bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 among Healthcare Workers of Teaching Hospitals Affiliated with Rawalpindi Medical University
Authors: Umar Muhammad , Shahid Rizwana , Khan Muhammad Mujeeb , Zeb Shazia , Rauf Fatima , Hayat Uzma
Published: February 2022

Objectives: To overview COVID-19 scenario among healthcare workers in teaching hospitals of Rawalpindi Medical University

Subjects & Methods: A cross-sectional descriptive research was done among 482 coronavirus infected healthcare professionals from three teaching hospitals (Holy Family Hospital, Benazir Bhutto Hospital and District Head Quarters) that were affiliated with Rawalpindi Medical University during January 2021. Healthcare workers with COVID confirmation via RT-PCR testing reports were included in the study through consecutive sampling. Their demographic profile, workplace attributes, clinical manifestations, oxygen saturation, source of infection, re-infection, hospitalization, requirement for oxygen supply and disease severity according to COVID-19 adult cases categorization were inquired. Data analysis was done by means of SPSS version 25.0.

Results: Mean age of 482 healthcare workers was 29.6 ± 5.7 years. Mainstream (69.1%) of our study participants was constituted by female healthcare staff. Majority (34%) were postgraduate trainees followed by 29% nurses and 20% house officers. Mean duration of sickness was 13.6 ± 6.4 days. About 63.1% of study subjects were COVID infected during July –December 2020. About 4.8% healthcare personnel were asymptomatic and 78% caught infection from their workplace. Approximately 82% suffered from fever while 71.4% and 55.8% went through bodyaches and cough respectively. Out of 39 hospitalized workers, 23 required oxygen supply for their vitality. Severe COVID infection was determined only among 5.4% healthcare professionals.

Conclusion: Healthcare workers are more susceptible to acquire COVID infection from their workplace. In view of this vulnerability, firm compliance to preventive measures against coronaviurs infection by healthcare staff and general public is deemed necessary for their viability.
Impact of COVID-19 on Ophthalmologists
Authors: Rasool Wajeeha , Abbasi Kanwal Zareen , Waqas Maria , Munshi Misbah , Sarfraz Rehmah , Niazi Fuad A K
Published: February 2022

Objectives: To determine the effects of COVID 19 pandemic on the professional lives of ophthalmologists

Methods: This cross sectional survey was conducted for 6 months in late 2020 and used google forms for data collection.

Results: Total 68 respondents gave their likert response for each of the 20 statements. No. %, median, mode and interquartile range, of all respondents likert sentiment for each statement, were calculated. Survey results showed general, ‘consent and consensus’.

Conclusion: Covid-19 has influenced professional lives of ophthalmologists.
Severity Index and Outcome of Hospitalized COVID-19 Patients in Capital Hospital, CDA, Islamabad
Authors: Nisa Aziz Un , Meraj Lubna , Maqbool Khizra , Ayaz Ifrah , Batool Anam , Shams Nadia
Published: February 2022

Objective: To assess clinical characteristics and outcome of patients with Covid-19 infection. Study design: Descriptive cross-sectional study.Place and duration of study: Department of Medicine, Capital Hospital Islamabad from February 01, 2021 to April 25, 2021.Methodology: A manual medical record of total of 221 patients was conducted, more than 18 years of age, both genders, who presented with features suggestive of Covid-19 infection were included. Patients were tested for COVID-19 PCR, blood complete picture and inflammatory markers. The data was analyzed by using SPSS version 42.Results: Among 221 patients, there were 125(56.6%) males and 96(43.4%) females. Mean age was 57.20+13.17 years. Total 155(70%) cases were Covid PCR +ve and 66(30%) –ve. 86(38.9%) cases had mild, 91(41.2%) had moderate and 44(19.9%) had severe covid-19 infection. Lymphopenia was observed in 154(69.7%) cases. C-reactive protein was positive in 178(80.5%) cases. Serum ferritin was raised in 114(51.5%) cases, D-dimers in 139(66.9%), lactic dehydrogenase in 167(75.5%) cases with significant association with disease severity. Serum interleukin, performed in moderate and severe cases only, had mean value of 54.1+105.94pg/ml. Diabetes mellitus was found significantly associated with mortality (p=0.007) as well as hypertension (p<0.0001). 207 cases were managed and discharged, 14 cases expired (6.33%). Mortality was significantly associated with disease severity (p<0.001). Remdesivir was given to symptomatic patients and 94.4 % patients were discharged vs 5.6 % expired. Remdesivir and tocilizumab was given in combination in severe/critical patients and 76.5% patients were discharged vs 23.5% expired.Conclusion: Covid-19 is a disease with variable presentations. Severity of Covid-19 infection is directly related to lymphopenia as well as inflammatory markers. IL-6 levels, raised in more severe cases, signify immune response to Covid-19. Disease is more severe in patients with comorbids. In moderate to severe disease remdesivir and in severe covid disease with high IL-6 levels combination of antiviral and tocilizumab may help to improve outcome.
Spectrum of Hematological and Non-Hematological Diseases on Bone Marrow Examination-A Study on 220 Cases at a Tertiary Care Centre
Authors: Rauf Fatima , Zafar Nowera , Asif Hira
Published: February 2022

Background: Bone marrow examination is an invaluable tool in the diagnosis of hematological and non-hematological diseases. Referral is made based on the clinical after analyzing CBC and peripheral film.Objective: This study aims at evaluating the spectrum of diseases diagnosed on bone marrow biopsy at a tertiary care hospital of Rawalpindi, Pakistan.Materials and Methods: This descriptive, cross-sectional study was carried out at the pathology department of Holy family hospital for a duration of 1 year after ethical approval from IRF. All 220 cases requiring bone marrow examination were included in the study by consecutive sampling technique. Variables like age, gender, presenting complaints, examination findings, CBC, peripheral blood film, indications and diagnosis of bone marrow examination were noted. Data was analyzed using SPSS v22.Results: Mean age was 29.15±20.9 years. 117(53.2%) specimens were of males and 103(46.8%) were of females. Spectrum of hematological and non-hematological diseases found on bone marrow examination ranged from acute leukemia in 37(16.8%), megaloblastic anemia in 29(13.1%).The relationship between indications of referral and diagnosis of bone marrow examination was found to be statistically significant showing that suspected diagnosis made by the clinician was same as the final diagnosis in many cases. Pancytopenia was found major indication in most diseases (32.7%).Conclusion: Bone marrow examination is a useful tool in ascertaining diagnosis of various hematological and non-hematological disorders. Pancytopenia was found to be major indication whereas, acute leukemia and megaloblastic anemia were most common malignant and benign hematological disorders on bone marrow examination, respectively.
Comparison of Erythropoietin alone with Erythropoietin plus oral Ascorbic Acid in the Treatment of Anemia in Chronic Kidney Disease Patients
Authors: Qaiser Mansoor Abbas , Aibideen Zain Ul , Yameen Mubashar , Roop Zarmina , Saleh Muhammad Awais , Chattah Fateh Sher
Published: February 2022

Objective Of the Study:   To compare efficacy of “Oral ascorbic acid in combination with Erythropoietin”  with “standard dose of erythropoietin alone” in renal anemia in terms of mean hemoglobin rise.

Introduction: Recombinant human erythropoietin (rhEPO) has a vital role in management of anemia in CKD (chronic kidney disease) patients. In the last decade, Ascorbic acid (AA) has emerged as a potential therapy to improve anemia probably by enhancing iron mobilization. We have conducted this study to compare the mean hemoglobin rise after treatment with standard dose erythropoietin alone with standard dose erythropoietin plus Oral ascorbic acid in CKD patients who were suffering from anemia.

Materials & Methods: A total of 70 patients of CKD with anemia, 18 to 70 years of age of both genders were included. Patients with laboratory proven iron deficiency anemia, obvious blood loss, pernicious anemia, hyperparathyroidism and contraindications for erythropoietin or ascorbic acid treatment were excluded. The patients which were selected randomly placed in two groups. Group A (erythropoietin alone) & Group B (erythropoietin plus oral ascorbic acid), by using lottery method. Outcome variable like hemoglobin was measured at 2, 4 and 6 months.

Results: Mean age was 48.90 ± 13.53 years. Male to female ratio was 1.6:1 with 43 (61.43%) males and 27 (38.57%) females. Mean pre-therapy hemoglobin  was 9.40 ± 1.03 g/dl in the Group A while it was 9.42 ± 0.98 g/dl (p-value = 0.901) in Group B and  mean post-therapy hemoglobin in the Group A was 9.34 ± 1.06 g/dl while in the Group B was 10.37 ± 1.16 g/dl with p value of 0.0002 which is statistically significant.

Conclusion: The study concluded that standard dose erythropoietin plus Oral ascorbic acid in CKD anemia is more effective  as compared to erythropoietin alone.

Keywords: Chronic kidney disease, Erythropoietin, Ascorbic acid, Anemia.
Infective agents in diabetic foot ulcers and their sensitivity patterns
Authors: Nadir Mehmood , Khan Muhammad Qasim , Ahmed Malik Irfan , Idrees Muhammad Anwar , Hassan Tehzeeb Ul , Nadir Maha
Published: February 2022

Background: Diabetic-foot syndrome is a difficult & debilitating complication of inadequately regulated Diabetes Mellitus. Attributed to neural & vascular pathology, the condition is further potentiated by glycemic healing impairment.  A wide array of microorganisms have been implicated & sensitivity-guided antibiotics are essential to save both limb as well as to minimize rampant microbial resistance. Present study aims to determine the culture & sensitivity pattern of bacteria in stated cohort of patients at a Surgical Unit.

Materials & Methods: This prospective cohort study was conducted over a period of 1 year-duration at a tertiary-care-Hospital. All patients presenting with diabetic-foot who had not been subjected to empiric antibiotic-therapy were enrolled. Demographic & lesion-based variables were studied and the Culture & Sensitivity pattern was evaluated and statistically analyzed.

Results:100 patients were included in the study,of which 80 were male (mean-age 60.8±12.7 years) & rest female (mean-age 58.4±11.3-years).35% cultures yielded no growth. Remaining cases showed following pathogens in descending order of incidence. Maximal sensitivity was also reported as mentioned. 1) Staphylococcus-aureus & Klebseilla-Pneumoenae– Piperacillin/Tazobactam,2) Pseudomonas-Aerugionas-Cefotaxime,3)E-coli–Amikacin& Sulbactam,4) Proteus -Gentamicin, 5) Streptococci– Amikacin and 6) Bacteroides – Cefoperazone & Aztreonam. Of 71 cases, 70  had aerobic-organisms isolates & only 1 had anaerobic-isolate.

 

Conclusions: Six pathogens were identified in present study of which Staphylococcus-Aureus was the most prevalent as well as the most resistant. Streptococci & Gram-negative Organisms were observed in remaining cases. While formulation of an adequate antibiotic regime is rendered difficult by resistance & mixed infections, targeted antibiotic administration is decisively crucial to achieve optimal & timely outcome in diabetic foot.
Knowledge and Practices of Student Nurses towards Prevention and Management of Pressure ulcers in Allied Hospitals of Rawalpindi Medical University
Authors: Ghafoor Nimra , Munir Rabiya , Niazi Inayat Mumtaz Khan , Azhar Faryal
Published: February 2022

Introduction: Pressure ulcer is a common preventable complication of prolonged hospitalisation. Although debilitating, but preventable through timely assessment and proper management. This study was conducted to access student nurse’s knowledge and practices towards the prevention and management of pressure ulcers. Materials and Methods: A cross-sectional study was conducted at Nursing Schools of Holy Family Hospital and Benazir Bhutto Hospital Allied with Rawalpindi Medical University. A pre-tested self-designed questionnaire was filled by 264 students selected through the non-probability convenient sampling technique. Data were analysed using SPSS 21. P-value <0.01 was considered significant.

Results: Mean percentage of Student nurse’s knowledge and practices were 58.7% 69.62% respectively. 21.7% of first-year students, 34.1% of second-year students, and 60.2% of third-year students had good knowledge. Correspondingly, 10.89% of first-year students, 32.9% of second-year students, and 56.2% of third-year students had good practice. There was a significant correlation between knowledge and practices i.e. r value is 0.92, the p-value is <0.000.

Conclusion: Knowledge and Practices of Student Nurses towards the prevention and management of pressure ulcers was found to be average. The practices of students gradually improved as their knowledge improved throughout their years of education.
Psychological Morbidity in patients with Idiopathic Hirsutism presenting for Laser Treatment at a Tertiary Care Hospital
Authors: Naheed Aqsa , Hayat Aalia Akhtar , Ain Qurat Ul , Razzaque Bushra , Fatima Sundus , Dar Nasser
Published: February 2022

Objective: The objective of our study was to determine the frequency of depression, anxiety, and stress in females presenting for laser treatment of hirsutism at a dermatology clinic.

Materials and Methods: This was a cross-sectional descriptive study. 152 female participants of all ages presenting for laser treatment of hirsutism to the dermatology department –removed for blind review--from June 2019 to Dec 2019, were included using a consecutive convenient sampling technique. Patients having an FG (Ferriman and Gallwey) score of 8 or more, were included whereas those having any underlying cause (as assessed by history and examination and laboratory investigations where required) for both hirsutism and psychological disorder were excluded. The participants were given an Urdu version of the DASS 21 (depression, anxiety, and stress scale) to complete.

Results: The participants had a mean age of 30.22 (SD = 9.17). The prevalence of depression, anxiety, and stress in the sample was found to be 13.2%, 23.7%, and 17.8%, respectively. Mean depression, anxiety, and stress scores on DASS 21 were 4.43(SD=4.87, Cut-off= 10), 4.34(SD=5.12, Cut-off= 8), and 8.21(SD=6.26, Cut-off=15), respectively, indicating that the scores were within the normal range. Anxiety was the most common illness in the sample and both depression and stress showed a decline with advancing age up till 45years of age. No statistically significant association was found between the severity of hirsutism and depression, stress, and anxiety scores.

Conclusion: Psychological morbidity was found to be lower in patients of idiopathic hirsutism presenting for laser treatment. The long-term efficacy of laser treatment needs further evaluation in future research.
Sturge Weber Syndrome (SWS): A case report in an infant
Authors: Afzal Erum , Noureen Asia , Iqbal Muhammad Khalid , Aftab Kausar , Rehman Asad , Muien Rubeena
Published: February 2022

Introduction: Sturge Weber Syndrome (SWS), known as encephalotrigeminal angiomatosis, is a rare neurocutaneous disorder and is having a prevalence of 1/20-50,000, live births. The syndrome consists of leptomeningeal angiomas and the angiomas of the face, characteristically in the ophthalmic and maxillary divisions of the trigeminal nerve. The neurological presentations include fits, deficits in cognition, glaucoma, and visual field abnormalities. The overgrowth of the soft tissues and extracranial angiomas can also occur in SWS.

Case presentation: We are presenting a rare case of Sturge Weber Syndrome in an infant who presented at an early stage of this disorder. The index case presented to us with a large port-wine stain and right-sided focal fits. The CT scan brain showed subtle gyriform tram-track calcification of the left cerebral cortex and the left-sided cerebral atrophy. Ophthalmological examination showed glaucoma of the left eye. The clinical and radiological criteria were used to make the final diagnosis of SWS.

Conclusion: The case is being reported in order to increase awareness among medical professionals.
A comparison of Male and Female Medical Student's Motivation towards Career Choice
Authors: Sattar Hina , Zain Zubaida , Sheikh Abdul Malik , Saleem Aniqua , Arshad Muhammad , Meraj Lubna
Published: February 2022

Objective: To compare motivation to become a doctor in both genders

Study Design: Observational cross-sectional study

Place and Duration of Study:  Rawalpindi Medical University in March 2019.

Materials and Methods: First and second-year M.B.B.S students were included in the study. Age, year of study, and gender were recorded.  The questionnaire included 18 questions assessing six motivational dimensions: status and security; nature of the occupation; career opportunities; patient care and working with people; use of personal skills; and interest in science. Responses were recorded as ‘agree’ or ‘disagree’ for each question and results were analyzed using SPSS v19.

Results: Out of 350 medical students, 247 (70.6%) were female and 103 (29.4%) were male. Most frequent motivational factors for females were “Opportunity to care for/ help people” (n=240; 97.1%) followed by “responsible job” (n=220; 89%) and “use of mental skills” (n=217; 87.8%). Male students were motivated mostly by “use of mental skills” (n=90; 87.3%) followed by “provides secure career” (n=87; 84.4%) and “challenging field” (n=83; 80.5%). In our study, (n=61; 25%) of females responded in agreement that boosts in marriage perspective was an underlying motivational factor for their choice of studying medicine while (n=41; 40%) males agreed to it. There was a significant difference between both genders with a p-value of 0.005. 

Conclusions: We infer that female medical students have more humanitarian grounds for choosing the medical profession and are more motivated than their male counterparts.
Alanine Transaminase levels in Patients of Dengue Fever in the Suburbs of Islamabad
Authors: Mumtaz Hassan , Mughal Irfan Afzal , Faruqi Amna , Irfan Noor -ul-Ain , Mumtaz Shamim , Irfan Asma
Published: February 2022

Introduction: Hepatic dysfunction is a highly varied condition that can show up as minor damage with elevated levels of transaminases, or appear as extensive damage and failure of liver cells. Thus, in order to reduce associated morbidity and mortality, this ailment should be diagnosed at the earliest possible so that appropriate therapy can be instituted. Our study was carried out to observe hepatic damage in patients with dengue fever (DF) by measuring alanine transaminase levels. Materials and Methods: A cross-sectional study of three months duration was carried out in the Department of Medicine, Dr. Akbar Niazi Teaching Hospital affiliated with Islamabad Medical & Dental College, Pakistan. The sampling technique was Non-Random consecutive sampling and 118 patients were included in our study. Serum Alanine Transaminase (ALT) (normal = 7-56 IU/L), serum Aspartate Transaminase (AST) (normal = 10-40 IU/L) were determined and ultra-sound abdomen was performed. Statistical analysis was done using SPSS Version 24. The Chi-square test was used to observe the relationship between categorical variables. Phi, Cramer’s V, Pearson’s, and Spearman’s Correlation tests were used to study the association of age and gender with ALT levels. Results: There were 72% males (n=85) and 28% females (n=33). Patients were grouped according to age and mean ALT (95+86 IU/L) and AST (134.7+ 98 IU/L) levels were calculated in the different age groups. These levels were found to be significantly raised (P=0.00) in the age groups of 9-18 years and 19-25 years as compared to the other age groups. Moreover, males had high ALT levels as compared to females, however, a significant difference was not observed. There was also no association seen of gender with raised ALT levels (P=0.564), Phi & Cramer’s V=0.56, and Spearman’s correlation coefficient=0.320.Conclusions: ALT and AST levels were elevated above the normal in our sample indicating hepatic involvement.
Comparison of frequency of low APGAR score in babies born to normotensive patients with and without hyperuricemia in a tertiary care hospital
Authors: Noman Faryal , Noor Nusrat , Anwar Rabiah , Akbar Rabiya , Yaqub Khan Muhammad
Published: February 2022

Objective: To compare the frequency of low APGAR scores in babies born to normotensive patients with asymptomatic hyperuricemia with those without hyperuricemia.Study Design: Cohort Study.Place and Duration: This study was conducted at the department of gynaecology/obstetrics, Liaquat National Hospital Karachi from January 2015 to January 2016.Materials and Methods: The sample size was calculated by using openepic.com version 2, an open-source calculator. The sample size was calculated to be 165 in each group, which made a total of 330 patients. Non-probability consecutive sampling was chosen as the sampling technique. All normotensive pregnant females with blood pressure of less than 130/90 between 18 to 40 years of age, with singleton pregnancy at 37 weeks and beyond were included in the study. Normotensive pregnant females with hyperuricemia were the exposed group while normotensive pregnant females with normal uric acid levels were the non-exposed group. The exclusion criteria included patients with multiple gestations, medical disorders like gout, chronic renal failure, APLS, Rheumatoid Arthritis, etc, on anti-hypertensives and smokers. Fetal outcomes were assessed in all patients after delivery and a comparison of outcomes was made between two groups. Results: The study was designed to compare the frequencies of low APGAR scores in babies born to normotensive patients with asymptomatic hyperuricemia to those without hyperuricemia. The main outcome in group A i.e. exposed group was 29 babies with low APGAR score (<7) with 17.5% and in group B, which was non-exposed, 12 (7.57%) of babies had low APGAR score (<7). P-value came out to be 0.0010. The difference was statistically significant.Conclusion: It is concluded that there is a significant difference between the frequency of low APGAR scores in babies born to normotensive patients with hyperuricemia to those without hyperuricemia.
Effect of Neodymium: Yttrium-Aluminium-Garnet Laser Posterior capsulotomy on refractive status of the Eye
Authors: Abbasi Kanwal Zareen , Mirza Bilal Humayun , Munshi Mibah , Rasool Wajeeha , Raza Ali
Published: February 2022

Objective: To assess the effect of Neodymium: Yttrium-Aluminium (Nd: YAG) laser posterior capsulotomy on the refractive status of the eye.Study Design: Quasi-experimental.Setting: Outpatient department of Benazir Bhutto Hospital, Rawalpindi.Duration: 1st January 2017 to 30th June 2017.Materials and Methods: A total of 95 eyes of 95 patients were included in this study. The patients were selected based on non - randomized convenient sampling. Among these patients 49 were females and 46 were males. The age range was 43 years to 85 years. These patients were those who had undergone uncomplicated cataract surgery with intraocular lens implantation 6 months or more than 6 months before presentation with posterior capsular opacification. Before Nd: YAG laser posterior capsulotomy, complete anterior and posterior segment examinations of these patients was performed and they were found to have no other associated anterior or posterior segment pathologies. Autorefractometre reading and best-corrected visual acuity were recorded and then after dilating the pupils, the procedure was performed. Post YAG capsulotomy, Autorefractometre readings were recorded again on the same day, at 1 week and the end of 4 weeks. Readings at the end of 4 weeks were considered for result purposes. These readings were converted into spherical equivalents for data analysis. Results: Data was analyzed through the SPSS version 18. The mean age was 60.14 years with a standard deviation of 9.241. Spherical equivalents were compared before and after YAG capsulotomy. Wilcoxon signed ranks test was applied. P-value (0.70) was found to be statistically insignificant which supported our hypothesis. Conclusion: Nd: YAG laser capsulotomy does not change the refractive status of the eye.
Surgical Site Infection with and without Prophylatic Antibiotic in Children undergoing Elecltive Inguinal Herniotomy
Authors: Napar Nabi Bux , Shaikh Noor Ahmed , Baloch Imamuddin , Shah Azhar Ali , Shaikh Bushra , Mahtam Ishrat
Published: February 2022

Objective: This study was aimed at determining the frequency of surgical site infection in children undergoing elective inguinal herniotomy with and without prophylactic antibiotic.

Study design: Prospective comparative study.

Settings: Pediatric surgery Department, Ghulam Muhammad Mahar Medical College Sukkur.

Study duration: From 1st February 2020 to 31th March 2021.

Methodology: One hundred and sixty patients selected for this study and were equally divided into two groups. Group A received antibiotic prophylaxis (Injection ceftriaxone 50mg/kg) before the induction of general anesthesia, whereas Group P received placebo before the induction of general anesthesia. Demographic data and duration of surgery was noted on a proforma. Surgical procedure was carried out following standard surgical protocols. Post-operatively all patients were observed by an independent observer. Patients were observed for post-operative fever, inflammation of the surgical site and discharge from the site of incision. Wound was examined on 1st, 3rd, 7th and 30th post-operative day. For labeling Surgical Site Infection, Center of Disease criteria was followed.

Results: Demographic data of both groups was comparable. Mean duration of surgery in group A was 29.61±7.47 minutes, while it was 32.97±8.73 minutes in group P with p-value of 0.08. Out of 160 patients, thirteen patients developed surgical site infection; 5 (6.25%) patients belonged to group A, while 8 (10%) belonged to group P with a p-value of 0.385.

Conclusion: It is concluded in our study that use of prophylactic antibiotics in elective herniotomy cases performed in pediatric patients do not significantly decrease the incidence of Surgical Site Infection.
Comparison of Ondansetron & Dexmedetomidine for Prevention of Post Spinal Shivering
Authors: Rana Sumbal , Wahid Faisal , Munir Ali Arslan , Naqvi Syed Ehtesham Haider , Mirza Zahoor Iqbal , Raziq Sohail
Published: February 2022

ABSTRACT:

INTRODUCTION:

Spinal Anaesthesia is a major component of Anaesthetist's tool set and is widely used in Anaesthesia practices. A frequent problem encountered after spinal Anaesthesia is shivering caused by hypothermia. Incidence is 10-40%, if no prophylactic measures are taken, in different studies conducted on this topic. Hypothermia during intraoperative period is caused by different causes like  cold ambient OR temperature, cold IV fluids, unhumidified cold inspired gases, body cavity exposure, extremes of age and prolonged procedures. Shivering occurs because of vasodilation caused by inhibition of vasoconstriction by spinal Anaesthesia and altered perception from anaesthetized dermatomes. Shivering has an array of adverse effects including increased workload for cardiopulmonary system , poorly tolerated by patients at extremes of age. A number of drugs have been studied for shivering.

Objective:

To compare efficacy of Dexmedetomidine and ondansetron for prevention of shivering under spinal Anaesthesia

Setting: AFIU 

Study design: Randomized quasi experimental study 

Study duration: 03 months 

Materials and Methods: 

The selected patients were randomly allocated to any of the two groups  with 50 patients each, according to computer generated random numbers. Both groups recieved study drugs after spinal Anaesthesia.

Ondansetron group, 0.1mg/kg (groupO) and Dexmedetomidine group 0.1mcg/kg (group D). Patients were scored for shivering at scheduled intervals and rescue doses of Pethidine were given for severe shivering not responding to study drugs.

Results: 

Our study in group O had high mean shivering scores at scheduled intervals as compared to group D 

Conclusion:

Dexmedetomidine provides better control of shivering than Ondansetron
Castleman Disease Mimicking Neurogenic Tumor Radiologically: A Case Report
Authors: Aqaash Haitham , Shahid Fatima , Qureshi Nousheen , Ayub Nayer , Hussain Asmara , Masood Sundas
Published: February 2022

Background: There are only few case reports of enlarged lymph node affecting carotid artery and mimicking neurogenic tumor radiologically. We have one such report to present

Case presentation: We presented a young male with mass in left upper part of neck mimicking carotid body tumor on CT scan and MRI. Post operatively histopathology sample was sent which was identified as a case of castleman disease. This case has been described in detail in our report.

Conclusion: Mass that was initially misunderstood as a case of neurogenic tumor and prepared accordingly showed out to a case of castleman lymphadenopathy. Thus the diagnosis of such unique presentation was made Due to castleman disease rarity and mostly asymptomatic presentation it is difficult to diagnose. Its similarity to lymphoma and paraganglioma radiologically further adds to its difficulty in diagnosis.. Thus it is important to consider castleman disease as a differential diagnosis of such mass.
Association of Neutrophil to Lymphocyte and Platelet To Lymphocyte ratio with Blood Glucose Regulation in Type 2 Diabetes Patients
Authors: Ahmed Sualeha , Khalid Muhammad Ali , Munir Muqadas , Arshad Imran , Maaz Muhammad
Published: February 2022

INTRODUCTION:                             

Diabetes is characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and lipid metabolism. Disorders of lipid metabolism are common in diabetes causing greater cardiovascular risks. Leukocytosis is a major marker of metabolic syndrome. Both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are related to subclinical inflammation worsening the glycemic control. HbA1c is used as a marker of blood glucose regulation.

OBJECTIVE:

 To investigate the association of  neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with blood glucose regulation in patients with type 2 diabetes mellitus.

 

METHODS:

This comparative analytical study was conducted in Shifa  International Hospital on diabetic patients. Sample size was calculated as 62 by WHO sample size calculator .  Non randomized convenient sampling was used. Patients were divided into two groups according to HbA1c level taking 7% as cut off point. Full blood count, lipid profile and liver profile were carried out. Data was analyzed by SPSS version 21. Descriptive statistics were calculated for categorical   variables. For quantitative normal and dispersed variables, independent student t and Mann Whitney U test were applied respectively. P Value less than 0.05 was considered significant.

 

RESULTS:

Out of total 93 patients,33 (35.4 %) were males and 60(64.5%) were females. The mean duration of disease was 8.26  ± 5.8 years. NLR and PLR were elevated in patients having poor glucose control but that difference was not significant. Significant difference between the groups was found with random blood glucose. LDL, triglycerides , cholesterol ratio, ALT and AST were raised in patients having poor glycemic control.

                            

CONCLUSION:

 Patients having poor blood glucose regulation have increased levels of   haematological and serological parameters posing greater cardiovascular health risks to patients with type 2 diabetes
PROFESSIONAL JUDGEMENT IN ACCOUNTING: CONTENTS AND CONDITIONS OF APPLICATION
Authors: Fomina Olena , Zadniprovsky Oleksandr , Korol Svitlana , Romashko Olha
Published: February 2022

The article considers the theoretical prerequisites and regulatory requirements that determine the practical approaches to the application of professional judgment in defining the best way to present reporting information. In the course of the research, the authors took as a basis the regulatory documents on the preparation of financial and integrated reporting, which take a principles-based approach and provide for the use of professional judgment. The authors assumed that the objects of a professional accountant are the facts of economic activity in order to identify, evaluate, recognize and reflect in the accounting and reporting of the company objects of accounting that are significant and of interest to users. The author investigated theoretical bases and practical aspects of application of professional judgment with the purpose of recognition of object and definition of its cost in the course of data collection, their analysis, and formation on their basis of professional judgment. The author has proved the need to adhere to the principle of additionality in finding the maximum complete description of the object and formulating a professional judgement about it. The author proposed a matrix model, which established the correspondence of risk levels and principles of application of professional judgment in accounting valuation and conducted an analysis of the conditions for the use of professional judgment in defining the fair value of financial instruments and inventories. The author considered the influence of uncertainties and corresponding risks in the application of professional judgment on the value of financial instruments and its adjustment in the conditions of unstable markets of countries with economies in transition. The author noted peculiarities of implementation of professional judgment in the process of preparation of financial and integrated reporting and the factors that determine them.
DEVELOPMENT OF CONCEPTUAL BASES OF THE EMPLOYEE LIFE CYCLE WITHIN AN ORGANIZATION
Authors: Gladka Olena , Fedorova Victoria , Dohadailo Yana
Published: February 2022

The purpose of the study is to review and integrate various definitions of the employee life cycle (ELC) and to develop new conceptual bases of ELC by applying logical analysis and systemic approach. In this article, we suggest the employee life cycle has a “client-based” approach. Therefore the development of the ELC is similar to the development of the client life cycle and each stage of this process requires adoption and use of external and internal personnel marketing tools. At the same time, it implies simultaneous various activities of employees and employers alike. A customer-centric process on the labor markets (external and internal) is initiated by the personnel marketing product. It is defined by three levels aiming to attract and retain employees. The model of the ELC proposed hereafter shows the bilateral mechanism of the employee-employer interaction. Through the activities of external (employee attraction) or internal (employee retention) personnel marketing the organization can build its “perceived” or “received” Employer Value Proposition (EVP). The refined definition of the ELC is based on the theoretical foundations of personnel marketing and takes into account the employee and the employer’s perspectives; our definition identifies the ELC time frame and defines indicators of the ELC measurement for further empirical studies. Suggested ELC stages were developed in a way to reflect characteristics and actions for the employer and the employee simultaneously. To maintain or renew the employee engagement level a set of measures were suggested for implementation at each stage of the ELC.
SELF ADAPTIVE VISCOSITY-TYPE INERTIAL EXTRAGRADIENT ALGORITHMS FOR SOLVING VARIATIONAL INEQUALITIES WITH APPLICATIONS
Authors: Tan Bing , Qin Xiaolong
Published: February 2022

In this paper, we introduce two new inertial extragradient algorithms with non-monotonic stepsizes for solving monotone and Lipschitz continuous variational inequality problems in real Hilbert spaces. Strong convergence theorems of the suggested iterative schemes are established without the prior knowledge of the Lipschitz constant of the mapping. Finally, some numerical examples are provided to illustrate the efficiency and advantages of the proposed algorithms and compare them with some related ones.
First Results from HERA Phase I: Upper Limits on the Epoch of Reionization 21 cm Power Spectrum
Authors: Abdurashidova Zara , Aguirre James E. , Alexander Paul , Ali Zaki S. , Balfour Yanga , Beardsley Adam P. , Bernardi Gianni , Billings Tashalee S. , Bowman Judd D. , Bradley Richard F. , Bull Philip , Burba Jacob , Carey Steve , Carilli Chris L. , Cheng Carina , DeBoer David R. , Dexter Matt , de Lera Acedo Eloy , Dibblee-Barkman Taylor , Dillon Joshua S. , Ely John , Ewall-Wice Aaron , Fagnoni Nicolas , Fritz Randall , Furlanetto Steven R. , Gale-Sides Kingsley , Glendenning Brian , Gorthi Deepthi , Greig Bradley , Grobbelaar Jasper , Halday Ziyaad , Hazelton Bryna J. , Hewitt Jacqueline N. , Hickish Jack , Jacobs Daniel C. , Julius Austin , Kern Nicholas S. , Kerrigan Joshua , Kittiwisit Piyanat , Kohn Saul A. , Kolopanis Matthew , Lanman Adam , La Plante Paul , Lekalake Telalo , Lewis David , Liu Adrian , MacMahon David , Malan Lourence , Malgas Cresshim , Maree Matthys , Martinot Zachary E. , Matsetela Eunice , Mesinger Andrei , Molewa Mathakane , Morales Miguel F. , Mosiane Tshegofalang , Murray Steven G. , Neben Abraham R. , Nikolic Bojan , Nunhokee Chuneeta D. , Parsons Aaron R. , Patra Nipanjana , Pascua Robert , Pieterse Samantha , Pober Jonathan C. , Razavi-Ghods Nima , Ringuette Jon , Robnett James , Rosie Kathryn , Sims Peter , Singh Saurabh , Smith Craig , Syce Angelo , Thyagarajan Nithyanandan , Williams Peter K. G. , Zheng Haoxuan ,   The HERA Collaboration
Published: February 2022

We report upper limits on the Epoch of Reionization 21 cm power spectrum at redshifts 7.9 and 10.4 with 18 nights of data (∼36 hr of integration) from Phase I of the Hydrogen Epoch of Reionization Array (HERA). The Phase I data show evidence for systematics that can be largely suppressed with systematic models down to a dynamic range of ∼109 with respect to the peak foreground power. This yields a 95% confidence upper limit on the 21 cm power spectrum of

Δ

21

2

≤

(
30.76
)

2

mK

2

at k = 0.192 h Mpc−1 at z = 7.9, and also

Δ

21

2

≤

(
95.74
)

2

mK

2

at k = 0.256 h Mpc−1 at z = 10.4. At z = 7.9, these limits are the most sensitive to date by over an order of magnitude. While we find evidence for residual systematics at low line-of-sight Fourier k
∥ modes, at high k
∥ modes we find our data to be largely consistent with thermal noise, an indicator that the system could benefit from deeper integrations. The observed systematics could be due to radio frequency interference, cable subreflections, or residual instrumental cross-coupling, and warrant further study. This analysis emphasizes algorithms that have minimal inherent signal loss, although we do perform a careful accounting in a companion paper of the small forms of loss or bias associated with the pipeline. Overall, these results are a promising first step in the development of a tuned, instrument-specific analysis pipeline for HERA, particularly as Phase II construction is completed en route to reaching the full sensitivity of the experiment.
FIRST J153350.8+272729: The Radio Afterglow of a Decades-old Tidal Disruption Event
Authors: Ravi Vikram , Dykaar Hannah , Codd Jackson , Zaccagnini Ginevra , Dong Dillon , Drout Maria R. , Gaensler B. M. , Hallinan Gregg , Law Casey
Published: February 2022

We present the discovery of the fading radio transient FIRST J153350.8+272729. The source had a maximum observed 5 GHz radio luminosity of 8 × 1039 erg s−1 in 1986, but by 2019 had faded by a factor of nearly 400. It is located at the center of a galaxy (SDSS J153350.89+272729) at 147 Mpc, which shows weak Type II Seyfert activity. We show that a tidal disruption event (TDE) is the preferred scenario for FIRST J153350.8+272729, although it could plausibly be interpreted as the afterglow of a long-duration γ-ray burst. This is only the second TDE candidate to be first discovered at radio wavelengths. Its luminosity fills a gap between the radio afterglows of subrelativistic TDEs in the local universe, and relativistic TDEs at high redshifts. The unusual properties of FIRST J153350.8+272729 (ongoing nuclear activity in the host galaxy, high radio luminosity) motivate more extensive TDE searches in untargeted radio surveys.
A Method to Characterize the Wide-angle Point-Spread Function of Astronomical Images
Authors: Liu 刘 Qing 青 , Abraham Roberto , Gilhuly Colleen , van Dokkum Pieter , Martin Peter G. , Li 李 Jiaxuan 嘉轩 , Greco Johnny P. , Lokhorst Deborah , Chen Seery , Danieli Shany , Keim Michael A. , Merritt Allison , Miller Tim B. , Pasha Imad , Polzin Ava , Shen Zili , Zhang 张 Jielai 洁莱
Published: February 2022

Uncertainty in the wide-angle point-spread function (PSF) at large angles (tens of arcseconds and beyond) is one of the dominant sources of error in a number of important quantities in observational astronomy. Examples include the stellar mass and shape of galactic halos and the maximum extent of starlight in the disks of nearby galaxies. However, modeling the wide-angle PSF has long been a challenge in astronomical imaging. In this paper, we present a self-consistent method to model the wide-angle PSF in images. Scattered light from multiple bright stars is fitted simultaneously with a background model to characterize the extended wing of the PSF using a Bayesian framework operating on a pixel-by-pixel level. The method is demonstrated using our software elderflower and is applied to data from the Dragonfly Telephoto Array to model its PSF out to 20′–25′. We compare the wide-angle PSF of Dragonfly to that of a number of other telescopes, including the SDSS PSF and show that, on scales of arcminutes, the scattered light in the Dragonfly PSF is markedly lower than that of other wide-field imaging telescopes. The energy in the wings of the Dragonfly PSF is sufficiently low that optical cleanliness plays an important role in defining the PSF. This component of the PSF can be modeled accurately, highlighting the power of our self-contained approach.
The Ionization and Destruction of Polycyclic Aromatic Hydrocarbons in Powerful Quasars
Authors: Xie Yanxia , Ho Luis C.
Published: February 2022

We reanalyze the mid-infrared (5–40 μm) Spitzer spectra of 86 low-redshift (z < 0.5) Palomar–Green quasars to investigate the nature of polycyclic aromatic hydrocarbon (PAH) emission and its utility as a star formation rate (SFR) indicator for the host galaxies of luminous active galactic nuclei (AGNs). We decompose the spectra with our recently developed template-fitting technique to measure PAH fluxes and upper limits, which we interpret using mock spectra that simulate the effects of AGN dilution. While luminous quasars can severely dilute and affect the detectability of emission lines, PAHs are intrinsically weak in some sources that are otherwise gas-rich and vigorously forming stars, conclusively demonstrating that powerful AGNs destroy PAH molecules. Comparing PAH-based SFRs with independent SFRs derived from the mid-infrared fine-structure neon lines and the total infrared luminosity reveals that PAHs can trace star formation activity in quasars with bolometric luminosities ≲1046 erg s−1, but increasingly underestimate the SFR for more powerful quasars, typically by ∼0.5 dex. Relative to star-forming galaxies and low-luminosity AGNs, quasars have a comparable PAH 11.3 μm/7.7 μm ratio but characteristically lower ratios of 6.2 μm/7.7 μm, 8.6 μm/7.7 μm, and 11.3 μm/17.0 μm. We suggest that these trends indicate that powerful AGNs preferentially destroy small grains and enhance the PAH ionization fraction.
Flux Rope Merging and the Structure of Switchbacks in the Solar Wind
Authors: Agapitov O. V. , Drake J. F. , Swisdak M. , Bale S. D. , Horbury T. S. , Kasper J. C. , MacDowall R. J. , Mozer F. S. , Phan T. D. , Pulupa M. , Raouafi N. E. , Velli M.
Published: February 2022

A major discovery of Parker Solar Probe (PSP) was the presence of large numbers of localized increases in the radial solar wind speed and associated sharp deflections of the magnetic field—switchbacks (SBs). A possible generation mechanism of SBs is through magnetic reconnection between open and closed magnetic flux near the solar surface, termed interchange reconnection, that leads to the ejection of flux ropes (FRs) into the solar wind. Observations also suggest that SBs undergo merging, consistent with an FR picture of these structures. The role of FR merging in controlling the structure of SBs in the solar wind is explored through direct observations, analytic analysis, and numerical simulations. Analytic analysis reveals key features of the structure of FRs and their scaling with heliocentric distance R, which are consistent with observations and demonstrate the critical role of merging in controlling the structure of SBs. FR merging is shown to energetically favor reductions in the strength of the wrapping magnetic field and the elongation of SBs. A further consequence is the resulting dominance of the axial magnetic field within SBs that leads to the observed characteristic sharp rotation of the magnetic field into the axial direction at the SB boundary. Finally, the radial scaling of the SB area in the FR model suggests that the observational probability of SB identification should be insensitive to R, which is consistent with the most recent statistical analysis of SB observations from PSP.
Gravitationally Decoupled Strange Star Model beyond the Standard Maximum Mass Limit in Einstein–Gauss–Bonnet Gravity
Authors: Maurya S. K. , Newton Singh Ksh. , Govender M. , Hansraj Sudan
Published: February 2022

The recent theoretical advance known as the minimal geometric deformation (MGD) method has initiated renewed interest in investigating higher-curvature gravitational effects in relativistic astrophysics. In this work, we model a strange star within the context of Einstein–Gauss–Bonnet gravity with the help of the MGD technique. Starting off with the Tolman metric ansatz, together with the MIT bag model equation of state applicable to hadronic matter, anisotropy is introduced via the superposition of the seed source and the decoupled energy-momentum tensor. The solution of the governing systems of equations bifurcates into two distinct models, namely, the mimicking of the θ sector to the seed radial pressure and energy density and a regular fluid model. Each of these models can be interpreted as self-gravitating static, compact objects with the exterior described by the vacuum Boulware–Deser solution. Utilizing observational data for three stellar candidates, namely PSR J1614–2230, PSR J1903+317, and LMC X-4, we subject our solutions to rigorous viability tests based on regularity and stability. We find that the Einstein–Gauss–Bonnet parameter and the decoupling constant compete against each other for ensuring physically realizable stellar structures. The novel feature of the work is the demonstration of stable compact objects with stellar masses in excess of M = 2 M
⊙ without appealing to exotic matter. The analysis contributes new insights and physical consequences concerning the development of ultracompact astrophysical entities.