bluuebunny/crossref_metadata_2025 huggingface dataset:
Stroke knowledge level among patients with ischemic stroke at Universiti Malaya Medical Centre
Authors: Varadan Parimalaganthi , Sivanandy Palanisamy , Hamzah Norhamizan
Published: October 2024

Background and Objectives: Stroke is a significant public health concern. The rising trend among stroke survivors, middle-aged, and multi-comorbid patients highlights the need for preventive intervention. In Malaysia, stroke survivors had insufficient understanding of stroke, despite being a common illness in the country.
Methods: A single-centre prospective study was conducted to determine the level of knowledge of stroke, its warning signs and symptoms, risk factors, and its association among stroke survivors who received treatment at the Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. A validated Stroke Knowledge Test (SKT) questionnaire was used to analyse stroke knowledge.
Results: The participant’s mean age was 57.79 (± 11.13) years old, with the majority being first-time stroke patients (87.2%), below 60 years of age (55.3%), had multiple comorbidities (93.4%), and male gender (68.1%). Most (71.4%) were non-adherent to their current medications. The study participants scored poorly on identifying warning signs compared to their knowledge of strokes in general and understanding of stroke risk factors. The majority have poor knowledge of smoking (1.8%) and atrial fibrillation (AF) (1.5%) as risk factors. However, there was good knowledge of the purpose of rehabilitation (98.9%).
Conclusions: Participants’ knowledge about stroke, warning signs, symptoms, and risk factors were insufficient. Stroke knowledge was significantly associated with education, medication adherence, habitation, and income.
Effects of thrombus characteristics on clinical outcome and success of recanalization in acute ischemic stroke
Authors: YABALAK AHMET , OGUN Muhammed Nur , Isimler Düzelitmeli Ayse Onalan , CAKIR KARAHAN EZGI AYSE , SAHAN HALIME , TOKMAK Hilmiye
Published: October 2024

Background: Despite current developments in mechanical thrombectomy (MT), successful recanalization cannot be achieved in all patients. One of the factors related to this is the characteristics of the thrombus. In this study, we aimed to evaluate the effects of thrombus length and permeability on procedural success and clinical outcome.
Methods: Patients with intracranial ICA, middle cerebral artery M1, or M2 occlusions, who underwent MT between November 2019 and January 2022 were included in the study. Thrombus length, density and permeability were calculated and the relationship between recanalization success and modified Rankin Scores (mRS) at the 3rd month was evaluated. Good clinical outcome was defined as an mRS score of 2 or less.
Results: Forty-six of the 79 patients included in the study had a good clinical outcome. Although thrombus length was shorter and permeability was higher in patients with good clinical outcome, statistical significance was not achieved. There was a positive correlation between thrombus density, thrombus length and the number of passes, and a negative correlation between permeability. There was no significant difference in thrombus length, density and permeability between patients with and without successful recanalisation. Thrombus length was found to be a predictor of clinical outcome at 3 months in univariate analysis, whereas only age was found to be an independent predictor in multivariate analysis.
Conclusions: In conclusion, despite certain findings not achieving statistical significance, the observed trends offer valuable insights for future research. A comprehensive understanding of thrombus nature could guide personalized stroke treatment strategies in the future.
Encephalopathy with a reversible lesion in the splenium of the corpus callosum in adults
Authors: Özdemir Gökhan , Eren Fettah
Published: October 2024

Background & Objectives: Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinical and radiological syndrome with a lesion in splenium of the corpus callosum. This lesion is typically detected in the corpus callosum with magnetic resonance imaging (MRI) and usually disappears within a few weeks. The clinical and radiological features of MERS were evaluated for this study.
Methods: Twelve patients were included in the study. They were treated between 2018 and 2021 years. The patients’ demographic and clinical features, laboratory data, treatment and prognoses were documented.
Results: There were 7 male and 5 female patients in the series. The mean age was 37.92 ± 15.32 (19–62) years. There was history of upper respiratory tract infection in 7 patients, visual loss episodes in 3 patients, epileptic seizure in 2 patients, arthroplasty in 1 patient, cardiac arrhythmia in 1 patient, and COVID-19 (SARS-CoV-2) infection in 2 patients. Focal lesion was detected in the splenium of the corpus callosum with diffusion-weighted MRI which resolved with repeat diffusion MRI and clinical symptoms improved.
Conclusions: Axial diffusion-weighted MRI images show typical splenium ovoid lesion of corpus callosum in patients with MERS. Patients with MERS have a good prognosis. It is important to consider MERS as one of the differential diagnoses in adult patients with fever and cognitive impairment.
Investigation of the effects of IL-13 and IL-22 cytokine levels on disease activity, prognosis, and treatment response in multiple sclerosis patients treated with fingolimod and glatiramer acetate
Authors: Demir Fidel , Deniz Evrim Kavak  , Fırat Karaaslan  , Mehmet Ufuk Aluçlu  , Sevgi Irtegun Kandemir
Published: October 2024

Background: Multiple Sclerosis (MS) is an inflammatory, demyelinating and neurodegenerative disease. In this study, we investigated serum protein levels of Interleukin-13 (IL-13) and Interleukin-22 (IL-22) cytokines. These cytokines play an important role in the generation and regulation of the inflammatory response, which is the pathogenesis of MS, and are potential biomarkers for monitoring therapeutic response. cytokines may play a role in the development of MS lesions.
Methods: The study included 66 MS patients and 22 healthy individuals. IL-13 and IL-22 cytokine protein levels were measured by ELISA from peripheral blood serum samples collected from the participants. Patient demographics and treatment history data were also collected.
Results: IL-13 and IL-22 parameters were lower in MS patients compared to the control group. There was a significant difference between the patient and control groups in terms of IL-13 (p<0.001). Although the mean IL-22 level of the control group was higher than the patient group, the difference did not reach a significant level (p: 0.257).
Conclusion: The results of the study suggest that IL-13 and IL-22 cytokines play an important role in the pathogenesis of MS and are affected by fingolimod and glatiramer acetate treatment.
Medication prescribing trends and its associated adverse drug reactions among hospitalized stroke patients from a main stroke center in Penang, Malaysia: A retrospective 5-year study
Authors: Danial Monica , ARULAPPEN ANN LISA , MOHDRADZI NURUL SHAHIRA IZWANI , LOOI IRENE
Published: October 2024

Adverse drug reactions (ADRs) are one of the major threats in our healthcare system, which profusely affects health, transience, and quality of life, especially among hospitalized patients. This 5-year study was conducted to determine the incidence and analyze the pattern of ADRs among stroke patients at Hospital Seberang Jaya (HSJ), Malaysia which is the main stroke center for all tertiary healthcare institutions in Penang, Malaysia. A total of 1,993 patients were hospitalized for stroke during the study period of 5 years out of which only 30 of them were reported to experience ADRs during hospitalization. The study patients had a mean (SD) of 61 (±11.8) years, Modified Rankin Score (mRS) score of 1.8 (±1.6), NIH Stroke Scale (NIHSS) score of 3.0 (4.0) with median (IQR) duration of adverse drug reaction of 3.0 (7.0) days. The majority of the patients were Malay (66.7%); female (50.0%); experienced ischemic stroke (90.0%); with first episode of stroke (93.3%); with comorbidity dyslipidemia (60.0%); and mostly recovered post ADRs (80.0%). The major drug classes that contributed to ADRs were vaccines, anti-infective, anti-epileptic, anti-platelets, and others. Evaluation of the causality of ADRs indicated majority were possible (50.0%) ADRs based on the Naranjo scale. The evaluated incidence of ADRs among stroke patients is low in this study. This low incidence rate could be possibly due to active clinical interventions by healthcare professionals during hospitalization. ADR monitoring is highly warranted among the sub-population of stroke patients due to the existence of multiple risk factors and their state of vulnerability.
Risk factors of acute stroke associated pneumonia and predictive value of serum amyloid A combined with neutrophil-to-lymphocyte ratio
Authors: Zhang Liuhai , Liu Fei , Nie Tian , Feng Danyu , Qiu Kefan , Wei Wan
Published: October 2024

Objectives: This study aimed to explore the risk factors for stroke-associated pneumonia (SAP) and assess the predictive value of Serum Amyloid A (SAA) combined with neutrophil-to-lymphocyte ratio (NLR) on SAP.
Methods: The study included acute ischemic stroke (AIS) patients from January 2021 to June 2022 in our hospital. The patients’ history of chronic diseases, the clinical characteristics, and the laboratory testing data were recorded. SPSS 22 was used for statistical analysis. Receiver operating characteristics (ROC) curves and logistic regression analysis were used to identify independent predictors.
Results: We studied 356 patients with AIS, of which 19.4% (n = 69) developed SAP. In the SAP group, the patients with higher the proportion of hypertension, coronary heart disease and higher the NIHSS score were older, the blood glucose, neutrophil count, NLR and SAA of the SAP group were significantly higher than the Non-SAP group. Multiple logistic regression analysis for SAP showed that age , NIHSS,SAA and NLR were independent risk factors for SAP. For SAA alone, the area under the curve (AUC) in the ROC curve was 0.765, For NLR alone, the AUC was 0.840. When SAA combined with NLR, the AUC increased to 0.853. we created a 4-item prediction model, the AUC increased to 0.881.
Conclusion: Age, NIHSS, SAA and NLR were independent risk factors for SAP. When SAA combined with NLR, its predictive value for SAP was higher than its alone, the value of prediction for SAP appeared to be much stronger when SAA and NLR incorporated in a prediction model including age, and NIHSS.
The impact of visual field defects following anterior temporal lobectomy
Authors: Nandana Jayakumari , Mary Thomas Tinu , Ramachandran Harikrishnan , Chandran Anuvitha , Menon Ramshekhar , Vilanilam George , Abraham Mathew , Radhakrishnan Ashalatha
Published: October 2024

Objective: This prospective study aimed to quantify visual field defects (VFDs) along with other defects in ophthalmic functions after anterior temporal lobectomy (ATL) in patients with mesial temporal lobe epilepsy (MTLE) and their impact on quality of life using a VFQ-25 questionnaire.
Methods: Ophthalmic evaluation was done during pre-operative evaluation as well as 3 months after surgery. It included the Best Corrected Visual Acuity (BCVA), visual field evaluation, colour vision examination, fundoscopy, extraocular movements and diplopia charting. Visual field evaluation was done using a Humphrey field analyser. The foveal threshold (FT), mean deviation (MD) and pattern standard deviation (PSD) were calculated for each patient. Quality of life assessment was done using the Visual Functioning Questionnaire-25 (VFQ-25). Two-tailed independent T-tests and Chi-square tests were performed for comparison of results.
Results: Thirty-four patients were included in this study (23 men and 11 women). The mean age was 26.6 years (range 9-44 years). Post-operatively, none complained of a visual field disturbance. Thirty-one (91.17%) of 34 patients had a new quantifiable superior quadrantanopia. FT, MD and PSD of patients ranged between 29db to 40db, -1.23 to -14.28 and 1.75 to 15.34, respectively. There was no detectable abnormality in visual acuity, colour vision, fundoscopy, diplopia charting or extraocular movements. VFQ-25 scores ranged from 84 to 100. The difference between VFQ scores of patients with and without quadrantanopia was not significant.
Conclusion: Standard ATL produces asymptomatic VFDs that do not affect quality of life. A combined effort of the neurologist and ophthalmologist is recommended to counsel the patient before surgery.
Efficacy of acetylcholinesterase inhibitors for cognitive impairment in multiple sclerosis: A systematic review and meta-analysis
Authors: Folloso Melmar C , Catindig Joseree-Ann S , Ditucalan Lovelle G , Villaraza Steven G , Joson Ma. Lourdes C , Ampil Encarnita R
Published: October 2024

Background & Objective: Multiple Sclerosis (MS) is a chronic demyelinating condition characterized by a myriad of neurologic deficits. The prevalence rate of Cognitive impairment (CI) ranges from 40 to 60 percent among community-dwelling individuals with MS. Cholinergic dysfunction is one of the different mechanisms proposed to cause CI, supporting the use of acetylcholinesterase inhibitors (AChEIs) in certain conditions. The study aims to determine the safety and efficacy of acetylcholinesterase inhibitors in multiple sclerosis patients with cognitive impairment through a review of randomized clinical trials.
Methods: Using the updated PRISMA guidelines, we searched MEDLINE by PubMed, Cochrane Central Register for Controlled Trials (CENTRAL), ClinicalTrials. gov website, Google Scholar, and HERDIN Database for relevant studies until November 15, 2022.
Results: A total of 73 records were identified and five studies were included in the analysis. Pooled evidence shows that AchEIs (donepezil 10 mg/day or rivastigmine 10 mg/day for 12 to 14 weeks) did not significantly improve Paced Auditory Serial Addition Test (PASAT) score for information processing and sustained attention and the Selective Reminding Test (SRT) score for verbal memory. Another study using the Weschler Memory Scale (WMS) also did not show significant improvement in their scores. However, a recent trial that used the Everyday memory questionnaire (EMQ), prospective and retrospective memory questionnaire (PRMQ), and the Digit span test (DST) showed significant difference between pre- and post-intervention mean scores in the donepezil group (p<0.001). The physical and mental health scores of the Multiple Sclerosis Quality of Life questionnaires (MSQOL) significantly improved in MS patients receiving donepezil. Both donepezil and rivastigmine were associated with non-serious adverse events.
Conclusion: The use of AchEIs among MS patients does not significantly improve objective measures of cognition but has positive impact on subjective scales of cognition (EMQ and PRMQ). AchEIs were shown to improve patients’ quality of life. AchEIs are safe and well tolerated among MS patients.
Estimation of maternal and fetal morbidity in high order cesarean section in Zawia
Authors: Hawisa Karima T. , Algerbi Somaia
Published: October 2024

To assess the maternal and neonatal risk associated with high order cesarean sections, a prospective study was carried out in Zawia hospital, maternity wards. The patient was interviewed in the labor word and performed case sheet filled with specific data. The outcome of 458 cases, 218 women undergoing cesarean section for the third time or more was compared with 240 women sectioned for the second time (P1c/s), the outcome measures were antenatal complication, maternal operative and postoperative morbidity and neonatal prematurity, Apgar scores and the need for intensive care. The antenatal complication is more in group of ≥ P2c/s, placenta previa 9 (3.7%) versus 3 (1.3%) and abruption 8 (3.3%) versus 1 (0.4%). Intraoperative complications found in 17.7% of the cases, 14.2% of the patients with P1c/s comparing with 20.8% among the cases with ≥ 2 Pc. Intra-peritoneal adhesions were more in women with ≥ P2c/s (10.8%) when compared with the women with the history of P1c/s (8.7%). The need for blood transfusion was 5.0% of women with history of ≥ P2c/s  compared with 4.1% for women with history of one previous section. The mean duration of operation for patients with P1c/s = 41.5 min and with P2 or more c/s = 47.8 min. Neonatal morbidity rate was 20.9%. There were an increased number of preterm babies in study group of ≥ 2 Pc/s.  It is concluded that high order repeat cesarean section carry risk of intraoperative and post operative complication in particularly, placenta previa and acreta and risk of blood transfusion and also neonatal morbidity is increased.
Steroid effect on serum leptin in Libyan children with minimal change nephritic syndrome
Authors: Alboashie Atwatif , Habas Elmukhtar , Rayani Amnna
Published: October 2024

Few studies have looked at the status of leptin in renal diseases especially nephrotic syndrome. The aim of this study was to investigate the effect of steroid therapy on serum leptin, anthropometric and appetite in patients with minimal change nephrotic syndrome (MCNS). Twenty children were recruited for this prospective study. Group I included ten children aged between 2 - 12 years with MCNS without any associated complications as impaired renal functions, hematuria, hypertension and others. Group II included ten healthy children with matching age, sex and BMI as a control group. Body weight, height, nutritional history including appetite, quantity of food, clinical examination, blood pressure and blood for kidney function parameter and serum leptin were taken before and after 3 days and after 2 weeks following prednisolone dose of 2 mg/kg/day. The same parameters were also performed for group II. Serum leptin was higher in group II than group I (1.575 ± 1.07 vs 0.575 ± 0.76 ng/ml p < 0.01). After 3 days and after 2 weeks of 2 mg/kg of prednisolone, serum leptin increased significantly in group II (t = 4.65, p < 0.014) without significant difference as it compared with group I (t = 1.65, p = 0.08). A highly significant increase in serum leptin concentration was detected in 2 weeks after prednisone therapy compared to the base line levels before therapy, compared to 3 days after therapy and to the control group (t = 5.69, p <  0.001, t = 3.95, p < 0.001 and t = 8.96, p < 0.001, respectively). In group I, serum leptin was higher in females than males (4.8 ± 2.8, p < 0.001). BMI was also higher in females compared to males. Patients' appetite improved after prednisolone for food quantity as recorded by the recall methods. Blood urea and serum creatinine in groups I and II did change significant within group II after steroid and even the changes were not significantly different from the control. Serum albumin, total serum protein, serum cholesterol concentrations and proteinuria revealed a significant difference between the two groups (t = 5.9, 8.9, 8.98 & 16.33, respectively, p < 0.01, for all). Weight, BMI in group I before and 2 weeks after intake of prednisone did not revealed any significant differences in weight, BMI before and after 2 weeks of prednisone (t = 0.99 and 0.88.8, respectively) in spite of the increase in appetite. Blood pressure had not changed significantly after the steroid therapy in MCNS patients’ group. Thus, serum leptin concentration and appetite were significantly higher especially in females without significant change in anthropometric, blood pressure and renal function indices after steroid therapy in minimal change nephropathy.
Interleukin 8 and tumor necrosis factor-α level in acute rheumatic fever and chronic rheumatic heart disease
Authors: Benzabya Wafa
Published: October 2024

Forty children were included in this study with age ranging between 5 - 15 years. They were divided into four groups according to clinical presentation. Group I with acute rheumatic arthritis, group II with chorea, group III with clinical carditis and group IV with chronic heart disease. Twenty healthy children were investigated for IL-8 and TNF-α as a control group. We found that the serum level of IL-8 was significantly higher than the control group and in carditis than arthritis. TNF-α was significantly higher in acute rheumatic fever than control group. The result showed that the level of IL-8 and TNF-α were significantly higher in patients with chorea than arthritis. These parameters also were significantly higher in rheumatic chorea than chronic rheumatic heart disease. The recurrence of rheumatic activity and development of chronic rheumatic heart disease was high in patients with high levels of interleukins in acute phase.
Antimicrobial properties of Libyan propolis against Staphylococcus aureus
Authors: Sarkez Najat Hossin
Published: October 2024

Libyan propolis Libyan propolis, bee glue" produced by honey bees feeding on plant buds, leaves and exudates was obtained from hives of apiary in Zawia area of western Libya. Its antimicrobial properties against pathogenic Staphylococcus aureus, coagulase positive obtained from Central hospital, Tripoli. The effects of ethanloic extract of propolis against S. aureus under different incubation temperatures (6, 20 and 37 C), salt concentrations (5 and 10%), and pH values (3.5, 6.3) was investigated. Several fractions were obtained during the partial purification of propolis: crude ethanolic extract, resinous material ethanolic solution, and alkaline hydrolysis of water soluble compounds solution. Tests conducted included measurement of inhibition zone by the disk diffusion method, minimal inhibitory concentration by tube dilution method, and minimal bactericidal concentration by agar plating. Only crude ethanolic extract of propolis exhibited effective inhibition zone at different seed concentrations: a diameter of 19.62 mm at 30 mg/150 µl (w/v) and 19.73 mm at 40 mg/ 200 µl (w/v). There was no antibacterial effect of the extract at 10 mg/50 µl concentration. The minimal inhibitory concentration and minimal bactericidal concentration were found at 26.04 mg/ml, and 34.72 mg/ml respectively. Higher temperature (37 ºC) under natural acidic pH of 3.5 enhanced the antimicrobial activity of ethanolic extract of propolis, while high salt concentration, 10%, showed no added antibacterial effect. Possible use of propolis extract as food or pharmaceutical preservative, or topical treatment for skin diseases caused by S. aureus is encouraging and feasible.
Employee Engagement Dynamics in High School Education: Investigating Influential Factors Across Contexts at a Ghanaian Institution
Authors: Apeadido Shine , Alomenu Clemence
Published: October 2024

Employee engagement, a key element of organisational success, is influenced by various factors. However, there is limited clarity on how these factors impact employee engagement in high schools, particularly within the Ghanaian context. Hence, this study investigated perceived influential factors of employee engagement among high school teachers at Opoku Ware School in Ghana and their varying levels of influence across contexts using a structured survey administered to teachers (n = 75). Data analysis involving descriptive and inferential statistics, specifically ANOVA, was conducted to examine relationships between variables and test hypotheses. Key findings indicate that the employees have moderate engagement levels (M = 3.3), which are significantly impacted by leadership style, organisational culture, professional development, work-life balance, and recognition and rewards, with leadership style emerging as the most influential factor (M = 4.0). Furthermore, the analysis revealed significant differences in engagement factors across different departments (p < 0.05) and levels of seniority (p < 0.05), indicating that targeted interventions are required to address the diverse needs of teachers. However, unique results uncovered a consistency in leadership style (p = 0.33) across departments, and organisational culture (p = 0.81) and work-life balance (p = 0.76) across levels of seniority, suggesting the widespread potential impact of these specific factors. The study’s findings aligned with existing research and theories on employee engagement, emphasising the universal importance of the influential factors in driving engagement and offering valuable insights into ways high schools can enhance teacher engagement.
Work and Environment Related Characteristics Associated with Voice Disorders among Primary School Teachers
Authors: Herath Maaheshi Deepika , Senarath Upul , Suraweera Inoka
Published: October 2024

The objective of this study is to assess work and environment related factors associated with voice disorders among primary school teachers in the Colombo district in Sri Lanka. Methods: An institution based cross sectional study was conducted among 790 primary school teachers, in the Colombo District in Sri Lanka.  They were selected by a stratified random sampling method. The validated Voice Handicap Index (VHI-30) questionnaire and a self-administered questionnaire were used for data collection. Sound levels within 10 selected classrooms were measured objectively using CR:303 sound level meter (Cirrus). Data analysis was by bivariate method with chi squared and logistic regression. Results: Among the work related characteristics assessed teaching 5 or more subjects (OR=1.40, CI = 1.039, 2.90), staying after school hours (OR=1.69, CI = 1.19, 2.38) were significantly associated with voice disorders. Among the factors associated with work environment, teachers having a speech pattern in yelling and shouting category (OR=2.25, CI=1.68, 2.99), speaking in noisy environments (OR=1.09, CI= 1.15, 3.15), being exposed to smoky dusty environments (OR = 1.61, CI= 1.19, 2.16), having average or high dust levels in classrooms (OR=2.03, OR=1.50, 2.76), having a moderate to high noise level in classrooms (OR= 1.93, CI=1.45, 2.58) and having ‘just adequate, inadequate and average’ space in a classroom (OR=1.74, CI=1.29, 2.34) were significantly associated with voice disorders. The sound levels objectively measured in classrooms revealed that all classrooms had higher than acceptable noise levels during a teaching session. Conclusions and recommendations: The association of voice disorders with work related characteristics were similar to the findings in other studies. However, the high noise levels detected in the classrooms on objective measurement were high. It is recommended that these findings be addressed through a multidisciplinary approach and National standards for acceptable noise levels within classrooms be established.
Feasibility Assessment of Polyethylene Terephthalate on Fresh and Hardened Traits of Blended Mortar Mixes
Authors: Rathore Rituraj Singh , Prakash Divya , Chouhan Harshwardhan Singh
Published: October 2024

Nowadays, the construction industry requires an ample quantity of non-renewable materials resulting in the excavation of natural beds and thus creating an imbalance in our environment. Besides this, plenty of waste material such as plastic waste in the forms of powder, fiber, etc. is produced daily. Sustainable disposal of this waste has appeared as a tough task across the world. The current work was undertaken to reduce the issue of plastic waste mainly polyethylene terephthalate, disposal by its effective utilization in cement mortar mixes without affecting their physical, chemical, mechanical, durability, and microstructural properties. For this, a total of ten cement mortar mixes with 1:3 and 1:6 mix proportions were prepared by using polyethylene terephthalate plastic waste [1mm (68%), 2mm (22%), 3mm (6%), and 4mm (4%)] in place of fine aggregate upto 20% replacement at an interval of 5%. These mortar mixes were evaluated for their workability, water absorption, compressive strength, flexural strength, acid attack, and shrinkage properties. Effects on internal structure were monitored by microstructural analysis such as X-ray diffraction, scanning electron microscopy, and Fourier transform infrared spectroscopy techniques. With 5% polyethylene terephthalate instead of river sand, the mixes displayed improved strength with the highest recorded 8.03 MPa and 2.36 MPa for 1:3 and 1:6 mixes respectively, and also obtained workability with increased density and homogeneity of structure. Benefits from polyethylene terephthalate were confirmed through microstructural analysis techniques except that there was a reduction in drying shrinkage. The results recommend that polyethylene terephthalate can be a reliable material in advanced construction applications offering enhanced structural parameters to save natural resources.
From Classroom to Clinic: Modernizing Nursing Education for a Digital Age
Authors: Badil .
Published: October 2024

Nursing education is an integral part of the healthcare system and is evolving to meet the demands of the healthcare environment. Nurses often serve as initial contacts for patients and play a crucial role in coordinating care among various healthcare professionals. Nursing facilities are evolving day by day due to the rapid medical and technological advancements all over the world, and the role of nurses has expanded significantly.
One of the impacts of modern medical technology on nursing education is the integration of electronic health records (EHRs) and other digital systems [1]. However, the traditional nursing education system fails to bridge the gap between what nurses do and how they conceptualize their work required in the modern healthcare system. A significant challenge is the increasing demand for nurses equipped with specialized knowledge and skills. To address this, nursing education must move beyond traditional methods and incorporate modern technological approaches.
As healthcare technology advances, nursing education must adapt accordingly. Nurses need to develop digital competencies to effectively utilize these technologies. Encouragingly, progress is being made in this area. Many educational institutions are now incorporating virtual reality training, simulation-based learning, and various online platforms to enhance critical thinking and clinical skills [2]. These innovative approaches set new standards for nursing education, helping to strengthen professional identity and stay current with the latest research and best practices.
Interdisciplinary Collaboration is also becoming a fundamental part of nursing education. By learning alongside medical, pharmacy, and allied health students, nursing students are better prepared for teamwork and holistic patient care. Additionally, cultural competency and diversity training are essential for preparing nurses to provide care to increasingly diverse populations. Similarly, the importance of mental health education for nurses cannot be overstated, both for providing patient care and maintaining their own well-being in a high-stress profession. Incorporating leadership and management skills into nursing curricula prepares nurses for roles in administration and policy-making.
By raising educational standards, nursing programs can enhance clinical skills and equip nurses with the knowledge needed to thrive in an ever-changing healthcare environment. In the upcoming years, there is an increase in the demand for healthcare services to be expected. Advanced healthcare technology prepares nurses through digital training, including EHRs, simulation labs, and mobile health applications, all of which are essential for enhancing patient care. All in all, enhancing nursing education is essential for meeting the needs of the modern healthcare system. We can empower nurses to thrive as frontline healthcare providers. And they ultimately lead to better healthcare outcomes and a stronger healthcare system.
Assessing the Level of Knowledge Regarding Medication Errors among Nurses in Karachi, Pakistan
Authors: Ahmad Ashfaq , Khan Shahab , Bibi Afsha , Afsheen . , Ali Akhter , Ullah Zeeshan , Shah Syed Abdul Jandal , Ullah Shakir , Ishaq Muhammad , Imtiaz Muhammad
Published: October 2024

One of the key elements influencing hospital service quality and decreasing patient safety in healthcare systems is medical error. In the healthcare industry, medication errors are a frequent source of harm and fatalities. Objective: To assess the level of knowledge among nurses regarding medication errors. Methods: This cross-sectional study was conducted in a tertiary care hospital in Karachi among 120 nurses from January 2024 to March 2024. Participants were selected through a convenient sampling technique. The sample size was calculated by open EPI softer by taking into consideration a 95% confidence level and a 5% margin of error. The data were entered and analyzed by Statistical Package Social Sciences software version 26. Results: According to the study results, 14 (12%) of the participants had a low level of knowledge, and 37 (31%), had a moderate level of knowledge. while 69 (57%) had a high level of knowledge regarding medication errors. Conclusion: This study concluded that most of the nurses had a high level of knowledge regarding medication errors.
Effect of Moderate Intensity Exercise on Serum Ferritin Concentration
Authors: Ashraf Aqib , Islam Zia Ul , Khan Alamgir , Jamil Muhammad , Asif Hozaifa Bin , Arif Tasleem , Farooqi Shehzadi Sanam Roohi , Waqas Rana , Alam Noor , Selamoglu Zeliha
Published: October 2024

An iron-containing blood protein is called ferritin. The amount of iron stored in the body may be determined with this test. Objective: To evaluate the changes in serum ferritin concentration induced by moderate-intensity exercise for 12 weeks. Methods: Participants (n=20) for this study were selected through the developed inclusion and exclusion criteria which included age (18-25 years), BMI (18.5-24.9), and no chronic disease in participants and non-athletes. After the selection of participants, the participants were divided into two groups which were the control group (n=10) and the experimental group (n=10). After division only the experimental group was allowed to follow the 12-week exercise plan (intervention). Fresh blood samples of around (2-5 ml) were obtained in Ethylene-diamine-tetra-acetic Acid (EDTA) vacutainers using 5cc syringes with the help of the hospital paramedic staff. After the sample was collected, the sample was sent to a laboratory for further process of examination of serum ferritin concentration, which was done by professionals. Results: The data were analyzed and evaluated statistically using Version 22 of IBM SPSS software. Different tests including mean, paired sample t-test and independent samples t-test were applied to calculate the p-values of all studied groups. Conclusion: It was concluded that based on data analysis and findings, the researcher concluded that moderate-intensity exercise has a significant impact on serum ferritin concentration among the respondents
The Future of Regenerative Medicine: Stem Cell Research in Pakistan
Authors: Lavezzi Anna Maria
Published: October 2024

The landscape of medicine is being revolutionized by the recent breakthroughs in stem cell research that offer new possibilities for treating diseases that were once deemed degenerative, incurable, or irreversible. In low and middle-income countries like Pakistan stem cell therapy holds promise for cost-effective solutions to non-communicable diseases. However, these advancements are hindered by ongoing debates, legal challenges, and public controversies.
Stem cells can differentiate into various cell types and self-renew themselves, making them appealing for regenerative medicine. Unlike traditional therapies, regenerative medicine focuses on the restoration of optimal functioning of the damaged tissues and organs. Stem cells can be categorized as embryonic and adult stem cells. Adult stem cells such as mesenchymal stem cells can differentiate into various cell types. These can be obtained from bone marrow, adipose tissue, umbilical cord tissue, and amniotic fluid.
Research shows that stem cells have the potential to treat cancers and advance regenerative medicine. Genetically modified stem cells can act as delivering systems for the treatment of genetic disorders and the development of therapeutic agents directly targeted to organs. Successful differentiation of stem cells into neurons, cardiomyocytes, insulin-producing cell clusters, hepatocytes, and hematopoietic precursors. These achievements are powerful tools that can help in combating human diseases.
In Pakistan, while the potential of stem cell therapy has generated significant excitement, the progress is hindered by regulatory and infrastructure challenges. Addressing these concerns and fostering a supportive research environment is essential for advancing stem cell and regenerative medicine in the country. According to the WHO International Clinical Trials Registry, there are over 3000 trials on adult stem cells in progress [1].  These trials are essential in advancing the knowledge of stem cell therapies and for the establishment of realistic expectations for their outcomes. The transplantation of stem cells into non-native environments can pose risks, including tumor formation and other complications. These risks underscore the importance of rigorous evaluation and monitoring to ensure that these promising therapies are both safe and effective before they become widely available.
In conclusion, stem cell research has great potential to revolutionize healthcare in Pakistan, but ethical, regulatory, and infrastructure challenges must be overcome before its benefits can be fully realized in regenerative medicine. An environment that is supportive and safe is imperative for clinical trials and research to ensure safe and effective therapies in the future.
Aortic valve neocuspidization using the Ozaki Technique for bicuspid aortic valve: The first case at Central Military Hospital of Azerbaijan
Authors: Hacizade Elgin , Ibrahimov Cavid , Adigozalzade Samir , Khalilov Rafiq , Karabacak Kubilay
Published: October 2024

Conventional aortic valve replacement (AVR) remains the standard treatment for aortic valve stenosis or insufficiency, but emerging techniques focus on valve reconstruction rather than replacement. One such method is the Ozaki procedure, which involves replacing each valve leaflet with glutaraldehyde-treated autologous pericardium to restore the natural anatomy of the aortic valve. Although challenging, especially for bicuspid aortic valves, this technique has shown success after a learning period. We report the case of a 54-year-old woman with a history of colorectal cancer, who underwent surgery for severe stenosis of a bicuspid aortic valve using tricuspidization with glutaraldehyde-treated autologous pericardium.
Investigation of the pharmacological characteristics of Sphaeranthus indicus flowers using phytochemical analysis
Authors: khanam Afsana , Roman Tahamina , Ferdous Afsana , Siddique Mohammed , Antu Nadia , Arman Mohammad , Islam Mohammad
Published: October 2024

Although the conventional usage of Sphaeranthus indicus flowers in medicine exists, there is a lack of research on the precise pharmacological characteristics and comprehensive phytochemical composition of its flowers, resulting in a knowledge gap on their whole therapeutic capabilities. The aim of this work is to identify and describe the phytochemicals found in the flowers of Sphaeranthus indicus and assess specific pharmacological effects, such as antioxidant, antibacterial, anti-inflammatory, thrombolytic, antidepressant, and antidiarrheal characteristics. The investigation revealed that the MESIF (methanol extract of S. indicus flowers) showed substantial antioxidant performance (IC50 = 26.33) accompanied by a moderate phenolic content (93.33 ± 1.76). At 250 and 500 µg/ml, the extract exhibited modest to moderate antibacterial sensitivity against many tested pathogens and significantly reduced inflammation by protein denaturation (41.63 ± 0.11 and 70.52 ± 0.20). Furthermore, MESIF exhibited remarkable thrombolytic activity with a statistically significant (***P<0.001) lysis of clots. The extract showed substantial reduction in immobility in both the Forced Swim Test (FST) and Tail Suspension Test (TST) at doses of 200 mg/kg and 400 mg/kg (***p<0.001). It also a showed significant potent antidiarrheal activity (**p<0.01 at 200 mg/kg and ***p<0.001 at 400 mg/kg), effectively reducing diarrheal episodes in the test models. These findings suggest that the MESIF holds potential for developing treatments with antioxidant, antibacterial, anti-inflammatory, thrombolytic, antidepressant, and antidiarrheal effects. Further research is recommended to isolate specific bioactive compounds and elucidate the mechanisms underlying these pharmacological actions.
Fowlpox virus in chicken’s skin: Persistence and the local immune response at the site of inoculation
Authors: Eldaghayes Ibrahim , Rothwell Lisa , Skinner Michael , Kaiser Pete
Published: October 2024

Background: Fowlpox virus (FPV) has been used as a vector for many years. To date, surprisingly, very little data exist on the persistence of fowlpox vaccines in chicken tissues, or what kind of immune cells respond to vaccination at the site of inoculation. Although both humoral and cellular- mediated immunity (CMI) play a part in overall immunity against FPV, little is known regarding the cell-mediated immune responses to FPV infection.
Aim: The main aim of this paper was to measure persistence of fowlpox vaccine in skin tissues following vaccination.
Methods: One-day-old chicks were vaccinated with Fowlpox virus FP9. Skin samples were collected from the site of inoculation for several days following vaccination to assess the presence of for FPV, as well as other immune cells including macrophages, CD4+ T cells, CD8+ T cells, and B cells.
Results: Results showed that FPV does not persist for long, and is cleared by 6 days post-vaccination (dpv). The response of immune cells (macrophages, B cells, CD4+ and CD8+ T cells) that infiltrated the site of vaccination was assessed.
Conclusion: The results in this paper reflected the response at the site of inoculation following single vaccination, therefore, further studies regarding viral persistence and infiltration of immune cells at the site of inoculation after booster vaccination should be done.
Langerhans cell histiocytosis diagnosed with spontaneous regression
Authors: Ogur Torel
Published: October 2024

Langerhans cell histiocytosis (LCH) is an uncommon disease spectrum that occurs mostly in children and young adults and is characterized by the proliferation of Langerhans cells in the affected organ or tissue. Due to its nonspecific clinical findings and symptoms and variable radiological appearances, sometimes problems can be experienced in the diagnosis of Langerhans cell histiocytosis. Histopathological results are still the basis for the diagnosis of LCH rather than imaging techniques. However, MRI not only characterizes the lesion but also plays an important role in the follow-up of the lesion and in the evaluation of the response to any treatment. In this case, the radiological and histopathological features of eosinophilic granuloma are discussed together with the follow-up MRI findings of a five-year-old girl who was diagnosed with eosinophilic granuloma (EG) with spontaneous regression findings in her clinico-radiological follow-up. The rarity of spontaneous regression of eosinophilic granuloma and the lack of a definitive histopathology make this case unique.
Molecular characterization of Newcastle disease virus (AOAV-1) obtained from Western region of Libya
Authors: Kammon Abdulwahab , Rammah Elhadi , Giweli Abdulhamid , Monne Isabella
Published: October 2024

Background:
Since its discovery in 1926, Newcastle Disease is still emerging in many avian species worldwide causing severe economic losses due to high mortality.
Aim:
This article aims to discuss the challenge of virulent Newcastle Disease (ND) in poultry in Libya, focusing on recent outbreaks investigated in Alzintan, Alrayaina, Nalut, and Surman, cities located in the western region of Libya.
Methods:
Clinical signs and lesions were recorded, and tissues, as well as tracheal and cloacal swabs, were collected. RNA extraction was performed for confirmation using PCR and sequencing.
Results:
Mortality in general reached 50-100% in vaccinated flocks with respiratory distress, diarrhea, swelling of the face and nasal discharges. Necropsy revealed severe hemorrhages in the proventriculus, necrosis and hemorrhages in the intestine and cecal tonsils. All tested samples were positive for AOAV-1 using rRT-PCR and genetic analysis. The sequences obtained are referable to AOAV-1, which is the same strain in all tested samples. The amino acid sequences deduced from the cleavage site of the F protein are referable to a velogenic strain of AOAV-1 belongs to genotype VII.2. The detected strains in the current study revealed 86-91 % identity with European isolates identified between 2020-2022 and isolates from Asia and Africa and 97% identity to the previous isolated Libyan strains in 2013 and 2016. It is slightly different by the presence of amino acid lycine at the position 111 on the cleavage site of the F0 gene as compared to previous Libyan strains in which arginine was found in the same position. The nucleotides sequence at this position changed from (aga) in AOAV-1 strains of years 2013 and 2016 to (aag) of the year 2023.
Conclusion:
Newcastle disease remains a significant threat to the poultry industry in Libya. Therefore, there is an urgent need to conduct an epidemiological study with a representative number of samples from all regions of the country, alongside the implementation of an inactivated vaccine targeting genotype VII.
Effects of fermented Crescentia cujete L. on the profile of haematology, clinical chemistry and circulatory CD4+/CD8+ in Sprague Dawley rats
Authors: Wijayanti Agustina , Prakoso Yos , Isla Krestel
Published: October 2024

Background:
The calabash (Crescentia cujete L.) is a tropical fruit that offers numerous health benefits. Its fermented form (FC) has been found to affect the neurological system positively. However, its impact on haematology, clinical chemistry, and CD4+ and CD8+ levels has yet to be documented.
Aim:
Therefore, this study aims to examine the effects of FC on haematology, clinical chemistry, and the levels of CD4+ and CD8+ in the circulatory system using rat models.
Methods:
This study used twenty male Sprague Dawley rats. The rats were divided into group 1 (0 mg/kg BW FC), group 2 (50 mg/kg BW FC), group 3 (500 mg/kg BW FC), and group 4 (2,000 mg/kg BW FC). The treatment was administered using a gastric probe once daily for 14 days. On day 15, the blood samples were collected and tested against haematology, clinical chemistry, quality of the erythrocytes, and CD4+/CD8+. The data was then analysed using SPSS with p-value at 0.05.
Results:
The conducted study demonstrated that the utilisation of FC at varying doses did not have a significant impact on the haematological profile changes (p≥0.05), except for total lymphocytes and a decrease in the neutrophils/lymphocytes (N/L) ratio (p≤0.05). Furthermore, FC did not influence the changes in clinical chemistry, circulatory protein, and electrolyte levels in rat models compared to the control (p≥0.05). The utilisation of FC decreased the percentage of haemolysis and elevated the ATP concentration (p≤0.05). Additionally, the use of FC led to a significant increase in CD4+ and the ratio of CD4+/CD8+ (p≤0.05), while no significant effect was observed regarding CD8+ (p≥0.05).
Conclusion:
The study highlighted FC’s beneficial effects on the haemorheology and immune system, specifically on the decrease in the percentage of haemolysis, elevated ATP concentration, number of lymphocytes, ratio N/L, CD4+, and the CD4+/CD8+ ratio, without causing significant changes to the haematological and clinical chemistry profiles in rat models.