bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis and Characterization of Rare Earth Doped Ferrite / Polyethylene Oxide Nanocomposites
Authors: Ishfaq Muhammad , Gul Mahvish , Alamri Hatem , Nasar Gulfam , Ur Raheem Faseeh
Published: March 2023

Nano-sized Li0.5Ni0.48Tb0.02Dy0.1Fe1.9O4 spinel ferrite nanoparticles were synthesized employing the micro-emulsion synthesis method. Polyethylene oxide was prepared through in-situ polymerization route. The ferrite-polymer nanocomposites have been synthesized by combining Li0.5Ni0.48Tb0.02Dy0.1Fe1.9O4 ferrite with polyethylene oxide polymer. Spectral, structural, morphological, and dielectric properties of the prepared nano-ferrite powders as well as nanocomposites were investigated by “X-ray diffraction analysis” (XRD), “scanning electron microscopy” (SEM), “Fourier transform infrared spectroscopy” (FTIR) and dielectric measurements. XRD analysis confirmed the synthesis of single-phase spinel structure only. The dielectric parameter was augmented with an increase of ferrite amount. FTIR spectra confirmed the existence of interactions between polyethylene oxide and ferrite particles. SEM study revealed that the nanocomposites comprised core/shell structure and inhomogeneous distribution of grain size. The dielectric parameters such as “real part of dielectric constant” (?), “imaginary part of dielectric constant” (?"), “tan loss”, “AC conductivity” and “quality factor” were investigated in the required range of frequency; that is, 1 MHz – 3 GHz. The peaking behavior has been observed for real (??) and “imaginary (???) parts of dielectric constant” and “dielectric loss” (tan?). “The peaking behavior” was detected beyond 1.5 GHz. A decrease in “the dielectric constants” and “dielectric loss” was found to with the increasing frequency. Dielectric parameters have been well elucidated by explaining “Debye-type relaxation model” in agreement with two layer “Koop's phenomenological theory”. The present investigated samples might have potential applications in high frequency.
Objeción de conciencia judicial: criterios para su interpretación utilizados por la Corte Constitucional desde Alexy Guatini
Authors: Murillo Lina M , Ospina Cristina , Restrepo Rubén Dario , Coll Alex Rodrigo , Carvajal L Angela M
Published: March 2023

En este artículo se identifican los criterios de interpretación utilizados por la Corte Constitucional de Colombia al derecho de objeción de conciencia judicial, desde las perspectivas de la interpretación y la discrecionalidad de Alexy y Guastini, resaltando la conciencia como concepto y en su dimensión jurídica, discurriendo sobre los antecedentes del derecho de objeción de conciencia y su interpretación de parte de la Corte Constitucional, para posteriormente determinar cómo las teorías de Alexy y Guastini impactan en el ejercicio interpretativo de la Corte Constitucional para cercenar la objeción de conciencia a las autoridades judiciales, específicamente las razones expuestas en la Sentencia T-388/2009, planteamientos que son producto de una revisión bibliográfica a través del método de análisis que evidencia la dicotomía existente entre la decisión del juez de obedecer al derecho, aun cuando represente un actuar contrario a sus convicciones y creencias filosóficas, religiosas o morales.
Hacia una nueva realidad de las familias desplazadas del litoral Pacífico colombiano a la ciudad de Cali - Distrito de Agua Blanca (DAB): comprensión actuante desde sus filosofías milenarias
Authors: Enríquez Martínez Fabio Alberto
Published: March 2023

Este artículo surge de los hallazgos de la tesis doctoral del mismo nombre, la cual permitió conocer a las familias afrodescendientes que han tenido que abandonar sus territorios, experimentando con ello el resquebrajamiento de sus relaciones familiares, y luego han cohabitado y, de alguna manera, construido territorios y familias del Pacífico en el Distrito de Agua Blanca (DAB), de la ciudad de Cali, que se constituye en el mayor centro de recepción de las familias desterradas y en situación de desplazamiento forzado en Colombia. El trabajo con las familias en el DAB se hizo a partir de las narrativas orales acerca del destierro y el desplazamiento, las cuales se constituyeron en el camino para reconstruir sus historias y generar marcos de referencia orientados por la crítica existencial, y las teorías que emergen de las resistencias cotidianas. Para lo anterior, se utilizaron las observaciones de campo, las historias de vida, la realización de entrevistas en profundidad, igualmente la revisión de fuentes primarias, así como la puesta en práctica de grupos focales
Factores socioeconómicos y demográficos asociados a los homicidios en 23 departamentos de Colombia, 2012-2017
Authors: Arboleda Castro María Elvira , Montaño Bardales Juan Fernando , Rojas Muñoz Sergio
Published: March 2023

El objetivo del artículo es identificar los factores socioeconómicos y demográficos que afectan la tasa de homicidios en 23 departamentos de Colombia en el periodo 2012-2017. El estudio consistió en analizar la dinámica de variables dependientes de este delito, al igual que los periodos de estimación a través de panel de datos. Se empleó un modelo econométrico con la información de las variables explicativas a lo largo del tiempo, para la evaluación de instituciones públicas eficientes y responsables para la prevención, donde se puede demostrar estadísticas para Colombia. Mediante la construcción de la base de datos y del modelo econométrico se analizó el proceder de los determinantes de esta expresión de la violencia, para encontrar soluciones viables para el control respectivo. Por último, se interpretaron los coeficientes significativos para entender de mejor manera los resultados y se hicieron recomendaciones en materia de políticas públicas que tengan como intención reducir esta criminalidad.
Fotoperiodismo en Venezuela: de “El Porteñazo” a las protestas y las caras del hambre
Authors: Ramírez Alvarado María del Mar , Pérez Daza Johanna , Mancinas-Chávez Rosalba
Published: March 2023

La presente investigación ofrece un estudio sociocultural de la fotografía periodística en el escenario venezolano mediante la revisión de las imágenes que han recibido reconocimiento internacional en los premios World Press Photo y Pulitzer. A partir del análisis y contextualización de fotografías de corte periodístico y documental, el objetivo ha sido el de reflexionar sobre la función social y usos de la imagen en la contemporaneidad. El corpus ha estado integrado por imágenes de fotógrafos venezolanos o radicados en Venezuela que han sido premiadas con los mencionados galardones: dos fotografías individuales y dos series de fotografías. La más antigua es la foto de Héctor Rondón, de 1962, sobre el suceso conocido como “El Porteñazo”. La segunda de las fotografías y la primera serie tienen como contexto común las protestas y disturbios del 2017 contra el gobierno de Nicolás Maduro. Sus autores son Ronaldo Schemidt y Juan Barreto, respectivamente. La última serie muestra las víctimas del hambre y la desnutrición en Venezuela y fue publicada por The New York Times. Su autora es la fotoperiodista Meridith Kohut. Todas estas fotografías han sido estudiadas empleando una matriz de análisis que incluye la profundización de los conflictos y realidades que muestran, su valor intrínseco como imagen, así como la repercusión y proyección de las mismas. Las conclusiones del trabajo dan cuenta de cómo la visualización de los hechos a través de la fotografía y su reconocimiento internacional afirman las posibilidades de la imagen para aproximarse a la realidad y mostrar sus matices y contrastes. También su valor de denuncia. El que estos premios se otorguen tiempo después de los sucesos registrados permite retomar los temas que documentan, a veces olvidados o desplazados ante la vorágine de nuevos acontecimientos.
The Rhetoric of Illiberal Democracy: Viktor Orbán’s Narratives of National Ascent and a Nation in Peril
Authors: Trifonov Svilen Veselinov
Published: March 2023

The rise of illiberalism and nationalism in Hungary is often attributed to Viktor Orbán’s leadership and rhetoric over the past decade. His ideas and words have also reverberated around the globe and served as models for conservative leaders. This article offers a rhetorical analysis with a focus on the role of the intertwining narratives of national ascent and a nation in peril as containers for the ideology of illiberalism. Taking a narrative perspective, it examines the way in which Orbán appeals to Hungarians to embrace nationalist, isolationist, and illiberal approaches to democratic governance. It concludes with a discussion of the implications of the rhetoric of illiberalism and the implications for future research into the rhetorics of the newest wave of conservatism spreading throughout the world.
Living with Substance Abused Spouse: A Phenomenological Approach
Authors: Touseef Saba , Iftikhar Rabia , Kazmi Syed Messum Ali , Majeed Ayesha
Published: March 2023

Introduction: Substance abuse is social problem throughout the world due to which not only the life of addicted person but also his families especially his spouses are also affected. Aim: The current study aimed to explore the lived experiences of the spouses of substance abused men and the impact of their husband addiction problem on different aspects of their lives. Material and Method: The design of this study was a cross sectional study design and this study was conducted at Mayo Hospital Lahore. A sample size of eight (N=8) were recruited. Interview guide consists of open ended questions which were developed for the purpose of data collection. Semi structured interview approach was employed for conducting interview. Interpretative phenomenological analysis was used to analyse the interviews. Results: Results from analysis yielded eleven super ordinate themes. These includes social support, challenges on societal level, unhealthy home environment, unhealthy relationship supportive wife, financial instability, physiological problems, psychological complaints, change in personality, concerned mother and religious coping. Conclusion: The results will contribute to understanding the impact of substance abuse of men on their spouses. It will help in developing an educational program for those people who are the risk by increasing their awareness and changing their behavior for preventing addiction problem and will also aid in developing counseling plans for the spouses of substance abusers. Keywords: Substance abuse, Interpretive Phenomenological Analysis, Financial Instability, Religious Coping
Diabetic Disease and its 2-4 Fold Mortality Rate, Patients Getting Standard Therapy in the Modern ERA of CVD Risk Reduction
Authors: Aslam Imran , . Asadullah , Ahmed Rana Nisar , Akhlaq Fizzah , Ali Asghar , Fatima Ayesha
Published: March 2023

Aim: This meta-investigation expected to explain the relationship between temperamental body weight by danger of type 2 diabetes mellitus, a connotation that was controversial in longitudinal researches. Methods: The design of this study was an Meta analysis study design. This study was conducted at mayo Hospital Lahore and a total of 160 patients were the participant of this study. Electronic font searches by means of EMBASE and MEDLINE were tracked. The relative risks of T2DM in individuals with moderate d body weight remained pooled by means of opposite change technique. Results: Ten researches qualified for meta-study. Mean period of estimates t of separately. Weight changes. The pooled and follow-up RR (96% annual certainty for learning margin (CI)) T2DM for were the least 13.5vs. moreover the most 10.6 years, stable classification (P=0.049). was Ob 1.34 (1.13-1.58). T2DM was Between study discovered clarified by heterogeneity blood test was really 67.1% of critical the change in risk of was logarithm not huge of RR (P=0.03). (RR (96% In CI), 3 examinations 1.06 (0.91-1.26)). in which blood Furthermore, test distribution was performed, inclination that T2DM extended T2DM danger was measurably identified by Egger's test (P=0.08). Practical Implication: The puspose of this study was to prevail the awareness among the people of the societies about the diabetes and their risk factors and to inform them about prevention of this diseases and what steps should be taken to avoid this diseases. Conclusion: Unsteady body weight may be inconspicuously associated with increased danger of T2DM, although genuine predispositions, for example, propensity to symptomatic doubt and distribution propensity, made it difficult to evaluate this association. Keywords: Type 2 Diabetes Mellitus, CVD Risk Reduction, Pakistan.
An Observational Study on the Early Stages of the Covid-19 Pandemic in Pakistan
Authors: Nasir Mehreen , Mehdi Muntazir , Qureshi Muhammad Waseem , Rahim Anum , Tahir Shakeeb , Awan Irum Shahzadi
Published: March 2023

Bachground: The coronavirus disease 2019 (COVID-19) pandemic, which started on February 26, 2020 in city of karachi, spread quickly throughout Pakistan. Material and Method: The design of this study was a observational study design and this study was conducted at king Edward medical University Lahore. More than 6,200 persons were afflicted by the illness in the first seven weeks, and there were more than 111 documented fatalities. Many problems arise if we contrast the COVID-19 tragedies in Pakistan with those in nations like China, Iran, and the European Union. The geography of the nation, poverty, poor literacy rates, environmental circumstances, sanitary conditions, and dietary habits are only a few of the difficulties we face in containing this epidemic. Although there are terrible circumstances in each of these areas, Pakistan's COVID-19 epidemic was slower than that of other developing nations. Results: The impact of COVID-19 appears to be lessened by Pakistan's humid hot temperature, early reaction to COVID-19, population immune system, BCG vaccination, and the proportion of young individuals. In this essay, we explore the COVID-19 pandemic outbreak in China, Iran, and Pakistan and present its day-to-day changes. We outline the COVID-19 structure and how it compares to SARS-COV and SARS-COV2. The use of Remdesivir (an adenosine analogue used against RNA viruses), Chloroquine (a widely used anti-malarial drug), convalescent plasma, neutralising antibodies targeting the ACE-2 receptor, and an ACE-2-like molecule that might bind to the S protein of the coronavirus are also covered in terms of treatment options and their drawbacks. Also covered are the effects of COVID-19 on Pakistan's economy and government relief measures. Conclusion: In conclusion, it may be said that the support systems in place may not be sufficient to stop the spread of the virus. Even with the meagre assistance offered, it is weaker for rural places where the virus's effects may be severe than in the nation's cities. Further research is required as the epidemic develops to better understand governmental efforts to contain the virus and its effects across the nation. Keywords: Coronavirus COVID-19 Pakistan Pandemic Outbreak
Frequency of Vitamin D Deficiency in the Mothers of Low Birth-Weight Newborns: A Cross-Sectional Study
Authors: Ashok Komal , Radhan Abdul Hameed , Shaikh Farzana , Khosa Khuda Bux , Qambrani Zamir Ahmed , Kumar Suresh , Chohan Muhammad Nadeem
Published: March 2023

Objective: To determine the frequency of vitamin D deficiency in the mothers of low birth-weight newborns Study design: A cross-sectional study Place and Duration: Postnatal/Neonatal ward, Liaquat University Hospital Hyderabad and Jamshoro, from December 2020 to June 2021 Methodology: The study includes full-term newborns who had low birth weights, regardless of gender, and who were admitted to a neonatal or postnatal unit. Each mother gave a 5ml blood sample, which was sent right away to the hospital laboratory. Within 24 to 48 hours following delivery, a diagnostic lab checked the mother's vitamin D level. To determine the neonatal birth weight in kilograms, all the neonates were measured. All of the information about the maternal vitamin D level, the neonatal birth weight, and demographic data were entered after the reports had been collected. The researcher performed all measures. The proforma had all of the information. With SPSS version 20, data analysis was carried out. Results: The average age of the mother was 26.46 + 3.91 years. A total of 53.6% of newborns were males and 46.4% of newborns were female. Overall 90% of women were housewives, while 10% were employed. Women made up 68.6% of the reservations, while 31.45% were not. A total of 33.6% of all newborns underwent caesarean procedures, compared to a normal vaginal delivery rate of 66.4%. Eighty-seven percent of mothers were vitamin D deficient, and of them, 45.0% had mild deficiencies, 23.6% had moderate deficiencies, 12.1% had severe deficiencies, and 19.3% had normal vitamin D levels. Related to maternal age, newborn gender, and occupation, vitamin D deficiency was statistically insignificant (p>0.05), but it was statistically significant (p-0.05) according to a place of residence, educational attainment, SES, parity, booking status, and delivery method. Conclusion: Frequency of vitamin D deficiency was found to be highly prevalent among mothers, of neonates who presented with low birth weight. Keywords: Newborn, vitamin D, Birth weight
A Study on the Effects of Pregabalin and Amitriptyline in Treatment of Patients with Painful Diabetic Neuropathy
Authors: Sharif Unaiza , Shabbir Awais , Khan Faramarz , Ain Farhat Ul , Khurram Muhammad , Baig Abdul Kabeer
Published: March 2023

Objective: To compare the effect of Amitriptyline and Pregabalin in treatment of painful diabetic neuropathy. Material and Methods: The design of this study was Randomized Controlled Trial study design. This study was conducted in the Department of Medicine in, Holy Family Hospital, Rawalpindi and the duration of this study was Six months after the approval of synopsis i.e from 1st November 2019 to 1st May 2020. Approval from ethical committee of the hospital was taken. Written informed consent was taken from patients. Consent form is attached with this. Patients were randomly allocated into two groups by lottery method. The dose of Pregabalin was used as 50mg thrice daily for a period of six weeks and label as group-A and group B received amitriptyline as 25mg once daily before bedtime for a period of six weeks as prescribed by a senior consultant who was blind to object of the study. At the start and end of treatment pain was marked by patients on Visual Analogue Scale (VAS) and numerical score. It was noted on the Performa. Results: Total 100 patients were included according to the inclusion criteria of the study. The dose of Pregabalin was given in patients in group-A and group-B received amitriptyline. Mean age (years) in the study was 55.87+6.43 whereas there were 55 (55.0) male and 45 (45.0) female patients who were included in the study according to the inclusion criteria. In our study, frequency and percentage of effect (pain relief) among Pregabalin and Amitriptyline in treatment of painful diabetic neuropathy was 27 (54.0) and 11 (22.0) respectively which was statistically significant (p-value 0.001). Practical Implication: In this study Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of amitriptyline and Pregabalin in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Conclusion: The study concluded that Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of Pregabalin and amitriptyline in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Keywords: Amitriptyline, Pregabalin, Neuropathy, Pain Relief, Diabetic Sensorimotor Polyneuropathy, Prevalence.
A Cros Sectional Study on the Plateletcrit and Platelet Indices in Different Forms of Dengue Fever
Authors: Hussain Sadaqat , Sharif Unaiza , Baig Abdul Kabeer , Raja Sehrish , Khurram Muhammad , Mahmood Saira
Published: March 2023

Background: Dengue fever is a viral disease caused by four different serotypes of dengue viruses from DENV, transmitted mostly by the Aedes aegypti mosquito. The disease has history of many outbreaks mostly in tropic and sub-tropic countries, costing many lives annually, with millions in mild to complicated forms, bringing stress to health systems and economies of poor countries. Dengue epidemic occurred in Pakistan in 2010 with 257 deaths during the epidemic and prevalence of 16580 cases in Rawalpindi, repeated epidemic in 2015, 2017, 2018 and 2019 with higher prevalence. Objective: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever. Materials And Methods: The design of this study was an observational cross sectional study design. This study was conducted in the Department of Infectious Diseases, Holy Family Hospital, Rawalpindi and the duration of this study was 6 months after the approval of synopsis i.e 1st May 2021 to 30th Oct 2021. Patients fulfilling selection criteria were enrolled in the study from emergency of Department of Infectious Diseases, Holy Family Hospital Rawalpindi. Informed consent was taken. Then patients were evaluated and divided for severity score (annexure I). Reports were assessed for Platelet indices including platelet count, mean platelet volume, platelet distribution width (as per operational definition). All this information were recorded on proforma (attached). Results: Total 150 participants were enrolled in the study as per the inclusion criteria. Mean age in the study was 38.42+13.74 whereas there were 94 (62.7%) male and 56 (37.3%) female patients who were included in the study according to the inclusion criteria. Among 150 patients, 28 (18.7%) patients were presented with dengue hemorrhagic fever in patients of dengue fever. Mean Platecrit indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 0.26+1.62 vs 0.08+0.02 (p-value 0.552) whereas mean platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 64.19+41.11 vs 78.10+32.74 (p-value 0.097). Practical Implication: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever Conclusion: The study concluded that different indices of platelets within different forms of dengue fever to assess the severity of the disease process may serve as an early indicator of disease progress and severity which will help to decide early intervention. Keywords: Dengue Fever, Hemorrhagic, Platelet, Indices, Serotypes, Epidemic, Participants
Leukocyte Count: A Reliable Marker for Severity of Organophosphorus Intoxication
Authors: Ain Farhat Ul , Sarfraz Muhammad , Khurram Muhammad , Sharif Unaiza , Malik Mudassar Latif , Anjum Nida
Published: March 2023

Introduction: To determine reliability of leukocyte count on admission for prediction of mortality among patients with organophosphorus intoxication. Early prediction can help in preventing the poor outcome and improved management. This is cost and time effective method and better management and preventive protocols can be developed. Objective: To determine the diagnostic accuracy of leukocyte count in prediction of mortality in patients with organophosphorus intoxication keeping actual mortality as gold standard. Material and Methods: The design of this study was a Cross sectional study design. The duration of this study was six months from 31-03-2020 to 30-09-2020 and this study was conducted in the Department of Medicine (unit II), HFH, Rawalpindi. A total of one hundred and sixty (n=160) patients of either gender between age between 16-85 years who were confirmed cases of organophosphorus poisoning were enrolled. Leukocyte count levels were noted at the time of admission and patients were monitored for 7 days in the hospital for mortality. Results: The results showed that sensitivity, specificity, positive predictive value, negative predictive value and accuracy of raised leukocytes counts (>12000/uL) at admission as 60.4%, 77.8%, 50.0%, 84.3% and 73.1% respectively. ROC curve showed best cutoff value of raised leukocytes counts (>12000/uL) at admission as 10253/uL, where sensitivity of 72.1% and specificity of 58.1% was achieved. Area under the curve (AUC) was calculated as 0.707. Practical Implication: To determine the diagnostic accuracy of leukocyte count in prediction of mortality in patients with organophosphorus intoxication keeping actual mortality as gold standard Conclusions: Raised leukocytes counts (>12000/uL) at admission allowed prediction of mortality in patients with organophosphorus poisoning with reasonable accuracy. Our study results showed sensitivity, specificity, PPV, NPV and accuracy of 60.4%, 77.8%, 50.0%, 84.3% and 73.1% respectively. Keywords: Leukocyte Counts, Organophosphorus, Poisoning, Mortality, Intoxication, Predictive Value, Morbidity.
Frequency of Anterior Knee Pain (AKP) in Different Gender Groups after Total Knee Replacement (TKR)
Authors: Khan Sajawal , Hanif Muhammad , Ishaq Mohammad , Ullah Usman , Ullah Ghareeb , Khan Jamshed
Published: March 2023

Introduction: Anterior Knee Pain (AKP) is one of the most common causes of persistent problems after knee replacement. Total Knee Arthroplasty (TKA) is a surgical procedure in which artificial joint or prosthesis replace the damage knee. A significant proportion of the patients experience AKP after surgery. Objective: To find out the frequency of Anterior Knee Pain after Total Knee Arthroplasty. Study Setting: Department of Orthopedics, KTH Khyber Teaching Hospital, Peshawar. Study Design: A Cross sectional study. Study Duration: June -2020 to February -2021. Subjects and Methods: After recording complete history, physical examination and routine baseline investigations were done. Patients were put on OT list and surgeries were performed in all patients by expert orthopedic surgeon designated for performing total knee arthroplasty. Post-operatively, patients were kept under observations for 5 days in ward and were discharged if indicated. Patients were followed at regular intervals and finally at the end of 3rd month to measure the intensity of pain on VAS. Results: Out of 205 patients, 69.3% were males and 30.7% were females. Means ± SD calculated for age was 48.62±7.98 years, for BMI was 24.63±3.07 and for Pain on VAS was 1.31±1.39. Most patients (51.7%) were recorded in 51-60 years age group. Rheumatoid Arthritis (RA) in 18% while Osteoarthritis (OA) was found in 82% patients. 21.5% patients were diabetic while 31.7% patients were hypertensive. AKP at 3rd month was found in 8.8% patients. Conclusion: It is evident that anterior knee pain (AKP) after the total knee arthroplasty (TKA), or total knee replacement (TKR) is prevalent and clinically relevant. There is an absolute need for further investigations to find out ways to decrease or eliminate the AKP after TKA in order to improve the quality of life after this surgery. Keywords: Anterior Knee Pain, Total Knee Replacement, Total Knee Arthroplasty.
Effectiveness of Manual Vacuum Aspiration in the Management of Miscarriage and Retained Products of Conception
Authors: Balouch Ifat , Akmal Hina , Sardar Faryal , Brohi Zahida Parveen , Talpur Sabreena , Phulpoto Maryam
Published: March 2023

Objective: To assess the efficacy of manual vacuum aspiration (MVA) in terms of complications and complete uterine evacuation of the product of conception. Study design: Descriptive cross-sectional study. Place and duration: Department of Obstetrics and Gynecology, Bilawal Medical College, DHQ Hospital Kotri and CDF Hospital Hyderabad, from April 2020 to March 2021. Patient and method: All the patients with gestational of <14 weeks, and the diagnosis of missed miscarriage, blighted ovum, partial miscarriage, or RPOCs, who were undergone MVA was carried out. Primary outcome measures were efficacy and secondary outcome measures were to assess prevalence of complications including pain and cramps, infection and bleeding. Effectiveness was considered in terms of complete or incomplete evacuation. All the information was documented via a self-made study proforma. Results: A total of 83 patients were scheduled to undergo MVA. Majority of the cases 41.0% were presented with gestation age of 9 to 12 weeks. Most of the cases 56.6% had incomplete miscarriage, 31.3% were with missed miscarriage and 12.0% women had RPOCs. Mild to moderate pain and cramps were present in 91.60% of the cases, while only 6.0% of the cases had bleeding, and infection developed in 2 cases. According to effectiveness, complete evacuation was achieved in 81.9% of the cases. Conclusion: MVA is effective in the complete emptying of the uterine cavity and has high rates of acceptability and satisfaction. It reduces the waiting time for surgery, hospital stays, and GA complications. It is gradually gaining acceptability as a standard surgical procedure for safe early pregnancy termination. Keywords: Efficacy, safety, MVA, uterine evacuation, conception
Frequency of Dyslipidemia in Patients Presenting with Nonalcoholic Fatty Liver Disease
Authors: Ullah Muhammad Imran , Lala Gul-E , Karim Rashid , Zaman Nayyar , Jan Ibadulllah , Shahzadi Annum
Published: March 2023

Introduction: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in the developed world with increasing incidence among adults and children, and it is estimated to turn out leading cause for liver transplantation in America by end of this year1 It can present with variety of liver disease from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and cirrhosis. Purpose of our study is to determine frequency of dyslipidemia in patients with nonalcoholic fatty liver disease2, although many studies had already been conducted on the same topic but no such study has been performed in our setup for the last many years. This study will give us the latest magnitude of dyslipidemia in patients with nonalcoholic fatty liver disease in our setup which will result in timely diagnosis, better management and future recommendations. Objective: To evaluate the frequency of dyslipidemia in patients presenting with nonalcoholic fatty liver disease at Hayatabad Medical Complex, Peshawar. Material and Methods: This cross sectional descriptive study was carried out at Gastroenterology Department, Hayatabad Medical Complex, Peshawar from Ist January 2022 to 31 June 2022. In the current study a total of 124 patients were observed. All the routine investigation, clinical examination and history were taken from the included patients as per hospital protocol. All the patients were subjected to radiology department for ultrasound of abdomen aimed at confirmation of nonalcoholic fatty liver disease. All radiological examination was done by an expert radiologist (FCPS) having at least 2 years of experience. 5 cc of blood sample was taken from the included patients and was referred to hospital laboratory for the diagnosis of dyslipidemia. Laboratory investigations were entirely done by expert pathologist (FCPS) having at least two years of experience. Dyslipidemia was considered positive if the lipid levels is other than the normal range in one or more laboratory tests. Results: In this study 22(18%) patients were in age range 18-30 years and 102(82%) patients were in age range 31-60 years. 38(31%) patients were male while 86(69%) patients were female. 33(27%) patients had duration of disease ≤ 5 year and 91(73%) patients had duration of disease > 5 year. 38(31%) patients had BMI ≤ 25 Kg/m2 while 86(69%) patients had BMI >25 Kg/m2. 82(66%) patients were diabetic while 42(34%) patients were not diabetic. 89(72%) patients were hypertensive while 35(28%) patients were not hypertensive. 32(26%) patients had dyslipidemia while 92(74%) patients didn’t had dyslipidemia. Conclusion: Our study concludes that frequency of dyslipidemia was 26% in patients presenting with nonalcoholic fatty liver disease at Hayatabad Medical Complex, Peshawar. Keywords: dyslipidemia, nonalcoholic, fatty liver disease.
Tetanus Neonatorum: its Associated Risk Factors and Mortality Rate in Khyber Pakhtunkhwa
Authors: Ullah Farid , Ullah Farman , Naz Rida , Muhammad Taj , Ali Mubarik , Jabeen Norina
Published: March 2023

Background: Tetanus neonatorum is a preventable cause of mortality and neurological squeal that is more prevalent in resource-poor nations, perhaps because to low rates of mother immunization and unclean cord care procedures. Objectives: The study was conducted in different districts of Khyber Pakhtunkhwa to investigate the prevalence of tetanus neonatorum, its associated risk factors and mortality rate. Methods: This was a retrospective study conducted in five districts of Khyber Pakhtunkhwa during the year 2020-22, through evaluation of the hospital records of 185 tetanus infected neonates, for the assessment of acute risk factors and clinical outcome of the infection. Results: It was found that a significantly higher proportion (p<0.05) of the infected were neonatal fetuses of age less than ten days with the incidence of 83.24%. High mortality rate of 31.35% was observed in the infected infants in which 58 out of 185 infected infants did not survive. Most of the infected patients (p<0.05) were born at home (129/185), through vaginal birth (104/185) and delivered in unhygienic environment (156/185). A significantly high number of women were not immunized against the tetanus infection (p<0.05) and fetal umbilical cords were not managed aseptically and were cut with used razors (12.97%) and fastened with unhygienic threads (38.37%), rendering them vulnerable to the fatal infections. Conclusion: It was concluded that poor tetanus toxoid immunization of the mothers and unhygienic conditions were likely causes. Keywords: Deep wounds; Immunization; Umbilical cord; Unhygienic deliveries.
Risk Factors Associated with Early Onset Group B Streptococcal Disease and Newborn Outcomes in a Tertiary Care Center in Pakistan
Authors: Khani Muhammad Naveed , Ariff Shabina , Afzal Amir , Salat Sohail , Ahmed Saeed , Usman Muhammad
Published: March 2023

Background: To assess the risk factors associated with early onset group B streptococcal disease and newborn outcomes in a tertiary care center in Pakistan. Methods: A prospective cohort study design was implemented in the postnatal wards and neonatal intensive care unit of Aga Khan Hospital between 15 December 2021 – 15 June 2022. The exposed group included all pregnancies with risk of GBS infection, the un-exposed group included all pregnancies with no risk factors for GBS. All births were followed for outcomes during admission and after discharge for 28 days of life. Information about the mother and baby dyad was retrieved from the medical records. A second proforma was filled out at the time of discharge (2 to 5 days of life for healthy babies and at 10 to 15 days of life for babies admitted for NICU). These were the average length of stay of healthy and ill newborns at our facility.) The final follow up was at 28 days of life which was at the clinic or telephonic. Data on morbidities such as sepsis, use of antibiotics and hospitalization breast feeding practices was captured at the day 28 follow up. Results: A total of 78 patients were included, with a mean maternal age of 30.82 ± 4.65 years and gestational age of 37.26 ± 2.1 weeks. GBS colonization was positive in high vaginal swab in 23 (29.5%) patients, in urine culture in 16 (20.2%) patients, and 1 (1.3%) patient who delivered a previous baby with GBS infection. Two patients suffered from pneumonia among them one patient also had sepsis and 77 patients were stable at 28 days. In 16 (41%) cases of GBS colonization, high vaginal swab yielded a negative result. Similarly, in 23 (59%) patients with GBS colonization, urine culture was also negative. Only one patient with GBS colonization had a history of a previous infant with GBS infection. Approximately 70% of GBS positive had PROM. Maternal Leukocytosis and tachycardia were significantly higher in patients with GBS (p<0.0001). Uterine tenderness was found in 14 (35.9%) mothers with GBS colonization (p<0.0001). Intrapartum fever was significantly more common in mothers with GBS colonization (p=0.011). Tachycardia was significantly higher in neonates of mothers with GBS colonization (p=0.01). Need of oxygen was significantly higher in neonates with mothers having GBS colonization (p=0.002). Conclusion: In hindsight, GBS colonization and the early onset of Group B streptococcus infection is a public health issue in Pakistan that requires attention. Recommended antenatal screening measures should be implemented, as well as the necessary steps, such as an antibiotics treatment regimen following a positive GBS colonization report, to protect newborns from this disease. Keywords: colonization, maternal risk factors, group B streptococcal, early onset group B streptococcal disease, GBS, PROM
Frustration Intolerance, Self-Efficacy and Sleep Quality in Medical Students During Pandemic of Covid-19
Authors: Huma Shafqat , Qasim Muhammad Fahim , Kamal Muhammad Asif , Khan Fatima Aamir , Naveen Nadia
Published: March 2023

Introduction: A novel coronavirus disease (COVID-19) was initially reported in China in December 2019. In a few months, the virus spread rapidly across the globe, and on 30 January 2020 the World Health Organization (WHO) declared the outbreak to be a Public Health Emergency of International Concern. Objectives: The main objective of the study is to find the frustration intolerance, self-efficacy and sleep quality in medical students during pandemic of COVID-19. Material and methods: This cross sectional study was conducted in University of Lahore during 2021-2022. The data was collected through questionnaire. The questionnaire covered sleep conditions, stores of infection control supplies, mood and stress, usage of social media and sources of acquiring COVID-19 information, risk perception, and sociodemographic data. Results: The data was collected from 200 patients. About half of them were young-aged (55.0%) and married (49.1%). In terms of social media use, 57.8% spent more than 2 h per day. With regard to sleep deterioration after the COVID-19 outbreak, the weighted proportions of those who reported worsening sleep quality, worsening sleep initiation, and shortened sleep duration were 38.3%, 29.8%, and 29.1%, respectively. The weighted prevalence of current clinical insomnia was estimated at 29.9%. Practical implication: This study will help to find out the effect of COVID-19 on sleep quality, sleep initiation and duration among Pakistani population. Conclusion: It is concluded that COVID-19 is widely spreading in Pakistan and it effects on their sleep quality, sleep initiation, and sleep duration had worsened since the outbreak of COVID-19. This study identified high prevalence of frustration intolerance and poor sleep quality in medical students during pandemic of Covid-19. Keywords: COVID-19, Prevalence, Frustration, Pakistan, Sleep, Identify
Training teachers to work on racism, prejudice and racial discrimination in early childhood education
Authors: Guimarães Junior José Carlos , Rodrigues de Sousa Adão , Costa de Santana Marttem , Carneiro Braga Francisco , Barbosa Pacheco Souza Lívia , De Oliveira Hellyegenes , De Souza Ferreira Tarciana Cecília , Costa e Silva Savio Lima
Published: March 2023

Early childhood education is absent from the legal regulations, so that there is an advance in an education free of racism, prejudice and discrimination. It is known that racism is a problem that permeates the Brazilian society, being present mainly in the school environment. With the enslavement of Africans, several myths about the supposed inferiority of blacks in relation to whites emerged as a way to show that they were and still are below whites. "Being white was considered a normal human condition, but being black required scientific justification" (Munanga, 1984). As a result, various prejudiced expressions were disseminated in the interaction between blacks and whites, leading to racial discrimination and racism. Even in early childhood education, it is important to be aware of racist practices, even if they often seem unconscious.  Thus, the purpose of this article is to examine instances of prejudice and racial discrimination among young children in the context of early childhood education and the coping strategies used by teachers.  Following a methodology based on qualitative research, using bibliographies, it brings the reader first-hand accounts from teachers about prejudiced and/or discriminatory situations involving young students in everyday school life.
MODELO FÍSICO DE CURVA CIFOESCOLIÓTICA PRODUZIDO POR IMPRESSÃO 3D PARA PLANEJAMENTO DE CIRURGIA DA COLUNA VERTEBRAL: UM ESTUDO DE CASO
Authors: Queiroz Leticia Almeida
Published: March 2023

RESUMO: O planejamento cirúrgico é essencial para melhorar os resultados em intervenções complexas, uma vez que evita desperdício de tempo, a instalação inadequada de instrumentação e reduz o risco relacionado ao procedimento. As cirurgias da coluna vertebral são intrincadas pela proximidade a estruturas importantes do Sistema Nervoso e Circulatório. Durante as últimas décadas, várias ferramentas de diagnóstico por imagem foram desenvolvidas para auxiliar os cirurgiões na visualização pré-operatória da anatomia patológica e, atualmente, destacam-se os esforços para construir modelos 3D físicos, em escala real, proporcionando melhor planejamento e orientação acerca da cirurgia. O objetivo deste trabalho foi criar um modelo da anatomia patológica de um paciente com cifoescoliose a fim de facilitar a compreensão do procedimento cirúrgico. Foi observado que, a partir da construção e utilização do modelo anatômico fabricado por impressão 3D o cirurgião responsável pelo procedimento foi capaz de identificar as estruturas em risco, planejar a ressecção ideal e contar com uma melhor orientação intraoperatória. A utilização do modelo 3D em escala real mostrou-se uma ferramenta poderosa para planejamento cirúrgico, poupando tempo, auxiliando na compreensão adequada da anatomia e diminuindo o risco cirúrgico para o paciente, ao aumentar a precisão e a confiança da equipe cirúrgica.
GESTÃO DA QUALIDADE: UM ESTUDO DE CASO EM UMA EMPRESA DO SETOR ÓPTICO
Authors: Câmara Jéssica Maria Damião de Arruda , Silva Rayla Ingrid Tomaz da
Published: March 2023

Com clientes cada vez mais exigentes, faz-se necessário que as empresas ofereçam produtos e serviços de qualidade. Para isso, é preciso monitorar e promover a melhoria contínua de seus processos e atividades. Diante disso, foram aplicadas as ferramentas da qualidade, Diagrama de Ishikawa, Matriz GUT e 5W1H, em uma empresa do ramo óptico que enfrenta um contexto atual de baixo fluxo de clientes. Essa medida teve o propósito de definir as causas desse problema e priorizá-las, para estabelecer um plano de ação. Após a análise constatou-se que questões relacionadas à mão-de-obra e a atrasos na entrega eram os principais causadores da perda de clientes. Assim, foram propostas medidas simples, que, se executadas de maneira ágil e eficiente, podem reverter a situação atual da empresa.
Prefácio
Authors: Guedes Filipe Eduardo Martins
Published: March 2023

Prefácio
An Example of a Soft Technology Machine
Authors: Abhyankar Girish , Vanarase Mrinalini
Published: March 2023

The Girish Tractor is an example of soft technology designed for ecological sustainability. It is a self-propelled machine that enables ploughing with minimal physical effort from the operator. The tractor converts the operator's weight force into a hauling force for ploughing. It is lightweight, easy to maneuver, and requires little maintenance. The machine is suitable for small landholders or hilly terrain. The tractor can be easily replicated anywhere according to local needs, without centralized production and distribution. The objective of soft technology is to provide self-reliant, environment-friendly alternatives that promote a healthy, happy, and egalitarian lifestyle.
Value At Risk Analysis Using Historical Method and Monte Carlo Simulation in Banking and Mining Sector Companies
Authors: Darman Saputra  , Zukhri Nizwan , Altin Darus , Agung Nugroho Ari , Daddy Setiawan Ryand , Fitari Tiara , Thohari Mustofa
Published: March 2023

Purpose – Investments in the capital market must be able to understand the risks that exist, because investments that will be faced in the future contain uncertainty. The growth of trading activity and the increasingly uncertain market makes market participants feel the need to develop more accurate and reliable risk measurement techniques. One of the risk measurement techniques is Value at Risk (VaR).

 Methodology/approach – Value at Risk (VaR) is a method of calculating market risk to determine the maximum risk of loss that can occur in a portfolio, both single and multi-instrument, especially the level of confidence, during a certain holding period, and under normal conditions. market conditions. This study uses secondary data in the form of stocks listed on the Indonesia Stock Exchange, the samples obtained are 2 companies. Processing data in this study using Microsoft Excel program for measuring Value at Risk in portfolios using Monte Carlo simulation.

Findings – The results of the study show that a greater return will provide a greater level of risk, judging from the return and VaR values of each portfolio. Where portfolio one has a greater return than the second portfolio, and portfolio one also has a greater risk level than the second portfolio. Investment in the capital market requires a good risk calculation in buying or selling shares, so the purpose of this study is to help investors take steps or policies that are in accordance with the company's conditions..

Novelty/value –  The results in this study illustrate that the purchase of BBRI shares with the banking sub-sector and ANTM's shares in the Mining Company sub-sector has its respective risks and benefits. Therefore, the VaR Monte Carlo simulation method can describe each stock.
Creating Customer Loyalty Through Commitment to Quality of Service Model of Brady Cronin
Authors: Susriyanti Susriyanti , Krisna Nandan Lima , Lusiana Lusiana , Nardo Rio
Published: March 2023

Purpose –This study aims to see how the effect of the service quality of the Brady Cronin model (quality of interaction, quality of the physical environment, quality of results) on customer loyalty directly or indirectly through commitment. Methodology/approaches – This Study used Quantitatif method. The Quistioner were distributing  to 200 customers of Bank Nagari in the city of Padang. Findings –It was found that the quality of the interaction and the quality of the physical environment in the service quality of the Brady Cronin model directly affected customer loyalty. Meanwhile, the quality of the results in the service quality of the Brady Cronin model does not directly affect customer loyalty. Indirectly, the three services of the Brady Cronin model of service quality affect customer loyalty through commitment. Novelty/values ​​–The quality of results that do not have a direct effect on loyalty indicates that customers have not got what they want. So it is important for Bank Nagari to improve the quality of results to increase customer loyalty in the future.