bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal and fetal complications from COVID-19; a comparative analysis
Authors: Shamsher Saadia , Amin Said 
Published: February 2025

Background
The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations of pregnant ladies to an unprecedented global health crisis. The data from previous human coronavirus pandemics suggest that pregnant women and their fetuses are particularly susceptible, leading to poor outcomes. The objective of this study was to summarize the clinical manifestations and maternal and perinatal outcomes during pregnancy in pandemic COVID-19 and compare them with non-pandemic in 2019.
Material and Methods
A total of 2169 pregnant women in the third trimester of their pregnancies who delivered in our hospital from May 2020 to August 2020 were selected as observation group (during pandemic COVID-19), while 1812 pregnant ladies who gave birth from May 2019 to Aug 2019 as a control group (during non-pandemic). A comparative analysis of the two groups was performed with the chi-square test, and P-value was calculated for significance between the two groups.
Results
The difference in the overall rate of maternal complications and fetal outcome was not statistically significant. The maternal complications post-term pregnancy and preterm delivery (P<0.05) are significantly more in the observed group than in the control group.
Furthermore, we found that among fetal outcome birth asphyxia was significantly more in the observed group than the control group.
Conclusion:
In the COVID-19 pandemic and the antenatal care provision, this comparative analysis of maternal and fetal complications shows an excellent management plan despite robust applications of pandemic SOPS, as there is no significant difference in both groups.
MICRONUTRIENTS DEFICIENCY IN PROTEIN CALORIC MALNUTRITION (PCM)
Authors: Rahman Syed Kaleem , Waheed Asma , Zeb Rifaq , Afridi Mukhtar 
Published: February 2025

Objective: To know about micronutrients deficiency in Children with PCM compared to standard values.
Methods: This cross sectional study was conducted at department of pediatric Khyber Teaching Hospital Peshawar from January 2017 to December 2017.Total of 100 patients who were diagnosed as PCM using Z scoring were included in the study. Data was calculated by non probability sampling technique using predesigned questionnaire including questions of interest. The data was analyzed with SPSS 18. For continuous variables like Hb level, ferritin level mean and SD was calculated while for categorical variables frequency and percentage was calculated. For comparison of Hb and Ferritin level with standard value one sample T test was used.
Results: Out of total 100 study population 44 were male,56 females, 40 from urban while 60 from rural area. Age of the patients showed that children of age from 8 - 14 months have maximum number of micronutrient deficiency, after 20 months, it slightly decreased but by 30 months again the number of children increases. Though there is downfall at 35 months but raises again by 40 months of life. When different variables of our study population were compared with standard normal level we found a significant difference between Hb (Mean 8.118 ±2.4, p<0.001), ferritin (Mean 186.27 ±373, p 0.01),zinc(Mean 77.08 ±21.9, p<0.001 ), and calcium level(Mean 6.9 , p <0.001 ).
Conclusion: We found a significant difference between Hemoglobin, ferritin, zinc and calcium level of our study population and standard values.
Functional outcome of THA in terms of Haris Hip Score
Authors: Kamran Aamir , Ihsanullah  , Farmanullah  , Khan Haroon Ahmed , Israr Ahmed  
Published: February 2025

Objective: The aim of this study was to compare the preoperative and 01 year follow up visit functional outcome of THA in terms of Harris Hip Scoring.
Introduction: Total hip Arthroplasty is the most rewarding procedure in recent reconstructive orthopaedics. The favourable outcome of THA is its ability to alleviate pain caused by the end stage hip arthritis sustaining the mobility and stability of hip joint.
Methodology:This prospective study was carried out at the Orthopaedic and Spine Surgery department HMC from January 2020 to January 2021. A total 60 patients were included in the study and there preoperative and 01 year follow up harris hip score was calculated and compared.
Results: A total of 60 patients with male 29 and female 31 were included.The preoperative HHS ranged from 25 to 64 with mean 45.96% while the 01 year follow up visit HHS ranged from 67 to 92 with a mean 82.46% showing significance improvement in functional outcome.
Conclusion: Total Hip Arthroplasty is a safe and effective procedure that relieves pain and leads to improvement in quality of life in patients with end stage arthritis.
EFFICACY, SAFETY, PATIENT SATISFACTION, DISCONTINUATION, AND NEED FOR HYSTERECTOMY IN PATIENTS USING MIRENA LNG-IUS AS TREATMENT OF HMB
Authors: Habib Sadia , Shams Ghazala , Nazneen Zainab , Akhtar Rubina , Afridi Sanodia 
Published: February 2025

Objective: To study the efficacy, safety, patient satisfaction, discontinuation and need for hysterectomy in patients using Mirena LNG-IUS as treatment of HMB.
Material & Methods: This study was conducted at the department of Gynecology & Obstetrics, Ayub Teaching Hospital from January 2016 to August 2021. All women who opted for Mirena LNG IUS as treatment of heavy menstrual bleeding, or already using Mirena during the study period were included. Data was collected on a structured pro forma and patients were followed initially for one year and then for five years of use of Mirena or till expulsion or discontinuation of use. A total of 88 women with heavy menstrual bleeding who had been inserted MIRENA LNG-IUS were enrolled in the study.
Results: Overall 88.1% of Mirena users reported improvement in HMB. Of these, about 36.4% of study participants reported improved menstrual flow during next menstrual cycle, 52.4% had improved / normal menstrual flow within 6 months of Mirena LNG-IUS use, while 7% had their Mirena LNG-IUS removed early due to side effects and only 4.54% failed to respond to Mirena LNG-IUS. Reported common side effects included spotting (25%), Amenorrhea (6%), oligomenorrhea (42%), weight gain (14%), breast pain and heaviness (7%), mood changes not including depression (7%) and depression (7%).
Conclusion: Mirena LNG-IUS is an effective, cost-saving non-surgical treatment option for women with heavy menstrual bleeding and should be offered as a preferred treatment option to such women
RISK FACTORS AND REASONS OF CONVERSION FROM LAPAROSCOPIC TO OPEN HOLECYSTECTOMY
Authors: Alam Jamshed , Ahmad Nisar , Ullah Muhib , Siddique Abubakar 
Published: February 2025

Objective: To identify the frequency, associated risk factors and intraoperative reasons for conversion of Laparoscopic Cholecystectomy to open Cholecystectomy.
Study Design: Case series study.
Setting: General Surgery Department Hayatabad Medical Complex Peshawar.
Study duration: January 2021 to December 2021.
Material & Methods: The research comprised a total of 160 patients who were planned for laparoscopic cholecystectomy. ASA score, demographic information, Physical health status, Ultra sonogram Abdomen findings and the presence of pericholecystic fluid were all documented. Internal bleeding, visceral injury, equipment failure, and injury to the common bile duct were all reasons for converting from laparoscopic to open cholecystectomy.
Results: Total 160 patients undergoing either elective or emergency laparoscopic cholecystectomy were included in the study. Age ranged between 21-65 years with a mean age of 43 years ± 14.92 SD. Out of 160, 8(5%) patients required conversion from laparoscopic to open cholecystectomy, while 152(95%) surgeries performed successfully. The most common reason of conversion was dense inflammation in the calot’s triangle 3(1.9%), followed by Mirrizi syndrome 2(1.2%), 1(0.6%) patient had ambiguous anatomy and 2(1.2%) patients were converted due to hemorrhage.
Conclusion: The most common reasons for conversion to open cholecystectomy are dense inflammation and adhesions, followed by mirrizi syndrome and hemorrhage.
RELATIONSHIP BETWEEN BONE MINERAL DENSITY AND BODY MASS INDEX IN ASSOCIATION WITH AGE AND GENDER IN PATIENTS REFERRED FOR DUAL-ENERGY X-RAY ABSORPTIOMETRY
Authors: Rehman Khan Mahnoor , Samad Mehreen , Iqbal Raheel , Rehman Khan Mahrukh , Wahid Ghazala , Rehana Kanwal 
Published: February 2025

Objective: The objective of our study is to investigate the association between Body mass Index and Bone Mineral Density in association with age and gender.
Methods: A cross sectional observational study was conducted from January 2020 to 2022 at Radiology Department of Hayatabad Medical Complex on individuals referred for DEXA scan. Association was assessed between Bone Mineral Density and Body mass Index in both male, pre and post-menopausal female.
Results: Out of 270 individuals 28.1% were male and 71.9% were female. Mean age was 51+/- 17.05 SD. 39.4% of male had BMI in range of overweight and obese, as opposed to female (86.5%). Increased BMI and decreased BMD was observed in age range of 41-70 years (p <0.05). 26% of post-menopausal female showed osteoporosis as compared to pre-menopausal (20%) (p <0.05).
Conclusion: There is increased risk of osteoporosis with increasing age. Post-menopausal female with increased BMI had decreased BMD.
RENAL ACCESS, TRACT DILATATION AND OPERATIVE TIME ARE SHORTER IN PATIENTS UNDERGOING MINI PERCUTANEOUS NEPHROLITHOTOMY (MINI PCNL) UNDER ULTRASOUND GUIDANCE
Authors: Ullah Hazrat , Khan Nasir , Rafi Ahsan 
Published: February 2025

Introduction: Traditionally, fluoroscopy is used to successfully perform various steps of PCNL. Ultrasound has emerged as new imaging modality to overcome the problem of radiation exposure associated with fluoroscopy.
Objective: To compare the outcomes of mini PCNL using ultrasound and fluoroscopy for renal access and dilatation.
Results: This non radomised study involved 160 patients from 1st Jan, 2019 to 30th Aug, 2022. Half cases (80) were performed under ultrasound (UG- mini PCNL) and half cases (80) under fluoroscopy guidance (FG- mini PCNL). Preoperative parameters were same in both groups. The UG- mini PCNL group had higher success rate of first puncture (73.7% vs 53.7%, P = 0.01). The mean renal access time was shorter (3.2 ± 1.1 min vs 4.1 ± 1.0 min, P = < 0.005) in UG- mini PCNL group. Similarly, the tract dilatation time was shorter in UG- mini PCNL group (7.0 ± 1.2 min vs 8.0 ± 1.4 min, P = < 0.005). The operative time was shorter in UG-mini PCNL group (73.9 ± 7.3 min vs 85.8 ± 5.2 min, P = < 0.005). The mean drop in hemoglobin was lesser in UG- mini PCNL group (1.26 ± 0.4 vs 1.42 ± 0.4, P = 0.02). The stone clearance, hospital stay, complications and ancillary procedures were the same in both groups.
Conclusion: The duration of renal tract puncture, dilatation and operative time can be shortened by using ultrasound with effective stone clearance and without higher complication or bleeding rates for renal stones ? 20 mm.
ELEVATED ALANINE AMINOTRANSFERASE AS A SEVERITY INDICATOR IN DENGUE FEVER
Authors: Afridi Nazir Shah , Mian Mufarih Shah , Rukh Gul , Khan Imran , Mehmood Nasir 
Published: February 2025

Objective: The aim of this cross sectional and comparative study is to find out the frequency of elevated alanine aminotransferase in dengue fever and its association with the severity of illness.
Methodology: This study was performed in the medical unit of Hayatabad Medical Complex Peshawar from Sep to Nov 2021. Total 243 patients, 147 males and 96 females, were included in this study. Patients were consecutively collected from the wards and medical outpatients department, both who needed admission to the hospital and those who could be managed as outpatient. The age range of the patients was 15 to 69 years. The patients with compatible history and clinical examination were diagnosed on dengue antigen test the dengue NS1. After diagnosis, the patients were subjected to different other investigations like liver enzymes and functions, renal function and peripheral blood smear. Those patients who were with other co morbidities like congestive heart failure, chronic kidney and liver diseases or acute viral hepatitis, were excluded from the study. Persistent vomiting, plasma leak as evident by pleural effusion or ascites and any type of hemorrhage were taken as warning signs for severe dengue.
Results: This study included 243 patients with dengue NS1 positive dengue fever. Male patients were 147 (60.5%) while females were 96 (39.5%). The age range was 15 to 74 years (mean 38.6 & SD +_18.45). The frequency of elevated alanine aminotransferase of 80U/L or more was found to be 51.44% (n=125) while the frequencies of elevated alanine aminotransferase in different age and gender groups were not significantly different from each other’s values (Table 1).
Elevated alanine aminotransferase was found in 28% of the patients without severity signs, 73.4% of the patients with persistent vomiting, 63.4% of the patients with Plasma leak as evident by pleural effusion or ascites and 62.12% of the patients with hemorrhage (Table 2). Table 3 and figure-1 shows correlation of the elevated ALT with the three mentioned warning signs for severity of dengue fever.
Conclusion: Elevated alanine aminotransferase level is an important indicator for severity of dengue fever. Elevated alanine aminotransferase level of more than 300U/L has strong association with persistent vomiting, plasma leak and hemorrhage.
OUTCOME OF SUPRACHOROIDAL TRIAMCINOLONE INJECTION IN THE TREATMENT OF CHRONIC MACULAR EDEMA SECONDARY TO RETINAL VEIN OCCLUSIONS
Authors: Khan Muhammad Tariq , Ahmad Imran , Khalid Ahmed Usman 
Published: February 2025

Objective: To assess the safety and efficacy of supra-choroidal Triamcinolone injection in chronic and refractory Macular Edema secondary to Retinal Vein Occlusions
Design and methods: Non-randomized clinical trail
Subjects: Eleven patients (twelve eyes) with RVO
Methods: A prospective study designed as 8-weeks, single-centered, non-randomized. A total of 12 eyes of 11 patients included.Triamcinolone Acetonide 4mg in 0.1 ml was injected into the supra-choroidal space and follow-up obtained for 8 weeks. Injection was performed with a 30-guage needled syringe having a piece of 23-guage IV cannula part sleeved on the needle. The 0.1 ml of Triamcinolone was injected directly into the suprachoroidal space. Details of all patients on a proforma (including BCVA, IOP, CMT on OCT and any adverse effect) were recorded as Pre-injection (baseline), 2-weeks and 8-weeks post-injection.
Results: Out of 11 patients, 4 were male and 7 were females. One female patient had bilateral Branch Retinal Vein Occlusions (BRVOs). Out of other 10 patients, 6 were BRVOs and 4 were CRVOs. All the patients enrolled had chronic Macular edema of at least one year duration. Best Corrected Visual Acuity, OCT macula and IOP were recorded before injection, 2-weeks and 8-weeks post injection. Mean baseline (pre-injection) CMT was 578 microns (SD +/- 126 µ). aLL eyes were thoroughly examined for any side effect or complication.
Conclusion: A single suprachoroidal injection of Triamcinolone Acetonide is fairly safe and effective in significant percentage of cases of chronic and refractory Macular Edema secondary to Retinal Vein Occlusions (both central and branch).
INTERMITTENT FASTING IN NALFD: LIGHTENING AT THE END OF TUNNEL
Authors: Khan Jibran Umar Ayub , Zahir Shah Azhar , Qaisar Ayesha , Abdul Wahab  
Published: February 2025

Non Alcoholic Fatty Liver Disease has been the cornerstone of hepatology diseases for the last so many years. 1It’s an incidental finding on routine scans done for different symptoms such as epigastric pain, jaundice,deranged liver function tests, constipation and even weight loss.2The consequence of NALFD and NASH to full blown cirrhosis and even hepatocellular cancer has shaken experts across the world to a colossal extent and they are puzzled about what should be the best course of action for it as it seems a benign disease with mere fat infiltration in the liver. 3Obesity has been found as the major culprit for it beside others such as diabetes and hypertriglycermia being components of metabolic syndrome which has own share of complications. 4
There are a large no of treatments which have been under trial for NAFLD.One of the drugs which has been used traditionally as anti diabetic drug for decades and still as first line drug in hyperglyceremia. 5Its utility for inducing weight loss in obese people has been quite known but it has got own side effects including bothersome gastrointestinal side effects and even life threatening lactic acidosis with renal impairment .The other class of drugs called statins for lowering increased cholesterol levels but can lead to deranged liver function tests and myopathies.
One of the effective modalities that is research proven and has revolutionised the management of Non Alcoholic Fatty Liver Disease is intermittent fasting with excellent effect on liver function beside hugely beneficial for body mass index (BMI).6 Obesity that has been linked to insulin resistance that is cardinal in leading to metabolic syndrome and type 2 diabetes .The combination of intermittent fasting and exercise have dramatically transformed the prospect of NALFD patients with studies reporting it to be more effective than aerobic exercise alone and vice versa .6
Generative AI in the Information Society: Implications for Higher Education and Research
Authors: Levin Ilya , Bukhshtaber Natalia , Minyar-Beloruchev Konstantin 
Published: February 2025

<p dir="ltr"><span>Generative Artificial Intelligence (GenAI) represents a fundamental shift in AI development, moving from rule-based systems to neural networks capable of creating novel content and solving complex problems through pattern recognition and contextual understanding. This evolution challenges traditional Computer Science (CS) paradigms, as evidenced by innovations in large language models and diffusion-based image generation. This paper investigates how GenAI's emergence affects education and research in computer science and related fields. Through White's cultural model—examining technological, societal, and institutional dimensions—we analyse how GenAI's capabilities diverge from traditional CS approaches in both theory and practice. Our research reveals specific challenges for higher education, including the need to teach contextual reasoning, handle emergent behaviors, and develop adaptive problem-solving skills. We propose educational strategies such as project-based learning with GenAI tools and cross-disciplinary integration. These recommendations aim to establish GenAI as a distinct academic discipline while preparing students and researchers for its increasing role in scientific and professional practices.</span></p><div><span><br /></span></div>
Psychological and Neurological Tests are Required to Reduce the Risk of Injuries in Paragliding
Authors: Szabo Dan Alexandru , Ene-Voiculescu Virgil , Teodorescu Silvia , Larion Alin , Mocanu George Danut , Puni Alexandru Rares , Ilea Iamina-Camelia , Pârvu Carmen 
Published: February 2025

<p dir="ltr"><span>The study’s objective is to analyse and comprehend the types, frequency, and causes of paragliding pilot accidents to identify preventative and reducing measures in the future, such as a suitable physical training program designed explicitly for paragliding pilots. This study hypothesized that several factors, including the pilot’s experience level, weather conditions, terrain, equipment quality, attitude toward the sport, and adherence to safety regulations, may be related to the frequency of paragliding accidents. The study’s findings indicated a high accident rate since 66% of respondents had injuries while paragliding, and 67% had an occurrence that may have resulted in a pilot suffering severe injury. The analysis shows the frequent causes of accidents are primary piloting mistakes and poor decision-making as technological faults played a minor role. Equipment used for paragliding seldom malfunctions if it is routinely inspected and tested; the only exception is when it is subjected to abnormally high stresses while in flight. Oversteering of the wing or, on the other hand, inadequate reaction—specifically, inadequate pilot training in flap control and active piloting—were the leading causes of these mistakes. Poor judgments about weather and flying conditions or inadequate familiarity with the area landscape and characteristics caused some of these mistakes. In conclusion, we address the necessity to establish a standard for the ideal paraglider, conceiving psychological and neurological tests without reducing the access to this adrenaline rush sport, but increasing its safety.</span></p><div><span><br /></span></div>
Workshop Pembangunan Rumah Manarrang : Desain Konvergensi Pencegahan Stunting Berbasis Kebijakan Desa Cerdas
Authors: Heryati Yati , Suryati Tri Frida 
Published: February 2025

The Workshop on the Development of Rumah Manarrang as a Convergence Design for Stunting Prevention based on the Smart Village Policy from the Ministry of Village, Development of Disadvantaged Regions, and Transmigration (KEMENDES PDTT RI) aims to address stunting in Bonda Village through a holistic and integrated approach. The workshop has successfully achieved four key objectives. Firstly, conceptual integration combines stunting prevention, healthy housing development, and the Smart Village policy into a comprehensive solution. Secondly, empowerment of the local community occurs through active participation in identifying needs, program planning, and the construction of Manarrang Houses. Thirdly, interagency collaboration generates synergy among stakeholders, including village governments, non-governmental organizations, academia, and the private sector. Fourthly, enhancing participants' knowledge and capacity, including village officials and local communities, represents a long-term investment in the welfare and health of the community. Thus, this workshop provides a solid foundation for addressing stunting and implementing Smart Village policies in Bonda Village.
Слобода као мотив у дубровачким ренесансним и барокним драмама
Authors: Raca Jelena 
Published: February 2025

Појам слободе представља једну од доминантних појава која је обиљежила стари Дубровник. Њен значај се одразио и на књижевност. Наиме, већ у самим почецима ренесансне књижевности, са првим појавама драме, осјетан је утицај и видљиво прожимање идеја слободе. Супротстављањем Дубровника другим подручјима окупираним туђом влашћу, слобода је још више добијала на значају. Преко пасторала, а онда и чувених Палмотићевих мелодрама, „либертас“ је много заступљен. Тако се уочавају стихови проткани директном апотеозом и глорификовањем независности, уз изношење и родољубивих осјећања. Упоређујући ове двије књижевне епохе, занимљиво је пратити како се обликује, доживљава и слави независност, нарочито кроз мјешавину различитих драмских врста. Самим тим, основни циљ овог рада односи се на што боље доказивање и освјетљавање слободе, која је у суштини на прави начин представљала и цјелокупну Дубровачку републику.