bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the addition of nanopowders on the strength of multilayer composite materials
Authors: Bokhoeva L. A. , Baldanov A. B. , Rogov V. E. , Chermoshentseva A. S. , Ameen T.
Published: August 2021

Modification of polymers with fillers provides the possibility of changing their physical and mechanical properties. The goal of the study is a comprehensive analysis of the effect of nanodispersed additives and other powdery substances on the strength of multilayer composite materials (CM). A series of multilayer composite specimens based on fiberglass and carbon fabric was made with the addition of fillers in a concentration of 1 and 3 wt.% to an epoxy polymer matrix. Nanopowders of silicon dioxide Tarkosil (T20, T50, T80, T110), fine powders of copper, collagen and cellulose fibers were used as fillers. Two types of tests, i.e., for compression and for impact were carried out. The introduction of nanopowders into CM changes their strength properties: the samples added with T110 nanomaterial withstand the maximum compressive load at a concentration of 1 and 3 wt.%. The results of impact tests of the samples with fillers and computer simulation of the impact and punching of the samples using the ANSYS/LS-DYNA software product, are presented. A method for numerical simulation of the impact process has been developed, which provides studying the dynamics of deformation and fracture of multilayer samples. Impact tests of the samples carried out at different values of the impact velocity (from 380 to 450 m/sec) revealed either puncture of the CM plates or damage such as delamination and splitting. In the impact test of multilayer specimens of composite materials with fillers added to the epoxy polymer matrix, the interlayer defects appeared in the form of delamination; samples without additives were pierced through under the impact. The experimental data on the degree of damage to multilayer plates after the impact matched the results of computer simulation.
Silicon carbide fibers and whiskers for ceramic matrix composites (review)
Authors: Shestakov A. M.
Published: August 2021

An increase the operating temperature range of structural elements and aircraft assemblies is one of the main goals in developing advanced and new models of aerospace equipment to improve their technical characteristics. The most heat-loaded aircraft structures, such as a combustion chamber, high-pressure turbine segments, nozzle flaps with a controlled thrust vector, must have a long service life under conditions of high temperatures, an oxidizing environment, fuel combustion products, and variable mechanical and thermal loads. At the same time, modern Ti and Ni-based superalloys have reached the limits of their operating temperatures. The leading world aircraft manufacturers — General Electric (USA), Rolls-Royce High Temperature Composite Inc. (USA), Snecma Propulsion Solide (France) — actively conduct fundamental research in developing ceramic materials with high (1300 – 1600°C) and ultrahigh (2000 – 2500°C) operating temperatures. However, ceramic materials have a number of shortcomings attributed to the high brittleness and low crack resistance of monolithic ceramics. Moreover, manufacturing of complex configuration and large-sized ceramic parts faces serious difficulties. Nowadays, ceramic composite materials with a high-temperature matrix (e.g., based on ZrC-SiC) and reinforcing filler, an inorganic fiber, (e.g., silicon carbide) appeared most promising for operating temperatures above 1200°C and exhibited enhanced energy efficiency. Ceramic fibers based on silicon compounds possess excellent mechanical properties: the tensile strength more than 2 GPa, modulus of elasticity more than 200 GPa, and thermal resistance at a temperature above 800°C, thus making them an essential reinforcing component in metal and ceramic composites. This review is devoted to silicon carbide core fibers obtained by chemical vapor deposition of silicon carbide onto a tungsten or carbon core, which makes it possible to obtain fibers a 100 – 150 μm in diameter to be used in composites with a metal matrix. The coreless SiC-fibers with a diameter of 10 – 20 μm obtained by molding a polymer precursor from a melt and used mainly in ceramic composites are also considered. A comparative analysis of the phase composition, physical and mechanical properties and thermal-oxidative resistance of fibers obtained by different methods is presented. Whiskers (filamentary crystals) are also considered as reinforcing fillers for composite materials along with their properties and methods of production. The prospects of using different fibers and whiskers as reinforcing fillers for composites are discussed.
Analytical control of silicified graphite SG-P
Authors: Kutyaeva K. M. , Cheblakova E. G. , Malinina Yu. A. , Shvetsov A. A. , Beylina N. Yu.
Published: August 2021

An analytical scheme for the analysis of silicified graphite SG-P, a four-phase composite material consisting of silicon, carbon, silicon carbide and silicon dioxide, has been developed. The procedure can be successfully used in the quality control of raw materials and in the study of the phase composition of finished products The porosity and density of the graphite base, as well as the impurities contained in the base and silicon change the course of silicification and the properties of the finished product as well. The impurities are the main reason for the formation of delamination, swelling, cracking and light spots on the treated surfaces. It should be noted that the iron content 0.023 – 0.17 wt.% in the carbon material intended for silicification, leads to catalytic graphitization of the artificial graphite and dispersion in the silicon melt. Methods of rapid assessment of the quality of raw materials are to be used to provide quick understanding of their suitability for manufacturing final products on their base. Quality control of the silicified graphite produced at the JSC «Research Institute Graphite» is carried out by determination of the phase composition of the finished product by chemical and X-ray diffraction methods of analysis. The content of silicon carbide (not less than 45%), unbound silicon and carbon (not more than 20 and 35%, respectively) affects the corrosion resistance and thermal expansion of silicified graphite.
THE HOSPITAL EPIDEMIOLOGICAL SURVEILLANCE NETWORK AS NA INSRUMENT FOR THE STRENGTHENING OF COMPULSORY DISEASE AND CONSEQUENTIAL NOTIFICATION, PERNAMBUCO 2018
Authors:   ¹Instituto Aggeu Magalhães – Fundação Oswaldo Cruz,   ² Secretaria Estadual de Saúde de Pernambuco
Published: August 2021

Objetive: Describe the contribution of the State Hospital Epidemiological Surveillance Network of Pernambuco (VEH/PE) for the registration of cases of diseases and conditions of immediate compulsory notification, in Pernambuco, 2018. Methods: Descriptive study, type of experience report, of surveillance of 31 hospitals of the VEH / PE Network, in 2018. The data sources were from the Notifiable Diseases Information System and the data referring to DNCI were from FormSus, available on the Center’s Platform Strategic Health Surveillance Information. The proportions of notifications for Compulsory Notification Disease from the VEH/PE Network were calculated in relation to the total number of notifications made at Sinan. Results: Among the DNC notifications registered by Sinan (Net, Online and Web influenza, 30,1% came from the 31 hospitals of the VEH/PE Network. When analyzed, by information system, the Network was responsible for 28,4% of the records made in Sinan Net by 2.687 reporting units, in Sinan Online, 25,9% in relation to 1.247 reporting units and for Sinan Web Influenza the contribution was 82,3% in relation to the 69 reporting units. Immediate compulsory notification diseases/conditions communicated to CIEVS, 50,2% of the communications came from the Network As for the opportunity for immediate notification of diseases and conditions, 90,7% were communicated in due time by the VEH/PE Network. Conclusion: It is important to strengthen the Network aiming at surveillance, disease/disease control and operationalization of information systems, in order to support the manager in decision making.
Nutritional Profile of Patients with Acquired Immunodefience Syndrome
Authors:   ¹Faculdade Pernambucana de Saúde – FPS ²Instituto de Medicina Integral Professor Fernando Figueira – IMIP
Published: August 2021

Objective: To evaluate the nutritional status of patients living with the human immunodeficiency virus and making use of antiretroviral medication. Methods: This is an observational cross-sectional analytical study that was conducted from May to July 2018. The nutritional status was determined through the evaluation of anthropometric data. The anthropometric measurements collected were: body mass index, brachial circumference, triceps skin fold and waist circumference. Results: We evaluated 120 patients in regular use of antiretroviral therapy. According to the body mass index, most individuals (41.2%) presented eutrophy, followed by overweight (35.7%). Regarding waist circumference, about 30% of patients presented a much increased risk for cardiovascular diseases. It was also observed that 47.5% of the patients presented eutrophy through the arm circumference parameter. Regarding the anthropometric parameter, triceps skin fold, it was observed that 29.9% of the patients presented severe malnutrition, followed by obesity (24.2%). Conclusion: It is known that even individuals undergoing antiretroviral therapy, aiming at slowing the progression of the disease, may present a possible involuntary weight loss during treatment. When related, the parameters of arm circumference, triceps skin fold, and waist circumference characterize the clinical signs of lipodystrophic syndrome, defined as abnormal redistribution of body fat. It is concluded that constant nutritional monitoring of patients in regular use of antiretroviral therapy drugs is necessary in order to prevent possible complications in the nutritional status of patients living with the human immunodeficiency virus.
Osmanlı Klasik Döneminde İstanbul’da Matematik İlimler
Authors: BAGA Elif
Published: August 2021

ÖZ
Osmanlı devleti tarih sahnesinde kaldığı uzun süre boyunca ilimden sanata, siyasetten askeriyeye, ekonomiden uluslararası ilişkilere kadar hemen hemen her yönden önemli tesirlerde bulunmuştur. Buna mukabil, Osmanlı ilim geleneği üzerine yapılan çalışmaların sayısı cüzi seviyededir. Öyle ki, matematik, astronomi, tabii ve tatbiki ilimler, askeriye, coğrafya ve musiki alanlarında ayrı ayrı yayınlanan Osmanlı Literatür Tarihleri hemen hemen tek başvuru kaynağıdır. Matematik ilimler söz konusu olduğunda ise çok daha fazla yeni araştırmaya ihtiyaç duyulduğu görülür. Bundan mülhem bu makalede Osmanlının son dönemine nispetle daha az çalışmaya konu olan klasik döneminde üretilen, öğrenilen, öğretilen, kullanılan, yaygınlaşan ve aktarılan matematiğin yüzeysel bir içeriği, matematikle ilgili bu eylemlerin gerçekleştiği mekanlar ve mezkûr matematiğin yakın ilişkide bulunduğu alanlar hakkında genel bilgiler verilmesi amaçlanmıştır. Böylece matematiğin, Osmanlıyı en iyi temsil eden şehir, yani başkent İstanbul üzerinden günlük yaşamla, şehirle, mimariyle, estetikle, yönetimle, ekonomiyle ne kadar iç içe olduğunun gösterilmesi hedeflenmiştir. Bunun için araştırma, genel bir girişin ardından matematik ilimler, bu ilimlerin üretildiği mekanlar ve matematik ilimlerin ortak çalıştığı ilimler olmak üzere üç ana bölüme ayrılmıştır. Tüm bunlar neticesinde de Osmanlı klasik döneminde matematik ilimlerin üretim ve kullanımının, muhasebe ve arazi ölçümü gibi birkaç saha ile sınırlı olmadığı, sanılanın aksine ister teorik ister uygulamalı birçok matematik alanının farklı mecralarda farklı seviyelerde tedavülde olduğu, dolayısıyla herhangi bir alanda üretilen bilgide veya yapılan işte matematiksel kesinlik ve doğruluk kavramlarının öne çıktığı gösterilmiştir.
A Análise da Motivação de Alunos a partir de um Processo de Escolha, Preparação e Apresentação de Experimentos de Química
Authors: Faitanini Beatriz Derisso , Bretones Paulo Sergio
Published: August 2021

O objetivo desse trabalho foi o estudo do perfil motivacional de alunos compreendendo quais fatores os motivam para o estudo da Química. Como referencial teórico, utilizou-se a Teoria da Autodeterminação, propondo um continuum de autodeterminação com seis níveis motivacionais. Os dados foram coletados entre alunos do 1° ano do Ensino Médio, a partir de um processo de escolha, preparação e demonstração de experimentos de Química; por meio da aplicação de dois tipos de questionários, um aberto e outro utilizando a escala Likert. A análise dos dados mostrou que antes da realização do projeto os alunos apresentavam valores de Ranking Médio (RM) mais altos para a Regulação Integrada e mais baixos para as formas menos autodeterminadas de motivação. Após a realização do projeto os valores de RM para a Regulação Integrada e Motivação Intrínseca aumentaram ainda mais, enquanto os valores para as formas menos autodeterminadas tiveram um decréscimo. Isso pode ser uma evidência de variação no perfil motivacional dos alunos, com relação aos motivos para a aprendizagem. Os dados evidenciam que a ocorrência de situações que favorecem a satisfação das necessidades psicológicas básicas desperta o entusiasmo dos alunos em situações consideradas favoráveis à promoção da motivação intrínseca. Buscamos contribuir para um aprofundamento sobre a motivação para o estudo da química, relacionando à satisfação das necessidades psicológicas básicas durante esse processo com a promoção da motivação.
Uma proposta de Modelo para Abordar Relações entre Práticas Epistêmicas e Questões Sociocientíficas no Ensino de Ciências
Authors: Ramos Tatiana Costa , Mendonça Paula Cristina Cardoso
Published: August 2021

No presente trabalho apresentamos um modelo que relaciona práticas epistêmicas e questões sociocientíficas (QSC) no ensino de ciências. Para desenvolvê-lo estabelecemos entrelaçamentos entre normas, práticas sociais, objetivos epistêmicos, cognição epistêmica, raciocínio informal, práticas epistêmicas e posicionamento justificado. Sugerimos que a cognição epistêmica é o elo entre raciocínio e práticas epistêmicas. Apresentamos três objetivos epistêmicos que devem direcionar o trabalho com práticas epistêmicas durante a resolução de uma QSC: reconhecimento e utilização de múltiplas linhas de raciocínio ao resolver a QSC, construção e avaliação de argumentos holísticos visando compreender as múltiplas dimensões da QSC e desenvolvimento de investigações céticas para resolver as QSC. Os objetivos apontados contribuem para a avaliação e resolução crítica dessas questões. Julgamos que para a resolução das QSC no ensino é importante a construção de normas sociais considerando-se que essas questões não requerem uma resposta “única” e, portanto, um espaço de reflexão, conscientização e justificação das diferentes perspectivas sobre a questão deve ser oportunizado. As relações estabelecidas no presente artigo contribuem para pesquisas que visam desenvolver e analisar práticas epistêmicas “in situ” em abordagem de ensino com QSC. Além disso, têm potencial de fornecer apoio aos professores que desejam favorecer a ocorrência de práticas epistêmicas em abordagem QSC.
ESP (english for specific purposes) vocabulary to improve reading at an a1.2/ a2.1 english level
Authors: Aulestia Vallejo Luis Enrique , Cuenca Fernández Mirian
Published: August 2021

The aim of this research was to investigate the use of ESP vocabulary in general English classes to improve English, by using the student-centered learning approach, concentrating mainly on reading skills. For the study case, 123 students of different careers offered at Central University of Ecuador, English A1.2, A2.2 levels, constituted the population studied, during the period May-November 2018. A teacher- made pre-test of basic technical vocabulary knowledge was administered. ESP vocabulary was taught to complement General English structures and grammar.  At the end of the semester, a post-test was given to the students to determine the influence of the technical vocabulary in their proficiency.  Data analysis showed that the student-centered approach using basic technical vocabulary in general English learning was effective.  Furthermore, the results showed that when focusing to student’s needs, degree program students are more motivated to learn and read more academic literature related to their careers.
Errores comunes de entonación de la producción del idioma inglés como lengua extranjera (EFL) en estudiantes adultos de nivel intermedio-bajo
Authors: Vaca Barragán Diana
Published: August 2021

Este proyecto investiga la entonación en preguntas y pedidos en 10 alumnos que aprenden inglés en un país cuyo idioma es español y que tienen un nivel intermedio. El objetivo de este estudio es identificar y analizar los errores de entonación más comunes. Analizar la situación actual de entonación es importante para la propuesta de actividades metodológicas que mejoren problemas específicos de entonación. En efecto, esta investigación compara los contornos tonales de dos preguntas y dos pedidos de hablantes nativos con estudiantes. Este estudio descriptivo concluyó que: los estudiantes parecen no estar conscientes de los contornos tonales y la función que desempeñan los patrones de entonación y que el idioma nativo influye en la producción del segundo idioma. Estos resultados sugieren que herramientas tecnológicas como Praat pueden servir en el proceso de aprendizaje y enseñanza sobre entonación.
الخصائص الزخرفية لمسجد ايا صوفيا
Authors: الخزعلي حيدر عبد الامير رشيد , الحسني افراح مالك محسن
Published: August 2021

تناول البحث الحالي خصائص الزخارف الإسلامية لمسجد ايا صوفيا في تركيا, وقسم البحث الى أربعة فصول, يتضمن الفصل الأول عرضا لمشكلة البحث اذ يعد مسجد ايا صوفيا رمزا حضاريا وتاريخيا للمساجد التركية, ومن خلال القيم الجمالية الموجودة في الفن الإسلامي, نحاول أن نكشف عن ما هو موجود من زخارف إسلامية جسدها وأنجزها الفنان المسلم في مسجد أيا صوفيا مما دعا الباحثة الى الكشف عن خصائص الزخارف الإسلامية في المساجد التركية آيا صوفيا فيما تحدد البحث بالزخارف الدائرية والرباعية والشريطية والمنفذة بالرسم المباشر والمتجسدة في زخارف هذا المسجد كما هي ألان 2019.

أما الفصل الثاني فقد اشتمل على الإطار النظري الذي تضمن مبحثين: اما الاول تناول (ايا  صوفيا بين الكنيسة والمسجد)أما المبحث الثاني فيتناول (الفلسفة البنائية والجمالية للزخرفة الإسلامية) من خلال اثر الفلسفة الزخرفية الإسلامية في بنائية التصميم الزخرفي أولاً والعناصر البنائية والأسس التنظيمية للزخرفة الإسلامية ثانيا ً.

وتضمن الفصل الثالث إجراءات البحث, التي اعتمدت فيها الباحثة على المنهج الوصفي بأسلوب تحليل المحتوى, إذ بلغ مجموع مجتمع البحث (6). أما الفصل الرابع فتضمن تحليل نماذج عينة البحث

وتضمن البحث العديد من الاستنتاجات والتوصيات والمقترحات وختمت الباحثة بحثها بقائمة المصادر والمراجع والملاحق
صورة الاهوار في الرسم العراقي المعاصر
Authors: Ibrahim Aref Waheed , Abbas Mustafa Sahib
Published: August 2021

يتحدد البحث الحالي في دراسة مفهوم صورة الاهوار في الرسم العراقي المعاصر وتكون من اربع فصول غرض الباحث في الفصل الاول مشكلة البحث اذ مثلت بيئة الاهوار مجالا بصريا غني بالمفردات والاشكال والرموز وصور مختلفة للحياة لانتاج اعمال تشكيلية تتجاور فيها الكائنات والمياه والطيور مع الانسان بوصف الفنان كائناً يدرك عنصر التحول في العالم الخارجي من بيئة ومكان ومحيط وظواهر اجتماعية وعرض تساؤلات كيف اشتغلت صورة الاهوار في الفن العراقي هل افرزت صورة الاهوار البيئة والمكان عنصر تغيير وخصوصية في الفن العراقي وتوصل بعدها الى هدف البحث التعرف على صورة الاهوار في الفن العراقي. ثم انتقل الى الفصل الثاني وهو الاطار النظري للبحث وقسمه الى مبحثين الاول مفهوم الصورة والثاني ملامح صورة الاهوار في الفن العراقي وتتبع الباحث التجارب الفنية التي اشتغلت على بيئة الاهوار واثراء التنوع الاسلوبي فيها بعدها الفصل الثالث وقام بتحليل خمس عينات. في الفصل الرابع توصل الباحث الى النتائج ومنها – للمكان المتخيل اثر في وعي الفنان وهو يتفاعل مع صورة الاهوار، انه جانب مهم ومؤثر لطريقة اشتغاله الجمالي في بناء عمل ابداعي يتخذ من الاهوار وبيئاتها المتنوعة وموروثاتها مصدراً مهماً في البحث عن الخصوصية والتفرد، تعددت اساليب الفن العراقي وهو يقدم صورة الاهوار ياختلاف الفنان منهم من راى الصيادين والفلاحين والشخوص والتركيز على اللون وايقاعه المنسجم، وهناك من صاغ مفردات اعماله فضاءات معمارية وبيوت طينية وقوارب وطيور، وبذلك صورة الاهوار الغنية اسهمت باساليب فنية غنية تمزج ما بين الانطباعية والتعبيرية والرسم الممثل للمرئي، ثم توصل الى الاستنتاجات ومنها ان الفنان يتعامل مع المكان والبيئة والمحيط عبر التفاعل الحدسي ذلك ان الحدس نشاط وفاعلية انسانية وهو منتج للصور كثمرة للانفعالات وبفضل الانفعالات تتحول الصور الى تعبير جمالي مدرك. ان الفنان المعاصر ينتقل من ادراك المكان الى تكوين التصور، يرى الفنان صورة العالم الذي يحاول تاطيره، ليغدو العالم متجسداً بشكل سعياً وراء الفهم والوعي بالاشياء، بعدها قدم الباحث التوصيات والمقترحات.
Evaluasi Pengaruh Parameter TIM Berdasarkan Multirate Terhadap Konsumsi Energi Jaringan IEEE 802.11ah
Authors: Riefi Daifi Afrila , Arif Teuku Yuliar , Syahrial
Published: August 2021

WLAN IEEE 802.11ah is wireless standard technology which potentially used for IoT networking to provide longer range transmission than WPAN and LPWAN. MAC layer IEEE 802.11ah introduces TIM segmentation scheme that provides effective management toward STA in large amount to make the energy consumption efficiently. STA is organized in hierarchical structure that allows TIM segmentation to reduce the length of frame beacon contains TIM. In case there’s no segmentation in a network with many STA, the TIM would be longer and requires all STA to wake-up receiving beacon TIM including STA without downlink data. This research intends to evaluate and analyze the TIM optimal parameters. Those are Page Period, Page Slice Length and Page Slice Count toward IEEE 802.11ah energy efficiency based on multirate using simulator NS-3 implemented on IEEE 802.11ah. As the result of STA experiment shows that Non-TIM is only optimal on sleep duration while TIM is optimal on energy consumption and delay packet. In the experiment of impact of STA/Slot amount based on Page Slice Length shows that sleep duration and energy consumption is optimal depends on the amount of the STA/Slot and data rate used while the optimal packet delay varies for each Page Slice Length.
Early Marriage in Medical View and Maqashid Sharia
Authors: Ridwan Rifanto Bin , Ifnaldi Ifnaldi , Jahidin Jahidin
Published: August 2021

This article aims to find out how the medical and legal views of Islam (Maqashid Sharia) on marriages are carried out by minors. Through library research methods, this study found; 1) from a medical point of view, early marriage is not recommended. Because it can harm the reproductive health of women who are still in their infancy. Mentally, the perpetrators will feel inferior and less able to control their emotions due to emotional unpreparedness, 2) in terms of Maqashid Sharia, early marriage should be avoided. Because, although the goal of Sharia, namely maintaining offspring, is fulfilled, in practice it often causes problems, so that the purpose of marriage, which is getting sakinah mawaddah wa rahmah, is not achieved
Comparison of insulin soaked dressing with the conventional dressing in diabetic ulcers.
Authors: Ahmed Hafiz Bilal , Ghazanfor Ramlah , Qureshi Usman , Akram Usman , Hassan Syed Waqas , Adnan Naqash , Malik Ahmed Mujtaba , Ahmad Raheel , Malik Sara , Khan Jahangir Sarwar , Rasheed Gohar , Aziz Munazzah , Mehr Asma
Published: August 2021

Objective: This study aims at demonstrating the benefits of insulin soaked dressing for the treatment and accelerating the healing process of diabetic ulcers thus helping the faster wound healing, reducing morbidity and also decrease the cost of management in patients with diabetic ulcers. Study Design: Randomized Controlled Trial. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi. Period: November 2016 to May 2017. Material & Methods: The study was initiated after approval from the institutional research forum of Rawalpindi medical college. Patients fulfilling the selection criteria reporting at surgical unit – I, Holy Family Hospital, Rawalpindi were included in the study. Written informed consent was taken. Random allocation of the study participants to either study group was done by using lottery method, 60 patients were randomly allocated to either group A(insulin soaked dressing) or Group B (conventional dressing), each with 30 patients. Results: In Group A, insulin soaked dressing was applied whereas patients in Group B were applied with conventional dressing. Mean age (years) of patients was 48.04+13.45 whereas there were 32 (53.3) male and 28 (46.7) female patients. In the study, mean duration (day) of complete wound healing in patients with diabetic ulcers receiving insulin soaked dressing and conventional dressing was 39.80 + 8.04 and 47.60+6.52 respectively which was statistically significant (p-value 0.000). Conclusion: The study concluded that in patients with diabetic foot ulcer, average duration of complete wound healing was significantly less in patients with insulin soaked dressing as compared to conventional dressing.
Frequency of fetal iron deficiency anemia at the time of birth in obese mothers.
Authors:   Nishtar Medical University, Multan., Aziz Amna , Sultana Hajra ,   Nishtar Medical University, Multan., Qadir Saima ,   Nishtar Medical University, Multan., Ashraf Saima ,   Nishtar Medical University, Multan., Masood Muhammad Sajjad ,   Nishtar Medical University, Multan.
Published: August 2021

Objectives: To determine frequency of fetal iron deficiency anemia at the time of birth in obese mothers. Study Design: Cross-sectional Descriptive study. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period: September 2018 to February 2019. Material & Methods: A total of 368 obese pregnant women with singleton pregnancy between 37 -40 weeks of gestation were included in the study after informed consent. Cord blood was collected after delivery via syringe aspiration from the umbilical vein. Fetal Iron status in the form of serum iron, hemoglobin, transferrin saturation was measured with calorimetric endpoint assay. Obesity in pregnancy is defined as BMI equal and more than 30kg/m2. Fetal iron deficiency anemia was defined as fetal hemoglobin less than 14.5g/dl, fetal iron 97.3micro gram/dl and transferrin saturation 39.6% at birth. Results: Among 368 cases, 87.8% of cases were having their BMI 30kg/m2 to 34.9kg/m2. BMI between35kg/m2 to 39.9kg/m2 was noted in 10% of cases and in 2.2% of cases BMI was equal to or more than 40kg/m2. Frequency of neonatal iron deficiency anemia was 22.8%. Conclusion: There is a increase prevalence of obesity in women of childbearing age however maternal obesity has no significant correlation of fetal iron deficiency anemia.
To explore the impact of following the pre-operative fasting guidelines by ASA (American society of anesthesiologists), in improving patient outcome.
Authors:   Ghulam Muhammad Mahar Medical College Hospital, Sukkur., Siddiqui Maqsood Ahmed , Perchani Ashok ,   Dow University of Health Sciences, Karachi., Raza Hamid ,   Liaquat University of Medical and Health Sciences, Jamshoro Hyderabad., Soomro Ahmeduddin ,   CMC Hospital, Larkana., Kamlesh  ,   Civil Hospital Karachi., Luhana Sorath ,   Civil Hospital Karachi.
Published: August 2021

Objective: To analyze the occurrence and consequences of a prolonged preoperative-fasting. Study Design: Cross-sectional study. Setting: Large tertiary care hospital in Pakistan. Period: October 2018 to October 2019. Material & Methods: We collected data for all the procedures that occurred during the study period and divided the cases into emergency procedures, add-on procedures and elective cases. We excluded the first cases of the day and excluded the emergency and add-on cases. We studied the patients NPO duration and their scheduled start time of the procedure and compared with their actual start time of the procedure. Results: The study population was n= 434 cases. Of these 434 cases n= 164 cases were performed on time and n= 270 cases were delayed by 60 minutes or more from their scheduled time. The most frequent reason was a previous cases running longer than expected in 59.25% of the cases, the second most common reason was a change in sequence and order of the procedures which was the case for delay in 14.44% of the cases. The overall mean time of NPO for the patients was found to be 770.1 +/- 130.6 minutes, for the delayed cases the mean time duration of NPO was 812.3 +/- 105.3 minutes. The mean time of case delay was 155.2 +/- 102.7 minutes for overall cases and for the significantly delayed case the mean time period of delay was 190.2 +/- 92.1 cases. Conclusion: Our results showed that 60% of the cases have a prolonged NPO status due to delays in start of their surgical procedure as compared to the scheduled times.
Epidemiological charactristics of acute hepatitis in tertiary care hospital.
Authors:   FMU/PMC. Faisalabad Medical University, Ghulam Mohammed Abad General Hospital, Faisalabad., Ather Hafiz Mughees , Mahmood Arfan ,   Faisalabad Medical University, Ghulam Mohammed Abad General Hospital, Faisalabad., Shahid Affan ,   Faisalabad Medical University, Ghulam Mohammed Abad General Hospital, Faisalabad., Osama Mohammed ,   DHQ Teaching Hospital, Sahiwal Medical College., Shani Mohammad Idrees ,   Faisalabad Medical University, Allied Hospital, Faisalabad
Published: August 2021

Objective: To record the epidemiological, characteristics of Acute hepatitis patients. Study Design. Cross Sectional study. Setting: Government General Hospital Ghulam Muhammad Abad, Faisalabad. Period: March 2019 to 30th of September 2019. Material & Methods: A total of 92 patients included in the study. Patient’s epidemiological characteristics, symptoms and lab results were recorded during hospital stay. Categorical variables were analyzed using Chi-Square and Fissure Exact tests. P value of <0.05 was considered statistically significant. Results: 78% were male & 22% were female. Water source was 16% filtered water, 32% ground water & 52% was Government supplied water. Most common symptom was yellow sclera (100%), Dark urine (100%), Nausea, fatigue and anorexia (Each 87%), Vomiting (83%), Fever (73%), Right hypochondriac pain (70%), Body aches (66%) and headache was 61%. Among the risk factors other than water source, outside eating was present in 74% and tattooing was present in 5% while blood transfusion history and Ear/Nose piercing was 0%. All 92 patients discharged in stable condition (100%). Tests for determination of cause i.e HAV & HEV serology were ordered in each case. Conclusion: Young males were affected more commonly. Presentation of acute hepatitis varies in symptoms but mostly the disease is self-limiting and running a mild course without leading to liver failure. Most common risk factor was outside eating in unhygienic environment which should be avoided.
Frequency of meconium stained liquor in low risk laboring women and its effect on perinatal outcome in a tertiary care hospital.
Authors:   Military Hospital, Rawalpindi., Choudry Abeera , Habib Maria ,   Shifa College of Medicine, Islamabad., Shamim Zaineb ,   FUMC RWP., Batool Syeda Zubda ,   Military Hospital, Rawalpindi., Haroon Marium ,   Military Hospital, Rawalpindi., Kallu Uzma Rehman ,   Military Hospital, Rawalpindi.
Published: August 2021

Objective: To evaluate the frequency of meconium stained liquor (MSL) in low risk women and its effect on perinatal outcomes. Study Design: Prospective Case Control study. Setting: Department of Obstetrics and Gynecology Military Hospital, Rawalpindi. Period: January to August 2017. Material & Methods: Distribution of MSL was studied according to its grade. Data included demographic profile, mode of delivery, intrapartum factors and neonatal outcomes. Descriptive statistics and chi-square were used for analysis. Results: Frequency of MSL was 376 (3.65%) among 10,281 deliveries during study period. A total of 752 women were included in the study which were divided into cases and controls. Nulliparity and advanced gestational age were significantly associated with MSL. Distribution of grade of meconium was 20.5%, 56.4% and 23.1% for grade I, II and III MSL. Breech presentation, fetal heart rate abnormalities and cesarean section were significantly associated with MSL. Low apgar score at 1 and 5 minutes, Neonatal intensive unit care admissions and fetal complications had positive correlation with MSL. Frequency of meconium aspiration syndrome (MAS) was 16.4%, birth asphyxia 5.31% and respiratory distress syndrome (RDS) 1.32% amongst all the cases of MSL. However, frequency of MAS, birth asphyxia and RDS was 0.6%, 0.19%, 0.02% in general obstetric population. Neonatal mortality was 29% in MAS, 3.4% in MSL and 0.12% in general population. Adverse neonatal outcomes had positive correlation with increasing grade of meconium. Conclusion: There is a significant frequency of meconium stained liquor even in low risk women. MSL is significantly associated with increased cesarean section rates and adverse neonatal outcomes.
Frequency of familial short stature identified in children presenting with short stature at a Tertiary Care Hospital in Multan, Pakistan.
Authors:   The Children Hospital & The Institute of Child Health, Multan., Khan Waqas Imran , Noreen Asia ,   The Children Hospital & The Institute of Child Health, Multan., Tabasum Summera ,   The Children Hospital & The Institute of Child Health, Multan.
Published: August 2021

Objectives: The objective of my study was to determine the frequency of familial short height in children aged 3 to 14 years with short height. Study Design: Descriptive study. Setting: Department of Pediatric Endocrinology at The Children Hospital & Institute of Child health Multan (CH& ICH). Period: 1st November 2018 to 31st October 2019. Material & Methods: Eighty four patients were enrolled after taking informed consent from parents/guardians. Heights of all patients, parental heights, mid parental heights were plotted on CDC growth charts. Patients having familial short stature were noted down. Results: Out of 84 patients, 59 (70.2%) were males and 25 (29.85%) were females. Age range was 3-14 years. Mean age of the population was 8.68 ± 3.42 years and mean height and weight were 114.29 ± 24.62cm and 28.95±10.01 kg, respectively. Mean height for mother and father of the patients were 154.39 ±4.56cm and 171.10 ± 3.52cm, respectively. Out of 84 children, 21 (25%) patients had FSS. In our study population FSS was more seen in children < 8 years of age, female gender and families with income of > 20K/months with p value of 0.879, 0.129 and 0.592 respectively. Conclusion: Majority of children presenting with short stature have FSS and CDG and do not have an endocrine disorder. In our study, frequency of familial short stature in children aged 3 to 14 years was 25%. The results should be validated in multicenter studies.
Species of plasmodium (P. Falciparum and P. Vivax) involved in children with malaria: An experience from a tertiary childcare hospital.
Authors:   The Children’s Hospital & ICH, Multan., Maqsood Muhammad Shahzad , Hussain Safdar ,   The Children’s Hospital & ICH, Multan., Khurshid Asim ,   The Children’s Hospital & ICH, Multan., Waqar Sana ,   The Children’s Hospital & ICH, Multan.
Published: August 2021

Objective: To find out different species of plasmodium (P. falciparum and P. vivax) involved in children with malaria at a tertiary childcare hospital. Study Design: Descriptive, Cross-sectional study. Setting: Department of Paediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 281 cases of either gender, aged 1 to 12 years and patients with malaria were enrolled. A special template was designed to record study information. Venous blood as five ml sample was drawn and dispatched to institutional laboratory for ICT malaria, complete blood count and giemsa stain smear and observed under light microscope. Data analysis was performed employing SPSS version 24.0. Results: Out of a total of 281 cases, 177 (63.0%) were male ande 104 (37.0%) female. Mean age of study participants was 4.29±2.48 years. A total of 135 (48.0%) children belonged to rural areas and 197 (70.1%) had monthly family income < 25000 rupees. Mean duration of illness was 4.21 ± 2.12 days. Previous history of use of anti-malarial drugs was noted in 62 (22.1%) of our study cases. Plasmodium falciparum was observed in 52 (18.5%) cases and plasmodium vivax in 229 (81.5%). Conclusion: Plasmodium vivax is predominantly more prevalent in our population as compared with plasmodium falciparum in children with malaria. Plasmodium falciparum and plasmodium vivax were significantly linked with age and disease duration. Malaria was noted to be more prevalent among poor families living in slum areas having inadequate sanitation facilities.
Early nasal continuous positive airway pressure in preterm neonates with Respiratory Distress Syndrome.
Authors:   Children Hospital and Institute of Child Health, Multan., Rehman Abdur , Quddusi Ahmad Iqbal ,   Bakhtawar Ameen Medical & Dental College Multan., Nadeem Aashee ,   Children Hospital and Institute of Child Health, Multan., Fatima Nazia ,   Children Hospital and Institute of Child Health, Multan., Iqbal Imran ,   Children Hospital and Institute of Child Health, Multan.
Published: August 2021

Objective: To assess the effectiveness of early nasal Continuous Positive Airway Pressure (nCPAP) in preterm neonates with respiratory distress syndrome (RDS). Study Design: Cohort study. Setting: Department of Neonatology, The Children’s Hospital and Institute of Child Health, Multan. Period: September 2018 to June 2020. Material & Methods: A total of 172 neonates admitted to neonatal intensive care unit (NICU), having RDS with gestational age as 28 to 34 weeks were enrolled. All study participants were administered early nCPAP (within 6 hours of onset of RDS). All babies with RDS were evaluated using Silverman–Anderson (SA) score, blood gas analysis and pulse oximetry. Results: Out of a total of 172 neonates, most, 91 (52.9%) were mal, nourished 89 (51.7%) had gestational age between 31 to 32 weeks and 97 (56.4%) with birth-weight between 1000 to 1500 grams. Majority of the neonates, 97 (56.4%) were found to have radiological grading of RDS as moderate. Successful outcome of early nCPAP was observed in 143 (83.1%) neonates. There was no statistical difference in terms of nCPAP outcome among study participants with respect to gender (p=0.4990). Gestational age, birth weight and severity of radiological grading of RDS were significantly associated with outcome of nCPAP (p <0.00001). Arterial blood gas parameters as PO2, PCO2 and HCO3 were also significantly associated with nCPAP outcome among study participants (p<0.0001). Conclusion: Early Nasal CPAP is safe, inexpensive and effective means of respiratory support in neonates with RDS. Early nasal CPAP is useful especially in mild to moderate grade RDS.
The effect of local tramadol infiltration in post pyelolithotomy pain.
Authors:   Sahara Medical College Narowal., Durrani Haq Dad , Sadaf Sairah ,   Sahara Medical College Narowal., Naqvi Syed Aushtar Abbas ,   D.G. Khan Medical College, Dera Ghazi khan., Bajwa Manzoor Hussain ,   M. Islam Medical and Dental College, Gujranwala., Ahmad Mirza Shakeel ,   D.G. Khan Medical College, Dera Ghazi Khan., Khalid Muhammad ,   D.G. Khan Medical College, Dera Ghazi Khan.
Published: August 2021

Objective: To compare the analgesic efficacy of tramadol wound infiltration with normal saline wound infiltration in patients undergoing Pyelolithotomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, ICU and Pain Medicine, DG Khan Teaching Hospital, Dera Ghazi Khan. Period: July 2019 to September 2019. Material & Methods: Total 60 patients were included in this study. There were 30 patients in whom normal saline was used for wound infiltration and in other 30 patients tramadol was used for wound infiltration. Analgesic outcomes were noted in terms of Numerical Rating Scale (NRS) of pain in the recovery room, at 06 hours and 24 hours after surgery, mean time of first rescue analgesia and total dose of tramadol within 24 hours after surgery. Results: Mean pain score in the recovery room was 5.20±2.10 in saline group versus 2.60±1.13 in tramadol group (p<0.001). Mean post-operative pain score after 06 hours of surgery was 5.43±1.45 in saline group versus 2.30±1.05 in tramadol group (p<0.001). Pain score was 3.63±1.40 in saline group versus 1.67±0.80 in tramadol group after 24 hours of surgery (p<0.001). Mean time of first rescue analgesia was 6.16±2.47hours in tramadol group versus 0.97±1.46hours in saline group (p<0.001). Total dose of tramadol used for analgesia within 24 hours after surgery was 56.67±70.38mg in tramadol group versus 253.33±73.02mg in saline group (p<0.001). Conclusion: Wound infiltration with tramadol provides better analgesia as compared to normal saline in patients undergoing Pyelolithotomy.
Anxiety and depression level in working mothers who leave their children at home as compared to those who leave them at day care.
Authors:   AMC/PGMI/LGH, Lahore., Zubair Fizza , Khan Muhammad Imran Hasan ,   AMC/PGMI/LGH, Lahore., Zulfiqar Maryam , Shakeel Salman ,   AMC/PGMI/LGH, Lahore.
Published: August 2021

Objective: We aimed to find out the differences in degree of depression and anxiety experienced by working mother who leave their children at daycare as compared to those who leave them at home. Study Design: Cross Sectional Descriptive study. Setting: Lahore General Hospital Lahore. Period: October, 2019 to March, 2020. Material & Methods: Through random sampling, 100 working mothers participated by filling a structured questionnaire after informed consent. It consisted of 50 women leaving their children at home and 50 women preferring day care centers while being on work. SPSS was used for analyzing the data. Beck Anxiety Inventory (BAI) and CES-D was used to calculate anxiety and depression levels respectively. Results: Mild to moderate depression and possibility of major depressive disorder along with moderate and severe anxiety is seen more in women leaving children at day care. Low and middle age, leaving kids at hand of maids, grandparents or day care or less educated family members, concerns regarding upbringing of children contribute to stress of working mothers. Our work shows that married women with their spouses develop more major depressive disorders and severe anxiety as compared to divorcees and widows. Nuclear and high-income families have more trend of leaving their children at day care. Conclusion: This study suggests that the women who leave their children at day care show increased rate of moderate and severe anxiety, mild to moderate depression and the possibility of major depressive disorders as compared to those leaving at home.
Axillary lymph nodes and breast cancer metastasis.
Authors:   Chandka Medical College Shaheed Mohtarma Benazir Bhutto Medical University Larkana., Soomro Shahid Hussain , Abro Abdul Sattar ,   Chandka Medical College Shaheed Mohtarma Benazir Bhutto Medical University Larkana., Shah Vaqar-e-Sahar ,   Chandka Medical College Shaheed Mohtarma Benazir Bhutto Medical University Larkana., Shaikh Saima Ather ,   Liaquat National Hospital & Medical College Karachi., Shaikh Shabnum Naz ,   Chandka Medical College Shaheed Mohtarma Benazir Bhutto Medical University Larkana., Malik Ehsan Ullah ,   Chandka Medical College Shaheed Mohtarma Benazir Bhutto Medical University Larkana
Published: August 2021

Objectives: The purpose of current study is to evaluate the correlation of axillary lymph node status with metastases in patients presented with carcinoma breast. Study Design: Prospective study. Setting: Surgical Unit 1, CMC Hospital Larkana. Period: March 2019 to January 2020. Material & Methods: Female patients presented with carcinoma breast were assessed clinically and by investigation then underwent a mastectomy and axillary dissection (sampling or clearance). Data was entered into pre-designed proforma. After proper staging, surgery was done in all patients accordingly. Lymph node involvement was confirmed histopathology. Then it was correlated with clinical findings. Results: Fifty-five female patients of proven carcinoma breast underwent a mastectomy and axillary dissection. The majority of the patients (76%) were between 30-60 years, the median age being 45 years. The left breast contained the tumor in 30 (55.5%) patients while the rest of the patients had the right breast involved. The size of the tumor varied from 2cm to 12cm. 33 (61%) patients were in the pre-menopausal state while 21 (38.88%) were in postmenopausal state. In 07 patients (13%) the axillary lymph nodes were not palpable while in the rest of the 47 patients (87%), the axillary lymph nodes were palpable to a variable extent. Most of the patients were in an advanced stages. Among seven patients (N0), histopathology revealed positive lymph nodes in 3/7 (42.85%) patients. Conclusion: Breast carcinoma is a serious type of carcinoma affecting the younger generation in our community, usually diagnosed at a late stage. Clinical examination is not an effective way for proper staging. Further investigations should be performed for accurate staging and management.
A study on prescribing patterns in patients with rheumatoid arthritis.
Authors:   Fazai Medical College Islamabad/, Naseem Sajid , Zahoor Ambreen ,   HBS Medical and Dental College Islamabad, Choudhary Zaidan Idrees ,   HBS Medical and Dental College Islamabad., Sultana Tania ,   HBS Medical and Dental College Islamabad.
Published: August 2021

Objective: The aim of this study was to assess the prescribing patterns and frequency of use of various drug classes in patients with rheumatoid arthritis in a teaching hospital in Islamabad, Pakistan. Study Design: Descriptive Cross Sectional study. Setting: Medical Outpatient Department of HBS General Hospital, Islamabad. Period: August 2018 to March 2019. Material & Methods: Patients of rheumatoid arthritis were included in the study using non-probability consecutive sampling technique. Socio-demographic details and medication history was collected on pre-designed proforma. Data was analyzed using SPSS version 22. Results: A total of 112 patients were included in the study.108 patients (96.4%) were using disease modifying anti-rheumatic drugs. The most prescribed medication in the patients was methotrexate (n=82, 73%). One disease modifying anti-rheumatic drugs with a steroid was the preferred combination (n=32, 28%). Non-steroidal anti-inflammatory drugs (21%) and steroids (20%) were the other major drug classes among the total medications prescribed. Only one patient included in the study was using biologics. Conclusion: Conventional disease modifying anti-rheumatic drugs in combination with steroids and non-steroidal anti-inflammatory drugs are the preferred therapy in patients of Rheumatoid arthritis in local settings. Methotrexate is the most commonly used disease modifying anti-rheumatic drugs. The use of biological agents remains low as compared to the developed world owing to their high cost.