bluuebunny/crossref_metadata_2025 huggingface dataset:
Data pipeline for GTFS transit arrival and departure information
Authors: Chin Teck Kean , Xian Tingsen (Tim) , Marks Benjy , Nelson John D. , Moylan Emily
Published: September 2022

Cities generate large volumes of data daily through digital services and smart city applications, these include Public Transport Authorities which generate big data as part of their daily operations, such as vehicle positions, counts of passengers and user travel patterns. The General Transit Feed Specification (GTFS) is a data format that allows public transport data to be consumed by a wide variety of software applications. This paper presents a data pipeline developed to manipulate the GTFS feeds into a general and flexible dataset of realtime transit arrivals. There are three barriers to widespread access to the information addressed by creating a one-size-fits-all data pipeline for realtime operations from GTFS. First, the protocol buffer format is not human readable and requires processing before use in most transport applications. Secondly, the general specificationdoes vary place-to-place and the conditionally required and optional fields are inconsistent between locations. Thirdly, the raw data may contain errors including missing stop sequence or a reverse direction bus being detected in the bus stop area. The pipeline is constructed of set of data cleaning and transformation steps to address these challenges. The paper briefly presents a potential use cases of the processed data to illustrate its relevance to researchers and practitioners.
Glomerular disease after renal transplantation: a multi-center protocol biopsy study in an Iberoamerican population.
Authors: Torres Rodolfo , Reina Maricely , Montero Camilo , Andrade David , Rosselli Carlos , Agudelo Estefy , Flechas Jonth , Rodriguez Laura , Trujillo Ana , yomayusa Nancy , Quintana Luis Fernando
Published: September 2022

Background
Renal transplantation is the treatment of choice in end-stage renal disease (ESRD)(1, 2), nonetheless; there are still limitations in improving long-term renal graft survival in a significant way, post-transplant glomerular disease being one of the main causes of renal graft loss (3, 4).
Methods
A retrospective cohort study, with renal transplant patients in 3 centers in the city of Bogota D.C
Results
399 patients were included, 61.15% predominantly male, with a median age of 44.3 years, interquartile range (IQR) (32.9–55.9). Post-transplant glomerular
The Cardinal Role of Digital Marketing in Morocco's Agricultural Sustainable Development
Authors: PIERRE BILIVOGUI , WENFANG FENG
Published: September 2022

With a contribution to the national economy of more than 14%, Moroccan agricultural sector today is a strong pillar for the economic growth of the Kingdom with its many advantages not only among rural populations, but also among agricultural businesses. Agriculture is an essential pillar of the country's economy and society growth, and its performance even determines the status of the entire economy. Moreover, the country's growth rate is strongly linked to of the agricultural production. However, Morocco's agricultural sector employs almost half of the working force and provides more than 23% of the country's exports. The dynamism of the agricultural export sector has enabled the Kingdom to become one of the world's leading exporters of agricultural products. This article aims to study the benefits of Digital Marketing to Moroccan farmers, whom struggling to profits from their production at the expense of agricultural products imported from other countries that taking the advantage of Digital marketing. The conducted study is of the qualitative and descriptive type, and a documentary to analyze the role of digital marketing in the Moroccan agricultural sector, beside an indicator for the unhealthy practices derived by certain actors in the field of digital marketing. The data are collected through semi-structured interviews with communication agencies and influencers (50), agricultural companies (50), and rural farmers (300) to investigate the issue.
Application of a Hybrid Camel Traveling Behavior Algorithm for Traveling Salesman Problem
Authors: DEMİRAL Mehmet Fatih
Published: September 2022

Camel Traveling Behavior Algorithm (CA) is a nature-inspired meta-heuristic proposed in 2016 by Mohammed Khalid Ibrahim and Ramzy Salim Ali. There exist few publications that measure the performance of the CA on scientific literature. CA was implemented to global optimization and some engineering problems in the literature. It was shown that CA demonstrates better performance than Particle Swarm Optimization (PSO) and Genetic Algorithm (GA) in global optimization. However, it gives poor solutions at combinatorial optimization as well as in traveling salesman problems (TSP). Besides, a modified camel algorithm (MCA) was applied in the field of engineering and was proved that it is better than Cuckoo Search (CS), PSO, and CA. Therefore, it is a need for improvement in CA by hybridizing with a constructive heuristic (Nearest Neighbor Algorithm-NN). A set of thirteen small and medium-scale datasets that have cities scales ranging from 29 to 195 was used in the comparative study. The results show that the hybrid algorithm (HA) outperforms Tabu Search (TS), GA, CA, and Ant system (AS) for 70% of all datasets, excluding wi29, eil76, pr76, and rat99. Also, it was given that a detailed analysis presents the number of best, worst, average solutions, standard deviation, and average CPU time. The metrics also stress that the hybrid meta-heuristic demonstrates 64% performance in finding acceptable solutions. Finally, the hybrid algorithm solves the discrete problem in short computational times when compared to other test algorithms for small and medium-scale datasets.
COVID-19 Pandemi Döneminde Eğitimde Derin Öğrenmeye Dayalı Duygu Analizi
Authors: KARGA Kemal , TOÇOĞLU Mansur Alp , ONAN Aytuğ
Published: September 2022

Keywords: Deep Learning, Sentiment Analysis, Text Mining, COVID-19, Higher Education

Öz

2020 yılında küresel COVID-19 pandemisi, ciddi ekonomik ve toplumsal kesintilere yol açtı. Pandemi sağlık, gıda, iş organizasyonları ve eğitim dahil olmak üzere hayatımızın neredeyse her alanını etkiledi. Eğitimin dijitalleştirilmesi ile birlikte yükseköğretim alanında önemli bir değişiklik yaşanmıştır. Pandemi ile mücadele amacıyla, dünya çapında birçok yükseköğretim kurumu, eş zamanlı veya eş zamansız olarak lisans ve lisansüstü derslerini çevrimiçi olarak sunmaya başlamıştır. Bu süre zarfında insanlar haber, bilgi, destek almak için ve sosyal bağlantılar kurmak için sosyal medyadan ciddi ölçüde yararlanmaktadırlar. Bu sayede, COVID-19 ile ilgili olarak Web'de çok miktarda elektronik metin belgesi paylaşılmıştır. Bu makalede, COVID-19 salgınının yüksek öğrenim üzerindeki etkisini analiz etmek için derin öğrenime dayalı bir duygu analizi yaklaşımı sunuyoruz. Bu bağlamda, geleneksel makine öğrenimi algoritmalarının (vektör destek makineleri, naive bayes, lojistik regresyon ve rastgele orman) ve derin sinir ağlarının (evrişimli sinir ağı, tekrarlı sinir ağı, uzun süreli bellek ve gated tekrarlı birim) performansları karşılaştırılmıştır. Buna ek olarak, transformerlardan gelen çift yönlü enkoder gösterimleri (BERT) tarafından elde edilen ampirik sonuçlar da değerlendirilmiştir. Farklı metin gösterim modelleri ve sınıflandırma algoritmalarına sahip kapsamlı ampirik sonuçlar, derin sinir ağlarının COVID-19 ile ilgili metin belgelerinin yüksek eğitim üzerindeki etkisini analiz etme görevi için umut verici sonuçlar verebileceğini göstermektedir.
Active particles driven by competing spatially dependent self-propulsion and external force
Authors: Caprini Lorenzo , Bettolo Marconi Umberto Marini , Wittmann René , Löwen Hartmut
Published: September 2022

We investigate how the competing presence of a nonuniform motility landscape and an external confining field affects the properties of active particles.
We employ the active Ornstein-Uhlenbeck particle (AOUP) model with a periodic swim-velocity profile to derive analytical approximations for the steady-state probability distribution of position and velocity, encompassing both the Unified Colored Noise Approximation and the theory of potential-free active particles with spatially dependent swim velocity recently developed.
We test the theory by confining an active particle in a harmonic trap, which gives rise to interesting properties, such as a transition from a unimodal to a bimodal (and, eventually multimodal) spatial density, induced by decreasing the spatial period of the self propulsion.
Correspondingly, the velocity distribution shows pronounced deviations from the Gaussian shape, even displaying a bimodal profile in the high-motility regions.
We thus show that the interplay of two relatively simple physical fields can be employed to generate complex emerging behavior.
Effect of gelatin drying methods on its amphiphilicity
Authors: Voroshilin Roman , Kurbanova Marina , Ostapova Elena , Makhambetov Eduard , Petrov Andrey , Khelef Mohammed El Amine
Published: September 2022

Gelatin is a natural amphiphilic biopolymer that is widely used in food products, pharmaceuticals, and cosmetics. We studied the effect of spray and freeze drying on the solubility and amphiphilicity of gelatin samples.

The control sample was a commercially produced edible gelatin. The experimental samples were spray- and freeze-dried gelatins obtained by enzymatic-acid hydrolysis of cattle bone. Amino acid sequences were determined by matrix-activated laser desorption/ionization. Solubility was assessed visually. Bloom strength of the gelatin gels was measured by a texture analyzer. The ProtScale online service was used to predict the amphiphilic topology of gelatin proteins. Molecular weight distribution of proteins was carried out by electrophoresis in polyacrylamide gel in the presence of sodium dodecyl sulfate.

Spray drying reduced protein degradation and retained more α-chains, while freeze drying increased gelatin’s hydrophobicity and decreased its solubility. The predicted topology of protein hydrophobicity based on the amino acid sequences was in line with our results on solubility. The freeze-dried gelatin had a 18% larger amount of low-molecular weight peptides, compared to the control and the spray-dried samples. This was probably caused by the cleavage of peptides during the drying process. Thus, freeze drying can lead to maximum degradation of gelatin components, which may be associated with a longer heat treatment, compared to spray drying.

Thus, spray drying is more suitable for gelatin, since this method improves the stability of its outer and inner structure, ensuring high hydrophilic properties.
Development of plant-based yogurt
Authors: Baskar Nehaa , Varadharajan Sabitha , Rameshbabu Mathushree , Ayyasamy Sudha , Velusamy Sangeetha
Published: September 2022

Fermented drinks are regarded as healthy food due to their probiotic nature. Vegan consumers who choose sustainable diet and people allergic to dairy products demand alternatives for dairy products. We aimed to develop a non-dairy plant-based yogurt from peanut, oats, and coconut milk.

Yogurt was formulated with addition of sugar, corn starch, pectin, and xanthan gum. Simplex-lattice mixture design was applied to optimize the composition of the yogurt and achieve the desired rheological properties, sensory attributes, and syneresis rate.

Our results revealed that the formulation containing 7.13 mL of peanut milk, 10 mL of oats milk, and 7.86 mL of coconut milk showed low syneresis rate, desired viscosity and flow behavior, as well as high overall acceptability. We found that increased amounts of peanut and oats milk improved the product’s viscosity due to high protein contents. However, coconut milk enhanced the taste and flavor of the yogurt. Flow behavior depended on viscosity and stabilizers used in accordance with the power law model. Syneresis rate was influenced by the viscosity of the yogurt. The utilization of corn starch, pectin, and xanthan gum not only improved the texture but also helped achieve the desired viscosity and flow behavior.

The nutrient composition, physicochemical properties, and high sensory characteristics of the yogurt based on peanut, oats, and coconut milk allow using it as a cow milk alterative in the diet of people with lactose intolerance.
A comparative study of phytochemical, antioxidant, anticarcinogenic, and antidiabetic potential of coriander (Coriandrum sativum L.): Microgreen and mature plant
Authors: Dhakshayani G. M. , Priya S. Janaki Alias
Published: September 2022

Microgreens are immature edible leafy greens with a higher concentration of phytonutrients than in mature leaves, which makes them a novel functional food. This research featured antioxidant, anticarcinogenic, and antidiabetic properties of coriander microgreens.

Aqueous and ethanolic extractions of coriander microgreens and mature leaves underwent a phytochemical analysis of antioxidant potential using the DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) free radical method and the ferric reducing antioxidant power (FRAP) assay. The analysis of antidiabetic and anticarcinogenic properties included the method of α-amylase enzyme inhibition and the MTT colorimetric assay.

The screening test inferred the presence of alkaloids, terpenoids, glycosides, steroids, tannins, flavonoids, phenols, carbohydrates, and proteins in both microgreens and mature leaves. The quantitative analysis showed that the ethanolic extract of the microgreen sample exhibited higher total phenols. Total flavonoids, steroids, carbohydrates, and proteins were higher both in microgreen extracts, if compared with those of mature leaves. Ascorbic acid, chlorophyll-a, chlorophyll-b, and carotenoids demonstrated a more substantial presence in mature leaves. The gas chromatography-mass spectrometry (GC/MS) analysis of coriander microgreens revealed such bioactive compounds as thienopyrimidines, phenolic amide, imidazo pyridazine, phenolic constituents, and essential oil. Mature leaves were rich in phenolic compounds, steroids, terpenoids, essential oils, and fatty acid esters. All these substances are known for their therapeutic antioxidant, antidiabetic, and anticarcinogenic properties. The microgreen samples exhibited greater ferric reducing antioxidant power, α-amylase enzyme inhibition, and cytotoxicity activity at a lower concentration of extract than mature leaves.

Coriander microgreens proved to have a promising antioxidant, anticarcinogenic, and antidiabetic potential and can be used in daily food additives.
Carboxymethyl cellulose and psyllium husk in gluten-free pasta
Authors: Faheid Siham M.M. , Rizk Ibrahim R.S. , Kishk Yasser F.M. , Ragab Gamal H. , Mostafa Sayed
Published: September 2022

Formulating high-quality pasta from wheat-free materials is a technological challenge. We aimed to make gluten-free pasta with carboxymethyl cellulose and psyllium husk and evaluate their effect on the quality of the final product.

Gluten-free pasta was produced from rice flour, white corn flour, potato starch, soy protein isolate, and carboxymethyl cellulose or psyllium husk used as binding agents. Then, we evaluated the effect of these hydrocolloids on the color, texture, cooking quality, and sensory characteristics of the product.

The uncooked gluten-free pasta containing psyllium husk showed significantly higher values of hardness compared to the samples with carboxymethyl cellulose, while the cooked pasta with psyllium husk had a significantly lower nitrogen loss. Also, psyllium husk improved the texture of the cooked gluten-free pasta, providing the highest values of resilience, springiness, and chewiness. Generally, the psyllium husk samples received higher quality values for texture, cooking quality, and sensory parameters, compared to the pasta with carboxymethyl cellulose.

Psyllium husk showed a better ability to bind gluten-free pasta than carboxymethyl cellulose. Consequently, psyllium husk could become a feasible alternative to wheat gluten in producing high-quality gluten-free pasta.
Effects of bioactive substances isolated from Siberian medicinal plants on the lifespan of Caenorhabditis elegans
Authors: Faskhutdinova Elizaveta , Sukhikh Andrey , Le Violeta , Minina Varvara , Khelef Mohammed El Amine , Loseva Anna
Published: September 2022

Medicinal plants are sources of natural antioxidants. Acting as reducing agents, these substances protect the human body against oxidative stress and slow down the aging process. We aimed to study the effects of bioactive substances isolated from medicinal plants on the lifespan of Caenorhabditis elegans L. used as a model organism.

High-performance liquid chromatography was applied to isolate bioactive substances from the extracts of callus, suspension, and root cultures of meadowsweet (Filipendula ulmaria L.), ginkgo (Ginkgo biloba L.), Baikal skullcap (Scutellaria baicalensis L.), red clover (Trifolium pretense L.), alfalfa (Medicágo sativa L.), and thyme (Thymus vulgaris L.). Their effect on the lifespan of C. elegans nematodes was determined by counting live nematodes treated with their concentrations of 10, 50, 100, and 200 µmol/L after 61 days of the experiment. The results were recorded using IR spectrometry.

The isolated bioactive substances were at least 95% pure. We found that the studied concentrations of trans-cinnamic acid, baicalin, rutin, ursolic acid, and magniferin did not significantly increase the lifespan of the nematodes. Naringenin increased their lifespan by an average of 27.3% during days 8–26. Chlorogenic acid at a concentration of 100 µmol/L increased the lifespan of C. elegans by 27.7%. Ginkgo-based kaempferol and quercetin, as well as red clover-based biochanin A at the concentrations of 200, 10, and 100 µmol/L, respectively, increased the lifespan of the nematodes by 30.6, 41.9, and 45.2%, respectively.

The bioactive substances produced from callus, root, and suspension cultures of the above medicinal plants had a positive effect on the lifespan of C. elegans nematodes. This confirms their geroprotective properties and allows them to be used as anti-aging agents.
Yogurt-like product from lupine (Lupinus albus L.) milk as an alternative to dairy products
Authors: Kavas Nazan
Published: September 2022

Recently, the number of people suffering from allergy to caw’s milk has increased. Lupine, a plant rich in protein, can be a good alternative product for non-dairy products production. We aimed to obtain a yogurt-like product based on lupine milk and evaluate its properties.

Lupine milk was obtained from lupine seeds, egg white protein powder, disaccharides, and starter cultures were added to the milk to obtain yogurt-like products: samples with maltose, samples with lactose, and samples without sugars. Physico-chemical and microbiological characteristics of the products were determined by the standard techniques. Sensory attributes were evaluated by trained panelists.

In the study, the effects of egg white protein powder and disaccharides on the activities of starter cultures and the properties of the yogurt-like products obtained were investigated. The relationship between the addition of sugar and the growth of starter cultures was found to be significant (P < 0.05). In terms of physico-chemical, rheological, and microbiological properties, the yogurt-like products obtained from lupine milk with disaccharides demonstrated good results, especially the sample with maltose. Sensory analysis revealed high sensory properties of the yogurt-like products.

Yogurt-like products from lupine milk can be used as an alternative to cow’s milk fermented products, but more detailed studies should be conducted on their formulations.
Positive Predictive Value of Computed Tomography Virtual Laryngoscopy in Detecting Laryngeal Carcinoma Taking Histopathology as Gold Standard
Authors: Rashid Nawaz , Noreen Aliya , Dogar Iqbal Hussain , Mansoor Ali , Hashmi Kamran Sajjad , Nawaz Fareeha
Published: September 2022

Background: Computed tomography virtual laryngoscopy (CTVL) is favored diagnostic tool in detecting laryngeal carcinoma because it delivers excellent temporal and spatial resolution. Objective: To determine the positive predictive value of computed tomography virtual laryngoscopy in detecting laryngeal carcinoma taking histopathology as gold standard. Methods: A cross sectional survey was conducted at department of Radiology, Mayo Hospital Lahore. The completion of study was done in six months [Feb 16, 2019 till Aug 16, 2019]. After obtaining approval from ethical committee and informed consent from subjects, 64 subjects were included in the study who presented in the Department of the Radiology having carcinoma of larynx on CTVL and then sent to department of ENT of mayo hospital, where they underwent direct laryngoscopy and afterwards biopsy obtained sent to the department of histopathology. All the subjects undergoing CT scan examination on the CT machine of hospital. Contrast injection was given to all subjects undergoing CT scan, through power injector at the rate of 4ml per min and dosage of 0.1ml/kg. Same machine was used to conduct all CT scans and was inferred through same radiologist and all the histopathology was performed by same pathologist to exclude bias. Results: The mean age of patients was 44.38 ± 9.57 years with minimum and maximum age as 22 and 60 years. There were 47(73.4%) male and 17(26.6%) female cases. On histopathology the laryngeal carcinoma was diagnosed in 56(87.5%) of the cases while it was negative in 8(12.5%) of the cases. On CT the laryngeal carcinoma was diagnosed in 59(92.2%) of the cases while it was negative in 5(7.8%) of the cases. The Positive Predictive Value of CT was 89.83%, while its sensitivity was 94.64%, specificity was 25.00%, negative predictive value was 40.00% and diagnostic accuracy was 85.94%. Conclusion: Through the findings of this study it is concluded that positive predictive value of computed tomography virtual laryngoscopy is high (89.83%) in detecting laryngeal carcinoma taking histopathology as gold standard. CT is a precise and non-invasive imaging method in detecting laryngeal carcinoma.
Intolerance of Uncertainty and Anxiety Sensitivity as Prospective Risk Factors for Cyberchondria in Undergraduate Students
Authors: Rashid Zubaida , Rathore Mommana Ali , Khushk Imdad Ali , Mashhadi Syed Fawad , Ahmed Moneeba , Shahzeb Muhammad
Published: September 2022

Background: Researchers have discovered a vicious loop of increased physical health concerns and online medical information seeking known as "cyberchondria," despite the benefits of widely accessible medical information on the Internet. Despite proposed theoretical models of cyberchondria, research on risk factors for the development ofcyberchondria is lacking in our setup. Anxiety sensitivity and intolerance of uncertainty are two potential risk factors.Objective: This study was conducted to determine the frequency of health related internet researches i.e cyberchondria and to locate and find association between the resultant health anxiety and intolerance of uncertainty among the medical andnon-medical students of different institutions of Islamabad and Rawalpindi. Methods: A cross-sectional study was conducted on a total of 300 students of medical and engineering universities between ages of 18 and 25 from October 2019 to March 2020 by using Cyberchondria Severity Scale, intolerance of uncertainty scale and anxiety sensitivity index scale questionnaires as data collection tool. Data collected was statistically analyzed by SPSSversion-22. Results: Out of 300 participants, 169 (56.3%) students were found positive for cyberchondria and 131 (43.7%) were found negative and majority of the positive participants were medical students. Results revealed significant association between intolerance of uncertainty (0.567, p < 0.000) as well as Anxiety sensitivity (0.805, p < 0.000) and cyberchondria among the medical and non-medical students of Islamabad and Rawalpindi.Conclusions: The current study's findings show that both Anxiety sensitivity and intolerance of uncertainty may have a role in the development of cyberchondria especially in medical students.
Validity of Pediatric Emergency Care Applied Research Network (PECARN) in Pediatric Trauma Patients - A Cross Sectional Study from a Tertiary Care Hospital in Pakistan
Authors: Naseer Naureen , Kapadia Nazir Najeeb , Masud Sarwat
Published: September 2022

Introduction: Head trauma in the pediatric age group is a common presentation in the Emergency Room (ER). The
Pediatric Emergency Care Applied Research Network (PECARN) tool can help an ER clinician to identify pediatric head
trauma patients at very low risk of clinically important traumatic brain injuries (ciTBIs) and avoid unnecessary CT scans.
Objective: To determine the validity of PECARN rule as compared to the head CT (gold standard) in identifying low risk
traumatic brain injury pediatric patients. Methods: A cross-sectional study was done at Aga Khan University Hospital (AKUH) Emergency Department ED. All pediatric head trauma patients were included in this study between 2017-2019. A total of 218 head trauma cases were reviewed which were evaluated for the PECARN criteria. Data were extracted on a prepared data collection form. Data were entered and analyzed using SPSS. Chi-square test was used. Results: Among the total 218, 190 cases (87%) had CT scans ordered. Out of these 190 patients 156 (82%) met PECARN criteria, while 34 (18%) were PECARN negative. The sensitivity and specificity of PECARN was calculated as 82% and 33% respectively, with a fair level of agreement with CT scan based on Kappa statistics. Conclusion: PECARN has a higher sensitivity but lower specificity in comparison to CT scan.
Assessment of Parental Satisfaction with Day-Care Surgical Services in a Tertiary Level Pediatric Hospital
Authors: Ahmed Riaz , Akhtar Jamshed , Zamir Naima , Taqvi Syed Muhammad Raees Hussain , Bibi Safia
Published: September 2022

Background: Parental feedback is important for improving quality of the surgical services provided.Objective: This study was conducted to assess the level of satisfaction of parents with the day-care surgical services so as to find out where improvement is needed. Methods: This was an observational cross sectional study conducted in the Department of Pediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University Karachi from September 2019 to April 2020. The parents of the children who underwent different day-care surgical procedures were included. A validated Parent Satisfaction Scale (PSS) which consist of 11-items was used. The responses were made according to Likert scale. Three groups of satisfied, undecided and unsatisfied study participants were made according to the scores obtained. The socio-demographic variables including age of parents and children, level of education, and income group were compared amongst study groups. Results: Total of 114 parents participated. The most common procedure performed was inguinal herniotomy (n=59). Seven (6%) patients were brought back after discharge due to pain. Eighty-seven (76.30%) parents were satisfied with the services provided while 18 (15.8%) were unsatisfied and 9 (7.9%) undecided. A significant difference in the satisfaction level of the study participants noted with respect to the mean age of parents (p=0.039), level of education (p< 0.001) and income groups (p< 0.001). Conclusion: Majority of the study participants were satisfied with the surgical services provided. Lack of respect given by the hospital staff and delay in getting treatment were the main reasons for dissatisfaction. Socio-demographic characteristics of the study participants were significantly associated with the level of satisfaction.
Pregnancy Outcome in Acute Viral Hepatitis E
Authors: Sultana Rashida , Humayun Shamsa , Manzoor Sofia , Humayun Sara
Published: September 2022

Background: Hepatitis E is associated with poor feto-maternal outcome. Patients with acute hepatitis E who are pregnant usually require hospital admission and monitoring with liver function tests and clotting profile. Objective: To evaluate maternal and fetal outcome among pregnant women who have positive serology for hepatitis E IgM. Methods: Data of women with clinical presentation of jaundice during pregnancy and who were diagnosed as acute hepatitis E was collected on pre-structured questionnaire after obtaining consent. Data were entered in Statistical Package for Social Sciences for analysis. Results: Three hundred and thirty three women had positive serology for hepatitis E IgM. Out of these three hundred were in last trimester of their pregnancy. The gestational age of two hundred and thirty two (77%) women was less than 37 weeks at presentation. Six (2%) pregnancies ended up in miscarriage, fifty four (16 %) had fetal demise in maternal womb while two hundred and seventy three (82%) were viable fetus. One third of live born babies were kept in NICU. Indications of neonatal admission were respiratory distress in 57(72%), jaundice neonatorum in 12(15%), asphyxia neonatorum in 9(12%), while one (1%) had transient tachypnea. Neonates who died in first week of their life were 18(23%).The cause of neonatal death was respiratory distress in 12 (67%) and anoxia in remaining 6 (33%) neonates. Most of the women were discharged home however maternal mortality was recorded in 80(24%) patients, mainly in postpartum period 73(91%). Conclusion: Pregnant women with acute hepatitis E have more complicated course of this viral infection with adverse fetal and maternal implications.
Comparison of Anterior and Posterior Kaltenborn Grade III Glide on Glenohumeral Joint for Improving External Rotation in Adhesive Capsulitis (Frozen Shoulder)
Authors: Asif Anum , Zia Amna , Liaqat Sidrah , Afzal Farjad
Published: September 2022

Background: Adhesive capsulitis is a common disabling and painful condition that causes limitation of both passive and active ranges of shoulder joint. Division of frozen shoulder can be into primary and secondary categories. Different techniques have been devised in physiotherapy to regain limited range of motion in adhesive capsulitis. Objectives: To compare the effects of anterior and posterior grade III Kaltenborn glides on glenohumeral joint for improving external rotation and functional ability in patients with adhesive capsulitis. Material and methods: This randomized controlled trial was conducted in University of Health Sciences, Lahore and 40 patients were recruited from Mayo Hospital, Lahore from 08-10-2019 to 10-02-2020 and divided randomly into two groups. Group A was given anterior glide and Group B was given posterior glide. Treatment was given for 4 weeks, 3 sessions in each week. Outcomes were measured in terms of external rotation and functional status of shoulder from Goniometry and SPADI scale. Results: Comparison of External rotation and SPADI score of group A (Anterior glider) and group B (posterior glide) has shown that both groups were similar at baseline (p>0.05 for all variables) but post-treatment mean external rotation range in group A was 36.50 ± 7.72 while in group B was 52.80 ± 7.14, with the P value
Plastic Surgery Improves Baseline Anxiety in Males Having Lesions on Face
Authors: Bashir Afzaal , Afzaal Sunaina , Bashir Muhammad Mustehsan , Sohail Muhammad
Published: September 2022

Background: Congenital and acquired lesions both cause marked elevation in anxiety due to decreased self-esteem and confidence. Plastic surgery can address and markedly improve the anxiety level by addressing such lesions. Medical and surgical concerns related to body may elevate baseline anxiety. Although females are more concerned and fretful about such lesions, we observed that males are also prone to similar levels of anxiety. Objective: The objective of the study is to find out effect of plastic surgery on anxiety level of males having facial lesions. Methods: This prospective study was conducted in Plastic Surgery Department of King Edward Medical University, Lahore, Pakistan from Feb 2018 to Jan 2019 and 100 male patients with either congenital or acquired lesions of face were enrolled and operated. Anxiety level was rated by applying Hamilton anxiety scale immediate preoperatively and satisfaction along with quality of scar was noted after 2 months. Results: 53% of enrolled patients were having educational status above secondary school, 63% patients were from urban, 56% patients were below 27 years of age, 44% were above 27 years of age and 33% were married. Trauma was the cause of lesion in 61% while 13% were with Rhomberg disease and 26% with congenital lesions disorder. Majority of patients had lesion involving forehead. On Hamilton anxiety scale, pre-operative anxiety score was high (21.76±5.846) as compared to
postoperative score (10.04±4.537). Scar scoring with Vancouver Scar Scale was 4.36±1.798 post operatively. Majority of patients showed significant improvement in anxiety scores post operatively. Conclusion: Irrespective of age, socioeconomic status and education level, lesions involving face elevated baseline anxiety
in males. Plastic surgery addresses these concerns permanently resulting in marked improvement in anxiety level.
Immediate Psychological Impact of COVID 19 Pandemic on Mental Health of Pediatric Healthcare Workers
Authors: Ijaz Samar Fatima , Ijaz Iftikhar
Published: September 2022

Background: COVID-19 pandemic has been effecting the world since December, 2019. Front line healthcare professionals faced increased stress level while dealing with overload of patients. Hence it triggered feelings of loneliness, despair and physical mental fatigue. Objective: To determine the immediate psychological impact of COVID-19 pandemic on mental health of pediatric healthcare workers by using Depression Anxiety Stress scoring scale, DASS-21 scale. Methods: This cross-sectional online survey was conducted from 1st July to 30th November 2020 in the department of Pediatric Medicine Unit II, King Edward Medical University/Mayo Hospital, Lahore. A 21-item Depression Anxiety Stress scoring scale was circulated online among Healthcare workers of Teaching hospitals of Lahore. These included Pediatric Specialists, General Physicians, Postgraduate Trainees in Paeds Medicine, House Officers in Paeds Medicine and Pediatric
Nurses. 150 Healthcare workers (HCWs) participated. Responses were analyzed with SPSS V.26. Results: Out of 150 healthcare workers, 101(67.3%) were falling in the range of 20-30 years, 76(50.7%) were females, 81(54%) were singles, maximum 59(39.3%) were postgraduate trainees and majority 65(43.4%) had
Behavioural Determinants for Hand Hygiene Practices among Primary School Children during COVID-19 Pandemic
Authors: Rana Mydah Tariq , Afzal Muhammad Faheem , Hamid Muhammad Haroon
Published: September 2022

Background: Children acquire SARS CoV-2 infection from their family members but they experience mild symptoms. Hand washing promotion programs are being executed in many countries to enhance child healthcare development. Objective: This study was designed to identify behavioural determinants to increase hand washing practices among primary school children during COVID-19 pandemic. Methods: This was a cross-sectional study conducted by the Department of Pediatrics, King Edward Medical University/ Mayo Hospital, Lahore from June to November 2020. Total of 195 mothers of primary school children were enrolled by non-probability consecutive sampling. A 23-item, 5 points likert scale questionnaire assessed 5 domains related to handhygiene. Data was entered in SPSS 24. Domains were presented as frequency tables. Independent sample t-test was applied to 8 mean score of sub-category of each domain, and to cumulative mean score of each domain. A cut off mean score of ≥3 was taken as satisfactory. Results: We found satisfactory mean scores amongst mothers for knowledge regarding the importance of hand-washing (3.59±0.62), and commitment regarding maintenance of hand-hygiene (3.44±0.773). Better mean score for liking hand washing with alcohol rub/sanitizer than with soap and water (3.14±1.063 versus 1.10±1.229) was seen. Children reported not feeling dirty if they did not practice hand-hygiene (2.99±1.195). Elders in the households promoted hand-washing, but lacked practicing it themselves (3.48±0.881 versus 2.85±1.242). There was below satisfactory mean score for hand-hygiene amongst children after sneezing, coughing, blowing their nose, or playing (2.50±1.253, 2.23±1.265, 2.27±1.301, 2.83±1.280 respectively). Norm and self-efficacy factors had adequate overall scores (3.17±0.84, 3.17±0.65). The total score for this study was 2.8759±0.419. Conclusion: We found satisfactory mean scores for risk, attitudes, norms, ability, and self-regulation factors of handhygiene among primary school children.
Comparison of Sublingual & Per Rectal Misoprostol versus Oxytocin in the Prevention of Postpartum Hemorrhage
Authors: Najeeb Wafa , Shahid Rabia , Sharif Sadia , Danish Sana , Masood Ayesha , Ali Mansab
Published: September 2022

Abstract:
Background: Postpartum Hemorrhage (PPH) is the most common reason of maternal death globally. Misoprostol and oxytocin are two first line and effective management protocols. But controversies exist in literature. For that matter, this study was conducted.
Objectives: To compare the frequency of postpartum hemorrhage with per rectal misoprostol in relation to intramuscular oxytocin in females undergoing normal vaginal delivery at term.
Methods: This randomized controlled trial was conducted in Department of Obstetrics & Gynaecology, Sheikh Zayed Hospital, Lahore from 01-01-2019 to 01-12-2019. Patients were divided randomly into equal halves through the lottery method. Group A received Misoprostol and group B received Oxytocin. Medications were administered within one minute of clamping and the cutting of cord. During 24 hours, soaked pads were evaluated for blood loss and total blood loss was calculated. If blood loss>500ml, then PPH was labeled.
Results: Mean age of women in Group A and in Group-B were 29.11±6.67 and 29.23±6.70 years. The mean gestational age for Group A came as 39.60±1.78 weeks and for Group-B, it was 39.53±1.72. In Group-A 24(15.7%) and in Group-B 59(38.6%) women suffered from PPH. PPH was significantly lower in comparison to the women in Group-B. Pvalue=0.000.
Conclusion: Results of this study showed that use of per rectal Misoprostol is more suitable and effective in the prevention of Post-partum hemorrhages compared to oxytocin in females undergoing normal vaginal delivery at term.
Outcomes of Suturing Triangular Shaped Trabeculectomy Flap Using Single Versus Double Suture Techniques
Authors: Kamil Zeeshan , Qurban Qirat , Dareshani Shehla
Published: September 2022

Background: A gold standard surgical technique, trabeculectomy is used in the management of glaucoma which is not controlled medically to lower the intraocular pressure (IOP) by creating a conduit via the sclera via which aqueous humor passes into the subconjunctival space through the anterior chamber. Objective: This study assesses the reduction in intraocular pressure (IOP) with two suturing techniques during trabeculectomy with a triangular shaped scleral flap. Method: This study was carried out from January 2019 to June 2019 at BHY Hospital, Karachi and engaged patients belonging to either gender between 40 to 60 years of age. Patients included had primary open angle glaucoma with IOP > 24 mmHg despite full medical treatment. Patients having other types of glaucoma or previous history of undergoing trabeculectomy were excluded from the study. Trabeculectomy with triangular shaped scleral flap was performed on patients of both the groups with the difference being the number of sutures placed and their site. In group A, flap was approximated using a single suture, applied at the apex of the triangular tip, whereas two sutures were passed in group B on each side of the triangle close to the flap apex. Results: The study comprised a total of twenty-four patients divided in two equal groups. Mean age was 49.3±3.61 years. Mean pre-operative IOP in all the patients was 26.9±1.48 mmHg whereas post-operative mean IOP at the end of follow up was 14.0±2.08mmHg in group A and 15.1±1.67mmHg in group B patients (p = 0.181). Two patients of group A reported
hypotony in the immediate postoperative period which was managed conservatively where as one patient from group A and one patient from group B required revision surgery owing to episcleral fibrosis. Conclusion: Both techniques were found to be equally effective for lowering the IOP with similar minimal risk profile.
Volume Assessment in Paediatric Hemodialysis Using Lung Ultra Sonography
Authors: Umer Razaq Ch Muhammad , Ijaz Iftikhar , Bint-e-Mansoor Khoola , Mehmood Kashif , Tariq Ayesha , Abbas Farnaz
Published: September 2022

Background: It is a significant challenge clinically to optimize the weight of children and infants. It is our hypothesis that in children receiving dialysis fluid overload can be quantified using lung ultrasound.
Objectives:
1. To determine the frequency of diagnosing pulmonary edema using lung ultrasound and clinical examination.
2. To determine association of percentage decrease in weight with number of B-lines in children with renal failure undergoing hemodialysis Methods: This cross sectional study was conducted in Division of Pediatric Nephrology, Paediatric unit II, Mayo Hospital
Lahore from June 2020 till December 2020 after approval of hospital committee. Patients aged 6 to 16 years undergoing regular hemodialysis after chronic kidney disease were enrolled. Lung ultrasound examinations were performed before start of dialysis and after completion of dialysis. B lines were measured on the ultrasound along with comparing the proportional increase in weight from the target weight. Results: Eighty one lung ultrasound assessments were performed in total. Mean age was 10.4±3.3 years. There were 56(69.1%) males and 25 (30.8%) female patients. Mean percentage decrease in weight was 5.5±2.4% before dialysis and 0.96±0.6% after dialysis, p-value
Problems in Physician-Patient Communication: What do our Students See and Hear? A Qualitative Study with a Pragmatic Approach
Authors: Younas Ayesha , Khan Rehan Ahmed , Yasmeen Rahila , Mahboob Usman , Ansar Ambreen
Published: September 2022

Background: Efficient communication with patients is an indispensable necessity for physicians of the 21 century. Over the past decades, much work has been done nationally and internationally to instill this essential skill in undergraduate students and medical graduates are now formally trained to become better communicators. However, deficiencies persist and medical students of today still observe various issues when they observe physician- patient communication interactions in their training. Objective: To understand perceptions of undergraduate medical students about the difficulties in Physician-Patient communication (PPC) & take suggestions on how to overcome them. Methods: A qualitative study design was employed, with data collection through three focus group discussions with medical students studying in Wah medical college, Pakistan in October 2019. Thematic data analysis was done using Atlas-ti 8
software. A pragmatic approach was used to understand student perceptions about difficulties in PPC. Conclusion: The various issues regarding the problems in physician patient communication portray a realistic picture of our current communication practices. Various factors have been identified in this study and, the most practical solution to these problems lies in the effective teaching of behavioral sciences.
A Case Report of Scar Endometrioma, A Rare Entity
Authors: Mushtaq Javeria , Wasim Tayyiba , Feroze Jamshaid
Published: September 2022

Scar endometriosis is an uncommon entity. Its diagnosis is often delayed because it often resembles to several surgical conditions and dermatological diseases. It is almost always iatrogenic in origin. Here we are discussing a 38 old year old women who presented with scar endometriosis after Lower Segment Caesarean Section (LSCS).
Intralesional Metronidazole (5%) VS Intralesional Meglumine Antimonate in Cutaneous Leishmaniasis
Authors: Iram Ayasha , Tahir Raheel , Akhtar Aliya , Mariam Madiha , Zafar Zahra
Published: September 2022

Background: Leishmaniasis is a vector-borne disease that causes skin infections around the world through the bite of sand fly. This leads to the formation of cutaneous leishmaniasis and scars on the area that a cosmetically significant. Objective: Our study aimed to evaluate the efficacy of intralesional metronidazole (5%) in comparison with intralesionalmeglumineantimonate in the treatment of cutaneous leishmaniasis. Methods: In the current study 40 patients with cutaneous leishmaniasis having upto 3 lesions on either upper limb, lower
limb or trunk with a maximum diameter of 3cm in the longest dimension were included in the study and were randomly allocated to either group A (intralesional meglumineantimonate) or group B (intralesional metronidazole). Both treatments were given as intralesional injections on weekly basis, for 12 weeks. Patients were assessed and clinical photographs of the site of treatment were taken on every visit. The response was recorded according to the reduction in the size of the lesion, flattening of the lesion, change in colour, re-epithelialization and disappearance of signs of inflammation. More than 80% improvement to complete resolution of the lesion was considered as a cure. Results: At the end of 12 weeks of treatment 18 out of 20 (90%) patients in treatment group A (intralesional meglumine antimonite) were cured (mean 1.10, SD 0.308), while15 out of 20 (75%) patients responded to the treatment with intralesional metronidazole (mean 1.25, SD 0.444). Although, group A patients had a better cure rate than group B patients but the response to both treatments was found statistically significant and the p-value was 0.0001. Conclusion: This study denoted that cutaneous leishmaniasis best responds to intralesional meglumineantimonate butintralesional metronidazole is found to be a safe and effective alternative treatment for this chronic ailment.
Effectiveness of Post Isometric Relaxation Versus Reciprocal Inhibition Technique on Hamstring Muscle Flexibility
Authors: Aleem Asma , Arfan Muhammad Tariq , Razzaq Ayesha , Khizar Rooh ul Husnain , Ali Mehboob
Published: September 2022

Background: To expand the muscular extensibility, alternation of muscle energy techniques have been upheld, yet proof present to help the general value of a specific methodology. Two strategies of muscle energy techniques have been explored in the osteopathic writing that differs principally in the group of muscles focused on. Objective: The objective of our study was to find out the effectiveness of post isometric relaxation and reciprocal inhabitation technique on hamstring muscle flexibility among students of Johar Institute of Professional Studies Lahore. Methods: The Quasi-experimental study was for comparison of two Relaxation Techniques with 50 healthy students of both gender were recruited by non-probability convenient sampling technique from different department of Johar Institute
st of Professional Studies Lahore from 1 October to March 2020. For enrolling the subjects in this study we used convenience sampling technique. Furthermore, 50 subjects were selected on the basis of inclusion exclusion criteria and were arbitrarily divided in to two groups with 25 in each group. Hamstring length was assessed using AKE test. For intervention, Group A performed post isometrics relaxation and Group B performed Reciprocal Inhibition Technique. Knee range of motion was assessed pre-intervention and post-intervention. Numeric Pain Rating Scale (NPRS) and Universal Goniometer were assessment tools accessed for all patients before and after 4 weeks of physical therapy intervention. Data were documented and analysis was done using SPSS version 20. Paired sample t-test and independent sample t-test was applied to find association between the variables of hypothesis. Results: In both groups, the pre-intervention and post-intervention measurements by statistical analysis found that there is significant improvement in hamstring muscle flexibility with P value ≤ 0.05 for both right side and left side. Conclusion: The current study found out that both post isometric relaxation and reciprocal inhibition are equally beneficial in the treatment of tight hamstrings.