bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Valsartan in Obese Versus Non-Obese Type 2 Diabetic patients presented with microalbuminuria
Authors: Khan Muhammad Kashif , Khan Shakeel , Khan Ahmad Shamim , Sultan Khawar , Ahmad Armughan , Khalid Usman
Published: November 2021

Aim: To ascertain efficacy of Valsartan, an angiotensin receptor blocker (ARB) in reducing microalbuminuria in obese verses non obese patients. Methods: This comparative study was done in Department of Nephrology Pakistan Institute of Medical Sciences Islamabad from July 1, 2018 to December 31, 1018. Patients fulfilling selection criteria were enrolled and categorized as two groups obese & non-obese; both groups were given valsartan. Urine ACR and serum creatinine was followed every month for 6 months. Results: Average age of all cases as 52.06 ± 4.11 years while the mean age in obese and non-obese cases was 52.48 ± 4.25 years and 51.63 ± 3.95 years, respectively. The mean change in Urine ACR (from baseline to 6th months) in obese cases was 41.76 ± 25.81 and non-obese cases was 76.05 ± 7.63, p-value <0.001. In obese cases mean urine ACR at 1st and 2nd month was same from baseline, p-value > 0.05 while at 3rd, 4th month was statistically lower as compare to baseline urine ACR, p-value < 0.05. Moreover, in non-obese cases the mean urine ACR was statistically decreased at 1st, 2nd, 3rd, 4th, 5th and 6th month when compared with baseline, p-value < 0.001. At 4th month in obese cases none of the cases achieved ACR < 30 while in non-obese cases 4(7.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.05. At 4th month in obese cases 12(22.2%) cases achieved ACR < 30 while in non-obese cases 31(57.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. At 6th month in obese cases 20(37%) cases achieved ACR < 30 while in non-obese cases 41(75.9%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. Conclusion: Valsartan is more effective in reducing microalbuminuria in non-obese patients as compared to obese patients. Keywords: Diabetes mellitus, obesity, microalbuminuria, Valsartan
Comparing Effectiveness of Letrozole Versus Clomiphene Citrate to Evaluate the Ovulation Induction in patients with POS
Authors: Zafar Tehmina , Asif Fiza , Naurin Rubina , Majeed Tayyaba , Mahmood Zahid
Published: November 2021

Background: Anovulation is the commonest cause of female infertility and polycystic ovarian syndrome (PCOS) is the most frequently seen cause of anovulation among infertile females. Letrozole and Clomiphene Citrate are two common drugs for PCOS. But controversial data was noticed regarding their effectiveness. Aim: To compare effectiveness of Letrozole versus Clomiphene Citrate to evaluate the ovulation induction in patients with polycystic ovarian syndrome Methods: After fulfilling the selection criteria, total 360 females were enrolled according to calculated sample size and were randomly divided into two equal groups. One is treated with letrozole and other is clomiphene citrate. Successful ovulation was noted on follow up. Data was collected in proforma and later on analyzed in SPSS version 23. Results: The mean age of patients in letrozole group was 26.61± 4.81 years and in clomiphene citrate was it 27.89±4.24 years. Successful ovulation induction was noted in 172 with letrozole and 150 with clomiphene citrate i. e p-value=0.001. Conclusion: Letrozole has significantly better efficacy for successful ovulation than Clomiphene Citrate for PCOS. Keywords: Ovulation, Clomiphene citrate, Letrozole, polycystic ovarian syndrome
Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic
Authors: Anwar M. Waseem , Anwer M. Faheem , Chaudhry Wasif Majeed , Anwar Farhana , Aslam M. Usman , Usman Rashid , Anwar Fizza
Published: November 2021

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.
Epidemiological Profile and Clinical Experience of Abdominal Wall Hernia in Tertiary Care Hospital, Pakistan
Authors: Rehman Umar , Mumtaz Wardah , Nauman Fazal-E- , Saeed Zahid , Mahmood Arshid
Published: November 2021

Background and Aim: Abdominal wall hernia is a communal surgical intervention complication with groin hernia being the most commonly presented hernia around the world. Delay in addressing these complications may cause morbidity and mortality. Hernias can be repaired using a variety of surgical techniques. The purpose of the current study was to assess the epidemiological profile and clinical experience of abdominal wall hernia in tertiary care hospital, Pakistan. Materials and Methods: This epidemiological prospective study was conducted on 226 patients with abdominal wall hernia at HBS General Hospital, Islamabad for period of one year i.e from July 2020 June 2021. All the hernia patients admitted to the surgery department for abdominal wall hernias during the study period were examined. The relevant details of each individual were gathered from hospital medical and clinical records and noted in pre-designed proforma. Epidemiological and clinical profiles were tabulated and analyzed. Results: The overall mean age of patients was 44.6± 5.6 with age ranges from 16 years to 72 years. Out of all the operated hernia patients, about 174 (77%) were male and 52 (23%) were female. The male to female ratio was 3.34:1. Of the total 226 abdominal wall hernia patients, 202 (89.4%) patients were operated on. The prevalence of emergency-based operated hernia patients was 40 (19.8%). The most common operated abdominal wall hernia was groin hernia in 162 (80.4%) followed by umbilical, epigastric, paraumbilical, and rarer hernia with respective prevalence 20 (9.9%), 8 (3.9%), 10 (4.9%), and 2 (0.9%). Ascites, prostatic problems, chronic cough, previous surgeries, chronic constipation, and obesity were the different predisposing factors. The prevalence of predisposing factors were ascites in 3 (1.3%), prostatic problems 46 (20.4%), chronic cough 113 (50%), previous surgeries 20 (8.8%), chronic constipation 41 (18.4%), and obesity 3 (1.3%). Conclusion: Our study found that the male population is more susceptible to abdominal wall hernia compared to the female population. Low socioeconomic status with major risk factors such as constipation, old age, lifting heavy objects, smoking, surgery phobia, homeopathy medicine treatment were the main factors for increased rate of morbidity and mortality. Keywords: Abdominal wall hernia; epidemiology; risk factors
Determining Major Stressors for Students at a Private Medical College in Lahore, Pakistan, Using MSSQ.
Authors: Raza Zaidi Syed Hussain , Mukhtar Sara , Yasmeen Rahila , Khan Rehan Ahmed , Azhar Tayyaba , Mukhtar Sara
Published: November 2021

Background: Undergraduate medical studies are tough and require long hours of study and thus can lead to significant stress for the students both physically and emotionally. Stress can affect a student’s mental wellbeing and can lead to anxiety, fatigue and depression. Medical undergraduates report a greater level of perceived stress then general population. We need to understand the stressors affecting the health of our students in order to prevent psychological and emotional consequences. Methods: A descriptive cross-sectional study using the Medical student stressor questionnaire (MSSQ) was designed to determine the different stressors that a medical student deals with during their educational career at the University College of Medicine (UCM) at University of Lahore (UOL). Student participation in this study was voluntary. 1st, 2nd and 3rd year MBBS students of UCM were included in the study. The questionnaire has 20 questions that determine the academic, interpersonal & intrapersonal, teaching and learning, social, drive and desire, and group activities related stressors. The students were further asked to answer questions related to their gender, study routine and physical activity. They were also asked about family and social support available to them. SPSS software version 23 was utilized for data analysis. Results: Data revealed that the 2nd and 3rd year students regard academic related stressors as the most bothersome for them, whereas the desire related stressors were regarded by them as causing mild to moderate stress. The remaining four domains were rated as causing only moderate stress. 1st year students graded the academic related stressors as the cause of most stress for them, while the teaching and learning related stressors, interpersonal related stressors and social related stressors were rated less than it. Drive and desire related stressors were regarded as causing mild stress. When we compared the data from all three years, we found that group activates related stressors were regarded as least stressful by 3rd year students. 3rd year MBBS students rated the intrapersonal & interpersonal stressors, social related stressors, drive and desire related stressors and group activity related stressors at a level that was lower than the 1st & 2nd year MBBS students. Conclusions: Academic related stressors and teaching and learning related stressors were rated as being most stressful by students of all three years. Institutions should take to make the learning environment less stressful for the students as continued stress can adversely affect the health and mental well-being of the students. Keywords: Undergraduate Medical Students, Stress, Medical student stressor questionnaire (MSSQ)
Prevalence of Thrombocytopenia in Neonates Born to Mothers with Pregnancy Induced Hypertension
Authors: Masood Anum , Jahan Raushan , Khanam Asima , Khanam Shaista , Firdous Tabassum , Khanam Saadia
Published: November 2021

Background: Pregnant women with hypertension are at high risk to deliver a newborn with severe thrombocytopenia. Little is known concerning the magnitude of thrombocytopenia in neonates born to mothers with PIH and controversy was also present. Objective: To determine the frequency of thrombocytopenia in neonates born to mothers with pregnancy induced hypertension. Material & Methods: This cross sectional study was carried out at department of Neonatology, Lady Aitcheson Hospital, Lahore for 6 months. A sample of 1ml from cord blood was taken and sent to hematology laboratory. Neonatal thrombocytopenia was labeled. All the data was entered and analyzed on SPSS version 16. Results: The mean age of babies was 13.31±7.07 days. The male to female ratio was 1.1:1. The mean platelet count of the babies was 150.23±29.39. Thrombocytopenia was present in 41.50% babies. Conclusion: Prevalence of thrombocytopenia was 41.5% in females with PIH. Keywords: Thrombocytopenia, Pregnancy Induced Hypertension, Mothers, Neonates, Neonatal Intensive care unit
Evaluation of Antimicrobial Effect of Oenothera biennis by Using Different Concentrations of Extract against Staphylococcus Aureus -An experimental study
Authors: errum Anila , zahid M. Talha , pervaiz Saima , ishtiaq Faiza , imran Nada , ikram Sadia , zahid Muhammad
Published: November 2021

Background: Staphylococcus aureus is a superbug which is infamous for causing wound infections. Unfortunately it is developing resistance quickly against commonly used antibiotics. Antimicrobial drugs effective against methicillin resistant staphylococcus aureus are too expensive to afford by impoverish population in our country. However, herbal medicines are seen to be equally effective with less severe adverse effects. There is need to explore alternative medicines of botanical origin to cure dangerous bacteria. Oenothera biennis contains phytochemicals which have antimicrobial activity against some gram negative and gram positive microorganisms. Objectives: To evaluate the minimum inhibitory concentration of Oenothera biennis seed extract against staphylococcus aureus by using different concentrations. Study Design: In Vitro antibacterial study. Settings: The study was conducted in microbiology laboratory of Shaikh Zayed Medical Complex, Lahore. Duration: One year. Methodology: Oenothera biennis extract was prepared in 95% Ethanol in biochemistry laboratory of Pakistan Council of Scientific and Industrial Research (PCSIR) Lahore. Staphylococcus aureus isolates were procured from microbiology laboratory and American Type Culture Collection (ATCC) strains used as quality control for MSSA & MRSA, were purchased from musaji adam and sons Karachi (imports@science-ware.com). The antibacterial activity of oenothera biennis seed extract against staphylococcus aureus was tested by deep well broth microdilution and disc diffusion method. Different concentrations of stock solutions (100μg/10μl to 500μg/10μl of DMSO) were used to test antimicrobial effect to establish dose response relationship. Results: Results were measured and compared according to Clinical and Laboratory Standard Institute. Oenothera biennis seed extract inhibited growth of methicillin sensitive and methicillin resistant staphylococcus aureus isolate from laboratory as well as ATCC strains with minimum inhibitory concentration 530μg/10μl solvent. Whereas other concentrations 50 μg/10μl ,100 μg/10μl ,150 μg/10μl ,200 μg/10μl ,250 μg/10μl ,300 μg/10μl ,350 μg/10μl ,400 μg/10μl ,450 μg/10μl and 500 μg/10μl had no effect at all. Conclusion: Oenothera biennis extract inhibits growth of staphylococcus aureus at concentration of 530μg remarkably. This can inhibit both MSSA & MRSA already proved in our study. This could be beneficial as an alternate medicine. However, further research is needed to be conducted for animal study. Key words: Oenothera biennis, ethanolic extract, Methicillin sensitive, Methicillin Resistant Staphylococcus aureus, MSSA, MRSA.
Effect of E-Learning on Higher Education
Authors: Ullah Muhammad Saif , Razaq Nadeem , Iqbal Nasir , Ain Qurat Ul , Hassan Unaiza , Ahmed Aminah , Ain Noor-Ul-
Published: November 2021

Background: Most institutions in the Pakistan face many educational troubles that innovation can offer assistance to overcome. A digital source, such as Zoom, LMS and Moodle e-learning stage has been actualized at national level in Pakistan. These learning makes a difference to supply e-content and to appear distinctive conceivable results for executing a synchronous e learning modules This paper appears highlighted the elearning increments which motivate the undergrad for online learning. Objectives: To evaluate the minimum inhibitory concentration of Oenothera biennis seed extract against staphylococcus aureus by using different concentrations. Study Design: Descriptive, cross sectional study design. Settings and Duration: The study was conducted during the period of six months from March 2020 to August 2020 at Mohi-ud-Din Islamic Medical College Mirpur Azad Kashmir. Methodology: Non probability convenient sampling technique was used and all the students of 1st and 2nd year MBBS were invited for the study. Approval of institutional ethical review committee and informed consent from the participants were obtained. The collected data was organized, entered on SPSS version 21 to analyze by the use of statistical tools. Results: Total 200 study participants, 43.5% were females and 56.5 % were males, 50% were from 1st year and 50% were from 2nd year of MBBS class. The majority of participants (63%) were from urban area. Father’s occupation of participants was businessman (35%), professionals including doctor, teachers and engineers (25%), landlord and farmers (15%), other Government employees (25%). Education level of fathers was bachelor degree or above in (75%) and among mother of the participants it was found as (54.5%). Conclusion: This review highlighted several important discoveries in the near-online learning mode, disproved others, and made a number of predictions about long-term online innovation for instructional purposes. Key words: e-learning, higher education, inspiration, web-based instruction
Patterns of Smartphone Usage among Clinicians in Clinical Settings
Authors: Majid Abdul , Sarfraz Fahad , Mehboob Usman , Sarfraz Farrukh , Zubair Ayesha , Khan Rehan Ahmed
Published: November 2021

Background: Mobile device use has become a necessity in one’s life. Much less is known about the patterns of mobile use by doctors while working in clinical settings. The aim of this study is to describe the patterns by which doctors use mobile devices in the clinical settings and doctors perceptions related to its use. Methodology: This cross-sectional descriptive survey was conducted from October 2019 to March 2020 and included 200 doctors working in Sheikh Zayed Medical College Hospital, Rahim Yar Khan. After obtaining ethical approval and taking informed consent, participants were requested to fill a self-designed questionnaire. Identity was kept anonymous and data was organized and analyzed through SPSS software version 23. Results: Out of 170 participants who responded, 92.4 % reported using mobiles phones in clinical settings for communication purposes, while 49.4 % used mobiles for information access. Only 18.2 % doctors used mobiles for organization and scheduling purposes. 27% percent doctors reported using social media application during clinical hours with Facebook being the most common application. Overall, the participants perceived use of mobiles to be useful and supplemental in patient care but issues of ethics and disruption in patient care with mobile usage needed to be dealt with. Conclusion: There is increasing utility of mobile phones in the lives of doctors in all domains including clinical settings. Clear policies regarding mobile phone usage can help health professionals use this technology in a more productive way to improve patient care. Key words: Mobile, clinical settings, clinicians
Examination of The Attitudes of Cycling Athletes' Towards Ecorecreation
Authors: Albayrak Veysel , Gacar Atalay , Nacar Eyyup , Tutar Ömer Faruk
Published: November 2021

Background: It is known that people's relations with nature can be greatly influential in all periods of their lives and especially in their future, which has increased their interest in concepts such as "environment", "nature", "natural life", "ecology", "ecosystem" as a result of the increase in natural awareness in humans. Aim: Based on these ideas, our research aims to measure the attitudes of cycling athletes in Elazig province towards ecorecreation.. Methods: A total of 178 athletes from 242 cycling athletes, including cycling sports clubs, associations, and individual athletes in Elazig province, participated voluntarily. It consists of 31 substances and 6 sub-dimensions developed by Ayyildiz and the 'Personal Information Form' prepared by the researchers as a data collection tool. Attitude Scale Towards Ecorecreation(ASTE), which was created in a 5-point Likert type format, was used. Spss 22.00 package program was used for the analysis of the data and the level of significance was determined as p<0.05. In the study, t-test analysis was applied to determine the significance of the differences between two groups and ANOVA was applied to determine the significance between more than two groups. Pearson correlation analysis was used to determine the direction and severity of the relationship between variables. Results: As a result of the research, there was a semantic difference in the individual and environmental sensitivities of licensed cycling athletes. A significant difference was observed in the Attitudes and Behavior towards Ecorecreation sub-dimensions of the athletes who are interested in another nature sport. Conclusion: The increase in positive behaviors towards nature has clearly become clear that it is directly related to being in nature. Accordingly, researchers believe and draw attention to the fact that in order to increase the positive effect on nature, it is necessary to be intertwined with nature and to adopt it. Keywords: Cycling, Outdoor Sport, Recreation, Ecorecreation
Examining Addiction Levels of Tablet, Phone, and Computer Gaming According to the Parents' Opinions of Students Participating Summer Sports Schools
Authors: Albayrak Veysel , Gacar Atalay , Nacar Eyyup , Tutar Ömer Faruk
Published: November 2021

Background: The universe of the research is the athletes of summer sports schools held in Elazig in 2021. The sample consists of the mothers of 669 randomly selected athletes from sports schools. Aim: The aim of the study is to examine the levels of gaming addiction according to the parental opinions of the students participating the 2021 Elazig Summer Sports Schools. Methods: In order to determine the demographic characteristics of the participants in the study, the personal information form(gender, age, school level, mother work status, child's tablet/phone ownership status), and an 18-item scale developed by Ulusoy (2019) was used. Analysis of the data in the research and the calculation of the results found were created through statistical programs in a computer environment. Frequency (f) and percentage (%) distributions of variables were calculated. The data were checked with skewness and kurtosis tests to determine whether they were normally distributed. As a result of these tests and controls, it was determined that the data of the research was parametric. Therefore, t test and variance analysis (Anova) test were used. The error level was taken as p<0.05 in the study. Results: It was determined that there was a statistically significant difference in computer game addiction depending on the gender, mother work status and tablet/phone/computer availability of the students participating summer sports schools in Elazig province. There was no statistically significant difference in computer game addiction depending on educational status and age variables. Conclusion: In line with the study findings, it was observed that the overall average of computer game addiction levels was below average at 45.30 within the framework of the parental opinions of the students participating summer sports schools in Elazig province. Keywords: Sports, Gaming, Addiction, Technological Device
The Effect of Participation in Educational Games Activity on Respiratory Values and Anthropometric Properties in Children
Authors: Köroğlu Yaşar , Ökmen Mehmet Şerif
Published: November 2021

Aim: In this study, it was aimed to examine the anthropometric properties and respiratory parameter values of students between the ages of 10-11 who regularly participate in educational games. Methods: 34 students studying, İncesu Kızılören Parlaklar Secondary School, voluntarily participated in the study. While the experimental group (n=18) participated in educational game activities three days a week along with physical education lessons for five weeks, the control group (n=16) attended only physical education lessons. They did not participate in the educational game activities. Two measurements were carried out to the students as pre-test and post-test. Results: While the anthropometric measurements of the students participating in the study were measured with the Tanita measuring device, their respiration values were determined with a spirometer. Data are shown as arithmetic mean and standard deviation. A dependent sample t-test was used to compare independent groups and also paired sample t-test was used to compare dependent groups. The significance level was determined as (p<0.05). In the study, it was seen that there was a significant difference in body fat mass, lean body mass (FFM), total body fluid (ibw) values of the experimental group (p<0.05), while only a significant difference was found in basal metabolic rate (bmh) values in the control group. In the respiratory function values, the forced vital capacity (fvc), the air volume removed in the first second of forced expiration (fev1) of the experimental group. While the difference in peak expiratory flow (pef) and maximum voluntary ventilation (mvv) values were found to be significant, fev1, pef, and mvv values were found to be significant in the control group (p<0.05). Conclusion: It was seen that educational games had a positive effect on anthropometric measurement and respiration values in primary school students aged 10-11 years. We think that increasing the time of the physical education lessons and sparing more time to educational games, explaining the importance of educational games to physical education teachers, school administration, and students, and regular educational game competitions will make a significant contribution to the development of children. Keywords: Educational Games, Anthropometric Measurement, Respiratory
Reviewing the psychological resilience levels of the students studying at the faculty of sports sciences in terms of different variables
Authors: Bas Muhammet , Gundogdu Cemal
Published: November 2021

Background: Resilience is a key psychological aspect of sport. Aim: The purpose of this study was to review the psychological resilience levels of the students studying at faculty of sports sciences in terms of different variables. Methods: The study was designed in general survey model. The study population was consisted of 670 participants who attended Mus Alparslan University Faculty of Sports Sciences whereas the study sample was consisted of 398 participants. Besides; 162 of the participants were female (x̄age=21.3±1.9) and 236 were male (x̄age=22.4±3.2). In the study; “Brief Psychological Resilience Scale” –developed by Smith et al., (2008) and adapted to Turkish by Dogan (2015)- was employed as data collection tool. To analyze the data; such descriptive statistical methods as t-Test and One-Way Analysis of Variance (ANOVA) were used. Results: It was identified that participants’ psychological resilience scale scores differed statistically and significantly on behalf of male participants according to gender variable (p<0.05). Conclusion: In sum; participants’ psychological resilience levels did not differ in terms of the variables of age, academic department, general average academic grades, mother’s educational status, father’s educational status and grade (class) but it differed on behalf of male participants according to gender variable. Keywords: Physical education, psychological resilience, sports.
The law of bare life
Authors: Ward Ian
Published: November 2021

2020 proved to be a remarkable year. Not the least remarkable was the realisation that, in a moment of perceived crisis, the instinctive response of the UK Government was to sweep away various so-called rights and liberties which might, in a calmer moment, have been presumed fundamental, and to rule by means of executive fiat. The purpose of this article is to interrogate both the premise and the consequence. Because, on closer inspection, there is nothing at all remarkable about how the Government reacted, for the same reason that there was little that was unprecedented about the experience of COVID-19. History is full of pandemics and epidemics, and government invariably acts in the same way. The first part of this article will revisit a particular theory of governance, again proved by history; that which brings together ‘bio-politics’ and the jurisprudence of the ‘exception’. The second part of the article will then revisit a prescient moment in British history; another disease, another panicked government, another lockdown. In the third, we will reflect further on the experience of COVID-19 and wonder what might be surmised from our foray into the past.
Şehir Hastanesi Yatırımları ve Gayrimenkul Katma Değer Yönetimi İlişkisi
Authors: ALİEFENDİOĞLU Yeşim , BOSTANCI Sevilay
Published: November 2021

Bu çalışmada Türkiye’de şehir hastanelerinin oluşum süreci anlatılmaktadır. Çalışmada konuya ilişkin dava örneklerine yer verilmiş, hastaneler açısından gayrimenkul katma değer yönetimi konusu irdelenmiş, gayrimenkulle ilgili dört bakış açısına bağlı hastane gayrimenkulünün katma değerlerini yenilikçiği artırmak, kullanıcı memnuniyetini artırmak, kültürü geliştirmek, maliyetleri azaltmak, verimliliği artırmak, esenkliği artırmak, görüntü desteği, kontrol riskleri ve finans pozisyonunu iyileştirmek şeklinde olduğu ortaya konulmuştur. Türkiye’ de tüm kamu projelerinde olduğu gibi hastanelerin inşası konusunda da en önemli sorun kamunun finansal kaynak bulma sorunudur. Bu sorunu aşmak için Kamu Özel Ortaklığı Modeli (KÖOM) çözüm olarak düşünülmektedir. Fakat bu modelin de inşa aşamasından sonra bir takım oluşacak kamuya yük olacak sorunları bulunmaktadır. Ayrıca kamu yatırımlarının çevresindeki gayrimenkkullerde rant oluşmaktadır. Kamu yatırımlarının çevresindeki gayrimenküllerin değeri artmaktadır. Bu rantın veya değer artışının kamuya kazandırılması bir zorunluluktur. Bunun içinde Türkiye’de yasal bir zemin oluşturulması gerekmektedir. Ayrıca teknik boyutu da düşünülmelidir. Bu da ancak gayrimenkul yönetimi ve geliştirme konusunda deneyimli ve eğitim almış uzmanlar tarafından yapılabilir.
Disbelief in Historical Examples
Authors: Gárdos Bálint
Published: November 2021

This paper discusses the different conventions of literary didacticism in Gray’s Elegy from almost medieval allegorical teaching, replete with capitalized moral qualities (“Ambition,” “Grandeur,” etc.), through the humanist model of exemplary history (teaching through the powerful rhetorical presentation of turning points in the lives of great men) to a modern model of teaching that is not directed at action but at sympathy evoked through the understanding of socio-economic and cultural forces. The analysis focuses on the transactions between exemplary history and the “annals of the poor” in the poem.
The Rhetorical Sources of Tristram Shandy
Authors: Hartvig Gabriella
Published: November 2021

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Laudare Necesse Est
Authors: Ittzés Gábor
Published: November 2021

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Nabokov's Cold Pudding
Authors: Sárdi Rudolf
Published: November 2021

Vladimir Nabokov was noted for his barbed criticisms on any number of the major 19th and 20th-century writers and their celebrated works. James Joyce is one of the few elect who escapes being tipped into Nabokov's disposal by dint of his extravagant stylistic accomplishment in Ulysses, while Finnegans Wake is wittily described as "a formless and dull mass of phony folklore, a cold pudding." In spite of Nabokov's disdainful comments on Finnegans Wake, this paper attempts to demonstrate the stylistic and structural influences Joyce's work exerted on Lolita, Pale Fire, and Bend Sinister.
'anythongue athall'
Authors: Takács Ferenc
Published: November 2021

This paper describes the ways Finnegans Wake impresses on its readers both the freedom and the necessity of multiple-language contextualisation of its linguistic items as a way to maximising meaning. As a consequence, this throws into doubt the routine assumption, made as a prerequisite for any act of reading or understanding any text, that the text in question is in a given language, or, in other words, that as an initial move in an act of reading the reader routinely assigns a language identity to the text. Thus Finnegans Wake problematises the language identity of its text as well as the routine assignment of a language identity to any text by its reader. In the act of reading Finnegans Wake, however, this foregrounding or thematisation gives rise to a concurrent higher-order act of metathematisation, where thematisation itself is thematised, with the result that, alongside specific assumptions about the language identity of a specific text as well as about the routine assignment of such an identity, more general or higher-order assumptions underlying the very notion of language identity are foregrounded and thus problematised. Through the radical "deviancy" of its text, Finnegans Wake is essentially "about" its own reading and, through meta­thematisation, it is also "about" reading, or the interpretative process, in general. The latter will be shown to involve the problematisation of several of our most general assumptions about language and literature we routinely and tacitly make whenever we embark on an act of reading, or interpretation, of any "normal" or "ordinary" text.
'The eye of man hath not heard'
Authors: Kállay Géza
Published: November 2021

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An English Magus Comes at Last to Hungary
Authors: Zemplén Gábor
Published: November 2021

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Imprisonment in Nelson Algren's The Man with the Golden Arm
Authors: Ward Robert
Published: November 2021

This essay treats the differing paradigms of imprisonment that I argue are prevalent in Nelson Algren's novel The Man with the Golden Arm. My argument explores the motifs of confinement through an analysis of the two central characters. I focus on Frankie Machine, whose incarceration functions as a sanctuary, which stimulates his "escape" from morphine addiction, and his wife Sophie Majcinek, whose figurative entrapment in the tenement room shapes her psychological and physical paralysis. I ask if the apparent development of the way prison dealt with prisoners in mid-century America, by focusing more on models of treatment than punishment, informs our understanding of Machine's gradual regeneration and empowerment. I also question whether the sphere of the tenement room also serves as a symbol of absolute enclosure. My argument is that such conflicting representations of confinement reveal the schism underlying the motif of imprisonment within The Man with the Golden Arm.
On 'Ode on a Grecian Urn’
Authors: Timár Andrea
Published: November 2021

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Fasting and Feasting in Hamlet
Authors: Turi Zita
Published: November 2021

This paper aims at discussing the features of carnival in Shakespeare’s Hamlet by focusing on the notions of fasting and feasting in the drama. Carnivalesque interpretations tend to identify the characters of Hamlet and Claudius as the allegorical figures of Lent and Carnival, who during the course of the play also fight their combat. Since Lent and Carnival are primarily characterised by food-related metaphors and imagery linked with corporeality and eating, the paper restricts its scope to the investigation of gustatory conceits and their possible implications. First, it seems reasonable to outline briefly the critical background of carnivalesque interpretations of Shakespeare. Secondly, the paper attempts to establish its argumentation by placing the main characters into a carnivalesque context and, thirdly, the last section proposes to explore the rich variety of conceits related to incorporation. Hopefully, by the end the article will be able to justify its thesis and the validity of such a carnivalesque interpretation of Hamlet.
Language and Ritual in T. S. Eliot's Sweeney Agonistes
Authors: Szele Bálint
Published: November 2021

T. S. Eliot's Sweeney Agonistes is one of the most important pieces in modern drama. The purpose of this study of Sweeney Agonistes is to explore the fertilising forces that made it possible for the play to bring new colours to the language of the theatre; another aim is to look at the background of the fragments, exploring the different elements of ritual, religion, and literary sources working in the play. Although the play is fragmentary, it can be regarded as a key to Eliot's dramatic art. The way Eliot used the language of Jazz is unique in early 20th century literature; the lack of characters, plot and settings naturally draw our attention to language, which is characterised by an unprecedented vitality and dynamism. Eliot clearly succeeded in establishing a new vehicle for dramatic expression. The rituals providing the background in Sweeney are closely connected with Greek drama and the religious turn in Eliot's life leading to the birth of the Ariel Poems, one of which, "The Journey of the Magi," opens up to further analysis if we approach it from the direction of Sweeney Agonistes.
An Untidy Finish
Authors: Cahill Samara Anne
Published: November 2021

In the controversial epilogue of Ian McEwan’s Atonement (2001), Briony Tallis informs the reader that she has “always liked to make a tidy finish.” The statement is formally ironic because it renders the conclusion of Atonement untidy: only in the epilogue do readers learn that Briony, a character within the narrative, also constructed the narrative. Her guilty consciousness, haunted by the ghosts of the past, the villains of the present, and the dementia that awaits her in the near future, is the filter through which readers have experienced the story of the love affair between Briony’s sister, Cecilia, and Cecilia’s lover, Robbie Turner. An exploration of the ethical crafting of narrative – both fictional and historical (that is, ostensibly “non fictional”) – Atonement formally mimics the comforting conventions of both religious ritual and realist description in order to suggest that “reality” is much more accurately apprehended (and represented) by a gothic, rather than a realist, sensibility.
Narrative Techniques in The Four Zoas
Authors: Csikós Dóra
Published: November 2021

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Saki as Dauphin of the Wildean Witticism
Authors: Birden Lorene M.
Published: November 2021

Saki and Wilde are often compared in biographical articles or book reviews, and the direct point of the comparison is their use of aphoristic humour. However, one notices that only one of these two authors is quoted regularly. This study attempts a considered comparison of the two authors on the basis of their terse commentaries, here called witticisms. It offers a more in-depth look at Saki, considering him as the “underdog” in the comparison. The article begins with basic information, including a brief explanation of the use of the term “witticism,” in keeping with humour studies practices. It then proceeds with theoretical considerations of humour and English culture, and ends with detailed analysis of some of each author’s productions. The final conclusion is twofold: first, that Wilde’s witticisms are more quoted because they can be more easily detached from their context; second, that Wilde produces more of the type of witticism that Saki produces, but these remain unquoted, for the same reason as Saki’s.
The Embodiment of Grief
Authors: Ruttkay Veronika
Published: November 2021

Following recent work by James Engell, this paper sets out to explore points of connection between romantic literary criticism and the "new rhetoric" of the late 18th century. More specifically, it looks at how the earlier concept of the "rhetoric of passion" was taken up by Coleridge in his lectures on Shakespeare, focusing primarily on his treatment of Constance's speech on grief in King John. The same passage was evoked and strongly criticised by such "new rhetoricians" as Lord Kames and Joseph Priestley, who claimed that its intricate imagery rendered it unnatural and unsuitable to the expression of profound grief. Coleridge, by refuting these charges, redefines the earlier concept of the "language of passion" and turns it into a more comprehensive critical idea, which is able to accommodate figurative language beyond the rules of classical rhetoric or a rigidly conceived associationist psychology. He is aided in this by two things: first, by his new understanding of reading as on-going experience (as opposed to Kames's method, based on the analysis of a given passage in the light of pre-established rhetorical and psychological rules), and second, by his emphasis on the rhetorical "embodiment" that takes place in the "impassioned" literary text.
Refocusing the Gendered Gaze
Authors: Murray John C.
Published: November 2021

Daniel Defoe makes use of subject-object patterns within his novel Moll Flanders in order to produce ruptures within eighteenth-century gender ideology and to reconstitute the subject-object relation between masculine and feminine within the novel. Even as Defoe affirms the dominance of gender ideology by positioning his readers as objects of the novel, Defoe uses his character of Moll Flanders to suggest the potential for transforming ideology through the performative act of gender. As Moll struggles to link fragments of her past, she explores the boundaries of gender identity and transgresses their limits in order to achieve movement within eighteenth century society. How Moll negotiates her conceptions and interpretations of her relation to her natural, cultural, and psychological landscapes suggests her success in tracing the presence of an identity that would inform and sustain the self by allowing her to assert a sense of economic individualism, which might release her from any moral obligation to the pervasive and dominant ideologies affecting gender in the eighteenth century.
Michelle Cliff's Non-Western Figures of Trauma
Authors: Croisy Sophie
Published: November 2021

This paper shows that Michelle Cliff's work puts Western trauma theory through the work of creolization. It critiques the inadequacy of trauma theory qua colonial theory in the process of understanding a historical trauma that centers around racial (and partially gender) difference. To do so, we look at Cliff's Abeng and No Telephone to Heaven in order to question certain givens in the field of trauma studies, reconceptualize the problematic theories of this Eurocentric frame of thinking, and promote the revision of the field's intentions in order to become productive in the postcolonial context. The paper also shows that Cliff takes her readers and characters through the difficult work of re-membering Caribbean history, a history erased by colonial fables. The dissemination of historical truths and positive images of prominent black characters which were, in the past, imposing figures of resistance, helps the readers and characters to reflect upon the damage done to the country of maroon warriors in the past and the repercussions of that damage on the present. This is one step in the process of identity recovery for the main character Clare Savage, whose progressive discovery and critique of social discrepancies based on racial difference and eventual struggle enable her to understand the historical trauma of her own people and use that trauma as the root for re-constructing a positive Caribbean identity.
The Boundaries of the Stage
Authors: Sándor Beáta
Published: November 2021

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'Actors' in 'Barbaresque Mantells'
Authors: Oroszlán Anikó
Published: November 2021

Ben Jonson's successive masques The Masque of Blackness and The Masque of Beauty have generally been interpreted in terms of Neo-Platonic symbolism and imagery. However, since these court masques were not only pieces of written poetry, but also well-organised spectacles, it might be of interest to approach them from the perspective of performance and in comparison to popular theatre. The present paper discusses how theatricality, popular entertainment, acting, and professional players are connoted by the "blackness" and the changeable nature of the female masquers in Ben Jonson's Masque of Blackness. Considering his ambiguous and vehement relationship to the stage designer Inigo Jones, I am also examining Jonson's antitheatrical attitude and his struggle to keep his poetry "white," "beauteous," at a distance from the mutability of performance.
Wild Words
Authors: Kérchy Anna
Published: November 2021

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Predestination in Milton's Paradise Lost and De Doctrina Christiana
Authors: Kocic Larisa
Published: November 2021

In 1992 William B. Hunter challenged Milton's authorship of the heterodox treatise De Doctrina Christiana. The mainstream of the debate following it was faithfully recorded on the pages of the Studies in English Literature but there were a number of articles published in both Milton Studies and Milton Quarterly that added to the discussion of the treatise's provenance. In this paper I aim to develop the issue of predestination in the above-mentioned debate based on Paul R. Sellin's article "Milton's Paradise Lost and De Doctrina Christiana on predestination." In his article, Sellin tries to maintain Hunter's assumption that Milton could not have been the author of the treatise, by demonstrating a discrepancy between De Doctrina Christiana and Paradise Lost in the matter of predestination. I, on the contrary, hoped to show by detailed analysis the uncanny resemblance between the two works regarding predestination, especially when observed from a broader perspective of the doctrine of grace.
The Narrative in Danger—Endangered Narrators
Authors: Mihály Árpád
Published: November 2021

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Present Buried in the Past
Authors: Dolmányos Péter
Published: November 2021

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Turning Japanese, Turning Japanese American
Authors: Dong Lan
Published: November 2021

This article examines the identity of the Sansei (third-generation Japanese Americans) as connected to their place of heritage - Japan. Focusing on David Mura's Turning Japanese: Memoirs of a Sansei (1991), we shall explore how a Sansei writer gains further understanding and realization of his ethnic identity as a Japanese American in multi-ethnic America through the re-established connection between him and his place of cultural origin. Mura, born and raised in Midwest, recollects his experience in Japan supported by a US/Japan Creative Artist Exchange Fellowship in 1984. Mura's book ends with his realization that Japan allows him to see himself, America, and the world "from a perspective that was not white American." My argument considers his procedure of "turning Japanese" as simultaneously a process of turning Japanese American. Along the thesis of the Sansei's identity construction, the following questions will be addressed: (1) starting his trip as a self-identified American, how is Mura challenged and therefore forced to reconsider his identity during his one-year residence in Japan; (2) how does he pursue his connection with Japan that has been absent in his childhood; and (3) how does such reconnection profoundly influence his understanding of identity; namely to change his self-identification from an American to a Japanese American?
Rosalind and Celia
Authors: Matus-Kassai Gyöngyi
Published: November 2021

This paper focuses on the relationship between Rosalind and Celia from Shakespeare’s As You Like It. The study investigates a hitherto undiscovered link between their friendship and that of David and Jonathan from the Bible. Both friendships are analysed in the context of the classical and Renaissance discourse on amicitia perfecta, highlighting the most important features of idealised friendship from Cicero’s De Amicitia and Montaigne’s essay On Friendship. Furthermore, amicitia perfecta is proposed as a new, alternative framework to understand the relationship of Rosalind and Celia, which is often discussed in the context of homoerotic desire. Finally, the essay emphasises the significance of the fact that the ideal friends presented in Shakespeare’s comedy are female in a culture when women were thought to be excluded from, and incapable of, true friendship.
The Story Goes On
Authors: Polyák Béla
Published: November 2021

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Issues of Representation
Authors: Szakács Borbála
Published: November 2021

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