bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence Of Peripheral Thrombophlebitis in Elective Versus Clinically Indicated Replacement of Intravenous Cannula. A Comparative Study
Authors: Prasad Acharya Bidur , Sharma Rasna
Published: April 2022

Introduction: Peripheral cannulations are one of the commonest procedures to be performed in hospital settings and peripheral thrombophlebitis is also a common complication that occurs after intravenous cannulations. The incidence rates are variable and there was a need to evaluate if it was different in our setting and also the reasons for its removal and other factors associated with this common but important problem.
Methods: We randomized 288 patients who were admitted to the general surgical ward into elective and clinically indicated groups (n=144) in either group after taking informed consent. Cannula in the elective group were re-sited every 48 hours and only removed if there were signs suggestive of peripheral thrombophlebitis. Current and previous cannulation sites were examined by the investigator every 24 hours for any signs and symptoms of peripheral thrombophlebitis.
Results: The incidence of peripheral thrombophlebitis was 15.3 % with 8.3 % (n=12) incidence in the elective and 22.2 % (n=32) in the clinically indicated group. The mean time of cannula removal was 56.86 hours.
Conclusions: Elective re-siting of intravenous cannula every 48 hours results in a significant reduction in the incidence of peripheral thrombophlebitis when compared with clinically indicated re-siting.
Perception and Knowledge of Medical Doctors and Dentist in Bharatpur towards COVID-19 Vaccination and Vaccine
Authors: Chhatkuli Ayam , Balami Saroj , Raj Shrestha Ashim , Paudel Shailes , Chaulagain Rajib
Published: April 2022

Introduction: COVID-19 vaccination has begun in many countries in the world and in Nepal too. However, many doctors and dentists have been reported missing in the vaccination program. Moreover, many those vaccinated had reported with several adverse effects along with being tested COVID-19 positive. This study aimed to assess the knowledge and perception of medical doctors and dentists towards COVID-19 vaccination program in Bharatpur.
Methods: A descriptive cross-sectional study was conducted using self-administered questionnaire survey among Nepal medical council registered Doctors and Dentist in Bharatpur during July 15, 2021 to September 15, 2021. The collected data was entered into Statistical package for social science (SPSS) version 26, and analyzed using descriptive statistical tool (frequency, percentages).
Results: The majority of the participants 160 (88.9%) were of age 25-30 years. Most of them 176 (97.8%) participants were vaccinated against COVID-19, among which 152 (84.4 %) received both the doses of vaccine. Majority of them 144 (77.8%) received AstraZeneca vaccine while 101 (56.1) experienced adverse symptoms. Among the participants, 121 (67.2%) participants replied that Covishield vaccine was developed on non-replicating vector platforms.
Conclusions: Majority of the participants of the study had taken COVID-19 vaccine which shows the negative hesitancy towards this deadly virus and importance vaccine for themselves and their patients too. The medical doctors and dentists need to be updated with the COVID-19 vaccine information.
Are Clinicians Communicating adequately with Radiologists through Radiological requisition? A Clinical Audit assessing Current local practice
Authors: Aabesh Koirala , Bhandari Shama
Published: April 2022

Introduction: A radiological request form is the only communicating tool between the treating physician and the radiologist. An incompletely filled form may fail to provide the correct diagnosis through imaging. This study was conducted to assess the adequacy of filled radiological request forms in a tertiary health institute.
Methods: Three hundred radiological requisition forms which were filled by doctors at tertiary hospital were selected randomly and analyzed. The forms were evaluated for completeness of the information entered by the physician. The request forms were selected by convenience sampling method to avoid the bias and included forms from multiple departments both inpatient and outpatient.
Results: Our audit data revealed that out of the total 250 request forms that were analyzed only the names of the patients and the part to be examined was filled completely. The age and gender of the patients were filled in 99.2% and 99.6% forms respectively. 58.4% forms had relevant history written and only 16.4% form had mentioned the relevant investigations. 59.6% forms had provisional clinical diagnosis, name and department of the physician requesting the investigation were present in 75.6% and 66% forms respectively. None of the forms contained the contact number of the requesting physician with 8% forms without the name of the physician and department who had filled the request form.
Conclusions: At the end of our audit, we concluded that radiological request forms are rarely filled completely which results in inadequate transmission of clinical information.
Quantitative Assay of Glucose-6-Phosphate Dehydrogenase in Normal Non-Icteric Early Neonates: A Hospital-Based Study
Authors: Acharya Shreeman , Jaiswal Subechhya , Amgain Kapil , Ahmad Shakil , Dhital Mukesh , Pun Magar Bibek
Published: April 2022

Introduction: Glucose -6- phosphate dehydrogenase (G6PD) a housekeeping enzyme found in the mitochondria of all cells of the body plays a crucial role in preventing cells from oxidative damage by reactive oxygen species (ROS). As Red Blood Cell (RBC) lacks a sub-cellular structure like mitochondria, it is most vulnerable due to the lack of G6PD enzyme resulting in mild hemolytic jaundice to fetal death. The Prevalence of neonatal jaundice is most common but due to  lack of newborn screening for the G6PD test, neonates are misdiagnosed and the whole treatment becomes worthless. The main aim of this study was to evaluate the level of G6PD in normal early neonates.
Methods: This was a cross-sectional study conducted on 43 normal early neonates of the Indian sub-population from January to June 2019 at the Laboratory Department, Padmashree institute of clinical research, Bangalore, India. Blood parameters like G6PD levels, direct and total bilirubin, and hemoglobin levels of the normal neonates were measured. This study was approved by the ethical board of the hospital.
Results: The bilirubin level (direct and total), and hemoglobin level were found within the established normal reference interval. The observed G6PD levels in normal healthy full-term neonates against the available various reference intervals were established. In this study the cut-off value of G6PD enzyme activity was determined as 8.05 ± 1.2 U/g Hb and this in-house obtained reference interval level was significantly (*p< 0.05) lower than that of other reference intervals such as Kit insert Ref. Interval (9.55 ± 4.6 U/g Hb) and Ref. interval (12.5 ± 2.3 U/g Hb) as inferred by other studies.
Conclusions: In conclusion, we found evidence for a newly established reference interval for normal neonates between the ages of 1 to 11 days and the reference value is remarkably lower than the available reference interval.
Efficacy of Vaccination in Reducing ICU Admission and Death due to COVID 19 in a Tertiary Care Hospital
Authors: Agya Shrestha , Samriddhi Karki , Pratyush Shrestha
Published: April 2022

Introduction: SARS-CoV-2 (Severe acute respiratory syndrome corona virus-2) is the virus that causes the worldwide pandemic of COVID-19 (corona virus disease-19). This pandemic has caused substantial morbidity and mortality. To date, no definite treat ment is available for the disease. The hope for controlling the pandemic lies in mass vaccination worldwide. However, vaccine hesitancy persists among the general population. The effectiveness of vaccination in prevention of severity of the disease needs to be proven. Through this study, we would like to emphasize the role of vaccination in reducing the severity of the disease.
Methods: This is a descriptive cross sectional study conducted at Nepal Police Hospital. The records of all the patients who came for COVID-19 testing between April 22, 2021 to June 22, 2021, were identified and included in the study. The data was imported from the D Code Heath software using Microsoft Office Excel, and Social Science Statistics program was used to perform the Chi-square test to assess the efficacy of the vaccine.
Results: A total of 292 patients tested positive for COVID-19 and were admitted. Of these, 103 were vaccinated and 189 were unvaccinated. Among the admitted patients, 53 were admitted to the ICU, and 239 were admitted to other wards. The Chi-square statistic was 9.4905, with a p-value is 0.002065, which is significant at p<0.05. There were 30 deaths among the admitted patients; 29 of these were in unvaccinated individuals, and one was in a vaccinated individual. The Chi-square statistic for mortality was 19.9402, with a p-value of 0.000111, which is significant at p<0.05.
Conclusions: Vaccination against COVID-19 has been shown to decrease hospital admissions, the need for critical care, and mortality in SARS-CoV-2 infection.
Prevalance of Shivering Among Parturients Receiving Intrathecal Tramadol During Cesarean Section
Authors: Ratna Bajracharya Ashis , Bajracharya Gautam Ratna , Dangol Sanam
Published: April 2022

Introduction: Spinal anesthesia is popular and preferred anesthesia of choice during cesarean section. Shivering is one of the inevitable complications of spinal anesthesia (which occurs due to heat loss and redistribution of body heat from core to periphery). T.he incidence of post-spinal shivering reported to be 40%-60%. Although shivering may have beneficial thermoregulatory effects, it places the body under increased physiological stress as it increases body oxygen demand by 3-4 folds, and increases metabolic rate, heart rate, blood pressure and even cause hypoxia, hypercapnia and lactic acidosis. Ideally, this should be prevented by pharmacological methods that are economically and practically feasible in all settings. Therefore, this study was conducted using tramadol 20 mg intrathecally along with bupivacaine prophylactically to prevent shivering after spinal anesthesia.
Methods: This prospective observational study was carried out in 200 patients posted for emergency as well as routine cesarean delivery who received intrathecal Tramadol along with Bupivacaine at NMCTH. Shivering if present was noted and graded using a five-point intensity scale by Wrench et al.
Result: Post-spinal shivering was observed in 36 (18%) patients. Among them, 22 (11%) patients had grade 1; 8 (4%) patients had grade 2; 6 (3%) patients had grade 3 shivering. None of the patients had grade 4 shivering. All patients had MOAA/S of 5, indicating that all the patients were fully awake and alert during the intraoperative period. Intraoperative nausea was seen in 26 (13%) patients while 14 (7%) patients had vomiting. None of the patients complaint of pruritus.
Conclusion: The prevalence of post spinal shivering in patients who received intrathecal tramadol in our study was 18 %, which is lower as compared to studies conducted in parturient who did not receive intrathecal tramadol along with bupivacaine.
Splanchnic Nerve Block as Minimally Invasive Procedure for Chronic Postsurgical Abdominal Pain: A Case Report
Authors: Karki Roman , Amatya Shirish , Shakya Eva
Published: April 2022

Chronic postsurgical pain is commonly prevalent following abdominal surgeries. It imposes negative impact on patient’s both physical and emotional wellbeing. Commonly, neural damage is the cause for persistent postsurgical pain, however in some instances the etiology remains undiagnosed. Splanchnic nerve block is a minimally invasive procedure that is often beneficial for chronic abdominal visceral pain. We present a case of 46 years male who came with the complaint of infra umbilical abdominal surgical scar pain for 9 months after mesh removal surgery following mesh infection. Diagnostic splanchnic nerve block was done and pain subsided by 70% immediately after the block which sustained even at two months follow up
Current Concepts Review: Orthotics In Post-operative Foot And Ankle Surgery
Authors: Slater Gordon
Published: April 2022

Minimally invasive image guided surgery and regenerative technologies have rapidly developed requiring changes in post-operative management protocols. With such a variety of options available for patients and varying ideas on which product is best suited for each procedure, practitioners play in important role in optimizing patient care when prescribing solutions. Function, aesthetics, and ease of mobility play key roles in patient acceptance of orthotic devices and determine the success of a product and recovery journey. This paper aims to investigate commonly utilized options for various foot and ankle conditions and compare their applications, advantages, and disadvantages. By analyzing available options, knowledge can be gained to create an optimized modular product that takes advantage of the best features of existing devices and offers a complete solution for every patient.
Systemic Human Htert Aav Gene Transfer Therapy And The Effect On Telomere Length And Biological Age, A Case Report
Authors: Sewell Patrick E
Published: April 2022

A single adult female human was treated with AAV hTERT gene transfer therapy on two separate occasions 5 years apart. Follow-up is 5.8 years. The first dose administered on 9.16.2015 consisted of a total intravenous dose of 3e15 AAV hTERT. The second dose administered on 9.24.2020 consisted of a total intravenous dose of 3e15 AAV hTERT. Before and after each therapy and periodically in between the doses, Human Leucocyte telomere analysis was performed. The initial telomere length measurements collected on 9.15.2015 at the initiation of the AAV hTERT gene transfer therapy demonstrated a baseline average telomere length of 6.71kb which corresponded to a telomere percentage relative to age and population at the 30th percentile. The most recent telomere length measurements collected on 7.13.2021 demonstrated an average telomere length of 8.94kb which corresponded to a telomere percentage relative to age and population at the 89th percentile. The results demonstrate the progressive lengthening of the recipient’s telomeres from 6.71kb to 8.94kb despite advancing 5.8 years in chronological age. Associated age as related to telomere length (also known as biological age) was calculated and compared to chronological age. Initially on 9.15.2015, and prior to the first AAV hTERT gene transfer therapy, the associated age was calculated to be 62 years. The latest telomere analysis dated 7.13.2021 demonstrated a calculated associated age of 25 years. This decrease in associated, or biological age, decreased at a rate of 5.3 years per year of chronological age advancement.
Editorial Note- Archives Of Clinical Trials And Case Reports
Authors: Hunis Adrian Pablo
Published: April 2022

We are experiencing a unique and unprecedented moment in the field of medicine in general and that of oncology in particular. Research and technological innovations are the drivers of great progress in the fight against cancer. Unfortunately, all these advances, during the years 2020 and 2021 were in "pause" mode because the world is experiencing a pandemic, but the fight and research in oncology continue. However, if we add this infection to the most common infectious diseases, the sum of all of them -I insist- does not reach the almost 10 million deaths from cancer that occur per year, in the world. The increase in life expectancy, the best and most accurate diagnostic methods, environmental carcinogens, lifestyle, low physical activity, viruses with oncogenic capacity and a whole series of factors that seem to play a key role in the development of these oncological diseases, called “cancer”, explain this enormous number of annual deaths, to which I previously referred.
Covid-19 Vaccines: Efficacy, Safety, And Side Effects
Authors: Bitar Rawan
Published: April 2022

Coronaviruses are a type of virus. There are many different kinds, and some cause disease. A coronavirus identified in 2019, SARS-CoV-2, has caused a pandemic of respiratory illness, called COVID-19. Coronavirus disease (COVID-19) is associate communicable disease caused by the SARS- CoV-2 virus. The general public infected with the virus can expertise delicate to moderate respiratory disorder and recover while not requiring special treatment. Anyone can get sick with COVID-19 and become seriously ill or die at any age. The virus can unfold from an infected person’s mouth or nose in tiny liquid particles after they cough, sneeze, speak, or breathe. However, some will become seriously ill and need medical attention. The short review discusses the ways to prevent to prevent and slow down transmission, different types of vaccine available and their effectiveness and the emergence need to get vaccinated.
El amparo desde una perspectiva de género
Authors: Ochoa Escribá Dina Josefina
Published: April 2022

La garantia constitucional del amparo por el ámbito amplio  para su aplicación en la protección de los derechos  humanos y en especial los derechos humanos de las mujeres, se hace necesario incorporar la herramienta de la perspectiva de género y poder garantizar esta tutela, aplicándola por medio de la metodología con perspectiva de género que permita conocer, analizar y resolver atendiendo el control de convencionalidad y en el marco de la igualdad y no discriminación por el más alto tribunal constitucional que reflejen  las condiciones y situaciones de género implicadas, generando sentencias emblemáticas que no solo tendrán impacto entre las partes, sino además acentuando de que el derecho no  puede aplicarse de manera imparcial, logrando extender este impacto en la sociedad, coadyuvando a reducir la violencia en contra de las mujeres.
Ethyl acetate partition obtained from the methanol extract of Muntingia calabura leaf exerts effective in vitro antiproliferative activity against the HT-29 colon cancer
Authors:   Universiti Putra Malaysia, Zakaria Zainul A , Nasir Nur L Md ,   Universiti Putra Malaysia, Kamsani Noorsyaza E ,   Universiti Putra Malaysia, Khaza'al Huzwah ,   Universiti Putra Malaysia, Sulistyorini Lilis ,   Universitas Airlangga, Azizah Roro ,   Universitas Airlangga
Published: April 2022

Methanol extract of Muntingia calabura L. leaf (MEMCL) has been shown to exert the antiproliferative activity against the HT-29 (human colon adenocarcinoma) cell line. To further investigate on the medicinal potential of this plant, MEMCL was sequentially partitioned to obtain the petroleum ether, ethyl acetate and aqueous partitions, which was then tested against the HT-29 cell line and also subjected to the in vitro anti-inflammatory study. The most effective partition was also subjected to the phytoconstituents analysis using the UHPLC-ESI-MS. Findings showed that the ethyl acetate partition (EAP) exerts the most effective antiproliferative activity (IC50 = 58.0±12.9 μg/mL) without affecting the 3T3 normal fibroblast cells, exhibits the highest anti-inflammatory effect when assessed using the lipoxygenase (> 95%) and xanthine oxidase (> 70%) assays, and contained various types of polyphenolics. In conclusion, M. calabura exerts apoptotic-mediated antiproliferative activity, partly via the anti-inflammatory action and synergistic action between the polyphenolics.
Morphology of the larvae and biology of the adults of Psilorrhynchus bifasciatus do not confirm previous hypotheses about systematics and feeding habits (Coleoptera: Cantharidae)
Authors: Biffi Gabriel , Migliore Letizia J. , Casari Sônia A.
Published: April 2022

Psilorrhynchus bifasciatus (Blanchard, 1844) is broadly distributed through South America, but its biology, behaviour and life cycle are unknown. The most characteristic feature of the adults is slender rostrum, presumably associated to a specialised feeding habit. However, new observations of P. bifasciatus feeding on nectar in inflorescences of Matayba guianensis Aubl. (Sapindaceae) do not support such a hypothesis. Here, we describe and illustrate their early larval instars in details and compare them with the other Chauliognathini. The larvae are remarkably characterised especially by a long and thick pubescence, conspicuous roughness on the head and thoracic terga, and head with sharp lateral projections. These features are unique amongst the known Cantharidae larvae and do not confirm a previous hypothesis of close affinity between Psilorrhynchus Gemminger & Harold, 1869 and bromeliad-inhabiting Chauliognathini species.
Comparative study of thermally activated delayed fluorescent properties of donor–acceptor and donor–acceptor–donor architectures based on phenoxazine and dibenzo[a,j]phenazine
Authors: Izumi Saika , Govindharaj Prasannamani , Drewniak Anna , Crocomo Paola Zimmermann , Minakata Satoshi , de Sousa Leonardo Evaristo , de Silva Piotr , Data Przemyslaw , Takeda Youhei
Published: April 2022

A new thermally activated delayed fluorescence (TADF) compound based on a donor–acceptor (D–A) architecture (D = phenoxazine; A = dibenzo[a,j]phenazine) has been developed, and its photophysical properties were characterized. The D–A compound is applicable as an emitting material for efficient organic light-emitting diodes (OLEDs), and its external quantum efficiency (EQE) exceeds the theoretical maximum of those with prompt fluorescent emitters. Most importantly, comparative study of the D–A molecule and its D–A–D counterpart from the viewpoints of the experiments and theoretical calculations revealed the effect of the number of the electron donor on the thermally activated delayed fluorescent behavior.
ROLE OF NUTRITION IN MATERNAL HEALTH
Authors: Joseline Jessica , Bajwa Dr. Rajinderjith Kaur
Published: April 2022

More than a third of all families in India (34 percent) had just one or fewer meals the day before, according to a report from the Global Standing Committee on Nutrition. For this reason, the researchers conducted this study in an effort to learn more about how the dietary habits of pregnant women and their babies, as well as the health consequences associated with childbirth, are affected by the socioeconomic and cultural environments in which they live. The University of Medical Sciences Ethics Committee has accepted the research plan. Informed consent forms and waivers of responsibility were signed by each participant. There were 453 pregnant women remaining, of whom 425 had their BMI recorded in their medical records. Together, the data demonstrate that the wealth index of families has no impact on children's nutritional health unless the mothers have received formal education and are knowledgeable of how to utilise the available resources to give appropriate and diversified meals to all children.
Petrifying Impact of Capitalism in Philip Roth’s The Human Stain
Authors: Muhamed Banimansoor Abdullah Jassim , Zhang Longhai
Published: April 2022

This study sheds light on impact of capitalism on American society and how it enforces racial discrimination to subject the majority of people and use them as a commodity in the hands of fewer as portrayed in Philip Roth’s The Human Stain. This article also attempts to focus on the effect of war on society as capitalist’s tool. It raises a question as to what extent capitalism is successful in deforming the American society. It aims to reveal the role of capitalism in planting social discrimination in American society. It also discusses the atmosphere of racial discrimination at the time of writing this article.
Review Article : Treatment of Bacterial Meningitis at Educational Al Hussein Hospital and Review of Antibiotics from Global Sources
Authors: Shakeir Jaber Dr. Amany
Published: April 2022

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In the main laboratory at Educational Al Hussein Hospital. antibiotics have been used to have bacteriocidal effect on bacteria and the review of empirical and specialized antibiotics for meningitis from global sources. In bacterial meningitis, the choice of an optimum initial empirical antibiotic depends on the resistance patterns. who demonstrate the use of cephalosporin groups, penicillins wth amoxicillin, according to the age groups and the amount of dose , also treatment (specific antibiotic) according to the bacterial species that causes meningitis and explains the duration. If you do not respond to this treatment, there is an alternative, this method is specialized in the elimination of meningitis.
Efficacy of Tranexamic Acid in Reducing the Blood Loss During Cesarean Section in Primigravida Patients with Breech Presentation
Authors: Bibi Safoora , Syed Wajeeha , Ali Khan Aamir , Saira
Published: April 2022

OBJECTIVES:
The objective of the study was to evaluate the efficacy of tranexamic acid in decreasing blood loss at the caesarian section (CS).
METHODOLOGY:
A descriptive case series study was conducted in the Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar, Pakistan. Data were collected from September 24, 2018, to March 24, 2019. A total of 114 term women (18-35 years age)  with singleton term breech cases were analyzed for a period of six months
RESULTS:
In this study the mean age was 30 years with SD±2.341 and the mean period of gestation was 38 weeks with SD±4.76. Moreover, tranexamic acid was effective in 91% of patients and was not effective in 9% of patients.
CONCLUSION:
Our study concludes that the efficacy of tranexamic acid was 91% in reducing the blood loss during CS in primigravida patients with breech presentation.
Outcome of Fistula in Ano after Incision Drainage of Acute Peri Anal Abscess
Authors: Wadud Fazal , Asif Zarka , Imran Asif , Ali Saad , Ali Ammad , Ayub Muhammad
Published: April 2022

OBJECTIVES: 
To determine outcome of fistula in ano after incision drainage of acute peri anal abscess.
METHODOLOGY:
This descriptive case series study was conducted after approval of the Ethical committee. A total of 154 patients were observed for a six-month duration. Pre-design proforma was used to collect data. An inclusive criterion was age between 18-50 years of both genders with acute perianal abscess with low-level fistula (submucosal and mucocutaneous) and high-level fistula (ischiorectal and pelvirectal). Exclusive criterion was observed in all admitted patients who include secondary abscess formation for example diabetes mellitus, tuberculosis, and carcinoma with any previous history of fistula in ano. The result was analyzed through the SPSS-24 version.
RESULTS:
Ratio 35 (22.72%) was obtained for age group 18-30, 49 (31.81%) for age group 31-40 and 70 (45.44%) were in age group 41-50. The mean age was 38.25 years with SD ±9.70. The ratio of Males 143 (92.85%) leads high to females 11 (7.15%).  The fistula was found in 64 (41.55%) patients postoperative after incision drainage for perianal abscess. Among 64 patients, 54 (37.01%) were male and 7 (4.54%) females. 90 (58.44%) patients had no fistula postoperatively. Low-level 45 (29.22%) and 19 (12.33%) high-level fistula was found in patients. Among the low-level ratio, 40 were male and 5 were female. Similarly, in high-level fistula 17 were male and 2 were female.
CONCLUSION:
Fistula is more common in males than females. Low lying fistula leads the chart more than a high lying fistula. The incidence of anal fistula in our observed patient’s abscess was 41.55%.
Association of Sociodemographic Factors with Trends of Self-Medication Practice and Its Hazard Perception for Oral Health Problems among Patient
Authors: Butt Hira , Liaqat Samra , Aqsa  , Khan Amna Nauman , Khan Nauman Rauf , Tahir Fizza
Published: April 2022

OBJECTIVES:
To assess the impact of sociodemographic factors with the trends of self-medication practice and its hazard perception among patients
METHODOLOGY:
A cross sectional descriptive study was conducted on the patients visiting Sharif Medical and Dental College from June 2019 to June 2020. Data was collected using a validated questionnaire from 142 patients. Chi-square and fisher exact tests were used to find the association of trends of self-medication practice and hazard perception with sociodemographic factors.
RESULTS:
The patients in the age range of 18 to 29 years practiced self-medication the most. The triggering factor for use of medication was toothache among all ages. The most commonly used drug was reported to be analgesics. The main reason for self-medication was lack of time to visit the doctor. The females practiced self-medication more than the males. The triggering factor for both the genders was toothache and analgesics were mostly used. The patients with tertiary level education and those who were unemployed practiced self- medication the most. The triggering factor was toothache across all levels of education and employed as well as unemployed patients. Drug resistance was stated the main hazard.
CONCLUSION:
The triggering factor for use of medication was toothache, most commonly used drugs were analgesics and the main reason for self-medication was lack of time across all ages, both the gender, married and unmarried patients, levels of education and employment. Un-employed patients and those with tertiary level of education-practiced self- medicated themselves the most. The highest percentage of patients considered drug resistance to be the biggest hazard.
Comparative Study of Critical View of Safety vs Infundibular Technique in Laparoscopic Cholecystectomy
Authors: Iftikhar Muhammad , Ahmad Siddique , Aziz Khalid
Published: April 2022

OBJECTIVES:
The purpose of this study is to compare the critical view of safety technique with the infundibular technique in laparoscopic cholecystectomy in terms of mean operative time and bile duct injuries (BDI).
METHODOLOGY:
Between 2018 and 2020, 220 patients had laparoscopic cholecystectomy in the Surgical "A" unit at Hayatabad Medical Complex in Peshawar, Pakistan. The patients were divided into two groups, with the first receiving a critical view of safety and the second receiving an infundibular procedure. Operation time and bile duct injury were compared between the two groups.
RESULTS:
The operative time was significantly reduced with the critical view of safety (CVS) approach, with a mean time of 35.07 minutes for CVS and 40.58 minutes for infundibular technique, with a significant P-value (0.013).  About 17 (7.7%) cases required open cholecystectomy; the conversion rate was higher in the infundibular group, with a significant P-value (<0.001).
CONCLUSION:
Although the "critical view of safety" requires more patience during dissections than the infundibular approach, it is proven to be faster and is considered a safe procedure in laparoscopic cholecystectomy.
KEYWORDS: Critical View of Safety (CVS), Infundibular Technique (IT), Bile Duct Injury (BDI)
Comparison of Outcomes of Topical Anesthesia with Peribulbar Anesthesia in Vitrectomy for Unresolving Vitreous Hemorrhage
Authors: Munir Muhammad , Khaqan Hussain Ahmaed , Akhtar Fahd Kamal , Imtiaz Usman , Basit Abdul , Naz Raheela , Afzal Mehreen
Published: April 2022

OBJECTIVES:
To compare the Surgeon's ease level and duration of surgery in topical anesthesia with peribulbar anesthesia for vitrectomy without sedation in patients with unresolving vitreous hemorrhage of duration greater than 3 months.
METHODOLOGY:
A randomized controlled trial was carried out at the Department of Ophthalmology, Lahore General Hospital, Postgraduate Medical Institute, Lahore from October 2017 to September 2018. A total of 110 patients were equally divided (n=55) in group A (topical anesthesia) and group B (peribulbar anesthesia) by lottery method. In group A, 0.5% proparacaine hydrochloride eye drops were instilled into the conjunctival sac every 3 minutes preoperatively 5 times before surgery. For group B patients, 5cc injection consisting of 2.5ml of 0.5% bupivacaine and 2.5ml of 1% lidocaine was injected thirty minutes before surgery. Surgical time was noted from first incision to enter the eye for vitrectomy till application of last closing suture. Surgeon ease was recorded with a 4 Grade scale. All data was recorded, entered, and analyzed by SPSS version 25.0. Continuous variables were presented as mean, standard deviation and independent t-test was applied.
RESULTS:
 The mean age of the patient was 43.83±9.76 years. Male cases were 78 (70.9%) and female cases were 32 (29.1%). Mean duration of surgery was 30.32±7.07 minutes and the surgeon’s ease was 2.30±0.98. There was a significant difference (P<0.05) with respect to mean duration of surgery and surgeon’s ease level in patients who were given topical anesthesia (28.12±6.57 minutes and 3.11±0.90) versus peribulbar anesthesia (32.52±6.92 minutes and 2.67±0.90).
CONCLUSION:
Topical anesthesia without sedation is better than peribulbar anesthesia for vitrectomy without sedation in patients with unresolving vitreous hemorrhage of duration greater than 3 months.
Comparison of Prognostic Indicators of Maxillary Impacted Canine using OPG (Orthopantomogram) with CBCT (Cone Beam Computed Tomography)
Authors: Mushtaq Nasir , Shamal Syeda , Hassan Nayab , Shah Jawad Ullah , Ali Haider
Published: April 2022

OBJECTIVES:
The aim of the present study was to compare OPG (orthopantomogram) in locating impacted canines with CBCT (cone beam computed tomography) scans of the same patients.
METHODOLOGY:
The cross-sectional study was carried out on the OPG (orthopantomogram) and CBCT (Cone-Beam Computed Tomography) of 27 patients (17 females and 10 males) presenting with impacted permanent maxillary canines. Thirty-five impacted canines were subsequently assessed on the four guidelines devised by McSherry and Pitt and applied to the panoramic films and CBCT scans. 
RESULTS:
The results show weak agreement for the canine’s angle to the midline and the canine’s horizontal root apex position (k value=0.55, 0.46, respectively). Moreover, significant differences were found between the OPG (orthopantomogram) and the CBCT (Cone-Beam Computed Tomography) for all the variables using Chi-square and Fisher’s exact test (p=.000)
CONCLUSION:
The results showed a significant difference in the 2D and 3D images of impacted maxillary canines, which can produce different diagnoses, and therefore treatment plans. OPG (Orthopantomogram) cannot be completely relied upon for the routine diagnosis of impacted canines.
IMPLEMENTASI MODEL PEMBELAJARAN KOOPERATIF TIPE SNOWBALL THROWING DALAM MENGATASI PEMBELAJARAN SISWA DIMASA COVID 19
Authors: Nurfirdaus Nunu , Sukma Nur Alam Fajar , Usamah Asep
Published: April 2022

Pandemi Covid-19 ini menjadi hal yang sangat berdampak pada pendidikan khusunya pada proses pembelajaran yang dilakukan selama masa pandemi, penerapan kebijakan Pembelajaran Jarak Jauah (PJJ) yang diterapkan pemerintah membuat para tenaga pengajar harus berpikir keras untuk membuat model pembelajaran yang efektif. Model pembelajaran kooperatif tipe snowball throwing merupakan model yang sudah diuji sebelumnya dengan bentuk penelitian dan hasilnya mampu mampu meningkatkan hasil belajar siswa. Tujuan dari PkM ini diharapkan dengan penerapan model pembelajaran kooperatif tipe snowball throwing pada masa pandemi akan terciptanya kenyaman siswa dalam melaksalanakan kegiatan belajar selama, meningkatnya kualitas pengetahuan siswa, terciptanya suatu model yang bisa menjadi sebuah rekomendasi untuk semua tenaga pendidik dalam menjalakan tugasnya selama masa pandemi. Metode pada kegiatan ini dibagi menjadi beberapa tahapan yaitu tahapan persiapan, tahapan pelaksanaan, tahapan evalusi dan tahapan pendampingan. Penerapan model pembelajaran kooperatif tipe snowball throwing dapat menjadi solusi bagi tenaga pengajar dalam melakukan kegiatan pembelajarannya selama masa pandemi. Dengan penerapan model kooperatif tipe snowball throwing pada masa pandemi dapat menciptakan kenyaman siswa dalam melaksalanakan kegiatan belajar selama pandemi, selain itu juga dapat meningkatkannya kualitas pengetahuan siswa pada masa pandemi, dengan kata lain model ini bisa menjadi sebuah rekomendasi untuk semua tenaga pendidik dalam menjalakan tugasnya selama masa pandemi.
PEMANFAATAN JAHE MERAH (Zingiber officinale var. Rubrum.) DALAM UPAYA MENINGKATKAN DAYA TAHAN TUBUH DI MASA PANDEMI COVID-19
Authors: Yayan  , Alvionita Elina , Fauziyah Siti
Published: April 2022

Menjaga daya tahan tubuh di masa Pandemi Covid-19 sudah menjadi kebutuhan bagi masyarakat. Banyak masyarakat yang kembali melirik bahan alam yang dipercaya dapat menjaga daya tahan tubuh. Tanamana Obat Keluarga (TOGA) banyak menjadi pilihan, salah satunya adalan jahe merah (Zingiber officinale var. Rubrum.). Kegiatan Pengabdian kepada Masyarakat ini dilakukan dengan tujuan melakukan pemanfaatan tanaman jahe merah (Zingiber officinale var. Rubrum.) dalam meningkatkan daya tahan tubuh di masa Pandemi Covid-19 dan mengolah tanaman jahe merah menjadi serbuk instan yang dapt dikonsumsi dengan rasa yang nikmat. Bahan penyusun dalam serbuk jahe merah instan  adalah jahe merah dan gula pasir. Peralatan yang digunakan pun sederhana, yaitu dengan menggunakan peralatan dapur. Selain itu dilakukan sosialisasi kepada masyarakat Desa Sindang Jawa, Kecamatan Dukupuntang, Kabupaten Cirebon. Kegiatan tersebut dilakukan dalam bentuk webinar melalui zoom meeting. Informasi yang disampaikan dapat diterima dengan baik, dan masyarakat sebagai peserta  memberikan respon positif dan penuh antusias.
FORMULASI, UJI EFEKTIVITAS DAN UJI HEDONIK MASKER GEL PEEL OFF KOMBINASI EKSTRAK RIMPANG KUNYIT (Curcuma longa L.) DAN MADU (Mel depuratum) SEBAGAI PENINGKAT ELASTISITAS KULIT
Authors: Monic Sri Cahnia  , Muhaimin  , Yuliawati  , Uce Lestari  , Fathnur Sani K
Published: April 2022

Salah satu upaya untuk mengembalikan kekencangan kulit adalah menggunakan sediaan kosmetik yang mengandung antioksidan. Kandungan yang terdapat dalam kunyit dan madu diketahui memiliki manfaat sebagai antioksidan. Salah satu sedian kosmetik yang dapat meningkatkan kekencangan kulit adalah sediaan masker wajah. Tujuan penelitian ini untuk mengetahui formula masker gel peel off ekstrak rimpang kunyit dengan kombinasi madu yang mempunyai sifat fisik yang baik dan untuk mengethaui efektivitasnya dalam mengencangkan kulit wajah. Penelitian ini menggunakan metode Rancangan Acak Lengkap. Sediaan masker gel peel off dibuat 3 formula dengan konsentrasi ekstrak kunyit dan madu yang berbeda yaitu F1 (1% : 4%), F2 (2% : 2%) dan F3 (4% : 1%). Tahapan prosedur dalam penelitian ini meliputi determinasi tanaman, penyedian sampel, pembuatan simplisia rimpang kunyit, pembuatan ekstrak rimpang kunyit, formulasi masker gel peel off, evaluasi sifat fisik, uji stabilitas, uji hedonik dan uji efektivitas sediaan dalam mengencangkan kulit. Hasil pengujian sifat fisik dan uji stabilitas menunjukkan bahwa sediaan masker ekstrak rimpang kunyit dengan kombinasi madu pada F1,F2 dan F3 menunjukkan hasil yang berada pada rentang yang sesuai dengan parameter dan stabil selama penyimpanan. Dari hasil uji hedonik, F1 lebih disukai panelis dibandingkan dengan formula lain, F1 efektif dalam meningkatkan kekencangan kulit wajah tiap minggu selama pemakaian empat minggu ditandai dengan peningkatan persentase kekencangan kulit setiap kali pemakaian.
Ketentuan Pendirian Perseroan Terbatas Setelah Berlakunya Undang-Undang Nomor 11 Tahun 2020 Tentang Cipta Kerja
Authors: Puspadewi Anak Agung Ayu Intan
Published: April 2022

Perseroan terbatas merupakan suatu badan hukum yang paling banyak diminati para pelaku usaha karena dapat menuju peluang bisnis yang terbuka. Perseroan terbatas merupakan badan hukum yang terdiri atas persekutuan modal dan saham. Setelah berlakunya UU Cipta Kerja perseroan terbatas bukan hanya badan hukum yang terdiri dari persekutuan modal dan saham tetapi badan hukum perseroangan dengan kriteria usaha mikro dan kecil. Permasalahan dari isu hukum penelitian ini yaitu berkaitan dengan kriteria perseroan terbatas yang ditentukan dalam UU Cipta Kerja dan pendirian perseroan terbatas yang memenuhi kriteria usaha mikro dan kecil. Penelitian ini menggunakan metode penelitian normatif dengan pendekatan pendekatan perundang-undangan, pendekatan analisis dan pendekatan konsep. Tehnik pengumpulan bahan hukum yang digunakan yaitu tehnik studi kepustakaan, yaitu mencari, mempelajari, memahami dan menganalisis berbagai pendapat, teori dan konsep. Kesimpulan dalam penelitian ini yaitu kriteria perseroan dalam UU Cipta Kerja yaitu perseroan yang terdiri atas modal atau saham, dan perseroan perseorangan yang memenuhi kriteria usaha mikro dan kecil. Pendirian perseroan perseroangan dengan surat pernyataan pendirian perseroan dan dapat didirikan oleh satu orang.
Rotationally Constrained Convection in the Sun: Applicable to Planetary Atmospheres?
Authors: Mullan D. J.
Published: April 2022

Rotational suppression of convection can occur on length scales which are larger than a critical length. Featherstone & Hindman suggest that this can account for a second preferred length-scale in solar convection on supergranule scales. Here, I explore if rotational suppression of convection also occurs in the atmospheres of Earth and Venus.
A SuperWASP Light Curve Displaying a Single Long-duration Transit: A Jupiter Size Exoplanet in a Very Distant Orbit?
Authors: Norton Andrew J. , Dickinson Hugh J. , McMaster Adam , Middleton Matthew , West Richard G.
Published: April 2022

We present the SuperWASP light curve of a 10th magnitude A7V star containing a single, well-defined U-shaped transit-like event lasting around 11 days with a depth of 1.1%. The star is otherwise non-variable throughout the 8 yr duration of the observations. If the event is modeled as an exoplanet transit, it is compatible with a 1.8 R
J exoplanet in a ∼205 au orbit with a period of ∼2200 yr.
Gangotri Wave—A High Density Gas Ripple in the Inner Galaxy
Authors: Veena V. S. , Schilke P. , Sánchez-Monge Á. , Sormani M. C. , Klessen R. S. , Schuller F. , Colombo D. , Csengeri T. , Mattern M. , Urquhart J. S.
Published: April 2022

Recently, we reported the discovery of a kpc-scale CO structure in the inner Galaxy which we named the Gangotri wave. The structure is at least 2 kpc in extent and its vertical distribution is wave-like in morphology. The analysis of the velocity data suggests Gangotri wave being a spur of the Milky Way or a sub-branch of the Norma arm. Following the discovery, there is a rebuttal published, expressing concerns on identifying the inner Galaxy CO emission features as a single coherent structure. In this article, we aim to address the concerns of the rebuttal article, hoping to clarify some of the criticisms.
Rapports de force en Méditerranée : le retour de la question maritime
Authors: Daguzan Jean-François
Published: April 2022

Cet article interroge l’évolution des récents rapport de force en Méditerranée du point de vue maritime. Les modèles de stabilité d’avant 2000 ont laissé place à des états de crise et de violence : lutte sans contrôle contre le terrorisme, mouvements arabes, révolutions, guerres civiles, crise économique. Cette situation de déséquilibre a ouvert le retour à la puissance maritime et au contrôle de la mer.
Les passages maritimes méditerranéens : continuité stratégique, utilité globale et enjeux nationaux
Authors: Tourret Paul
Published: April 2022

Comme la plupart des mers plus ou moins fermées, la Méditerranée compte quelques passages spécifiques, les plus importants en sont sa sortie occidentale du détroit de Gibraltar vers l’Atlantique et les détroits turcs qui la connectent avec le bassin annexe que représente la mer Noire. Ces deux passages sont autant des seuils maritimes que des lieux stratégiques entre continents. Avec l’ouverture du canal de Suez en 1869, une nouvelle sortie maritime pour la Méditerranée se dessine mais également un nouveau corridor dans les échanges avec l’Asie. Ces derniers s’inscrivent désormais dans le grand phénomène de la globalisation qui fait transiter des millions de tonnes de marchandises dans l’espace méditerranéen. Le canal de Suez est fondamental pour les échanges euro-asiatiques et l’Égypte entend être plus qu’un état de passage pour développer économiquement son positionnement stratégique avec des ports et des plateformes logistiques. C’est aussi ce que fait désormais le Maroc sur la rive sud du détroit de Gibraltar avec un développement portuaire aussi impressionnant que réussi. Quant à la Turquie, elle poursuit une voie singulière en tentant de faire d’un canal latéral au Bosphore un objet de développement économique dont le futur est encore hypothétique. L’objectif pour l’Égypte, le Maroc et la Turquie est bien de faire de leur position dans l’espace maritime un atout de développement à l’échelle de la globalisation maritime en cours.
La mer Noire, tremplin de la stratégie russe en Méditerranée
Authors: Migault Philippe
Published: April 2022

Vieille puissance méditerranéenne, la Russie a opéré un retour en force dans la région à la faveur de sa reconquête de la Crimée et de son intervention en Syrie. Cette politique, contrairement aux apparences, répond à un sentiment de menace de Moscou et à une stratégie de défense de l’avant correspondante. Les autorités russes, s’appuyant sur un renouveau de leurs armées, nourrissent cependant essentiellement des ambitions économiques en Méditerranée, aspirant davantage à un partage des opportunités avec les Occidentaux qu’à un affrontement avec ceux-ci.
Le gaz en Méditerranée orientale, un déterminant dans la géopolitique régionale
Authors: Rebière Noémie
Published: April 2022

Depuis le début du XXI e siècle, la découverte des réserves de gaz naturel en Méditerranée orientale alimente des conflits historiques entre les pays de la région et soulève de nouveaux enjeux géopolitiques liés au contrôle des ressources énergétiques. La délimitation des frontières maritimes et la question de l’exportation des ressources gazières sont au cœur des enjeux. On assiste à un rapprochement entre la Grèce, la République de Chypre, Israël et l’Égypte face à une Turquie isolée dans le jeu méditerranéen. L’intérêt croissant des puissances extérieures pour le gaz de la Méditerranée orientale se traduit par une militarisation de la région.
« Pêcher par excès » en Méditerranée : enjeux et conflits autour d’une ressource commune menacée
Authors: Panaget Julien
Published: April 2022

Avec près de 75 % des stocks de ressources halieutiques considérés en surexploitation par la communauté scientifique, la Méditerranée est l’un des espaces maritimes le plus surexploité au monde. Les habitudes de pêche qu’elles soient techniques, spatiales ou temporelles, se modifient sans cesse afin de continuer à satisfaire une demande en produits de la mer en constante augmentation depuis les années 1960. Ces deux facteurs contribuent à l’intensification de la compétition entre pêcheurs d’un même État et, surtout, d’États différents. Si on ajoute à cette situation les particularités de la situation méditerranéenne telles que : l’absence d’une instance de gestion possédant les pouvoirs normatifs nécessaires pour appliquer une gestion régionale de la pêche ou encore, l’inadaptation des principes du droit international de la mer au contexte méditerranéen, on prend rapidement conscience des tensions qui caractérisent l’exercice de cette activité en Méditerranée. Cet article s’efforce d’appréhender les éléments structurants de cette situation de tensions entre pêcheurs et, entre États interposés. Afin de les illustrer, l’article revient sur une situation bien particulière, celle de « la guerra del pesce » qui oppose depuis plus de soixante ans l’Italie et la Tunisie et, plus récemment, l’Italie et la Libye.