bluuebunny/crossref_metadata_2025 huggingface dataset:
FREQUENCY OF PROTEUS MIRABILIS INFECTION IN RHEUMATOID ARTHRITIS
Authors: Saleem Muhammad Hasan , Nisar Shazia , Saleem Muhammad Zulqurnain , Saleem Husnain , Mukhtar Shoaib , Anjum Muhammad Ali
Published: January 2022

Objective: To assess the frequency of proteus mirabilis infections in patients of rheumatoid arthritis.

Study Design: Cross-sectional study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jul 2018 to Jan 2019.

Methodology: A total of 100 cases of rheumatoid arthritis with urinary tract infection were enrolled. Freshly voided urine samples were obtained and sent to the pathology lab. The serotypes of proteus mirabilis were evaluated by enzyme-linked immunosorbent assay (ELISA) and immunoblotting and presence of proteus mirabilis was noted.

Results: A total of 100 cases of rheumatoid arthritis with urinary tract infection were recruited. The mean age of patients was 61.22 ± 10.18 years. There were total 67 (67%) females and 33 (33%) were males. About 79 (79%) patients had sedentary lifestyle while 21 (21%) had active lifestyle. There were 41 (41%) patients had positive urine culture with proteus mirabilis while 59 (59%) had other organism involved in urine infection.

Conclusion: The high frequency of proteus mirabilis infection has been detected and the frequency was of females with complaint of urinary tract infection was high.
MAGNITUDE OF VANCOMYCIN RESISTANT ENTEROCOCCUS FECAL COLONIZATION AND BACTEREMIA IN PATIENTS WITH HEMATOLOGICAL DISEASES AT TERTIARY BONE MARROW TRANSPLANT CENTRE RAWALPINDI
Authors: Sabir Nargis , Satti Luqman , Ahmed Abeera , Zaman Gohar , Iftikhar Raheel , Din Nasir Ud
Published: January 2022

Objective: To discover the frequency of vancomycin resistant enterococci (VRE) fecal colonization and subsequent bacteremia in patients with hematological diseases in a bone marrow transplant center.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), in collaboration with Armed Forces Bone Marrow Transplant Center, Rawalpindi, from Jan 2016 to Dec 2019.

Methodology: Stool specimens/anal swabs from all enrolled patients were collected aseptically and transported to the laboratory without delay. Blood cultures were collected aseptically from only those enrolled patients who developed signs and symptoms of bacteremia. Stool and blood cultures were processed as per standard microbiological protocols. Enterococci were identified to species level by colony morphology and biochemical tests. Modified Kirby Bauer disc diffusion method and VITEK-2 system (Version-8.01 bio Merieux, France) were used to perform antimicrobial sensitivity of each isolate.

Results: A total number of 246 patients were studied. Among them, 67 (27%) patients had fecal colonization by vancomycin resistant enterococci. We report a statistically significant association of recent hospitalization, prolonged exposure to antimicrobial therapy, chemotherapy exposure and use of indwelling devices during the hospital stay with vancomycin resistant enterococci colonization. Vancomycin resistant enterococci bacteremia was detected in 57 (23%) patients. Among these 57 patients, 53 (93%) were vancomycin resistant enterococci colonizers. Vancomycin resistant enterococci colonization was significantly associated with vancomycin resistant enterococci bacteremia.

Conclusion: A considerable burden of vancomycin resistant enterococci fecal colonization exists among patients with hematological diseases. vancomycin resistant enterococci colonization poses a considerable risk of vancomycin........
OUTCOMES OF VIDEO ASSISTED THORACOSCOPIC DECORTICATION VERSUS CONVENTIONAL OPEN DECORTICATION IN PATIENTS WITH STAGE II OR STAGE III EMPYEMA
Authors: Baloch Ibrahim , Umair Bilal , Asghar Asif , Khan Muhammad Imtiaz , Hanif Muhammad Shoaib , Bilal Azfar
Published: January 2022

Objective: To compare outcomes of video assisted Thoracoscopic Decortication (VATD) with conventional open decortication (COD) in patients with stage–II or stage–III empyema thoracic.

Study Design: Prospective comparative study.

Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi, Pakistan, from Jun 2018 to May 2019.

Methodology: A total 60 patients underwent in this study. Patients of both gender who reported for decortication of empyema thoracic were evaluated. All patients diagnosed to have Stage II or III empyema with age 25-50 years were studied for outcomes. All patients were evaluated for operative time, blood loss, post-operative pain, pneumonitis, duration of airleak and post-operative drainage, duration of chest drains and length of hospital stay.

Results: Mean operative time in group-1 was 133.63 ± 8.55 min and in group-2 was 147.83 ± 10.36 min (p-value 0.037). Mean blood loss in group-1 was 296.66 ± 46.11 while in group-2 was 207.30 ± 53.81. Post-operative pain score on VAS for pain was 5.8 ± 1.7 for group-1 and 4.06 ± 1.4 for group-2 (p-value 0.032). Chest tubes were retained for an average of 5.58 ± 0.8 days in group-1 while 3.86 ± 0.8 days in group-2 (p-value <0.001).

Conclusion: Video-Assisted Thoracoscopic Surgery Decortication is superior to open decortication in operative management of Stage II and Stage III Empyema thoracic in terms of post op pain, duration of chest intubation, air leak and hospital stay of the patient.
EFFECTS OF NOISE STRESS ON THYROID STIMULATING HORMONE IN ADULT RATS
Authors: Safdar Saba Saleem , Qamar Khadija , Mehboob Khadija , Faisal Tayyaba , Atta Fahad , Ambreen Aisha
Published: January 2022

Objective: To determine the effect of noise stress on Thyroid Stimulating Hormone in adult rats.

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 to Dec 2020.

Methodology: A total of 30 adult Sprague Dawley rats were distributed into three groups as ten rats/group. Group A served as the control group, rats in group B were exposed to 100 dB noise for continuous 4 hours/day for four months, and the rats in group C were exposed to 100 dB noise for continuous 6 hours/day for four months. At the end of the study, serum samples were collected from the rats’ tail veins. Thyroid-stimulating hormone levels were compared among the groups.

Results: At the start of the study, mean serum thyroid stimulating hormone level of control group A rats was 0.34 ± 0.15 µIU/ml. Mean serum thyroid stimulating hormone level of experimental groups B and C rats at the start of the study was 0.46 ± 0.18 µIU/ml and 0.41 ± 0.14 µIU/ml, respectively Mean serum thyroid stimulating hormone of rats did not differ statistically significantly between the group p=0.26, By the end of study mean serum thyroid stimulating hormone level of control group. A rats was 0.6 ± 0.2 µIU/ml. Mean serum thyroid stimulating hormone levels of experimental groups B and C rats at the end of the study were 1.32 ± 0.35 µIU/ml and 1.86 ± 0.67 µIU/ml, respectively.......
A COMPARATIVE STUDY REGARDING PAIN PERCEPTION AMONG MALES AND FEMALES OF UNIVERSITY STUDENTS IN PUNJAB, SINDH & BALOCHISTAN
Authors: Tasmeera Saiyida , Akhtar Tanvir , Kiani Shoaib , Afaq Yasir Masood , . Naveeda
Published: January 2022

Objective: To compare gender differences on pain perception in Pakistani culture.

Study Design: Cross-sectional study.

Place and Duration of Study: Public and private universities of Rawalpindi, Islamabad, Gujrat, Karachi, and Quetta, from Mar to May 2019.

Methodology: A scale of religious identity was developed (n=300). Additionally, participants (n=240) were assigned to pain condition and no pain condition (control condition). Pain condition made them aware of headaches, while the control condition made them aware of death. Participants in both conditions were informed to jot down their emotions. They were also pro-vided Positive and Negative Affect Schedule (PANAS), a distractor task in the form of a story followed by a religious identity scale to compare the difference in percentages of males and females in pain and no pain perception on religious identity.

Results: The alpha reliability of the religious identity scale was 0.60 depicting a moderately internally consistent scale. Furthermore, the findings of the present study showed significant gender differences on pain perception. Mean values indicated high score for females (226.39 ± 28.43) than males (216.39 ± 31.73) in pain condition and similar was the case of no pain condition for females (130.81 ± 23.27) and males (133.35 ± 20.06). Whereas, males 33 (63.04%) were high on religious identity as compared to females 35 (56.06%) in pain condition whereas females 34 (50.84%) were high in no pain condition on religious identity as compared to males 22 (37.31%).

Conclusion: Findings suggested that significant differences exist between males and females in perceiving pain.
LOCAL ANAESTHETIC SYSTEMIC TOXICITY AWARENESS AMONG CLINICAL PRACTITIONERS
Authors: Abbas Sana , Akram Amjad , Abbas Beenish , Fayyaz Mohsin , Mehmood Basit , Hayat Umer
Published: January 2022

Objective: to assess comprehension of local anaesthetic systemic toxicity among clinical practitioners.

Study Design: Cross-sectional study.

Place and Duration of Study: Tertiary Care Institute, from Dec 2019 to Mar 2020.

Methodology: Methodology constituted of a web-based questionnaire. A pilot study carried out at 15-20 participants forquestionnaire validation and reviewed by independent experts for face validity, a final questionnaire comprised of 10 multiple-choice questions in addition to demographic profile.

Results: A total of 950 participants participated in the study and data was extracted from their responses. Out of 738 (77.8%) participants declared that they are unaware of local anaesthetic systemic toxicity complication, 26 (2.7%) encountered local anaesthetic systemic toxicity and 185 (19.5%) never experienced. Ninety (9.5%) were aware of the availability and utilization of 'Lipid Emulsion' therapy to treat ‘Local Anaesthetic Systemic Toxicity’ (LAST).

Conclusion: Although clinicians have significant awareness level regarding local anaesthetic toxicity but unfortunately compliance with management of this life-threatening complication is deficient.
EVALUATION OF PROGNOSTIC FACTORS IN PATIENTS WITH RELAPSED HODGKIN’S LYMPHOMA UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANT
Authors: Iftikhar Jhanzeb , Sarwar Hafiz Abubakar , Sheikh Fareeha , Shah Mohammad Iqbal , Khan Shafqual Ali , Bakar Muhammad Abu , Siddiqui Neelam
Published: January 2022

Objective: To identify the prognostic factors in relapsed Hodgkin’s Lymphoma patients with regards to their impact on the outcome of autologous hematopoietic stem cell transplant.

Study Design: Retrospective observational study.

Place and Duration of Study: Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Jun 1999 to Jun 2019.

Methodology: Out of a total of 2061 Hodgkin’s Lymphoma patients, 37 (1.8%) patients with relapsed disease underwent autotransplant and were studied using the Hospital Information System. We obtained details of clinicopathological factors, treatment, and outcome. In our study, the outcome variable was event after transplant (relapse/disease progression/death).

Results: Among the 37 relapsed Hodgkin’s Lymphoma patients undergoing auto-transplant, 24 (64.9%) patients had an early relapse after first-line chemotherapy. In this early relapse group of 24 patients, 9 (37.5%) remained well after auto-transplant but 15 (62.5%) patients had an event. Out of 37 relapsed Hodgkin’s Lymphoma patients undergoing auto-transplant, a complete response on pre-transplant imaging was observed in 24 (64.9%) patients. In those 24 patients with a complete response on pre-transplant imaging, 16 (66.7%) patients remained well after transplant while 8 (33.3%) patients had a worse event. Twoyear progression-free and overall survival proportions were 56% and 77% respectively.

Conclusion: Complete metabolic response on pre-transplant imaging was associated with better overall survival. Adverse factors observed were initial short duration of complete response, bulky disease at relapse, variables comprising international prognostic score, B symptoms, and raised erythrocyte sedimentation rate at relapse.
THREAT OF COVID-19 AND PERCEIVED STRESS: THE MEDIATING ROLE OF CHALLENGE, UNCONTROLLABILITY AND STRESSFULNESS
Authors: Bilal Ahmad , Aamir Minahil
Published: January 2022

Objective: To find out the mediating role of challenge, uncontrollability, and stressfulness in predicting perceived stress from threat during COVID-19 pandemic in the general public.

Study Design: Cross-sectional survey.

Place and Duration of Study: Bahawalpur City, from Mar to May 2020.

Methodology: A total of 360 participants (men=154, women=206) were recruited from different cities of Punjab province. The stress appraisal measure, perceived stress scale, and coping scale were administered through Google forms using social media platforms. The participation in the online survey implied signing the written informed consent available in the survey.

Results: The primary and secondary appraisals of challenge (IE=0.84, SE=0.27, 95% LL=0.31, 95% UL=1.40), uncontrollability (IE=1.03, SE=0.36, 95% LL=0.34, 95% UL=1.76), and stressfulness (IE=-0.28, SE=0.12, 95% LL=-0.56, 95% UL=-0.08) fully mediated the relationship between threat of COVID-19 and perceived stress. Additionally, there was statistically significant positive relationship between threat of COVID-19 and use of coping strategies (r=0.14, p<0.01). The statistics of women regarding appraisals of threat, uncontrollability, stressfulness and perceived stress (2.94 ± 0.88); (2.49 ± 0.84); (2.87 ± 0.73); (19.92 ± 6.08), were found to be slightly higher on as compared to men (2.76 ± 0.82); (2.25 ± 0.81); (2.58 ± 0.76); (18.41 ± 5.37) respectively with p=0.01, Cohen’s d=0.21); p=0.001, Cohen’s d=0.29); p=0.001, Cohen’s d=0.38); (p=0.01, Cohen’s d=0.26).

Conclusion: The threat of COVID-19 significantly led to the experience of perceived stress through the mediating role of primary and secondary appraisals of challenge, uncontrollability, and stressfulness.
HAEMATOLOGICAL PROFILE DERANGEMENTS IN PATIENTS DUE TO NON-RESISTANT AND RESISTANT TYPHOID FEVER
Authors: Tashfeen Sunila , Asif Naveed , Farooq Muhammad
Published: January 2022

Objective: To assess and compare the frequency of haematological parameter derangements in patients due to non-resistant and extended drug resistant (XDR) typhoid fever.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Pathology Department of Combined Military Hospital Quetta, from Jan to Dec 2019.

Methodology: A total number of 172 blood culture Salmonella positive patients irrespective of age and gender were included in this study. Salmonella strains were isolated and grouped further according to their drugs sensitivity. 3ml venous blood was collected from these patients in Ethylene diamine tetra acetic acid container and blood complete count was done by semiautomated haematology analyser XP-100.

Results: There were 126 (73%) males and 46 (27%) females with mean age of 17.5 ± 10.3 years. Out of 172 subjects, 106 (61.6%) had non-resistant typhoid and rest 66 (38.4%) were diagnosed with extended drug resistant Typhoid. We compared anaemia, leucopenia and thrombocytopenia between two groups and found anaemia statistically significant with the p-value of 0.001.

Conclusion: This study has documented that changes in haematological parameters are significant in typhoid fever and early patients diagnosis, management and disease course can be monitored with them. Patients with significant anaemia and not responding to first line therapy should be considered as a case of extended drug resistant (XDR) Salmonella.
HEPATITIS B AND HEPATITIS C SEROPOSITIVE SURGICAL CASES AND ITS IMPACT ON PERIOPERATIVE BLOOD TRANSFUSION
Authors: Ikram Mobeen , Mahboob Saira , Yusuf Rizwan
Published: January 2022

Objective: To evaluate the frequency of Hepatitis B and Hepatitis C on our surgical patients and its impact on operation theater delay, change of anesthesia plan and requirement of perioperative blood and blood products transfusion.

Study Design: Cross sectional, analytical study.

Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital, Okara, from Apr to Sep 2019.

Methodology: After the approval of the hospital ethical review committee, 154 patients with either Hepatitis B or Hepatitis C undergoing various surgeries were included in our study. Data was analyzed using SPSS-20.

Results: The overall frequency of chronic liver disease was 154 (4.71%). A total of 23 (0.70%) were found to be seropositive as viral Hepatitis B and 127 (3.88%) as Hepatitis C; whereas 4 (0.12%) patients were diagnosed to have both virus serology positive. There was mean delay of 26.2 ± 8.29 minutes in 78 (52%) patients. The anesthetist had to change the plan of anesthesia for only 1 (0.7%) patient. There was also no difference in frequency of change of anesthesia plan (p=0.35); delay in surgery (p=0.16) and blood transfusion between the patients with Hepatitis B or Hepatitis C infection (p=0.72).

Conclusion: The frequency of Hepatitis B and Hepatitis C was lower (4.71%) in our surgical patients with no effect of Hepatitis B and Hepatitis C on blood loss, peri-operative transfusion, delay in surgery or change in anesthesia plan.
DIAGNOSTIC UTILITY OF SERUM LACTATE DEHYDROGENASE LEVELS (LDL) IN DIFFERENTIATING MEGALOBLASTIC ANEMIA FROM MYELODYSPLASTIC SYNDROMES IN PAKISTAN
Authors: Rana Faraz Ali , Robert Helen Mary , Ilyas Madiha , Mahmood Asad , Amir Muhammad , Khan Nabeela
Published: January 2022

Objective: To study the diagnostic utility of lactate dehydrogenase levels in differentiating megaloblastic anemia from myelodysplastic anemia in Pakistan.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from Feb, 2019 to Aug, 2019.

Methodology: In this study, total 240 patients (18-75 years of age) males and females were selected by consecutive sampling technique and were equally divided into 3 groups; patients with megaloblastic anemia, patients with myelodysplastic syndromes and healthy control group. The clinical history and duration of anemia were recorded on special designed proforma. The laboratory investigations including lactate dehydrogenase levels were also noted. Both types of anemia were compared on basis of Lactate Dehydrogenase Levels.

Results: The lactate dehydrogenase levels in megaloblastic group were more than 3000 IU/L in 58 out of 80 patients (72.5%). On other hand, myelodysplastic group had 79 out of 80 patients with lactic acid dehydrogenase levels below 450 IU/L (98.75%). The difference in lactic acid dehydrogenase levels between both groups was found to be statistically significant.

Conclusion: Serum lactate dehydrogenase levels can be used to differentiate megaloblastic anemia from other anemia especially myelodysplastic syndromes before doing a bone marrow examination. High lactate dehydrogenase levels above 3000 IU/L in megaloblastic anemia can differentiate it from other anemia.
COMPARISON OF DEPRESSION, ANXIETY AND STRESS SCORE AMONG CLINICAL AND NON-CLINICAL HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC
Authors: Iqbal Mishal , Iqbal Mehak , Iftikhar Nadia , Inam Syed Hashim Ali , Jamil Hamza , Nisar Shazia
Published: January 2022

Objective: To assess the psychological impact of COVID-19 pandemic on healthcare workers.

Study Design: Cross sectional study.

Place and duration of Study: Armed Forces Institute of Cardiology/National Institute of Health Diseases in June 2020.

Methodology: A total of 317 healthcare professionals, of different designations, affiliated with different public and private sector hospitals in Pakistan participated in this project. They were asked to complete Depression, anxiety and stress scales-42 (DASS-42).

Results: Out of 317 healthcare workers, 107 (33.75%), 111 (35.02%), 103(32.49%) were depressed, anxious and stressed respectively. Female gender was associated with a higher prevalence of depression, anxiety and stress.

Conclusion: More than one third of healthcare workers were depressed, anxious or stressed during the COVID-19 pandemic. Two out of five female healthcare workers were suffering from depression, anxiety or stress.Keywords:,  , .
TECHNETIUM-99M MIBI GATED MYOCARDIAL PERFUSION SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IMAGING – VALIDATION OF STRESS ONLY PROTOCOL
Authors: Dar Zaigham Salim , Raza Mehdi , Atif Muhammad , Bukhari Aown Raza
Published: January 2022

Objective: To validate ‘stress only’ protocol against ‘rest stress protocol in normal and essentially normal cases undergoing Tc99m MIBI gated myocardial perfusion Single Photon Emission Computed Tomography imaging.

Study Design: A retrospective observational study.

Place and Duration of Study: Department of Nuclear Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi, Pakistan, from Jul to Sep 2019.

Methodology: 136 cases were included. Patients underwent Tc-99m gated Single Photon Emission Computed Tomography MPI using a single day, rest/stress protocol. The rest study was performed first with 8-10 mCi Tc-99m MIBI followed by stress study, 3 hours later with 3 times the rest dose. The most common stress technique was pharmacological stress and bicycle ergometer exercise with 0.14 mg/kg/min adenosine infusion. Few patients underwent physical stress using Bruce protocol, achieving a minimum of 85% of the target heart rate. Mages–stress followed by rest–were evaluated by two experienced nuclear cardiologists (blinded to the MPI reports) and interpreted as ‘normal’ or ‘essentially normal’.

Results: Evaluation of stress-only and rest-stress Single Photon Emission Computed Tomography myocardial images yielded a concordance rate of 84.56% with Cohen’s kappa coefficient of 0.69.

Conclusion: Substantial agreement and good concordance were found in normal and essentially normal ‘stress only’ and ‘rest stress protocols.
ADHESIVE CAPSULITIS; MANAGEMENT BY PHYSIOTHERAPY VERSUS INTRA-ARTICULAR CORTICOSTEROID INJECTION
Authors: Hashmi Muhammad Umair , Chughtai Babar Bakht , Ahsan Muhammad Nadeem
Published: January 2022

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale.

Study Design: Comparative prospective study.

Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021.

Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale.

Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05).

Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.
THE ASSOCIATION OF CATARACT TYPE ON CENTRAL CORNEAL THICKNESS AFTER PHACOEMULSIFICATION CATARACT SURGERY
Authors: Abbas Hussnain , Rauf Abdul , Perveen Shagufta , Mehmood Shahid Hamid , Hussain Irshad , Naimat Khalid
Published: January 2022

Objective: To assess any association between the type of cataract and the central corneal thickness at pre-operative and postoperative three-day and one-month appointments after phacoemulsification surgery.

Study Design: Prospective, comparative study.

Place and Duration of Study: Eye Department Combined Military Hospital Multan, from Jun 2020 to Apr 2021.

Methodology: A total of 89 patients requiring cataract surgery by phacoemulsification were recruited. Age and gender were recorded for each patient. Patient’s type of cataract based on maturity was recorded before the surgery. Phacoemulsification cataract surgery using ‘divide and conquer’ technique was carried out. Patients’ central corneal thickness was measured at the pre-operative, three-day post-operative and one-month post-operative appointment using traditional non-contact tonopachymeter.

Results: There were 49 (55.1%) male and 40 (44.9%) female patients with a mean age of 62.15 ± 12.40 years. No significant association was found between the type of cataract and central corneal thickness at the three-time intervals (p=0.14). Central corneal thickness significantly increased from 0.48 ± 0.04 mm pre-operatively to 0.51 ± 0.04 mm at the three-day post-operative appointment (p<0.001). It then reduced to 0.49 ± 0.04 mm at the one-month appointment (p=0.01).

Conclusion: The type of cataract is not associated with the variation in central corneal thickness due to cataract surgery. Central corneal thickness significantly increases from the pre-operative to right after the cataract surgery. However, it returns to preoperative levels after a one-month period.
IMMUNOEXPRESSION OF CD-10 IN BASAL CELL CARCINOMA AND SQUAMOUS CELL CARCINOMA OF HEAD AND NECK
Authors: Ilyas Maria , Rafiq Muhammad Yasir , Farhan Farha , Ali Misbah , Afzal Saeed , Niazi Zainab
Published: January 2022

Objective: To compare the expression of CD-10 in basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from Jun 2016 to Jun 2017.

Methodology: After taking ethics approval from the ethical review committee AFIP, previously diagnosed, thirty-eight cases of each basal cell carcinoma and squamous cell carcinoma were taken from the histopathology department of Armed Forces Institute of Pathology, Rawalpindi. CD-10 was applied according to standard protocol. The intensity of the CD-10 expression is assessed and categorized into three groups. CD-10 expression less than 10% in the tumour cell was taken as negative (-), 10 to 50% staining was taken as positive (+) and greater than 50% staining in tumour cells was taken as strong positive (++).

Results: Out of the total 76 cases included in the study, 9 (24%) were strongly positive (++) whereas 20 (52.6%) were positive (+) and 9 (23.7%) were negative (-) for CD-10 expression. Out of the total 38 cases of SCC 4 (11%) cases showed positive CD-10 expression and 34 (89%) showed negative (-) results. A significant association (p-value <0.001) was seen when CD-10 expression in BCC was compared with SCC.

Conclusion: CD-10 expression was higher in basal cell carcinoma when compared to squamous cell carcinoma in which CD-10 expression was very low/absent, hence CD-10 can serve as a useful adjunct marker in differentiating between basal cell carcinoma and squamous cell carcinoma in problematic cases.
IMPACT OF CANCER ON QUALITY OF LIFE & DEPRESSION AMONG CAREGIVERS
Authors: Khan Mahwash Zulfiqar , Qamar Nusrat , Ahmad Shahbaz , Siddique AbuBakar
Published: January 2022

Objective: To determine the impact of cancer on quality of life and depression among caregivers.

Study Design: Cross-sectional survey.

Place and Duration of Study: Anmol Hospital, Lahore, from Jul 2019 to Jan 2020.

Methodology: Data collected from caregivers of female cancer patients by purposive sampling technique using Standardized Questionnaire of Caregiver Assistance Scale and emotional distress was assessed by the Profile of Mood States. Data were entered into Statistical Package for Social Sciences for statistical analysis.

Results: Among 110 participants (caregivers of female cancer patients) 28 (25.5%) were female while 82 (74.5%) were male caregivers. Patients other than breast cancer were 79 (71.8%), while breast cancer patients were 31 (28.2%). There was a significant association between caregiver health, quality of life and level of depression, one year ago, and at current with p-values= 0.001, 0.001 and 0.01 respectively.

Conclusion: There was a negative impact on the health and quality of life of caregivers. Their health was better in the beginning but with time, their lives became more difficult.
EARLY OUTCOMES OF FLEXIBLE INTRAMEDULLARY NAILING IN PEDIATRIC SHAFT OF FEMUR FRACTURES
Authors: Hashmi Muhammad Umair , Ahsan Muhammad Nadeem , Chughtai Babar Bakht , Majeed Saqib
Published: January 2022

Objective: To study the early outcomes and complications of fixation of pediatric shaft of femur fractures using flexible intramedullary nail.

Study Design: Prospective observational study.

Place and Duration of Study: Orthopedic Department, Bahawal Victoria Hospital Bahawalpur, from Jan to Jun 2021.

Methodology: Children between the ages of 5-11 years with shaft of femur fractures were included in the study. Fixation of fracture was done using elastic intramedullary nail. Final outcomes of fixation were observed using Flynn and Schwend Scoring System. Six-month follow-up was done in all cases. Data was analyzed using SPSS-20.

Results: Total 70 cases having shaft of femur fracture were included in the study. Age range of cases was 5-11 years with mean age of 7.75 ± 1.66 years and mean weight of 24.44 ± 4.77 kilograms. Mean diameter of femur medullary canal was 7.48 ± 0.63 millimeters and mean diameter of flexible nail was 3.03 ± 0.26 millimeters. Mean post-operative period of radiological union of fracture was 8.57 ± 1.05 weeks. Per-operatively, fracture site was approached in 4 (5.7%) cases. Migration of nail was not seen in any case. Final outcomes according to Flynn and Shwend Score were excellent in 62 (88.5%), satisfactory in 7 (10%) and poor in 1 (1.4%) case.

Conclusion: Fixation of shaft of femur fracture using flexible intramedullary nailing technique is safe and reliable with good outcomes among children between 5-11 years of age.
PATIENT AND OBSERVER SCAR ASSESSMENT FOLLOWING BASAL CELL CARCINOMA SURGERY: MULTICENTER QUASI EXPERIMENTAL STUDY
Authors: Tahir Moizza , Ali Ghazanfar , Ahmad Najia , Khan Jauhar Mumtaz , Sadiq Sakina , Tahir Muhammad Ali
Published: January 2022

Objective: To assess patient and observer reported scar quality after Basal cell carcinoma surgery of face using the Patient and Observer Scar Assessment Scale (POSAS).

Study Design: Quasi experimental study.

Place and Duration of Study: Dermatology Department, Tertiary Care Hospitals at Multan and Karachi and Plastic Surgery Department, Tertiary Care Hospital Multan, from Apr to Sep 2020.

Methodology: Patients with basal cell carcinoma that full filled inclusion and exclusion criteria were enrolled by consecutive sampling technique at Dermatology and Plastic Surgery Department after informed consent. Surgical excision was followed by reconstruction of defect either by direct closure or by rotation or advancement flap. Surgical scar was assessed independently at 8 weeks by POSAS. Data was analyzed with SPSS-23.

Results: A total of 27 patients were enrolled in study. There were 11 (37.9%) males and 16 (59.25%) females between ages of 45-70 years. Basal cell carcinoma was located on cheek in 15 (55.5%), nose in 9 (33.3%), temple 2 (7.4%) and forehead 1 (3.7%) cases. Direct closure was performed in 6 (22.2%), rotation flaps in 10 (40.7%), and advancement flaps in 11 (40.7%) cases. Mean score of observer opinion about surgical scar between different surgical techniques was not statistically significant (p=0.191). How-ever, mean score of patient opinion of scar between different surgical techniques was statistically significant (p=0.032).

Conclusion: POSAS is a valid tool for scar evaluation by patient and observer-reported scar qualities after Basal cell carcinoma surgery.
MYRINGOTOMY FOR THE TREATMENT OF OTITIS MEDIA WITH EFFUSION; A COMPARISON IN THE OUTCOME WITH AND WITHOUT GROMMET INSERTION
Authors: Akhtar Sunarays , Gul Uzma , Jawaid Arfat , Azam Khalid , Niazi Muhammad Sohail Babur , Najam Atif
Published: January 2022

Objective: To compare the outcome of myringotomy with and without grommet insertion in the patients of otitis media with effusion in terms of improvement of hearing in a one-month follow-up.

Study Design: Quasi experimental study.

Place and Duration of Study: Pakistan Airforce Hospital Jacobabad and Combined Military Hospital Lahore Pakistan, from Jan to Dec 2020.

Methodology: A total of 28 patients aged 4-12 years diagnosed to have conductive hearing loss due to otitis media with effusion not responding to medical treatment were included. Non probability convenience sampling was done. Children aged less than 4 years and above 12 years were not included in the study. They were randomly divided into two groups of 14 patients each using lottery method. Group A underwent myringotomy alone whereas group B underwent myringotomy with grommet insertion. Patients in both groups also underwent adenoidectomy on case-to-case basis. Both groups were compared in terms of improvement in hearing post operatively in a one-month follow-up.

Results: There was statistically significant reduction in air bone gap at the end of follow up period as compared to preoperative air bone gap in group B (p=0.007). In group A there was statistically significant reduction in air bone gap at one week (p=0.002) however this improvement was not maintained at 4 weeks (p=0.386).

Conclusion: Myringotomy with grommet insertion had significantly more patients with improved hearing as compared to myringotomy alone after one month.
EFFICACY OF ANTIOXIDANT WITH ALOE VERA GEL VERSUS INTRA-LESIONAL STEROIDS IN THE MANAGEMENT OF ORAL SUBMUCOUS FIBROSIS - A PROSPECTIVE COMPARATIVE STUDY
Authors: Tahir Muhammad , Abbas Asim , Nawaz Faiz Ul Hassan , Raza Mohsin , Rafique Atif , Niazi Muhammad Sohail Babar
Published: January 2022

Objective: To compared efficacy of alpha lipoic acid (antioxidant medication) and aloe vera gel together versus intralesional steroids (hydrocortisone) in management of oral submucous fibrosis by evaluating post treatment clinical features of mouth opening and burning sensation.

Study Design: A prospective comparative study.

Place and Duration of Study: Department of ENT, Combined Military Hospital, Malir Karachi, from Jul 2018 to Mar 2020.

Methodology: Twenty-eight patients were involved in the research and were distributed into two groups, I and II. Alpha lipoid acid with aloe vera gel was given in group I and hydrocortisone was given in group II. Burning sensation and mouth opening were recorded both at start and at monthly interval later on for three consecutive months. The data collected were statistically analyzed by using SPSS-22.

Results: A significant lessening in burning sensation (p<0.001) and improvement in mouth opening were noticed in both groups. However, comparison between alpha lipoic acid with aloe vera gel group versus hydrocortisone group showed almost similar results.

Conclusion: Alpha lipoic acid and aloe vera gel can significantly improve oral submucous fibrosis clinically. So, these can be utilized as an alternative option in cases where intralesional steroid is poorly tolerated or is contraindicated.
THE MANAGEMENT OF PATIENTS PRESENTED WITH BLACK STONE POISONING: AN EXPERIENCE OF A TERTIARY CARE HOSPITAL
Authors: Haqdad Mehwish , Qureshi Sameer , Ahmed Anam
Published: January 2022

Abstract
El potencial de OneNote para el desarrollo de la competencia digital docente
Authors: Mena Octavio Manuela , González Argüello María Vicenta
Published: January 2022

La situación de pandemia generada por la COVID-19 ha puesto en jaque a los diferentes agentes de la comunidad educativa, obligándolos a realizar una transición forzosa a modelos de aula cada vez más digitalizados y tecnológicos. Esta precipitada migración hacia un nuevo paradigma educativo ha supuesto un aumento de la carga de trabajo para los docentes, quienes han tenido que reestructurar y repensar los contenidos y materiales didácticos hasta ahora empleados en el modelo de aula tradicional. Asimismo, el desarrollo de la competencia digital docente (CDD) se ha convertido en el principal objetivo de las instituciones educativas con el fin de satisfacer las nuevas demandas del proceso de enseñanza-aprendizaje y limitar, a su vez, las desigualdades entre el alumnado derivadas de la carencia de una CDD efectiva. En este contexto se presenta el Cuaderno Digital Colaborativo de Observación (CDCO), una propuesta de plan de observación y formación interno desarrollada en OneNote con el objetivo de favorecer la observación entre iguales y desarrollar la competencia digital docente en contexto.
ÜRETİM SİSTEMLERİNDEKİ DİJİTAL DÖNÜŞÜMÜN İŞ ETÜDÜ TEKNİKLERİ ÜZERİNDEKİ ETKİSİ
Authors: ADEM Aylin , YILMAZ KAYA Burcu , ÇAKIT Erman , DAĞDEVİREN Metin
Published: January 2022

Amaç: Endüstri 4.0 ile hızlı bir dijitalleşme süreci emek yoğun işletmeler le birlikte tüm işletmeler için kaçınılmaz olmuştur. Öte yandan geleneksel iş etüdü teknikleri verimlilik ölçüm ve izlemede oldukça kritik bir role sahiptir. Bu çalışmada iş etüdü tekniklerinin dijitalleşme sürecindeki rolü ve değişimine yönelik bir araştırma ve değerlendirme yapılması amaçlanmıştır.
Yöntem: İlgili değerlendirmeyi yapmak için ele alınan tekniklere ilişkin kapsamlı literatür araştırması ve gerçek dünya örneklerinin incelenmesi şeklinde bir yol izlenmiştir.
Bulgular: Dijitalleşen iş süreçleri karşısında iş etüdü tekniklerinin gösterdiği tepki incelendiğinde, geleneksel tekniklerinin bu dönüşüm sürecine büyük oranda adapte olduğu söylenebilir. Endüstri devriminde işletmelerin dijitalleşmesinde kritik rol oynayan yapay zekâ tekniklerinin iş ölçümü tekniklerindeki dijitalleşmeyi de tetiklediği görülmektedir. Dahası, geleneksel iş etüdü tekniklerinin, işletmelerin Endüstri 4.0’a geçiş süreçlerinde ortaya çıkan ihtiyaçlarına yapay zekâ ve Endüstri 4.0 ile birlikte gelen diğer dijital teknikler ile bütünleşerek uyum sağladığı görülmektedir.
Özgünlük: Üretim ortamlarındaki dijital dönüşüm süreçlerinin geleneksel iş etüdü teknikleri üzerindeki etkisinin incelenmesi, değişimin analiz edilmesi, bununla birlikte ilgili tekniklere yönelik bir gelecek projeksiyonunun sunulması bu çalışmayı özgün kılmaktadır.
Sistem Pendukung Keputusan Penilaian Widyaiswara Pendidikan dan Pelatihan CPNS Menggunakan Metode TOPSIS Pada BPSDM Sulawesi Tenggara
Authors: Bakrim La Ode , Susanto Aris , Wahid Omar
Published: January 2022

Penelitian ini bertujuan untuk mengembangkan sistem pendukung keputusan yang dapat mengevaluasi widyaiswara pelatihan CPNS pada BPSDM Provinsi Sulawesi Tenggara. Metode pengumpulan data yang digunakan dalam penelitian ini yaitu studi literatur, observasi, dan kuisioner. Sedangkan metode analisis data yang digunakan yaitu algoritma TOPSIS dengan merangking setiap widyaiswara berdasarkan nilai preferensi yang diperoleh. Hasil pengujian akurasi metode TOPSIS dalam penelitian ini sangat rendah. Namun, berdasarkan alternatif keputusan yang direkomendasikan TOPSIS memiliki kesesuaian dengan alternatif yang direkomendasikan secara konvensional.
The observee’s paradox
Authors: Rutten Gijsbert , Krogull Andreas
Published: January 2022

Ego-documents are at the heart of historical sociolinguistics. Contrary to what a label such as ego-document may suggest, Early and Late Modern ego-documents constitute a heterogenous group of genres comprising, among others, private letters, diaries and travel journals. Empirical studies have shown that there are important linguistic differences between private letters on the one hand, and diaries/journals on the other. The latter often seem surprisingly standard-like or formal. Theoretical models of register variation and conceptual orality can partially explain the differences, without however offering a full explanation of the surprising formality of diaries/journals. We argue that it is crucial to take into account recent work by social historians concerning diaries/journals in the eighteenth and nineteenth centuries. Diary-writing was an inherently reflexive practice allowing authors to reflect on their lives, and to create a textually fixed point of reference. Authors of diaries had a variable and multilayered audience in mind of known and unknown readers. We introduce the observee’s paradox: while creating private texts for themselves in which they were their own observers and observees, authors of diaries also reckoned with unknown readers in a possibly distant future, which prompted them to shift into a more formal or standard-like register.
MINERÍA DE AMIANTO: UNA APROXIMACIÓN A LOS RIESGOS TECNOLÓGICOS AMBIENTALES Y LA SALUD OCUPACIONAL
Authors: Nunes Antônio José Ribeiro
Published: January 2022

Brasil es uno de los mayores productores mundiales de asbesto o asbesto, este constituye un mineral, cuyo ﬁbrilo natural tiene sedosidad y propiedades físicas y químicas de gran valor para la industria automotriz y de la construcción, debido a su resistencia mecánica y capacidad para soportar altas temperaturas. El amianto tiene un alto riesgo para la salud humana, con efectos devastadores. La minería en el Estado de São Paulo y Río de Janeiro fue prohibida, en vista de los problemas de los trabajadores afectados por la asbestosis, pero dada su gran escala de uso en la industria nacional, la mayoría de las regiones brasileñas continúan con las actividades mineras. El propósito de este artículo es demostrar los riesgos tecnológicos y ambientales en las actividades productivas contemporáneas de la minería del asbesto. Su objetivo es demostrar los riesgos inminentes de las operaciones, los efectos sobre el cuerpo humano en los trabajadores con exposiciones prolongadas; enfermedades profesionales resultantes de la exposición continua al mineral. Los resultados muestran que el uso a gran escala en grandes sectores de producción determina su uso mediante la aplicación de medidas restrictivas y límites de exposición de los trabajadores. Aun así, este tema sigue siendo controvertido, considerando que São Paulo y Río de Janeiro abolieron el uso del asbesto ante los efectos negativos en la salud de los trabajadores. La Confederación Nacional de Trabajadores de la Industria – CNTI ha buscado alternativas en vista de la importancia del asbesto en la economía nacional, cuyas tendencias son la extracción controlada y la inspección con métodos de pruebas de contaminación ambiental y el uso obligatorio de EFI.
Introducing: Queer Theory (in Three Shorts)
Authors: Basiuk Tomasz
Published: January 2022

Antke Antek Engel, member of the editorial board of InterAlia, co-operated with Filmfetch (Magda Wystub; Tali Tiller) and FernUniversität Hagen to create three educational films which discuss the tenets of queer theory in a manner suitable for non-academic viewers. The films were released in 2021 and are available on the university’s website:
https://e.feu.de/queer-theory-videos
and on Youtube:
https://www.youtube.com/channel/UCh98rBDWATF6bkxKNvpR4gQ
Dealing with spatial heterogeneity in pointwise-to-gridded- data comparisons
Authors: Souri Amir H. , Chance Kelly , Sun Kang , Liu Xiong , Johnson Matthew S.
Published: January 2022

Abstract. Most studies on validation of satellite trace gas retrievals or atmospheric
chemical transport models assume that pointwise measurements, which roughly
represent the element of space, should compare well with satellite (model)
pixels (grid box). This assumption implies that the field of interest must
possess a high degree of spatial homogeneity within the pixels (grid box),
which may not hold true for species with short atmospheric lifetimes or in
the proximity of plumes. Results of this assumption often lead to a
perception of a nonphysical discrepancy between data, resulting from
different spatial scales, potentially making the comparisons prone to
overinterpretation. Semivariogram is a mathematical expression of spatial
variability in discrete data. Modeling the semivariogram behavior permits
carrying out spatial optimal linear prediction of a random process field
using kriging. Kriging can extract the spatial information (variance)
pertaining to a specific scale, which in turn translates pointwise data to
a gridded space with quantified uncertainty such that a grid-to-grid
comparison can be made. Here, using both theoretical and real-world
experiments, we demonstrate that this classical geostatistical approach can
be well adapted to solving problems in evaluating model-predicted or
satellite-derived atmospheric trace gases. This study suggests that
satellite validation procedures using the present method must take kriging
variance and satellite spatial response functions into account. We present
the comparison of Ozone Monitoring Instrument (OMI) tropospheric NO2
columns against 11 Pandora spectrometer instrument (PSI) systems during the
DISCOVER-AQ campaign over Houston. The least-squares fit to the paired data shows a low slope (OMI=0.76×PSI+1.18×1015 molecules cm−2, r2=0.66), which is indicative of varying biases in OMI. This perceived slope, induced by the problem of spatial scale, disappears in the comparison of the convolved kriged PSI and OMI (0.96×PSI+0.66×1015 molecules cm−2,
r2=0.72), illustrating that OMI possibly has a constant systematic
bias over the area. To avoid gross errors in comparisons made between
gridded data vs. pointwise measurements, we argue that the concept of
semivariogram (or spatial autocorrelation) should be taken into
consideration, particularly if the field exhibits a strong degree of spatial
heterogeneity at the scale of satellite and/or model footprints.
Types of pulsating aurora: comparison of model and EISCAT electron density observations
Authors: Tesema Fasil , Partamies Noora , Whiter Daniel K. , Ogawa Yasunobu
Published: January 2022

Abstract. Energetic particle precipitation associated with pulsating aurora (PsA) can reach down to lower mesospheric altitudes and deplete ozone. It is well documented that pulsating aurora is a common phenomenon during substorm recovery phases. This indicates that using magnetic indices to model the chemistry induced by PsA electrons could underestimate the energy deposition in the atmosphere. Integrating satellite measurements of precipitating electrons in models is considered to be an alternative way to account for such an underestimation. One way to do this is to test and validate the existing ion chemistry models using integrated measurements from satellite and ground-based observations. By using satellite measurements, an average or typical spectrum of PsA electrons can be constructed and used as an input in models to study the effects of the energetic electrons in the atmosphere. In this study, we compare electron densities from the EISCAT (European Incoherent Scatter scientific radar system) radars with auroral ion chemistry and the energetics model by using pulsating aurora spectra derived from the Polar Operational Environmental Satellite (POES) as an energy input for the model. We found a good agreement between the model and EISCAT electron densities in the region dominated by patchy pulsating aurora. However, the magnitude of the observed electron densities suggests a significant difference in the flux of precipitating electrons for different pulsating aurora types (structures) observed.