bluuebunny/crossref_metadata_2025 huggingface dataset:
A Low-Power Remote Information Monitoring System of Cold Chain Logistic Based on NB-IoT
Authors: Zhi-Bo Xie Zhi-Bo Xie , Zhi-Bo Xie Li-Yuan Zheng , Li-Yuan Zheng Rui-Hua Zhang , Rui-Hua Zhang Qiao-Weng Zhang , Qiao-Weng Zhang Yong-Qiang Bai
Published: October 2022

With the development of information technology, cold chain logistics monitoring systems are widely used in transportation of fresh food to detect the quality parameters in real time. Poor network transmission performance, high packet loss rate and high maintenance cost are the main problems in the current cold chain logistics monitoring. To solve these problems, the paper presents a low-power monitoring system based on Narrow Band Internet of Things (NB-IoT). Considering the characteristics of the moving carriage, the polling mode of Bluetooth is proposed for the communication of one sink node to three sensor nodes. An improved working sequence is designed to reduce the power consumption of Bluetooth modules. Subsequently, analyzing the standard NB-IoT terminal state transition diagram, combining with the practical applications of cold chain logistics, an improved terminal state transition diagram is proposed and its terminal power consumption is analyzed. In the experimental test, the packet loss rate is less than 1% within 8 km. And the battery life of improved Bluetooth module is 143 times of that of traditional one. The power consumption of main service of NB-IoT is discussed, the formula is given which includes the transmission quality, random access times, number of concurrent users, sleep interval and other parameters. Through simulation and calculate, the battery life of terminal is up to 17 years. These improvements will greatly reduce the cost of cold chain logistics monitoring system. In addition, the packet loss rate test experiment proves the high reliability of the communication system.

 
Effectiveness of Sofosbuvir and Velpatasvir Combination in Chronic Hapatitis C
Authors: Wali Agha , Hassan Ghulam , Hussain Sohail , Aslam Muhammad Naeem
Published: October 2022

Objective: The purpose of this research is to evaluate the efficacy of a combination medication consisting of sofosbuvir and velpatasvir in treating individuals with chronic hepatitis C. Study Design: Observational/ Prospective study Place and Duration: Conducted at Department of Gastroenterology Mayo Hospital Lahore, during from the period Feb 2021 to Jan 2022. Methods: There were 67 participants in this study. The patients' ages ranged from 18 to 70. We gathered demographic information about the patient, such as age, gender, height, and weight, after getting written consent. Hepatitis C patients with known genotypes were shown. A SOF/VLP regimen containing sofosbuvir and velpatasvir was administered to patients for a total of 12 weeks. The entire set of data was examined using SPSS 18.0. Results: In current study, 42 (62.7%) were males and 25 (37.3%). Included patients had mean age 31.12±15.80 years and mean BMI 24.7±8.34 kg/m2. We found that efficacy rate was higher and found in 63 (94.03%) cases. As per laboratory findings, aspartate aminotransferase (AST) 37.5± 11.21, alanine aminotransferase (ALT) 26.2±6.44, and haemoglobin level 12.24±10.17 all showed considerable improvement after therapy. Most common adverse outcomes were headache 35 (52.2%), fatigue 22 (32.8%) and nausea 10 (14.9%). Conclusion: In patients with or without cirrhosis, and regardless of the HCV genotype, the combination of sofosbuvir and velpatasvir has shown to be extremely successful in treating chronic HCV infection. This is true regardless of the HCV genotype. Keywords:, Hepatitis C, Sofosbuvir, Comorbidities, Velpatasvir,
Rate of Malignancy in the Complex Renal Cystic Lesions (Bosniak Iif, Iii, Iv) Single Center Study
Authors: Shah Syed Rafi Uddin , Khan Jamal Muustafa , Furqani Hafiz Dur E , Jabeen Mehnaz , Maheshwari Pardeep Kumar , Hashmi Altaf
Published: October 2022

Aim: To determine the rate of malignancy in the complex renal cystic lesions. Material and methods: We studied 111 patients both male and female above the age of 18 years with complex renal cystic lesions classified as Bosniak category IIF, III, and IV on CT. Patients with Bosniak categories I and II were excluded from the study. The rate of malignancy was analyzed. Results: The mean age of the patients was 47.58±15.05 years. 27% of patients were Bosniak category IIF, 29.7% of patients were category III and 43.2% were category IV. The overall rate of malignancy was 62.2% in all patients who presented with complex renal cystic lesions. The rate of malignancy in Bosniak categories IIF,III and IV were 33.3%, 54.5% and 85.4% respectively. Conclusion: Malignancy was observed in 62.2% of the patients who presented with complex renal cystic lesions. The rate of malignancy in Bosniak categories IIF,III and IV were 33.3%, 54.5% and 85.4% respectively. Keywords: Malignancy, Renal cysts, Bosniak classification
Both The Folate Therapy and the Folate Treatment Combined with Zinc Had an Effect on the Endocrine Markers and Sperm Characteristics of Sub-Fertile Males
Authors: Ahmed Shakeeb , Ubaid Muhammad , Baig Muhammad Babar , Bashir Adeel , Rasheed Rafat , Aslam Zeeshan
Published: October 2022

Aim: The purpose of this study was to see how folate and folate + zinc treatment affected endocrine markers and sperm properties in sub fertile males. Methods: The methodical research in addition meta-analysis was carried out. From 1969 to May 2020, databases were searched by Medline, Scopus, Google scholar, and Persian databases have been examined that used the set of pertinent keywords comprising "folate or folic acid AND (infertility, infertile, sterile)". Any standardized clinical studies that took oral folic acid or folate plus zinc on a selection of sub fertile males for semen analysis are included in the. Endocrine characteristics and sperm parameters were among the information gathered. Comprehensive Meta-analysis Version 2 was used for data methods. Results: Eight researches remained comprised in the total. Seven researches have enough information for a meta-analysis. "Sperm concentration was significantly greater in males treated using folate than in men not supplied using folate (P.002)." Furthermore, folate supplementation unaided did not appear to remain additional beneficial than the placebo in terms of sperm morphology (P =.057) or motility (P =.653). In comparison to the placebo, folate with dietary supplementation had no measurable difference in blood testosterone (P =.87), inhibin B (P =.85), FSH (P =.056), or sperm motility (P =.168). However, as given a placebo, folate with zinc had a substantially bigger influence on semen parameters (P.002), morphology (P.002), and blood folate level (P.002). Conclusion: Folate and zinc supplementation improves sperm qualities in infertile men. Nonetheless, because of the significant heterogeneity of the papers used in this meta-analysis, those findings must be regarded with care. More research is necessary to corroborate the existing results. Keywords: Effect of Folate, Folate Plus Zinc Supplementation, sperm properties, sub fertile males.
Perioperative Problems in Infants Having Pulmonary Hypertension Following Ketamine General Anesthesia
Authors: Ali Fizzah , Ahmed Khan Raja Altaf , Bashir Adeel , Khalid Syed Saqib , Aslam Zeeshan , Rana Muhammad Zafar
Published: October 2022

Aim: In adolescents, pulmonary arterial hypertension (PAH) is linked through the substantial postoperative danger of serious problems such as pulmonary severe illness and heart attack. The efficacy of ketamine anesthesia inside this patient group is still unknown. Examine the health information about children having PAH in the past to identify the kind and occurrence of peri-procedural issues, as well as whether ketamine medication been connected to peri-procedural difficulties. Methods: Adolescents having PAH who had general anesthesia for operations throughout the one-year interval (May 2020–April 2021) were eligible to participate. Specifics concerning the patient, PAH, surgery, anesthesia, and post-procedural course were recorded, as well as any untoward events that occurred while or inside 48 hours of the operation. Complication rates were reported separately for each surgery. The relationship among ketamine and peri-procedural problems has been investigated. Results: Seventy-five children (median age 8.4 years, average weight 23 kg) had 193 surgeries performed on them. PAH intensity has been classified as mild (26%), medium (37%), or severe (37%). (41 percent). Medical intervention (n = 21), moderate surgery (n = 28), cardiac catheterization (n = 129), and nonsurgical treatments (n = 18) have been performed. During 152 surgeries, ketamine has been given. Thirty mild problems and nine significant problems reported identified. Cardiac arrest occurred in 0.79 percent of cardiac catheterization operations, 11 percent of significant medical procedures, and 2.7 percent of all processes. There has been no death as a result of the surgery. Ketamine administration was not linked to increases in problems. Conclusion: Ketamine looks to be a safe anesthetic alternative for patients. people suffering from PAH We present data on cardiopulmonary resuscitation rates and significant death rates that are higher than that found. Keywords: Pulmonary Arterial Hypertension, Infants, Hypertension, Cardiac Arrest.
Frequency of Preeclampsia Induced Acute Kidney Injury
Authors: Elahi Irfan , Rasool Bilal , Javaid Bilal , Anees Muhammad , Hussain Yasir , Pervaiz Shahbaz
Published: October 2022

Objective: The purpose of this study is to ascertain the prevalence of preeclampsia-related acute renal injury among patients who report to a tertiary care facility. Methodology: This Cross-sectional study was conducted at King Edward Medical University and allied hospitals in Department of Nephrology/Mayo hospital Lahore and department of Gynecology, Lady Atchison Hospital Lahore, affiliated with King Edward Medical University. After obtaining the patient's informed consent, if the patient is able to give it; otherwise, consent was obtained from the attending guardian; the study included all 180 pregnant females with acute kidney disease who were in the third trimester of pregnancy and were presenting for delivery. Patients' ages ranged from 15 to 50 years. Women who were pregnant and had a blood pressure reading that was greater than 140/90 mmHg after 20 weeks of pregnancy and who had proteinuria on a urine dipstick examination were recorded. This information was taken from a previous record. The laboratory at King Edward Medical University and Mayo hospital in Lahore was where all of the investigations were carried out. Following the establishment of a diagnosis, the patients were then treated in a hospital environment in accordance with the protocols. Results: Patients' mean ages were 30.21+5.35, their mean blood pressure was 154.27+108.15 mm Hg, their mean serum creatinine was 4.39+0.28 mg/dl, the mean frequency of urine protein was 112.22 percent, and the mean frequency of preeclampsia-induced AKI in pregnancy was 26.11 percent. Conclusion: This research led me to the conclusion that preeclampsia-induced acute kidney damage occurs frequently and must be detected and treated effectively to prevent maternal mortality and morbidity and to improve foetal outcome. A nephrological workup should be performed on women with pre-eclampsia if their proteinuria and hypertension persist longer than 6-8 weeks after delivery. Keywords: Pre-eclampsia, acute kidney injury, frequency
Distraction Osteogenesis for Mandibular Ramus lengthening in Temporomandibular Joint Ankylosis Patients simultaneously with Interposition Gap Arthoplasty
Authors: Malik Shahzad Iqbal , Firdous Saadia , Saeed Tooba , Hanif Saba , Mahmood Hafiz Nasir , Khatak Kashif , Zafar Sadia , Chaudhry Sana
Published: October 2022

Temporomandibular joint ankylosis is the most common cause of facial deformity.1-4The main etiology of TMJ ankylosis include trauma and infection3,5.TraditionallyTemporomandibular joint Ankylosis patients had been managed with different treatment options including Gap arthoplasty6,Interpositiongap arthroplasty ,distraction osteogenesis and total joint replacement.To prevent reankylosis interposition of fascia or muscle had been documented and if reconstruction of the joint was needed Alloplastic(sialistic)or Autogenous graft ( Costochondral bone graft) had been used.6, 7,8,9 Costochondral graft is preferred for reconstruction because morphological it is similar to the condyle of mandibleandhas agrowth capacity.9But thisgraft is unpredictable in nature and different results are reported and documented including facial asymmetry, over growth, graft resorption, graft failure and even reankylosis.9 Distraction osteogenesis is a recent treatment method for the correction of hypo plastic mandible in Temporomandibular joint ankylosis patients. By using distraction osteogenesislarge skeletal movements are possible with little or no relapse commonly seen in other orthognathic corrections. In this study of 30 patients all patients were treated with TMJ Interposition gap arthoplasty (interposition of temporalis fascia) followed by the application of distractors at ramus of mandible. Mean age was14.96±4.17 years. Patient’s minimum and maximum age was 8 and 24 years respectively. Gender distribution shows that 15(50%) of the patients were male and 15(50%) were females. Male to female ratio was 1:1.Mean ramus length before distraction was 38.70±7.28 mm with 28-52 mm range. Mean ramus length after distraction osteogenesis was 49.00±8.01 mm. Mean increase in vertical ramus length was 10.26±2.86 mm. Minimum increase was 5mm and maximum increase in vertical ramus length was 15 mm respectively. In this study we were able to achieve increase in ramus length in all patient and only patient require reoperation due to failure of distractor appliance which was replaced successfully.
Frequency of Various Breast Disorders Presenting in HBS Hospital: A Local Experience
Authors: Bibi Asma , Ahmed Iftikhar , Rahman Bashir Ur , Rehman Adeel Ur , Muhammad Gul , Shahid Sosan
Published: October 2022

Objective: To determine frequency of different breast disorders in female patients of varying age groups presenting to HBS Hospital Islamabad. Study design: A prospective descriptive study Place and duration: This study was conducted in department of General Surgery HBS Hospital from 1st May 2019 to 31 Dec 2021. Methodology: All female patients presenting to surgical OPD and indoor department from 1st May 2019 to 31 Dec 2021 for different breast diseases with no age limitation were included in the study. Data of the patients as age at presentation, symptoms, clinical features, and risk factors, investigations as ultrasound and specimen reports if any were recorded and submitted for histopathology analysis. Results: A total of225female patients were included in the study. Frequency of the disorders was as follows. Fibroadenoma breast presenting as lump breast was found in (n=69) followed bicyclical mastalgia (n=62),breast abscess (n=27), duct ectasia (n=18), carcinoma breast (n=13),sebaceous cyst breast (n=9), mastitis (n=8), cracked nipples (n=8),non-cyclical mastalgia (n=4),galactorrhea (n=3), breast budding (n=1), phylloides tumor (n=1), blood stained nipple discharge (n=1) and nipple eczema (n=1) in frequency. Age of patients ranged from 9-85 years with mean age 51.5 years. Conclusion: Fibroadenoma is the commonest disease but the pattern is rapidly changing towards fibrocystic disease especially in young females. Incidence of Inflammatory disease increases in peak reproductive age group. Carcinoma breast presents late in our setups. Keywords: Breast Lump, Breast Disease, Carcinoma Breast, Fibroadenoma Breast
Lipid Profile Levels in Smokers
Authors: Javed Gulfam , Hafiz Ahmed Hakeem , Tahir Ayesha , Ikram Naila , Ammar Ali , Zahid Natasha
Published: October 2022

Objective: The objective of this study was to record mean lipid profiles in smokers Methodology: All 200 (Two hundred) smokers were enrolled from Cardiology Department, Punjab Institute of cardiology Lahore during 2015 to 2016, the demographic profile of the patients’ was taken. Their ECG was done to ensure that they do not have any cardiac disease. After 12 hours over night fasting, blood samples were withdrawn from a cubital vein into blood tubes. The blood samples were sent to hospital laboratory for the analysis of lipid profile. Serum triglyceride (TG) level by GPO – PAP enzymatic colorimetric method, Serum total cholesterol (TC) level by CHOD – PAP enzymatic colorimetric method, Serum HDL-c level by precipitation method, Serum LDL-c level by using Friedewald’s formula, LDL-c = TC ˗ (HDL + TG/5), Serum VLDL-c level by using Friedewald’s formula VLDL-c = TG/5. Results: Of 200 cases 45%(n=90) were between 18-40 years of age while 55%(n=110) were between 41-60 years of age, mean+sd was calculated as 41.98+11.02 years, 89.5%(n=179) were male and 10.5%(n=21) were females, mean lipid profiles in smokers was calculated as 188.38+16 55 for total cholesterol, 157.33+15.93 triglycerides, 42.47+4.88 HDL, 114.44+13.43 LDL and 31.47+3.19 for VLDL. Conclusion: the smokers are at higher risk of developing dyslipidemia. Our results are encouraging for smokers to quit their habits to live a healthy life. Keywords: Smokers, lipid profile, mean
Compare Short Term Post-Operative Complication of Laparoscopic Transabdominal Preperitoneal (TAPP) and Lichtenstein’s Tension Free Hernia Repair
Authors: Nazir Mashal , Ullah Rahman , Saleema Aqsa , Ahmed Nisar , Hashmi Javaid Sajjad , Khan Muhammad Tariq , Shujjah Ibrahim
Published: October 2022

Objective: To compare short term post-operative complication of laparoscopic transabdominal preperitoneal (TAPP) and Lichtenstein’s tension free hernia repair. Study Design: Randomized clinical trial. Place & Duration of Study: Surgical Unit of Khyber Teaching Hospital (KTH) Peshawar during the period of 6 months from 1st January, 2020 to 30 June, 2021. Material and Methods: In this study 492 cases of inguinal Hernia with 246 in each group. For group A, laparoscopic TAPP repair were performed with 10cmx 15cm polyprophlene mesh (prolene-Ethicon) and were fixed with tackers (Protack 5mm fixation device - covidien). For Group B Lichtenstein’s repair were performed through supra inguinal incision, using 10cmx 15 cm polypropylene mesh (prolene- ethicon). Then the patients were monitored for short term post-operation complication post-operatively. Results: Our study shows that in Group A(Laparoscopic TAPP) mean age was 42 years with SD ± 8.13 and in Group (Lichtenstein repair) mean age was 45 years with SD ± 8.13. In Group A (Laparoscopic TAPP) 99% patients were male and 1% patients were female while in Group B (Lichtenstein repair) 99% patients were male and 1% patients were female. In Group A(Laparoscopic TAPP), urinary retention was 5(2%), hematoma was 5(2%), surgical site infection was 10(00%), Ischemic orchitis was 2(1%), seroma was 20(8%) While in Group B (Lichtenstein repair). urinary retention was 25(10%), hematoma was 39(16%), surgical site infection was 66(27%), Ischemic orchitis was 5(2%), seroma was 54(22%). Conclusion: Frequency of short term post operative complication are higher in Lichtenstein’s tension free hernia repair as compare to laparoscopic transabdominal preperitoneal (TAPP) group. Keywords: Short Term, Post-Operative Complication, Laparoscopic Transabdominal Preperitoneal (TAPP), Lichtenstein’s Tension Free, Hernia Repair.
Is Vaginal Progesterone more Effective to Treat Threatened Preterm Labour than Oral Nifedipine?
Authors: Hafeez Sajia , Khan Bushra , Khan Maria , Syed Sadaf Zahra , Waheed Fatima , Mustafa Rubina , Khan M. M.
Published: October 2022

Objective: To evaluate the efficacy of oral nifedipine against vaginal micronized progesterone to treat threatened premature labour (24 wks to 36+6 wks). Design : Randomized Controlled Trial. Setting : Obs and Gynae Deptt, Bakhtawar Hospital, Multan. Study Duration : Six months (15-12-20 to 14-6-21) Material and Methods: 126 patients with diagnosis of threatened preterm labour were included in this study. Baseline demographic information of patients (age, gestational age and parity, previous history of preterm labour, smoking, BMI and socioeconomic status) was recorded. In 63 patients oral nifedipine was given for treating threatened premature labour and in remaining 63 patients, progesterone was administered vaginally to prevent preterm labour.Efficacy was noted for both groups on a especially designed proforma. Results: Mean of ages of women included was 28.05±4.49 yrs. Mean GA of patients was 33.54±1.83 weeks. Mean parity was 1.81±1.11. Mean BMI of patients was 24.33±3.33 Kg/m2. Previous history of preterm labour was found in 16 (12.70%). Oral nifedipine was effective in 47 (74.60%) patients & vaginal progesterone was noted successful in 58 (92.10%) patients with p-value of 0.009. Conclusion: Vaginal micronized progesterone is more effective than oral nifedipine for the prevention of threatened preterm labour. More research work is required to ascertain the superiority of vaginal progesterone over nifedipine for the prevention of preterm labour. Keywords: Oral nifedipine, micronized progesterone, preterm labour.
Superiority of the Hyperbaric Bupivacaine 0.50% Over 0.75% Hyperbaric Bupivacaine in patients Undergoing Electivecesarean Section: A Uni-Center Double Blind Randomized Control Trial
Authors: Ayub Farrukh , , Malik Bilqees Akhtar , Momina Shahzad Bashir
Published: October 2022

Objective: The objective of this study was to compare 0.75% and 0.50% hyperbaric bupivacaine in terms of hemodynamic stability in elective cesarean section. Study Design: Randomized Controlled Trial. Place and duration: Department of Anesthesiology, Intensive care and pain management, Combined Military Hospital, Mardan from September 2021 to March 2022. Methodology: Total 104 women were randomly divided into Group-A (0.50% drug concentration) and Group-B (0.75% drug concentration) hyperbaric bupivacaine. Base line systolic blood pressure was noted. Lumber puncture was done in L3/L4 or L4/L5 space. Reading were taken at 1-min, 3-min, 5-min and 30-min. Drop in SBP<20% from baseline was taken as hemodynamic stability. Stability in SBP systolic blood pressure among the two groups A and B were compared. Results: The mean systolic blood pressure of group A was 123.77±8.43 mmHg while in group B it was 123.66±9.14 mmHg. In group A more than 20% decrease in SBP were noted in 42.3% while in group B it was observed in 63.5% patients. Hemodynamic stabilitywas noted in 57.7% patients and 36.5% patient respectively in study group A and B and difference was significant (p=0.031). Conclusions: The Hyperbaric Bupivacaine 0.50% is found superior than 0.75% interms of hemodynamic stability in patients undergoing elective Cesarean Section. Keywords: Hyperbaric Bupivacaine, Hemodynamic Stability, Elective Cesarean Section
Frequency of Adequate Knowledge and Attitude of Females of Reproductive age towards IUCD as Emergency Contraception after an Unprotected Intercourse
Authors: Leghari Nadia , Rehman Abida , Nazir Sadia
Published: October 2022

Objective: The objective of this study is to determine the frequency of adequate knowledge and attitude of females of reproductive age about IUCD as emergency contraception after an unprotected intercourse. Study Design: Cross sectional study Settings: Obstetrics & Gynecology, D. G. Khan Hospital D. G Khan Study duration: 6 months (April 2021 to October 2021) Procedure for data Collection: A total of 305 females who met the selection criteria were enrolled in the study through the OPD of the Department of Obstetrics and Gynecology at D. G. Khan Hospital D. G Khan. All females were asked for their knowledge and attitude towards IUCD as emergency contraception by researcher herself. A predesigned proforma was used to assess their knowledge and attitude of females towards IUCD as emergency contraception. Knowledge and attitude was labeled. Results: In this study 274(89.94%) women’s knowledge was adequate regarding IUCD as EC and 156(51.15%) women showed positive attitude for it. Knowledge adequacy for IUCD was higher in women in the age group 30-40 years as compared to lower age group. I.e. 20-30 years. I.e. 20-30 years: 88.9% vs. 30-40 years: 91.2% (p-value=0.511). However no statistically significant difference was observed for knowledge adequacy in both age groups women. The same trend was seen for positive attitude of women for IUCD in terms of age group. I.e. 20-30 years. I.e. 20-30 years: 48.9% vs. 30-40 years: 54.4% (p-value=0.344). Conclusion: Results of this study showed high level of knowledge and positive attitude of women for IUCD use as EC. EC has the potential to provide women with an important fertility control option. Healthcare providers can play an important role in educating their patients about EC. Keywords: EC, IUCD, Knowledge, Pregnaancy.
Parents’ Perception regarding Nursing Care of their Child in Tertiary Care Hospital, Lahore
Authors: Maqbool Naila , Raza Hasnain Ahmad , Iqbal Imran
Published: October 2022

Background: The nursing care of child effect the health of the child somehow. As, the health of child is effecting the health of the parents. This research was planned to check the perception of parents related to nursing care of their admitted child in the hospitals. Materials and Methods: This study was a crossectional and conducted at Sir Ganga Ram Hospital, Lahore from Septmeber 2021 to January 2022. After getting approval and review from hospital committee, a total of 120 parent were selected for data collection out of which 100 filled out structured questionnaires. Data was analysed on SPSS version 21.0, and different tables were generated. Results: The average age of parents was 31.19 years, while about 45% of them have some bachelor level education. The level of good perception was maximum in parents having higher eduation while bad perception was in having secondary education. Overall perception rates of good and bad perception was 63% and 37%, respectively. Conclusion: The majority of the parents have a good perception of nursing care of their ill child. More than one-third of the participants agreed that nurses should not be rude, hostile, and unkempt. Nurses’ managers should support the nurses to get a higher level of education and to get admissions in specialization so the number of specifically skilled holders should be increased in the specific ward. Keywords: Perception, Parents, Nursing care
Association between HBA1C and Coronary Artery Disease Severity in patients of Diabetes Mellitus Type 2 presented as Acute Coronary Artery Syndrome and Non Diabetic
Authors: Qadir Mahboob , Khan Muhammad Shahid Nawaz , Khan Humayun Riaz , Ullah Nadeem , Ahmed Muddasar , Rashid Hafiz Muhammad Farhan
Published: October 2022

Aim: to investigate the prevalence of diabetes mellitus type 2 (T2DM) and association of HbA1c with the severity of coronary artery disease (CAD) in patients presenting at tertiary care center as acute coronary syndrome and non-diabetic. Study Design: Prospective observational study Duration and Place Study was conducted at department of general medicine Nishter Hospital, Multan from January 2021 to January 2022 in 1 year duration. Methodology: A total of 200 patients were enrolled in study. Main variables of study were BMI, smoking status, dyslipidemia, hypertension, STEMI, angina, HbA1c and treatment strategy. SPSS version 23 was used for data analysis. P value below or equal to 0.05 was taken as significant. Results: Among total 83.5% patients intervened by therapeutic, whereas 48.0% used thrombolytic drug in STEMI. 70.7% patients were thrombolysis in therapeutic intervention and 44.8% were streptokinase in thrombolytic drug. In fasting blood sugar, 53.0% patients were diabetic, whereas in HbA1c levels, 52.3% patients were diabetic. Conclusion: This study highlights the significance of testing for diabetes in individuals in poor nations who report with non-diabetic acute coronary syndrome. One of manifestations of diabetes mellitus may be the acute coronary syndrome. Keywords: Acute coronary syndrome, Coronary angiography, Diabetes, HbA1c.
Frequency of Urinary Tract Infection (UTI) in Neonates Admitted with Indirect Hyperbilirubinemia
Authors: Ahmed Syed Moeed , Jan Pir , Zaman Saeed , Kakar Shams-Uddin , Shah Sajid Ali , Ayub Ammara
Published: October 2022

Objective: To determine the frequency of urinary tract infection (UTI) in neonates admitted with indirect hyperbilirubinemia. Study Design: A cross-sectional study. Place and Duration of the Study: Inpatient department of Pediatric Medicine, Bolan Medical College/Hospital Quetta from Jan 2019 to Dec 2020. Methodology: A total of 130 neonates of either gender (delivered at ≥ 32 weeks) admitted with primarily complaints of jaundice (with evidence of indirect hyperbilirubinemia) were included. Sex, age, weight and height of all neonates were noted. Serum bilirubin levels were asses and urine samples were also evaluated for the existence of urinary tract infection (UTI). Results: In a total of 130 neonates, 58 (44.6%) were males and 72 (55.4%) females. The UTI was found to be present in 41 (31.5%) neonates admitted with indirect hyperbilirubinemia. Among these 41 culture proven UTI cases, most common organism was E. coli found in 15 (36.6%) cases while Klebsiella was the 2nd most commonly found microorganism noted in 11 (26.8%) cases. Conclusion: Frequency of UTI was high (31.5%) among asymptomatic jaundiced newborns. Children presenting with jaundice needs to be evaluated for UTI. Keywords: E.Coli, indirect hyperbilirubinemia, Klebsiella , Urinary tract infection (UTI).
Clinical Outcomes of Post Placental Intrauterine Contraceptive Device Insertion in Women Delivering by Cesarean Section
Authors: Neelum Shahzadi , Saleem Javeria , . Sumayya , Safi Saeeda , Amina Noor-Ul- , . Mehwish
Published: October 2022

Background: Short pregnancy interval after caesarean section increases the risks of morbidity, mortality and surgical interventions. This can be easily avoided by post placental insertion of IUCD during caesarean section. Immediate post placental IUCD insertion is defined as insertion of IUCD within 10 minutes of delivery of the placenta. It is a very promising an appealing approach as patient does not have to come for a separate postpartum visit. Objectives: To determine the outcome (safety, complications, failure and continuation rate) of post placental IUCD insertion during caesarean section. Materials and Methods: Our study was a prospective cross-sectional study, carried out in the Department of Obstetrics and gynecology at Qazi Hussain Ahmad Medical Complex, Nowshera. All the pregnant women willing for post placental intrauterine contraceptive device were included in the study. Women who had postpartum hemorrhage, chorioamnionitis, structurally malformed uterus and fibroid uterus were excluded from the study. Follow up visits were scheduled at one month, 3 months and 6 months. Results: 156 women were included in this study. Majority(35.2%) belonged to 31- 35 years age group. 46.7% of them were illiterate and 30.7% have just primary education. 40.38% of women belonged to low socio-economic group. 26.2% of women were para 4. 26.9% had previous 3 caesarean section. The most common adverse events during follow up of 6months were vaginal discharge, menstrual irregularities and pelvic pain. At the end of 6 months there were 9expulsions, 12 removals and 2 pregnancies with the gross cumulative expulsions, removal, failure and continuation rate of 5.7%, 7.6%, 1.28% and 85.2% respectively. The incidence of undescended strings at the end of 6 months was high (32.4%). Conclusion: Post placental intra uterine Copper T 380 A insertion is a safe, effective and easy reversible method of contraception with low expulsion and high continuation rates. Keywords: Intrauterine device,Intra-cesarean section, Post placental insertion
Usefulness of Clinical Lectures in First Two Years of Integrated Teaching; Student’s Perspective
Authors: Ahmed Aashi , Bibi Anwar , Nisar Nadia , Salman Roma , Yasmin Raheela , Aslam Ummara
Published: October 2022

Background: Integrating clinical content into problem-based learning tutorials is associated with learning motivation of undergraduate medical students. Medical students are being exposed to clinical lectures and rotations starting from 1st year in most of the medical colleges across Pakistan. Aim: To determine perspective of 1st and 2nd Year MBBS students regarding clinical lectures as part of integrated teaching. Study Design: Cross-sectional study Place and Duration of Study: HITEC Institute of Medical Sciences, Taxila from 1st July 2021 to 31st December 2021. Methodology: One hundred and seventy eight students of 1st and 2nd year were enrolled. Students who attended clinical lectures for last three months were randomly selected in this study. Structure proforma having ten items scored on five-point Likert scale was used to collect data. Data was analyzed using SPSS version 28. Frequencies were calculated for categorical variables, whereas mean and standard deviation was calculated for continuous variables (age). Results: Eighty (44.9%) were males and 98 (55.1%) were females. Ninety eight (55.1%) were from first year and 80 (44.9%) were from second year. Integration of clinical lectures in early years was reported to help in concept building by 46.6% (n=83, strongly agree) students. According to 45.5% (n=81) students, integration of clinical content makes learning interesting. Median score calculated for the participant’s perception about role of integrated teaching in stimulating interest, concept building, passing exams, ease of schedule was 4 which suggested that majority of the participants agreed to it. Conclusion: Our data showed that early clinical exposure through lectures and clinical rotation stimulates interest in learning by concept building and helps medical students to perform better in their professional examinations. Keywords: Medical education, Integrated curriculum, Early clinical exposure, Students perception
Investigations on Tissue Lipid Peroxidation, Glutathione and Antioxidant Enzyme Levels in the Hippocampus of Adult Rats in Experimental Hypo- and Hyperthyroidism Induced by Propyl Thiouracil (Ptu) and L-Thyroxine
Authors: LİMAN Bilal Cem
Published: October 2022

Background: Thyroid hormones (TH) thyroxine (T4) and triiodothyronine (T3) are known to be essential for maintaining optimal cognitive ability in adults. TH deprivation (hypothyroidism) or excess (hyperthyroidism) may alter signaling pathways involved in adult hippocampal neurogenesis and synaptic plasticity, thus increasing the risk of neurodegenerative disorders and leading to changes in cognitive performance. Aim: This study aimed to explore the effect of experimental hypo- and hyperthyroidism on the lipid peroxidation and glutathione levels, and the activities of antioxidant system enzymes SOD, catalase (CAT) and glutathione peroxidase (GPx) and glutathione reductase (GR) in the rat hippocampus. Material and Methods: The study included 72 adult male Wistar albino rats which were grouped as follows: (1) control; (2) hypothyroidism [hypothyroidism was induced by intraperitoneal injection of 10 mg/kg/day propylthiouracil (PTU) for 4 weeks]; (3) hyperthyroidism [hyperthyroidism was induced by 4-weeks' thyroxine injection (0.3 mg/kg/day)]. The levels of lipid peroxidation, glutathione, antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR) in the hippocampus of rats with hypo- and hyperthyroidism were examined using ELISA techniques. Results: The ELISA analysis results of our study show that in the hyperthyroid and hypothyroid rats, the lipid peroksidasyon levels in the hippocampus did not differ significantly from the control groups (P
Tannins; Use in Silage and Animal Feeding Applications
Authors: BACAKSIZ Oğuz Koray , AZMAN Mehmet Ali
Published: October 2022

Aim: This review was made to determine the effects of using tannin on the fermentation quality and animal nutrition as a different alternative to the additives used to prevent the spoilage of silages, which are widely used in today's livestock. Tannins are polyphenolic compounds and are natural compounds with a characteristic odor, acrid taste, and different colors from yellow to white, which can also be found in feeds such as gallnut, oak, chestnut and rapeseed, broad bean, sorghum. Since BC 1500 they have been used in various fields from medicine to food. Apart from its antidiarrheal, antiseptic and anthelmintic effects, its most well-known feature is that it forms compounds with proteins. The high protein/water presence of the feed to be ensiled makes ensiling difficult and affects fermentation negatively. High protein will reduce lactic acid formation in silages due to proteolysis and the desired pH value will not be reached. It is thought that tannins can form compounds with proteins and prevent proteolysis in silages and provide by-pass properties to proteins. Thus, the proteins that pass through the rumen will be digested in the small intestine and their utilization will increase. In addition, methane gas produced by ruminants causes loss of gross energy and contributes to global warming with greenhouse gas. Tannins are considered as an alternative to reduce methane gas and dispose of waste ammonia.
Conclusion: The use of tannin in silages can facilitate the ensiling of high protein feeds, increase their quality, and meet the nutrient needs of animals better. It can improve the storage conditions of roughage. An innovative feeding method can be provided by reducing the methane production of animals that consume tannin-containing feeds. It can be a natural approach to the disposal of ammonia.
Political patterns in literary messages in the eras of modern sects and the Almoravids, the Diwani model
Authors: Saadi Zahraa Nima Hassan Al , Hadi Doaa Ali
Published: October 2022

The study seeks to shed light on the political patterns in the literary messages in the era of the sects and the Almoravids, and that the political messages are concerned with matters of concern to the state. Therefore, the caliphs worked on investing writers and writers, so the writers were the mouthpiece of the state. The study concluded that these messages carried several formats, including the order and prohibition system, which is through which orders are issued and directed to the soldiers and the people in compliance with the system. On the Sultan and the authority, and there the format of media correspondence is what was circulated between the kings of the sects and the Almoravids of correspondence in the exchange of information and news between them in all circumstances of accidents; These media discourses are one of the ways that develop trust between individuals, enhance communication and develop relations. These formats expressed the political aspects in some ways, with the most accurate expression.
sujeto psicológico y la microgénesis
Authors: Molina Aguilar Jorge
Published: October 2022

Este ensayo busca visibilizar los aportes de la psicóloga suiza Bärbel Inhelder a la psicología, la pedagogía, la educación y la epistemología. Su obra se vincula a los hallazgos de Jean Piaget, con lo que se pierde de vista una amplia contribución independiente a disciplinas como el trabajo social, la educación, la pedagogía, la psicología, la epistemología y el desarrollo de la ciencia en general. Previo a ser heredera de la cátedra de Epistemología Genética en Ginebra, su tesis doctoral sobre el retraso mental surge en el umbral —y como respuesta— a la patologización de los espacios escolares. Inhelder fue una mujer comprometida con la ciencia y con reivindicar los atropellos a la niñez y a la adolescencia que surgen en el contexto de una creciente medicalización en el siglo XIX y en siglo XX. Sus estudios acerca de las funciones en la construcción del conocimiento la llevaron a conceptualizar la etapa de operaciones formales y a profundizar en los procesos y mecanismos de transición entre las etapas del desarrollo cognitivo, y, en consecuencia, aportar una nueva visión desde la microgénesis (una propuesta centrada en el sujeto psicológico), la cual a su vez aportaba pilares fundamentales en torno al estudio de la diversidad funcional intelectual.
Reflexiones sobre temáticas sociales en la publicación católica El Buen Pastor 1937-1941
Authors: Chanta Martínez René Antonio
Published: October 2022

En este artículo se hará una breve reflexión sobre algunos escritos, notas y artículos aparecidos en la publicación El Buen Pastor redactada en la ciudad de Atiquizaya ubicada en el departamento de Ahuachapán. Los escritos a los que se hará referencia en esta investigación son diversos textos sobre temáticas sociales que se realizaban en dicha revista. En efecto, el cristianismo siempre ha mostrado una fuerte sensibilidad hacia los temas sociales a tal punto que hoy en día existe un acervo textual y documental conocido como pensamiento social cristiano. Desde ese sentido, en El Buen Pastor es usual encontrar textos en donde se hacía referencia a temáticas que afectaban la realidad social de ese momento como el comunismo, el trabajo, las necesidades de los obreros, la administración de los bienes y la juventud. Esto demostraría que las publicaciones impresas católicas no solamente estaban concentradas en las grandes ciudades del país, sino que también en diversas parroquias de los pueblos y que los temas sociales fueron prioritarios para los editores de estas publicaciones.
Reflexiones sobre el atomismo y las partículas elementales, a la luz de la filosofía de la química.
Authors: Badía Serra Eduardo
Published: October 2022

El autor sostiene la hipótesis, a la luz del análisis histórico del atomismo, de su evolución vista desde la filosofía y de la ciencia, y de su posición a la luz de la actual visión de la realidad científica y filosófica, de que la actualidad y vigencia del atomismo se comprueba y se sostiene, al margen de las concepciones aceptadas hoy en torno a la estructura de las partículas elementales. Para él, las sustancias últimas de la realidad universal siguen siendo los átomos; las partículas elementales, quarks y leptones, son sólo manifestaciones de ellos que para nada alteran su composición y estructura.
Acciones y habitudes humanas
Authors: Fúnez Rubén
Published: October 2022

El autor del presente artículo expone las acciones y habitudes humanas tal y como lo hace Xavier Zubiri en su libro Sobre el hombre. Se pretende que en la medida en la que se vayan exponiendo dichos temas vayan apareciendo nociones que son fundamentales no sólo para entender la antropología de Zubiri, sino su filosofía en general.
Volin, La revolución desconocida.
Authors: Grenni Héctor
Published: October 2022

El autor de este trabajo apasionante es el historiador y militante ruso, Vsévolod Majaílovich Eijenbaum, conocido como Volin, vocablo ruso que significa ‘voluntad’; de esta manera se le conoce en círculos anarquistas y académicos.
DISEÑO INSTRUCCIONAL: UNA ESTRATEGIA DE APRENDIZAJE APLICADA A LA HISTORIA DE LA ENFERMERÍA EN LA ENSEÑANZA A DISTANCIA
Authors: Gama de Sousa Aperibense Pacita Geovana , Tavares Uchoa dos Santos Xavier Bruna , Lustosa Ribeiro Rafael , Aparecida Masson Valeria
Published: October 2022

Objetivo: describir la elaboración de un objeto virtual de aprendizaje para enseñar la asignatura académica de Historia de la Enfermería.

Método: informe de experiencia descriptivo y exploratorio sobre la elaboración del objeto de aprendizaje como metodología activa en clases a distancia de la asignatura Historia de la Enfermería utilizando el modelo ADDIE (Análisis, Diseño, Desarrollo, Implementación y Evaluación) en el diseño instruccional. La asignatura se dictó entre diciembre de 2020 y marzo de 2021 en Macaé, RJ, Brasil.

Resultados: tuvo una carga horaria de 30 horas, distribuidas en 10 encuentros sincrónicos y nueve actividades asincrónicas, con la participación de 26 estudiantes a través de la plataforma MOODLE, además de otras estrategias pedagógicas. Los desafíos fueron principalmente de carácter motivacional y la interacción de los estudiantes con las plataformas demostró compromiso e interés, además de ser fundamental para que el proceso de enseñanza-aprendizaje sea dinámico y ameno.

Conclusión: elaborar el Objeto Virtual de Aprendizaje representó una estrategia que contribuyó a mejorar el rendimiento de los estudiantes, además de promover la innovación en los métodos pedagógicos de los profesores.
Growth Strategies and Performance of Commercial Banks in Nairobi County, Kenya
Authors:   Jomo Kenyatta University of Agriculture and Technology, Mutua Miriam Muthoki , Kori Blandina ,   Jomo Kenyatta University of Agriculture and Technology
Published: October 2022

Changing trends globally and customers’ expectations are forcing banks to search for new ways of income generation. Growth strategies often play a vital role in a business’s management as it allows a company to choose a direction of action and determine how to achieve its goals. The general objective of the study was to determine the effect of growth strategies on performance of commercial banks in Nairobi County, Kenya. The specific objective was to examine effect of diversification strategy on performance of Commercial banks in Nairobi County, Kenya. The study was anchored on porters’ theory of competitive advantage and modern portfolio theory. This study adopted a descriptive research design. The target population was 794 bank staff from 39 commercial banks in Nairobi County. Stratified random sampling was used to sample 238 bank staff. The study used primary data which was collected using questionnaires. A pilot study was conducted with 24 respondents representing 10% of the sample. The research used content validity. Cronbach’s Alpha Coefficient method was used to measure questionnaire reliability. Ethics of confidentiality, anonymity, no harm to the respondents’, and voluntarily participation was adhered to strictly when collecting data. Quantitative data was analyzed using descriptive and inferential statistics and tabulated. The findings showed that diversification enables the bank to leverage its resources effectively and that diversification enhances risk minimization in the banks’ investments. It was also found that diversification influences good decision making on profitable investments. In addition, the study established that risk mitigation strategies are reinforced through diversification. The study concludes that diversification strategy has a positive and significant effect on the performance of commercial banks in Nairobi County, Kenya. This study recommends that the banks should adopt diversification in their operations through use of technological advancements and other aspects such as innovation and benchmarking strategies to realize full benefits of diversification. Further, the management of commercial banks in Nairobi County should formulate and implement effective strategies to enhance regional, national and new customer segments development. Key words: Growth Strategies, Diversification Strategy, Organizational Performance