bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the Effect of Hypnotherapy on Reducing Anxiety and Pain during Labor
Authors: Sahour Anahita , Fakhri Mohammad Kazem , Pourasghar Mahdi
Published: December 2024

Background: Majority of women go through levels of anxiety during pregnancy. In this respect, anxiety and fear of labor pain are among the most common causes for elective Cesarean-section as a preferred type of childbirth by pregnant women. However, Caesarean-section delivery as a surgical technique can be accompanied by adverse side effects and outcomes for mother-infant health. Thus, the use of non-pharmaceutical approaches moderating anxiety and pain during labor can be beneficial in promoting the health status of mothers and babies. Accordingly, the purpose of the present study was to investigate the effect of hypnotherapy on reducing anxiety and pain during labor among pregnant women.

Methodology: This study was an experimental research with a pre-test/posttest design comprised of experimental and control groups. Among the pregnant women referring to hospitals affiliated to Social Security Organization in Mazandaran Province, 30 nulliparous pregnant women with gestational age of 27-33 weeks were selected via convenience sampling method and then they were randomly designed to experimental and control groups of 15 individuals. The research instruments in this study included the Spielberger State-Trait Anxiety Inventory (STAI), McGill Pain Questionnaire (Index), as well as the Standard Numeric Rating Scale (NRS) and Visual Analogue Scale (VAS). In addition to routine prenatal care for pregnant women in the experimental group, hypnotherapy was used for 8 sessions to reduce prenatal anxiety and then it was employed to moderate pain during labor as an analgesic. However, the control group only received routine prenatal care. The data were also analyzed using the SPSS software (version 25) and parametric test of Covariance (ANCOVA); independent t test and nonparametric U Mann Whitney

Findings: Comparing the post-test state-trait anxiety in both control and experimental groups, it was found that hypnotherapy could reduce anxiety in pregnant women in the experimental group. Furthermore; comparing the variable of pain in the experimental and control groups revealed that the mean score of pain in the experimental group was lower than the significance level (p-value<0.00).

Conclusion: It was concluded that hypnotherapy was effective in reducing anxiety and pain during labor and it could be used as a non-pharmaceutical approach during pregnancy and childbirth care.
A New Method for Routing in Home Health Care Services
Authors: Çolak Recep , Işik Ali Hakan , Yiğit Tuncay
Published: December 2024

Home Health Care Service (HHC) is a continuously growing new model in the healthcare sector. In HHC, patients are treated in their homes rather than at a healthcare provider. Treatment of patients in their own homes reduces health expenditures and increases the patient satisfaction at the same time. In HHC, the patients to be visited during the work day are determined in advance, necessary visits are made to the patient addresses, and treatment and care are provided to the patients at home. In this study, it was demonstrated that HHC problem can be solved by modelling it in a manner similar to Capacity Restricted Vehicle Routing Problem (C-VRP). In the new model obtained, the vehicles included in C-VRP, healthcare teams, the number of vehicles on hand, the number of healthcare teams active, customer addresses, patient addresses, vehicle capacity, daily working time of healthcare workers, the amount of load to be delivered to the customer, time to be spent for patient care or treatment at patient addresses were all included. Then, the obtained model was tried to be solved by using a heuristic approach. Experimental studies have shown that it is possible to prepare routes for patient visits in a way that does not exceed the daily working time of health workers.
Application of Non-Relational Databases in the Social Networks
Authors: Dechev Miroslav , Galabov Miroslav , Georgieva-Trifonova Tsvetanka
Published: December 2024

The purpose of this research is to present knowledge in the field of work of databases that contain semi-structured data, also known as NoSQL, in applications using large array data structures. The characteristics of the main categories of the non-relational databases and some of their typical representatives (MongoDB, Redis) have been reviewed from the point of view of using them for saving and analysis of data in the social networks. The article presents a study, conducted on the already existing studies in regards to the implementation of the non-relational databases in social networks. Some of the perspectives of the future research are outlined as well.
A Comparative Study on the Risk Factors of Musculoskeletal Disorders among Laparoscopic Surgical Technologists in Circulatory and Scrub Roles
Authors: Shahijani Golchin , Ghadami Ahmad , Shakerian Mahnaz
Published: December 2024

Background: Musculoskeletal disorders are of the most important occupational injuries and diseases, in which the work environment and individual activities play an essential role in their prevalence. Since laparoscopy has become a preferred approach to treating many of the actions, the aim of this study was to determine the risk factors of musculoskeletal disorders among laparoscopic surgery technologists and comparing them between circulatory and scrubbing roles. Materials and Methods: In this descriptive-analytical cross-sectional study, 49 participants were evaluated by REBA method in Al-zahra Hospital, Isfahan, Iran, 2017. Data was collected through REBA form and analyzed using SPSS software version 20. Results: 94% of our samples were women mostly married with an age range of 32/17 years. The prevalence of musculoskeletal disorders was 98.87% with a mean overall risk of 7.2 ± 0.75 in the role of circulatory and 5.31 ± 0.63 in the role of scrub. Conclusion: Considering the fact that surgical technologists are at risk due to the nature of their job and to promote their health, ergonomic interventions are critically suggested for equipment, tools and environments as well as including ergonomics in their educational curriculum and regular exercise programs.
University Teachers Plagiarism - A Preliminary Review of Research
Authors: Ghiațău Roxana Maria , Mâță Liliana
Published: December 2024

The purpose of this paper is to explore three different themes within university teacher plagiarism via the use of a systematic literature review: definition of concepts, the relationship between Information and Communication Technologies and university teacher plagiarism and the attitudes and perceptions regarding university teacher plagiarism. The motivation of the research is related to the fact that there is a very comprehensive literature on plagiarism in general, but rather limited literature on university teacher plagiarism. Teachers are role-models; hence, their actions and attitudes are often assumed by students. The data composing the present literature review were extracted from one of the databases very frequently used in Romania: Springer Link. A literature search in this database was performed using the following keywords: “teacher plagiarism” and “researcher plagiarism “. We found that the concept of university teacher plagiarism does not exist as such, and authors support a unique delimitation, irrespective of context. The least represented domain is that related to ICT and university teacher plagiarism, which urges for an immediate approach to this topic by means of empirical studies.
Relationship of Obesity on Self-esteem and Academic Performance Among Undergraduate Students
Authors: Mansoor ul Haque  , Muhammad Ilyas Siddiqui  , Parveen Akhtar  , Aisha Shaoowal  , Husan Bano Channar  , Tasleem Akhtar
Published: December 2024

Introduction: Overweight is a major global health concern that has a wide-ranging impact on people's life, particularly physical health, psychological wellness, and academic achievement. Obesity can have a substantial impact on under graduates’ physical well-being, self-esteem, and their academic achievement. Material and Methods: A comparative cross-sectional research was carried out at Liaquat University of Medical & Health Science Jamshoro. Subjects of the study were Students of BS Nursing (Generic), Doctor of Pharmacy and Doctor of Physiotherapy, both males and females were included, and the sample size was 351. The Questionnaire was used as a data collecting tool consisting of three sections. Section One Demographic variables. Section 2 consists of Academic Performance Scale while Section 3 consists of Rosenberg Self-esteem Scale. Results: Data was analyzed by statistical package for social sciences version (SPSS) 23 Latest version. among351 undergraduate students. The mean age was 21.6 years, 34.8% females and 65.2% males. There was a significant association between self-esteem and BMI, with low self-esteem linked to higher BMI (p=0.016). Conclusion: Study revealed a significant association between BMI and academic performance, with students performing excellently more likely to have lower BMI and poorer academic performance association with higher BMI.
A BRIEF COMPARATIVE OVERVIEW OF THE TYPES OF RAIL LINES AND METRO TRACKS
Authors:   Azerbaijan State Oil and Industry University, TURABOV A E , HASHİMOV KH KH ,   Azerbaijan State Oil and Industry University
Published: December 2024

The article presents a brief and comparative overview of the technical and operational rail lines used in the Baku Metro. The principles of schemes and rules for fixing rail lines on wooden sleepers and on concrete foundations, as well as their advantages and disadvantages, are described. It is established that relative to the construction with "metro" type fasteners, the path on the concrete structure is characterized by a low intensity of deviations. It is also shown that the main defects of the it stops alow structure can be associated, firstly, with the lack of restriction of the vertical degree of freedom of the rail (terminals), as a result of which the contact points of the fastening elements experience increased wear, and secondly, with rotting, shrinkage and deformation of wooden sleepers. All the described defects are massive in nature and lead to a large number of deviations in the current content of the GRK, including deviations that require limiting the speed of trains.
NEUTRAL MODES OF 110 KV AND HIGH VOLTAGE NETWORKS
Authors:   Azerbaijan State Oil and Industry University, ALIYEV I H
Published: December 2024

Due to its high technical and economic advantages, the appropriateness of the effective and deep penetration grounding of the neutral in electrical installations of 110 kV and higher voltage has been determined. It was determined that the overvoltages in such devices are lower than in networks with neutral insulation (2.5Un, does not pass), and therefore the cost of insulation of lines and devices is much lower than in networks with neutral insulation. It is suggested that to reduce the single-phase short-circuit current, it can be done by abandoning the third winding, isolating the neutral and finally increasing the total resistance by introducing an additional reactive resistance in the zero-sequence circuit.
ANALYSIS OF THE INFLUENCE OF VOLTAGE ASYMMETRY IN ELECTRICAL NETWORKS ON THE OPERATION OF ELECTRICAL DEVICES
Authors:   Azerbaijan State Oil and Industry University, HAMIDOV M H , KARIMOV A O ,   Azerbaijan State Oil and Industry University
Published: December 2024

When we say asymmetry in electric networks, it means that the distribution of voltage and current on phases is not equal. One of the main reasons for this is due to the incorrect distribution of single-phase consumers in 0.4 kV supply networks by phases according to the load. In all cases, asymmetry causes uneven heating, lighting and mechanical torques in the windings and other elements of 3-phase electrical equipment. This, in turn, lowers the quality indicator of electrical equipment, and also leads to a shortening of their service life and, as a result, an increase in the rate of depreciation.
RESEARCH OF THE ISSUES OF LOSS REDUCTION BY COMPENSATING REACTIVE POWER IN ELECTRICAL NETWORKS
Authors:   Azerbaijan State Oil and Industry University, SADIGOVA N R , GANBAROV S F ,   Azerbaijan State Oil and Industry University
Published: December 2024

Despite the use of various methods and techniques for compensation of reactive power, this power flow maintains its presence in the network. The article discusses the issue of voltage regulation by changing the flow of reactive power transmitted along the line.For this purpose, capacitor batteries (CB) were connected to the phase of the line in series, measures to reduce the voltage losses in the lines by compensating the inductive reactance were evaluated. It has been determined that by reducing the current in network elements it is possible to significantly reduce the cross-section of lines.
CURRENT SITUATION OF WIND ENERGY IN THE WORLD AND IN AZERBAIJAN MODERN PROBLEMS CHARACTERISTICS AND NEW PROJECTS
Authors:   Azerbaijan State Oil and Industry University, NAZERLI A R , YUSIFBEYLI N A ,   Azerbaijan State Oil and Industry University
Published: December 2024

This article provides information on the current state of wind energy in the world and in Azerbaijan, the problems related to wind energy and their solutions, the steps taken and planned to turn wind energy into a more promising type of renewable energy, and new types of projects. The article also touched on the characteristics of wind energy and how important it is for future electricity production.
CALCULATION OF STARTING CHARACTERISTICS OF A TWO-ROTOR ENGINE
Authors:   Azerbaijan State Oil and Industry University, SHIKHALIEVA S Y
Published: December 2024

In the presented article, blocks of the Simulink subpackage of the special MATLAB program were used to calculate the starting characteristics of a two-rotor engine and extract the operating characteristics. The goal is to create a functional block that allows you to simulate the operating modes of electrified mechanisms with active and reactive moments of static resistance both during engine movement and when stopping. It can be determined that the designed machine meets high specifications, the operating process is close to the reference, and the performance indicators correspond to natural characteristics compared to a standard engine. For this reason, a standard motor design was completed with parameters P = 15 kW, Un = 220/380 V, p = 2, and all its parameters and characteristics were accurately calculated. For comparison, a three-phase precision standard asynchronous motor of the 4A series is taken.
The 10th Annual Open Source Jobs Report: Critical Skills, Hiring Trends, and Education
Authors:   The Linux Foundation
Published: December 2024

According to 93% of the hiring managers surveyed, open source talent is increasingly difficult to find. As a result, companies are now turning towards training their staff in new cloud automation, orchestration, and developer productivity tools to close that gap as much as possible – and where they cannot train their staff or find adequate new hires, they’re hiring consultants to avoid delaying important projects.

This year the Linux Foundation once again teamed up with edX to produce the 10th Annual Open Source Jobs Report to shed light on these changes and challenges. This year’s study, which is the most comprehensive yet, includes survey findings and analysis generated from more than 1,900 open source professionals, in addition to 500 individuals with responsibility for hiring such professionals.

In addition to our findings on employee retention, the report contains practical information on the state of open source talent that employers may use to guide their hiring, training, and diversity awareness efforts. It also provides IT professionals with clear, unbiased insights on which skills are most marketable.
Artificial Intelligence and Data in Open Source
Authors: Haddad Ibrahim
Published: December 2024

Artificial intelligence (AI) is no different from any other technology domain where OSS dominates. As with other industries, OSS adoption in the AI field has increased the use of open source in products and services, contributions to existing projects, the creation of projects fostering collaboration, and the development of new technologies.

Artificial Intelligence and Data in Open Source reviews critical challenges in the open source AI ecosystem, discusses common characteristics across AI and data projects, and presents the role of the LF AI & Data Foundation in empowering innovators and accelerating open source development.
Optimalisasi Penerapan Sanksi Administratif Melalui Pendekatan Partisipatif dan Kolaboratif
Authors: Ihsanul Maarif
Published: December 2024

Penerapan sanksi administratif di Indonesia menghadapi berbagai tantangan, termasuk rendahnya tingkat kepatuhan, persepsi ketidakadilan, dan kurangnya efektivitas regulasi. Pendekatan tradisional yang cenderung retributif sering kali tidak mampu menciptakan penegakan hukum yang adaptif dan berkeadilan. Penelitian ini bertujuan untuk mengembangkan model sanksi administratif berbasis pendekatan partisipatif dan kolaboratif yang lebih responsif terhadap kebutuhan masyarakat dan pemangku kepentingan. Menggunakan metode penelitian hukum normatif, penelitian ini menganalisis peraturan perundang-undangan, doktrin hukum, dan praktik terbaik dari berbagai yurisdiksi melalui pendekatan perundang-undangan, konseptual, dan komparatif. Hasil penelitian menunjukkan bahwa integrasi pendekatan partisipatif dapat meningkatkan legitimasi kebijakan melalui keterlibatan masyarakat dan sektor swasta dalam proses perumusan dan implementasi sanksi administratif. Sementara itu, pendekatan kolaboratif terbukti efektif dalam memperkuat transparansi dan akuntabilitas melalui mekanisme evaluasi berbasis data dan sistem pengawasan lintas sektor. Pengembangan model yang adaptif, berkeadilan, dan akuntabel ini tidak hanya mendorong tingkat kepatuhan, tetapi juga meningkatkan kepercayaan publik terhadap sistem hukum administrasi. Implikasi penelitian ini memberikan kontribusi penting bagi pengambil kebijakan dalam merancang sistem hukum administrasi yang progresif, dengan mengedepankan inklusivitas, efisiensi, dan keberlanjutan. Rekomendasi berbasis bukti yang dihasilkan diharapkan dapat menjadi landasan dalam penguatan tata kelola hukum yang lebih demokratis dan berorientasi pada kebutuhan masyarakat modern.
Antimicrobial Resistance Pattern of Pseudomonas Aeruginosa Specie in Patients of Shaikh Zayed Hospital Lahore Pakistan
Authors: Muhammad Roman  , Atif Ahmad khan  , Husnul Hayat  , Abdul waheed  , Muhammad Nadeem  , Naveed Abbas Akhtar  , Shah jahan  , Hafiz Ullah Khan
Published: December 2024

Background: Pseudomonas aeruginosa is gram negative rod, motile, and an aerobic bacterium. It is the leading cause of opportunistic Nosocomial infections. It is a typical pathogen correlated with respiratory tract infections, cystic fibrotic patients and is also the causative of pseudomonal pneumonia.
Material and Methods: Present retrospective hospital record based cross sectional analytical study included a total of 2680 clinical samples was compile from patients of Shaikh Zayed Hospital, Lahore Pakistan from January 2013 to December 2014. Samples were processed and identified by standard protocol. The P. aeruginosa was tested for antibiotic resistance by Kirby Bauer disc method according to CLSI guidelines.
Results Three groups which are described in detail, as a result of studying among the 200 isolated Pseudomonas aeruginosa the following antibiotics was used i.e. IPM, MEM, AK, CN, CIP, CAZ, SCF and TZP. We finally came to a conclusion that IPM, MEM, CAZ, SCF, TZP are having less resistivity and more sensitivity, and the AK, CN, CIP is more resistant while the sensitivity is less. The percentage detail for resistivity in IPM was 33%, MEM was 29%, CAZ was 45%, SCF was 40.5%, the TZP was 40.5%, AK was 51.5%, CN was 64%, and the CIP was 58%.
Conclusion: This hospital based epidemiological data will help to follow better infection control strategies and improve the knowledge of antibiotic resistance patterns among clinicians. Thus there is a need for antimicrobial surveillance to monitor the resistance patterns in local hospitals.
Frequency of Sexually Transmitted Diseases in Pakistani Blood Donors
Authors: Muhammad Javaid Iqbal  , Ayesha Junaid  , Imran N. Ahmad  , Muhammad Usman
Published: December 2024

Objective: To determine the frequency of HIV and syphilis infection among Pakistani blood donors presenting to blood transfusion services of Shifa International Hospital (SIH) Islamabad through serological testing and to determine accuracy of serological testing for Human Immunodeficiency Virus (HIV) taking nucleic acid testing (NAT) as gold standard.
Methodology: Present study was a descriptive cross-sectional, conducted at SIH Islamabad over a period of six months (July- December 2016). A total of five thousand one hundred and seven (n=5,107) adult blood donors were enrolled and underwent serological testing for syphilis. For HIV, serology was performed followed by NAT screening.
Results: There were 1.3% (n=68/5107) donors came out to be serologically positive for syphilis with a yield of 1:75 or 14686 donors per million. There were 0.2% (n=12/5107) donors came out to be serologically HIV positive with a yield of 1:426 or n=2350 donors per million. All HIV patients on NAT testing proved to be negative for HIV. 
Conclusions: A remarkable proportion of blood donors presented at our institute during the study period harbored STD, which can be detected through meticulous and stringent screening of blood donors. NAT has an incremental value in identifying false positive HIV cases on serological testing.
D-DIMER – As A Biomarker for Severity of COVID-19
Authors: Seemab Abid  , Samar Saleem  , Masooma Rubab  , Hassan Mumtaz  , Sania Sabir  , Ahmed Sohail  , Zoobia Khan
Published: December 2024

Objective: To see the association of D-dimers with the prognosis of covid-19.
Material & Methods: This Retrospective Cross-sectional study was done at Benazir Bhutto hospital Rawalpindi during May –June 2020 obtaining a sample of 200 patients. All those patients being admitted in COVID ward were assessed on the basis of D-dimers and their 28-day outcome. Ethical approval was solicited from the Institutional Research Forum of Rawalpindi Medical University. Results: The study yielded 200 participants in which the patients with moderate severity of the disease had a mean age of 40.33±6.65, that with severe disease had a mean age of 53.18±12.1 and critical patients had a mean age of 56.67±14.79. The disease severity is significantly related to increased mean age of the patient (p = 0.050). Mean serum ferritin levels in patients with moderate disease was 235.67±22.27 micrograms per liter, the patients with severe disease had mean value of 760.75±574.63 micrograms per liter and critical patients had a mean ferritin level of 974.10±773.85 micrograms per liter. This revealed that the ferritin levels increased significantly in patients with severe disease. Our findings establish a consistent increase in the levels of D-dimers with increasing severity of the disease, from mild to severe to critical patients.
Conclusion: D –Dimers are important predictors of prognosis and disease severity which can be utilized to evaluate the treatment outcomes in COVID-19 infection. Further studies are recommended to find out the cut-off value of D-dimers as a biomarker of disease severity.
Association of Hyperglycemia and Hyperuricemia in Diabetic Patients at Tertiary Care Hospitals of District Bannu, Khyber Pakhtunkhwa, Pakistan
Authors: Arif Ullah  , Moiz Ul Haq  , Muhammad Shoaib Khan  , Ishrat Ullah
Published: December 2024

Objective: The aim and objective of current study was to find association of hyperglycemia and uric acid in diabetic patient at district Bannu, Khyber Pakhtunkhwa, Pakistan
Methods: This cross sectional descriptive was conducted in tertiary care hospitals of district Banu , Khyber Pakhtunkhwa Pakistan, from  July 2020 to August, 2021. Blood samples was collected form patients using gel tube, centrifuged and then serum separate was subjected to Micolab-300 for the estimation of uric acid and glucose level in subjects.  
Results:  In this study, total 209 cases were analyzed, among them 114 were males and 95 were female. Frequencies of high Serum Uric Acid levels in diabetic patients were observed in adults’ group and significant association was observed between blood sugar levels and uric acid levels in these patients.
Conclusion: From the current study it has been concluded that statistically significant association was found between hyperuricemia and hyperglycemia in diabetic patients and such association was most commonly observed in Adult patients s compared to other groups.
Prevalence of Primary Brain Neoplasms and Neoplasm-Like Lesions Reported at Central Pathology Laboratory, Peshawar- A Retrospective Study
Authors: Ghaazaan khan  , Shafi Ullah
Published: December 2024

Objectives: The aim of present study is to know the frequency of primary brain tumors and tumor like lesions reported at Central Pathology Laboratory, Peshawar.
Materials and Methods: The retrospective study was conducted by reviewing the biopsy reports from the files of Central Pathology Laboratory, Peshawar from 1st January 2017 to 30th Mar 2020.
The specimens were received in 10% formalin, stained with H & E and reported by 03 experienced histopathologists. A total of 153 biopsy reports were reviewed. In addition to morphological types of tumors, patients’ demographic details like age and gender were also recorded.  Data gathered was analyzed using SPSS Version.20.
Results: A total of 153 cases were reviewed. Out of these, 95 (62.09%) were males while 58(37.90%) were females with M: F ratio of 1.63:1 showing male predominance. Most of the patients (41.83%) were in the age range of 40 years and above. The mean age of study sample was 37.45+/- SD 17.64. The most common brain tumors were astrocytomas (41.83%), followed by meningiomas (27.45%) and oligodendrogliomas (6.53%).
Conclusion: Astrocytomas are the most common intracranial tumors in our study, followed by Meningiomas. Psychiatrists should always be vigilant in their clinical practice to rule out organic lesions including brain tumors.
Association of Serum Ferritin and Hematological Parameters in Investigation of Iron Deficiency Anemia
Authors: Jamil Akhtar  , Waheed Alam  , Fatima Khan  , Jaleel Kamran
Published: December 2024

Objective: To find out a correlation between serum ferritin and hematological parameters and age of patients visiting National Institute of Health, and also to establish the role of this biochemical indicator in the diagnosis of IDA.
Methodology: This comparative cross-sectional study was conducted in Endocrinology and Special Chemistry Department of PHLD, National Institute of Health Islamabad from July 2019 to December 2020. A total of 235 patients including males and females of different age groups, manifesting anemic clinical history, diminished hematological parameters and showing microcytic hypochromic blood film, were selected for the study. Sysmex K-1000 auto analyzer and Roche Elecsys 2010 immunoassay analyzer were used for the measurements of various hematological parameters and ferritin respectively. Stained blood films were also prepared to examine red blood cell morphology and their staining pattern.
Results: Serum ferritin results were statistically analyzed against Hb and other hematological parameters. Significant correlation (P > 0.05) was observed in low serum ferritin groups with iron deficiency anemia of both males and females. However, this correlation was not observed in normal and high ferritin groups of both genders. Also low serum ferritin levels did not show any strong correlation with the age of the patients. Similarly, it was also found that when serum ferritin significantly varies from subnormal values towards normal or above normal levels, a significant difference results in Hb levels accordingly and more or less in other hematological parameters, indicating a strong interdependence. No such relationship in serum ferritin and age of the patient was observed. The results were also supported by hypochromic, microcytic blood picture and by investigating clinical history of the patient.
Conclusion: Iron deficiency anemia can be treated and cured with proper diagnosis, diet and treatment. Therefore, to investigate and differentiate iron deficiency anemia among other different types of anemias, serum ferritin determination is decisive in diagnosis as it decreases only in this type of anemia as is established in the study conducted.
A Sep-wise Approach to Diagnose Pancytopenia: Experience from a Tertiary Care Hospital in AJ&K, Pakistan
Authors: Wazeer Akhlaaq , Qasim Zahida , Waheed Usman , E Saba Noor , Shaukat Amnah , Shaukat Ayesha , Azam Sara
Published: December 2024

Objective: To find out the occurrence of pancytopenia in relation to the age and sex of the patients. To establish a step-wise approach by correlating the clinical, haematological and bone marrow findings to reach a diagnosis, and to evaluate the cause of pancytopenia individually.
Material and Methods: This study was a prospective study over a period of one year conducted at a teaching hospital of Mirpur, AJ&K, with a catchment population of 1.6 million with a wide range of diversity in its terrain ranging from plains to mountains. This was the first ever study conducted on this topic in this region. Basic tests including blood complete picture followed by peripheral film, Reticulocyte percentage, Bone marrow examination including aspiration and trephine biopsy along with other supportive tests were used to reach a diagnosis in each patient.
Results: Out of a total of 119 patients, with age ranging from 2 months to 90 years, the mean age was 59 years with female predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Anaemia was the predominant finding in blood film examination. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause of pancytopenia was megaloblastic anaemia (74.04%), followed by aplastic anaemia (18.26%).
Conclusion: The present study concludes that detailed primary haematological investigations along with bone marrow studies in cytopaenic patients are helpful for understanding the disease process and diagnosis to rule out the causes of cytopaenia.
Environmental Health and its Impacts on Mental Health and Health-related Quality of Life in District Bannu: A Cross-Sectional Study
Authors: Mohammad Akram  , Sibghatullah  , Asad ullah  , Syed Mohammad Bilal Shah  , Muhammad Zarak  , Abdul Qadus
Published: December 2024

Objective: To determine the effect of environmental health parameters on mental Health in District Bannu.
Methodology: A cross-sectional study was conducted in district Bannu from October 2015 to March 2016 by using a Two-stage stratified cluster sampling technique. The total sample size was 548 households. The dependent variable was Mental Health, and independent variables were Environmental health status (water, noise and odor), age, marital status, education, socioeconomic status, occupation and smoking. Proportions were compared by applying the chi-square test. STATA 13.1 was used for analysis.
Results: This study consists of 548 household. Adults from 314(33.91 house hold) from urban areas and 612 (66.09) from rural areas, across district. Age was having significant association with physiological wellbeing (P value = 0.07). Females showed significant sleep disturbance due to noise (P Value= 0.008) while in male it was not significant (p Value 0.06). Smell (odor) also has an impact on the participant’s residence areas. Male were more affected (P. value 0.01) compared to females (P. value 0.48). Rural and urban both areas showed significant association with water satisfaction (Value 0.006). The mean GHQ score is 21.13 (SD ± 6.7) which shows a severe mental health problem and physiological distress in adult household occupants of district Bannu.
Conclusion: The problems occurring to mental health due to environmental factors are more in Pakistan especially in District Bannu compared to other countries. Environmental factors such as water, noise and smell has a greater impact on the mental health of the people living in the District Bannu.
Generalized Pruritus: An Etiological Breakup of 700 patients presenting to dermatology opd of a local hospital.
Authors: Tareen Attiya , Irfan Ullah  , Ammara Safdar  , Hadia Yaqub Khan  , Uzma Rajar  , Habiba Yaqub Khan
Published: December 2024

Background: Pruritus is an itching sensation or a constant urge to itch over skin that may be localized in response to a local stimulus or generalized due to an underlying condition  with or without presence of causative agent.  It can be caused by dermatological or systemic conditions, iatrogenic or as a response to external substances such as parasites. Generalized pruritus may not be necessarily due to dermatological causes and systemic, neurologic, endocrinologic, and psychogenic conditions may have pruritus as a primary cutaneous manifestation. Skin conditions like Scabies, eczema and airborne dermatitis are commonly incriminated as reason for intense itching and so lab workup or clinical examination and history taking is often omitted, in our busy outdoors. Therefore, the purpose of this study is to rule out underlying common systemic diseases like hypothyroidism, diabetes mellitus and chronic renal and liver disease as cause of severe generalized pruritus.
Objective: To identify the underlying cause of generalized pruritus in patients presenting to dermatology outdoor excluding pruritic dermatological diseases.
Methodology: This is a cross-sectional observational study conducted on 700 patients from January 2018 to October 2021, in Fauji Foundation hospital Rawalpindi. Patients between the ages of 15 to 69 years visiting dermatology OPD of the department with complaints of generalized pruritus, who were recruited for the study after filling the consent form. Clinical investigations (Blood Cp, LFTS, RFTs, TFTs) and past medical history were taken to identify the underlying cause of pruritus was conducted and diagnoses were documented Only the patients who were having non dermatological causes were included in the study and the diagnoses were further categorized as idiopathic, systemic, endocrinological, neurogenic, psychogenic and drug induced. Results were compiled and analyzed using SPSS version 22.
Results: The results of this study show that 700 participants with mean age of 47.39, out of which 110 were males and 590 were females had generalized pruritus. Out of them, 126 (19%) had pruritus due to chronic renal disease, 119(17%) had chronic liver disease, 63 (9%) had diabetes mellitus, 42 (6%) had paraneoplastic, 126(18%) senile pruritis, 35(5%) had cholinergic pruritus,21 (3%) iron deficiency anemia. 14(2%) had atopic dermatitis of elderly. Drug induced pruritus 56(8%).
Conclusion: Pruritus without known pruritic dermatoses is a common presenting complaint in patients presenting to outdoors having one of the underlying systemic disease. Further work is needed to evaluate impact of pruritus on quality of life in these already diseased patients.
Correlation of Myopia with the use of Smart Phones and Outdoor Activities
Authors: Urwa Ghafoor  , Maham Fazal  , Asfandyar Asghar  , Sana Nadeem  , Rana Intisar Ul Haq  , Tariq Munawar
Published: December 2024

Objective: To determine the correlation between smart phone usage and outdoor activities in the development of myopia.
Methodology: A descriptive cross-sectional study was conducted at the Department of Ophthalmology, Fauji Foundation Hospital Rawalpindi, from December 2021 to November 2022. A total of 200 eyes from 100 myopic patients of either gender between 4 – 16 years of age were included. Complete ophthalmic examination was carried out along with measurements of the height, weight, and axial length of each patient. Data was recorded on the time spent daily on smart phones and in outdoor activities, along with school grade, family history of myopia, dietary habits, indoor activity time, after-school study hours and sleep time. The Statistical Package for the Social Sciences (SPSS) version 23 was used to analyse the data.
Results: The 100 patients included 65 males and 35 females with a mean age of 11.52 ± 7.43 years. Mean outdoor activity was 34.1 minutes per day while mean daily smart phone usage was 151.90 minutes per day. A positive significant linear correlation was established between daily smart phone usage and refractive error (r=0.386 p= 0.000) whilst a non-significant moderate inverse correlation between the time spent in outdoor activities and refractive error was found (r= -0.114 p=0.258)
Conclusion: The prevalence of myopia is increasing in modern times, owing in part to extensive screen time and near work. Time spent outdoors offers some degree of protective role in prevention of myopia.
Medical Management of Infantile Hemangioma: Is oral Propranolol Superior to Oral Prednisolone?
Authors: Saad Siddiqui  , Muhammad Saaiq  , Somia Iqbal  , Hira Iqbal
Published: December 2024

Objective: To compare the efficacy of oral propranolol versus oral prednisolone for treating infantile hemangioma.
Methodology: This randomized controlled trial was conducted at the Department of Plastic Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from January 2015 to December 2016. Written informed consent was taken from the parents. The trial included 80 patients who were randomly assigned to two treatment groups, each comprising of 40 patients. Patients in Group-A received oral propranolol treatment, whereas patients in the Group-B received oral prednisolone treatment. Greater than 75% regression in size (as determined by the length, width, and height measured in millimeters) of the hemangioma as compared to the pre-treatment status was determined for each group and comparisons were drawn. The percentages of various outcome variables were compared by employing chi-square test. A p-value of less than or equal to 0.05 was regarded as statistically significant.
Results: The age of the children ranged from 1-36 months, with a mean of 15.20±10.40 months. The majority (n=51, 63.8%) of them were aged between 1-18 months. There were 33 (41.3%) male whereas 47 (58.7%) female children. Maximal possible matching of the two groups was ensured with regards to the various demographic and clinical entry parameters. The frequency of efficacy was significantly higher (92.5% vs. 25.0%; p=0.000) with propranolol as compared to prednisolone. Similar significant difference was seen across all age and gender groups.
Conclusion: Propranolol had superior efficacy, 6-weeks post-treatment irrespective of the patients’ age and gender. Hence, oral propranolol should be the preferred choice for treating infantile hemangiomas.
Experience of Individual Living with Prolong Ostomy: A Qualitative Study
Authors: Ullah Naeem , Muhammad Dildar , Shah Muslim , Ullah Barkat , Zareef Dr. Adil , Akhtar Jamil , Khan Dr. Aamir Ali
Published: December 2024

Objective
This study was conducted to explore individual experiences living with prolong or permanent ostomy to uncover the areas that remained ignore or untreated. Many individuals undergo ostomy surgery every year across the globe. They faced many challenges after surgery however, without knowing their experiences it is impossible to understand how their life is going on with a stoma.
Design:
A phenomenological research design was implemented for conducting this study by following SRQR checklist of equator network reporting guideline. Approval was obtained from the Ethical Review Board.
Place and study duration: The research work was accomplished in Hayat Abad Medical Complex (HMC) as per direction of the institutional review board of Khyber Medical University from March 2019 to March 2020.
Methodology: In current study a phenomenological research design was implemented and eight individuals including both male and female were interviewed following the purposive sampling technique. Face to face in depth interviews were conducted, data were recorded, transcribed in the form of verbatim and then translated. The data was further analyzed, codified and categorized; finally different themes were extracted through thematic analysis method.
Result: Five themes were generated including compromised nutritional status; sleep deprivation, financial challenges; restricted social relationship and compromised nutritional status
Conclusion: The outcomes of this study excellently explored and highlighted the experiences of individuals living with prolongs ostomy.
Comparison of Pre and Post Vaccinated Covid-19 Antibody titers in General Population
Authors: Ali Haider  , Juwayria Omar  , Hameed Mumtaz Durrani  , Muhammad Afzal  , Abid Ali  , Akash John
Published: December 2024

Objective: The aims and objectives of this study to examine the general population one year later following immunization for changes in anti-SARS-CoV-2 IgG levels.
Methodology: The study enrolled 18,610 individuals, including rural and urban areas. The quantities of IgG antibodies were determined using an ELISA.
Results: At 5–8 months following complete immunization, both vaccines produced comparable amounts of anti-SARS-CoV-2 IgG. On the other hand, BBIBP-CorV had a much lower IgG concentration. Anti-SARS-CoV-2 IgG levels in a large cohort of volunteers increased nine months after vaccination, indicating asymptomatic infection. Anti-SARS-CoV-2 IgG antibody levels were significantly higher following the booster dose than following the second dose. Antibodies began to build approximately five days after the booster dosage injection and peaked around the fourteenth day.
Conclusion: Cut-off dates for the effectiveness of mRNA and vector vaccines appear to be 8–9 months and 5–6 months following vaccination, respectively. With the potential to have a significant impact on the virus's ongoing transmission, providing a booster dose was a brilliant idea.
Key words: SARS-CoV-2, IgG antibody, mRNA.
Using the Relevant Condition at Death (ReCoDe) classification system for Classifying Stillbirths in a Tertiary-Care Hospital
Authors: Abrar Saida , Fawad Khwaja , Hussain Shehzadi saima
Published: December 2024

Objective: To find the different causes of stillbirths at our institution, using the Relevant Condition at Death (ReCoDe) classification system.
Methodology: This was a cross-sectional study that included 421 cases, complicated by stillbirth after 24 weeks of pregnancy at the Department of Obstetrics and Gynecology, Lady Reading Hospital, between January to December 2021. A structured proforma was used to gather data on their age, gestation, booking status, parity, mode of delivery, fetal weight, body mass index, maternal diabetes, pre-eclampsia, thyroid dysfunction, and the information related to stillborn babies, and findings of placental and umbilical cord examination.
Results: The stillbirth rate in the Obstetrics department during the study period was53 per 1000 births. About 78.4% of cases were coded after the application of ReCoDe classification, while 21.61% of cases were labeled as unexplained.The majority of the cases were in the age group 18-35 years, 205 (48.6%), with most women having a spontaneous vaginal delivery, 321 (76.2%), un-booked status, 353 (83.8%), and a BMI >30, 251 (59.6%). The fetal causes were most common,144 (34.20%), with fetal growth restriction contributing to the most common fetal cause, 101 (23.99%). Maternal causes contributed to 99 (23.5%) of stillbirths, with pre-eclampsia the most commonly associated maternal condition, 36 (8.55%).
Conclusion: Classification of stillbirths using ReCoDe classification is simple and, practical to use, especially in low-resource settings, with the ability to identify underlying cause in the majority of cases
Comparison of Various Factors Related to Severity of Ischemic Stroke in Patients with and Without Good Glycemic Control
Authors: Latif Faiqa , Niaz Asif , Ishfaq Afsheen , Sohail Saera , Tahir Muhammad , Hussain Aamir
Published: December 2024

Abstract
Background: Stroke medicine is an evolving speciality under the umbrella of neurology. It not only covers the neuropathological impact of stroke but provide holistic care to these patients for early recovery with minimum disability.
Objective: To compare various factors related to severity of ischemic stroke in patients with and without good glycemic control managed at our Neurology/Medicine Department 
Material and Methods: In this comparative cross-sectional study, carried out at the Department of Neurology/Medicine, Pak Emirates Military Hospital Rawalpindi. From September 2022 to December 2022. Out of 100 patients of acute ischemic stroke suffering from diabetes mellitus was included. Patients of ischemic stroke with confirmed diagnosis on neuroimaging were recruited. Severity of stroke by NHSS classification and size of infarct on CT scan was assessed for all the study participants. Glycosylated hemoglobin was performed on all patients and patients were classed as having glycemic control or not. On the basis of this investigation, stroke severity parameters were compared in groups with and without glycemic control.
Results:  In the study. Male were 66 (66%) , while 34 (34%) were female. Mean age of patients of stroke recruited in analysis was 56.31 ±8.18 years. Out of total, 44 (44%) patients had glycemic control while 56 (76.25%) had no glycemic control. Statistical analysis revealed that when comparison was made among two groups, more stroke severity and infarct size of more than 50 ml were seen statistically significantly more in patients who did not have glycemic control (p-value<0.001).
Conclusion: Poor or no glycemic control was seen in almost half of the patients who presented with ischemic stroke. More stroke severity and large size of infarct were seen in patients without glycemic control in our study participants.
Vaccination Status in Children presenting with severe complicated Measles
Authors: Ullah Kalim , Haq Sami Ul , Ali Sadaqat , Hussain Mulazim , Mehmood Arif , Ghaffar Abdul
Published: December 2024

ABSTRACT
Background:  Measles occurs worldwide and remains a leading cause of mortality especially among children ≤5 years of age. Present study will determine this association in our local population.
Objective: The aim of the study was to determine the frequency of unvaccinated children in patients presenting with severe Measles.
Material and Methods: After permission from Hospital ethical committee. Total 145 patients of severe measles were enrolled, and frequency of unvaccinated children was noted. This study was conducted in Children Ward, Women & Children Hospital,  MTI Bannu from  October 2022 to  April 2023. The results obtained were presented in the form of tables and graphs and level of significance was determined statistically.
Results: In our study, total 145 patients were enrolled. Mean age of patients was 7.07±2.3 years. Minimum age was 3 years and maximum age was 12 years. There were 46.2% males and 53.8% female patients. Most of patients belonged to middle socioeconomic status i.e. 57.2. Regarding maternal education 50.3% were having 6-10 years of education, 20.9% had less than 5 years of education, 16.6% had 11-12 years of education while only 4.1% had more than 12 years of education. In our study participants 47.6% lived in urban area and 52.4% lived in rural area. There were 66.2% unvaccinated children and 33.8% were vaccinated. Data stratification for age group, BMI, residential status and socioeconomic status was significant i.e. p-value≤ 0.05.
Conclusion: Severe measles infections are prevalent among unvaccinated children due to their susceptibility to complications such as pneumonia and encephalitis. Vaccination remains the most effective measure to prevent measles outbreaks and safeguard public health.