bluuebunny/crossref_metadata_2025 huggingface dataset:
Editorial Motricidades (v. 5, n. 2)
Authors: Mizuno Lemos Fábio Ricardo
Published: September 2021

Editorial Motricidades (v. 5, n. 2)
Atendimento educacional hospitalar em uma perspectiva lúdica: processos educativos emergentes
Authors: Brito Miriã Martins de
Published: September 2021

ResumoEste artigo teve como objetivo central identificar e compreender os processos educativos emergentes da prática social do atendimento educacional hospitalar em uma perspectiva lúdica junto a uma classe de hospital de uma cidade do interior do estado de São Paulo. Consistiu em pesquisa participante com o registro das observações em diários de campo para a coleta de dados. Com base na análise destes construímos a categoria “atenção e cuidado com outrem”. Consideramos que a atenção e o cuidado da Educadora da classe hospitalar, a partir da perspectiva lúdica, possibilitaram processos educativos como: amorosidade, diálogo, acolhimento e construção de laços de confiança, contribuindo com a ressignificação do contexto de hospitalização vivenciado pelas crianças.Palavras-chave: Processos Educativos. Atendimento Educacional Hospitalar. Lúdico.
Hospital educational care from a ludic perspective: emerging educational processesAbstractThis article aimed to identify and understand the educational processes emerging from the social practice of educational hospital care in a ludic perspective with a hospital class in a city in the interior of the state of São Paulo. The investigation consisted of researching the participant, relying on the systematic record of the analyzes in a field diary as resources for data collection. An analysis of the data enabled the construction of the category “attention and care for others”. We believe that the attention and care of the hospital educator, from a ludic perspective, found aspects such as: lovingness, dialogue, welcoming and building bonds of trust, as human principles of the social practice of hospital educational care, contributing to the re-signification the context of hospitalization experienced by children.Keywords: Educational Processes. Hospital Educational Care. Ludic.
Atendimiento educacional hospitalario desde una perspectiva lúdica: procesos educativos emergentesResumenEste artículo tuvo como objetivo central identificar y comprehender los procesos educativos emergentes de la práctica social de lo atendimiento educacional hospitalario desde una perspectiva lúdica junto a una clase de hospital en una ciudad en el interior del estado de São Paulo. Consistió en investigación participante con lo registro de las observaciones en diarios del campo para la coleta de datos. Con base en el análisis de eses construimos la categoría “atención y cuidado con otren”. Consideramos que la atención y lo cuidado de la Educadora de la clase en hospital, desde la perspectiva lúdica, posibilitaran procesos educativos como: amorosidad, diálogo, acojínenlo y construcción de lazos de confianza, contribuyendo al re-significación del contexto de hospitalización vivenciado por los niños.Palabras clave: Procesos Educativos. Atendimiento Educacional Hospitalario. Lúdico.
Exploring Multi-Level Composition and Efficient MCM Schemes for an Energy-Efficient Wavelet Haar Architecture
Authors: Seidel Henrique , Rosa Morgana da , Paim Guilherme , Costa Eduardo , Almeida Sergio , Bampi Sergio
Published: September 2021

This work explores multi-level fixed-point Haar transform compositions combined with MCM (multiple constant multiplication) schemes for an energy-efficient hardware architecture.  We investigate a set of six lower-level Haar transforms for composing a Haar-9 architecture. The multiple-level Haar transforms use as a base M=1, M=2, and M=3 resolution levels.  The processing module (PM) of the Haar explores efficient MCM schemes.  The architectures were described in VHDL and synthesized employing the ST 65nm CMOS cell library. The results show that Haar-II architecture presents the lower circuit area results since this architecture requires fewer arithmetic operators. However, the most energy-efficient Haar-9 hardware architecture employs a combination of two M=2 with five M=1 blocks with a efficient MCM architecture reduced to only two arithmetic operators.
A Survey on System-Level Design of Neural Network Accelerators
Authors: Seto Kenshu
Published: September 2021

In this paper, we present a brief survey on the system-level optimizations used for convolutional neural network (CNN) inference accelerators. For the nested loop of convolutional (CONV) layers, we discuss the effects of loop optimizations such as loop interchange, tiling, unrolling and fusion on CNN accelerators. We also explain memory optimizations that are effective with the loop optimizations. In addition, we discuss streaming architectures and single computation engine architectures that are commonly used in CNN accelerators. Optimizations for CNN models are briefly explained, followed by the recent trends and future directions of the CNN accelerator design.
Racism towards African American Women in “Hidden Figures”
Authors: Febriani Jeany Jean , Arianto Tomi
Published: September 2021

Racism is issue that still going on in the world. Different race and skin color make some people believe that they have more privilege than others. The issue of racism can be seen from Hidden Figures movie that was addapted from the book with the same title. Hidden Figures by Theodore Melfi is a story about racism towards African American women who worked in NASA during the space race in 1960. In this research, the researcher takes three main characters named Katherine, Dorothy and Merry who get discrimination in their life because they have different race and skin color as a source. Qualitative descriptive method is the method that was used in this research. The tehcnique of collecting data is by watching the movie and reading the book then collect the utterances and dialogue that have racism issue. The aim of this research is to find out racism in what field that happened in America during 1960 espesially in NASA through Hidden Figures. The result of this analysis found that the racism reflected trough discrimination in education, facility, social, and work.
Improving Reading Comprehension and Speaking Performance of the Eight Graders Using ICM
Authors: Saputra Eko
Published: September 2021

The aim of this experimental study was to investigate whether or not there were significant improvements in students’ reading comprehension and speaking performance after being taught by using Instructional Conversation Method. This study also aimed to see the significant difference in reading and speaking achievements between the students who got the treatment and those who did not. Sixty eight eighth graders with the same reading level were selected as the sample and were divided equally into experimental and control groups. Pretest and posttest were given to both groups, but the treatment was only for the experimental group. The data obtained from reading comprehension and speaking pretest and posttests in both groups were analyzed by using paired and independent sample t-tests. The result showed that after the students were taught by using ICM there were significant improvements in their reading and speaking achievements. There were also significant differences in reading and speaking achievements between both groups. In conclusion, ICM could help students improve their reading comprehension and speaking performance.
The Difficulties Faced by Indonesian EFL Learners in Pronouncing "S" and "Es" Suffixes in the Simple Present Tense Verbs and in Plural Form of Nouns
Authors: Saputra Andri , Hakim M.Arif Rahman , Saputra Eko , Rahmat Yurike Nadiya
Published: September 2021

The authors perceive that Indonesian EFL learners find it challenging to pronounce -s and -es suffixes properly. This position was first established during the authors’ teaching experiences in some high schools, English centre course and colleges (for students majoring in English Education) in Indonesia. The observations were confirmed not only during teaching, but throughout the authors’ own English study. It seemed difficult to adhere to the rules of suffix use in spoken language, i.e. How -s and -es suffixes should and should not be pronounced during a conversation. Generally speaking, Indonesian EFL learners do not pay much attention to pronouncing the suffixes of -s or –es, and although many English users accept such mistakes in conversation with non-native speakers, it is not, however, an error a native-speaker is likely to make. In fact, this issue could lead to misunderstanding when non-native English users have conversations with native speakers. This study aims to present comparative literature review of a number research studies related to teachers’ experiences and other EFL learners. Firstly, this study explains a presentation of existing relevant research on pronunciation is offered. This is followed by an explanation of the specific difficulties faced by Indonesian EFL learners in pronouncing -s and -es suffixes in the present tense verbs and plural form of nouns. The discussion part suggests practical ways of dealing with the difficulties in pronouncing -s and -es suffixes of present tense verbs and the plural form of nouns, and proposes several activities to this end.
Reading Journal Articles for Thesis Preparation: Voices from EFL Undergraduates
Authors: Rahman Kasyfur
Published: September 2021

This paper seeks to explore the undergraduates’ experiences when reading journal articles as references for their thesis composition through a narrative inquiry. Four undergraduates of English Language Education program at UIN Mataram were interviewed to analyze  what they encountered when reading such genre. The findings suggest that their experiences mostly circulated around their motivation and challenges, therefore the narratives were focused on these facets. In terms of motivation, these students seemed to be strongly driven by controlled motivation that entailed the need for a model, accessibility and currency, as well as demands from supervisors and institutions. Furthermore, these students also encountered challenges in terms of unfamiliar academic technical terms and vocabulary, boredom due to text complexities, and failed reading strategies. These findings imply the need of scaffolding the reading of journal articles for undergraduates in their final year of study.
Cross Culture Understanding in EFL Teaching: An Analysis for Indonesia Context
Authors: Maulana Andri
Published: September 2021

This study attempts to elaborate on the importance of cultural understanding of English foreign learners’ communicative competence. In the English language teaching in Indonesia, the role of culture is a crucial thing which needs to be combined with the teaching material to assist teachers and students for reaching the learning objective. Based on the findings of some studies, English learners in Indonesia face several obstacles when they find some terms which are unable to get its point in the literal meaning. Understanding the background culture in learning English is expected to minimize students' misunderstanding and lead them to use proper English in real communication. Integrated teaching material which contains cultural contents and its backgrounds is one way to introduce English to the learners, not only as a language but as a culture as well. Providing topics of learning based on authentic sources from native English speaking countries such as fable, short story, conversation role-play, songs, and movie. Arranging integrated teaching material that covers listening, speaking, reading, and writing with included cultural or arts contents of English native speakers. The teacher should not only teach students in linguistic competence but should teach them communicative competence as well because mastering linguistic competence is insufficient to use English in natural discourse. The appropriateness of English in use toward communication context is the objective of understanding the culture and language.
Gender Based Students’ Learning Autonomy in English Flipped Classroom
Authors: Irianti Leni , Syafryadin Syafryadin , Wibowo Elda Resi Moneta , Febriani R.Bunga
Published: September 2021

This research is aimed at finding out the effectiveness on applying flipped classroom to enhance learning autonomy and how its impact on gender based students’ learning autonomy. The researchers was applied convergent parallel mixed methods design. The populations of this study were senior high school in Pangandaran and the researchers selected a particular class. The class which participated is X MIPA 4 which consist of 11 male and 19 female as the experimental group and X MIPA 1 as the control one which consist of 12 male and 18 female. The totals of participants are 60 students. The data collected from pre-post Learning Autonomy Questionnaire (LAQ) and pretest-posttest as quantitative data and interview as qualitative data. The questionnaire was analyzed by using SPSS 16.0 for Windows. The result showed there is a significant difference in students’ learning autonomy between students who are taught by means of flipped classroom and those who are not. Moreover, female indicates more autonomy than male in both class even before or after the treatment. Pretest-posttest indicated although the score of autonomy is increased, it does not have significant impact on their narrative reading comprehension test. On the other hand, based on the interview both female and male students respond positively about applying flipped classroom to enhace their learning autonomy even though there is no huge difference for male. In conclusion, flipped classroom has given a good impact in students’ learning autonomy even for female or male students although not give significant impact in students’ learning outcomes especially in narrative reading comprehension.
The Impacts of Explicit and Implicit Instructions of English Connectors on EFL Students’ Reading Comprehension
Authors: Pangestu Adjie Putra , Hidayah Jumatul , Apriani Eka
Published: September 2021

There have been many studies on English grammar, but a dearth of studies has been conducted in the cross-sectional fields such as seeking how the field of grammar makes contributions to reading comprehension. Accordingly, the current study sought to find out the impacts of explicit and implicit instructions of English connectors on EFL students’ reading comprehension. 50 third semester students from an English department at a university in Bengkulu were incorporated as the samples. Adopting a quasi-experimental method, those 50 students were split into two classes, the so-called experimental and control classes. Students in the experimental class were taught English connectors explicitly, and those of the control class were taught English connectors implicitly. Before eight times of treatments in the form of the two ways of instructions, students of the two group were given a valid and reliable reading comprehension pre-test, and a similar construct of post-test was given after the eighth treatments ended. The data of the current study were analyzed by deploying paired sample t-test and independent sample t-test. The present study revealed that explicit and implicit instructions of English connectors had positive impacts on EFL students’ reading comprehension. However, the explicit instruction of English connectors enhanced EFL students’ reading comprehension more significantly and more effectively. It is recommended that further studies be conducted to replicate the present study in different contexts for the sake of providing rich data to confirm the current study’s results.
SMALL BABIES
Authors: ASHRAF MUHAMMAD , Ahmad Zamir , KHAN MUHAMMAD NASARULLAH , Khawaja Tariq Ferroz , KHAN MUHAMMAD AYUB , Salam Abdul
Published: September 2021

Zinc is an essential trace mineral. It is considered a growth factor as it isthe metallic component of enzymes DNA polymerase, DNA dependent RNA polymerase and thymidine kinase.Objective: To find out the relationship of maternal serum zinc levels with birth weight of the babies. Period: January1989 to May, 1991. Setting: Lady Wellingdon Hospital Lahore, King Edward College, Lahore and MetallurgyDepartment PCSIR Laboratories, Lahore. Design: Prospective study Patients & methods: Among the 216 registeredpregnant women 46 subjects had no feto-maternal complications during pregnancy and they delivered babies havingbirth weight adequate for Gestational Age (AGA). Thirteen women gave birth to babies Small for Gestational Age(SGA). Blood samples were taken at the end of each trimester and serum zinc was measured by atomic absorptionspectrophotometer. Results: Serum zinc levels were significantly low (P<0.001) throughout pregnancy in women givingbirth to SGA babies. Conclusion: Serum zinc levels throughout the course of pregnancy are associated with intrauterinegrowth of the babies.b
PASSIVE SMOKING
Authors: GARDEZI SHAH NAWAZ HASSAN
Published: September 2021

Definition: Breathing other people’s smoke is calledpassive, involuntary or second hand smoking.Types:- Side stream – from burning tip of the cigaretteMaintenance – inhaled and exhaled by smoker.Environmental tobacco smoke (ETS) is a major sourceof indoor air pollution.
ANAL FISSURE
Authors: HUSSAIN SYED MUKARRUM , ARIF MUHAMMAD , AZIZ ISHTIAQ
Published: September 2021

Objectives: To compare role of topicalglycerol trinitrate Ointment with lateral internal sphincterotomy. Setting: Department of Surgery CMH Kohat & PAFHospital Karachi. Period: From Mar 2003 to August 2004. Patients & Methods: Sixty patients suffering from chronicanal fissure were selected and equally divided into two groups. Group A was managed by topical glycerol trinitrate(GTN) ointment and group B was treated by internal sphincterotomy. Patients were followed up in the out-patientdepartment fortnightly. Results: Eight weeks after treatment, 66.6% patients in group A and 86.5% patients in groupB had healed fissures. Complications seen in group A were headache 9(30%), anal horny sensation 4(13.3%) andperianal soiling 2(6.7%) patients. In group B complications included infection 2(6.7%), soiling of under clothes 5(16.7%)and flatus incontinence 4(13.2%)patients. Conclusions: Although topical GTN ointment is non-invasive therapy withno permanent complications, it achieves low healing rates as compared to lateral internal sphincterotomy.
TRIGEMINAL NEURALGIA
Authors: SHAMS SHAHZAD , BUTT FARHAN SHAHZAD
Published: September 2021

Objectives: trigeminal Neuralgia is a severe lancinating pain and isassociated with conflict between a vessel and 5th cranial nerve. Micro vascular Decompression (MVD) of the nerverelieves this pain. Material & Methods: We reviewed 60 patients who underwent MVD for medically intractabletrigeminal neuralgia. The outcome of procedure was assessed retrospectively. Results: Preoperative symptoms rangedfrom 3 months to 10 years. Right side of face was affected in 32 and left in 28 patients. Mandibular division (21.6%)was the most commonly involved branch for referred pain. Superior cerebellar artery was the commonest offendingvessel in 86.6% of cases. Trigeminal root entry zone location (70%) was the commonest site of conflict. Postoperativepain relief showed excellent results in 86.6%, good in 10.0% and poor in 3.4%. Recurrence rate was 1.5% per year.Conclusion: MVD is safe, effective and treatment of choice for trigeminal neuralgia.
SEVERE HEAD INJURY
Authors: AHMAD TARIQ , HUSSAIN NAZAR , HUSSAIN M. AKMAL
Published: September 2021

Objective: To assess the outcome of severe head injury in patients with GCS 8 or below. Design:Retrospective study. Setting: Department of Neurosurgery, Allied Hospital, Punjab Medical College, Faisalabad.Period: Two years Aug 2002 to July 2004. Material and Methods: Two hundred patients admitted in the departmentof Neurosurgery, Allied Hospital, with Glasgow Coma scale 8 or below irrespective of mode of injury and age wereselected with a follow up of up to twelve months. The patients were assessed on arrival in the emergency room on thebasis of GCS. The patients were managed accordingly. Results: 71% patients were managed conservatively and 29%patients under went surgical intervention. Overall mortality was 40%. Outcome was good in 15% where as 11% patientsremained vegetative. Conclusion: Severe head injury has a mortality of 40%, especially in very young and very oldpatients.
ADRENALINE & ITS ANTAGONIST
Authors: TURABI AFTAB , Baluch Naseer , HASAN S. SAUD , Ali Mehar , DANYAL AHMED
Published: September 2021

Objective: This research work deals with the mechanism involved in determining the therapeuticpotential of adrenaline and its blockers in gastrointestinal motility. Method: The classical method of Craig & Clark wasused for obtaining the longitudinal and circular muscles strip of rabbit intestine for in-vitro studies. Each muscle stripseparately was subjected to the effect of adrenaline and its blockers. The results were recorded on polygraphapparatus. Results: The effects were recorded in vice versa fashion i.e. agonist v/s antagonist and antagonist v/sagonist on each muscle strip separately. Adrenaline had significant effect on the force of contraction of muscle strip.On addition of antagonist in the presence of agonist the effects were increased. Longitudinal muscle showed morepronounced effects i.e. 69% with beta-blocker in comparison to the effect with alpha-blocker, which was only 27%.Circular muscle showed reduction in the force of contraction with adrenaline, which was further reduced on additionof beta-blocker, whereas the effects were increased when treated with alpha-blocker. Conclusion: This studyconcluded that adrenaline released in vitro in response to sympathetic stimulation or given from external source,increases the force and reduces the rate of contraction. Hence decreases the intestinal motility due to its antispasmodiceffect. The result of this study can be utilized in the development of new drug related to G.I. motility mediated throughadrenoceptors.
THE EFFECT OF HALOTHANE
Authors: ASLAM ADEEL , ALAM FAWAD , ASLAM ANEEL
Published: September 2021

Design: Comparative study Setting: In CMH, Kharian and NishtarHospital, Multan. Period: From April 2003 to March 2004. Material & Methods: We studied 100 patients aged 18-45years undergoing elective surgery. We compared the effects of halothane in two groups, one premedicated and otherunpremedicated on the variability in the blood pressure. Group-I was premedicated with diazepam 5 mg orally andmidazolam 7.5 mg orally, aged between 18-45 years undergoing elective surgery. The blood pressure was monitorednon-invasively in the ward, in the operation theatre during induction and when halothane is switched on. These groupsof patients did not show any significant haemodynamic changes. The blood pressure remained within the normal limits.The second group of fifty patients underwent elective surgery, but they were not given any above mentioned premedication,they also belong to same age group. They showed significant haemodynamic changes i.e. rise in bloodpressure and beat to beat heart rate variability. This variability was caused by fluctuating balance of sympathetic andparasympathetic tone at the sino-artrial node. Statistical analysis was carried out using student “t” test. Differences wereconsidered significant when P > 0.05 & all values were presented 95 mean (SEM).
THE UPPER LIP BITE TEST
Authors: CHOHEDRI ABDUL-HAMEED , TABARI MASOOMEH , ALLAHYARI ELAHE
Published: September 2021

Objective: We conducted a prospective, double-blind study todetermine whether a difficult endotracheal intubation could be predicted preoperatively by a simple new technique, theupper lip bite test and compared it with three other tests used for prediction of difficult intubation: Modified Mallampaticriteria (MMC), Thyromental distance (TM) and Mouth opening (MO). Materials and Methods: Five hundred patients,aged above 16 years, and presenting for elective surgery were subjected to the following assessments: (1) Upper lipbite test (ULBT), class I: lower incisors can bite the upper lip above the vermilion line; class II: lower incisors can bitethe upper lip below the vermilion line; class III: lower incisors cannot bite the upper lip; (2) Oropharyngeal classaccording to the MMC. (3) The distance between the chin and thyroid cartilage (thyromental distance). (4) Extend ofmaximum mouth opening test. Results: ULBT had significantly higher accuracy (96%) and specificity (98.3%) and thelowest rate of false positive (p< 0.001). The most sensitive test was the TM test (42%). Conclusion: We concludedthat comparison of the three tests, UPBT has sufficient value in predicting difficult intubation in adults
SERUM TUMOR MARKERS
Authors: LODHI FAISAL BILAL , IFTIKHAR DR , ALI MUHAMMAD , Hussain Riaz
Published: September 2021

With the advent of new generations of chemotherapeutic agents andadvances in radiation therapy in the management of malignancies, an understanding of tumor markers is becomingincreasingly important. These soluble molecules in the blood are usually glycoproteins detected by monoclonalantibodies. Each tumor marker has a variable profile of usefulness for screening, determining diagnosis and prognosis,assessing response to therapy, and monitoring for cancer recurrence. Monoclonal antibodies are used to detect serumantigens associated with specific malignancies. These tumor markers are most useful for monitoring response totherapy and detecting early relapse. With the exception of Prostate-Specific Antigen (PSA), tumor markers do not havesufficient sensitivity or specificity for use in screening. Cancer Antigen (CA) 27.29 most frequently is used to followresponse to therapy in patients with metastatic breast cancer. Carcinoembryonic antigen is used to detect relapse ofcolorectal cancer, and CA 19-9 may be helpful in establishing the nature of pancreatic masses. CA 125 is useful forevaluating pelvic masses in postmenopausal women, monitoring response to therapy in women with ovarian cancer,and detecting recurrence of this malignancy. Alpha-fetoprotein (AFP), a marker for hepatocellular carcinoma,sometimes is used to screen highly selected populations and to assess hepatic masses in patients at particular riskfor developing hepatic malignancy. Testing for the beta subunit of human chorionic gonadotropin (b-hCG) is an integralpart of the diagnosis and management of gestational trophoblastic disease. Combined AFP and b-hCG testing is anessential adjunct in the evaluation and treatment of nonseminomatous germ cell tumors, and in monitoring theresponse to therapy. AFP and b-hCG also may be useful in evaluating potential origins of poorly differentiatedmetastatic cancer. PSA is used to screen for prostate cancer, detect recurrence of the malignancy, and evaluatespecific syndromes of adenocarcinoma of unknown primary. This review article describes the use of common tumormarkers in primary care practice. Particular emphasis is given to when these tests should be ordered and to commonfactors that influence the interpretation of tumor marker levels.
FACTORS ASSOCIATED WITH BREECH DELIVERY AT TERM
Authors: MALIK ASLAM MAHMOOD , AZIZ ASIA , RIAZ ABIDA , Shah Capt (R) Ijaz Ahmad
Published: September 2021

Objectives: To assess the various factors associated with breech delivery at term. Design: Casecontrol study. Period: Apr 2004 to Sep 2004 Setting: Department of Obstetrics & Gynaecology unit-I, Bahawal VictoriaHospital Bahawalpur. Materials & Methods: This case control study was carried out in women with the age group 20-40 years. Various risk factors (Parity, multiple pregnancy, placenta Previa, amount of liquor and congenitalabnormalities) associated with breech (50 cases) at term (37-42 completed weeks) were compared with vertex (50controls) after matching. Results: Different factors associated with breech were oligohydramnios 44% vs controlgroup, placenta previa 34% vs control group, primiparity 46% vs control group, multiple pregnancy 14% vs controlgroup and congenital abnormalities 18% vs control group. Conclusion: Our study concluded that factors associatedwith breech delivery were oligohydramnios, placenta previa, multiparty, multiple pregnancy & congenital abnormalities.
PATTERN OF DYSLIPIDEMIA IN PATIENTS WITH CRF
Authors: AMIN KHALID , Iqbal Muhammad Naeem , JAVED MASOOD , Qayyum Abdul , ABID MUHAMMAD
Published: September 2021

Objectives: (1)To find the pattern of dyslipidemias in patients with CRF.(2.)To compare the results with international studies. Design: Prospective observational study. Setting: In Medical UnitI, II, III and Nephrology ward of Allied Hospital Faisalabad. Period: (06 Months) From: Nov 2004 to April 2005. . AlliedHospital is a teaching hospital attached with Punjab Medical College Faisalabad having 1100 beds. Chronic renalfailure, a very common disease, is accompanied by many complications. One of such complications is abnormality oflipids. The lipids are disturbed in a characteristic manner. This disturbed lipid pattern predisposes the patients toatherosclerotic complications and increased mortality due to cardiovascular and cerebrovascular accidents. Presentstudy was conducted to determine the pattern of dyslipidemias in patients of CRF.50 patients diagnosed to have CRFwere subjected to fasting lipid profile, irrespective of cause and sex. Maximum patients had elevated triglyceride levels(46%). A considerable percentage (16%) had decreased HDL levels and a small percentage had elevated LDL (4%).Total lipids were found to be elevated in 04 patients (8%). All the patients with elevated total lipid were suffering fromdiabetes mellitus. Total cholesterol was elevated in 08 patients (16%). This disturbed lipid pattern has role inatherosclerosis. The patients of CRF who are already having disturbed endothelial function are more prone to it.
MICROBIAL KERATITIS
Authors: NAIMAT KHALID , AMIN MUHAMMAD SHAHBAZ , AHMAD FAROOQ
Published: September 2021

Objective: To find out the incidence ofmicrobial keratitis in patients with red eyes. Design: randomized prospective study. Period: 07 months ranging from1st Jun 2001 to 31 Dec 2001. Place of study: Eye Department, Military H st ospital, Rawalpindi. Results: Out of 857patients with red eye 32 cases were found to have Microbial Keratitis (3%). Conclusion: Preventive aspects of ocularinfection should be taught to the people, like, proper washing of eyes, wearing of protective glasses. Patients comingwith ophthalmic problems, i.e., red eye, photophobia, irritation and watering to the general practitioner should bereferred as soon as possible to the ophthalmology department.
STAPLER HAEMORRHOIDECTOMY
Authors: SHIEKH SAJID , HAMEED FAKHAR , MIRZA MUHAMMAD KHALID NASEEM , Afzal Muhammad
Published: September 2021

Objectives: To demonstrate advantages of staplerhaemorrhoidectomy and its applicability to all patients who require surgical treatment of haemorrhoids. Design: CaseDescriptive Study. Place & Duration of study: Allied/DHQ Hospitals, Faisalabad. (February 2004 – July 2005).Patients & methods: A total of 20 patients having grade III or IV haemorrhoids were included in the study. After adetailed GIT history, patients were subjected to standard stapler haemorrhoidectomy under regional anaesthesia.Patients were asked to record the postoperative pain intensity according to visual analogue score ranging from (0-10)on daily basis and the drugs required for pain control noticed. Patients were followed at weekly intervals for one month.Main outcome measures were postoperative pain, bleeding, sepsis, urinary retention, continence, relief of preoperativesymptoms, operation time, hospital stay & recovery time. Results: Pain was the most common postoperativecomplication affecting 18 patients (90 %age).There was significant reduction in postoperative pain except for onepatient in which pain was severe (VAS=8) due to technical error. Two patients developed urinary retention on the dayof surgery. Postoperative bleeding was not observed in any of the patients. Pelvic sepsis & incontinence was not foundin any patient. Preoperative symptoms were resolved in majority of the cases (80%age) with marked improvement inthe rest(20 %age). The mean operative time was 17 minutes & mean hospital stay 1.3 days. Most patients were backto their work after 11 post operative day. Conclusions: th Stapler Haemorrhoidectomy is a simple, quick & safeprocedure that gives benefit in terms of reducing the postoperative complications namely pain & its sequelae with earlyreturn to activity. The vast majority of patients currently undergoing conventional surgical haemorrhoidectomy wouldbe suitable for stapler approach, however the long term benefits need to be evaluated.
RELATIONSHIP OF TYPE OF CEREBRAL PALSY WITH THE ETIOLOGY
Authors: NAZIR BUSHRA , Shamoon Muhammad , Sheikh Saifullah , AYESHA HINA , Bhatti Muhammad Tariq
Published: September 2021

Objectives: To determine the relationship of etiology with the type ofcerebral palsy in children. Study Design: Descriptive case series. Setting: Department of Paediatrics, Allied Hospital,Faisalabad. Period: From January 2002 to December 2004. Patients and Methods: 120 children from 1-12 years ofage of either sex who presented in Paediatric Department with abnormalities of tone, posture and movement andsubsequently diagnosed as cerebral palsy on the basis of history, physical examination and investigations, wereincluded. Results: Out of 120 cases the majority had spastic CP, 72% (n = 86) such as quadriplegic, diplegic andhemiplegic types. The spastic quadriplegia was mainly associated with birth asphyxia and meningoencephalitis.Prematurity and low birth weight were the major contributors towards diplegic CP, while spastic hemiplegia althoughless common was caused by meningoencephalitis in 5 cases and intra cranial bleed and asphyxia in 3 cases each.Atonic or hypotonic CP found in 23 cases, were caused by meningoencephalitis, kernicterus, birth asphyxia andprematurity. 10 cases of atonic CP did not have any reason (hence idiopathic). Athetoid CP was mainly due tokernicterus, meningoencephalitis and asphyxia. Ataxic and mixed types of CP were present in 3 cases each and weredue to meningoencephalitis and birth asphyxia.
COEXISTENCE OF ENDOMETRIOID ADENOCARCINOMA OF THE OVARY AND THE UTERUS
Authors: HAMEED SADIA , AHMED JANBAZ , HUSSAIN ARIF
Published: September 2021

The coexistence of carcinoma of the endometrium and ovaries is uncommon and occurs in about10% of women with ovarian carcinoma. We are presenting such as a case with a review of the relevant literature
URINARY BLADDER GOSSIPYBOMA
Authors: IJAZ MUHAMMAD , REHMAN BASHIR UR , KIBRIA REHAN-E-
Published: September 2021

A 57 years old gentleman was brought with history of recurrent UTI (Urinary tract infection) of 01 yearduration. Following transvesical prostatectomy. UTI could not be controlled after using appropriate antibiotics. Allrelevant investigations were performed. His cystoscopic examination revealed retained gauze piece (12 inches ) inurinary bladder, which was retrieved.
NODULAR GOITERS
Authors: IQBAL ZAFAR , ZAFAR TASNEEM
Published: September 2021

Objective: The purpose of the study was to estimate the levels of amino sugars and glycosylatedproteins in the blood and thyroid tissues of the patients suffering from thyroid disorders. Study design: The study wascarried out at Basic Medical sciences Institute, J.P.M.C. Karachi. Period: From 1990 to 1992. Materials & Methods:Twenty control subjects and 35 thyroid patients (Non toxic goiter = 14, Non toxic nodular goiter = 12 and Toxic nodulargoiter=9) were studied. T4, TBG and T4/TBG ratio, serum and tissue glucose, protein, glycosylated proteins andhexosamine with their correlation coefficient (r) were estimated Results: Significantly raised levels of TBG in non toxicgoiter and toxic nodular goiter while T4/TBG ratio was significantly decreased in non toxic goiter and toxic nodulargoiter. In non toxic goiter patients correlation coefficient analysis showed a direct relationship (serum to tissue levels)of glucose(r=0.47), glycosylated proteins(r=0.40) and hexosamine (r=0.23) while an inverse relationship was found incase of protein(r= -0.38). In non toxic nodular group inverse relationship was only found in proteins (r= -0.48) estimationwhile direct correlation coefficient was observed in glucose (r= 0.29), glycosylated proteins (r=0.13) and in hexosamine(r=0.14). In toxic nodular group hexosamine shows a direct correlation coefficient(r=0.73)while glucose (= -0.53),proteins (r= -0.87)and glycosylated proteins(r= -0.12) have an inverse relationship. Conclusion: It was concluded fromcorrelation coefficient analysis (blood to tissue levels) that in non toxic goiter and non toxic nodular patients glucose,glycosylated protein and hexosamine showed a direct relationship while protein showed an inverse relationship.
COLORECTAL CARCINOMA
Authors: MAHMOOD QAISER , MASOOD AHMED IJAZ , SIDDIQUE NASREEN
Published: September 2021

Objective: To note the frequency of colorectal carcinoma in southern Punjab. Design: Retrospectiveobservational study. Place and duration of study: Histopathology department Nishtar Hospital Multan from January1993 to December 2003. Subject and Methods: Among 45114 surgical specimens received from January 1993 toDecember 2003, 526 were diagnosed as cases of colorectal carcinoma out of these 316 were male and 210 werefemale patients. Peak age for male was 51-60 years while for female it was 31-40 years. From all the receivedspecimens, appropriate number of sections were passed, haematoxylin and eosin staining was done and lightmicroscope was used for the diagnosis. Result: During ten year period total 526 cases were diagnosed as a case ofcolorectal carcinoma. Among them, rectal carcinoma was the most common with over all male predominance.Colorectal carcinoma was one to two decade earlier more common in female than in male. The commonest histologicalvariant was adenocarcinoma with an increasing tendency towards left side of colon. Conclusion: Colorectal carcinomais more common in males, earlier in females than males which needs further work up.
CARCINOMA OESOPHAGUS
Authors: KIBRIA REHAN-E- , MALIK ASAD MAHMUD
Published: September 2021

Objective: To compare various modalities of treatment in management of carcinoma oesophaguswith particular stress on relief of dysphagia due to ca. Design: Descriptive, retrospective study. Setting: Surgicaldepartment CMH Rawalpindi. Period: From 1996 to 2000 (4 years). Patients & Methods. The study subjects included33 patients with histopathological diagnosis of carcinoma oesophagus (including criteria), 28 patients were operatedupon (curative 18, palliative 10) with 17.5% operative mortality, 4 merited solely on chemo/radiation therapy (advancestage tumor), while 01 patent opted for chemo/radiation despite being favorable candidate for surgery. Results: Of the33 cases, 29 were operated out of which 11 were subjected to Ivor-lewis procedure, 15 were operated upon throughtranshiatal approach while in the remaining cases, palliative bypass procedures were done. Conclusion: Surgery(transthoracic + tans hiatal approach) proved to be the only reliable mode of treatment whether supplemented byadjuvant therapy or not, Chemo/radiation as a sole mode of treatment had drastic results.
FUNGAL KERATITIS
Authors: HAQ ANWAR-UL- , QAZI ZAFARULLAH , HASHMI SAFDAR
Published: September 2021

Previously no topical antifungal was available and only dermatological preparationlike bifonazole (mycospore) and some systemic antifungal were used for treatment of fungal ulcers. Nowmiconazole is available as topical ophthalmic ointment for the management of fungal ulcer. Objectives: To Studythe efficacy of topical miconazole ophthalmic ointment in the management of fungal keratitis and to know the timeperiod required for complete healing with topical miconazole ophthalmic ointment. Setting: Department ofOphthalmology, Nishtar Hospital, Multan. Duration: One year (from March 2001 to February 2002). Material andmethod: Sample size: 20 patients. Results: According to this study of 20 cases it is apparent that the fungalkeratitis occurred most frequently in patients between 20-70 years of age. It is apparent those males who work atdifferent places are more prone to disease. Out of 20 cases, 10 (50%) were farmers by occupation. Trauma withfingernail in 1(5%) patient, trauma with stone in 2(10%) patients. No specific eye disease was present in 12(60%)cases. Trachoma was present in 4(20%) cases. Blephritis was diagnosed in 2(10%) cases, 2(10%) patients weresuffering from chronic illness like chest infection. Fungal keratitis in 12(60%) was not associated with hypopyon,6(30%) patients were associated with hypopyon and 2(10%) were associated with end-ophthalmitis. The responsewas good in 12(60%) patients and satisfactory in 3(15%). Poor response in 3(15%) and there was no response in2(10%) cases. Conclusion: Miconazole ophthalmic ointment is a good drug for the treatment of fungal keratitis.
VARIANT ANGINA
Authors: GILANI MUHAMMAD SHAH , Mahmood Qaiser , GARDEZI SHAH NAWAZ HASSAN , Khan Abrar Ahmad , SATTAR ABDUL , Khan Arif Rahi
Published: September 2021

Introduction: The syndrome of variant angina occurs in patients with awide spectrum of coronary artery obstructions, ranging from normal coronary arteries to severe 3-vessel coronary arterydisease (CAD). Treatment of these patients is, in large part, determined by the extent and severity of the underlyingfixed coronary obstructions. Objective: To determine the clinical features of variant angina with and without fixed severecoronary artery disease. Setting: Nishtar Hospital, Multan. Duration: Two years. Study design: Descriptive,comparative analytical study. Material & methods: Sample size 108 patients. Sampling technique: Convenientprobability sampling done. Results: 43 patients with variant angina who had less than 50% fixed coronary luminaldiameter narrowing (group-I) were compared with 65 patients with variant angina who had 70% or greater diameternarrowing (group-II). Statistically significant differences were found in 3 clinical features between group-I and group-IIi.e. (1) a more than 3 months history of angina at rest before diagnosis (80% vs 23%, P <0.001); (2) an abnormalelectrocardiogram at rest (19 vs 48%, P <0.01). (3) an abnormal stress test (26% (8 of 30) vs 84% (15 of 18), P <0.01.However, these features were not clinically reliable in separating patients with variant angina with and without fixedsevere obstructions because of overlap between the two groups. No difference was found between the 2 groups in age,sex, predominant symptoms at the time of catheterization, history of exertional angina, syncope with angina, prolongedangina, previous artery disease. Conclusion: Coronary arteriography should be performed to define the underlyingcoronary anatomy and to determine optimal therapy in patients with variant angina.
TYPHOID PERFORATION
Authors: ALI SHAUKAT , SATTAR ABDUL , AMIN MUHAMMAD AMJAD
Published: September 2021

Introduction:- Typhoid fever is an infectious disease caused by a bacterium salmonella typhi. Thespread of infection is usually by an oro-fecal route. Food handlers are a major source of spread in developed countries.In undeveloped countries like ours, contamination of drinking water and edibles are the major source. Infected shellfishare occasionally a source of an outbreak. Objectives To review the present practice of managing patients with typhoidperforation and comparison between the primary closure and exteriorization. Setting Surgical Unit-II, Nishtar Hospital,Multan. Duration Two years. Patients and methods Sample size 50 patients. Results:- A total of 50 patients werefinalized for the analysis. There were 14 females and 36 males (1:2.5). The age ranged from 18 years to 35 years, themean age was 28 years. In patient who underwent ileostomy, death occurred in 3 cases (10%). Most of the patientsbelonged to low socioeconomic class. Delay in reaching the hospital was significant for several reasons includingtransportation and pretreatment at peripheral private hospitals. 46 patients presented after 48 hours of perforation(92%). Conclusion:- In cases with good reserves and earlier hospitalization primary repair is certainly the procedureof choice
FOREIGN BODY IN OESOPHAGUS
Authors: SHEIKH M. SALEEM , MAHMOOD TALLAT , SHEIKH M. AMIN
Published: September 2021

Objectives. To study the attitude of parentsabout the coins given to their children, especially about their knowledge of coins that these may become F.B. inoesophagus and can cause an unexpected problem. Design: A questionnaire- based survey presented to parents ofthe children admitted in ENT ward having coin trapped in their oesophagus. Place and Duration of Study: ENTDepartment Bahawal Victoria Hospital, Bahawalpur from July 2004 to June 2005. Subjects and Methods: Parents ofthe children, who were admitted in ENT ward B.V.H, Bahawalpur, were interviewed using a questionnaire proformafocusing especially about the knowledge of parents about coins as a possibility of F Body. Ethical requirements includingthe administration of written informed consent and provision of confidentiality were ensured. SPSS computer softwarewas used for data management. Results In our study 84 out of 100 patients were less then 7 years age. Sixty two weremale and 38 were female children. Seventy four of the children were from rural areas. Most of the parents were illiterateand of poor social class. Fifty nine had history less then 1 days and 28 had 1-3 days. Eighty eight patients wereoperated with one day. Most of the parents (54%) were anxious and worried Thirty five were ashamed while 11% werenot bothered. Most of parents pointed out risk factors as easy availability of coin (78%), easy access of coin for children(56%), bad habit of children to put every object in mouth (42%) and lack of knowledge of parents about the risk of coinas foreign body in esophagus (88%). Future commitments of the parents were noted as follows:-restriction of coin forchildren (60%) education of children (32%) and 8% of parents did not bother about care of children for this.Recommended Suggestion by parents were these Govt. Should ban (92%), role of press and newspaper (62%), roleof T.V and radio.(74%), role of health workers to educate people (88%). Conclusion: In our setup, most of the parentsare illiterate and unaware of the risk that the coin can become a foreign body in esophagus in children. They can beawarded and educated via media like press, television and radio and compaign by health workers. Incidence of theseemergency cases can be reduced by these measures to negligible level.
MYOMECTOMY DONE DURING CAESAREAN SECTION
Authors: ROOHI DR. MAHNAAZ , CH RAHILA FARHAT
Published: September 2021

Objective: To evaluate the outcome of myomectomy during caesarean section. Study Design: Aretrospective study. Setting: Gynae unit I, Allied Hospital Faisalabad . Period: From 2001 to 2002. Material andMethods: A total of 40 patients attending gynae unit I of Allied Hospital having pregnancy with fibroid were includedin the study. A special consent was taken from the patients for performing myomectomy. A performa was used to collectthe data regarding maternal morbidity and mortality and perinatal outcome, the results were then analyzed. Results:It was seen in this study that in 28 patients the duration of hospital stay was 7-10 days which is not more than the stayduring caesarean section. It was only in 02 patients the stay was more than 10 days. Regarding blood transfusion in90% of the cases required only two pint of blood during operation. Regarding blood loss in 20 patients it was only500ml. The loss was more than 1000 ml in only 04 cases. Perinatal outcome. The outcome was satisfactory and thebabies weight corresponded with the gestational age.
WOMEN WITH PREGNANCY INDUCED HYPERTENSION
Authors: AKMAL NOREEN , RAANA GUL-E-
Published: September 2021

Objective: To identify the epidemiological differences betweennormotensive pregnant women and women in pregnancy induced hypertension. Designs: A descriptive analytical casecontrol study. Setting: Department of Obs and Gynae of Sir Ganga Ram Hospital Lahore. Period: From January toDecember 2004. Materials & Methods: 2 groups with 100 patients in each were studied. Results: PIH is morecommon in young, obese, primigravidas with a family or past history of PIH or hypertension and in those with poorsocioeconomic status and no regular dietary calcium supplementation.