bluuebunny/crossref_metadata_2025 huggingface dataset:
GOVOPS-PSECO: A Model for Governance of Technology Platform Operations in Proprietary Software Ecosystem
Authors: Costa Luiz Alexandre M. , Fontão Awdren , Santos Rodrigo
Published: February 2023

Proprietary Software Ecosystems (PSECO) are those that concern data and knowledge concentrated on a proprietary software platform with contributions protected by intellectual property rights. The growing number of demands, added to the market pressure for a state-of-the-art solution for every business need in PSECO, causes organizations to work at a highly accelerated pace to deliver results in an increasingly short time. As a consequence, the software projects may be deployed with low quality, provoking financial loss. In this scenario, the central organization (keystone) must establish governance strategies on the technical, business, and social dimensions to ensure a sustainable technological platform. This work aims to develop and evaluate a model involving these dimensions to support the IT management team in the governance of the technological platform operations of PSECO.
Kleine (Sozial-) Geschichte des spanischen Fernsehens
Authors: Palacio Manuel
Published: February 2023

Die vorliegende Kleine Geschichte des spanischen Fernsehens versteht sich als ein Teil der Sozialgeschichte Spaniens. Wer über die Geschichte eines nationalen Fernsehens spricht, spricht natürlich zugleich über ein Land, seine Menschen, seine Sitten und seine Manien, sowie über sein soziales Klima, das in manchen Fällen demjenigen anderer europäischer Länder entspricht, sich in anderen wiederum völlig davon unterscheidet. Vor diesem Hintergrund ist es keine leichte Aufgabe, eine Geschichte eines nationalen Fernsehens für nicht-spanische Leserinnen und Leser zu schreiben, denen die unterschwelligen Kanäle meistens unbekannt sind, über die sich Fernsehsendungen mit ihrem nationalen Zielpublikum verbinden. Genau das aber macht es auch zu einem faszinierenden Unternehmen. Dementsprechend habe ich versucht, Merkmale der spanischen Gesellschaft aufzuzeigen, die zugleich zu einem Verständnis von spanischer Kultur führen sollen. Dabei bin ich mir bewusst, dass sich jedes Fernsehen aus der Dynamik zwischen nationalen Publika und internationalen Variablen ergibt, die aus bestimmten Produktionsvorgängen und industriellen Konfigurationen hervorgehen. Dies gilt in besonderem Maß für unsere Gegenwart, in der das spanische Fernsehen, so wie dasjenige anderer Länder auch, seine spezifischen Merkmale an die Prozesse der Globalisierung anpassen muss.
The Association Between the Maternal Body Mass Index and the Birth Weight of Infants Born
Authors: Mohammadnuri Marjan , Shojaei Parisa , Khanjari Mahsa
Published: February 2023

Background: Birth weight is one of the most important and reliable indicators of neonatal survival, physical and mental development of the neonate and is influenced by various factors including genetics, socio-cultural and demographic factors of the mother and one of the most important factors is mother's body mass index (BMI) which directly and indirectly reflects the health and well-being of the mother and her nutritional status. Objectives: The relationship between maternal body mass index and birth weight of neonetes born in hospitals of Islamic Azad University, Tehran Medical Sciences from 2021 to 2022. Methods: In this cross-sectional descriptive study, 288 neonates born in hospitals of Azad University are selected. Information about neonates (gender and birth weight) and maternal information (BMI, age, occupation, education, type of delivery, gestational age, parity and history of preeclampsia) and family income are included in the designed questionnaire. Results: The mean age and BMI of the studied pregnant mothers were 30 and 29, respectively, and the mean weight of the newborns born from these mothers was estimated to be 3200 g. Among the mothers studied, 232 had abnormal body mass index, of which 41% were overweight and about 40% were obese. Among the neonates studied, 25 had abnormal weight, of which 11 were low birth weight and 14 were macrosomic. Analysis of the data of this study showed that maternal BMI can affect pregnancy outcome and birth weight of neonates. Between the mother's BMI and the baby's birth weight, there is a significant relationship. Conclusions: Due to the high mean BMI in pregnant women in this study and the possibility of giving birth to overweight neonate in obese mothers and the complications and risks of macrosomia and the possibility of weight gain and obesity in adulthood, it is necessary to pay attention to overweight pregnant women.
Anglicismy v ruské a české marketingové terminologii
Authors: Dunajeva Oksana
Published: February 2023

Článek přináší vhled do problematiky vzniku nové marketingové slovní zásoby v ruštině a češtině. Jsou charakterizovány obecné tendence vzniku nových marketingových termínů v daných jazycích. Výzkum vychází z předpokladu, že většina marketingové terminologie je do obou jazyků převzata z anglického jazyka. Zvláštní pozornost je věnována roli transkripce a transliterace v procesu formování ruské a české marketingové terminologie. Cílem výzkumu bylo zjistit, do jaké míry vznikají v ruštině a češtině vlastní marketingové nominace k termínům, které byly již dříve přímo přejaty z anglického jazyka.
Effect of a practice-intensive course on doctoral teaching assistants' teaching self-efficacy and priorities
Authors: Isaac Siara , de Lima Joelyn
Published: February 2023

Doctoral teaching assistants (TAs) provide key support for learning in STEM fields because they are present during exercises, labs and projects when students are actively engaging with course material. While some institutions provide training for TAs, their effect on teaching activities is rarely assessed. We use the lens of Social Cognitive Theory (SCT) to analyse data on the pre and post course teaching priorities of 20 doctoral TAs who followed a 5 day practice-intensive course on STEM HE. Course time was split between instructors modelling interactive teaching strategies to engage TAs in a data-driven reevaluation of their beliefs about teaching and having each TA teach a lesson everyday using a structured feedback loop to promote reflection. TAs reported self efficacy gains for designing instruction, addressing disruptive behaviour and managing student attention spans after the course. Their priorities also appear to shift away from ‘teaching’ and towards ‘learning’. TAs’ affective reactions and utility judgements after the course indicated that they thought the course was useful and they intended to use the strategies that they had learnt. This practice and reflection intensive course model, able to accommodate up to 40 TAs, is relevant for institutions seeking to improve the quality of undergraduate education or doctoral candidates' preparation for academic roles.
Fighting poverty: Labour markets and inequality in South Africa
Authors:   University of Cape Town, Bhorat Haroon , Leibbrandt Murray ,   University of Cape Town, Maziya Muzi ,   University of Stellenbosch, van der Berg Servaas ,   University of Stellenbosch, Woolard Ingrid ,   University of Stellenbosch
Published: February 2023

Unquestionably, poverty and inequality are among the major challenges that face South Africa today. In this well-researched, comprehensive volume, the authors: • use new techniques to measure and analyse household inequality and poverty in South Africa; • analyse the nature and functioning of vulnerability in the labour market; • explore the links between labour market participation and household poverty and inequality; • investigate current social and labour market policies; and • examine the implications of current anti-poverty policies and strategies. An exciting aspect of this ground-breaking work is the proposals for the development of new and effective strategies to fight poverty in South Africa.
Waves of change: Coastal and fisheries co-management in southern Africa
Authors:   Youth 4 Conservation, Hauck Maria , Sowman Merle ,   University of Cape Town
Published: February 2023

The oceans that meet along the southern African coast contain a diversity of ecosystems ranging from tropical coral reefs to cool-water kelp forests. Many of the coastal and marine species living in these waters are resources that are harvested by coastal communities to provide important sources of nutrition, income and livelihood. However, ongoing over-exploitation of fisheries resources, the degradation of coastal areas and conflicts among coastal resource users, call for urgent intervention. Co-management is being explored as a possible strategy to address these problems. This approach reflects a worldwide trend to involve local user groups and communities in the management of coastal and fisheries resources. This book provides an overview and analysis of nine coastal and fisheries co-management case studies in South Africa. It outlines the concepts and theoretical underpinnings of co-management and examines the policy and legal framework governing coastal and fisheries resource management in South Africa. Waves of change provides policy makers, resource managers, researchers, learners and environmentalists with a comprehensive understanding of co-management in South Africa. Case studies examine co-management in action, highlighting the conditions conducive to success, as well as the positive outcomes and principal challenges of this approach. The viability of implementing coastal and fisheries co-management in the South African context is explored and comparisons are made with international experience.
Opdualag for Metastatic Melanoma
Authors:   Editors from The Medical Letter
Published: February 2023

Opdualag (BMS), a fixed-dose combination of two immune checkpoint inhibitors — nivolumab (Opdivo), a programmed death receptor-1 (PD-1) inhibitor, and relatlimab-rmbw, a lymphocyte-activation gene-3 (LAG-3) blocking antibody — has been approved by the FDA for treatment of unresectable or metastatic melanoma in patients ≥12 years old.
Appraisal of Inter-Professional Education (IPE) in the World and its Importance in Delivery of Health Care
Authors: Farah  Asad Mansuri
Published: February 2023

Inter-professional education is one  of  the  transformations  in  medical  education.  Though  prevalent  more in developed than developing countries for about half a century, but only in the last 10 years has shown an overriding role in various health  related  fields.  Inter-professional  or  collaborative  education was started in order to  improve  health  care  delivery  by  incorporating  better  communication,  team  work, assigning responsibilities to individual providers and observing ethical values in a  health  care  setting, among  providers  of  various  professional  background.  World  Health  Organization  and  other  top rated education agencies have necessitated the role of IPE but with insufficient evidence from dif-   ferent fields of medical practice. The role of IPE has been  determined  in  medical  education,  by  se- lecting work setting, types of professionals, content of the course, data collection procedures and use         of subsequent analysis. Most of the evidence regarding effectiveness of IPE in  actual  collaborative  practice is demonstrated from developed countries. While developing countries basically reported dy- namics of IPE and lack enough evidence in evaluating Inter-Professional Practice (IPP).

This review is written in order to identify the global incidence of IPE and particularly that of the devel-   oping world. An attempt has been made to identify the gaps in available literature for its fields of prac-      tice or research techniques applied in IPE and the types of its domains that has been studied.
Epinephrine in Paediatric Clinical Practice - Clinical Update
Authors: Anwarul Haque  , Hassaan Sadiq  , Muhammad Abdullah
Published: February 2023

Epinephrine is a "friend of the doctor" because it is a life-saving drug used in the rescue of patients at difficult times when other things do not help. It is widely used in paediatric emergency and paediatric intensive care units. This  short  commentary  on  pharmacology  provides  a  clinical  update  about  the use of epinephrine in paediatric clinical practice. The first part  of  this  article  briefly  reviews  the  clinical pharmacology and the second part describes the clinical indications and adverse effects of epinephrine.
Frequency and Risk Profiles Associated with Antenatal Anxiety and Depression in Middle Socioeconomic Women
Authors: Syeda Rabia  , Uzma Nusrat  , Sarah Qazi
Published: February 2023

Objective: To  determine the frequency of antenatal anxiety and depression and its risk profile including demographic, psychosocial and obstetric risk factors, in middle socioeconomic women.

Methods: A cross-sectional study was carried out at two private hospital centres of Karachi, over a pe-    riod of five months from October 2016 to March 2017. A questionnaire (age, education, parity, socio- economic status, employment) and the Hospital Anxiety and Depression Scale (HADS) were the tools    used to gather required information from pregnant women. Data collected was entered in SPSS 16  software. Descriptive statistics were used  to  calculate  frequency  and  mean  values.  Logistic  regres-  sion both binary and multinomial was performed to identify significant predictors of anxiety and de- pression.

Results: Our study showed that out of 520 pregnant women, 130 (25%) women had anxiety, whereas

220 (42.3%) had depression. The mean  age  of  women  was  26.9  ±  4.198  years.  The  range  being  from 18 years to 35 years. Significant risk factors among anxiety group were: working woman; 30.8% (p-value=0.000, OR=0.286), domestic violence; 84.6%  (p-value=0.000,  OR=2.8),  difficult  relationship  with in-laws;  84.6%  (p-value=0.000,  OR=12.375),  sleep  disturbance;  76.9%  (p-value=0.000,  OR=9.667), primigravida; 23% (p-value=0.000, OR=2.576) and unplanned pregnancy; 23.1% (p- value=0.029, OR=0.511).

Significant risk factors among women with depression were: working woman; 31.8% (p- value=0.000,OR=0.286), domestic  violence;  68.2%  (p-value=0.000,  OR=3.571),  difficult  relationship  with in-laws; 22.7% (p-value=0.000, OR=4.8), sleep disturbance; 54.5% (p-value=0.008, OR=2.0), primigravida; 45.5% (p-value=0.000, OR=17.246) and unplanned pregnancy; 18.2% (p-value=0.000, OR=3.0). Other factors that were found to be significant in the  depression  group  only  were: unsatis- factory relationship with husband; 22.7% (p-value=0.000, OR=4.118),  stressful  life  event  in  previous  year; 45.5% (p-value=0.000, OR=2.167), and tertiary education; 68.2% (p-value=0.002, OR=0.916).

Conclusion: Psychosocial and demographic factors such as working woman, domestic violence, and difficult relationship with in-laws and sleep disturbance had a  significant  association  with  antenatal  anxiety and depression. Obstetric risk factors were primigravida and unplanned pregnancy. Significant association with depression was unsatisfactory relationship with husband, stressful  life  event  in  a  previous year and tertiary education.
Aneurysmal Bone Cyst of Ischiopubic Ramus: A Rare Location with Literature Review
Authors: Rehana Shaikh  , Saba Sohail  , Badaruddin Sahito
Published: February 2023

Aneurysmal bone cyst (ABC) is a locally destructive lesion of the bone rather than a true neoplasm. The pelvis is not an unusual site for an ABC; approximately 12% of cases occur in this location. We present a case of aneurysmal bone cyst (ABC) in ischiopubic ramus in a 22 years old male who presented with right inguinal swelling and pain. He was evaluated with X-ray and  Magnetic  Resonance Imaging (MRI) of pelvis. A review of literature regarding this rare site of ABC with radiological features is also described in this case report.

ABC of ischiopubic ramus is an uncommon entity hence diagnosis of such  a  case  requires  proper  clinical, radiological and histopathological evaluation to rule out other differential diagnoses  of  an  expansile, osteolytic lesion. This will help in selecting a proper treatment plan.
Transhumanism: The Epitome of Doom and Gloom
Authors: Noorulain Hyder  , Muhammad Liaquat Raza  , Azfar Athar Ishaqui
Published: February 2023

Ever since the idea of "Transhumanism" came into being, it has divided our society into two opposing factions i.e. the bioconservatives and transhumanists. The  transhumanist  movement  is  based  on  the idea that enhancements should be made in  humans  through  technology  while  bioconservatives  oppose this idea. Transhumanism is already feared to  be  world's  most  dangerous  idea  by  bioconservatives such as Francis Fukuyama, as it is not justified or proven yet that transhumanism is safe for our future. The notion is believed to be not only de-humanising but also poses many threats to the rest of humanity.  As  explicitly  suggested  by  bioconservatives  human  enhancing  technologies  are more of a bane than a boon. Furthermore, many of the transhumanist technologies  have  many demerits to them. Bioconservatives believe that the technological enhancements will lead to obscenity and be a blemish on the human race. It is highly possible that humans will suffer from autocracy by the hands of the posthumans, since the posthuman age will certainly give rise  to  several  moral  di- lemmas, such as racism, which will plague the human world. There are four fundamental aspects of transhumanism; nanotechnology, biotechnology, information technology (IT)  and  cognitive  sciences,  which come with many promising advantages, but can also turn our future into a dystopia. Even with constant opposition from the bioconservatives, the dark scenarios related with the ascend of the  transhuman era are inevitable and the amalgamation of machines with man is equivalent to forfeiting true humanity.
Transportation Difficulties Faced by Female Students of Karachi Medical and Dental College (KMDC) and University of Karachi (UoK)
Authors: Afreen Humayun  , Hira Saleem  , Rimsha Raza
Published: February 2023

Objective: To determine the frequency of different modes of transportation used by female students of KMDC and UoK, and to study the difficulties faced by them while commuting to their universities and the subsequent effect on their studies.

Methods: An institutional  and  questionnaire-based  study  was  conducted  among  the  female  students of KMDC and UoK aged 17-25 years from May to December 2016. The study was approved by the Ethical Review Board of Karachi Medical and Dental College. A total of 600 students were included in the study by probability (simple, random) sampling method. Students responded to a series of questions regarding mode, convenience and difficulties related to transportation and the impact transportation difficulties had on their education. The data was analysed by using SPSS Version  20.0.  Written consent was obtained from the students prior to filling the questionnaire.

Results: Out of 600 students, 50.8% used transport provided by the university/college, 53.8% did not consider any means of transportation safe,  54.5%  students  reported  that  their  studies  were  affected due to indirect factors such as stress, trauma,  fatigue,  pollutants,  congestion  and  the  consequences were fewer study hours and delayed arrival in class. The frequency of physical along with verbal ha- rassment faced by the students while commuting was reported as 31.3%.

Conclusion: Majority of participants complained that their studies were affected by stressful travelling  and other transport issues but those travelling by the transport provided by the institute had  fewer  problems. Efforts should be made to overcome these problems affecting female education.
Rubber Dam: Is it a Popular Method of Field Isolation among Dentists in Karachi?
Authors: Asaad Javaid Mirza  , Maaz Asad Javaid  , Shama Asghar
Published: February 2023

Objective: To find out the frequency of rubber dam usage among clinical students, interns and dental practitioners and the barriers they come across to place it routinely in their practices.

Methods: An observational cross-sectional study was performed from October 2016  to  January  2017 using non-probability convenience sampling. A questionnaire was meticulously designed based on questionnaires used in similar studies in the  past.  The  target  population  in  this  study  was  clinical  dental students, interns and the faculty  members  working  in  various  teaching  institutions  in  Karachi  and involved in  general  dental  practice.  Data  from  completed  questionnaire  was  analysed  using  SPSS version 20.

Results: With the healthy response rate of 81%, this study shows that the majority (76%) of clinical students, interns and practicing dentists in Karachi, Pakistan continue to  ignore  the  rubber  dam  placement in their routine practices. Total 89% of non-users did not use  it  as  they  find  it  time  con- suming and 66% of them mentioned that  it  is  difficult  to  place.  Couple  of  other  reasons  for  which  more than 50% of respondents  avoid  using  rubber  dam  are  frequent  tearing  of  the  sheet  and patient's fear or abhorring attitude towards placement of rubber dam.

Conclusion: This study suggests that use of rubber dam is an unpopular method for isolation of op-  erative site among clinical students, interns and clinicians working in Karachi.
Anaemia Frequency and its Socioeconomic and Dietary Determinants among Teenage School Girls of Karachi
Authors: Zaira Batool  , Saadiya Aziz Karim  , Amna Begum
Published: February 2023

Objective: To assess the frequency of anaemia and to determine its socioeconomic and dietary de- terminants among teenage school girls of Karachi.

Methods: A cross-sectional study was carried out from January to July, 2015. The study subjects were chosen from four schools, two each  from  high  socioeconomic  and  poor  neighbourhoods  of  Karachi.  Our study was conducted on 497 school girls aged 13 to 18 years, who were enrolled by employing convenient sampling, after informed consent of parents and principal of the school. All study subjects were interviewed using a questionnaire, clinically examined for signs  of  anaemia  and  measurements taken for anthropometric and haemoglobin estimation.

Results:  The primary study outcome was the anaemia status of the study participants as determined by their haemoglobin level using a cut  off  of  11  gm/dl.  The  study  results  showed  that  only  167  (36.5%) of the participants were anaemic and majority of them was negative for signs of skin pallor  (66.6%), conjunctival pallor (79.8%),  koilonychia  (95.8%)  or  brittle  hair  (86.4%).  The  factors  found  to be significantly associated with anaemia included lower socioeconomic status (p<0.0001),  paternal  illiteracy (p=0.022) and paternal unemployment (p<0.0001). Furthermore, the study findings  also  re-  vealed infrequent consumption of eggs (p=0.015), milk (p=0.019), spinach/green leafy  vegetables  (p=0.004)  and  chocolates/candies/biscuits/cakes  (p=0.039)  to  be  significantly  associated  with anaemia.

Conclusion: The study suggest that frequency of anaemia in teenage school girls was significantly associated with  lower  socioeconomic  status,  paternal  illiteracy,  unemployment,  infrequent  consump- tion of eggs, milk, spinach/green leafy  vegetables  and  chocolates/candies/biscuits/cakes.  Hence,  urgent needs of improving paternal illiteracy, decreasing unemployment and increasing educational  awareness in teenage girls regarding the consumption of iron rich foods.
Correction of Serum Potassium Level in Hypokalaemic Patients with Hypomagnesaemia	and	Normomagnesaemia
Authors: Azfar Athar Ishaqui  , Muhammad Liaquat Raza  , Iyad Naeem Muhammad
Published: February 2023

Objective: To  determine the extent of increase in potassium level after intravenous infusion of potassium chloride in hypokalaemic patients  with  hypomagnesaemia  and  normomagnesaemia  and  to overview the impact of different concentrations and dilutions of potassium chloride infusion for rapid correction of hypokalaemia.

Methods: A prospective, cohort study was conducted in Abbasi Shaheed Hospital, Karachi from January to March 2016. Convenience sampling was done, 46 patients were included who had a Serum Potassium level less than 3.5 meq/L at the time of admission to the hospital. Protocols of potassium  chloride infusion such as such as 20 mEq/200 ml, 30 mEq/300 ml, 40 mEq/400 ml and 50 mEq/500 ml were given  to  three  groups  of  hypokalaemic  patients  having  hypomagnesaemia, normomagnesaemia  and  hypermagnesaemia  to  figure  out  the  correlation  of  potassium  correction   with serum magnesium level. The pre and  post-infusion  serum  potassium  levels  were  checked along with the outcome of the extent of increase in potassium levels.

Results: For 46 patients (mean age 60 ± 3 (r= 21-96 years), the mean pre-infusion serum potassium and magnesium levels were found to be 3.12 ± 0.04 (r= 2.30-3.5) mmol/L and 0.81 ± 0.03 (r= 0.52- 1.58) mmol/L respectively. The difference in the pre/post-infusion  serum  potassium  levels  in  hypokalaemic patients with hypomagnesemia (n=  46)  was  not  found  be  significant  (p>0.05)  whereas the pre/post-infusion serum potassium level was significant (p<0.05) in hypokalaemic patients with normomagnesaemia or hypermagnesaemia.

Conclusion: Serum magnesium level needs to be concurrently monitored and corrected in mild to  moderate hypokalaemic patients as low magnesium levels were found to have profound effect on serum potassium level  in  patients  receiving  potassium  supplement  for  correction  of  potassium  level  back to normal.
Obesity-An Impactful Risk Factor for Gastro-Oesophageal Reflux Disease
Authors: Ajeet Kumar  , Syeda Urooj Riaz  , Syeda Urooj Riaz
Published: February 2023

Objective: To determine over-weight and obesity  as  risk  factors  for  Gastro-oesophageal  reflux  dis-  ease (GERD) in the outpatient department (OPD) of a tertiary care hospital.

Methods: One hundred patients of  both  genders,  presenting  with  symptoms  of  GERD  were  selected as cases and one hundred controls from attendants of various patients not suffering  from  GERD  by random sampling during October 2016 to April 2017. Both the cases and controls were weighed (kilo- grams) and their heights (centimetres) were measured. Their  BMIs  (body  mass  index)  were  calcu-  lated. The cases and controls were then categorised into  normal  weight,  over  weight  and  obese  subjects on basis of BMI by WHO criteria. Subjects, with ischaemic heart disease, hypertension, diabetes, peptic ulcer disease those taking NSAIDs (non-steroidal anti-inflammatory  drugs),  and  steroids were excluded.

Results: In this present study, the frequency (the percentage) of male and female was 48.5%, 51.5% respectively. It was found that there were about 52.0% and 48.0% males and females respectively in controls while 45.0% and 55.0% in case. Mean and SD of weight of cases and controls were as 73.17 ± 9.853 kg and 68.78 ± 6.738 kg respectively. The p-value=0.000 showing that there was a significant association between BMI and outcomes i.e. occurrence of GERD (cases and  controls).

Conclusion: This study showed that over-weight and obesity were associated with a statistically  significant increase in the risk for GERD symptoms i.e. increased by 3 times in all patients, 2 times in males and 7 times in females.
Analysis of Optic Nerve Types in Relation to Posterior Paranasal Sinuses: A Computed Tomographic (CT) Study
Authors: Mubina Lakhani  , Muhammad Ali  , Madeeha Sadiq
Published: February 2023

Objective: To assess the variations in  the  course  of  optic  nerve  (ON)  in  relation  to  sphenoid  sinus with the help of CT scan.

Methodology: A cross-sectional study was carried out using  computed  tomographic  (CT)  paranasal  sinus scans of two hundred and seventy study participants between January 2017 and May 2017. Non-probability consecutive sampling technique was used and data was entered on SPSS version 23. Inclusion criteria comprised of adults coming for CT head and  brain  who  did  not  have  bony  abnor- mality of sphenoid and ethmoid sinuses or adjacent structures. However, individuals  with  sinonasal  tumors, chronic rhinosinusitis, prior sinus surgery, facial fracture, nasal polyposis and  congenital  craniofacial anomaly were excluded from this study. Analysis of optic nerve was carried out according to DeLano's classification.

Results: Type 1 ON was found to be the most frequent type; 55.93%, followed by type 2 with a frequency of 26.85%. However, type 3 and type 4 appeared less frequently, that is 11.1% and 6.11%, re- spectively. When comparing right and left sides it was noted that the frequency of type 1 optic nerve was found to be higher on both right and left sides with a value of 56.30% and 55.5%, respectively. Type 2 showed a frequency of 26.67% on right side and 27% on left side. Type 3 was identified to be   11.4% and 10.7% on right and left sides, respectively. Type 4 optic nerve was found to be the least  common type in our study on both sides, i.e. 5.56% on the right side and 6.67% on the left side.

Conclusion: The combined percentage of type II and type III ON that is 37.96% in our sample brings us to this conclusion that  fairly  high  percentage  of  our  population  is  exposed  to  increased  potential risk of iatrogenic optic nerve injury thus emphasising the need for careful evaluation of ON in relation to sphenoid sinus anatomy on CT scan prior to endoscopic sinus surgery.
Detecting Anatomical Variations of Coeliac Trunk Branching Pattern in the Population of Karachi Using 3D Multidetector Computed Tomographic Angiography	(MDCTA)
Authors: Rosheena Nabeel Khan  , Muhammad Ali  , Madeeha Sadiq
Published: February 2023

Objective: To find out the frequency of variations in coeliac trunk branching pattern by Using 3D Multidetector Computer Tomographic Angiography (MDCTA),in patients referred to Radiology Department  of Ziauddin University Hospital with abdominal pain, altered bowel habits, kidney or adrenal pathologies

Method: For this study, 160 individuals aged 20-60 years, without any abdominal vascular or upper ab- dominal visceral disease who presented to Radiology Department, Ziauddin University Hospital, Clifton Karachi, for abdominal 3D-MDCTA (3-dimensional multidetector  computed  tomographic  angiography)  from March 2017 to August 2017 were recruited in this study.  It  was  a  cross-sectional  study  and  samples were collected through non-probability convenience sampling technique. Recruitment of study participants was done from patients who were referred to radiology department of Ziauddin University Hospital for abdominal contrast MDCTA examination due to various indications such as abdominal pain, altered bowel habits, kidney and adrenal pathologies. Persons having serum creatinine levels <1.4 mg/dl with no hepatobiliary pathologies, pancreatic or abdominal vascular lesions were included while patient having, abdominal malignancy distorting vascular anatomy, vasculitis and atherosclerosis were ex- cluded from the study. Patients having history of liver transplant or upper abdominal surgeries or those having history of allergic reaction to contrast agents and pregnant ladies were also excluded from the   study. Coeliac trunk variations were categorised according to Uflacker's classification into 8 types. Statis- tical analysis was done on SPSS version 20. Data is presented in percentages and frequencies.

Results: Classical coeliac trunk (type I) was present in 134 out of 160 (83.9%)  individuals  while 26 (16.1%) individuals showed coeliac trunk variations. Type II and type V variations were second most fre- quent variations i.e. in 9 (5.6%) individuals each, followed by type VII in 5 (3.6%) individuals. Type  III, IV  and VI showed variations in 1 (0.6%) individual each. Type VIII was not found in our sample.

Conclusion: The present study reports normal configuration of coeliac trunk i.e, classic or type I coeliac trunk in 83.9% individuals and coeliac trunk variations in 16.1% individuals.
Liver Dysfunction in Hypothyroid Non-Pregnant Women
Authors: Mohammad Yousaf  , Zahoor Ahmad
Published: February 2023

Objective: To evaluate the effects of under secretion of thyroid hormones and its  relation  with  liver markers i.e. alanine transaminase (ALT) and aspartate transaminase (AST) in non-pregnant women.

Methods: This cross-sectional study was  conducted  in  Khyber  Teaching  Hospital  Peshawar  from  March 2014 to March 2015. The study was performed on 150 non-pregnant women in the age group of 18-70, attending the  outpatients  departments  of  Khyber  Teaching  Hospital  for  thyroid  screening.  The exclusion criteria were pregnancy, hypertension, renal impairment and known history of liver ab- normalities. Thyroid and liver function tests were performed for all the patients and control using standard kits and procedure. Normal subjects in the  same  age  group  were  selected  randomly  from  the  local population of Peshawar city and were used as control (N) for the study. Competitive ELISA tech-   nique was used for the analysis of T3 and T4 on Dia 710 microplate reader, while sandwich ELISA was used for TSH analysis. Quantitative tests for both ALT and AST were performed according to the international federation of clinical chemist (IFCC) protocols on Erbamannhein chemistry auto-analyser (Germany) using standard Erba kits.

Results:  ALT  and  AST  level  was  found  to  be  lower  in  the  patient  groups  [Overtly  hypothyroid (Oh): 24.35 ± 1.11 IU/L, sub-clinically hypothyroid (Sh): 16.85 ± 0.55 IU/L] than the control group (N: 29.69 ±3.28 IU/L). A significant positive correlation was observed between AST and TSH (thyroid-stimulating hormone) in the control group (N) (p=0.002) and negative correlation in overtly hypothyroid (Oh) and sub-clinically hypothyroid (Sh) groups, respectively. No other significant correlation was  observed  be- tween ALT, TSH, T3 (triiodothyronine) and T4 (thyroxine) in any other groups.

Conclusion: Both liver enzymes (ALT and AST) were found to be lower in the patients groups (Oh and Sh) as compared to control group (N).
Frequency of Immunisation Status, Complications and Outcome in Children Admitted with Measles in Public and Private Sector Hospitals of Karachi
Authors: Musarrat Ameer  , Sina Aziz  , Shaista Ehsan  , Ume Kulsoom
Published: February 2023

Objective: To assess the immunisation status, frequency  of  complications  and  the  outcome  in  chil-  dren admitted with measles in public and private sector hospitals of Karachi.

Methods: In this cross-sectional study a total  of  382  patients  admitted  with  measles,  of  either  sex  from 3 months to 13 years, who presented from March 2016 to March 2017 were included. A total of 265 (69.3%) children were from Ziauddin University Hospital (ZU) and  117  (30.6%)  from  Abbasi   Shaheed Hospital (AS). Non-probability convenient sampling technique was  used.  Those  with  con-  genital anomalies and chronic medical illnesses were excluded from the study. Detailed history  and  physical examination was done, and findings entered in a  Proforma.  Immunisation  status  of  the  pa- tients was recorded. All the patients were observed for complications like encephalitis,  pneumonia,  diarrhea, otitis media, epiglottis, febrile fits and  corneal  ulcers.  Statistical  analysis  was  done  using  SPSS version 22. Categorical values were compared by chi-square test, p-value of  <0.05  was  con- sidered significant.

Results: A total of 382 were patients admitted with measles, 265 (69.3%) from  Ziauddin  University  hospital and 117 (30.6%)  from  Abbasi  Shaheed  Hospital.  Overall,  57.4%  were  completely  vaccinated in ZU vs. 32.5% in AS. Despite being completely vaccinated, children in ZU; 152/265 (80%) and in AS; 38/117 (30.6%) had complications with a statistically significant (p<0.0001) difference between private     and government sector hospitals.  Predominantly,  in  both  hospitals  pneumonia  was  common  followed by gastroenteritis. Overall mortality was 13/382 (3.4%) in both hospitals combined.

Conclusion: A sizeable number of children admitted with measles in both private and  government  hospitals were unvaccinated. A significant number developed measles despite receiving two doses of vaccine. Frequency of complications was higher in private versus government hospitals. Mortality from measles was high (3.4%) especially in the unvaccinated.
Correlation between Blood Pressure Levels and Clinical Signs and Symptoms of Hypertensive Patients: A Gender and Age Based Comparison
Authors: Nargis Anjum  , Muhammad Naveed uz Zafar  , Sana  Noor  , Summaiya Iqbal  , Syed Muhammad Zulfiqar Hyder  , Adnan Anwar
Published: February 2023

Objective: To determine correlation between  systolic  and  diastolic  blood  pressure  levels  and  selected signs and symptoms among different gender and age groups of hypertensive patients.

Methods: A cross-sectional study was carried out  at  urban  hospital  after  taking  ethical  approval,  among patients with self-reported history of hypertension and on  anti-hypertensive  medication.  After  taking ethical approval, a total of 372 patients aged 18 or above were included in the study by employing convenient sampling technique. A detailed history was taken from each patient  about  hypertension associated symptoms with the help of a questionnaire  whereas  designed  specifically  for  the study. Blood pressure was measured using sphygmomanometer  with  stethoscope.  SPSS  version  20  was used to analyse the collected data and the duration of study was 6 months.

Results: Among males older age, belonging to older age group >40 years, having more  height  and positive history of irregular heartbeat/palpitation were highly correlated with increase in systolic blood pressure (p<0.001 for  all),  among  females,  positive  history  of  sleep  apnoea  was  highly  correlated  with increase in systolic blood pressure  (p<0.001)  and  having  more  height  and  positive  history  of  sleep apnoea were highly correlated with increase  in  diastolic  blood  pressure  (p<0.001  for  both),  among   <40 years old milder change in urinary frequency was highly correlated with increase in systolic blood pressure (p<0.001) whereas among >40 years  old  positive  history  of  headache,  vertigo,  sleep apnoea and irregular heartbeat/palpitation were highly correlated with increase in systolic blood pressure (p<0.001 for all) and having  more  height  was  highly  correlated  with  increase  in  diastolic  blood pressure (p<0.001).

Conclusion: Among other signs and symptoms, positive history of irregular  heartbeat/palpitation  was found to be significantly correlated with both high systolic and diastolic blood pressure levels in both  males and females as well as in >40 years old patients.
Gestational Trophoblastic Disease and Gestational Trophoblastic Neoplasm - An Experience at Tertiary Care Hospital
Authors: Shakira Perveen  , Shazia Jabbar  , Shafia Nizar
Published: February 2023

Objective: To determine the frequency of gestational trophoblastic diseases and gestational  tropho-  blastic neoplasm, its risk factors and prognosis.

Methods: This was a descriptive,  cross-sectional  study  conducted  at  Civil  Hospital,  Karachi  from  March 2015 to September 2015. All cases of gestational trophoblastic disease after necessary inves- tigations like tumour marker b-hCG, ultrasound with classical picture of "bunch  of  grapes"  or  "snow  storm" pattern and X-ray chest (for lung metastases) under went suction evacuation.  In  all  cases  specimen was sent for histopathology to confirm gestational trophoblastic disease. After primary treat- ment, cases were followed with  b-hCG till complete remission was achieved. During follow-up, cases     were labelled as gestational trophoblastic neoplasm on the basis of International Federation of Gyne-  cology and Obstetrics (FIGO) criteria. After risk scoring on World Health Organization (WHO) criteria, chemotherapy was given.

Results: Out of 497 pregnant ladies, 40 were cases of gestational trophoblastic disease (8.05%). Frequency/obstetric case was 1.7% and frequency/delivery was  2.1%.  Out  of  40  cases  13  (32.5%)  were cases of gestational trophoblastic neoplasm. Out of 13 cases  of  gestational  trophoblastic  neo-  plasm 9 (69.23%) were labelled as low-risk and 4 (30.76%) as high-risk cases. All cases  achieved  complete remission. One case of high-risk group expired.

Conclusion: All women with gestational trophoblastic disease must  be  followed  as  per  recommenda- tion with serum b human chorionic gonadotropin  measurement  until  the  levels  are  undetectable,  for early diagnosis and optimum treatment of gestational trophoblastic neoplasm.
Frequency of Compartment Syndrome in Patients Presenting with Fractures of Tibia in A Tertiary Care Facility
Authors: Saeed Ahmed Shaikh  , Mushtaq Saeed Qureshi  , Muhammad Qasim Ali Samejo
Published: February 2023

Objective: To determine the  frequency  of  compartment  syndrome  in  patients  presenting  with  fracture of tibia in a tertiary care facility.

Methods: In our descriptive cross-  sectional  studied  conducted  from  January  2018  to  June  2018  at the Department of Orthopaedics, Jinnah Postgraduate Medical Centre, Karachi,  we  included  136  pa- tients in this study with age range between 18 to 45 years of either gender presenting with closetibial      shaft fracture within 24 hours of  injury.  Brief  history  regarding  the  duration  of  fracture  and  comorbid like HTN was obtained. Patients with diabetes mellitus, chronic  bleeding  and  renal  disorders  and  I.V drug abusers were excluded from the study. Presence of any one or more of the following within 24       hours of injury were labelled as compartment syndrome: severe pain: VAS  score 7 or more, limb pa-  ralysis: unable to move limb, paraesthesia: mild or no sensation on pin prick, pallor, as compared to contralateral limb and pulselessness: absence of pulse on Doppler.

Results: Mean age of the patients was 35.01 ± 9.34 years.More patients (n=72, 52.9%) were found older than 35 years of age while 64 (47.1%) patients with ?35 years of age. There were 99 (72.8%) males         and 37 (27.2%) females. Mean weight, height and BMI of the patients were 60.11  ± 5.12 kg, 1.53 ±      0.06m and 27.23 ± 5.02kg/m2 respectively. Average duration of fracture was 21.85 ± 1.63 hours. Majority (n=114, 83.8%) of the patients presented with >20 hours. Compartment syndrome was found in 9 (6.6%) patients out of 136 cases. A significant association of compartment syndrome was found with age (p-    value 0.025), and BMI (p-value 0.043) of the patients. Out of nine patients with compartment syndrome, eight patients were older than 35 years. In contrast, BMI in eight patients diagnosed with compartment syndrome were less than 30. However, no significant findings were noted in relation to duration of frac-    ture (p-value 0.201), smoking status (p-value 0.097) and HTN (p-value 0.108).

Conclusion: Compartment syndrome is a surgical emergency, which needs timely diagnosis and im- mediate decompression to avoid complications including limb loss.
Clinical Efficacy of Probiotics as An Adjunct to Scaling and Root Planning in The Treatment Of Chronic Periodontitis
Authors: Sana Ikram  , Muhammad Arsalan Raffat  , Saeeda Baig  , Shazia Akbar Ansari  , Kevin Joseph Jerome Borges  , Nuzhat Hassan
Published: February 2023

Objective: The objective of this study was to assess  the  clinical  efficacy  of  scaling  and  root  planing  (SRP) alone and SRP along with adjunctive probiotic containing Lactobacillus reuteri (L.reuteri) in the management of chronic periodontitis (CP) and comparing the efficacy of two treatment modalities.

Methods: Twenty-eight systemically healthy participants, clinically diagnosed with CP on  the  bases  of  pocket depth were enrolled from the outpatient department of Periodontology, Ziauddin College of Den-     tistry, Ziauddin University, Clifton, Karachi, Pakistan. After complete periodontal examination all clinical periodontal parameter i.e.,  Probing  Pocket  depth  (PPD),  Clinical  attachment  level  (CAL),  percentage  sites for plaque accumulation (PI) and bleeding on probing (BOP)  were  measured  and  recorded  at  baseline, 6 weeks and 12 weeks after therapy. Patients meeting the inclusion criteria  underwent  non-  surgical periodontal therapy i.e. SRP both with  hand  instruments  and  with  ultrasonic  scalers. After  SRP oral hygiene measures were reassured and then participants were  randomly  allocated  to  one  of  two  groups i.e., Probiotics (N=14) or Placebo (N=14). Both L. reuteri and placebo were given twice daily for          12 weeks and patients were recalled for assessment.

Results: At baseline both groups were similar clinically. Intra-group comparison of clinical periodontal parameters showed improvement in the participants of both  groups.  Inter-group  comparison  showed  greater reduction in PPD and BOP and more gain in CAL in probiotic group on each follow up visits and statistically significant difference was  observed  in  two  groups.  Whereas  for  PI  the  difference  between  two groups at follow-up visit was insignificant i.e. both treatment strategies were equal in reducing per-  centage sites of plaque accumulation.

Conclusion: The results of our study concludes L.reuteri containing probiotic along with SRP is superior   when compared to SRP alone in terms of resolving inflammation and  improving  periodontal  health.  Probiotics can be used as a promising alternative adjunctive therapy with minimal or no side effects in           the treatment of chronic periodontitis.
Knowledge of Community Physicians Regarding Ischemic Stroke: Interesting Results
Authors: Shazia Jatoi  , Syeda Urooj Riaz  , Shariq Mukarram  , Aijaz Ali  , Ajeet Kumar  , Muhammad Ishaq Ghauri
Published: February 2023

The aim of study is to assess the knowledge of community doctors regarding stroke and its prevention. A cross-sectional study at Department of Medicine, Jinnah Medical and Dental College, from Feb-  ruary 2018 to August 2018. A total of 263 questionnaires were distributed among medical practitioners  along with a proforma regarding physician's information and consent to participate. In this survey 201 participants filled the  questionnaire,  showing  a  reasonable  response  rate  of  76.42  percent.  Their  mean time duration of practice was 13 ± 8 years. Almost 95% of the practitioners were aware of risk factors but a great majority had a misconception regarding high density lipoprotein(HDL), noise pollution and driving. All 201 participants agreed on brain imaging but modalityof choice was variable. Their knowledge regarding treatment and unusual presentation of stroke was not adequate and only  79% believed the need for referral to a neurologist.This survey revealed a wide gap in the knowledgeof practitioners regarding diagnosis and current guidelines of management.