bluuebunny/crossref_metadata_2025 huggingface dataset:
THE CONCEPT OF STEREOTYPE AS A SOCIAL AND PSYCHOLOGICAL PHENOMENON. THE GENERAL APPROACHES TO THE REVIEW OF STEREOTYPES
Authors: Никифоров Максим Александрович , Марин Егор Борисович
Published: July 2023

В работе исследуется понятие такого социального и психологического феномена, как стереотип. Данное явление проявляется в разных сферах человеческой деятельности и получает разные интерпретации в различных областях знания. В статье представлены подходы к пониманию стереотипа и выделяется общее понятие термина, для выявления аспектов и возможностей для дальнейшего исследования такого феномена.

The paper explores the concept of such social and psychological phenomenon as stereotype. This phenomenon manifests itself in different spheres of human activity and receives different interpretations in different fields of knowledge. The article presents approaches to the understanding of stereotype and highlights the general concept of the term, to identify aspects and opportunities for further research of such a phenomenon.
VIRTUAL DUET AS A SPECIAL KIND OF VOCAL DUET IN POP MUSIC
Authors: Мунтяну Анжелика Ивановна
Published: July 2023

Предлагаемая статья посвящена виртуальному дуэту - оригинальному явлению, опирающемуся на современные достижения в области аудио- и видеозаписи, компьютерных технологий. Автор характеризует разновидности виртуального дуэта как специфического феномена, имеющего место в популярной музыке.

The proposed article is devoted to the virtual duet - an original phenomenon based on modern achievements in the field of audio and video recording, computer technology. The author characterizes the varieties of the virtual duet as a specific phenomenon taking place in popular music.
COMMERCIAL SCHOOLS AND CHARITABLE ACTIVITIES OF THE RUSSIAN MERCHANTS
Authors: Костриков Станислав Сергеевич , Костриков Сергей Петрович
Published: July 2023

Рассмотрено участие российского купечества в создании коммерческого образования в России. Коммерческие училища создавались и содержались на средства отечественных предпринимателей-купцов. Они видели в этих учебных заведениях возможность дать своим детям добротное образование, выучить нужные профессиональные кадры, найти пути своей общественной самореализации, а в начале ХХ столетия - реализации политической

The participation of Russian merchants in the creation of commercial education in Russia is considered. Commercial schools were created and maintained at the expense of domestic entrepreneurs-merchants. They saw in these educational institutions an opportunity to give their children a good education, to learn the necessary professional personnel, to find ways of their social self-realization, and at the beginning of the twentieth century - the realization of political.
ROLE OF LIPOPOLYSACCHARIDE IN DEVELOPMENT OF SEPSIS (REVIEW)
Authors: Хомякова Татьяна Ивановна , Рябинина Ольга Михайловна
Published: July 2023

Липополисахариды грамотрицательных бактерий (LPS) считаются наиболее иммуногенными бактериальными компонентами, ассоциированными с развитием системного воспаления и сепсиса. В обзоре описываются механизмы действия LPS на основные органы-мишени,- легкие, сердце и головной мозг тяжелое поражение которых ассоциировано с развитием дыхательной и сердечной недостаточности.

Gram-negative bacterial lipopolysaccharides (LPS) are considered to be the most immunogenic bacterial components associated with the development of systemic inflammation and sepsis. The review describes the mechanisms of action of LPS on the main target organs - the lungs, heart and brain, the severe damage of which is associated with the development of respiratory and heart failure.
THE CONCEPT OF FINANCIAL LIABILITIES AND THEIR ELEMENTS
Authors: Прудникова Альбина Евгеньевна , Сердюк Арсений Александрович
Published: July 2023

В рамках данной статьи авторами исследуется понятие финансовых обязательств и их элементы, являющихся разновидностью финансово-правовых норм. Финансово-правовые нормы, будучи разновидностью, юридических норм, все же имеют смежные черты. Анализируются наиболее актуальные проблемы, связанные с финансово-правовыми нормами.

In this article the authors explore the concept of financial obligations and their elements, which are a kind of financial and legal norms. Financial and legal norms, being a kind of legal norms, nevertheless have some related features. The most relevant problems associated with financial and legal norms are analyzed.
ASSESSMENT OF THE EFFECTIVENESS OF OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT
Authors: Бердникова Лариса Николаевна
Published: July 2023

В статье доказано, что одним из основных элементов управления охраной труда является оценка риска. В статье обосновано, что цель управления охраной труда заключается в сокращении рисков, связанных с трудовой деятельностью, и предотвращении производственных несчастных случаев. В статье отмечено, что управление охраной труда является общественной задачей.

The article proves that one of the main elements of occupational safety management is risk assessment. The article proves that the purpose of occupational safety management is to reduce the risks associated with work and prevent industrial accidents. The article notes that occupational health and safety management is a public task.
ЗАВИСИМОСТЬ ВЛИЯНИЯ МАГНИТНОГО ПОЛЯ НА ВЯЗКОСТЬ КРОВИ ПРИ РАЗЛИЧНЫХ ПАРАМЕТРАХ МАГНИТНОГО ПОЛЯ
Authors: Захаров Ю.Б. , Перов Ю.М. , Минасян Б.Л. , Скугарь М.М. , Рефатов Э.А.
Published: July 2023

в данной статье были исследованы зависимости между вязкостью крови и интенсивностью и частотой магнитного поля. Проведён анализ различных исследований по данной теме. Были рассмотрены процессы, протекающие в кровеносных сосудах при различных частотах и интенсивностях.
ЛОЖНЫЕ СРАБАТЫВАНИЯ В СИСТЕМАХ IDS: СПОСОБЫ ИДЕНТИФИКАЦИИ И МЕТОДЫ СНИЖЕНИЯ ИХ КОЛИЧЕСТВА
Authors: Дуров С.С. , Резниченко С.А. , Хохлов Е.А.
Published: July 2023

Кибербезопасность все более важна в связи с ростом кибератак. Системы обнаружения вторжений (IDS) созданы для обнаружения и предотвращения таких атак.
ИССЛЕДОВАНИЕ ВЗАИМОСВЯЗИ НАРУШЕНИЙ ПИЩЕВОГО ПОВЕДЕНИЯ И ЧУВСТВА ОДИНОЧЕСТВА
Authors: Самойлова М.Н.
Published: July 2023

В данной работе затрагиваются вопросы изучения взаимосвязи таких феноменов, как чувство одиночества и расстройств пищевого поведения, их причин и последствий. Авторы приводят результаты проведённого ими исследования, которое оценивает и сопоставляет уровень переживания одиночества у пациентов с РПП и респондентов без данного диагноза.
РАЗЛИЧНЫЕ ВЗГЛЯДЫ, ТЕОРИИ И КОНЦЕПЦИИ СУЩНОСТИ И ПРИРОДЫ ЦИКЛОВ
Authors: Толстухин В.В.
Published: July 2023

Представлена история развития цикличности. Обусловлена повторяемость экономических процессов и событий. Определены основные причины цикличности явлений. Выделены достижения историков, философов и ученых на протяжении исторических событий. Затронута продолжительность различных циклов. Обозначена целесообразность своевременного выявления, определения циклической составляющей.
АКСЕЛЕРОМЕТРЫ В РЕАБИЛИТАЦИОННОЙ МЕДИЦИНЕ ДЛЯ ДЕТЕЙ И ВЗРОСЛЫХ
Authors: Богданов Е.В.
Published: July 2023

Последние технологические разработки привели к производству недорогих миниатюрных датчиков акселерометра с потенциалом для использования в клинических условиях. Эти датчики могут предоставить достоверную информацию о подвижности и объективном измерении походки. В настоящее время они используются главным образом в исследовательской среде; однако, благодаря последним достижениям, включение в клиническую практику возможно.
ИНФЕКЦИОННЫЕ ЗАБОЛЕВАНИЯ НАРУЖНЫХ ПОКРОВОВ
Authors: Иванова И.В. , Лыженкова М.М.
Published: July 2023

В данной работе представлено изучение видов возбудителей инфекционных болезней наружных покровов, факторов и механизмов проникновения в организм человека, клинических проявлений болезней, вызванных этими возбудителями и способов их профилактики.
ВОВЛЕЧЕНИЕ ПОТРЕБИТЕЛЕЙ: СОЗДАНИЕ ДОЛГОСРОЧНЫХ ОТНОШЕНИЙ И ЛОЯЛЬНОСТИ К БРЕНДУ ЧЕРЕЗ СОЦИАЛЬНЫЕ СЕТИ, БЛОГИ, ФОРУМЫ И ДРУГИЕ КАНАЛЫ
Authors: Демитриев А.Н.
Published: July 2023

Данная научная статья исследует роль вовлечения потребителей в установлении долгосрочных отношений и повышении лояльности к бренду через различные онлайн-каналы, включая социальные сети, блоги и форумы. Рассматриваются методы и стратегии, которые компании могут использовать для активного взаимодействия с потребителями, с целью установить эмоциональную связь и повысить степень приверженности к бренду. Дополнительно, исследуются основные факторы, способствующие эффективному вовлечению потребителей, а также предлагаются рекомендации для практической реализации данного подхода.
СУЩНОСТЬ ПОНЯТИЯ "ЭМОЦИОНАЛЬНАЯ ОТЗЫВЧИВОСТЬ" В ПСИХОЛОГО - ПЕДАГОГИЧЕСКИХ СБОРНИКАХ
Authors: Головачёва А.С.
Published: July 2023

Материал данной статьи раскрывает сущность понятия «эмоциональная отзывчивость», где само понятие эмоциональная отзывчивость является одним из важнейших составляющих показателей ценностного отношения к искусству и является эмоционально - ценностным компонентов художественно - эстетических видах деятельности младших школьников. Также в статье на основе последовательного изучения сущности понятия эмоциональная отзывчивость в психолога - педагогической литературе, формируется ценностное отношение учащихся младших классов к содержанию комплексных занятий по искусству в самом педагогическом процессе.
A meta-analysis of event-related potential correlates of recognition ﻿memory
Authors: Kwon Simon , Rugg Michael D. , Wiegand Ronny , Curran Tim , Morcom Alexa M.
Published: July 2023

A longstanding question in memory research is whether recognition is supported by more than one mnemonic process. Dual-process models distinguish recollection of episodic detail from familiarity, while single-process models explain recognition in terms of one process that varies in strength. Dual process models have drawn support from findings that recollection and familiarity elicit distinct electroencephalographic event-related potentials (ERPs): a mid-frontal ERP effect that occurs at around 300–500 ms post-stimulus onset and is often larger for familiarity than recollection contrasts, and a parietal ERP effect that occurs at around 500–800 ms and is larger for recollection than familiarity contrasts. We sought to adjudicate between dual- and single-process models by investigating whether the dissociation between these two ERP effects is reliable over studies. We extracted effect sizes from 41 experiments that had used Remember-Know, source memory, and associative memory paradigms (1,000 participants). Meta-analysis revealed a strong interaction between ERP effect and mnemonic process of the form predicted by dual-process models. Although neither ERP effect was significantly process-selective taken alone, a moderator analysis revealed a larger mid-frontal effect for familiarity than recollection contrasts in studies using the Remember-Know paradigm. Mega-analysis of raw data from six studies further showed significant process-selectivity for both mid-frontal and parietal ERPs in the predicted time windows. On balance, the findings favor dual- over single-process theories of recognition memory, but point to a need to promote sharing of raw data.
Comparative Metabolic Properties of Aloe Vera Extracts and Sitagliptin in Diabetic Rats
Authors: Sobia Javaid, Maleeha Zafar
Published: July 2023

Introduction: Diabetes Mellitus, a global epidemic affecting millions of people is pretty challenging to cure as all the available antidiabetics have various health hazards, especially, in long-term administration. So, a safe alternative is always desired.Objective: To compare the metabolic (hypoglycemic and hypolipidemic) effects of Aloe Vera extracts with novel anti-diabetic medicine, “Sitagliptin” on diabetic rats.Materials and Methods: The study design was a Randomized Control Trial. The study was conducted in the Pharmacology department of Islamic International Medical College, Rawalpindi in collaboration with NIH, Islamabad, Pakistan, from September 2019 to August 2020. Adult, fifty Albino rats were taken and randomly grouped into A and B. After induction of type 2 diabetes with low dose streptozotocin, group B was subdivided; GroupB1 (Diabetic Control), Group B2 (Aloe Vera whole leaf treated), GROUP B3 (Aloe Vera gel treated), and Group B4 (Sitagliptin treated). Fasting blood sugar (FBS), Hemoglobin A1c (HbA1c), and triglycerides were measured. Statistical Analysis was done by SPSS version 25. A one-way ANOVA test was used for assessing any difference in the mean values. Post-hoc Turkey analysis was conducted to compare any inter-group mean differences. A p-value of <0.05 was considered significant.Results: On completion of study, Fasting blood sugar in Group A was 82.40mg/dl, Group B1 498.40 mg/dl, Group B2 89.30 mg/dl, Group B3 95.70 mg/dl, Group B4 93.00mg/dl; HbA1c in Group A was 3.71%, Group B1 11.84%, Group B2 4.02%, Group B3 4.17%, Group B4 3.73%; Serum triglycerides in Group A 125.40mg/dl, Group B1 221.00 mg/dl, Group B2 112.50 mg/dl, Group B3 129.70 mg/dl, Group B4 125.00 mg/dl respectively, showing significant improvement in Diabetes Mellitus in study subjects.Keywords: Aloe Vera gel, Sitagliptin, diabetes, glycated haemoglobin.
A Comparative study of online and traditional (face to face) learning
Authors: Fatima Sumia , Idrees Tayyaba , Hamid Sidra , Umar Muhammad
Published: July 2023

Introduction:
Ever since the advent of usage of internet as a medium of teaching  in late 1980s, the method of distanced teaching using online methods has been on the rise.We did a comparative study of online vs. Traditional learning in order to assess student’s viewpoint about the different ways of learning and to assess various aspects of online classes when compared with physical classes
Materials and Methods:
A cross sectional, descriptive study was conducted in may-june 2021 in –removed for blind review---in order to analyse the response of students towards the online mode of learning, and compare it with the traditional learning. The target population were the students of 1st, 2nd and 3 year MBBS at the Rawalpindi Medical University. Self structured questionnaires were disributed among a total of 600 students, 200 students from each year. The data collected was analysed using SPSS v 22 and using chi square test.
Results: 
87% (522 out of 600) students responded that traditional learning is more effective as compared to online learning. It was shown that there is no association between year of study and mode of learning also no association between gender and mode of learning. Weak internet connection is the biggest hurdle to online learning.
 
Discussion and Conclusions:
Majority of the participants, acknowledging the positive aspects of online learning; like making management of assignments easier,promoting creativity, easier access to contents and facilitation of giving feedback, still favoured traditional, face-to-face learning, for it ensures a better study environment, allows adequate clinical practice, and improves interaction with the teacher and the fellow students. The biggest hurdles to online learning were connectivity issues, lack of technical expertise, and the need for stricter self-discipline. In short,with removal of the problems associated with online learning, it can evolve into an efficient mode of learning in the near future.
 
Key words:
Educational technology; Higher education, Online learning, traditional learning, interaction
Word Count Of Abstract :  299
Frequency of congenital hypothyroidism in new born admitted with neonatal jaundice at tertiary care hospital peshawar
Authors: Ahad Abdul , Bibi Romana , Rehman Sijad Ur , Shah Majid Ali , Ullah Matea , Shahinda
Published: July 2023

Neonatal jaundice is a common disorder worldwide affecting 30-70% of newborn infants. Severe neonatal jaundice and its progression to kernicterus is a leading cause of death and disability among newborns in poorly-resourced countries.
OBJECTIVES:
To determine the frequency of congenital hypothyroidism in new born admitted with neonatal jaundice at tertiary care hospital Peshawar.
METHODOLOGY:
Settings: removed for blind review
Duration: Period of 1 year from January 2020- January 2021.
Study Design: Descriptive (cross sectional) study.
Results:
In our study 489 mothers 386(79%) mothers were in age range 18-30 years while 103(21%) mothers were in age range 31-40 years. 279(57%) babies were male and 210(43%) babies were female. 303(62%) newborns had maternal  gestation age ≤38 weeks and 186(38%) neonates had gestation age >38 weeks. 352(72%) newborns had duration of jaundice ≤14 days and 137(28%) newborns had duration of jaundice >14 days. Birth weight was analyzed as 200(41%) newborns had birth weight ≤2.5 kg and 289(59%) newborns had birth weight >2.5 kg.  15(3%) Mothers had positive history of hypothyroidism  while 474(97%) mothers had negative history of hypothyroidism .  24(5%) mother had positive history of anti-thyroid drug intake while 465(95%) mothers had negative history of anti-thyroid drug intake. 5(1%) newborn had congenital hypothyroidism while 484(99%) newborn didn’t had congenital hypothyroidism.
Conclusion:
Our study concludes that the frequency of congenital hypothyroidism was 1% in new born admitted with neonatal jaundice at tertiary care hospital Peshawar.
Key words:
Hypothyroidism, Jaundice, kernicterus, bilirubin, morbidity, anti-thyroid drugs.
Clinical outcome of tetanus based on dakar tetanus severity score in paediatric intensive care unit of a tertiary care hospital
Authors: Jamil Anila , Sarwar Muhammad , Kausar Fareeha , Sultan Nighat , Aslam Ambreen , Azeem Umer Waqar
Published: July 2023

Objective: To evaluate the validity of  Dakar scoring system in predicting the outcome of tetanus in children of post neonatal age.
Method: A prospective single center study conducted at ICU (Intensive Care Unit) of –removed for blind review-- 131 children with diagnosis of tetanus from January 2020 to June 2021 by analyzing demographic and clinical parameters.
Results: Mean age of children was 8.11 ± 3.45 years with male predominance 91(69.5%). Major proportion of children were in range of 5-10 years comprising 65(50%). Period of onset of spasm was < 2 days in 92(70%) that correlate well with shorter incubation period (p-value <0.001). Mean duration of ICU stay was (18.81 ± 11.73) days. Only 14(10.7%) received three doses of vaccination but no one received booster dose. In majority of patients trauma due to road traffic accident 86(65.6%) was the predisposing factor followed by ear discharge 31(23.7%) and other causes 14(10.7%). Out of 131 patients 104(79.3%) received mechanical ventilation because of disease severity. Regarding outcome mild cases 2(1.5%), moderate 61(46.6%) and severe were 68(51.9%) according to Dakar scoring system and out of these severe cases 18(13.7%) expired (p-value < 0.001). However, 53(40.4%) discharged, 50(38.1%) shifted out to other wards after stabilization and 10(7.6%) left against medical advice. (p-value 0.001)
Conclusion: Dakar scoring system correlates well with disease severity and should be adopted to aid clinical triage and management as with effective and appropriate treatment patients can have good prognosis. However, preventive aspects should be emphasized regarding booster dose of tetanus.
Keywords: Tetanus, Outcome, Dakar scoring system
Association of hyperglycaemia at admission with in-hospital mortality and severity of illness among patients with COVID-19.
Authors: Zaman Sadaf , Khan Mujeeb , Khatana Arif , Rehman Fazal Ur , Umar Muhammad , Meraj Lubna
Published: July 2023

Objectives
The association between hyperglycemia at admission and COVID-19 severity and in-hospital mortality is an area of active medical research. Our study aims to explore this association across diabetics and hyperglycemic patients while keeping normoglycemic patients as control.
Methods
This retrospective cohort study involved a total of 90 patients with confirmed diagnosis of COVID-19 infection. Patients were divided into three equal groups based on their history and BSR levels (diabetics, hyperglycemic, normoglycemic). Various laboratory parameters and inflammatory markers were compared across the study groups using Kruskal Wallis test. Finally, chi-square test was use to assess the association of severity and mortality across the study groups.
Results
Out of 90 patients, 38 (42.2%) were males with a mean age of 57.1 ± 14.7 years. Serum ferritin, LDH and lymphocyte levels were significantly higher in diabetics and hyperglycemic patients than in normal COVID-19 patients (p<0.05). hyperglycemia at admission was significantly associated with disease severity (p=0.03) but not with in-hospital morality (p=0.07).  
Conclusion
Patients with diabetes and stress hyperglycemia have increased levels of inflammatory markers than normoglycemic patients. Hyperglycemia at admission is associated with poor COVID-19 severity. More studies a required to validate and further explore this relationship.
Latent iron deficiency in non-anemic children under five years of age
Authors: Riaz Qurat ul Ain , Ahsan Saima , Chaudhary Tanveer Hussain , Soomro Abdul Hafeez , Khan Muhammad Sabir , Nazish Shanza
Published: July 2023

Background: The most common nutritional deficiency in world is iron deficiency. The iron deficiency is the most common cause of anemia due to nutritional deficiency and is seen most commonly in children under five years of age.
Objective: To determine the frequency of iron deficiency in non-anemic children under five years of age.
Methods: A descriptive cross-sectional survey was conducted in pediatrics department of –removed for blind review---from August 2020 to February 2021. A total of 145 non-anemic children, ages 2-59 months were enrolled through non-probability consecutive sampling in this study. The complete blood count and C-reactive protein were sent for laboratory tests to rule out infection/inflammation. In children with normal hematocrit (30-40%) and CRP (≤ 6), serum ferritin levels were sent. Those children in whom serum ferritin levels were ≤12ng/ml was regarded as cases of latent iron deficiency. SPSS version 23 was used for data entry and analysis. Age and gender for effect modifiers were controlled by stratification. The chi square test was used for post stratification. The value of p ≤ 0.05 was considered significant.
Results: The mean age of the patients was 3.20±5.41 years. Among all children, 69 (47.6%) were boys and remaining 76 (52.4%) were girls. Out of 145 children, 62 (42.8%) were iron deficient whereas 83 (57.2%) were non-iron deficient. The male to female ratio of iron deficiency was 1:1.3. The prevalence of iron deficiency among infants was 46%, followed by toddlers 42% and preschoolers 41%. The mean serum ferritin level was 22.96±2.21 ng/ml. The mean hematocrit was 33.84±2.68. The statistical analysis showed that there was an insignificant association between iron deficiency and age groups of children (p ≥ 0.5).
Conclusion: The study concluded that the iron deficiency in children is very common, especially in infants. Screening of iron deficiency in children under five years of age seems to be a very important task for better child care.
Key words: Anemia, Iron-Deficiency; Child, Preschool; Malnutrition.
Maxillary Impacted Second Premolar; A Surgical Intervention in an Orthodontic Case
Authors: Zia Syed Hamza , Rizwan Zarnab , Rizwan Ghina
Published: July 2023

In clinical settings, impacted teeth are a typical occurrence. Because of their proximity to the nasal and oral cavity, impacted teeth have the potential to create more severe and catastrophic difficulties, such as the formation of dentigerous cysts and other disorders. The goal of this report is to look into the fundamentals of treating maxillary premolars that have been palatally impacted. A case report of a palatally impacted right maxillary second premolar is presented in this case report.
Practice of standard Cross Infection Protocol in Private Dental Clinics of Khyber Pakhtunkhwa, Pakistan: A cross-sectional study
Authors: Maqbool Hassan , Sajid Khadija , Rizwan Zarnab
Published: July 2023

Background: Infection control, which is considered to be the backbone of dentistry, has become a particularly essential piece of dental training because both the dentists and patients are at an expanded danger of cross-contamination. Dental clinical settings represent a high organic hazard of spreading a wide scope of microorganisms. The objective of this study is to gather information of different dentists regarding their practice of standard cross infection protocols and how can they improve the same in their private practices.
Materials and Methods: This cross-sectional study was conducted in dental clinics of Khyber Pakhtunkhwa, KPK from January 2020 to July 2020 by distributing a questionnaire among dentists. It was a pre-designed questionnaire that was circulated in Google forms through Whatsapp and emails. The questionnaire was divided into 2 sections. Data was compiled and statistical tests were applied using the Statistical Package for Social Sciences SPSS® ver.23.0
Results: Regarding cross infection control measures, maximum dentists seem to have knowledge of cross infection control techniques. A significant difference was found (p= 0.05) between male & female dentists in disposing dental waste from clinical set up properly. A significant difference was also found between male & female dentists about rubber dam isolation (p=0.02).
Conclusion: The result of this study showed that practice of dentists in KPK is not up to standard protocols of cross infection control. In this way, the need of great importance is to authorize and execute better proportions of infection control to improve dental practice in KPK.
Key words: Infection control, Dental practice, Sterilization
Comparison of intra-articular lidocaine versus intravenous sedative and analgesic for reduction of anterior shoulder dislocation in terms of mean pain reduction using vas score
Authors: Akhtar Rahman Rasool , Qammar Muhammad Umair , Ahmed Riaz , Arif Adnan , Khan Armaghana Qamar , Liaquat Maria
Published: July 2023

INTRODUCTION:

The most common dislocation presenting to emergency department is anterior shoulder dislocation. Posterior dislocations and inferior dislocations are rare. Dislocations of the anterior shoulder mostly occur with the position of the arm is abducted and externally rotated. This results in injury of the humeral head, labrum, capsuloligamentous structures and glenoid. Such patients experience severe pain, therefore prompt reduction is necessary to ameliorate the pain. Intravenous analgesia combined with sedation or intra-articular lidocaine injection can be used for closed reduction of anterior shoulder dislocation. Due to its side effects, Intra-articular lidocaine (IAL) is recommended for use as a probable alternative to intravenous sedation-analgesia especially for patients with contraindication to intravenous sedation-analgesia.

OBJECTIVE:

To compare intra-articular lidocaine versus intravenous sedative and analgesic for management of anterior shoulder dislocation in terms of mean pain using VAS during reduction of shoulder joint.

STUDT DESIGN:  

Randomized controlled trial (RCT).

SETTING:

Removed for blind review

DURATION:

6 months (November 22nd, 2017 to May 21st, 2018)

SAMPLE SIZE:

60 patients (30 in each group)

RESULTS:

We included sixty patients in my study. 19 (31.7%) were females and 41 (68.3%) were male patients. Out of all the patients 38 (63.3%) had right sided shoulder dislocation, while the rest 22 (36.7%) patients had left sided shoulder dislocation.

Patients mean age was 33.27±10.535 years and mean pain score of all the patients was 4.966±1.930. The mean pain score in Group A was 4.200±1.648, while the mean pain score in Group B was 5.733±1.910 (p value = 0.002. Stratification was done according to gender and age group of the patients, and post-stratification t-test was applied.

CONCLUSION:  

Intra-articular lidocaine is better option in pain control during reduction of anterior shoulder dislocation.

KEY WORDS: Intra venous analgesia, Intra-articular lidocaine, shoulder dislocation.
Hemodynamic Comparison between modified saddle block and subarachnoid block for Transurethral Resection of Prostate
Authors: Anjum Waqas , Zareen Abeera , Siddique Faisal , Anwar Muhammad Haroon , Rehman Abdul
Published: July 2023

BACKGROUND:  

Spinal anesthesia is often the mode of anesthesia in transurethral resection of prostate (TURP) albeit with risk of hypotension. However, hemodynamic derangement is often less pronounced in saddle block. This study was conducted to compare the mean fall in Mean arterial Pressure (MAP) and Heart rate (HR) between modified saddle block and subarachnoid block for TURP. 

OBJECTIVE:  

To compare the mean fall in MAP and HR between modified saddle block and subarachnoid block for TURP. 

METHODS:  

In this randomized controlled trial 120 patients undergoing elective TURP were included and divided into two groups. Group A Patients received subarachnoid block and Group B received modified saddle block. Baseline hemodynamics were recorded before and then at 5 minutes after anesthesia. All the collected data was entered into SPSS version 22 and analyzed. Quantitative data like age, BMI, ASA-PS score, duration of surgery and baseline hemodynamics were presented as means and standard deviations. The fall of mean arterial pressure (MAP) & heart rate (HR) were compared among groups by independent t test and P value < 0.05 was considered as statistically significant.  

RESULTS: 

Mean fall in MAP was 8.98±1.28 mmHg and 3.13±0.68 mmHg (p<0.001) in group A and B, respectively. Mean fall in HR was 7.17±0.98 and 2.78±0.59 (p<0.001) in group A and group B, respectively. 

CONCLUSION:  

Modified saddle block resulted in significantly decreased fall in MAP and HR as compared with subarachnoid block for TURP. 

KEY WORDS:  

Modified Saddle Block; Subarachnoid Block; Mean Arterial Pressure
Pattern of Thrombocytopenia In Pregnancy At Teaching Hospital Of Rahim Yar Khan, Pakistan
Authors: Ghafoor Muhammad Bilal , Sarwar Faiza , Durrani Tahira Afzal , Azher Zainab Quratulain , Jabeen Saleha , Ali Khan Muhammad Haris
Published: July 2023

Background:  Platelet count less than 150 × 109 / L is referred to as thrombocytopenia, which is the second common blood disorder in pregnancy after anemia. Although pregnancy is related with physiological variations in platelet count, however, several pathological conditions also cause thrombocytopenia showing significant impact on health of mother and her baby. The prevalence of thrombocytopenia during pregnancy is 7 to 11%. The physiological thrombocytopenia is multifactorial, related to hemodilution, increased platelet consumption and increased platelet aggregation.

Objective: To determine the pattern of thrombocytopenia during third trimester of pregnancy in Rahim Yar Khan.

Methodology: This cross-sectional study was carried out at Teaching Hospital of Rahim Yar Khan with effect from May 16, 2022 to September 30, 2022. Five hundred (500) pregnant females in their third trimester were the part of this study. All the study subjects were selected from the department of gynecology and obstetrics at Sheikh Zayed Hospital, Rahim Yar Khan which is a renowned teaching hospital of the region attached with Sheikh Zayed Medical College. Data collection was done on a pre-designed questionnaire. Sample of blood was taken in EDTA and Gel containing vacutainers by convenient sampling technique.

Results: The frequency of thrombocytopenia during pregnancy was found 10.4%. Gestational thrombocytopenia was the most common type among thrombocytopenic pregnancies with frequency of 63.46% in comparison to pre-eclampsia 30.76%, HELLP Syndrome 3.80% and immune thrombocytopenic purpura 1.90%. The mean age of pregnant women was observed 27.53±5 years. There is no significant difference in number of thrombocytopenic patients from rural and urban areas (p=0.2). Conclusion: The frequency of thrombocytopenia during the third trimester of pregnancy is observed high, so the regular screening is necessary to avoid any adverse outcome. Specially the patients with Pre-eclampsia and HELLP syndrome should be monitored critically.

 

Key words: Platelet Count, Thrombocytopenia in Pregnancy, Types of Thrombocytopenia, Pre-Eclampsia
FREQUENCY OF OCULAR SYMPTOMS IN COVID-19 PATIENTS
Authors: Zubair Maria , Hafeez Nida , Rasool Wajeeha , Abbasi Kanwal Zareen , Seher Ain Us , Niazi Fuad A.K.
Published: July 2023

Objective: To determine the frequency of ocular symptoms in COVID 19 patients and its association with systemic symptoms in active COVID 19 patients.  
Methods: This is a cross sectional observational study of laboratory confirmed COVID-19 patients who were admitted in isolation wards for a period from Dec 16, 2020 to Jan 15, 2021. A structured form was used to extract the data from electronic medical records. Data collected included sociodemographic characteristics, presenting symptoms, systemic signs and symptoms, ocular symptoms, past medical history, RT-PCR and chest radiographic findings. 
Results: A total of 44 patients (30 (68.2%) males and 14 (31.82%) females) were admitted to the isolation wards during the study period. The mean age (+ SD) age was 55.75 + 14.53 with median range 57.50 (14-92). Age <30 years i.e. 4.5%, 30-50 i.e. 27.3% and >50 i.e. 68.2%.Ocular symptoms were present in 17 patients (38.6%).  
Conclusion: 
We conclude from our study that Ocular symptoms were present in 17 patients (38.6%) out of 44 (Total number of patients) However, these symptoms were mild, had no fixed pattern of occurrence, neither associated with the severity of the systemic disease nor associated with any serious ocular outcome
Effectiveness of clean intermittent self catheterization in patients with recurrent urethral stricture post visual internal urethrotomy
Authors: Ullah Naqib , Nawaz Jamshid , Shoaib Muhammad , Khan Asif , Din Nizam ud , Fareed Tauheed
Published: July 2023

OBJECTIVE : 
 Objective of the study is to determine the effectiveness of CISC in management of recurrent urethral strictures after visual internal urethrotomy. 
METHODOLOGY : 
This study   performed in department of urology   Saidu teaching hospital Swat  from June 2016 to July 2019 on 215 patients who were diagnosed as having urethral stricture disease. Patients were counseled  for CISC after removal of catheter 2 times a day for 8 weeks  and  at 8th  week cystourethroscopy performed along with detail  evaluation of symptoms of urethral stricture to know  recurrence of stricture. 
RESULTS:  
81.39% patients have no urethral stricture on cystourethroscopy  and symptomatic evaluation at 8th week  post visual internal urethrotomy  while 18.60%  patients have recurrent urethral stricture . Length of urethral stricture is the most important prognostic factor, stricture of less than 1 cm has success rate of 62.39% while stricture of more than one cm length has success rate of 20% as shown in table IV. 
CONCLUSION: 
In this study it has been confirmed that CISC  is safe ,cost effective procedure and most of the patients can do it in home with out any complications.
Emergency Peripartum Hystrectomy and Postnatal Depression
Authors: Khalid Tabinda , Nawaz Sobia , Ahmed Malik Irfan , Malik Saima Nawaz , Salim Ruqyyah , Manzoor Shahla
Published: July 2023

Objective: to investigate postnatal depression after emergency peripartum hysterectomy versus controls.  Material and methods: This case control study was conducted at District headquarters teaching hospital Rawalpindi between July 2020 and June 2021.We compared postnatal depression among patients who underwent emergency peripartum hysterectomy (EPH)versus control group where surgical procedures other than hysterectomy (B-Lynch, uterine artery ligation or internal iliac artery ligation) were performed.  Results: A total of 88 patients were included, 44 in hysterectomy group and 44 in non hystrectomized/control group. The scores on Edinburgh post-natal depression scale were high in hysterectomy group (11.61±2.48) , compared to non hysterectomy group(6.79±2.13) which was statistically significant. ( p=0.001).Uterine atony, Placental abruption, placenta previa and accrete, were identified as main reasons for surgical intervention in both groups. Emergency peripartum hysterectomy is a  traumatic birth event with serious physical, emotional and psychological consequences. It is empirical to not only screen the women in immediate postpartum period, but a long term follow up in community is required.
Prevention of Ovarian Hyper stimulation Syndrome by using gonadotrophic releasing hormone analogue to induce final ovulation trigger in invitro fertilization cycles
Authors: Sultana Safia , Sultana Misbah , Ashraf Shazia , Khan Muhammad
Published: July 2023

Objectives: To find out occurrence of ovarian hyperstimulation in patients who were hyper responders in in vitro fertilization cycles. Secondary outcome was to assess number of metaphase II oocyte and fertilization rate, cleavage rate and pregnancy outcome when GnRHa is used for final maturation and triggering ovulation.
STUDY DESIGN, SIZE, and DURATION: This is retrospective descriptive analysis of cases managed at single center from June 2017 till May 2018.
PATIENTS & METHODS: Twenty patients were identified as hyper responders based on baseline, ovarian reserve characteristics, that is antral follicle count, (AFC) > 25, AMH > 4ng/ml and on day  of  trigger,  follicles  >-25  in  number  of  ≥  11mm  were administered GnRHa trigger and 1500IU hCG on oocyte retrieval day while luteal phase was supported with daily vaginal  progesterone and twice daily estradiol valerate. Sixteen patients underwent fresh transfer while four patients had their embryos frozen.
MAIN RESULTS: Twenty patients were identified as high risk and their baseline characteristics were, mean age 31.7 ± 4.50, mean antral follicle count 25.7 ± 5.01, Anti Mullerian hormone level mean 4.64 ± 2.52 and PCOS was present in 35% cases. Peak estradiol level mean 13455-± 6632pmol/l and mean follicles count of 25.45 ± 8.78 confirmed a high response. Oocyte yield was 11.45+ Metaphase oocyte retrieved were 85.5% and cleavage rate of 93%. No case of early onset OHSS was identified. Only one patient developed moderate OHSS. Pregnancy rate was 31.25%. Miscarriage rate was 6.3% and ongoing pregnancy was 25%.
CONCLUSION:  This small retrospective descriptive analysis supports the view of current literature that GnRH trigger not only prevents early onset OHSS also achieves increase of M11 oocytes. In addition, pregnancy outcome is not statistically different to those cycles where hCG is used as trigger.
In vitro efficacy of fosfomycin against E. coli and prevalence of MDR and XDR E. coli isolates from UTI Patients
Authors: Nasir Farhina , Kashif Shahida , Uddin Fakhar , Khalid Muhammad , Memon Ishtiaque , Samreen Talat
Published: July 2023

Objective:  The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined.
Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips.
Results: Out of 350 urine samples 213 (60.85%) were E. coli.  Patients with E. coli had an average age of 38.75 15.01 years.  Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%).
Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.
The Prevalence & Severity of Depression in patients with chronic obstructive airway disease
Authors: Awan Shomaila , Ambreen Asma , Zaheer Nabila , Sabir Asma , Daud Sara , Athar Rizwan
Published: July 2023

Objective:  To determine the Prevalence & Severity of depression in Chronic Obstructive Airway Diseases (COPD) patients.
Background: Chronic Obstructive Airway Disease is a chronic heterogeneous disease that is also progressive. Depression is a common entity in chronic diseases. COPD causes long-term respiratory symptoms and depression is commonly found in these patients. The symptoms of these two diseases are overlapping and depression in COPD patients’ needs to be diagnosed and adequately treated. Untreated patients lead to poor control of respiratory symptoms and further deterioration of the illness. Our study aimed to determine prevalence and severity of depression in COPD patients using HAM-D score.
Material and Methods: This study was conducted in Medicine & Pulmonology OPD, Fuji Foundation Hospital, Rawalpindi from August 2019 to February 2021. Using a cross sectional study design, a total of 169 cases of COPD were recruited and tested for the presence of absence of depression using the HAM-D rating scale and observations were recorded.
Results: Total 169 patients recruited in this study with female & male percentage of 59% and 47% respectively.  The Mean duration of illness was 11.5 years ± 6.48. The incidence of Anxiety & Depression was high (45% and 36%) in moderate to severe disease with total prevalence of 54 % among participants in the study.
Conclusion: Anxiety & depression is commonly prevalent in COPD patients. Female patients are found to have more psychological disturbance irrespective to their COPD severity. Psychological impairment must be carefully evaluated in patients having COPD.
Association of Central Corneal Thickness among Myopic and Emmetropic Patients Visiting Ophthalmology Department of a Tertiary Care Hospital in Islamabad.
Authors: Khan Sufian Ali , Shah Muthair , Sharif Ahad , Ullah Saif , Imdad Anjum , Khalid Ayesha
Published: July 2023

Aim The aim of the study was to determine difference between central corneal thickness (CCT) among myopic and emmetropic eyes. 
Material and Methods A total of 186 participants participated in this comparative cross-sectional study. Sample size was calculated using the WHO calculator and enrolled by consecutive sampling technique. Detail eye examinations were performed of anterior and posterior segments with slit-lamp and refractive status were determined with Auto-refractometer (Nidek ARK 1a) and Pachymetry with Specular Microscope (Topcon SP2000P). The analysis of data was performed in SPSS 22. 
Results To carry out the study, 186 candidates volunteered their time and effort. Male and female participants were included in the study. About 56% of the candidates were men, and 44% were women. Individuals' ages varied from 16 to 49, on average (16-49). As for the control group, the average central corneal thickness was 522.30 microns and standard deviation of ± 29.563. Their sizes varied from 439 microns to 619 microns. The average CCT of myopic people was 515.18 microns, and the standard deviation was ±28.972 microns. The relationship between CCT in myopic eyes and CCT in emmetropic eyes was analysed using a paired t test. The P value was only 0.09, the relevance of the test was not significant. 
Conclusion: CCT difference between myopic and emmetropic eyes was no statistically significant (P 0.09).
Emotional Distress Among Pediatric Cancer Patients and their Siblings
Authors: Manzoor Ruqayya , Yasmeen Nuzhat , Shaheen Hijab , Mushtaq Nazia
Published: July 2023

Objectives: Cancer being a serious chronic illness, causes profound effects on physical and mental health of the individual as well as affects their caregivers and family members' mental health. This study aims to find out the burden of emotional distress in patients of childhood cancer as well as their healthy siblings.
Methods: It was a descriptive cross-sectional study. Parents of the children undergoing cancer treatment or having completed treatment within past one year were asked to complete an interview proforma (Pediatric Emotional Distress Scale) about their child’s behaviour over past one month, scoring each behaviour on a scale of 1 to 5 according to the frequency of symptoms. The data was then analysed using SPSS 20. The frequency distribution, central tendencies and standard deviations were calculated accordingly.
Results: Almost eighty-five% of the patients showed scores above the clinical threshold for emotional distress. Eighteen% of the healthy siblings also had scores above the clinical threshold. Patients as well as their healthy siblings showed high levels of anxiousness in their behaviours.
Conclusions

Childhood cancer is a cause of major emotional trauma in patients.
Age-matched siblings usually cope well with the illness.
Effect of Reperfusion on Time Domain Parameters of Heart Rate Variability
Authors: Mubarak Sadia , Riaz Bushra , Ashfaq Mehvish , Hamid Sidra , Rasul Amina , Shafiq Mamoona
Published: July 2023

Objective: To compare effect of reperfusion by measuring time domain parameters of heart rate variability before and after percutaneous transluminal coronary angioplasty. Study design: Quasi experimental study design Place and Duration: Department of Clinical Cardiac Electrophysiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi from January 2014 till January 2015. Patients and Methods: 40 patients with coronary artery disease having mean age of 55.20 ± 8.03 years were recruited by non-probability convenience sampling. DMS 300-4A Holter monitors were used to obtain 24 hours ambulatory ECG recording before and within 24 hours after percutaneous transluminal coronary angioplasty. Digital ECG data were transferred to the computer and edited with the help of DMS Cardioscan software. Heart rate variability was analysed in time domains measures. For time domain analysis normal heart rate, SDNN, SDNNi, SDANN, RMSSD and pNN50 were recorded from 12 lead digital ECG data.

Results: The results of our study demonstrated significantly decreased heart rate variability in coronary artery disease patients on comparison of pre and post-angioplasty values only SDNNi was significantly reduced (p-value = 0.035) whereas the reduction in SDNN and pNN50 was statistically insignificant (p-value > 0.05). On the contrary, SDANN and RMSSD displayed slight rise after angioplasty but it was not significant (p-value > 0.05).

Conclusion: Reperfusion after percutaneous transluminal coronary angioplasty decreases heart rate variability within 24 hours after the procedure. Whereas, heart rate during the same period after angioplasty increases. This reflects autonomic balance shifts towards sympathetic predominance as indicated by reduced heart rate variability and rise in heart rate. This makes the susceptible patients vulnerable for development of ventricular arrhythmias especially during 24 hours after angioplasty. Therefore, patients with decreased heart rate variability are at risk of ventricular arrhythmogenesis so they may be kept under medical surveillance for at least 24 hours after percutaneous transluminal coronary angioplasty.