bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges of integration of Traditional Health Services in Primary Health Care in North Minahasa Regency
Authors: Rahman Asep , Adam Hilman , Maino Irny E.
Published: February 2025

Traditional health services are an integral part of the healthcare system, but they have not developed as significantly as other healthcare services. This research aims to investigate the challenges faced in integrating traditional health services into primary healthcare in North Minahasa Regency. The research method used is a case study, employing in-depth interviews with relevant stakeholders involved in traditional health policy and practices. The study seeks to identify potential strategies to address these challenges, including enhancing dialogue and collaboration between both health systems and developing clearer and more inclusive regulations. Based on the interview findings, traditional health services in North Minahasa Regency face significant challenges in terms of legal recognition, a lack of trained personnel, and limited budgetary and regulatory support. Nonetheless, there are substantial opportunities for development, particularly in utilizing medicinal plants and providing skills training, such as acupressure, for the community. Further government support in terms of regulation and funding is necessary to overcome these challenges and promote the broader development of traditional health services.
El desarrollo de las EPSV de empleo e individuales en el País Vasco
Authors:   IKEI, Izurieta Clara , Zabala Iñaki ,   Newfield Consulting
Published: February 2025

Tras la finalización del periodo de vigencia del Plan de Previsión Complementaria de Euskadi realizamos una valoración de su implantación y desarrollo en comparación con los objetivos que establecía dicho Plan. En concreto se aspiraba a que el 70% de la población ocupada generara una pensión complementaria mínima del 20% de las rentas del trabajo o profesionales o empresariales. En este sentido efectuamos una estimación que concluye que sólo aproximadamente un 30% del objetivo del 70% (un 21% del total), por una vía u otra, estaría en condiciones de alcanzar ese objetivo. Otro 30% no lo alcanzaría, por mucho, pero hace aportaciones significativas a la previsión social complementaria, mientras que otro 40% tiene una PSC irrelevante. En definitiva, se está muy lejos del cumplir el objetivo; algunas razones son achacables a la política y comisiones de gestión de las inversiones y no a la falta de aportaciones.
Las políticas públicas para promover la previsión social complementaria
Authors:   OCDE, Yermo Juan
Published: February 2025

Este artículo aborda las distintas opciones de políticas que pueden aplicarse para promover los planes de previsión complementarios y evalúa su validez basándose en la experiencia de países que las han implementado. De esta manera se percibe la obligatoriedad como la política más efectiva para asegurarse un alto grado de cobertura, unas aportaciones adecuadas y un alto grado de equidad en la distribución de la cobertura. No obstante otras opciones contempladas para lograr niveles de cobertura elevados y homogéneos incluyen la adhesión automática, la provisión de incentivos financieros, el desarrollo de programas de formación financiera así como facilitar y simplificar el acceso y las decisiones ligadas a los planes privados de pensiones. Por último se explica la importancia del buen diseño de los planes teniendo en cuenta la interacción con las prestaciones públicas básicas.
El futuro del empleo en Euskadi
Authors:   Prospektiker, Serrano Raquel , Zugasti Ibon ,   Prospektiker
Published: February 2025

El empleo va a tener importantes transformaciones en los próximos años a nivel internacional y Euskadi no va a ser ajena a estos cambios. Si bien tendencias como el cambio demográfico, la diversidad cultural, la conciliación de la vida personal y laboral, los entornos laborales cambiantes o la convergencia de tecnologías, son hoy en día ya evoluciones bastante claras, otros hechos disruptivos podrían transformar de forma inesperada el mercado de trabajo: la migración inversa, los valores cambiantes de los empleados o la inteligencia artificial y los robots. Trasladadas las proyecciones de empleo de CEDEFOP a Euskadi, y con ligeras variaciones según el tipo de análisis efectuado, un comportamiento similar a la media de la UE significaría 27.000 nuevos empleos hasta 2025 (3%), 38.000 nuevos empleos si el comportamiento se asemeja a Austria y 55.000 nuevos empleos si se basa en la evolución prevista para España (7%).
El papel de las políticas activas: una perspectiva desde las comunidades autónomas
Authors:   Universidad de Oviedo, Cueto Begoña , Suárez Patricia ,   Universidad de Oviedo
Published: February 2025

El objetivo de este artículo es proporcionar un panorama de las políticas activas de mercado de trabajo en España, atendiendo al papel del servicio público de empleo (SPE), la formación y los incentivos al empleo. Los datos utilizados muestran el escaso papel del SPE en la intermediación, con diferencias importantes por comunidades autónomas. También para las políticas de formación se obtienen cifras muy bajas de participación en relación al número de desempleados de nuestro país. En cambio, la mayor parte de los recursos se dedican a incentivos al empleo, a pesar del previsible efecto muerto que tienen estos programas teniendo en cuenta sus características. El artículo finaliza con una reflexión sobre las principales líneas que podrían considerarse para mejorar su eficiencia.
Hacia dónde van y hacia dónde deberían ir las normas de fiscalidad internacional
Authors:   Licenciado en Derecho y en Ciencias Económicas, Sanz Gadea Eduardo
Published: February 2025

El trabajo desarrolla algunas ideas sobre la actual fiscalidad internacional y cómo debería ser. Actualmente los patrones de tributación heredados del pasado siglo, y hoy vigentes, no son idóneos para afrontar la realidad de los grupos multinacionales y se plantea proponer unos esquemas actualizados, modernos y adecuados y que se acepten por la comunidad internacional. Con esa finalidad se examinan las recientes iniciativas de la UE y la OCDE bajo dos enfoques. En el enfoque BEPS (modelo CBIT) gran parte de las operaciones de transferencia artificial de resultados hacia entidades del grupo que tributan en régimen privilegiado se realiza mediante el endeudamiento excesivo, los instrumentos híbridos y los precios de transferencia que se apartan del principio de libre competencia. En este trabajo se sugiere un modelo de Impuesto sobre Sociedades alternativo al actualmente vigente, resultante de combinar el modelo CBIT con una tributación sobre la base imponible consolidada mundial. Este enfoque, denominado CCCTB, da importancia a la consolidación y una tributación sobre la base imponible consolidada mundial. Es concebible una estructura de Impuesto sobre Sociedades con una síntesis de ambos enfoques apoyada en la información contable proporcionada por las cuentas anuales consolidadas en lo concerniente a la tributación de las entidades dependientes, y no precisaría la fórmula de reparto predeterminada.
El Concierto Económico, la fiscalidad del futuro y su encaje internacional
Authors:   Diputación Foral de Bizkaia, Rubí Cassinello José , Martínez Bárbara Gemma ,   Diputación Foral de Bizkaia
Published: February 2025

La globalización y la evolución de las tecnologías están obligando a revisar las bases sobre las que tradicionalmente se ha sustentado el orden tributario internacional, desplazando la preocupación por evitar la doble imposición internacional a la atención por eludir la doble no imposición. En este proceso, la eliminación del secreto bancario y de los paraísos fiscales, las nuevas y más efectivas vías de la colaboración administrativa y el intercambio de información se convierten en el nuevo paradigma impulsado por los actores internacionales: el G-20, la OCDE y las Unión Europea. Desde este punto de vista, las administraciones tributarias están involucradas y comprometidas con el éxito del proceso. Por ello, el Concierto Económico debe también adaptarse a la nueva realidad internacional, incorporando las modificaciones necesarias para que las Instituciones competentes del País Vasco actúen, con todas sus consecuencias, en el que será el nuevo escenario tributario internacional.
Análisis empírico de la solvencia financiera y de la equidad del sistema de pensiones de jubilación español desde la perspectiva del empleo
Authors:   Universidad de Extremadura, Rosado Cebrián Beatriz , Domínguez Fabián Inmaculada ,   Universidad de Extremadura, Alonso Fernández Juan J. ,   Universidad de Extremadura
Published: February 2025

Este trabajo analiza la solvencia financiera y la equidad del sistema de pensiones de jubilación español tras las reformas aprobadas por la Ley 27/2011 y por la Ley 23/2013, teniendo en consideración diferentes comportamientos del empleo. Para ello se trabaja con la Muestra Continua de Vidas Laborales y la Encuesta de Población Activa lo que posibilita construir historias laborales probables de los actuales cotizantes, que permiten analizar, en términos de Tasa Interna de Rendimiento probable, el efecto del desempleo en el sistema de pensiones de jubilación español.
La adopción de la estrategia de servitización: estudio Delphi para incrementar el conocimiento sobre la transformación del sector manufacturero
Authors:   Aston Business School, UK, Baines Tim , Bigdeli Ali ,   Aston Business School, UK, Galera Zarco Carlos ,   Universidad de Granada
Published: February 2025

El estudio de investigación que se describe a lo largo de este artículo tiene como principal objetivo poner de manifiesto las principales evidencias obtenidas sobre la adopción de la estrategia de servitización. Con la aplicación del Método Delphi se recogieron los testimonios y opiniones de 33 altos ejecutivos, pertenecientes a 28 organizaciones de diferentes tamaños, las cuales representan una interesante sección transversal del tejido productivo británico. Los resultados obtenidos se han centrado en cinco áreas fundamentales: (1) servitización y servicios avanzados, (2) proceso de transformación: estímulos, incentivos y cambio organizacional, (3) impacto en el cliente y el fabricante, (4) facilitadores e inhibidores y (5) potencial para las empresas y la economía. Como resultado se presentan ocho puntos clave que contribuyen colectivamente a ampliar nuestro conocimiento del proceso estratégico que adoptan las manufacturas para competir en servicios.
Subnational Government’s Budget Deficit Targets in a Monetary Union: The Spanish Case 1995-2010
Authors:   Universidad de las Islas Baleares, Rosselló Villalonga Joan , Sansó Rosselló Andreu ,   Universidad de las Islas Baleares
Published: February 2025

We set out an analysis of the factors that explain subnational budget balances. Ours results suggest that long run deficit targets should not be distributed linearly across Autonomus Communities, and cannot be expected to be fulfilled in the same time-horizon. More important, financing agreements should be redesigned in order to avoid the central government having the opportunity to transfer its deficit to Autonomous Communities. Finally, more budgetary coordination is needed in order to prevent that Autonomous Communities circumvent central governments fiscal rules using their public entities.
¿Es siempre aconsejable la actividad emprendedora para el crecimiento económico?
Authors:   Universidad de Extremadura, Almodóvar González Manuel
Published: February 2025

Esta investigación aborda el problema de la relación entre la actividad emprendedora y el crecimiento económico, centrándose en dos aspectos: por un lado, la controversia en torno a cuál de las dos variables es la causa y cuál la consecuencia; por otro, si es recomendable utilizar el emprendimiento en las economías más desfavorecidas. A partir de un planteamiento empírico novedoso, y mediante un estudio a nivel internacional de un periodo de seis años, nuestros resultados parecen sugerir que la actividad emprendedora no es una herramienta recomendable para alcanzar el crecimiento económico en las economías en desarrollo, y sí en los países desarrollados.
High-growth Firms and Innovation in European Countries
Authors:   Universitat Rovira i Virgili, Segarra Blasco Agustí , Teruel Carrizosa Mercedes ,   Universitat Rovira i Virgili, Jové Llopis Elisendra ,   Universitat Rovira i Virgili
Published: February 2025

This paper analyses the effect of innovation on a high-growth firm (HGF). The micro-data belongs to the Community Innovation Survey 2008 provided by Eurostat covering the period 2006-2008 for 15 European countries. We classify the EU countries in two groups according to the share of business R&D on GDP: leader countries (Germany, Slovenia, Czech Republic, Norway, Portugal, Spain and Italy) and laggard countries (Estonia, Hungary, Slovakia, Lithuania, Romania, Bulgaria, Latvia and Cyprus). Firms in leader countries are more prone to invest in R&D but the presence of HGFs is more moderated than firms in laggard countries. Our main results show that the drivers to innovate and become a HGF differ across European countries. In leader countries, the HGF firms presence is related to R+D inversions and innovation, whereas in laggard countries depend directly on the size of the firm, as well as the turbulence rate in the economy as a whole. All in all, our results show light on the different entrepreneurial ecosystems of the European Union member countries.
El reto de un nuevo modelo de crecimiento económico para China
Authors:   Centro de Estudios Chinos Lu Xun, Xiao Fang , Rubio Ardanaz Eduardo ,   Universidad del País Vasco
Published: February 2025

Los últimos 35 años de la economía china son los años del cambio: en la estructura económica del país, en las reglas económicas internas y en la manera en la que China se relaciona con el resto del mundo. De esta manera hemos asistido a un gran esfuerzo orientado al desarrollo industrial, y al mantenimiento de un alto volumen de exportaciones. En los últimos cinco años, y tras la crisis financiera internacional de 2008, los llamamientos de las autoridades a reformar el modelo y la estructura económica de China, nos llevan a preguntarnos si podemos dar por acabada esa primera gran revolución económica y somos testigos de un nuevo cambio que ha comenzado ya a producirse. Igualmente nos lleva a interesarnos por las consecuencias que ello pudiera tener sobre la economía del país y sus empresas, y por el equilibrio al que de una forma natural en el desarrollo histórico y cultural está orientado desde hace milenios el pueblo chino.
Mediating Role of Organizational Commitment on the Influence of Workload and Organizational Culture on Organizational Citizenship Behavior
Authors: Febry Rizky Al Fadilla Sitompul  , Sri Rahayu
Published: February 2025

The purpose of the study was to determine the direct and indirect influence of workload variables, organizational culture on organizational citizenship behavior through organizational commitment on employees of PT. Daihatsu Capella Medan. The type of research is associative causal and uses quantitative research methods. The population in this study were all employees at PT. Capella Medan Daihatsu totaling 78 people. The sampling method used the nonprobability sampling method with the census sampling technique. So the sample in this study was 78 employees at PT. Capella Medan Daihatsu. The results of the study are workload directly has a significant effect on organizational commitment at PT. Capella Medan Daihatsu. Organizational culture directly has a significant effect on organizational commitment at PT. Capella Medan Daihatsu. Workload directly has a significant effect on organizational citizenship behavior at PT. Capella Medan Daihatsu. Organizational culture directly has not significant effect on organizational citizenship behavior at PT. Capella Medan Daihatsu. Organizational commitment directly has a significant effect on organizational citizenship behavior at PT. Capella Medan Daihatsu. Workload indirectly has a significant effect on organizational citizenship behavior through organizational commitment at PT. Capella Medan Daihatsu. Organizational culture indirectly has a significant effect on organizational citizenship behavior through organizational commitment at PT. Capella Medan Daihatsu.
ASSESSMENT OF PILOT STUDY ON ECONOMIC IMPACT OF PRADHAN MANTRI UJJWALA YOJANA (PMUY) ON TRIBAL WOMEN IN SELECTED TALUKAS IN NANDED
Authors:   Professor, School  of Educational Sciences , Swami Ramandan Teerth Marathwada University, Nanded (MS), India, Singh Sinku Kumar
Published: February 2025

Background: PMUY is a process to improve the quality of life and economic well-being of women living in rural areas. Pradhan Mantri Ujjwala Yojana (PMUY) was launched in May 2016 by the Ministry of Petroleum and Natural Gas with the objective of ensuring availability of clean cooking fuels like LPG to rural and underprivileged households.
Objective: The primary objective of the study is to analyze the impact of Pradhan Mantri Ujjwala Yojana on the economic status of women of Tribal community district. Pradhan Mantri Ujjwala Yojana aims to provide free cooking gas connections to women living below the poverty line.
Sample Population: A total of 142 samples were the target population of the study. The population included in the research included tribal women of selected taluka of Nanded district of Maharashtra, beneficiaries of Pradhan Mantri Ujjwala Yojana (PMUY).
Tools of the Study: Self-administered Interview Schedule (Marathi version ) was used to measure Economic status of beneficiaries of PMYU who are belong to Tribal community . Interview Schedule includes six questions namely , Improvement in purchasing decisions, any increase in physical assets like livestock, jewelery etc., easy access to financial institutions, increase in annual income, habit of saving and capital formation, increase in movable and immovable assets
Technique of Data collection: Data was collected through demographic information and interview schedule from women living in tribal area in selected taluka in Nanded district of Maharashtra.
Results: The result shows that Pradhan Mantri Ujjwala Yojana (PMUY) is playing an important role in improving the economic status of tribal women. The respondent also said that their tendency to save money has improved.
Exploring the Role of Bank-Specific Factors in Nonperforming Loans: A Study of Islamic Banks in Bangladesh
Authors: Limon Asaduzzaman
Published: February 2025

Nonperforming loans (NPLs) have posed a significant challenge to the banking sector in Bangladesh for decades, particularly within Islamic banks, where little research has been conducted to assess the relationship between agency costs and nonperforming loans. This study explores the role of agency costs and other bank-specific factors in determining nonperforming loans (NPLs) in Islamic banks in Bangladesh. This study employs pooled ordinary least squares (OLS) regression with panel data from Q1 2013-14 to Q4 2023-24 to analyze the relationship between the cost-to-income ratio (as a proxy for agency costs), return on assets (ROA), loan-to-deposit ratio (LDR), capital adequacy ratio (CAR), and NPL ratios. The study confirms that agency costs play a central role in influencing NPLs, alongside other bank-specific factors such as profitability, capital adequacy, and lending practices. The results indicate that a high level of operational inefficiency significantly influences NPLs, whereas ROA and CAR act as mitigating factors for credit risk. Conversely, aggressive lending practices, as indicated by an increased LDR, are associated with higher NPLs. Islamic banks face significant institutional flaws, and agency costs reflect deeper governance issues that cannot be ignored. The study further argues for the need to improve governance, operational efficiency, and prudent lending practices within Islamic banks.
Effects of Land Cover Change on River Discharge Conditions in the Mamasa Watershed Using the SWAT Model
Authors: Asrianto  , Samsuar  , Daniel Useng  , Hazif  Ichwan  , Febriana Intan Permata Hati
Published: February 2025

Land cover changes occurring in a watershed  will affect the ecosystem in that area. The Soil and Water Assessment Tool (SWAT) model is a tool that can be used to predict the impacts of land use on water, sedimentation, and chemical levels in a watershed. The Mamasa watershed is one of the sub-watersheds of the Saddang watershed, covering approximately 105,253 ha. This study aims to determine the land cover changes in the Mamasa watershed and their impacts on water discharge using the SWAT model. Several steps were undertaken, including image interpretation to obtain an overview of land cover in the years 2011, 2016, and 2020, which were then used to form Hydrology Response Units (HRU). Next, the SWAT model was run, involving delineating the watershed boundaries, defining HRU, integrating climate and HRU data, running SWAT simulations, and performing validation. The results of land cover classification from 2011 to 2016 showed an increase in secondary forest land by 4,896.68 ha (4.65%) and a decrease in shrubland by 9,500.60 ha (9.03%). The land cover classification from 2016 to 2020 indicated a decrease in secondary dry forest land by 6,349.43 ha (6.03%), with an increase in paddy field area by 3,141.92 ha (3%). These land cover changes led to a decreasing trend in water availability, as evidenced by increased discharge fluctuations from 16.50 to 21.65, in accordance with the SWAT simulation results, which increased from 6.73 in 2011 to 9.93 in 2020. The validation results of the SWAT model for the year 2011 showed a Nash-Sutcliffe Efficiency (NSE) value of 0.58 and and R2 value of 0.61. The validation for the year 2016 resulted in an NSE of 0.6 and an R2 of 0.68, while the validation for the year 2020 produced an NSE of 0.6 and an R2 of 0.65. All three validations fall under the satisfactory category, indicating that the SWAT model can be used to simulate the discharge of the Mamasa watershed.
Identifications of Wavelenght, Absorbance and Reflectanc of Robusta Coffee During the Postharvest Process
Authors: Nur Ismi Syarifuddin  , Olly Sanny Hutabarat  , Daniel Useng  , Febriana Intan Permata Hati
Published: February 2025

Spectrometer is one of the tools that can produce a spectrum of light with certain wavelengths. A wavelength produced by measurements using a spectrometer will produce absorbance, reflectance and transmittance values. The result of light absorbed by the object is called absorbance, the light reflected by the object is called reflectance, while that which is not absorbed and not reflected by the object is called transmittance.Objective. The purpose of this study are the wavelength, absorbance value, reflectance and its relationship to color in the post-harvest process so that it is expected to be a reference and can provide information about wavelength, absorbance value, reflectance and its relationship to color in the post-harvest process.Methods. Measuring wavelenght, absorbance and reflectanceduring the postharvest process, both before treatment and after treatment.  Results. The results obtained are the absorbance value of fresh green coffee of 0.98%, fresh yellow coffee of 0.18% and red coffee of 0.27%. However, after going through the post-harvest process there is a change in the absorbance value where green coffee that has been dried using the yellow honey method has decreased by 0.92% and the black honey method is 0.38% while yellow and red coffee beans have increased at wavelengths ranging from 300-400 nm and 400-500 nm, as well as roasted coffee. While the reflectance value can be seen that fresh green coffee has a reflectance value of 92%, yellow coffee is 89% and red is 69%. However, after going through the post-harvest process where green and yellow coffee that has been dried using the black honey and yellow honey methods has decreased and red coffee beans have increased at wavelengths around 900-1000 nm, as well as roasted coffee. Conclusion. So it can be concluded that the post-harvest process causes the ab sorbance and reflectance values to change at the same wavelength.
Manejo clínico de crises convulsivas relacionadas ao uso excessivo de medicamentos
Authors: Pinheiro Déborah Helena Pereira , Discacciati Renato , Nogueira João Vitor Dourado de Oliveira , Sleiman Lara Pechulo , Silva Alana Araújo Lima da , Cavalcante André Sobreira , Moraes Bruno Amorim , Pereira Mayara Gomes , Pereira Mariana Carolina Machado , Souza Ana Beatriz Lopes , Nascimento Fabio Rodrigo Barbosa Dutra , Dezan Elisa Souza , Dias João Vitor Duarte Henrique , Lobo Carol Damasceno
Published: February 2025

O presente estudo revisou o manejo clínico de crises convulsivas relacionadas ao uso excessivo de medicamentos, utilizando uma abordagem de revisão integrativa. O objetivo foi investigar as abordagens clínicas mais eficazes para o diagnóstico, estabilização e tratamento de crises convulsivas desencadeadas pelo uso excessivo de medicamentos. A metodologia consistiu em uma revisão integrativa realizada nas bases de dados Scientific Electronic Library Online (SCIELO), Cochrane e Medline, utilizando descritores de ciências da saúde relacionados ao tema, como “Seizures”, “Drug Abuse” e “Disease Management”. Os resultados mostraram que o manejo clínico de crises convulsivas relacionadas ao uso excessivo de medicamentos envolve ajustes na dosagem e acompanhamento rigoroso, com ênfase na redução gradual dos fármacos. A resposta ao tratamento é geralmente positiva, com controle adequado das crises.
Cirurgia metabólica em pacientes com obesidade Grau I e Diabetes Tipo 2
Authors: Gonçalves Fellipe Alves Rodrigues , Cabrera Matheus Alves , Carvalho Francisco Iromar Júnior de Souza , Maccari Paula Mascarello , Lima Vitória Costa , D’Apolito Nicoly Layla Bonifácio , Neto Nilton Ramos Bezerra , Jafet Paula Fontes , Aoude Carolina Lopes , Ribeiro Thaís Viana , Campos Mariana , Moreno Larissa Oliveira Soave , Reis Paulo Garcia dos
Published: February 2025

O presente estudo revisou a cirurgia metabólica em pacientes com obesidade grau I e diabetes tipo 2, utilizando uma abordagem de revisão integrativa. O objetivo foi analisar a efetividade e a segurança da cirurgia metabólica como alternativa terapêutica para indivíduos com obesidade grau I e diabetes tipo 2. A metodologia consistiu em uma revisão integrativa realizada nas bases de dados Scientific Electronic Library Online (SCIELO), Cochrane e Medline, utilizando descritores de ciências da saúde relacionados ao tema, como “Bariatric Surgery”, “Obesity” e “Diabetes Mellitus, Type 2”. Os resultados mostraram que a cirurgia metabólica tem mostrado ser uma alternativa eficaz e segura para indivíduos com obesidade grau I e diabetes tipo 2, promovendo remissão do diabetes e melhor controle glicêmico. A melhoria da sensibilidade à insulina é um dos principais mecanismos dessa abordagem.
Primera cita en América del Sur de Capitophorus formosartemisiae (Takahashi) (Hemiptera, Aphididae)
Authors: Nieto Nafría Juan Manuel , Ortego Jaime
Published: February 2025

Capitophorus formosartemisiae (Hemiptera, Aphididae, Aphidinae, Macrosiphini) is recorded for the first time in Argentina (Tucumán province) and in South America, and also for the first time hosted on Artemisia verlotiorum, an introduced plant to the continent. The morphological features of the collected apterous viviparous females are exposed, with graphic support.
A Comparative Study of Undergraduate Students' Reading and Writing Preferences in Digital and Print Formats
Authors:   Mogadishu University, Sheikh Ahmed Prof. Said Abubakar
Published: February 2025

This comparative study aimed to investigate undergraduate students' preferences for digital and print formats in reading and writing activities. A descriptive research design was employed, and data were collected through a questionnaire distributed among students from various faculties at Mogadishu University.
Statistical analysis, including mean, standard deviation, and tests
such as Kruskal Wallis, Mann-Whitney U, and Wilcoxon W, were conducted to examine potential differences in format preferences. The findings indicate that students generally hold positive perceptions of both digital and paper-based reading and writing, although some differences and advantages were noted between
the two mediums. Students demonstrated a preference for paper- based reading, acknowledging the convenience and advantages of digital devices for information searching. Similarly, students
perceived benefits in both digital and handwritten writing, with revision and organization, and
handwritten writing fostering comfort and creativity. It is recommended to promote a balanced approach to literacy skills development, enhance digital reading experiences, foster digital writing skills, cultivate handwriting abilities, and conduct further research to explore the factors influencing preferences and the impact of different mediums on learning outcomes.
Tuberous Sclerosis Complex
Authors: Naeem Ume Hani , Noor Mohammad , Rahim Fawad
Published: February 2025

Tuberous Sclerosis Complex (TSC) is a rare, autosomal dominant, neurocutaneous disease characterized by the development of benign tumors that affect the brain, skin, retina, and other viscera. The clinical presentation is variable between and within families with respect to the number and severity of clinical manifestations. Nearly all patients have one or more dermatological manifestations, the most common being adenoma sebaceum, and most patients have epilepsy. The classic triad of facial adenoma sebaceum, epilepsy, and cognitive deficit (Vogt triad) is present only in one-third of the patients. Published cases of tuberous sclerosis had a maximum of four major clinical criteria. We report a 28-year-old lady with five major criteria for TSC who remained undiagnosed till she presented to the medical outpatient department for an unrelated complaint.
Long-term outcome of laparoscopic & open Palomo varicocelectomy in terms of complications and recurrence rates
Authors: Ur Rehman Ashfaq , Alam Muhammad , Ahmad Siddique , Iftikhar Muhammad , Ali Sohaib
Published: February 2025

Objective: To investigate the long-term outcome of open and laparoscopic Palomovaricocelectomy in terms of complications.
Methods: Data was obtained prospectively about clinical features, complications, recurrence during the two-year period. Statistical analysis was done in order to compare the long-term outcome for the procedures.
Results: 72 patients fulfilled the inclusion criteria with a mean follow up time of 16.25 months ± 4.99 SD. Out of these 42 (58.3%) were treated with the open technique while 30 (41.7%) with laparoscopic technique. Overall mean age was 23.82 years ± 4.86 SD with a mean duration of symptoms 11.06 months ± 5.59 SD. 72.4% of complications were encountered within the open Palomo technique group while 27.6% of complications occurred in the laparoscopic group. Similarly, 62.5% of the total recurrent cases occurred in the open group while 37.5% of recurrent cases occurred in the laparoscopic group. Median overall complications rate for open technique (mean rank = 40.00) and laparoscopic technique (mean rank = 31.60) were statistically significantly different, U = 483, z = -1.976, p = 0.048. The distribution of recurrence rates across the two treatment groups is also not significantly different, U = 618.00, z = -0.252, p = 0.801. On the other hand, the distribution of the varicocele grade was not statistically significantly different across the treatment groups, U = 582, z = -0.604, p = 0.546.
Conclusions: Laparoscopic and open Palomo techniques for varicocelectomy have comparable outcome in terms of recurrence rates. Overall incidence of complications is higher in the open group.
Risk factors associated with surgical site infection post-appendectomy
Authors: Akbar Khayam , Farman Ullah  , Hassnain  , Abdul Wahid  , Tariq Jamil
Published: February 2025

Objective: To find out possible risks factors associated with surgical site infection post-appendectomy. SSI is multifactorial and there is threat of serious surgical site infection in complicated ruptured appendicitis.
Methods: Observational cross-sectional study conducted at the general surgical ward of Hayatabad medical complex (HMC). Total 40 patients having appendectomy procedure taken into study. Data collected through Research Questionnaire. Variables of risk factors like age, gender, comorbidities, surgery duration, type of procedure, postoperative antibiotics, and surgeon experience, collected and analyzed.
Results: It was revealed that among 40 patients 11(27.5%) developed SSI. The overall rate of SSI is 27.5%. The age of 40 patients ranged from 10-69 years and it was highest 60% in age group of 40-49 years. Among 40 patients, 57.5% are male and 42.5% are female. SSI in males is 26.08% and in females, it was 29.41% slightly higher than males. SSI in procedures performed by TMOs is 46.66% and those by assistant professors is 25% and by the professor is 7.69%.
Conclusions: It can concluded from study that surgical site infection is multifactorial. Patient-related risk factors, surgery-related risk factors, can cause surgical site infection. Host factors like obesity, diabetes, can cause surgical site infection. Duration of surgery, type of surgery, gangrenous and ruptured appendicitis, and experience of operating surgeon greatly contribute to occurrence of SSI. Therefore, quality of surgical care including immediate patient assessment, preparation of an aseptic environment can reduce SSI.
EFFICACY OF LEFLUNOMIDE IN PATIENTS PRESENTING WITH RHEUMATOID ARTHRITIS
Authors: Sajjad Faisal , Bilal Muhammad , Khattak Saima , Khattak Muhammad Bilal , Khan Yaseen , Khan Ashraf Ali
Published: February 2025

Objective: To determine the efficacy of leflunomide in patients presenting with rheumatoid arthritis.
Methods: This descriptive case series was conducted in the Medicine Department, Lady reading Hospital, Peshawar, for a period of six months on 158 patients. Thorough history, detailed clinical examination and necessary investigations (Full blood count, ESR, Blood glucose, ALT, creatinine & RA Factor) were carried out and DAS28 score was calculated. All diagnosed patients meeting criteria were started on Leflunomide 20 mg daily. During the follow up appointments, DAS28 Score was recalculated; blood counts, creatinine and liver function tests were performed. Effectiveness assessment was done on the basis of DAS28 score. Confounding variables were controlled by strictly following exclusion criteria based on history, clinical examination and investigations.
Results: In this study mean age was 43 ± 9.38 years.  Seventy eight percent patients were female while 22% patients were male. More over in 65% of the patients leflunomide was effective and in 35% patients it was not effective.
Conclusions: Our study concludes that leflunomide was 65% effective in patients presenting with rheumatoid arthritis
FREQUENCY OF LEFT VENTRICLE THROMBUS IN PATIENT WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION
Authors: Syed Imran Ahmed Kazmi  , Khan Shahid , Amir Rashid Qureshi  , Muazzam Ali shehzad  , Syeda Anam Noor Kazmi  , Ahmed Raheel
Published: February 2025

Objective: This experimental and observational study was conducted to study the Frequency of left ventricular thrombus in patients with acute anterior wall myocardial infarction attending the Cardiology department, Ayub Teaching Hospital, Abbottabad during January 2020 to April 2020.
Material and Methods: In this study 203 patients diagnosed with acute anterior wall STEMI were included in the study after obtaining an informed consent. Patients were managed as per hospital protocols during their stay in the hospital. Echocardiography was performed in lateral decubitus position at a follow up visit at least 3 months following acute myocardial infarction to look for left ventricular thrombus. The written informed consent was taken from all patients before start of study. The permission of Ethical Committee was taken before collection of data and publishing in Medical Journal. The data was analyzed for result by SPSS version 20.
Results: Left ventricle thrombus was diagnosed in 17 (8.37%). No statistically significant association was found between LV thrombus and age and sex of the patients.
Conclusion: Left ventricle thrombus is a fairly common complication of acute anterior wall myocardial infarction.
FREQUENCY OF HYPOMAGNESEMIA IN RHEUMATOID ARTHRITIS PATIENTS WITH TRPM6 GENE POLYMORPHISM IN PESHAWAR
Authors: Asmat Sara , Shuaib Ambar , Hassan Javaid , Fareed Shahid , Hussain Shah , Farooq Ghulam
Published: February 2025

Objectives: The goal of the current study was to find the frequency of hypomagnesemia in rheumatoid arthritis (RA) patients and possible association between TRPM6 gene polymorphism and onset of rheumatoid arthritis.
Material and Methods: A cross-sectional analysis was performed from June 2019 till May 2020. 150 patients and 150 control samples were included in the study from assigned health care facilities of Peshawar and blood samples and other information was collected. The experimental work was performed in Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. Non-probability sampling technique was used, and written informed consent was obtained from the subjects. Serum magnesium levels were measured. A modified salting out protocol was used to extract DNA. The TRPM6 gene polymorphism was genotyped using the ARMS-PCR (amplification refractory mutation system polymerase chain reaction) method. The Chi-square test was used to determine the relationship between TRPM6 genotypes and rheumatoid arthritis disease. The odds ratio at the 95 percent confidence level was used to calculate the risk of rheumatoid arthritis.
Results: According to our results, serum magnesium level was found normal in 110 (36.67%) patients with RA. Hypomagnesemia was found in 35 (11.67%) while magnesium levels of 05 (1.67%) patients were found to be at the borderline. A significant association was found between TRPM6 gene polymorphism (rs2274924) and hypomagnesemia in patients with RA (p-value <0.05) but was not a risk factor for RA in predisposed people (odds Ratio = 0.23).
CLOVES SYNDROME: A CASE REPORT
Authors: Irfan Ullah  , Shiraz Zarak Khan , Khan Mehran
Published: February 2025

CLOVES syndrome is an extremely rare PIK3CA-related overgrowth syndrome encompassing, but not restricted to, congenital lipomatous overgrowths (CLO), vascular malformations (V), epidermal naevi (E) and spinal deformities (S). The syndrome can have features overlapping with other overgrowth syndromes resulting in a challenging diagnosis and frequent misdiagnosis. To the best of our knowledge, reports on the syndrome are lacking from Pakistan. We report a rare case of CLOVES syndrome in a previously misdiagnosed 2-year-old male child from Khyber Pakhtunkhwa, Pakistan.
COMPARISON OF LIP LENGTH AND THICKNESS AMONG THREE VERTICAL GROWTH PATTERNS IN SKELETAL CLASS II JAW RELATIONSHIP IN THE POPULATION OF PESHAWAR
Authors: Shah Ahsan Mehmood , Afridi Mashal , Muhammad Saood  , Kamran Mashal , Javaid Aatikah , Sardar Wagma
Published: February 2025

Objective: To compare upper lip length and thickness and lower lip length and thickness among high angle, normal angle and low angle patients with a skeletal class II jaw relationship and to compare these four variables among the sexes in the population of Peshawar.
Methods: This cross-sectional study was conducted at Khyber College of Dentistry, Peshawar in January and February, 2021. Clinical and radiographic records of 120 patients, with the age range of 9 to 33 years, were used. 60 males and 60 females were equally distributed into 3 groups based on their vertical growth pattern, with 40 patients each in the high angle group, normal angle and low angle group. The one-way ANOVA and independent-samples t test were used for comparison between the three groups and sexes for the four research variables. P value of lesser or greater than .05 was considered significant.
Results: The mean age for the entire sample was 17.61 years ± 5.14. There was no statistically significant difference in means of lip lengths and thicknesses amongst the 3 groups and sexes.
Conclusions: Lip lengths and thickness are similar among the three vertical growth patterns and among the sexes in skeletal class II in the population of Peshawar.
INCIDENCE RISK OF STROKE AFTER CORONARY ARTERY BYPASS GRAFTING (CABG)
Authors: Islam Nasir , Iqbal Muhammad , Malik Abdul , Shah Shahid Ali , Wazir Ibrar Mohibullah , Mohibullah Shehryar
Published: February 2025

Objective: “To determine the incidence risk of stroke after Cardiopulmonary Bypass Grafting (CABG) in Lady Reading Hospital Peshawar.”
Methodology: The cross-sectional quantitative project was undertaken in the Cardiovascular Surgery Department of Lady Reading Hospital, KPK, Pakistan (LRH). The period of this study was six months. Data was collected from two hundred and twenty-one patients who were participants of the study. SPSS version 14 was used for data analysis. Stoke was stratified by gender and age to see the stratal effects. A p-value of less than 0.05 was taken as significant in the chi-square test after data stratification.
Results: Two hundred and twenty one patients who had CABG in the cardiology unit of LRH were included in our study. The gender distribution of the participants was 1.63:1 male to female with the average age of the participants being 64.79 years +7.79SD with a range of 50-80 years. The stroke in patients after CABG was observed in 17(7.69%).
Conclusion: We found in our study that the incidence of post-CABG stroke is common after 55 years of age. Whereas stroke incidence increases further in patients who get an MI within a day of surgery
CORRELATION BETWEEN LIVER FUNCTION TESTS AND FATTY LIVER DISEASE/NON-ALCOHOLIC STEATOHEPATITIS
Authors: Khan Jibran Umar Ayub , Fayaz Humera , Qaisar Ayesha , Amin Said , Shah Azhar Zahir
Published: February 2025

Objective: This study aims to determine the correlation between liver Function Tests and fatty liver disease/non-alcoholic steatohepatitis
Methodology: This cross-sectional study was performed in two major tertiary care hospitals (Maqsood Medical complex and Hayatabad Medical Complex) in Peshawar, Pakistan, from 1st January to 30th June 2022. to  The study was approved by the institutional review board of Khyber Girls Medical College/Hayatabad Medical Complex, Peshawar, Pakistan. After informed consent, all patients aged 18 years and above were included in the study. Ultrasound was performed for each patient to determine the stage of fatty liver disease. History alcoholism was ascertained in all patients. In addition, hepatitis-B surface antigen and Anti-HCV, Anti-Hepatitis E and anti-Hepatitis A were performed in all patients.A sample size of 69 patients is calculated with a 90% confidence level, 7.1% margin of error and by taking an expected percentage of non-alcoholic fatty liver disease in Pakistan as 15%.Data entry and analysis were done with SPSS version 25. Study variables were age, gender, height, weight, ALT, SGOT, and bilirubin.
Results: A total of 69 patients fulfilled the inclusion criteria, with predominant female patients at 75.36%. The mean age of participants was 39.71±14.8.
The mean ALT was 77.88±70.52 in the male group and 53.40±29.12 in the female group. The alkaline phosphatase was 243.29±65.27 in the male in comparison to the female group 249.36±115.07. The ALT was positively correlated with ALP (r=0.328, p-value=0.006) and bilirubin (r=0.363, p-value=0.002). However moderate positive correlation was observed between ALP and bilirubin (r=0.549, p-value=0.000).
SAFETY OF DIRECT TROCAR INSERTION THROUGH UMBILICAL PORT IN LAPAROSCOPIC SURGERY AT KHYBER TEACHING HOSPITAL, PESHAWAR
Authors: Jameel Usba , Eid Faryal , Saeed Tahir , Ahmad Munir
Published: February 2025

Objectives: To determine the safety of direct trocar insertion through an umbilical port in laparoscopicsurgery with regards to potential complications.Methods: This descriptive cross-sectional study was carried out at the surgical department of KhyberTeaching Hospital, Peshawar, from 1st July 2019 to 30th June 2020. The study included 213 patientsof both genders fulfilling the inclusion and exclusion criteria. They were enrolled and booked forlaparoscopic surgery. Under general anesthesia, a 10mm trocar was inserted through the umbilicusafter an incision through the skin. Intra-operative and post-operative complications were noted anddata was collected in pre-printed proforma documents. The final data was analyzed through SPSS 22.Results: Out of the 213 patients, 77(36%) were male and 136(63%) were female. The mean age was37.97 ±5.30 years while BMI was 25.37±4.18 kg/m2. Pneumoperitoneum was safely and successfullycreated via direct trocar insertion in 182 patients (85.4%). There was no statistically significant effectof age, gender, BMI, and type of surgery on the safety of direct trocar insertion in the creation ofpneumoperitoneum for laparoscopic surgeries as the P- value was more than 0.05.Conclusion: Based on our study, it is concluded that the technique of direct trocar insertion is safe forthe creation of pneumoperitoneum in laparoscopic surgeries.Keywords: Laparoscopic Surgeries, Direct Trocar Insertion, Pneumoperitoneum, Safety,Complications.
ASSESSMENT OF INFRAZYGOMATIC BONE THICKNESS FOR SAFE PLACEMENT OF INFRAZYGOMATIC IMPLANT IN PAKISTANI POPULATION; A CBCT STUDY
Authors: Saif Ujala , Mehmood Shah Ahsan , Shabir Sundus , Sajjad Sana , Majeed Komal , Noor Rubina
Published: February 2025

Objective: To evaluate infrazygomatic bone thickness for safe placement of infrazygomatic implant using CBCT.
Methods: This retrospective cross-sectional study was conducted in Orthodontics department of Khyber College of Dentistry, Peshawar. Computed tomographic records of 116 patients were taken to assess bone thickness in the coronal view. Measurements were made along the distobuccal root of 1st molar at angles ranging from 55° to 75° to maxillary occlusal plane and a line tangent to distobuccal root of 1st molar. Data was represented as tables and figures. Independent samples t test was employed to see the relation of the insertion angles and mean height from occlusal plane with gender.
Results: Bone thickness at infrazygomatic crest region varied at different insertion angles. Bone thickness at insertion angles of 55° to 75° ranged from 3.07 ± 0.94mm to 4.91 ± 1.59mm to maxillary occlusal plane. This value increased with increasing insertion angles. The height from occlusal plane also varied with higher values at small insertion angle i.e., 18.5mm at 55° and smaller values at high insertion angle i.e., 16.02mm at 75°. There was a significant difference in insertion heights from occlusal plane at insertion angles of 60°-75° according to gender, with higher insertion position in males (p value <0.05).
Conclusions: For minimum bone support of 3mm at infrazygomatic bone crest & safe placement of screw without injuring distobuccal root, the miniscrew should be inserted at an angle of 55° to 70° at distances of 16mm to 18mm from maxillary occlusal plan.