bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of cross-tropopause convection within the Asian monsoon region from May through October 2017
Authors: Clapp Corey E. , Smith Jessica B. , Bedka Kristopher M. , Anderson James G.
Published: March 2023

Abstract. We constructed a database of cross-tropopause convection
in the Asian monsoon region for the months of May through October of 2017
using overshooting tops (OTs), deep convective features that penetrate the
local cirrus anvil layer and the local tropopause, with Meteosat-8
geostationary satellite detections. The database of 40 918 OTs represents a
hemispheric record of convection covering the study domain from
10∘ S to 55∘ N and from 40 to 115∘ E. With
this database, we analyzed the geographic, monthly, and altitude
distribution of this convection and compared it to the convective
distributions represented by satellite observations of outgoing longwave
radiation (OLR) and precipitation. We find that cross-tropopause convection
is most active during the months of May through August (with daily averages
of these months above 300 OTs per day) and declines through September and
October. Most of this convection occurs within Northern India and Southern India, the
Bay of Bengal, and the Indian Ocean regions, which together account for
75.1 % of all OTs. We further identify distinct, differing seasonal trends
within the study subregions. For the Northern India, Southern India, and Bay of
Bengal regions, the distribution of OTs follows the development of the Asian
monsoon, with its north–south movement across the study period. This work
demonstrates that when evaluating the effects of convection on lower
stratospheric composition over the Asian monsoon region, it is important to
consider the impact of cross-tropopause convection specifically, as well as
the contributions from both land-based and oceanic regions due to the
significant geographic and monthly variation in convective activity.
Aerogeophysics and light detecting and ranging (LiDAR)-based lineament interpretation of Finland at the scale of 1:500 000
Authors: Engström Jon , Markovaara-Koivisto Mira , Ovaskainen Nikolas , Nordbäck Nicklas , Paananen Markku , Aaltonen Ismo , Martinkauppi Annu , Laxström Heidi , Wik Henrik
Published: March 2023

Abstract. Lineaments, linear structures on the surface of the Earth, often represent the surface expressions of brittle structures, e.g., fault zones and fracture zones, or ductile shear zones. In addition, they may also represent other geological features such as lithological contacts, tectonic boundaries and Quaternary structures, or potentially a superposition of any of these. A lineament interpretation is usually the first step in the structural assessment of a crystalline bedrock setting, and the lineaments can further be used as basis for scientific research to more accurately determine the location of the previously mentioned various geological features. In this study, a multi-source lineament interpretation was performed within ArcGIS for the whole of Finland, based on light detecting and ranging (LiDAR), aerogeophysical and bathymetric raster data. The lineament database enhances the capability to produce more accurate geological maps for various geological purposes in Finland.
SCIATRAN software package (V4.6): update and further development of aerosol, clouds, surface reflectance databases and models
Authors: Mei Linlu , Rozanov Vladimir , Rozanov Alexei , Burrows John P.
Published: March 2023

Abstract. Since the initiation of development at the Institute of Environmental Physics (IUP), University of Bremen, in 1994, the radiative transfer model SCIATRAN (formerly GOMETRAN) has been continuously improved and new versions have been released (Rozanov et al., 1997, 2002, 2005, 2014, 2017). In the course of development, the
SCIATRAN software package became capable of simulating radiative transfer processes through the Earth's atmosphere or coupled atmosphere–ocean system with a variety of approaches to treat the sphericity of the atmosphere (plane-parallel, pseudo-spherical, approximately spherical and full-spherical solutions) in both scalar and vector modes. Supported by a variety of built-in databases and parameterizations, these capabilities made SCIATRAN widely
used for various remote-sensing applications related to the retrieval of atmospheric trace gases and characteristics of aerosols, clouds and surfaces. This paper presents an overview of the cloud, aerosol and surface (CAS) databases and models implemented
in the SCIATRAN software package (V4.6) and provides some recommendations on their usage.
The new implementations offer potential users a flexible interface to perform radiative transfer simulations:
(1) accounting for multilayer liquid water, ice and mixed-phase clouds; (2) employing typical aerosol-type parameterizations (including vertical variability) used in the satellite and model communities as well as updated databases;
(3) including various surface bidirectional reflectance distribution function (BRDF) and albedo models for land, vegetation, ocean, snow and melt ponds on sea ice. The most recent version of the radiative transfer model SCIATRAN is freely available at the website of the IUP, University of Bremen: http://www.iup.physik.uni-bremen.de/sciatran (last access: November 2022).
Regionalisation of rainfall depth–duration–frequency curves with different data types in Germany
Authors: Shehu Bora , Willems Winfried , Stockel Henrike , Thiele Luisa-Bianca , Haberlandt Uwe
Published: March 2023

Abstract. Rainfall depth–duration–frequency (DDF) curves are required for the design
of several water systems and protection works. For the reliable estimation of
such curves, long and dense observation networks are necessary, which in
practice is seldom the case. Usually observations with different accuracy,
temporal resolution and density are present. In this study, we investigate
the integration of different observation datasets under different methods
for the local and regional estimation of DDF curves in Germany. For this
purpose, two competitive DDF procedures for local estimation
(Koutsoyiannis et al., 1998;
Fischer and Schumann, 2018) and two for regional
estimation (kriging theory vs. index based) are implemented and compared.
Available station data from the German Weather Service (DWD) for Germany are
employed, which includes 5000 daily stations with more than 10 years
available, 1261 high-resolution (1 min) recordings with an observation period
between 10 and 20 years, and finally 133 high-resolution (1 min) recordings
with 60–70 years of observations. The performance of the selected approaches
is evaluated by cross-validation, where the local DDFs from the long
sub-hourly time series are considered the true reference. The results reveal
that the best approach for the estimation of the DDF curves in Germany is by
first deriving the local extreme value statistics based on
Koutsoyiannis et al.'s (1998) framework and later
using the kriging regionalisation of long sub-hourly time series with the
short sub-hourly time series acting as an external drift. The integration of
the daily stations proved to be useful only for DDF values of a low return
period (T[a] < 10 years) but does not introduce any improvement for
higher return periods (T[a] ≥ 10 years).
Name of the Year Report 2022
Authors: Nick I. M.
Published: March 2023

On January 23, 2023, for the 16th year in a row, the American Name Society (ANS) held its annual conference of the American Name Society. The 2023 online vote was chaired by Deborah Walker, the former ANS Name of the Year (NoY) Coordinator. This report gives a summary of this year’s NoY deliberations and offers readers background information about some of the leading onomastic nominations.
The aesthetics of the self: The meaning-making of Internet aesthetics
Authors: Giolo Guilherme , Berghman Michaël
Published: March 2023

In this study we explore the so-called Internet aesthetics, labels applied on heterogenous collections of materials and activities by Internet users, which are discussed and constructed primarily on the Internet. We conducted qualitative content analyses on entries of AestheticsWiki, as well as interviews with 11 Internet aesthetics enthusiasts. In contrast to established notions such as genre, style or subculture, Internet aesthetics are characterized by few conventions, but seem fundamentally open for individual interpretations. We therefore theorize that they primarily serve as toolkits, through which individuals give sense and coherence to personal experience, in line with a situation-specific self-image. In doing so, they contribute to a reflexive myth of the self.
Anatomy of Twitter followership
Authors: Uppala Vishal , Palvia Prashant , Ankem Kalyani
Published: March 2023

Digital platforms such as Twitter enable people to interact with and influence one another, producing emergent phenomena. This study addresses the Twitter followership phenomenon. Focus groups and qualitative analyses were employed to generate insights into the Twitter followership phenomenon. Likely the first study in this domain, this research is the basis for future followership research on digital platforms and indicates the need for continued attention to this domain.
‘We the people, not the sheeple’: QAnon and the transnational mobilisation of millennialist far-right conspiracy theories
Authors: Jones Callum
Published: March 2023

QAnon is a U.S.-based conspiracy theory that has been branded as far-right, yet it remains unclear which tenets of transnational far-right ideology are present within QAnon discourse and how adherents actively participate in the movement. To address this problem, a multi-phase content analysis on 1,000 tweets and 8kun posts explores the presence of transnational far-right tenets and millennialist themes within QAnon discourse. A posting frequency analysis of 37,782 tweets and 9,023 posts determines how QAnon adherents participate in precipitating a millennialist apocalypse, and how they can be disrupted. The results suggest that Australian QAnon communities integrate national themes and narratives to ground discourse in the Australian context, and communicate far-right tenets to identify a complex, interconnected left-wing deep state, that must be combatted through a coming apocalypse that QAnon adherents will participate in. This research develops new understandings of how far-right ideology can mould to fit different national contexts, can covertly manifest in discussion topics that are not explicitly far-right, and shows that millennialist movements can be both accelerated and disrupted using social media.
Aktivitas Antiadhesi Kombinasi Ekstrak Daun Pepaya dan Daun Sirih Hijau Terhadap Neutrofil pada Streptococcus Mutans, Staphylococcus Aurues dan Escheriachia Coli
Authors: Kurniati Nining
Published: March 2023

Indonesia, menurut survei nasional riskesdas 2018, sebanyak 45,3% setara 1,2 juta  penduduk mengalami karies gigi, untuk menanggulangi penyakit infeksi tersebut digunakan antibiotik.  Antibiotik merupakan substansi yang dihasilkan suatu mikroorganisme, yang mempunyai kemampuan untuk menghambat pertumbuhan atau membunuh mikroorganisme. Negara berkembang terjadi masalah, timbulnya strain bakteri resisten terhadap antibiotik pada penyakit infeksi. Papain yang terkandung dalam daun pepaya merupakan enzim proteolitik juga memiliki efek bakterisid dan bakteriostatik, diharapkan kombinasi daun sirih menguatkan aktivitas penghambatan pertumbuhan bakteri Gram positif maupun negatif. Metode penelitian desain eksperimen laboratorium, rancangan acak lengkap. Telah dilakukan uji aktivitas anti adhesi melalui penambahan kombinasi ekstrak daun pepaya dan daun sirih hijau 5%, 15% dan 25% pada isolat neutrofil yang dipaparkan Streptococcus Mutans, Staphylococcus Aureus, Escheriachia Coli  dibandingkan Kontrol. Kemampuan  aktivitas anti adhesi diamati penurunan adhesi bakteri pada sel Neutrofil, diuji anova  dan Benferroni. Uji Antiadhesi ekstrak 15% dan 5% dengan uji statistik terjadi penurunan adhesi terhadap Streptococcus mutans pada neutrofil (Sig 0,00) dan tidak menurunkan adhesi pada Staphylococcus aureus dan Escheriachia coli (Sig 1,00).
Fake News in der Bach- und Graupner-Forschung: Die Besetzung des Thomaskantorats 1722/1723 als unilaterale Überlieferung
Authors: Sorg Beate
Published: March 2023

When the Leipzig position of Thomaskantor became available, following the death of Johann Kuhnau in June 1722, it was first offered to Georg Philipp Telemann, then Johann Friedrich Fasch, and fnally to Christoph Graupner. Several other competitors were rejected, before Johann Sebastian Bach was accepted in the end. This story is well known, and has been reported by musicologists for about two and a half centuries, with different consequences and different intentions. This article gives a short overview of selected publications, hereby showing quite a few errors, and even lies and fraud, that have managed to enter the discourse and to survive until our days. In particular, our example focuses on Ernst Pasqué’s openly fictional depiction, which was published in 1853/1854 in a popular journal, and Wilhelm Kleefeld’s apparently scholarly but in fact fictionalised account published in 1897. Especially an invented letter, in which Graupner allegedly praises Bach as an outstanding organist and composer, has found its way into subsequent scholarship. “Truthiness” or a truth-like feel in what is really invention or fiction, is often found in today’s media – but was actually used in former times as well. Comparing old and new contributions not only reveals scientifc or personal motivations of the authors in their time, but also a playful approach that can give us many new ideas about a well-worn topic.
Bank Marketing and Its Effects on Customer Retention in Microfinance in Yaounde, Cameroon
Authors: Grimbald Ndah , Chelsea Mah Tarbot
Published: March 2023

This study seeks to assess bank marketing and its impact on customer retention in microfinance in Yaoundé, Cameroon. A cross-sectional research design consisting of 348 clients of category two microfinances were sampled from the center region of Cameroon. Data for the study was sourced using closed structured questionnaires. The analysis was concluded using statistical software’s such as Statistical Package for Social Sciences (SPSS 24) and Analysis of Moment Structures (AMOS24). The results from the analysis reveal that Customer service and retention have a significant positive impact on customer retention. The study therefore concluded that emphasis on better customer services leads to a high customer retention rate in category two microfinances in Yaounde, Cameroon. A new model called Bank Marketing and Customer retention Model (BMCR Model) was developed to test the relationship amongst variables. This study contributes to the limited theoretical and empirical evidence of the impact of bank marketing on customer retention in microfinances in Yaounde, Cameroon.
Insects, Age, and Failure: The Suppressed Chapter of “The Wasp in a Wig”
Authors: White Laura
Published: March 2023

Why did Lewis Carroll decide to suppress “The Wasp in a Wig” from Through the Looking-Glass and What Alice Found There (1871)? Certainly, he was acting on the advice of John Tenniel. However, the chapter’s suppression was likely not just because a wasp in a wig is hard to draw but because Carroll determined that the chapter was weaker in literary value than the rest of Looking-Glass. This article will argue that the weakness of the chapter follows from Carroll’s lifelong habit of digging at ideological sore points (in this case, how insects should be understood within a Christian as opposed to Darwinian view), conjoined with his growing anxieties about aging. These two themes work in tandem inadvertently to reach beyond the pleasures of nonsense to fall into genuine pathos; the human wasp, far more anthropomorphized than the looking-glass insects, is indeed both a social failure and close to death. Perhaps even a child reader cannot be much consoled by Alice’s reflection when she leaves the wasp that she was “quite pleased that she had gone back and given a few minutes to making the poor old creature comfortable” (AA 298).
“Let us veil our meaning”:Holiday Romanceand the Second Reform Act of 1867
Authors: Hamby James
Published: March 2023

Dickens’s final completed fiction, Holiday Romance, is a neglected and misunderstood work. It is a suite of four short stories and what little critical attention it has garnered has missed the main idea behind the work. While most scholars who have written about Holiday Romance consider it as little more than children’s entertainment, it is better interpreted as political commentary on expanding voting rights. Read in the context of Dickens’s complex views on the Second Reform Act of 1867, this work reflects his support for expanding the vote, his pessimism that Parliament could introduce any meaningful reform, and also his anxiety over mob rule. Throughout the four stories, children dream of role reversals with adults, sometimes resulting in utopic visions and sometimes descending into disturbing fantasies of violence. This article explores the way Dickens used the image of the abused child one last time as a potent symbol of the need for reform.
What Is Consciousness and Does Nietzsche Really Think It Is Unimportant?
Authors: Clark Maudemarie
Published: March 2023

What does Nietzsche mean by consciousness, and does he really consider it unimportant? And if he doesn’t, why does he make so many disparaging remarks about it? In this article the author considers and rejects Mattia Riccardi’s recent claim that Gay Science (GS) 354, Nietzsche’s most important passage on consciousness, is concerned only with reflective or Rconsciousness. The article shows that GS 354 attempts to explain why mental states ever became conscious, not Rconscious. Nietzsche accepts “Sartre’s thesis” that a conscious mental state is always prereflectively self-conscious, hence brings with it the potential to activate the “mirror effect” emphasized in GS 354 but missing from the consciousness of one absorbed in an activity. A conscious mental state is one its possessor “knows” from “the inside,” hence can report to self or others without further observation or inference. The resulting communication is essential to culture, hence to what is of value in human life.
Joy of the Black South: Zora Neale Hurston and the Politics of Black Joy—A Review Essay
Authors: Jelks Randal Maurice
Published: March 2023

This review article examines Zora Neale Hurston’s views on the joyful existence of Afro-Southerners. She did not believe the South was backward or inferior to middle-class northerners. The article explores philosopher Lindsey Stewart’s book The Politics of Black Joy: Zora Neale Hurston and Neo-Abolitionism and Henry Louis Gates Jr.’s and Genevieve West’s Zora Neale Hurston, You Don’t Know Us Negroes and Other Essays to think through issues of Black blame and self-loathing.
Estranging Adorno: The Dialectics of Alienation in Leonard Michaels’s “I Would Have Saved Them If I Could”
Authors: Coker William Norman
Published: March 2023

Reflecting on his relatives’ deaths in the Shoah, Leonard Michaels lets their story unfold through a meditation on how not to tell it. He resists both the consolatory aestheticism he finds in Jorge Luis Borges and the teleological closure of Hegelian-Marxist history. Both modes press something positive out of Auschwitz’s absolute negativity. Yet Michaels finds he cannot do without Borges and Marx. As his standpoint emerges from theirs, light falls on what both tacitly teach: the necessity of alienation. Enabling a new reading of this key Marxian term, Michaels’s story complements and challenges the revisionary Marxism of Theodor W. Adorno. Adorno’s late works convey the awareness that a certain alienation inheres in subjectivity and that emancipation requires us to accept our own self-estrangement. In Michaels’s story, Borges and Marx appear as figures for the “nonidentity,” the internal contradiction, that every self must own in order to achieve an identity. By foregrounding the mismatch between narrative forms and their content, Michaels affirms narrative itself as “nonidentical.” Only through the alienation implicit to literature as self-conscious artifice, he finds, can one hope to grasp an experience in either its singularity or its universality.
Memory and the Exigencies of Literary Form: Anthony Hecht’s “The Book of Yolek”
Authors: Weisman Karen
Published: March 2023

Anthony Hecht’s “The Book of Yolek” may be read as a test case for understanding a strand of twentieth-century American Jewish poetry, one that takes up a series of questions about the very meaning of the term “Jewish poetics,” especially when it sets itself to the task of remembering what Hecht once described as the “very terrible aspects of existence.” Hecht’s resistance to sentimentalism in “The Book of Yolek,” which is also a resistance to the consolations of culture, engages his complicated inheritance of elegy and pastoral. Such anti-sentimentalism also resists confidence in the perpetuation of memory, even though “The Book of Yolek” is centrally concerned with the burdens and the imperatives of memory. The poem implicitly interrogates the tensions inherent in the post-Holocaust American Jew establishing a ground for joining the tradition of high lyric.
Fertility Outcome in Polycystic Patient after Bariatric Surgery
Authors: Abbas Shah , Sayed Nazia , Khan Inayatullah , Fateh Reema , Usman Mohammad
Published: March 2023

Background and Aim: Medically induced weight loss often restores ovulation among polycystic ovarian syndrome (PCOS) women with obesity. Women with PCOS are more likely to be obese and have abdominal fat than women without PCOS, which is the most prevalent metabolic condition in premenopausal women. The present study aimed to determine the fertility outcome in polycystic obese women after bariatric surgery. Patients and Methods: This cohort study was conducted on 56 polycystic women with obesity undergoing bariatric surgery in the bariatric surgery department of Luqman International Hospital, Saidu Sharif Swat for the duration from 2017 to 2022. Polycystic patients were investigated for main outcome such as liver birth rates and pregnancy. SPSS version 26 was used for data analysis. Results: The live birth rates and pregnancy rates in PCOS women seeking fertility were 83% and 94.8% whereas in control cases were 77.6% and 68.4% respectively. PCOS women took 34 ± 26 months to get pregnant for the first time following surgery, and controls took 31 ± 24 months. There was no significant difference between PCOS neonates and controls in terms of their birth weight means (2856 + 624 g vs. 3246 + 592 g), but the number of newborns with low birth weights was similar between the two groups. Maternal problems (18.4% in PCOS and 23.6% in controls) and newborn complications (24.6% in PCOS and 15.4% in controls) were uncommon, with no differences between groups. Conclusion: Women with PCOS were more likely to have high fertility rates after bariatric surgery, especially in those seeking fertility, with no difference between those with hyper androgenic PCOS and those without. There were few maternal or neonatal complications such as preeclampsia and gestational diabetes associated with these pregnancies. Keywords: Bariatric surgery, Polycystic patients, Obesity, Fertility outcome
Frequency of Successful Vaginal Delivery after Induction of Labour in Obese Pregnant Women Presenting at Tertiary Care Hospital Peshawar
Authors: Latif Aqsa , Azam Maimoona , Khan Hina , Khan Imran , Iqbal Madiha , Khan Zakia , Naz Shagufta , Abid Muhammad Sabtain
Published: March 2023

Introduction: The incidence of induction of labour is 20% of all deliveries and is considered as the most common techniques in modern obstetrics. But both medically indicated and elective inductions are thought to increase the risk of instrumental and cesarean deliveries. Objective: Aim of this study was to determine the frequency of successful vaginal delivery after induction of labour in obese women. Methodology: This study was descriptive study carried out at Gynecology and Obstetrics Department, Hayatabad Medical Complex, Peshawar. The duration of study was Six months (from 1/2/2021 to 1/8/2021). Detail history, clinical examination, routine investigation were performed for the confirmation of obese pregnant women. All the data i.e. age, gestational age, parity, gravidity, number of induction, duration of labour, previous history of C section was recorded in pre design performa. All the recorded information on performa was entered in statistical software SPSS ver 23. Results: Our study shows that among 149 patients mean maternal age was 29 years with standard deviation ± 5.91. Among 149 patients successful vaginal delivery was observed in 86(58%) patients while 63(42%) patients were observed with un-successful vaginal delivery. Conclusion: Our study concludes that the frequency of successful vaginal delivery was 58% after induction of labour in obese pregnant women presenting at tertiary care hospital Peshawar. Keywords: Successful vaginal delivery, Induction of labour, obese pregnant women
Effect of Smoking on Periodontal Health: Awareness among Azra Naheed Dental College Patients
Authors: Riaz Marryam , Kashif Rahmah , Mujtaba Ahmed , Mukhtar Sara , Shujaat Sohaib , Tahir Easha
Published: March 2023

Background and Aim: Smoking is one of the most preventable causes of premature mortality around the globe. In addition to causing unattractive tooth staining, periodontal disease, bad breath, wounds impaired healing, and precancerous conditions, smoking is also detrimental to oral health. The present study aimed to determine the effect of smoking on periodontal health and to identify the level of awareness among smokers about the effects of smoking on their oral health. Methods: A cross-sectional study was carried out on 200 participants in Azra Naheed Dental College (ANDC), Lahore from January 2022 to September 2022. This self-administrated questionnaire survey was used to determine sociodemographic characteristics, smoking cessation programs and individuals' willingness to quit smoking, as well as awareness of oral health affected by smoking. Dental patients aged ≥19 were enrolled. The questionnaires asked about the demographics of participants, their awareness regarding smoking effects on oral conditions, including staining of teeth, oral cancer, delayed wound healing, gum disease, and dental implants. Results: Of the total 200 participants, there were 144 (72%) male and 56 (28%) females. The overall mean age was 35.8±14.1 years. Age-wise distribution of patients was as follows: 138 (69%) in 19-40 years, 51 (25.5%) in 41-60 years, 6 (3%) in 61-80 years, and 5 (2.5%) >80 years. About 57 (28.5%) had past medical history, out of which hypertension (HTN) was the most prevalent medical history 32 (16%) followed by combined hypertension and diabetes cases 13 (6.5%), diabetes 5 (2.5%), asthma 4 (2%), and vocal cord surgery 3 (1.5%). Regarding Dental history, the incidence of extraction and scaling, scaling, filling, extraction, extraction and filling, scaling extraction and filling, restoration, Root canal treatment (RCT), restoration and RCT, denture, artificial teeth, and capping were 21 (10.5%), 28 (14%), 15 (7.5%), 15 (7.5%), 12 (6%), 6 (3%), 1 (0.5%), 1 (0.5%), 1 (0.5%), 2 (1%), and 2 (1%) respectively. About 82 (41%) participants were smokers among total participants. The incidence of toothless, staining, halitosis, bad taste, effect on gums, delay in healing, tenderness, pain cured, bleeding gums, loose tooth, prostho work, and bad experience were 83 (41.5%), 151 (75.5%), 161 (80.5%), 75 (37.5%), 101 (50.5%), 63 (31.5%), 83 (41.5%), 113 (56.5%), 101 (50.5%), 65 (32.5%), 39 (19.5%), and 23 (11.5%) respectively. Conclusion: The present study concluded that only 8% of respondents knew that smoking is associated with periodontal diseases, illustrating the lack of awareness of patients regarding the link between smoking and periodontal diseases across the board. Keywords: Periodontitis, Smoking, Periodontal health, Assessment
MRI's Diagnostic Reliability in Cervical Cancer Screening Detecting Cancer using Magnetic Resonance Imaging is a Reliable Method (MRI) A Single Center Study
Authors: Ahmad Iqbal , , Habib Erum , , Nabi Muhammad
Published: March 2023

Aim: to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for cervical cancer detection in patients with cervix carcinoma who had received a clinical diagnosis. Study Design: A Single Center Study Place and duration Department of Radiology Qazi hussain ahmad medical complex Nowshera from january 2018 to December 2019. Methods: In all, 75 individuals between the ages of 31 and 62 with clinically suspected cervical cancer were recruited in this research. After obtaining written agreement, extensive patient demographic information was gathered, including their age, place of residence, socioeconomic status, co-morbidities, and clinical presentation. An MRI of the pelvis was performed on each patient to find the malignancy. Histopathology was used as the standard. Results: Patients' ages ranged from 31 to 41 years for 15 (21%) patients, 42 to 52 years for 26 (34%) patients, 53 to 63 years for 21 (28%) patients, and beyond 61 years for 13 (18%) patients. The most prevalent symptom, post-menopausal bleeding, was seen in 32 (42%) patients, followed by atypical vaginal bleeding in 25 (34%) patients, foul-smelling watery discharge in 18 (24%) patients, and pelvic discomfort in 15 (21%) patients. By MRI, 53 patients (71%) had positive results, while 22 patients (29%) had negative findings. By histological examination, 56 patients (75%) had positive findings, while 19 patients (24%) had negative. The diagnostic accuracy of MRI was 90%, 87, 96, 74%, and 87%, respectively. Sensitivity, specificity, PPV, and NPV were also high. Conclusion: For cervical cancer diagnosis, magnetic resonance imaging is a beneficial diagnostic technique. Keywords: Cervical Carcinoma, Accuracy, Magnetic Resonance Imaging
Management of HCV Positive Patients on Maintenance Dialysis
Authors: Khan Samee Ullah , Elahi Irfan , Ahmed Rizwan Munir , Batool Aeliya , Haider Shajia , Araujom Oliva
Published: March 2023

The prevalence of hepatitis C virus (HCV) is quite high in Pakistan, especially among patients on maintenance hemodialysis (MHD). HCV infection is associated with increased morbidity and mortality among patients on maintenance hemodialysis. The current availability of direct-acting antiviral therapy has changed the picture of HCV prevalence in many countries. Objective: The aim of our study is to assess the prevalence and treatment of HCV infection among patients on maintenance hemodialysis in our setting. Methods: This descriptive cross-sectional study was held in the Medicine department of Mayo Hospital, Lahore for six-months duration from 13th January 2022 to 12th July 2022. The study was conducted on 130 patients to assess HCV seroprevalence among patients on MHD. Data on HCV status, PCR positivity and number of patients receiving active treatment were evaluated. Results: A total of 130 patients on maintenance hemodialysis were included in this study. The incidence of HCV infection was 49 (37.7%). All patients underwent PCR and 32 patients were PCR positive. All except 5 of the 32 PCR positive patients started HCV antiviral treatment. Conclusions: In conclusion, our study helps highlight the high prevalence of HCV among maintenance hemodialysis patients and the need to maintain adequate infection control measures. However, it is encouraging to know that most patients have been treated, and future research will highlight the importance of prompt treatment for MHD patients. It is recommended that all of HCV PCR positive patients were being treated with DAA. Keywords: HCV, Hemodialysis, Antivirals, Seroconversion, Health insurance, Infection.
Frequency of Left Ventricular Mechanical Dyssynchrony in Chronic Heart Failure
Authors: Khan Zahoor Ahmad , Khan Javaidullah , Ahmad Salman , Ullah Hameed
Published: March 2023

Objective: To determine the frequency of left ventricular mechanical dyssynchrony in chronic heart failure patients. Material and Methods: After approval from the Hospital ethical committee, the study was conducted in the department of cardiology Hayatabad medical complex Peshawar from 1st September 2021 to 28th February 2022. In this descriptive cross-sectional study, 155 patients in total were examined while 27% of heart failure patients had mechanical dyssynchrony, a 95% confidence interval, and a 7% margin of error were maintained according to WHO sample size computations. Results: This study's participants had an average age of 60, with a standard deviation of ±1.26 years. 62% of the patients were male, compared to 38% of females. 35% of patients had a Broad QRS complex, whereas 65% of patients had a Narrow QRS complex. Mechanical dyssynchrony was identified in 32% of chronic heart failure patients. Conclusion: Patients in chronic heart failure with QRS > 150ms and having mechanical dyssynchrony are benefited with Cardiac Ressynchronisation Therapy (CRT) implantation which reduces morbidity and mortality, while those with a narrow QRS (<150ms) are generally non – responders. Keywords: Mechanical dyssynchrony, chronic heart failure, left ventricular ejection fraction
The Impact of Surgical Technique and Extent of Thyroidectomy in Voice Outcomes a Prospective Study
Authors: Alam Jamshed , Hussain Musarrat , Ullah Muhib , Zahid Muhammad Jawad
Published: March 2023

This prospective study aimed to evaluate the impact of surgical technique and extent of thyroidectomy on voice outcomes in 46 patients undergoing thyroidectomy. Patients were divided into three groups: limited thyroidectomy (n=20), total thyroidectomy (n=19), and extended thyroidectomy (n=7). Voice assessments were performed preoperatively and at 3 and 6 months postoperatively. Results showed that the surgical technique and extent of thyroidectomy had no significant effect on voice outcomes. However, a greater proportion of patients with limited thyroidectomy experienced a decrease in voice quality at three months postoperatively compared to patients with total or extended thyroidectomy. This study suggests that surgical technique and extent of thyroidectomy do not significantly affect voice outcomes in the long term. Further research is needed to understand these factors' impact on voice outcomes. Methodology: This prospective study was conducted in the department of surgery hmc Peshawar from Jan 2020 to Jan 2021 over the 01 years of a pride sample size of 46 patients (30 male and 16 female) who underwent thyroidectomy. Patients were divided into three groups based on the surgical technique and extent of thyroidectomy: limited thyroidectomy (n=20), total thyroidectomy (n=19), and extended thyroidectomy (n=7). All patients underwent preoperative and postoperative voice assessments at 3 and 6 months. The assessments included acoustic analysis and perceptual evaluation of voice quality. Results were compared between the three groups to evaluate the surgical technique's impact and thyroidectomy's extent on voice outcomes. Statistical analysis was performed to analyze the data. Results: The results showed that the surgical technique and extent of thyroidectomy had no significant effect on voice outcomes. However, a greater proportion of patients with limited thyroidectomy experienced a decrease in voice quality at three months postoperatively, compared to patients with total or extended thyroidectomy results shown in tables 1 to 7. Conclusion: This study suggests that surgical technique and extent of thyroidectomy do not significantly affect voice outcomes in the long term. Further research is needed to understand these factors' impact on voice outcomes. keywords: thyroidectomy, voice outcomes, surgical technique, the extent of thyroidectomy
Papillary Carcinoma in a Patient with a Thyroid Nodule: Role of Ultrasonography and its Diagnostic Accuracy
Authors: Khan Muhammad Noor , Alam Sahibzada Fakhre , Ahmad Ijaz
Published: March 2023

Introduction: While it can be difficult to categorize thyroid lesions, employing ultrasound may enable correct diagnosis, classification, and therapy of thyroid nodules, particularly papillary carcinoma of the thyroid, and assist save unneeded biopsy. Objective: Taking histopathology as the gold standard, assessing the diagnostic precision of ultrasound in the identification of papillary cancer in thyroid nodule patients. Study design: Cross sectional study Study Settings: Department of ENT & Surgery, Jinnah Teaching Hospital, Peshawar Study Duration: This study was conducted from 1st August 2021 till 30th June 2022. Materials and Methods: Patients of both gender who sought assessment for a thyroid nodule were included. On ultrasonography, papillary carcinoma was detected. The gold standard for diagnosing cancers, histology, was used to confirm papillary carcinoma. Using a 2×2 table, diagnostic accuracy was assessed in terms of sensitivity, specificity, PPV, and NPV. Results: Overall 241 participants recruited. The patients were between the ages of 18 and 75. The patients' mean age was 57.80 + 9.245 years. The ratio of men to women was 1.2:1. The ultrasound's sensitivity, specificity, PPV, NPV, and diagnostic accuracy for the diagnosis of papillary thyroid cancer were, respectively, 85.1%, 97.5%, 88.8%, 96.5%, and 95.1%. Conclusion: With clinically significant diagnostic accuracy for the early diagnosis of thyroid papillary carcinoma, ultrasound is a cost-effective, non-invasive diagnostic method that may lessen the need for invasive diagnostic methods like thyroid biopsy. Keywords: Papillary Carcinoma of Thyroid, Ultrasound, Diagnostic Accuracy
Use of Nitroglycerine Patch in the Management of Preterm Labor
Authors: Umar Saima , Anwar Sadia , Bashir Humaira , Faizan Muhammad , Qurashi Qandeela Irum , Saleem Umm-E-Aimen
Published: March 2023

Background: Preterm birth is the delivery of the baby before 37 completed weeks of pregnancy. The goal of tocolytic therapy is to reduce neonatal mortality and morbidity by delaying birth, allowing for corticosteroid administration and maternal transfer to the tertiary care center. This study was conducted to observe the tocolytic efficacy of GTN transdermal patches in preterm labor between 28 – 36 weeks of pregnancy. Methods: This cross-sectional study was done in Obstetrics & Gynecology Department at Mufti Mehmood Memorial Hospital, Dera Ismail Khan, from July 2017 to December 2017. Non-probability consecutive samplings of 186 pregnant women with preterm labor were included in the study. Detailed history and examination, routine investigations and ultrasound were performed to confirm viability, gestational age and exclusion of multiple pregnancies, lethal fetal malformation and intrauterine death. Effectiveness of the GTN patch was considered successful if the cessation of uterine contraction occurred within 24 hours of the application of the GTN patch and persisted for 48 hours to achieve the effect of steroids. Results: Tocolytic efficacy of GTN transdermal patch in preterm labor between 28 to 36 weeks of pregnancy was 88.71%. Regarding the parity of the women, 75.8% of women had multipara (parity 2 to 5) and 24.2% had primipara. The average gestational age was 33.15±2.28 weeks. . Two to three uterine contractions per 10 minutes were observed in 75.8% of women while four uterine contractions per 10 minutes were observed in 24.19% of cases. 2cm cervical dilatation was observed in 82 women (44.09%) and 3cm was 75 women (40.32%). Practical implication: The incidence of preterm delivery can be minimized using GTN patch to reduce the uterine contractions and increase the fetal viability inside the womb. Conclusion: There is no better incubator than a mother's womb. The GTN patch appears to be a safe, non-invasive method of suppressing uterine contractions in pre-term labor and also a simple, quicker and cost-effective tocolytic agent. Keywords: Pre-term labor; Tocolytic; Transdermal patch; Uterine contractions.
Diagnostic Accuracy of Risk of Malignancy Index RMI in Patients with Adnexal Mass
Authors: Zahir Neelum , Ali Saima , . Rukhsana
Published: March 2023

Background: Gynecological cancers often begin in the ovaries. Malignant pelvic masses may often be predicted using the Risk of Malignancy Index (RMI). Objective: To evaluate the RMI for its ability to differentiate between benign and malignant adnexal masses. Methods: A cross-sectional study in a gynecology and obstetrics OPD of Saidu Group Of teaching hospital,swat was carried out. 55 women who were hypothesized to have adnexal masses were included after informed consent. Each patient menopausal status, ultrasonography (USG) score and blood CA-125 level was measured. For every participant, the RMI was determined. Results: Thirty-five of the recruited women had noncancerous adnexal mass, whereas twenty had cancerous ones. Benign adnexal mass was seen in 19 premenopausal women and 16 postmenopausal women, and in malignant adnexal mass there were 13 premenopausal women and 7 postmenopausal women. Participants' mean ages were 44 years for benign adnexal mass and 40 years for malignant adnexal mass. USG score and CA-125 have significant variation between the benign and malignant adnexal masses, with p value of 0.000. High sensitivity (80%) and specificity (71.3%), as well as positive (77.3%) and negative (74.7%) predictive values, were found for the RMI at a cut-off of <200 when used to differentiate between benign and malignant adnexal masses. Conclusion: In conclusion, the RMI seems to be a trustworthy, easy, and cost-effective technique for clinical distinction between benign and malignant adnexal masses. Keywords: adnexal mass, USG score, ovarian cancer, ovary malignancies
Epidemiology of Acute Lower Respiratory Tract Infections in Children
Authors: Altaf Sania , Muhammad Taj , Ullah Farman , Naz Rida , Qazi Shaista
Published: March 2023

Background: Lower respiratory tract infections attack the airways below the larynx, including the trachea and alveolar sacs. It is related to infants and young children more frequently. Purpose: Therefore, this study was conducted on children less than five years to determine their LRTI epidemiological trends. Methods: The study comprised 761 children up to 5 years old who were presented at the outpatient department (OPDs) and were admitted to Tertiary care hospitals in district Dera Ismail Khan, Lakki Marwat and Tank from January 2022 to January 2023. Results: The study included 488 boys (64.12%) and 273 girls (35.87%), diagnosed with LRTIs. Our findings revealed that the LRTI showed the highest incidence in infants (p<0.05) with less than a year of age (327/761). Female children (57.03) in our study were most often infected (p<0.05) with LRTIs than males (42.96%), respectively. Significantly lower-weighed children were more prone to the infection (p<0.05) of weight less than 10 Kg with an incidence of 64.52% and a high proportion (p<0.05) of the infected kids belonged to poor families (85.41%) of mostly (p<0.05) rural area (60.84%). The clinical manifestations were characterized by coughing (93.95%), followed by fever (78.97), phlegm (70.95%), tight chest (42.96%), shortness of breath (36.92%), dyspnea (15.90%) and 14.06% (107/761) children manifested with wheezing sounds during infection. Conclusion: It was concluded that infants had the highest frequency of LRTIs rendering them to hospitalization. Practical Implications: Therefore, public intervention to prevent LRTIs in children should be implemented prior to the seasonal spread of infectious diseases. Keywords: Coughing; Dyspnea; Epidemiology; Phlegm; Wheezing.
Molecular Characterization of Intestinal Microsporidia in Immunocompromised Patient in THI-QAR Province
Authors: Kadhim Al-Zihiry Khalid Jameel , Alshuwaili Saleem Abdul Amir Jaber
Published: March 2023

Introduction: Immunocompromised host has one or more defects in the normal defense mechanisms that protect against infectious agents. Microsporidia are group of protozoa characterized via obligate intracellular and spore formation, detected in many hosts. Up till now, 1300 microsporidia species or more, related to 150 genera, were, microsporidiosis caused by microsporidia. Objectives: To conduct Molecular characterization of intestinal microsporidia in immunocompromised patient in Thi-Qar province cases. Patients and Methods: Totally, two hundred stool samples were collected and subdivided into 185 cancer patients and 15 organ transplantation patients. Samples were examined for microsporidiosis by light microscopy smears stained by Chromotrope Kenyon stain and by PCR techniques. Results: using Polymerase chain reaction technique (PCR), microsporidia were detected in eleven sample out of 116 sample that were positive by microscopic examination and Chromotrope Kenyon stain. Positive sample by PCR were sent for sequencing and the result showed that the samples of the current study were similar to three microsporidia, Enterocytozoon bieneusi, Encephalitozoon cuniculi and Encephalitozoon intestinalis. Conclusion: The present study confirmed the presence of Microsporidia infection is among immunocompromised patients. Keyword: Molecular, immunocompromised , microsporidia, PCR
Kell Blood Group System Antigen Genotypic Frequencies in Northern Pakistani Healthy Blood Donors a Multi Center Study
Authors: Mehmood Afsheen , Haq Anwar Ul , Shahab Khalid , Ullah Hameed , Irfan Muhammad , Zeb Farhan
Published: March 2023

Objective: To investigate the genotypic frequencies of the K and K blood group system antigens in Northern Pakistan's healthy blood donors. Material and Method: this Multi center study conducted in department of medicine Hmc Hospital Peshawar From February 2021 to February 2022, The study comprised 59 blood donors in total. The traditional PCR method was used for genotyping, and the amplified products were then run over polyacrylamide gel electrophoresis. Version 26 of SPSS was utilised for the analysis. Results: In this study, 59 blood donors with a mean age of 31.47.07 years were totaled. Male to female ratio was 29.22 to 1. KEL*2/KEL*2 was the most prevalent genotype, found in 53 (91%) donors, followed by KEL*1/KEL*2 in 3 (06%) and KEL*1/KEL*1 in 03 (03%) donors. Conclusion: Identify the antigens in our nation and contrast the findings with those of other populations. The results of this research may be utilised to create a database of genotypic frequencies. Keywords: genotyping, Kell blood group, polymerase chain reaction, and blood donors (PCR).
The Accuracy of 0.3 Tesla MRI for Diagnosing Meniscal Tears in the Knee a Multi-Center Study
Authors: Habib Erum , Aziz Faiz Ul , Yaseen Muhammad , Ali Nasir , Iqbal Mian Javed , Rahim Shah Abdur
Published: March 2023

Objective: This study aims to compare the accuracy of a 0.3-tesla MRI in diagnosing meniscal injury in the knee to that arthroscopic findings. Duration and place of study Qazi Hussain Ahmad Medical Complex Nowshera, Pakistan, from Jan 2021 to Jan 2022. (departments of Radiology and Orthopedic). Methodology: One hundred patients who satisfied the study's inclusion criteria were sent from the orthopedics. We successfully collected patient data and permission from the Qazi Hussain Ahmed Medical Complex Nowshera. outpatient department and tertiary care hospital kpk between January 2021 and January 2022. All of the 0.3 Tesla scans were completed by a single MRI tech. To confirm the findings of the MRI, an arthroscopy was done by a professor of orthopedics. We tracked everything in a proforma spreadsheet and analyzed the data. Results The result is that 100 patients participated in the trial. There were 96 males (or 95%) and four females (5%). Individuals' ages varied from the low teens to the high fifties. Patients had a mean age of 30.3 +/- 6.82 years. We found that, in contrast to arthroscopy, our method for diagnosing meniscal injuries of the knee joint was susceptible (96%), specific (95%), and accurate (95%). Conclusion:For the evaluation of meniscal injuries, MRI is a reliable, accurate, and noninvasive method. Keywords: Arthroscopy, MRI, and Knee Replacement are Some Key Terms