bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATION OF INFLUENCE OF DISPLAY OF INSTRUCTIONAL RESOURCES ON CHILDREN’S PERFORMANCE IN EARLY LITERACY IN PUBLIC PRE-SCHOOLS IN KANDUYI SUB-COUNTY, KENYA
Authors: Mideva Mugami Margaret
Published: February 2023

Availability and utilization of instructional resources play an important role in the attainment of educational goals, objectives and learners’ performance. In this study, the researcher argues that many learners are still not proficient in early literacy skills despite going through pre-school education. The factors associated with the teaching and learning of early literacy skills may have been addressed but influence of instructional resources continues to be a concern. This study focused on the influence of display of instructional resources on children’s performance in literacy. The study was framed on the constructivism theory propounded by Jean Piaget in 1896-1980. The study adopted a descriptive survey design and targeted 90 public pre-schools comprising of 5460 pre-school learners and 180 pre-school teachers. A simple random sampling technique was used in selecting the pre-schools and the sample size for teachers and learners for the study was arrived at using Krejcie and Morgan (1970) formula. Through these methods, 27 pre-schools, 359 learners and 123 pre-school teachers were selected for the study. Data was collected using questionnaires and a literacy skill test administered to the learners. Questionnaires were administered to pre-school teachers to seek information on pre-school teachers’ training skills and use of instructional resources. Content validity of the instruments was determined by employing the expertise of my supervisors and lecturers in the Department of Education while reliability was determined through split-half technique. Data was analyzed using descriptive and inferential statistics such as means, percentages, frequencies and Pearson Correlation analysis. The findings were presented in tables, pie charts and bar graphs. The study found that there was a positive correlation between display of instructional resources and learners’ achievement in writing skills (r = .646; p = .000) and reading skills (r = .780; p = .000). The study concluded that instructional resources play a significant role in imparting of reading and writing skills to the pre-school learners. The study recommended that there is need for provision of audio and audio-visual materials to pre-schools since these materials are known to positively affect the acquisition of writing and reading skills among pre-school learners. It also recommends that the government of Kenya through the Ministry of Education ensure that pre-schools acquire instructional resources equitably distributed in the various pre-schools across the country to facilitate timely implementation of the curriculum especially in reading and writing skills for good educational foundation of the learners.
INFLUENCE OF AVAILABILITY OF INSTRUCTIONAL RESOURCES ON CHILDREN’S PERFORMANCE ON EARLY LITERACY IN PUBLIC PRE-SCHOOLS IN KANDUYI SUB-COUNTY, KENYA
Authors: Mideva Mugami Margaret
Published: February 2023

The factors associated with the teaching and learning of early literacy skills may have been addressed but influence of instructional resources continues to be a concern. This study focused on how availability of instructional resources influences children’s performance in early literacy in public pre-schools in Kanduyi Sub-County, Kenya. The study was framed on the constructivism theory propounded by Jean Piaget in 1896-1980. The study adopted a descriptive survey design and targeted 90 public pre-schools comprising of 5460 pre-school learners and 180 pre-school teachers. A simple random sampling technique was used in selecting the pre-schools and the sample size for teachers and learners for the study was arrived at using Krejcie and Morgan (1970) formula. Through these methods, 27 pre-schools, 359 learners and 123 pre-school teachers were selected for the study. Data was collected using questionnaires and a literacy skill test administered to the learners. Questionnaires were administered to pre-school teachers to seek information on pre-school teachers’ training skills and use of instructional resources. Content validity of the instruments was determined by employing the expertise of my supervisors and lecturers in the Department of Education while reliability was determined through split-half technique. Data was analyzed using descriptive and inferential statistics such as means, percentages, frequencies and Pearson Correlation analysis. The findings were presented in tables, pie charts and bar graphs. The study found out that concrete materials, were used by majority of the pre-school teachers in the study area. However, audio and audio-visual resources were lacking in all the schools in the study area hindering the acquisition of writing and reading skills. The study concluded that instructional resources play a significant role in imparting of reading and writing skills to the pre-school learners. The study recommended that there is need for provision of audio and audio-visual materials to pre-schools since these materials are known to positively affect the acquisition of writing and reading skills among pre-school learners. It also recommends that the government of Kenya through the Ministry of Education ensure that pre-schools acquire instructional resources equitably distributed in the various pre-schools across the country to facilitate timely implementation of the curriculum especially in reading and writing skills for good educational foundation of the learners.
Qual seria o melhor modelo para análise dos custos que interferem nas instituições de ensino superior? uma revisão bibliográfica sobre o tema
Authors: Smith Menezes Abel , Filho Deoclecio Jorge Gonçalves , Ouro Abimael , Oliveira Kleber
Published: February 2023

O presente estudo se propôs a analisar, através de uma Revisão Bibliográfica, quais são os principais Métodos de Custos utilizados para a tomada de decisão nas Universidades Públicas Brasileiras. Para essa análise foram classificados dezessete artigos, os quais apresentaram diversos tipos de custos. Após essa análise, foi possível ter uma visão geral sobre o assunto abordado levando em consideração diversos aspectos apresentados de forma clara e simples em gráficos, figuras. Através dessas análises foi possível identificar que entre os diversos Métodos de Custos, o modelo ABC foi o mais utilizado em grande parte dos artigos.
Ultrassonografia no diagnóstico diferencial de escroto agudo
Authors: Conceição Daiana Lopez , Neves Thaline Mairace Hernandez , Maldonado João Paulo , Reis Alan Timoteo Rodrigues , Lalier Rafael Teodoro Lopes
Published: February 2023

O diagnóstico de escroto agudo deve ser considerado quando o paciente refere dor escrotal, sobretudo na ocasião em que se manifesta de maneira unilateral. O uso da ultrassonografia pode complementar a investigação após a anamnese e exame físico direcionados às causas mais comuns. É importante também estar atento aos possíveis diagnósticos diferenciais para que seja indicada a melhor condução terapêutica para cada paciente.
Improvement in organ failure in acute on chronic liver failure (ACLF) upon liver transplantation
Authors: Aziz Afridi Sikandar , Khan Shoaib , Hussain Azhar , Ashraf Atif , Dogar Abdul Wahab , Bhatti Abu Bakr Hafeez , Husnain Ali , Bhatti Talal Khurshid , Haider Muhammad Adnan
Published: February 2023

Background &Aim: The prognostic factors determining the outcome of patients with cirrhosis and multi-organ failure are currently under evaluation. Reversal of organ failure pattern in response to Liver Transplant has not been studied much. It is an understood phenomenon that different organs that failed as consequence of ACLF will ultimately recover from injury upon liver transplantation. The aim of the study was to determine the mean number of days a failing organ in a pre-transplanted patient will take to recover after liver transplantation. Methods: Data was collected from April 2013 till February 2020 in the department of Liver Transplantation, Hepatobiliary and Pancreatic Services, Shifa International Hospital, Islamabad. In this cross-sectional retrospective study, 82 ACLF patients of both genders of age >15 years who fulfilled EASL-AASLD definition and underwent liver transplantation were included in the study. And patients who fulfilled APASL criteria but did not fulfilled EASL-AASLD criteria of definition of ACLF or those who required ventilator support or triple inotropic support before surgery were excluded. Patients with serum creatinine level >1.5mg/dl were labeled as having renal failure. Those with total bilirubin level of >12 mg/dl were labeled as hepatic failure and those with INR >2.5 were having coagulation failure.
Keloid with intra-lesional steroid injection
Authors: Gul Sana , Junaid Shakila , Kashir Muhammad , Izhar Madiha , Farooq Nadia , Zahoor Fatima
Published: February 2023

Introduction: Keloids are the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury. The exact pathogenesis of Keloids is unknown and their occurrence is spontaneous. The uncontrolled overgrowth of dense fibrous tissue extends beyond the borders of original wound and does not regress. No single therapeutic modality has been proven to be most effective for treatment therefore this study is plan to use intralesional steroids injection in keloid and measure the efficacy and to see if it is a better and cost effective method and also to determine its utility for clinical practice in dermatology in future. Objective: To determine the efficacy of intralesional steroid injections in keloids with dental syringe. Settings: Dermatology department, Jinnah Medical College Hospital in outpatient department (OPD). Duration: 06 months from 14th April’2018 to 14th Oct’ 2018. Design: Cohort Study. Subject and Methods: A total of 79 patients with having keloid were included in this study. During each visit, the size of the keloid was recorded centimeter using the Vernier's calipers, in terms of length, breadth, and height Injection triamcinolone acetonide was used in strength of 40 mg/ml.
Competencias docentes: demanda, condiciones y líneas investigativas para una formación posgraduada en innovación educativa
Authors: Mendoza Jhonny Francisco , Blandino Obando José Roberto , Santana Ruíz Maynor Alberto
Published: February 2023

El avance mostrado en la Educación a Distancia Virtual en las Instituciones de Educación Superior del Consejo Nacional de Universidades requiere de los docentes competencias para la innovación educativa en esta modalidad. Por tal motivo, el objetivo de este trabajo fue realizar un diagnóstico de hallazgos que justifique la formación continua para el fortalecimiento de competencias de innovación educativa virtual. Esto, con la intención de documentar los requerimientos de formación continua de los docentes que justifique la pertinencia de un programa de Maestría de Innovación Educativa virtual en el Programa Universidad Abierta en Línea de Nicaragua del Consejo Nacional de Universidades. En este diagnóstico se aplicó un formulario virtual de evaluación diagnóstica a una muestra de 633 docentes, mediante la herramienta Google Forms. Los resultados del estudio mostraron información general de los docentes, con edades entre 35 y 40 años con nivel de posgrados; el 73.8 % cuenta con equipos de cómputo, principalmente Laptop; conexión a Internet; participan en investigaciones y publicaciones, en grupos de investigación; tienen interés en realizar estudios de posgrado, pues es la modalidad y metodología que mejor se ajusta a ellos. Los docentes poseen interés para realizar estudios en la modalidad virtual, ya que cumplen con los requisitos básicos para iniciar un programa de maestría virtual. Del mismo modo, también demandan la oportunidad de realizar investigaciones en temas de innovación tecnológica y educativa.
Influence of the biopreparation "silostan" on the nutritional and energy value of cereals and bean mixtures
Authors: Пузик А.А. , Никитин А.Н. , Птицына Н.В.
Published: February 2023

В статье представлен экспериментальный материал по изменению качества злаково-бобового силоса при введении в него биопрепарата «Силостан». Показано влияние, оказываемое силосами, заготовленными на его основе, на продуктивность дойного стада крупного рогатого скота. Установлено, что внедрение в Смоленской области в систему кормопроизводства и кормления сельскохозяйственных животных силоса, полученного из овсяной смеси с бобовыми компонентами, является оправданным приемом, позволяющим получить корм с более высокими показателями качества в сухом веществе. Обработка зеленой массы препаратом «Силостан» при приготовлении силоса положительно сказалась на таких показателях качества, как сырой протеин, сырая клетчатка, сырая зола, что в свою очередь привело к увеличению энергоемкости корма. Использование биопрепарата «Силостан» при заготовке силоса может потенциально способствовать получению дополнительно от 0,7 до 0,9 кг молока, по сравнению с удоем, полученным при использовании силоса, заготовленного без данного биопрепарата

The article presents experimental material on changing the quality of cereal-bean silage with the intro- duction of the biopreparation "Silostan" into it. The influence exerted by silos harvested on its basis on the productivity of a dairy herd of cattle is shown. It has been established that the introduction of silage obtained from an oat mixture with legumes into the system of fodder production and feeding of farm animals in the Smolensk region is a justified technique that allows obtaining feed with higher quality indicators in dry matter. The treatment of green mass with the "Silostan" preparation during the preparation of silage had a positive effect on such quality indicators as crude protein, crude fiber, crude ash, which in turn affected the increase in the energy intensity of the feed. The use of the "Silostan" biological product in the preparation of silage can potentially contribute to the production of an additional 0.7 to 0.9 kg of milk, compared with milk yield obtained when using silage harvested without this biological product.
Optimization of operating modes of the teasing machine of the combine harvester for harvesting industrial crops
Authors: Виноградов А.В. , Фирсов А.С. , Кудрявцев А.В. , Блинов Ф.Л. , Голубев В.В.
Published: February 2023

Материал, представленный в данной работе, был реализован в период с марта по ноябрь 2022 года в ФГБОУ ВО Тверская ГСХА и несёт научно-практический характер этапа уборки технических культур. В представленной работе отражены результаты цифровой трансформации на этапе подготовки к лабораторным исследованиям с применением аддитивных технологий, что позволило снизить трудоёмкость и материалоёмкость при изготовлении конструктивных элементов лабораторной установки. Полученные результаты лабораторно-полевых исследований достоверны, что подтверждается проверкой в соответствии с общепринятыми методиками. Использование инновационного теребильного аппарата с оптимальным количеством выступов 6 штук позволяет снизить растянутость стеблей до 3 – 7% в сравнении со штатным шкивом.

The material presented in this work was implemented from March to November 2022 at the Federal State Budgetary Institution of Higher Education of the Tver State Agricultural Academy and carries the scien- tific and practical nature of the stage of harvesting technical crops. The presented work reflects the results of digital transformation at the stage of preparation for laboratory research using additive technologies, which made it possible to reduce the labor and material consumption during the manufacture of structural elements of the laboratory installation. The obtained results of laboratory and field studies are reliable, which is confirmed by verification in accordance with generally accepted methods. The use of an innovative tiebreaker with an optimal number of protrusions of 6 pieces allows you to reduce the stretch of the stems to 3 – 7% in comparison with the standard pulley.
Assessment of the quality of work of flax combing machines during the processing of flax by the factory technology
Authors: Романенко В.Ю. , Соловьев С.В.
Published: February 2023

В статье представлен анализ работы стационарных очесывателей льнотресты, применяемых в процессе переработки льна-долгунца, на отечественных и зарубежных линиях льнозаводов. Кратко описаны технологии уборки льна и приведены преимущества заводской технологии в сравнении с другими. Рассмотрены причины и факторы, влияющие на нарушение плавного протекания технологического процесса. Даны рекомендации по устранению замечаний и повышению качества работы стационарных очесывателей тресты.
Economics Of Progress & Peace
Authors: Phatak Ajay
Published: February 2023

The author argues that conventional economics, which views market prices as the result of free choice by individuals and households, is a flawed concept. In reality, the choice is not free due to the influence of social, religious, and political factors. The private profit motive leads to an inequitable distribution of wealth, leading to a failure of demand and recession. The rise of mass production and service sector post World War II created an illusion that man-made capital and natural capital are interchangeable. The drive for more, or growth economics, has resulted in the strain on non-renewable resources and environmental pollution. The author argues that economics of progress must balance resource availability, renewability, allocation, and fair distribution of wealth.
A Preliminary Empirical Study on the Influencing Factors of China's Economic Growth
Authors: Luo Yilang , Li Wenbo
Published: February 2023

Many countries or regions around the world have seen their economic growth slow in recent years due to the impact of the COVID-19 pandemic. It is of great significance to the world that China's economy is the first to recover from the impact of COVID-19. This paper selects the data of various economic development indicators of China from 2002 to 2021, establishes the multiple linear regression model of economic growth, and makes a preliminary analysis of the influencing factors of China's economic growth. This paper explores the influence of export, consumption and investment on China's economic growth. Finally, it puts forward relevant suggestions for further high-quality sustainable development of China's economy.
Research on Modular Teaching Reform of Financial Markets Course Based on Financial Software
Authors: Li Yang
Published: February 2023

At present, there are some problems in the Financial Markets Course of finance major, such as outdated teaching content, emphasizing theory over practice, and single evaluation method. Therefore, it is necessary to carry out teaching reform on this course, including: modular design of teaching content, introduction of financial software as a comprehensive training platform, and implementation of diversified assessment methods with more process assessment. After the implementation of the teaching reform, satisfactory results have been achieved, but there are still problems to be solved.
Corporate Social Responsibility, Tariff and Technological Innovation in an Open Economy
Authors: Meng Bin
Published: February 2023

By constructing a mixed oligopoly competition model in an open economy, the internal relationship between tariff policy changes, domestic corporate social responsibility and technological innovation is deeply revealed. The theoretical deduction shows that the tariff rate has a negative correlation with the social responsibility preference of domestic consumer-friendly enterprises, and reducing the tariff can improve the social responsibility preference of domestic enterprises; Higher tariff rates will reduce domestic consumer surplus and reduce the efficiency of tariff collection of regulators. Higher investment in technological innovation can increase domestic consumer surplus and improve domestic corporate social responsibility preference.
Research on the Impact of Environmental Investment and Environmental Performance
Authors: Wang Yingfeng , Han Xiaoli , Guo Jialing
Published: February 2023

In the context of the national "double carbon" goal, it is important to advocate enterprises to make environmental investment, increase environmental protection investment, improve the environmental performance of enterprises, and take the path of green and sustainable development. This paper selects data related to A-share listed companies in Shanghai and Shenzhen from 2019 to 2020, takes the environmental protection input of enterprises as the starting point, adds financial indicators and corporate governance indicators and other related variables, and elaborates the relationship between environmental protection input and other related variables and the environmental performance of enterprises through descriptive analysis, correlation analysis and regression analysis as well as robust type analysis. This paper concludes that corporate environmental investment is significantly and positively related to environmental performance. The environmental protection investment of enterprises is crucial to the improvement of the whole social environment, and government departments should formulate relevant policies to strengthen the guidance for enterprises to increase their environmental protection investment, require them to strictly comply with the social responsibility disclosure system, and promote the in-depth development of ESG concept in China.
Impacts of Corporate Business Tactics on Maintaining the Competitiveness of China’s Automotive Manufacturers During the Covid-19 Pandemic
Authors: Li Jiayi
Published: February 2023

The purpose of this study is to investigate the impacts of corporate business tactics on maintaining competitiveness of China's automotive manufacturers during the Covid-19 pandemic. A case analysis of Jiangling Motors Corporation Ltd. was conducted. Data were collected from Jiangling's yearly financial reports between 2019 and 2022, and from a questionnaire administered to 62 participants from the company. The data was analyzed through SPSS, and the findings suggest that Jiangling has been able to maintain its competitiveness despite the Covid-19 pandemic due to a number of factors, including its focus on innovation, cost-effective production, and flexible marketing strategies. The study provides insights into how other automotive manufacturers in China can maintain their competitiveness in the face of crises such as the Covid-19 pandemic. Overall, the objective is to investigate the impacts of business tactics on maintaining the competitiveness of China's automotive manufacturers during the Covid-19 pandemic. The researcher will use Jiangling Motors Corporation Ltd. as a case study to examine how different business tactics can help a company remain competitive in the post-pandemic market. Given the limited scope, this research cannot be generalized to all automotive companies in China. However, it can provide valuable insights into how some companies are successfully adapting to the post-pandemic market.
How Hedonic Value and Perceived Mental Benefits Affect Electronic Loyalty in The Shopee.Vn Online Market (Vietnam).
Authors: Zhao Guochen
Published: February 2023

Nowadays, many consumers remark that they frequently feel happier when shopping than they did previously. Many customers have reported feeling happy when shopping, which is motivated by their desire to improve their emotions. However, there is currently very little research in the area of psychology pertaining to purchasing in general and online shopping in particular websites such as shopee.vn. Instead of examining specific mental states, previous research primarily relied on only the positive and negative emotions measured using rather broad psychological instruments. They just asked customers to express themselves broadly about how they felt while shopping without identifying the particular shopping or item. Consumer satisfaction is defined as the difference between what a customer expects and receives after utilizing a product or service. Thus, anticipation and result make up the basis of contentment. In contrast, the relationship benefit is the relationship marketing principle articulated.
Research on the Influence of Strategic Difference on Stock Price Synchronization
Authors: Wang Jingjing , Yuan Yihan
Published: February 2023

Stock price synchronization is an important index to measure the content of idiosyncratic information in a company's stock price. Taking the increasingly fierce market competition as the background, this paper discusses the relationship between strategic difference and stock price synchronization in China's stock market with more noise trading, and considers the influence of property right nature and ownership concentration on this relationship. The results show that: (1) the higher the difference of corporate strategy, the lower the synchronization of stock price; (2) State owned enterprises and ownership concentration can promote the negative correlation between them. From the new perspective of noise interpretation, this study finds that when noise trading becomes the main influencing factor of stock price synchronization, a higher degree of strategic difference will increase the degree of corporate information asymmetry, cause investors to blindly follow the crowd and other more irrational noise trading, improve the heterogeneous fluctuation level of stock price, and then reduce the level of stock price synchronization.
Is Bitcoin A Blessing or A Curse?
Authors: Lu Yawen
Published: February 2023

In this article, several perspectives of bitcoin are briefly stated. First, there is an introduction for bitcoin, such as the concepts and the process of its launch, in order to have a general idea. Then, I borrow a few main ideas from Adam Smith, which help to support that bitcoin is a blessing. Based on six behavioral motivations from Adam Smith, I tried to define the property of bitcoin and find out the development of bitcoin in the future. In the other hand, bitcoin is limited, which can not satisfy all the consumers and do not have a supervision department.
Research on Video Content Presentation with Commercial Advertisements in Bilibili from the Perspective of Creators
Authors: He Sui
Published: February 2023

As a kind of network video in the new media environment, videos with commercial advertisements are developed on the Bilibili video platform, which mostly refers to a series of actions taken by Uploader for livelihood (This kind of advertisement is specially named as "Qiafan" video). It is the transformation of video creators from pure interest in making video to actual profitable work. This paper focuses on the presentation of video content with commercial advertisements in Bilibili, from the creator's perspective, through typical case studies and content analysis, it is found that this type of video has the characteristics of originality, stratification (Circle nature) and perceptual similarity. According to the video construction and expression strategy, it can be divided into six content presentation methods. Different ways will directly affect the user ' s sensory and communication effect of video advertising.
Use Promote Inclusive Entrepreneurship Among Farmers?
Authors: Li Lu
Published: February 2023

The development of Internet technology has a huge impact on social equity and efficiency, fully mobilize the potential of innovation and entrepreneurship of social vulnerable groups, which is of great significance to achieve common prosperity. Using CGSS2017 data and the characteristic data of prefecture-level cities, this paper evaluates the inclusiveness of Internet development for farmer entrepreneurship. Research findings: First, Internet application not only promotes individual entrepreneurship but also significantly promotes entrepreneurship of rural residents. It can be seen that the development of the Internet is conducive to the equalization of entrepreneurial opportunities between urban and rural areas in China. Second, compared with the impact of Internet use and application on entrepreneurship of rural vulnerable groups, the frequency of Internet use has greater promoting effect on rural vulnerable groups; However, the scope of Internet use has a more significant promotion effect on entrepreneurship of the rural mainstream population. Therefore, it is proposed to accelerate the construction of network coverage in rural areas; Strengthen the training of farmers' Internet use skills; We have made policy recommendations on improving regulations for the Internet and fostering a sound cyberspace.
Penguatan Numerasi dalam Meningkatkan Higher Order Thinking Skill (HOTS) Siswa Sekolah Dasar di Era Digital
Authors: Natsir Siti Rahmalia , Manaf Abdul
Published: February 2023

Kemendikbud mengemukakan bahwa era digital merupakan zaman dimana informasi mudah didapat. Negara yang tidak dapat menyesuaikan dengan perkembangan teknologi maka akan menjadi Negara tertinggal. Melhat kondisi ini ditambah dengan fakta bahwa Indonesia memiliki minat yang rendah dalam hal numerasi, maka pengutan numerasi di sekolah dasar sangat penting. Melalui budaya numerasi di sekolah melatih siswa dapat menyelesaiakan soal HOTS. Dalam proses belajar mengajar matematika, guru perlu membiasakan siswa menyelesaiakan soal pemecahan masalah dengan harapan agar siswa memiliki karakter untuk meghadapai masa yang akan datang. Program penyuluhan ini terkait dengan penguatan numerasi dalam meningkatkan Higher Order Thinking Skill (HOTS) siswa sekolah dasar di era digital di lingkungan sekolah. Dilingkungan sekolah harus tercipya budaya dan suasana numerasi. Dengan adanya budaya numerasi di lingkungan sekolah, diharapkan timbul minat siswa dalam bidang matematika dan tidak ada perasaan cemas dalam menyelesaikan soal HOTS atau pemecahan masalah.
The Perinatal and Maternal Outcomes of Instrumental Vaginal Delivery
Authors: Alwazzan Ahmed
Published: February 2023

Instrumental vaginal delivery is necessary under special circumstances to facilitate a safer delivery process. Objective: To assess the perinatal and maternal outcomes of instrumental vaginal delivery. Methods: This retrospective study was conducted at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia and included patients from July 2018-June 2021. All females with singleton pregnancy who underwent instrumental delivery using vacuum or forceps were included. Data were analyzed using SPSS 19. Results: There was a total of 346 instrumental delivery cases during these three years, out of which 337 (97.4%) were vacuum and 9 (2.6%) were forceps. A significant difference was observed between both groups regarding 3rd & 4th-degree tears and hospital stay, where the mean hospitalization and the rate of 3rd & 4th-degree tears were higher among forceps groups than the vacuum group (4.1±2.8 forceps vs 2.1±1.0vacuum, p value<0.0001) and (44.4% forceps vs 9.5% vacuum, p value=0.009) respectively. There was a significant difference between the two groups regarding Apgar score at 1 m and Apgar score at 5 m, where the means of both Apgar scores were higher among the vacuum group than the forceps group (8.1±1.6 vacuum vs 6.4±3.2 forceps, p value=0.002) and (9.5±1.3 vacuum vs 8.3±3.2 forceps, p value=0.006) respectively. Conclusions: It is critical to renovate the training and use of operative vaginal delivery to improve these skills which is underutilized today. When it is performed by a skilled provider it is a perfect alternative to Caesarean delivery in the chosen patients.
Analysis of Manheim Peritonitis Index Scoring in Predicting Outcome in Patients with Perforation Peritonitis
Authors: Furrukh Aftab Muhammad , Niaz Khurram , Talha Bukhari Muhammad , Kareem Talha , Munir Abdul , Ali Rabbani Muhammad
Published: February 2023

Scoring systems are essential to calibrate the severity of abdominal sepsis for adequate management. Disease specific scoring system based on easy to handle clinical parameters can help the cause. Objective: To study the role of Manheim peritonitis index scoring in predicting outcome and prognosis in patients with perforation peritonitis. Methods: This prospective study was carried out in Surgical Unit 1, Nishtar Hospital, Multan from 20th of August 2019 to 31st of December, 2019. It includes both sexes aged 20 years and above diagnosed at laparotomy after confirmation of peritonitis due to perforated viscus regardless of the etiology. Data were analyzed using SPSS version 19.0 Software. The outcome (death vs discharge) was compared separately to different predictors using Chi-square test. Fischer Exact test was used where assumptions of Chi-square were not met. Results: Advance age, female gender, colonic perforation, organ failure and fecal contamination were associated with high mortality. The mean MPI Score was 25.06 ± 4.96. The lowest score was 16 and the highest was 37. Overall, the in-hospital mortality rate was 14.3% in patients with MPI ≥26 compared to 6.4% in patients with MPI <26, implying over a twofold higher risk in the former group. For a score of 26 or greater as a predictor of mortality, the sensitivity was 75.0%, specificity was 38.2% at an accuracy of 94%. Conclusion: MPI enables us to categorize patients into different groups so as to tailor management according to individual needs
Assessment of Knowledge towards radiation hazards and protection protocols among medical and dental students
Authors: Fatima Nazish , Ehsan Shaista , Rehman Amna , Azeem Syeda Arzoo , Azeem Samir
Published: February 2023

Recently the use of radiography is growing significantly due to technology advancements and overdependence for diagnosis that's the reason everyone is exposed to radiation and there is a linear relationship exists between radiation exposure and adverse effects on the body. Objectives: To compare the radiation hazards and protection protocols knowledge among the final year medical and dental students of private university. Methods: It was an analytical cross-sectional study conducted on final year students of Medical and Dental College of private university at Karachi Pakistan in year 2022. All students in final year MBBS and BDS irrespective of age and gender were the source population. The study populations (n=85) were those students who were randomly chosen to fill the questionnaire. The study tool in this research included a structured questionnaire. Each correct answer was scored as 1 point. Percentages and frequencies will be recorded for qualitative variables. The total knowledge scores between medical and dental students were compared using the independent t-test. Results: The data were analyzed on a total of (n=85) students. The mean ages were 22.91±0.71 and 59 (69%) were girls and 26 (31) % were boys. There were (n=45) students from the final year MBBS and (n=40) students from BDS referred as group I and II respectively. There was significant difference (t (83) = -3.052, P=0.003) in the knowledge scores group I (8.95±3.30) and group II (11.40±4.07). Conclusion: Majority of Dental students have high knowledge scores as compare to medical students
Relationship of Periodontal Health and Multiple Common Stress Factors Among The Socially Deprived Women
Authors: Malik Aeeza , Javaid Qurat ul Ain , Shafi Ahmad , Khalid Basil , Dogar Fahad , Rehman Rohana , Saleem Malik
Published: February 2023

Periodontitis is a prevalent chronic inflammatory disease in developing countries which may impose multiple negative impacts on the quality of life. The possible role of psychosocial factors in the aetiology of inflammatory periodontal diseases needs further investigations to establish the fact. Objective: To evaluate the general periodontal health and the relationship of periodontal inflammation with multiple common stress factors among the socially deprived and separated women residing in a shelter home of Multan city. Methods: This group comparative study spanned over one month. Through  purposive sampling, a cohort of 115 women aged 20-40 years, residing in the SOS village shelter home, Multan  for more than a month were included. Women were divided into Cases (with stress) and Controls (without stress) and were matched for age and educational status. Periodontal examination was done employing Community Periodontal Index while Life Events Scale was used to assess the type of stress. A structured and validated questionnaire was used to record the readings. Descriptive statistical measures including mean and frequency percentages along with Logistic regression analysis were used employing SPSS version 21. Results: Significant relationship (P<0.001) was found between periodontal disease and self-health-related stress, financial stress and family health-related stress. Logistic regression analysis revealed that subjects who felt self-health-related stress are 0.016,  financial stress are 0.125 and  family health-related stress are 0.207 times more prone to have periodontal disease than those who never or rarely felt such stresses. Conclusion: Self-health-related stress, financial stress and family health-related stress are the potential risk indicators for the development of periodontal disease among socially deprived women
Work Related Upper Limb Musculoskeletal Disorders among Dentist; A Cross-Sectional Study with site and onset of Upper Limb Symptoms
Authors: Arif Abida , Aziz Khalid , Tasneem Sharjeel , Bashir Kiran , Nouman Hussain Muhammad , Kashif Muhammad
Published: February 2023

Dentists' working day involves awkward and static standing and sitting positions to work within a precise mouth area, resulting in musculoskeletal problems. Objective: To determine frequency of musculoskeletal pain and disorders along with the body-site–specific upper limb (UL) symptoms among dentists. Methods: A cross-sectional study with non-probability convenience sampling was done from March to December 2021. Data were collected using three validated questionnaires, Rapid Upper Limb Assessment (RULA), Visual Analog Scale (VAS) and Upper Extremity Functional Index (UEFI). SPSS was used to analyze data. Results: Fifty-three dentists were enrolled, with 5 (9.4%) males and 48 (90.6%) females. Pain regions were assessed in terms of frequency and severity of pain. There were significant differences found in different regions with p-value less than 0.001. Severe pain was found more in elbow with 42.9%, moderate pain in shoulder was observed with 37.5% however, 31.8% mild pain was observed in neck region with significant p-value of 0.004. Mean Posture Score (Neck, Shoulder, Elbow and Wrist) was found to be 5.32 ± 0.85 and Mean Posture Score (Upper Back) was found to be 4.08 ± 1.68. Female Gender was found common 25.8% in neck pain, 20.9% in shoulder pain, 16.1% in elbow, 12.9% in upper back with significant p-value of 0.016. Conclusions: Elbow was the most painful area in upper limb among dentists working with Clients. Female were more vulnerable in pain than male and majority reported pain related problem, which results in restricted range of motion
To Determine the Frequency of Urinary Tract Infection in Women with Preterm Premature Rupture of Membranes
Authors: Ayoub Saba , Tasneem Maria , Pathan Sara , Shoukat Sadia , Kaleem Rabia , Fazal Kamran
Published: February 2023

Preterm labor affects around thirteen million of births worldwide annually and is more observed in developing nations as compared to developed world. While 2 to 3% of pregnancies develop preterm premature rupture of membranes (PPROM) that result in increased morbidity and mortality of mother and child. Pregnancy induced hypertension and ante partum hemorrhage remained other important factors to develop preterm labor. Once diagnosed, needs expert consultation and management. Objective: To determine the frequency of urinary tract infection(UTI) in women with preterm premature rupture of membranes. Methods: This Cross Sectional study was done in department of Obstetrics and Gynecology, ATH, Abbotabad. From 30th August 2019 to 29th February 2019. We included 202 patients fulfilling the inclusion criteria. Informed consent was taken. The data were collected on prepared proforma. Results: In our study 202 patients with mean age of 25.93 ± 4.70 years were included. Mean gestational age was 33.09 ± 1.69 weeks. Mean parity was 2.36 ± 0.92. In our study, frequency of urinary tract infection (UTI) in women with PPROM was found in 09 (4.46%) patients. Conclusion: This study concluded that frequency of UTI in women with PPROM was found in 4.46% patients.
Assessment of Self-care Practices among Heart Failure Patients in District Head Quarter Hospital Timergara Dir Lower
Authors: Sohail Mohammad  , Naz Najma , Nasir Khan Muhammad , Rahim Khan Muhammad , Haq Sami Ul
Published: February 2023

In both hospitals and the community, nurses play a critical part in the provision of healthcare. The improvement of heart failure patients' self-care behaviors is greatly helped by nurses. Objective: To determine the level of self-care practices among heart failure patients at the District Headquarter Hospital of Timergara Dir Lower. Methods: A cross sectional study design was used to determine the level of self-care practices among heart failure patients. Self-Care Heart Failure Index (SCHFI) version 7.2 was used for data collection. After receiving written informed consent, 150 hospitalized heart failure patients were recruited through a consecutive sampling technique from the Department of Internal Medicine and Cardiology at DHQ Hospital Timergara Dir Lower. Data were analyzed with SPSS version 26.0. Results: It was found out that 44% of the study participants were females, 56% were males, 80% were married, 6% were illiterate and 86% had caregivers at home. Moreover, the mean score of the self-care subscales were inadequate (i.e., self-care maintenance: 68.5, symptoms perception: 67.26, self-care management: 68.56 and self-care confidence: 69.15, cutoff value: 70). The level of self-care was significantly associated with gender. In-addition, the marital status was significantly associated with the level of self-care in the sub-domains of self-care maintenance (p=0.011) and self-care management (p=0.001). Conclusions: Results of the study specified that majority of the heart failure patients had lack of adequate self-care practices. Therefore, efforts should be done to help them in performing an adequate self-care activity to remain healthy and reduce their hospital re-admissions.
Factors Influencing The Outcome Of Severe Pneumonia Among Children Having Age From 2 Months To 5 Years In A Tertiary Healthcare Hospital
Authors: Iqbal Noureen , Zafar Farhana , Iqbal Mohammad
Published: February 2023

One of the leading causes of high rate of morbidity and mortality among pediatrics under the age of five years is pneumonia. A report of WHO published in 2013 stated that pneumonia is accountable for about one hundred and twenty million patients each year and the most vulnerable are developing countries. Objective: To find out the rate of occurrence of different factors and pneumonia’s outcome among children having age from two months to five years in tertiary healthcare hospital. Methods: It was carried out at ICU of Pediatric Department of Ziauddin Hospital Karachi, from June 2021 to December 2021. It included 145 patients under the inclusion standard.  Results: Average weight, height, age and duration of hospitalization in this research work was 7.72 ± 3.87 kilograms, 68.23 ± 15.28 centimeters, 8.72 ± 4.24 years and 8.72 ± 4.24 days. Total were 63.40% (n: 92) male and 36.60% (n: 53) female patients. out of total 145 patients, 27.60, 73.10, 29.70, 38.60, 35.20, 40.0 and 7.60% patients had mechanical ventilation’s requirement, delayed hospitalization, URTI history in family, mostly suffered children suffered from pneumonia in less than 2.5yrs of age. And regarding outcome, prolonged hospital stay, mechanical ventilation and mortality has significant association with younger age. Conclusions: It was concluded that association can cause the improvement in the management strategies and possibility of the survival for the children suffering from pneumonia. So, there is need of close monitoring of all the patients with consistent follow up visits.
Association of Quality of Life and Pain Intensity in Patients of Trigger Points
Authors: Ali Kazim Syed , Nawaz Arshemah , Taha Javed Muhammad , Liaquat Mariam , Noor Sara , Sheeraz Muhammad , Hashim Adnan
Published: February 2023

Myofascial trigger points are hyperirritable, unpleasant when compressed, and they have the ability to generate anomalies of the autonomic nervous system, referred pain, and motor dysfunction. Objective: To determine the Association of quality of life and pain intensity in patients of trigger points. Methods: Data were gathered from the Central Park Teaching Hospital, the Mayo Hospital, the Doctors Hospital, and the Jinnah Hospital. Our investigation focused on the prevalence of disability and quality of life in patients with trigger points. For quality of life and pain, we used the SF 36 Functional Limitation and General Health questionnaire; a visual analog scale was used. Results: Out of 152 patients, 87(57.2%) were males, and 65(42.8%) were females. The patients mean age was 38 ± 12.78 yrs. with a minimum age of 22 yrs. And maximum age of 72 yrs. 4(2.6%) patients has mild Pain, 67(44.1%) have moderate pain, 81(53.3%) have severe pain. 67(44.1%) patients have poor Health quality, 81(53.3%) have moderate health quality, and 4(2.6%) have good health quality. P-value for pain intensity and general health was 0.00, so we reject the null hypothesis and accept the alternative hypothesis, which indicated a significant difference between pain intensity and general health. p-Value was 0.012 for pain intensity and physical functioning. Conclusion: Hence it was concluded that the majority of the patients with trigger points have a poor quality of life and severe Pain. There was an association between quality of life and pain intensity.
Association of Severity of Diabetic Foot Ulcer with Glycated Hemoglobin A1C Levels
Authors: Din Nizamud , Khan Mahnoor , Danyal Khan Bakht , Ghaffar Tahir , Tabish Ikram Muhammad , Aamir Salman Muhammad , Khan Hadi Niktash , Khan Shafiullah
Published: February 2023

Diabetic foot ulcer is a well-documented complication of uncontrolled diabetes and its association with the variables involved in Diabetes like FBS, RBS and HBA1C has been thoroughly researched. This research aims to identify the association of diabetic foot ulcer under Wagner classification with HBA1C classes. Objectives: To determine the severity of diabetic foot ulcer at various level of HBA1C and determine the association. Methods: A cross-sectional study with 360 diabetic patients who after giving consent filled questionnaires. The information was analyzed using SPSS v26 (IBM) through Chi Square test. The results were tabulated and inferred from. Results: Our work depicts a statistically significant correlation between grades of diabetic foot ulcer and HBA1C levels of the patients (p-value <0.001). Patients with higher levels of HBA1C suffered foot ulcer of higher grades. Specifically, patients with Grade 1 foot ulcers primarily had HBA1C levels of ≤ 11.00 with 6(50%) falling in the group “7.01-9.00” while patients with Grade 5 ulcers had higher HBA1C levels with bulk of patients having levels of >11.00. Conclusions: This research further supplemented an already strongly established association between uncontrolled diabetes and diabetic foot ulcer. We focused on specifically HBA1C and how increased lab values are linked with different grades of Diabetic Foot ulcer and found a strong association demanding a proactive approach towards patient care and education