yang digunakan adalah observasi, tes, dan dokumen hasil belajar siswa. Untuk analisis data menggunakan teknik analisis deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa hasil belajar gerak dasar melempar siswa kelas II SDN 013 Tana Tidung mengalami peningkatan setelah penerapan metode permaianan Tembak Ikan. Hasil ini ditunjukkan dengan adanya peningkatan hasil belajar siswa pada setiap siklusnya. Peningkatan hasil belajar siswa dilihat dari dua aspek yaitu berdasarkan kognitif siswa dan psikomotor. Hasil observasi psikomotor siswa mengalami peningkatan ditunjukkan dengan meningkatnya nilai rata-rata 73 pada siklus I dan meningkat menjadi 87 pada siklus II dan mampu melewati nilai KKM ? 75.
HUBUNGAN PERAN ORANG TUA DENGAN TINGKAT KECEMASAN ANAK USIA SEKOLAH YANG MENGALAMI HOSPITALISASI
Authors: Simamora Febrina Angraini , Siregar Hotma Royani , Hidayah Arinil , Batubara Novita Sari
Published: September 2022

Peran orang tua adalah suatu tindakan orang tua untuk memberikan motivasi, bimbingan, fasilitas belajar, serta perhatian yang cukup terhadap anak-anaknya untuk mencapai tahapan tertentu. Tujuan penelitian ini adalah Untuk Mengetahui hubungan Peran Orang Tua dengan Tingkat Kecemasan Pasien Anak Usia Sekolah (6-12 Tahun) yang Mengalami Hospitalisasi di RSUD Padangsidimpuan. Desain penelitian adalah deskriptif korelatif. Responden dalam penelitian ini adalah 40 orang. Dari hasil uji Korelasi Spearman antara hubungan peran orang tua dengan tingkat kecemasan anak anak usia sekolah diperoleh nilai p = 0,002 < α (0,05), maka dapat disimpulkan bahwa ada hubungan peran orang tua dengan tingkat kecemasan anak usia sekolah di RSUD Padangsidimpuan. Penelitian ini dapat menjadi bahan pembelajaran dan tambahan pengetahuan bagi responden terkait pentingnya peran orang tua dalam setiap intervensi keperawatan yang dilakukan pada anak usia sekolah. Dapat digunakan sebagai masukan perawat dalam memberikan intervensi keperawatan yang tepat untuk mengatasi tingkat cemas pada anak.
PENGARUH DZIKIR TERHADAP PENURUNAN TINGKAT KECEMASAN PASIEN PRE OPERATIF BEDAH MAYOR DI RUANG RAWAT BEDAH
Authors: Harahap Mei Adelina , Siregar Nurelilasari , Ritonga Nefonavratilova
Published: September 2022

Tindakan operasi bedah telah menjadi komponen pelayanan kesehatan yang essensial pada banyak negara di dunia. Respon psikologi yang biasanya terjadi pada pasien pre operasi yaitu kecemasan. Penelitian ini bertujuan untuk mengetahui pengaruh dzikir terhadap penurunan tingkat kecemasan pasien pre operasi bedah mayor. Desain penelitian ini adalah eksperimen semu (quasy experiment) dengan one group pre and post testdesign. Teknik sampling yang digunakan pada penelitian ini adalah total sampling dengan jumlah responden 21 pasien pre operasi bedah mayor di Ruang Rawat Bedah Rumah Sakit Umum Daerah Kota Padangsidimpuan. Uji statistik yang digunakan yaitu uji Wilcoxon. Hasil penelitian ini menunjukkan ada pengaruh yang bermakna sebelum dan setelah diberikan terapi dzikir dengan nilai P-Value = 0,000< 0,05. Dzikir terbukti memiliki pengaruh dalam menurunkan tingkat kecemasan pre operasi bedah mayor, sehingga dzikir dapat dijadikan sebagai salah satu alternatif yang bisa digunakan untuk menurunkan kecemasan pada pasien pre operasi.
PENGARUH REBUSAN BAYAM MERAH TERHADAP PENINGKATAN KADAR HEMOGLOBIN IBU HAMIL DI KELURAHAN LOSUNG KECAMATAN PADANGSIDIMPUAN SELATAN KOTA PADANGSIDIMPUAN TAHUN 2020
Authors: Dewi Sri Sartika Sari , Panjaitan Meliana Nurhayati , Ramadhini Delfi
Published: September 2022

Anemia in pregnancy is a major health problem in developing countries with high morbidity rates in pregnant women. The pregnancy rate due to anemia in Asia is estimated at 72.6%. The high prevalence of anemia in pregnant women is a problem currently facing the Indonesian government. Anemia often occurs due to a lack of iron content in food, very low absorption of iron from food, the presence of substances that inhibit iron absorption. Iron anemia in pregnancy is a condition in which the mother with an Hb level below 11 grams / dL in the first and third trimesters and an Hb level less than 10.5 grams / dL in the second trimester of pregnancy. This study aims to determine the effect of red spinach stew on increasing hemoglobin levels in pregnant women in the Losung village, Padangsidimpuan Selatan district. The research method is Quasi Experiment with research design One group pre test post test design. Samples were taken using total sampling. The number of samples was 20 pregnant women. Data analysis using Paired T Test. The results showed P = 0.000 (P <0.05). The conclusion is the effect of red spinach decoction on increasing hemoglobin levels in pregnant women. It is hoped that pregnant women who experience anemia or low Hb during their pregnancy are advised to consume red spinach stew. Key: Red spinach stew, Hemoglobin levels for pregnant women and maintaining dietary nutrition are highly recommended for foods containing iron.
ANALISIS KEMAMPUAN PEMECAHAN MASALAH MATEMATIS SISWA BERKEMAMPUAN AWAL TINGGI DAN RENDAH DENGAN MENGGUNAKAN PENDEKATAN OPEN-ENDED DI SMA NEGERI KABUPATEN PADANG LAWAS UTARA
Authors: Siregar Yulia Pratiwi
Published: September 2022

Education and these skills can be obtained from the learning process in schools including students' mathematical problem solving abilities. This study aims to look at the description of mathematical problem solving abilities in students with high and low initial abilities, especially in Class X SMA Negeri 1 Padang Bolak. The population in this study were all students of Class X SMA Negeri 1 Padang Bolak which consisted of 5 classes totaling 150 people. The sampling technique was carried out by random sampling technique so that the sample in the study was as many as two classes, namely X2 and X3 classes. The research instrument in this study was to use an essay test in the form of open questions (Open-Ended). Based on the first hypothesis test, it was concluded that the value of Sig. < 0.05 or 0.0005 < 0.05 then H0  is rejected and H1 is accepted. Thus, it can be concluded that the problem solving abilities of students with high initial abilities who are taught using an open-ended approach are better than students with high initial abilities who are taught using a conventional approach. Furthermore, based on the second hypothesis test, it can be seen that the problem-solving ability has a Sig value. of 0.0195. It means the value of Sig. < 0.05 or 0.0195 < 0.05 means that H0 is rejected and H1 is accepted. Thus, it can be said that the problem solving abilities of students with low initial abilities who are taught with an open-ended approach are better than students with low initial abilities who are taught using conventional learning.
PENGARUH PEMBERIAN CINCAU HIJAU TERHADAP PENURUNAN TEKANAN DARAH PADA LANSIA PENDERITA HIPERTENSI DI DESA HUTA TONGA
Authors: Mei Adelina
Published: September 2022

Hipertensi sering ditemukan pada lansia dan biasanya tekanan sistoliknya yang meningkat. Upaya pengobatan hipertensi secara tradisional dapat dilakukan dengan konsumsi cincau hijau. Kasus hipertensi pada lansia ditemukan sebesar 185.857 jiwa di Indonesia, dan sebesar 55 orang di desa huta Tonga. Tujuan penelitian untuk mengetahui Pengaruh Pemberian Cincau Hijau Terhadap Penurunan Tekanan Darah Pada Lansia Penderita Hipertensi Di Desa Huta Tonga. Metode menggunakan desain quasi eksperimen.  Dengan rancangan one grup pretest-postest. Populasi penelitian yaitu lansia penderita hipertensi sebanyak 55 orang. Sampel penelitian sebanyak 17 orang menggunakan tehnik consecutive sampling. Uji statistik yang digunakan yaitu wilcoxon dengan derajat signifikan (p<0.05). Hasil penelitian diperoleh nilai P-value (0.000). Hasil penelitiaan rata-rata MAP tekanan darah lansia sebelum adalah 121 mmHg (Stadium 2) dan setelah perlakuan adalah 115 mmHg (Stadium 1), Sehingga ada selisih 6 mmHg. Maka terdapat pengaruh pemberian cincau hijau terhadap penurunan tekanan darah pada lansia penderita hipertensi. Sehingga responden lebih aktif dan termotivasi untuk melakukan cara pencegahan hipertensi dengan pemberian Cincau hijau.

 

Hypertension is common found for the elderly and it is caused by the increasing of systolic pressure. One tradition health-effort on this condition is having gress jelly-green. The case of elderly with  hypertension is about  185.857 people in indonesian, and there are 55 people in desa huta tonga. The aims of this research is to know the effect of giving grass jelly-green toward decreasing blood pressure for the elderly with hypertension in desa huta tonga.  Then this research uses quasi eksperimen design to cover methodof the research with one group pretest-posttest. The population belongs to the elderly with hipertension about 55 people. The sample is taken about 17 people with consecutive  sampling. Then the statistical test is gained with willcoxon test on significant degree (p<0.05). the result  is gained about p-value (0.000). the other result, the MAP of blood preesure of the elderly previously is about 121 mmHg stadium 2 then they get 115 mmHg stadium 1 after having the experiment. Thus, there is 6 point of difference. By having that, itcan  besaid that there is an effect of giving grass jelly-green toward decreasing blood pressure for the elderly with hipertension. The suggestion, the hipertension sufferers should have more motivation and be active in checking their condition, especially havean effort to decreasethe hypertension with having thegrass jellu-green.
Hubungan Umur, Paritas dan Kepatuhan Konsumsi Tablet Tambah Darah Dengan Kejadian Anemia pada Ibu Hamil di Puskesmas Batunadua Kota Padangsidimpuan Tahun 2021
Authors: Ramadhini Delfi , Dewi Sri Sartika Sari
Published: September 2022

Kekurangan gizi pada ibu hamil dapat menyebabkan kekurangan darah (anemia). World Health Organization (2019) prevalensi anemia pada ibu hamil sebesar 41,8%. Penyebab terjadinya anemia kehamilan diantaranya umur, paritas dan kepatuhan konsumsi tablet tambah darah. Tujuan penelitian ini adalah untuk mengetahui hubungan umur, paritas dan kepatuhan konsumsi tablet tambah darah dengan kejadian anemia pada ibu hamil di puskesmas batunadua kota padangsidimpuan tahun 2021. Jenis penelitian adalah penelitian kuantitatif dengan pendekatan cross sectional study. Populasi dalam penelitian ini adalah semua ibu hamil di Puskesmas Batunadua Kota Padangsidimpuan sebanyak 229 orang dan jumlah sampel sebanyak 70 orang dengan teknik pengambilan sampel menggunakan simple random sampling. Analisa yang digunakan adalah uji Chi Square. Hasil penelitian ini menunjukkan bahwa ada hubungan umur (p=0,001), paritas (p=0,006) dan kepatuhan konsumsi tablet tambah darah (p=0,001) dengan kejadian anemia pada ibu hamil. Kesimpulan diperoleh bahwa umur, paritas dan kepatuhan konsumsi tablet tambah darah ada hubungan dengan kejadian anemia pada ibu hamil. Saran diharapkan pada ibu hamil di Puskesmas Batunadua Kota Padangsidimpuan dapat memperhatikan umur dan jumlah telah melahirkan anak apabila merencanakan kehamilan, apabila ibu telah hamil maka harus rutin memeriksakan kehamilannya di tempat pelayanan kesehatan terdekat dan patuh dalam mengkonsumsi tablet tambah darah sehingga dapat terhindar dari kejadian anemia.
Impact Assessment of Project: Provision of Laptops to the Students of Public Sector Universities of Punjab (Pakistan)
Authors: Mubin Sajjad , Gavrishyk Ekaterina , Mubeen Ghazanfar
Published: September 2022

Government of the Punjab (GOP) initiated a development project through which two hundred thousand (200,000) laptops were provided to meritorious students in two phases of the project along with free of cost on campus access to internet facility to cope with the challenges of the digitization brought about by the spread of Information and Communication Technology. The rationale behind the project was enhance the IT skills of students and to help students overcome the obstacles in the way of learning and professional growth in the modern times. It was envisaged that the laptops will improve the IT skills along with improvement in grades and outcomes of students’. At completion, the project was evaluated for assessment of outcomes and impact of the project on the beneficiaries. Moreover, the qualitative aspect of scheme was also analyzed, in terms of quality of laptops, warranty support, quality of internet connectivity, laptop distribution on merit and etc. Questionnaire was developed covering all the aspects of the project. Data was collected online from 3600 sampled students through Google form on a broad based methodology. Based on the data analysis, positive outcomes were observed almost in almost all quantitative and qualitative indicators defined for this evaluation. Detailed conclusions and recommendations are given in the last section of the paper.
Factors Influencing Water Saving Measures and Water-Use Efficiency of Wheat Growers in Sindh, Pakistan
Authors: Khajjak Akbar Khan , Mangan Tehmina
Published: September 2022

As the food supplies will have to be increased according to the growing population, water demand will be on the rise in the future. Therefore, improved water consumption patterns must be followed to match future food demands. The paper analyzes the farmer’s adoption of improved irrigation technology to avoid excessive irrigation water use in cultivating crops. In addition, this paper also investigated the factors influencing the water-use efficiency of the farmers. A total of 390 farmers who grew wheat crops were selected from the Naushahro Feroz and Benazirabad districts of Sindh, Pakistan. Socio-economic variables and efficiency scores of the respondents were taken as variables, and both binomial logistic and Tobit regression models were applied.  Results indicated that household head’s experience and formal education have a positive and significant impact on their decision to adopt improved irrigation and their efficiency scores. The elasticities reveal that a 1 % increase in experience of farming possesses the probability of lining the water courses by 23%. Whereas, with the change of 1% in the formal education of respondents, the tendency to laser land leveling changed by 0.1%. In comparison, the distance of the farm from the canal and the area of the farm bears a negative impact on water conserving measures opted by them and their water-use efficiency scores. It was found that proper lining of the water courses, usage of drought tolerant varieties of crops, irrigation technology adoption, and laser land leveling were the measures taken to avoid the excessive use of irrigation water. These measures were found to significantly impact the water-use efficiency scores of sampled farmers.  These findings might be helpful for researchers and policymakers to realize such factors influencing the adoption of farmers and their farm efficiency.
Between the Village and the Void: Spatiality of (Non)Being in Jibanananda Das’s Tale of City and Village
Authors: Samanta Anik
Published: September 2022

This article examines the topological psychodynamics of spatiality vis-à-vis the myriad and complex configurations of subjectivity underpinned by the unconscious dynamics of psychosexuality operative and observable amongst the protagonists in the great modern Bengali poet and author Jibanananda Das’s short story ‘Tale of City and Village’ who find themselves in an impossibly triangulated situation attendant upon the trope of the a visit(ation) of/from the past. It concisely and closely examines the unconscious dynamics of fantasy, desire and drive mapped onto the daseinal displacement from the country to the city which answer to the existential void or originary lack in being deploying the theoretico-critical framework of Lacanian psychoanalysis, semiotics, narratology, Russian Formalism, Bakhtinian dialogism, and continental philosophy.

Keywords: Being, subjectivity, fantasy, desire, drive, jouissance, displacement, anxiety, pastoral, sublime.
A rare cause of small bowel bleeding
Authors:   Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel., Gluck Nathan
Published: September 2022

We present a rare cause of gastrointestinal bleeding resulting from fistulae between the mesenteric artery and portal venous system, caused as a late complication of sleeve gastrectomy. A high index of suspicion, based upon venous engorgement without an occluding thrombus, enabled prompt diagnosis and occlusion of the fistulae with coils, leading to marked clinical improvement.
Menstrual Knowledge Status among School Going Girls in Mulundi Sub-Location, Kitui County
Authors: Kalio Mercy Mukai , Ngunzo Felix Kioli , Wanjala Kennedy Barasa
Published: September 2022

Menstruation is part of female human health that signifies the transition from childhood to adulthood. Correct menstrual knowledge entails having accurate knowledge of physiological changes, which accompanies body changes. Knowledge extends to being well versed with the advantages of correct menstrual practices and the consequences of poor menstrual management. Menstrual hygiene knowledge was evaluated in four (4) primary and 3 secondary schools within Mulundi sub Location. Mulundi sub Location was chosen among many areas due to its economic status, which is similar to that of most sub-Locations within Kitui County. The sampled schools draw their learner's population within the location and the immediate locations thus a good representation of the area. The study adopted a mixed-method approach, which involved the collection of qualitative and quantitative data. Quantitative data was collected using questionnaires administered to 140-school going girls aged between 10-19 years. The qualitative data was acquired through the use of focused group discussions and key informant interviews. The qualitative data reported as verbatim quotes suggest more campaigns are needed to enlighten girls on the menstrual subject. The study reveals that 68% of the girls could define menstruation correctly while 14% and 9% thought it was a disease and curse respectively. A percentage constituting 9% had no idea of menstruation. The parents were ranked as the highest source of menstrual information constituting a percentage of 39.1%. Based on the study findings, teachers contributed 33.2% of the menstrual knowledge by girls. Other sources of menstrual knowledge included individuals, peer educators and religious groups. Though over half of the sampled population were knowledgeable, the study recommends the inclusion of more sessions on the menstrual subject in the school’s curriculum.
The status of the use of traditional and modern methods in the management of malaria in some communities in Badagry Division, Lagos State, Nigeria
Authors: Sahdat Ajoke Salami  , Okwa Omolade Olayinka
Published: September 2022

Malaria is a leading parasitic disease in Nigeria and the risk exist throughout the country. This study examined the status and use of traditional and modern methods in malaria management in five communities in Badagry Division of Lagos State, Nigeria. Structured questionnaires were used to collect data from 100 participants, with 20 randomly selected from each community. Data analysis revealed that 85% of the respondents were knowledgeable of the relationship between malaria and mosquitoes. 66% believed that modern methods is better for preventing mosquitoes. 44% believed that traditional methods work faster and 56% felt that this method is cheaper for mosquito control while 15% nurture mosquito’ repellant plants within their vicinity. 43% considered malaria to be a serious disease with fever as the most recognized symptom among 50%. 35% preferred the home treatment by nurses due to promptness and cheaper charges while 59% practiced self-medication. 55% preferred treating malaria with modern medicines because of safety and specificity. 41% preferred both herbal and modern medicines which they believed work together to manage malaria better. 7% never used modern drugs because they believe herbs are more effective. Amatem (11%) was the most preferred drug among 12 commonly used modern drugs. 12% still used chloroquine because of its affordability and 21% preferred injections. Health care workers are needed to reduce long waiting times in hospitals in order to curb self -medication. Herbal treatment appears as alternative to modern treatment so traditional practitioners should receive standard training in clinical medicine. Modern health practitioners should appreciate the potential of traditional practitioners and collaborate in malaria management.
Comunicación asertiva y relaciones interpersonales en docentes universitarios de la carrera de medicina: caso UCACUE
Authors:   Universidad Católica de Cuenca, Vinueza Morales Silvia Ximena ,   Maestría en Administración de Empresas con mención en Dirección y Gestión de Proyectos. Cuenca, Ecuador, Ramón Poma Glenda Maricela ,   Universidad Católica de Cuenca; Maestría en Administración de Empresas con mención en Dirección y Gestión de Proyectos. Cuenca, Ecuador
Published: September 2022

En la actualidad los individuos forman parte de un proceso de cambios sociales acelerados a nivel mundial. Donde, la comunicación asertiva es la acción que realiza un individuo para comunicarse en forma pacífica, evitando que el otro individuo interprete que dicho comunicado se lo hace despectivamente. Por consiguiente, la comunicación asertiva es fundamental para promover buenas relaciones entre docentes y educandos, estimulándolos a la adquisición de hábitos de autonomía educativa, puesto que existe relación directa con ciertos criterios como la creatividad, reflexividad y criticidad. El objetivo del manuscrito es determinar la relación entre la comunicación asertiva y relaciones interpersonales en docentes universitarios de la carrera de medicina de la Universidad Católica de Cuenca. La metodología responde a una investigación cuantitativa, no observacional, transversal y correlacional. La población fue de 141 docentes de la Unidad Académica de Salud y Bienestar de la Universidad Católica de Cuenca que se encontraban laborando durante el periodo abril 2022 – septiembre 2022, y la muestra final fue de 104 profesores. Los resultados indican una correlación significativa entre la comunicación asertiva y las relaciones interpersonales. Se puede concluir que el estilo asertivo por su correlación directa con la inclusión y el control permitirá mejorar las relaciones interpersonales de los sujetos de estudio, de igual manera, la comunicación precisa es una opción que permitirá mejorar la inclusión de los docentes al desarrollar sus actividades académicas, además, se demuestra que la estrategia de asertividad no tiene relación alguna con las dimensiones (inclusión, control y afecto) de las relaciones interpersonales.
Association of Severity of Diabetic Retinopathy with Levels of HbA1c
Authors: Taimoor Khan Raja Muhammad , Saleem Haroon , Bhatti Shahid Anwar , Sadiq Muhammad Usman , Sadiq Muhammad Irfan
Published: September 2022

Aim: To assess the association between the severity of retinopathy and HbA1c status in patients with diabetes mellitus. Study design: A Cross-sectional study. Place and duration: In the department of Ophthalmology, Al Shifa Trust Eye Hospital, Rawalpindi for six-months duration from December 2020 to May 2021. Methods: The study included 120 patients of both sexes with type I and type II diabetes, aged 35-80 years. Full ophthalmology examination was carried out including the slit lamp examination, best visual acuity correction, fundus examination and Goldman applanation tonometry. The diabetic retinopathy is graded from Grade 0-Grade V. Results: Of the 120 cases, 58 (49%) were male and 52 (51%) were female. 60 ± 2.4 years was the mean age of patients with 35-80 years of age range for men and 40-75 years for women. Figure 1 is a bar graph showing the severity of diabetic retinopathy. Grade-I diabetic retinopathy was seen in 45(37.5%) patients and Grade-V was noted in 5%. The good control of glycemia was seen in 38 patients and 20.8% had Grade III glycemic control. The worst glycemic control was seen in patients with Grade-IV diabetic retinopathy having 11.8 of HbA1c. Conclusions: This analysis found that severe diabetic retinopathy was seen in patients with poor control of glycemia in comparison to patients with better diabetes control. There is a direct relationship between the severity of diabetic retinopathy and levels of HbA1c levels. Keywords: Diabetic retinopathy, Vitreous hemorrhage, HbA1C, Proliferative diabetic retinopathy, Non-proliferative diabetic retinopathy.
Pembrolizumab and Chemotherapy with Radiology Comparative Analysis in Patients with Untreated Metastatic Triple Negative Breast Cancer
Authors: Ur Rehman Muhammad Usama , Ali Ibrar , Zia Hamna
Published: September 2022

Objective: This research compares the results of radiography, chemotherapy, and pembrolizumab usage in patients with metastatic triple-negative breast cancer who have not previously received any treatment. Study Design: Observational/Comparative study. Place and Duration: Sadiq Abbasi Hospital Bahawalpur. November 2021-May 2022 Methods: 100 females between the ages of 20 and 80 participated in this study. Included were patients with metastatic triple-negative breast cancer who had not yet begun therapy. Patients were split into two groups equally. 50 patients in group A got pembrolizumab 200 mg every two weeks while 50 patients in group B got chemotherapy (75 mg of Adriamycin) every 21 days for six months. Patients were followed up with often. Post-treatment results for both groups were evaluated and contrasted with regard to effectiveness, disease control, mortality, and recurrence rate. The full set of data was analyzed using SPSS 20.0. Results: We found that efficacy in group A was higher in 22 (44%) cases as compared to group B in 15 (30%) cases. Frequency of partial recovery in both groups were 14 (28%) and 10 (20%). Frequency of stability in disease among patients of group B was higher 16 (32%) as compared to group A 9 (18%). Mortality and recurrence rate was lower in pembrolizumab group as compared to chemotherapy group with p value <0.004. Frequency of adverse outcomes in group A was higher. Conclusion: We came to the conclusion from this study that the usage of pembrolizumab injection for the breast cancer treatment was beneficial and successful in terms of low mortality with recurrence rate and greater number of recovery, although rate of stability among illness was higher in chemotherapy group. Decreased illness rate was achieved with both therapies. Keywords: Mortality, Chemotherapy, Recurrence, Pembrolizumab, Breast Cancer
Compare Mean Blood Loss in Patients Undergoing Tonsillectomy with and without Tranexamic Acid
Authors: Ashraf Muhammad Asif , Ahmed Ishfaq , Bhatti Sanaullah , Rai Deepak , Tasleem Rana Farrukh
Published: September 2022

Introduction: Tonsillectomy is one of the most common surgeries in ENT department and bleeding is one of the most serious complications related to tonsillectomy. Tranexamic acid is a plasminogen inhibitor which has been successfully used to control bleeding in a variety of surgeries. Objective: The objective of this study is to compare mean blood loss in patients undergoing tonsillectomy with and without Tranexamic acid. Study Design: Randomized controlled trail Setting: This study was carried out at the Department of ENT Jinnah Hospital Lahore Sample Technique: Non-probability, consecutive sampling Study Duration: The study was done in 6 months after the approval of synopsis [March 8, 2017 till September 8, 2017] Materials and Methods: Sixty Patients were randomly divided into 2 equal groups using lottery method in group-A and group-B. Patients in Group-A received tranexamic acid after induction intravenously as 15 mg/kg (single bolus dose) over 10 min. Patients in group B were served as control group and they did not receive tranexamic acid before tonsillectomy. All surgeries were carried out by a single consultant having more than 5 years of experience after post-graduation. Blood loss was measured by researcher himself as per operational definition. Results: The mean age of cases in Tranexamic group was 19.70 ± 12.12 years while in control group was 21.53 ± 15.44 years. In Tranexamic acid group there were 18(60%) male and 12(40%) female cases while in control group there were 21(70%) male and 9(30%) female cases. The mean blood loss in Tranexamic acid group were 30.27 ±8.85 ml and in control group was 67.67 ± 14.91 ml. The mean blood loss was significantly less in Tranexamic acid group as compared to control group, p-value < 0.05. Conclusion: The mean blood loos in cases with Tranexamic acid were significantly lower as compared to control group. So in future every patient selected for tonsillectomy must be given TXA to reduce the blood transfusion and related complications of the patients. Keywords: ENT, Tonsillectomy, Bleeding, blood transfusion, Tranexamic acid
Assesment of Quality of Life in Patients Undergoing Hemodialysis in RMI, Peshawar
Authors: Amin Anam , Jamil Mashal , Ahmad Awais , Amjad Aalia , Khan Zarghuna , Khaliq Saad Ul
Published: September 2022

Introduction: Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. It has been affecting the quality of life (QOL), an important parameter which needs to be addressed. This study assessed QOL keeping in view WHO criteria for patients undergoing hemodialysis at Rehman medical institute (RMI). The study also evaluated the effects of various socioeconomic and demographic factors affecting life of such patients. Materials and Methods: A cross sectional descriptive study was conducted by selecting a convenient non-probability sample of 100 patients with chronic kidney disease (CKD) undergoing hemodialysis at Rehman Medical Institute /Dialysis center. The project duration was five months, and during this period data collection was done using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Patients aged 18 years and above and on regular MHD for at least 3 months were included in this study. Patients with cognitive impairment and coexisting diseases such as stroke, chronic obstructive pulmonary diseases, heart diseases, and chronic liver diseases were excluded from the study as these factors could potentially affect their QOL and act as confounding factors. Results: Out of the 100 hemodialysis patients, 51% were men while 49% of the participants were females. 36% of the subjects were above 60 years old. The total score of quality of life was found to be higher in participants <60 years, of higher educational level, being very informed about the health problem, not experiencing difficulties with social or family environment, had help at home. Among them 43% subjects were not happy with their quality of life, only 13% were satisfied. Conclusion: Patients with chronic kidney disease on dialysis had overall low QOL scores in all four domains. Age, education, marital status and gender affected one or more domains of QOL in such patients. Low income status was the only independent negative predictors of QOL of patients on maintenance hemodialysis. Education level is a positive factor for improving QOL of hemodialysis patients. Keywords: quality of life, hemodialysis, WHOQOL-BREF, chronic kidney disease, End-stage renal disease (ESRD).
Anemia in Patients with Ulcerative Colitis in Remission: A Cross-Sectional Study from Pakistan
Authors: Qaisar Muhammad Arsalan , Saleem Sheraz , Ishaque Aishah , Ubaid Muhammad , Javaid Usman , Zaman Muhammad
Published: September 2022

Background and Aim: Anemia is an extra intestinal manifestation of inflammatory bowel disease that frequently causes complications. In inflammatory bowel disease (IBD) such as ulcerative colitis and Crohn’s disease, anemia is mostly caused by iron deficiency which impacts the patient's quality of life [1, 2]. The present study aimed to assess the anemia in ulcerative colitis patients in remission. Methodology: A cross-sectional study was conducted on 82 ulcerative colitis patients at the Department of Medicine and Gastroenterology, Jinnah hospital, Lahore from February 2021 to January 2022. All the patients were assessed for anemia based on Mayo clinical score <3 for at least three months. Hemogram tests such as CBC, vitamin B12 serum levels, ferritin, folic acid levels, concentration of C - reactive protein (CRP), and transferrin were performed for the initial screening. Further, patients were evaluated for the determination of different causes of anemia. Patients were categorized into mild, moderate, and severe anemia cases. Oral iron, intravenous iron, and blood transfusion were given to mild, moderate, and severe anemia patients respectively. SPSS version 25 was used for data analysis. Results: Of the total 82 ulcerative colitis patients, there were 48 (58.5%) male and 34 (41.5%) females. The prevalence of anemia in ulcerative colitis patients and control was 51.2% (n=42) and 11.9% (n=5) respectively. The hemoglobin mean values in UC patients and control was 11.95 g/dL and 13.21 g/dL respectively. Out of 42 ulcerative colitis patients, the prevalence of mild, moderate, and severe anemia was 52.4% (n=22), 35.7% (n=15), and 11.9% (n=5) respectively. Iron deficiency was the prevalent etiology of anemia found in 22 (52.4%) patients followed by chronic anemia disease with iron deficiency found in 8 (21.9%). Hemoglobin level has no association with ferritin level. Hemoglobin level has no association with ferritin level. The hemoglobin level was increased with oral iron and intravenous iron by 1.6 g/dL and 2.3 g/dL respectively. Conclusion: The present study concluded that prevalence of anemia was higher in ulcerative colitis patients. The most common etiology of anemia was iron deficiency in both groups. Increased CRP and moderate activity associated to anemia disease was significantly related with comorbid anemia. Oral iron and intravenous iron could increase hemoglobin levels in ulcerative colitis associated anemia patients. Keywords: Anemia, Ulcerative Colitis, Iron deficiency
Compare the Efficacy of Oral Versus Intravenous Medicine in Treatment of Spontaneous Bacterial Peritonitis
Authors: Khan Sarwar , Inam Tahira , Raja Kapeel , Ali Rahila , Siddique Furhaj Mueen , Fatima Kiran
Published: September 2022

Objective: The purpose of this study is to determine whether or not oral medication is more effective than intravenous medication in the treatment of peritonitis caused by bacteria. Study Design:Comparative study Place and Duration: Department of Internal Medicine Gangaram hospital Lahore and Medical ward, THQ Hospital Dargai, from October, 2021 to March, 2022. Methods: There were 102 cases of both genders having spontaneous bacterial peritonitis because of cirrhosis were included. Included patients were aged between 18-60 years.After taking informed written consent, detailed demographics of enrolled cases were recorded. Patients were equally divided in two groups. Group I received intravenous antibiotic in 51 patients and group II received oral antibiotics in 51 patients. Post-treatment outcomes were compared among both groups. SPSS 22.0 was used to analyze all data. Results: We found that effectiveness in group I was higher 47 (92.2%) as compared to group II44 (86.3%) but not a significant difference observed. Frequency of mortality in group II was 4 (7.8%) and in group I 3 (5.9%). Diarrhea, nausea, vomiting, rashes and gastrointestinal distress were the most common adverse effects in both groups. Conclusion: We concluded in this study that the use of antibiotics orally and intravenously for SBP treatment was affective equally. There was no any significant difference observed in both procedures. Keywords: Cirrhosis, Oral Antibiotics, Intravenous Antibiotics, SBP, Efficacy
Comparison of Various Techniques for Left Ventricular Ejection Fraction
Authors: Khan Asad , Shireen Farhat , Shah Auqib Ghulam , Baig Imran Mehboob , Mateen Muhammad Abdul , Shahid Muhammad
Published: September 2022

Objective: The purpose of this study is to compare the sufficient accuracy of three different techniques of echocardiography for left ventricular ejection fraction. Study Design: Retrospective study Place and Duration: Saidu Group Of Teaching Hospital, Saidu Sharif, Swat, KPK, From September, 2021 to February, 2022. Methods: Total 90 patients of both genders with age 18-70 years were included. All the patients admitted to hospital with complaint of chest pain. After getting informed written consent detailed demographics of enrolled cases were recorded. All of these techniques (M-mode echocardiography, simpson’s biplane mode and global longitudinal strain) were used to measure the left ventricular ejection fraction of patients within a 3-month period that did not include a myocardial infarction or revascularization. SPSS 23.0 was used to analyze all data. Results: We found that 82 (91.1%) were male patients and 8 (8.9%) were females. Mean age of the patients was 53.6±12.47 years and had mean BMI 25.8±11.44 kg/m2. Hypertension was found in 50 (55.6%) cases, followed by dyslipidemia in 35 (38.9%) patients, diabetes mellitus in 23 (25.6%) cases. Cigarette smokers were 15 (16.7%). We found that accuracy of global longitudinal strain was higher for left ventricular ejection fraction than that M-mode echocardiography and simpson’s biplane mode but the difference was insignificant. Conclusion: We concluded in this study use of these three techniques for LVEF was highly useful to diagnose accuracy but global longitudinal strain was showed better accuracy than that of simpson’s biplane mode and M-mode echocardiography. Keywords: Chest Pain, LVEF, global longitudinal strain, M-mode echocardiography, Simpson’s biplane mode, Accuracy
Stage Wise Presentation of Breast Cancer in Patients Aged Less Than 40 Years Verses Age Above 40 Years
Authors: Munir Maryam , Riaz Sara , Sahar Sana , Amin Muhammad , Ayub Munazza , Jan Muhammad Yasir
Published: September 2022

Introduction: Worldwide most common malignancy in females is breast carcinoma and accounts for almost one-third of all women cancers. In developing countries of Asia like in Pakistan, breast carcinoma has the highest incidence. With an age-standardised incidence rate (ASR) of 51.7, and the rate of the new cases of breast cancer is on the rise similar to the Western population. Objectives: The main objective of the study is to analyse the stage wise presentation of breast carcinoma in patients aged <40 years verses age >40 years. Material and methods: This cross sectional study was conducted in Khyber teaching Hospital Peshawar from 2017 to 2020. The data was collected from 200 female patients who were suffering from breast cancer at different stages. The data was collected through a systematically prepared questionnaire after taking consent. Results: The data was collected from 200 female breast cancer patients. Out of which 68 patients were < 40 years and 132 patients were >40 years of age. Majority of patients 90 presented in 41—50 years, followed by 50 cases in 51—60 years and least cases observed in 21—30 years of age. Stage III was the commonest stage in younger patients followed by stage II while in older patients stage ii was common than stage iii. 82 patients presented in stage iii while 70 patients in stage ii. Least cases presented in stage i. 82 patients out of 200 patients presented with stage iii. Overall ductal carcinoma is the most common type of breast carcinoma. Left breast carcinoma is more than right breast carcinoma. Conclusion: It is concluded that breast cancer is more common in older age as compared to young age. In young patients stage iii is more common than stage ii while in old patient’s stage ii is more than stage iii, however overall stage iii has the highest frequency. Keywords: Breast, Cancer, TNM, Factors, Patients
Knowledge Attitude and Practice of Food Handlers Regarding Food Safety Practices District Kohat Khyber Pakhtunkhwa Pakistan
Authors: Khan Muhammad Jibran , . Naeemullah , Khan Nadia , Wazir Anwar Khan , Iqbal Arif , Ishtiaq Muhammad , Khan Said Akbar , Ali Jawad
Published: September 2022

Objective: To assess the knowledge, attitude and practice of food handlers regarding food safety and personnel hygiene practices among the local food handlers of District Kohat Khyber Pakhtunkhwa Pakistan. Methodology: The Department of Community Medicine at the KMU-Institute of Medical Sciences (KIMS), Kohat, conducted a cross-sectional study between December 2021 and May 2022. A cross-sectional study with a sample of n=265 adults was conducted, with a 95% confidence interval and a 5% margin of error. The respondents' food safety knowledge, attitudes, and behaviours were evaluated using a well-designed questionnaire. Data were entered and analysed using SPSS version 26.0. Final results were tabulated and presented. Results: Out of those surveyed, 39.25% were found to have a basic understanding of the written word; 82.648% earned less than 30,000 PKR per month; 58.87% had worked for at least four years; and 67.74% were in the service industry (mostly as cooks and wait staff). In addition, 32.83 percent of those who handled the food had adequate expertise, 90.94 percent had an upbeat mentality, and 47.92 percent followed adequate procedures to ensure the safety and cleanliness of the food they handled. Conclusions: It was concluded that knowledge of food handlers was not up to the standards of food safety and personnel hygiene practices. Moreover, the attitude of food handlers was satisfactory whereas the practice was below the average satisfactory level and thus needs strategies to enhance knowledge, and to improve practices of food handlers regarding food safety to reduce food borne diseases. Keywords: Knowledge, Food Contamination, Practice, Food Handlers, Attitude, Kohat.
Patient Perception for 24 Hours Discharge after Minimal Invasive Gynecological Surgery in Saudi Population
Authors: Mousa Ahmed
Published: September 2022

Same day discharge are considered safe and are cost effective in patient with minimal invasive gynecological surgery. Objectives: To evaluate patient perception of 24 hours discharge after minimally invasive gynecological surgery in selective type of patient depended on specific criteria in Saudi population. Methodology: It is a retrospective study conducted at Dr. Soliman Fakeeh Hospital during 1st January 2016 till 30 December 2019, looking for patient perception of 24 hours discharge after minimal invasive gynecological surgery in Saudi population. Results: Excellent health status was observed in 49.1% of the patients, while 34% been in a good status, and 17% with fair level. Age range of 49.1% was between 25 to 34 years. Almost 84.9% respondents were holding a university degree, 9.4%, 3.8%, and 1.9% had high school, elementary, and intermediate degree, respectively. Women living with their children or grandchildren were 66% while 18.9% were living with other family members, 13.2% living with spouse, and only 1.9% were living alone Conclusions: Same day discharges are associated with a better overall prognosis and patient satisfaction. There are specific criteria to be met before a surgeon determines if a patient is fit for same day discharge. The implementation of same day discharge programs would promote economic benefits, better access to surgical care, and overall greater efficacy. Surgeons should be made aware of the better prognostic implications of same day discharges as well as their impact on patient satisfaction
Quality of Life in Outpatient Primary Hypothyroidism in Riyadh
Authors: Alrudian Naif , Parameaswari P.J. , Alqahtani Rayan , Khawaja Rajab Ali , Alreesh Saleh Emad Abu- , Alkraidis Yaser Saleh , Alhonaizil Abdulaziz Ibrahim , Pathania Deepak
Published: September 2022

Objective: To estimate the Primary Hypothyroidism and to study its effects on the Quality of Life of those patients. Study design: It was a Cross-Sectional Study done using random sampling. Sample size: 463 patients Duration and location of the study: It was done between December 2018 and December 2019 in outpatient clinics of a tertiary care hospital in Riyadh. Study tool: The quality of life of these patients was assessed by World Health Organization (WHO) Health Survey 36-Item Short Form (SF-36) questionnaire with a score less than 50% was considered to be ‘Poor quality’. Results: The response rate of participants was 92.6% and the prevalence of Primary Hypothyroidism was observed to be 47.8%. They experienced a poor mental health with an average score (35.1 ± 1.6). Factors such as illiteracy (35.0 ±1.0), primary level of education (29.4 ± 3.6), housewife (43.49 ± 38.19) and the retired patients (20.31 ± 37.88) had a poor Physical function (P=0.001). However, the patients without primary hypothyroidism had better quality of life with physical, social and mental functional scores (P=0.001). The statistically significant poor quality of life observed due to poor education, income level and marital status exposed the need for the guidelines and management of this morbidity in the Saudi community. Keywords: Primary Hypothyroidism, SF-36, Quality of Life, Cross-Sectional study