bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Social Demographic Factors on the Use of Extended Post-Partum Family Planning Methods Among Post-Delivery Women in Tanzania
Authors: Ibrahim Rogate Phinias , Mtae Harrieth
Published: January 2021

Extended Post-Partum Family Planning (EPPFP) refers to the prevention of unplanned and/or closely spaced pregnancies from six (6) weeks to 12 months period after childbirth. It is revealed that 61% of women in the world do not use effective contraception within 24 months postpartum to prevent unplanned pregnancy. This study examined the influence of social demographic factors on the use of Extended Post-Partum Family Planning (EPPFP) methods among post-delivery women from four selected health care facilities in Tanzania. 255 post-delivery women aged 15-49 years who delivered a child between January 1, 2019 and January 31, 2020 were subjected to a facility-based cross-section study design through convenience sampling. Data were analyzed by SPSS version 20; multiple regression analyses were done to establish the relationships between social demographic factors and the use of Extended Post-Partum Family Planning (EPPFP) methods. It was found that there is a significant relationship between social demographic factors and the use of Extended Post-Partum Family Planning (EPPFP). The study recommends provision of family planning education to the community through mass and social media.
Poverty Response to the Household Type of Elderly and Old-Age Pension
Authors: Agblobi Andrews Doeh , Osei-Fosu Anthony Kofi , Yusif Hadrat
Published: January 2021

This paper investigates the effect of household type and old-age pension on poverty in Ghana. Primary data was collected from households with the elderly across six Districts in the country. A binary logistic regression estimation was used for the analyses. The result shows that whereas there was 14.4 times probability of being poor by living in an elderly only household, there is a 2.2 times probability of being poor in a household of the elderly and working-age person. The findings also show that the probability of a pension recipient being poor was 0.143 times less likely as compared to those that were not. Thus, there was a significant negative relationship between receipt of old-age pension and poverty. The study recommends that public policy on old age poverty alleviation must include pension provisions while those that use basic salary should consider using gross salary for pension calculation.
Accreditation of Tour Guides: The World Experience and the Implementation in Russian Hospitality Industry
Authors: Bunakov Oleg Aleksandrovich , Semenova Liudmila Valerievna , Zokhidov Firuz Fakhritdinovich , Eidelman Boris Mojshevich
Published: January 2021

The purpose of the study is to consider professional accreditation of tour guides as an important mechanism for improving and maintaining the overall image of tourist destinations, analyze the main current world types of guide certification and then present another certification model as a mechanism for improving the quality of services provided. The first part of the article describes the results of a publications review and the results of an empirical study of guide accreditation programs. In countries with developed tourism, there is no single approach to the accreditation of guides, and governmental institutions, together with professional communities, decide if it is mandatory. In its second part, the article overviews the approaches to the accreditation of guides in some regions of the Russian Federation. The necessity to regulate the market of guided tour services is certain since poor quality services develop a negative impression of travel destinations, and only professionally trained guides can tell a good story about a particular place or object. The lack of government regulation in the provision of services by tour guides has resulted in a significant proportion of incompetent people who often form a negative impression on tourists. This undoubtedly affects both the brand of tourist destinations in the eyes of current and potential visitors, and economic indicators, since an insufficient influx of tourists does not encourage the development of destinations. The value of the work lies in systematizing the international practices of individual tourist destinations, examining the experience of tour guides in the Russian Federation, and analyzing the legal framework of guided tours. This study contributes to a better understanding of the need to introduce the process of accreditation of guides in the Russian Federation.
Impacts of Top Five Executives’ Compensation on Employee Wages
Authors: Li Qianqian , Pyo Unyong
Published: January 2021

This paper studies the impacts of incentive compensation to top five executives on employee wages. We employ pay-performance sensitivity to measure executive incentive compensation. Using the sample during 1992 – 2017, we find that executive compensation has negative impacts on employee wages. In addition, we examine the impacts of executive incentive compensation on employee wages in different industries and find that the impacts are more severe in technology firms than in non-technology firms. Finally, we show that the executives with higher incentive compensation are more likely to suppress employee wages in financially safe firms. Our results suggest that while top management teams are compensated as a team on average, they are compensated as isolated individuals on other aspects. Furthermore, firm performance may not always improve in the long run by granting high incentive compensation to top executives.
Corporate Social Responsibility Management
Authors: Chumarina Gulnara Raisovna , Abulkhanova Guzel Azatovna
Published: January 2021

This article considers current trends and features of the development of corporate social responsibility in Russia in the current crisis, the reasons for the lack of organizations activity in the social responsibility field. The article also determines the impact of the company's social policy on the formation of labour motivation and loyalty of company employees, a positive image of the company for both personnel and the environment. Social responsibility is relevant for all types and sizes of organizations, but it has received the greatest development in large public and the private business community. Russian companies are actively involved in this process. The number of such companies is increasing from year to year. Small and medium-sized businesses are gradually connecting to them. And in the current crisis, corporations and large companies are in an environment where charity projects are actually a “matter of honour" for the company. The problem urgency of corporate social responsibility is due to modern requirements for companies presented by society and the authorities to conduct socially responsible business. In turn, this approach to doing business ensures the sustainable development of companies and leads to the creation of a favourable investment and reputation image.
The Effects of COVID-19 Pandemic on the Economies of the Gulf Cooperation Council States due to Low Oil Prices
Authors: AL-Tamimi Khaled Abdalla Moh'd
Published: January 2021

This paper shows the effect of a drop in oil price on the economic growth of GCC states as a result of the Covid-19 pandemic using monthly data for (2019/2020 M1 – 2019/2020 M12) where oil priceis an explanatory variable and economic growth is the affected variable. Because the economies of the GCC countries are centered mostly on oil, the spread of COVID-19 pandemic has become a serious concern since they depend on the outside world in diverse ways. The confirmed number of cases in the GCC countries is eliciting fear about security in these countries. This paper focuses on analyzing theoretical and empirical literature reviews to show the effects of oil price on economic growth and explaining this effect in GCC states for this period using the autoregressive distributed lag (ARDL) technique in Eviews program. This paper concluded that there are negative and significant effects of oil price on the economic growth of Kuwait and Qatar,but insignificant effects of oil price on the economic growth of Bahrain, Oman and the United Arab Emirates and a positive and significant effect of oil price on the economic growth of Saudi Arabia by using monthly data for (2019/2020 M1 – 2019/2020 M12) at a significance level  of 5%.Also, this paper reaches a recommendation of the GCC states to improve their economies through other sectors and not by relying on oil to enhance their economic growth.
Economic Assessment of Optimization of Machine-Building Production on the Basis of Restructuring Outsourcing Taking Into Account the Cyclical Nature of Economic Development
Authors: Farkhoutdinov Il'nur Ildusovich , Isavnin Aleksei Gennadevich
Published: January 2021

Nowadays using outsourcing and models of sourcing’s maneuver, becomes as one of the most leading tools for optimizing domestic engineering production. Many entrepreneurs reject outsourcing because they think that outsourcing will incur additional costs. However, they make mistakes in calculating the value of missed opportunities because they spend so much time on hard, energy-intensive work that it would be better to leave that to others. Therefore, outsourcing may be toxic to some businesses, and the same activity can be very successful if done within the organization. Outsourcing simplifies many tasks and is profitable for organizations and companies, but only if the conditions are carefully considered, and security points are observed. Every business, large or small, needs to outsource some of its activities, whether it hires an individual or a team to do their work at the company or do it elsewhere.In this paper, the authors consider the optimization of domestic machine-building enterprises through the use of restructuring production outsourcing. An approach to the economic evaluation of the machine-building production optimization based on the restructuring outsourcing, taking into account the cyclical nature of economic development, is developed.
Reviewer Acknowledgements for Global Journal of Health Science, Vol. 13, No. 1
Authors: Grey Erica
Published: January 2021

Reviewer Acknowledgements for Global Journal of Health Science, Vol. 13, No. 1, 2021.
Utilization of Intravenous Lidocaine Infusion for the Treatment of Refractory Chronic Pain
Authors: Tully Janell , Jung Jai Won , Patel Anjana , Tukan Alyson , Kandula Sameer , Doan Allen , Imani Farnad , Varrassi Giustino , Cornett Elyse M. , Kaye Alan David , Viswanath Omar , Urits Ivan
Published: January 2021

Context: Chronic pain accounts for one of the most common reasons patients seek medical care. The financial burden of chronic pain on health care is seen by direct financial cost and resource utilization. Many risk factors may contribute to chronic pain, but there is no definite risk. Managing chronic pain is a balance between maximally alleviating symptoms by utilizing a therapeutic regimen that is safe for long-term use. Currently, non-opioid analgesics, NSAIDs, and opioids are some of the medical treatment options, but these have numerous adverse effects and may not be the best option for long-term use. However, Lidocaine can achieve both central and peripheral analgesic effects with relatively few side effects, which may be an ideal compound for managing chronic pain. Evidence Acquisition: This is a Narrative Review. Results: Infusion of lidocaine (2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide), an amino-amide compound, is emerging as a promising option to fill the therapeutic void for treatment of chronic pain. Numerous studies have outlined dosing protocols for lidocaine infusion for the management of perioperative pain, outlined below. While there are slight variations in these different protocols, they all center around a similar dosing regimen to administer a bolus to reach a rapid steady state, followed by infusion for up to 72 hours to maintain the therapeutic analgesic effects. Conclusions: Lidocaine may be a promising pharmacologic solution with a low side effect profile that provides central and peripheral analgesia. Even though the multifaceted mechanism is not entirely understood yet, lidocaine may be a promising novel remedy in treating chronic pain in various conditions.
Association of GSTM1 and GSTT1 Null Deletions and GSTP1 rs1695 Polymorphism with the Risk of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis
Authors: Khosravi Mohammad Hossein , Sharafi Heidar , Alavian Seyed Moayed
Published: January 2021

Context: Hepatocellular carcinoma (HCC), as the most common type of primary liver cancer (accounting for 70% - 90% of all liver cancers), is the seventh most common malignancy worldwide. Glutathione S-transferases (GSTs) are a specific group of enzymes that are responsible for the detoxification of carcinogens. According to the available literature, genetic variations in this group of enzymes may be associated with the risk of HCC. In this study, we aimed to assess the association of GSTM1 and GSTT1 null deletions and GSTP1 rs1695 polymorphism with the risk of HCC. Methods: We systematically searched electronic databases, including PubMed, Scopus, and Web of Science, using appropriate keywords to gather relevant data until March 2019. Studies that met the inclusion criteria were included in the meta-analysis, using either fixed- or random-effects models based on the presence of heterogeneity. Results: This meta-analysis pooled 19 studies for GSTM1 null deletions, 14 studies for GSTT1 null deletions, and five studies for GSTP1 rs1695 polymorphism. In terms of heterogeneity, the pooled odds ratio (OR) was calculated in a random-effects model for both Asian and non-Asian populations. HCC was found to be associated with GSTM1 null deletions (OR = 1.26, 95% CI: 1.00 - 1.58, P = 0.05) and GSTT1 null deletions (OR = 1.39, 95% CI: 1.10 - 1.74, P = 0.005); however, no significant association was found between HCC and GSTP1 rs1695 polymorphism (OR = 1.14, 95% CI: 0.86 - 1.50, P = 0.36). Conclusions: We found that GSTM1 and GSTT1 null deletions increased the risk of HCC; however, the GSTP1 rs1695 polymorphism did not have a similar effect.
Development of a Health Literacy Program for Parents of Children with Cancer: A Mixed-Methods Study Protocol
Authors: Bahrami Masoud , Eslami Ahmad Ali , Moafi Alireza , Sayahi Somaye
Published: January 2021

Objectives: Parents’ health literacy plays an important role in the proper management of symptoms and providing appropriate care for their children living with cancer. However, studies conducted on health literacy in Iranian culture is very limited. Therefore, this study will identify the health literacy needs of parents of children with cancer and will design a program for promoting their health literacy. Methods: This exploratory mixed-methods study, using qualitative-quantitative methods including 4 consecutive phases. In the first phase, the literature review will be carried out to conceptualize and determine the domains of health literacy. In the second phase, a qualitative study will be conducted to identify and determine the needs and strategies for promoting the health literacy of parents using deep semi-structured interviews. Participants will be selected by purposive and snowball sampling methods and data will be analyzed using the directed content analysis method. In the third phase, participants’ needs will be prioritized using a panel of experts and the initial draft of the program will be designed. In the fourth phase, the modified Delphi method will be used to prioritize program strategies and select the final program. Discussion: Developing a program using a qualitative method and literature review can provide some evidence for promoting health literacy in parents of children living with cancer. Moreover, it is expected that this program promotes knowledge and empowerment of health team members, especially nurses to provide family-centered care for children with cancer. This, in turn, will increase the quality of provided treatment and care and will decrease the costs.
Post-Exchange Transfusion Sodium Change Within a Laboratory Reference Range of Serum in Hospitalized Severe Neonatal Jaundice Cases
Authors: Hardani Amir-Kamal , Zadkarami Masood , Sharhani Asaad , Rashidi Mehrabadi Shirin
Published: January 2021

Background: Blood exchange transfusion (ECT) therapy is an essential part of the modern health care for high-risk icteric neonates. Objectives: Therefore, this study sought to examine the effectiveness of monitoring sodium disorders and the required interventions indicating the overall state of health of hospitalized jaundiced neonates. Methods: This prospective analytic study was performed on 49 neonates diagnosed with severe jaundice undergoing screened exchange blood transfusion from November 2018 to May 2019. Serum sodium ion concentrations testing was performed before the exchange, then 1 - 3 hours later, and again 24 hours after receiving ECT, using a sensitive ELISA kit in a laboratory. Using the newest version of SPSS 24 software program, the association between different numerical variables was calculated by a repeated-measure ANOVA test. P < 0.05 criterion was set as the threshold of significance. Results: Out of the total 49 neonates, 24 (48.5%) were girls and 25 (51.5%) were boys, of which 93.9% and 6.1% were term and preterm-born neonates, respectively. The average birth weight was 2843 ± 267/510 g and the mean period of hospital stay was 4.55 ± 2.399 days. The various causes of severe neonatal jaundice of all the hospitalized cases were 45% unknown, 43% combined ABO and Rh incompatibility, 10% breastfeeding pattern, and 2% G6PD deficiency. A continual fall in serum sodium was observed following banked blood exchange (P < 0.05). However, these reversible changes were outside the expected normal range. Despite a diminished sodium concentration, the mean sodium levels were within the laboratory reference range of serum (137 - 142 mEq/L) in all the three measured duration times. Moreover, variation in the amount of serum sodium was associated with an unknown underlying cause that led to neonatal jaundice (P = 0.04) and this difference did not reach statistical significance in terms of birth weight, gestational age, and other causes accounting for high bilirubin (P > 0.05). Conclusions: Given these facts, it was concluded that neonatal jaundice was significantly associated with post-exchange serum sodium changes within the laboratory reference range of serum.
Evaluation of Human Mesenchymal Stem Cells Differentiation to Neural Cells on Polycaprolactone Nanofiber Scaffolds
Authors: Karimian Seyedeh Sara , Kaviani Saeid , Soleimani Masoud
Published: January 2021

: Differentiation of human mesenchymal stem cells (hMSC) to neural cells on Nano-scaffolds is a promising method for the treatment of the damaged nervous system through bionanomaterial-cell transplantation. The hMSC’s multipotential features have been discovered in various tissue engineering researches. This investigation shows the in-vitro development and neural differentiation of hMSC in 3D and 2D environments. The 3D environment which used in this study is nanofibrous polycaprolactone (PCL). The differentiation potential of mesenchymal stem cells (MSCs) to neural cells, on the random polycaprolactone (PCL) nanofibrous scaffolds, and tissue plate was examined. Researches have proved that interaction of extracellular nanofibrous matrix with in-vivo cells, gives mechanical maintenance to the cells and plays a functional role in the control of cellular behaviour. Stem cells are developing as a fundamental tool in the evolution of tissue engineering and regenerative medication. PCL characterization was determined employing scanning electron microscopy (SEM). Agents like, retinoic acid, epidermal growth factor (EGF), fibroblast growth factor (FGF-2), and Ibmx, which they are neural inducing agents, added in DMDM/F12 to differentiate MSCs to neural cells. Reproduction of mesenchymal cells on PCL nanofibrous scaffolds and neural morphology revealed through a scanning electron microscope (SEM) and optical microscope outcomes. The differentiated mesenchymal cells on nanofibrous scaffolds express neural gene markers including; β- tubulin III and Map2 on the day of 14. Our investigation recommends the potential usage of differentiated neural cells from hMSCs on Nano-scaffolds toward the improvement of neural cells. This study conducted in 2011.
The Effect of Family-Centered Educational Supportive Intervention on Parental Stress of Premature Infants Hospitalized in the NICU
Authors: Rajabzadeh Zahra , Moudi Zahra , Abbasi Abdolhosein , Miri-Aliabad Ghasem
Published: January 2021

Background: Premature birth and infant hospitalization in the neonatal intensive care unit (NICU) is stressful for parents; therefore, training and supporting couples with the aim of reducing stress are very important. Objectives: The present study aimed at investigating the effect of family-centered educational, supportive intervention on parental stress of premature infants hospitalized in the NICU. Methods: This quasi-experimental study was performed on the eligible parents of 80 premature infants admitted to the NICU ward of Ali-ibn Abitaleb Hospital in Zahedan, in two groups of 40 intervention and control. Samples were selected by convenience sampling and randomly divided into two groups. The intervention group received five sessions of a family-centered educational support program in five days, with an average of 60 minutes per session, and the control group received only routine training and care. Data were collected using the Parental Stress scale (PSS) questionnaire with approved validity and reliability before and after the end of educational interventions at discharge from the hospital. Data were analyzed by SPSS, version 22 using paired t-test, independent t-test, and chi-square. Results: Mean of parental stress scores of mothers and fathers of premature infants was not significantly different in the intervention and control groups before family-centered educational-supportive intervention (P > 0.05), but after the intervention, the mean of parental stress scores of parents in the intervention group was significantly lower than the control group (P = 0.001). Conclusions: Family-centered educational supportive intervention has a positive and significant effect on reducing stress in parents of preterm infants admitted to NICU. Therefore, training and support of parents during the hospitalization of their infants is recommended.
A Study on the Relationship Between Burnout and Job Satisfaction of Iranian EFL Teachers Working in Universities and Schools
Authors: Safari Ibrahim
Published: January 2021

A teacher plays an important role in the development of the students’ potential and helps to form their future. This research intends to study the degree of burnout and job satisfaction in English as a foreign language (EFL) teachers of universities and Schools in Iran, as well as their association with demographic characteristics. To measure teachers’ burnout, Maslach Burnout Inventory questionnaire was applied, which has also been validated by experienced teachers for the Iranian population and the Employee Satisfaction Inventory questionnaire, prepared for the Iranian population, was applied to estimate job satisfaction. Questionnaires were answered completely by 159 teachers, who work at universities and schools in Iran. After data analysis, the findings showed a negative correlation between teachers’ burnout and their job satisfaction; their experience relatively moderate burnout levels, and their job satisfaction level is high. The findings also represented that the type of workplace influences satisfaction regarding the factor “job conditions”. The study was for the first time that Iranian EFL teachers’ burnout and job satisfaction in universities and schools were investigated and the findings showed that by increasing the level of job satisfaction, the perceived burnout decreases, where burnout and job satisfaction presented medium to high negative correlation.
Impact of Using Personalized E-Course in Computer Science Education
Authors: Mudrák Marián , Turčáni Milan , Reichel Jaroslav
Published: January 2021

At current e-learning platforms, is often seen non-efficient usage of their possibilities when creating educational content. This article deals with the possibilities of using adaptive tools that are offered by learning management system (LMS) Moodle when creating a personalised e-course. The methodology created by the authors of the article for personalised e-course adjusts the study content based on characteristics of each student stated by his or her initial knowledge, learning style, and motivation. The article is aimed at the presentation of the created methodology and its impact on the level of student's output knowledge as well as overall learning efficiency. By using the methodology, there was an opportunity to compare the impact of two different approaches – the personalised one and non-personalised. Statistical analysis revealed that the use of personalized e-course has a positive impact on students' activity, motivation, and their level of output knowledge. The results showed that the attended secondary school has no or only minimal impact on the output knowledge if the students studied through the personalized e-course. An interesting finding was that students in all surveys have a stronger tendency to prefer the same learning styles over the years.
Flat topped hypopigmented micropapules on the flank and neck
Authors: Henning Ania , Weaver Joshua
Published: January 2021

Lichen nitidus (LN) is a rare inflammatory condition which presents as multiple small, shiny, pale to flesh colored papules measuring 1-2mm in diameter. Lesions typically occur on the abdomen, chest, genitalia and extremities. However, cases of LN involving the nails, oral mucosa and acral skin have been described. Although, it typically presents in children and young adults, there is no gender or racial preference. Clinical and histopathological findings are characteristic for LN and treatment is rarely warranted. Herein we report a case of LN in a 26-year-old African American female who presented with multiple areas of LN.
Potestad administrativa sancionadora: la conveniencia de su reconocimiento constitucional
Authors: Gómez González Rosa Fernanda
Published: January 2021

Este trabajo tiene por objeto analizar el reconocimiento constitucional de la potestad administrativa sancionadora. Si bien su ejercicio ha operado bajo un régimen de tolerancia respaldado por una profusa construcción jurisprudencial, cabe analizar la necesidad de efectuar una regulación expresa de dicha potestad en la Carta fundamental. Junto con ello, el trabajo propone una serie de principios y reglas que una eventual regulación general de la potestad sancionadora debiera considerar.
Aguas servidas tratadas contenidas en instalaciones sanitarias: Su naturaleza jurídica
Authors: Vergara Blanco Alejandro
Published: January 2021

Análisis de la naturaleza jurídica de las aguas servidas tratadas contenidas en instalaciones sanitarias. Primero, revisa la temática en las leyes, jurisprudencia y doctrina; además, muestra la cambiante praxis administrativa. Luego, ofrece un desarrollo dogmático sobre la naturaleza jurídica de las aguas servidas tratadas, analizando las diversas fases de la actividad sanitaria y los vínculos jurídicos de las empresas sanitarias con sus instalaciones y los volúmenes de agua que escurren en ellas. Analiza en fin la vigente regulación que le asigna la condición jurídica de derrame a las aguas servidas tratadas.
Fundamentos constitucionales de la potestad fiscalizadora de la Administración del Estado
Authors: Vergara Soto Andrés
Published: January 2021

El presente artículo tiene por objeto analizar la manera en que la Constitución ha previsto el estatuto jurídico de la potestad fiscalizadora de la Administración del Estado. Para ello, previamente, se efectuará una aproximación al concepto de fiscalización administrativa de acuerdo a sus rasgos genéricos de actividad de ordenación y revisando su particular naturaleza potestativa, sus fines y su estructura. Luego, se analizarán las diversas fórmulas constitucionales para su atribución a diferentes órganos públicos. Por último, se estudiarán los principios constitucionales que sustantivamente informan la potestad fiscalizadora de la Administración Pública en el derecho nacional, especialmente, en sus dimensiones nomogenética y ejecutiva.
¿Qué tan plena es la acción de “plena” jurisdicción?
Authors: Harris Moya Pedro
Published: January 2021

Este comentario de jurisprudencia analiza la calificación de las acciones administrativas, a propósito de la Sentencia de Corte Suprema Sociedad Chamy con I. Municipalidad de Valparaíso (8 de octubre 2019), que distingue los ámbitos de aplicación del recurso de nulidad y de plena jurisdicción.
COVID -19 and its environmental impacts.
Authors: Parrey Imtiyaz Rasool
Published: January 2021

This analysis aims to show the impact of COVID-19 on the environment, particularly in the countries, which are deadly affected by COVID-19, such countries include China, USA, Italy, and Spain. Our experiment suggested that there are significant contingency measures and improvements in air quality, clean beaches, rivers, and environmental noise reduction. However, on the other side, there are some negative effects of COVID -19 such as the reduction in cycling, large waste, fishing, unemployment. In order to build back, better UN has given six climate-related actions to shape the recovery for the future.
Prevalence of Clinical Artesunate Resistance among Cases of Complicated Malaria in Southern Odisha, India
Authors: Das Sindhusuta , Padhi Sanghamitra
Published: January 2021

Introduction: Drug resistant malaria represents the most challenging health problem worldwide. The major threat to malaria control is the increasing incidence of complicated and drug-resistant cases. Aim: To determine the prevalence of clinical artesunate resistance among complicated malaria cases by invivo method. Materials and Methods: The study included 241 patients with complicated malaria, which showed trophozoites of malarial parasite Plasmodium in the blood smear. They were administered with artesunate monotherapy. They were then followed-up for clinical response to therapy and quantification of parasitaemia levels on day 1, day 2, day 3, day 7, day 14 and day 28. Clinical examination included core body temperature recording, assessment of associated complications like vomiting, altered sensorium, anaemia, bleeding tendencies and investigation of renal parameters, liver function test and hypoglycaemia. Results: Out of 241 complicated malaria cases showing malarial parasite in peripheral blood smear, 204 cases were of Plasmodium falciparum, 32 cases were of Plasmodium vivaxand five were cases of mixed Plasmodium falciparum and Plasmodium vivax infection. Among the 241 malaria positive cases, the most commonly associated complication was severe anaemia in 87 (36.1%) cases. All the 32 cases of Plasmodium vivax malaria and the five cases of mixed infection responded and recovered after administration of artesunate monotherapy. But among the 204 cases of Plasmodium falciparum, clinical artesunate resistance was detected in 6 (2.94%) cases and the rest 198 (97.06%) cases were sensitive to artesunate monotherapy. Conclusion: Clinical artesunate resistance was noticed in 2.94% cases of Plasmodium falciparum malaria. Hence, continuous monitoring of antimalarial therapy is required, especially in complicated cases of Plasmodium falciparum malaria, to prevent the emergence of artesunate resistance.
Biomechanical Analysis of the Zirconia and Graphene-based CAD-CAM Dental Bridges at Different Pontic Length: A Finite Element Analysis
Authors: Alruthea Mohammed Sulaiman
Published: January 2021

Introduction: During masticatory loading, dental bridges are subjected to various forces that might generate deflections in the bridge framework. For this reason, designing long-span bridges require great care about flexions that happen during the function. This can be compensated by increasing occluso-gingival height, using rigid materials and enhancing resistance to deflection by modifying the abutments’ preparations. The current study hypothesied that the stress, deflection, strain and deformation of the fixed partial dentures are guided by the three-dimensional configurations of the pontic areas, and all other parameters could be mutually changed with different influence on the overall outcome. Aim: The study aimed to evaluate the difference in the amount of stress, deflection, strain and deformation on using different materials and configurations in the pontic and connector area of the dental bridge using the 3D Finite Element Analysis (FEA). Materials and Methods: An invitro virtual biomechanical analysis using 3D FEA method was conducted. 3D models were created from the Cone Beam Computed Tomography (CBCT) of a dentulous patient and two materials were selected for this study, Zirconia and enhanced graphene-based polymer. The study models were assembled into four groups as the following: Group I: 3-unit Zirconia fixed-fixed bridge; Group II: 3-unit Graphene fixed-fixed bridge; Group III: 4-unit Zirconia fixed-fixed bridge; Group IV: 4-unit Graphene fixed-fixed bridge. Using FEA software a 600 N load was applied and the resultant normal stress, deflection, maximum equivalent strain and total deformation data were monitored, collected and interpreted. Results: The findings of the current study showed higher values of normal stress, deflection, equivalent elastic strain and total deformation in Graphene-based bridges (group II and IV) than the Zirconia-based bridges (group I and III). It should also be mentioned that normal stress, deflection, equivalent elastic strain, and total deformation showed higher values in the three-unit bridge (group I and II) than their corresponding 4-unit bridge groups (group III and IV). Conclusion: This biomechanical analysis confirmed that the stress concentration and deflection of the fixed bridge are influenced by material characteristics. However, configuration of the pontic area could influence the studied mechanical parameters regardless the length of the dental bridge.
Analysis of WHONET Surveillance Data of Antimicrobial Sensitivity of Uropathogens in a Tertiary Care Hospital: An Indicator to Empirical Antimicrobial Treatment for Urinary Tract Infection
Authors: Agarwal Vandana A , Agrawal Gopal Nandlal , Bazare Bhavana , Zodpey Sunanda
Published: January 2021

Introduction: Urinary Tract Infections (UTIs) are among the most common bacterial infections. A regular surveillance of local aetiology and susceptibility profile could support the most effective empirical treatment. WHONET (World Health Organisation Network) is free software developed since 1989 by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance. Aim: Analysis of WHONET surveillance data was undertaken to know the aetiological profile of uropathogens and their antimicrobial susceptibility pattern to formulate an empirical treatment policy in a tertiary care hospital. Materials and Methods: The present study was retrospective and cross-sectional study. Uropathogens and their antimicrobial susceptibility from a tertiary care hospital during July 2018 to June 2019 were studied. For analysis, the software WHONET 5.6 version was used. An inclusion criterion was uropathogens with significant growth of one pathogen and only the first isolate of a given species encountered in case there were repeat samples from the same patient. Chi-square test was used to compare percentages and p-value <0.05 was considered as statistically significant. Results:Of the 1152 non-duplicate uropathogens, Enterobacteriaceae was the causative agent in 75% cases, E. coli accounting for more than two third of the cases. Gram positive cocci and Non-fermenters were isolated in 13% and 10% cases respectively. S. aureus, E. faecalis and Enterobacteriaceae showed high sensitivity to nitrofurantoin. Conclusion: For uropathogens, nitrofurantoin can be the drug of choice for empirical treatment of UTI. However, in serious hospitalised patients with UTI, additional parenteral administration of piperacillin-tazobactam may be considered.
Serum Magnesium Levels among Pregnant Women with and without Complications: A Cross-sectional Study
Authors: Sethulekshmi Santhini Gopalakrishnan , Sumathy S , Dutta Banani
Published: January 2021

Introduction: Pregnancy is a period that is characterised by remarkable physiological changes which are needed to support the growing fetus. Micronutrients play a crucial role in the maintenance of pregnancy. Among the micronutrients, magnesium has got ample amount of clinical relevance to pregnancy. Magnesium deficiency has been associated with reproductive risk during pregnancy such as anaemia, pre-eclampsia, eclampsia, fetal growth retardation, preterm labour, low intrauterine growth rate and leg cramps. Aim: To find out whether there was significant difference in the magnesium levels among pregnant women with and without pregnancy related complications and also to find out whether the magnesium levels differed significantly among the three trimesters. Materials and Methods: This was a cross-sectional study done among 240 pregnant patients from different trimesters attending the Obstetrics and Gynaecology Outpatient Department. Out of them 164 women had complications like pre-eclampsia, Gestational Diabetes Mellitus, leg cramps and history of abortions. Demographic details were obtained from all the women. BMI was calculated for each subject using the formula BMI=weight(kg)/height(m2). Haemoglobin was assessed in all samples using cyanmethaemoglobin method. Magnesium levels were analysed in the all samples using automated analyser in the Biochemistry laboratory. Student’s t-test was used to compare the levels of magnesium among the groups with and without complications. ANOVA test was used to compare the three trimesters. Results: The pregnant women were divided into three groups based on the different trimesters in which the samples were taken. Magnesium levels among the women in the first trimester were (2.96±0.83) second trimester (2.99±1.48) and third trimester (3.05±1.48) respectively. Women with previous abortions were found to have less magnesium levels (2.71) compared to women without a history of abortion (3.11) and value was found to be statistically significant (p<0.007) and magnesium levels among vegetarians (2.45) were lower than non vegetarians (3.08) and it was found to be statistical significant (p<0.013). There was no significant difference in the magnesium levels among pregnant women with complications and those without complications. Conclusion: The study shows the importance of maintaining the magnesium levels among pregnant women. There was no difference in the magnesium levels among the three trimesters. Study also points out the influence of parity, diet and occupation of pregnant women on the levels of magnesium.
Dental Practice in the Era of nCOVID-19 Pandemic
Authors: Chhabra Vandana , Sood Poonam , Chhabra Ajay , Ahuja Gourav , Chhabra Krittika
Published: January 2021

The recent outbreak of nCOVID-19 pandemic has shaken the world. Dentists are at a great risk of contracting and transmitting this fatal disease. However, as health care personnel, this is our duty to treat patients especially in emergency situations when treatment is inevitable. Equipping ourselves with adequate knowledge and safety measures will not only protect us, but our patients as well. The routes of transmission of nCOVID-19 include direct and indirect contact with the infected person. Dental operatory offers plethora of opportunities for transmission because of the nature of the work done so it is important that clinical management should begin even before the patient enters the dental clinic. Dentist should be aware of the disinfection protocols and proper use of barrier techniques and Personal Protective Equipment (PPE) and about the disposal of the waste generated.
Detection of Rifampicin Resistance among Patients with Tuberculosis using GeneXpert MTB/RIF Assay: A Retrospective Study
Authors: Durairaj Gayathridevi , Rathinam Sridhar , Vishwanathan Vinodkumar , Satagopan Kumar
Published: January 2021

Introduction: Tuberculosis (TB) remains one of the major cause of death worldwide, and the leading causes of mortality in developing countries like India. Smear microscopy has certain limits as it requires 10,000 bacilli/mL for positivity, culture methods takes longer turnaround time of around 6-8 weeks. The recent advancement like Genexpert Mycobacterium tuberculosis/Rifampicin (MTB/RIF) Assay, which has more accuracy and analysis where it detects MTB and RIF resistance in smear negative including immunosuppressive patients even with a volume of 138 cfu (colony forming units)/mL in less than two hours. World Health Organisation (WHO) also recommended new Cartridge Based Nucleic Acid Amplification Test (CB-NAAT) on 2010 and named as GeneXpert system for diagnosis of TB. Aim: To evaluate the patterns of RIF Resistance by GeneXpert as a Rapid and primary screening test in TB patients. Materials and Methods: Both pulmonary and extra pulmonary samples were subjected to AFB (Acid Fast Bacilli) smear microscopy before being tested for GeneXpert MTB/RIF Assay. MTB detected samples were further tested at National Institute for Research in Tuberculosis (NIRT) to confirm RIF resistance and to find out associated resistance to Isoniazid and other second line drugs like fluroquinolones, kanamycin, capreomycin and amikacin. All statistical analysis were performed using Statistical Package for the Social Sciences (SPSS) version 15.0. Results: A total of 8140 samples were tested for CB-NAAT, MTB was not detected in 4414 samples, MTB detected and RIF Sensitive in 3554 samples, MTB detected and RIF resistance in 172 samples. Among these RIF Resistant samples 97% were retreatment patients and the primary drug resistance was less common. HIV/TB co-infected contributes to 1% of resistance and there was no gender preponderance. RIF mono-resistance was found in majority of patients. Conclusion: Genexpert has higher specificity for early detection of RIF resistance as a surrogate marker of MDR-TB to initiate early treatment and prevent transmission of Multi Drug Resistance (MDR) strains.
Identification of a Rothia mucilaginosa Strain in a Clinical Specimen Based on PCR-Sequencing with Mycobacterium hsp65 Primers
Authors: Chin Kai Ling , Sarmiento Maria E , Mustapha Zainal Arifin , Acosta Armando
Published: January 2021

Introduction: Tuberculosis (TB) is one of the top 10 causes of death worldwide. Xpert Mycobacterium tuberculosis (MTB)/Rifampicin (RIF) has been recommended by World Health Organisation (WHO) to diagnose TB, while hsp65-Polymerase Chain Reaction (PCR) has been used for mycobacteria identification. Aim: To report a false positive result (Rothia mucilaginosa) using hsp65-PCR for detection of mycobacteria in a clinical specimen. Materials and Methods: A sputum sample from a 58-year-old, male, suspected-TB patient was studied by Xpert MTB/RIF and hsp65-PCR. The amplified hsp65-PCR product was sequenced and analysed using bioinformatics for bacterial identification and primer specificity. Results: Xpert MTB/RIF showed a negative result, while hsp65-PCR was positive, suggested the presence of Pulmonary Non-Tuberculous Mycobacterial (PNTM) Infection. The analysis of the sequencing result of the amplified hsp65-PCR fragment showed 98% similarity to Rothia mucilaginosa, a member of the normal flora of the human oropharynx and upper respiratory tract, which may cause pneumonia. Further analysis showed that the mycobacteria hsp65 primers used have high percentage of similarity with Rothia mucilaginosa gene sequence, resulting in non-specific detection. Conclusion: This study showed the possibility of false positive results in clinical specimens using PCR-hsp65 primers considered specific for mycobacteria, therefore, this test should be used in clinical samples with caution and it is suggested the need of its further re-optimisation.
Arginase and Procalcitonin: Promising Biomarkers for Early Diagnosis of Sepsis
Authors: Mulgund Shruti Rahul , Abhang Subodhini Anant
Published: January 2021

Introduction: Sepsis remains a major cause of death in critically ill patients in Indian population because of high susceptibility towards infectious diseases in the world. Procalcitonin (PCT) is a well-studied marker in foreign countries but needs to be established in Indian population. In the last few years, importance of Arginase as a marker of immunity has also increased exceptionally, because this enzyme is essentially involved in different inflammatory processes. Keeping these facts in mind PCT and Arginase were evaluated for their utility as markers to diagnose sepsis. Aim: To evaluate Arginase and PCT as biomarkers for early diagnosis of sepsis. Materials and Methods: Hundred adult patients (age >18 years) with Systemic Inflammatory Response Syndrome (SIRS) attending BJ Medical College which is affiliated with Sassoon General Hospital (Pune, Maharashtra, India) during May 2012-July 2015 were incorporated in the study. Age n sex-matched of 100 samples healthy controls were also collected. Arginase was estimated by Roman and Ray method and PCT by Enzyme-linked Immunosorbent Assay Kit (ELISA) method. Unpaired t-test was done to compare the mean biomarker levels between the cases and controls. The Area Under Curve (AUC) was calculated using Receiver Operating Curve (ROC). All the data analysis was set at 95% Confidence Interval (CI) and value p<0.05 are statistically significant. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: In the study, a significant increase was observed in the levels of arginase (p<0.01) and PCT (p<0.01) in cases as compared to controls. ROC curves were plotted to find out the cut-offs of arginase (4.6 IU/L) and PCT (0.04 ng/mL) to check the diagnostic efficacy of both the biomarkers. Conclusion: Serum PCT and arginase offers a high level of accuracy than other currently available tests and hence can be helpful in the management of sepsis. In addition to this apart from high sensitivity and specificity arginase estimation is cost effective as compared to PCT.