bluuebunny/crossref_metadata_2025 huggingface dataset:
Gel-permeation chromatography as a method for monitoring transformations of heavy petroleum fractions during secondary oil refining
Authors: Prudnikova E. V. , Dyachkova S. G. , Artemeva Zh. N.
Published: August 2021

A rapid and easy to use method for monitoring transformations of heavy oil fractions during secondary processes of oil refining is proposed. The method is based on the study of changes in the molecular weight characteristics by gel-permeation chromatography (GPC) using a refractometric detector. Optimal conditions for registration of the chromatograms (temperature, eluent consumption and its composition) were specified. Heptane, toluene, and toluene added with 1% and 5% of methanol were studied as eluents, the polarity indices being arranged in a series 0.2; 2.4; 2.43; 2.54. The effect of the nature of the solvent on the type of the product chromatogram is determined. It is shown that addition of a polar solvent to a nonpolar one increases the polarity index, reduces both the degree of association of petroleum molecules and adsorption on the gel. The most available toluene which meets the GPC requirements is chosen as an eluent. Addition of 1% CH3OH to the eluent promotes suppression of polyelectrolyte effects and adsorption. The revealed absence of the dependence of the retained volume and the type of chromatograms on the eluent flow rate and temperature indicates that separation is carried out under conditions of exclusion and completely obeys the theory of exclusive liquid chromatography. The transformation of raw materials during a technological process of oil production at the JSC «ANKhK» was studied using the GPC method under above-mentioned chromatographic conditions. We have studied vacuum distillate of the primary oil refining unit ELOU+AVT-6 (VD) and the product of hydrocracking of the vacuum distillate of the 123PM unit (HVD). It is shown that determination of the molecular weight characteristics provides an important information about the behavior of technological processes. The HVD meets the requirements for hydrocracking products. A decrease in the content of aromatic hydrocarbons in comparison with the raw feedstock is proved by the data of thin layer chromatography (TLC).
Evaluation of Young’s modulus of construction materials by instrumented indentation using a ball indenter
Authors: Matyunin V. M. , Marchenkov A. Yu. , Abusaif N. , Goryachkina M. V. , Rodyakina R. V. , Karimbekov M. A. , Zhgut D. A.
Published: August 2021

Methods for evaluation of Young’s modulus (Em) of structural materials by instrumented indentation using ball indenter have been considered. All these techniques are based on the solution of elastic contact problems performed by H. Hertz. It has been shown that registration of the initial elastic region in the «load – displacement» indentation diagram provides the Em determination for metals and alloys. However, it is necessary to evaluate accurately the elastic compliance of a device, to use an indenter with a large radius R, and ensure a high surface quality of the test material in advance. Methods for Em determation, when indentation diagrams are recorded in the elastoplastic indentation region, should include the effect of plastic deformation on the elastic displacement calculated by H. Hertz expression. However, it appeared essential to determine the relation between the elastic αel and plastic h components of the total elastoplastic displacement α and the elastic displacement α0 estimated by H. Hertz expression for a definite indentation load. A close correlation between α0 and αel is revealed for steels, aluminum, magnesium, and titanium alloys when using indenters with a radius of R = 0.2 – 5 mm (diameter D = 0.4 – 10 mm) and maximum indentation load Fmax = 47 – 29430 N (4.8 – 3000 kgf). It is also shown that a gradual decrease in Em is observed with an increase in R(D) at the same degree of loading F/D2 for the same material. This fact was explained by the scale factor effect.
Association Between Perceived Academic Stress And Suicide Behavior Among College Students From Pernambuco
Authors:   1,2,4,5UFPE,   3FUNESO
Published: August 2021

OBJECTIVES: To verify whether there is an association between perceived academic stress and suicidal behavior in young people in the university community. METHOD: Cross-sectional study approved by ethics committee (n°2,581,563), with a sample of 609 undergraduates from the Federal University of Pernambuco from: health, human sciences and exact sciences from 17 to 50 years. For the collection, we used: Mini International Neuropsychiatric Interview, Questionnaire of Academic Experiences reduced version, and a sociodemographic questionnaire. The data were tabulated in the SPSS program in version 21.0. Descriptive and inferential statistical techniques were used for analysis, considering a significance level of 5%. RESULTS: Of the sociodemographic data, 34.6% (n=211) were in the age group of 21 to 23 years, the majority were female, 64.5% (n=393). There was a significant difference in economic organization, the university students of human sciences presented lower per capita family income than health students (p<0.001). There was an association between perceived academic stress and suicidal behavior, specifically for ideation (p< 0.001) and suicide attempt (p< 0.001). Suicidal ideation was present in 44.2% of those who suffer academic stress, and only present in 24% who did not report academic stress. 15.5% of students with academic stress reported previous suicide attempt, while 4.2% of students without academic stress reported attempting at some point in their lives. CONCLUSION: There was an association between perceived academic stress and suicidal behavior. The data reveal the vulnerability of this group to risk behaviors where academic pressure can intensify such behaviors, and these should be investigated throughout the university segment.
A Model Proposal to Address Relationships Between Epistemic Practices and Socioscientific Issues in Science Education
Authors: Ramos Tatiana Costa , Mendonça Paula Cristina Cardoso
Published: August 2021

In this paper, we present a model that relates epistemic practices and socio-scientific issues (SSI) in science education. In order to develop it, we establish interweavings between norms, practices, epistemic objectives, epistemic cognition, informal reasoning, epistemic practices and justified positioning. We suggest that epistemic cognition is the link between reasoning and epistemic practices. We present three epistemic goals that should guide work with epistemic practices when solving a SSI: recognising and using multiple lines of reasoning when solving the SSI, construction and evaluation of holistic arguments aiming to understand the multiple dimensions of the SSI and the development of sceptical investigations to resolve the SSI. The stated objectives contribute to the critical assessment and resolution of the SSI. We believe that for the construction of social norms in teaching environments with SSI, it should be considered that these questions do not require a “single” answer and, therefore, a space for reflection, awareness and justification of the different perspectives on the question must be allowed. The relationships established in this article contribute to research that aims to develop and analyse epistemic practices “in situ” in teaching contexts with SSI. In addition, they have the potential to provide support to teachers who wish to favour the occurrence of epistemic practices in a SSI approach.
IMPACT OF AI IN INTERNET OF MEDICAL THINGS FOR HEALTH CARE DELIVERY
Authors: NATHANI NEETA , Hasan Zohaib
Published: August 2021

The Internet of Things (IoT) is a network of wireless, interconnected, and networked digital devices that can gather, send, and store data without the need for human or computer interaction. The Internet of Things has a lot of promise for expediting and improving health care delivery by proactively predicting health issues and diagnosing, treating, and monitoring patients both in and out of the hospital. Understanding how established and emerging IoT technologies may help health systems deliver safe and effective treatment is becoming increasingly critical. The purpose of this viewpoint paper is to present an overview of existing IoT technology in health care, as well as to describe how IoT devices are improving health service delivery and how IoT technology can alter and disrupt global healthcare in the next decade. The promise of IoT-based health care is explored further to theorize how IoT can increase access to preventative public health services and help us migrate from our existing secondary and tertiary health care systems to a more proactive, continuous, and integrated approach. The intersection of the Internet of Medical Things (IoMT) for patient monitoring and chronic care management and the use of Artificial Intelligence (AI) is becoming more promising than ever as the adoption of telemedicine continues to grow dramatically. Connected devices generate huge volumes of data based on real-time measurements of patient vitals, which is delivered to cloud-based applications that are monitored by medical specialists in virtual contact centres. The policy is applied per-patient, and healthcare providers receive warnings and messages when a patient's heart rate, oxygen level, glucose level, blood pressure, or other measurement reaches a set threshold. Depending on the sort of telemedicine and telehealth platforms in use, this data is tracked and acted upon by specialists who monitor many patients for many different practices, and in other circumstances, this data is sent directly to the provider. AI in healthcare, as well as other crucial technologies are essential for resolving the issue and producing future prosperity.
methodological strategy in foreign language teaching through artistic creations with seeds
Authors: Proaño Proaño Eugenia del Pilar , Muñoz Ernesto , Ferigra Maria Rosa
Published: August 2021

After using for years many traditional didactic materials in the EFL classroom, it was experienced with something different taken from nature; seeds from fruit and other plants in order to create with them forms of art and uncover from the students their talents and capacities. Seeds are mainly disposed as garbage, but they constitute a marvelous resource that is close to our hands. A big storage was collected and given to the students of third level of English at Universidad Técnica del Norte so that they can propose new images and generate original ideas based on them in their spoken and written texts. The seeds’ forms, colors, sizes and texture captivated the students who created with them original and creative designs. This is a simple classroom project that has delighted many students.
Review: Making sense of Bad English
Authors: Padilla Alexander
Published: August 2021

To recognize what is or what is not the good use of English, language scientist have disposed the official term “Standard English”. If so, what does this term really means? and what were the conditions and bounds where this term was created? and in consequence, who are the people that really speak on this strict way? This book discusses through an anthropological and linguistic way the term “Good English”. Thus, in general words the author will discuss: How can somebody know whether his use of English is good or bad? What are the causes of such distinction (good/bad) in real practices using this language? Moreover, the specific objective beyond the common negative answer about the not standardized English, this book will offer an explanation from the social, cultural and historical facts about the meaning of being an English user in different parts of the world.
cyberbullying en los adolescentes y su incremento por las nuevas tecnologías
Authors: Bastidas Velandia Miguel Angel Bastidas Velandia , Bazurto Sebastian , Bedoya Nicolas , Barrionuevo Nicolas , Artos Steven
Published: August 2021

Actualmente el mundo entero está viviendo una pandemia ocasionada por el virus Covid – 19, motivo por el cual varios aspectos de la vida cotidiana se vieron afectados, uno de ellos, la educación, la cual cambió de ser presencial a ser tomada en línea llevando consigo problemas del mundo físico, en este caso el bullying, al mundo digital, dando lugar al cyberbullying. En esta problemática social los más vulnerables son los adolescentes, quienes al ser victimizados por un agresor presentan varias consecuencias negativas en varios aspectos de su vida, motivo por el cual se realizó la presente investigación, cuyo objetivo principal es identificar cuáles son las consecuencias del cyberbullying en los adolescentes, para así, presentar posibles soluciones a esta forma de acoso, conocer el porcentaje de víctimas de ciberbullying dentro de la población analizada y si esta tiene conocimiento acerca de la misma. La presente investigación tiene carácter cualitativo, y la herramienta de recolección de datos implementada fue la encuesta hacia una muestra de 186 estudiantes pertenecientes a unidades educativas de Quito – Ecuador. Mediante las encuestas se pudo registrar que 86% de la muestra analizada tiene conocimiento acerca del cyberbullying, el resto tiene una idea vaga o no sabe nada al respecto, así también se pudo reconocer que 22,6% de la muestra ha sufrido de cyberbullying, que a pesar de ser un porcentaje bajo indica que si hay casos existentes y entre otras situaciones que se pudieron corroborar con la herramienta de recolección de datos. De manera que, mediante la aplicación de la encuesta y el respaldo de un marco teórico estructurado se concluyó que las principales consecuencias del cyberbullying son emocionales (comportamiento), académicas (desempeño en los estudios) y sociales (relaciones interpersonales).
Clases virtuales y su efecto en el estado fisico y mental de los estudiantes universitarios
Authors: Arias Paul Arias , Armas Erazo Anahí , Arévalo Peruano Alexis , Andrade Calle Henry
Published: August 2021

El dolor físico causado por la mala ergonomía en clases virtuales en tiempos de epidemia nos ha dificultado algunos estudiantes. La siguiente investigación realizada a los estudiantes de la ESPE de primer y segundo grado muestra que los malos hábitos alimenticios y muy poco ejercicio físico no son porque no somos conscientes de esto, sino por el simple hecho de que no tenemos buenos hábitos, si practicaramos buenos hábitos nuestro cuerpo nos recompensará.

Los buenos hábitos se generan en ser mejor cada día es decir si se quiere tener una vida plena sin ninguna molestia o malestar por algún síntoma nosotros debemos cuidar nuestro cuerpo, en esta investigación veremos una serie de recomendaciones que ayudará a evitar esos posibles problemas y que mejor cura que es la prevención, a base de ejercicios una buena alimentación y meditación con resultados comprobados.

Mejorando nuestro cuerpo libre de molestias también tendremos recompensas psicológicas ya que nos sentiremos bien con nosotros mismos nuestro cuerpo se hará más ligero tendremos más energía rendiremos mejor en la universidad sus efectos colaterales nos beneficiaran en la gran mayoría, sin embargo la investigación nos demuestra que para que ocurra eso nos falta grandes cambios de disciplina y constancia en un estudiante promedio.
Factors that motivate ecuadorian public school english teachers to code-switch in the english as foreign language classroom
Authors: Intriago Alcivar Wellintong Segundo , Hidalgo Delia
Published: August 2021

Code-switching is a sociolinguistic phenomenon that usually occurs in bilingual or multilingual communities. Regarding English Language teaching contexts, it seems that code-switching also occurs in EFL classrooms. Therefore, this paper attempts to find out and describe the factors that motivate Ecuadorian English teachers to code-switch as well as establish the foundation for further researches about the code-switching effect and the role that L1 should play in the EFL classroom. This descriptive, combined, and ethnographic research gathered data through a surveys compound by 6 questions framing the Likert scale, which were answered by 17 Ecuadorian English teachers. The results show that the factors that motivate them to code-switch are related to pedagogical and affective purposes; nevertheless, it seems that its usage is neither planned nor applied to get pedagogical purposes that let them know how and when code-switching might enhance the SLA process.
visualización lírica de canciones y sus repercusiones en la enseñanza de inglés como lengua extranjera
Authors: Lizaldes Orlando
Published: August 2021

El propósito de la siguiente investigación se encamina en dos direcciones: primera, determinar en qué aspectos didácticos influye la Visualización Lírica de Canciones (VLC) en el aprendizaje de Inglés como Lengua Extranjera (ILE) y segunda, proponerla como estrategia pedagógica a ser incluida en el aula de ILE. Para lograr estos propósitos, 76 estudiantes del Instituto de Idiomas de la Universidad Nacional de Loja en Ecuador fueron observados y expuestos a la técnica durante un semestre académico y encuestados al final del proceso de aplicación. 38 estudiantes fueron parte del grupo control y 38 se expusieron al desarrollo directo de la misma como parte del grupo experimental. Se recogieron datos de percepción de los participantes sobre los efectos que la música produce en su aprendizaje a través de una encuesta y en una ficha de observación dicotómica para analizar la correlación de las variables para una muestra reducida en función de la  motivación.  El  estudio  revela  que,  ante  la exposición musical y el input perceptivo, la motivación estudiantil mejora considerablemente y el miedo a la mala pronunciación disminuye ampliamente. Finalmente se observó que las capacidades nemónicas de los expuestos mejoran considerablemente y se confirma la incidencia causal entre variables.
Developing english as a foreign language (EFL) teacher’s identity
Authors: Ramírez Basantes Raúl Sebastián
Published: August 2021

Early teaching and student experiences act as cultural references for English as a Foreign Language teachers. Tools and strategies are articulated in the form of roles, which are constantly tested and negotiated within the classroom, modeling the EFL teacher’s identity. The following is a case study on three EFL teacher’s identity development from the Pontificia Universidad Católica del Ecuador. The presence of roles related to EFL teaching was identified through a semi-participant observation and compiled in an observation grid. Observed tools and strategies origin was deepened in the transcription of interviews based on life stories, using a biographical methodology. The use of Socializing / Empathizing skills from the Acculturator role were present in codeswitch using an Ecuadorian pitch, aimed to deal with emotional transactions in the class successfully. Previous working experiences allowed teachers to find strategies to incorporate EFL teaching roles with low emotional labor. Role models from the family and working context played a crucial role in the integration of emotional tools to negotiate roles within the class with low emotional labor.
الفاصلة القرآنية وأثرها في تحولات الخطاب القرآني في قصتي إبراهيم وموسى (عليهما السلام)
Authors: خفيف هبة كامل , عبد عقيل عكموش
Published: August 2021

فتدور فكرة هذا البحث في الكشف عن أثر الفاصلة القرآنية في تحولات الخطاب القرآني في قصتي إبراهيم وموسى- عليهما السلام-, إذ أن القرآن الكريم لا سيما في قصصه يحرص على التقيد بنظامه الإيقاعي التنغيمي, فإذا كان هناك إيقاع موسيقي في الآيات فاللفظة المنتقاة تأتي لتؤدي معنى في السياق وتؤدي تناسباً في الإيقاع من دون أن يطغى هذا على ذاك, أو يخضع النظم للضرورات. وجاء التنوع في الفاصلة القرآنية مراعياً أمرين أحدهما؛ الانسجام الصوتي والإيقاعي  للألفاظ, والآخر؛ المعنى والسياق, إذ لم يكن القرآن الكريم يعنى بالفاصلة  على حساب المعنى أو السياق (مقتضى الحال) بل يختار الفاصلة مراعياً فيها المعنى والسياق والجرس الموسيقي للألفاظ , وكذلك مراعيا فيها خواتم الآي, وجو السورة والمحيط الخارجي فيها.

أما خطة البحث فتضمنت توطئة في  مصطلح الفاصلة القرآنية في القرآن الكريم ,وثلاث فقرات فكانت كالآتي:- أولاً:-التقديم والتأخير     ثانياً:-الحذف            ثالثاً:-التغاير بين الاسم والفعل
Prototype Sistem Pakan Ikan dan Pemantauan PH Berbasis Android dengan Metode PLC
Authors: Oktaviani Maria Rosaria , Rizky Pradana
Published: August 2021

Abstract

During the pandemic of covid-19, betta fish cultivation is one of the income alternatives. It makes the cultivation of betta fish is increasing. However, not all cultivators can successfully cultivate betta fish. Water quality and fish feed must be maintained in order for betta fish can grow perfectly and attractive. The problems that often encountered to the betta fish cultivator is about feeding and monitoring pH levels, which is still manual. This is can failure in betta fish cultivation of the cultivators are not disciplined. To minimize it, then will be made “Prototype Fish Feeding System and PH Monitoring Based Android”. This research is used PLC method: (a) Requirements Analysis, (b) Design, and (c) Implementation. Divided into 2 functions: Automatic Betta Fish Feeding System Based Android Function using Node MCU ESP8266 and Monitoring PH Levels Function using Arduino Uno. The result from this research is the user can control the open and close feed on the servo through an android application, the system can provide a distance of the feed supply to a user in real-time by notifications, the LCD always display pH value, the buzzer provides a sound when the water quality has reached the acid or alkaline index.
Comparison of Bupivacaine injection versus normal saline in port sites & intraperitoneal spray for postoperative pain in laparoscopic cholecystectomy.
Authors:   Shaikh Zayed Hospital, Lahore., Ali Syed Mehmood , Shuja Hajra ,   Jinnah Hospital, Lahore., Adil Mehak ,   RHC, Sukhekhi Mandi, Hafizabad., Bokhari Sadaf ,   Shaikh Zayed Hospital, Lahore.
Published: August 2021

Objective: To compare mean pain using bupivacaine injection versus normal saline in port sites & intraperitoneal spray in laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, Shaikh Zayed Hospital, Lahore. Period: October 2, 2018 to April 2, 2019. Material & Methods: Laparoscopic cholecystectomy patients were allocated to obtain either bupivacaine 0.25% or regular saline (N / S) randomly by lottery method. In bupivacaine group-A, 15ml 8of 0.25% bupivacaine spray on gall bladder bed, dissection surface and in ports area after surgery. In normal saline group-B received 15 ml of normal saline in the same area and ports after surgery. Pain was measured on VAS as per operational definition. All the data was entered with SPSS v25.0 and analyzed. A t-test study was used to evaluate the mean pain for both groups at 24th hours. In order to address the effect modifiers, the data was stratified for age, gender, and BMI (obese, non-obese). The independent t-test sample after stratification was used taking p-value 0.05 as relevant. Results: A total of 60 patients were included for elective laparoscopic cholecystectomy. In group-A, mean pain score was 3.33±0.81 and 4.37±1.16 in group-B, which is statistically significant with a p-value of 0.0002. Conclusion: This study demonstrates that bupivacaine spray at the surgical bed and in ports site in elective laparoscopic cholecystectomy result in significant lowering of the intensity of postoperative abdominal and shoulder pain.
Predictive significance of first trimester serum uric acid as risk factor for the gestational diabetes mellitus.
Authors:   Shaheed Muhtrama Benazir Bhutto Medical College, Layari General Hospital Karachi, Sindh, Pakistan., Rehman Anjum , Saeed Sadia ,   Hamdard Medical University, Karachi, Sindh, Pakistan., Hasny Syeda Fariha ,   Dow University of Health Sciences, Karachi, Sindh, Pakistan., Maheshwari Nathumal ,   Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital Karachi, Sindh, Pakistan., Tabassum Urooj ,   Dow University of Health Sciences., Ali Arshad ,   Karachi Institute of Medical Sciences, Malir Cantonment, Karachi, Sindh, Pakistan.
Published: August 2021

Objective: Determining the predictive significance of first trimester serum uric acid for the development of gestational diabetes mellitus (GDM) in pregnant women. Study Design: Case Control study. Setting: Department Gynecology and Obstetrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital Karachi. Period: March 2017 to December 2018. Material & Methods: Sample of 172 pregnant women in first trimester (<14 weeks gestation) were divided into; 72 controls and 72 cases through purposive sampling. Pregnant women with fasting blood glucose (FBG) ≥100 mg/dl were defined as GDM. FBG was estimated by hexokinase and uric acid by enzymatic method (uricase) using commercial colorimetric assay (Nikken Seal Co., Ltd, Japan). Data was analyzed on SPSS software 21.0 (IBM, Inc USA) at 95% CI. Results: Maternal age of control and cases was noted 30.23±1.47 and 30.14±1.41 years. Gestational age in controls was 9.80±2.23 weeks compared to 10.37±2.34 weeks in cases. Serum Uric acid in control was 3.19±0.49 mg/dl compared to 3.73±0.43 mg/dl in cases (P=0.0001). Logistic regression analysis model generated ROC curve shows excellent area under the curve (AUC) of 0.92 [95% CI (0.87-0.97)] with a diagnostic threshold of 3.91 mg/dl for uric acid. At this Uric acid threshold, the specificity and sensitivity was 96.4% and 69.7% respectively (P=0.0001). Conclusion: It is concluded first trimester serum uric acid may be used for predicting the future development of gestational diabetes mellitus.
Frequencies, sensitivity pattern and molecular characterization of bacterial isolates in blood in neonatal sepsis.
Authors:   Sahara Medical College., Nabat ul Hassan Saeeda , Bhutta Ghulam Asghar ,   Sahara Medical College Narowal., Farva Khushbu ,   Sahara Medical College.
Published: August 2021

Objective: To determine frequency, molecular characterization and sensitivity of bacterial isolates against commonly used antibiotics in neonatal sepsis. Study Design: Cross Sectional study. Setting: Department of Pathology Sahara Medical College Narowal. Period: October 2019 to March 2020. Material & Methods: Neonates admitted in neonatal intensive care unit (NICU) of study institution having signs and symptoms of neonatal symptoms such as fever, irritability, seizures, anorexia and lethargy, were included in the study using consecutive sampling technique. Blood sample from all study patients taken and sent for culture to determine bacterial isolates and antibiotic sensitivity against commonly used antibiotics for neonatal sepsis. Bacterial isolates identification was done using standard bacteriological technique performed by modified Kirby & Bauer disc diffuse method as per Clinical and Laboratory standards institute (CLSI) guidelines. Results: Total 200 cases were studied having neonatal sepsis and admitted in NICU including 58% female and 42% male children. Bacterial growth occurred in 10.5% samples and in 89.5% samples no bacterial growth seen. There were 1% samples with gram positive and 9.5% samples with gram negative bacterial isolates. Klebsiella was the commonest organism isolated in 38.1% cases out of total positive isolates. There were 72.5% neonates having age 1-14 days and 27.5% neonates having age 15-28 days. Conclusion: Gram negative bacteria are common cause of neonatal sepsis, out of which Klebsiella is the commonest organism. Antimicrobial drug resistance in different infections is a serious emerging issue.
Frequency of surgical complications and recurrence rate after extracapsular dissection of benign tumors of the parotid.
Authors:   Rawalpindi Medical University, Rawalpindi., Arham Muhammad , Khan Jahangir Sarwar ,   Holy Family Hospital, Rawalpindi., Arish Muhammad ,   Rawalpindi Medical University, Rawalpindi., Malik Naveed Akhtar ,   Holy Family Hospital, Rawalpindi., Qureshi Usman ,   Holy Family Hospital, Rawalpindi., Rasheed Gohar ,   Holy Family Hospital, Rawalpindi., Shafique Salman ,   Holy Family Hospital, Rawalpindi., Farooqi Sarosh Afzal ,   Holy Family Hospital, Rawalpindi.
Published: August 2021

Objective: To determine surgical complications and recurrence rate in patients with benign lesions of the parotid undergoing extracapsular dissection. Study Design: Case Series. Setting: Department of Surgery, Rawalpindi Medical University, Rawalpindi. Period: January 2010 and December 2018. Material & Methods: The hospital records of all 50 patients who underwent extracapsular dissection with a diagnosis of either Pleomorphic adenoma or War thin tumor between reviewed retrospectively. Data regarding demographics, tumor, complications and recurrence was collected. Results: Out of 50 patients, 40 were males and 10 were females with age ranging from 26 to 52 years and mean age of 42 years. 44 of 50 parotid lumps were diagnosed as Pleomorphic adenoma and 6 were cases of Warthin tumor. The range of lesion size was 1.5 to 3 cm. 15 (30%) patients suffered from transient facial nerve weakness, whereas only 1 (2%) sustained a facial nerve injury which required repair. There was no case of Frey syndrome, sialocele and hematoma, however, salivary fistula was seen in 1 (2%) patient. Capsule rupture during surgery occurred in 15 (30%) patients and recurrence was seen in only 1 patient (2%). Conclusion: Extracapsular dissection has low recurrence rate, very few complications and is a safe and effective treatment for Pleomorphic adenoma and Warthin tumor.
Complete heart blocks and in-hospital mortality after ST segment elevation myocardial infarction.
Authors:   Nawaz Sharif Medical College, University of Gujrat., Ali Muhammad Zahid , Younus Irfan ,   Nawaz Sharif Medical College, University of Gujrat., Yousuf Sohail ,   Punjab Institute of Cardiology, Lahore., Javed Muhammad ,   Nawaz Sharif Medical College, University of Gujrat., Iqbal Khalil ,   Nawaz Sharif Medical College, University of Gujrat., Altaf Faiza ,   Aziz Bhatti Shaheed Teaching Hospital, Gujrat.
Published: August 2021

Objective: To determine the frequency and in-hospital mortality of patients with complete heart blocks after STEMI. Study Design: Comparative Cross Sectional study. Study Setting: Department of Cardiology, Aziz Bhatti Shaheed Teaching Hospital, Nawaz Sharif Medical College, Gujrat. Period: January 2019 to December 2019. Material & Methods: Patients meeting selection criteria having age 35 to 65 of both genders with STEMI either thrombolysed or not were enrolled in the study after their informed consent, whereas patients with prior history of MI, PCI or CABG or patients with prior AV blocks were excluded from the study. All patients remained admitted and followed up for 3 to 4 days. Patients were evaluated by ECG for diagnosis of AV blocks. Two groups were made, one with and second without complete heart blocks. Incidence and mortality of CHB after STEMI noted. Data was analyzed with SPSS -23. Results: Out of167 patients, 103(61.6%) male, while 64(38.4%) were female. Mean age was 50.5+10. Patients with AWMI 85 (50.8%), IWMI 63(37.7%) and LWMI were 18(10.77%). Ten (5.9%) developed CHB. Two groups were made on the basis of presence or absence of CHB. In first group 7 out of 10 having CHB were expired, 2 discharged and one referred for permanent pacemaker or revascularization. In second group 23 (15%) expired out of 157, 110(70%) discharged while 24(15%) were referred for invasive management. Patients having IWMI (60%) developed CHB more as compared to anterior (20%) or lateral wall MI (20%). Mortality due to CHB complicating STEMI was 4.19% while overall mortality was 17.96% (30). Conclusion: Complete heart block is a known complication of patients with STEMI and is associated with poor prognosis. Thrombolytic agents were very useful in patients with STEMI for reversal of CHB in most of the patients.
Accelerated method of casting for correction of clubfoot applicable?
Authors:   The Children Hospital & The Institute of Child Health Lahore., Alam Farhad , Shahid Abdul Latif ,   The Children Hospital & The Institute of Child Health Lahore., Hussain Islam ,   The Children Hospital & The Institute of Child Health Lahore., Sami Abdul Latif ,   The Children Hospital & The Institute of Child Health Lahore.
Published: August 2021

Objective: To see the results of accelerated method against standard Ponseti method for correction of clubfoot by using Pirani scoring system. Study Design: Randomized controlled trial. Setting: Children’s hospital and the institute of child’s health, Lahore. Period: June 2019 Dec 2019. Material & Method: 100 patients included in this study and divided into two groups. In group A (50 patients) correction was done by standard Ponseti method while accelerated method was applied in group B(50 patients). Weekly serial casting was done in group A while twice weekly in group B. Assessment was done by Pirani scoring system in both groups at beginning of correction, at each cast and at end of correction. Results: Average casting time for group A was 38 days while it was 20 days in group B. Correction rate was 94% in group A and 89% in group B. This difference was not found to be statistically significant (p=0.396). Conclusion: Accelerated method is applicable for correction of clubfoot because treatment time is shorter and results are similar to standard Ponseti method. Hence, this method should be adopted in Pakistan so that poor and rural parents can easily manage travel and financial issues because only 2 to 3 weeks are required for whole casting treatment.
A rare case of obstructive supracardiac TAPVR (Total Anomalous Pulmonary Venous Return) with aberrant right subclavian artery.
Authors:   NICVD, Karachi., Rehman Fazal ur , Khan Sabiha ,   Govt. Shahbaz Sharif DHQ Hospital, Multan., Ali Waqas ,   Ghurki Trust Teaching Hospital, Lahore., Khuhro Asif Ali ,   Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana., Hussain Basharat ,   NICVD, Karachi., Ahmed Shakeel ,   NICVD, Karachi.
Published: August 2021

Congenital aortic arch malformations manifest a broad-spectrum of differences and abnormalities that come from disturbed embryogenesis of branchial arches. Current case was a 10 months old baby girl with length of 69 cm (less than –3 SD) and weight of 5.5 kg (less than –3 SD). The patient had history of recurrent lower respiratory tract infections since the time of birth and failure to gain adequate weight since the time of birth. The patient has been having multiple check-ups with registered medical practitioners in the nearby locality and multiple courses of antibiotics with only partial resolution of symptoms. The 2-D echocardiogram showed her to be a case of supracardiac type of “Total Anomalous Pulmonary Venous Return (TAPVR)”. All pulmonary veins making a confluence and draining into the right atrium. Significant turbulence observed at the level of superior vena cava to right atrium junction. A level of obstruction was recorded at the junction of the confluence of pulmonary veins and the vertical vein. There was aberrant right subclavian artery from the aortic arch as its third branch with no obstruction or aneurysm formation, having retrotracheal and esophageal course.
Human papilloma virus prevalence and its correlation with clinical presentation and histological grading in oral squamous cell carcinoma.
Authors:   Faculty of Dentistry & Allied Sciences, Isra University, Hyderabad., Ahmed Fahad , Shahid Hassan ,   Isra University, Hyderabad., Shafique Salman ,   Isra University, Hyderabad., Ahmed Aswad ,   Isra University, Hyderabad., Shaikh Alvina Ali ,   Isra University, Hyderabad., Ali Sheikh Sajjad ,   Dar us Sehat Hospital. Karachi.
Published: August 2021

Objectives: The objectives of this study were to determine the prevalence of Human Papilloma virus 16 in patients with oral squamous cell carcinoma presenting at Isra University Hospital and to correlate the existence of Human Papilloma virus 16 in squamous cell carcinoma with clinical presentation, habits and histological grading. Study Design: Interventional Study. Setting: Department of Oral Surgery, Isra Dental College Hospital. Period: July 2017 to December 2017. Material & Methods: A sample of 60 patients presenting were selected by non-probability purposive sampling. Patients reporting to Isra Dental College, Oral Surgery OPD Isra University during the study period with clinical suspicion of Oral Squamous Cell Carcinoma were included. Results: Age category was from 20 till 60+ years of age whereas age group of 40-49 (36.7%) was the most frequent age in the study population followed by 30-39 (30%) years and 50-59 (23.3%) years of age respectively. The mean and standard deviation was 43.35 ± 10.156 respectively. Maximum numbers of people were seen to have more than one habit i.e. they were using guthka with smoking or areca nut with guthka and smoking etc. areca nut, cigarette smoking and guthka were among the others most used. The mean was 6.32 with standard deviation of 2.954. Most of the patients had submucous fibrosis on the right side of buccal vestibule 24 (40%) and 22 (36.7%) had submucous fibrosis on the left side of buccal vestibule. 56 (93.3%) of the patients had well differentiated squamous cell carcinoma whereas 4 (6.7%) has moderately differentiated squamous cell carcinoma. No patients were seen to have poorly differentiated squamous cell carcinoma. Conclusion: In conclusion, the Prevalence of HPV 16 in our study was found to be 11.7%. There was no association between habits and histological grading with Human Papillomavirus 16 in patient with oral squamous cell carcinoma. But there was association between HPV16 and clinical presentation of OSCC because of p-value (.015) which was significant.
Antibacterial effect of Allium cepa (onion), Allium sativum (garlic), Azadirachta indica (neem) extract against different bacteria isolated from clinical sample.
Authors:   Sheikh Zayed Medical College Rahim Yar Khan., Hussain Muhammad Shahbaz , Ghafoor Muhammad Bilal ,   Sheikh Zayed Medical College Rahim Yar Khan., Cheema Umar Khalid ,   Sheikh Zayed Medical College Rahim Yar Khan., Sajjad Muhammad ,   Sheikh Zayed Medical College Rahim Yar Khan., Akhtar Muhammad Shoaib ,   Sheikh Zayed Medical College Rahim Yar Khan.
Published: August 2021

Objective: The objective of this study was to evaluate and screen the antibacterial activity of medicinal plant which were most cultivated in ancient time. Study Design: Experimental Study. Setting: Microbiology Section, Pathology Department, Sheikh Zayed Hospital/Medical College Rahim Yar Khan. Period: February 2019 to May 2019. Material & Methods: The fresh aqueous extract of garlic cloves (Allium sativum), onion bulb (Allium cepa) and neem (Azadirachta indica) leaves used against the clinically isolated Staphylococcus aureus(S.aureus), Escherichia coli (E.coli), Klebsiella, Acinetobacter and Pseudomonas species by using agar well diffusion method. Aqueous extract of used plant tested at different concentrations of 100%, 75%, 50%, 25%. Results: All these concentrations showed inhibitory effect towards Gram positive bacteria (S.aureus), while Gram negative bacteria more sensitive to higher concentration. In this analysis, on comparison we observed that fresh garlic juice extract was more efficient on all tested bacteria either Gram positive or Gram negative than other and give maximum zone of inhibition on S.aureus (40mm) due to their high chemistry. Gram negative bacteria mainly E. coli somehow resistant to onion and neem extract because they possess the ability to rapidly mutate their genetic makeup towards phytochemical compounds. Conclusion: The result of study also elicits that efficacy of fresh extract depends upon concentrations levels. The plant showed maximum zone of inhibition at 100% than at 25% because on higher level they contain higher bioactive compounds.
Effectiveness of laparoscopy in management of patients with penetrating and blunt abdominal trauma.
Authors:   Rawalpindi Medical University., Rashid Sajid
Published: August 2021

Objectives: To study the role of laparoscopy in reducing the incidence of non-therapeutic Laparotomies in abdominal trauma, and management of penetrating (PAT) and blunt (BAT) abdominal trauma. Study Design: Prospective Experimental study. Setting: Department of Surgery DHQ Hospital Rawalpindi. Period: January 2018 to June 2018. Material & Methods: All Patients (n=50) were admitted through emergency and were allocated to one of two groups Laparoscopy or Laparotomy group (25 in each) by lottery method according to the inclusion criteria of haemodynamically stable patients with systolic BP>90 mm of Hg. Patients in the Laparotomy group were managed according to the conventional protocol and decision of laparotomy was based on clinical examination, imaging and laboratory investigations. Where as in Laparoscopy group after clinical examination and chemical labortary. Reports diagnostic laparoscopy (screening tool) was done to identify injuries and decide whether patient needs laparotomy or not. Forward viewing 0 degree 10 mm laparoscope was used in all the cases following standard protocols for laparoscopy. Data analysis was done by SPSS 20. P-Value was set at 0.05. Results: Out of total 50 selected haemodynamically stable abdominal trauma patients (n=50) there were 77% males and 23% females. Average age of the patients was 37 years. Overall out of total of 50 patients 30 (60%) patients presented with PAT and 20 (40%) patients presented with BAT. Diagnostic laparoscopy was able to identify abdominal injuries in 96% (24 out of 25) patients. There were no missed injuries in both groups. Similarly there were no non-therapeutic laparotomies in Laparoscopy group where as in Laparotomy group 6 (24%) non-therapeutic laparotomies were done. Conclusion: Laparoscopy reduces the incidence of non-therapeutic laparotomies and missed injuries. It correctly identifies the injuries depending upon the experience of surgeon in selected stable trauma patients.
Frequency of cusp of carabelli in maxillary permanent first molars and its association with dental caries in patients visiting Peshawar Dental Hospital, Peshawar.
Authors:   Peshawar Dental College Peshawar., Arbab Sana , Khattak Munawar Aziz ,   Peshawar Dental College Peshawar., Shah Syed Amjad ,   Peshawar Dental College Peshawar.
Published: August 2021

Objective: To find out the frequency of cusp of Carabelli and its association with dental caries in maxillary permanent first molars in both male and female patients of Peshawar. Study Design: Cross Sectional Study. Setting: OPD of Peshawar Dental Hospital, Peshawar. Period: July 2016 to December 2016. Material & Methods: A total of 300 patients (125 males and 175 females) were selected through consecutive sampling technique and the number of teeth examined was 600 (two teeth per patient). Age group selected for the patients was from 13 to 30 years. Both the genders having fully erupted maxillary permanent first molars on both sides of the jaw were included in the study and the teeth were examined usin0g mouth mirror while the presence of caries in Carabelli groove was checked with the help of dental explorer (probe). Results: Of the total 300 patients, 118 (39.3%) presented the cusp of Carabelli on maxillary permanent first molars and the number of teeth having the cusp was 192 (32%) out of the total 600 among them. 24.7% of the patients had cusp present on both right and left MPFM while 10.3% of patients had CC present only on right maxillary molars and in 4.3% of patients, it was located on left molars. Gender differentiation of the cusp did not show a statistically significant difference (p-value 0.140). The frequency of caries associated with the cusp of Carabelli groove was found to be 17.7%. Out these patients, 8 males (34.7%) and 15 females (65.2%) were affected. P value for this distribution was 0.651, which shows no statistically significant difference between genders for the presence of caries. Conclusion: The cusp of Carabelli is a common finding on the palatal surface of mesiolingual cusp of maxillary permanent first molars in a hospital-based population of Peshawar with no statistically significant difference between males and females. Caries in cusp of Carabelli groove is a common association with the cusp having no significant difference between genders.
Reasons for not seeking early dental care in patients presenting in the exodontia department at a Tertiary Care Hospital in Lahore, Pakistan.
Authors:   De’Montmorency College of Dentistry Fort Road, Lahore., Waseem Anoosha , Hussain Varda ,   De’Montmorency College of Dentistry Fort Road, Lahore., Zahid Rida Binte ,   De’Montmorency College of Dentistry Fort Road, Lahore., Shahbaz Maliha ,   Rashid Latif Dental College, 35 Km Ferozpur Road, Lahore.
Published: August 2021

Objective: The aim was to gain insight on patient factors and administrative shortcomings in the dental health department that prevent patients from seeking timely dental care. Study Design: Cross Sectional Survey. Setting: Punjab Dental Hospital, Lahore, Pakistan. Period: 7 January 2020 to 28 February 2020. Material & Methods: A structured close ended questionnaire was filled by information obtained from 400 patients that presented in the Exodontia OPD requiring extractions due to irreversible tooth damage. The data was collected from 244 (61%) females and 156 (39%) males. It was analyzed using SPSS version 20.0 and post stratification chi-square test was applied to see the significance of all comparative statistics. P value of <0.05 was taken as significant. Results: Out of 400 patients, 350 had not visited a dentist when the symptoms first appeared. Of these n=213 (60.86%) were females and n=137 (39.14%) were males. Majority of the patients were in the age range of 40-65 years and belonged to the low socioeconomic class n=213 (60.9%). The main causes of patients presenting now were pain and swelling. The major reasons reported for delayed visit were: “Self-medication” n=113 (24.57%),” Symptoms will resolve on their own” n=79 (17.17%),” No awareness” n=64 (13.91%),” Non serious and lazy attitude” n=39 (8.48%) and “Busy schedule” n=36 (7.83%). Conclusion: Our findings suggested that only a small proportion of people visited the dentist when the symptoms first appeared. Most of the patients ignored their symptoms to such an extent that the only possible treatment that could be offered was extraction of the concerned tooth. There was a general misconception that dental diseases are not very serious and can be resolved by over the counter medications. Thus, more dental awareness programs should be incorporated in the government health policy to increase focus on oral health.
VATS Sympathectomy for the management of Primary Hyperhidrosis: An experience at Aseer Central Hospital, Saudi Arabia.
Authors:   Aseer Central Hospital, Abha Saudi Arabia., Tarar Javed Mirdad , Nadeem Kashif ,   Prince Mansour Military Hospital, Taif Saudi Arabia., Khan Durre Sadaf ,   Combined Military Hospital (CMH), Multan, Pakistan.
Published: August 2021

Background: Hyperhidrosis is bilateral, symmetrical and profuse sweating beyond physiological limits of the body. It is an important disease that causes social and emotional disturbances. Conservative treatment has poor results and most of the patients end up in surgical remedy eventually. The choice of operation is Bilateral Sympathectomy which has excellent results. Objective: The aim of this study was to assess the demographic features of patients and to evaluate the outcome of VATS Sympathectomy. Study Design: Prospective Study. Setting: Aseer Central Hospital, Saudi Arabia. Period: September 2017 to March 2020. Material & Methods: Bilateral VATS with resection of sympathetic chain from T2 to T5 was done depending upon the area involved in hyperhidrosis. Results: 28 (58.3%) male and 20(41.6%) female patients with mean age 21 years (range 19 to 53) were documented. 40% of the patients related their condition to be familial. Most common site of involvement was combined Palmer Plant and Axillary in 26(54%) whereas isolated facial hyperhidrosis was the least involved area. Complication rate was 12% with no mortality recorded. Excellent results with 98% patient’s satisfaction was found. Conclusion: Bilateral VATS sympathectomy is the gold standard surgical treatment for Primary Hyperhidrosis with excellent results.