bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of HbA1c and total cholesterol levels in child bearing age using injectable contraceptives.
Authors: Farooq Javeria , Aamir Kausar , Baig M. Farooq 
Published: January 2024

Introduction: Injectables contraceptives are convenient and highly effective methods for fertility regulation, being simple to administer and long acting, but affect lipids by increasing total cholesterol and triglycerides1 , the major health risk of injectables contraceptives are cardiovascular diseases (CVS), particularly heart attacks (myocardial infarction), stroke and venous thromboembolism2 Hormonal contraceptives have traditionally being thought to adversely affect carbohydrate metabolism by increasing insulin resistance and decreasing glucose tolerance.3
Objective: To determine and compare the values of HbA1c and total cholesterol levels in child bearing age using Depot Medroxy Progesterone Acetate (DMPA).
Methodology: This comparative cross-sectional study was conducted at Department of Pharmacology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, from January 2016 to December 2016. Total 200 fertile females in their child bearing age were selected. They were divided into two groups, Group 1 (controls) and Group 2 (DMPA users). Total cholesterol levels were measured before starting therapy, in the middle and the end of the therapy by using standard procedures on semi- automatic clinical chemistry analyser (Microlab 400). HbA1c levels were measured by using semiautomatic clinical chemistry HbA1c analyser (Microlab 300). Results were analyzed by using Statistical Package for Social Sciences (SPSS) version 21.
Results: DMPA causes significant increase (p < 0.05) in total cholesterol, but insignificant changes (p > 0.05) in HbA1c levels.
Conclusion: It is suggested that total cholesterol and HbS1c levels should be measured before starting and during the course of injectable contraceptives to the subjects. As deranged cholesterol levels can increase the risk of cardio- vascular disease outcomes.4 Also injectable contraceptives may cause pre- diabetes (increased in levels of HbA1c 5.7-6.4)5.
Key Words: Depot medroxyprogesterone Acetate (DMPA), Glycated hemoglobin (HbA1c), Total Cholesterol, Statistical Package for Social Sciences (SPSS).
Prevalence of dental erosion in Pakistani children: A cross-sectional study
Authors: Najmi Naheed , Muhammad Nadeem  , Tahera Ayub  , Talha Maqsood  
Published: January 2024

Introduction: Dental erosion has remained a topic of interest for more than a decade and now gripping greater attention with the rise in the number of cases being reported in children and young adults. Prevalence of dental erosion varies in different countries according to their different geographical locations, dietary habits and life styles of their people. However, little is known about the prevalence of tooth erosion in Pakistani children particular regarding the associated risk factors. Aims: This study was designed to explore the prevalence of dental erosion and to determine the associated predictors of dental erosion in school children of Pakistan aged 12 to 14 years.
Methodology: A comparative cross-sectional Analytical study was conducted at a private school of Karachi, Pakistan from April 2016 till March 2017. The subjects were selected on the basis of non-probability convenient sampling. Children aged 12-14 years were included for this study and children having frequent hospitalizations were excluded. The two previously calibrated examiners participated in the clinical examinations and visited the selected schools. The clinical examinations were performed in well-lit classrooms or in shaded places under natural light using plane mouth mirrors and sterilized cotton to remove debris. The central incisors, lateral incisors, and first molars in the upper and lower jaws were examined.
Results: School children were assessed by O’sullivan index which showed dental erosion of 42.8% on labial or buccal surface, 9.7% on lingual or palatal surface, 7.4% on occlusal or incisal, 4% on labial, incisal/occlusal and 7% on lingual, incisal/occlusal. Grade of severity of dental erosion showed normal enamel in 43.1%, matt appearance of enamel surface with no loss of contour in 20.1%, loss of enamel only in 35.8% and loss of enamel with exposure of dentine in 1%.
Conclusion: The study concludes that dental erosion is a multifactor in origin and with time is becoming increasingly commonly in younger age group. It is important that as health providers we need to identify the possible risk factors and make the community aware of the ways to prevent this condition.
Key words: Surfaces of teeth, enamel surface, Soft drinks and straw.
Knowledge, Attitude and Practices of Health Professionals towards Nosocomial Infection
Authors: Umair Mustafa  , Sana  , Mubeen Nasir  
Published: January 2024

Introduction: A hospital-acquired infection, also known as Nosocomial Infection, is an infection whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff, that becomes clinically evident after 48 hours of hospitalization.
Objectives: To assess the knowledge, attitude and practices of Health care professionals towards Nosocomial Infection, to find the gap present between knowledge, attitude and practices and to give suggestions to remove the gap.
Methodology: This cross-sectional study was conducted among the doctors and nurses in different units of Allied Hospital Faisalabad. Out of 250 only 244 participants replied, and convenient sampling was used. It was an anonymous survey and participation was voluntary. SPSS used for data entry and analysis. Means ± SD were calculated for continuous data and tables and figures used for categorical data. All the tests were performed using alpha=0.05
Results: For this KAP study the response rate was 97.6%, majority of the participants (89.3%) were females; the mean age was 24.52 ±3.240 years, 79.50% were doctors and 20.5% were nurses, more than half were house officers (60.7%).87.7% had a good idea about nosocomial infection, and majority thought it was either respiratory tract infection (31.6%) or surgical wound infection (31.6%). Most common causative organism is thought to be all 3 of E.coli, Staphylococcus Aureus, and Pseudomonas (38.1%). Immunocompromised adults were the most important risk factor. Among practices of health care professionals, majority denied washing their hands before touching every patient (62.7%), before aseptic procedures (60.2%), after exposure to body fluids (52.5%) or after touching a patient (42.2%). Out of 244, 215 (88.1%) agreed that all equipment should be properly sterilized, while, only about 119 (48.8%) responded that they always used a newly sterilized equipment for every new patient. Only 22.1% of health care professionals kept themselves well updated with latest antibiotics prescribing information.
Conclusion: Knowledge and attitude of doctors and nurses of Allied Hospital towards nosocomial infection is good. There is lack of obligation towards practices and major factors such as hand washing, ward hygiene, and proper sterilization are frequently ignored.

Keywords: Health Professionals, Nosocomial Infection. KAP study. Methicillin-resistant Staphylococcus aureus.
Efficacy of Lactulose Vs Lactulose with Rifaxamin in patients with Hepatic Encephalopathy: A Randomized Control Trial
Authors: Ahmed Raja Shoaib , Muhammad Adnan  , Hira Jabeen  
Published: January 2024

Introduction: Hepatic encephalopathy (HE) is one of the deadliest complications of cirrhosis. The basic underlying pathophysiology is the increased production of ammonia which can cross the blood brain barrier and can influence in multiple ways. For managing HE various therapeutic regime have been tried in the past with varying degree of success grate and side effect profiles. Neomycin, Enema, Lactulose, Metronidazole, Vancomycin, Rifaxamin etc. are the various modalities used. Lactulose is the most widely used and Rifaxamin; an antibiotic is recently used with good success rate.
Objective: To compare the outcome of lactulose alone versus lactulose with Rifaxamin in cases with hepatic encephalopathy.
Methodology: A randomized control trial was conducted on indoor patients of medical departments, Mayo Hospital. Lahore from June 2017 to December 2017. The cases of hepatic encephalopathy of any grade within last 7 days of its onset with age range of 20-60 years were included. The cases with end stage cardiac or renal failure were excluded. The cases were divided into two groups; A and B. The group A was treated with lactulose alone in a dose to 20 to 100 ml per day to maintain stool frequency of at least 2 per day and the group B was treated with same amount of lactulose along with Rifaxamin in a dose of 550 mg thrice a day. The efficacy was assessed daily till there were no signs and symptoms of hepatic encephalopathy till day 7 where final outcome was seen to label efficacy or mortality as Yes or No.
Results: In the present study, 100 cases of hepatic encephalopathy were included. Out of these 50 were in each group. The maximum cases were in Child Pugh class in both groups comprising 26 (52%) and 25 (50%) in group A and B respectively. The mean age at presentation was 46.73± 9.13 years in A as compared to 51.25± 9.04 years in group B with p= 0.54. The efficacy in group A was seen in 28 (56%) of cases and in group B as 38 (76%) of cases with p= 0.01. This difference was also statistically significant in terms of mortality which was seen I n 22 (44%) of cases in group A and 12 (24%) in group B (p=0.01).
Conclusion: Combination of lactulose plus Rifaxamin is significantly better as compared to lactulose alone for the treatment as well as to reduce mortality in cases of hepatic encephalopathy.

Key words: Lactulose, Rifaxamin, Cirrhosis, Encephalopathy
Complications of early Cholecystectomy in acute Biliary Pancreatitis
Authors: Muhammad Adnan  , Ahmed Raja Shoaib , Hira Jabeen  
Published: January 2024

Introduction: Pancreatitis, inflammation of pancreas, is an acute emergency having mortality rate 2 to 7%. Acute pancreatitis can be caused by various factors, like drugs, alcohol, toxins, gallstones, trauma, infection etc. and amongst these, gallstones are the most common cause and is seen in around 75% of the cases. Regarding gall stones, the size of it and number are important parameters. Management usually depends upon the clinical scenario, underlying conditions of pancreas, presence of co morbid conditions and cholecystectomy. This can be done immediately or with an interval while the acute episode of pancreatitis is settled; each having their own benefits and complication rates.
Objective: To determine the complications of early cholecystectomy in acute biliary pancreatitis.
Methodology: A descriptive cases series study was carried out at Mayo Hospital Lahore during June through December 2017. The cases of either gender aged 18 years and above of acute biliary pancreatitis diagnosed clinically with epigastric pain, tenderness and vomiting with raised pancreatic enzymes with history of gall stones were selected purposively. The cases underwent open laparoscopic cholecystectomy in the same admission within 5 days of admission. These subjects were then followed to lo ok for duration of surgery, duration of hospital stay and recurrence of pancreatitis. Final outcome was seen at 3 months to look for recurrence.
Results: We took 50 cases of acute biliary pancreatitis. There were 20 (40%) males and 30 (60%) females. The mean age at presentation was 43.56± 4.68 years. The mean duration of surgery was observed as 54.56 ±12.33 minutes. Total complications were seen in 9 (18%) of the cases; few had combination of these. The most common complication seen was prolonged duration of hospital stay (18%), followed by prolonged duration of surgery (10%) and recurrent pancreatitis (8%).
Conclusion: Early cholecystectomy has higher compilations rate and the most common is long duration of hospital stay.

Key words: Pancreatitis, Early cholecystectomy
Association of blood lipids, cortisol and Hemodynamics Under stress: A possible role in early Atherogenesis
Authors: Ghulam Mujadid Qureshi  , Zafar Ali Pirzado  , Fayyaz Memon  , Siraj Ahmed Abbasi  
Published: January 2024

Introduction: High blood cholesterol is claimed as a risk factor but recently it is accepted that cholesterol is increased under psychological stress. When raised in blood, cholesterol plays role in atherosclerosis formation; a role which is being debated since last many decades but still various questions is un-answered. Role of stress in early atherogenesis with association to alteration in blood lipids has been proposed but the available literature is scanty on the subject.
Objective: To explore the association of alterations in blood lipids, cortisol level and hemodynamics under mental stress in youth with no apparent heart disease.
Methodology: 114 male participants were selected from 397 volunteers as per ‘selection criterion’ approved by scientific committee. The volunteers were examined two times: during stress task as ‘stress-study’ and during non-stress period as ‘control’ according to ‘paired sample’ design. Thus, 56.54% apparently healthy subjects were included with exclusion ratio of 43.58%. All experiments were conducted under standard methods at LINAR-Larkana and Physiology Department of Sindh University, Jamshoro. Blood sample were taken between 9.00 am to 12.00 pm.
Results: Cortisol, systolic and diastolic blood pressures and heart rate were significantly increased during stress session. Different lipid levels were changed with different significant values. Correlations of some altered lipid levels with raised values of hemodynamics and cortisol detected were positive and significant.
Conclusion: Most changes in the level of variables were found prone to be “atherogenic in pattern” due to psychological stress. This work may pave a way for better understanding of relationship in between lipid alterations, mental stress and early atherogenesis. For that further studies are needed.

Key Words: Cholesterol, Hemodynamics, Cortisol, psychological stress.
Conference Proceedings: Southeastern Regional Society of Academic Emergency Medicine Meeting, 2023
Authors: McLean Mary , Gue Shayne , Little Andy , Ganti Latha 
Published: January 2024

The Society of Academic Emergency Medicine Southeastern Regional Meeting Research Forum featured a peer-reviewed line-up of emergency medicine research, innovations, and case reports in oral presentation format at the 2023 SAEM Southeastern Regional Meeting on July 8th, 2023, in Orlando, Florida. Dr. Wendy Coates, President-Elect for SAEM, gave the keynote address. Awards were given to winners in 3 categories: Faculty/Fellow, Resident, and Student.
NUTRIENT`S POCKET GAMES THE EFFECTIVENESS OF INTERACTIVE MEDIA IN UNDERSTANDING CHILD NUTRITION IN KEDUNGPEDARINGAN II KEPANJEN ELEMENTARY SCHOOL STUDENTS
Authors: Halizah Amilatun Nur , Soesanto Muhammad Ravi Maulana , Risky Aulia Dwi Nur 
Published: January 2024

Child nutrition is important for children's physical and cognitive development. However,
many children do not have a good understanding of child nutrition. Interactive media has the potential
to be an effective tool to teach children about child nutrition. This study aims to determine the
effectiveness of interactive media (Game Saku Gizi) in improving students' understanding of child
nutrition. This study used a pre-experimental research design with a one-group pretest-posttest design.
The participants of this study were a group of grade 1 to grade 5 elementary school students at SDN
Kedungpedaringan II Kepanjen, Indonesia. The results showed that there was a significant difference
in students' understanding of child nutrition between the pretest and posttest. This means that the useof interactive media (Game Saku Gizi) can improve students' understanding of child nutrition. Thefindings of this study have important implications for the use of interactive media in education.Interactive media can be used to develop educational games and simulations that can help students to learn about various topics, including child nutrition. However, it is important to note that interactivemedia is not a magic bullet. It is important to use interactive media along with other teaching methods,such as lectures and discussions. In addition, it is also important to choose interactive media that isappropriate for the age and learning level of the students. Based on the results of the study, it can beconcluded that the Nutritional Pocket Game can improve the nutritional knowledge of students of
Strategi Keluarga Kristen dalam Membangun Anak Yang Berprestasi di Sekolah
Authors: Malau Indah Margaretha , Desika Sihombing  , Ganda Marito  , Ronald Sianipar  
Published: January 2024

Keluarga merupakan unit terpenting dalam struktur kemasyarakatan. Keluarga memegang peranan pembinaan pendidikan anak-anak dalam keluarga. Banyak para ahli yang memberikan predikat bahwa keluarga merupakan tempat yang pertama dan utama dalam memperoleh pendidikan. Orang tua memiliki peranan penting dalam meningkatkan perkembangan dan prestasi belajar anak. Tanpa dorongan dan rangsangan orang tua, maka perkembangan prestasi belajar anak akan mengalami hambatan. Oleh sebab itu, tujuan dari penelitian ini adalah untuk memberikan gambaran kepada keluarga Kristen untuk menolong bagaimana strategi dalam memmbangun anak yang berprestasi, khususnya di sekolah. Penelitian ini menggunakan metode penelitian kualitatif deskriptif dengan pendekatan pustaka. Hasil yang diperoleh, antara lain: Pertama, orang tua harus dapat menjadi seorang pembimbing bagi anak. Kedua, orang tua perlu memberikan fasilitas belajar yang memadai di dalam keluarga. Ketiga, orang tua perlu memberikan motivasi belajar kepada setiap anak-anaknya. Keempat, orang tua harus terus menerus pendukung utama anak dalam mencapai prestasi. Kelima, orang tua harus dalam mengetahui kelebihan dan kekurangan anak-anaknya dan membantu mereka dalam mengatasi setiap kekurangannya dan mendukung kelebihannya agar dapat lebih ditingkatkan. Keenam, Orang tua harus dapat menjadi mentor yang baik bagi setiap anak-anaknya.
Effect of dynamic taping on neck pain, disability, and quality of life in patients with chronic non-specific neck pain: a randomized sham-control trial
Authors: Sidiq Mohammad , Chahal Aksh , Janakiraman Balamurugan , Kashoo Faizan , Kumar Kedia Sharad , Kashyap Neha , Hirendra Rai Richa , Vyas Neha , Veeragoudhaman T.S. , Vajrala Krishna Reddy , Yadav Megha , Zafar Shahiduz , Jena Sanghamitra , Sharma Monika , Baranwal Shashank , Alghadier Mshari , Alhusayni Abdullah , Alzahrani Abdullah , Selvan Natarajan Vijay 
Published: January 2024

Background
In 2020, 203 million people experienced neck pain, with a higher prevalence in women. By 2050, it is predicted that neck pain will affect 269 million people, representing a 32.5% increase. Physical rehabilitation is often employed for the treatment of chronic non-specific neck pain (CNSNP) and the associated functional loss. Taping is frequently used as an adjunct treatment alongside primary physical rehabilitation. Unlike kinesio tape (KT), the therapeutic benefits of dynamic tape (DT) have not been thoroughly explored and documented in non-athletic conditions. Therefore, the aim of this trial was to determine the effects of DT on pain, disability, and overall well-being in individuals experiencing CNSNP.

Methods
A prospective parallel-group active controlled trial was conducted at a single center, involving 136 patients with CNSNP, randomly allocated in a 1:1 ratio. The sham taping group (STC) received standard physiotherapy care (n = 67) alongside DT without tension, while the dynamic taping group (DTC) (n = 69) underwent standard cervical offloading technique with appropriate tension in addition to standard physiotherapy care. Demographic information and three patient-reported outcome measures (PROMs), namely the Neck Disability Index (NDI), Visual Analogue Scale (VAS), and the World Health Organization—Five Well-Being Index (WHO-5), were collected for each participant at three time points (baseline, four weeks post-taping, and four weeks follow-up).

Results
At baseline, no significant differences were observed between the STC and DTC for any outcome measure. Notably, all three PROMs exhibited a significant improvement from baseline to four weeks post-intervention, with moderate to small effect sizes (NDI ηp2 = 0.21, VAS ηp2 = 0.23, and WHO-55 ηp2 = 0.05). The WHO-5 scores for both groups demonstrated improvement from baseline through follow-up (p < 0.001). The NDI and VAS scores ameliorated from baseline to the four weeks post-taping period, with marginal improvements observed during the four weeks follow-up.

Conclusion
The incorporation of DT as an adjunct to standard physiotherapy care yielded enhancements in pain levels, functional disability, and well-being among patients with CNSNP when compared to the sham group. However, the sustainability of these improvements beyond the taping period lacks statistical significance and warrants further validation.
Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia
Authors: Al-Refai Mohammad F. , Wakid Majed H. 
Published: January 2024

Background
Diversity in clinical signs and symptoms are associated with soil transmitted diseases (STD), which are spread to humans by intestinal worms and transmitted in a variety of ways. There is a need for the present study, which aimed to investigate the prevalence of intestinal parasites and to compare between the common detection techniques for soil-transmitted helminths (STHs) among newly arrived expatriate labors in Jeddah, Saudi Arabia.

Methods
A total of 188 stool samples were analyzed by macroscopic examination, and microscopic examination using direct iodine smear and the formal ether sedimentation technique. Trichrome and modified Kinyoun’s stains were used to confirm the morphology of any detected protozoa stages and oocyst of Cryptosporidium, respectively. A chromatographic immunoassay kit was used for Entamoeba histolytica, Giardia lamblia and Cryptosporidium. In addition, real-time PCR was employed only to identify various STHs.

Results
Out of 188, several types of parasites were detected in 35 samples (18.62%), of which some with multiple infections. Nine samples (4.79%) were positive for Entamoeba coli, seven samples (3.72%) for Trichuris trichiura, six samples (3.19%) for Necator americanus, four samples (2.13%) for Strongyloides stercoralis, four samples (2.13%) for Ascaris lumbricoides, four samples (2.13%) for E. histolytica, three samples (1.60%) for Blastocystis hominis and two samples (1.06%) for Ancylostoma duodenale. In comparison between laboratory techniques for STHs, real-time PCR was able to detect the DNA of 19 samples (10.1%) followed by Ritchie sedimentation technique (18, 9.6%), and direct smear (7, 3.7%) (p > 0.05).

Conclusion
The high rate of newly arrived foreign workers infected with intestinal parasites could lead to a risk to society. Continuous and regular surveys are needed to deal with the occurrence of intestinal parasitic infections including STHs. To improve the identification of these infections, we recommend a supporting infrastructure for the application of concentration methods and molecular assays.