bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of an education session by pharmacists for patients with asthma: A randomised controlled trial
Authors: Zairina Elida , Nugraheni Gesnita , Achmad Gusti NV , Sulistyarini Arie , Nita Yunita , Faisal Shah , Bakhtiar Arief , Amin Muhammad 
Published: December 2022

Background: Asthma education interventions are provided by pharmacists in many developed countries, although it is still a matter of concern in developing countries. This study aimed to evaluate the effectiveness of pharmacist education sessions on asthma patients.
Methods: A three-month single-blinded randomised control trial was conducted to evaluate the impact of pharmacist education sessions on asthma patients. The 60-minute pharmacist sessions provided education to patients about asthma management. The primary outcome of the study was to measure the change in the score of the asthma control questionnaire (ACQ).
Results: The 82 participants who completed the study were grouped into two groups. A clinically significant improvement of p>0.5 in the ACQ score was found in the symptoms and environment domains in the intervention group. A significant difference in the ACQ score was also found between the two groups (p=<0.05) after 1 and 2 months of intervention. The proportion of patients with controlled asthma increased from 26 (63.4%) to 31 (75.6%) after the second follow-up in the intervention group. Furthermore, a significant increase (p=0.043) in the AQLQ score was noticed from 4.834 at baseline to 5.433 after the intervention.
Conclusion: This study concluded that short-time pharmacist education sessions could improve patients asthma status and quality of life.
A IMPUNIDADE DOS FEMINICÍDIOS NO MÉXICO E NA ARGENTINA
Authors: Santana Juliana dos Santos 
Published: December 2022

Este artigo tem como meta comparar a representação dos feminicídios no romance 2666 (2004), de Roberto Bolaño, que retrata diversos crimes impunes praticados contra mulheres em Ciudad Juárez, no México, e em Chicas muertas (2014), de Selva Almada, que resgata investigações sobre execuções de mulheres nas quais não houve a punição dos culpados no interior da Argentina. Metodologicamente, adotamos uma abordagem de análise a partir das teóricas feministas latino-americanas, valendo-nos de conceitos como “feminicídio”, de Marcela Lagarde (2004, 2006, 2008), “violência sistêmica”, de Rita Segato (2013), “colonialidade de gênero”, apontado por Maria Lugones (2008, 2014), e “tipologias do feminicídio”, de Julia Fragoso (2010). Como resultado, destacamos a possibilidade de que, ao atravessar as fronteiras literárias, Bolaño e Almada nos proporcionam uma representação da impunidade do feminicídio que desnuda a perversidade misógina desse crime.
AS ESCREVIVÊNCIAS EM MARYSE CONDÉ e JEFFERSON DE E O PACTO DA BRANQUITUDE NA DIÁSPORA NEGRA
Authors: Souza Alessandra Corrêa de 
Published: December 2022

Este texto é fruto das partilhas do grupo de pesquisa Escrevivências de Mulheres Negras em Diáspora e de práticas cotidianas (des)coloniais. O tema inicial é problematizar as mortes físicas e simbólicas das personagens do romance: Eu, Tituba: bruxa negra de Salem de Maryse Condé e do filme: M-8 Quando a Morte Salva a Vida de Jefferson De. Resgatar as escrevivências de Conceição Evaristo (2009) a partir do prisma das mulheres não brancas e de como essas estratégias são utilizadas como instrumentos de resistência na diáspora negra. Para além da literatura e o cinema, articula-se o pacto da branquitude alcunhado por Cida Bento (2022) para tensionar os acordos “silenciosos” entre os meios de comunicação e a segurança pública como dispositivos de manutenção de poder a partir do imagético individual e coletivo construído por membros da sociedade brasileira que possuem privilégios simbólicos e materiais. Para o estado da arte, estabeleceu-se os diálogos com o(a)s teórico(a)s: Conceição Evaristo (2009), Cida Bento (2022), Silvio Almeida (2018), Achille Mbembe [2011(2006)] e outros como estratégias metodológicas de fissura a essa narrativa eurocêntrica que vem sendo imposta como única “verdade” no imaginário social da sociedade brasileira.
Pakta Keamanan Trilateral Aliansi Amerika Serikat, Australia, dan Inggris (AUKUS) Dalam Perspektif Neorealisme
Authors: Mujahadah Khoiriyah Nur , Aidini Nur 
Published: December 2022

Tulisan ini dibuat untuk mendiskusikan terbentuknya pakta keamanan aliansi Amerika Serikat, Inggris dan Australia (AUKUS) sebagai manuver terbaru untuk memperkuat hegemoni Laut Tiongkok Selatan. Terdapat dampak positif dan negatif dari Australia sebagai negara yang direncanakan akan menerima bantuan armada kapal selam bertenaga nuklir selama beberapa dekade mendatang. Topik ini menjadi penting karena AUKUS dinilai membahayakan perdamaian dan keamanan kekuasaan dengan penggunaan senjata nuklir, meskipun dengan kesepakatan ini menjadi langkah untuk menghentikan Cina berkonfrontasi atau melakukan pelanggaran perbatasan di beberapa negara di kawasan. Metode penelitian dalam tulisan ini menggunakan pendekatan kualitatif dengan memperoleh berbagai literatur yang berkaitan dengan kebijakan pertahanan dan keamanan dan teori neorealisme. Tulisan ini turut mengkorelasikan topik AUKUS dengan konsep high politics. Dalam tulisan ini juga dipaparkan bagaimana dampak AUKUS dan sikap Indonesia dalam menghadapinya.
A Small Place: Education in Rural Tasmania
Authors: Corbett Michael , Roberts Philip 
Published: December 2022

The field of rural education has consistently demonstrated that spatial disadvantage has material dimensions related to distance from urban nerve centres that contain services. In turn, distance from urban services entwines with multiple dimensions of social privilege and disadvantage to create specific, more or less place-based, rural, regional and remote cultural geographies. This is a problem that has historically been addressed in a number of ways, including distance-mitigation incentives to a range of system actors such as teachers, principals, students, and parents.Â In Tasmania, an island state to the south of the mainland Australian continent, the idea that young people have a right to a reasonably accessible, nationally and internationally normative education in their own communities, has only relatively recently been accepted.Â There is now a persistent, indeed insistent, multi-sectoral call for cultural change in Tasmanian regarding access to education.Â At this writing the state government has committed to extending all high schools which are defined as years 7-10 facilities, to offer years 11 and 12 programming by 2022 (Street, 2017).Â Some of this discourse responds to the positioning of Tasmania itself as a â€˜wicked problemâ€™ (West, 2013; Cranston et al, 2014).Â Notably, this discourse related to rural Tasmania echoes similar thinking about social and economic development in advanced capitalist societies around the world.Â
Education From The Periphery: Intersectionality And Rural Uyghur Students In Higher Education In China
Authors: Clothey Rebecca , Otkur Arafat , Morrison JeanÃ¡ 
Published: December 2022

This paper examines how rural origin combines with ethnicity as a factor in higher education access among one ethnic group, the Uyghur, a Muslim minority who mostly reside in Chinaâ€™s northwestern Xinjiang Uyghur Autonomous Region. As one of Chinaâ€™s 55 officially recognized minority groups, many of whom reside in rural areas, Uyghurs make an interesting case study for equality of higher education access. The paper is based on a review of relevant policies, ethnographic fieldwork and semi-structured interviews with Uyghur university students, graduates, and the faculty who teach them. The paper uses â€˜intersectionalityâ€™ to illustrate that the circumstances of ethnic minorities from some rural areas are unique and distinct from those of ethnic minorities from urban areas, and thus ethnicity and rural origin should not be considered in isolation in policy-making or research endeavors.
Prevalence of Acute Gastro Intestinal Tract Bleeding in Patients Undergoing Primary Percutaneous Coronary Intervention After Acute Myocardial Infarction
Authors: Tariq Muhammad Naeem , Samore Naseer Ahmed , Rashid Muhammad Humayoun , Chaudhery Ghoza , Shafique Hafiz Muhammad , Shahzad Syed Khurram , Nadeem Asif , Noeman Ahmad , Bukhari Syeda Neelam Yamin , Aziz Zohair 
Published: December 2022

Objective: To determine the prevalence of acute gastro-intestinal tract bleeding and the factors associated with it in patients undergoing Primary PCI after acute myocardial infarction.
Study Design: Analytical Cross sectional study.
Place and Duration of Study: Department of Interventional Cardiology, Tertiary Cardiac Care Center, Rawalpindi Pakistan, from May 2021 to April 2022.
Methodology: Five hundred patients (n =500) between 30-80 years of age, presented at the emergency of Tertiary cardiac care center, Rawalpindi and diagnosed with Acute Myocardial Infarction were planned to undergo the Primary Percutaneous Coronary Intervention (PCI) procedure. After the procedure, patients were evaluated for acute gastro-intestinal tract bleeding within first 48 hrs. Blood samples were taken before and after 24 hrs and 72 hrs of primary PCI. The blood hemoglobin level was assessed and fall in its level was noted. SPSS 26 was used to enter and analyze the collected data.
Results: Out of n=500 patients enrolled in the study, 440(88%) were males and 60(12%) were females. The mean age of patients was 64.27 ± 6.47 years. The mean time from symptoms onset to primary PCI was 9.74±5.15 hrs. The mean duration of the procedure was 34.99 ± 6.01 mins. After the procedure, 23(4.60%) patients had developed the acute gastro-intestinal tract bleeding. In patients who developed acute gastro-intestinal bleeding, mean blood hemoglobin level before the procedure was 11.95 ± 1.05 g/dl, which was reduced to 8.46 ± 0.51 g/dl after the procedure. In patients who did not develop it, the mean blood hemoglobin level before the procedure was 11.94±1.03 g/dl, which was reduced to 11.80 ± 1.04 g/dl after the procedure. The blood hemoglobin level after the procedure was significantly less in patients who suffered from acute gastro-intestinal tract bleeding.
Conclusion: The research study concluded that the frequency of acute gastro-intestinal tract bleeding in patients after primary PCI for acute myocardial infarction was very low but on the other hand marked reduction in blood hemoglobin level was observed, which can lead to many adverse sequelae.
Spectrum of Cardiac Arrhythmias During Initial 48 Hours of Acute Myocardial Infarction Patients and their Association with in-Hospital Outcome
Authors: Shiram Syed Ali , Shabbir Muhammad , Rehman Waheed Ur , Ali Jahanzab , Virk Mutahir Abbas , Mehreen Sobia , Ahmed Iftikhar , Imtiaz Areeba , Azad Naseem , Chaudry Azhar Ali 
Published: December 2022

Objective: To determine the spectrum of arrhythmias during initial 48 hours of AMI and their impact on the in-hospital outcome.
Study Design: Analytical Cross-sectional study.
Place and Duration of Study: This study was conducted at a Tertiary Cardiac Center of Rawalpindi Pakistan from Jun 2021 till Jan 2022.
Methodology: A total of (n=150) patients of Acute Myocardial Infarction (AMI) undergoing immediate or early revascularization and meeting the inclusion and exclusion criteria were included in the study. They were monitored for arrhythmias during initial 48 hours of hospitalization and their in-hospital outcomes were noted on a predesigned Performa.Chi square test applied for arrhythmia association with adverse outcome at 95% confidence interval and 5% margin of error.
Results: This study comprised (n=117; 78%) males and (n=33; 22%) females. Mean age was 62.9 years. ST elevation MI(STEMI) constituted (n=127; 84.7%) and Non-ST Elevation MI (NSTEMI) (n=23;15.3%) of total patients. Arrhythmias documented in overall (n=122;81.3%) patients, 81.8% (n=104) in STEMI and (n=18; 77.2%) in NSTEMI. Sinus tachycardia(n=52;34.7%) was most common rhythm followed by accelerated idioventricular rhythm (n=20;13.4%) and sinus bradycardia12.7% (n=19). In-hospital mortality was (n=25;16.7%) with p-value=0.009, mostly in patients with ventricular tachycardia/ventricular fibrillation, atrial fibrillationand complete heart block. Other outcomes included (n=23;14.7%) acute left ventricular failure, (n=9; 6%) cardiogenic shock (n=5;3.3%) acute stent thrombosis, (n=2; 1.3%) cerebrovascular accident (CVA)and (n=31; 20.7%) prolonged hospitalization (p-value 0.05).
Conclusion: Arrhythmias are common in acute myocardial infarction during initial 48 hours of presentation with sinus tachycardia being most common followed by accelerated idioventricular rhythm and sinus bradycardia. Arrhythmias are associated with increased in-hospital mortality and adverse outcome.
Maternal and Neonatal Outcomes in Pregnant Patients with Pre-Existing Cardiac Diseases
Authors: Rahman Fahd Ur , Saif Mohsin , Khan Ismail Ahmed , Siddique Muhammad Bilal , Yousaf Husnain , Alam Waqas , Safi Shoaib Iqbal , Khan Aleena , Samore Naseer Ahmed , Azad Naseem 
Published: December 2022

Objective: To assess the maternal and fetal outcome in pregnant patients with preexisting cardiac conditions and to determine the prevalence of different cardiac diseases among pregnant patients.
Study Design: This was across sectional study.
Place and Duration of Study: Tertiary Cardiac Care Center in Rawalpindi Pakistan, from Dec 2021 to Apr 2022.
Methodology: This was across sectional study done in a tertiary cardiac care center in Rawalpindi. A total of (n=100) pregnant patients with pre-existing cardiac diseases were included in the study from Dec 2021 to Apr 2022 over a period of 5 months. Prospective data including patients' demographics and their outcomes was collected using preformed proformas. Data was analyzed by SPSS version-23. Prevalence of maternal death, fetal death, maternal complications and neonatal complications were the primary outcomes of study. 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: A total of (n=100) patients were included in our study which was conducted from Dec 2021 to Apr 2022. Maternal mortality was observed in 6% (n=6) of patients. Maternal outcomes of pulmonary edema were seen in 24% (n=24) of patients and post-partum hemorrhage was seen in 14% (n=14) patients. Three parameters of perinatal outcome were studied i.e., low birth weight, preterm delivery and death. 39% (n=39) neonates were found to have low birth weight, 22% (n=22) were preterm and perinatal mortality was 21% (n=21). The primary results of our study showed 6% (n=6) maternal mortality and 21% (n=21) perinatal mortality.
Conclusion: Overall maternal mortality was 6% while perinatal mortality was 21%. There existed a statistically significant (p<0.05) association of age and neonatal outcome with maternal complications. With proper counseling, some of the avoidable maternal and perinatal deaths can be prevented.
Mitral Annular Disjunction in Mitral Leaflet Prolapse: Prevalence, Clinical Profile and Echocardiographic Features at Tertiary Cardiac Care Centre, Rawalpindi
Authors: Virk Mutahir Abbas , Siddique Muhammad Bilal , Iqbal Usman , Ahmed Sajjad , Shiram Syed Ali , Ahmed Adeel , Shahzad Syed Khurram , Sana Ayesha , Yousaf Hussain 
Published: December 2022

Objective: To determine the prevalence of Echocardiographically-recognizable Mitral Annular Disjunction in patients of Myxomatous Mitral Valve Disease/Mitral Leaflet Prolapse.
Study design: Analytical Cross sectional .
Place & Duration of study: Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD),Rawalpindi Pakistan from Jul 2021 to Sep 2021.
Methodology: A total (n=45) diagnosed patients of Myxomatous Mitral Valve disease, were included through non-probability consecutive sampling. Mitral Annular Disjunction (MAD) was assessed by 2D TTE imaging as the distance between the point of insertion of the posterior leaflet into the left atrial wall (upper boundary of the disjunction) and the link between the left atrium and the left ventricle myocardium (lower border of the disjunction)at end-systole in parasternal long axis view. A distance equal to or greater than 2mm was used as a threshold for diagnosing the presence of MAD. The data analysis was done with the help of computer software programme SPSS version 24.
Results: Total number of patients were 45 patients with males being 32 (71.11%) while females being 13 (28.88%), with a mean age of 30.24 + 5.21 years. MAD was present in 26 (57.8%) of the patients with mean length of 2.88mm + 2.77 mm. Patients with MAD had more chest pain, palpitations and dyspnoea than those without MAD. Mitral regurgitation was more severe in patients with MAD than without. The MAD severity correlated with the presence of Non Sustained Ventricular Tachycardia.
Conclusion: MAD is not an uncommon finding in patients having myxomatous mitral valve disease/mitral valve prolapse........
Comparison of Left Ventricular Ejection Fraction in Heart Failure Patients on Echocardiography, Cardiac Magnetic Resonance Imaging and Single Photon Emission Computed Tomography
Authors: Ahmed Iftikhar , Nadeem Asif , Saeed Nazish , Shiram Syed Ali , Hussain Zahid , Tariq Muhammad Naeem , Kamran Javeria , Mustafa Attiya , Azad Naseem , Shahzad Syed Khurram 
Published: December 2022

Objective: To compare the left ventricular ejection fraction on echocardiograph, cardiac magnetic resonance imaging and single-photon emission computed tomography scan in heart failure patients.
Study Design: This was a prospective cross-sectional study.
Place and Duration of Study: Tertiary Cardiac Care Center of Rawalpindi, Pakistan, from Nov 2021 to Apr 2022.
Methodology: This was a prospective cross-sectional study conducted from November 2021 to April 2022 at a tertiary cardiac care center of Rawalpindi. Thirty (n=30) heart failure patients of either gender with reduced ejection fraction were selected by consecutive sampling technique and were analyzed to quantify their left ventricular ejection fraction (LVEF) using Echo, CMR and SPECT scan. All three modalities were used to measure LVEF in these patients and were compared accordingly.
Results: The LVEF measured by Cardiac Magnetic Resonance Imaging, Single Photon Emission Computed Tomography Scan and Echocardiography was in the range of 15% to 67%. The mean LVEF was 37.2±14.2 by CMR, 37.17±14.1 by SPECT and 38±12.3 by Echo. The mean LVEF determined by SPECT was slightly lower while that determined by Echocardiography was slightly higher. The measured p-value of LVEF by the three modalities, however, indicated statistically difference (p-value <0.05).
Conclusion: Although the literature shows diversity in results of these modalities, CMR is considered the standard reference for assessment of LVEF when interpreted by an expert observer. We in our study found that all three modalities are complimentary to each other and can be used interchangeably depending upon the availability of the equipment and reporting expertise of the observers.
In-Hospital Outcome of Early Versus Late Coronary Intervention in Patients Undergoing Thrombolysis after Acute Myocardial Infarction
Authors: Tariq Muhammad Naeem , Samore Naseer Ahmed , Rashid Muhammad Humayoun , Nadeem Asif , Saif Mohsin , Jokhio Abdul Rehman , Azad Naseem , Noeman Ahmad , Yamin Bukhar Syeda Neelam , Chaudhry Azhar Ali 
Published: December 2022

Objective: To determine the In-hospital outcome of early versus late coronary intervention in patients undergoing thrombolysis after acute myocardial infarction (STEMI).
Study Design: Analytical Cross sectional study.
Place and Duration of Study: Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan from Jul 2021 to Dec2021.
Methodology: Total of (n=100) patients regardless of gender between 30-80 years of age, presented with acute ST-elevated myocardial infarction (STEMI) at emergency room of PIC, Lahore and undergo thrombolysis with a thrombolytic agent after taking the informed consents were selected by a consecutive sampling technique. The demographic information which includes (name, age, gender, H/O diabetes, duration of STEMI) was noted. Then patients were randomly divided in two groups (Group A & B). In Group-A, patients were undergone PCI within 24 hours of thrombolysis. In Group-B, patients were undergone PCI after 24 hours of thrombolysis. Then all patients were followed-up in coronary care units for 07 days. If reinfarction occurs or patient was died during hospital stay, it was recorded. All the information was noted in a preformed structured proforma.
Results: Out of 100 patients, 10 % (n=10) were in age group of 30-45 years and 90 % (n=90) were in age group of 46-80 years. The mean age was calculated as 60.16 ± 7.13 years. There were 90 (90 %) males whereas 10 (10 %) were females. The frequency of Re-Infarction in early Intervention group was 2(2%) and in late Intervention group it was 10%. (p<0.05).The frequency of mortality in early Intervention group was 2 (02%) and in late Intervention group it was 10%. (p< 0.05).Conclusion: Frequency of re-infarction as well as mortality was comparatively low in Intervention group. Therefore, the immediate restoring the patency of occluded coronary arteries can prevent or decrease myocardial damage due to acute myocardial infarction and henceforth, decrease morbidity and mortality..
Renal Artery Doppler as Screening Imaging Modality Required for theEvaluation of Hypertension in Cardiac Patients Experience at Tertiary Cardiac Care Centre
Authors: Israr Afshan , Dildar Nazia , Azmat Sadia , Khan Sara , Nadeem Farrukh , Khan Sehrish Shawrez 
Published: December 2022

Objective: To evaluate the efficiency of renal artery Doppler in diagnosis of secondary hypertension among cardiac patients.
Study Design: Analytical Cross-sectional study.
Place and Duration of Study: The present study was performed at Tertiary Care Center, Rawalpindi from Jan 2019 to July 2019.
Methodology: The study comprised of 50 patients with age range of 12-75 years with 90% confidence interval and 10% margin of error with prevalence of hypertension in Pakistan as 26.34%12. The study population included hypertensive patients referred for Doppler assessment of renal artery stenosis (RAS), in order to assess secondary cause of hypertension. The patients underwent angiography of kidneys within 14 days following Doppler assessment of RAS. The positive and negative outcome was presented as frequencies and percentages. The mean age was depicted as means ± standard deviation. The diagnostic features of specificity, sensitivity, negative predictive value and positive predictive values were calculated through a 2x2 table with angiographic findings considered as gold standard.
Results: In only 4(8%) patients bilaterally raised resistive index (RI) were evident. The diagnostic attributes of Doppler showed sensitivity of 48%, positive predictive value of 100% and diagnostic accuracy of 48%.
Conclusion: The role of renal artery Doppler in evaluating secondary hypertension has been over estimated. Thus, its application needs to be restricted for elderly patients to minimize time and cost expenses.