bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing the community decision making to purchase pet insurance: Case study of animal lovers in Indonesia
Authors: Sukono Sukono , Susanti Dwi , Ridwan Fadhilla , Riaman Riaman , Hertini Elis , Saputra Jumadil
Published: November 2022

This study aims to measure people's decision-making to buy their pet insurance and compare it with the amount of insurance premium rates offered. It is important due to the increase in people's income which has triggered the birth of a community of pet lovers as part of the middle-class people’s lifestyle in Indonesia. The survey data was conducted using the Stated Preference (SP) format through questionnaires and interviews to determine the public response to pet insurance premiums. The collected data were analyzed using descriptive methods, decision-making analysis was on the basis of the choice of the dichotomous Contingent Valuation Method (CVM), and logistic regression analysis. Based on the calculation analysis using the logit method shows that the ability of the public to pay pet insurance premiums is IDR289,454.54. Analysis of calculations using the Turnbull method was obtained at IDR365,000.00. The results of the WTP amount, both using the logit method and using the Turnbull method, are greater than the minimum premium amount offered which is IDR190,000.00. The results of this study indicate that the premium rates for pet insurance offered are still within reasonable limits, compared to the size of the decision-making by the animal lover community in Indonesia. This provides a very good prospect for insurance companies that have insurance products for pets in Indonesia. This study was conducted to provide empirical evidence that the decision-making of the animal lover community is greater than the premium rate for pet insurance that has been offered. Thus, this research strongly supports the development of pet insurance companies in Indonesia, which can provide pet protection to stay healthy and well looked after.
The relationship between the transportation export value and energy consumption of Thailand
Authors: Choochote Kitimaporn , Sirimat Sukanya , Watchallanun Tanawat , Nonthapot Sakkarin
Published: November 2022

This study was conducted to consider the relationship between the transportation export value (TR) and energy consumption of Thailand (EN) in the long run by a comparative analysis that relied on testing by the ARDL and NARDL models. The Granger causality of each item was also tested by quarterly time series data from Quarter 1 of 2011-Quarter 4 of 2021. The results revealed a long relationship from the EN to TR. However, only the reduction of the TR affected the EN. According to the results, the energy agencies of Thailand should maintain the balance of EN and sufficient energy imports to drive the TR for its stability.
The relationship between economic growth and e-commerce at the beginning of covid-19 pandemic in east Java
Authors: Arisanti Restu , Utami Efrilla Rita , Muslim Agus , Hayati Ma’rufah
Published: November 2022

The purpose of this study is to analyse the simultaneous spatial relationship between economic growth and e-commerce as well as the spillover effect between the two variables in East Java at the beginning of the Covid-19 pandemic in 2020. To answer the research objectives, spatial simultaneous modeling is used with the Spatial Autoregressive Generalized Spatial Three Model. Stage Least Square (SAR-GS3SLS) using rook contiguity. Based on the results of the SAR-GS3SLS, it can be concluded that at the beginning of the Covid-19 pandemic in 2020 in East Java, economic growth and e-commerce were simultaneously spatially interconnected. Variables that affect East Java's economic growth are e-commerce activities, the number of villages that have Base Transceiver Stations (BTS) and the spatial lag of economic growth (ρ1) while the open unemployment rate (TPT) and the Gini ratio have no significant effect on growth. economy. Variables that affect e-commerce are economic growth, internet banking users, percentage of population who have cellphones, number of millennials, number of villages that have ATMs and spatial lag of e-commerce (ρ2) while the number of villages with 4G/LTE signals has no effect on e-commerce. commerce. Regencies/cities that provide the highest spillover of economic growth and e-commerce in East Java are Malang, Mojokerto and Madiun Regencies. The three districts were able to provide a positive net spillover.
Predicting determinant factors and development strategy for tourist villages
Authors: Ariyani Nafiah , Fauzi Akhmad , Umar Farhat
Published: November 2022

Tourist village program is one development priority program for rural development. Despite numerous opportunities to develop tourist villages such as the availability of natural resources and high demand for tourist villages recently, some challenges are still faced to develop tourist villages, especially in a developing country such as Indonesia. Governance problems, infrastructure, and effective partnership are among other factors that remain challenging in developing tourist villages. This study attempts to identify factors that determine the state of tourist villages in Indonesia and determine the appropriate strategies for better tourist village development. Using the case of tourist villages in Kedung Ombo, Central Java, a water based attractive tourist village, this study uses both machine learning and multicriteria approaches by means of Promethee in order to address the objective of the study. This study shows that government support, application of information technology, infrastructure, local participation, partnership, and attractive variations, are among the determinant factors that affect tourist village development. The study also reveals that the appropriate strategies for tourist village development include, improving infrastructure, institutional strengthening, and capacity building. This study could be used to assist local national as well as sub-national governments to effectively manage tourist villages in Indonesia.
Intervenções nas instituições federais de ensino: reitoras e reitores eleitos e não empossados — nossa luta, nossa história
Authors: Parentoni Marcel Fernando da Costa , Ribeiro Anderson André Genro Alves , Farias Camilo Allyson Simões de , Alexandrino Carlos Henrique , Tutikian Jane Fraga , Ferreira Lísia Regina
Published: November 2022

Nos quatro anos do governo Bolsonaro, vinte e cinco instituições federais de ensino sofreram intervenção. Este livro foi escrito por reitoras e reitores, vice-reitoras e vice-reitores eleitos em suas instituições e não nomeados pelo então Presidente da República. Decidimos não nos calar. Em vez de assistirmos passivamente a história passar, resolvemos registrá-la. Reafirmamos nosso compromisso com as comunidades que nos elegeram, não permitindo que esta história seja esquecida ou minimizada. Nos relatos aqui apresentados, fica clara a brutalidade da ação interventora e o oportunismo utilizado para subjugar as universidades aos interesses ideológicos e político-partidários. Ao mesmo tempo que traz uma elevada carga de sentimentos, este livro também é um convite à renovação das esperanças. É a nossa luta para que reitoras e reitores eleitos sejam, hoje e sempre, reitoras e reitores empossados. É a nossa luta para que, nunca mais, as instituições federais de ensino tenham que ser submetidas ao que estamos vivenciando. Prof. Dr. Marcel Fernando da Costa Parentoni
Germination Pattern of Four Soybean Varieties on Media Containing Al, Fe, and Mn
Authors: Timotiwu Paul Benyamin , Ermawati Ermawati , Lestari Dyah Tri , Manik Tumiar Katarina
Published: November 2022

Acid soils in Lampung contain a lot of Al, Fe, and Mn, which inhibit soybean growth and production. The study of seed germination is important since plant growth begins with seeds. The study aimed to determine (1) the viability of various local soybean seeds: Anjasmoro, Grobogan, Dena-1, and Devon-1 on Al, Fe, and Mn heavy metal media and (2) the highest effect of dissolved metals among Al, Fe, and Mn on the viability of soybean seeds. The research was conducted at the Laboratory of Seed and Plant Breeding, Faculty of Agriculture, the University of Lampung from November 2019 to March 2020. The research applied a randomized complete block design (RCBD) with three replications and the data were averaged and presented as bar charts and standard deviation. The experiments were evaluated based on germination variables including germination capacity, average seed germination time, primary root length of normal germination, and dry weight of normal seedlings.The results showed that Grobogan and Anjasmoro varieties had high resistance to dissolved metals Al, Fe, and Mn, followed by Dena-1 varieties while Devon-1 was the most susceptible. The fourth day of germination showed that Fe caused the highest damage to the seeds, followed by Mn and finally Al. Interestingly, on the fifth day of germination, dissolved metal Mn had the highest toxicity effect, followed by Fe and Al.
Eptinezumab-jjmr, a humanized monoclonal specific to Calcitonin Gene Related Peptide, for the preventive treatment of migraine in adults
Authors: Berger Amnon A. , Keefe Joseph , Stark Cain W. , Moore Matthew , Ramírez Giovanni F. , Cucarola Julia R. , Han Andrew H. , Kaye Alan D. , Ganti Latha
Published: November 2022

Purpose of Review

Migraines are prevalent and cause significant morbidity, decline in quality of life and healthcare costs universally. Treatment options are varied, but efficacy is limited. This review centers on Eptinezumab-jjmr, a humanized monoclonal specific to CGRP for the prevention of migraines in adults. Herein presented are the science and mechanism of action, indication and clinical evidence for use.

Recent Findings

Migraines are severe, recurrent headaches, which are either episodic or chronic in nature. The pain is severe, often accompanied by co-morbid symptoms, such as photophobia, phonophobia, nausea and emesis, and is limiting in nature. It is a prevalent disorder that causes significant, worldwide disability, morbidity, suffering, and costs.

The pathophysiology of migraines is actively studied, though recent research points to an initiating event causing migraine generation, that is then propagated by other brain regions, a significant one being the trigeminocervical complex. This is driven by biochemical transmitters, chiefly CGRP. This discovery led to the development of CGRP-targeting drugs, including gepants (small molecular antagonists) and anti-CGRP antibodies, such as Eptinezumab-jjmr.

Traditional therapy includes preventative and abortive treatment; however, adherence with preventative treatment has been historically poor, and certain types of abortive therapy carry risks and side effects that preclude them from a large patient population. Moreover, traditional therapy often falls short in migraine therapy. CGRP antagonist, including Eptinezumab, aims to cover the gaps in migraine therapy. We present here evidence to support the safe and effective use of Eptinezumab for the prevention of migraines.

Migraines are a prevalent primary headache disorder causing significant morbidity worldwide. Traditional abortive and preventative treatments fall short for many patients. Eptinezumab is part of new generation of CGRP-targeting medications and has shown significant evidence to support its use for the prevention of migraines. Further research is required to properly compare eptinezumab with existing pharmacotherapy and update guidelines on the appropriate combinations of therapies that are not available and the correct patient selection for each.
The Implications of Mental Health and Trauma in Interstitial Cystitis
Authors: Bendrick Tyler R. , Sitenga Graison L. , Booth Cameron , Sacco Matthew P. , Erie Christine , Anderson Danyon J. , Kaye Alan D. , Urits Ivan
Published: November 2022

This review aims to assess the relationship between interstitial cystitis (IC) and significant traumatic events or PTSD. It was shown that there is a strong correlation between past trauma and the development of interstitial cystitis, as well as a much higher incidence of PTSD in patients diagnosed with IC. It was also established that for individuals with early traumatic experiences, the more likely the development of IC later in life, and with more severe symptoms and adverse effects on quality of life. We describe three distinct hypotheses for the possible physiologic mechanism for development of IC with relation to mental health and trauma, although definitive evidence in this area is still lacking, which poses interesting avenues for further research. This review also revealed an apparent lack of, and need for, trauma informed care and screening for PTSD in patients diagnosed with IC or other chronic pain syndromes.
La iglesia sinodal de Hipona en tiempos de San Agustín
Authors: Luis Vizcaíno Pío de
Published: November 2022

Sobre la sinodalidad, tema recurrente en la reflexión católica actual, se puede hablar desde una perspectiva teórica o desde una perspectiva práctica. Estas páginas responden a la segunda opción, con la mirada puesta no en el futuro inmediato, sino en el pasado autoritativo de los Padres de la Iglesia, concretado en la persona de san Agustín. De las dos partes del estudio, una –breve– contempla en el marco de la sinodalidad la concepción monástica del santo; la otra –más amplia–, su concepción de la vida cristiana en general. La primera halla expresión en un “caminar juntos hacia Dios” (anima una in Deum); la segunda, en un «ser con vosotros» y un «ser para vosotros». Ambas partes incluyen el fundamento teológico de la comunión que, hecha vida por los monjes o los fieles, se convierte en fundamento del actuar sinodal de unos y otros. La segunda parte integra tanto la perspectiva intraeclesial como la intereclesial.
Hermenéutica del fenómeno maniqueo contemporáneo desde los aportes de San Agustín en sus Confesiones
Authors: Ibarra Orlando
Published: November 2022

La investigación busca destacar la experiencia maniquea de Agustín de Hipona, narrada en las Confesiones, para confrontar su evolución en la búsqueda de Cristo, con algunas de las actuales búsquedas de lo trascendente. En el desarrollo del trabajo, se analiza la falta de identidad religiosa en el sincretismo religioso neomaniqueo, para detectar las nociones de interferencia que, en algún sector creyente, impiden la consolidación de compromisos ante los desafíos emergentes de la humanidad.
Aproximación a las raíces de los abusos sexuales en el seno de la Iglesia Católica.
Authors: Noriega Fernández Roberto
Published: November 2022

Al leer los testimonios de las víctimas de los abusos sexuales en el seno de la Iglesia católica, es posible descubrir justificaciones religiosas, que unidas a otras causas han provocado las actuaciones delictivas de los responsables primarios y el ocultamiento por parte de la institución. Se denuncian especialmente las aparentes razones y pretextos teológicos que giran en torno a: la antropología y la teología de la sexualidad, la eclesiología y la concepción del poder ministerial, y la compresión del pecado y de la gracia. Se anotan, además, posibles vías de solución y reparación.
Exposición del credo de los Apóstoles
Authors: Resines Llorente Luis
Published: November 2022

Un antiguo manuscrito anónimo (s. XIV-XV) realiza un comentario del credo apostólico, dando por supuesto que cada una de las frases fue formulada por un apóstol, según una expresión común. Más allá de la autoría de las frases, lo que presenta es la fe cristiana común, con unas explicaciones originales. Además, añade un segundo comentario más breve, que condensa lo precedente; finalmente añade una profesión personal de la fe cristiana y la asume con pleno convencimiento.
Community-Level Factors Associated with Body Mass Index Among Pakistani School-Aged Adolescents
Authors: Tanveer Moazzam , Tanveer Umar , Afzal Mubeen , Rana Nasrullah , Nagra Rashid , Anjum Waqar , Haseeb Musa
Published: November 2022

Aim: To investigate the most recent estimates of underweight, overweight, and obesity prevalence with association of community-level factors in Pakistani school-aged adolescents aged 12 to 17 years. Methods: A cross-sectional study was conducted using a convenience sampling approach with 1,997 Pakistani from 40 schools in central Punjab province. The CDC US 2000 was used to define underweight < 5th percentile BMI, overweight 85th ≤ BMI to < 95th percentile BMI, and obese 95th percentile ≤ BMI, the Chi-square test was used. The Pearson correlation coefficient (r) was used to determine the correlation. The statistical significance level was set at p < 0.05. Results: prevalence of underweight U/W, overweight O/W, and obesity O/B was (23.5%, 4.6%, and 6.9%, respectively. There were no chances for students to engage in physical activity in the community, according to 72.9% of parents. Conclusion: Underweight, overweight, and obesity were prevalent among Pakistani school-aged adolescents. The community-based characteristics we discovered here have detrimental influences on school going adolescents’ health. The relationship between weight-status, behavioral, and other health variables should also be investigated in future research using longitudinal or interventional approaches. Keywords: Body Mass Index, School-aged adolescents, Community-Level
Determine the Functional Limitations in Activities of Daily Living Through Short Physical Performance Battery Test Among Asthmatic Adults
Authors: Babar Hafiza Ayesha , Anwer Nadia , Azfar Hanan , Tauseef Saman , Shahid Sara , Saleem Arslan
Published: November 2022

Background: To determine the functional restrictions in functional activities of daily lives in middle aged asthmatic adults and association of BMI with limitations in their daily life activities. Method: An observational cross sectional study was carried out at pulmonology opd of Shalamar hospital. A sample of 36 diagnosed asthmatic adults of middle aged with moderate to severe allergic asthma was taken. A Purposive sampling technique was used to conduct the study. Prediction of functional limitations in everyday activities through Short Physical Performance Battery test was determined. Three series of tests named balance test, gait speed test, repeated chair stand test were conducted which were the part of short physical performance battery test. Each test scored 4 and there was the total of 12 score. Those subjects who had less than 10 score were at risk of limitations in their daily life activities in future. Result: Sample of 30 participants were included for this study from age 35 to 55. Out of which 13 participants were of normal weight with BMI of less than 23.9 and 17 were overweight with the BMI ranges from 24.0 to 30.0. Participants with greater BMI were at the high risk of mortality. The results showed that the 13 subjects were overweight had the high risk of mortality, 13 had the risk of functional limitations in activities of daily living and 4 had the good functional status. There was statistical difference between the BMI and Short Physical Performance Battery test score. (P value= 0.001) Conclusion: This study concluded that middle aged asthmatic adults with moderate allergic asthma had greater risk of functional limitations and high risk of mortality due to the disease effect. This study also showed that the predictive value of functional limitations was more pronounced in females with greater BMI than males. Keywords: Allergic asthma, Activities of daily living, Functional Limitations, Short Physical Performance Battery test,
Menstrual Pattern of Reproductive Age Group Women and Their Association with Thyroid Dysfunction
Authors: Abbasi Sughra , Bukhari Amina , Sadiq Sadia Suboohi
Published: November 2022

Background and Aim: Thyroid hormones play a significant role in physiology of normal reproductive system. Thyroid dysfunction is extremely common in women and effect certain metabolic process and menstrual irregularities. The present study aimed to assess the menstrual pattern of reproductive age group women and their association with thyroid dysfunction. Methodology: This cross-sectional study was carried out on 140 women with menstrual irregularities who were assessed for thyroid dysfunction in the Department of Obstetrics and Gynecology outpatient Department of Sindh Government Hospital Karachi, January 2021 to December 2021. All the reproductive age group women between (15-45 years) with menstrual irregularities were enrolled. Women with a history of thyroid dysfunction and taking anti-thyroid drugs were excluded from the study. Individual age, thyroid hormones level, and type of menstrual irregularities were recorded. ELISA technique was used for the determination of thyroid hormones. Thyroid stimulating hormone (TSH) levels, serum free triiodothyronine (T3), and free thyroxine (T4) were used for the assessment of thyroid dysfunction. SPSS version 25 was used for data analysis. Results: The overall mean age of the study population was 27.8 ± 5.3 years with an age range from 15 years to 45 years. The age-wise distribution of patients were as follows; 15-25 years n=67, (47.8%), 26-35 years n=46 (32.9%), and 36-45 years n=27 (19.3%). The prevalence of thyroid dysfunction was 22% (n=31). The clinical presentations of menstrual patterns were as follows; Irregular menstruation 66.4% (n=93), Oligomenorrhea 4.3% (n=6), Menorrhagia 15.7% (n=22), Polymenorrhea 7.9% (n=11), and Metropathia 6.4% (n=9). Of the total 31 thyroid dysfunction women, the incidence of normal, hypothyroidism and hyperthyroidism was 82 (58.6%), 12 (38.7%) and 1 (1.4%) respectively. The median TSH level was 2 mIU/L IQR (1.0-4.0). The mean level of T3 and T4 was 2.83±1.13 pg/ml and 1.38±1.1 ng/dl respectively. Conclusion: The present study found that hypothyroidism is the most prevalent thyroid dysfunction among women of reproductive age with different menstrual irregularities. The most common clinical presentation was menorrhagia, polymenorrhea, and oligomenorrhea.. Hence the thyroid function evaluation should be mandatory in cases of DUB to detect thyroid dysfunction so the cases have to evaluated for further medical help Keywords: Menstrual Pattern, Reproductive age group women, Thyroid dysfunction
Effects of Pursed Lip Breathing with Arm Ergometry after Chin Support Position in Copd Patients
Authors: Rana Mashaal , Tariq Muhammad Iqbal , Syed Anayatullah , Zeb Uffaq , Tariq Farrakh , Tahir Aqsa
Published: November 2022

Background: COPD is the 4th leading cause of mortality around the globe and is expected to be the 3rdleading cause of mortality by 2020. It is a life limiting condition with symptoms of distress such as dyspnea, fatigue, pain and depression as it reaches the terminal stage. The condition decreases the pulmonary function values and QoL. Aerobic training and breathing maneuvers are essential components of pulmonary rehab improving pulmonary function values and QoL. Objective: To find out the effects of pursed lip breathing with arm ergometry after chin support position on respiratory parameters, spirometry tests and quality of life in patients of COPD.. Methods: It was a Randomized control Trial conducted on mild to moderate stage COPD patients. Purposive sampling was used to gain the study sample and then allocated randomly into two groups by coin toss method. The sample size calculated was 74 with 37 subjects in control group and 37 subjects in interventional group. It was conducted at Rehman Medical Institute Peshawar. Spirometer Testing (FEV1,FVC,PEF), HR,SPO2, RR, BORG dyspnea scale and CAT questionnaire were used as outcome measures to measure breathlessness and QoL respectively. Results: Mann-Whitney U test was used between the two groups to measure the effect of the two interventions. There was significant difference between group results (p-value<0.05) were found post-intervention for HR, FEV1, FVC, PEF, BORG score and CAT score. Freidmann test was used for within group analysis and reported significant results (p-value >0.05) for RR, oxygen saturation along with significant BORG and CAT results. Conclusion: It was concluded that there were significant effects of pursed lip breathing with arm ergometry after chin support position on respiratory parameters, spirometry tests and QoL in patients with COPD. Keywords: Chin Support Position, Arm Ergometry, Oxygen Saturation.
Effect of Continuous Positive Airway Pressure in Phase-I Cardiac Rehabilitation after CABG
Authors: Salal Memoona , Ubaid Sumaiyah , Batool Amena , Razzaq Maria , Rana Mashal , Suleman Hanifa , Anwer Nadia , Niazi Attaullah Khan , Muneeb Muhammad
Published: November 2022

Background: Coronary artery bypass surgery is associated with sever alteration of Lung parameters after 1st post-operative day. The purpose of this study to determine The effect of CPAP on, arterial blood gasses, walking time and long term effect on Ejection fraction and quality of life. Objective: To determine the effect of continues positive airway pressure on arterial blood gases, walking time, long term effect on ejection fraction and quality of life in post coronary artery bypass grafting patients. Methods: Randomized control study was conducted in North West General Hospital Peshawar, from July 2019 to December 2019. Patients underwent coronary artery bypass grafting were included in cardiac rehabilitation. 60 patients were randomly divided into two groups with equal half’s. Experimental group received exercises with continues positive airway pressure (CPAP) and control group received only exercise. PAP was applied 20 minutes prior to exercise and ABG’s test and Vitals were recorded after 5minutes of exercise. Walking time was observed by 6MWT on last day of hospital discharge. Ejection fraction was observed by Echo and quality of life by SF12 questionnaire after four weeks. Results: mean age in control group was (55.27±8.80) and in experimental group was (4.70±1.535). Mean and standard deviation of post Echo in experimental group was 48.30±1.493 and control group was 46.17±1.191. Both groups showed significant difference P value less than 0.05 in arterial blood gases PH, HCO3, and PCO2. PO2 showed significant difference only in experimental group. Both groups showed statistically significant difference for 6 MWT. Mean of quality of life in experimental group was 37.4±5.062 and in control was 36.54±4.46. Conclusion: it is concluded that the use of CPAP in post CABG patients have effective outcome in arterial blood gases, walking time, ejection fraction and in quality of life. Keywords: Continuous Positive Airway Pressure, Coronary artery bypass graft surgery, Inpatients rehabilitations.
Outcomes of Propofol or Thiopental Sodium and Oral Midazolam as an Induction Agent for Day Care Surgery
Authors: Saleem Maryam , Zeeshan Usman , Shahwar Dur I , Zafar Madiha , Iqbal Umar
Published: November 2022

Background: The increasing popularity of outpatient surgery has prompted the search for new anesthetic agent that can provide safe and effective anesthesia with a rapid and smooth recovery. Day care surgical procedure is extensively accepted and has been attaining recognition for over a time. The cost effectiveness and early recovery are an essential part of day-care surgical treatment in evolving countries. Aim: To compare the recovery score and cost-effectiveness after oral induction of midazolam and thiopental sodium with propofol alone in day-care surgical procedure. Methods: Eighty patients were selected, 40 in each ASA grade I and II group. In A group; patients were administered propofol at dose of 2 mg / kg for induction, and in group B; 0 2.5 mg / kg thiopental sodium and 0.25 mg / kg midazolam orally were given 30-mints prior to induction. Perioperative heart rate, time to ready to go home, blood pressure and recovery score were observed. The average induction cost was determined in group A and B. Results: After 30 minutes of reversal, the score of recovery in groups A and B were 8.90 ± 1.82 and 8.02 ± 1.01, correspondingly. The group B has significantly lesser cost (PKR 90.25±10.73) in comparison to the group A (PKR 700.0 ± 100.0) (p <0.05). Conclusions: Preoperative induction of oral midazolam and low doses of thiopental sodium is comparatively cost effective compared to induction of propofol in day-care surgical procedure. Keywords: Oral midazolam, Day care surgery, Propofol and Thiopental sodium.
Induction of Labour at 40 Weeks May Reduce Likelihood of Caesarean Section
Authors: Iqbal Saima , Bibi Razia , Hanif Sadia , Mehtab Aiman , . Nosheen , Afridi Nighat
Published: November 2022

Objective: Aim of current study is to determine either induction of labour at 40 weeks may reduce likelihood of cesarean section. Study Design: Controlled trial Place and Duration: Gynaecology and Obstetrics Department Combined Military Hospital Peshawar for the duration of six months from 1st Jan 2021 to 31st December 2021. Methods: Total 48 pregnant females of age 18-45 years were presented in this study. After receiving informed written consent, detailed demographic information about the enrolled cases; including age, parity, gestational age, level of education, and region of residence was collected. Frequency of cesarean section with respect to labour induction was calculated among all cases. SPSS 22.0 was used to analyze all data. Results: Among 48 cases, 28 (58.3%) had age 18-28 years, 15 (31.3%) patients had age 29-38 years and 5 (10.4%) cases had age >38 years. There were 26 (54.2%) patients with BMI <25kg/m2 and 22 (45.8%) with BMI >25kg/m2. There were 18 (37.5%) patients with gestational age 34-36 weeks, 16 (33.3%) patients with gestational age 37-38 weeks and 14 (29.2%) patients with gestational age 39-40 weeks. Frequency of cesarean section among all cases were 15 (31.3%) in which majority of the cases were from gestational age 34-36 weeks. There was no mortality found among mothers. Conclusion: In this study we found that labour induction at 40 weeks significantly reduce the frequency of cesarean section. There were benefits for the fetus and no increased risk of maternal death. Keywords: Pregnant patients, Labour Induction, C-section, Gestational age
A Study of Cancer of Ovaries among Women and it’s Linked with the Stem Cells present in Body: A Review
Authors: John Saira , Anthony Nickson Subeston , Bhatti Shees Bazr
Published: November 2022

Background: Ovarian cancer (OC) is the seventh most commonly diagnosed cancer among women in the world. A woman’s lifetime risk of developing OC is 1 in 75, and her chance of dying of the disease is 1 in 100.Cells which initiate cancer cells in the body are somehow known as stem cells. Objective: The objective of this review was to evaluate the published literature on epidemiologic risk factors for ovarian cancer among women and it’s linked with the stem cells present in the body. Material and methods: A review of literature search was conducted in PubMed and Scopus. Studies comparing ovarian cancer among women and its linked with the stem cells present in the body were included. Results: Eight of 94 articles met the inclusion criteria. The articles revealed that there are no rules to separate out the cells which are spreading tumor cells or in short from this research they said that we are not able to separate them out but we can clarify the issue that either they are spreading this deadly disease or not. Stem cells are not linked with ovarian cancer. Conclusion: It is concluded that phonetically both cancer cells and stem cells are not same. They are showing their opposite impacts. In this study we have seen that first they initiate from a single cell and then start replicating and make groups. There are many other ways through which tumor cells can generate themselves so it is not easy to say that they are growing from stem cells. Keywords: Ovarian cancer, Stem cells and Women
Determination of association between different Risk Factors & Cardiac Anomalies with Stroke among Adults
Authors: John Saira , Anthony Nickson Subeston , Siddique Parveen
Published: November 2022

Background: There is presence of different risk factors for cerebrovascular complication as well as coronary artery. It is well acknowledged that diseases of the coronary artery enhance the stroke risk. In opposition to this, there is variation in the prevalence of these risk factors across ischemic stroke and disease of coronary artery as well as between the sub-types of stoke because of highly complicate etiology. Objective: The objective of this research work was to determine different risk factors and cardiac anomalies, which have association with the incidence of stroke among adults. Methodology: Study Design: This cross sectional study design. Place and Duration: Medicine Department of Services Hospital, Lahore from November 2020 to May 2022. Adult patients having age from fifteen to forty-five years of age who got admission in hospital due to occurrence of stroke were the samples of this research work. Results: Among the participants, most of the patients were in age group of 41-45 years making 36 percent of whole strength. The percentages of the patients in age groups 26-30, 31-35 and 36-40 years were 18%, 20% and 22% correspondingly. Only four percent patients were having less than twenty-five years of age. Sixty-four percent patients were suffering from VHD (Valvular Heart Disease). Myocardial infarction was present in sixteen percent patients. Eight percent patients were present with atrial fibrillation and ten percent patients were present with IHD (ischemic heart disease). The risk equation of Framingham heart study discovered that seventy five percent patients of stroke were also having some types of cardiac complications. Conclusion: Diseases of hearts among adults can result in stroke that is severe abnormality and requires to be handled meticulously. One leading cause of disability and mortality is stroke. Ischemic strokes among adults are likely to be related with heart than cerebral when there is unknown exact cause of complication. Keywords: Ischemic, complication, meticulously, determine, occurrence, VHD, ISHD, cardiac, risk factors.
Nutritional Status of Children Under the Age of Five Years in Pakistan
Authors: Mahmood Zahid , Ghaffar Junaid , Mahmood Khalid , Uzair Muhammad , Farrukh Riffat , Masood Shaheen
Published: November 2022

Background: Malnutrition has become quite common among children especially in rural areas of Pakistan. The nutritional status of children under the age of five was assessed and the degree of malnutrition and its associated factors were studied. The socioeconomic status, delayed weaning and lack of education of parents are some of the key reasons of malnutrition in case of children. Objectives: This study aimed to analyze the nutritional status of children under the age of five years in Pakistan Study design: This is a cross-sectional study conducted on 250 children that visited the tertiary care center Shaikh Zayed Hospital, Rahim Yar Khan and Abbasi Shaheed Hospital, Karachi from May 2021 to April 2022.The study duration was one year. Materials and methods: The data was taken from 250 children, among these there were 147 boys and 103 girls. Written consent was taken from the parents, and they were fully aware of the study. The children were selected as per Non-probability convenient sample method. The physical growth and nutritional condition was evaluated by making use of basic anthropometric technique. A semi-structured questionnaire was prepared and face to face interview was carried out with the mothers of the children. SPSS version 16 was used for calculations and statistical analysis was done by using the same software. Results: Out of 250 children that were included in the study, 147 were boys and 103 were girls. By using the Gomez classification, the degree of malnutrition was analyzed among the children. It was observed that 150 children were facing malnutrition. 28% of the cases had first degree malnutrition, 14% and 17% had second and third degree condition. Stunted growth was observed in 130 children. There were 285 children with mild stunted growth; however 8% and 11% had moderate and severe form of stunted growth problem. Lack of education of mothers was seen to be directly linked with malnutrition in this study. Conclusion: Health education about proper breast feeding and immunization of children should be provided to the parents to prevent malnutrition among children. Keywords: Nutritional status, Risk factors, Child, Malnutrition
Histological Type and Tumor Site of Gastric Cancer; Helicobacter Pylori, Vitamin C and E, Sodium Intake and Smoking as a Risk Factor of Gastric Cancer
Authors: Alam Shaista , Daud Fatima , Khan Mohibullah , Sarwar Nayab , Roghani Asfandyar Shah , Sarwar Adnan , Tariq Kalsoom , Ali Sajid , Bangash Sudhair Abbas
Published: November 2022

Introduction: Stomach bacteria Helicobacter pylori (H. pylori) & diet are peril variables that are most strongly linked to gastric cancer. Using a case-control research of hospital, this research analyzed whether the H. pylori, vitamin C and E, sodium intake and smoking play any role as a risk factor of gastric cancer. Methodology: There were 207 cases and 410 controls in this research. Preference of taste of salt was evaluated for all participants, IgG antibodies were used against H. pylori to ascertain infection, and questionnaires consisting of questions about gastric cancer & its potential risk factors were administered to cases & control. Statistical analyses were used to calculate measures of risk. Results: At intervals of 1.7-7.3 g/l & 7.2 g/l salt taste percentage was significantly greater in cases than controls (2.12- 4.11), Individuals who consume a lot of salt are more likely to get stomach cancer when they have H. pylori infection. The varied salt intake measurements were significantly modified by tumor site & smoking; the highest salt taste was correlated with inflated chance of developing cancer in people who have never smoked or who have non-cardia malignancies. Conclusion: Salt or sodium intake, smoking, drinking and H. pylori infection is the risk factors for gastric cancer while no evidence of vitamin C intake as a risk factor of gastric cancer was observed. Keywords: gastric cancer, H. pylori, tumor, risk factor, diet intake
Proportion of Type 2 Diabetes Mellitus Patients with Hypoglycemia
Authors: Ali Baber , Sarwar Muhammad Umair , Hameed Sarah , Bashir Junaid , Hussain Syed Imad , Ashraf Asma
Published: November 2022

Objective: The purpose of this particular study is to examine the incidence of hypoglycemia in people who have diabetes type 2. Study Design: Cross-sectional Place and Duration: In the department of Medicine/ Endocrinology of Allied Hospital, Faisalabad for the duration from November 2021 to April 2022. Methods: Overall, 86 patients of both sexes were presented with type-2 diabetes mellitus. Among the patients were those as young as 18 and as old as 65. Before having their demographic information collected, participants signed a consent form indicating they had read the information and understood its importance. Whipple's triad questionnaire data were used to record the occurrence of hypoglycemia. Hypoglycemia symptoms were also documented. All data were analysed with SPSS 20.0. Results: All instances shared the most typical symptoms of dizziness, weakness, and sweating. In all cases, metformin was the most often used medication, followed by glynase and insulin. Among all, 43 (50%) patients diagnosed with hypoglycemia and majority were females. Eight of the 43 cases of hypoglycemia were extremely severe, seventeen were moderate, and eighteen were mild. Conclusion: The majority of the patients in this study were women from rural areas who were diagnosed with type 2 diabetes. Due to its prevalence, primary care physicians should inquire about hypoglycemia in all patients with diabetes. It is also important to teach patients how to recognise the signs of hypoglycemia and how to report them so that their dosage can be adjusted and further attacks can be prevented. Keywords: Glynase, Dizziness, Hypoglycemia, Type 2-diabetes Mellitus, Hypoglycemia
Comparison of Hemiarthroplasty and Total Hip Arthroplasty in Elderly Patients with Displaced Femoral Neck Fractures
Authors: Shafi Muhammad Kamran , Buzdar Muhammad Iqbal , Mahmood Shahid , Khan Mujtaba Afzal , Mubeen Faisal
Published: November 2022

Background and Aim: Hemiarthroplasty (HA) and total hip arthroplasty (THA) are the two alternate surgical interventions required for displaced femoral neck fractures in elderly patients. Though THA is superior in certain aspects such as hip pain, reoperation rate and function but had higher dislocation rate compared to HA. The present study aimed to compare the hemiarthroplasty and total hip arthroplasty in elderly patients with displaced femoral neck fractures. Patients and Methodology: This retrospective cohort study was conducted on 20 displaced femoral neck fractures patients in the Department of Orthopedic QAMC/ BVH Bahawalpur from January 2021 to August 2022. Prior to start of study, ethical approval was taken from the institute research and ethical committee. Written informed consent was obtained from each individual. Patients aged >60 years and had femoral neck fractures were enrolled. Rheumatoid arthritis in fracture hip patients, non-ambulatory patients, and pathological fracture patients were excluded. Patients were categorized into two groups; group-I patients undergoing hemiarthroplasty and group-II patients undergoing total hip arthroplasty. Post-operative complications such as fracture, medical issues, dislocation, surgical site infection, and mortality (1 year) were assessed in both groups. Harris Hip Score (HHS) was used for the assessment of function outcome at one month, three months, six months, and twelve months. SPSS version 25 was used for data analysis. Results: Of the total 20 femoral neck fractures patients, 10 patients underwent hemiarthroplasty and 10 underwent total hip arthroplasty. The overall mean age was 69.44±7.91 years. Demographic details or baseline features were almost similar in both groups. During follow-ups, patients who underwent total hip arthroplasty (group-II) had higher Harris hip score than group-I patients. The mean HHS score in group-I patients were 61.53, 68.24, 70.81, and 76.16 at follow-up visit after one month, three months, six months, and twelve months respectively while In group-II, the mean HHS score were 66.23, 69.82, 73.25, and 78.92 respectively. Conclusion: Our study concluded that total hip arthroplasty in elder patients with femoral neck fractures provided better hip functional outcome and lower morbidity and mortality as compared to hemiarthroplasty group. THA could be considered as priority based treatment modality for femoral neck fractures patients than HA due to higher Harris hip scores and lesser complications. Keywords: Femoral neck fractures, Hemiarthroplasty, Total hip arthroplasty
Factors Linked With an Increased Risk of Death in Patients with Covid-19
Authors: Salman Muhammad , Hameed Sarah , Hashim Husnain , Sayed Tahir Mukhtar , Ashraf Asma , Hussain Syed Imad
Published: November 2022

Objective: The purpose of this study was to determine the factors that increase a patient's chances of death from COVID-19. Study Design: Retrospective study Place and Duration: Medicine department of Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH), Rawalpindi during the period from November 2021 to April 2022. Methods: Total 142 patients of both genders of confirmed coronavirus disease were included. After receiving informed written consent from each participant, detailed demographic information was obtained. This information included the participant's age, gender, body mass index, and list of co-morbidities. Frequency of mortality and factors that increase a patient's chances of death were recorded. SPSS 24.0 was used to analyze all data. Results: We found that 87 (61.3%) cases were males and 55 (38.7%) patients were females. Majority of the patients 53 (37.3%) had age >45 years. 65 (45.8%) patients were smokers. Severity of disease was found in 76 (53.5%) cases. There were 95 (66.9%) patients had hypertension, diabetes mellitus found in 75 (52.8%) cases, cardiovascular disease in 48 (33.8%) cases, pulmonary disease in 40 (28.2%) cases and chronic kidney disease in 34 (23.9%) cases. Among 142 patients, 27 (19.01%) patients were died. Among non-survivals, kidney dysfunction was the most common reason found in 17 cases, followed by cardiovascular and diabetes mellitus. Conclusion: We came to the conclusion that clinical risk factors for a fatal consequences associated with coronavirus include chronic chronic conditions, complications, and demographic variables. These risk factors include acute renal injury, diabetes, hypertension, heart disease, male sex, older age, current smoker, and obesity. The findings might be used to future study on the disease as well as its control and prevention. Keywords: Coronavirus, Comorbidities, Mortality, Severity
Frequency, Distribution and Determinants of Obesity
Authors: Khan Salman , Haq Moeen-Ul- , Badshah Umar , Essa Muhammad Asghar , . Roya , Shafique Muhammad
Published: November 2022

Objective: Obesity is the state of the body where weight of the individual is high as compared to his/her weight. It is taken with reference to body mass index according to WHO. In this study we are going to determine the frequency, distribution and determinants of obesity in a selected area. Study Design: A cross sectional study Place and Duration: Gomal Medical College, D.I.Khan, Pakistan. 16/08/2020 to 20/05/2020 Material and Results: Out of 206 subjects, 18 (8.73%, 90% CI 5.47-11.93%) were obese, while 188 (91.3%, 90% CI 88.07-94.53%) were non obese. There is no association between obesity and sex, obesity and age groups and obesity and occupation in our population. Conclusion: The frequency of obesity was significantly less in our population than the other national and international studies. The proportion of obese men in our study is more than expected values from literature and the reverse is true for women. The proportion of obese persons in age group 19-39 years in our study is more than the expected values from literature and the reverse is true for the age group of 40-59 years. The proportion of obese office workers in our study is same as in other studies and the same is true for obese physical workers. There is no association between obesity and sex, obesity and age groups and obesity and occupation in our population. Keywords: Obesity, Obese, Healthy.