bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaccination Approaches of Primary Healthcare Personnel and Their Communication Levels with Parents Having Childhood Vaccine Hesitancy
Authors: Şirin Hülya , Şimşek Asiye Çiğdem , Birinci Şuayıp , Ülgü Mustafa Mahir , Gürer Giray Burcu
Published: September 2023

Vaccines have saved more lives than any other health development in the 20th century. One of the most cost-effective programs for reducing infant/child morbidity and mortality is the vaccination of children against common vaccine-preventable diseases. Türkiye is one of the countries that has managed to achieve a significant reduction in the incidence of vaccine-preventable diseases by increasing immunization rates. Currently, 13 different antigens are included in the vaccination calendar of the Ministry of Health of the Republic of Türkiye, and all vaccines to be administered (vaccination calendar) are determined and continuously updated by the Immunization Advisory Board of the Ministry of Health of the Republic of Türkiye. Our study is a cross-sectional descriptive study. A total of 410 family physicians and family health workers were included in the study. An interactive training meeting on vaccines, vaccine hesitancy, communication, and counseling was organized in 18 groups (including the study participants) in May-June 2019. A questionnaire form consisting of 24 topics was applied to the participants before the training presentation. When comparisons between groups were analyzed according to the answers given by the participants to some questions, it was found that 57.1% of the group with a good average of knowledge, attitude and behavior score reflecting the level of communication with parents with vaccine hesitancy had received training on vaccines and their characteristics, while 43.6% of the group with a poor average had received this training, and the difference was statistically significant (p=0.008). Parents with vaccine refusal were most hesitant about Measles-Mumps-Rubella (MMR) vaccine (87.7%). Healthcare professionals play a very important role in the provision of healthcare services and in the decision-making of families about vaccination with the counseling they provide all over the world. To reduce vaccine hesitancy, continuous education activities on vaccination for health professionals, the creation of educational materials for public education, the use of mass media, and legal regulations can be made.
The Relationship between Stress and the Number of Hours That Students in Bangkok Spend Traveling to and Back from School
Authors:   Assumption College, Bangkok, Thailand, Phaisarnmahasombat Jirat , Jitjang Kandee ,   Mater Dei School, Bangkok, Thailand, Nawamongkhon Nollaphan ,   Patumwan Demonstration School, Bangkok, Thailand
Published: September 2023

People living in Thailand spend approximately 2 hours traveling every day due to traffic jams and long distances from their home to the destination.[1] The problem is also faced by Thai adolescents, particularly high school students, who are susceptible to experience stress due to traveling to and from school. Thus, this study analyzes the relationship between stress and the number of hours high school students in Bangkok spend commuting to and from school by conducting survey research. The survey was conducted using online questionnaires given out to Thai high school students in Bangkok, where a total of 273 responses were collected and analyzed using Statistical Product and Service Solutions (SPSS). The result shows that commute time, leisure, and the change of transportation types are significantly related to stress with the p values of 0.27, 0.005, and 0.045, respectively. This indicates that stress increases in high school students are due to long commute times greater than 2 hours, less leisure time less than 3 hours, and transportation. Nonetheless, there is no considerable relationship between students’ grades and stress. Thus, travel time can influence teenagers’ stress levels, so children may consider studying near their home to prevent themselves from being stressed.
The Dilemmas of the Creative Industries: Developing a Checklist of the Challenges Faced by Arts-Related Creative Enterprises
Authors:   Sultan Qaboos University, Almamari Dr. Badar , Alhajri Dr. Salman ,   Sultan Qaboos University, Saadi Dr. Najlaa Al ,   Sultan Qaboos University, Monji Dr. Yasser ,   Sultan Qaboos University, Heba Dr. Islam ,   Sultan Qaboos University
Published: September 2023

The creative industries are considered one of the most important economic sectors in most countries around the world. This is because micro, small, and medium-sized enterprises have become more important than giant institutions in terms of sustaining their resilience in the face of financial crises. However, despite the superiority of their products in terms of quality, the creative industries are considered very fragile given the special nature of the consumers of said products. This fact has created significant challenges for the sector. This study wishes to reflect on these challenges in order to find solutions to them and devise proposals that will pave the way to understanding the nature of the creative industries. The study will review the difficulties in question to develop a checklist that can improve the working mechanisms of small arts-related creative enterprises.
Serrapeptasa como coadyuvante anti-inflamatorio posterior a trauma quirúrgico. Estudio experimental
Authors:   Cirujano plástico, reconstructivo y posbariátrico. Directora de la Unidad de Cirugía Plástica y Posbariátrica. Caracas, Venezuela, Rincón-Rubio Linda
Published: September 2023

Los antiinflamatorios no esteroideos (AINES) son muy efectivos para controlar la inflamación y el dolor, pero son lesivos en la mucosa gástrica y en promover el sangrado. En la búsqueda de una alternativa terapéutica mediante el uso de enzimas proteolíticas y antiedematosas, en este estudio se evaluó el efecto antiinflamatorio de la serrapeptasa (serratia peptidasa) versus AINES. Se presenta un estudio experimental, comparativo, transversal, de casos y controles.
Estudio piloto de la prevalencia del consumo de cigarrillos en adultos jóvenes en Maracaibo, Venezuela
Authors:   Universidad del Zulia, Facultad de Medicina. Cátedra de Fisiología Humana, Silva Paredes Carlos
Published: September 2023

Introducción: El tabaquismo se asocia con el desarrollo de enfermedades pulmonares crónicas, enfermedades cardiovasculares y distintos tipos de canceres. Los cigarrillos electrónicos son productos que se han considerados como una alternativa segura a los cigarrillos convencionales y, promocionados como menos dañinos. Estos dispositivos se han asociado a enfermedades pulmonares graves llamado EVALI. Objetivo: determinar la prevalencia del consumo de cigarrillos electrónicos y convencionales en la población de adultos jóvenes. Materiales y métodos: Se realizó un estudio piloto de tipo no experimental, transversal y descriptivo en 225 individuos seleccionados mediante un muestreo no probabilístico, de ambos sexos con edades comprendidas entre los 17 y 25 años de la ciudad de Maracaibo, Venezuela.
Effect of Moringa leaf supplements during pregnancy: Follow-up study on the development of pre-school children in rural area, Indonesia
Authors:   Master Program of Department of Nutrition, Faculty of Public Health, Hasanuddin University, Indonesia, Purnama Sari Syafri Andi Dian
Published: September 2023

This study is a follow-up study from experimental research that provides moringa supplements in the form of flour (GTK) and extract (GEK) as well as iron folate supplements (GBF) to pregnant women. Micronutrients are very important for the development of the child's brain during the womb and infancy. This study seeks to see the extent of the effect of Moringa leaf supplementation during pregnant women on the development of children at preschool age (5-6 years) in Jeneponto Regency. This study is an analytical observational study with a cross-sectional design with a total sample of 301 preschool-age children (5-6 years) taken by purposive sampling.in six sub-districts in Jeneponto Regency who when pregnant their mothers received moringa and iron folate supplements.
Validation study of the Gratitude Questionnaire–Six Item Form in a Venezuelan general population sample of young adults
Authors:   Universidad Metropolitana, Caracas, Venezuela. Universidad de Montevideo, Montevideo, Uruguay, García-Álvarez Diego
Published: September 2023

Introduction: Gratitude is widely contemplated in philosophy and theology, although its dissemination in psychology and health sciences is scarce. It is defined as the cognitive and affective state of appreciation in a person favored by a benefactor’s contributions. The Gratitude Questionnaire–Six Item Form is one of the most used scales for measuring this construct in several sociocultural contexts. Objectives: The aims were to determine the factorial, convergent, and discriminant validity and to identify its reliability and invariance according to gender, age, and residence.
COVID-19: Hematological and laboratory parameters in patients hospitalized during the second and third epidemic wave (2021-2022) at a private hospital in Caracas, Venezuela
Authors:   Clínica El Ávila, Caracas, Venezuela. Escuela de Medicina Luis Razetti, Facultad de Medicina, UCV, Müller Aixa
Published: September 2023

The first wave of COVID-19 in Venezuela began in March 2020 and had a maximum of cases in August 2020. New outbreaks occurred in 2021 and 2022, during which we studied 603 hospitalized cases at the Clinica El Avila de Caracas: 370 (61.35 %) male and 233 (38.14 %) female. The average age was 65 years (range: 18-99 years). The hematological and laboratory studies were similar to those reported in 2020other studies outside of Venezuela. One hundred two (102) patients were transferred to the Intensive Care Unit (ICU). 80 % of these patients had not been vaccinated or did not receive the full vaccination schedule against COVID-19. The overall mortality of the 603 patients was 11.27 %.
Effect of Pumpkin Seed Capsules on Nutritional Status and Hemoglobin Levels of Pregnant Women with Chronic Energy Deficiency
Authors:   Magister Student of Nutrition Science Departement, Faculty of Public Health, Hasanuddin University, Indonesia. 90245, Tri Nurrahmi Arine
Published: September 2023

The nutritional state of pregnant women will affect the growth and development of the fetus from birth to adulthood. One of the nutritional problems of pregnant women is Chronic Energy Deficiency (CED). CED is one of the malnutrition problems that often occur in pregnant, caused by a lack of food intake and energy over a long period of time. One of the effects of pregnant suffering from CED is to increase the risk of maternal and short baby mortality. Pumpkin seeds are rich in macro and micronutrients. The content of micronutrients in pumpkin seeds can improve the nutritional status of pregnant women.
Urogenital disease morbidity among the adult and child population of the Osh Region for the period from 2010 to 2019
Authors:   Osh State University, Tazhidinovich Gulamov Isabek
Published: September 2023

It is presented the results of a study on the prevalence, structure, and trends in urogenital diseases in the adult population of the Osh Region of Kyrgyzstan for the period between 2010 and 2019. Official statistics on morbidity provided by the National Statistical Committee of the Kyrgyz Republic are used as materials for the study. Information on the main indices characterizing adult morbidity is selected and summarized, and dynamic statistical analysis of the data is performed. The data analysis demonstrates that the highest morbidity of urogenital diseases in the Osh Region was registered in 2017, and the lowest – in 2019.
Conceptos actuales del diagnóstico y tratamiento de la artritis psoriásica
Authors:   Grupo de Investigación Espondiloartropatías, Universidad de La Sabana. Chía, Colombia, Santacruz Juan Camilo
Published: September 2023

La artritis psoriásica (APs) es una enfermedad autoinmune sistémica asociada a la psoriasis, conocida ahora dentro de un único espectro llamado enfermedad psoriásica, y otras comorbilidades como lo son enfermedad cardiovascular, síndrome metabólico, inflamación intestinal subclínica, trastornos del estado de ánimo, mayor riesgo de infecciones crónicas y fibromialgia. El compromiso articular en esta enfermedad es de presentación heterogénea, incluyendo tanto las articulaciones periféricas como axiales, acompañadas de otras manifestaciones clínicas como lo son la presencia de entesitis, dactilitis y el compromiso ungueal. Gracias a los avances en el entendimiento de su fisiopatología se ha logrado desarrollar en los últimos años un arsenal terapéutico suficiente para controlar la mayoría de sus dominios clínicos.
Utilización de un disolvente biocompatible del polidimetilsiloxano (silicón) en un modelo experimental
Authors:   Cirujano plástico, reconstructivo y posbariátrico. Directora de la Unidad de Cirugía Plástica y Posbariátrica. Caracas, Venezuela, Rincón-Rubio Linda
Published: September 2023

La ruptura o filtración de los implantes de la glándula mamaria hacen necesario retirar el silicón del bolsillo periprotésico, por lo que se plantea el uso de una sustancia inocua que permita eliminar la mayor cantidad del mismo. El objetivo del presente estudio fue evaluar la posibilidad de la existencia de un disolvente del polimetilsiloxano, biocompatible y eficiente, para ser utilizado en el bolsillo periprotésico que contenga silicón libre. Se realizó un estudio experimental, comparativo, transversal, de casos y controles. La muestra estuvo compuesta por 7 ratas de la cepa Sprague-Dawley, con peso comprendido entre 150 y 200 g. En la primera fase se elaboraron disolventes de silicón biocompatibles, se probaron macroscópicamente en 2 colgajos resecados de abdominoplastias de 2 pacientes femeninas que se impregnaron con gel de silicón cohesivo de implantes mamarios lisos.
El ejercicio profesional de la medicina y las redes sociales: consideraciones bioéticas
Authors:   Universidad Austral De Chile. Instituto de Anatomía, Histología y Patología, Urdaneta José Ramón
Published: September 2023

El desarrollo de las redes sociales ha impactado en diferentes aspectos de la vida de las personas incluyendo la salud. Día tras día surgen nuevas redes sociales con las cuales interactúan millones de personas alrededor del mundo, incluyendo los médicos y otros profesionales sanitarios. Sin embargo, poco se sabe de las dificultades y retos que implican su utilización en el campo de la salud y las implicancias bioéticas que conllevan su uso en el ejercicio profesional de la medicina. Por ello, se presenta una revisión narrativa de este tema, a fin de aquilatar sobre las consideraciones bioéticas inherentes a la interacción de los médicos en las distintas redes sociales disponibles en la actualidad.
Systematic review on the efficacy of behavioral activation therapy in the management of adult patients with depression
Authors:   Universidad de Santander Campus Cúcuta, Riaño-Camperos Mariajose
Published: September 2023

Introduction: This work aimed to assess the approach of behavioral activation for the treatment of adult patients diagnosed with depressive disorder; the importance of this study in the clinical setting is significant since it allowed us to know the viability and acceptability of the treatment. Behavioral activation is the basis of this study. Materials and method: Systematic review, under the PRISMA methodology, the PICO tool was implemented to formulate the research question. Results: 42 articles were located, of which, upon complete reading, 23 met the inclusion criteria established for the review.
A case report on attempted suicide by self-slitting resulting in laryngeal fracture
Authors:   Department of Otorhinolaryngology - Head and Neck Surgery Medical Faculty Hasanuddin University, Makassar, Indonesia, Perkasa Muhammad Fadjar
Published: September 2023

Introduction: Laryngeal fractures cause significant problems with airway patency, vocal production, and swallowing function. The mechanism of injury can be sharp or blunt and can occur in the supraglottic, glottic, or infraglottic regions. Blunt external trauma to the neck caused by motor vehicle accidents, sports-related trauma, assault, and strangulation are the most frequent causes of laryngeal ruptures and fractures. Penetrating trauma is the second leading cause, often due to gunshot or stab wounds to the neck. The immediate goal in patients presenting to the emergency department with laryngeal rupture is to secure the airway. One of the indications for tracheostomy placement includes acute respiratory failure with the need for prolonged mechanical ventilation.
Hablemos de honorarios médicos en la publicidad de las redes sociales
Authors:   Especialista en Pediatría y Puericultura. Magister Scientiarum en Bioética. Doctorando en Ciencias de la Salud de la Universidad de Castilla-La Mancha. Miembro Titular de la Sociedad Venezolana de Puericultura y Pediatría. Miembro de Número del Centro Nacional de Bioética. Invitado de Cortesía de la Academia Nacional de Medicina, Rojas Loyola Germán
Published: September 2023

La mención explícita de honorarios en la publicidad de algunos médicos en las redes sociales es un grave problema que afecta a la profesión médica y a los pacientes. En una simple búsqueda de Instagram o Facebook se tomaron dieciséis imágenes publicitarias. En ellas se identificó el problema y se describieron las estrategias de Marketing utilizadas en conflicto con el valor del acto médico. El Código de Deontología Médica señala que esta conducta está expresamente reñida con las normas de la ética médica (artículo 28.c); sin embargo, se requiere deliberar sobre el tema para hacer visible el problema y mostrar salidas óptimas que ayuden al médico al logro progresivo de su autonomía moral.
Academic procrastination in students at a private university in the Peruvian Amazon: A cross-sectional study
Authors:   Universidad Nacional Amazónica de Madre de Dios, Estrada-Araoz Edwin Gustavo
Published: September 2023

Introduction: Procrastination is considered a fairly recurring behavior since ancient times, as people tend to postpone activities that are considered complex, not very motivating, stressful or that do not generate interest. Objective: To analyze academic procrastination in students from a private university in the Peruvian Amazon. Methods: The approach was quantitative, the design was non-experimental, and the type was descriptive and transactional. Academic procrastination was evaluated in 275 students of the Administration, Accounting, and Law careers by applying the Academic Procrastination Scale, an instrument with adequate psychometric properties.
Efectos de la inyección subdérmica de pentoxifilina en la integración de los injertos cutáneos de espesor total en un modelo animal
Authors:   Cirujano plástico, reconstructivo y posbariátrico. Directora de la Unidad de Cirugía Plástica y Posbariátrica. Caracas, Venezuela, Rincón-Rubio Linda
Published: September 2023

Los injertos cutáneos son una herramienta ampliamente utilizada en el campo de la cirugía plástica y reconstructiva, por lo que es de gran importancia la búsqueda de técnicas que permitan una optimización de la integración de los mismos. Este estudio evaluó los efectos macro y microscópicos de la administración subdérmica de pentoxifilina (PTX) en la integración de los injertos cutáneos de espesor total. En un modelo experimental, controlado, aleatorizado, en 8 ratas, distribuidas en 2 grupos, 2 para control y 6 del ensayo experimental.
Eficacia de la citología, colposcopia y microcolpohisteroscopia en el diagnóstico de lesiones intraepiteliales de cuello uterino
Authors:   Ginecólogo Obstetra. Fellow en Microcolpohisteroscopia y Endocervicoscopia. Residente del Postgrado de Ginecología Oncológica, SOH-IVSS, Leal Diaz Claudia
Published: September 2023

Introducción: La identificación temprana de lesiones preinvasoras de cuello uterino es fundamental y se realiza a través de procedimientos no invasivos. Objetivo: Evaluar la eficacia de la citología, colposcopia y microcolpohisteroscopia en el diagnóstico de lesiones intraepiteliales de cuello uterino. Método: Se realizó una investigación de carácter descriptivo observacional y transversal. Con población de 185 pacientes, mediante la elección de criterios de inclusión y de exclusión, se realizó selección intencional de la muestra que estuvo representada por 17 pacientes, los procedimientos se realizaron en cuatro fases en orden de citología, colposcopia, microcolpohisteroscopia para observar las características de las células en vivo y biopsia.
Estandarización de la técnica PCR anidada para la detección de las translocaciones PML/RARα, RUNX1/RUNX1T1 y BCR/ABL en pacientes con leucemia mieloide aguda remitidos a la Unidad de Diagnóstico Molecular de la Fundación Jacinto Convit
Authors:   Licenciada en Biología, Mención Biología Celular, Rivodó Thais
Published: September 2023

La detección de alteraciones genéticas en pacientes con leucemia mieloide aguda (LMA) permite un mejor pronóstico de la enfermedad y de la respuesta clínica de los pacientes. A través de la técnica de reacción en cadena de la polimerasa con transcripción reversa (RT-PCR, por sus siglas en inglés) anidada, es posible detectar hasta 1 célula mutada/10-6 células sanas, de las translocaciones cromosómicas más frecuentes en pacientes con LMA: t(15;17), t(8;21) y t(9;22). La sensibilidad y eficacia de esta técnica depende fundamentalmente del diseño de los cebadores utilizados en la reacción.
Gender Differences in the Morphological Severity of Mitral Stenosis in Patients Presenting in a Tertiary Care Hospital
Authors: Imran Hanif  , Masooma Ahmad  , Wardah Anwar  , Maria Ilyas  , Ambreen Anjum  , Umair Hanif  , Majid Kaleem
Published: September 2023

Introduction: Mitral stenosis is most common among rheumatic valvular heart disease. The morphological severity of the mitral valve is assessed by Wilkins scoring on echocardiography. Substantial gender-related differences regarding mitral valve and other cardiovascular diseases are reported. Data showed men and women had a different risk for valvular heart diseases. This study aims to ascertain if there is any gender-specific difference in the morphological severity of mitral stenosis based on Wilkin’s scoring in a tertiary care Cardiology Center.
Aims & Objectives: To report differences in morphological severity of mitral stenosis in male and female gender based on Wilkin’s scoring.
Place and duration of study: Cardiology Department of Gulab Devi Teaching Hospital. This Study was completed in one year.
Material & Methods: A descriptive cross-sectional study on 152 patients presenting in the Cardiology Department of Gulab Devi Teaching Hospital. The study was conducted after obtaining ethical approval from the Institutional Ethical Review Board.
Results: A total of 152 subjects participated among which 80 male patients and 72 females. The severity of the disease was divided into mild, moderate and severe. No gender related difference was observed in echocardiographic parameters. Regarding morphological assessment based on Wilkin’s score, significant difference was observed only in the values of Valve leaflet thickness.
Conclusion: The results of this study didn’t show a clear and significant difference in morphological severity of mitral stenosis when compared between male and female gender. So, each patient regardless of gender should be carefully screened and assessed while deciding treatment strategy.
Comparison of Xanthine Oxidase Inhibitory Effect of Swertia chirayita and Febuxostat in Vitro
Authors: Qura-Tul-Ain  , Sidra Mushtaq  , Naveeda Manzoor  , Mahreen Akhtar  , Anila Errum  , Naseem Saud Ahmad
Published: September 2023

Introduction:Plasma uric acid ? 6.5 to 7.0 mg/dl increases the incidence of gout, hypertension, diabetes mellitus type 2, stroke and heart failure. Low purine diet, use of xanthine oxidase inhibitors allopurinol and febuxostat; or uricosuric agent’s probenecid, sulfinpyrazone and Benzbromarone are being used for treatment. Swertia chirayita extract (SCE) being practiced as anti-inflammatory and anti-oxidant was evaluated for inhibition of xanthine oxidase.

Aims & Objectives: To observe the in vitro effect of Swertia chirayita ethanolic extract on xanthine oxidase inhibition and its comparison with medicine febuxostat.

Place and duration of study: The study was conducted in Pharmacology Department, University of Health Sciences Lahore during June-August 2017.

Material & Methods: Xanthine oxidase (XO) inhibition by ethanolic extract of the herb was compared with febuxostat. Serial dilutions of test compounds ranging from 1.25µg/ml to 100 µg/ml were prepared in absolute ethanol. Fixed volumes of xanthine, xanthine oxidase, phosphate buffer and test compounds were incubated. Uric acid concentration in the reaction mixture was calculated by measuring absorbance at 295nm by using Ultraviolet- Visible Spectrophotometer. Mean values and percent inhibition (± SD) was calculated. EZ Fit Enzyme Kinetic program was also used to calculate inhibitory concentration 50 percent (IC50), Michaelis constant (Km) and maximum rate of reaction (Vmax).

Results: At maximum dose, (100 µg/ml) xanthine oxidase inhibition by febuxostat and Swertia chirayita was 98% and 80% percent respectively (p=0.01). Swertia chirayita extract showed IC50 at 9.15± 1.2 µg/ml whereas IC50 of febuxostat was 7.91± 0.9 µg/ml.

Conclusion: In the light of XO inhibition, Swertia chirayita has potential to be explored as antihyperuricemic agent.
High Body Mass Index a Risk Factor of Preeclampsia: A Hospital Based Case-Control Study
Authors: Zoofishan Qureshi  , Muhammad Ashraf Chaudhry  , Nayyer Uzair  , Tariq Mukhtar Farani  , Uzair Mumtaz  , Muhammad Umer Farooq
Published: September 2023

Introduction: Preeclampsia is a disease which is associated with pregnancy and enhances perinatal and maternal morbidity and mortality. The relationship of obesity and preeclampsia is still under research among different populations.

Aims & Objectives: The objective of this study is to determine the strength of association of body mass index with preeclampsia in pregnant women.

Place and duration of study: Gynecology/Obstetric Departments of Services Hospital, Lahore General Hospital and Sir Ganga Ram Hospital Lahore from 1st January 2019 to 30th June 2019.

Material & Methods: It was a matched case-control study. Sixty six diagnosed pre-eclamptic antenatal women were selected as cases and they were matched with equal number of normotensive antenatal women. The definition, source and eligibility criteria of cases and controls were pre-determined. Odds ratio was calculated to measure strength of association between preeclampsia and body mass index (BMI).

Results: Among 66 preeclamptic women, the mean age was 26.76+5.82 years and among 66 normotensives mean age was 25.36+4.69 years. Among cases, 49.7% had BMI >25 and 30.3% had BMI <25. Likewise among controls, 40.9% had BMI >25 and 59.1% had BMI <25. Odds Ratio was 3.32. The result was found statistically significant (P=0.001).

Conclusion: Study concluded that high body mass index is a risk factor of preeclampsia among pregnant women.
Effectiveness of Amnion on Chronic Wounds Vs Saline Dressing
Authors: Muhammad Ali Rafique Mirza  , Ammara Mazhar  , Waheed Bhutto  , Abdul Saeed Khan
Published: September 2023

Introduction: Chronic wounds have deleterious effects on patient health and quality of life. Human placental membranes consist of amnion and chorion which are conjoined and avascular structures. These membranes have abundant growth factors and cytokines and extracellular matrix which can induce angiogenesis and dermal fibroblast proliferation and recruit mesenchymal stem cells involved in wound repair supplying an ideal environment for wound closure.

Aims & Objectives: To compare the effectiveness of human amnion vs. normal saline dressing in chronic wounds.

Place and duration of study: This study was conducted at Shaikh Zayed Medical Complex for a period of 6 months.

Material & Methods: This randomized control trial was carried out in the Department of Plastic Surgery at Shaikh Zayed Hospital, Lahore from 20-08-2019 to 20-02-2020. 60 patients of both genders,18 - 65 years of age having ulcers of more than six weeks duration and larger than 10 x 10 cm were inducted using non -probability consecutive sampling technique. They were divided into two groups of 30 patients each. Group A (Amnion) and Group B (Saline Dressing). Patients were assessed pre-treatment, wound dressings applied daily and followed up for 6 weeks for efficacy of dressing based on reduction in wound size and its relation to wound chronicity. Data was entered and analyzed using SPSS version 20.

Results: There were 27 (90%) male and only 3 (10%) females patients in group A and 21 (70%) male and 9 (30%) females patients in group B. Mean age of the patients was 45.60±12.51 years for group A and 44.20±11.65 years for group B. 27 (90%) patients demonstrated good efficacy of treatment at six weeks in group A as compared to 5 (17%) patients in group B which is statistically significant (P 0.041). Significant healing was noted in amnion treated chronic wounds of up to 21 weeks duration.

Conclusion: Our randomized control trial shows that amniotic membrane dressing are beneficial in the treatment of chronic wounds as compared to normal saline dressings.
Knowledge, Attitude and Practice of Breast Cancer Screening in Medical and Non-Medical Females Students of Lahore, Pakistan
Authors: Jawaria Ghazanfar  , Ayesha Khalil  , Aniqua Tahir  , Muhammad Imran Anwar  , Hina Mahmood  , Ayesha Humayun
Published: September 2023

Introduction: Breast cancer is the most common cancer in women all over the world and a leading cause of death in women of Pakistan. Programs promoting awareness about breast cancer, breast self-examination (BSE), clinical breast examination (CBE) and mammography are in place but still BSE is poorly practiced by females of Pakistan.

Aims & Objectives: To assess and compare the knowledge, attitude and practice about breast cancer screening among female medical and non-medical students of two institutes in Lahore, Pakistan.

Place and duration of study: Study conducted during May-June 2017 in Shaikh Khalifa Bin Zayed Al-Nahyan Medical College and Kinnaird College University in Lahore, Pakistan.

Material & Methods: A cross sectional survey was conducted during May-June 2017 on a conveniently selected sample of 200 female students from two colleges in Lahore. A self-constructed and self-administered questionnaire was used to assess the knowledge, attitude and practice of breast cancer screening. Data was entered and analyzed using SPSS version 21.

Results: Mean age of 21.66+1.50 and 22.58+ 2.138 was observed in medical and non-medical students respectively. In the age group 18-23 we had 85% of medical girls and 61% of non-medical while 39% of non-medical girls were in age group 24-29. Among 100 female medical students, 84% were knowledgeable about BSE as compared to 65% non-medical students. Knowledge was adequate for CBE in 74% and 53%, and for Mammography in 83% and 58% of medical and non-medical students respectively. The attitude was positive towards BSE in 92% and 75%, for CBE 89% and 74%, and for mammography 94% and 83% among medical and non-medical students respectively. The BSE practice was reported by 20% medical girls and only 13% non-medical girls, while CBE practice was in 13% medical and 5% non-medical girls.

Conclusion: Medical students were more knowledgeable and had a better attitude about breast cancer screening as compared to non-medical girls but when it came to practice, it was found to be very low in both groups.
Flax Seed Oil Alleviates Caffeinated Energy Drink Induced Metamorphosis in Femur Weight and Relative Tissue Weight Index of Adult Male Albino Rat
Authors: Afifa Waseem  , Muhammad Suhail  , Tayyaba Muzaffar  , Javed Iqbal  , Hadia Zulfiqar
Published: September 2023

Introduction: Consumption of caffeinated energy drinks has been increased worldwide specially in younger population in order to increase mental and physical performance. Side effects on various systems of human body have been reported due to their usage. Flax seed oil has been well known since ancient times owing to its beneficial effects and has now become a major part in our functional food.

Aims & Objectives: To evaluate the Protective effects of flax seed oil on caffeinated energy drink induced changes in adult male albino rat femur weight and relative tissue weight index.

Place and duration of study: This study was accomplished in department of Anatomy, at Shaikh Zayed Postgraduate Medical Institute Lahore for 8 weeks.

Material & Methods: 32 adult male albino rats average weight (250-300g) were randomly divided into four groups of 8 animals each. Group A (Control) received corn oil 5ml/kg body weight by gavage in addition to basal diet daily for 8 weeks. Group B (Experimental) received caffeinated energy drink (15ml/kg body weight) and corn oil 5ml/kg body weight. Group C (Experimental) received caffeinated energy drink (15ml/kg body weight) and 40% of flax seed oil (5ml/kg body weight), while group D (Experimental) received caffeinated energy drink (15ml/kg body weight) and 60% flax seed oil (5ml/kg body weight) daily for 8 weeks respectively. The animals were weighed before and after experiment. After 8 weeks, they were dissected to remove both femur and each femur was weighed, further the right femurs were used for statistical purpose.

Results: The mean difference in weight of femur was nonsignificant amongst experimental groups (p= 0.950). The relative tissue weight index (RTWI) was significant (p-value 0.001).

Conclusion: Flax seed oil helped in restoring altered femur weight and RTWI changes caused by caffeinated energy drink in adult male albino rats.
Toxic Effects of Ribavirin on the Testicular Interstitium in Albino Rats
Authors: Alvia Batool  , Maryam Fatima  , Fozia Farzana
Published: September 2023

Introduction: Ribavirin due to its mutagenic property exerts cytotoxic effects on gonads in a transient fashion that have been studied on the testicular tissues of various experimental animals. Ample data is not available regarding its toxicity on testicular interstitium that has led this research.

Aims & Objectives: Aim of the study was the evaluation of the toxicity of ribavirin in different doses on the testicular interstitium at different time points in albino rats.

Place and duration of study: The experiment was performed in Anatomy Department of Postgraduate Medical Institute, Lahore and completed in three months.

Material & Methods: 72 adult male albino rats were divided into 4 equal groups with 18 rats in every group. 0.75ml distilled water was given to Control (A) group intraperitoneally and Ribavirin was administered by same route in doses: 20mg, 100mg and 200mg/kg body weight, single dose for 5 days to experimental groups B, C and D respectively. Every group was subdivided into 3 small subgroups in accordance with 20th, 40th and 60th sacrificial days from the last dose of drug. On each sacrificial time 6 rats from a group were selected and sacrificed. Data was entered on SPSS 23.0 software and comparison among groups was made by Pearson’s chi square test. P-value <0.05 was considered significant.

Results: Interstitial widening and edema with congested vessels were observed in all study groups on 20th sacrificial day in comparison to control group. Signs of recovery in the form of decrease in widening, edema and congestion were only observed in rats of low dose groups on day 40th and 60th in comparison with high dose groups that didn’t show reversibility of these changes.

Conclusion: A patient who is taking Ribavirin as an antiviral therapy should be counselled about the reversibility of its gonadotoxicity.
A Quality Improvement Project: Development and Implementation of a Modified I-PASS Handover in the General Surgery Department of Tertiary Care Hospital in Pakistan
Authors: Farooq Anis , Haroon Javaid  , Imran Anwar
Published: September 2023

Introduction: In tertiary care settings, multidisciplinary teams are responsible for providing hi-tech, state of the art health care to the patients, which is impossible without a transparent, accountable communication system within and between teams, i.e. the patient handover.
Aims & Objectives: This project aimed to introduce a handover document, based on handover best practices, in the General Surgery Department of Shaikh Zayed Hospital, Lahore, and improve it over time to make it compatible with the unique local demands.
Place and duration of study: From 01 October 2019 to 30 March 2020 in General Surgery Department of Shaikh Zayed complex, Lahore, Pakistan.
Material & Methods: The need for an official and standard handover for the general surgery department was discussed with a few stakeholders. Upon a thorough search of the literature, a slightly modified version of the I-PASS handover system was introduced. It contained items such as Biodata, diagnosis, active complaint, management, tasks to be done, potential risks, verbal handover and severity of the disease. Before the introduction of handover documents, a training session was held with three residents. Six months after the handover was introduced, qualitative feedback was collected from trainee residents and consultants in the General Surgery department.
Results: Results showed compliance of 80% by residents (n=20), perceived improvement in patient safety standards and better organization of patient data by 95% of respondents (n=20). First Plan, Study, Design, Act cycle was completed. A second PSDA cycle was initiated. A new form of I-PASS handover system, based on feedback, was put in place in the General Surgery Department.
Conclusion: This undertaking has fulfilled one of the recommendations of the Joint Commission and WHO to improve patient safety, and it also demonstrates that a structured handover improves the transfer of information among residents, minimizes errors and help avoidance of negligence.
A Comparative Study Between-Small Bore and Large Bore Tubes for Therapeutic Pleural Drainage
Authors: Muhammad Ramzan  , Talha Mahmud  , Muhammad Saqib  , Abdul Saeed Khan  , Qazi Abdul Saboor  , Ali Rafique Mirza
Published: September 2023

Introduction: Pleural effusions due to various pulmonary and extra pulmonary causes are common clinical problems. Some pleural diseases require therapeutic pleurocentesis to decompress the pleural space like in malignant and benign pleural effusions, pyothorax, chylothorax, pneumothorax, complicated parapneumonic effusion and haemothoraces. Traditionally large bore tubes have been used with trocar or through blunt dissection. Nowadays small-bore catheters are gaining popularity, as they are less painful and believed to be equally efficacious as compared to large bore tubes.

Aims & Objectives: To compare the success rate of small bore tubes with standard large bore chest tubes in therapeutic pleural drainage and to compare complications rate between small bore and large bore drains.

Place and duration of study: The study was conducted at Department of Pulmonology of FPGMI, Shaikh Zayed Hospital, during one year (2015-2016).

Material & Methods: Total 152 patients who required therapeutic evacuation of pleural space suffering from pneumothorax, empyema, parapneumonic and malignant effusion, were enrolled and underwent therapeutic drainage with small bore (< 20 F size) and large bore tubes (> 20 F size), randomized by lottery method.

Results: The mean duration of drain placement for large bore drain was 7.9±3.8 days, which was significantly higher than small bore drains with a mean value of 3.0±1.6 days (p-value <0.001). The pain score was also quite high in large bore group with mean value 5.67±1.68 as compared to small bore 1.07±0.81(p-value<0.001). Similarly the mean bleeding during the procedure was significantly higher in large bore group as compared to small bore with mean values 11.9±7.8 and 0.1±0.2 ml respectively (p-value<0.001). The wound infection which is a significant complication was found only in large bore group with 14.5% cases as compared to none in small bore group (p-value 0.001). In large bore group surgery was required for 9(11.8%) cases while in small group there were 2(2.6%) patients referred for surgical intervention.

Conclusion: Small bore thoracostomy drains are more effective than large bore tubes, for the treatment of pleural disorders requiring therapeutic drainage and they are associated with minimal pain and other complications.
Effect of Atorvastatin Alone and in Combination with Aspirin on Uric Acid Handling of Normal Rats
Authors: Usman Aslam  , Muhammad Ubaidullah Khan  , Sadia Chiragh  , Abdul Karim  , Mushtaq Ahmed
Published: September 2023

Introduction: Low doses of aspirin and statins are usually given in conjunction to patients with coronary artery disease. Aspirin at low doses is known to cause hyperuricemia in these patients which can further worsen their condition, while statins can theoretically counteract this effect. However, this interaction needs to be tested.

Aims & Objectives: To estimate the effect of atorvastatin and low dose of aspirin alone and in combination on serum uric acid level and urinary uric acid excretion in normal rats.

Place and duration of study: Post Graduate Medical Institute, Lahore from July, 2018 to August, 2018.

Material & Methods: Twenty-four healthy Sprague Dawley rats were distributed equally into four groups (Normal control, Aspirin, Atorvastatin and Combination groups). They were given distilled water, aspirin (6.75mg/kg), atorvastatin (5mg/kg) or combination of the same doses of aspirin and atorvastatin for 4 weeks. One ml blood and twenty-four-hour urine sample was collected on week 0 and 4 for estimation of uric acid and creatinine concentrations. Fractional excretion of uric acid was calculated.

Results: At the end of four weeks the Aspirin group had higher serum uric acid level and lower fractional excretion of uric acid as compared to the Normal control group. Atorvastatin group had lower serum uric acid and higher urinary uric acid level as compared to Aspirin group while combination had higher serum uric acid level versus Normal control. fractional excretion of uric acid decreased from 0-4 weeks in Aspirin and Combination groups only.

Conclusion: The role of atorvastatin in lowering serum uric acid levels in group receiving atorvastatin alone and in combination group emerged non-significant.
Acute Anterior Uveitis (Ocular Manifestation of COVID-19): A Case Report
Authors: Tayyaba Gul Malik
Published: September 2023

A 55 years old female presented in an eye clinic of Lahore, Pakistan with redness, dull ache and mild blurring of vision in her left eye for 2 days. On examination, her best corrected visual acuity was 6/6 partial in right eye and 6/9 partial in left eye. Slit lamp examination revealed bilateral follicular conjunctivitis and circum-corneal congestion of the left eye with mild flare and +2 cells in anterior chamber. Fundus examination was normal on both sides. Prednisolone eye drops were suggested six times a day and patient was called after two days. On follow up visit, circum-corneal congestion was reduced and cells in anterior chamber were +1. The patient had moderate fever with mild respiratory symptoms. COVID RT- PCR was done which came out positive. The patient was isolated. Topical steroids were tapered over two weeks and telephonic follow-up was continued. Systemic and ocular symptoms improved over a period of two weeks without any sequelae.
Criminal liability of the Director in case of tax evasion offences
Authors: Teliceanu Viorel-Gabriel
Published: September 2023

Tax evasion, which is included in the category of economic and financial offences, essentially consists of all unlawful procedures by means of which natural or legal persons evade taxable income by failing to fulfil their fiscal obligations.Tax evasion offences are mainly based on economic activities carried out by companies, which raises the question of the criminal liability of the statutory Director, de facto Director or the Company. The criminal liability of the natural person does not remove the criminal liability of the legal person, although in the judicial practice, there is a temptation to use the criminal liability of the legal person as a form of strict liability for the act of another. The criminal liability of the legal person includes the actual analysis of the elements of guilt of the legal person.
Analisis Metode K-Nearest Neighbor Menggunakan Rapid Miner Untuk Memprediksi Hujan Kota Surakarta
Authors: Ahmada Akhbar Alvian , Hartanti Dwi
Published: September 2023

This study aims to implement the K-Nearest Neighbor (KNN) algorithm using the Rapid Miner application to predict rain in Surakarta City. Rainfall has an erratic pattern making it difficult to predict manually. Rainfall cannot be determined with certainty but this can be estimated. Thus, the existence of Data Mining can enable machines to recognize and study complex data patterns. Therefore program learning can learn patterns of rainfall data to make some predictions. This study uses three variables as criteria, namely temperature, wind speed, and humidity. The test results using the K-Nearest Neigbor (KNN) algorithm and the Rapid Miner application with a value of K = 3, found an accuracy of 83.87%. From 31 data taken in July 2023. The results of the analysis prove that the KNN method using the Rapid Miner application can be used to predict rain in Surakarta City.
Role of glial fibrillary acidic protein (GFAP) and neurofilament (NF) expression in the pathophysiology of canine distemper encephalomyelitis
Authors: DİNÇEL Güngör Çağdaş , YAVUZ Orhan , YILDIRIM Serkan
Published: September 2023

Objectives: Canine distemper virus (CDV), a member of the genus Morbillivirus of the family Paramyxoviridae, is the causative agent of canine distemper, a fatal and highly contagious disease that affects dogs and other carnivores. This study aimed to investigate whether there is a correlation between glial fibrillary acidic protein (GFAP) and neurofilament (NF) expression in canine distemper encephalomyelitis (CDE) and the severe neuropathology that occurs.

Materials and Methods: GFAP and NF expression levels in the brain tissue of 13 dogs diagnosed with CDE were investigated by immunohistochemical method.

Results: The results of the study revealed that GFAP (P < 0.005) and NF (P < 0.005) expression levels in brain tissue were significantly increased in CDV-infected dogs compared to healthy, uninfected dogs. GFAP expression was mainly observed in endothelial cells and astrocytes, whereas NF expression was mainly found in neurons. In addition, it was found that the expression of both GFAP and NF was more pronounced in the areas with the most severe neuropathological findings.

Conclusions: This study demonstrated pathological astrocyte reactivation and neuronal degeneration at the molecular level. These findings provide information about the stage of the disease. This study clearly demonstrated that detailed information about the prognosis of the disease can be obtained from GFAP and NF expression. Since GFAP/NF levels provide information about the severity of the disease, they can be used clinically. Therefore, further research into the involvement of GFAP and NF expression in the pathophysiology of CDE has great potential to improve our understanding of this complex neurological disorder.