bluuebunny/crossref_metadata_2025 huggingface dataset:
Earnings management behavior rural banks: The role of moral character based on religiosity
Authors: Sari Nurshadrina Kartika , Fadah Isti , Hariyati Yuli , Nurhayati
Published: February 2025

The purpose of the study is the impact of moral character based on religiosity on earnings management behavior through the Theory of Planned Behavior (TPB). This study was conducted in Indonesia Rural Bank. The research method uses a quantitative approach with PLS SEM analysis of data collected from 257 Rural Bank Directors in Indonesia. The main results of the study are the moral character based on religiosity significantly influences earnings management behavior both directly and indirectly through TPB. Despite strong moral character based on religiosity, individuals with expertise in accounting policies may still engage in earnings management. Based on the results obtained conclude that regulatory measures alone are insufficient to curb this behavior, a spiritual approach is essential to reinforce ethical business conduct, emphasizing integrity and honesty. This research concludes that building individual commitment through honesty and integrity must come from personal beliefs, by complying with applicable regulations in preparing financial reports in order to create an ethical and moral business environment. The practical implication of this study is the importance of a spiritual approach that emphasizes the values of integrity and honesty in fostering individual commitment, alongside regulatory measures, to establish an ethical and moral business environment in financial reporting management.
Socio-economic factors and personality traits influencing the sustainability of female agri-entrepreneurs in emerging economies
Authors: Tshikororo Mpho , Khorombi Takalani Isaac , Molepo Tebogo Ferdinand
Published: February 2025

Entrepreneurship is the future, particularly for developing economies that are still striving to meet societal needs with the bare minimum of resources. With the urgency of entrepreneurship in South Africa, the study sought to investigate the influence of socioeconomic characteristics and personality traits on the sustainability of women agripreneurs. The study was conducted in the Mopani district of Limpopo province, South Africa. Structured questionnaires were administered to 119 women agripreneurs during face-to-face interviews. Descriptive statistics were used to gain insight into the distribution of socioeconomic characteristics among women agripreneurs. At the same time, a multinomial logistic regression model was used to determine the influence of socioeconomic characteristics and personality traits on the sustainability of female entrepreneurship. The study discovered that the sustainability of women agripreneurs during their start-up phase was significantly influenced by their hard work and resilience traits. At the same time, their traits of innovativeness and independence positively influenced their short-term sustainability. The long-term sustainability of the women agripreneurs was primarily influenced by their willingness to learn, household size, problem-solving, and can-do attitude. The study recommends that potential women agripreneurs be assisted in developing personality traits that enhance their sustainability during different phases of their businesses. The study findings imply the importance of considering the socioeconomic status and personality traits of potential agripreneurs when developing mechanisms to enhance their agribusiness sustainability.
Poverty trends and their determinants in Peruvian households
Authors: Quispe-Mamani Julio Cesar , Hancco-Gomez Miriam Serezade , Aguilar-Pinto Santotomas Licimaco , Ulloa-Gallardo Nelly Jacqueline , Ponce-Quispe Lucas
Published: February 2025

The objective was to analyze the trend behavior of poverty and its main determinants in Peruvian households, between the periods 2019-2023. The Lobit-Binomial type regression model was considered, with a quantitative, non-experimental and correlational approach; data from the National Household Survey was used. During the analysis period, a trend towards increasing poverty in Peruvian households was shown; where the determinants towards the decrease in poverty were the monthly per capita income, the water and sewage service at home, the electricity service at home, the age of the head of the household, the primary educational level, secondary educational level, non-university higher educational level, university higher educational level, has a formal job, location of the home in the natural region of the jungle and the location of the home in the natural region of the mountains; who showed a significant change in these periods. Therefore, before the pandemic (2019), the age of the head of the household explained the decrease in poverty; in the pandemic period (2020-2021), access to the water and sewage service at home determined the decrease in poverty; and in the post-pandemic period (2022 and 2023), the university and non-university higher educational level of the head of the household determined the decrease in poverty.
Conducto deferente ectópico como hallazgo incidental en paciente con asociación VACTERL
Authors: Chaustre Soledad Jose Eduardo , Pérez Valentina , Mejía León Andrés Felipe , Piñeros Nieto Diego Alejandro
Published: February 2025

La ectopia del conducto deferente es una anomalía congénita poco común. Usualmente se encuentra asociada a otras anomalías congénitas anorrectales y del sistema urinario. Puede tener repercusiones como infecciones recurrentes urogenitales. Del conocimiento de la embriología del sistema reproductor y del tracto urinario se logra la comprensión del desarrollo de esta entidad. La yema ureteral surge del conducto mesonéfrico, la falla en la conexión entre estas dos estructuras primitivas lleva a la formación de un conducto deferente ectópico. Se presenta el caso de un paciente de un mes de nacido con antecedente de asociación de VACTERL y ectopia del conducto deferente.
Hernia vesical inguinoescrotal. A propósito de un caso
Authors: Sequea Martínez José Jaime , Caballero Buelvas Diana Carolina
Published: February 2025

Las hernias inguinales con contenido vesical son una entidad rara, usualmente diagnosticada intraoperatoriamente. Se presenta el caso de un paciente masculino de 86 años de edad, quien consultó por síntomas urinarios obstructivos y antecedente oncológico de carcinoma escamocelular de pene; se realizó diagnóstico de hernia vesical inguinoescrotal izquierda, identificada mediante resonancia magnética (RM) de pelvis, la cual fue intervenida quirúrgicamente con evolución posoperatoria satisfactoria.
Evaluación dosimétrica de mamografías 2D y tomosíntesis con imágenes sintetizadas en la Fundación CTIC
Authors: Barbosa Nathaly , Pareja Aura María , Villamizar Karen
Published: February 2025

Objetivos: Debido a la preocupación por el uso de una dosis de radiación mayor en la mamografía con tomosíntesis y las pocas publicaciones sobre las dosis de radiación comparativas entre mamografía 2D y tomosíntesis, se busca demostrar que la mamografía con tomosíntesis e imagen sintetizada no incrementa la dosis frente a una mamografía digital 2D estándar. Material y métodos: Estudio retrospectivo de corte transversal. Los datos incluyen información del paciente, parámetros de adquisición, dosis de entrada y dosis glandular media por proyección, diferenciando entre adquisiciones 2D y tomosíntesis. Resultados: Se documentaron 689 proyecciones mamográficas, de las cuales 367 son de tomosíntesis. Las dosis mostraron similitudes notables entre las técnicas de mamografía 2D y tomosíntesis. Para la proyección CC la dosis promedio fue de 1,48 mGy en adquisición 2D y de 1,45 en tomosíntesis (p = 0,6) y en MLO de 1,63 mGy y 1,58 mGy respectivamente (p = 0,09). Conclusiones: Los valores dosimétricos en la mamografía por tomosíntesis resultaron ligeramente inferiores a los de la mamografía convencional, destacando además la  capacidad de sintetizar imágenes 2D. Se propone la implementación de imágenes sintetizadas como estrategia para optimizar la dosis de radiación en los estudios mamográficos, con la consiguiente mejora en la seguridad y eficiencia de la práctica clínica.
Exploring the Management of Workplace Diversity, Inclusion and Equality - A Glance of Workplace Diversity Management
Authors: Woldeyesus Alemayehu Shiferaw
Published: February 2025

The increasing emphasis on workplace diversity, equity, and inclusion (DEI) has become a key factor in shaping modern
organizational success. As businesses operate in an increasingly globalized and multicultural environment, fostering a
diverse, equitable, and inclusive workforce is essential not only for compliance with social and legal standards but also
for enhancing innovation, performance, and employee satisfaction. This research explores the evolving role of DEI in
the modern workplace, examining its significance, challenges, and the strategies employed by organizations to effectively
manage diverse, equitable, and inclusive environments. The study reviewed existing literature on DEI frameworks and
practices, identified key themes such as leadership commitment, management practices, bias mitigation, and cultural
competence. Additionally, it highlights the impact of DEI initiatives on organizational outcomes, including job satisfaction,
productivity, and retention. Through qualitative and quantitative analysis, the research investigated how organizations can
address barriers to DEI, such as unconscious bias, structural inequities, and resistance to change. By providing insights into
best practices for managing DEI, the research aims to offer actionable recommendations for fostering inclusive workplaces
where all employees could thrive. The findings underscore the importance of a holistic and sustained approach to DEI that
aligns with both organizational goals and societal progress
Práticas gímnicas na educação infantil
Authors: Zaia Thaynara Cristina , Batista Maria Isabel Pedrazzani Montero , Guedes Gustavo Batista da Silva , Ribeiro Gabriel Enrique dos Santos , Villani Brenda Luisa Pires , Gonçalves Pedro Henrique Alves , Toledo Rafael Rodrigues de , Machado Lucas Eduardo da Silva , Pereira João Lucas Gaspar , Manzini Maria Augsuta Bacchin , Sarracini Maycon Rodrigo , Pereira Cynara Cristina Domingues Alves
Published: February 2025

Este estudo tem como objetivo analisar a aplicabilidade das práticas gímnicas na educação infantil. A pesquisa é justificada pela necessidade de ampliar o conhecimento sobre a utilização pedagógica da ginástica nesse nível de ensino, considerando a importância das atividades lúdicas e do brincar para o desenvolvimento infantil. Para isso, foi realizada uma revisão integrativa. As fontes selecionadas foram dos periódicos: Google Scholar, Portal de Periódicos CAPES, LILACS, Movimento Conexões e SCIELO. Utilizamos os descritores: "Ginástica", “Educação Física Escolar” e “Educação Infantil”. Com exceção do SCIELO que os descritores que melhor se encaixam na busca foram “Educação Infantil” e "Educação física”. Foram selecionados estudos de 2019 a 2024.  A seleção baseou-se no título, resumo dos estudos e palavras-chave. Foram selecionados 11 (onze) estudos conforme critérios de inclusão e exclusão. Os critérios de inclusão foram artigos científicos que abordam o tema ginástica e educação física escolar na infância. Foram excluídos estudos repetidos, textos que não se enquadram em artigos científicos, textos que não tratam especificamente da temática ginástica e educação física escolar na infância.  A metodologia permitiu identificar propostas que utilizam elementos lúdicos e culturais para integrar a ginástica à educação infantil, promovendo habilidades motoras, cognitivas, sociais e culturais. Os resultados apontam que o brincar é uma estratégia essencial para introduzir elementos gímnicos, possibilitando uma educação física mais significativa e alinhada aos interesses das crianças. Conclui-se que a abordagem lúdica da ginástica favorece o desenvolvimento integral de aluno no ensino infantil, destacando a relevância de formação docente e projetos interdisciplinares no contexto escolar.
Seitai and Shiatsu as physiotherapy resources for pelvic alignment and relief of lumbar and/or lumbocycal pain symptoms: a pilot study
Authors: Murakami Adriana Emiko , Santos Sérgio Luiz Carlos dos
Published: February 2025

This article studied low back pain affecting humans and can occur in any age group. Within physiotherapy using a manual therapy to effectively treat syndromes such as low back pain. In Seitai and Shiatsu stand out in the treatment of pain, which can restore the balance of the musculoskeletal system, thus restoring the function of bones, muscles and nerves. This was a pilot study, carried out in the city of Paranavaí-PR, with a sample of 19 people. The methodology used was quantitative, with data collection using questionnaires for anamnesis, the Visual Analog Scale and the Oswestry Index. The evaluations were carried out before and after the intervention by a physiotherapist who used the tools of physiotherapy, and by the academic who used the evaluations according to the seitai and Shiatsu techniques. And after the intervention, all participants achieved better pelvic alignment in all axes of motion. The results obtained with the experiment were positive for all the volunteers present, although more research is needed because these are treatment techniques in the evolving phase.
Da floresta à sala de aula: educação ambiental com estudantes do Ensino Fundamental em Ecoporanga – ES
Authors: Rocha Gerliane Ferreira Sant’anna , Cirilo Kelva Ferreira da Rocha , Monteiro Leidiane de Oliveira Dorotea , Damaceno Ivani Vieira , França Juliany Morosini , Santos Vinícius da Silva , Sabino Gérbison Esmero , Magalhães João Paulo Teodoro
Published: February 2025

O bioma Mata Atlântica é reconhecido por sua rica biodiversidade. Entretanto, enfrenta desafios significativos devido à fragmentação e degradação causadas por atividades antrópicas. Em resposta a esse contexto, a educação ambiental foi escolhida como abordagem central, visando cultivar uma nova geração de indivíduos comprometidos com a preservação dos recursos naturais. Neste sentido, o projeto teve como principal objetivo promover a sensibilização sobre a importância da conservação do bioma Mata Atlântica e do Jequitibá rosa (Cariniana legalis). A metodologia foi desenvolvida com estudantes do 9º ano do Ensino Fundamental, com aulas teóricas sobre biodiversidade e preservação, seguidas por uma visita prática a um fragmento florestal, onde os alunos observaram a biodiversidade local e realizaram atividades de medição e observação. Após a visita, foram elaborados relatórios e materiais educativos, e uma palestra com um especialista complementou o aprendizado. O projeto resultou em maior sensibilização dos alunos sobre os impactos das atividades humanas na biodiversidade, além de propostas de ações de preservação, evidenciando a importância da Educação Ambiental na formação de cidadãos comprometidos com a proteção do meio ambiente.
Ensino de Física na perspectiva inclusiva: estratégias contextualizadas e problematizadas para a construção de aprendizagens significativas
Authors: Reis Mazoniel Guedes , Pimentel Elizabeth Tavares , Araújo Monica Dias de , Dias Cleverton Oliveira , Santos Junior Laziomar Martins dos
Published: February 2025

O presente estudo teve como objetivo analisar as práticas contextualizadas no ensino de Física, destacando sua relevância para a promoção de uma aprendizagem significativa e inclusiva. Buscou-se compreender como a integração entre conteúdos de Física e as realidades socioculturais dos estudantes pode contribuir para superar desafios relacionados à abstração excessiva e à exclusão educacional. A pesquisa foi desenvolvida por meio de uma revisão de literatura utilizando a metodologia PRISMA, com critérios rigorosos de inclusão e exclusão. Foram analisados 60 artigos encontrados em bases de dados acadêmicas, resultando em 10 estudos selecionados para discussão. Os resultados apontaram que as práticas contextualizadas, além de facilitarem a compreensão de conceitos complexos, aumentam o engajamento dos estudantes e promovem maior equidade no ensino de Física. Estratégias como o uso de problemas do cotidiano, experimentos simples e tecnologias digitais mostraram-se eficazes para conectar os conteúdos da disciplina às experiências concretas dos alunos. Além disso, essas práticas revelaram-se fundamentais para a inclusão educacional, especialmente para alunos com necessidades específicas ou provenientes de contextos de vulnerabilidade social. Nas considerações finais, destacou-se a necessidade de investimento em formação docente e desenvolvimento de materiais pedagógicos que incorporem a contextualização como eixo central. Também se evidenciou a importância das tecnologias digitais como ferramentas complementares para enriquecer o ensino e facilitar a inclusão. Concluiu-se que as práticas contextualizadas no ensino de Física são uma via estratégica para transformar a aprendizagem, tornando-a mais significativa e alinhada às demandas de uma sociedade plural e em constante transformação.
El origen de la democracia neoliberal en México
Authors: Rojas Gómez Pablo Carlos
Published: February 2025

En la presente investigación se analiza cómo se originó la democracia neoliberal en México. Esto a partir de un método socio-histórico y del reconocimiento teórico de que el concepto de democracia implica una multiplicidad de proyectos políticos que dependen del contenido que le asignan los sujetos sociales. De ese modo, en este trabajo, se caracteriza el proceso mediante el cual tuvo lugar una divergencia conceptual entre distintas perspectivas de democracia, pues de esta emergió triunfadora la democracia neoliberal empresarial, misma que finalmente se consolidó como la forma predominante de organización política y electoral bajo una lógica mercantilista.
Potential Obstacles to Achieve Successful Outcomes Following Stuttering Interventions
Authors: Hassan Alia , Shah Syed Tariq , Saqulain Ghulam
Published: February 2025

Stuttering is a common speech problem affecting all age groups. Speech-language pathologists face barriers in attaining favourable therapeutic results. Identification of these barriers could help attain therapy results. Objectives: To identify the perceived barriers that speech-language pathologists encounter in achieving successful outcomes following stuttering interventions. Methods: The current qualitative study was conducted at Riphah International University from September 2023 to February 2024. A sample of n=10 speech-language pathologists was taken from Rawalpindi and Islamabad using purposive sampling. The sample included qualified speech-language pathologists of both genders, any age, practicing for at least 05 years with clients having fluency disorder. The study involved semi-structured interviews with the option of face-to-face and online interviews using an interview guide. Information obtained was transcribed followed by thematic analysis. Results: The study revealed six major themes including collaborative approaches in intervention and the role of various professionals, Patient engagement and empowerment for successful intervention outcomes, empowering families for effective communication and support in successful intervention, strengthening speech-language pathologists' practices, therapeutic accessibility and holistic approach to stuttering intervention. The findings demonstrated that speech-language pathologists understanding of stuttering especially their unique roles within it, is somewhat restricted due to barriers including i). Diverse perspective held by the speech-language pathologists, ii) Clinical challenges, iii) Systematic and environmental factors and iv) lack of collaboration and support. Conclusions: It was concluded that speech-language pathologists perceive the following main barriers i) Diverse perspectives held by the speech-language pathologists, Clinical challenges, Systematic and environmental factors and lack of collaboration and support.
Prevalence of Tardive Dyskinesia and Its Association with Antipsychotic Drug and Depression in Geriatric Population in Lahore, Pakistan
Authors: Mustafa Maria , Kamal Kanzul , Irsa . , Minahil . , Azam Laiba , Eman Aira
Published: February 2025

“Tardive Dyskinesia” is the subtle onset of rhythmic, stereotype, repetitive movement of the face, mouth, and tongue. The basic pathology behind this disease is hypersensitization of dopamine receptors. Objective: To find out the prevalence of tardive dyskinesia and its association with depression and antipsychotic drug administration in the geriatric population. Methods: A cross-sectional descriptive study was conducted for a period of four months from February 2023 to May 2023. The data were collected from different hospital settings in Lahore. A sample size of 150 elderly individuals aged 55-80 years were included. Depression was evaluated through Geriatric Depression Scale whereas abnormal involuntary movement Tardive Dyskinesia is evaluated through AIMS scale. Chi square test was used to determine the association between variables Depression, Antipsychotic drug and Tardive Dyskinesia. Informed consent and ethical approval were taken from all participants. Results: Out of 150 respondents, 78 (52%) male and 72 (48%) were female. Mean age was 65 years ± 7.21 SD. Among all individuals 20% experienced mild, 42.7% with moderate and 37.3% experienced severe depression.27.3% of the population taking antipsychotic drug experienced Tardive dyskinesia while it was absent in 22.67% of the individuals who were taking antipsychotic drug.20.67% of old individuals with severe depression were with Tardive dyskinesia. Conclusions: It is concluded from above study depression is common among geriatric population. Antidepressant drugs used to treat depression for longer duration because abnormal movement called tardive dyskinesia. There is significant relation of Tardive Dyskinesia with depression and antipsychotic drugs.
Thyrotoxicosis: What is the Cause in Our Population?
Authors: Ali Ashfaq , Khan Sulaiman , Anees . , Hassan Tariq , Mufti Farah
Published: February 2025

Thyrotoxicosis is an endocrine disorder in which excess amount of thyroid hormone is secreted in the blood stream and causes its action at the tissue level. Thyrotoxicosis highly affects the quality of life of patients suffering from the disease in carrying out daily activities. Proper treatment of thyrotoxicosis requires an accurate diagnosis. Objective: To determine the causes of thyrotoxicosis in patients reported for evaluation and management to specialized endocrine unit. Methods: This was a descriptive cross sectional observational study conducted by convenient sampling in Outpatient Department (Endocrinology Clinic) Khyber Pakhtunkhwa in six month’s duration (15th December 2023 to 15th May 2024) having sample size n=118. Thyrotoxicosis was labeled if patient has high T3, T4 (thyroxine and/or triiodothyronine) levels and suppressed thyroid stimulating hormones TSH levels. Information was gathered from the patients regarding their clinical signs and symptoms and anthropometrics. Laboratory investigations of thyroid function tests were obtained and analyzed. Results: The mean age of 118 patients was 40.39 ± 13.69 years, 28% male and 72% female patients were in enrolled in the study. Graves’ disease was most common form thyrotoxicosis making count of 50% of patients followed by toxic adenoma, toxic MNG, thyroiditis 16% and 14 % respectively. Anti-thyroid drugs count 43% of most of the patient’s treatment offered followed by radioactive iodine 28%. Conclusions: In conclusion, the main cause of thyrotoxicosis, includes grave’s disease, toxic adenoma and toxic MNG in Pakistani population. Thyrotoxicosis was more prevalent among female population as compared to males.
Association of Age Shock Index with Mortality among Trauma Patients in the Emergency Department
Authors: Zehra Areej , Khan Inayat Ali , Khan Muhammad , Shaikh Shahid Pervez , Rathore Padma , Irfan Ghazal
Published: February 2025

Trauma injuries cause significant global morbidity and mortality. While current scoring systems like ISS and TRISS are complex, the Age Shock Index (ASI) offers a simpler, potentially more effective method for estimating patient outcomes. Objective: To evaluate the association of Age Shock Index with 48-hour in-hospital mortality in a trauma population in an Emergency Department (ED). Methods: A comparative cross-sectional study was conducted over eight months in the Emergency Department of Ziauddin University, focusing on pre-selected trauma patients aged 18-65 years. Patients were divided into two groups: the exposed group and non-exposed group, with an Age Shock Index (ASI) ≥ 50, and < 50 respectively. Data analysis was carried out using descriptive statistics, the chi-square test, and independent t-tests with the Statistical Package for Social Sciences (SPSS) version 21.0. Results:  Patients with an Age Shock Index (ASI) ≥ 50 had significantly higher 48-hour in-hospital mortality (72%) compared to those with an ASI < 50 (12%) (p < 0.001). The exposed group also received more intravenous fluids, inotropic support, and blood products. No deaths occurred in the emergency room among the exposed group, but a trend towards higher overall mortality was observed (hazard ratio 48.584, 95% CI: 0.511 - 4622.17, p = 0.095). Conclusions: The Age Shock Index (ASI) ≥ 50 is associated with significantly higher 48-hour in-hospital mortality in trauma patients. The exposed group required more intensive interventions, indicating a higher severity of injury. ASI may serve as an effective predictor of patient outcomes in emergency settings.
Assessing the Alkaline Phosphatase Levels as A Bone Biomarker in Gingival Crevicular Fluid during Semi-Rapid Expansion
Authors: Shamim Ahmad , Shaheen Asmi , Azeem Muhammad , Atiq Noman , Hussain Shabbir , Mahmood Shaker
Published: February 2025

In orthodontics, the expansion of the maxilla is done to treat transverse maxillary deficiency in childhood. The cause of maxillary constriction may be genetic or environmental leading to crowding of teeth, cross bite and development of malocclusions. This expansion leads to increased maxillary dimensions. Objectives: To detect changes in alkaline phosphatase level as a bone biomarker in crevicular fluid during the phases of semi-rapid palatal expansion. Methods: Fifteen growing patients with an age range from 8-13 years were selected who needed maxillary semi-rapid palatal expansion as a part of orthodontic treatment. This quasi-experimental study was based on a non-probability purposive sampling technique conducted from August 2023 to July 2024. The samples were collected by inserting paper points in the gingival sulcus. The Periodontal status was evaluated before starting the sampling. The probing depths were recorded at different levels throughout the study until the completion of the retention period. The alkaline phosphatase levels in the gingival crevicular fluid were measured at buccal and palatal sites before, during and in the retention period after treatment. The alkaline phosphatase values were compared using the ANOVA test at different points in time with p<0.05 considered as statistically significant. Results: The ANOVA test showed a statistically significant increase in enzyme activity at different sites throughout maxillary semi-rapid palatal expansion treatment. Conclusions: It was concluded that the enzyme alkaline phosphatase as a biomarker is an indicator of active bone metabolism in growing children while going through the maxillary semi-rapid palatal expansion treatment.
Effectiveness of Cognitive Behavioral Techniques for Diabetes Distress in Patients Presenting With Diabetes Related Distress at a Tertiary Care Hospital
Authors: Mahmood Salahudin , Fatima Iqra , Khan Shahzad Alam , Ahmed Mamoon , Zubair Fatima , Arshad Fatima , Tahir Muhammad
Published: February 2025

Diabetes-related distress is a common psychological issue among diabetic patients, often affecting their ability to manage the condition effectively. Objective: To determine the effectiveness of cognitive behavioral techniques for diabetes distress in patients presenting with diabetes related distress at a tertiary care hospital. Methods: This study was conducted in the General Medicine Department at Nishtar Medical University and Hospital, Multan, a tertiary care hospital, over a period of 12 months. It was a Quasi Experimental Study. Sample size was 64 patients with diabetes related distress, (32 in each group) calculated by using sample size formula for comparing two proportions. Sampling technique was non probability consecutive sampling. Results: The mean age of patients experiencing diabetes-related distress was 51.45 ± 8.34 years, with an age range of 37 to 65 years. Among the 64 participants, only 20 (31.3%) had controlled diabetes, while 41 (64.1%) had uncontrolled diabetes. Efficacy was observed in 23 (35.9%) of the study cases. Specifically, 17 (53.1%) participants in group an exhibited efficacy, compared to 6 (18.8%) in group B (P=0.004). Conclusions: The findings of the study supported cognitive behavioral techniques for the management of diabetes related distress as these techniques were found effective and reliable in the management of diabetes related distress. Effectiveness of therapy was significantly higher among experimental group as compared with control group.
Endometrial Hyperplasia on Rising Trends among Peri-Menopausal Women
Authors: Tabassum Shagufta , Aziz Amna , Suman Faiza
Published: February 2025

Endometrial hyperplasia demonstrates a uterine pathology characterized by a range of endometrial morphological remodeling. The clinical importance of endometrial hyperplasia lies in its progression to endometrial carcinoma. Objectives: To analyze histopathological findings of endometrial biopsy in perimenopausal women having abnormal uterine bleeding and to observe the correlation of various risk factors with endometrial hyperplasia. Methods: The cross-sectional study was conducted at the Department of Gynaecology, Nishtar Medical University, Pakistan. Two hundred and fifty-five perimenopausal women having abnormal uterine bleeding of 3-12 months’ duration were included. The participants were subjected to histopathological analysis of endometrial biopsy obtained by dilatation and curettage. All the information and the histopathology report were entered on a specific proforma. Data analysis was performed using SPSS software version 26.0. Results: Out of a total of 255 patients, the mean age was 48+/-6 years. A vast majority was grand multiparous (n=163, 64%). Out of a total of 255 endometrial samples, the majority (n=88, 34.5%) turned out to be proliferative endometrium, indicating hormonal imbalance like unopposed estrogen stimulation. In total, 66 (25.9%) samples fulfilled the criteria of endometrial hyperplasia. 54 (21.7%) had endometrial hyperplasia without atypia, while 12 (4.2%) had atypical endometrial hyperplasia. Regarding atypical uterine bleeding, the commonest symptom was heavy regular cycle (n=74, 29%) followed by irregular vaginal bleeding (n=70, 27.5%). Conclusions: It was concluded that atypical uterine bleeding in the peri-menopausal life period is alarming. All such women should undergo endometrial histopathological examination to detect endometrial hyperplasia to prevent its progression to endometrial carcinoma.
Corneal Endothelial Cell Loss after Cataract Extraction by Phaecoemulsification versus Conventional Extra Capsular Cataract Extraction Technique
Authors: Khoso Ayaz Ali , Pirzado Imran Ali , Bhutto Shabeer Ahmed , Gopang Zakaullah , Kandhro Prince Aakash Gul , Azam Muhammad
Published: February 2025

A cataract is a condition affecting the eye in which the lens, previously clear, has developed cloudiness and flexibility, obstructing the passage of light. This condition progressively deteriorates and is a significant contributor to global blindness. A cataract is identified through a thorough examination of the pupil using a torch light and a slit lamp, both in dilated and non-dilated states. In 1967, Charles Kelman introduced phacoemulsification, an innovative surgical technique for the treatment of cataracts. Objective: To compare the corneal endothelial cell loss after cataract extraction performed with conventional extra capsular cataract extraction versus standardized Phacoemulsification. Methods: Non-randomized clinical trial study was conducted at Department of Ophthalmology, Chandka Medical Hospital Shaheed Mohtrama Benazir Bhutto Medical University Larkana in time frame of six months by using probability consecutive sampling technique. Data analysis was performed by using SPSS version 24.0. The Chi-square test was utilized for cross-tabulation. Results: In comparison to individuals receiving ECCE, those undergoing PHACO tended to be younger and exhibited a greater proportion of females. While the PHACO group consistently exhibited a higher endothelial cell count during all post-operative intervals, both techniques led to a significant decrease in the number of endothelial cells observed post-operation. Conclusion: The present study supported the common understanding that phacoemulsification is linked to a significantly reduced incidence of endothelial cell loss.
Autoimmune Hemolytic Anemia in Children: Clinical Profile and Outcome
Authors: Ali Kamran , Ahmed Bakhtiar , Bharo Mumtaz Ali , Khuhro Asif , Bahalkani Ubedullah , Kamran Faiza
Published: February 2025

Autoimmune Hemolytic Anemia (AIHA) is an idiopathic condition marked by red blood cell destruction. Objective: To compare the clinical features, laboratory parameters, treatment approaches, and responses between idiopathic and secondary AIHA in pediatric patients, with the aim of identifying key distinctions that can inform the development of tailored diagnostic and therapeutic strategies. Methods: This was cross sectional study and conducted for six months from April 2024 to September 2024 at Department of pediatrics at Khairpur medical college khairpur mirs. Data were collected on demographics, presenting symptoms, laboratory findings (hemoglobin, bilirubin, LDH levels), antibody profiles, and treatment outcomes. SPSS 23 was used for statistical analysis to compare treatment responses and clinical characteristics between idiopathic and secondary AIHA patients. Chi-square tests were used for categorical variables and t-tests for continuous variables. Results: The mean age of participants was 6.8 years, with 58% male. Patients with idiopathic AIHA had higher hemoglobin levels (7.5 g/dL versus 6.9 g/dL for secondary, p=0.03) and lower bilirubin (3.6 mg/dL versus 4.1 mg/dL, p=0.02). Treatment varied significantly: 89% of idiopathic patients received steroids compared to 86% of secondary patients. Secondary patients were more likely to receive IVIG (51% versus 34%, p=0.04) and rituximab (37% versus 11%, p<0.01). Complete response rates were higher in idiopathic AIHA (83% versus 63%, p=0.01). Conclusions: Significant differences exist in the clinical presentation and treatment responses of idiopathic versus secondary AIHA. Tailored treatment strategies on AIHA type are essential for improving patient outcomes, warranting further research into these distinctions and new therapies.
Knowledge and Practices of Breast Self-Examination among Female Students of Bahria University of Health Sciences Karachi
Authors: Tanwir Farzeen , Razzaq Abida , Ijaz Bushra , Bibi Tauqeer , Hafeez Nabeel , Gulzada Muhammad , Fahim Muhammad Faisal
Published: February 2025

Breast Self-Examination is an efficient approach for investigating physical and visual abnormalities in breast tissue. Objective: To evaluate the awareness, knowledge, practice of breast self-examination among female university students in five colleges of Bahria University Health Sciences Karachi. Methods: A cross-sectional study at Bahria University Health Sciences Campus Karachi with random sampling among female students from the Dental, Medical, Doctor of Physical Therapy, Nursing sections and Medical Laboratory Technicians. The data were collected using a self-administered google questionnaire form distributed online via WhatsApp. The questionnaire encompassed sections on the socio-demographic characteristics of the participants, as well as their awareness, knowledge, attitude, and practice towards BSE. For data analysis SPSS Software version 25.0 was used. Results: 240 female participants were enrolled in study, 77.5% knew the meaning of BSE, while 31.7% had complete knowledge. 5.4% BDS students did it in routine practice, 63% believed, it helps in cancer monitoring, 22.8% performed to detect nodules and 8.7% carried out because of family history. Out of 110 participants from nursing section, 7.3% followed BSE in routine practice, 65.5% believed it’s beneficial in the detection of cancer. However, the main reason for performing was detection of cancer 62.9%. Several barriers were encountered such as time constraint, lack of knowledge 46.7%, uncomfortable 6.7%, fear 30.4% and misconception. Conclusions: Participants had understanding of BSE but they lacked complete knowledge of breast self-examination due to limited access to health care resources and insufficient understanding about the technique also encounter significant barriers during practicing.
Prospective Study on the Incidence of Hospital Acquired Infections in Intensive Care Unit
Authors: Hayee Phulpoto Abdul , Aziz Asif , Memon Abdul Qayoom , Channa Munir Ahmed , Pervez Safdar Ali , Ramani Ratan Kumar
Published: February 2025

Hospital-Acquired Infections (HAIs) in the ICU significantly impact patient morbidity, mortality, and length of stay. Objective: To determine the incidence of HAIs, identify key risk factors, and analyze their impact on clinical outcomes in ICU patients. It was prospective observational study. Methods: A total of 220 ICU patients were included. Data on demographics, ICU stay duration, device use (e.g., central lines, ventilators, urinary catheters), comorbidities, and infection control practices were collected. HAIs were diagnosed based on CDC definitions and categorized as Ventilator-Associated Pneumonia (VAP), Central Line-Associated Bloodstream Infection (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), and Surgical Site Infections (SSI). Incidence rates were calculated using descriptive statistics, and risk factors were identified through multivariate logistic regression. Results: Results showed that 150 (68.2%) patients developed HAIs, with VAP being the most common (30%), followed by CAUTI (16.7%), CLABSI (20%), and SSI (13.3%). Independent risk factors for HAIs included ventilator use (p<0.001), prolonged ICU stay (p=0.004), and use of urinary catheters (p=0.002) and central lines (p=0.003). Patients with HAIs had higher mortality (30% vs 12%, p=0.003) and longer ICU stays (21 days’ versus 12 days, p<0.001). Conclusions: HAIs are frequent in ICU patients, particularly VAP. They significantly increase mortality and prolong ICU stays, highlighting the need for enhanced infection control practices, especially for patients with extended ICU stays or those requiring invasive devices.
Frequency and Pattern of Retinopathy in Newly Diagnosed Type 2 Diabetic Patients
Authors: Mehmood Faisal , Mazhar Syed Abdullah , Farooq Nesr , Afzal Muhammad Awais
Published: February 2025

Diabetic Retinopathy (DR) is among the leading causes of blindness in adults, particularly in individuals with type 2 Diabetes Mellitus (T2DM). Diabetic Retinopathy (DR) is one of the commonest reasons for blindness in the adult population especially in the type 2 Diabetes Mellitus (T2DM) population. It is important to detect and manage these diseases early to prevent vision loss. Objective: To evaluate the prevalence and pattern and the associated risk factors of Diabetic Retinopathy (DR) in newly diagnosed T2DM. Methods:  The study design was descriptive cross-sectional which was conducted at Arif Memorial Teaching Hospital/Rashid Latif Medical College, Lahore. The study enrolled 300 participants (age≥35 years) with newly diagnosed T2DM. After a general and systemic examination, data were collected, including laboratory data with blood glucose, HbA1c, serum cholesterol, and serum creatinine. Retinopathy grading was performed by fundoscopic examination into background, pre-proliferative and proliferative grades. The statistical analysis was performed in SPSS version 23.0. Results: In newly diagnosed T2DM, the overall prevalence of DR was 22% (66/300). Among cases of DR, 78% were NPDR, and 22% were PDR. Most of the NPDR was moderate (43%), mild (35%) and severe (22%). DR risk factors were HbA1c > 8% (OR: 3.5, p < 0.001) and hypertension (65% DR, p < 0.05). DR was not significantly correlated with BMI and other biochemical markers including serum creatinine. Conclusions: The prevalence of diabetic retinopathy was notably high among newly diagnosed T2DM patients, with HbA1c levels and hypertension identified as significant risk factors.
Impact of Dengue Fever on Pregnancy Outcomes: A Prospective Observational Study
Authors: Zubair Muhammad , Azmat Saddiqa , Malik Muhammad Khan , Khan Rida Ajmal , Asghar Sadia , Shahwar Durr E
Published: February 2025

Dengue in pregnancy has a profound negative impact on both maternal and fetal outcomes, leading to increased maternal and neonatal mortality. Objective: To evaluate the maternal and fetal outcomes in pregnant women affected by dengue fever. Methods: A prospective observational study was carried out at Niazi Welfare Foundation Teaching Hospital, Sargodha. Non probability convenient sampling technique was used to collect data from 36 pregnant women enrolled after confirming dengue infection through NS-1 and IgM/IgG tests. Maternal and fetal outcomes were monitored throughout pregnancy, labor, and the postpartum period. Data was analyzed using SPSS version 26.0 and presented in frequency and percentages. Results: Fetal complications observed in this study were, preterm delivery in 16 cases (44.4%), term delivery in 14 cases (39%), fetal growth restriction in 8 cases (22%), and intrauterine death in 6 cases (16.6%). Maternal outcomes included, postpartum hemorrhage in 6 cases (16.6%), 7 infected women (19.4%) were admitted to the ICU, and two mothers (5.5%) died. The frequency of neonatal admission to the NICU was 30.5%. Conclusions: Dengue infection in pregnancy is linked to heightened risk of maternal and perinatal morbidity and mortality. Timely clinical interventions are necessary to avoid devastating consequences.
Importance of computed tomography for identifying the second mesiobuccal canal in endodontic procedures: a systematic review of clinical studies
Authors: Grotto Renata Aparecida , Oliani Fernanda Alves de Souza , Sant'Anna Junior Arnaldo
Published: February 2025

Introduction: Endodontists must have detailed knowledge of the typical anatomy of the dental structure and the atypical forms of external and internal root canals. The first permanent maxillary molar and the second permanent maxillary molar are the teeth with the greatest complexity of root canals, presenting higher rates of endodontic failure. Cone beam computed tomography (CBCT) has made it possible to visualize anatomical structures that are difficult to access in three dimensions, and has become a valuable aid as a complementary examination for endodontic diagnosis and treatment. Objective: This study aimed to address the main considerations and outcomes of clinical studies on the use of cone beam computed tomography in the identification and treatment of second mesiobuccal canals. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to November 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 14 articles were evaluated in full and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 46 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=91.5%<50%. Results and Conclusion: It was concluded that endodontic treatment success can be increased and clinicians’ time can be saved by using the newly developed AI-based models to identify variations in root canal anatomy before treatment. Patient gender, tooth type, and treatment modality play essential roles in identifying the MB2 canal. Furthermore, the availability of preoperative CBCT images was associated with a greater ability to localize the MB2 canal. Understanding the incidence of MB2 canals and the distribution pattern of canal orifices in the pulp floor can help clinicians quickly identify and locate MB2 canals.
Sexualidad y Estado: un análisis crítico desde la comunicación
Authors: Rodríguez Rojas Mirtha Concepción
Published: February 2025

Este estudio analiza los ejes temáticos comunicacionales del Plan Nacional de Salud Sexual y Reproductiva 2014-2018 del Ministerio de Salud Pública y Bienestar Social (MSPBS), abarcando el periodo de enero de 2014 a junio de 2017. La investigación se diseñó como un estudio no experimental, descriptivo y cualitativo, que incluyó el análisis de siete trípticos, dos afiches, una calcomanía, siete artículos en la web, siete publicaciones en Facebook y entrevistas con tres informantes clave. Uno de los hallazgos más significativos revela una línea discursiva centrada en la función reproductiva de la sexualidad, sin hacer referencia a un concepto integral que contemple el bienestar y el placer. Se concluye que los rasgos fundamentales de la comunicación del Plan Nacional de Salud Sexual y Reproductiva son, su enfoque biologicista y de riesgo, priorizando la profilaxis y la planificación familiar. Aunque se promueve el derecho a la salud sexual y reproductiva, esto no se complementa con programas y servicios de salud adecuados. El discurso sobre el derecho a la salud contrasta con el ocultamiento de segmentos importantes de la población. Además, aspectos críticos como la igualdad de género y su relación con la salud sexual y reproductiva no son encarados con profundidad.
Francisco Gaona, su invaluable ejemplo
Authors: Coronel Prosman Jorge
Published: February 2025

Francisco Gaona, considerado el creador de la Historia Social del Paraguay, fue un destacado militante sindical y documentalista de principios del siglo XX. Desde su juventud como profesor rural hasta su muerte en el exilio en 1980, dedicó su vida al activismo sindical y a la documentación meticulosa del movimiento obrero paraguayo. Participó activamente en las luchas sindicales de su época, enfrentándose tanto al gobierno como a las tendencias revisionistas de la historia. Su mayor legado es el Archivo Gaona, una vasta colección de documentos sindicales, y su obra "Historia Social y Gremial del Paraguay" publicada en tres tomos. Actualmente, existe una necesidad urgente de digitalizar este valioso archivo para preservar esta parte crucial de la historia paraguaya.