bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARISON OF PUBLIC AND PRIVATE SECONDARY SCHOOL TEACHERS’ PERCEPTIONS ABOUT CREATIVITY AS A CULTIVATED SKILL IN THE CLASS ROOM PRACTICES
Authors: Afsar Sultana, Anjum Bano Kazimi
Published: December 2021

The research examines and compares public and private secondary school teachers’ perceptions about creativity as a skill that can be cultivated in their class room practices. The researcher adopted PBA, a psychological model of professional behavior analysis for analyzing professionals’ perception. Any professional expert’s positive perception is essential regarding the strategies, to handle the task properly and achieve its maximum objectives. In the present study secondary school teachers of Malir district were taken as population of the study and were divided into two clusters; public and private. For selecting the sample of 560 sizes, each sub group of the sample remained equal by using probability technique. All the clusters were collected randomly. Mixed Method was the adopted research method; quantitative analysis contributes 80% and qualitative analysis contributes 20%. Survey was the research design to collect the data. Close ended questionnaire was developed for collecting quantitative data. In-depth Interview was developed for collecting qualitative data. Independent sample t-test was used to compare the groups quantitatively and thematic analysis for qualitatively. The data triangulation determined the degree of strength of their perceptions. Obtained findings depict that private school teachers’ perceptions are stronger than public school teacher regarding the issue
IMPLICATIONS OF PENTAGON THEORY OF CONTEXTUALIZED MULTIPLE INTELLIGENCES (CMIs) FOR FUTURE JOB PROSPECTS OF UNIVERSITY STUDENTS
Authors: Hina Amin, Abid Hussain Chaudhary
Published: December 2021

The Purpose of the study was to test the Pentagon theory of Contextualized Multiple Intelligences (CMIs) in the context of fourth industrial revolution. It also explored the awareness of students regarding the trends and challenges of future job market. Lastly, skills and competences required by graduate to meet the complexities of future job market were also investigated. This study followed the critical paradigm, therefore sequential explanatory mixed method research design was used. All the masters’ level students, heads of departments/ senior faculty members and experts of social sciences were considered as population for this study. Multistage sampling techniques was employed to select the sample size for quantitative phase (n=786). For qualitative phase, purposive sampling technique was used and 12 experts of social sciences were selected. Self-developed questionnaires were used to collect data from respondents. Contextualized Multiple Intelligences questionnaire has 32 statements under 6 factors with Cronbach’s Alpha value of 0.92. Similarly, Future Job Market Prospects questionnaire has 20 statements under 4 factors with Cronbach’s Alpha value of 0.91. Semi-structured Interview protocol was developed and used during the qualitative phase. Study revealed positive and strong correlation between the contextualized multiple intelligences and future job market prospects. However, the public universities students showed relatively larger correlation (r=.631, p=.000) as compared to private universities students (r=.556, p=.000). Furthermore, male and female students have differences in their contextualized multiple intelligences. Besides, students exhibited high level of understanding regarding the need of market driven content and importance of employability skills. Experts (Qualitative data analysis) highlighted the need for active role of universities in re-skilling students with contextualized multiple intelligences to make them more desirable for employability.
MEASURING THE ABSOLUTE LITERACY: TO CONTEXTUALIZE WITH OFFICIAL CLAIMS OF LITERACY RATE IN DISTRICT BAHAWALPUR
Authors: Muhammad Tahir Nadeem, Irshad Hussain, Nosheen Malik
Published: December 2021

The goal of the study was to provide documented evidence of the absolute tested literacy and to detect the gap, if any, between tested and reported literacy rates in Bahawalpur District. Two types of research instruments were used to collect the data. One of the tools was a survey sheet to obtain demographic and other details of the respondents. The second tool was a test to measure the literacy rate. All the age groups between 10-50 years were the population of the study. A total number of 194 persons joined the test willingly, out of 589 people who reported as literate population. After the application of the test, the obtained data was inserted into two separate sheets with code numbers. The coded data analyzed and average and percentages were ascertained. It was concluded that a gap is visible in the two data sets; reported literacy and assessed literacy
A RESEARCH STUDY ON THE ESSENTIALITY OF MEDICAL AWARENESS CAMPAIGNS / PROGRAMS FOR COLLEGE STUDENTS AT THE PUBLIC SECTOR IN KARACHI, PAKISTAN
Authors: Anila Fatima Shakil, Rabia Abdul Karim, M. Urooj Fatima
Published: December 2021

This research study is conducted on the essentiality of medical awareness campaigns/programs in public colleges, as it is seen that there is a dire need of providing students with many medical and health related information. This research is purposed to enlighten this issue and to make colleges to pay attention and take the initiatives of conducting medical awareness campaigns. These campaigns/programs provide basic life and therapeutic skills, first aid training, medical check-ups, and hygiene information. Furthermore, these campaigns/programs arrange training sessions, workshops, and seminars where students are trained and taught about basic facts and new researches made in the medical field. Besides, knowledge about new emerging issues, problems, and solutions, it also provides awareness regarding diseases and preventions. It is a cross-sectional, quantitative research based on survey method. Data is collected from 60 respondents; 40 female students and 20 teachers, from 6 colleges of 2 towns of Karachi through Likert Scale, comprised of close-ended 43 structured items. The data is apprehended by taking SPSS Mean. It is a small effort done to aid the conduction of medical awareness campaigns/programs as to aware students regarding health and medical information to the concern to meet challenges of the globalized world.
IMPACT OF ACCREDITATION OF TEACHER EDUCATION PROGRAMS IN PAKISTAN ON PROSPECTIVE TEACHERS`LEARNING; A COMPARATIVE STUDY
Authors: Tasneem Saifuddin
Published: December 2021

The world is recently moving towards quality criteria in every field. For this Accreditation process has been introduced in every Discipline, Institute and Program to maintain the standards of quality. Accreditation refers to the authenticity and fairness in achieving the benchmarks of standards of program, a course, a module or an Institution. (Harvey, 2004). Accreditation provides certainty that the course or program will meet the demands and requirements of the quality standards. In order to produce trained professionals’ quality in higher education is required and Accreditation process will provide the Quality Assurance. As the teachers are the roots of every profession, therefore the Accreditation Process is also introduced in the field of teacher Education Program to maintain and improve the quality of Teacher Education Programs. When talking in context of Pakistan, there is always an issue regarding in quality of Education in Pakistan. In order to meet this demand NACTE (National Accreditation Council for Teacher Education) is established so that the quality criteria can be achieved through the process of Accreditation of different Teacher Education Programs in Pakistan. (Shakoor, & Farrukh, 2016). The programs or courses having NACTE Accredited certificate can be accepted globally and thus can serves as a basis of good professional start. The present study aims to find out the comparative analysis of the impacts of NACTE Accredited and Non-Accredited Teacher Education Programs on student's Achievement. The study is conducted on students of B. Ed honors studying in different institutions in Karachi. To carry out comparative analysis MGA (Multigroup Analysis) is carried out on Smart PLS: 3. The analysis done revealed high ‘values of Accredited groups as compared to nonAccredited groups, concluding that there are significant differences in the impact of two types of programs; Accredited and Non-Accredited teacher Education Programs on student teacher`s achievement. The results declared that Accredited Programs
The Relevance of The Value System in the Performance of Multinational Companies in Karachi, Pakistan
Authors: Irfan Ul Haque  ,  Muneera Moulabuksh  ,  Dr. Syed Zubair Ahmed
Published: December 2021

This paper aims to explore the multinational companies operating in Pakistan that are convincingly aware of Islamic, cultural, and ethical values. To study a sample survey designed to gather and analyze information on the significance of these values? Do non-Muslim Pakistani multinational executives have scant knowledge of cultural, religious, and moral values? Is the impact of the existence of multinational companies on the local culture of Western values? Do the expectations differ to some degree from those of the locals? Will the contribution of foreign corporations to the host countries make a meaningful contribution to the socio-economic stability and economic growth of the host country? Will the perception of the administrators of global corporations vary from that of multinational clients? The targeted survey consists of two categories, i.e. multinational managers and multinational clients, and found that multinational managers are mainly Muslim in the education sector, while 96 percent of multinational respondents have been residing in the residential sector since birth. When the Asian financial crunch severely affected the region, transnational businesses played a significant role in the rebuilding of Pakistan's economy and caused a considerable export-oriented character in economic development, the economy recovered rapidly compared to any other region with the aid of multinational companies.
Freedom of Speech in the Context of Media and Democracy
Authors: Dr. Sadia Mahmood  ,  Dr. Masroor Khanam
Published: December 2021

It is easy to forget the basic values at risk when it comes to a busy journalist, editor, broadcaster or media owner everyday life. This paper unfolds globally accepted democratic media law norms and best practise models. It reviews widely recognised democratic broadcasting and democratic media standards as well as standards to prohibit or otherwise regulate media content. Time limits, shrinking budgets, restricted electronic and library resources, demanding managers, challenges with distribution and harsh media legislation, not to mention news topics which are frequently worried about reporters if not openly antagonistic, are part of news rooms and among studio limitation. This is a difficult workplace and journalists may easily lose sight of the broader picture. The overall picture is that journalists' work reflects how we human beings connect and how effectively our company works. The interaction concepts that apply to each other as people are implemented and apply to the interaction between wider social entities, such as the medium and government. You can learn a lot about the status and dedication of a nation through democratic, economic and social progress by looking at respecting its people and media.
GEO-STRATEGIC CONSEQUENCE OF CHABAHAR AND GWADAR SEA PORTS AND THE INTERESTS OF EXTERNAL PLAYER
Authors: Mohammad Yousaf, ,Dr. Adil Zaman Kasi ,Dr. Mulazim Hussain
Published: December 2021

In this study, we are trying to examine the Geostrategic and economic potentials of Gwadar and Chabahar deep Sea ports recently two constructed ports while Gwadar situated in Balochistan Province of Pakistan and Chabahar located in Sistan and Balochistan area of Iran has been recognized as coagulated strategic agreements between China and Pakistan and between India and Iran. These sea port politics are forming an unbalance of powers in the region after the United States of America is expanding its military role in the region and attended more strategic partnership with India. Both ports could change the dynamics of regional politics, oceanic trades and transshipment, therefore, in this developing scenario both Gwadar and Chabahar Iranian port have taken a central stage in the current phase of international politics and have taken a unique geo- strategic and geo-political significance. Gwadar deep sea port is weighted as a strategic base from where; China can monitor US movement in the Persian Gulf, Indians naval actions in the Arabian sea and US-Indo maritime cooperation in the IOR (Indian Ocean Region). India, in response of this strategic move developing Chahbahar port with Iranian assistances and partnership of Afghanistan, desire to Central Asian countries coupled with to reduce the influence of Chinas future long -run geo-economic and strategic interest in the entire region. The new economic, strategic and development move have created a new power structure which places the indigenous people better off after the new wave of globalization in this region. The development of Chabahar and more specifically Gwadar port could go nowhere, if the property rights of local masses and their socio economic security are not protected. One solution is to provide free and fair access of local masses to the new developments with equal distribution of resources and other opportunities to the locals at their doorsteps
OVERVIEW STRUGGLE FOR ISLAMIC EMIRATE OF AFGHANISTAN
Authors: Naseem Akhtar , Dr. Abdul Qadeer Khan
Published: December 2021

Afghan history evident mostly, war and battles, ranging from civil wars to international forces, Taliban came in power after the withdrawal of soviet forces. Destruction of world trade center proved way for US lead international forces to root Taliban, who were seated in Afghanistan and pushed them out of power, in 2001 this defeat could not be proved to be ultimate. Taliban insurgency caused a number of national and international concern for--- of the Taliban must ruined the women education and participation in all the sphere of life A number of international organization and NGOs examined the pathetic situation of female education in the country, this study emphasis and accessed the efforts of changing scenarios of powers and government and the center and context of Taliban and warriors groups .on the basis of the available result of interviews taken by the different international bodies found its roots in al-Qaeda. On different occasion and different instances were adopted by the Taliban about the implementation and interpretation of Islamic law previously, girls schooling. The facts found different view pointed many Taliban commander was not only their because of their religious extremes approaches but the tribal condition and restriction, contributed to intensified the situation despite on the effort of USA and allies, Taliban adopted the strategy to participate to government physical presence in the state. Wherever they got power. They prolonged the agitation by adopted the gorilla war.it completed the international forces to lose the patience China had it’s over strategy aiming at constitutional its boarder in the wakhan, ultimately the Taliban announce the Islamic emirate of Afghanistan after leaving number of US forces. A large number of Afghanis seeking refuge in different countries. Taliban could not so far achieving the confidence of their people which will rise new challenge for establishment of a strong state and sound government, while the long duration of wars destroyed the infrastructure completely
KASHMIR POLITICAL LANDSCAPE AND CHANGE IN PAKISTAN’S POLICY
Authors: Dr. Fida Bazai ,Dr. Ruqia Rehman ,Amjad Rashid
Published: December 2021

Kashmir was a princely state, outside the orbit of the united India two major political parties; All India Muslim League and All India National Congress. The level of political mobilisation was considerably lower than in the India’s mainland. However this political isolation was eventually broken by a youth group, the Young Men’s Muslim Association, spearheaded by a school teacher and charismatic leader Sheikh Muhammad Abdullah, graduated from the celebrated institution, the Aligarh Muslim University, created All Jammu and Kashmir Muslim Conference (MC) in October 1932. It major objective was to liberate Jammu and Kashmir from the tyranny of the Maharaja Hari Sing. Later on, the politics of united India extended to the state of Jammu and Kashmir. National Conference with its socialist leaning was inclined toward the Indian National Congress due to its ideological affinity and personal relationship (Sheikh Abdullah and Nehru were friends). Whereas
CPEC: POLITICAL ENVIRONMENT CHANGER FOR CENTRAL ASIAN REPUBLICS
Authors: Dr. Suwaibah Qadri
Published: December 2021

States are more inclined to create alliances with one another for economic growth since regional cooperation has the potential to boost small governments. As part of their efforts to shift the political atmosphere, Pakistan and China have taken steps towards improving their regional cooperation through connectivity. The China-Pakistan Economic Corridor (CPEC) is a significant component of China's Belt and Road Initiative (BRI). As a result of the China-Pakistan Economic Corridor (CPEC) and the economies of its neighbours, notably the Central Asian Republics, Pakistan's GDP will develop dramatically. The signing of the agreement between Central Asia and South Asia is another CPEC-related economic initiative, as is CASA-1000 (CASA-1000). The TAPI oil pipeline, which will link Turkmenistan with Afghanistan, Pakistan, and India, will be inaugurated at the same time. It is written from the perspective of Pakistan and the CARs' harmonic basis. The CPEC's value for China, Pakistan, and other nations as well as CARs is also examined.
GENDER INEQUALITIES AS A GLOBAL ISSUE AND ITS EFFECTS ON WORLD DEVELOPMENT
Authors: Muneera Moulabuksh , Shabnam Rasheed , Shahzad Amir
Published: December 2021

We are born in a world full of stereotypes, from the moment we are conceive both boys and girls are subjected to be a stereotype. Gender inequality has been seen in every sector and every norm of life and has a major impact on world development. Inequality is one of the most sensitive topics of all time and has an economic phenomenon that has existed in human history. Gender inequality is considered to be one of the most important issue which has been thoroughly highlighted globally and we as a nation have seen its worst impact on world development. The article is a blended study of qualitative and quantitative analysis regarding gender issues and its impacts on the development of different sectors of the world. The dimensions of women empowerment and economic development are the main focuses in this writing. The results found that women play an important role in the development of the world, either it is economic or social or political. It also found that the underdeveloped countries are facing more concerns regarding gender inequalities as compare to the developed world.
Electrical Resistivity and Geotechnical Attributes and The Dynamics of Foundation Vulnerability
Authors: Bawallah Musa Adesola , Ilugbo Stephen Olubusola , Ozegin Kesyton Oyamenda , Adebo Babatunde A , Aigbedion Isaac , Salako Kazeem Adeyinka
Published: December 2021

This research evaluates the significance of geotechnical and Electrical Resistivity methods in studying structural integrity as fundamental factors that may account for failure in a typical sedimentary environment of Ukpenu Primary School, Ekpoma, Edo State, Nigeria. Two methods were used in this study such as the Electrical Resistivity approach involving the use of Lateral Horizontal Profiling (LHP), 2D Electrical Resistivity Tomography (ERT), and Vertical Electrical Sounding (VES) techniques. While geotechnical method involved the collection of soil samples from the study locations for the characterization of the soil properties that are very vital to foundation studies. Nine VES were carried out using Schlumberger array with current electrode spacing varying from 1 to 40 m, with 2-D ERT using Dipole-Dipole electrode array with inter-station separation of 5 m and an expansion factor varied from 1 to 5 while LHP involve Wenner array with an electrode spacing of 5 m interval and was used to determine the vulnerability factors for the building sustainability. The VES interpretation results were used to determine the second-order parameters for the determination of vulnerability. The results obtained from the two methods review that both are very fundamental to foundation dynamics. However, electrical attributes were found to give better information in terms of depth, lateral extent, layer stratification, and nature of materials which make it an indispensable tool over geotechnical attributes whose depth of investigation is up to a maximum of 5 m which poses great limitation in the evaluation of structural integrity, against stress, and strain occasion by geodynamic activities that often result into fracture, crack, highly weathered formation that usually goes beyond the shallow depth of investigation. Therefore, it can be stated that resistivity attributes account for 90% of the major contributing factors that affect foundation vulnerability.
Description of the biogeography of the Mymaridae Family (Insecta: Hymenoptera)
Authors: Carlos Henrique Marchiori
Published: December 2021

The objective of this manuscript is to research the management, biology, habitat, ecology, geographic distribution, taxonomy, life cycle, phenology, parasitoidism (parasitism) of the Mymaridae Family (Insecta: Hymenoptera). The research was carried out in studies related to quantitative aspects taxonomic and conceptual aspects. A literature search was carried out containing articles published from 1984 to 2021. The mini review was prepared in Goiânia, Goiás, from September to October 2021. The mini-review was prepared in Goiânia, Goiás, from September to October 2021, through the Online Scientific Library (Scielo), internet, ResearchGate, Academia.edu, Frontiers, Biological Abstract, Publons, Qeios, Pubmed, Dialnet, World, Wide Science, Springer, RefSeek, Microsoft Academic, Science, ERIC, Science Research.com, SEEK education, Periodicals CAPES, Google Academic, Bioline International, VADLO, Scopus, Web of Science, LILACS, Medline, LIS and Portal of Scientific Journals in Health Sciences.
Elucidating the relationship between meningitis and SARSCoV-2 infection: a literature review
Authors: Reis Luana Brandão de Sales , Moreno Beatriz do Nascimento Garcia , Carmo Junior Ricardo Moreno do , Garrido João Guilherme Santos , Oliveira João Gustavo dos Anjos Morais
Published: December 2021

Background: The Covid-19 pandemic has become a major challenge for public health, once this disease can even affect the nervous system, causing severe conditions, such as meningitis. The association between meningitis and Covid- 19 is not yet well established, but it is believed that it can be caused both by a bacterial co-infection or by the involvement of meninges due to the action of the virus itself. Objective: The aim of the present study is to elucidate the relationship between meningitis and SARS-CoV-2 infection. Methods: In order to carry out a literature review, case reports were searched in the PUBMED database, in which only articles in English were considered, without year restriction, resulting in the following research formula: “((COVID-19) OR (SARS-CoV-2)) AND (meningitis)”. Results: 33 case reports were found, of which only 12 met the eligibility criteria. The reported cases provide evidence of meningeal and brain involvement by the SARS-CoV-2 virus, some with confirmation by CSF RT-PCR. Isolation of the SARS-CoV-2 virus in the CSF is challenging and has not been possible in other patients; however, the exclusion of bacterial involvement by culture and other viral agents in the CSF analysis points to infection by SARS-CoV-2 in a patient with positive RT-PCR by nasopharyngeal swab or bronchoalveolar lavage. Conclusions: The possibility of SARS-CoV-2 meningitis reinforces the need to investigate this condition in patients with COVID-19 who have neurological symptoms.
Unraveling the mysteries of the midbrain – A case report
Authors: Rufino Adonai Alencar , Portela Beatriz Girão , Cidrão Alan Alves de Lima , Rangel Deborah Moreira , Marinho Vitor Araújo
Published: December 2021

Context: The rostral midbrain and thalamomesencephalic junction are the supranuclear premotor control of vertical eye movements, and is supplied by the posterior thalamo-subthalamic paramedian artery originated from P1 segment of posterior cerebral artery. Case report: A 51-year-old man presented with sudden speech difficulties, dizziness and dyplopia, associated with moderate intensity headache. Neuroophthalmological examination revealed incomplete ptosis of the right eye, with mydriatic pupil, poorly reactive to light. No eye movements were present on attempted upward gaze. On attempted downward gaze, depression of the left eye was observed but with absent saccades. Lateral gaze to the right was intact, while attempted gaze deviation to the left revealed adduction deficit of the right eye with incomplete abduction of the left eye without nystagmus. Convergence was absent. He exhibited left hemiataxia with left hypoestesia. MRI showed acute right paramedian thalamic and mesencephalic stroke. Conclusions: About the vertical one and a half syndrome, it was suggested damage in the pathway to contralateral downgaze neurons before its decussation with the unilateral interstitial nucleus of Cajal. As for the contralateral lateral rectus palsy we infer that this patient’s abduction deficit was due to pseudo-abducens palsy, with several mechanisms that could explain abduction deficits associated with upgaze palsy. Claude’s syndrome is usually explained by a lesion of oculomotor nerve fascicle and the superior cerebellar peduncle, affecting cerebellothalamic connections.
Brain stroke in patients with Covid-19 disease
Authors: Maltri Rebecca , Marino Fernanda Peronti , Santos Jorge Ygor Gonçalves dos , Melgaço Nathalia Polliana Rodrigues , Cunha Vitória Aparecida , Nogueira Paola Falcão Moreira , Correia Rafaela Charles , Carvalho Tiago Silva
Published: December 2021

Background: Currently, the world is facing a pandemic caused by the SARSCoV-2, which has already infected millions of people and has accumulated countless deaths. Association has been reported between severe conditions of this disease and the occurrence of neurological manifestations, including stroke. The mechanisms that trigger this cerebrovascular disease in infected people are not defined yet, but it’s believed that they involve inflammatory reaction, vascular endothelial dysfunction and hypercoagulopathy present in SARS-CoV-2 infection. Objectives: Verify the studies which relate the cerebrovascular disorders caused by the infection of SARS-CoV-2, in order to elucidate its performance and determine the patient’s management as a way to avoid outcomes such as stroke and other neurological conditions losses. Methods: The subject is approached through a narrative review of the literature without meta-analysis. A bibliographic survey was made out, from December 2019 to June 2020, in digital databases. Results: The relation between ischemic and hemorrhagic strokes with coronavirus infection shows a possible mechanism of action of the virus related to ACE2, damaging tissues, including the brain. In addition, a huge relation has been identified between coagulopathy induced by the infectious condition and the occurrence of stroke, since the intense inflammatory storm produced raises the risks of occurrence of cerebrovascular events. Conclusions: The activity of this coronavirus against ACE2 has been shown to increase the secretion of pro-inflammatory substances, causing brain damage. Although this is a new disease, it’s possible to establish the stroke as a complication of COVID-19. It should be considered, especially in critically ill patients, and promptly assisted.
Demographic characteristics of subjective cognitive decline studies’ samples. A systematic review
Authors: Pedrini Natália Menegassi , Machado Matheus da Silva Calabresi , Ballestero Matheus Fernando Manzolli , Vale Francisco de Assis Carvalho do
Published: December 2021

Background: Subjective cognitive decline (SCD) consists on self-perception of cognition decline without an objective impairment. It has gotten attention from researchers because it may be an early stage of Alzheimer’s disease, before dementia Objectives: This research aimed to determine the characteristics of the SCD studies’ samples across the countries. Methods: It was searched for complete articles from 2014 to 2020 on MEDLINE, PubMed, EMBASE and others, using the keyword “Subjective Cognitive Decline” and its respective translations in both Spanish and Portuguese. Results: Of 3,470 papers, 487 were eligible. The mean age of SCD participants was 71.98 in 2014 to 66.14 in 2020, (mean 66.81) as the number of participants, there were 104 in 2014 and 5233 in 2020 (mean: 1729), and 59% of the participants were women. The mean scholar years were 13.4, in 2014 there were 8 articles and 167 in 2020. Conclusions: The increased number of publications and samples represents the crescent importance of the theme. The decrease in the mean age, possibly demonstrates efforts to an earlier detection of the condition. The majority of women, could represent a prevalence of this gender on the disease, or be related with the fact that woman participate more in scientific studies and also use the health services more than men. The high level of scholarly contrasts with the wrong conception of dementia being related only to poor education, showing that it also affects higher levels of schooling.
Association of pre-stroke hyperglycemia with hemorrhagic transformation in patients undergoing thrombolysis.
Authors: Freire Gabriel Praxedes , Fontes Juliana de Alencar , Silva Gabriel Nascimento , Jesus Pedro Antonio Pereira de
Published: December 2021

Background: Hyperglycemia is a frequent finding in patients suffering from ischemic stroke. Hemorrhagic transformation is a complication associated with thrombolytic treatment, with poor prognosis. In addition, hyperglycemia and diabetes are related to worse outcomes in vascular events. Objective: This study aims to analyze the association between hyperglycemia at admission and hemorrhagic transformation in patients undergoing thrombolysis after ischemic stroke. Methods: A cross-sectional study was carried out with patients from the DISPASS cohort (DOI: 10.1161 / STROKEAHA.120.026425), admitted in a reference stroke unit in Salvador-BA. Those over 18 years of age who underwent thrombolysis with alteplase were included and patients without data on glycemic control or who did not meet the admission criteria in the cohort were excluded. Results: Of the 173 patients within the therapeutic window for thrombolysis, 14 underwent hemorrhagic transformation evidenced in computed tomography of the skull and, among these, only 04 presented with hyperglycemia at admission and beginning of thrombolytic treatment, which represented a non-important association (p <0.485) between hyperglycemia and hemorrhagic transformation after thrombolysis. Discussion and Conclusion: The findings are in line with what was reported by Olsen in 2009 and with what was expected, due to the known relationship between hyperglycemia and diabetes with hemorrhagic complications in patients who suffered a stroke. The present study found no association between the incidence of hemorrhagic transformations in patients with pre- thrombolysis hyperglycemia in a stroke context.
Influence of Pain on Social Participation and life habits after stroke
Authors: Araújo Denise Soares de , Silva Emanoelle C. Vilela da , Gondim Afonson L. Medeiros , Gomes Camila L. de Aguiar , Dantas Emanuel Sávio de Macedo , Medeiros Ana Loyse de Souza , Apolinário Emille de S. , França Monalisa Silva de , Pacheco Thaiana Barbosa Ferreira , Cacho Roberta de Oliveira , Cacho Enio Walker A.
Published: December 2021

Background: One of the main symptom present in post-stroke subjects is chronic pain. Chronic pain and physical dependence can decrease the level of social participation of these population. Objective: characterize the correlation between pain and the social participation of post-stroke individuals living in the region of Trairi Potiguar. This is a cross-sectional and observational study, approved by the institution’s research ethics committee (#2.622.853). Methods: Thirty-four participants were assessed by McGill Pain Questionnaire (MPQ), LIFE-H 3.1, Functional Independence Measure (FIM), Mini-Mental State Examination (MMSE), Fugl-Meyer Scale (FMS) and Nottingham Sensory Assessment (NSA). Spearman correlation test were performed in the statistical analyse. Results: The following scores were reported in median (1ºQ/3ºQ): FIM (65: 0/116), MMSE (18: 0/23.75), FMS (21: 0/88), NSA (45,5: 0/238), LIFE-H total (338: 0/757) and MPQ (0: 0/0.75). A moderate positive correlation between the sensory domain of the MPQ (pain) with the subdomains of nutrition (rs=0.5913, p=0.0002) and mobility (rs=0.5083, p=0.0021) of LIFE -H were founded. Conclusions: There are presence of pain in this population, but no correlation was found between pain and social participation in post-stroke individuals.
Application of Principal Component Analysis in the estimation of potential factors associated with the prevalence of deaths in cases of spinal cord trauma
Authors: Beltrão Letícia Viana Martins , Braga Ana Paula Cecília , Miranda Anna Luiza Alves de Oliveira MIranda , Carvalho Walther Augusto de , Teixeira Cláudio Eduardo Corrêa
Published: December 2021

Background: In Brazil, the mortality indicators for spinal cord trauma (SCT) are poorly known. Therefore, identifyng potential risk factors for death due to SCI is fundamental for preventive actions which suits each country region’s specificities. Design and setting: Cross-sectional study (Parecer no. 1.451.493), with the analysis of 786 medical records of SCT cases hospitalized between 2010 and 2015 at a reference hospital in Belém, Pará, Brazil. Methods: We used Principal Component Analysis (PCA) to estimate potential factors that contribute to the SCT, the following factors were analyzed: intervention (conservative/surgical), hospitalization period ( one week), vertebral segment affected (cervical or not), treatment cost ( 1 minimum wage), management (multiprofessional or not), distance to care, sequels, age and gender. Data analysis was performed using R. Results: The type of management and intervention and patients’ age were factors that most influenced (~20%) the outcome (death/survival). However, this indicates that ~ 80% of the outcome’s variability is due to other factors. Conclusions: PCA is useful to indicate potential factors to be considered as influencing the prevalence of death in SCT cases. The use of these data in discriminatory analyzes, hereafter, can help to clarify this topic.
Relationship between stroke etiologies and clinical manifestations/Oxfordshire
Authors: Souza Silas Paulo Lima de , Andrade Antonio Carlos Dias , Cruz Vinicius Leal Borges da , Paste João , Almeida Tiago Timotio de , Araújo Catarina Secundino Tavares de , Jesus Pedro Antônio Pereira de
Published: December 2021

Introduction: The classification of strokes subtypes is important, since they have different management and prognoses. This study aims to verify associations between the etiologies of the stroke according to the TOAST classification and the clinical presentation by the subtypes of the Oxfordshire scale. Methods: A descriptive cross-sectional study, with patients admitted to a stroke unit of a reference hospital in Salvador-BA between 11/2017 and 03/2020. We included patients over 18 years of age and didn’t include patients with inaccuracies in the filling of medical records or who didn’t meet the criteria for admission to the cohort. Results: 300 patients between 25 and 98 years old (mean: 64 years; SD: 13.34) were analyzed. Regarding cardioembolic etiology (CE), 34 patients (45.3%) had lacunar syndromes (LACS) and 25 (33.3%) Partial Anterior Circulation Syndrome (PACS). Patients with Large Artery Atherosclerosis (LAA) 24 (40.7%) had PACS while 21 (35.6%) of the LACS patients diagnosed with small vessel occlusion (SVO) 22 (62.9%) had LACS. Futhermore, patients with cryptogenic strokes (CS) had predominantly PACS and LACS, 27 (31%) and 40 (46%) respectively. Conclusion: Based on the results of acute strokes of CE, SVO and CS origin are related to LACS. The events originated by LAA are more associated with PACS. Events caused by SVO were related to lacunar syndromes, corroborating with findings in the literature.
Progressive lacunar stroke presenting as cheiro-oral syndrome, dysarthria and hemiataxia
Authors: Disserol Caio , Ferreira João Henrique Fregadolli , Britto Carolina Magalhães , Spesotto Maria Clara , Guariglia Carla , Lange Marcos Christiano
Published: December 2021

Context: Lacunar infarcts are small infarcts caused by occlusion of a single penetrating vessel, affecting mostly the basal ganglia, subcortical white matter and pons1. Around 20-30% of patients may progress symptoms over hours to days, and this presentation is associated with disability and poor prognosis2. Case report: A 70-year-old man with history of smoking, hypertension and a previous right occipital stroke reported right upper lip paresthesias since awakening. In 2-hours the right perioral region and his right hand were affected. After 3-hours he noted slurred speech. After 4-hours, imbalance was added to the previous symptoms. On admission, NIHSS was 4, mostly by previous left hemianopia, new right arm ataxia and cerebellar dysarthria. There were no weakness or sensory déficits. Brain MRI showed a subacute lacunar stroke in the left thalamus. Discussion: Thalamic lacunar strokes can present in a wide range of symptoms depending on the affected nuclei. The ventral posterior lateral nucleus (VPLn) and the ventral posterior medial nucleus (VPMn) carries sensory input from the contralateral body and face, respectively3. Cheiro-oral syndrome (COS) is considered a pure sensory thalamic lacunar syndrome with symptoms that affect the face, hand and/or foot, but may be accompanied by ipsilateral ataxia if the ventral lateral nucleus is also affected4 . Although classically associated with thalamic ischemic lesions, there are descriptions of hemorrhagic strokes5 and multiple different affected regions presenting as COS, including brainstem5 , internal capsule6 , operculum7 , cortex8 , corona radiata9 and thalamus10. Early recognition and diagnosis is essencial to institute adequate early treatment and secondary prophylaxis.
Vogt-Koyanagi-Harada Syndrome: case report
Authors: Silva Vitória Pimentel da , Gonçalves Lucas Immich , Passos Giordani Rodrigues dos , Kappel Maísa , Charão Mayumi , Becker Jefferson
Published: December 2021

Context: Red eye complaints are common in medical practice. Trauma, infection and autoimmune disorders are possible causes. It is essential to diagnose early to avoid sequelae. Case report: Female, 58 years old, 30 days of progression of bilateral frontal and retro-orbital headache associated with red eye and decreased visual acuity in both eyes, otalgia and tinnitus in the left ear. No trauma history. She started treatment in another hospital with acyclovir for suspected viral meningitis and was referred for evaluation after 10 days due to the lack of improvement. In our evaluation, the patient had severely impaired visual acuity (counted fingers in the RE and 20/400 in the LE), with uveitis, papilloedema and bilateral serous retinal detachment. Lumbar puncture showed aseptic meningitis (940 leukocytes with 100% lymphocytes, 66 mg/dL proteins, normal glucose and negative evaluation for CSF infections). Laboratory tests showed an increase in inflammatory markers (VSG 121) and positive anti-TPO, with other negative autoantibodies. Brain MRI with subacute retinal detachment, without intracranial lesions. Audiometry with mild to moderate bilateral sensorineural hearing loss. The patient was treated with IV methylprednisolone for 5 days with partial symptom improvement. Conclusion: Among the bilateral uveitis causes, it is crucial to remember Vogt-Koyanagi-Harada Syndrome (VKH), which occurs through bilateral uveitis, sometimes accompanied by retinal detachment, in association with hypochromic skin lesions, sensorineural hearing loss, headache and aseptic meningitis2 . VKH results from an autoimmune lesion in the melanocytes3 . Treatment should be done with topical corticosteroid, associated with cycloplegics and systemic corticosteroid therapy with long-term immunosuppression2.
Probiome: knowing our second genome, the gut microbiota
Authors: Dias Grazielle Suhett , Yamanaka Aline Sereia, Lais , Rubin Paloma , Christof Ana , Oliveira Luiz Felipe Valter de
Published: December 2021

The gut microbiota a plays an important role in the physiology and pathology of the human body. In recent years, studies are unraveling how the gut microbiota influences not only health and gastrointesPnal disorders, but also other distal organs and systems. Recently, studies are been showing that gut’s bacteria can affect central nervous system physiology and inflammaPon. The gastrointesPnal tract and the nervous system communicate each other through a bidirecPonal signaling network known as brain-intesPne axis. This network is made up of mulPple connecPons that include vagus nerve, immune system and metabolisms, such as metabolites and products derived from intesPnal bacteria. Depression, MulPple Sclerosis, Alzheimer’s, Parkinson’s Disease and AuPsPc Spectrum Disorders are among the most studied neurological condiPons in the gut microbiota field. BiomeHub is a biotechnology StartUP that pioneered the development and performance of analyzes based on cuXngedge genomics and bioinformaPcs technologies applied to microbiology. The company developed the first validated Brazilian intesPnal microbiome test, which all steps are performed in Brazil, in its own infrastructure, using the state of the art in DNA sequencing technologies and analysis of biological data. Probiome is a molecular test capable of detecPng the complex bacteria community that make up the IntesPnal Microbiota, by sequencing the DNA of these bacteria. The growing knowledge accumulaPon about human microbiome allowed rapid advances and it has been building a solid foundaPon for the development of prognoses, diagnoses and clinical intervenPons, while it creates a new paradigm in personalized medicine. Probiome enables a targeted medical and nutriPonal approach through cross-checking between the profile data of the gut microbiota and the paPent clinical condiPons, assisPng in the elaboraPon of more accurate diets and therapies, selecPon of probioPcs and prebioPcs, among other approaches to gut microbiota intervenPons.
The importance of cephaliatric anamnesis in the diagnosis and early treatment of spontaneous intracranial hypotension: an experience told in a case report
Authors: Leite Juliana Magalhães , Andrade Rafael de Souza , Leite Thaís Magalhães Lima , Melo Neto Fernando de Paiva , Esteves Vanessa Barreto
Published: December 2021

Introduction: Spontaneous intracranial hypotension (SIH) is a rare syndrome, still underdiagnosed. It manifests with orthostatic headache and improves with decubitus, and may present nausea, vomiting, diplopia, vestibular and auditory symptoms. The main cause of SIH is spontaneous CSF leaks usually in the cervicothoracic transition. Case report: RSA, male, 36 years, he presented holocranial headache triggered in the orthostatic position and decubitus improvement associated with nausea. He denied visual complaints, fever, trauma or invasive procedures. Neurological examination: discrete neck stiffness, fundoscopy and others exams without abnormalities. Brain and cervical spine MRI, also venous AngioMRI were normal. Dorsal spine MRI with extradural collection. Arterial AngioMRI with 2,50x2,0mm aneurysmatic dilation in the right supraclinoid internal carotid artery. Opening pressure of CSF 6cmH2 O. Analgesia, decubitus rest and parsimonious hydration were performed. In cisternoscintigraphy, CSF leakage into the extradural space at the level of D3/D4 and D4/D5 on the left, delay in the rise of the tracer for brain convexities in 24 hours images, suggestive of CSF hypotension. Blood patch guided by radioscopy was performed, with improvement after 2 weeks of the 3rd procedure. Conclusion: Knowing the types of headache and its etiologies is essential to orientate diagnosis and treatment, avoiding unnecessary exams. In this case report, the microaneurysm found did not justify the complaint of orthostatic headache. The rapid diagnosis of spontaneous CSF leaks provided early treatment avoiding complications such as subdural hematomas, cerebral venous thrombosis, pituitary dysfunction.
Consequences of isolation in elderly with and without dementia during the COVID-19 pandemic: a literature review
Authors: Garcia Ana Carolina Pereira , Meneses Alice Campos , Cavalcante Ana Karolinne Cruz , Morais Caroline Rodrigues de , Henz Gabriel Dias , Pessôa Gabriela Rodrigues , Fernandez Liana Lisboa
Published: December 2021

Background: Elderly patients with and without dementia are especially vulnerable to COVID-19 infection due to their disease status, age and comorbidities, needing to face measures of social restrictions. However, it is known that social isolation is a risk factor for decline of cognitive functions. Objectives: Gather information about consequences of isolation in elderly patients with and without dementia during the COVID-19 pandemic. Methods: Narrative literature review through active search for publications on the topic on the PubMed platform, resulting in 17 articles for evaluation. Results: Apathy has shown to be the most common neuropsychiatric symptom of social isolation in the elderly, followed by irritability, agitation, aggression and depression. In institutionalized patients with dementia, there was an increased burden of neuropsychiatric symptoms by 60%, the main symptoms being anxiety, depression, sleep disorder, behavior aberrant motor and changes in appetite. In addition, limitation of outdoor activity and absence of direct social contact required an increased dosage of antipsychotic drugs and mood stabilizers. In a sample of individuals with mild cognitive decline, had decreased physical activity, reduced adherence to Mediterranean diet, and more than 35% had weight gain. Conclusions: Isolation has mental, physical and social consequences for the elderly with and without dementia, enhancing their fragility and vulnerability. Hence, it is necessary a follow up by the health system and family members, as well as the development of strategies to minimize such losses.