bluuebunny/crossref_metadata_2025 huggingface dataset:
ADULT PNEUMOCOCCAL MENINGITIS PRESENTING WITH STROKE LIKE SYMPTOMS
Authors: Sajjad Muhammad Mohsin , Yousaf Sidra
Published: January 2022

Meningitis can present as a stroke mimic. We report a case of a 69 years old lady who presented to accident and emergency 2-hours after an episode of vomiting followed by sudden onset left sided weakness and drowsiness. Examination revealed left sided weakness with dysphasia. Initial plan was to decide if the patient was for thrombolysis. An urgent CT scan ruled out hemorrhage. On re-examination the patient was febrile and there was some degree of neck stiffness. Magnetic resonance imaging of brain was performed (DW1 no stroke) which ruled out acute ischemia. A lumber puncture was done eventually that showed low glucose, high leukocyte count, and gram staining revealed diplococci in chains. Clinicians should bear in mind the differential diagnosis of meningitis when there are risk factors and overlapping clinical symptoms.
EFFICACY OF TWO APPROACHES OF TRANSFORAMINAL EPIDURAL INJECTIONS IN PATIENTS OF LUMBAR RADICULOPATHY
Authors: Ali Moazzam , Iqbal Rashid , Waseem Majid , Ali Liaquat , Talib Tahseen , Khawar Maliha
Published: January 2022

Objective: To determine the efficacy of transforaminal epidural steroid injection (TFESI) using conventional versus Kambin’s triangle approaches in patients of lumbar radiculopathy.

Study Design: Quasi experimental study.

Place and Duration of Study: Department of Pain Medicine, Combined Military Hospital Rawalpindi Pakistan, from Oct 2019 to Apr 2020.

Methodology: Eighty patients suffering from lumbar radiculopathy fulfilling the inclusion criteria were included in this study and were randomly assigned to undergo transforaminal epidural steroid injection using either conventional approach (group C) or the Kambin’s triangle (group K) approach. Pain scores and patient satisfaction levels were recorded at 4 and 8 weeks after the procedure.

Results: In both groups, the pain score (group C pre-procedure NRS =7.28 ± 1.26 vs post-procedure NRS = 2.14 ± 0.81, group K pre-procedure NRS = 7.33 ± 1.16 vs post-procedure NRS=2.70 ± 0.94) and patient satisfaction improved 4 and 8 weeks after the procedure. The pain score (p-value=0.21) and patient satisfaction score (p-value=0.88) however were not significantly different between groups.

Conclusion: This study demonstrated that using conventional or Kambin’s approach exhibits no difference in decreasing pain score or patient satisfaction level.
USE OF 20 MINUTE WHOLE BLOOD CLOTTING TIME IN PATIENTS OF SNAKEBITE; AN EXPERIENCE FROM KOHAT, KHYBER PAKHTUNKHAH
Authors: Javed Hammad , Bashir Tariq , Rauf Atif , Murtaza Syed , Jibran Raja
Published: January 2022

Objective: To study the diagnostic accuracy of 20-minute whole blood clotting time in hemotoxic snakebite.

Study Design: Cross sectional validation study.

Place and Duration of Study: Combined Military Hospital Kohat Pakistan, from Jul 2015 to Jun 2017.

Methodology: Study included 52 patients who presented with the complaint of a snakebite. The data was recorded on predesigned proforma including clinical, laboratory features. All the patients were kept indoor for observation for a minimum of 72 hours from the time of presentation.

Results: The study showed that males were more affected with age group between 20-50 years. Most common presenting features were local swelling 33 (71%) and pain and most common snakebite type was hemotoxic 33 (71%). The 20-minute whole blood clotting time was found to have low sensitivity (61%) and specificity (58%). A significant association was found between the dose of anti-snake venom and severity of coagulopathy (p<0.001), respiratory failure (p<0.001) and development of side effects due to anti snake venom (p<0.001). The mortality rate was 6.5% and was significantly related to age of the victims (p=0.003). The diagnostic accuracy of 20-minute whole blood clotting time was 60.25%.

Conclusion: The use of 20-minute whole blood clotting time can not only be misleading but also a source of delay in administering anti snake venom given the low sensitivity and specificity and high false negative rate.
IDENTIFICATION OF TORCH PATHOGENS IN CONGENITAL CATARACT PATIENTS VISITING ARMED FORCES INSTITUTE OF OPHTHALMOLOGY
Authors: Javaid Mamoona , Masud Hannan , Sajjad Rathore Hassan , Ali Dilshad , Javaid Haroon
Published: January 2022

Objective: To assess the rate of positivity of Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex (TORCH) pathogens in patients suffering from congenital cataract in Pakistan.

Study Design: Cross sectional comparative study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jun 2017 to Mar 2018.

Methodology: Cataract group included sixty children already diagnosed with congenital cataract and control group included 60 children not suffering from congenital cataract. Serum samples of all children were collected to test against IgG and IgM antibodies of Toxoplasma gondii, Rubella, Cytomegalo, Herpes simplex pathogens using enzyme linked immune essay (ELISA) technique. Data were analyzed observe in difference between unilateral and bilateral cataract and between cataract and control group.

Results: Out of 60 children in cataract group, 29 were tested positive for Toxoplasma gondii, Rubella, Cytomegalo (CMV), Herpes simplex infections. CMV IgG antibodies were identified in 21 (35%) children followed by Rubella IgG 13 (21.7%), Toxoplasmosis IgG 8 (13.3%), CMV IgM 7 (11.7%), HSV I IgG 5 (8.3%), HSV II IgG 2 (3.3%) and HSV I IgM 1 (1.7%) antibodies. None of the children was positive for Toxoplasmosis, Rubella and HSV II IgM antibodies. There was no statistical difference in rate of positivity of Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex pathogens between unilateral and bilateral cataract and between cataract and control group.

Conclusion: Toxoplasma gondii, Rubella, Cytomegalovirus, Herpes simplex pathogens are an important cause of congenital cataract with Cytomegalovirus and Rubella virus being most common respectively. In order to prevent paediatric complications, we need........
FREQUENCY OF SYMPTOMATIC SPONTANEOUS BACTERIAL PERITONITIS AND ASSOCIATED CLINICAL PARAMETERS IN PATIENTS WITH LIVER CIRRHOSIS
Authors: Gilani Syed Fayyaz Mehmood , Hassan Fayyaz , Siddiqui Fuad Ahmad , Gardezi Syed Anees Ahmed
Published: January 2022

Objective: To study association between spontaneous bacterial peritonitis and clinical symptoms in liver cirrhosis.

Study Design: cross-sectional study.

Place and Duration of Study: Combined Military Hospital Kharian, from Jul 2019 to Apr 2020.

Methodology: A total of 122 patients of liver cirrhosis (irrespective of aetiology), presented with various clinical symptoms such as fever, pain abdomen and hepatic encephalopathy were randomly selected. Patients between 18-80 years of age, were included in the study. Asymptomatic patients, with ascites other than liver cirrhosis were excluded. Spontaneous Bacterial Peritonitis was defined as positive ascitic fluid culture and/or ascitic polymorphonuclear leukocyte ≥250 cells/mm3 in ascitic fluid.

Results: Of the 122 randomly selected patients, the mean age was 56.5 ± 20.2 years. Forty-Five (46.8%) were male and 67 (54.2%) patients were female. Chronic Hepatitis C was the commonest cause of liver cirrhosis (92%). The frequency of spontaneous bacterial peritonitis was 37.7%. Majority, (83%) of the culture positive ascitic isolate was Gram negative bacilli and E.coli (72%) being the commonest organism isolated. Severe ascites, high International Normalized Ratio (INR), hepatic encephalopathy, fever, low ascetic fluid protein count, high serum bilirubin and creatinine were considered to be independent predictor of Spontaneous Bacterial Peritonitis.

Conclusion: Clinical symptoms of fever, hepatic encephalopathy, severe ascites, International Normalized ratio high and deranged renal profile was highly suggestive of Spontaneous Bacterial Peritonitis in cirrhotic patients.
ASSOCIATION OF PERCEIVED STRESS AND COPING STRATEGIES WITH DEPRESSIVE SYMPTOMS IN STUDENTS AT A PRIVATE MEDICAL COLLEGE IN ISLAMABAD
Authors: Mansoor Sawera , Azad Nadia , Zubair Usama Bin , Khan Khalid Hayat
Published: January 2022

Objective: To determine the association of perceived stress and coping strategies with depressive symptoms in students at a private medical college in Islamabad.

Study Design: Correlational study.

Place and Duration of Study: Foundation University Medical College, Islamabad, from Jun to Dec 2019.

Methodology: Fourth and Final year medical students of Foundation university medical college were enrolled in the study. Beck’s Depression Inventory was used to assess the depressive symptoms, perceived stress scale (PSS) was the tool used to look for the perceived stress and the coping strategies were assessed using the Brief Coping Orientation to Problems experienced (Brief COPE) Inventory. The association of perceived stress and coping strategies with depressive symptoms and other sociodemographic factors was established with the help of the chi-square test.

Results: Out of 262 medical students included in the study, 211 (80.5%) had none or mild depressive symptoms while 51 (19.5%) had moderate to severe depressive symptoms. Sixty-six (25.2%) had low stress, 127 (48.4%) had moderate stress while 69 (26.3%) reported high stress levels. Pearson chi-square test revealed that perceived stress and the coping strategies used including self-distraction, active coping, denial, substance use, behavioural disengagement, positive reframing, acceptance, religion/spirituality and self-blaming had a statistically significant relationship with the presence of depressive symptoms among the target population.

Conclusion: Considerable number of medical students had the presence of moderate to severe depressive symptoms in our study. Perceived stress and some specific kinds of coping strategies had a significant association with the presence of depressive symptoms among the target.......
RISK FACTORS AND OUTCOMES OF NEW ONSET ARRHYTHMIA IN SURGICAL INTENSIVE CARE UNIT: A RETROSPECTIVE STUDY
Authors: Hanif Sadaf , Shamim Faisal , Sohaib Muhammad
Published: January 2022

Objective: To assess the frequency of new-onset cardiac arrhythmias among patients admitted in surgical intensive care unit as well as associated risk factors.

Study Design: Retrospective observational study.

Place and Duration of Study: Surgical Intensive Care Unit, Aga Khan University Hospital, Karachi, from Jan 2018 to Dec 2019.

Methodology: The medical record numbers of all patients admitted in surgical intensive care unit were obtained from Surgical intensive care unit case log entries and reviewed. Patients` and healthcare providers` identification were kept confidential. Data was analyzed using SPSS version 19.

Results: Only 13/1076 patients included in the study had cardiac arrhythmias during their stay in Surgical intensive care unit. Among all patients with arrhythmias (n=13), atrial fibrillation was the most common type of arrhythmia 7 (53.8%). The study found higher occurrence of arrhythmias among the patients in the age category of 66 years or above 8 (4.6%) and when compared to younger patients with age categories 18-40 years 2 (0.3%) and 41-65 years 3 (0.3%) respectively (p-value<0.05). Similarly, arrhythmias were higher among patients who had relatively prolong intensive care unit stay and post-operative status as the primary cause of intensive care unit admission.

Conclusion: Occurrence of cardiac arrhythmias is relatively low among patients admitted to surgical intensive care patient population. Patients age (>65 years), prolong intensive care unit stay, post-operative status are positively associated with development of cardiac arrhythmias among critically ill patients admitted in surgical intensive care unit.
EXPERIENCE WITH DOLUTEGRAVIR IN HIV PATIENTS AT A PUBLIC SECTOR HOSPITAL IN KARACHI, PAKISTAN
Authors: Batool Farzana , Manzoor Sohaima , Dhiloo Azizullah Khan , Ismail Humera Muhammad , Shaikh Shah Muhammad , Baqi Shehla
Published: January 2022

Objective: To study the tolerability and efficacy of dolutegravir in naïve and experienced patients, their management and outcome.

Study Design: Cross sectional study.

Place and Duration of Study: Ruth KM Pfau Civil Hospital, Karachi Pakistan, from Apr 2018 to Apr 2020.

Methodology: In this study all treatment-naïve and experienced HIV infected patients were included and started on integrase strand-transfer inhibitor dolutegravir (DTG) containing fixed dose combination at Sindh AIDS Control Program (SACP) was conducted. We documented virological suppression, defined as a viral load of <1000 copies/ml, immunological and clinical outcomes.

Results: Eighty-two patients, of whom 53 (64.6%) were ARV naïve and 29 (35.4%) experienced, were started on DTG. Fifty six (68.3%) were males. The median age was 31.6 ± 9. Of 82, 61 returned for their first follow-up visit for assessment and viral load determination. Of 61, adverse effects to DTG were reported in 12 (19.6%), including 9 with pruritis. Of 35 naive patients, 30 achieved virological suppression by 3.3 ± 0.7 months and 1 at 8 months. All 26 experienced patients achieved virological suppression by 4.5 ± 0.9 months. Overall, of 61 patients, 57 (93.4%) achieved virological suppression, of whom 1 had immunelogical failure and none had clinical failure after 6 months of DTG. Three (3.6%) patients died within the first two months ofinitiating DTG.

Conclusion: Dolutegravir has good tolerability, with virological suppression achieved in the majority, including in highly ARV experienced patients.
ASSESSMENT OF MEAN DISTANCE OF MANDIBULAR INCISIVE CANAL USING CONE BEAM COMPUTERIZED TOMOGRAPHY; A CROSS-SECTIONAL STUDY
Authors: Sharif Mubashir , Haroon Nighat , Alam Muhammad Anwaar , Durrani Adil Umar , Hussain Talib , Anwar Khawar
Published: January 2022

Objective: To determine the mean distance of mandibular incisive canal from the mental foramen in patients reporting to a tertiary care centre using Cone Beam Computerized Tomography for placement of dental implants in the anterior/interforaminal region.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Prosthodontics, Foundation University College of Dentistry Rawalpindi, Jun to Nov 2019.

Methodology: A total of 70 patients participated between the age of 20-45 years. Cone Beam Computerized Tomography (the investigation was carried out and measurements of the mandibular incisive canal from mental foramen were recorded with the help of measuring tools in the software and noted down on the proforma. Data were analyzed using SPSS-20.

Results: The number of patients selected for this study was 70. Out of these 70 patients, 33 (47.1%) were males and 37 (52.9%) were females. The mean age of patients in this study was 36.31 ± 6.38 years. The mean distance/extension of the mandibular incisive canal from left mental foramen and right mental foramen in all patients was recorded to be 14.49 ± 6.31 mm and 14.97 ± 7.10 mm respectively.

Conclusion: Within the limitations of this study, it is concluded that a maximum distance of 22mm of the incisive canal from the mental foramen was observed using cone-beam computerized tomography.
PROCEDURAL TECHNICALITIES AND OUTCOME OF TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT USING OCCLUTECH DEVICE IN TERTIARY CARE CENTRE
Authors: Kanwal Asma , Shiekh Abdul Malik , Azim Kiran , Khattak Khushal Khan
Published: January 2022

Objective: To determine the safety and efficacy of transcatheter closure of atrial septal defects and to evaluate the initial, midterm and long-term results of the treatment.

Study Design: Cross sectional study.

Place and Duration of Study: Department of Paediatric Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, from Jul 2017 to Jun 2018.

Methodology: Sixty-four patients underwent transcatheter closure of atrial septal defect. Size of the defect was measured by Transoesophageal/Transthoracic. Follow up was carried out at twenty-four hours, one month, six months and at twelve months. Early, Midterm and late complications after device occlusion were analysed using SPSS-22 statistical software.

Results: Minimum size of atrial septal defect on echocardiography was 7 mm and maximum size was 31 mm with mean of 18.3 ± 5.7 mm. The procedure was successful in 96.8% cases. There was only one device embolization (1.56%). Cobrahead” configuration malformation of the device occurred in one case (1.56%). Mitral valve regurgitation did not occur in any of the case. There was no residual shunt across the device in the present study. ECG abnormalities associated with transcatheter closure did not occur in any of the patient. In intermediate and long-term follow up, no complication like cardiac erosion was seen in all cases under study.

Conclusion: Transcatheter occlusion of ASD with device was found effective and safe procedure with minimal complication rate, short hospital stay, good short, intermediate and long-term results.
THE ROLE OF DIAGNOSTIC OESOPHAGO-GASTRODUODENOSCOPY (OGD) AND COLONOSCOPY IN CANCER OF UNKNOWN PRIMARY
Authors: Ismail Muhammad , Khan Rao Saad Ali , Saeed Farrukh , Yusuf Muhammed Aasim
Published: January 2022

Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy (OGD) and colonoscopy, in helping to establish a definitive primary tumour site in cancer of unknown primary.

Study Design: Prospective observational study.

Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2018 to Jan 2019.

Methodology: A total of 115 patients included in the study were those, who underwent OGD and a colonoscopy for the diagnosis of a cancer of unknown primary. Data collected included demographics, baseline clinical characteristics, definitive diagnosis, tissue diagnosis and immune-histochemical stains. Primary outcome was the attainment of a definitive diagnosis via OGD and/or colonoscopy.

Results: A total of 115 patients underwent a diagnostic gastrointestinal procedure. Of these 70 (61%) were males. Mean age was 63 ± 12.6 years (range 22-88 years). Abdominal pain comprised the most common presenting complaint, found in 61 (53%). The most common tissue diagnosis of the metastatic sites was adenocarcinoma 81 (70.45%). Tumour markers including carcinoembryonic antigen, alpha-fetoprotein and carbohydrate antigen 19-9 were checked in 90 (78.2%), 46 (40%) and 69 (60%) patients respectively. No patient reached a definitive diagnosis by means of OGD and/or colonoscopy.

Conclusion: OGD and colonoscopy when done collectively as diagnostic procedures to look for a primary tumour, have no value in the evaluation of patients with cancer of unknown primary.
CYTOGENETIC ANALYSIS OF PATIENTS WITH AMBIGUOUS GENITALIA
Authors: Zaidi Sara Ali , Mahmood Asad , Mahmood Rafia , Latif Aamna , Robert Helen Mary , Fatimah Sarah
Published: January 2022

Objective: To determine the magnitude and classification of cases of ambiguous genitalia presenting to our setup.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019.

Methodology: All the patients with ambiguous genitalia referred for cytogenetic analysis, were included in the study. The patients were subjected to a detailed history and physical examination. The record of radiological investigations was were obtained. Cytogenetic analysis was performed using the conventional G-banding technique. Hormonal testing included 17- hydroxyprogesterone (17-OHP) levels was also performed.

Results: Fifty-one cases of ambiguous genitalia were studied. The median age was 15 months. Thirty-three patients (64.7%) had a 46XY karyotype, 17 (33.3%) had a 46XX karyotype while 1 (1.9%) had 45X/46, XY mosaic karyotype. Thirty patients (58.8%) were products of consanguineous marriage. Congenital adrenal hyperplasia was diagnosed in 12 cases (70.5%) of 46 XX karyotype and in 3 cases (9%) of 46XY karyotype.

Conclusion: Ambiguous genitalia, currently categorized as disorders of sex development, are not uncommon in our populartion. Increased awareness and early diagnosis are crucial to prevent life threatening complications of congenital adrenal hyperplasia, to determine sex of rearing, and to counsel the parents or patients.
PATTERNS OF MYOINVASION IN ENDOMETRIOID ADENOCARCINOMA OF ENDOMETRIUM
Authors: Shakeel Mehroosh , Mushtaq Sajid , Akhtar Noreen , Rana Iftikhar Ali , Muhammad Raza
Published: January 2022

Objective: To assess the patterns of myoinvasion of endometrial endometrioid adenocarcinoma, their frequencies in our hospital and to correlate these patterns with survival.

Study Design: Retrospective observational study.

Place and Duration of Study: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, from Aug 2019 to Apr 2020.

Methodology: All cases of endometrial endometrioid adenocarcinoma between 2015 and 2017 were retrieved from the archives, independently reviewed by two researchers, all key reporting parameters recorded in addition to the pattern of myoinvasion as per their operational definitions described by Cole and Quick. The follow-up of 3-5 years was obtained from archives and through telephonic contact for outside hospital patients. Disease free survival and relapse-associated mortality were represented through Kaplan-Meier curves.

Results: Eighty cases of myoinvasive endometrial endometrioid adenocarcinoma were reviewed. We found that infiltrating irregular gland pattern was the most frequent in all the age groups. Thirty-five (43.75%) cases showed this type of invasion, followed by broad front pattern 23 (28.75%), Microcystic Elongated and Fragmented (MELF) pattern 15 (18.75%) and adenomyotic pattern 6 (7.5%). One case showed a combination of the last two patterns, whereas adenoma malignum pattern was not seen. Follow-up of these patients showed 8 (10%) patients with relapse related mortality including 5 (62.5%) infiltrating irregular glands, 2 (25%) adenomyosis-like and 1 (12.5%) broad front pattern of myoinvasion. Seventy-two (90%) patients had recurrence free survival.

Conclusion: Frequency of infiltrating irregular pattern of myoinvasion in endometrial endometrioid adenocarcinoma is high and associated with recurrence related mortality. Recognition....................
THE IDEAL PROFILE (INCREASE IN B-LINES/DELTA B-LINES) ON LUNG ULTRASOUND FOR DIAGNOSING WEANING INDUCED PULMONARY EDEMA IN VENTILATED PATIENTS
Authors: Rasheed Ghulam , Shad Zahid Siddique , Mehreen Tooba , Kharadi Nusrat , Ramzan Moazma , Abdullah Azmat , Abbas Kiran
Published: January 2022

Objective: To ascertain the ideal number of B-lines on lung ultrasound for the diagnosis of weaning induced pulmonary edema in ventilated patients.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Medicine, Shifa International Hospital, Islamabad, from Jan to Aug 2020.

Methodology: All the patients over the age of 18 years who were on mechanical ventilation in a medical intensive care unit were included in the study. The patients were given spontaneous breathing trials as a protocol for weaning from mechanical ventilation. Lung ultrasound was performed on 4 points of anterior chest wall before and after spontaneous breathing trials. Before and after spontaneous breathing trials counting of B lines was done on ultrasound of lung and comparison of increase in B lines (Delta-B-lines) was done with reference diagnosis of weaning induced pulmonary edema diagnosed by intensivist who was blinded to the results of lung ultrasound.

Results: The study included 42 patients including 23 (54.8%) men and 19 (45.2%) women. 14 cases failed spontaneous breathing trials. Seven cases (16.7%) had weaning induced pulmonary edema. Delta-B-lines ≥6 diagnosed weaning induced pulmonary edema with 100% accuracy. Out of the remaining seven patients with weaning failure but without weaning induced pulmonary edema, 6 (28.6%) had Delta-B-lines ≥6. The ultrasound lung technique had a 100% sensitivity profile to detect weaning induced pulmonary edema and a specificity of 77.78%.

Conclusion: The study indicates that Delta-B-lines ≥6 diagnosed the weaning induced pulmonary edema with the best accuracy.
EXPERIENCE OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 (SARS-COV-2) - COVID-19 AT A TERTIARY CARE HOSPITAL IN QUETTA, BALUCHISTAN
Authors: Asif Naveed , Satti Shahzeb Ahmed , Younas Alveena , Gilani Mehwish , Shaikh Waqas , Ain Qurat Ul
Published: January 2022

Objective: To share the experience of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-COVID-19 at a tertiary care hospital in Quetta, Baluchistan.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Mar to Dec 2020.

Methodology: This study included 14,741 study participants presenting to CMH Quetta with signs and symptoms of Coronavirus Disease-19 (COVID-19) and others undergoing COVID-19 PCR for screening purpose. Nasopharyngeal swab collected from these study participants were tested for COVID-19 viral RNA by real-time Reverse Transcription Polymerase Chain reaction (RT-PCR) assay.

Results: Out of these 14,741 study participants, 1886 (12.7%) were found to be SARS-CoV-2 PCR positive. Among 1886 study participants, 1503 (80%) were males while 383 (20%) were females. Mean age of the study participants was 36 ± 14 years. Most frequent clinical presentations were body aches (96.5%), fever (94.1%), cough (66.8%) and loss of appetite (68.2%). Around 67 (3.5%) positive study participants were asymptomatic.

Conclusion: In this study, we observed male predominance but severity of signs and symptoms among female study participants. SARS-COVID-19 caused disease with wide range of clinical spectrum and disease can be fatal as well.
COMPARISON BETWEEN TRAGAL CARTILAGE WITH PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT BY UNDERLAY ENDOSCOPIC TYMPANOPLASTY
Authors: Tahir Muhammad , Abbass Asim , Nawaz Faiz Ul Hassan , Shabir Syed Asad , Rafique Atif
Published: January 2022

Objective: To compare the results of tragal cartilage with perichondrium versus temporalis fascia graft in endoscopic tympanoplasty using underlay technique.

Study Design: Comparative prospective study.

Place and Duration of Study: Study conducted in Tertiary Care Hospital, Karachi, from Jul 2018 to Feb 2020.

Methodology: Overall, 34 patients having permanent unilateral tympanic membrane perforations were included in this study, in whom underlay endoscopic tympanoplasty was performed. Group A patients underwent temporalis fascia graft while group B received a tragal cartilage with perichondrium graft. The success rate between groups was compared in respect of reduction in postoperative air-bone gap and healing of perforation.

Results: The success rate of graft was 88% (30/34) in group A and 94% (32/34) in group B after 6 months follow-up, the difference was not found to be statistically significant (p=0.368). Hearing improvement in the form of closure of air bone gap in group A was from 24.52 ± 1.73 dB (decibel) to 13.56 ± 5.67s dB and in group B it was from 19.76 ± 3.47dB to 11.94 ± 3.9dB, the difference was not significant statistically (p=0.333).

Conclusion: Keeping in view the results of our study, we conclude that both tragal cartilage with perichondrium and temporalis fascia graft are considered equally successful in endoscopic tympanoplasty.
MAGNITUDE OF DIABETES MELLITUS IN PATIENTS OF SUDDEN SENSORINEURAL HEARING LOSS AND ITS EFFECT ON CORTICOSTEROID THERAPY
Authors: Sajid Tahira , Sajid Fatima , Sajid Zara , Naqvi Syeda Rifaat Qamar , Ali Syed Maisam , Shah Muhammad Imran
Published: January 2022

Objective: To determine the magnitude and effects of diabetes mellitus in patients of sudden sensorineural hearing loss and on the final outcome of therapy.

Study Design: Cross sectional study.

Place and Duration of Study: ENT unit of Medical Teaching Institution Abbottabad, from Jul 2018 to Jun 2020.

Methodology: A total of 84 patients presented who had idiopathic sudden sensorineural hearing loss by using non probability consecutive sampling enrolled in the study. Basic parameters, age, diabetes mellitus and hearing loss were used for data collection. The data was analyzed by using SPSS version 23.

Results: Out of total 52 (61.9%) were male and 32 (38.1%) were female, mean age was 45.62 ± 14.12 years from 14-85 years. A large number of patients presented within one week of onset of hearing loss 57 (67.86%). In our patient group 18 patients (21.4%) had diabetes mellitus and 66 patients (78.6%) did not have diabetes mellitus at presentation. Initial Hearing loss at presentation was significantly more in patients who had diabetes mellitus p=0.006 and there was statistically strong association between the final hearing improvement and diabetes mellitus p<0.001.

Conclusion: Diabetes mellitus is associated with more severe hearing loss at initial presentation and poorer final outcome in patients with Idiopathic sudden sensorineural hearing loss. As glycemic control does not affect the result so corticosteroid therapy must be given to all patients of sudden sensorineural hearing loss with diabetes mellitus.
HYPOCALCEMIA IN TOTAL VERSUS SUBTOTAL THYROIDECTOMY
Authors: Sajid Tahira , Naqvi Syeda Rifaat Qamar , Sajid Zara , Sajid Fatima , Akbar Ismail , Mallhi Muhammad Ayub Ashraf
Published: January 2022

Objective: To compare the occurrence of hypocalcemia in patients undergoing subtotal and total thyroidectomy.

Study Design: Comparative prospective study.

Place and Duration of Study: Surgical departments of Ayub Teaching Hospital, Abbottabad and Combined Military Hospital, Rawalpindi, from Mar 2018 to Feb 2020.

Methodology: A total of 171 patients were selected for this study and they were divided into 2 groups. Group 1 consisted of 95 patients undergoing Total thyroidectomy whereas group 2 had 76 patients undergoing Subtotal thyroidectomy. It was a comparative prospective study and the groups were made by convenience sampling. The data was analyzed by SPSS-23.

Results: In total thyroidectomy group Hypocalcemia was detected after 48 hours in 34 patients (35%) while in subtotal thyroidectomy group hypocalcemia was detected in 20 patients (28%). Tests for hypocalcemia were also done after two months of surgery and low levels were detected in 7 patients (7.5%) who had total thyroidectomy and in 2 patients (5%) in the group undergoing subtotal thyroidectomy. There was no significant difference in hypocalcemia after 48 hour (p=0.22) and 2 months postoperatively (p=0.6) between patients of Total Thyroidectomy and Subtotal Thyroidectomy.

Conclusion: Total thyroidectomy is not associated with increased risk of permanent hypocalcemia as compared to Subtotal thyroidectomy. Because of its advantages Total thyroidectomy should be the preferred surgical procedure for patients presenting with benign euthyroid multi nodular goiter.
PROBOSIS LATERALIS
Authors: Ayub Muhammad Waqas , Waleem Saadat , Feroz Faheem , Waqas Asma
Published: January 2022

Proboscis lateralis is an embryological inconsistency which is identified with the middle facial cleft. This outcomes in fragmented arrangement of one side of nose. This underdeveloped nose structure is situated close to the nose but off the midline. It seems like a cylinder and is appended at the undeveloped combination line anytime between the foremost maxillary interaction and the frontonasal cycle. This issue ought to be tended to at an early age and with stage shrewd methodology as this proboscis itself is a valuable design for remaking. We report an instance of proboscis lateralis in a 1-year-old female patient.
EFFICACY OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY(FESS) IN TREATMENT OF POST NASAL DRIP (PND) AS AN ANCILLARY PROCEDURE: A COMPARATIVE STUDY
Authors: Niazi Saleem Asif , Maqbool Shahzad , Khan Zafar Ullah , Hakim Abdul , Aasim Muhammad Umair , Maqsood Shahid , Riaz Yousra
Published: January 2022

Objective: To assess efficacy of functional endoscopic sinus surgery (FESS) in treatment of postnasal drip (PND) as an ancillary procedure to Septoplasty with Turbinoplasty.

Study Design: Quasi experimental study.

Methodology: Sample size was n-200, Patients were placed in two groups Group A (n-126) had septoplasty with turbineplasty. Group B (n-74) included patients with Septoplasty and Turbinoplasty combined with functional endoscopic sinus surgery. Post operative results regarding postnasal drip were compared amongst the Two groups.

Results: Data was analysed in SPSS-17, Septoplasty along with turbinectomy was performed in n-126 patients (group A). And septoplasty, turbinectomy along with functional endoscopic sinus surgery was performed in n-74 patients (group B). Post nasal drip was significantly reduced in group B at 3 months follow up (p<0.046). More significant difference was noted at 6 months follow up (p<0.003).

Conclusion: Patients having Chronic rhinosinusitis with postnasal drip as predominant symptom, should undergo functional endoscopic sinus surgery as an ancillary procedure to conventional nasal surgery.
Educación financiera en píldoras: jeroglíficos financieros y posts en el Portal del Cliente Bancario
Authors: Andújar Nagore Inés
Published: January 2022

La educación financiera de los usuarios bancarios tiene un carácter eminentemente práctico. Esta –entendida como combinación de conocimientos, actitudes y conductas– permite tomar decisiones de gasto, ahorro y endeudamiento informadas, responsables y sostenibles en el tiempo, lo cual es indispensable para asegurar el bienestar financiero, individual y colectivo: no hay más que remitirse a la última crisis financiera para recordar las desastrosas consecuencias económicas y sociales derivadas, entre otras causas, de decisiones financieras desinformadas e irresponsables de una gran masa de consumidores. Sin embargo, a pesar de su trascendencia, los datos muestran un analfabetismo generalizado de la población (España no es una excepción) y un escaso interés por conocer los rudimentos financieros más básicos. En este contexto, estimular la curiosidad de los ciudadanos por sus finanzas personales y familiares se presenta como un auténtico reto para aquellos que trabajamos en el ámbito educativo-institucional. Este trabajo explora algunas claves para ello, adoptando un enfoque conductual, y presenta una aplicación práctica materializada en dos series de contenidos educativos publicados en el Portal del Cliente Bancario del Banco de España, analizando su impacto, así como sus limitaciones y potencialidades.
Apropiación social de la tecnología: una necesidad como consecuencia de la COVID-19
Authors: Calanchez Urribarri ´´África , Chávez Vera Kerwin José
Published: January 2022

La «apropiación social» se entiende como un proceso en el cual los ciudadanos (hombres y mujeres) y las comunidades utilizan de manera intencional y consciente herramientas tecnológicas, comprendiendo su función desde un punto de vista conceptual y práctico, percibiéndolas como útiles para su desarrollo educativo, laboral y social. El presente artículo de revisión tiene como propósito analizar el papel de la apropiación social de las tecnologías en época de pandemia. El análisis se realizó en el ámbito de la educación y del teletrabajo durante la cuarentena provocada por la COVID-19. La investigación se fundamentó en el paradigma interpretativo. El tipo de investigación fue documental y se aplicó el método del análisis de contenido de documentos científicos publicados en relación con las categorías de estudio. La reflexión final es que, a pesar de los beneficios que aportan las tecnologías de la información y la comunicación (TIC) en el ámbito educativo y laboral y su apropiación en época de pandemia, es inevitable pensar en las consecuencias negativas que pueden provocar en los jóvenes si no existe una supervisión adecuada por parte de padres o tutores.
HAVACILIKTA DİJİTALLEŞME VE VERİMLİLİK İLİŞKİSİ ÜZERİNE BİR İÇERİK ANALİZİ
Authors: YAVAŞ Volkan
Published: January 2022

Amaç: Bu çalışma, havacılıkta dijitalleşme ve verimlilik ilişkisini ele alan akademik çalışmaların analizi ile Endüstri 4.0 ve elementlerinin havacılıkta verimlilik üzerine katkısını ortaya koymayı amaçlamaktadır. Yöntem: Dijital dönüşüm sürecinin çok yeni olması, uygulamadaki kısıtlı imkânlar ve sektörde bu etkiyi doğrudan araştırmak için yeterli veri olmadığı düşünüldüğü için akademik araştırmalar üzerinden bir içerik analizi yapılmıştır. Web of Science ve Scopus veri tabanlarında ‘Havacılık, Dijital ve Verimlilik’ kelimeleri üzerinden yapılan aramada listelenen sonuçlar içerisinde anahtar kelimelerin eş-birlikteliğine dayalı eşleşmeyi görselleştirmek için VOSViewer yazılımı kullanılmıştır. Bulgular: Alfabetik sıra ile ‘Dijital İkiz, Nesnelerin İnterneti, Teknoloji, Yapay Zekâ, Yenilik’ anahtar kelimeleri sonuçlarda öne çıkmaktadır. İlgili çalışmalar teknolojik, çevresel ve yönetimsel ana başlıklarında sınıflandırılmıştır. Teknoloji kümesini oluşturan çalışmalar ‘aerodinamik, havaaracı, motor, kalite, yenilikçi’ gibi kelimeleri içermektedir. Çevresel kümeyi oluşturan çalışmalar “yakıt, emisyon, enerji gibi kelimeleri” içerirken yönetimsel kümeyi oluşturan çalışmalar ‘Çevresel’ ve rekabet, havalimanı, havayolu, kalkınma gibi kelimeleri içermektedir. Tüm çalışmaların odağındaki “dijital ikiz” kavramı üzerinden değerlendirmeler yapılmış ve kavramın yönetim ve pazarlama açısından yaklaşımlarına dikkat çekilmiştir. Özgünlük: Çalışma bu alanda yapılan ilk ve tek içerik analizi olması sebebiyle özgün bir çalışma iken elde edilen sonuçların da araştırmacılar ve profesyonellere yol gösterici olabileceği düşünülmektedir.
ENDÜSTRİ 4.0 VE VERİMLİLİK: TÜRK BEYAZ EŞYA SEKTÖRÜNDE KEŞFEDİCİ DURUM ÇALIŞMASI
Authors: ŞİMŞEK DEMİRBAĞ Kübra , YILDIRIM Nihal
Published: January 2022

Amaç: Türk beyaz eşya sektörünün önde gelen iki ana üreticisi ve bu üreticilerin tedarikçisi konumundaki bir yan sanayi şirketi için Endüstri 4.0'ın durumunu, uygulama örneklerini, dönüşüm sürecinde elde edilen avantajları/karşılaşılan zorlukları ve Endüstri 4.0’ın verimliliğe etkisini ortaya koymak amaçlanmaktadır.
Yöntem: Yin (2002, 2017) tarafından önerildiği şekliyle keşfedici durum çalışması yöntemi kullanılmıştır. Kanıtlar ise yarı-yapılandırılmış mülakatlar, doğrudan gözlemler ve şirketlere yönelik online belgelerden elde edilmiştir.
Bulgular: Türk beyaz eşya sektörü şirketleri Endüstri 4.0 dönüşümü için çaba sergilemekte ve dönüşümü zorunluluk olarak algılamaktadır. Şirketler, Endüstri 4.0’a özel bütçe ayırmakta ve en çok veri toplama/analitiğine önem vermektedir. Yapılan yatırımların ise kısa vadede dahi verimliliğe etkisi olumlu olmuştur.
Özgünlük: Mevcut makale, dünyanın en büyük ikinci beyaz eşya üreticisi ve Türkiye'nin en yenilikçi ve en yüksek dijital olgunluğa sahip sektörlerinden biri olan beyaz eşya sektöründe Endüstri 4.0’ın durumunu vaka analiziyle ortaya koyan ilk akademik çalışma niteliğindedir.
SANAYİ İŞLETMELERİNİN TEDARİK ZİNCİRİ FONKSİYONLARININ DİJİTAL DÖNÜŞÜMÜ
Authors: ÇALLI Çiler , ÖZER ÇAYLAN Didem
Published: January 2022

Amaç: Bu çalışma sanayi işletmelerinin Endüstri 4.0 unsurlarına hangi düzeyde hâkim olduğunu belirlemek, literatürde belirtilen etkilerin reel ile ilgisini anlamak ve adaptasyon sürecinde yaşananları tespit etmek amacıyla yapılmıştır.
Yöntem: 2019 Şubat ayında yapılan ön çalışma listesinde yer alan sanayi işletmeleriyle çevrim içi olarak yarı yapılandırılmış görüşmeler yapılmıştır. Nitel araştırma yöntemlerinden fenomenoloji deseni kullanılarak içerik analizi tekniğiyle incelenen görüşme deşifreleri MAXQDA programında kodlanarak değerlendirilmiştir.
Bulgular: Büyük sanayi işletmelerinin Endüstri 4.0 unsurlarından en çok hangilerini kullandıkları, adaptasyon süreçleri, yaptıkları yatırımın geri dönüşü başlıklarda bulgulara ulaşılmıştır.
Özgünlük: Literatürde dördüncü sanayi devriminin sanayi işletmelerine, özellikle satın alma ve lojistik fonksiyonlarına etkilerine dair kaynakların sayısının yetersiz olmasına karşın bu çalışmada Endüstri 4.0 unsurlarını uygulayan sanayi işletmelerinin satın alma ve lojistik fonksiyonu yetkili/yöneticilerinin görüşlerinin yer alması bu çalışmanın özgünlüğünü sağlamaktadır.
A FORMAÇÃO DO PROFESSOR DE 2ª LICENCIATURA EM SOCIOLOGIA: ANÁLISES, REFLEXÕES E PERSPECTIVAS - IMPLICAÇÕES, DESAFIOS E POSSIBILIDADES PARA A DOCÊNCIA NA CONTEMPORANEIDADE
Authors: de Souza Dantas Hildeci
Published: January 2022

O artigo em pauta reflete na formação do professor de Sociologia traçando duas vertentes da (profissão/professor) na contemporaneidade. Por um lado, consistem em análises, reflexões e perspectivas. E de outro, implicações, desafios e novas possibilidades incutidas na docência (formação do professor de Sociologia). O estudo pautou-se das indagações do pesquisador em atribuir a docência do ensino de Sociologia como um aliado-chave em sua formação de pedagogia quando unido ao (saber empírico/práticas docentes) como professor de Sociologia, este, atribuído ao que se confere no papel do professor de Pedagogia para ensinar Sociologia. No entanto, o pesquisador traça uma narrativa profissional como um saber empírico e necessário para a profissão de Sociologia. Diante dessas abordagens o trabalho busca também focar nas dificuldades encontradas pelo professor em sala de aula enquanto ator no processo de ensinagem (Pedagogia e Sociologia). O estudo é de origem (pesquisa descritivo/qualitativa e documental/bibliográfica) na figura do pesquisador crítico e reflexivo pautando-se de uma abordagem limitada da (prática/ensino) quando atrelado pelo saber da profissão de pedagogo para a formação de Sociologia na contemporaneidade. O objetivo é refletir e analisar a docência quando praticada na formação do professor de Sociologia, que no mínimo, tem gerado novos desafios para o pedagogo em atuação uma vez que as implicações e novas possibilidades se travam em um (diálogo/análise) proferido nesta base de (atuação/formação) que a nós é conferido nos dia de hoje como (segunda licenciatura em Sociologia e/ou formação pedagógica em Sociologia) isto é, para não licenciados.
Scriptures Fit for a King
Authors: Diem Matthew
Published: January 2022

This paper examines the use of translational doublets (multiple translations of a single expression presented together in a translated text) in the revised text of the Later Version of the Wycliffite Bible found in Oxford University MS. Bodley 277 (1420s or 1430s). The manuscript in question contains a large number of doublets found in no other copy of the Wycliffite Bible, and these appear to be the contributions of an independent revisor. The various functions that doublets have in this text are discussed, and it is argued that, in his use of doublets, the revisor focused primarily on clarifying or explaining details of the text’s literal, immediate meaning, especially in Old Testament historical books. It is suggested, moreover, that a large proportion of the revisor’s doublets reflect the interests of an aristocratic or royal audience, in line with the probable origin of MS. Bodley 277 (which was once owned by King Henry VI). Special attention is paid to the apocryphal 3 Ezra, for which Bodley 277 is the only copy of the Wycliffite Bible to include translational doublets and which appears in no other manuscript of the Later Version.
Mehrsprachigkeit und Multikulturalität in original deutschsprachigen und ins Deutsche übersetzten Comics im Wandel der Zeit
Authors: Liimatainen Annikki
Published: January 2022

In diesem Beitrag werden die Multikulturalität und die Mehrsprachigkeit in Comics unter­­sucht. Unter Mehrsprachigkeit versteht man die Verwendung von zwei oder mehr Sprachen in demselben Text. Das Gesamtkorpus für diesen Beitrag besteht aus für unterschiedliche Zielgruppen publizierten älteren wie auch neueren Comics. Anhand einer Beleg­sammlung von ursprünglich deutschsprachigen und ins Deutsche übersetzten Comics soll gezeigt werden, wel­che Änderungen im Gebrauch von Wortgut aus anderen Sprachen im Laufe der Zeit fest­­gestellt werden können, welche Funktionen die Mehr­sprachig­keit in Comics hat, welches die sprachlichen Varia­tio­nen und Kombinationen sind, die in Comics vorkom­men, und was passiert, wenn diese ins Deutsche übersetzt werden. Im Mittelpunkt der Untersuchung steht darüber hinaus die Frage, wie die Mehrsprachigkeit der Ausgangskultur so übersetzt wer­den kann, dass die Mehrstimmigkeit beim Übersetzen nicht verloren geht, so dass man auch in der Zielkultur die Bedeutung der sprachlichen Variationen genau so verstehen kann wie in der Ausgangskultur.
The Paradoxes of PrEP: Rejection, Reluctancy, and Novel Gay Identities in Biomedical HIV Prevention in Serbia
Authors: Milosavljević Zoran
Published: January 2022

This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men – who have achieved undetectable HIV status through a potent ARV therapy – and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia – "undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone’s HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.