bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGGUNAAN GOOGLE FORM DALAM MENINGKATKAN EFEKTIVITAS EVALUASI PEMBELAJARAN DARING SISWA PADA MASA COVID19 DI SD IT BAITUL MUSLIM WAY JEPARA
Authors: Pipah Siti ngafifah
Published: December 2020

This article aims to determine the advantages and disadvantages of using Google Forms in evaluating student online learning during the Covid19 pandemic at SD IT Baitul Muslim Way Jepara, East Lampung. This study uses qualitative methods and data collection techniques using observation, interviews, and documentation. The learning process at SD IT Baitul Muslim was carried out using Whatsapp, Zoom, and cellphone media. However, when the learning evaluation arrives, both the daily, mid-semester, and end-semester evaluations of SD IT BM use Google Form because the application from Google is very easily accessible to anyone provided they have a gmail.com account. The results showed that the learning evaluation using Google Form implemented by SD IT Baitul Muslim Way Jepara East Lampung was less effective. Due to feature limitations, design, and lack of editing history. In the realm of assessment, teachers are expected to not only refer to one type of Learning Evaluation but need to apply assessment (evaluation), namely continuity, objectivity, comprehensive, practical and cooperative which aims to optimize the ongoing learning. The positive contribution of this article is expected to provide information to education actors to improve skills and integrity in various learning activities in general, as well as in distance learning (online) specifically to facilitate the learning evaluation process during the current Covid19 pandemic.
COMPARISON OF MICRONIZED PROGESTERONE (CYCLOGEST PESSARY) AND PLACEBO IN PREVENTION OF PRE-TERM BIRTH IN TERTIARY CARE HOSPITAL
Authors: Afridi Nighat , Fatima Ambreen , Fareed Amna , Khan Saifullah , Khan Shah Gul
Published: December 2020

Objective: To compare efficacy of micronized per rectal progesterone (cyclogest pessary) and placebo inprevention of preterm birth in tertiary care hospital.

Study Design: Randomized controlled trial (RCT).

Place and Duration of Study: Study was conducted at department of gynecology and Obstetrics, CombinedMilitary Hospital Nowshera, Khyber Pakhtunkhwa, from Jan 2018 to Jun 2018.

Methodology: A sample size of 140 patients was calculated using WHO calculator. Non probability consecutivesampling was used for recruitment of participants. Ethics approval and consent forms were taken. Women weredivided into two groups randomly. Group A was given micronized progesterone (cyclogest pessary) per rectalusage and group B was given placebo. Patients were followed for maternal and neonatal outcomes. Data wasanalyzed using SPSS version 23. Independent t-test was applied. p-value ≤0.05 was considered significant.

Results: Total 140 patients were included in study. Mean age of women was 29.4 years ± 4.6SD. Patients in micronized progesterone (cyclogest pessary) was more effective in increasing birth weight (p=0.00), Apgar score maintenance at 1st (p=0.00) and 5th minute (p=0.000) and reduction in length of hospital stay (p=0.000) as compared to placebo. Patients were more satisfied with micronized progesterone (cyclogest pessary) per rectal as compared to placebo (p=0.00).

Conclusion: Preterm birth is remained as significant issue in health care system of Pakistan. However, micronized progesterone (cyclogest pessary) per rectal usage had positive impact in improving maternal and neonatal health outcomes. Effective strategies for prevention of preterm birth in Pakistan are required.
DOG 1 EXPRESSION IN DIFFERENTIAL DIAGNOSIS OF CHONDROBLASTOMAS AND ITS HISTOLOGICAL MIMICKERS
Authors: Nisar Maryam , Mushtaq Sajid , Hassan Usman , Akhtar Noreen , Azam Muhammad
Published: December 2020

Objective: Chondroblastoma is rare benign cartilage forming tumor of bone predominantly in individuals less than 20 years of age. Recently immunohistochemical marker DOG 1 has been reported to help in the diagnosis in difficult cases where histological features overlap with other similar entities. Current study aims to assess the sensitivity and specificity of DOG 1 in the diagnosis of chondroblastomas.

Study design: descriptive cross-sectional study

Place and duration of study: The study was conducted from June 2015 to July 2017 in Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.

Patients and methods: Total fifty-two patients were included in this study including 19 chondroblastomas, 21 giant cell tumors and 12 chondromyxoid fibromas. DOG 1 antibody was applied on all the cases

Results: DOG 1 was positive in 100 % of cases of chondroblastomas. However, intensity and proportion of staining pattern was variable among them. 78% (n=15) cases showed diffuse moderate to strong expression while 22% (n=4) cases showed focal weak expression. Only 10% (n=2) cases of giant cell tumors and 33% (n=4) of chondromyxoid fibromas expressed focal weak expression for DOG 1.

Conclusions: This study confirms 100 % expression of DOG 1 in cases of chondroblastomas but intensity and proportion of staining pattern was variable. Therefore DOG 1 may prove to be a useful immunohistochemical marker for diagnosis of chondroblastomas in the future in difficult cases in correlation with histological and radiological features.
SIGNIFICANCE OF RENAL FUNCTION IN TRAUMA: AN OBSERVATIONAL STUDY TO ASCERTAIN CORRELATION TO EGFR
Authors: Ahmed Syed Faraz , Uzair Muhammad , Saif Anas Bin , Khan Ahmed Mushtaq , Faraz Saima
Published: December 2020

Objective: To assess renal function in combat patients at the time of arrival from Balochistan in Accident & Emergency (A&E) of an ‘A’ Class Military Hospital.

Study Design: Retrospective observational study with analysis to find correlation between measurable variables and glomerular filtration rate. 

Place and Duration Of Study:  Combined Military Hospital Malir Cantonment, Karachi, from October 2015 to October 2018.

Material and Methods: All patients with major injuries (New Injury Severity Score NISS ≥16) were included in the study to assess kidney function by calculating their estimated glomerular filtration rate (eGFR) using serum creatinine. Correlation was calculated between eGFR and other variables which were pulse, mean arterial pressure, temperature and haemoglobin.

Results: 75 patients were brought to A&E. 14 (18.66%) were brought in dead. There were 44 (58.6%) gunshot wounds, 14 (18.6%) blast injuries and 17 (22.6%) accidents post ambush attack. 26 (34.66%) were included in the study, with NISS ≥16. All patients were male with mean age 29.73 ± 5.08. 20 (77%) patients were fluid resuscitated in pre-hospital setting whereas 6 (23%) were not. Statistically significant correlations were found among eGFR and pulse rate, body temperature, mean arterial pressure, hemoglobin and NISS. 6 out of 26 patients not resuscitated in pre-hospital setting had a median eGFR of 53.5, as compared to median eGFR of 70 in 20 patients who were resuscitated before evacuation to CMH Malir, in the field medical units.

Conclusion: Fluid resuscitation in the field lowers the possibility of renal dysfunction.
COMPARISON OF MANIFESTATIONS OF GIARDIA AND ASCARIS INFESTATIONS BETWEEN BOTH GENDERS PRESENTING WITH DIARRHEA
Authors: Jehanzeb Kanwal , Haq Zia Ul , Khattak Saeed Zaman , Shah Sajid Ali , Lodhi Munir Akmal , Ashraf Nadeem
Published: December 2020

Objective: To assess the occurrence and intensity of Giardia and Ascaris infestations in children of both genders reporting with diarrhea.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Paediatrics department, Combined Military Hospital, Gilgit, from Jul 2016 to Jul2018.

Methodology: Patients of either gender with worm infestation were included in the study. Patients more than13 years old were excluded. The sampling technique used was non probability consecutive sampling. The stoolexamination (R/E) for the diagnosis of worm infestation was done. Stratification was done with regards to age,mother education, gender, type of water used and post stratification chi square test was applied. p-value was0.613 when calculated for the manifestation between both genders. p-value ≤0.05 was considered significant.

Results: Total number of patients in our study was 100. Among them, males were 65 (65%) and females were 35(35%). Mean age of patients in our study was 4.20 ± 2.61 years (Mean ± SD). Abdominal pain being most common symptom in 43 (43%) of patients. Majority of the patients were from 2 to 10 years of age, 79 (79%). Helminthic infestation was the most common observed in 52 (52%) whereas Protozoal infestation was observed in 48 (48%) patients. The most common parasite isolated was Giardia 41 (41%) followed by Ascaris 36 (36%). p-value of 0.613 was found between both gender.

Conclusion: In our study Helminthic infestation was more common. The most common parasite isolated wasGiardia followed by Ascaris.
EFFECT OF BEHAVIORAL PROBLEMS OF CHILDREN WITH AUTISM ON THEIR MOTHER’S QUALITY OF LIFE
Authors: Waheed Ayesha , Khan Mussarat Jabeen , Khurshid Maryam
Published: December 2020

Object: The aim of the present study was to assess effect of behavioral problems of children with Autism on their mother’s quality of life.

Study Design: Cross-sectional study design

Place and Duration of Study: The sample was selected from different special education institutes of Islamabad and Rawalpindi. Duration of study was from March 2017 to September 2017.

Participants and Methods: The Study was conducted on 100 participants (N=100, n= 50 mothers, n=50 diagnosed children with Autism). Convenient and snowball sampling technique was used to collect data. Two questionnaires were administered to assess Quality of life (WHO Quality of life scale -BREF) and behavior problems of children with Autism (Childhood Autism Rating Scale-CARS).

Results: Results showed that quality of life of mothers has a significant negative relationship with their children’s autism related behavioral problems. Quality of life was found high in postgraduate mothers, while autism related behavioral problems were less in children with postgraduate mothers. Mothers living in joint family scored high on quality of, whereas child with Autism belonging to joint family system had fewer behavioral problems. Quality of life among working mothers was found high and children of working mothers exhibited less autism related behavioral problems than children of non-working mothers.

Conclusion: Present study highlighted the importance of behavioral problems of children with Autism on their mother’s quality of life. The study would be helpful for the professionals for devising educational programs for mothers and treatment plans for their children with Autism.

Keywords: Quality of life, Autism, behavioral problems
ASSOCIATION OF HUMAN CHORIONIC GONADOTROPHIN WITH PREGNANCY INDUCED HYPERTENSION
Authors: Chatha Nayab Afzal , Jaffery Humaira Osman , Qamar Saima , Mustafa Nilofar , Kamran Rizwana , Ashraf Viqar
Published: December 2020

Objective: To determine the positive predictive value of beta Human Chorionic Gonadotrophin in early secondtrimester for predicting pregnancy induced hypertension.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Obstetrics and Gynaecology Combined Military Hospital, Lahore,from Jun 2017 to Nov 2017.

Methodology: A total of 214 female pregnant patients met the criteria for inclusion in this study. Patients withbeta human chorionic gonadotrophin (βHcg) levels ≥2 MoM were followed at 22, 26, 30 and 34 weeks of gestation. Blood pressure was monitored. Pregnancy induced hypertension (PIH) was labelled after 20 weeks (as per dating scan) of gestation in patients who did not have proteinuria (≥300 mg 24 hour urine sample) and had a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg (blood pressure readings taken at two separate points in time four hours apart).

Results: Patients ranged between 18-35 years of age, with the mean age being 27.3 ± 4.3 years. Mean gestational age was observed to be 15.6 ± 1.8 weeks. Mean BMI was 23.8 ± 3.2 kg/m2. Out of 214 patients, 30 patients (14%) had beta human chorionic gonadotrophin level >2 MoM. Out of these 30 patients, 25 patients (83.3%) developed PIH. There were 100 primigravida (46.7%) and 114 multigravidas (53.3%). Beta human chorionic gonadotrophin in predicting pregnancy induced hypertension showed sensi-tivity of 96.1%, a specificity of 97.3%, with a PPV83.3%, a NPV 99.4% and diagnostic accuracy of 97.2%.
ROLE OF COMBINED KETOCONAZOLE AND TAMSULOSIN IN SUCCESSFUL TRIAL OF VOIDING WITHOUT CATHETER (TWOC) IN PATIENTS WITH ACUTE URINARY RETENTION DUE TO BENIGN PROSTATIC OBSTRUCTION
Authors: Asim Muhammad , Ahmed Syed Farhan , Ali Muhammad Sajid , Memon Imran , Memon Waqas , Rashid Muhammad , Abbas Kiran , Ahmed Moiz
Published: December 2020

Objective: To compare the frequency of patients with successful Trial of voiding without catheter (TWOC) after acute urinary retention secondary to benign prostatic hyperplasia in patients taking ketoconazole and tamsulosin vs tamsulosin alone.

Study Design: A randomized controlled trial. 

Place and Duration: The current study was conducted at Urology Ward, Liaquat National Hospital, Pakistan for a period of six months.

Methodology: A total of 162 patients presenting with acute urinary retention were divided into two groups. Group A received tamsulosin 0.4mg OD and ketoconazole 200mg while Group B received tamsulosin and placebo. Trial of voiding without a catheter was induced after one week of medication. SPSS version 20 was used for data compilation and analysis.

Results: In Group-A, 85.2% of patients were able to void as compared to group B, where only 74.1% of patients were able to void (p<0.05). Successful trial of voiding without catheter was observed in 79.0% and 60.5% in patients of Group-A and Group-B respectively. The association of successful TWOC with the two study groups was found significant (p=0.010).

Conclusion: TWOC in men catheterized for AUR due to BPH was significantly more successful if treated in a combination of ketoconazole and tamsulosin as compared to tamsulosin only.
COMPARISON OF POST PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE INSERTION BETWEEN VAGINAL DELIVERY AND CAESAREAN SECTION IN A TERTIARY CARE HOSPITAL
Authors: Tasneem Saira , Kashif Sanum , Pervaiz Erum , Azam Faisal
Published: December 2020

Objective: To compare the acceptability of insertion of post placental intra uterine contraceptive device, withrespect to gravidity between vaginal deliveries and caesarean sections.

Study Design: Prospective comparative study.

Place and Duration of Study: Frontier Corp Hospital, Quetta, from Jan 2019 to Jan 2020.

Methodology: A total of 399 females with age of 18 to 45 years with gravidity (primi, multi and grand multigravida) were counselled during antenatal visits about benefits and risks of post placental intrauterine contraceptive device (PPIUCD) insertion. For complications, females were assessed at 1 and 6 weeks after delivery.

Results: A total of 399 females with mean age 27.95 ± 5.07 years were included in study. About 235 (55.9%)women delivered vaginally and 164 (41.4%) women by caesarean section. Acceptance rate was 3.8% and 4.3% for vaginal and caesarean deliveries respectively. Eleven (73.3%) women were grand multi gravida and 4 women(26.6%) were multi gravid in vaginal delivery acceptance group versus 8 women (47%) grand multi and 9 women (52.9%) multi gravida in caesarean acceptance group. Five (15%) females presented with complications (3 with abdominal pain and 1 each with infection and expulsion).

Conclusion: The overall acceptance rate of PPIUCD was low in this study, the acceptance rate was higher inwomen undergoing normal vaginal delivery (NVD) as compared to lower segment caesarean section (LSCS),similarly more of the grand multiparas accepted the method as compared to other participants however thedifferences were not statistically significant.
RETROSPECTIVE DATA REVIEW TO FIND THE ASSOCIATION OF LUMBOSACRAL TRANSITIONAL VERTEBRA AND DEGENERATIVE DISC DISEASE IN YOUNG PATIENTS
Authors: Gul Nadia , Mehmood Khalid , Ikram Muhammad
Published: December 2020

Objective: To find out the frequency of lumbar disc degeneration among the patients having lumbosacraltransitional vertebra between 20-40 years.

Study Design: Retrospective cross sectional study.

Place and Duration of Study: Radiology department POF Wah Cantt, from Jan 2018 to Dec 2019.

Methodology: Six Hundred patients between 20-40 years having lumbosacral transitional vertebra and historyof low back pain >1 year were studied. X ray and MRI lumbar spine of these patients was studied retrospectivelyon PACS. Two hundred patients having history of traumatic or other non-traumatic etiologies, in addition toLumbosacral transitional vertebra were excluded. Four hundred patients with only lumbosacral transitionalvertebra were included. Data analysis was done by SPSS-22. Castellvi types of transitional vertebra was calculated among patients with degenerative lumbar disc.

Results: One hundred and four (26.6%) were having degenerative disc disease while 296 (74.4%) patients werenot having degenerative disc disease. Patients having degenerative disc disease were between 24-40 years withthe mean age 29.96 ± 0.417 years. Among the patients having degenerative disc disease were 59 women and45 males but no statistical significance association was found between gender and degenerative disc disease with p-value = 0.55. Castellvi type III had significant association with degenerative disc disease, p-value = 0.006.

Conclusion: Age related disc degeneration is commonly seen in middle age people but in younger age group in2nd and 3rd decade it is observed frequently in those patients having lumbosacral transitional vertebra especially in the setting of no other associated traumatic or non-traumatic etiology, which leads to early degenerative disc disease.
SHORT TERM EFFECT OF HEMODIALYSIS ON PERIPAPILLARY RETINAL NERVE FIBER LAYER AND MACULAR THICKNESS
Authors: Jabbar Bushra , Islam Qamar Ul , Hanif Muhammad Kashif , Yasin Ubaidullah , Farooq Omer , Fatima Saman
Published: December 2020

Objective: To determine the thicknesses of retinal nerve fiber layer (RNFL) and macula by fourier-domain (FD)optical coherence tomography (OCT) in diabetic patients with end-stage renal failure (ESRF) undergoinghemodialysis.

Study Design: Cross-sectional study.

Place and Duration of Study: Pakistan Naval Ship, Shifa Karachi, from Jan 2019 to Jul 2019

Methodology: Fifty four patients presenting to nephrology department who met the inclusion criteria wereincluded in the study. Macular and retinal nerve fibre layer thicknesses were compared pre and post 30 minutesof hemodialysis and their correlation (r=-0.89) with age, duration of hemodialysis and gender was examined. Pre hemodialysis temporal, inferior, average retinal nerve fibre layer thicknesses were observed thinner than Post hemodialysis.

Results: Pre-hemodialysis macular thicknesses were thinner than post hemodialysis. Thinning of Macular andRNFL showed a negative relationship with age and duration of hemodialysis (r=-0.89 & -0.76). Temporal, superior quadrants and average retinal nerve fiber layer thickness values were found statistically different in pre and post 30 minutes hemodialysis examination (p-value = 0.002, 0.001 & 0.0021) while, nasal and inferior quadrants were found statistically insignificant. Whereas in macula, temporal and superior quadrants were found statistically significant (p-value=0.005 & 0.002) and nasal, Inferior and average thickness were found statistically insignificant (p-value = 0.0641, 0.0594 & 0.083).

Conclusion: Macular and retinal nerve fiber layer thicknesses of patients receiving hemodialysis were lessthan the normal population. Age has no effect on these thinning. The duration of hemodialysis effects more than gender. Hemodialysis session causes a consistent.............
PAIN RELIEF WITH PREVENTIVE MEASURES AMONG KNEE OSTEOARTHRITIS PATIENTS: A COMPARISON BETWEEN FOLLOWERS VERSUS NON FOLLOWERS
Authors: Ikram Muhammad , Ijaz Sadia , Memon Munawer Latif , Balouch Varda , Rao Sajid Ejaz
Published: December 2020

Objective: To compare mean pain scores among knee osteoarthritis patients following or not followingpreventive measures.

Study Design: Comparative prospective study.

Place and Duration of Study: The study was conducted at the department of orthopedics, Pakistan OrdinanceFactory (POF) Hospital, Wah Cantt, from Jun 2018 to May 2019.

Methodology: Patients were divided into two groups (using random number table); group A was given painrelief medications only while group B was given a combination of pain relief medication and preventive measure. Patients were followed for 3 and 6 months after the intervention. Data was analyzed with SPSS software.

Results: Total 52 knee osteoarthritis patients were included in study (26 patients in each group). Mean age ofpatients was 54.3 ± 6.4 year. Significantly lower pain scores were found in group B as compared to group A after3 (5.50 ± 0.98 vs 4.84 ± 1.00 respectively, p=0.02) and 6 months (3.53 ± 0.50 vs 4.96 ± 1.11 respectively, p<0.01) ofintervention. Knee injury and osteoarthritis outcome scores were significantly lower in group B as compared togroup A (p<0.05) after 6 months.

Conclusion: Pain is most common knee osteoarthritis symptom. Combination of pain relief medicines andpreventive measures in daily life are more effective in controlling pain intensity as compared to pain reliefmedications only. Early diagnosis and management can improve disease prognosis.
CORRELATION OF IMPACTED MANDIBULAR THIRD MOLAR WITH INCIDENCE OF IPSILATERAL ANGLE AND CONDYLAR FRACTURES IN MANDIBULAR TRAUMA
Authors: Abidi Syed Yasir Ali , Babar Adnan , Niazi Kaleem Ullah , Khan Ali Akhtar , Maryam Atiqa , Rasheed Nazish
Published: December 2020

Objective: This study aims to evaluate association of impacted lower third molars with incidence of ipsilateral mandibular angle and condylar fractures.

Study design: Observational study.

Place of study: Maxillofacial Surgery Department Armed Forces Institute of Dentistry

Materials and methods: Patients reporting to armed forces institute of dentistry maxillofacial surgery department OPD were diagnosed on the basis of history, clinical signs and symptoms and radiological examinations were categorized as Mandibular Angle and Condylar fractures and impacted lower third molars. A total number of 234 radiographs of patients were examined.

Duration of study: 01 year from 01 January 2019 to 31st December 2019.

Results:

Out of total sample size of 234 patients, 70% (79 patients) Mandibular angle fractures occurred with patients with impacted lower third molars (112 patients) and 65% (80 patients) mandibular condylar fractures occurred with patients without impacted lower third molars (122 patients). Statistically significant P-value was 0.000 that is <0.05 that signifies positive correlation of impacted mandibular third molars to cause ipsilateral mandibular angle fractures and indirectly preventing condylar fractures.

Conclusion: Patients that do not have impacted lower third molars are more prone to suffer Condylar fractures in case of mandibular trauma which is associated with more postoperative risks and morbidity as compared to mandibular angle fractures that occur more commonly in patients with impacted lower third molars. As mandibular fractures are common, practice for prophylactic removal of lower third molars should be discontinued.

Keywords: Mandibular Condylar fracture, Mandibular Angle fracture, Impacted mandibular third molars
IMPACT OF A SINGLE TUTORIAL SESSION ON THE TECHNIQUE OF USING PERSONAL PROTECTIVE EQUIPMENT BY HEALTH CARE WORKERS
Authors: Khan Jamal Azfar , Ali Asif , Muneer Farzana
Published: December 2020

Objective: To determine the impact of a single tutorial session on the technique of donning and doffing the personal protective equipment by health care workers.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: CMH Landi Kotal Cantt, from 1st March 2020 to 10th June 2020.

Patients and Methods: The study was conducted on 62 health workers, working in CMH Landi Kotal Cantt. They were asked to demonstrate donning and doffing surgical masks, gowns and gloves and the steps were evaluated as per a standardized checklist. Then, the participants were given a single tutorial of the donning and doffing technique of personal protective equipment. They were asked to demonstrate their technique of personal protective equipment use one week, one month and three months after the tutorial. Any improvement was recorded in the checklist used earlier.

Results: The correct donning and doffing technique of personal protective equipment were demonstrated by 22 and 14 participants respectively before the tutorial. When evaluated one week after the tutorial, this number increased to 48 and 38 respectively, showing significant improvement (p<0.05). The technique of personal protective equipment use deteriorated significantly one month of the tutorial and deteriorated further after three months (p<0.05). The most common fault while donning and doffing the equipment was the incorrect donning sequence, and self-contamination while taking off the gloves, respectively.

Conclusion: A single tutorial session results in significant improvement in the technique of using personal protective equipment by health care workers but the effect is lost over time.
CLINICAL SYMPTOMS AND CHEST X-RAY FINDINGS FOR EVALUATION OF CHEST X-RAY IN MANAGEMENT AND PREDICTION OF CLINICAL OUTCOME OF CONFIRM CASES OF COVID-19
Authors: Hassan Khawaja Muhammad Baqir , Hassan Tathir Baqir , Sarwar Shakil , Sheen Irfan Najam , Islam Farrukh , Bukhari Syed Aown Raza Shah , Shoaib Muhammad Shahbaz
Published: December 2020

Objective: To study clinical symptoms and chest X-ray findings for evaluation of chest X-ray in management ofconfirmed cases of COVID-19 and predicting the clinical outcome.

Study Design: Cross sectional study.

Place and Duration of Study: The departments of Radiology & Medicine of Combined Military Hospital Malir,from Mar to May 2020.

Methodology: The sample used in this study consists of 73 patients. All the standard frontal projections of chest X-ray of PCR confirmed COVID-19 patients were studied on computer and findings were noted

Results: At the aggregate, the study indicates that there is no Significant Connection in between the clinicalsymptoms, their severity and chest X-ray findings.

Conclusion: There is no significant connection found between the severity of clinical symptoms and chest X-rays suggesting that chest X-Ray cannot be a reliable indicator to predict the clinical outcome of the patient and has limited role in management of patient. Clinical assessment is still the main stay of the patient management.
MILK AGGRAVATES ASTHMA – THE TRUTH OR THE PERCEPTION
Authors: Khan Muhammad Khalid Azam , Naz Shazia , Khattak Abdul Latif , Kashif Nauman , Bukhari Syed Karamat Hussain Shah , Khan Asif Ullah
Published: December 2020

Objective: To assess the notion that milk can cause or aggravate asthma and break this myth.

Study Design: A cross sectional study.

Place and Duration of Study: Medicine department, Combined Military Hospital Lahore, from Jan 2019 to Dec2020.

Methodology: A survey was conducted whereby known asthmatics were questioned about their opinion weather milk aggravates their asthma. Those who confirmed their positive response were exposed to milk and some liquid resembling milk, and their Lung functions were tested after each drink. The 42 patients who considered milk as the primary aggravator were called for the study for spirometry

Results: A total of 600 people from the general population were surveyed. Two hundred and six (34.3%) of them were illiterate, 394 (65.6%) were educated from middle to graduates. In the first milk/milk encounter, the combined dyspnea scale showed increase of 50.3% and improvement of 0.008% in FEVI/FVC. In the second substitute/milk encounter, the dyspnea score showed an increase of 61.8% and an increase of 0.90% in FEVI/FVC. In the third milk/substitute encounter the dyspnea score showed a decrease of 22.9% and the FEVI/FVC decreases by 5.5%. In the 4th substitute/substitute encounter, dyspnea scores decreased by 8.4% while the pre and postencounter FEVI/ FVC scores were 2726 and 2711 with 0.55% decrease with insignificant p-value >0.05.

Conclusion: Drinking milk or milk substitute has negligible effect on the spirometric parameters.
THE CORRELATION OF SYMPTOMS AND OBJECTIVE WHEEZE IN ASTHMATICS
Authors: Khattak Abdul Latif , Khan Muhammad Khalid Azam , Naz Shazia , Kashif Nauman , Shah Syed Karamat Hussain , Ibrahim Muhammad Tahir
Published: December 2020

Objective: To determine the correlation between symptoms and objective wheeze in asthmatics.

Study Design: A cross sectional study.

Place and Duration of Study: Medicine department, Combined Military Hospital Lahore, from Jul to Dec 2019.

Methodology: Two hundred patients of asthma were selected reporting in Medicine department, CMH Lahore.Patients were interviewed regarding their primary chest symptom and it was correlated with the clinical examination for wheeze to find which particular symptom correlated most with the presence of wheeze. The 130 symptomatic cases were subjected to spirometry to assess their lung functions tests.

Results: Two hundreds patients of asthma were interviewed of whom 130 patients were symptomatic. Out of 130 patients, 59 (45.3%) complained of difficulty in breathing, 40 (30.7%) complained of shortness of breath, 20 (15.3%) had wheezing, 7 (5.3%) had cough and 4 (3%) had chest pain. Eighty five (65.3%) patients when examined had wheeze. The distribution of objective wheezing in the above cases were 100% for wheezing patient, 66.1% for Difficulty in breathing, 57.5% for shortness of breath 28.5% for cough and 25% for chest pain. The FEV1/FVC ratio was lowest for wheezing patients at 0.55 and highest for cough at 0.70.

Conclusion: Difficulty in breathing was the commonest symptom in symptomatic asthmatics being presentin 66.1% of patients. The symptom which correlated best with the presence of wheeze was wheezy chest anddifficulty in breathing and was also associated with lowest FEV1/FVC ratio.
EFFECTIVENESS OF PARENTAL PRESENCE/ABSENCE TECHNIQUE AS A BEHAVIOR MANAGEMENT TECHNIQUE IN PAEDIATRIC DENTSTRY
Authors: Shiraz Fatimah , Mustafa Laila , Zakir Nabhan , Bangash Madeeha , Khan Gulandama Alam , Sami Ammara
Published: December 2020

Objective: To assess the deliberate use of a parental presence/absence (PPA) intervention as a behaviormanagement technique to manage uncooperative children as well as its association with age.

Study Design: Cross sectional study.

Place and Duration of Study: Study was conducted at department of Paediatric dentistry, Rehman College ofDentistry, Peshawar, from Jan to Apr 2019.

Methodology: Practice patient records were examined over a period of 3 months, during which Frankel behavior ratings were made for each patient. About 2 to 14 years olds were included in the study who had no previous dental treatment, accompanying by their parents. Sixty one children were selected out of 200 who showed uncooperative behavior Frankl 1 and Frankel 2. Their parents were asked to step out of the operatory until the patient become cooperative.

Result: The study included 61 children out of 200 who showed uncooperative behavior according to Frankel‟sbehavior rating scale. The result showed significance in age group 4-6year, kinder garden (p=0.035).

Conclusion: The Parental Presence/Absence technique (PPA) can be successfully used in gaining the cooperation of children displaying negative behavior aged 4-6, thus minimizing the need for other more aversive Behavior management techniques (BMT‟s).
FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
Authors: Nasir Shafia , Asif Naveed , Nasir Oroosa , Arif Sunila Tashfeen , Azam Muhammad
Published: December 2020

Objectives: To determine frequency of multidrug resistant (MDR) and extensive drug resistant (XDR) strains of Salmonella typhi (S. typhi) and Salmonella paratyphi (S. paratyphi) in Quetta, Balochistan of Pakistan

Study Design: Descriptive Cross-Sectional

Place and Duration: Department of Microbiology, CMH Quetta, Pakistan. from March 2019 to March 2020

Materials and Methods: A total of 2760 (n) suspected cases of typhoid fever, irrespective of age and gender, reporting at the hospital in this duration and underwent blood culture. Isolates were cultured and identified using standard microbiological procedures. Antimicrobial sensitivity against typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2018) and all the XDR isolates were confirmed by Vitek 2 system.   

Results: A total of 173 (6.3%) cultures showed positive results. with mean age of 18.9 ± 11.1 years, out of which 136 (78.6%) were male and 37 (21.1%) were female patients. Antibiotic susceptibility results showed that 166 (96%) of isolates were S. typhi. MDR strains were observed in 104(60.1%) and XDR strains were observed in 81 (46.8%) cases.

Conclusion:  A significant proportion of S. typhi isolates from confirmed cases of enteric fever demonstrated MDR (60.1%) and XDR (46.8%) strains in Quetta, Balochistan. We recommend empiric therapy with azithromycin in patients with uncomplicated and therapy with carbapenem for complicated cases of enteric fever acquired in Karachi or Quetta. Large scale population-based studies are recommended to get better information about antibiotic susceptibility pattern of S. typhi and S. paratyphi in other areas.
NEUTROPHIL TO LYMPHOCYTE RATIO VS PLATELETS TO LYMPHOCYTE RATIO: BIOMARKERS TO PREDICT SEVERITY OF DISEASE AND THEIR COMPARISON IN PATIENTS OF COVID-19
Authors: Adil Muhammad , Baig Zahid Farooq , Amir Muhammad , Chatha Sohail Saqib , Habib Aamir , Majid Muhammad
Published: December 2020

Objective: To determine and compare Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in predicting severity of disease in patients with COVID-19.

Study design: Descriptive comparative study.

Place and Duration of study:  Department of Medicine, CMH Thal from April to July, 2020

Patients & Methods: 61 patients of COVID-19 confirmed through polymerase chain reaction were recruited and divided into severe and non severe disease. Complete blood counts were done. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio were calculated and analyzed.

Results: 14 patients (23%) of severe disease had mean age of 49.93±19.42 and 47 patients (77%) with non-severe disease had mean age of 33.32±9.16. The mean Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte ratio in patients who had severe disease was 7.20±4.20 and 204.25±148.42 (p=0.001 and p=0.026) respectively. The diagnostic performance of both Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio produced statistically significant area under the curve (AUC), (p <0.001). The adjusted and unadjusted area under curve for Neutrophil to Lymphocyte Ratio was 0.92 (95% CI: 0.85–1.00) and 0.923 (95% CI: 0.839-1.000) and for Platelet to Lymphocyte Ratio it was 0.883 (95% CI: 0.781–0.985) and 0.825(95% CI:  0.707-0.943) respectively.

 Conclusion: Elevated Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are independent biomarkers which predict severity of disease in COVID-19 patients with Neutrophil to Lymphocyte Ratio being better predictor in terms of diagnostic accuracy. 

Keywords: Corona virus disease 2019 (COVID‐19), Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio
AWARENESS AND PRACTICES APPLIED BY HEALTH CARE WORKERS TO ACHIEVE PATIENT SAFETY DURING PHLEBOTOMY AND ULTRASOUND BIOPSY
Authors: Balooch Salahuddin , Noureen Fakhra , Khan Abid Saeed , Rehman Ibad ur , Bakhtawar Aleena , Raza Waseem
Published: December 2020

Objective: To assess awareness and practices applied by health care workers to achieve patient safety during phlebotomy and ultrasound biopsy.

Study Design: Cross-sectional study

Place and duration of study: The present study was conducted from Jan 2019 to Jan 2020 at Combined Military Hospital (CMH), Kharian, Pakistan.

Patients and Methods: The health care providers were interrogated about their knowledge and practices regarding patient safety with respect to phlebotomy and ultrasound biopsy. The responses of participants were evaluated through correlation analysis by SPSS v.17.

Results: The results show that awareness and practice implementation for patient safety in phlebotomy and ultrasound biopsy enhance in accordance to age, education and experience. The findings of present study suggest that physicians and nurses tend to have better awareness and practices of patient safety as compared to other health care workers. However, all the health care workers included in present study showed adequate level of awareness and practice implementation.

Conclusion: The managers and co-workers need to support the health care workers’ groups that tend to show lower levels of awareness and practice implantation in patient safety. This will not only enhance their competence but also help in better and secure provision of health care.
POWER SHARING IN MEDICAL CONSULTATIONS
Authors: Junaid Ayesha , Rafi Muhammad Shaban , Khan Najm Us Saqib , Khan Junaid Sarfraz
Published: December 2020

Objective: To examine the management of power by doctors in medical consultations. The power is defined here as a dialogic, egalitarian, and patient-centered.

Study Design: Qualitative study.

Place and Duration of Study: Out-patient departments of Mayo Hospital, Lahore, Pakistan, from Nov 2019 fortwo weeks.

Methodology: The data were collected through in-depth interviews and observations from outpatient departments of Mayo Hospital. Bourdieu's Social Practice Theory and Fairclough’s theory of Power and Language were used as a theoretical framework in the community of practice, for the interpretation of the qualitative data sets.

Results: The interpretations of relational power by doctors and patients surface three themes: Power, Powerand Solidarity, and Solidarity. Although power-sharing is the modern rhetoric, it is hardly conceptualized in theselected hospital.

Conclusion: With a proliferation of patient-centered approach of the medical profession, power-sharing withpatients might perpetuate dissatisfaction among the participants.
PREVALENCE OF COGNITIVE DECLINE IN PATIENTS WITH STROKE
Authors: Malik Fatima Naseem , Zubair Usama Bin , Alamgir Wasim , Hashmat Asif , Arif Saeed , Nawaz Khurram Haq
Published: December 2020

Objective: To determine the prevalence of cognitive decline among the patients of stroke and analyze the associated socio demographic factors.

Study Design: Cross sectional study.

Place and Duration of Study: Tertiary care hospital of Rawalpindi, from May 2018 to Aug 2018.

Methodology: The sample population comprised of n=180 patients of hemorrhagic or ischemic stroke presenting at a tertiary care hospital in Rawalpindi, Pakistan. Cognitive decline was assessed by using the British Columbia Cognitive Complaints Inventory (BC-CCI) four weeks after the acute stroke. Relationship of age, gender, marital status, education, type of stroke, presence of physical impairment and tobacco smoking was assessed with the presence of cognitive decline among the patients of stroke.

Results: Out of 180 patients of stroke screened through British Columbia Cognitive Complaints Inventory, 129 (71.7%) showed the presence of cognitive decline while 51 (28.3%) had no cognitive decline. After applying the logistic regression we found that female gender and presence of physical impairment had significant association with the presence of cognitive decline among the patients of stroke.

Conclusion: This study showed a high prevalence of cognitive decline among the patients of stroke in Pakistan. Routine screening for cognitive decline should be done at the stroke follow up clinic and special attention should be paid to the female patients of stroke and those with physical impairment.
PERANAN GURU BIMBINGAN KONSELING DALAM MEMOTIVASI PESERTA DIDIK SELAMA MASA PANDEMI COVID-19 DI SMA DARUT TAQWA PASURUAN
Authors: Setiadi Gatut , M. Sholihun  , Nurma Yuwita
Published: December 2020

Motivasi belajar menjadi aspek penting guna mencapai tujuan pembelajaran yang telah direncanakan baik itu di dalam sekolah maupun di luar sekolah. Penelitian ini bertujuan untuk mengetahui tindakan guru BK dalam memberikan motivasi belajar terhadap peserta didik di SMA Darut Taqwa selama masa pelaksanaan pembelajaran di rumah akibat dari pandemi COVID-19 di Indonesia. Mewabahnya COVID-19 ini memaksa pihak sekolah harus melaksanakan pembelajaran secara online dikarenakan untuk memutus rantai penularan virus tersebut dan demi keselamatan semua peserta didik. Metode penelitian yang diterapkan yakni deskriptif kualitatif, sedangkan teknik pengumpulan data dilakukan melalui observasi, wawancara, dan dokumentasi. Setelah diperoleh berbagai data yang dibutuhkan, maka semua data valid tersebut dianalisis dengan tahapan reduksi data, hingga dapat dilakukan penyajiaan data dan penarikan kesimpulan. Hasil penelitian ini menunjukkan bahwa peran guru BK untuk memberikan motivasi belajar pada peserta didik dengan cara memberikan pemahaman tentang pentingnya belajar dalam kondisi yang tidak stabil disebabkan karena mewabahnya suatu virus memberikan suatu pengaruh yang signifikan, karena di saat pembelajaran dilaksanakan secara daring peserta didik justru semakin membutuhkan perhatian dan bimbingan lebih intens. Beberapa tindakan yang dilakukan guru BK di SMK Darut Taqwa yakni dengan cara memberikan informasi cara belajar yang efektif terhadap seluruh peserta didik, mulai teknik menghafal, mengorganisasi materi pelajaran secara daring, dan teknik menghadapi ujian online dengan memberikan tips cara meningkatkan kesadaran metakognitif peserta didik.
ANALISIS MANAJEMEN PEMBIAYAAN PADA BANK SYARIAH
Authors: Sri Mulyani
Published: December 2020

Penelitian ini bertujuan untuk mengetahui dan menganalisis manajemen pembiayaan pada PT.Bank Syariah Mandiri, Tbk. Manajemen pembiayaan merupakan  hal yang sangat penting bagi bank syariah karena dengan manajemen pembiayaan yang bagus, bank syariah akan bisa menjaga kinerja keuangannya tetap sehat dan mengurangi resiko pembiayaan macet.

Penelitian ini merupakan penelitian kuantitatif dengan pendekatan deskriptif yang dilakukan dengan menganalisis rasio NPF (Non Performance Financing), FDR (Financing to Deposit Ratio) dan Aset Produktif Bermasalah pada PT.Bank Syariah Mandiri, Tbk. Penelitian ini menggunakan data sekunder secara time series mulai tahun 2014-2018. Hasil dari penelitian menemukan bahwa rasio keuangan Bank Syariah Mandiri termasuk dalam kategori yang sehat yaitu rata-rata rasio NPF Bank Syariah Mandiri adalah sebesar 2,75%, rata-rata rasio FDR Bank Syariah sebesar 85,41%  dan rata-rata rasio Aset Produktif Bermasalah sebesar 4,23%. Penelitian ini juga menghasilkan manajemen pembiayaan yang dilakukan oleh Bank Syariah  diantaranya adalah dengan menerapkan sistem manajemen resiko pembiayaan dengan baik yaitu pemberian pembiayaan sesuai prosedur dan prinsip kehati-hatian, penetapan limit resiko, serta menerapkan analisis 5C (Character, Capacity, Capital, Condition dan Collateral)  dan analisis 7A (aspek yuridis, aspek manajemen, aspek teknik/ teknologi, aspek pemasaran, aspek keuangan, aspek ekonomi dan aspek agunan)  dalam pemberian pembiayaan.
UNA EXCURSIÓN A MACHUPICCHO
Authors: Gabriel Cosio José
Published: December 2020

Es monomanía de los que viajan contar  sus impresiones, en público, los que escriben, y en privado los otros; así ha dicho un escritor.  Y en verdad que, cuando uno que excursiona o viaja encuentra impresiones que merecen anotarse, cuadros que exigen ser descritos y  paisajes dignos de retratarse; parece que contrae con su propia conciencia la obligación de dar a conocer lo que ha visto, mucho más si ello puede ser útil para desentrañar profundos e insondables problemas que permanecen rodeados de misterios y dudas.

Tal vez si el pasado primitivo de la América Precolombina, hoy incierto y nebuloso, pueda resolverse en soluciones claras y definitivas, cuando del acervo de las investigaciones oficiales y particulares  surja al conjunto del análisis científico la anhelada clave de tantas incertidumbres y contradicciones y aparezcan dominando tan culminante posición los Schielleman, los Botta y los Mariette de este continente.
RED RADIAL UNIVERSITARIA
Authors: Cáceres Huambo Paulino Max
Published: December 2020

El presente artículo propone la implementación de la Red de Radiodifusión Sonora Regional de Radio Universitaria como   instrumento   para    gene rar   Integración, Comunicación   para   el  Desarrollo  permitiendo  a  la Universidad Nacional  de  San Antonio Abad del Cusco realizar  Proyección Social  y  Extensión Universitaria. El estudio  demostró  que  la Universidad Nacional  de  San Antonio Abad del Cusco puede  constituirse en un centro promotor   de  Inte gración,   Comunicación   para   el Desarrollo, Proyección Social y Extensión Universitaria a partir de  la  Red  de  Radiodifusión  Sonora  Regional  de Radio  Universitaria.  La  Universidad  Nacional   de  San Antonio Abad  del  Cusco  alcanzaría   prestigio  social  y lograría  posicionarse  en el usuario  regional  a partir de una  comunicación  horizontal participativa y  plural con enfoque intercultural, puesto que la Red de Radiodifusión Sonora  Regional  de  Radio  Universitaria permitirá  una interacción circular. Finalmente, es necesario que la institución allane  los  trámites  administrativos  para   su funcionamiento
CONSTITUCIÓN Y CULTURA
Authors: Espezúa Salmón Boris
Published: December 2020

La relación entre derecho y cultura siempre ha conllevado posturas controversiales que han tratado de acercar una empatía constructiva; sin embargo, la resistencia del Derecho ha sido más notoria en razón de su carácter positivista y su razón instrumental que, en no pocos casos, han colisionado con la cultura en cuanto a su contenido identitario y de autoafirmación del pueblo. En las últimas décadas asistimos a un cambio de tal escenario donde se evidencia un resurgir étnico, un reconocimiento internacional de los derechos indígenas y otra forma desde la Constitución de acercar el Derecho a los derechos colectivos y los derechos fundamentales, por donde se reorienta una valoración más social y ética de encauzar interculturalidad e interdisciplinaridad en los aspectos de legitimidad e interpretación. Entre estas disciplinas pendulan cambios en los próximos años, para reconfigurar un producto válido y contributivo en la relación juscultural. El método que se tomará en cuenta es el dogmático-cualitativo y se considerará el referente de la doctrina constitucional.
UNA MIRADA SITUADA: APUNTES SOBRE LA CONFLICTIVIDAD AMBIENTAL LATINOAMERICANA Y EL CAMPO DEL DERECHO
Authors: Joaquín Giles Alejo
Published: December 2020

En este trabajo se parte de identificar una tipología de conflictos ambientales compartidos por los países latinoamericanos y, sobre esa base, se busca reflexionar acerca del significado de ese dato para el campo del derecho. La conjunción entre las matrices económicas preponderantes en esos países y un acervo común de protección constitucional al ambiente nos permitirá identificar una tipología de conflictos ambientales jurídicamente relevantes, que tienen alta probabilidad de suceder en cada uno de ellos. Ese dato está llamado a incidir, sostendremos, en el diseño de nuestros sistemas jurídicos y en el modo en que éstos son estudiados y actuados dentro del campo del derecho. Al hacerlo se estará logrando un objetivo político crucial: gestar miradas situadas sobre la conflictividad latinoamericana y sus mecanismos de abordaje jurisdiccional.