bluuebunny/crossref_metadata_2025 huggingface dataset:
PLASMAPHERESIS IN THE TREATMENT OF MYASTHENIA GRAVIS: OUTCOME AND COMPLICATIONS
Authors: Abbas Maryam , Robert Helen Mary , Mahmood Asad , Khan Saleem Ahmed , Naeem Mohammad Abdul , Ayaz Muhammad Ahsan
Published: May 2021

Objective: To assess the outcome and complications of plasmapharesis in treatment of myasthenia gravis and factors linked to poor outcome at hematology unit of a tertiary care teaching hospital of Pakistan

Study Design: Prospective comparative study.

Place and Duration of Study: Pak Emirates Military Hospital/Armed Forces Institute of Pathology, Rawalpindi, from Jan 2018 to Jul 2019.

Methodology: A prospective study was conducted on patients of myasthenia gravis presented at our neurology department. All the complications of the procedure were recorded. Outcomes included recovery, shifting to intensive care unit and death. Pearson chi-square was applied to relate the factors with presence of complications or poor outcome.

Results: Hypotension 3 (6%) was the commonest complication faced by the patients followed by chest discomfort 2 (4%) during or after the plasmapharesis. Out of 50 patients, 47 (94%) recovered, 8 (16%) had minor complications, 2 (4%) were shifted to the intensive care unit and 1 (2%) died. Long duration of time between onset of symptoms and first session of plasmapharesis had a significant relationship (p-value <0.05) with presence of complications or poor outcome among the patients of myasthenia gravis undergoing plasmapharesis.

Conclusion: Plasmapharesis emerged as effective treatment for this immune based neurological disorder with limited side effects. A neurologist should be aware of these common minor and rare major side effects and pay special attention to the patients with generalized myasthenia gravis and those with long duration of time between onset of symptoms and first session of plasmapharesis.Keywords:  ,.
EFFICACY OF MAGNESIUM SULPHATE ON MATERNAL MORBIDITY AND MORTALITY IN ECLAMPSIA
Authors: Arif Nadia , Ahmed Raja Qaseem , Zafar Bushra , Shehzad Farrukh
Published: May 2021

Objective: To study efficacy of Magnesium Sulphate in reducing maternal morbidity and mortality in patients presenting with eclampsia.

Study Design: Prospective observational study.

Place and Duration of Study: Gynae/Obs Department, Combined Military Hospital Bannu, from Jan 2018 Sep 2019.

Methodology: A total of 134 patients fulfilling inclusion criteria were included in the study. Patient management was multidisciplinary. Convulsions were controlled by 4gram magnesium sulphate intravenously over 20 minutes as a loading dose, followed by 1gram per hour of maintenance infusion. Blood pressure was controlled with injection Labetalol 10 milligram followed by injection Hydralazine repeated after every 20 minutes till the blood pressure was controlled.

Results: A total of 134 patients had eclampsia constituting 6.8% of obstetric admissions. Case fatality was 14 (10.4%) while 120 (89.55%) of the cases responded well to treatment and survived the event. Mean age of patients was 22 years. Thirty patients 22.4% were booked and 104 patients 77.6% were un-booked. Mostly patients 122 (91%) came from rural area and only 12 (9%) were from urban areas with booked pregnancies having regular antenatal visits. One hundred and twenty six (94%) patients with eclampsia presented in antenatal period and only 8 (6%) presented in post natal period. Mode of delivery was cesarean section in 87 (64.9%) and 47 (35.1%) delivered vaginally. Frequency of patient requiring ventilator support, acute renal failure,disseminated intravascular coagulation, adult respiratory distress syndrome, HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome was 11 (8.2%), 46 (34.3%), 43 (32.1%), 35 (26.1%), 7 (5.2%) respectively..........
RELUCTANCE OF PATIENTS WITH DIABETES MELLITUS TO INSULIN THERAPY; PSYCHOLOGICAL INSULIN RESISTANCE
Authors: Ali Umair , Munir Muhammad Wajid , Maqsood Jahanzeb , Jamil Mahwash , Rehman Syed Saif Ur , Ansari Abida Mateen
Published: May 2021

Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus.

Study Design: Cross sectional study.

Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019.

Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naïve, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians

Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), difficult insulin storage 98 (76.6%), risk of hypoglycemia 82 (64.1%).The mean negative perception Score was 7.35 (SD 0.98).

Conclusion: Psychological insulin resistance is present in significant diabetic population, and it is a big obstacle in insulin therapy initiation and compliance.
RISK OF DEVELOPMENT OF HYPERTENSION AFTER DONOR NEPHRECTOMY
Authors: Mansoor Khurram , Sabir Sohail , Rana Sumbal , Munir Ali Arslan , Yasrab Muhammad , Shahzad Kaubaib , Sajid Tanveer , Haider Naqvi Syed Ehtesham
Published: May 2021

Objective: To assess live donor nephrectomy for development of hypertension.

Study Design: Retrospective observational study.

Place and Duration of Study: The study was conducted at Armed Forces Institute of Urology (AFIU) Rawalpindi, from May 2016 to May 2020.

Methodology: All consenting kidney donors for live renal transplant were introduced with the process. Baseline blood pressure at time of workup of donation and annually afterwards after transplant on follow up examinations using retrospective data analysis of donor’s workup and follow up was used. Comparison of 1,2,3 and 4-year occurrence of hypertension among (normotensive) donors with 1,2,3 and 4-year of donation using estimates from Framingham Hypertension Risk Score.

Results: A total of 79 donors with a completed annual follow-up rate of up to100 % during a 4-year period. The average age at donation was 33.96 ± 10.23 SD years; 50 donors (63.4%) were women. Overall 27% (22 out of 79) of all live donors developed post donation hypertension who were normotensive at the time of donation. Almost 2/3rd of the patients developing hypertension were females. There was a significant increase in blood pressure measurements each year after donation. Increased BMI of the patient was a risk factor for post donation development of hypertension. The donors who continue being normotensive 1-year post donation yielded an analogous risk to that fit Framingham populace.

Conclusion: Live organ kidney givers are at augmented risk of development of hypertension post kidney donation. The study ascertains the potential significance of following donors and handling risk factors aggressively................
EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA
Authors: Tahir Ali Mujtaba , Akhtar Waqas , Balooch Salah Ud Din , Ahmed Waqas , Samar Ali Murtaza , Sohail Amina
Published: May 2021

Objective: To assess efficacy of salbutamol delivered through metered dose inhaler (MDI) - spacer in paediatric patients with acute exacerbation of asthma.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Paediatrics, Pakistan Naval Ship, Shifa Hospital, Karachi-Pakistan, from Jan to Dec 2018.

Methodology: Ninety Five patients aged ≥6 to ≤12 years, with acute asthma exacerbation were enrolled. Any patient with fever, clinical asthma score (CAS) >7, on home treatment with drugs delivered through nebulization or on oral steroids was excluded. Clinical asthma score recorded on presentation, followed with salbutamol via Metered Dose Inhaler & spacer at dose of 400 µgm (4 x puffs of 100 µgm). Clinical asthma score rechecked after 20 min. Response to salbutamol was then compared in relation to the presenting Clinical asthma score.

Results: Out of 95 children, 45 (47.9%) were male & 50 (52.1%) female with 67.4% having positive family history for asthma. Average premedication clinical asthma score was 2.44. Sixty nine (72.9%) patients had an adequate response as they exhibited clinical asthma score of 0 or fall in score of ≥2. Patients with adequate response had average clinical asthma score of 2.07 on presentation in contrast to 3.42 with inadequate response.

Conclusion: Salbutamol delivered via Metered Dose Inhaler & spacer at dose of 400 µgm is an effective medication for quick relief in children with acute exacerbation of asthma. Moreover, its administration at a point where exacerbation is not much severe steers us towards more favourable outcome.
A COMPARISON OF EFFICACY OF INTRADERMAL TRANEXAMIC ACID WITH TOPICAL 20% AZELAIC ACID IN THE TREATMENT OF MELASMA
Authors: Komal Sayyida , Mashhood Asher Ahmed , Farooq Muhammad , Qayyum Nida
Published: May 2021

Objective: To compare the efficacy of Intradermal Tranexamic acid and topical 20% Azelaic acid cream in the treatment of melasma.

Study Design: Comparative prospective study.

Place and Duration of Study: Dermatology department, Combined Military Hospital Peshawar, from Sep 2018 to Mar 2019.

Methodology: A total of 116 female patients, at the outpatient department of dermatology at Combined Military Hospital Peshawar, were randomly assigned into two groups; group A (intradermal tranexamic acid) and group B (topical azelaic acid) by lottery method. Patients in group A received intradermal injection, while the participants of group B received topical azelaic acid only, fortnightly for 6 weeks. Melasma area severity index score was calculated for each patient in both groups at the start and at the end of the treatment.

Results: The mean Melasma area severity index score in group A (intradermal tranexamic acid) before and at 6 weeks of treatment was 7.10 ± 2.94 and 5.27 ± 2.44, respectively. The mean Melasma area severity index score in group B (topical azelaic acid) before and at 6 weeks of treatment was 7.56 ± 2.57 and 5.76 ± 2.89, respectively. Efficacy of intradermal tranexamic acid, as poor response, good response and excellent response was 27.6%, 41.4% and 31% respectively. While, efficacy of topical azelaic acid group as poor response, good response and excellent response was 62.1%, 20.7% and 17.2% respectively. The difference was statistically significant, (p=0.001).

Conclusion: It can be concluded that intradermal tranexamic acid is more effective as compared to topical 20% azelaic acid in..................
MEDICAL PRFESSIONALISM: COMPARING VIEWS OF PUBLIC AND DOCTORS
Authors: Bano Uzma , Ahmed Anis , Tassadaq Noreen
Published: May 2021

Objective: To compare the views of public and doctors about importance of attributes of medical professionalism.

Study Design: cross-sectional comparative study.

Place and Duration of Study: Study was carried out at Fauji Foundation Hospital Rawalpindi from Oct 2019 to Mar 2020.

Methodology: Study included 115 public participants and 115 doctors. Their perceptions about the importance of different attributes of medical professionalism were recorded on a structured questionnaire by rating on a 5-point Likert scale of importance. Independent samples t-test was used to compare the mean scores of the public group to the mean scores of the doctors for every attribute.

Results: View of public and doctors were very similar. “Honesty and integrity, sound judgment and decision making, responsible behavior, confidentiality, professional development, abiding professional rules, and being reliable” were ranked among the top ten important attributes by both groups. On the other extreme “maintaining a high standard of living” was ranked at the bottom of list by both groups. Significant differences in views of public and doctors were found regarding attributes of social justice among doctors (4.4 vs 4.09, p=0.012) and among patients (4.43 vs 4.09, p=0.05) and autonomy (4.42 vs 4.2; p=0.042).

Conclusion: The opinions of public and doctors on what constitutes medical professionalism are similar with integrity and honesty being the most important attribute and to maintain a high standard of living being the least important attribute.
A RARE CASE REPORT OF PARATESTICULAR RHABDOMYOSARCOMA IN AN ADULT PATIENT
Authors: Ali Mussadique , . Chandumal , Khan Manzoor , Iftikhar Jhanzeb , Yasmeen Samia , Kalsoom Awan Umm e
Published: May 2021

Rhabdomyosarcoma is a malignancy of mesenchymal tissue origin typically occurring in childhood and adolescence, with an incidence rate of of 4.3 patients per million population per anum. Primary rhabdomyosarcoma of para-testicular origin is an infrequent condition, making up to 7% of all the cases of rhabdomyosarcoma tumors in children and adolescents. Here we describe a case of a 25 years old man with left paratesticular solid mass. He underwent left sided orchiectomy with histopathology revealing paratesticuler embryonal rhabdomyosarcoma. He underwent definitive chemo-radiotherapy and orchidopexy with complete remission and is on active surveillance for 4 years.
ENDOSCOPIC FINDINGS IN PATIENTS PRESENTING WITH DYSPEPSIA AND ASSOCIATION OF AGE AND GENDER WITH ORGANIC DYSPEPSIA
Authors: Batool Safia , Sajid Muhammad Usman , Waris Jamal , Satti Shahzeb Ahmed , Hassan Fayyaz , Aziz Faisal
Published: May 2021

Objective: To determine frequency of general and specific endoscopic findings in patients diagnosed with dyspepsia and to determine association of age and gender with organic dyspepsia.

Study Design: Cross sectional study.

Place and Duration of Study: Gastroenterology department, Combined Military Hospital, Kharian, from Jul to Dec 2018.

Methodology: A total of 180 patients participated in the study after being selected through non probability consecutive sampling. Age, gender and history of dysphagia, weight loss, gastrointestinal bleeding, and smoking were recorded. All underwent standard electronic video upper gastrointestinal endoscopy. Abnormal findings of inflammation, narrowing, strictures, furrowing, erosions, ulcers, atrophy, nodularity, polyps, masses and malignancy were recorded. The abnormal findings were presented as frequency and percentages. On the basis of endoscopic findings the sample was divided into two groups of functional (normal endoscopy) and organic dyspepsia. Chi-square test was selected to compare the frequencies of organic and functional dyspepsia with age and gender.

Results: Majority 99 (55%) of the patients with dyspepsia had a normal endoscopic finding while in organic dyspepsia, reflux esophagitis 41 (22.8%) was the most common finding followed by gastritis 16 (8.9%), duodenal ulcer 12 (6.7%) and gastric ulcer 9 (5%). Three patients with organic dyspepsia had malignancy. Most common specific findings were non erosive esophagitis 25(30.8%). Age above 40 years and male gender was found to be statistically significantly associated with organic dyspepsia (p<0.01).

Conclusion: Majority of the patients with dyspepsia have a normal endoscopic finding. There is a higher incidence of organic dyspepsia in males and in patients..................
ANTENATAL CARE AND NEONATAL MORTALITY AND MORBIDITY IN THREE HOSPITALS OF PUNJAB, PAKISTAN
Authors: Akbar Rizwana , Azam Naila , Mughal Fatima Ali Raza , Rahman Mahmood Ur , Tariq Ahmed , Wajahat Maira
Published: May 2021

Objective: To find out the association between neonatal morbidity & mortality and the number of ante-natal visits of the mother of the newborn.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Neonatal Intensive Care Units (NICUs) of three military hospitals of the Punjab province, from Jan to Mar 2019.Methodology: Data of all newborns (total of 3065 neonates) delivered in selected Military Hospitals, and all newborns admitted to Neonatal Intensive care units, of Military Hospitals born in same hospital (in born) and born outside the Military Hospital (out born) during this period along with their mothers was collected. Neonatal morbidity and mortality in the selected hospitals was recorded. Mothers were classified as booked and unbooked according to the number of antenatal care visits. Data was analyzed by Statistical Packages for Social Science (SPSS) version 20.

Results: Neonatal morbidity including prematurity, low birth weight, birth asphyxia, neonatal sepsis, pneumonia, diarrhoea, congenital malformation, and fits was significantly less (p-value <0.001) in children whose mothers had at least 4 or more antenatal visits (booked) than those newborns whose mothers had less than 4 antenatal visits (unbooked). The neonatal mortality in booked mothers was less than half of that in unbooked mothers.

Conclusion: Booked mothers had better outcomes in terms of neonatal health and survival, and the neonatal health and survival was strongly correlated with the number of antenatal visits of the mother.
DETERMINATION OF CEPHALOMETRIC SOFT TISSUE NORMS FOR LOCAL POPULATION WITH NORMAL OCCLUSION USING HOLDAWAY ANALYSIS
Authors: Panezai Saadia , Mengal Nasrullah , Ahmed Khalil
Published: May 2021

Objective: To assess soft-tissue values in a group of local ethnic population with Class I occlusion by Holdaway‟s soft tissue cephalometric analysis, and to verify the pertinence of Holdaway‟s norms to local sample subjects.

Study Design: Cross sectional study design.

Place and Duration of Study: Orthodontics department, Bolan Medical College, Civil Sandman Hospital, Quetta, from Jun 2018 to Dec 2018.

Methodology: Cephalometric radiographs of 69 Adults (33 males and 36 females) aged between 18-28 years, with normal occlusion and well aligned arches, were measured. Cephalometric landmarks were identified as stated by Holdaway analysis. On each radiograph two angular and nine linear measurements were evaluated.Results: Local ethnic population showed more convex profiles with higher skeletal convexity (1.97 ± 1.85) and H angles (15.05 ± 3.31), greater nose prominence (18.25 ± 3.73), upper lip thickness (13.43 ± 1.64), and soft tissue chin thickness (12.64 ± 1.94) compared to Holdaway‟s values. All values showed sexual dimorphism, amongst these statistically significant values (p<0.05) were of soft tissue subnasale to H line, total upper lip thickness, nose prominence, soft tissue chin thickness and inferior sulcus to H line.

Conclusion: Racial variance was present in sampled population, compared to Caucasian norms. These differences must be kept in the mind when planning and executing orthodontic therapy.
DONOR SITE MORBIDITY OF FIBULAR FLAP
Authors: Ali Ghazanfar , Majid Abdul , Almas Danish , Hameed Shahid , Aslam Rizwan , Khan Zubair Ahmad
Published: May 2021

Objective: To present the early and late outcomes related to donor site morbidity of Free Fibular Flap.

Study Design: Prospective observational study.

Place and Duration of Study: Plastic surgery department, Combined Military Hospital Rawalpindi, from Jan 2009 to Jan 2020.

Methodology: In total 361 patients were enrolled for the study through consecutive purposive sampling. All patients requiring free fibula flap for reconstruction of the defect were included in the study. However, the patients with Diabetes Mellitus, Smoking or peripheral vascular disease were excluded from the study. The patients were asked to visit on second week and then at three months for late outcomes. The results were entered SPSS-24 for analysis and interpretation of data.

Results: Out of total 361 patients enrolled for study 293 (81.16%) were male and 68 (18.83%) were female. The men age was 51.43 years SD 14.6 (range 4 year to 68 years). In early outcomes, graft loss 29 (8.03%) and sensory deficit 19 (5.26%), are the commonest adverse outcomes. Results of late follow up revealed chronic pain in 29 (8.03%), ankle instability in 24 (6.64%), gait abnormality in 29 (8.76%) and claw toe in 33 (9.14%) patients. The American Orthopedic Foot and Ankle Society (AOFAS) score was 88.45%. Majority (52.63%) patients were very satisfied.

Conclusion: The free Fibula is excellent choice for reconstruction of a wide range of osseous defects with minimum donor site morbidity and high satisfaction rate among the patients.Keywords:
CLINICAL AND RADIOLOGICAL OUTCOMES OF MANDIBULAR CONDYLAR FRACTURES AFTER CONSERVATIVE TREATMENT
Authors: Sarwar Humaira , Shah Irfan , Khan Ali Akhtar , Babar Adnan , Mehmood Saad , Meraj Wajid
Published: May 2021

Objective: To assess the clinical as well as radiological outcomes of the conservative management of mandibular condyle fractures.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), Armed Forces Institute of Dentistry (AFID), Rawalpindi, from Feb 2018 to Aug 2019.

Methodology: A total of 60 patients diagnosed as isolated mandible trauma with unilateral condyle fractures were studied. All patients were assessed radiologically on orthopantomogram (OPG) before the start of treatment. They were assessed clinically for maximum mouth opening (MMO), occlusion, pain and masticatory satisfaction before the start of treatment and after conservative management. Conservative Management includes soft diet only or maxillomandibular fixation (MMF) followed by active physical therapy. After 6 months of follow up, pre-treatment and post-treatment clinical parameters and radiological finding were compared.

Results: Sixty patients were managed conservatively, among them 37 (62%) were male and 23 (38%) were female with age range of 21-53 years. There was statistically significant decrease in pain (p-value 0.002) and improvement in mastication (pvalue 0.079) before and after the conservative treatment of mandibular condylar fractures. Overall 46 (77%) patients treated with conservative management were satisfied with their mastication and 40 (67%) patients had mild pain on mastication. All the patients showed satisfactory occlusion and had no occlusal discrepancy on last follow up visit. Maximum mouth opening improved from 32.38 ± 4.54 to 40.90 ± 1.75 after treatment. The mean of preoperative ramus length difference of both sides of the mandible was 4.23 ± 2.3 mm............
COMPARISON OF OLFACTORY DISTURBANCE IN COVID-19 POSITIVE CASES WITH NON COVID-19 RHINITIS CASES
Authors: Sheikh Zeeshan Ayub , Ahmed Azeema , Ashfaq Ahmed Hasan , Riaz Naeem , Ahmed Naveed , Ahmed Naeema
Published: May 2021

Objective: To determine association of anosmia as an early symptom of COVID-19 infection.

Study Design: Comparative cross sectional study.

Place and Duration of Study: ENT department, Combined Military Hospital, Quetta, from Apr to Oct 2020.

Methodology: A total of 6411 consenting patients with symptoms of viral upper respiratory tract infection presenting at ENT department, Combined Military Hospital Quetta, from Apr to Oct 2020 were tested for COVID 19 via PCR studies.

Results: Out of 6411 individuals 1109 (17.3%) were found to be COVID positive and 5302 (82.7%) were COVID negative. Of the COVID positive cases 611 (55.1%) of COVID positive individuals had anosmia, whereas only 68 (1.2%) of COVID negative individuals had anosmia, this observation was statistically significant (p<0.001 on chi square test). Whereas only 33 (2.9%) patients had nasal obstruction in COVID positive group, and 68 (1.2%) cases in COVID negative group had nasal obstruction, this observation was not statistically significant (p>0.05 on chi square test).

Conclusion: Anosmia has a definite association with COVID 19 infection.
DEATH ITSELF - STUDENTS’ PERSPECTIVE OF AZAD JAMMU & KASHMIR MEDICAL COLLEGE
Authors: Manzoor Shamaila , Rehman Atiq -Ur- , Kiyani Ziyad , Younas Ayesha , Minhas Rafia
Published: May 2021

Objective: To outline a frame-work which would help to regulate the emotions of under graduate students, on the death of their patient.

Study Design: An exploratory qualitative study.

Place and Duration of Study: Azad Jammu & Kashmir Medical College (AJKMC), from Nov 2019 to Dec 2019.

Methodology: Purposive sampling was done from the final year medical students and focus group discussions were carried out for data collection. Twenty five students shared their feelings at the death of first patient under their care. As a whole, 92% of volunteers experienced the death of their first patients in medical settings. Subsequently, four main themes have been emerged after data analysis. Including; unexpected death, crisis, anticipated death & resolution.

Results: Inadequate preparation of medical scholars to handle this tragic incidence leads to anxiety, anger, guilt and sense of helplessness. These undesirable sentiments would seriously affect their performance in future. So, they must be handled wisely and professionally.

Conclusion: Consequently, a curricular model emerged as a result of this study recommending following steps. There should be regular debriefing sessions of students from their supervisors and reflective journaling practice of students, as a part of curriculum. Likewise, faculty training for „end of life theme‟ would help their students to become more valuable for ailing community.
CLINICAL PROFILES AND OUTCOMES OF PATIENTS ADMITTED WITH MODERATE TO CRITICAL CORONAVIRUS DISEASE 2019 (COVID-19)
Authors: Hussain Mehmood
Published: May 2021

Objective: To evaluate various demographic, clinical, radiological and hematological manifestations of moderate to critical coronavirus disease 2019 (COVID-19) and to assess its complications and outcomes in the Pakistani population.

Study Design: Retrospective observational study.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, from Apr to Jul 2020.

Methodology: Demographic, clinical, radiological and hematological data of 600 consecutive patients were retrieved and analyzed from hospital registry.

Results: Overall, 449 (74.8%) patients had at least 1 comorbidity, diabetes mellitus being commonest; 228 (38%) [95% CI, 34.1- 42%]. The most common symptoms were cough; 451 (75.2%), fever; 450 (75%) and shortness of breath; 419 (69.8%). At presentation, 222 (37%) patients had moderate disease, 296 (49.3%) severe and 82 (12.7%) had critical disease. At admission, 277 (46.2%) patients required respiratory support and further 185 (30.8%) patients required treatment escalation later on correlated with disease severity and age (p<0.001). A total of 92 (15.3%) patients died out of which 38 (21.2%) were on noninvasive ventilation and 36 (66.6%) on invasive ventilation, (p<0.001). Overall survival (OS) was 84.7%; log rank <0.001. Mortality was highest in critical disease, 72 (31.3%) (p<0.001). A majority of patients, 440 (73.3%) developed complications, the most commonbeing Cytokine release storm (CRS); 57.5% respiratory failure; 43.8% and Acute respiratory distress syndrome (ARDS); 38.8%. Thrombotic events occurred in 106 (17.6%).Conclusion: Majority of patients with moderate to severe COVID-19 had comorbidities and ended up in variouscomplications.
PROPHYLACTIC EFFECT OF COENZYME Q10 ON GROSS PARAMETERS OF RAT TESTIS EXPOSED TO MOSQUITO COIL SMOKE INHALATION
Authors: Atta Muhammad Fahad , Qamar Khadija , Iram Maria , Safdar Saba Saleem , Faisal Tayyaba , Shan Maryam
Published: May 2021

Objective: To determine the toxic effect of mosquito coil smoke inhalation on gross parameters of rat testis and explore the protective effect of Coenzyme Q10on testicular toxicity profile.

Study Design: Laboratory-based experimental study.

Place and Duration of Study: Department of Anatomy Army Medical College, Rawalpindi in collaboration with National Institute of Health, Islamabad, from Jan 2020 to Dec 2020.

Methodology: This study was carried out among 30 male Sprague Dawley rats, distributed into three groups as 10 rats/group; group A served as control group, rats in group B were exposed to allethrin-based mosquito coil smoke 4hours/day for 12 weeks. Rats in group C were administered Coenzyme Q10 (10 mg/kg/day) via oral gavage for 12 weeks along with mosquito coil smoke exposure. At the end of study, gross parameters of body weight gain, testicular weight and volume, and relative tissue body weight index of testis were compared among groups.

Results: Rats exposed to mosquito coil smoke alone showed significantly less weight gain (p<0.001)), testicular weight (p<0.001), volume (p<0.001), and relative tissue body weight index (p<0.001) as compared to control group. Rats administered Coenzyme Q10 along with mosquito coil smoke exposure exhibited significantly higher weight gain (p<0.001), testicular weight (p<0.001), volume (p<0.001) and relative tissue body weight index (p<0.001) as compared to rats exposed to mosquito coil smoke alone.

Conclusion: Long-term inhalation of allethrin-based mosquito coil smoke caused testicular atrophy among rats, as evident by reduced testicular weight, volume and relative tissue body weight index. Whereas, prophylactic oral administration of Coenzyme......................
DIAGNOSTIC DILEMMA AND TREATMENT CHALLENGES IN IDIOPATHIC GRANULOMATOUS MASTITIS
Authors: Latif Humera , Qamar Naqvi Syeda Rifaat , Bano Razia , Farrukh Nida , Ali Kishwar , Sana Faiza
Published: May 2021

Objective: To outline diagnostic difficulties and problems in the treatment of Idiopathic Granulomatous Mastitis

Study Design: Prospective observational study.

Place and Duration of Study: Breast clinic, Combined Military Hospital Rawalpindi, from Aug 2019 to Jul 2020.

Methodology: Patients with tender mass with or without signs of inflammation, mass with abscess, sinus formation, and with recurrent abscesses were included. Those cases were labelled as IGM whose histopathology showed granulomatous mastitis with no evidence of malignancy and tissue cultures were negative. Patients with mild to moderate symptoms were treated with reassurance, analgesia and multivitamins. Abscesses were treated with incision & drainage and empirical antibiotics for 1-2 weeks. All these patients were followed at 1, 3, 6 and 12 months.

Results: A total of 35 patients fulfilled the criteria for Idiopathic Granulomatous Mastitis and were included in the study. Two patients had lactational abscess, 3 had bilateral disease and 1 patient was with diabetes 0% patients were having mass with abscess; spontaneous resolution was observed in majority of them with a few requiring incision and drainage. Of 31.4% presented with tender mass only; majority of them resolved with observation, except mass excision in two patients, 19.7% presented with discharging sinuses with underlying mass; among them 71% responded to conservative treatment while 29% were treated with anti-tuberculous therapy for recurrent sinuses. 8.5% presented with spontaneously ruptured abscesses with sinuses; they were managed conservatively.

Conclusion: We concluded that Idiopathic Granulomatous Mastitisis a benign self-limiting disease which can be effectively managed with conservative treatment.
EMOTIONAL INTELLIGENCE AND JOB SATISFACTION AMONG MEDICAL TEACHING FACULTY
Authors: Bano Uzma , Ahmed Anis , Aziz Shahid , Tassadaq Noreen , Ahsan Omar , Wasim Minahil
Published: May 2021

Objective: To measure the correlation between emotional intelligence (EI) and job satisfaction (JS) among teaching faculty of Foundation University Medical College.

Study Design: Cross-sectional study.

Place and Duration of Study: Study was carried out at Foundation University Medical College (FUMC), Islamabad, from Mar to Apr 2021.

Methodology: Participants were recruited through survey sampling using “Google Forms.”Faculty members with a total teaching experience of more than 05 years in FUMC were included in the study. EI was measured using Wong and Law Emotional Intelligence scale- Short version (WLEIS), while JS was measured using Brayfield and Rothes scale on a 5-point Likert scale. Data was entered and analyzed using SPSS version 17. The WLEIS score was correlated to the JS score using Pearson r correlation.

Results: Total 89 faculty members had a teaching experience of more than 5 years. Survey had a response rate of 76.4%. Study included 68 faculty members; 26 (38.2%) were from basic sciences and 42 (61.8%) were from clinical sciences. The mean EI score was 3.22 ± 0.70; and the mean JS satisfaction score was 3.05 ± 0.86. All facets of emotional intelligence as well as overall emotional intelligence scores showed significant positive correlation with job satisfaction scores; which were statistically significant; p<0.05.

Conclusion: There was a statistically significant positive correlation between all components of emotional intelligence and job satisfaction. Hence, it is important for the medical colleges to concentrate on those practices that promote emotional intelligence among their teaching faculty.
Evaluasi Sistem Akuntansi Penerimaan dan Pengeluaran Kas pada PT. Alfa Global Indonesia
Authors: Yunus Rostiaty
Published: May 2021

This research aimed to find out the implementation of system of cash flow accountancy at PT. Alfa Global Indonesia. The design of this research was done to analyze the system of cash flow accountancy at PT. Alfa Global Indonesia. The method used was descriptive qualitative to describe the theory of accountancy cash flow system at PT. Alfa Global Indonesia. The result of this research indicated cash flow accountancy system at PT. Alfa Global Indonesia was done well. The system used was more accurate and the information released was very supporting to make decision.
Pengaruh Gaya Kepemimpinan Transaksional Dan Gaya Kepemimpinan Transformasional Terhadap Kinerja Karyawan Dengan Komitmen Organisasi Sebagai Variabel Moderating Pada PT. Bangun Mitra Abadi Medan
Authors: Putra Rizky
Published: May 2021

Penelitian ini bertujuan untuk mengetahui pengaruh gaya kepemimpinan transaksional dan transformasional terhadap kinerja karyawan baik secara parsial maupun simultan. Untuk mengetahui apakah komitmen organisasi memoderasi pengaruh gaya kepemimpinan transaksional dan gaya kepemimpinan transformasional terhadap kinerja karyawan pada. Jumlah sampel sebesar 116 orang dengan menggunakan teknik regresi linier berganda dan MRA.  Hasil

penelitian menunjukkan bahwa gaya kepemimpinan transaksional dan gaya kepemimpinan transformasional berpengaruh terhadap kinerja karyawan secara parsial dam simultan. Komitmen organisasi terbukti signifikan dalam memoderasi gaya kepemimpinan transaksional terhadap kinerja karyawan serta komitmen organisasi terbukti signifikan dalam memoderasi gaya kepemimpinan transformasional terhadap kinerja karyawan.
The inclination toward funding cash waqf-based education: evidence from Kuwait Waqf Public Foundation
Authors: Al-Daihani Meshari
Published: May 2021

Kuwait Awqaf Public foundation plays a vital role in supporting Community development in Kuwait. However, it is undeniable that support for the educational forums by Kuwait Awqaf public foundation (KAPF) is significantly low graded compared to other distribution channels of Waqf. Besides, the literature that discussed the factors influencing behavioral intention to Waqf giving behavior is extremely limited in Kuwait. Therefore, this study aims to investigate the factors influencing behavral intention to endow to the education sector, particularly among the employees of Kuwait Awqaf public foundation (KAPF), based on the theory of planned behavior (TPB). A set of questionnaires was constructed to measure the validity of the theory in the field of Waqf giving behavior in Kuwait. This study found that all variables attitude, subjective norms, and perceived behavioral control were significantly related to intention to contribute to the education sector by Waqf in Kuwait.
Avaliação da monitoria da disciplina Fisiologia Humana no ensino superior: um relato de experiência
Authors: Silva Maria Pastora Neres , Cruz Francisca Nimara Inácio da
Published: May 2021

O presente trabalho teve como objetivo avaliar o processo de onitoria da disciplina Fisiologia Humana no curso de Licenciatura em Educação Física do Instituto Federal de Educação, Ciência e Tecnologia do Ceará, campus Canindé. Trata-se de um estudo descritivo, do tipo relato de experiência. As atividades de monitoria iniciaram em dezembro de 2019 e seguiram até dezembro de 2020. Os resultados indicaram que a vivência na monitoria foi de suma importância para a vida pessoal e acadêmica da estudante monitora, uma vez que proporcionou o aprimoramento de conhecimentos, desenvolvimento de competências e experiências que serviram como visão real das atividades na docência. Destaca-se como dificuldade a pouca participação dos alunos na monitoria, principalmente, devido a problemas enfrentados no ensino remoto no contexto pandêmico, merecendo destaque o acesso limitado à internet e ao uso de aparelhos tecnológicos para o acompanhamento das aulas por parte de muitos dos estudantes.
Reasons for Hand Pulling Public Employees from Their Position and Judicial Oversight of the Decision to Pull Hand in The Iraqi and Jordanian Laws
Authors: Al-Kubissi Abdulwahhab Gumaah , Al-Assaf Shatha Ahmed
Published: May 2021

This research focuses on the reasons for withdrawing the public employees hand from his position in the Iraqi and Jordanian Laws and judicial oversight over the decision to withdraw. He public employees. The research tries to answer a very important problem which is the extent of the legal regulation for the reasons for withdrawing the employees hand from the work of this job and the judicial: The first topic focuses on the reasons for withdrawing the public employees hand from his position. The second topic deals topic deals with judicial oversight of decisions to withdraw the employees hand from his position. A number: 1- that the administrative courts look into the penalties directed at the employee from the administrant to the employee who has withdrawn the hand from his public office. especially in the penalties of dismissal and dismissal, provided that the appeal is mandatory either by the employee or by investigative committee to raise all the investigative papers and the penalty directed to the employee to the administrative court consider whether the punishment is correct or not, the two penalties mentioned above are among the most serious penalties that are applied to the employee. 2- He suggested to the civil service system, setting time to suspend the year from work and not to be dismissed because in this it generates the state treasury and harms the public employee who is suspended from work to receive half of his salaries and does not provide any community service.
Adopting General Rules to Regulate Writer with Traditional Justice in Organizing the E-Certification Body in Contemporary Iraqi Legislation
Authors: Mohammed Abdulbasit Jasim , Abdulhameed Sarah Husham
Published: May 2021

The legal and legal necessity in electronic and third-party legal transactions dictates, and keeps abreast of modern developments in this field, The Iraqi legislature, according to the Electronic Signature and Electronic Transactions Law No. (78) Of 2012, created the electronic authentication body, and set out the conditions for its establishment, scope of work, terms of reference and mechanisms for carrying out its activities, to be -from a functional point of view -an extension of the writer with traditional justice, organized under the provisions of the Notary Book Law No. (23) for the year 1998, However, the texts regulating the work of the first are not at the level of the legislative organization of the work of the second, which necessitates researching the extent of the success of the adaptation of the general rules regulating the writer with traditional justice, in completing the aspects of organizing the electronic documentation body in contemporary Iraqi legislation, to ensure the achievement of the goal for which this body was established , The study showed the possibility of adapting texts related to the substantive aspect, which do not contradict the default nature of the documentation side, and the impossibility of this with regard to the functional aspect, related to the nature and entity of each of them.
Urban Ruralization and its impact on the residential environment of the city of AL-Qaim
Authors: Ali Ahmed Mahmood , Abed Salah Othman
Published: May 2021

The research has a more important and important study of the Iraqi cities in general and the cities of Anbar in particular, through field study and investigation in order to know the reasons that contribute directly or indirectly to the prevalence of this phenomenon, as it is affecting the quality of urban life and the nature of the urban texture of the city، By asking questions to the community sample about the behaviors of the existing city community, and focusing on the most prominent customs and traditions that the residents brought through the move of their place of residence from the countryside to the city, and it has been inherited from the life of the countryside, since significant numbers of the city's residents have rural origins, Where the city of Al-Qaim was distinguished by the area expansion and population size resulting from several factors, whether the natural increase of the population or through migration from the neighboring countryside or through the process of urban integration represented by the integration of the Karbala region of rural nature within the basic design of the city of Al-Qaim.
Marriage Choice Standards for Male Students in Al-Maarif University College
Authors: Al-Marsoomi Abdulmunim Jabir Hamid
Published: May 2021

The research aims at knowing the order of the choice standards according to their importance and priorities in marriage used by male students at Al-Maarif University College in the light of hadith Sharif: women got married for four characteristics: wealth, lineage, or religion: choose the one of religion to be the winner. the research also intends to uncover whether there is a relationship between their choice for marriage and some variables such as: study specialization, study stage, economic and social levels. the research took as a sample (264) students from the different departments of the college. Thus, the researcher wrote a questionnaire consisting of (12) items and made sure of their validity and consistency. The results of the work show the order of the four standards according to their priority and preference as follows: the standard of religion is the first, followed by the standard of beauty, and thirdly the standard of lineage, while the standards of wealth come last. as far the relationship between the standard and some variables is concerned, the results show that the order of the choice standards differs according to the different departments of the college and the study specialization. it also differs according to the study stages and similarly differs according to the economic and social levels of the students.
Heritage Manifestations in The Palestinian Novel
Authors: Dhahi Jabbar Abd
Published: May 2021

This research deals with the use of heritage in the novel "Sunflower", after it was able to make a distinct space for itself in the arena of the novel, due to its diagnosis of the living reality, through ideological messages and aesthetic values. The writer sought to establish an integrated narrative experience, and she searched for forms through which to prove her identity. Heritage was a prominent milestone that made the novel open to broad horizons and that her concern is not only to celebrate heritage, but to re-employ it, to discover and invest in its artistic energies. It employed heritage of all kinds (popular, religious, and historical), as the novel celebrated the heritage in form and content.
The Human Being in The Philosophical Thought
Authors: Abbas Omar Saadi
Published: May 2021

The human being is the basis of philosophy, and this concept has crystallized mainly in most philosophical currents. Therefore, we see that these trends fall into one subject, which is (man), and every philosophy of these philosophies and currents or philosophical trends tries to set a concept for the human being of its own, and therefore we see a clear difference in Interpretations of these conflicting philosophical currents among themselves, which consider the human being and problems are the core of the topics of their thinking and with this research which is (the human being in the philosophical thought), so we see that Jaroudi's cognitive, philosophical and cultural system is poured into one topic, which is the human being, and this is what we found when talking about the concept of the human in Marxist thought, which was embodied in the principle of freedom, equality and respect for the other, then moving to the concept of man in existential philosophy, with its atheistic and believing parts, and its characterization of the human being because it is considered the fundamental difficulty in existential philosophy, and after that, Jarudi moved to the study of man to the personal philosophy of Jean Lacroix and Monet, which emphasizes the individual's responsibility and emphasis On a position on nature and history, and finally he studied man in structural philosophy. We see that the research began with a general introduction in which the human being is its main focus, and many researchers attribute their writing on the subject of man and humanity to Abu Hayyan al-Tawhidi and Ibn Miskawayh, as two of the flags of humanism in the Islamic civilization, and how these successive currents have looked at the human being and have been interested in all aspects of man Not only what he is aware of and what he thinks about or what he intends, because there are things in him that always go beyond awareness, thought and intent, and we see from the important results at the beginning of the conversation the consequences of studying a person from the deep crisis that he lived with all his conscience due to his presence in a concerned world, a world from which there is no way out. Likewise, Arkoun stems from the necessity of re-regard for philology as an indispensable approach in establishing the scientific approach to texts as a primary entry point for dropping sacredness from it and thus liberating the Islamic mind from the mythical thought that was associated with it with the Islamic vision of the phenomenon of revelation. On the other hand, existential philosophy emphasized the ability of man to conquer reality, transcend it and give it a special meaning.
Snapshot of The Ajlan On the Called “Naq’at Al-Saddiyan”
Authors: Al-Nuaimi Osama Mohammed Swailem
Published: May 2021

The book 'Naqat Al-Siddiyan', talking about 'Falaan', was attributed by its verifier, Dr. Ali Husayn al-Bawab, to the famous linguist Al-Saghani. After verification, it became clear that the current title of the book is not correctly attributed to Al-Saghani. But they are two separate books. The first 'Naqat Al-Siddiyan' is about those whose companionship is doubtful, which is a printed book about their names. The second book is Falaan or Al-Falaan, which is under investigation. In addition to that, the material of the book is a collection of audio sources from the Arabs based on the rhythm of 'Falaan', and his verifier has mentioned more than two hundred sources. The researcher has looked at more than seventy of those sources that were missed, and I have proven them from the reliable compilations of language.