bluuebunny/crossref_metadata_2025 huggingface dataset:
School Readiness in Children: Types and Correlation with Duration of School Preparation Activities
Authors: Lubovsky D.
Published: June 2019

The article presents results of a study on personal readiness for school in children aged 6—6,5 years who engaged in school preparation activities for different periods of time either at kindergarten only or at any additional classes as well. It was assumed that longer periods of school preparation would be associated with lower levels of school motivation in children entering school. The study involved 80 preschoolers aged 6 to 6,5.The following techniques were used: the conversation "Internal position of the student" (by N.I. Gootkina), the technique for academic motivation research in first-graders (by M.R. Ginzburg), Raven’s Coloured Progressive Matrices, the first subtest of the Kern—Jirasek School Maturity Test (drawing of male figure), and the author's questionnaire about the forms and duration of school preparation activities (for parents).The outcomes of the study showed that those children who began preparing to school early and continued attending school preparation activities for much longer than a year had lower levels of school motivation and, therefore, lower levels of personal readiness for school. Interestingly, there were no significant differences in intellectual readiness between them and the children with shorter school preparation experiences. The paper concludes with discussing the practical applications of the present study.
Features of Development of Socio-Communicative Competence in Primary Schoolchildren with Developmental Delays
Authors: Egorova M.A. , Zarechnaya A.A.
Published: June 2019

The paper presents outcomes of a study on the features of social and communicative competence in joint activities in children aged 7—8 years with developmental delays.In our study, the children displayed reduced ability to negotiate, to distribute actions, to adhere to the plan, to resolve conflicts.We outline the principles of designing the educational environment for children with developmental delays within comprehensive schools in accordance with the specifics of the children’s socio-communicative competence and with a focus on the tasks set by the Federal State Education Standard of Primary Education for Students with Disabilities.Specially organised conditions as a system of specific measures ensuring the dynamics, integrity, technological effectiveness and productivity of socio-communicative competence development in children with developmental delays include the following: promoting development through a specially designed learning environment; arranging activities based on collaboration in pairs and small groups; monitoring, supporting and assessing communicative knowledge, skills and personal traits in children.
m. Dereceden Cebir Üzerine Bir Not
Authors: AKPINAR Atilla , OZEN ERDOGAN Fatma
Published: June 2019

Bu makalede, girdileri bir  cisminden alınarak oluşturulan nxn  boyutlu özel bir matris cebiri üzerinde çalışıldı. Bu cebir üzerinde tanımlanan bir ek (adjoint) alma dönüşümü (bir matrisin eki), bir norm form (bir matrisin determinantı) ve bir iz form (bir matrisin izi) yardımıyla bu cebir ile ilgili bazı cebirsel özellikler elde edildi. Üstelik bu cebirin  m. dereceden bir cebir yapısına sahip olduğu gösterildi. Bu örnek sayesinde kübik cebir tanımını m.  dereceden cebir tanımına genişletildi.
Yüksek Sıcaklık Hacim Yanma Sentezi ile Üretilen Fe3Al Malzemede Presleme Basıncının ve Isıtma Hızının Gözeneklilik ve Mikro Sertlik Üzerine Etkisinin Araştırılması
Authors: ÖZTÜRK KÖRPE Neşe , YÜCEL Berk Can , KOÇ Nurşen
Published: June 2019

Kısa işlem süresi, düşük enerji gereksinimleri ve
düşük maliyetli özellikleri nedeniyle yanma sentezi yöntemiyle üretim,
günümüzde oldukça popüler hale gelmiştir. Küçük başlangıç enerjisi ile
oluşturulan ve kendiliğinden ilerleyen ekzotermik kimyasal reaksiyon sonucu
istenilen ürünün elde edildiği bu işlemin dezavantajlarından biri malzemenin
gözenekliliğidir.

Bu çalışmada, Fe3Al tozları farklı
presleme basınçlarında (75 Bar, 150 Bar, 300 Bar) preslenmiş ve iki farklı
yanma sentezi yöntemiyle (yüzey dalgası yayılım modu (PWP), termal patlama modu
(VCS)) ile sentezlenmiştir. Aynı zamanda VCS modu ile üretilen Fe3Al(Fe-at.%
28Al) alaşımında yavaş ısıtma hızıyla da sentezleme yapılmıştır. Gözeneklilik,
mikroyapı ve faz  incelemeleri için
X-Işını kırınımı(XRD), elektron mikroskobu(SEM) görüntü analizi ve Vickers
mikrosertlik ölçümü kullanılmıştır. Arşimet yöntemi ile nihai ürün yoğunluk ve
gözeneklilik değerleri bulunmuştur. Sonuç olarak Fe3Al fazının elde
edilebildiği 150 Bar presleme basıncı optimum değer olarak belirlenmiştir.
Çoklu Hedeflerin Çoklu Robotlara Paylaştırılması İçin Bir Yük Dengeleme Sistemi
Authors: DÖNMEZ Emrah , KOCAMAZ Adnan Fatih
Published: June 2019

Günümüzde
robotik alanında verilen görevi icra etme, yol planlama, kontrolör tasarımı
gibi konularda yaygın olarak tek robot ile yapılan sistemlere
odaklanılmaktadır. Çoklu robotlar ve çoklu hedef/görev paylaşımı üzerine ise
daha az sayıda çalışmalar bulunmaktadır. Ancak bu alandaki yöntemlerin
geliştirilmesi ve kolektif çalışma modelleri üzerine derinlemesine çalışmalar
yapılması gerekmektedir. Bu çalışmada, birden fazla robot ile çok sayıda
hedefin gezilmesine için görev paylaşımı ve yük dengeleme sistemi (YDS)
geliştirilmiştir. Çalışma çok sayıda hedefin asgari maliyet ile gezilmesi
bakımından çoklu gezgin satıcı (Çoklu-GSP) problemine de benzemektedir. Görev
paylaşımı sisteminde YDS pasif veya aktif durumlarına göre görev dağılımları
yapılmıştır. Yük dengelemede amaç bir robota gereğinden fazla görev
verilmesinin önüne geçerek enerji ve maliyeti gözetmektir. İlgili robotlara
görev dağılımı yapıldıktan sonra robot sayısı kadar hedef küme oluşturulur. Her
bir küme için robot konumu ve mevcut hedefler birer çizge düğümü olarak kabul
edilmiştir. Oluşan bu çizge düğümleri tam bağlantılı hale getirilerek mesafe
matrisi oluşturulmuştur. Daha sonra başlangıç düğümü olan robotun ilk
pozisyonundan hedef düğümlere yol planı en yakın komşu (NN) ve genetik
algoritma (GA) yöntemleri ile yapılmıştır. Gidilen bir sonraki düğüm yeni
başlangıç pozisyonu olarak kabul edilirken, gezilen her bir düğüm ise çizge
bağlantı matrisi içerisinden çıkarılmıştır. Hedef ve robotlar renkli etiketler
ile etiketlenmiş ve nesnelerin konumları renk tabanlı nicemleme ve eşikleme
yöntemleri ile hesaplanmıştır. Yapılan deneyler sonucunda tasarlanan sistemin
değişken sayıda hedef ve farklı hedef dağılımlarında iyi bir şekilde görev
paylaşımı yaptığı ve elverişli yol planı oluşturduğu gözlemlenmiştir.
Elazığ Keban Baraj Gölü Pertek Bölgesi Su Kalitesinin Bazı Parametrelerle Belirlenmesi
Authors: TOPAL Murat
Published: June 2019

Bu çalışmada, Keban Baraj Gölü Pertek Bölgesinden
yerüstü su numuneleri 2018 yılı yaz mevsimi boyunca alındı ve yerüstü su
kalitesi yönetmeliğinde verilen su kalite parametreleriyle karşılaştırıldı.
Elde edilen verilere göre pH 8,7-8,84 arasında, sıcaklık 20,1-27,5oC
arasında, Eİ 264-398 µS/cm arasında, nitrat konsantrasyonları 1,1-1,34 mg/L
arasında, BOİ5 konsantrasyonları 2,3-3,6 mg/L arasında ve KOİ konsantrasyonları
25,2-33 mg/L arasında değerler aldığı belirlendi. Sonuç olarak, Keban Baraj
Gölü Pertek bölgesinden alınan yerüstü sularının pH, sıcaklık, Eİ, Nitrat, BOİ5
konsantrasyonları açısından Sınıf-1 kalitesinde su olduğu, KOİ açısından ise
Sınıf-2 kalitesinden su olduğu tespit edildi.
Çerçeve Türü Betonarme Binaların Periyod Hesaplarının Farklı Ampirik Bağıntılara Göre İrdelenmesi
Authors: AKSOYLU Ceyhun , ARSLAN Musa Hakan
Published: June 2019

Deprem etkisi altında bir yapının göstereceği davranış genel olarak yapının kütlesi ve yatay rijitliğine bağlıdır. Yapının dinamik karakterinin elbette sadece iki parametreye bağlı olmayacağı açıktır. Fakat diğer etmenlerle beraber periyod hesabın zorlaşması nedeniyle literatürde yaklaşık yöntemler verilmiştir. Bunlardan en çok kabul göreni ise Rayleigh’in önermiş olduğu birinci doğal titreşim periyodu denklemidir. Bu çalışmada 1998, 2007 ve 2018 Türk Deprem Yönetmelikleri başta olmak üzere 7 farklı ülkenin 16 farklı periyod formülleri kullanılarak analitik bir çalışma ile periyod karşılaştırması yapılmıştır. Karşılaştırmanın yorumlanabilir sonuçlar vermesi için bünyesinde herhangi bir düzensizlik bulunmayan çerçeve türü bir model bina seçilmiştir. Seçilen model için kat sayısı 2-3-5-7-9-11 olarak değiştirilmiştir. Çerçeveler ETABS programında modellenmiş ve programdan elde edilen sonuçlara göre periyod hesapları yapılmıştır. Karşılaştırmalarda deprem yönetmeliklerinde verilen periyod bağıntıları ve Rayleigh yöntemi kullanılmıştır. Yapılan karşılaştırmaya göre çatlamamış kesit kabulü ile 5 kata kadar Rayleigh formülüne göre elde edilen sonuçların 2018 yönetmeliğinde verilen yaklaşık periyod formülüne 0.82-1.09 oranlarında yaklaştığı fakat yaklaşık formülün daha yüksek sonuçlar verdiği görülmüştür. Bununla beraber kesitlerin çatlamış olduğu düşünülecek olursa Rayleigh formülüne göre elde edilen sonuçların yaklaşık yönteme göre 1.16-1.62 kat daha fazla sonuç verdiği görülmektedir. 5 kattan sonra ise söz konusu oranların sırasıyla 1.21-1.39 ve 1.82-2.10 oranlarında değiştiği gözlenmiştir.
Ag katkılı NaPO3 camları: Sentez ve karakterizasyon
Authors: ATEŞ Tankut , KESER Serhat , KAYGILI Ömer
Published: June 2019

Bu çalışmada, Ag katkısının NaPO3 camlarının yapısal özellikleri ve morfolojisi üzerine etkileri araştırıldı. Bu amaçla farklı oranlarda Ag içeren NaPO3 camları 850 °C’de üretildi. Hazırlanan numunelerin karakterizasyonu X-ışını kırınımı (XRD), Fourier dönüşümlü kızılötesi (FTIR) spektroskopisi ve taramalı elektron mikroskopisi (SEM) teknikleri kullanılarak gerçekleştirildi. Elde edilen tüm numuneler için gözlemlenen tek faz, ortorombik kristal yapıdaki NaPO3’tür. Ag katkısıyla ikincil bir fazın oluşumu gözlenmedi. Ag katkılanmasının, sodyum fosfat camlarının kristal büyüklüğü, kristalleşme miktarı ve örgü parametrelerinde belirgin değişimler meydana getirdiği görüldü. FTIR spektrumlarında fosfat grubuna ait bantlar tespit edildi. Morfolojinin Ag katkısından etkilendiği gözlendi.
Static Analysis of Orthotropic Euler-Bernoulli and Timoshenko Beams With Respect to Various Parameters
Authors: SARAÇOĞLU Mustafa , GÜÇLÜ Gökhan , USLU Fethullah
Published: June 2019

In
this study, deflections of orthotropic beams along the beam length are
calculated by using static analysis according to Euler-Bernoulli and Timoshenko
beam theories. Since the mechanical properties of the materials change as the
orientation angle of fibers changes, the formulation is carried out using the
equivalent Young’s modulus and the equivalent shear modulus. Orthotropic beams
are modeled as isotropic beams by using equivalent moduli. Governing equations
are derived. Two numerical examples with different orthotropic materials
are given for different boundary and loading conditions. The effect of changing the orientation angle
of the fibers on the deflection values is also considered. Orientation angle,
material properties, length to depth ratio has been considered as parameters in
the static analysis of orthotropic beams. Results are also compared with
steel which is an isotropic material and presented in the form of tables and graphs which may be
useful.
Gaziantep-Kahramanmaraş Bölgesinde Meydana Gelen Deprem ve Taş Ocağı Patlatmalarının Zaman ve Frekans Ortamı Yöntemleri ile Sınıflandırılması
Authors: YAVUZ Evrim , SERTÇELİK Fadime , LİVAOĞLU Hamdullah , IRMAK T. Serkan
Published: June 2019

Gaziantep-Kahramanmaraş
bölgesi, Türkiye'nin güneydoğusunda tektonik yönden aktif bir alanda yer
almaktadır. Bölgede, maden ve taş ocakları yaygın bir şekilde bulunmaktadır.
Bunlara ait işletmelerde malzeme temini için patlayıcılar kullanılmaktadır.
Dolayısıyla bölgede sadece tektonik olaylar değil yapay kaynaklı patlatmalar da
sismik istasyonlar tarafından kayıt edilmektedir. Yapay ve doğal kaynaklı
sarsıntı kayıtlarının sismik kataloglarda meydana getirdiği karmaşıklık,
sismoloji çalışmaları için büyük sorun teşkil etmektedir. Bu çalışmanın amacı,
çalışma alanında doğal ve yapay kaynaklı olayların ayırt edilerek
kataloglardaki tanımlamanın net olarak ortaya konulmasıdır. Bu çalışmada,
Boğaziçi Üniversitesi Kandilli Rasathanesi Deprem Araştırma Enstitüsü Bölgesel
Deprem-Tsunami İzleme Merkezi (KRDAE-BDTİM) tarafından işletilen GAZ sismik
istasyonunun kayıtları kullanılmıştır. Büyüklüğü en fazla 3.0 olan ve 2013-2016
yılları arasında meydana gelen 95 adet sismik olay kayıtlarının sadece yatay
bileşenleri kullanılmıştır. Genlik oranı, karmaşıklık ve Sürekli Dalgacık
Dönüşümü yöntemleri ile analizler yapılmıştır. Sınıflandırmada istatistiksel
yaklaşım olarak lineer ve karesel ayrımlaştırma fonksiyonları (LAF-KAF)
kullanılmıştır. Genlik oranı yöntemine göre, LAF sonucunda 69 adet ve KAF
sonucunda 70 adet deprem ayrımlaştırılmıştır. Karmaşıklık yöntemine göre ise tüm
olaylar arasında 24 patlatma kaydı yine aynı fonksiyonlar ile kategorize
edilmiştir. Sürekli Dalgacık Dönüşümü analizine göre ise tüm olaylar kategorize
edilmiştir. Sonuçlar, ilk gözlem ile kıyaslandığında KAF'ın LAF'a ve genlik
oranı yönteminin karmaşıklık yöntemine göre daha iyi bir sınıflandırma sunduğu
şeklinde yorumlanmıştır. Ayrıca, Sürekli Dalgacık Dönüşümü analizi ile de
olaylar %100 başarı ile sınıflandırılmıştır.
Doğu Anadolu Bölgesi’nde Thornthwaite tipi aylık su bilançosu analizi
Authors: TOPÇU Emre
Published: June 2019

Kurak
ve yarı kurak bölgelerdeki su kaynakları, iklim değişikliği ve artan su
taleplerinden büyük ölçüde etkilenmektedir. Aylık akış hidrolojik çalışmalarda
en önemli faktörlerden biridir. Aylık ortalama akış, havzaların bölgesel aylık
su dengesi modelleri ile tahmin edilebilir. Bu çalışmada Türkiye’nin Doğu
Anadolu Bölgesi’nde bulunan 13 meteoroloji istasyonunun 2010-2018 yılları
arasındaki aylık toplam yağış ve aylık ortalama sıcaklık verileri kullanılarak
Thornthwaite tipi aylık su bilançosu hesap edilmesi amaçlanmıştır. Potansiyel
evapotranspirasyon Hamon metodu kullanılarak elde edilmiştir. Su bilançosu
parametre sonuçları her istasyon için tablo haline getirilerek verilmiştir.
Sonuçlara göre Elazığ, Erzincan, Iğdır ve Malatya istasyonlarında su fazlası ve
akış yoktur. Su açığı en fazla Malatya istasyonundadır. Akışın en fazla olduğu
istasyon Bitlis istasyonudur. Çalışma alanındaki sulak alanların korunması için
kurak bölgelerin su kaynakları yönetiminde yeterli su talebini belirlemek için
Thornthwaite tipi aylık su bilançosu modeli kullanılabilir.
Toxicity and efficacy of FOLFIRI regimen and aflibercept combination in metastatic colorectal cancer: first results of a Russian multicenter retrospective study
Authors: Fedyanin M. Yu. , Vladimirova L. Yu. , Chubenko V. A. , Zagorskaya L. A. , Belyayeva A. V. , Bolotina L. V. , Moiseyenko F. V. , Fakhrutdinova O. L. , Belukhin S. A. , Zhabina A. S. , Khalikova L. V. , Moiseyenko V. M. , Meshcheryakov A. A. , Artamonova E. V. , Pokatayev I. A. , Khasanova A. I. , Belonogov A. V. , Musayeva Kh. S. , Novikova O. Yu. , Stradayeva I. Yu. , Popova I. L. , Mukhametshina G. Z. , Orlova R. V. , Erdniev S. P. , Ivanova A. K. , Androsova A. V. , Feoktistova P. S. , Kuzmina Ye. S. , Karabina Ye. V. , Nekrasova O. V. , Sherstnev V. M. , Mishchenko A. A. , Mukova L. A. , Kertiev B. Kh. , Kosar G. I. , Osodoyeva S. N. , Katz A. I. , Malina R. R. , Tryakin A. A. , Tyulyandin S. A.
Published: June 2019

Purpose. To assess the incidence and severity of adverse events; to explore clinical factors associated with grade 3–4 non-hematologic toxicity; to assess the immediate efficacy and progression-free survival during treatment with the FOLFIRI regimen in combination with aflibercept in Russia.

Materials and Methods. A retrospective multicenter study has been conducted with data collected from 20 clinics in 15 regions of Russia. There was no statistical hypothesis. Progression-free survival was the main efficacy criterion. The statistical analysis was performed using IBM SPPS Statistics v. 20 software.

Results. FOLFIRI and Aflibercept combination was administered to 264 patients. The mean number of treatment cycles was 6 (1 to 29). The toxicity of aflibercept was addressed by dose reduction and dosing delay in 10.1 % and 11.4 % of patients, respectively, and dose reductions and dosing delays in any of FOLIFRI components were reported in 20.1 % of participants. The objective response rate was 20.3 %. The median progression-free survival in patients receiving second-line treatment was 6 months (95 % CI: 5.3–6.6 months). Seventy-two percent of patients experienced any grade of adverse events most of which were limited to grade 1–2 (62.1 %). Non-hematologic toxicity was reported in 64 % of patients (grade 3–4 in 17.9 %). Hematologic events were detected in only 17.9 % of patients. Multifactorial analysis has shown that drug therapy for concomitant diseases (OR 1.98, 95 % CI: 1.04–3.78, p = 0.037) and the number of chemotherapy lines prior to aflibercept (ОR 1.5, 95 % CI: 1.06–2.11, p = 0.02) were independent predictors of grade 3–4 non-hematologic toxicity.

Conclusions. Objective response rate, progression-free survival, and frequency of toxicity-related aflibercept discontinuations in the Russian study with patients receiving aflibercept in combination with FOLFIRI regimen as a second-line treatment has shown the results that were comparable with VELOUR study. Comorbidities requiring drug treatment and the number of prior chemotherapy lines appear to be risk factors for grade 3–4 nonhematological toxicity events.
Use of single-photon emission computed tomography combined with computed tomography for breast cancer diagnosis
Authors: Kislichko A. G. , Ramazanova M. S.
Published: June 2019

Objective. To evaluate the efficacy of single-photon emission computed tomography combined with computed tomography (SPECT-CT) in the diagnosis of breast cancer (BC).

Materials and methods. We performed 44 SPECT-CT examinations in 40 women with malignant breast neoplasms.

Study Results. The obtained data enabled us to calculate the characteristics of SPECT-CT in the evaluation of the primary tumor. The sensitivity, specificity, and diagnostic accuracy of the method were 88.1 %, 78.3 %, and 88.0 %, respectively. When the method was used to detect nodal and distant metastases, these characteristics were 87.3 %, 76.8 %, 86.9 % and 82.6 %, 73.1 %, 81.4 %, respectively.

Conclusion. SPECT-CT is one of the most accurate methods to assess the primary tumor, lymph node involvement and distant metastases in BC.
Güzel Sanatlar Lisesi Öğrencilerinin Yalnızlık Düzeyleri ile Kişilik Özellikleri ve Yeterlik Algıları Arasındaki İlişkilerin İncelenmesi
Authors: ŞAHAN Mehmet , CEYHAN Esra
Published: June 2019

Ülkemizde

sanat eğitimcisi adaylarını yükseköğretime hazırlayan aynı zamanda sanatçı

adayları yetiştiren en önemli kurumlardan biri güzel sanatlar liseleridir. İlgi

ve yetenekleri doğrultusunda sanat alanı ile ilgili eğitim verilen güzel

sanatlar lisesi öğrencileri, gerek içinde bulundukları gelişim dönemi gerekse

alanlarına özgü yaşantıları nedeniyle yalnızlık duygusunu daha yoğun

deneyimleyen bir grup olarak ön plana çıkmaktadır. Bu çalışmada güzel sanatlar

lisesinde öğrenim gören ergenlerin yalnızlık düzeyleri ile kişilik özellikleri

ve yeterlik algıları arasındaki ilişki incelenmektedir. Çalışma grubu,

Eskişehir Atatürk Güzel Sanatlar Lisesinde öğrenim gören 133’ü kadın ve 91’i

erkek olmak üzere toplam 224 öğrenciden oluşmaktadır. Çalışmada veriler UCLA

Yalnızlık Ölçeği, Ergenler İçin Yeterlik Algısı Ölçeği ve Sıfatlara Dayalı

Kişilik Testi ile toplanmıştır. Veriler korelasyon ve hiyerarşik regresyon

analizi ile incelenmiştir. Bulgular, kişilik özelliklerinden dışadönük ve

duygusal dengesizlik ile sosyal yeterliğin yalnızlığı anlamlı bir biçimde

yordadığını ve değişkenlerin birlikte yalnızlığı %39,8 düzeyinde açıkladığını

göstermektedir. Bu bulgular dikkate alındığında, dışadönüklük ve sosyal

yeterlik özelliklerinin geliştirilmesinin yanı sıra duygusal dengesizliğin

azaltılmasının ergenlerin yalnızlık duygusunun olumsuz etkileri ile daha

işlevsel biçimde baş etmesine yardımcı olabileceği ifade edilebilir.
Retos de la educación intercultural trilingüe en el contexto de una isla del Caribe colombiano: caso San Andrés Isla
Authors: Sanabria James Luz Amparo , Sanmiguel Ardila Raquel , Schoch Angel Monique
Published: June 2019

The unsuccessful experience that two researchers, authors of this article, witnessed as they participated in the joint construction of a trilingual educational model for the island of San Andres, Colombian Caribbean, serves to illustrate the challenges that the passage from a monolingual and monocultural educational model to a plurilingual and intercultural one entail. Underlying this experience is the issue of how national policies of education, which intend to put the country on the path to a globalized world aligned with the neoliberal trends of education, clash with the multicultural and plurilingual characteristics of the country, acknowledged in its 1991 Political Constitution. As an alternative to the complex relations of power, we present a newly formed self-learning network of teachers from basic and secondary education, who seek to have an effect on the teacher training policies of the nation, through their own proposals of classroom action-research.
A study of cardiological autonomic neuropathy in Type 2 Diabetes Mellitus with reference to QT interval for its diagnosis
Authors: Inapakolla Lakshmi Priya , Kotla Ramgopal Teja
Published: June 2019

Background: Presence of cardiac autonomic neuropathy (CAN) is responsible for silent myocardial infarction and sudden death in diabetics. Hence recognizing cardiac dysautonomia early, which is asymptomatic will help to delay or arrest its progression.Methods: A cross-sectional study to evaluate the Prevalence of Cardiovascular Autonomic Neuropathy in Type 2 diabetes and correlate it with duration of Diabetes and to investigate the relationship between cardiac autonomic dysfunction and corrected QT interval.Results: In the study population, the prevalence of definite CAN was 8%, 24% and 58% in group A, B and C respectively. The prevalence of definite CAN increases with increase in duration of diabetes. P value <0.001 significant.Conclusions: A significant correlation is present between Cardiovascular autonomic dysfunction and QTc prolongation. QTc interval in the ECG can be used to diagnose Cardiovascular autonomic neuropathy with a reasonable sensitivity and specificity.
Seroprevalence of syphilis in human immunodeficiency virus patients
Authors: Lakshmi N. , Prasanthi K. , Kamala P. , Kalyani C. Siva , Rao P. Appa , Gowtham B.
Published: June 2019

Background: Syphilis is a sexually transmitted infection caused by, Treponema pallidum. Syphilis facilitates the transmission and acquisition of human immunodeficiency virus (HIV) and causes transient increase in the viral load. Sexually transmitted infections (STI) are 3-5 times more likely to acquire HIV infection, if exposed to the virus through sexual contact. Aim of the study was to estimate the seroprevalence of Syphilis in HIV patients.Methods: A total of 920 blood samples were collected from HIV patients attending ART (Antiretroviral therapy) centre and were tested for Syphilis by using Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA). A total of 100 HIV non-reactive individuals were taken as a control group.Results: Out of 920 samples, 102 (11.1%) were positive for Syphilis. Out of 102 Syphilis seropositive patients, males (76.5%) were more commonly affected in age group of 21-40 years. Both RPR and TPHA were reactive in 46% of cases and only TPHA reactive in 53.9% of cases. Out of 100 HIV non-reactive patients, 5% of patients are reactive for Syphilis.Conclusions: In the present study, prevalence of Syphilis was more in HIV patients compared to HIV non-reactive persons. Persons with HIV infection acquired through sexual route should be screened for Syphilis by one nonspecific test along with specific test to confirm the diagnosis. This will help in proper management of the patients having Syphilis and HIV co-infection.
Depression in type 2 diabetes mellitus patients: a cross sectional study from rural tertiary care hospital of South Karnataka, India
Authors: Bettegowda Shruthi , Kalegowda Manojkumar B. , Mallam Srikanth Goud , Ramalingaiah Vinay H.
Published: June 2019

Background: Depression is associated with a 60% increased risk of Type 2 Diabetes mellitus and diabetes doubles the odds of depression. This study was undertaken to estimate the prevalence of depression and to assess the association between glycemic control and depression in diabetic patients.Methods: Total 130 type 2 diabetes mellitus patients were included in this cross-sectional hospital-based study. Study protocol included detailed clinical history, examination, administering of questionnaire-based scale and investigations. Fasting plasma glucose, post prandial plasma glucose, HbA1c, lipid profile, renal function test and electrolytes of these subjects were determined. Becks depression inventory (BDI) scale was used for diagnosis and grading the severity of depression among these patients.Results: Out of 130 diabetic patients, depression was present in 39.23% of the individuals, among which, 16.15% had mild depression, 10% had borderline depression, 7.69% had moderate depression, 3.07% had severe depression and 2.3% had extreme depression. Prevalence of depression in patients with glycated haemoglobin levels of ≤6.4 was found to be 29.16%, 6.5 to 7 was 33.76% and ≥7.1% was 62.07%.Conclusions: Depression was found to be more common in diabetic patients compared to general population. The prevalence of depression was more among patients with long duration of diabetes, female sex, Muslim religion, substance abuse, complications associated with diabetes and poor glycaemic control. More case control studies with larger sample size are needed to confirm this association.
Relationship of qSOFA values to gastric perforation patients in A. W. Sjahranie General Hospital, Samarinda, Indonesia
Authors: . Uwais , Nahusuly Fritz , Sampetoding Samuel
Published: June 2019

Background: Authors hypothesized the qSOFA score would be useful in sepsis patients caused by gastric perforation. The present study investigated the relationship of qSOFA value to outcome of patients with gastric perforation in Samarinda.Methods: This research was analytical, descriptive research method using cross-sectional study design 70 patients. Data analysis was obtained to see the relationship between age, gender, vital sign qSOFA and survival in gastric perforation patients.Results: Mean systolic blood pressure was significantly higher in subjects who lived than those who died, i.e. 105.5 vs 92.5 (p <0.001). Mean diastolic blood pressure was significantly higher in subjects who lived than those who died, ie 80.0 vs 66.8 (p <0.001). The respiration rate was significantly lower in subjects who lived than those who died, namely 22.9 vs 24.6 (p <0.001). The mean GCS score was significantly higher in subjects who lived than those who died, ie 14.2 vs 12.2 (p <0.001).Conclusions: The higher the qSOFA score in the study subjects with gastric perforation, the higher the mortality rate. There was a relationship between the qSOFA value and the outcome of patients with gastric perforation where the mean qSOFA score was significantly lower in subjects who lived than those who died.
Role of HbA1c and duration of diabetes in predicting mortality in patients of diabetic ketoacidosis in type II diabetes mellitus
Authors: Sonwani Srishti , Sonwani Sutakshee
Published: June 2019

Background: Previous studies have reported the presence of diabetes ketoacidosis in patients of type 2 diabetes mellitus (T2DM). India reported that up to 30% of hospitalized DKA cases result in inpatient death. Aims and objectives of the study was to study the role of HbA1c and duration of diabetes in outcome of patients of diabetic ketoacidosis in type 2 diabetes mellitus.Methods: Hundred T2DM patients having DKA admitted in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, were included. Data on demography (age, sex and diabetes duration, random blood sugar (RBS) and glycated hemoglobin (HbA1c) were recorded for each patients. Outcome was also recorded and compared with duration of diabetes and HbA1c level.Results: DKA was more common in age group of51-55 years (21%) with mean age of 56.10±10.40 years. Male preponderance was observed. Mean duration of diabetes, hemoglobin, random blood sugar (RBS) and HbA1c were 7.28±3.81 years, 9.8±1.42 gm%, 351.72±22.32 mg/dl, and 7.14±0.10 respectively. Mortality was higher among the patients with longer duration of diabetes (23.1%; p=0.012) and higher HbA1c (25%, p>0.05).Conclusions: Duration of diabetes play a significant role in deciding mortality in T2DM patients with DKA however HbA1c has no role in that.
Gall bladder ejection fraction as a marker of autonomic neuropathy in type 2 diabetes mellitus
Authors: Kalyani D. Vasantha , Sheela P. R. , Kumar P. Suresh , Nagalingam Saranya
Published: June 2019

Background: Diabetic neuropathy is one of the commonest complications of diabetes mellitus and associated with considerable morbidity and mortality. The influence of diabetes on gall bladder function was not demonstrated in many studies. In this study, the association of fasting gall bladder volume and gall bladder ejection fraction with degree of cardiac autonomic neuropathy was assessed and correlated with duration of diabetes and severity of diabetes..Methods: The study was conducted in Government Sivagangai Medical College Hospital, Sivagangai, Madurai during a period of January 2018 to September 2018 as a Prospective observational study conducted among 100 patients in study group and 50 healthy subjects in control group. The aim of the study was to find out the incidence of autonomic neuropathy in study group by simple bed side tests, to determine the fasting gall bladder ejection fraction in diabetics, comparison of gall bladder volume in both study and control group, correlation of gall bladder ejection fraction with autonomic neuropathy.Results: The incidence of CAN is found to be high with longer duration of the disease and the degree is also correlated with duration of the disease. The correlation coefficient of this association is 0.792 which indicates high correlation. The correlation of severity of DM   with incidence and degree of CAN was 0.81 which indicates high correlation and also the study showed an increase in the FGBV and a decrease in the GBEF with increase in the severity of cardiac autonomic neuropathy.Conclusions: In patients with type 2 diabetes mellitus, the gall bladder ejection fraction is  significantly  related  to  the  duration  of diabetes mellitus and degree of hyperglycemia in addition to cardiac autonomic neuropathy(CAN). Similarly,  fasting  gall  bladder  volume (FGBV)  is  significantly increased  in  type 2  diabetes  mellitus  patients  with  cardiac autonomic neuropathy.
Aerodynamic measurement-Maximum Phonation Time in young patients with benign vocal fold lesions and with normal voice: a comparative analysis
Authors: Dar Nisar Hussain , Ahmad Mukhtar , Lone Zubair A. , Patigaroo Suhail Amin
Published: June 2019

Background: Clinicians use Maximum Phonatory Time (MPT) as one of tool to verify the glottic efficiency objectively. Impairment of vocal fold mucosa integrity due to lesions results in alteration in MPT. The aim of current study was to compare MPT in young adults with vocal fold lesions and age and sex matched normal subjects.Methods: This study was conducted in the Department of ENT & Head and Neck surgery of Government Medical College Srinagar on 41 adult patients with benign vocal fold lesions and 41 healthy subjects matched for age and sex for a period of 2 years from April 2017- April 2019. The aerodynamic measure was measured as maximum phonation time in seconds and the results were analysed statistically. Both patients and controls were explained the procedure. Results: Mean MPT in seconds in males with vocal fold lesion was 14.42 seconds with SD of 5.62 seconds and in females was 10.81 seconds with SD of 3.44 seconds. Coefficients of variation (CV) was 0.35 and 0.21 respectively. In control group it was 18.15 seconds with SD of 5.88 in males and in females it was 15.72 seconds with a SD of 6.21. Mean difference between patients and controls in males and females was 3.8 and 4.9 respectively. P-Value in males and females was 0.053 and 0.003 respectively.Conclusion: Vocal cord lesions decrease MPT in both sexes even in young adults.
Ketamine and propofol: safe for short procedures
Authors: Borkar Patil Vijaya P. , Upadhye Jayshree J.
Published: June 2019

Background: Patients who attend the hospital for any form of operative procedure frequently undergo physical or mental pain and agitation. These patients are extremely anxious. It is important to choose the most appropriate form of anesthesia for induction for the analgesia or sedation. This study examined the safety and effectiveness of the Ketamine and Propofol combination technique for short procedures like D and C, MTP, evacuation and marsupilisation of Bartholin’s abscess.Methods: The present observational study was carried out in association with the Gynecology and Obstetrics department and Department of Anesthesiology of PDMMC and hospital, Amravati, Maharashtra, India over a period of 3 months from 1st January to 31st March 2019.Results: In present study, 28 (56%) patients were of 25-40 years age, 14 (28%) patients were of 41-50 years age while 8 (16%) patients were of 51-60 years age. 7 (14%) patients were underweight, 26 (52%) patients had normal BMI, 10 (20%) patients were overweight while 7 (14%) patients were obese. MAP before surgery was 100 ± 12, which decreased to 92±9.2 during operation and increased to 97±19.4 in the postoperative period. Heart rate and arterial SPO2 were not significantly different before, during, and after the operation. Mean VAS score for pain was 5.2±5.1 and the mean Ramsay’s score of sedation was 5.8 ± 0.01. 1 (2%) patient had apnea, 1 (2%) patient had skin reaction, 1 (2%) patient had cough, 1 (2%) patient had agitation while 2 (4%) patient had nausea and vomiting.Conclusions: Ketamine and Propofol combination technique can be recommended for use in the short procedures safely and effectively.
Correlational study of interleukin-6 with albuminuria in type 2 diabetes mellitus
Authors: Vaishya Ganga Prasad , Kumar Granth , V. Vijayavarman , Pandey Sanjeev Kumar , Kumar Arun , K. Kiran
Published: June 2019

Background: Individuals with type 2 diabetes display features of low-grade inﬂammation. Mediators of inﬂammation such as IL-6 have been proposed to be involved in the events causing as well as progression of diabetes. Diabetic nephropathy is one of the commonest causes of chronic kidney failure throughout the world. Although diabetic nephropathy is traditionally considered a non-immune disease, accumulating evidence now indicates that immunologic and inflammatory mechanisms play a significant role in its development and progression.Methods: This cross sectional study was conducted in the department of medicine, UPUMS, Saifai. The study was conducted from June 2018 to February 2019. A total of 80 type 2 diabetes patients were included in the study. After informed consent, patients were recruited. FBS, PPBS, HbA1C, 24 Hrs Urinary protein and interleukin-6 levels were measured. The data was analysed using SPSS 23. Pearson co relation co efficient was determined between IL -6, HbA1c and Urinary protein.Result: A total of 80 type 2 diabetes patients were studied. The study subjects were divided into 3 groups based on the urinary protein level into normo-albuminuria, Micro- albuminuria and macro- albuminuria. FBS, PPBS, HBA1c, 24 Hrs Urinary protein and Interleukin – 6 were significantly associated with proteinuria (p<0.001). Urinary protein was positively correlated with IL-6 (R2=0.57, p<0.01). The blood glucose was positively correlated with IL-6 (R2=0.413, p-0.01).Conclusion: Raised IL-6 levels in diabetics revealed the presence of inflammation. Our study showed positive correlation between IL-6, HBA1c and Urinary protein.
Retrospective analysis of random and systematic errors in radiation therapy of head and neck cancer patients and its clinical predictive implications with VMAT treatment
Authors: Deb Jui , Chaudhuri Santanu , Panda Debashis , Sinha Sujit Nath , Kumar Sasi , Kumar Navin , Basu Saumen , Kumar Neeraj , M. Aneesh P. , Gupta Sanjeev K.
Published: June 2019

Background: The accuracy of radiotherapy is based on the matching of 2D portal/CBCT image with a reference image. The aim of this study is to determine the random and systematic setup errors (in cm) in radiotherapy of head and neck cancer patients and to derive the setup margin and its clinical implications.Methods: Author retrospectively reviewed the records of 25 head and neck cancer (HNC) patients treated with radiotherapy between Dec 2017 and July 2018. After immobilization, setup accuracy was assessed by registration of XVI image with planning reference image using Elekta XVI image guidance system and the isocenter correction was applied. For each patient 10 CBCT image sets were taken. The translational errors in X, Y and Z directions were used to estimate systematic (Σ) and random (σ) errors and to derive the final setup margin by using van Herk’s formula (2.5Σ + 0.7σ).Results: The mean translational errors ranges from -0.23 cm to 0.32 cm in Lateral (X), -0.15 to 0.16 cm in Longitudinal (Y) and -0.11 to 0.17 cm in vertical (Z) directions. The Mean and SD for systematic errors 0.21±0.13, 0.11±0.18, 0.14±0.11 and random error (in cm) are -0.03±0.33, 0.00±0.21 and 0.05±0.30 in X, Y and Z axis respectively. The final total margin for CTV to PTV including setup margin in the X, Y and Z directions (in cm) were 0.56, 0.61, and 0.47 respectively.Conclusion: Thus, the precise immobilization techniques are very important to reduce the setup margins, and the number of CBCTs during head and neck radiotherapy treatment.
A study to assess effectiveness of video assisted teaching programme on gastro intestinal tract assessment among student nurses of tertiary care hospital: a statistical approach
Authors: Bhosale Trupti S. , Bhosale Sagar B. , Zagade Tukaram B. , Kakade Satish V.
Published: June 2019

Background: The gastro intestinal is important system in the human body. Many times it is found that its uneasy for student nurses to check the patient. So, there is need to improve the available learning programmes regarding gastro intestinal tract assessment.So, it was necessary to conduct this study for educating student nurses regarding the gastro intestinal tract assessment to improve their knowledge. The objectives of this study were to assess the knowledge of student nurses regarding gastro-intestinal tract assessment and to evaluate the effectiveness of video assisted teaching programme on knowledge regarding gastro intestinal tract assessment.Methods: Material and methods used for the study is the evaluative approach; one group pre test, post test design was used. Study was conducted on sample of 70 student nurses by using convenient sampling technique. The data were collected by structured questionnaire. The data were analyzed using descriptive and inferential statistics.Results: The mean knowledge score of student nurses during the pre-test was 39.89% where as it had raised up to 72% during the post-test regarding gastro intestinal tract assessment as effectiveness of video assisted teaching programme. Therefore, the difference assessed was 32.11% between pre-test and post-test.Conclusions: There was significant difference between the pre-test knowledge level and post-test knowledge level of student nurses on gastro intestinal tract assessment. Hence health education programs and on-going teaching both can further improve the knowledge of student nurses.
Utility of scrape cytology in the diagnosis of ovarian masses
Authors: Ghosh Sanchita , Jain Bhawna Bhutoria , Nandi Ayandip , Banerjee Uma
Published: June 2019

Background: Cytology is a useful adjunct to frozen section for rapid diagnosis of neoplastic pathology. However frozen section facility is available in limited centres. Therefore, we undertook this study to find out role of scrape cytology for diagnosis of ovarian masses.Methods: It is an observational study done in a medical college. One hundred ovarian masses were collected for a period of eighteen months. Cut surface of ovarian masses were scraped with edge of a glass slide. Smears were prepared and stained with H and E stain, examined and a presumptive diagnosis was given. The verification of cytological diagnosis was done by histopathological report. All the data were recorded, tabulated and analyzed with the help of standard statistical methods using Microsoft XL.Results: A total of hundred cases were studied. Left ovary was involved in 38 cases, right ovary in 52 cases and bilateral ovaries in 10 cases. Malignant cases mostly yielded hyper cellular smear. On Chi square test, it was significant with value of less than .001. The overall sensitivity and specificity of scrape cytology in diagnosing ovarian neoplasm, considering HPE as gold standard, are 98% and 78% respectively. In Dysgerminoma, Papillary adenocarcinoma, Mucinous Cystadenoma, Benign cystic teratoma, Granulomatous lesion of ovary, Lymphoma and Mucinous adenocarcinoma, scrape diagnosis corroborated with the histological diagnosis. Notable discrepancy was seen in cases of Endometrioid carcinoma.Conclusions: Scrape cytology can serve as a powerful tool for early diagnosis of ovarian masses in close cooperation of the clinician, radiologist and pathologist. It has a potential for widespread use as knowledge and experience of interpreting cytopathologists increase.
Dengue: experience from a tertiary care centre in Northern Karnataka, India
Authors: Waheed Mohammad A.
Published: June 2019

Background: Epidemiology of dengue infection is evolving, and research gap exists in the region. The clinical features, laboratory parameters, complications and treatment outcomes of patients diagnosed of dengue infection at a tertiary care centre were analysed in the present study.Methods: More than 12 years old patients, presenting with features suggestive of acute febrile illness were subjected to detailed history taking and thorough clinical examination. All the suspected cases were further evaluated with complete blood count, liver function test, kidney function test, along with ultrasonography of abdomen. Blood samples were tested for dengue antibodies (IgG and IgM) by hemagglutination inhibition method for confirmation of the diagnosis. The clinical course was closely monitored during hospital stay and complications and deaths, if any, were noted.Results: Total 140 patients were studied. Fever (100%), headache (80%) and myalgia (73.6%) were the commonest symptoms. Thrombocytopenia (136, 97.1%) was the commonest hematological finding, while severe thrombocytopenia (<50,000/cu. mm) was observed in 38 (27.1%) cases. Hepatomegaly (61, 43.6%), splenomegaly (42, 30.0%), ascites (54, 38.6%), pleural effusion and gall bladder edema (18, 12.9% each) were the commonest findings on ultrasonography. Shock and ARDS were the major complications.Conclusions: Dengue remains an important public health problem even at a tertiary care centre and strong suspicion is needed in adult patients with acute febrile illness. The management should focus on averting shock and ARDS, which would help in larger aim of reduction in mortality.
Gender differences in clinical profile and risk factors for obstructive sleep apnea in a public health care setting
Authors: Kapse Vijay , Patel Vikas , Mhaisekar Dilip , Kulkarni Mithilesh
Published: June 2019

Background: Obstructive Sleep Apnea Syndrome is an increasingly prevalent chronic condition which is, unfortunately, still underdiagnosed. It is peculiarity of this noisy disease that it announces itself to everyone within earshot-except its victims. The intermittent hypoxemia and sleep fragmentation caused by recurrent episodes of upper airway collapse are chiefly responsible for the pathophysiology associated with this condition.Methods: The present study was carried out from January 2014 to August 2015 in a tertiary care government hospital. In this comparative hospital based study 94 patients with Sleep Disordered Breathing and >13 years of age were included. There were 58 males and 36 females in the present study. All patients who satisfied inclusion criteria were studied after taking written consent. Collection of data was carried out with predesigned proforma.Results: Of all the 94 patients who underwent overnight Polysomnographic study,80 patients were diagnosed as Obstructive Sleep Apnea. Risk factor of OSA have gender differences in their distribution. Female patient is older with significantly higher mean age compared to male patients with OSA (52.9 vs 44.7 years). Females are having significantly higher BMI compared to male OSA(38.2 vs 31.5) but neck circumference is higher in males (44.7 Vs 38.1 cm).The prevalence of Smoking and Alcoholism as a risk factor is higher in male patients while endocrine disorder are more common in females. ENT abnormalities are present more or less equally in both the sexes.Conclusions: In the present study females’ patients with Obstructive Sleep Apnea were mainly Older, Obese, Postmenopausal and endocrine disorder like Hypothyroidism were more prevalent while male patients were Smoker, Alcoholic and had higher neck circumference.
Ross syndrome: a case report
Authors: Mahata Manoj Kr. , Ghosh Saikat , Ghosh K. C. , Bhattacharyya R. , Mondal G. P.
Published: June 2019

Ross syndrome is a rare partial dysautonomic syndrome of unknown aetiology, characterized by segmental hypo/ anhidrosis associated with Holmes-Adie syndrome (tonic pupil and hypo/areflexia). The hypohydrosis or anhydrosis is patchy initially, later it becomes segmental or diffuse. This is due to affection of postganglionic cholinergic parasympathetic and sympathetic fibers involvement. There are a very few cases (approximately 50) have been reported in the literature since its original description. Author report a 22 years old male with classical features of Ross syndrome.
Giant vesical calculus
Authors: Vergadia Ankita , Bansal Neeraj , Gupta Nitin
Published: June 2019

Author presented a case report of a 42-year-old male patient who presented with dysuria, heaviness in lower abdomen since last 3 years associated with pain over bilateral lumber region since 2 years. He had history of recurrent urinary tract infection for last 6 months with blood in urine occasionally. Routine urine examination detected red and white blood cells with culture growth of E. coli. Ultrasound of abdomen confirmed the presence of vesical calculus of 10x7x5 cm.