bluuebunny/crossref_metadata_2025 huggingface dataset:
THE DESIGN OF THE ARTERIOVENOUS VASCULAR LOOP DOES NOT AFFECT ITS PATENCY: EXPERIMENTAL STUDY
Authors: SAITO MATEUS , REZENDE MARCELO ROSA DE , SANTOS GUSTAVO BISPO DOS , BITTENCOURT THIAGO , NUNES MARIA DO CARMO , MATTAR JUNIOR RAMES
Published: May 2020

ABSTRACT Objective: To evaluate the effect of the design of a femoral vascular loop with anastomosis in the femoral artery of rabbits on the presence of flow (patency) after seven days. Methods: A total of 39 rabbits underwent arteriovenous microanastomosis using the microsurgical technique. Two loop designs were used: one circular and the other angled. The parameters evaluated were presence or absence of flow, signs of hemolysis and hemodynamic changes. Results: After seven days, flow was present in 68% of the angled loops and 75% of the circular loops (p > 0.05). There was a significant intragroup decrease in pCO2 and a significant increase in pH. For the other parameters evaluated, no significant differences between the two loop models were found. Conclusions: A reproducible vascular loop model was shown. There was no significant difference between the two vascular loop models about the presence of flow after seven days. Level of Evidence V, Animal experimental study.
Área de vida de Cistothorus platensis (Aves: Troglodytidae) no Cerrado brasileiro
Authors: Fujikawa Aline , Tubelis Dárius P.
Published: May 2020

RESUMO A corruíra-do-campo Cistothorus platensis (Latham, 1790) apresenta ampla distribuição geográfica, ocorrendo ao longo de todo o continente americano. Informações sobre sua biologia têm sido obtidas principalmente em regiões temperadas, e o conhecimento sobre suas áreas de vida em campos tropicais é inexistente. O objetivo deste trabalho foi estudar as áreas de vida de C. platensis no Parque Nacional da Chapada dos Veadeiros, Cerrado do Brasil central. Quatorze machos foram anilhados em um campo sujo e cinco deles puderam ser acompanhados continuamente entre fevereiro e dezembro de 2008. O tamanho médio das áreas de vida (n = 5) foi de 6,10 ± 2,09 ha (Mínimo Polígono Convexo) e 4,57 ± 1,92 ha (Kernel 95%) e variaram significativamente entre as estações estudadas. As áreas de vida foram maiores na estação seca (período não-reprodutivo) do que na estação chuvosa (que abrangeu os períodos reprodutivo e não-reprodutivo). Houve baixa sobreposição entre áreas de machos vizinhos. As aves estudadas não estabeleceram áreas de vida em trechos de campo recentemente queimados. Alguns indivíduos foram registrados durante todo o período do estudo, sendo assim considerados residentes. Entretanto, nove dos 14 machos não persistiram no local. Não houve evidência de poliginia, uma vez que somente casais ou aves solitárias foram registradas. Este estudo indica que C. platensis habitando campos naturais no Cerrado são monogâmicos e têm áreas de vida maiores do que em regiões temperadas.
On-Road Emission Characteristics of Volatile Organic Compounds from Light-Duty Diesel Trucks Meeting Different Emission Standards
Authors: Wang Menglei , Zhu Rencheng , Zhang Ruiqin , Li Shunyi , Bao Xiaofeng
Published: May 2020

On-road tailpipe volatile organic compounds (VOCs) were sampled from light-duty diesel trucks (LDDTs) compliant with Euro III to V, and a total of 102 VOC species were quantified. The composition characteristics and carbon number distributions were investigated, and the contribution of individual VOC to ozone formation potentials (OFPs) was weighted. Results showed that alkanes were the major VOC species, accounting for approximately 65.5%. VOC emissions decreased significantly as the standards became stricter, especially for alkanes and aromatics; and the VOC emissions on highway were much lower than those on urban roads. Carbon number distribution of VOCs was mainly concentrated in C3–C4 and C10–C12. Aromatics were the major contributors to ozone formation, taking up 49.3–57.6% of the total OFPs, and naphthalene, 1-butene, dodecane, 1,2,3-trimethylbenzene and 2-propenal were the top five species. The information provided insight into the tailpipe VOC emission characteristics and may help decision makers drafting related emission policies.
Östemperlenmiş Küresel Grafitli Dökme Demirlerde XRD Yöntemiyle Yüksek Karbonlu Östenit Faz Hacim Oranını Belirlemede Yüzey Koşullarının Etkisi
Authors: NALÇACI Burak , KILIÇLI Volkan , ERDOĞAN Mehmet
Published: May 2020

Bu çalışmada XRD
(X-Işınları kırınımı) yöntemiyle yüksek karbonlu östenit faz hacim oranı belirlenmesinde
yüzey koşullarının yüksek karbonlu östenit faz hacim oranı üzerine etkisi
araştırılmıştır. Böylelikle XRD analizinde uygun yüzey koşulunun belirlenmesi
hedeflenmiştir. Bu amaç doğrultusunda, alaşımlı küresel grafitli dökme demire 900°C’de
2 saat östenitleme ve 375°C’deki tuz banyosunda 2 saat östemperleme ve ardından
oda sıcaklığına havada soğutma işlemi uygulanmıştır.

Isıl işlem
sonrası dört eşit parçaya ayrılarak farklı yüzey koşullarında hazırlanan numuneler
optik ve SEM ile incelenmiş, XRD analizleri yapılmış ve makro sertlik ölçümleri
gerçekleştirilmiştir.

XRD
yöntemiyle yüksek karbonlu östenit faz hacim oranı ölçümlerinde farklı yüzey
koşullarının östenit faz hacim oranı ölçümü üzerinde oldukça etkili olduğu
gözlemlenmiştir. XRD yöntemiyle faz hacim oranı belirlenmesinde polisaj+dağlama
işleminin yüzey pürüzlülüğünü azalttığı için oldukça etkili olduğu tespit
edilmiştir.
Çocuklarda Akılcı İlaç Kullanılmasının Önemi Ve Ebeveynlere Öneriler
Authors: ÇALIŞIR Özlem , ÇALIŞKAN Zehra
Published: May 2020

Çocuk sağlığını olumsuz etkileyen faktörlerin başında enfeksiyon hastalıkları gelmekte olup, enfeksiyon hastalıklarının tedavisi ilaç kullanımını beraberinde gerektirmektedir. Son dönemlerde çoklu ilaç kullanımının artması (Polifarmasi), olumsuz ilaç reaksiyonlarına, ilaç etkileşimlerine ve artan maliyet sorunlarına neden olduğundan “akılcı ilaç kullanımı” kavramı ön plana çıkmıştır. Dünya Sağlık Örgütü (DSÖ), ilaçların yarıdan fazlasının akılcı kullanılmadığını belirtmekte ve Akılcı İlaç Kullanımı’nı; hastaların klinik ihtiyaçlarına uygun, kendi bireysel gereksinimlerini karşılayan dozlarda, uygun bir süre boyunca ve en düşük maliyetle ulaşması olarak tanımlamaktadır. Dünya çapında ilaçların güvenli, bilinçli ve etkili kullanımı; kamu sağlığının yanı sıra, çocuk sağlığının iyileştirilmesinde de temel stratejilerden biri olarak karşımıza çıkmaktadır. Çocukların dinamik bir büyüme-gelişme-olgunlaşma sürecinde olmaları, bazı ilaçların çocuklarda kullanımına dair farmakokinetik/farmakodinamik verilerin sınırlı olması nedeniyle, ilaç güvenliği ve akılcı ilaç kullanımı çocuklarda daha da önem kazanmaktadır. Hemşirelerin, çocuklarda akılcı ilaç kullanımı konusunda ebeveynlere özellikle annelere, eğitim ve danışmanlık vererek çocuk sağlığının iyileştirilmesine katkı sağlayacağı düşünülmektedir.
Activation of educational activities of schoolchildren under the development of mathematical methods of knowledge
Authors: Bekoeva Marina I.
Published: May 2020

The paper is devoted to the problem of improving the teaching of mathematics in a comprehensive school, enhancing educational and cognitive activities based on mathematical methods of cognition, identifying the most effective teaching technologies that promote students to develop creative thinking, the ability to independently solve non-standard problems, and modeling complex mathematical objects. In connection with the introduction of innovations in the general education school, which posed fundamental questions to scientists and teachers about the specifics of teaching and educating schoolchildren, it became necessary to resolve the dialectic contradiction between the desirability of implementing a competencybased approach based on methods and techniques of scientific knowledge, mathematical logic, and a system of algorithmic prescriptions providing creative activities for students and still practicing the deductive nature of traditional methods dove teaching mathematics. The paper focuses on the fact that in order to enhance the creative educational and cognitive activity of students, it is important to constantly correlate the studied mathematical models with their real prototypes by abstracting and generalizing the phenomena of the real world, substantive and methodological connection of theoretical conclusions with practical work. The methods and approaches proposed in the paper for teaching students how to solve problems and equations together form the methodological field of various teaching methods and techniques in new, more flexible combinations and in non-standard contexts for the general course of mathematics. The creative development of the richest opportunities, characteristic for the practice of the work of the best teachers, should be the property of all teachers of mathematics, should be reflected in innovative approaches to teaching mathematics, the formation of logical thinking among schoolchildren.
The Comparative of Attitudes Towards People with Disability in Russia and Israel.
Authors: Fedorova A. , Shcherbakova A.M.
Published: May 2020

This article provides a review of comparative research on working in helping professions people’s attitudes towards people with physical and intellectual disability in Russia and Israel. The sample includes 44 middle-aged persons of both genders working with students with different forms of disability as well as without any. Results suggested that diagnostic methods of Anna Shcherbakova are relevant for the multicultural researches and can be used not only for Russian-speaking sample. With those methods in both samples were found statistically significant difference in the attitudes towards people with intellectual disability and those with other forms of disabilities. Considering other disabilities categoty, subjects showed mostly accepting or ambivalent attitude, in 30% cases — rejecting attitude. In case of intellectual disability, it is mostly rejecting (only 12% of respondents show accepting attitude towards those people). There was also found interesting connection between gender and answers concerning possibility of people with disability to run for important political positions: women much more likely to vote for the candidate with disability than men. We also have got evidence of significantly different social, cultural and psychological ways of dealing with attitudes towards people with disability. For example, for Russian respondents the main thing about people with disabilities is their weakness and inability, and Israel respondents (37% of respondents) discuss mainly the feelings and thoughts of disable persons. The conclusion is that the further examination of those differences is necessary and can help provide more accepting environment for people with various kinds of disability.
The Inclusive Education: Policy Issues and Challenges. The Rights in the Amended Special Edu- cation Law in Israel (1988)
Authors: Shaked L.
Published: May 2020

This paper discusses the effects of Special Education law (1918) in Israel and amendments followed in 2002; 2018 on school placement policy and attitudes toward inclusion. The critics on differential budget to different setting that the budget doesn’t support the least restrictive environment concept and inequality in the allocation of resources among students in special education and students integrated in the regular education lead to the amendment nr.11 of Special Education law. Present paper argues that while state policy makes an ongoing effort to increase access to general edu- cation by innovative legislation, increasing the state funding in order to accommodate and meet the needs of students with disabilities in inclusive education the practices of educational institutions perpetuated exclusion from general education. For regular teachers to feel confident in their ability to teach all students, a change in teacher preparation programs should be implemented. A change in teacher preparation programs still needs a profound reform.
Attitude to co-Education of Children with Disabilities and Healthy Children in Students of Pedagogical Specialties
Authors: Simanovskij A.E.
Published: May 2020

The article examines the attitude of students of pedagogical specialties to inclusive education, examines the causes of negative attitudes and identifies students’ perceptions of the psychological qualities of people who are in favor and against inclusive education. The author’s questionnaire used as a research method. The survey involved students of Yaroslavl State Pedagogical University named after K.D. Ushinsky and Rostov Pedagogical College. The results obtained in the study showed that the majority of students support the idea of inclusive education, and almost all of them are ready to help people with disabilities. The negative attitude towards inclusion in different students has different reasons, in particular, related to problems of healthy students, problems of students with disabilities and problems associated with difficulties for teachers and the lack of conditions necessary for such training. Based on a qualitative analysis of respondents’ opinions, concluded that a positive attitude towards inclusion is often a result of the subjective experience of a student communicating with people with disabilities, and not the result of an objective analysis of the situation in inclusive education.
Representations of Teachers about Their Own Work in Inclusive Practice
Authors: Sunko T.Y.
Published: May 2020

The work of teachers in inclusive education inextricably linked with the assuming of the values of inclusion concept, adaptation and individualization of the education process. The aim of the pilot study conducted in 2018 was the determination of the representations of teachers about the inclusive practice and the characteristics of their work activities. Educational workers of Moscow schools aged 30 to 50 years (N = 16) with higher education and experience in inclusive practice for more than three years participated in the study. Data was obtained with the use of questionnaire; conventional content analysis used to process the results. The results demonstrate that the specificity of teachers, who implements an activity-based and differentiated approaches, position on the necessity of conditions for learning in an inclusive school is the following: making of host environment (24 %), educational content adaptation (26 %), individualization of tasks (30 %).
Certain Inclusion Problems in Autism Spectrum Disorders
Authors: Morozov S.A. , Morozova S.S. , Morozova T.I.
Published: May 2020

The term “Inclusion” is not identical to the concepts of “Inclusive education”, which is much wider. The educational system of children with autism spectrum disorders (ASD) in Russia is only developing and the focus on inclusion is a great achievement. Inclusive education in autistic disorders is a special case. The most difficulties in organizing of inclusion of children with ASD caused by main symptoms — communication and social interaction disorders, repeated stereotypical patterns of behavior, interests and activities. After all, these symptoms create a special development situation that makes necessary to solve the following problems: improving the organization of the inclusive process, feasibility and possibility of inclusion process. Typical difficulties faced by domestic and foreign experts reviewed, for example: increased social anxiety in children, lack of trained personnel, and lack of diagnostic in children. Emphasized that the success of inclusion process depends on several things: the readiness for inclusion of the child with autism, the readiness of the environment where inclusion carried out, the level of its tolerance and, finally, the competence of psychological and pedagogical staff. The age of the child and the environment plays a large role: ceteris paribus, the early onset of inclusion contributes to the stability of inclusive readiness of the environment.
Etnosentrik Eğilim Bağlamında Yerli Üretim Logosunun Satın Alma Niyeti Üzerindeki Rolü
Authors: DÖNMEZ Mevlüt Sedat
Published: May 2020

Bireylerin etnosentrik eğilimleri doğrultusunda markalara yönelik satın alma niyeti geliştirdikleri varsayılmaktadır. Markalar ise ait oldukları menşei ülke bilgilerini bir avantaja çevirme ve bu avantajı tüketicileri ikna etme aracı olarak kullanma gayreti içerisine girmektedir. Bu bağlamda işletmeler ambalajlarında veya iletişim çalışmalarında yerli üretim ifadelerini kullanarak bireylerde kendi ürünlerine yönelik satın alma niyeti oluşturmaya çabalamaktadır. Söz konusu varsayımdan yola çıkan bu araştırma kapsamında etnosentrik eğilim bağlamında yerli üretim logosunun bireylerde satın alma niyeti oluşturmadaki rolü duş jeli ve meşrubat ürün kategorileri çerçevesinde sorgulanmıştır. Anket tekniğinin kullanıldığı ve 316 katılımcı ile gerçekleşen araştırmada aynı zamanda katılımcıların etnosentrik eğilim seviyeleri doğrultusunda ilgili ürün kategorilerine yönelik satın alma niyeti arasındaki farklılıkları da sorgulanmıştır. Sonuçlar doğrultusunda bireylerin etnosentrik eğilimlerinin yerli üretim logosunun kullanıldığı duş jeli ve meşrubat ürünlerine yönelik satın alma niyeti oluşumu üzerinde pozitif yönde etkili olduğu görülürken, etnosentrik eğilim seviyeleri ile bu ürünlere yönelik oluşan satın alma niyeti arasında da anlamlı farklılıkların olduğu sonucuna erişilmiştir.
Walking for Transportation on Campus: Perspectives from Faculty and Students
Authors: McMullen Jennifer , Kercsmar Sarah , Poole Kimberly , Ickes Melinda J.
Published: May 2020

Background: Walking is a recommended strategy for meeting physical activity (PA) requirements and benefiting from associated health outcomes. Walking for transportation, which is walking to get from ”Point A” to ”Point B,” may help individuals in fulfilling their weekly recommended PA, though little research has been done as it relates to walking for transportation on a college campus.Aim: To qualitatively explore attitudes and barriers toward walking for transportation and cues to action among a convenience sample of faculty, staff, and students.Methods: Through a non-experimental design, qualitative data were collected through conducting focus groups (n = 10) at a public, southeastern university with college students, staff, faculty (n = 13 students; n = 25 staff; n = 19 faculty).Results: The main themes emerging included: definitions of walking for transportation, factors that encouraged walking for transportation, barriers to walking on campus, and campaign/incentive suggestions.Conclusion: Findings support previous research which indicates situational factors prohibit individuals from walking for transportation. Further, findings indicate it would be of value for future research to determine best practices for promoting and incentivizing walking across various sub-groups not explored in this study. Lastly, point-of-decision prompt use (i.e., campus signage to promote walking) should be explored as a strategy to promote walking and active transport to determine what various groups respond most positively to.
Guest Editorial: Uniquely Human
Authors: Bartos Susan
Published: May 2020

No abstract available.
Leveraging System-wide Well-being and Resiliency in Higher Education During the COVID-19 Pandemic
Authors: Amaya Megan , Melnyk Bernadette Mazurek
Published: May 2020

No abstract available.
A cross sectional study to assess knowledge, attitude and practices of pharmacovigilance by interns in a tertiary care hospital in North Karnataka
Authors: Bannale Sheshidhar Gajanan , Suresh Kirtana
Published: May 2020

Background: Adverse drug reactions (ADRs) are an important contributor to morbidity and mortality burden in modern health care system. Continuous monitoring of drug after entering into market is necessary as it helps in improving care and safety of patient. In India, there is ongoing National Pharmacovigilance program to monitor ADRs. However, there is marked under-reporting of ADRs due to various reasons. Hence this study was taken to evaluate the knowledge, attitude and practices by the next generation doctors i.e., interns working in a tertiary care hospital, Bagalkot, Karnataka.Methods: After ethics committee approval, a pretested questionnaire containing 15 questions was given to 80 interns. Finally, 60 sets were used for analysis, as 20 were incomplete.Results: In our study it showed interns have good knowledge about pharmacovigilance as 67.4% correct responses were seen in knowledge domain and similarly 79% responses related to attitude were correct. However, there was a marked difference in the practice of ADR reporting as only 9.6% participants have reported an ADR. This study highlights that in-spite of having knowledge and awareness there was lesser ADR reporting practices. Major reasons for hindering ADR reporting found were difficulty in identifying an ADR, lack of time, not knowing how and where to report, lack of incentives and no compulsion.Conclusions: Under reporting issues can be addressed by conducting more educational activities especially at undergraduate and intern’s level, including continuous medical educations, workshops, problem-based learning about pharmacovigilance in detail in curriculum. These activities will increase reporting culture and sensitize interns to inculcate it in their future clinical practice also.
Cerebrospinal fluid adenosine deaminase level as a diagnostic marker in adult tuberculous meningitis: a study conducted in a tertiary care hospital of Eastern India
Authors: Biswas Biswajit , Ghosh Balaram , Mandal Arpan , Saha Dipan
Published: May 2020

Background: Tubercular meningitis is one of the highly prevalent form of meningitis in the world and is a significant cause of morbidity and mortality in developing countries like India. Lack of early and timely diagnosis and subsequent initiation of treatment makes the fatality rate even higher. Cerebrospinal fluid (CSF) analysis is most important aspect of lab diagnosis in tuberculous meningitis (TBM) worldwide. The objective of this study was to study the cerebrospinal fluid CSF adenosine deaminase (ADA) levels in TBM and non-TBM meningitis cases and to determine its diagnostic significance as a biochemical marker of TBM infection.Methods: The study population comprised three different patient groups. TBM (n=36), pyogenic meningitis (n=17) and aseptic meningitis group (n=12). Total 75 subjects were enrolled consecutively in the study and CSF specimens were collected from them. ADA and other cytological and biochemical estimation were carried out using standard protocol.Results: ADA level in TBM in compare to non-TBM was more and mean ADA level of TBM, AM and PM are 26.423±3.8, 2.602±0.5 and 6.29±0.3 respectively. There are highly significant differences between the TBM and non-TBM groups and also in compare with individual groups.Conclusions: CSF ADA levels are elevated in the TBM cases as compared to the non-TBM - meningitis cases.  Results are statistically significant. It is a simple and inexpensive diagnostic adjunctive test in the rapid and early diagnosis of TBM.
Psychotropic drug utilization in psychiatric outpatient department of a tertiary care government hospital
Authors: Jena Pragyan Paramita , Naik Birendra Narayan , Rath Bhabagrahi
Published: May 2020

Background: Mental disorders are associated with significant distress in social, occupational and other important activities. Of the ten health conditions contributing to the DALYs, four are psychiatric disorders.  Psychiatric disorders form an important public health priority and major causes of morbidity. Psychotropic drugs had a remarkable impact in psychiatric practice. The utilization, clinical practice, effectiveness and safety in real life situation need continuous study.Methods: A cross-sectional study was carried out by analyzing prescriptions of patients who visited the OPD of the psychiatry department of VIMSAR, Burla for a period of 4 months. Patients of all ages and both sexes were included in this study with exclusion of patients suffering from epilepsy and cases with uncertain diagnosis. The prescribing pattern was analyzed using WHO basic drug indicators.Results: Average number of drugs per prescription was 3.17. Bipolar affective disorder (BPAD) was the most common psychiatric condition (44%) with a male predominance followed by schizophrenia. Olanzapine was the most common antipsychotic used. The most frequently used fixed dose combination was tri-hexiphenydyl and risperidone. Prescribing frequency of different psychotropic drugs (antipsychotics, antianxiety, selective serotonin reuptake inhibitors, tricyclic antidepressant, mood stabilizers) were compared.Conclusions: The study advocated a rational use of psychotropic drugs with fewer deviations due to socio-economic status of patients and prescription practices of healthcare providers.
A study on prescribing pattern of antibiotics in medicine ward of tertiary care teaching hospital
Authors: Patel Akhilesh , Naagar Mamta , Singh Rajveer
Published: May 2020

Background: Antibiotics are most frequently prescribed and problem associated with antibiotics over and under use leads to treatment failure and on the other side resistance to drugs increases. Assessment of antibiotics prescribed is important for checking quality and standard of prescriptions. The objective of the study was done for assessing the prescribing pattern of antibiotics using WHO indicator in medicine ward of tertiary care teaching hospital.Methods: Prospective observational study was carried out for a period of six months in medicine ward after ethical committee approval. Data was collected in data collection forms and evaluated using WHO indicator.Results: A total of 190 prescriptions was collected in which 1145 drugs were prescribed. Total number of antibiotics in prescription was found to be 164. Percentage of antibiotics was found to be 14.32% which was according to WHO prescribing indicator. Various class of antibiotics was prescribed in which cephalosporin with total of 90 (54.87%) followed by penicillin 18 (10.97), macrolide 18 (10.97%) fluoroquinolones 11 (6.70%), nitroimidazole 8 (4.87%), amino glycoside 8 (4.87%) and other classes 11 (6.70%).Conclusions: The study shows that pattern of antibiotics was according to the WHO prescribing indicator but still practice was lacking in terms of selection of antibiotics as there was no culture sensitivity test was performed.
A prospective study of adverse drug reactions associated with chemotherapy in patients of carcinoma head and neck in Government Cancer Hospital Indore, India
Authors: Pandit Sameer , Verma Manish , Mishra Pooja Solanki
Published: May 2020

Background: Adverse drug reactions (ADRs) has become one of the major health issues due to wide use of medications worldwide. Chemotherapy is one of the treatment lines in which multiple drugs are commonly used for long term in cancer patients, are more prone to cause ADR.Methods: Head and neck cancer patients admitted in government cancer hospital, Indore for chemotherapy were included in study for a period of 6 month from March to August 2019. Data from chemotherapy related ADR was obtained either from patient’s case reports or interview of patients, recorded in suspected adverse drug reaction reporting form (version 1.3) of CDSCO and analyzed.Results: During 6 months duration total 126 patients (M:F=108:18) were enrolled in the study, among which 251 ADRs were reported. Majority of ADRs occur in 45-60 years of age group followed by 30-45 years. Paclitaxel, cisplatin, 5-florouracil (5-FU) combinations (45.2%) implicated highest number of ADRs followed by paclitaxel and carboplatin combination (38%). Most common ADR was alopecia and constipation. ADR related mostly with GIT system followed by integumentary, haematological system while CNS was least affected.Conclusions: In this study Ca tongue was most commonly seen head and neck cancer followed by Ca buccal mucosa. Age group 45-60 years were commonly affected. Paclitaxel, cisplatin, 5-FU combination was commonly used regimen and primary cause of ADR. Alopecia and constipation were noted to be most common ADR. Other ADRs reported were mild and easily manageable.
Evaluation of detoxifying activity of ORGCHP against acetaminophen induced hepatotoxicity in Sprague Dawley rats
Authors: Vasudevan Subbu KesavaRaja , Seetharam Suresh , Poongavanam Anbudhasan
Published: May 2020

Background: Accumulation of toxins in the body over a period of time interferes with the normal body functioning. The removal of toxins from the body is called ‘detoxification’. The liver is the main organ involved in detoxification and damage to the liver may impede the removal of toxins. The present study assessed the hepatoprotective activity of an organic Chlorella vulgaris in acetaminophen-induced liver damage model.Methods: A total of 35 animals were randomized to five groups with seven animals in each group. The test drug, organic Chlorella vulgaris (ORGCHP; 350 mg/kg and 700 mg/kg) was compared with a reference standard (200 mg/kg). The positive control group and the vehicle control group were administered 0.5% w/v carboxy methyl cellulose. All groups received dose volume of 10 ml/kg for 10 days. Acetaminophen was given on day 8 and day 9. Blood collections were done at baseline day 1, day 8 and day 10. Outcome measures were the change in body weight, oxidation biomarkers, histopathological evaluation, gross pathological evaluation and relative body weight.Results: Test drug ORGCHP Chlorella vulgaris showed dose dependent reduction in hepatoxicity with high reduction in aspartate transaminase (AST) and modest lowering of alanine transaminase (ALT) (350 mg/kg; p.o.); while at high dose (700 mg/kg; p.o.) there was significant reduction in alkaline phosphatase (p<0.05), ALT (p<0.001) and AST (p<0.001) levels. No pathological or histopathological abnormality was seen in control group. In drug group, one animal showed minimal necrosis, while mild and moderate necrosis was seen in three animals each respectively.Conclusions: The test drug exhibits detoxifying and hepatoprotective activity against acetaminophen induced hepatotoxicity.
Polypharmacy and cost analysis in patients suffering from type 2 diabetes mellitus with associated comorbidities
Authors: Dhongdi Snehal R. , Siddiqui Riyaz A.
Published: May 2020

Background: Diabetes mellitus is a common health problem worldwide, associated with several co-morbidities. It requires longer therapy, and is crippling in terms of cost management. The objective of this study was to evaluate co-morbidities in patients suffering from type 2 diabetes and concomitant medications used along with antidiabetic drugs, also analyzing individually cost of drug therapy.Methods: It is an observational, cross sectional study. The study was conducted at outpatient department, Medicine at a tertiary care hospital. Prescriptions of patients attending the clinic, suffering from type 2 diabetes were analyzed for antidiabetic drugs and other concomitant medications for associated co-morbidities. Their age, sex, number of medications and their costs were noted.Results: Out of 60 patients evaluated, 36 (60%) were males and 24 (40%) were females. Hypertension in 54 (90%) of the patients and hyperlipidaemia in 23 (38.33%) are the important comorbidities. Metformin was most commonly prescribed antidiabetic drug in this study in 41 (68%), followed by glimepiride 18 (30%), tenegliptin 10 (16.67%), voglibose in 6 (10%) and others. Mean cost of drug therapy to a person was INR 1408.8 per month and INR 16905.6 per annum.Conclusions: Hypertension 54 (90%) and hyperlipidaemia 23 (38.33%) were the most common associated comorbidities. Metformin and glimepiride were the most common antidiabetic drugs used. Antihypertensive and hypolipidemics were commonly prescribed concomitant medications. Mean cost of drug therapy per person was INR 1408.8 per month and INR 16905.6 per annum.
Visual analogue scale: a simple tool in rural region for physician’s global evaluation and patient’s self-evaluation in allergic rhinitis
Authors: Pentewar Ganesh S. , Wagh Ranjit J. , Chincholkar Aparna S.
Published: May 2020

Background: The study was done with the objective to study whether the physician’s global evaluation of the consultation corelates with patient’s self-evaluation to patient outcome concerning symptom relief of nasal congestion by using visual analogue scale.Methods: A total of 52 patients completed a visual analogue score questionnaire presented at the consultation. 52 patients were reached in a seven days follow-up after the consultation. Patient’s outcome measures conducted at MIMER Medical College and Dr. Bhausaheb Sardesai Hospital in rural Maval Taluka in Pune district of Maharashtra state.Results: Physician’s self-evaluation of the consultation was much more strongly associated with outcome than the patient’s evaluation.Conclusions: The difference between the physician’s and patient’s evaluation of the consultation to predict patient outcomes indicates that the physician’s self-evaluation of the consultation is of importance.
Comparison of teneligliptin with sitagliptin as an add on to metformin in patients of type 2 diabetes mellitus: an observational study
Authors: Dange S. V. , Narkar Nimish S. , Rane Pratik , Das Sayan , Madrewar Vishwadeep , Kothari Revati
Published: May 2020

Background: Teneligliptin is a new dipeptidyl peptidase-4 (DPP-4) inhibitor, available in India. It has been widely prescribed in type 2 diabetes mellitus (T2 DM) due to its low cost. However, there are few studies comparing it with other DPP-4 inhibitors. The objective of this study is to compare the efficacy of teneligliptin with sitagliptin in patients of T2 DM.Methods: Patients of T2 DM, attending the OPD of a hospital during the period of January to August 2017 were scrutinized. Those uncontrolled on metformin monotherapy (1 g/day) were selected and were administered either sitagliptin (100 mg/day) or teneligliptin (20 mg/day) in addition to metformin. Base-line clinical features (age, sex, body-weight, BP, pulse rate etc.) and laboratory parameters (hemogram, fasting blood sugar and postprandial blood sugar, HbA1c, serum creatinine etc.) were recorded initially and at the end of three months. Side effects were assessed with the help of a questionnaire. The data obtained were analyzed by student’s t-test. P<0.05 was considered as statistically significant.Results: 35 and 32 patients received sitagliptin and teneligliptin respectively. After 12 weeks of therapy, FBS, PPBS and HbA1c significantly reduced in both the groups as compared to base-line values. Both drugs were well tolerated. There was no significant difference in the glycemic parameters between the two groups at the end of the study.Conclusions: Teneligliptin significantly improved glycemic control in patients with T2 DM when prescribed as an add on to metformin. It was equally effective when compared to sitagliptin. As teneligliptin is less costly than other gliptins, it may be considered as a good cost-effective option as an add on to patients of T2 DM uncontrolled on metformin monotherapy.
A probable case of sodium valproate monotherapy induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report in Indian population
Authors: Arunnair Vijayamathy , Kumaraswamy Girish , M. Ramesh
Published: May 2020

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome most commonly caused by anti-epileptics like carbamazepine, phenytoin. It usually manifests as maculopapular rash, fever, eosinophilia, generalized lymphadenopathy, hepatitis, atypical lymphocytosis, and leucocytosis with the involvement of other organs. Valproate, a broad-spectrum antiepileptic, also used in bipolar disorders and migraine prophylaxis, is generally well tolerated. To date, very few cases of valproate monotherapy induced DRESS syndrome have been reported worldwide and here we are reporting one such rare case in a 72 years old Indian woman with a history of generalised tonic convulsions. The patient was classified as a ‘probable’ case of DRESS syndrome using the WHO-UMC criteria and Naranjo scale. Discontinuation of the offending medication and treatment with intravenous (IV) fluids, antihistamines, and steroids helped in recovery of the patient. Healthcare practitioners must be aware of valproate monotherapy induced DRESS syndrome and take effective measures to avoid severe side effects.
A study on mean anion gap over 6 hours after admission as a predictor of pediatric mortality in pediatric intensive care unit
Authors: Jain Mayank , Jain Priya , Lal Sandeep Narayan , Ranjan Vivek
Published: May 2020

Background: The aims of the study was to correlate change in anion gap at 0 and 6 hours of admission with mortality in pediatric intensive care unit (PICU).

Methods: Fifty children up to 12 years of age, admitted in PICU were included in the study. Blood gas anion gap levels were taken at 0 and 6 hours of admission and change in anion gap was calculated. Final outcome was recorded.  

Results: Out of 50 patients enrolled in the study, 18 (36%) patients died and 32 (64%) survived. Mortality was higher in group with increased anion gap after 6 hours of admission as compared to survived. Change in anion gap was higher in expired patient as compared to survivors.

Conclusions: Mortality was higher in group with increased anion gap after 6 hours of admission.
Nasopharyngeal cancers in University of Port Harcourt teaching hospital: a five year review
Authors: Uju Ibekwe Matilda
Published: May 2020

Background: Nasopharyngeal cancer though an uncommon head and neck cancer, has high morbidity and mortality. It is a cancer that has peculiar geographic variations and hence has been studied by a lot of researchers globally. It however has not been studied as an entity in the South region. This study was to determine the clinical and histologic presentations as well as the prevalence of this disease in Port Harcourt.

Methods: Hospital based retrospective review of all patients with confirmed diagnosis of nasopharyngeal cancer seen within the period of January 2014 to December 2018 at ENT Department University of Port Harcourt teaching hospital. The hospital records were the source of data. The demographics, clinical presentations, histology, investigations and outcome were all collated from the records and were analyzed with IBM SPSS version 25.  

Results: Forty-one patients were studied with age range of 12-85 years. The mean age was 43±15.1 years. Male to female ratio was 1.2:1. Age 40 to 49 years was the most affected. Nasopharyngeal carcinoma was the commonest cancer recorded 68.29% followed by non-Hodgkin’s lymphoma 19.5%. Keratinizing squamous cell carcinoma was the commonest histologic type 43.9%. Commonest symptoms were neck swelling and nasal congestion 24.55%. Age distribution showed a statistical difference with histology of cancer. Mortality of 4.87 was recorded; the rest was lost to follow up.

Conclusions: Nasopharyngeal carcinoma is the commonest cancer in the nasopharynx. It is significantly related with age. Patients often present late and it has very high morbidity and mortality rate. Attention to early vague symptoms will enhance early diagnosis, treatment therefore prognosis.
Does epithelial mesenchymal transition markers snail and slug correlate with clinical stage of oral cancer: a clinico-pathological study of 258 patients
Authors: Arya Suvercha , Arora Vipin , Taneja Harish C. , Gogoi Priyanka
Published: May 2020

Background: Head and neck cancers are the 6th most common cancers worldwide. In contrast, according to population-based cancer registries these constitute the commonest cancer in Indian men and third most common cancer in women. Oral cancer is the commonest head neck cancer, attributed to rampant smoking and chewing of tobacco and areca nut in India. Epithelial mesenchymal transition (EMT) is the process in which committed epithelial cells undergo transformation into mesenchymal phenotype, that has invasive properties and thus contribute to metastatic potential of cancers.

Methods: The current study was undertaken to correlate the expression of EMT markers snail and slug with tumor stage at the time of presentation.  

Results: In present study, snail positivity was 60% in patients presenting at stage 1, 73% in stage 2, 85% in stage 3 and 90% in stage 4 patients. There was no significant association between clinical staging and snail positivity (p=0.549). Slug positivity was 40% in patients presenting at stage 1, 26.7% in stage 2, 59% in stage 3 and 77% in stage 4 patients. There was significant association between clinical staging and Slug positivity (p=0.002). Either snail or slug expression was found in 89.53% patients.

Conclusions: We found that EMT marker slug expression was significantly associated with advanced clinical stage of oral cancer at the time of presentation.

 
A comparative study between tinnitus masking and tinnitus retraining therapy on perceived tinnitus handicap and cognition
Authors: Chatterjee Indranil , Gore Geeta
Published: May 2020

Background: Since last one decade there were no such studies done in India on the efficacy of tinnitus retraining therapy (TRT) on tinnitus treatment. Here, in this study we try to find out whether TRT is an effective tool than tinnitus masking as a treatment procedure of tinnitus in Indian context.

Methods: A total of 60 participants (with no prior history of presence of hearing loss) were divided into two groups. Group 1 was consisted of 30 subjects provided tinnitus masking using relief app at the ease of their home environment for 2 months. Group 2 was consisted of another 30 subjects have been provided tinnitus retraining therapy (TRT) for 2months (60 sessions). The design is experimental design. The study was carried out in eight phases.  

Results: The findings of this study suggested that both the tinnitus masking therapy as well as TRT helped tinnitus sufferers to improve after 60 days of therapy continuation at initial stage. But a significant marked difference was found in terms of performance in participants from group 2 who had undergone TRT i.e., they performed very well after one month of post transfer therapeutic sessions than those who had undergone tinnitus masking therapy.

Conclusions: The findings of this study are suggestive of that TRT is more effective than tinnitus masking therapy in tinnitus individuals even after one month of stopping therapy sessions. It also suggests that TRT has a long-term effect on tinnitus management than tinnitus masking.
Study of laryngeal lesions undergoing microlaryngeal surgery in a tertiary health centre
Authors: K. S. Gangadhara , Vadva Chaitanya , S. Sridhara
Published: May 2020

Background: Patients with laryngeal lesions were evaluated for age and sex ratio, analysis of clinical features, videolaryngoscopic findings and histopathological features. Assessment of therapeutic role of microlaryngeal surgery (MLS) by telescopic method and also prognosis after surgery and voice therapy were evaluated.

Methods: A prospective institutional based study. A total of 18 patients with vocal cord lesions the chief complaint being hoarseness of voice were subjected to surgery in a tertiary health centre. After thorough evaluation patients underwent MLS by telescopic method.  

Results: In our study 6 patients stand out to be benign lesions and 12 patients stand out to be pre malignant and malignant lesions. Improvement in voice after surgery was reported in all patients. No recurrence was reported after 6-8 months of follow-up.

Conclusions: MLS is a good tool as it is precise and cost effective. MLS by telescopic method is a good therapeutic tool in both benign and malignant vocal cord lesions.
Tracheostomy in paediatric patients
Authors: Saraf Aditiya , Begh Raies Ahmad , Jyoti Deep , Jamwal Padam Singh
Published: May 2020

Background: The objective of the study was to evaluate paediatric tracheostomies in the Department of ENT, GMC.

Methods: The present prospective study was performed in the Department of ENT, GMC Jammu from January 2018 to 2020 on 20 paediatric patients (<17 years of age). All children were evaluated with respect to age, indication of tracheostomy, complications (intra-operative and post-operative) and mortality.  

Results: The most common indication for tracheostomy was prolonged intubation (85%). Intraoperative complication in the form of creation of false passage was seen in 1 patient (5%). The most common early post-operative complication was tube obstruction (20%). Late complication in the form of stomal granulation was seen in 2 patients (10%).

Conclusions: Over the years, more specific indications for tracheostomy are followed and better results are observed. Paediatric tracheostomy at our institute was associated with less procedure related morbidity and mortality.
Pleomorphic adenoma of parapharyngeal space: a rare case report
Authors: Peruvaje Vijay , Narasappa Yogesh Bandiahanapalya
Published: May 2020

Parapharyngeal space is one of the potential facial planes for neoplasms representing less than 1% of all head and neck tumours, often pose therapeutic and diagnostic problems due to variable nonspecific symptoms and the complex anatomy of the space and tend to delay the diagnosis resulting in poor prognosis. We here with report a 21 years old female patient, who presented with change in voice and swelling in right submandibular area. On examination of oral cavity, a smooth firm bulging mass was seen in the right tonsillar and para-tonsillar region with medialisation of right tonsil. Contrast enhanced computed tomography showed minimally enhancing encapsulated soft tissue density mass in right parapharyngeal space. Patient underwent excision through transcervical approach. Histopathology of the specimen showed pleomorphic adenoma. No evidence of recurrence till date.
A rare case report of chronic suppurative osteomyelitis of the mandible in modern era of broad spectrum antibiotics
Authors: Gupta Shilpi , Saikia N. J. , Singh Anurag
Published: May 2020

Historically, osteomyelitis of the jaw was a common complication of odontogenic infection (infections of the teeth). The term osteomyelitis refers to an inflammation of cortex and medulla of the bone that can develop in the jaw after any infection of the oral cavity. Since the introduction of potent antibiotics, the incidence of osteomyelitis has been dramatically decreasing. This case report describes an interesting presentation of chronic suppurative osteomyelitis of the mandible in a 73 years old male patient from North Eastern part of India. Investigations revealed chronic osteomyelitis of right ramus and body of mandible. The treatment included a pre surgical course of antibiotics followed by right side hemimandibulectomy and again post-operative antibiotics. The post-operative healing was uneventful. Detailed discussion of etiology, risk factor, symptoms, signs, management and prevention has been done in this case report. We conclude that surgical debridement in addition to empirical antibiotics should be considered as an early approach for treating such cases.
A giant tonsillolith camouflaging as a peritonsillar abscess
Authors: Vijayan Vikas , Sebastian Susan K. , Raj Abhijeet , Amar Priyanka S.
Published: May 2020

Giant tonsillolith is a rare clinical entity. We present the case of a 7 years old male who presented with sore throat and difficulty in swallowing. Right tonsil was bulging into the oropharynx with marked peritonsillar swelling and inflammation and a provisional diagnosis of peritonsillar abscess was made. Contrast enhanced computed tomography scan revealed a large-sized tonsillolith on the right side. The patient underwent elective stone removal and tonsillectomy.