bluuebunny/crossref_metadata_2025 huggingface dataset:
Reviews and syntheses: Greenhouse gas emissions from drained organic forest soils – synthesizing data for site-specific emission factors for boreal and cool temperate regions
Authors: Jauhiainen Jyrki , Heikkinen Juha , Clarke Nicholas , He Hongxing , Dalsgaard Lise , Minkkinen Kari , Ojanen Paavo , Vesterdal Lars , Alm Jukka , Butlers Aldis , Callesen Ingeborg , Jordan Sabine , Lohila Annalea , Mander Ülo , Óskarsson Hlynur , Sigurdsson Bjarni D. , Søgaard Gunnhild , Soosaar Kaido , Kasimir Åsa , Bjarnadottir Brynhildur , Lazdins Andis , Laiho Raija
Published: December 2023

Abstract. We compiled published peer-reviewed CO2, CH4, and N2O data on managed drained organic forest soils in boreal and temperate zones to revisit the current Tier 1 default emission factors (EFs) provided in the IPCC (2014) Wetlands Supplement: to see whether their uncertainty may be reduced; to evaluate possibilities for breaking the broad categories used for the IPCC EFs into more site-type-specific ones; and to inspect the potential relevance of a number of environmental variables for predicting the annual soil greenhouse gas (GHG) balances, on which the EFs are based. Despite a considerable number of publications applicable for compiling EFs being added, only modest changes were found compared to the Tier 1 default EFs. However, the more specific site type categories generated in this study showed narrower confidence intervals compared to the default categories. Overall, the highest CO2 EFs were found for temperate afforested agricultural lands and boreal forestry-drained sites with very low tree stand productivity. The highest CH4 EFs in turn prevailed in boreal nutrient-poor forests with very low tree stand productivity and temperate forests irrespective of nutrient status, while the EFs for afforested sites were low or showed a sink function. The highest N2O EFs were found for afforested agricultural lands and forestry-drained nutrient-rich sites. The occasional wide confidence intervals could be mainly explained by single or a few highly deviating estimates rather than the broadness of the categories applied. Our EFs for the novel categories were further supported by the statistical models connecting the annual soil GHG balances to site-specific soil nutrient status indicators, tree stand characteristics, and temperature-associated weather and climate variables. The results of this synthesis have important implications for EF revisions and national emission reporting, e.g. by the use of different categories for afforested sites and forestry-drained sites, and more specific site productivity categories based on timber production potential.
Spatiotemporal snow water storage uncertainty in the midlatitude American Cordillera
Authors: Fang Yiwen , Liu Yufei , Li Dongyue , Sun Haorui , Margulis Steven A.
Published: December 2023

Abstract. This work quantifies the uncertainty of accumulation-season peak snow water storage in the portions of the midlatitude American Cordillera where snow is a dominant driver of hydrology. This is accomplished through intercomparison of commonly used global and regional products over the Western United States (WUS) and Andes domains, which have similar hydrometeorology but are disparate with respect to the amount of available in situ information. The recently developed WUS Snow Reanalysis (WUS-SR) and Andes Snow Reanalysis (Andes-SR) datasets, which have been extensively verified against in situ measurements, are used as baseline reference datasets in the intercomparison. Relative to WUS-SR climatological peak snow water equivalent (SWE) storage (269 km3), high- and moderate-resolution products (i.e., those with resolutions less than ∼10 km) are in much better agreement (284±14 km3; overestimated by 6 %) compared to low-resolution products (127±54 km3; underestimated by 53 %). In comparison to the Andes-SR peak snow storage (29 km3), all other products show large uncertainty and bias (19±16 km3; underestimated by 34 %). Examination of spatial patterns related to orographic effects showed that only the high- to moderate-resolution Snow Data Assimilation System (SNODAS) and University of Arizona (UA) products show comparable estimates of windward–leeward SWE patterns over a subdomain (Sierra Nevada) of the WUS. Coarser products distribute too much snow on the leeward side in both the Sierra Nevada and Andes, missing orographic and rain shadow patterns that have important hydrological implications. The uncertainty of peak seasonal snow storage is primarily explained by precipitation uncertainty in both the WUS (R2=0.55) and Andes (R2=0.84). Despite using similar forcing inputs, snow storage diverges significantly within the ECMWF Reanalysis v5 (ERA5) (i.e., ERA5 vs. ERA5-Land) products and the Global Land Data Assimilation System (GLDAS) (modeled with Noah, Variable Infiltration Capacity (VIC), and Catchment model) products due to resolution-induced elevation differences and/or differing model process representation related to rain–snow partitioning and accumulation-season snowmelt generation. The availability and use of in situ precipitation and snow measurements (i.e., in WUS) in some products adds value by reducing snow storage uncertainty; however, where such data are limited, i.e., in the Andes, significant biases and uncertainty exist.
Da concepção à função do contrato: Um olhar contemporâneo
Authors: de Azevedo Domingues Alessandra
Published: December 2023

The Contract is one of the most important private law institute for society and the economy, adapting to social desires and market demands. It responds to socio-economic changes and that justifies the evolution of its concept over the years. Its flexibility and importance to the economy and to the business models has justified economists’ interest in studying this theme. The Law and Economics has provided important reflections and has contributed to the construction of the contemporary legal concept of contract. The challenges resulting from Economy 4.0 are decisive to a Contract Law study focused on the function, which allows us to investigate the effectiveness of the contract to the new business models.
A saga do meio ambiente, de valor político a fato social: A análise crítica da decisão na Ação Direta de Inconstitucionalidade nº 4.983/CE
Authors: Sampaio Siqueira Natércia , Fernandez Gomes Karla
Published: December 2023

This paper aims to analyze, from the understanding of the maxim of coherence, the decision set forth in Direct Action of Unconstitutionality n.º 4.983/CE by the Federal Supreme Court, which concluded that the Law n. º 15.299/2013, which regulated the vaquejada within the state of Ceará, was unconstitutional. The hypothesis is that the practice of weighting principles, especially when the rule of origin is extended indiscriminately, contributes to the social phenomenon of the dogmatization of values, which undermines their purpose in the democratic context. To prove this, the work is carried out through bibliographical research, which addresses the constitutional regime of the environment, its transformation of value into social fact, the relation between coherence, non-arbitrariness and equanimity in hermeneutics. To conclude, that the basement of the decision, by insisting on the excessive expansion of the rule of origin and moving away the coherence, undermines equanimity through the dogmatization of a value: the environment
Jovens e Geografia escolar no contexto do “novo” Ensino Médio
Authors: Bezerra da Silva Gabrielle , Nedel Oliveira Victor Hugo
Published: December 2023

Diante dos impactos gerados pelo “Novo” Ensino Médio, encontram-se aqueles que atingem os jovens escolares, sobretudo, os que frequentam as instituições públicas de ensino. É nesse contexto que escola e Geografia Escolar adquirem papéis indispensáveis no que tange a aproximar as juventudes dessas pautas, fomentando ainda mais o protagonismo juvenil. Este texto tem como objetivo principal investigar as relações de jovens estudantes com a Geografia no contexto do “Novo” Ensino Médio. A pesquisa qualitativa, em forma de um estudo de caso, produziu dados a partir da realização de um grupo focal com jovens estudantes do Ensino Médio Regular e membros do Grêmio Estudantil. Os sujeitos participantes, que vêm vivenciando na prática e em tempo real a implementação da “reforma” curricular, evidenciaram a situação da redução da carga horária da Geografia e de outros componentes na escola. Por sua vez, a Geografia apareceu associada a objetos do conhecimento como localização, orientação, tectônica de placas, biomas, relevo e clima, sendo, ao mesmo tempo, uma matéria capaz de dar informações, por vezes interessantes, mas, em geral, sem sentido. Considera-se que as relações e percepções dos jovens em relação à Geografia ao longo do estudo apontam para a necessidade de reflexão do papel e da relevância da Geografia Escolar, de modo que a defesa e a luta pelo seu espaço no currículo e na escola também façam sentido.
O "archeologii sztuki i krytycyzmie naukowym" w polskiej architekturze sakralnej drugiej połowy XIX wieku
Authors: Majdowski Andrzej
Published: December 2023

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Perbedaan Tingkat Stres Serangan Pertama dengan Serangan Berulang pada Pasien Stroke
Authors: Haerianti Masyita , Yunding Junaedi , Muflih Muflih
Published: December 2023

Latar Belakang: Stroke merupakan penyebab kematian nomor dua dan disabilitas nomor satu di dunia. Stroke menyebabkan penderita stroke mengalami dua kali serangan yakni serangan pertama dan serangan berulang. Stroke terjadi akibat pembekuan dan pecahnya pembuluh darah di otak yang jika tidak tertangani dengan baik akan menyebabkan stres. Tujuan: mengetahui perbedaan tingkat stres serangan pertama dengan serangan berulang pasien stroke. Metode: Penelitian ini menggunakan rancangan observasional analitik dengan metode cross-sectional study. Pengambilan sampel dilakukan dengan teknik purposive sampling sehingga didapatkan sampel sebanyak 48 responden. Instrumen yang digunakan yakni kuesioner karakteristik demografi dan kuesioner Depression Anxiety Stres Scale 42 (DASS 42) yang dianalisis dengan uji statistik Independent sampel T-Test. Hasil: Kelompok stroke serangan pertama mengalami stres normal (57.9%), sementara serangan berulang mengalami stres sedang (50.0%) dengan hasil uji beda rerata p= 0.017 (p<0.05) yang menunjukkan terdapat perbedaan rerata skor stres antara kelompok stroke serangan pertama dengan serangan berulang. Kesimpulan: Terdapat perbedaan rerata skor stres antara kelompok stroke serangan pertama dengan serangan berulang dengan rerata mayoritas serangan pertama mengalami stres normal, sementara serangan berulang mengalami stres ringan sampai sedang. Keluarga dan petugas kesehatan diharapkan dapat memberikan dukungan, edukasi dan terapi kepada pasien untuk mencegah terjadinya stroke berulang dan menurunkan tingkat stres untuk mencegah komplikasi buruk akibat stres seperti aterosklerosis.Kata kunci: Stres; Stroke Serangan Pertama; Stroke Serangan Berulang
Efektivitas Kombinasi Rebusan Daun Kersen Dan Daun Sirih Terhadap Penurunan Gout Di Lingkungan Kerja Puskesmas Karangharja Tahun 2023
Authors: Attawwabie Hilmie Hilmanie , Fauzi Achmad , Jumari Jumari
Published: December 2023

Background: gout atau dikenal di kalangan masyarakat yaitu asam urat adalah penyakit sendi yang disebabkan oleh tingginya Asam urat dalam darah. Etiologi gout meliputi jenis kelamin, umur, konsumsi purin, alkohol, dan riwayat keluarga. Gejala yang khas pada penderita arthritis gout adalah nyeri pada bagian sendi dapat menganggu  aktivitas.  Peradangan  sendi  pada arthritis  gout  dapat  terjadi  pada  seluruh  sendi tubuh   yang   menyebabkan   pembengkakan, sendi  teraba  panas  serta  nyeri. Penelitian ini dilakukan karena adanya suatu pengobatan non farmakolokgis yang sudah turun temurun yaitu pengobatan rebusan daun kersen dan rebusan daun sirih untuk mengatasi gout sudah sering dilakukan oleh masyarakat dilingkungan kerja puskesmas karangharja. Solusi yang dilakukan dalam penilitian ini  yaitu menggabungkan atau mengkombinasikan antara rebusan daun kersen dan rebusan daun sirih untuk meningkatkan efektivitas pemanfaatan kedua daun tersebut dalam menurunkan gout.Purpose: untuk mengetahui pengaruh kombinasi antara rebusan daun kersen dan daun sirih terhadap penurunan Gout.Methods: jenis penelitian yang digunakan yaitu penelitian kuantitatif dan desain yang digunakan yaitu “Quasi Eksperimental Pre-Post Test” Penghitungan jumlah sampel bisa dilakukan dengan metode statistik menggunakan formula Slovin. Metode uji statistik  menggunakan uji univariat, uji normalitas, dan uji wilcoxon.  Result: adanya pengaruh kombinasi rebusan daun kersen dan daun sirih terhadap penurunan gout dengan nilai p Value 0,000 < 0.005.Conclusion :dari hasil penelitian yang telah dilaksanakan bahwa diketahui adanya pengaruh kombinasi rebusan daun kersen dan daun sirih yang dapat menurunakan kadar asam urat. Diketahui bahwa terdapat perbedaan yang bermakna dalam penurunan gout pada pengukuran sebelum dan sesudah intervensi. Serta ditemukan bahwa mayoritas responden dengan karakteristik pada usia muda dengan umur < 60 tahun, Jenis kelamin perempuan, mayoritas responden memiliki riwayat asam urat, dan mayoritas responden juga merupakan seorang ibu rumah tangga.
Peningkatan Pengetahuan Lansia dengan Hipertensi Menggunakan Booklet QR-Code Terintegrasi Website
Authors: Prastiyo Muhammad Dodik , Ni'mah Azizah Khoirotun , Ardiansyah Fino , Firdaus M Nur Cahyo , Rakhmawati Rani
Published: December 2023

Background: Hypertension is still a major burden of health financing around the world known as the silent killer becauseit causes sufferers to be unaware of the threat of complications such as stroke, myocardial infarction, kidney failure, andheart failure that can result in death. The World Health Organization (WHO) reported that in 2019, the number of people with hypertension in the world was 1.13 billion. The high prevalence of hypertension can be lowered by self-managementbehavior.Objective: Knowing the effect of hypertension self-management behavior education based on Booklet QR code integratedWeb health on the elderly in Bakalan Krajan Hamlet, Malang City.Method: The sample in this study was 10 hypertensive patients from Bakalan Krajan Hamlet, Malang City. The sampling technique uses purposive sampling and Quasy experimental one-group pretest-posttest research design.Results: This study used the Wilcoxon signed–rank test because the data was not normally distributed to determine thedifference between pretest and post-test dependent samples. The results showed significant p = 0.046 with an alpha valueof p < 0.05.Conclusion: There is an influence of hypertension education based on self-management behavior based on Web healthintegrated QR code Booklet on the elderly in Bakalan Krajan Hamlet, Malang City. Future studies are needed to involvemore samples.
Respecting the right to asylum for Ukrainian refugees in the Republic of Moldova
Authors: Pirtac Grigore
Published: December 2023

This article analyzes the phenomenon of respecting asylum for Ukrainian refugees in the Republic of Moldova. The author point out that the Russian invasion of Ukraine resulted in approximately 8 million Ukrainians being internally displaced by the end of May, and more than 7.9 million fleeing the country by January 24, 2023. For the first time in the history of our country, in a limited time, a record number of asylum applications was registered,15,000 people. The author mention the prodigious activity of state institutions in our country, the Republic of Moldova demonstrated remarkable solidarity with refugees from Ukraine. All state institutions were mobilized to provide the refugees with the best possible conditions and to ensure the transit of several hundred thousand more refugees.
Tendencies of the evolution of energy resources prices in the context of the factors influencing renewable energy in the Republic of Moldova
Authors: Sargu Lilia , Guzun Sorina
Published: December 2023

The importance and complexity of the energy field worldwide, including for the Republic of Moldova, the problems and challenges that it faces (including and especially in the Republic of Moldova when it comes to security of supply and pricing), have led us to choose this field as an object of research for this research. The perspective of the price regulation mechanism, of the evolution of prices during the last decade, but also in order to present some aspects of energy security (in conditions of energy crisis in Europe), including a presentation of the measures intended by the authorities of the Republic of Moldova for the development of the sector energy sector of the Republic of Moldova will be an important source for those interested in this topic.
Turbulence in the development of Ukraine and Russian aggression as a destroyer of the agricultural sector
Authors: Varchenko Olga , Krysanov Dmytro , Tkachenko Kateryna
Published: December 2023

Turbulence acts as a key characteristic of the development of systems, processes, and structures of various natures, and when it increases, their destruction or self-organization occurs at a new level, resulting in transitions from disorder to order and vice versa. Stochastic systems have a state determined by a random combination of its components, both internal and external, at different times, and the final result cannot be clearly predicted or precisely predicted. Therefore, the key problem of modern times is to ensure sustainable development of socio-economic and other multi-sectoral systems under the conditions of increased turbulence. An extremely powerful source of turbulence is the Russian-Ukrainian war, which arose suddenly and avalanche-like destroyed and continues to destroy the existing order and is accompanied by unpredictable and catastrophic consequences. The devastating consequences of military operations on Ukrainian territory caused and continue to cause significant damage to the national economy, including and the agricultural sector, and its restoration requires significant financial, material and human resources and a long time.
Obesity stigma between identity and wellbeing
Authors: Roca Tatiana
Published: December 2023

The work derives from the felt need to dissect the dimension of lived bodily experience and to investigate the facets that are involved in the psychological well-being of the individual. Although this issue is present and central in various contexts of the individual's daily life, it is addressed by resorting to a psychosocial dictionary characterized by stereotypes, prejudices and aesthetic standards, which approach corporeality in a superficial and reductive way, instead of seeking to explore deeper meaning of the body.
Some psychological aspects of the development of intellectual abilities of junior schoolchildren in the process of learning activity
Authors: Tomilina Liliana , Ushnurtseva Nina
Published: December 2023

Nowadays there is a change in the mentality of society, the growth of information and culture. These processes necessitate the development of intellectual abilities. In elementary school the basic mental functions of personality (attention, perception, memory, imagination, thinking, speech) are most intensively developed, its tasks are revealed, intellectual qualities are formed, and intellectual abilities are developed. The article presents some aspects of improving the intellectual abilities of junior schoolchildren, as well as methods of identifying the levels of intellectual abilities. The results of application of the system of specially organized classes for the purpose of development of intellectual ability of pupils are presented.
Phytochemistry, Ethnobotanical uses and Pharmacology of Borago officinalis Linn: A Review
Authors: Kumari Archana , Jeet Kamal , Kumar Sanjay
Published: December 2023

The plant Borage (Borago officinalis L.) family-Boraginaceae, also known as "starflower" is an annual herb originating in Syria, but naturalized throughout the Mediterranean region, as well as Asia Minor, Europe, North Africa, and South America. Aims of the Review The purpose of this study is to provide comprehensive scientific information on the phytochemistry, traditional uses and pharmacological activities of Borago officinalis L. The plant is reputed as hepatoprotective, gastrointestinal, respiratory anxiolytic, antispasmodic, antihypertensive, antipyretic, aphrodisiac, demulcent, diuretic and is also considered useful to treat asthma, bronchitis, cramps, palpitations and kidney ailments. Borage oil has been reported to lower serum cholesterol, phospholipids and triglyceride levels and increases the levels of 6 polyunsaturated fatty acids in the plasma, liver, aorta and renal artery tissues and ω -3 polyunsaturated fatty acids (PUFAs) obtained from Borago officinalis L. Dietary use of borage oil exhibited immuno -modulatory, cytotoxic and free radical scavenging activities. Borage has gained importance, due to the occurrence of high levels of g-linolenic acid in its seed oil. Flavonoids and phenolic compounds were the important essential oils in this plant and no have tannin. Borago officinalis extracts demonstrated excellent antioxidant properties and these effects were attributed to their phenolic constituents. Few studies examining Iron, Copper, Zinc and Manganese fertility in Borage have been conducted, but they are not specific to the medicinal use of this plant.
Review Article on Phytochemical and Pharmacological Activities of Alpinia purpurata and Erythrina variegata
Authors: Sumi P. , Devi N. Nirmala
Published: December 2023

In this review the phytochemistry and pharmacology of an ornamental ginger, Alpinia purpurata (red ginger) and Erythrina variegata are updated. Alpinia is the largest genus in ginger family in which. The phytochemical studies on Alpinia purpurata revealed that it possess flavonoids, rutin, kaempferol-3-rutinoside and kaempferol-3-glucuronide. These phytoconstituents promote antimicrobial activity, anti-inflammatory disease and also have the potential to treat tuberculosis. It also serves as a potential source of natural antioxidants. Alpinia purpurata also used for headache, sore throat and renal disease. Plant Erythrina variegata rich in secondary metabolites such as phenolics, alkaloids, tannins. and saponins in their ethanolic extract. They also show anti-allergic, anti-inflammatory, antimicrobial and anticancer activity. In the phytochemical investigation, ethanolic extract of Erythrina variegata L. flowers confirmed more phytoconstituents while comparing to leaf and bark. The Erythrina variegata flowers exhibit more antioxidant activity and also have high protective activity against oxidative stress and also helps to fight against diseases like cancer, diabetes mellitus and other diseases.
MANAJEMEN KURIKULUM MADARISUD DINIYAH NAHDLATUT THULLAB PONDOK PESANTREN AL IHYA â€˜ULUMADDIN KESUGIHAN CILACAP
Authors: Muammarulloh Abdul Gina Arrouf
Published: December 2023

Penelitian ini bertujuan untuk menganalisis keberjalanan manajemen kurikulum Madarisud Diniyah Nahdlatut Thullab Pondok Pesantren Al Ihya â€˜Ulumaddin Kesugihan Cilacap. Metode penelitian yang digunakan dalam penelitian ini adalah kualitatif dengan pendekatan deskriptif.

Manajemen kurikulum Madarisud Diniyah Nahdlatut Thullab Pondok Pesantren Al Ihya â€˜Ulumaddin Kesugihan Cilacap secara umum sudah baik, hal ini bisa dibuktikan dengan bahwa didalam manajemen di madrasah tersebut terdapat perencanaan, pengorganisasian, pelaksanaan dan evaluasi.
UPAYA PENINGKATAN KETERAMPILAN SISWA MELALUI PROGRAM KELAS KETERAMPILAN TKR (TATA KECANTIKAN KULIT DAN RAMBUT) DAN TOKR (TEKNIK OTOMOTIF DAN KENDARAAN RINGAN) DI MAN 2 NGAWI
Authors: Amelia Innayah  , Zamzam Mustofa  , Mukminin Amir
Published: December 2023

This study aims to reveal: (1) Mechanisms of Implementation of the SHB (Skin and Hair Beauty) and ALVE (Automotive and Light Vehicle Engineering) Skills Class Program (2) Students’ Enthusiasm for Participating in the SHB (Skin and Hair Beauty) Skills Class Program and ALVE (Automotive and Light Vehicle Engineering). The method of this research uses qualitative methods, and the data is obtained through interviews. The results of this study are: First, this skills class program is held once a week after school. The SHB class is held every Monday, while the ALVE class is held every Saturday.  Each meeting takes approximately 45 minutes. Second, students at MAN 2 Ngawi are very enthusiastic about participating in the skills class program, because they can hone their talents and interests which will certainly be useful in the future.
IRRATIONAL ATTITUDES, GENDER STEREOTYPES OF PERSONALITY
AND ATTITUDE TO BODY ”I”
(ON THE EXAMPLE OF OLDER ADOLESCENTS)
Authors: STRIZHONOK E. , ANDRIEVSKAYA S.
Published: December 2023

The article analyzes the relationship between irrational attitudes, gender stereotypes and attitudes towards the
bodily “I” in older adolescents. The study revealed the relationship between some indicators of irrational attitudes and
attitudes towards their body and health in adolescents. It has been established that the higher the irrational attitudes of
catastrophization, irrationality of thinking, obligations towards other people in adolescents, the lower the indicators of
health orientation, physical education orientation, positive assessment of one's health and satisfaction with parts of one's
body. Adolescents with a high level of tolerance for frustration better assess their physical fitness and health, and those
adolescents who are more susceptible to stereotypes about gender differences in professional activities are more focused
on their appearance.
Revisão sistemática de Internet das Coisas aplicada em restaurantes e bares
Authors: Mai Natan José , Spohn Marco Aurélio
Published: December 2023

Apesar da importância do setor de restaurantes, presente em todos os 5570 municípios brasileiros, observa-se problemas recorrentes. As principais dificuldades são o desperdício alimentar, segurança alimentar, falta de mão de obra qualificada,consumo elevado de energia, gerenciamento de estoque e controle e monitoramento de equipamentos. A utilização de tecnologias para automação de processos, coleta de dados e suporte na tomada de decisões pode possibilitar odesenvolvimento e gerenciamento desses estabelecimentos. Neste trabalho, objetiva-se mapear soluções que utilizem Internet das Coisas na área de restaurantes. Para isso, o método de pesquisa utilizado foi a revisão sistemática de literatura. Os resultados mostram que o setor de hospitalidade compõe uma fatia importante da economia dos países,mas que ainda possui dificuldades em gerenciar questões relevantes como desperdício e segurança alimentar. Por essas e outras necessidades, a aplicação de tecnologias em evolução, como é o caso da Internet das Coisas, pode se tornar uma ferramenta útil para o desenvolvimento de restaurantes.
To Evaluate the Frequencies of Post- Traumatic Cerebrospinal Fluid Leak in Patients Presenting with Traumatic Brain Injury
Authors: Ullah Hameed , Khan Hashim , Khan Hamza , Malik Sahar
Published: December 2023

Introduction: Traumatic brain injury is the fourth largest cause of fatal trauma worldwide. The social and economic implications of traumatic brain injuries are immense whilst the physical and mental bearing upon the patient is devastating. Objective: Objective of this study is to evaluate the frequencies of post- traumatic cerebrospinal fluid leak in patients presenting with traumatic brain injury. Methodology of the study: This study was conducted at Neuro Surgery Department of Lady Reading Hospital, Peshawar during 20/7/2020 to 20/1/2021.In the current study a total of 303 patients presenting with initial head trauma presenting within 24 hours with Glasgow coma score ≤15, patients in age between 18 to 65 years and both gender (male/female) were included in the study. All the patients were subjected for detailed history, clinical examination and radiological examination i.e. CT and MRI was done for the confirmation of brain injury. All the patients were followed till 7th post operative day for the diagnosis of Cerebrospinal fluid leak. It is clear water cerebrospinal fluid discharge diagnosed on clinical examination till 7th post-trauma day and was determined in terms of rhinorrhea or otorrhea. Results: Our study shows that among 303 patients was analyzed as 215(71%) patients were in age range 18-40 years, 88(29%) patients were in age range 41-65 years. 239(79%) patients were male and 64(21%) patients were female. More over 18(6%) patients had CSF leak while 285(94%) patients didn’t had CSF leak. Practical Implication: This study will be useful for finding the post-traumatic cerebrospinal fluid leak. Conclusion: Our study concludes that the frequencies of post-traumatic cerebrospinal fluid leak was 6% in patients presenting with traumatic brain injury. Keywords: Post-traumatic cerebrospinal fluid leak, traumatic brain injury.
Evaluation of the Efficacy of Ultrasound-Guided Interventions in Managing First-Trimester Vaginal Bleeding
Authors: Naz Aasma , Khatoon Hafiza , Jamali Abid Hussain , Irum Fozia , Memon Kiran , Jatoi Shazia Ahmed , Aamir Kiran , Ramzan Aamir
Published: December 2023

Objective: Aim was to evaluate the efficacy of ultrasound-guided interventions in managing first-trimester vaginal bleeding. Study Design: Observational study Place and Duration: Gynaecology and Obstetrics Department people university of Medical and health sciences jamshoro Hyderabad. January 2022-December 2022 Methods: Total 116 pregnant females of first trimester were presented in this study. All the presented women had complaint of vaginal bleeding. Included patients had gestational age between 6-12 weeks. After a thorough clinical evaluation and diagnosis, patients were sent for an ultrasound. Ultrasound results were evaluated in terms of pregnancy type and types of abortions. SPSS 23.0 was used to analyze all data. Results: There were majority primi-gravida women 72 (62.1%) and 44 (37.9%) females were multigravida. Females mean age 27.5±12.19 years and had mean BMI 27.8±4.23 kg/m2. Mean gestational age of the females was 10.2±4.17 weeks. Frequency of viable patients was 36 (31.03%) and non-viable patients was 80 (68.97%). Among 80 non-viable cases, different type of abortions was found in 62 (67.5%) cases, ectopic pregnancy in 10 (12.5%) cases and molar pregnancy in 8 (10%) cases. Conclusion: Ultrasonography is the most accurate and non-invasive diagnostic method for distinguishing between the various conditions and phases of first trimester bleeding in pregnant women. The use of ultrasonography for prenatal screening has opened up new avenues for the timely treatment of patients, which has been shown to minimize death rates associated with pregnancy complications. Keywords: Abortion, First Trimester, Molar pregnancy, Ectopic Pregnancy
Immediate Effects of Dry Needling vs. Functional Dry Needling in Patients with Shortened Calf Muscles
Authors: Javed Muhammad Taha , Mughal Samraiz , Rani Ayesha , Jabbar Kinza , Kanwal Zahra , Nadeem Zainab , Fiaz Muhammad Khurram , Qamar Hamza
Published: December 2023

Background: Shortened muscle is a condition of physical shortening of the length of the muscle and is also accompanied by other soft tissues surrounding the muscle. In shortened calf muscles the muscles (gastrocnemius and soleus) of lower leg have reduction in their length resulting in pain, reduced range of motion of joint and somehow limiting the functional ability and capability of and individual. The use of dry needling as well as functional dry needling is thought to reduce pain and increase range of motion. Objective: This study was aimed at finding the immediate effects of dry needling versus functional dry needling on pain and range of motion. Methods: It was a quasi-experimental study conducted at Buch International Hospital, Multan & Ali Rehabilitation & pain relief center, Multan from February 01, 2023, to April 31, 2023. There were two groups in total. One group was provided with functional dry needling and the other with dry needling. Only single session was taken and measurements of Numeric Pain Rating Scale and range of motion with goniometry were recorded before and after the treatment. SPSS-27 was used to analyze the data. Results: There were a total of 40 patients. 20 patients were assigned to functional dry needling group and 20 patients to dry needling group. The mean age of patients was 27.65 + 2.368 and 27.80 + 1.852 in functional dry needling and dry needling groups respectively. Pain severity in functional dry needling group reduced significantly compared to dry needling group at the end of the session (p-value=<0.01). Active range of motion and passive range of motion were found non-significant at the end of session (p-value=.089 and p-value=.146) respectively. Conclusion: Both functional dry needling and dry needling reduces pain severity but functional dry needling resulted in reduction in pain severity more than dry needling whereas, both showed non-significant effects on range of motion. Keywords: FDN; functional dry needling, DN; dry needling, AROM; active range of motion, PROM; passive range of motion.
Relationship Between High Sodium Chloride Intake and Obesity in Hypertensive Population A Cross-Sectional Study
Authors: Shahid Muhammad Nauman , Saad Khawaja Allah Ditta , Sherazi Alizea Fatima , Zubair Dania , Faseeh Maryam , Murtaza Syed Mohammad
Published: December 2023

Background: High Sodium chloride intake and obesity are significant, regarding hypertension in the population which may develop several medical complications. Objective: The aims and objectives of the current study were to introduce lifestyle medicine awareness in people for managing high blood pressure caused by high sodium chloride intake and obesity. Study Design: It was a cross-sectional clinical Study of the management of high blood pressure in a population with the help of nutrition & physical exercise. Place and Duration: The present study was conducted from January to May 2023 and Patients were selected from the community health center and Ghurky Hospital Lahore. Methodology: ToA total of 10 of 0 hypertensive individuals were selected and divided into different groups regarding hypertension, obesity, sodium chloride intake in daily life, and other demographics. People were separated into different groups based on their sodium intake levels and BMI people were separated into different groups. In group- A there was 50 male and female while in group B other 50 male and female were included respectively. Results: Significant (P≤0.05) changes in systolic and diastolic blood pressure were seen in the individuals of both groups regarding NaCl intake. The mean standard deviation levels, BMI, Systolic and Diastolic blood pressure of men in Group-A and Group-B in the beginning (27.03±0.02, 130.01±0.01, 90.01±0.02), (30.01±0.02, 135.01±0.01, 90.01±0.02) after 15 days (27.03±0.02, 125.01±0.01, 83.01±0.01), (30.01±0.02, 140.01±0.01, 90.01±0.02) and after30 days (27.03±0.02, 124.01±0.01, 80.01±0.01), (30.01±0.02, 145.01±0.01, 100.01±0.01) were measured respectively. Similarly the mean standard deviation levels, BMI, Systolic and Diastolic blood pressure of women in Group-A and Group B in the beginning (28.03±0.02, 131.01±0.01, 88.01±0.02), (31.02±0.02, 131.01±0.01, 88.01±0.02) after 15 days (28.03±0.02, 125.01±0.01, 83.01±0.01), (31.02±0.02, 140.01±0.01, 90.01±0.02) and after30 days (28.03±0.02, 120.01±0.01, 84.01±0.01), (31.02±0.02, 150.01±0.01, 92.01±0.01) were calculated. Conclusion: All recommendations suggest limiting dietary salt as one of the tried-and-true ways to lower high blood pressure because there is a well-established link between excessive salt consumption and hypertension. A current study proved that high sodium chloride intake may increase blood pressure in humans. Keywords: Hypertensive, Sodium Chloride, BMI, Systolic and Diastolic blood pressure.
Dysfunction of the Gut Microbiome and its Onset Progression of Chronic and Mental Health Disorders
Authors: Ameen Ayesha , Amir Anam , Aziz Muhammad Nauman , Irshad Asma , . Maryam , Hayat Shehr
Published: December 2023

The gut microbiome is a complex community of microbes that inhabits the gastrointestinal tract and plays a crucial role in maintaining human health. Recent research has demonstrated that gut dysbiosis, or an imbalance in the microbiome, is associated with the development of various chronic and psychiatric diseases, such as obesity, cardiovascular disease, and depression. The mechanisms by which gut dysbiosis contributes to disease development involve alterations in the gut-brain axis, gut-liver axis, and gut-immune system interactions. Studies have shown that gut microbiome dysbiosis can cause up-regulation of certain pathways involved in disease development, including systemic inflammation, oxidative stress, and intestinal permeability. Additionally, gut dysbiosis has been linked to alterations in neurotransmitter synthesis and gut hormone secretion, which can influence the brain and contribute to mood and cognitive disorders. Further research is necessary to fully comprehend the mechanisms underlying this relationship and to develop effective strategies for the prevention and treatment of chronic and psychiatric diseases. In conclusion, gut microbiome dysbiosis plays a critical role in the up-regulation and development of chronic and psychiatric diseases and is an area of growing interest in the scientific community. Further investigation is needed to fully understand the mechanisms underlying this relationship and to develop effective treatments and interventions. Keywords: Gut microbiome , chronic, mental health, dysfunction
Rethinking Prophylaxis: Evaluating Surgical Site Infection Rates in Pediatric Orchidopexy without Prophylactic Antibiotics
Authors: Ullah Waqar , Khan Naseem , Muhammad Amir , Rashid Fazli , Saeed Khawar
Published: December 2023

Introduction: Undescended testes (UDT) is the most common congenital anomaly of the urogenital system in male newborns. Testicular descent into scrotum is necessary for normal spermatogenesis. The scrotal temperature is 2-7 degrees below body temperature. UDT are prone to impaired spermatogenesis, Surgical site infection (SSI) is a leading cause of postoperative morbidity and mortality. It is the third most common cause of hospital acquired infections. However injudicious use of antibiotics is responsible for increased costs, unwanted drug side effects like Clostridium difficile infection as well as the emergence of resistant strains and multidrug resistant infections. Objective: To determine the frequency of surgical site infection in pediatric patients undergoing orchidopexy without the administration of prophylactic antibiotics. Study Design: Descriptive Study Setting: Department of pediatrics, Lady Reading Hospital Peshawar. Duration of Study: From 08-July-2020 to 08-January-2021. Materials and Methods: In overall 126 respondents of undescended testis were selected in a consecutive manner OPD and subjected to orchidopexy. Follow up was done to detect the presence or absence or SSI. Results: The average age of the sample was 12.9+6.8 months. Mean weight of the included children was 12.8 4.9 kg and mean height was 73.1+ 13.5 cm. 50.8% Presented with right side undescended testis and 57.1% were in ASA class Mean operative time for orchidopexy was 44.4 10.3 minutes. SSI was recorded in 31 (24.6%) of children. Conclusion: Surgical site infection (SSI) is a significant concern in pediatric patients undergoing orchidopexy for unilateral undescended testis. Additional investigation is required to determine the factors that contribute to surgical site infections (SSI) in children and create successful measures for prevention. The use of prophylactic antibiotics should be carefully considered, considering the potential risks and benefits. Addressing SSI in this population is crucial for improving patient outcomes and reducing the burden of complications. Keywords: Orchidopexy, pediatrics, surgical site infection
Relationship and Prevalence of Death Anxiety and Religious Coping among Death Care Workers in Pakistan
Authors: Tufail Lubaba , Riaz Wajeeha , Rizvi Vania , Imtiaz Sana , Qureshi Zarbab
Published: December 2023

Purpose: Death is an inevitable experience that may generate a reduced sense of safety and strong apprehension in humans. Some jobs that require the workers to deal with human deaths, corpses, and people grieving the loss of their loved ones for a larger part of their professional existence such as graveyard workers, morgue workers, ambulance drivers, and emergency medical workers, possess the potential to impact their death anxiety.Given this, the study aims to find the prevalence of death anxiety among death care workers, as hypothesized that the nature of professions would impact the levels of death anxiety, and the positive religious coping would be negatively correlated with the death anxiety while the negative religious coping to be positively correlated to the death anxiety. Design: The sample consists of Pakistani, adult males and females (N=200), belonging to the aforementioned professions. Moreover, the study follows quantitative survey-based research design, using Templer’s Death Anxiety Scale (DAS)-Urdu version and Pargament’s Brief R-COPE-Urdu version Scale. For this purpose, a variety of hospitals, cemeteries, and mortuaries around Karachi were visited to gather relevant data. Findings: The results indicate that the levels of death anxiety varied across all professions, wherein the highest death anxiety was experienced by graveyard workers in contrast to ambulance drivers who had the lowest. With reference to religious coping, positive coping surpassed negative coping and emerged as the superior coping. However, there was no significant correlation between death anxiety and religious coping (positive and negative). Conclusion: This study exhibited some significant patterns of interest but encompasses the potential for further replication. Keywords: Death anxiety, prevalence, religious coping, death care workers, emergency medical workers
A Comparison of Clinical Outcomes of Single Versus Two Miniplate Fixation of Parasymphysis Fracture
Authors: Hashmi Safoora , Ch., Asif Nazir , Fareed Inqalab , Liaqat Sahrish , Waqas Muhammad Abi , Ahmad Fareed
Published: December 2023

Background: Many methods have been discovered to treat the fracture of parasymphysis region of mandible i.e., using miniplates. However not many studies have been done to prove the good clinical outcomes of one miniplate versus two miniplates. Aim: The purpose of the study is to compare the clinical results of one miniplate vs two miniplate for the parasymphysis of mandible. Material and Methods: 20 patients were treated with single miniplate and 20 for 2 miniplates. Many outcomes variable after surgery such as post-surgical scar, mental nerve paresthesia, need for plate removal and interincisal opening were calculated and interpreted using chi square test. Results: All outcome variables such as post-surgical scar, mental nerve paresthesia, need for plate removal and interincisal opening did not show any statistically significant relation with both groups(P value >0.05). Conclusion: Both types of miniplate ensure osseous healing but depending upon the individual factors such as mandible height and bio mechanics pattern should be considered before deciding scheme of treatment for an individual. Keywords: miniplate fixation, parasymphysis mandible, osteosynthesis.
Demographic Characteristics of Patients with COVID in Private Tertiary Hospital in Islamabad
Authors: Naseer Sajjad , Nawaz Qasim , Hameed Aima , Khan Imran , Gul Wajiha , Ali Asad
Published: December 2023

Background: the demographic characteristics of 100 COVID-19 patients from a private tertiary hospital in Islamabad were examined. The majority of the patients (72% of whom were female) were married (62%) and from the lower middle class (76%), with a median age of between 30 and 50 (47%). 57% of the patients were employed, putting them in a middle-class socioeconomic situation. The most often reported underlying comorbidities were coronary artery disease (5%), chronic lung disease (13%), diabetes (42%), and hypertension (47%). These results highlight the need to increase public awareness of the warning signals and preventative actions for this condition in vulnerable populations. Objective: In this study, the socioeconomic level, age, and gender of patients with COVID-19 who were being treated at a private tertiary hospital in Islamabad, Pakistan, were examined. Methods: The demographic information of 100 patients hospitalized with COVID-19 at a private tertiary hospital in Islamabad between January 2021 and January 2022 was examined in a retrospective research that we carried out. From patient records and medical reports, we gathered information on the patient's age, gender, socioeconomic position, present and underlying comorbidities, and other pertinent features. Results: The bulk of the patients (72% of whom were female) were aged between 30 and 50 (47%), were married (62%) and were from the lower middle class (76%). In terms of socioeconomic position, 57% of the patients were employed. Hypertension (47%), diabetes (42%), chronic lung disease (13%), and coronary artery disease (5%) were the most frequently reported underlying comorbidities. Conclusion: The findings highlight the need to raise public knowledge of the danger signs and protective measures for this illness in susceptible groups. Further study is required to understand the root causes of COVID-19 in Pakistan fully. Keywords: COVID-19, demographic characteristics, Islamabad, private tertiary hospital
Short Term Clinical Outcomes in Spine Surgeries. A Descriptive Cross Sectional Study in a Tertiary Care Hospital
Authors: Khan Muhammad Idris , Munir Adnan , Aziz Syed , Ali Hubab , Shah Syed Mansoor , Nasir Fawad
Published: December 2023

Objective: To find out the short-term post operative outcomes faced by patients undergoing various spine procedures. Study Setting: Neurosurgery department Khyber Teaching Hospital Peshawar Khyber Pakhtunkhwa. Study Duration: January 2022 to January 2023 Study Design: Cross-sectional study (descriptive). Material and Methods: After taking approval from the hospitals ethical and research committee a single center review of the medical records of all patients who underwent common surgical procedures of the spine were collected and patients followed for short term post -operative outcomes. Data was analyzed by using the statistical software SPSS version 23.0 and the results were presented in the form of tables and charts. Results: Out of 360 patients included in the study, 206 (57.2%) were males and 154 (42.8%) were females with a mean age of 41.3 ± 13.4. The highest percentage of patients presented with a PIVD at L4-L5 (n=176, 48.9%). It turns out that aged patients had more VRS scores compared to young candidates after surgery (p-value= 0.05) and patients who underwent only decompressive laminectomies had noticeable reduction frequency of discitis (p-value= 0.40) and a remarkable improvement in the VRS score after surgery (p value=<0.01) as compared to other procedures. Conclusion: Even though laminectomy, being the procedure of choice in so many cases, significantly treats neurogenic claudication, still unresolved back pain is the most common complaint made by patients in the post operative period. However, despite complications, patient satisfaction rates have improved over the period of time. Keywords: Post-operative complications, laminectomy, discectomy, neurosurgery