bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurodidáctica como estrategia pedagógica en el programa virtual - de doctorado en salud pública
Authors: Polo Andrade Dra. Sonia 
Published: October 2022

La presente investigación tiene por objetivo determinar el nivel de influencia de la neurodidáctica como estrategia pedagógica en el desarrollo del aprendizaje en el Programa de Doctorado en Salud Pública Versión I del CEPI de la UMRPSFXCH.
Se recurrió al paradigma positivista, con enfoque mixto, se aplicaron técnicas cuantitativas (32 Test de Hemisferio Cerebral Dominante Modificado-Test de memoria) y cualitativas (36 entrevistas a expertos), investigación de tipo descriptivo. Entre los principales hallazgos en relación a la predominancia cerebral se encontró que el 32% de los estudiantes alcanzan un predominio cerebral izquierdo al aplicar la neurodidáctica como estrategia pedagógica, lo que nos indica que estos estudiantes tienen habilidades y destrezas lineales, Pensamiento lógico, sintaxis y desarrollan cálculos matemáticos. Mientras que un gran porcentaje; el 68% de los estudiantes adquieren dominio cerebral derecho, lo que indica que las habilidades generadas son facultades viso-espaciales, capacidades analíticas y desarrollo de la memoria a largo plazo.
En relación a la memoria, al finalizar el Programa virtual; el 25% genera lazos mentales, 24% aplica imágenes, 25% genera lógica analítica y el 26 % aplica acciones aprendidas.
El 89% de los expertos entrevistados afirmó la importancia de la neurodidática como estrategia pedagógica en el desarrollo del aprendizaje.
Comparación de 2 dietas y adaptabilidad del litopenaeus vannamei en un sistema sostenible (arroz-camarón)
Authors: Loqui Sánchez Aldo José , Zhangallimbay Naula Mayra Estefanía , Zambrano Alarcón Marcelo Erik , Meza Cabrera Washington Guillermo 
Published: October 2022

En la presente investigación, se utilizaron 2500 post-larvas de L. vannamei con un grado de salinidad al 2 ‰, el principal objetivo fue estudiar la adaptabilidad desde la etapa post-larva hasta la etapa juvenil en piscina de agua dulce. Después de 35 días de adaptación se procedió a la comparación de dos dietas alimenticias para camarones juveniles, el primer grupo consistió con alimentación comercial y el segundo grupo con alimentación comercial más complemento del 5 % de harina de soja hidropónica. Se tomaron datos de temperatura, pH, salinidad, oxígeno disuelto del agua diariamente. Siendo una investigación exploratoria donde utilizamos el software infoStat con dos tipos de test, Kruskal Wallis para el análisis no paramétricos y Duncan para la parte estadística de las dietas (testigo y tratamiento). Mediante la prueba de Kruskal Wallis se analizó la significancia (p>0.05) de los pesos y tallas promedios finales obtenidos durante los muestreos realizados cada 7 días por 5 semanas en piscina de agua dulce, el promedio de finalización del peso fue de 0,76 g y 3,76 cm de talla. Durante esta etapa el porcentaje de sobrevivencia fue de 62 %. Utilizando el test de Duncan se observó la diferencia significativa (p>0.05) entre los promedios de finalización de los pesos y tallas obtenidos durante los muestreos realizados semanalmente por 14 día, el promedio de finalización de peso del grupo testigo fue de 0,91 g y el grupo tratamiento 2,64 g. con CV de 39,74%, y los promedios de finalización de las tallas del grupo testigo fue de 4,5 cm y 6,47 cm para el grupo tratamiento, con CV 10,36%.
Diseño de una estrategia para el cambio de percepción y conducta ambiental: Teoría y estudio de caso del proceso cognitivo de divulgación y apropiación de conocimiento en usuarios
Authors: García Jiménez Esteban , Mendoza Sánchez Magdalena , Maldonado Azpeitia Luis Fernando , Hernández López Ma. Sandra 
Published: October 2022

Uno de los problemas actuales es la disposición apropiada de los residuos sólidos urbanos (RSU); sin embargo, no solo basta pensar y actuar enfocados en la disposición. Es necesario considerar el origen y las decisiones de compra que los distintos usuarios toman sin considerar la está de disposición de los residuos generados de manera diaria. Es por lo que esta investigación busca desarrollar de manera teórica y práctica una estrategia que favorezca el cambio de percepción ambiental en los individuos haciendo uso de herramientas de divulgación y apropiación del conocimiento.
La presente estrategia cuenta con un eje metodológico centrado en la escucha del usuario, mismo que es segmentado acorde a la precepción ambiental. Comprender la segmentación del usuario es primordial para fomentar la flexibilidad cognitiva mediante el uso de algunas herramientas lúdicas y herramientas centradas en el usuario como los diagramas de afinidad. Así bien, se valida la estrategia con 3 diferentes grupos de usuarios bajo diferentes condiciones y frecuencias de aplicación de la estrategia.
La investigación muestra el impacto positivo en usuarios con más de una inmercion en la estrategia planteada, así como se logra identificar un impacto significativo en grupos de personas en los cuales con una percepción ambiental intermedia – alta. Es sumamente importante trabajar en estrategias que se implementen antes de la generación de RSU, ya que de esta forma se desarrollaran estrategias de corrección y no solo de contención
“Deficiencies in mention of post-op complications on consent form”
Authors: Tehniyat Wajiha 
Published: October 2022

Introduction: Consent is an art, which is mandatory to be undertaken before any intervention on a patient. For surgical procedures, it becomes even more important, and written formal consent is required for patient safety, quality assurance, and medico-legal aspects later. Procedure-related complications are the most important part of consent on which decisions to undergo surgery are made and also post-operative course is determined.
Many times the consent forms are found to have missing information which results in medico-legal issues later on. Our aim, therefore, was to look at the accuracy of complications mentioned on the consent form. For the audit, we selected the 2 most frequently performed surgical procedures (Cholecystectomy and inguinal hernias).
Materials and Methods: Consent forms for the mentioned procedures were reviewed retrospectively to look for the mention of standard well-known complications associated with the procedures. Duration of study one month with consecutive sampling. Data were analysed for the accuracy of all known complications.
Results: %age accuracy of the documented complications were calculated for consultants and non-consultants. Overall average % accuracy was also calculated.

Conclusion: We concluded that in our standard consent forms documenting complications varies from the person-person and often few complications are missed leading to problems later on. Hence patient safety and quality assurance are compromised. Also, legal issues can arise affecting the surgeon.
Consultants and trainees both are involved in consenting patients. Our consent forms are general. Procedure-specific forms/ Stickers might help in the reduction of deficiencies and thus can improve the experience and prevent litigation and medico-legal implications.
“Efficacy of current familial breast cancer screening practices and its impact on national cancer programme”
Authors: Tehniyat Wajiha 
Published: October 2022

Introduction: Breast cancer has been the leading cause of cancer in females over the last few decades. Familial inheritance of breast cancer is proven and investigated deeply. The need of the day is to risk stratify it before the actual problem arises and to standardise the process across the UK which is not yet addressed.
Objective: The objective of this study is to assess the efficacy of current referrals to familial breast cancer clinics from all sources and their impact on the national breast cancer programme.
Materials and Methods: This is a retrospective study of patients referred to the breast cancer family history clinic at King’s Mill Hospital Breast Surgery Department between Jan-Dec 2017. A case note review of these cases was undertaken and data was collected on a proforma shown below. For analysis data was entered on FaHRAS and according to the risk calculated appropriateness of referrals to secondary care was measured.
Results: Results of our study showed that 73% of the referrals made in 2017 from primary care were appropriate, while 27% were stratified as in-appropriate referrals. Those missed might be more than expected but there is no way to assess the missed ones.
Conclusion: In the conclusion, this study identifies the tip of the iceberg regarding the issue but the problem is far bigger. If screening is done in primary care, missed cases and inappropriate referrals could be effectively reduced significantly.
Comparison of Histoacryl® plus Lipiodol® versus Histoacryl® plus vitamin D3 in the management of isolated fundal varices: A retrospective comparative study
Authors: Khan Dilaram , Aamir Naveed , Hassan Muhammad Kamran , Ali Farman , Alam Fakhare , Khan Hashmatullah 
Published: October 2022

Objective: According to recent guidelines Histoacryl® (N-butyl-2 -Cyanoacrylate) injection is the first line therapy for the endoscopic obliteration of gastric varices. Lipiodol is commonly used to facilitate injection Histoacryl® but it is expensive. In this study we compare Lipiodol with Vitamin D3 injection as priming agents for Histoacryl injection in terms of efficacy and safety in the management of isolated fundal varices.
Methods: This is a retrospective comparative study conducted at Gastroenterology Unit, Lady Reading hospital Peshawar. Patients’ information was collected from March, 2012 to January, 2020 from medical records and statistically analyzed in terms of fundal varices obliteration, re-bleeding, mortality, and adverse events related to treatment.
Results: From March, 2012 to January, 2020, 171 patients met the criteria. 7 cases lost follow up, and all the cases in both groups were treated successfully. There were no adverse events related to procedure in either group. Twenty six patients developed upper GI re-bleeding, which did not differ significantly betweenthe twogroups. There was also no difference between the groups in terms of treatment failure, complications, varices obliteration, and mortality.
Conclusion: Vitamin D3 is as safe and effective as Lipoidol when used as priming agent for Histoacryl injection for obliteration of isolated fundal varices and can be used as a cheaper alternative to Lipoidol.
Lipid Profiles and Its Association with Pre-Eclampsia and Eclampsia in Nulliparous Pregnant Women
Authors: Shaheen Asmat , Luqman Muhammad Waqas , Shah Syed Fahim , Zeb Fozia , Khan Atta Ullah , Ahmed Zahoor 
Published: October 2022

Objectives: To access the lipid profiles and its association with pre-eclampsia and eclampsia in nulliparous pregnant women.
Material and Methods: This cross-sectional study was performed on 234 nulliparous pregnant women with gestation period of > 20 weeks and aged 15-45 years, from March to October 2014, in Institute of Basic Medical Sciences (IBMS), Khyber Medical University (KMU), Peshawar, Pakistan with cooperation from gynecology and obstetrics departments of three tertiary-care hospitals of Peshawar & Khyber Medical College, Peshawar, Khyber Pakhtunkhwa (KP), Pakistan. Subjects were assigned to three groups i.e., group A, group B and group C. For performing biochemical assays and lipid profiling, through ELISA, blood samples were collected from already subjects both with the disease and the controls.
Results: Both subjects having pre-eclampsia and eclampsia showed significant elevated levels (p < 0.001) for low density lipoproteins cholesterols (LDL-c), high density lipoprotein cholesterol (HDL-c), total cholesterol (TC)/HDL-c and LDL-c/HDL-c ratio. But TC of pre-eclampsia subjects were found significantly elevated (p < 0.001) in relation to controls. LDL-c/HDL-c and TC/HDL-c also revealed an elevated significant change (p < 0.001) both for pre-eclamptic and eclamptic subjects. On the other hand, only TG/HDL-c in pre-eclamptic patients was found significantly higher (p<0.004) when compared to control group.
Conclusion: Serum lipid levels were observed higher in pre-eclampsia and eclampsia patients hence an early assessment is necessary to prevent complications in such patients.
Skin Changes in Newly Diagnosed Cases of Hypothyroidism
Authors: Niaz Furquana , Shams Nadia , Meraj Lubna , Ahmed Sadaf , Ahmed Najia , Sheikh Irfan 
Published: October 2022

Introduction: Thyroid disorders are frequent in our population that leads to variety of cutaneous manifestations. Aim of our study was to determine the frequencies of skin changes of hypothyroidism and their association with gender.
Methodology: This observational study was conducted at RIHS Islamabad (Ist Jun to 31st Dec 2019) after ethical approval. 105 patients (>18years age) of both genders. Confirmed to have hypothyroidism on the basis of thyroid function tests were included. Secondary hypothyroidism, sick thyroid disease, pregnant women, receiving thyroxin therapy, carcinoma of thyroid, critically ill cases, post-thyroidectomy and iatrogenic thyroid cases were excluded. After informed consent, demographic details were documented. Patients were clinically evaluated and examined in detail including dermatological examination for cutaneous manifestations. Various skin findings are studies with respect to gender. Data was analysed by SPSS version 21 with Chi-square test as a test of significance, significant p<0.05.
Results: Among 105 cases of hypothyroidism (62% females and 38% males, mean age was 38.04+12.61 years. Mean TSH level was found to be 32.08 + 33.96 (mean TSH was 35.31+37.31 in females Vs. 26.96 + 27.19 in males; p=0.001). Common skin findings were dry skin in 69.5%, diffuse hair loss in 58%, coarse skin in 57%, pruritis in 51.4%, madarosis 37%, seborrheic dermatitis 34%, coarse scalp hairs 27% and slow nail growth in 23%. The brittle nails, alopecia areata, chronic urticaria, acanthosis nigricans, ivory yellow skin, purpura ecchymosis, ichthyosis, herpes simplex and certain other findings were found in <20% cases. Obesity was observed in 53(50.5%) cases, Type 2 diabetes in 20(19%), hypertension in 23(21.9%), dyslipidaemia in 12(11.4%) and anaemia in 9(8.6%). Obesity, diabetes, dyslipidaemia had no association with gender (p>0.05). However, hypertension and anaemia were significantly frequent amongst females (p<0.05). The dry, coarse skin, diffuse hair loss and seborrheic dermatitis were associated with female gender (p>0.05). Slow nail growth, brittle nails, acne vulgaris, acrochordons, vitiligo, xanthelasma were more common in males however the difference wasn’t statistically significant.
Conclusion: Skin acts as an important diagnostic window to diseases affecting internal organs including thyroid disorders. Authors recommend screening for thyroid functions, diabetes, hypertension, dyslipidaemia, obesity and anaemia in patients presenting with suggestive dermatological manifestations irrespective of age and gender.
KEYWORDS: Hypothyroidism. Thyroid Diseases. Skin Changes. Thyroid Stimulating Hormone. Thyroid Gland.
Can “HINTS” aid the Diagnosis of Posterior Circulation Stroke among patients with Acute Vestibular Syndrome?
Authors: Tahir Sidra , Tahir Nouvaira , Meraj Lubna , Zaka Neelum , Zaman Sadaf , Malik Kausar 
Published: October 2022

Introduction:
Identifying posterior circulation stroke in patients with AVS without obvious focal neurological deficits poses a difficult diagnostic challenge. It is estimated that about 10% to 20% of patients who present with acute dizziness to the Emergency department have AVS7. Most AVS patients have a benign peripheral vestibular cause (vestibular neuritis or nonbacterial labyrinthitis), but about 25% have brainstem or cerebellar strokes7, 9-10. Rapid, accurate diagnosis of posterior stroke is important for early management as well as prevention of devastating complications. HINTS is a clinical three-step bedside oculomotor exam, that has been suggested of high diagnostic accuracy in identifying posterior circulation stroke in patients with isolated continuous vertigo.
Methods:
A comprehensive systematic search of literature was done using the NHS Evidence healthcare databases Medline, EMBASE, CLINIL, Google scholar and Cochrane.
Results:
10 relevant articles were identified, combining the results of all six prospective studies showed a total of 338 patients on which Clinical HINTS exam was performed. The overall Hints exam sensitivity was 96.86% 95%CI (92.8-99), specificity 96.09% 95%CI (92.1-98.4) and negative predictive value was 0.03 95%CI (0.01-0.08). ROC analysis was done in which area under curve was found to be 0.965.
Conclusion:
Delay in diagnosis of posterior stroke can result in 8-fold increase in mortality7. HINTS is a useful clinical bed side oculomotor exam, which if done appropriately by trained ED doctors, could aid in the early recognition of a subtly presenting posterior stroke with “acute isolated continuous vertigo”. Hence, will improve the overall diagnostic evaluation of acute vestibular syndrome.
Impact of Dermatophytosis on the Quality of Life in Patients Attending a Tertiary Care Hospital, Karachi
Authors: Khoso Bahram Khan , Uddin Fakhur , Hussain Wajid , Dashti Meeran Mohammad Omar 
Published: October 2022

Abstract
Objectives: To determine the impact of dermatophytosis on quality of life (QoL) of patients at tertiary care hospital, Karachi.
Methods: The cross-sectional descriptive research was piloted in the Departments of Dermatology and Microbiology, Jinnah Postgraduate Medical Centre (JPMC) Karachi, a leading public tertiary care hospital during the July 2019 to December 2019. The patients <16 years aged were excluded from this study. The KOH (10%) wet mount was performed for fungal hyphae and spore observation in specimens. Quality of life was determined by dermatology life quality index (DLQI) scores and their association with different variables was evaluated by using t-test and Fisher test.
Results: A total of 300 dermatophytosis patients were analyzed. The majority of the patients were of no education category. The active age group (16-30 years) showing higher frequency (138; 46.0%) and followed by age group of 31-50 years (126; 42.0%)). In present study DLQI score mean was 13.4 ± 7.3. Unexposed area was the main site 249 (83.0%). Dermatophytosis has effect on the quality of life (QoL) in majority (98.7%) of the patients. The DLQI score was significantly higher in unexposed and both sites involvement (P < 0.001). DLQI score was not affected by the age, sex, literacy, addiction and other demographic variables.
Conclusion: This study revealed that dermatophytosis has a significant impact on the quality of life (QoL) in these patients.
Relapse Rate after Opioid Detoxification in Drug Addict Patients
Authors: Gul Beenish , Asghar Rabia , Ahmad Hafiz Shafique , Shaheen Azmat , Arshad Naveed 
Published: October 2022

Background: Drug addiction is widely regarded as a pathological condition that involves the continued abuse of drugs in the development of drug-seeking behavior and a decrease in the ability to respond to naturally rewarding stimuli.
Objective: To determine the frequency of relapse after opioid detoxification in drug addict patients.
Methods: A descriptive cross-sectional survey was performed in psychiatry department of Pakistan Institute of Medical Sciences, PIMS, Islamabad, from October 2017 to April 2018. All adult patients who were using cannabis for at least 1 year, irrespective of gender ages between 18 to 60 years were included in the study. For drug use characteristics about preferred choice of drugs and injection-related risk behaviors were noted and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 21 and analyzed. Effects modifiers like age, gender, marital status, types of drugs, etc., were controlled by stratification. Post stratification chi square test was applied. A p value ≤ 0.05 was considered significant.
Results: Total 310 patients were included; 83% patients were male and 17% were females. The mean age of the patients was 39.02±21.42 years. 70% patients had relapse after opioid detoxification while 30% patients had NO relapse. The relapse rate after detoxification was more common in first month of detoxification (56%). After 3 months the relapse rate after detoxification was 12.5%. The statistical analysis showed that there was a very significant association between types of drugs, ages of patients, marital status and relapse rate (p ≤ 0.05). There was an insignificant association between gender and relapse rate (p ≥ 0.5).
Conclusion: The study concluded that the relapse within six months of opioid detoxification in drug addicts is very common. Many factors contribute in relapse rate.
Emerging Risk Factors for Impaired Lung Function in Chemical Industry Workers of Faisalabad
Authors: Shireen Jawed, Benash Altaf, Anam Rehman, Noor-i-Kiran Naeem Shireen Jawed, Benash Altaf, Anam Rehman, Noor-i-Kiran Naeem 
Published: October 2022

Objective: To determine the impact, obesity and age on the lung functions determined by PEFR of healthy workers of chemical industries.
Methodology: This was a cross sectional study performed at private medical college of Faisalabad. Three days medical camp was arranged during 2nd to 4th September 2020 after taking approval from institutional ethical committee. All relevant information including age, residence and history about chemical exposure were recorded in a structured proforma. Obesity was determined on basis of BMI grading. BMI was calculated from estimated Height and weight PEFR of each participant was determined using Wright’s Peak flow meter. Data was analyzed by SPSS21.
Results: Mean± SD age, height and weight of the studied population was 38.85 ± 12.1, 170.07 ±12.0 and 78.12 ±12.7. lowest PEFR value was found in subjects with age range 61 to 70 years as compred to youger subjects . The mean PEFR value were significantly different with respect to various age catagoeies with p value= 0.000 Highest mean PEFR values were found in taller subjects having height ≥ 180 cm and lowest values were found in subjects with height 150-159 cm, the difference in means was statisticaly significant with p value= 0.05.
Morbid obese subjects showing comparatively lower PEFR values in morbid obese with significant p value =0.002.
. PEFR was found to be negatively associated with age ( p- value= 0.000*) and BMI( p value =0.001*). Our results also showed weak positive association of PEFR with height, however this relation was not found to be statistically significant (p value= 0.081).
Conclusion: Peak expiratory flow rate is negatively associated with increasing BMI and age, reflecting that elderly and obese subjects are more prone to have affected lung function due to exposure to chemicals