bluuebunny/crossref_metadata_2025 huggingface dataset:
Öğrencilerin Sıra Dışı Bir Tepkimenin Isısını Belirlemeyle İlgili Bilimsel Muhakemelerinin İncelenmesi
Authors: KADAYIFÇI Hakkı
Published: June 2020

Öğrencilerin mevcut anlayışlarına dayalı olarak
kurdukları hipotezlerle uyuşmayan beklenmedik bulguları değerlendirmelerinin,
onların sorgulayıcı araştırma etkinliklerindeki kavramsal değişimlerinde önemli
yeri vardır. Beklenmedik bulgularla karşılaşılabilecek konulardan biri kimyasal
enerji konusudur. Öğrencilerin çoğu, istemli tepkimelerin ekzotermik olacağına,
endotermik tepkimelerin ise dışarıdan ısıtmayla gerçekleşebileceğine inanır. Bu
çalışmada günlük hayatta sık karşılaşılmayan bir olgu olarak istemli endotermik
bir tepkimenin ısısına karar vermeyle ilgili bir sorgulayıcı araştırma deneyine
katılan öğrencilerin bilimsel muhakemeleri incelendi. Çalışma bir eğitim
fakültesinin birinci sınıfındaki 58 öğrenciyle gerçekleştirildi. Veri toplamada
öğrencilerin deney föylerinden ve onlarla gerçekleştirilen görüşmelerden
faydalanıldı. Katılımcıların kurdukları hipotezler ve tepkimenin ısısıyla
ilgili kararları incelendiğinde, bazılarının tutarlı bilimsel muhakemeler
sergilerken, birçoğunun doğrulama yanlılığı gösterdiği; yine bir kısmının
alternatif anlayışlarını değiştirirken, çoğunun değiştirmediği belirlendi.
Matematik Derslerinde Öğrenci Performansını Artırmaya Yönelik Bir Ters Yüz Öğrenme Modeli
Authors: YORGANCI Serpil
Published: June 2020

Bu çalışmada, matematik dersinde ters yüz öğrenme modelinin etkili kullanılmasına yönelik Merrill (2002) tarafından geliştirilen Öğretimin Temel İlkeleri Modeline dayanan bir öğrenme ortamı tasarlanmıştır. Çalışma grubunu, 2018-2019 akademik yılında bir devlet üniversitesinin ön lisans programında öğrenim gören toplam 95 birinci sınıf öğrencisi oluşturmaktadır. Araştırmada, deney grubunda, Merrill’in temel ilkelerine göre tasarlanmış ters yüz öğrenme yöntemine göre etkinlikler yapılırken kontrol grubunda geleneksel öğretim yöntemleri ile dersler yürütülmüştür. Araştırmanın verileri, başarı testi ve motivasyon anketinden oluşmaktadır Araştırma sonuçlarına göre, deney grubu ile kontrol grubu arasında matematik başarısı ve motivasyon açısından deney grubu lehine anlamlı fark olduğu belirlenmiştir. Ayrıca, motivasyon ölçeğinin dikkat-uygunluk ve güven-tatmin alt faktörlerine ilişkin deney ve kontrol gruplarının düzeltilmiş son-test puan ortalamaları arasında anlamlı bir farkın olduğu ve bu farkın da deney grubu lehine olduğu belirlenmiştir.
8-10 Yaş Çocukları İçin Eleştirel Okuma Ölçeği Geçerlik Güvenirlik Çalışması
Authors: ŞAHİN Güliz , DİLİDÜZGÜN Selahattin , LEANA TAŞCILAR Marilena
Published: June 2020

Araştırmanın amacı, 8-10 yaş grubunda yer alan öğrencilerin eleştirel okuma düzeylerinin belirlenmesinde kullanılmak üzere, Ünal (2006) tarafından ortaokul 5. sınıf öğrencileri için geliştirilen “Eleştirel Okuma Ölçeği”nin geçerlik ve güvenirlik ölçümlerini belirlemektir. Çalışma grubunu basit seçkisiz örnekleme yöntemi ile belirlenen Balıkesir İl Milli Eğitim Müdürlüğüne bağlı iki ilkokulda öğrenim gören 290’ı erkek, 260’ı kız olmak üzere toplam 550 dördüncü sınıf öğrencisi oluşturmaktadır. Ünal (2006) tarafından geliştirilen “Eleştirel Okuma Ölçeği” ilköğretim 5. Sınıf düzeyinde, 11 yaş grubu için düzenlenmiş, tek faktör ve 22 maddeden oluşan beşli likert türünde bir ölçektir. Eleştirel Okuma Ölçeği için gerçekleştirilen güvenirlik analizleri neticesinde hesaplanan Cronbach Alpha iç tutarlılık katsayısı .906 olarak bulunmuştur. Ölçme aracının geçerlik kanıtlarının ortaya konması için gerçekleştirilen doğrulayıcı faktör analizi sürecinde MLR yöntemi tercih edilmiş ve ölçeğin tek boyutlu yapısının doğrulandığı sonucuna ulaşılmıştır.
Matematikte Bilimsel Süreç Becerileri: Test Geliştirme Çalışması
Authors: ÖZKAN Tuba , KİLİCOGLU Elif
Published: June 2020

Bu çalışmada, matematik dersinde ortaokul öğrencilerinin bilimsel süreç becerilerini ölçmeye yönelik, güvenirliği ve geçerliği sağlanmış bilimsel süreç becerileri testi geliştirmek amaçlanmıştır. Bu amaçla 35 çoktan seçmeli maddeden oluşan test, uygun teknikler kullanılarak geliştirilmiştir. Ortaokul 7. ve 8. sınıfta öğrenim gören toplam 353 öğrenciye uygulanan testin gerekli güvenirlik ve madde analizleri yapılmıştır. Cronbach alpha güvenirlik katsayısı 0.90 olarak bulunan testin kapsam geçerliğini sağlamak için uzman görüşüne ve meslektaş teyidine başvurulmuştur. Testin madde analizinde ise, ayırt edicilik ve güçlük indisleri incelenmiş, testin 0.56 ile orta güçlükte bir test olduğu ve ayırt ediciliğinin yüksek olduğu ortaya koyulmuştur. Bu sonuçlara göre testin ortaokul 7. ve 8. sınıf öğrencilerinin bilimsel süreç becerilerinin ölçülmesi amacıyla kullanılabilecek, geçerliği ve güvenirliği sağlanmış bir test olduğu sonucuna ulaşılmıştır.
Investigation of Turkey's PISA 2015 Science Achievement and Associated Variables Using Hierarchical Linear Modeling
Authors: YILDIZ Mustafa , ERDAŞ KARTAL Eda , MESCİ Günkut
Published: June 2020

The purpose of this study is to investigate the variables related to science achievement of high school students in Turkey portion of PISA 2015, by using hierarchical linear modeling (HLM) approach. The findings revealed that the relationship between the science achievement and demographic characteristics of the students is stronger than the relationship between science achievement and the affective domain as well as the learning environment. Based on these findings, it is thought that improving students’ science achievement is possible by taking into account the variables that affect the success, especially with improvements that can provide equal opportunities in the context of demographic variables and the construction of inclusive school systems.
Rehberlik Öğretmenlerinin Bakış Açısıyla Okul Rehberlik Hizmetlerinde Yaşanan Sorunlar
Authors: GÜRGAN Uğur
Published: June 2020

Duygusal-davranışsal sorun yaşayan çocukların erken ve zamanında belirlenmesi ve çocuklara gereksinim duydukları hizmetlerin sunulması oldukça önemlidir. Okullar, çocuklara ulaşma, hizmetleri sağlama ya da yönlendirmenin yapılabilmesine olanak sağlayan kurumlardır. Okul psikolojik danışmanları, okul ruh sağlığı hizmetleri olarak tanımlanan hizmetlerin sunulmasında önemli bir role sahiptir. Bu araştırmanın amacı okul psikolojik danışmanlarının okul ruh sağlığı hizmeti uygulamalarında karşılaştıkları sorunları ortaya koymaktır. Araştırma betimsel nitelikli durum tespitine yönelik tasarlanmıştır. Araştırmaya Türkiye çapında 47 ilde resmi ve özel kurumlarda görev yapan 1147’si kadın, 542’si erkek olmak üzere toplam 1689 psikolojik danışman katılmıştır. Verilerin analizinde frekans yüzdeler elde edilmiş ve detaylı bilgi toplanması amacıyla rehberlik öğretmenleriyle birebir görüşmeler yapılmıştır. Verilerin analizi sonucunda karşılaşılan sorunlar beş başlık altında toplanmıştır: 1. Yönetmelik ve sorumluluklarla ilgili sorunlar, 2.ailelerle ilgili sorunlar, 3. rehberlik anlayışının yerleşememesi ile ilgili sorunlar, 4.psikolojik danışman eğitimi ile ilgili sorunlar, 5. Motivasyon eksikliği sorunları.
TREATMENT MODALITIES AND OUTCOMES OF IDIOPATHIC GRANULOMATOUS MASTITIS
Authors: Qadir Azhin , Saeed Kamal
Published: June 2020

Background 

Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast disease. The etiologies of IGM are presently unclear, that is why treatment is still a challenge, Medical therapy, Wide Local Excision(WLE), abscess drainage, and even mastectomy were introduced to treat this disease.

Objectives 

To review clinical, diagnostic features and outcomes of treatments, also to indicate which method can be practical for treatment of IGM.

Patients and Methods

This study is retrospective in which prospectively maintained in Breast Clinic in Sulaimani city. Ninety-three (93) female patients with histopathologically proved IGM and treated from 1st January 2014 till 15th March 2019. Mostly Core needle biopsy(CNB) and excisional biopsy were used for accurate diagnosis. Plans of the treatment were designed according to the presentations and results of the histopathology.

Results

The baseline characteristics of 93 female patients revealed that the average age of the patients was 35.73±7.96 SD years old with the majority of patients (75%) being between 21 and 40 years old. Based on Fine Needle Aspiration Cytology (FNAC), Core Needle Biopsy and excisional biopsy, they were diagnosed with Idiopathic Granulomatous Mastitis. Medical and surgical therapies included use of antibiotic alone in 18(19.3%) cases, steroid in 26(28%) cases, anti-prolactin in 14 (15%) cases. One 1 (1%) of the patients underwent mastectomy, 39 (42%) of them underwent wide local excision after medical treatments failure, and 8 (8.6%) of them who had abscesses were drained. The overall cure rate in both treatment modalities were 75 (81%) and recurrence rate of 18 (19%).

Conclusion

There is still no standard treatment for IGM, the results of this study concluded that wide local excision is the best treatment of choice. Most of the patients do not respond to one treatment modality and recurrence is common; that’s why the disease is called ‘idiopathic.’ Thus, there are no known causes to have an effective treatment modality.
ASSOCIATION BETWEEN SERUM TRIGLYCERIDE LEVEL AND CHRONIC KIDNEY DISEASE IN TYPE 2 DIABETES MELLITUS
Authors: Mahwy Taha , Hamahussien Karokh , Al-Attar Delman
Published: June 2020

Background 

Diabetes mellitus type 2 is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and a relative lack of insulin. Diabetic kidney disease which is known as diabetic nephropathy is the chronic loss of kidney function occurring in those with diabetes mellitus and is the single strongest predictor of mortality in patients with diabetes. However, in spite of the achievement of recommended targets for blood glucose and blood pressure, the residual risk for diabetic nephropathy remains high among patients with type 2 diabetes. Hypertriglyceridemia may be one of the factors responsible for this high residual risk. Recent studies demonstrated that intra-renal accumulation of lipids may contribute to glomerular injury.

Objectives 

This study aimed to find an association between hypertriglyceridemia and chronic kidney disease in type 2 diabetes mellitus patients.

Patients and Methods

In this cross-sectional study 241 patients evaluated with documented type 2 diabetes mellitus to find any relation between hypertriglyceridemia and chronic kidney disease in type 2 diabetes mellitus. Data collected from 300 patients with type 2 diabetes mellitus, 161 males and 139 females. Of these 59 cases were excluded, 35 males and 24s female patients because of incomplete data was available, with mean age was 54.24 years. laboratory test for measuring fasting (total cholesterol, HDL, LDL, triglyceride, urinary albumin, and urinary creatinine) done using COBAS INTEGRA 400 PLUS (Roche), then ACR measured two samples was obtained.

Results

In our study 139 patients had high serum triglyceride level, the other 102 patients had normal serum triglyceride level. 154 patients had normal urine ACR, (n=77, 50.0%) had high triglyceride level, (n=77, 50.0%) had normal triglyceride level, 57 patients had microalbuminuria, (n=42, 73.7%) had high triglyceride level, (n=15, 26.3%) had normal triglyceride level, 30 patients had macroalbuminuria, (n=20, 66.7%) had high triglyceride level , (n=10, 33.3%) had normal triglyceride level, p-value was significant, (p<0.005) 

Conclusion

In the current study we found that hypertriglyceridemia is an independent risk factor for CKD. Furthermore, hypertension, hypercholesterolemia, high HbA1c and duration of diabetes were also identified as risk factors for CKD.
THICK ENDOMETRIUM IN SYMPTOMATIC AND ASYMPTOMATIC POSTMENOPAUSAL WOMEN: SONOGRAPHIC AND HISTOPATHOLOGICAL CORRELATION
Authors: Muhammad Shano , Murad Srwa , Jawad Ariana
Published: June 2020

Background 

Incidence of premalignant and malignant endometrial diseases increase in postmenopausal women. 

Objectives 

to identify at which endometrial thickness in symptomatic and asymptomatic postmenopausal women endometrial sampling is optimal and cost effective. Besides, use of ultrasound as a screening tool for detection of endometrial pathology.

Materials and Methods

A cross-sectional study was conducted in Sulaymaniyah Maternity Teaching Hospital during April 2018 to April 2019. 100 postmenopausal women with thick endometrium were recruited; 61 women with bleeding and 39 women without symptoms. All women subjected to endometrial biopsy. The results were recorded, T Test and Chi-Squared Test was used to identify statistical differences between the two groups at a P-value of 0.05 and Receiver Operating Characteristic (ROC) curve of endometrial thickness measurement for prediction of endometrial cancer were analyzed.

Results

Endometrial cancer was detected in 16.5% symptomatic women and 5% asymptomatic women. Best cutoff point of endometrial thickness in predicting endometrial carcinoma in symptomatic women was 14.5 mm, which provided 70% sensitivity and 66.7% specificity. Area under curve (AUC) was 0.71, and P-value was 0.32. While in asymptomatic women, cutoff point of endometrial thickness in predicting cancer was 17.25 mm which provided 50% sensitivity and 86.5% specificity. Besides, AUC was 0.49, and P-value was 0.97.

Conclusion

Ultrasound measurement alone for endometrial thickness has no diagnostic value in asymptomatic women at cutoff point of 17.5 mm. Therefore, it is not a good predictor for endometrial cancer; we should consider other ultrasound features and risk factors while assessing symptomatic and asymptomatic postmenopausal women.
PREVALENCE OF HEPATITIS C VIRUS INFECTION AMONG CHILDREN WITH BETA THALASSEMIA MAJOR IN SULAIMANI
Authors: Hasan Karzan , Rashid Jamal , Ghafoor Ibrahim
Published: June 2020

Background 

Hepatitis C infection is a worldwide problem, especially in multi transfused patients including those with Thalassemia. Thalassemia is one of the inherited diseases, in which there is partial or complete failure of globin chain synthesis.

Objectives 

To evaluate the prevalence of hepatitis C virus infection in multiple blood transfused children with beta-thalassemia major and related risk factors.

Patients and Methods

A cross-sectional study was conducted on 459 patients (229 males and 230 females) with β-thalassemia major at Sulaimani thalassemia centre from January 2015 to June 2015. Data regarding age, sex, number of blood transfusions, chelating agents and history of splenectomy were obtained. Serum was used for detection of antibodies against hepatitis C virus, hepatitis B surface antibody, hepatitis B surface antigen and, human immunodeficiency virus, also in liver enzymes (Aspartate aminotransferase, Alanine aminotransferase) were checked. 

Results

Sixty-four (13.9%) patients were found to be seropositive for anti-Hepatitis C virus antibodies; this was correlated with age, sex, history of splenectomy, number of blood transfusions and chelating agents. Liver enzymes were significantly higher in infected patients. The risk of exposure to hepatitis C virus was higher than the hepatitis B virus surface antigen and human immunodeficiency virus among the same patients.

Conclusion

Multi transfused thalassemic patients are at high risk for HCV infection, so more accurate techniques for screening of blood products is suggested.
DIFFERENT CARDIOVASCULAR MANIFESTATIONS OF PRIMARY HYPOTHYROIDISM IN SULAIMANI TEACHING HOSPITAL
Authors: Khaznadar Amanj , Mareay Aiman
Published: June 2020

Background 

Hypothyroidism is a common clinical condition of variable prevalence in different regions that has significant effect on cardiovascular function. Deficiency of thyroid hormones can cause great changes in cardiovascular hemodynamics and regulation of cardiac function. Hypothyroidism directly influences vascular smooth muscles, provokes diastolic hypertension, changes coagulability, and increases the circulation level of highly atherogenic low-density lipoprotein (LDL) cholesterol particles, which consequently leads to an increase in the risk of atherosclerotic cardiovascular diseases. 

Objectives

To identify the different cardiovascular manifestations and complications of primary hypothyroidism. 

Patients and methods

A cross-sectional retrospective study was carried out at Sulaimani Teaching Hospital in Sulaimani city, the Kurdistan Region of Iraq from July, first 2018 to Jun, first 2019. A total number of 103 patients were recruited in the study, of whom, 93 were females and 10 were males. The patients’ age ranged from (19 to 82) years. The patients were grouped based on their age, sex, residency, heart rate, blood pressure, BMI, and presence of other cardiovascular risk factors. All the participants were sent for thyroid function test (thyroid-stimulating hormone (TSH), and T4), electrocardiogram (ECG), and echocardiogram (Echo), with full history and clinical examination had been done.

Results

The total number of cases were (103) patients with primary overt hypothyroidism who received thyroxin therapy. Their age group was between (19 and 82) years with a mean age of 50.99. Female predominance is obvious with a female-to-male ratio of about 9:1. The results showed that the patients’ age, sex, and family history of cardiovascular diseases did not have a significant association with the incidence of hypothyroidism or euthyroid (p>0.05). 

Conclusions

Cardiovascular risk factors were found to be associated with euthyroid and hypothyroid. Both electrocardiogram (ECG) and echocardiogram (Echo) were significantly effective in detecting cardiovascular complications in patients with thyroid disorders. TSH level assessed through thyroid function test was found as the more reliable means of detecting thyroid diseases.
INCIDENCE AND RISK FACTORS OF LYMPHEDEMA AFTER REGIONAL TREATMENT OF BREAST CANCER
Authors: Ghalib Hawar , Mohammed Dara , Xaznazdr Kanar , Abdullah Khalid
Published: June 2020

Background 

Lymphedema is a limb swelling caused by the accumulation of protein- rich fluid in the body tissues secondary to the disturbance of lymphatic drainage. Moreover, the most common risk factor is the regional treatments for breast cancer. 

Objectives

To find out the incidence of lymphedema and the risk factors for development of lymphedema after wide local excision, modified radical mastectomy, axillary lymph node dissection and radiotherapy in patients with breast cancer. 

Patients and Methods

This retrospective study of 288 patients with breast cancer collected from Hiwa Oncology Hospital, Zhianawa Cancer Centre and Breast Diseases Center in Sulaimani Governorate who underwent surgery, chemotherapy and/or radiotherapy during 1st January 2016 to 31st December 2017. All patients had been followed up for duration of (6 - 36) months. Data were collected from each patient. Breast ultrasonography, mammography, fine needle aspiration cytology, and tru-cut biopsy were collected. The arm circumference of the affected-side was measured ten centimeters above and below supracondylar region and the diagnosis of lymphedema was considered if the arm circumference differences were two centimeters or higher.

Results

The mean ± standard deviation of age (year) was 48.6 ± 10.8 (ranged from 23 to 84) and the majority of the participants were females, with a male to female ratio of (0.03). 74 (25.7%) of the patients were developed lymphedema, 17% of them had lymphedema after surgery, 6.9% of them had lymphedema after radiotherapy and 1.7% of them had lymphedema after both surgery and radiotherapy. 

Conclusions

The types of treatment for breast cancer will affect the occurrence of lymphedema especially if the treatment involves the disturbance of lymphatic drainages and there was a statistically significant association with the lymphedema.
RESEARCH OF A FOREIGN EXPERIENCE OF THE INFLUENCE OF CLUSTERIZATION ON THE DEVELOPMENT OF THE REGION
Authors: Stepanenko D. A.
Published: June 2020

We carried out the analysis of cluster development in EU Member States, based on the reports of the European Center for Research on Clusters and Industrial Change and the European Center for Innovation in Services. We identified directions of support and differences within each direction. In article, we determined the criteria for evaluating clusters by the example of the USA, China, South Korea and other developed countries of the world. We proved that the economic development of regions depends on the effectiveness of the exchange of experience at the cluster level. The study evaluated the results of support for regions in industrial development. We considered the strategies of cluster transformation and made conclusions about introducing a regional aspect as mandatory in the cluster policy of all developed states.
STRATEGY FOR OPENING A CROSSFIT CENTER IN MOSCOW
Authors: Vakin A. N. , Pitucha A. V. , Asrori A.
Published: June 2020

This paper describes the opening of a crossfit center in Moscow. A deep study of the project was carried out, starting from the choice of the location of the new center and ending with the calculation of the economic effect. When modeling business processes, we used MS Excel.
ACCOUNTS INSURANCE
Authors: Pavlenko K.
Published: June 2020

A scientific article is devoted to the analysis of the role of insurance in the management of receivables of enterprises of the economy of the Russian Federation. The relevance of scientific research is associated with the ongoing process of increasing the size of receivables from domestic organizations. The theoretical aspects and fundamentals of accounts receivable insurance are considered. The advantages by which insurance is one of the most relevant methods for managing receivables of enterprises are highlighted. The main negative fundamental factors that increase the degree of problems of managing receivables from domestic organizations are listed. The main disadvantage of insurance is described as a method of managing receivables. The features of the policy and general scheme of insurance of receivables of enterprises are considered.
Awareness on antibiotic usage among undergraduate medical students in a teaching hospital, Guntur
Authors: Mattam Bheemesh Naidu , Prathyusha D. L. N. , Yedurupaka Santhi S. , Yerram Sai V.
Published: June 2020

Background: Antibiotics are the mainstay treatment of most of the infectious diseases. Inappropriate and irrational use of antimicrobial agents has led to increase in the development of antimicrobial resistance. Medical students are a part of health care system and they must be aware of increasing antibiotic resistance as they are the future prescribers. The objectives of the study were to assess the awareness on antibiotic usage and its resistance among medical students and to study the perception on antibiotic medication among medical students.Methods: This was a cross-sectional, semi-structured questionnaire-based study. Questionnaire consists of 4 parts- socio-demographic details, awareness on antibiotics and its resistance, knowledge on specific treatment of a disease, perception levels. Prior IEC approval was taken. The obtained data was statistically analyzed using Microsoft excel sheet.Results: Among 230 participants, majority of the students have awareness on general antibiotic usage and 97.8% were having knowledge about antibiotic resistance. The main source of information on antibiotic resistance is identified as classroom teaching (67.8%). 46.9% and 25.2% students correctly identified the drug of choice for treating enteric fever and community acquired pneumonia respectively.Conclusions: Degrees of awareness on antibiotics and its resistance is found to be good. Antibiotic usage pattern is not on par with knowledge. Knowledge on specific treatment of infectious disease is found to be less. So, antibiotic teaching should be integrated with clinical subjects.
A prospective observational study of drug prescription pattern of antibiotics in diabetic foot ulcer in tertiary care teaching hospital
Authors: Paramasivamsasanger Kamalavarshini , Mariappan Prema , Govindasamy Dhivya , Karunakaran Padmavathi , Ramesh Rajalakshmi
Published: June 2020

Background: Our aim was to study a prescribing pattern of antibiotics used in diabetic foot ulcer (DFU).Methods: 50 patients were selected by inclusion and exclusion criteria basis. It was a prospective observational study conducted in Department of Surgery, Rajah Muthiah Medical College Hospital (RMMCH), Annamalai University.Results: This study reveals that male patients 60% are more prone to develop diabetic foot ulcer than the female patients 40%. Patients of 50 to 60 age group 32% has higher prevalence of DFU. The most commonly prescribed antibiotics are metronidazole 48% and cefotaxime 48% followed by piperacillin and tazobactam combination 30%, ciprofloxacin 20%, linezolid 18%, amoxicillin and clavulanic acid combination 12%, cefixime 6%, clindamycin 4%, amikacin 4%, faropenam 4%, ceftriaxone 2%, amoxicillin 2%, gentamicin 2%, cefoperazone sodium and sulbactam combination 2%.Conclusions: Lack of antibiotic sensitivity test leads to growth of organism, wrong antibiotic selection and irrational use of antibiotics. And also observed patient developed resistance to linezolid antibiotic when used as a first choice of drug to treat diabetic foot infection including methicillin-resistant Staphylococcus aureus (MRSA) infected patients.
Comparative efficacy study of brimonidine tartrate 0.15% and timolol maleate 0.5% ophthalmic solution (benzalkonium chloride free) versus Brimolol® (with benzalkonium chloride) following single ocular instillation in New Zealand white rabbits
Authors: Thavkar Amit , Chauhan Sateesh Kumar , Bhowmick Subhas , Burade Vinod
Published: June 2020

Background: Benzalkonium chloride (BKC) is the most used preservative in topical eye drops but it causes effects such as dry eye and trabecular meshwork degeneration. Polyhexamethylene biguanide (PHMB) is a polymeric biguanide is a less harmful preservative used in ophthalmic solutions. The objective of this study to com-pare the efficacy of PHMB preserved versus BKC preserved ophthalmic solutions containing brimonidine tartrate and timolol maleate on intraocular pressure (IOP) following single ocular instillation in New Zealand white (NZW) rabbits.Methods: This study was conducted on 12 normotensive male NZW rabbits (2.9-3.6 kg) between 6-9 months of age. Animals received single ocular instillation of 35 µl ophthalmic solution containing brimonidine tartrate 0.15 %w/v and timolol maleate 0.5% w/v with PHMB as preservative (n=6, test) or BKC as preservative (n=6, reference) as per the randomization. Intraocular pressure (IOP) was measured before and 2, 4, 6, 8 and 24 hours after instillation using a pneumatonometer. Percentage change in IOP from pre-instillation values were calculated. Changes in IOP were analysed using the repeated-measures analysis of variance followed by Bonferroni post-test.Results: Single ocular instillation of PHMB and BKC formulations show significant IOP reduction up to 6 hours as compared with baseline (p<0.05). Reduction in IOP was 35.8% and 32.0% at 2 hours with PHMB and BKC formulations respectively. No differences were observed between the test and reference groups for change in IOP from baseline.Conclusions: PHMB preserved brimonidine tartrate 0.15% w/v and timolol maleate 0.5% w/v ophthalmic solution was comparable to BKC preserved solution in normotensive NZW rabbits.
Study on outcome of N-acetylcysteine in rodenticide poisoning cases in a rural tertiary care teaching hospital
Authors: Padmavathi K. , Rajalakshmi R. , Dhivya G. , Kamalavarshini P. , Umarani R.
Published: June 2020

Background: Rodenticide is one of the pesticides and heterogeneous substances used to kill rats. Rodenticide poisoning is the major health problem in Asian countries, particularly mode of self-poisoning, prevalent in India. It causes hepatotoxicity and no antidote has been found. N-acetylcysteine (NAC) is a powerful antioxidant and used in the treatment of acetaminophen-induced hepatotoxicity.  The aim of the study is to find the outcome of use of NAC in rodenticide poisoning.  The main objectives of this study were to determine the role of NAC in liver impairment rodenticide poisoning patients.   Methods: A record based observational study was conducted for the period of 3 months from August 2019 to October 2019 at Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu. Data were collected according to the proforma designed and results were analyzed using standard methods.Results: Out of 50 patients, 21 (42%) were males and 29 (58%) were females. Age group between 21-30 years contributes the highest 20 (40%). Majority of type of rodenticide compound consumed by patients were paste 29 (58%) and less than four hours 34 (68%) patients were admitted. Patients with abnormal liver functions were tested, serum glutamic oxaloacetic transaminase/ aspartate aminotransferase -12 patients, 7 treated with NAC. serum glutamic pyruvic transaminase/ alanine aminotransferase - 9 patients, 2 treated with NAC. 37 (74%) were recovered out of 50 (100%), among them 28 (56%) treated with NAC.Conclusions: In liver impairment rodenticide poisoning patients, early use of NAC shows a significant result and the rate of recovery is also high.
Prescribing pattern of nutraceuticals in pediatric outpatient department at tertiary care teaching hospital
Authors: Kulkarni Madhuri , Ambekar Priyanka , Athawale Siddharth
Published: June 2020

Background: Nutraceuticals use is increasing in a health-conscious society. Because of varying lifestyle diseases, people have changed their outlook towards nutraceuticals. The objective of the study was to study the prescription pattern of nutraceuticals by doctors in paediatric outpatient department of government medical college and hospital, Aurangabad, Maharashtra, India.Methods: This study was done between November 2018 to March 2019. Total of 156 patients were included in the study after obtaining written informed consent from parents of patients. The data was gathered, analysed and results were concluded.Results: Total 156 patients were prescribed nutraceuticals in paediatric outpatient department of which 51.92% female patients and 48.78% male patients received nutraceuticals. In this study, 62% patients received vitamins and 38% patients received vitamins and minerals. 67.31% patient receiving nutraceuticals were above the age of 6 years and 32.69% patients were under the age of 6 years. Among patients receiving nutraceuticals, B complex was received 55.77%. After that calcium lactate + vitamin D tablet were prescribed 21.80%. Ferrous sulfate + folic acid was received by 8.33% patients. Calcium carbonate + vitamin D3 were received by 7.69% patients. Folic acid tablet was received by 5.13% patients and poly-vitamin tablet by 1.28% patients. 100% prescriptions were prescribed in generic names.Conclusions: Nutraceuticals are being increasingly perceived as beneficial to health and are being continuously used in the treatment. The future of nutraceuticals is bright and can transform healthcare in a developing country like India.
A comparative study of tapentadol versus tramadol in the treatment of low back pain
Authors: Verma Laxman , Chaudhary Pankaj Kumar , Gupta Chandresh , Saroj Umesh
Published: June 2020

Background: Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department with Rachialgia being the most common reason to request medical assessment among them. Methods: This was a prospective, randomized, parallel group open labelled study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients were randomized into two groups. Group I (63 patients) received tablet tramadol 50 mg twice daily orally and group II (63 patients) received tablet tapentadol 50 mg twice daily orally.Results: The mean age of the patients of group I was 40.6±9.6 years and in the group II was 42.7±10.6 years. A total of 61 males participated in the study of which 31 males were enrolled in group I and 30 in group II while 65 females participated in the study of which 32 females were enrolled in group I and 33 in group II. The mean reduction of pain intensity VAS score at the end of 4 weeks from baseline in group I and group II were 34.57 and 37.55 respectively. The difference in the mean reduction of pain intensity VAS between the two groups was not statistically significant.Conclusions: We conclude that both the drugs show significant reduction in the pain intensity in moderate to severe CLBP patients. Tapentadol is as efficacious as tramadol in moderate to severe CLBP. However, tapentadol is better tolerated than tramadol.
An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate
Authors: Hingorani Sadhana K. , Desai Anupama S. , Shastri Manisha B.
Published: June 2020

Background: Cataract is the leading cause of blindness worldwide. Treatment of cataract is surgical. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by topical steroids (dexamethasone and difluprednate) and to detect adverse effects.Methods: All patients operated by phacoemulsification in ophthalmology Department of SMIMER Surat were taken as subjects. Depending on topical steroids prescribed after surgery, subjects were separated into 2 groups, group 1 - difluprednate and group 2 - dexamethasone. Changes in intra-ocular pressure (IOP) of patients were collected from the data available pre-operative, 1st ,2nd ,3rd ,4th week after surgery and were analyzed. Other parameters whose data were collected are-adverse effects and compliance of patients.Results: In group 1 preoperative mean IOP was 15.5. At the end of 1st week, the mean IOP was significantly increased to 15.8. There was equal rise in IOP during 3rd week and 4th week which means that after 3rd week IOP remains stable. In group 2 preoperative mean IOP was 15.4. At the end of 1st, 2nd, 3rd and 4th there was significant increase in IOP as compared to preoperative mean IOP. Adverse effects were reported more in group 2.Conclusions: In group 1 there was a rise in IOP up to three weeks but after 3rd week IOP remained stable. In group 2 rise in IOP was seen throughout 4 weeks of treatment. Adverse effects seen more in group 2. Compliance of patients was better in group 1.
Evaluation of hematological parameters in oral cancer and oral pre-cancer
Authors: Singh Shruti , Singh Jaya , Samadi Fahad Mansoor , Chandra Shaleen , Ganguly Roop , Suhail Shaista
Published: June 2020

Background: Oral squamous cell carcinoma (OSCC) is the most common public health issue in Indian population. Quite a large number of OSCC cases are preceded by potentially malignant disorders of oral cavity. The need for simple diagnostic marker for early diagnosis and thus better therapeutic outcome is imperative. The current study aims to evaluate hematological parameters such as hemoglobin, bleeding time, clotting time, total leucocyte count (TLC) and differential leucocyte count (DLC) in OSCC and oral potentially malignant disorder cases along with normal healthy controls.Methods: A total of 150 subjects; 50 in each group were taken and 2.5 ml of blood were withdrawn from each subject and TLC, DLC and hemoglobin assessment was done using autoanalyzer while bleeding time and clotting time was recorded through Duke’s method and modified Dale’s method respectively.Results: All the data were tabulated and recorded as mean±standard deviation and comparison was done using one-way ANOVA test (p<0.05). TLC count, neutrophil count and lymphocyte count showed statistically significant difference amongst three groups while other parameters such as hemoglobin percentage, bleeding time, clotting time, eosinophil count, monocyte count and basophil count were statistically non-significant.Conclusions: This study showed TLC count, neutrophil count and lymphocyte count might prove as useful determinant factor in oral squamous cell carcinoma and oral potentially malignant disorders. However, further study with larger sample size is required to establish their role as diagnostic, prognostic marker or predictor of malignant transformation.
Assessment of medication adherence in Helicobacter pylori positive patients on standard triple therapy: a prospective study
Authors: Francis Aleena , Nair Arathi S. , Gomez Limi Joseph , Rahim Bushra Abdul , V. Soumya R. , R. Prasobh G.
Published: June 2020

Background: In the current study patient compliance to the standard triple therapy were assessed. The objective behind this research was to assess the patient medication adherence to the standard triple therapy in Helicobacter pylori infection.Methods: A prospective study was carried out for a period of 1 year and samples were taken from the gastroenterology department. Patient who was RUT (rapid urease test) positive by endoscopy were considered as H. pylori infected and they were prescribed with standard triple therapy. This regimen involves amoxicillin 1000 mg and clarithromycin 500 mg and proton pump inhibitor (PPI) twice a day for 14 days. Adherence to this triple therapy was assessed during the study. Medication adherence assessed using Morisky, Green and Levine (MGL) adherence scale. MGL adherence questionnaire was given to patients during first week and second week of therapy. The patients will be counselled regarding the drug administration, drug related problems and the infection. They were also provided with written instructions in leaflets. 88 patients were analyzed.Results: In this study, 84 patients had a good adherence 95.5%; but other 4.5% didn't fully comply with the physician's order. After the first week of standard triple therapy, adherence was increased to a mean score from 2.193±0.1301 to 3.5227±0.0704 in the second week. The medication adherence score significantly increased along with patient counselling.Conclusions: Medication adherence was improved in the 14 days course along with patient education helped to comply with the standard triple therapy.
Knowledge and practices regarding pharmacoeconomics among resident doctors in a tertiary care teaching hospital
Authors: A. R. Reshma Raj , Sudha M. J. , Viveka S.
Published: June 2020

Background: With skyrocketing health care costs, even the essential care provided by the health care service providers need to be evaluated under the lens. The development of nationwide awareness of cost-benefit, cost-utility and cost-effectiveness of services is the need of the hour. The objectives of the present study were to assess the knowledge about pharmacoeconomics among resident doctors and to assess the clinical application of pharmacoeconomics among them.Methods: A cross sectional questionnaire-based survey was conducted among resident doctors involving both interns and post-graduates of a teaching medical college. There were 20 questions; initial ten were for knowledge assessment and next ten questions assessed practical applications. Questions assessed the knowledge regarding components of pharmacoeconomics, direct and indirect medical costs, and application of pharmacoeconomics, local cost-effectiveness decisions and advantages of pharmacoeconomics.Results: Of the 118 participants who took part in the study, 42 were clinicians working in medical college hospital, 12 were clinicians working in dental college hospital, 24 medial postgraduates, 30 dental postgraduates and 10 interns. Nearly 90% of the respondents opine that concepts of pharmacoeconomics are not followed in every teaching hospital in India. Many participants (90%) opined that health economics and pharmacoeconomic are different. Nearly 94% of participants have not under gone any training regarding pharmacoeconomics. More than 95% respondents have opined that principles of pharmacoeconomics has to be introduced into current medial undergraduate curriculum.Conclusions: This study shows light on the knowledge and practices of resident doctors regarding principles of pharmacoeconomics. This study has revealed the level of awareness of younger generation regarding pharmacoeconomics.
Assessment of knowledge on pharmacotherapeutics among undergraduate medical students in a South Indian medical college
Authors: Palacherla Surekha , Mattam Bheemesh Naidu , Burli Kodanda Ramu , Moorthy Sachidananda
Published: June 2020

Background: Pharmacotherapeutics knowledge is important for rational drug therapy. Assessment of knowledge on emergency and non-emergency medical conditions in medical students will be helpful to   develop a methodological approach in building knowledge on patient care and in improving quality of medical education.Methods: It was a questionnaire based cross- sectional study conducted among undergraduate medical students in MIMS college after taking Institutional ethical committee permission. The students of final MBBS part-I and final MBBS part-II and house surgeons were given semi-structured questionnaires. It constitutes questions on awareness of pharmacotherapeutics of non-emergency (20) and emergency (8) medical conditions.Results: Received a total of 284 responses, of them 43.32%, 39.43% and 17.25% are from final MBBS part-I, final MBBS part-II and house surgeons respectively. 48.1% students agreed that undergraduate training sufficient to confidently give a safe prescription to the patient. The overall knowledge of the students in pharmacotherapeutics relating to certain non-emergency conditions is found to be 64.89% and relating to emergency conditions, it is 62.98%.Conclusions: Knowledge on emergency and non-emergency PT is moderate. Appropriate training programs are needed to improve this situation. Regular evaluative measures also help to overcome the present situation.
Avapritinib: novel hope for patients with metastatic gist with PDGFRA exon 18 mutation
Authors: Maggo Sachin , Dubey A. P. , Dhull Pawan , Singh Nilabh Kumar
Published: June 2020

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. The activating mutations in platelet-derived growth factor receptor A (PDGFRA) have been linked to the development of GISTs, and up to approximately 10% of GIST cases involve mutations of this gene. Current treatment options for metastatic GIST are minimal, mainly trusting on tyrosine kinase inhibitors (TKIs) such as Imatinib, Sunitinib and Regorafenib. However, eventually, most patients develop resistance to TKIs, usually due to the acquisition of secondary mutations. Moreover, 5-6% of patients with unresectable of metastatic GIST have the primary PDGFRA D842V mutation, which makes it resistant to all approved treatment options. Avapritinib, a potent and selective TKI of KIT and PDGFRA activation loop mutants. The drug demonstrates anti-tumor activity by inhibiting the autophosphorylation of KIT D816V and PDGFRA D842V, thereby terminating the downstream signalling. The drug is available in oral formulation with a recommended dosage of 300 mg once daily. The onset of Avapritinib is fast, shows rapid absorption and linear pharmacokinetics. Most common adverse reactions seen are edema, fatigue, abdominal pain, and neurocognitive defects. Clinical trials for Avapritinib have been positive, and results suggest that the drug may be a new safe and effective option for metastatic GIST treatment. With Blueprint Medicines having already received US FDA approval in January 2020, Avapritinib may soon be an addition to the mounting armoury of drugs against metastatic GIST harbouring PDGFRA exon 18 mutation.
Effect of hydroxychloroquine in viral clearance in nCOV-19 infected patient admitted in tertiary care centre, Ranchi, Jharkhand, India
Authors: Mishra Brajesh , Munda Manish K. , Dungdung Ajit , Ekka Nishit M. P. , Prasad Manoj K. , Kumar Prabhat , Kumar Abhay , Guria Rishi T. , Bakhla Ajay K.
Published: June 2020

Background: In view of recent publications of conflicting evidence on the safety and efficacy of hydroxychloroquine as prophylaxis and as a treatment for COVID-19 patients, we need to assess the effect of hydroxychloroquine in COVID-19 patients of authors own local population.Methods: In this retrospective chart review study, categorization of confirmed COVID-19 cases nasopharyngeal swab of RT-PCR was done into a group of patients who received hydroxychloroquine standard dose and another control group who did not receive hydroxychloroquine. The main comparing parameter was to see virus clearance days across both groups.Results: A total of 112 patients were included for the study, and grouped of 72 patient who received HCQS and remaining 40 patients as control. The virus clearance time in days was found to be 9.01±3.08 for HCQS group and for control group it was 8.64±2.34 days (Man Whitney U test value = 2.13, p=0.756).Conclusions: There is no significant difference found in attaining virus negative status with use of HCQS administration in this study.
Histomorphological study of salivary gland neoplasms: fifteen year study
Authors: Hemalata M. , Manjula C. P. , Nandi Rishitha
Published: June 2020

Background: The neoplasms of salivary glands are relatively uncommon and represent less than 2% of all human tumors. They are morphologically diverse, with marked heterogeneity among the different subtypes and even within the same tumor. The unpredictability in the long term outcome imposes a significant challenge in the clinical management.Methods: This is a descriptive study done in a tertiary care teaching hospital over a period of 15 years. Patient details were collected from medical case records. All specimens were evaluated for site, laterality, size, nature of the cut surface and intactness of the capsule. Two to 5 representative bits were taken from each specimen and subjected to routine fixation, processing and section cutting followed by Haematoxylin and Eosin staining.Results: A total of 138 salivary gland tumors were diagnosed from patients in the age group of 13 to 90 years with a mean age of 41.8 years. There were 53 (38.4%) males and 85 (61.6%) females with male to female ratio of 1:1.42. There were 115 (83.3%) benign tumors and 23 (16.7%) malignant tumors. Pleomorphic adenoma accounted for 70.3% of all salivary gland tumors followed by mucoepidermoid carcinoma (10.9%), Warthin tumor (8%), basal cell adenoma (2.9%), adenoid cystic carcinoma (2.2%), squamous cell carcinoma (2.2%), myoepithelioma (1.4%), oxyphillic adenoma (0.7%), acinic cell carcinoma (0.7%) and salivary duct carcinoma (0.7%).Conclusions: The salivary gland neoplasms are relatively uncommon head and neck tumors. Parotid gland is the commonest site of occurrence. Pleomorphic adenoma is the commonest benign and mucoepidermoid carcinoma the commonest malignant salivary gland tumor.