bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accessibility and Health Facility Factors Influencing Maternal and Fetal Outcomes among Mothers Referred with Obstetric Emergencies in Baringo County Referral Hospital, Kabarnet, Kenya
Authors: Kandie Phylis 
Published: December 2022

Purpose: To determine the accessibility to a health facility and health facility factors influencing maternal and fetal outcomes among mothers referred with obstetric emergencies in Baringo County referral Hospital.
Methodology: A descriptive cross-sectional study which employed a mixed method approach of data collection was adopted. Simple Random technique was used in selecting 284 respondents into the study. The study population also included nurses, gynaecologist and medical officers who were purposively sampled. Qualitative data collection was analysed through content analysis while descriptive and inferential statistics were used to analysed quantitative data.
Findings: results show that mothers who are accompanied by nurse are 4.3 times more likely to have complications than those accompanied by relatives (AOR:4.3;95% CI:1.2-16.1;p=0.03). Moreover, mothers who were coming from distant health facilities were 70% less likely to have experience complications than those who live closer to the referral hospital (AOR: 0.3; 95%CI: 0.1-1.1; p=0.07). Neonates whose mothers received treatment within 30 min (OR: 0.5; 95% CI: 0.3 – 0.8; p = 0.005) were 50% less likely to have had abnormal outcome. In contrast, the risk of abnormal outcome was higher for neonates whose mothers received treatment before referral (OR: 2.3; 95% CI: 1.4 – 3.8; p = 0. 001) suggesting possible delay in providing treatment as a possible cause of deteriorating condition of the foetus. Mothers who stated that nurses listened and explained things (3.9%) or those seen within less than 30 minutes to be attended to (p = 0.3) experienced complications. On the other hand, the odds of complications increased where the main reason for referral was lack of expertise and equipments at the referring health facility (p = 0.09) though the result was not statistically significant.
Unique Contribution to Theory, Practice and Policy: This study has identified accessibility and health facility factors influencing the obstetric emergencies in a marginalized county. The study will provide insight to policy maker’s hence evident-based interventions will be made. No literature review has been published on this topic at the study site therefore, this study will form a basis for other researchers.
Портал гипертензия сабабли ошқозон ва қизилўнгач варикоз кенгайган веналаридан қон кетишини болаларда даволаш усуллари
Authors: Абдувалиева Чулпаной , Халилов Шукрулло 
Published: December 2022

Болаларда портал гипертензия синдроми ва қизилўнгач-меъда қон кетиши учун малакали тиббий ёрдам кўрсатишнинг самарадорлиги ўз вақтида ташҳис қўйиш, зарур ҳолларда уни вақтида якунлаш, қон кетишини тўхтатиш ва тегишли жарроҳлик даволаш усулларига боғлиқ. Aммо қон кетишининг дастлабки белгилари пайдо бўлган кундан 1-2 кун ўтгач касалхонага ётқизилганида натижа асосан қон кетишини тўхтатиш учун ишлатиладиган усуллар, жигар ва кўп аъзолар етишмовчилигининг патогенетик мослиги билан белгиланади. Қизилўнгачнинг ва ошқозоннинг томирларидан портал гипертензия ва қон кетиш синдромини даволаш: дори терапияси, Блэкморе зондини ўрнатиш, эндоскопик лигатуралаш ва склеротерапия, зарурат туғилганда жарроҳлик даволаш каби терапевтик ва профилактика чораларини ўз ичига олади. Ўз вақтида ташҳис қўйиш касалликни компенсацияланган ва компенсацияланмаган босқичда аниқлашга имкон беради, бу даволанишни сезиларли даражада осонлаштиради ва ўлим хавфини камайтиради.
Interpreting living urban-industrial heritage: The Jewellery Quarter, Birmingham
Authors: Rifaioğlu Mert Nezih 
Published: December 2022

In light of the studies related to the theory of interpretation of cultural heritage sites, the holistic interpretation approach of heritage areas has developed, and a new interpretation culture has emerged. It includes new approaches, local and regional interpretation strategies, new policies and comprehensive analysis and evaluations. The new interpretation culture is important not only to produce interpretation themes, but also to the transfer and sustainability of the values of heritage sites that need to be preserved to the society. In this context, studies are being brought up in order to find the most appropriate ways to understand and transfer living urban heritage sites; tangible and intangible values, existing or non-existent urban structures, ongoing or non-existent social and cultural practices, used or ongoing structures and all cultural and historical layers of areas. Beyond the current interpretation studies carried out for the heritage sites, it is important to develop interpretation strategies including the historical importance of the areas for living urban heritage sites and therefore complex cultural heritage areas, the connections to the places, cultural and social relations networks, urban memory, and the spirit of the place. For this purpose, the study focuses primarily on the critical viewpoint of theoretical content of the interpretation of cultural heritage sites. In the light of theoretical and practical knowledge, the research then concentrates on key themes and discussions on heritage interpretation in the UK. Accordingly, the research discusses the interpretation strategies in the Jewellery Quarter, Birmingham which is the one of the most influential areas by means of historical urban-industrial heritage site.
Correlation of ECG changes at high altitude with findings on Coronary Angiogram.
Authors: Saif Mohsin , Rahman Fahd Ur , Liaqat Jahanzeb , Sajid Usman , Saeed Farrukh , Khan Aleena , Khan Muhammad Nadir , Samore Naseer Ahmed , Siddique Muhammad Bilal , Arshad Junaid 
Published: December 2022

Objective: To highlight association of coronary artery disease on angiograms and high altitude-related ECG abnormalities that is thought to be ischemic in origin.
Place and Duration of Study: This was a cross sectional study done in Armed Force Institute of Cardiology/National Institute of Heart Disease from Oct 2016 to Oct 2021.
Methodology: This was a cross sectional study done in AFIC/NIHD from Oct 2016–Oct 2021 (5years). A total of 103 patients at a range of 9000 to 22000 feet in altitude, with new ECG changes were selected via consecutive sampling. Data was analyzed by SPSS version-23. Descriptive statistics were run to present categorical data in frequencies and percentages. Chi-square and Fisher Exact Test was applied to find the association between study variables at 95% CI and 5% margin of error (α= 5%).
Results: The data was collected from a total of 103 respondents, mean age (years) of the respondents was 30.57±6.27, and mean duration of stay (days) at high altitude was 64.8±68.3 (Table-I). ECG changes that were recorded were: T-wave inversion in anterior leads (V1, V2, V3) were reported in n=33(32%), T- wave inversion in Inferior leads (II, III, aVF) in 21(20.3%), T-wave inversion in lateral leads (V3-V6) 10(9.7%). Normal Ejection fraction was observed in 97% of the study participants while only 3% had mild left ventricular systolic impairment. Angiographic findings were found to be normal in n=92 (89.30%), minor coronary artery disease (CAD) in n=9 (8.70%), muscle bridge in LAD in n=2 (1.90%). Our results also showed that amongst other final diagnosis, of note were vasovagal syncope (n=5; 4.8%), pulmonary embolism (n=5; 4.8%) and pulmonary arterial hypertension (n=3; 2.9%).
Conclusion: Our work leads us to the conclusion that ECG abnormalities at high altitude do not indicate coronary artery disease since they do not reflect a delay in electrical conduction or ischemia. These patients should be treated separately based on their high altitude disease symptoms (HAI).
A Case of Extensive Myocardial Calcification
Authors: Yusuf Rizwan , Balqees Nayab , Hussain Sajjad 
Published: December 2022

Aortic valve and mitral annular calcification are commonly seen in elderly patients with chronic kidney disease and/ or altered calcium hemostasis. Extensive myocardial calcification is rare. We present a case of an elderly female who presented with sepsis and heart failure on a clinical background of chronic kidney disease and showed extensive myocardial calcification on multi-modality imaging, leading to severe impairment in systolic and diastolic function with restrictive physiology.
Conclusion: Myocardial calcification is an under diagnosed entity that leads to considerable morbidity and mortality. Modern imaging methods allow a prompt diagnosis but a high index of suspicion has to be maintained for accurate detection of medical condition.
Comparision of Myocardial Viability Assessment Between Cardiac Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in Patients with Coronary Artery Disease
Authors: Ahmed Iftikhar , Nadeem Asif , Saif Mohsin , Saeed Nazish , Ali Jahanzab , Anwar Maida , Fayyaz Muhammad , Mustafa Attiya 
Published: December 2022

Objective: To assess the myocardial viability on cardiac magnetic resonance imaging compared with single photon emission computed tomography scan in patients with coronary artery disease.
Study Design: This study was cross sectional study.
Place and Duration of Study: Cardiac Magnetic Resonance Imaging and Nuclear Medicine Departments of a Tertiary Cardiac Care Center of Rawalpindi Pakistan, from Dec 2021 to May 2022.
Methodology: This study was cross sectional study conducted from December 2021 to May 2022 at Cardiac Magnetic resonance imaging and Nuclear Medicine departments of a Tertiary Cardiac Care Center of Rawalpindi Pakistan. Thirty patients (n=30) with coronary artery disease were selected using non-probability consecutive sampling technique to determine the viable myocardium using cardiac magnetic resonance imaging (CMR) and single photon emission computed tomography (SPECT) scan. Patients with left ventricular dysfunction having ejection fraction equal to or less than forty-five percent and coronary artery disease were included.
Results: Using 20 segment models, the mean number of viable segments in SPECT scan and CMR were 16.6±3.18 and 15.47±3.84, respectively while the non-viable segments were 3.4±3.1 and 5.17±4.6, respectively. There was statically little difference in results of Single-photon Emission Computerized Tomography and Cardiac Magnetic Resonance Imaging to determine viable myocardium (p<0.05).
Conclusion: Assessment of myocardial viability has keen role in diagnostic and prognostic work up of coronary artery disease patients who are candidates of revascularization. Stunned and hibernating myocardium are two states oreversible myocardial dysfunction.....
Diastolic Dysfunction in Asymptomatic Type 2 Diabetic Patients Having Preserved Systolic Function
Authors: Baloch Mir Waqas , Zameer Imran , Khan Kashif , Majeed Zoha , Asad Muhammad , Asad Muhammad , Abbass Khurrum , Sana Ayesha 
Published: December 2022

Objective: To determine frequency of diastolic dysfunction in asymptomatic type 2 diabetic patients by employing twodimensional (2D) echocardiography as a measurement method.
Study Design: It was an Analytical Cross sectional study.
Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi Pakistan, from Jul 2021 to Nov 2021
Methodology: Patients, already diagnosed as diabetics for more than 5 years and on dietary control or on medications,presenting to the outpatient department of the hospital were enrolled. They were subjected to a 2D echocardiography in left lateral position. We excluded patients with valvular heart disease, ischemia, congestive heart failure, cardiomyopathy of any aetiology, renal failure, pulmonary illness, anemia, hemoglobinopathies, prior myocardial infarctions in any region, smokers,and hypertension. Diastolic dysfunction was evaluated as per the guidelines of American society of Echocardiography.
Results: Overall (n=150) patients were calculated with reference to 11% prevalence of LVDD by sample size calculator, being the part of study who were fulfilling the inclusion criteria. There were 102(68.0%) male and 48(32.0%) female patients; mean age was 45.02±6.07 years. Mean duration of diabetes mellitus in years was 6.93±2.53 with ranges from 5 to 16 years. Patients on oral hypoglycemic were 121(80.7%), on insulin were 5(3.3%), on dietary control were 12(8%) and on mixed treatment were 12(8%). There were 58 (38.7%) patients who had diastolic dysfunction present on echocardiogram. Effect modifiers of durationof diabetes (p=0.2) did not show significant association; however, Age (p=0.001) and Gender (p=0.038) significantly associated with Diastolic Dysfunction.
Conclusions: One of the simple and noninvasive approaches to diagnose diastolic dysfunction is doing 2D echocardiography which can identify large percentage of diabetic subjects having pre-clinical diastolic dysfunction. Thus, by on time detection we can initiate treatment and retard the progression of diastolic dysfunction.
Five Year Experience of Mitral Valve Repair Surgery at Armed Force Institute of Cardiology
Authors: Ali Nasir , Masroor Rehan , Iqbal Muhammad Afsheen , Hasan Kirmani Syed Muzaffar , Khurshid Hannah , Akram Muhammad Adnan 
Published: December 2022

Objective: Experience of the conventional and a de novo Mitral repair techniques for the treatment of Severe Mitral Regurgitation (MR) in a Tertiary Care Cardiac Hospital of Pakistan.
Study Design: Descriptive cross sectional
Place and Duration of Study: Cardiac Surgical Division, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan
Methodology: This was a cross sectional study conducted over a period of 5 years from 2016 to 2020, which included SeventyFive (n=75) patients in the trial, 55 females and 20 males. The mean age was 23±9.5 years (range from 16 to 52 years). Amongst all cases of mitral regurgitation (MR) were five (6%) myxomatous degenerative changes, three (4%) ischemic MR & Sixtyseven (91%) patients had rheumatic aetiology. Five (05) patients with myxomatous diseases required only ring annuloplasty. In patients with ischemic MR, two required chordal shortening for anterior leaflet resuspension, and one required quadrangular resection of the posterior leaflet. Restrictive annuloplasty±Coronary Artery Bypass Grafting (CABG) was alsoperformed as part of the procedures. Sixty-seven (91%) patients having severe Mitral Regurgitation with rheumatic aetiology, required a myriad of procedures; including neo-chordae suspension for anterior & posterior mitral leaflets, quadrangular resection & reattachment of the posterior mitral leaflet. A novel innovative procedure, “Posterior annulus-sliding-plasty” (Nasir’s Technique) was adopted in patients with relatively fixed posterior mitral leaflet. Semi-rigid rings (Carbomedics® or Medtronic CG future®) were used in all the patients to stabilize our repair.
Results: There was no operative mortality. Patients were followed up for 01-year. Most of the patients have been found to have adequate intact Mitral Valve Repair. Only 01 patient developed Grade-II MR after 06 months (ischemic aetiology). This patient is being followed up at 06 monthly intervals with transthoracic echo and is being treated as per guideline-directed medical therapy (GMDT) for functional MR.
Conclusion: Mitral Valve Repair in the carefully selected subset of patients with severe MR, irrespective of aetiology can effectively be treated with satisfactory short-term and medium-term results.
The Effect of Body Mass Index on Bleeding After on Pump Coronary Artery Bypass Grafting
Authors: Siddiqeh Musfireh , Khan Imran , Fayyaz Fakher-e- , Dawood Muhammad Awais , Hasan Kirmani Syed Muzaffar , Khurshid Hannah , Javaid Rehana 
Published: December 2022

Objective: To study the relationship of body mass index (BMI) and postoperative bleeding in patients undergoing isolated coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB).
Study Design: Analytical cross sectional study
Place and Duration of Study: Cardiothoracic services, Almana General Hospital, Al Khobar, Saudi Arabia, from Oct 2019 to Oct 2021.
Methodology: Two hundred and twenty (220) consecutive patients who underwent CABG using cardiopulmonary bypass were included in the study. Patients who had additional procedures, those who were operated in emergency and those with significant comorbidities like hepatic and liver dysfunction were excluded from the final analysis. Patients were divided into three groups according to their BMI, healthy weight (BMI 18.5 to <25), overweight (BMI 25 to <30) and obese (BMI >30). The world health organization (WHO) definition was used to define different categories of BMI. Various perioperative variables were recorded for all the patients. Only the immediate postoperative follow up period was included in the study. Data was analyzed using IBM SPSS-statistics 23.0 (IBM, SPSS Inc., Chicago, IL).
Results: Of the 220 patients included in the study, 184(83%) were male patients and 36(16%) female patients. There was no significant difference in the mean age of the patients in the three groups (p=0.481). There were significantly more hypertensive patients 46(45%) in the overweight group compared to other two groups (p=0.025). Baseline diabetic status was not significantly different among the three categories (p=0.978). Total mediastinal drainage in the first 24 hours was significantly less in the obese group (3.7±4.45 ml) compared to overweight (4.4±2.7 ml) and healthy weight (7.35±8.5 ml) patients (p=0.001). There was no mortality in the studied cohort.
Conclusion: Bleeding after isolated coronary artery bypass grafting is inversely related to BMI. Patients with healthy and overweight BMI are at higher risk of bleeding compared to obese patients.
Transcatheter Closure of Cardiac Defects with Lifetech™ Konar-MultifunctionalOccluder Experience in a Tertiary Care Center
Authors: Ara Andaleeb , Akhtar Khurram , Mahmood Amjad , Sadiq Nadeem , Rafique Saima , Imtiaz Sana , Ahmed Tufail , Akbar Hajira , Farhan Mohammad Asad 
Published: December 2022

Objective: To assess the immediate and short-term efficacy and safety of transcatheter closure of cardiac defects with Lifetech™ Konar-MFO in a Tertiary Cardiac Care Center.
Study Design: Descriptive cross-sectional study.
Setting and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Mar 2019 to Dec 2021
Methodology: Patients of all ages and both gender undergone transcatheter closure of a cardiac defect with Konar-MFO from Jan 2021 to Dec 2021 were included in the study through non-probability consecutive sampling and approval by the institutional ethical review committee was taken prior to data collection. Data of patients undergone transcatheter closure with Konar-MFO from Mar 2019 to Dec 2020 was extracted retrospectively to assess the immediate and short-term efficacy and safety of the occluder. SPSS version-23 was used for data entry and analysis.
Results: A total of 138 patients had transcatheter closure of a cardiac defect with Lifetech™ Konar-MFO during the study period. Case of VSD were 124(89.9%), PDA 9(6.5%), post-operative cases were 4(2.9%) along with 1(0.7%) case of coronary artery fistula (CAF) to the right ventricle. Out of 138 patients, 73(52.9%) were females while 65(47.1%) were males. The mean age was 9.3 ±8.1 years with a range of 6 months to 36 years. Mean fluoroscopy time was 13.68±9.74 min. The procedure was successful in 137(99.27%) cases. The device embolized in 2(1.45%) cases.
Conclusion: In selected cases of VSD, PDA and in some post-operative cases the occlusion with Lifetech™ Konar-MFO is safe and efficacious with the added benefits of softness and versatility of the approach.
PERILAKU PROSOSIAL REMAJA PADA SISWA SMA ATAU SEDERAJAT YANG MENGIKUTI KEGIATAN EKSTRAKURIKULER
Authors: Arifah Siti Fatonatul , Haryanto Handrix Chris 
Published: December 2022

This research aims to describe about Adolescents’s Prosocial Behavior on High School Students Whose joining Extracuricular Activities. Respondent of this research were High School Students Whose joining Extracuricular Activities. The number of respondents in this research were 210 respondents. Convenience sampling technique is used to sample the population. The measuring instrument in this research was Revise Prosocial Tendencies Measure (R-PTM) from Carlo and Randall (2002). There was 22 items in the questionnaire, and there was open question about respondents perceived benefit of Extracuricular Activities. The results showed that the majority of Prosocial Behavior in low categories. Extracuricular that was having the highest mean was pramuka. The most perceived benefit was training cooperation.
Et si le loup entrait dans la bergerie
Authors: Rosenthal Olivia 
Published: December 2022

Ce texte a été écrit lors d’une résidence qui s’est déroulée à Bonneval-sur-Arc en juillet 2020 à l’initiative de l’Espace Malraux scène nationale Chambéry Savoie et de sa directrice, Marie-Pia Bureau. Pendant quinze jours, Olivia Rosenthal a suivi le travail des éleveur·ses et des bergers·ères qui vont faire pâturer leurs bêtes sur les alpages. Le texte, dont aucune publication n’était prévue dans le cadre de la commande, a fait l’objet d’une lecture à Bonneval-sur-Arc, le 29 août 2020, lors du festival « Andiamo ! ».
Alisa van de Haar et Annelies Schulte Nordholt (dir.), Figurations animalières à travers les textes et l’image en Europe. Du Moyen Âge à nos jours. Essais en hommage à Paul J. Smith, Leiden / Boston, Brill, coll. « Faux Titre », 2021.
Authors: Pouillard Violette 
Published: December 2022

Compte rendu de Alisa van de Haaret Annelies Schulte Nordholt (dir.), Figurations animalières à travers les textes et l’image en Europe. Du Moyen Âge à nos jours. Essais en hommage à Paul J. Smith, Leyde / Boston, Brill, coll. « Faux Titre », 2021.