bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediksi Faktor yang Mempengaruhi Hipertensi dengan Metode Data Mining untuk meningkatkan Pelayanan Kesehatan di UPT Puskesmas Ngoro
Authors: Novari Alliza Sapto , Nisak S Umi Khoirun
Published: January 2024

Menentukan prediksi dari faktor yang mempengaruhi hipertensi di puskesmas ngoro, mojokerto. Hipertensi merupakan salah satu dari penyakit tidak menular yang sampai saat ini menjadi masalah kesehatan masyarakat daerah. Pasien dengan hipertensi selain membutuhkan pengobatan yang berkelanjutan, bahkan bisa dibilang harus dilakukan terus menerus selama hidup. Maka dari itu perlu di bentuk prediksi pasien hipertensi agar pelayanan kesehatan dapat meningkatkan pelayanannya. Prediksi ini menggunakan beberapa metode yaitu studi awal, identifikasi masalah, pengumpulan dataset, identifikasi dan perumusan masalah, data processing, dan hasil evaluasi prediksi dari algoritma logistik regresi dan naïve bayes. Tujuan penelitian ini untuk sesuatu kebutuhan atau aktifitas pada masa-masa mendatang, maka satu prinsip yang tidak boleh dilupakan adalah meramalkan, mengenai yang akan terjadi pada masa yang akan datang. guna perbaikan penanganan pelayanan dan lebih tersedianya obat-obat yang menunjang untuk para penderita Hipertensi. Hasil dari penelitian ini menghasilkan prediksi pasien hipertensi pada tipe kategori pra hipertensi, sistole dan distole, jenis kelamin, dan rentan umur. Hasil evaluasi model prediksi menggunakan metode regresi logistik menunjukkan kinerja yang baik dalam memprediksi faktor yang mempengaruhi hipertensi. Dengan menggunakan model ini, faktor risiko seperti usia, jenis kelamin, kebiasaan merokok, konsumsi alkohol, dan IMT dapat diprediksi dengan akurasi yang tinggi. Kesimpulan dari penelitian ini adalah bahwa faktor risiko hipertensi di UPT Puskesmas Ngoro meliputi usia di atas 60 tahun, jenis kelamin perempuan, IMT ideal, serta tidak adanya kebiasaan merokok dan konsumsi alkohol yang signifikan. Model regresi logistik dapat digunakan sebagai alat prediksi untuk faktor risiko hipertensi
Feasibility of MHealth Interventions towards Promoting HIV Self-testing Uptake in Sub-Saharan Africa: A Systematic Review of Literature
Authors:   Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State, Nigeria, O. A. Adaka, , E. T. Owoaje, ,   Department of Community Medicine, College of Medicine, University of Ibadan, Oyo State, Nigeria, A. O. Tella, ,   Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State, Nigeria
Published: January 2024

Background: HIV self-testing (HIVST) with mobile health technology (mHealth) support is the use of mobile phone-based interventions to complement HIVST in order to improve its efficiency and uptake. Existing reviews leaves a gap in the evidence that summarizes efforts on the feasibility of mHealth to promote HIVST uptake within Sub-Saharan Africa (SSA). Objective: This study synthesized existing research on the feasibility of mobile health technology (mHealth) aimed at promoting HIV self-testing (HIVST) uptake within SSA using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result: Eleven studies met the inclusion criteria and were narratively synthesized, 63% of which were observational studies while 37% were randomized control trials. Mobile applications, SMS or a combination of mHealth strategies were mostly used to promote HIVST uptake. Most studies were carried out in South Africa (54%), and in the general population (54%). Feasibility metrics were inconsistently reported across studies because its definitions varied, nonetheless most studies reported one or more feasibility metrics and HIVST uptake was the most common way (81%) of assessing feasibility. SMS-based interventions significantly increased HIVST uptake among hard-to-reach populations and were effective for reporting testing outcomes. Mobile applications guided participants through testing, result interpretation, and self-reporting HIVST results, and most studies reported high HIVST uptake (89.0%–100%). Compared to HIVST alone, call-based intervention enhanced HIVST uptake and linkage to care or prevention (p = 0.021). Most studies found combined mHealth interventions highly feasible (78.9%–99.2%). Conclusion: Feasibility was variable between the diverse mHealth supports used to promote HIVST uptake. While findings pave the way for greater use of mHealth supported HIVST, future research should consider using rigorous research designs and focus on populations disproportionately affected by HIV within diverse SSA regions to ensure broad applicability. Feasibility measures should also be standardized for uniform reporting across studies.
Stuttering Language Disorder of an Adult Male in Bondowoso: A Case of MR AG
Authors:   Master of Linguistics, Faculty of Cultural Studies, Jember University. Indonesia, Nuryani Dewi Ikke , Wibisono Bambang ,   Master of Linguistics, Faculty of Cultural Studies, Jember University. Indonesia, Salikin Hairus ,   Master of Linguistics, Faculty of Cultural Studies, Jember University. Indonesia, Sofyan Akhmad ,   Master of Linguistics, Faculty of Cultural Studies, Jember University. Indonesia, Asrumi Asrumi ,   Master of Linguistics, Faculty of Cultural Studies, Jember University. Indonesia
Published: January 2024

Stuttering is a condition where a person experiences language insufficiency caused by a person's psychological condition. The more unstable the person's emotions, the more chaotic the sentence structure produced by that person will be. This study aims to determine the form and factors causing the stuttering experienced by MR.AG. This research uses a qualitative descriptive method using a psycholinguistic approach. The data in this research is in the form of verbal data, namely sounds, words, phrases, sentences, as well as non-verbal data in the form of expressions and gestures. The data source comes from an adult man who has a severe stuttering disorder, who lives in Petung village, Curahdami District, Bondowoso Regency, East Java, Indonesia. Data collection was carried out by means of observation and interviews. The results of the research showed that there were five forms of stuttering experienced by MR AG, namely repetition, pause, insertion, extension and circumlocution. The forms of repetition experienced by MR AG are repetition of sounds, both vowels and consonants, repetition of words, repetition of syllables and repetition of phrases. The pause experienced by MR AG lasted between 2 until 6 seconds. The form of insertion experienced by MR AG is the insertion of sounds “ eeeee, eeeeb, eeed”. Then the form of extension experienced by MR AG is the extension. The last is a form of circumlocution that occurs in MR AG. Based on the results of interviews and observations, it can be concluded that there are two main possible factors causing the stuttering experienced by MR AG. The first is neurological disorders and family pressure factors. There is a close connection between the dyslexia and epilepsy problems experienced by MR AG towards his stuttering.
The rise of counterfeit medication: an emerging threat?
Authors: Larik Muhammad Omar
Published: January 2024

Madam,
The definition of health is far more complex than initially imagined. As per the World Health Organisation (WHO), the “health” is defined as complete physical, mental, and social well-being instead of simply the absence of any disease.1 In the era of modern healthcare, medications are undoubtedly important in ensuring well-being worldwide. Despite monumental advances within the medical industry, the rise of counterfeit medication has become an emerging threat. Counterfeit medications are known as products sold with the deception of providing therapeutic benefits but consist of little-to-no active ingredients, which may or may not be harmful.2 Traditionally, the regulation of drug distribution falls under the responsibility of the health authorities of the relevant region, such as the Drug Regulatory Authority of Pakistan (DRAP).
 Reports of an escalating influx of counterfeit medications into Pakistan have recently created pivotal concerns within the local communities.3,4 In Karachi, officials seized a large quantity of cefixime and aspirin suspension powders, which were found to be “fake and spurious”.3 The counterfeit medication was created by repackaging locally-manufactured powder into branded bottles, which were subsequently sold across the city. In another case affecting various cities in Pakistan, a factory was illegally manufacturing spurious medication, leading to a nationwide cautionary announcement to avoid the purchase of affected drugs, including the lifesaving meropenem, among various other cephalosporin drugs.4
The distribution of counterfeit medications can have drastic consequences for the population. Patients in critical conditions may suffer further harm due to defective treatment, as a result of the failure of substandard products.5 Moreover, counterfeit drugs manufactured with inappropriate doses or concentrations may lead to fatal adverse effects, such as respiratory paralysis or death.5 In order to address this pressing issue, the national authorities must take proactive measures to tackle the production and distribution of counterfeit medication:

There is a need for frequent and strict raids integrated within each city of Pakistan, in which local pharmacies have their inventory tested for substandard or inappropriate substances. Secondly.
The import of medications must also be strongly monitored, in order to prevent the arrival of counterfeit or unregistered medications from foreign regions.
It is recommended that the authorities establish pharmaceutical support programs for those individuals who cannot afford proper medications and eventually resort to purchasing substandard medication.
Dental health in the shadows of global commitments: Addressing neglected priorities in lower middle-income countries
Authors: Qamar Wajiha
Published: January 2024

I am writing to draw your attention to a serious concern that requires our attention around global health commitments: the frequently disregarded and undervalued dental reforms. In the realm of global health commitments, dental reforms are often ignored and underestimated. (1) Despite significant advancements in many other facets of health owing to these commitments, dental health remains marginalized within its sphere creating a glaring disparity, especially in lower middle-income countries where it’s a crucial concern.(2)
Dental health has a significant impact on a person's quality of life in addition to preventing oral diseases. It has a significant impact on a person's quality of life, having an impact on their mental and physical well-being. Neglected oral health can affect speech, self-esteem, and psychosocial wellbeing as well as cause pain, infections, malnutrition, and systemic health problems.(3) The disruptive relationship between oral diseases and significant medical conditions like diabetes, cardiovascular disease, and adverse pregnancy outcomes emphasizes the complex relationship between dental health and overall health.
Despite efforts to promote understanding, such as Universal Health Coverage (UHC) and the International Health Regulations (IHR), oral health is often disregarded in global discussion. Particularly in lower middle-income countries, oral health is neglected due to a lack of tailored interventions, which decreases its significance. A significant leap forward has been made with the recent World Health Organization (WHO) resolution that declares oral health a global priority and calls for its inclusion in national strategies. The WHO has acknowledged the need to address this problem immediately.(4) The challenge, however, is recognition into concrete, commitment-backed activities and specific interventions. The resolution has potential, but its effectiveness will be judged by the concrete measures taken to bridge the gaps.
The Sustainable Development Goals (SDGs) offer a potential reference point for rectifying this gap. By integrating oral health in SDGs like Goal 3 on excellent health and well-being, a holistic approach may be taken. This integration could help bridge the gap between international commitments, raise the public's awareness of oral health, and foster tailored initiatives for dental reforms.
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Is Cancer a different Disease in the developing World?
Authors: Itrat Mehdi  , Suad Sulaiman Al Kharusi
Published: January 2024

The mounting rise in figures of non-communicable diseases globally, is noticeably disproportionate in prevalence and mortality in low- and middle-income countries (LMICs). The epidemiologic trend of cancers in LMICs is of distinct apprehension. In 2018, an estimated 18.1 million new cancer cases were diagnosed and 9.6 million cancer deaths occurred. The WHO estimates that by 2040, this will increase to 29.5 million new cancer diagnoses and 16.5 million cancer-related deaths annually.1 Given the population boom and gradual increase in life expectancy in developing countries, a significant increase in cancer incidence in the developing world is projected. The rising figures of cancer and mortality are set to double, and more than 70% of new cancers will occur in people in the developing world.2 In 2030, cancer deaths in LMICs are estimated to increase from 65% to 75%.1,3 The higher income countries (HICs) have rising cancer incidence rates, but the mortality rate is significantly higher in lower- and middle-income countries (LMICs) and continue to rise, whereas mortality rates in HICs are either decreasing or stable. Despite a lower incidence, cancer-related mortality is significantly higher in younger patients in LMICs. This has an immense economic impact of premature mortality and lost years of productive life.3,4
Ellis-van Creveld syndrome: a case report
Authors: Marya Hameed  , Jesrani Ameet Kumar , Syed Maaz Tariq  , Hanif Hina , Bansari Suneeta , Kumar Ashok
Published: January 2024

Ellis-van Creveld syndrome (EVC), also known as chondroectodermal dysplasia, is a rare entity. It most commonly affects the tubular bones leading to dwarfism and a long trunk with ossification defects. Other presentations are wide hands and feet, dysplastic nails, thin hair, and cardiac malformations. An eight-year-old female patient presented to our tertiary care centre with complaints of short stature, abnormal dentition, and fatigue. The child’s parents were first-degree relatives. On radiological imaging, it was revealed that the patient had postaxial polydactyly, short stature, and genu valgum deformity along with mild cardiomegaly. All these features were indicative of Ellis-van Creveld syndrome. EVC is a rare clinical syndrome with a distinctive clinical presentation. It requires comprehensive radiological investigations and the management is best done with a multidisciplinary approach.
Keywords: Cardiomegaly, Polydactyly, Ellis-van Creveld Syndrome.
Maxillofacial trauma and its management presenting in tertiary care hospital in Lahore during Covid-19 pandemic
Authors: Syed Shumail Ahmad  , Gulraiz Zulfiqar  , Bisma Iftikhar
Published: January 2024

Objective: The objective of this study was to assess the patterns of maxillofacial injuries, etiology and their management during the pandemic of Covid-19 in a tertiary care hospital in Lahore, Pakistan.
Methods: This is a single center, prospective cross-sectional study. Patients from all age groups who were presented at the Emergency room of Jinnah Hospital Lahore and managed by the Oral and Maxillofacial Surgery Department during 1st December 2020 till 31st January 2021 were included. Data were analyzed using IBM SPSS for Windows, Version 20.0.
Results: Total 202 patient were analyzed, 161 (79.7%) were male and 41 (20.3%) were females. Male to female ratio was 4:1. About fifty three percent of patients belonged to the age group 15-35 years. The most common cause was road traffic accidents (RTA), followed by fall. Eighty-three (41.1%) had only soft tissue injuries without any bony fracture and 119 (58.9%) had facial bones fractures. Zygomatic bone fracture was most common (53.8%) followed by mandible fracture (31.1%). Sixty-one out of 119 patients with fractures were treated with Open Reduction Internal Fixation (ORIF). Three patients had complete loss of vision because of facial trauma. Only 56 (28%) patients were managed under General Anesthesia.
Conclusion: During initial pandemic era, a large majority of patients presented with maxillofacial injuries were young male adult. The most common cause of maxillofacial trauma was RTAs. Soft tissue injuries were predominant followed by facial bone fractures and zygomatic bone was more frequent among the fracture cases. Covid-19 pandemic increased the difficulties faced in the management of maxillofacial trauma patients.
Keywords: Covid -19, Maxillofacial Injuries, Tertiary Care Centers.
Retrospective analysis of the clinical significance of Ro52/TRIM21 antibody and specific antinuclear antibody patterns by indirect immunofluorescence
Authors: Kaifang Liu  , Yunfeng Liao  , Pu Li  , Jing Shi
Published: January 2024

Objectives: To determine the clinical significance of Ro52 protein/tripartite motif-containing 21 antibody and specific antinuclear antibody patterns using indirect immunofluorescence technique.
Method: The retrospective study was conducted at the clinical laboratory of the First Affiliated Hospital of Chongqing Medical University, China, and comprised data from January 2017 to December 2021 of patients who underwent antinuclear antibody and anti-extractable nuclear antigen antibody detection. Inpatients with Ro52 antibody-positive status were taken as the cases, while anti-Ro52 negative patients with clear clinical diagnosis were taken as the controls. Data was analysed using SPSS 19.
Results: There were 1802 cases and 1211 controls. Positive Ro52 showed significantly greater frequency in patients with primary Sjogren’s syndrome, systemic lupus erythematosus, inflammatory myositis, dry eyes and interstitial lung disease (p<0.05). Ro52 antibody showed high positive predictive value for primary Sjogren’s syndrome 25(96.15%), systemic lupus erythematosus 259(91.20%), connective tissue disease-associated interstitial lung disease 45(86.67%) and inflammatory myositis 60(86.67%). Antinuclear antibody indirect immunofluorescence patterns most frequently detected were nuclear speckled 128(40.89%) and cytoplasmic speckled 126(40.26%) (p<0.05). Interstitial lung disease was associated with the presence of cytoplasmic speckled antinuclear antibody indirect immunofluorescence pattern 24(19.2%), while tumours 47(36.5%) and hepatitis B 26(20.3%) seemed to be more frequent with nuclear speckled pattern (p<0.05). The simultaneous reactivity extractable nuclear antigen antibodies most frequently detected were antinuclear antibody+Ro52+anti-Sjogren's syndrome A+ 558(33.96%).
Conclusion: Ro52 antibody positivity was found to be associated with Sjogren’s syndrome, systemic lupus erythematosus, inflammatory myositis, dry eye and interstitial lung disease. The antinuclear antibody immunofluorescence pattern of Ro52 positive was single and primarily granular cytoplasm type. Antinuclear antibody negative and Ro52 positive in the serum of patients also had certain significance in auxiliary disease diagnosis.
Key Words: Anti-Ro52 autoantibody, Autoimmune disease, Sjogren's syndrome, Xerophthalmia, Tripartite motif-containing 21 protein.
Mitral leaflet separation index correlation with mitral stenosis severity, a reliable easy 2-d echocardiography technique
Authors: Hussain Saba , Fateh Ali Tipoo Sultan  , Mariam Naz  , Sumyia Gurmani  , Shazia Rasheed
Published: January 2024

Objective: To evaluate accuracy of mitral leaflet separation index for the determination of mitral stenosis severity in patients with rheumatic mitral stenosis.
Method: The prospective, cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from March 2021 to February 2022, and comprised patients with rheumatic mitral stenosis detected on echocardiography. The best end-diastole parasternal long axis and apical four-chamber views were acquired and Mitral leaflet separation was measured as the distance between the inner edges of the tip of mitral leaflets. Pearson correlation coefficient was computed for mitral leaflet separation index and mitral valve area. Receiver operating characteristic curve was used to determine the cut-off value of the mitral leaflet separation indexto categorise mitral stenosis. Data was analysed using SPSS 19.
Results: Of the 277 patients, 205(74%) were females and 72(26%) were males. The overall mean age was 39.93±11.22 years. The mean mitral leaflet separation index value was 7.65±2.23. The correlation was significant and strong between mitral leaflet separation index and mitral valve area on planimetry (p<0.001), and was significant and moderate when measured by pressure half-time (p< 0.001). Mitral leaflet separation index cut-off value <8.625mm and <8.25mmcould predict severe mitral stenosis with 84% and 86.3% sensitivity and 84.6% and 78.3% specificity on planimetry and pressure half-time, respectively.
Conclusion: The mitral leaflet separation index was found to be an independent, reliable and simple measure for assessing mitral stenosis severity.
Key Words: Echocardiography, Mitral stenosis, Mitral leaflet separation index, Pressure half-time, Planimetry.
Effectiveness of problem-based learning strategies compared to conventional anatomy teaching approaches
Authors: Quratulain Javaid  , Ambreen Usmani
Published: January 2024

Objective: To determine the effectiveness of problem-based learning compared to conventional teaching strategies, and to determine the impact of sub-disciplines of Anatomy on learning outcomes of the subject.
Method: The cross-sectional, descriptive study was conducted at Bahria University Health Sciences, Karachi, from August to October 2022, and comprised 1st and 2nd year medical students and 1st year dental students of either gender who were being taught by the hybrid method including both conventional and problem-based learning strategies. Data was collected using a questionnaire circulated through Google Forms. It had close-ended questions that were scored on a Likert scale. Anatomy sub-disciplines explored were gross, embryology and histology. Data was analysed using SPSS 23.
Results: Of the 251 subjects, 125(49.8%) were males and 126(50.2%) were females. The overall age ranged aged 18-23 years. There were 115(45.8%) 1st year medical students, 111(44.2%) 2nd year medical students and 25(10%) 1st year dental students. Among 1st year medical students 60(52.17%), among 2nd year medical students 64(57.6%) and among 1st year dental students 14(56%) respondents favoured problem-based learning compared to conventional methodology. Highly significant results were obtained regarding need of topic revision (p<0.001), whether knowledge of conventional teaching method is enough for understanding the clinical scenarios (p=0.017, whether pictures shown during the problem-based learning sessions were enough for understanding anatomy (p=0.035), relevance of questions in oral structured practical examination (p=0.019) and viva (p=0.002). When the participants were asked regarding the anatomy sub-discipline that required revision for comprehensive learning, 72(28.3%) mentioned gross anatomy.
Conclusion: Students considered problem-based learning to be more inducive in enhancing learning compared to conventional teaching.
Key Words: Problem-based learning strategies, Conventional anatomy, Teaching approaches.
Role of granulocyte colony stimulating factor (G-CSF) in dengue patients with severe thrombocytopenia
Authors: Khan Kamran Amir , Sameed Ullah Qureshi
Published: January 2024

Objective: To determine the effects of granulocyte colony-stimulating factor in improving platelet count in patients with dengue fever.
Method: The retrospective, cross-sectional study was conducted at Northwest General Hospital and Research Centre, Peshawar, Pakistan, between January 2021 and October 2022, and comprised dengue fever inpatients regardless of age and gender who received granulocyte colony-stimulating factor subcutaneously. The impact of colony-stimulating factor on platelet and white blood cell counts as well as any unfavourable consequences was assessed. Convenient sampling was used and a structured format was used for data collection. Data was analysed using SPSS 21.
Results: Of the 100 patients, 67(67%) were males and 33(33%) were females. The largest age group was that of >55 years 31(31%), fever was present in all the 100(100%) cases, bleeding in 18(18%) and platelet count <30,000 in 83(83%) cases. Dengue fever was confirmed by rapid dengue nonstructural protein 1 antigen in 76(76%) cases, dengue immunoglobulin G antibody test 28(28%), and immunoglobulin M antibody test in 31(31%) cases. Overall, 72(72%) patients received only one dose of granulocyte colony-stimulating factor. Post-administration, a substantial rise in the median platelet and white blood cell counts was seen compared to the baseline (p<0.05) on day 2.
Conclusion: Granulocyte colony-stimulating factor helped increase platelet and white blood cell counts quickly in dengue fever patients.
Key Words: Granulocyte colony-stimulating factor, Dengue, Thrombocytopenia.
Comparison of saddle contoured metal matrix and pre-contoured self-adhesive matrix in composite resin class II restorations; an in vivo study
Authors: Sarwar Nosheen , Khokhar Sheharyar Akhtar
Published: January 2024

Objective: To evaluate composite class II restoration proximal contacts and contours by comparing saddle-contoured metal matrix and pre-contoured self-adhesive matrix system.
Method: The randomised controlled trial (NCT05414656) was conducted at the Department of Operative Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from May to October 2022, and comprises the patients having supra-gingival class II cavities. They were randomised into class II restoration with saddle-contoured matrix band group A, and restoration with pre-contoured self-adhesive matrix group B.  The tightness of proximal contacts was evaluated using the Fédération Dentaire Internationale criteria and the quality of proximal contours was assessed using clinical and radiographic examination. Data was analysed using SPSS 16.
Results: Of the 60 subjects, 42(70%) were females and 18(30%) were males. The overall mean age was 38.03±15.33 years. There were 30(50%) subjects in each of the 2 groups. The highest restoration was needed in the upper premolar 20(33.3%). The tightness of proximal contact was not significantly different between the groups (p=0.94). Clinical examination for production of good contours was higher in group A compared to group B, but the difference was not significant (p>0.05).
Conclusion: There was no significant difference between saddle-contoured metal matrix and pre-contoured self-adhesive matrix for composite class II restoration proximal contacts and contours.
Clinical Trial Link: https://clinicaltrials.gov RCT (NCT05414656)
Key Words: Dental restoration, Composite resin, Dental caries, Matrix bands.
An insight into the clinical learning environment of dental institutes: a study in the twin cities of Pakistan
Authors: Muhammad Muhammad , Ahmad Zaina , Shahzad Fatima , Sethi Ahsan
Published: January 2024

Objectives: To assess the perceptions of dental students regarding their clinical learning environment in an urban setting.
Method: The descriptive, cross-sectional study was conducted from March 2020 to May 2021 after approval from the ethics review committee of Islamic International Dental College, Islamabad, Pakistan, and comprised clinical year students, house officers and postgraduate trainees from 6 dental teaching hospitals of Rawalpindi and Islamabad. Data was collected using a pre-validated instrument assessing the dental clinical learning environment. Data was analysed using SPSS 24.
Results: Of the 1030 students approached, 561(54.4%) responded. Of them, 448(80%) were girls, 234(41.7%) were 3rd year students, 110(19.6%) were 4th year students, 120(21.4%) were house officers and 97(17.3%) were postgraduate trainees. Female students had a better patient attitude and were more confident in their abilities to keep up with their peers (p<0.05). The students were content with the performance of their clinical teachers, with a mean score of 70.99+/-16.0, while the lowest score of 54.67+/-22.9 was for clinical infrastructure and materials. Students of Islamabad pointed out the lack of clinical materials and maintenance of equipment but noted better research opportunities compared to their Rawalpindi counterparts (p<0.05).
Conclusion: The clinical learning environment for Islamabad and Rawalpindi cities individually was good. Overall, students were satisfied with their clinical teachers, learning and training experience. Dental materials, infrastructure and maintenance factors scored the lowest.
Key Words: Dental education, Dental graduate education, University hospital, Health facility environment, Clinical clerkship.
Comparing the effects of positional versus myofascial release of gluteus medius to manage patellofemoral pain syndrome: single blinded randomized clinical trial
Authors: Kumar Priyanka Ratan , Soomro Rabail Rani
Published: January 2024

Objective: To determine the effects of positional release technique in comparison to myofascial release technique on gluteus medius trigger point along with exercises to manage patellofemoral pain syndrome.
Method: The single-blind, two-arm, randomised clinical trial was conducted at the Department of Physiotherapy, Sindh Institute of Physical Medicine, Karachi, from December 7, 2020, to March 24, 2021, and comprised patellofemoral pain syndrome of either gender with gluteus medius trigger point. They were randomly allocated to positional release technique group A and myofascial release technique group B. The intervention comprised 3 sessions per week for 6 weeks for a total of 18 sessions, with each session lasting 45 minutes. Function through anterior knee pain scale, pain through visual analogue scale, strength via hand-held dynamometer, and quality of life via World Health Organisation quality of life brief questionnaire were assessed alongside pressure pain threshold via algometer which was taken as the gluteus medius trigger point. All measurements were taken at baseline and 6 week post-intervention. Data was analysed using SPSS 21.
Results: Of the 64 participants, 38(59.4%) were females and 26(40.6%) were males. There were 32(50%) subjects in group A with mean age 29.50+5.84 years and 32(50%) in group B with mean age 29.50+5.43 years (p>0.05). Both the groups showed a significant reduction in pain, improvement in function, pressure pain threshold, strength, and quality of life (p<0.05). Intergroup comparisons revealed no significant differences (p>0.05).
Conclusion: Treating myofascial trigger points of gluteus medius muscle, using either positional release technique or myofascial release technique together with exercise therapy was found to be equally beneficial.
ClinicalTrials.gov ID: NCT04667091
Key Words: Anterior knee pain, Exercise therapy, Trigger points, Manual therapy.
True brachial artery aneurysm: A systematic review
Authors: Alam Syed Muhammad Hammad , Saima Moin  , Rabia Gilani  , Nida Jawad  , Kiran Abbas  , Aayat Ellahi
Published: January 2024

Objective: To identify and critically appraise literature on true brachial artery aneurysm, exploring its demographic characteristics, aetiologies, clinical manifestations and different methods of repair along with complication rates to determine future treatment strategies.
Method: The systematic review was conducted at Liaquat National Hospital, Karachi, from September 30, 2021, to November 30, 2022, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature was searched on MEDLINE, EMBASE and Cochrane databases for relevant studies in English language or with English translation published till May 31, 2022. The key words used for the search were “brachial artery aneurysm”.  Data was noted on a proforma and was subjected to descriptive analysis.
Results: Of 113 the articles, 6 (5.3%) were retrospective studies, 7 (6.1%) were case series and 100 (88.4%) were case reports. The total number of patients involved was 157 with mean age 43.1+23.4 years (range: 2 months to 84 years). The gender was mentioned for 152(96.8%) patients; 111(73%) and 41(27%) females. The mean diameter of true brachial artery aneurysm was 36.2+17.5mm and 106(67.5%) patients presented with localised swelling, 65(41.4%) with pain, 41(26.1%) with distal ischemic symptoms, and 28(17.8%) with median nerve compression. True brachial artery aneurysms were more common in renal failure patients having a history of arteriovenous fistula creation in the affected limb and were on immunosuppressant drugs due to renal transplant 81(51.5%). Less common causes included primary/idiopathic 27(17.1%), trauma 13(8.2%), connective tissue disorders 8(5%) and vascuilits 7(4.5%).
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Identification of specific codon 201 mutation of the DCC Gene in the colonoscopic specimen of colorectal cancer
Authors: Serwer Tehmina , Mohsin Wahid  , Imtiaz Fauzia , Memon Amjad Siraj
Published: January 2024

Objective: To identify the mutation in codon 201 of the deleted in colorectal cancer gene in colorectal cancer, and to correlate that mutation to the histopathological grading of colorectal cancer.
Method: The cross-sectional study was conducted from February 2019 to February 2021 after approval from the ethics review board of the Dow University of Health Sciences, Karachi, and comprised biopsy-proven colorectal cancer patients regardless of age and gender. After histopathological reporting, formalin-fixed paraffin-embedded tissue blocks of colorectal cancer were used for deoxyribonucleic acid extraction, followed by polymerase chain reaction optimisation and deoxyribonucleic acid Sanger sequencing for mutational analysis. Data was analysed using SPSS 25.
Results: Of the 100 biopsy specimens assessed, 45(45%) were selected. Of them, 13(29%) samples failed to show any band on gel electrophoresis. The remaining 32(71%) samples were used for Sanger sequencing. Of these, 1(3%) sample did not sequence, while 31(97%) showed sequencing. All the sequenced samples identified a mutation in codon 201 of exon 3 in the deleted in colorectal cancer gene; 30(97%) showed homozygosity, and 1(3%) showed heterozygosity. No significant association of point mutation was noted with various demographic and clinicopathological parameters (p>0.05).
Conclusion: The deleted in colorectal cancer gene's missense mutation in codon 201 was frequently observed in colorectal cancer patients.
Key Words: Colorectal cancer, Single nucleotide polymorphism, DCC gene, Codon 201 mutation.
Adaptation and validation of the west haven-yale multidimensional pain inventory for Pakistani population
Authors: Liaqat Hira , Dawood Saima
Published: January 2024

Objective: To evaluate the adapted version of West Haven-Yale Multidimensional Pain Inventory for patients with chronic pain.
Method: The multiphase study was conducted from January to December 2021. The factorial structure of the Urdu version of West Haven-Yale Multidimensional Pain Inventory was evaluated on a sample of adult patients aged 18-45 years with non-specific chronic pain, taken from public and private hospitals and clinics of Lahore, Pakistan. The Urdu version was then subjected to factor analysis, while Cronbach’s alpha, composite reliability, convergent and discriminant validity of the scale were also calculated. Data was analysed using SPSS 24.
Results: Of the 306 subjects, 204(66.7%) were females and 102(33.3%) were men. The overall mean age was 30.94+/-8.44 years. There were 166(54.2%) subjects who were married, and 137(44.8%) reported experiencing pain daily. The confirmatory factor analysis showed a 45-item structure for 12 sub-scales as the best fit. The statistics for the final model were observed as minimum discrepancy function by degrees of freedom divided was 1.69, root mean square error of approximation was 0.05, and standardised root mean square residual was 0.06. Comparative fit index value was 0.91 and Tucker-Lewis coefficient was 0.90. Cronbach’s alpha reliability ranged between 0.68 and 0.89 for the subscales, while for the total scale, it was 0.72.
Conclusion: The Urdu version of West Haven-Yale Multidimensional Pain Inventory was found to be a reliable and valid tool for chronic pain assessment for patients in Pakistan.
Key Words: Chronic pain, Non-specific chronic pain, Psychometrics, Urdu, Pakistan.
Compliance with smoke-free legislation and smoking behaviour: an observational field study in Karachi, Pakistan
Authors: Moorpani Komal , Shaikh Shiraz , Tariq Hira
Published: January 2024

Objectives: To observe compliance with smoke-free law at different public places in an urban setting.
Method: The cross-sectional study was conducted from January to June 2022 after approval from the ethics review board of Jinnah Sindh Medical University, Karachi, at public places, including public and private offices, health institutions, education institutions, malls, markets and eateries, in 5 districts of Karachi. Boundary, entrance, waiting areas/corridors, toilet areas and eating areas were assessed using a checklist for smoke-free law compliance. Places were considered compliant if no smoking activity, cigarette butt litter or ashtrays was found. Data was analysed using SPSS 21.
Results: Out of 400 places observed, there were 80(20%) in each of the 5 districts. Overall, 36(44%) of the venues showed indoor compliance and 10(12%) showed outdoor compliance. Presence of cigarette butts was observed at 350(87.5%) outdoor places around the boundary of the premises. Only 38(9.5%) of the places had no smoking boards outdoors and at the entrance, with 16(4%) being clearly visible. Also, 27(43%) of educational institutions had a cigarette shop within 50 metres of the boundary.
Conclusion: The city was found to have poor implementation of smoke-free laws, especially for outdoor areas, exposing the public to constant second-hand smoke.
Key Words: Smoking, Second-hand smoke, Smoke-free policies, Karachi.
Sports-related concussion history, reporting behaviours, knowledge, and attitudes in Pakistani university student-athletes
Authors: Mahfooz Masood , Noh Young-Eun , Teo Eng Wah , Savila Zubia
Published: January 2024

Objective: To assess student-athletes’ knowledge and attitudes towards sport-related concussions and to investigate concussion history and reporting behaviours.
Method: The cross-sectional, survey-based study was conducted from September 2020 to June 2021 after approval from the research ethics committee of Universiti Malaya, Malaysia, and comprised student-athletes of either gender aged 18 years or above at various universities across Pakistan and who played contact or collision sports for their universities. Data was collected using the Urdu version of the Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version. Data was also gathered about the participants’ self-reported exposure to formal concussion education, previous sport-related concussion history, and reporting behaviours, where applicable. Data was analysed using SPSS 23.
Results: Of the 369 participants, 224(60.7%) were males and 145(39.3%) were females. The overall mean age was 19.95±1.75 years. Among the participants, 327(88.6%) had not received formal concussion education. The mean knowledge score was 12.76±2.73 out of a possible 25 points, and the mean attitude score was 38.63±10.30 out of 75 points. Knowledge had a weak positive correlation with attitude towards sport-related concussions SRC (p<0.05). Females displayed better attitudes towards sport-related concussions than their male counterparts (p<0.05). Overall, 126(34%) participants had experienced sport-related concussion symptoms following a blow to the head in the preceding 12 months, and 81(64.3%) of them had continued playing while being symptomatic.
Conclusion: Pakistani university student-athletes lacked adequate concussion knowledge and held poor attitudes towards sport-related concussions.
Key Words: Brain concussions, Brain injuries, Traumatic, Athletes, Incidence.
Femoral neck system versus dynamic hip screw for fixation of femoral neck fracture in the adult: a meta-analysis
Authors: Qi Long Jiang  , Yong Cao  , Xinwen Bai  , Yu Deng  , Li Yan
Published: January 2024

Objective: To determine the efficacy of femoral neck system compared to dynamic hip screws in treating femoral neck fractures.
Method: The systematic review was conducted from January to March 2023, and comprised literature search on PubMed, Embase, Scopus, Ovid, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure and Wanfang databases for relevant studies published up to March 1, 2023. Study data as well as demographic and outcome parameters related to the patients were extracted, and the methodological index for non-randomised studies was used to assess the risk of bias. Review Manager software was used to conduct meta-analysis.
Results: Of the 567 studies initially found, 6(1%) were included, with the publication date ranging from August 2021 to February 2023. There were 5(83.3%) studies published in English and 1(16.7%) in Chinese. Of the 577 patients with femoral neck fractures, 287(49.7%) were treated with femoral neck system and 290(50.3%) with dynamic hip screws. Significant differences were shown between the two groups regarding operation duration, blood loss, internal fixation failure rate and Harris hip score (p=<0.05). There was no significant differences between the groups regarding time from injury to surgery, hospitalisation, complication rate and femoral neck shortening rate (p>0.05).
Conclusion: The novel femoral neck system could optimise surgical procedures, with shorter operation times and lesser blood loss. The femoral neck system and dynamic hip screws were comparable in terms of complication rates and postoperative hip function.
Key Words: Femoral neck fractures, Internal fixators, Meta-analysis.
Impact of a Mindfulness-Based Intervention on Stress and Burnout among Physical Education Teachers in South Africa
Authors: Gugulethu Jabulisile
Published: January 2024

Abstract

Purpose: The aim of the study was to impact of a mindfulness-based intervention on stress and burnout among physical education teachers

Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.

Findings: This study investigated the impact of an eight-week mindfulness-based intervention on stress and burnout in 24 physical education teachers. The intervention included guided meditations, group discussions, and experiential exercises. Results revealed that the intervention group displayed significantly lower stress and burnout levels compared to the control group at both post-test and follow-up assessments.

Unique Contribution to Theory, Practice and Policy: Stress and Coping Theory, self-determination theory (sdt) & job demands-resources (jd-r) model may be used to anchor future studies on impact of a mindfulness-based intervention on stress and burnout among physical education teachers. Practitioners and program developers should collaborate to create interventions that address the unique stressors and challenges faced by educators in physical education settings. Policymakers in the field of education should acknowledge the potential benefits of mindfulness-based interventions for teacher well-being and, subsequently, for student outcomes.
Role of Information and Communication Technologies in Promoting Financial Inclusion in Rural African Communities in Rwanda
Authors: Mugisha Blessing
Published: January 2024

Purpose: The aim of the study was to investigate role of information and communication technologies in promoting financial inclusion in rural African Communities

Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.

Findings: This transformation has led to increased savings, facilitated seamless payments, and expanded access to credit, contributing to economic growth, poverty reduction, and enhanced financial resilience in rural communities. Nonetheless, persistent challenges such as limited infrastructure and digital literacy gaps underscore the need for ongoing efforts to fully harness the potential of ICTs, making them a crucial driver of rural development and inclusive growth in Rwanda.

Unique Contribution to Theory, Practice and Policy: Diffusion of Innovation Theory, Social Capital Theory & Resource-Based Theory may be used to anchor future studies on role of information and communication technologies in promoting financial inclusion in rural African Communities. Collaborate with technology providers to develop and deploy ICT solutions tailored to the specific needs and preferences of rural African communities. Policymakers should ensure that regulations support innovation, competition, and consumer protection.
Pendidikan Moderasi Beragama pada Masyarakat Moderen (SOCIETY 5.0)
Authors: Faizin Husnul
Published: January 2024

Dalam artikel ini membahas pentingnya pendidikan moderasi beragama bagi kehidupan sosial masyarakat modern (society 5.0). Moderasi beragama merupakan sikap, pandangan, dan perilaku yang tidak ekstrem dalam pengamalan keberagamaan. Dalam konteks kehidupan bernegara, moderasi beragama memiliki posisi urgent dalam mewujudkan keutuhan dan kerukunan kehidupan sosial berbangsa dan bernegara. Salah satu upaya internalisasi dan insersi nilai moderasi beragama dilakukan melalui pendidikan (education) sehingga dapat memperbaiki pemahaman yang keliru tentang konsep beragama pada masyarakat modern (society 5.0).

Pemahaman beragama yang moderat dan inklusif (terbuka) sangat dibutuhkan di era masyarakat modern (society 5.0) yang multicultural dan multiagama sehingga pendidikan moderasi beragama perlu hadir sebagai upaya preventif dari paham beragama yang ekstrim ataupun penyebaran sikap radikalisme di Indonesia.
The brothel system as a social network: an approach to the sexual exploitation of women from a perspective of feminism and social network analysis
Authors: Riganti Ma. Valentina
Published: January 2024

This article reconstructs the sexual exploitation networks that acted in the brothel system of Bahía Blanca and identifies its main actors between 2003 and 2015 from a feminist perspective and using Social Network Analysis (SNA) as a methodology. In the phase that began with post-convertibility, Bahía Blanca, a town located in the southwest of Buenos Aires (Argentina), had a series of geographical, economic and social characteristics that gave it relevance in the national brothel system. In addition, there were local ordinances regulating cabarets and clubs that came into tension with national laws on the prevention of pimping and provided the possibility for sexual exploitation networks to act legally. In this scenario, the main actors moved constantly in the tension between what was legal and what was illegal. The use of diverse sources, ranging from court cases to journalistic articles, analyzed considering the ARS, allowed us to characterize the resulting network and compute the degree centrality and the betweenness centrality of each node. Thus, we were able to recognize the central actors and link their prominence with some attributes they had. Likewise, among the final considerations we point out that the actors, relationships and norms of the brothel system were intertwined with Bahian society and that its operating logic was crossed by the existence of power relations based on gender.