bluuebunny/crossref_metadata_2025 huggingface dataset:
Dijital ve manşonlu manuel tansiyon cihazları ile ölçülen brakiyal ve radiyal ölçüm değerlerinin karşılaştırılması
Authors: Çeliktepe Murat , Sarı Oktay , Aydoğan Ümit , Ciğerli Özlem , Sönmez Alper , Koç Bayram
Published: April 2018

Giriş: Kan basıncının doğru ölçülmesi, hipertansiyon tanı ve tedavi takibinde çok önemlidir.Gereç ve Yöntem: Referans olarak kabul edilen manşonlu manuel tansiyon cihazı (CTÖC) ilekan basıncı ölçüm değerlerinin, 3 farklı brakiyal ve 3 farklı radiyal dijital tansiyon ölçüm cihazları (DÖC) ile karşılaştırarak, klinik olarak değerlendirilmesi amaçlanmıştır. Çalışmaya alınan 110 hipetansif hasta ve 100 normotansif birey arasındaki tansiyon ölçüm farkları ile yaş, cinsiyet ve vücut kitle indeksine (VKİ) göre tansiyon ölçümleri analiz edildi. Ölçümler arasında klinik anlamlı fark >5mmHg olarak kabul edildi.Bulgular: Araştırmaya katılan toplam 210 kişinin (ortalama yaş 53.77±15.31yıl), %51,9’u kadın (n=109) idi. Normotansif grupta, CTÖC sistolik kan basıncı değerleri ile bilekten ölçüm yapan DÖC ölçümleri arasında istatistiksel olarak anlamlı fark saptanmadı. Normotansif grupta, bilekten ölçüm yapan DÖC’nın diyastolik ölçümleriyle, CTÖC ölçümleri arasında klinik önemli, istatistiksel olarak anlamlı fark tespit edildi. Hipertansif hasta grubunda CTÖC diyastolik kan basıncı ölçümleri ile bilekten ölçüm yapan DÖC’nın ölçümleri arasında istatistiksel olarak anlamlı fark olmasına rağmen, klinik önemli fark tespit edilmedi. Yaşa, cinsiyete ve VKİ’ne göre, CTÖC ile DÖC kan basıncı ölçümleri arasında klinik önemi olan anlamlı fark tespit edilmedi. CTÖC kan basıncı ölçümleri ile koldan ve bilekten DÖC ölçüm değerleri arasında pozitif yönde anlamlı ve güçlü korelasyon saptandı.Sonuç: Hipertansiyon tanısı ve takibinde, referans kabul edilen ölçüm cihazları ile karşılaştırıldığında, normotansif bireylere göre hipertansif hastalarda, dijital tansiyon cihazlarının doğru ve korele ölçüm sonuçları verdiği saptandı.
Rahim içi araç kullanımı ve pelvik aktinomikoz: Olgu sunumu
Authors: Çelik Neslihan , Alay Handan , Şahiner Melek , Kadıoğlu Berrin Göktuğ
Published: April 2018

Aktinomikozis, Aktinomycesler tarafından oluşturulan kronik bakteriyel bir enfeksiyondur. Hastalığın tanısı karakteristik semptom ve bulguları olmadığı için zordur. Semptomlar bazı malign pelvik tümörleri veya pelvik abseye neden olabilen diğer bakteriyel etkenleri, tüberküloz ve nokardiyayı taklit eder. Aile planlaması yöntemlerinden biri olan RİA kullanımı pelvik actinomikoz için predispozan bir faktör olarak rol oynamaktadır. Tanı sıklıkla cerrahi sonrası histopatolojik tetkiklerle konulmaktadır. Bu sunumda 12 yıl aralıksız RİA kullanımı olan, pelvik kitle ayırıcı tanısıyla opere edilen, pelvik abse tedavisi başlanan, cerrahi sonrası pelvik aktinomiçes tanısı konulan bir vaka irdelendi.
Geleneksel, tamamlayıcı, alternatif tıp uygulamalarına genel bir bakış
Authors: Şahin Saliha
Published: April 2018

Modern tıp, Hipokrat’ın tıbbın tanı, tedavi ve prognoz süreçlerinin detaylı bir gözlem, neden-sonuç ilişkisi ve biriktirilmiş deneyim üzerine kurulması gerektiği fikri ile doğmuş ve (öneri: Hipokrat sonrası dönemde) rahip-hekimler tarafından uygulanan dini inanç, sihir, ampirik tedavi odaklı yöntemlerin karışımı olmaktan kurtulup gerçek bir bilim olma yolunda (buraya bir zaman dilimi, dönem vs konabilir mi?) temelleri atılmıştır. 19.yy başı itibariyle de hekimlik uygulamalarında klinik deneyimin bilimsel araştırma sonuçları ile desteklenmesi anlamına gelen kanıta dayalı tıp olarak yoluna devam etmiş, farmakoloji ve biyokimya gibi temel bilimlerin katkısıyla hastalıkların tanı, tedavi ve rehabilitasyonu sürecinde önemli gelişmeler sağlayarak günümüze değin ulaşmıştır. Ancak son yıllarda ülkemizde ve tüm dünyada isimlendirilmesinde hâlâ fikir birliği sağlanmamış bir dizi geleneksel-tamamlayıcı-alternatif tıp uygulamaları hekim-hekim dışı kişilerce uygulanır ve halkın büyük çoğunluğu tarafından kullanılır olmuştur. Bu uygulamaların ne olup ne olmadığı, ne derece güvenli ve etkin olduğu, halkın sağlığı üzerine potansiyel riskleri ve tehditleri, hali hazırda kullanılan tedavilerle etkileşimlerinin bilinmesi, aynı zamanda olası faydalarının bilimsel olarak araştırılmasının desteklenmesi ve kanıtlanmış faydaların modern tıbba kazandırılması gerekmektedir.
Akılcı ilaç kullanımı: Düzce’de Aile Hekimlerinin bilgi ve davranışları
Authors: Yılmaz Muammer , Yılmaz Ayşe , Özyörük Mustafa , Turunç Fatih , Erkman Naile Gürleyik , Kınalıkaya Ali , Arslan Evren
Published: April 2018

Amaç: Düzce’de görevli aile hekimlerinin akılcı ilaç kullanımına (AİK) yönelik bilgi ve tutumlarının değerlendirilmesi amaçlandı.Yöntem: Bu tanımlayıcı çalışmada Düzce’deki 31 Aile Sağlığı Merkezinde görev yapan 114 aile hekimi çalışmanın evrenini oluşturdu. Örneklem alınmadı, çalışmaya katılmayı kabul eden tüm hekimler çalışmaya dâhil edildi. Veri toplama aracı olarak Sağlık Bakanlığının (SB) hazırladığı 17 sorudan oluşan Hekim Değerlendirme Formu kullanıldı.Bulgular: Çalışmaya 106 AH katılmıştır. Hekimlerin %91,5’i (n=97) mezuniyet sonrası meslek içi eğitimlerine katılırken, AİK konusunda %85,8’i (n=91) eğitim almıştır. Hekimlerin %82,4’ü (n=75) SB’den, %34,1’i (n=31) tıp fakültelerinden AİK eğitimi almıştır. Hekimlerden mesleğinde 10 yıldan az çalışanların %44,7’si (n=21) 10 yıldan fazla çalışanların %22,7’si (n=10) tıp fakülteleri tarafından verilen AİK eğitimi almıştır (p=0,03). SB tarafından verilen AİK eğitiminde gruplar arasında fark bulunmamıştır (p=0,34). Hekimlerin %23,6’sı (n=25) beklenmeyen advers etkilerin bildirimini yapmıştır. AH’ler reçeteleme yaparken bilgi kaynaklarından %94,3 (n=100) oranında yararlanmaktadır. Hekimlerin reçeteleme yaparken en çok faydalandığı bilgi kaynağı internettir.Sonuç: Örgün tıp eğitimi sırasında tıp fakültelerinin AİK eğitimine verdiği önemin artırılması gerektiği görülmektedir. Bulgular hekimlerin ilaç bilgisi, reçeteleme konusunda kaynak olarak daha çok interneti kullanması; internet üzerinden kolay, ücretsiz ulaşılabilecek güvenilir kaynaklar oluşturulması ve hekimlere tanıtımı yapılması gerektiğini düşündürmektedir. Hekimlerin ilaç advers etkilerini yeterince bildirmediği görülmektedir. İlaç advers etkilerinin bildiriminin önemi hekimlere anlatılmalıdır.
EVS data-based analysis of tax evasion: Descriptive vs. regression modelling
Authors: Zídková Hana , Tepperová Jana , Helman Karel
Published: April 2018

Perception of tax evasion by individual citizens is of considerable interest to politicians, since people’s perceived attitudes affect the approach to tax compliance throughout the society. It is thus worth identifying personal characteristics that are related to a higher degree of tolerance and justification for tax evasion. Based on the 2008 European Values Survey data and using descriptive statistics, the paper discusses the relationship between the respondents’ characteristics and their tendency to justify tax evasion. The study finds a strong relationship between this tendency and age, educational attainment and economic activity, the two other variables (parenthood and income) indicating only a weak relationship. Moreover, the current issue allows us to convincingly argue against the regression analysis stereotypes which often yield biased and confl icting results. The paper confirms our constructive criticism, thus opening up space for an extended discussion of a more balanced use of both descriptive statistics and regression models.
José Joaquim da Rocha e a experiência do constitucionalismo na historiografia da Independência do Brasil no século XIX
Authors: E Silva Luana Melo
Published: April 2018

Neste artigo, examinamos algumas obras produzidas ao longo do século XIX sobre a Independência do Brasil. Disputas relativas a distintos projetos nacionais e formas de escrever a história atravessavam essas narrativas. Concorriam, entre outras, duas versões principais do "evento" Independência: a de um processo conduzido pelo Estado corporificado pela monarquia bragantina e a de uma nação que emergira do “patriotismo” e do envolvimento direto da sociedade civil no processo. Acompanhamos nas obras de José da Silva Lisboa, Francisco Adolfo de Varnhagen, Alexandre José de Mello Morais e autores ligados ao Instituto Histórico Geográfico Brasileiro (IHGB) o cotidiano, os eventos principais e personagens como José Joaquim da Rocha, laureado em certas narrativas como “o primeiro motor da independência”. Acreditamos que a versão apresentada pela historiografia que viria a se tornar hegemônica, a de um processo conduzido pela dinastia bragantina, suprimiu a ação da sociedade civil, parte importante da experiência constitucional e de uma tradição historiográfica que resistiu a essa versão preponderante.
Em busca do futuro perdido: Ernst Bloch, a história e a subterrânea “tradição da esperança”
Authors: Marques Danilo Araujo
Published: April 2018

Mais conhecido na história do pensamento ocidental como “filósofo da esperança”, Ernst Bloch (1885-1977) parece ainda não ter sido suficientemente lido pelos historiadores. A partir de um breve percurso sobre a vida e a produção intelectual desse pensador, com este artigo – orientado pelo olhar do historiador –, visa-se abrir perspectivas para um estudo mais acurado a respeito daquilo que nos é indicado por sua concepção de história. Anima-nos a hipótese de que o retorno a Bloch e a reelaboração de suas ideias neste início de século talvez possam nos oferecer a possibilidade de uma alternativa teórica para o momento histórico de crise em que vivemos – marcado por uma historicidade premida e perdida entre um passado que já não é e um futuro [porvir] que parece longe de se cumprir.
Briefing: Politics, planning and health – an inconvenient truth
Authors: Barton Hugh
Published: April 2018

The prevailing public discourse about health – at least in the United Kingdom – is much more about illness and how to cope with it than health. It is about the crisis of the National Health (or illness) service and the related issue of social care. However, much research demonstrates that wellness is tied up with income, equality, lifestyle choices (diet and exercise) and environment. And there is powerful evidence that we are literally building unhealthy conditions into the environment. This paper does not provide all the evidence in a systematic way – that has been done very fully in other sources – but takes the theme of the urban environment and relates it back to political philosophy and forward to health and well-being, telling the stories of three contrasting cities.
Methyl-C sequencing of single cell nuclei: snmC-seq2 v1
Authors: Luo Chongyuan , Ecker Joseph
Published: April 2018

Protocol to apply bisulfite conversion of methyl cytosineto the analysisof the epigenomeof single cell nuclei isolated from brain tissue, as performed withinthe Center for Epigenomics of the Mouse Bain Atlas (CEMBA) and in coordination with the BRAIN Initiative Cell Census Network (BICCN).
Okulomotor activity at the perception of dynamic and static expressions of the face
Authors: Barabanschikov V.A. , Zhegallo A.V.
Published: April 2018

A comparison of the parameters of oculomotor activity in the perception of static and dynamic images of the face was made. It is shown that in both static and dynamic conditions, the trajectory of eye movement is determined by the internal structure of the face of the and the functional connections of the facial areas of his face. Differences were found at the level of individual parameters of oculomotor activity: the duration of examination of the face zones, the duration of fixation and the amplitude of saccades. Routes for reviewing static images are fully cyclic in nature. Recurrent fixations in the same zone of interest are poorly expressed, and their contribution to the overall structure of movements is negligible. When perceiving dynamic images, the survey routes have a degenerate, partially reduced character, determined by the current dynamics of facial expressions; the contribution of repeated fixations in the same zone of interest increases.
Dynamics of metacognitive determinants of management activity in the process of professionalization
Authors: Karpov A.V. , Karpov А.А. , Karabuschenko N.B. , Ivashchenko A.V.
Published: April 2018

The study is devoted to the research of identification of characteristics and patterns of development of metacognitive processes and personal qualities of management activity during professionalization. Hypothesis of the existence of a direct connection between the level of professionalization of the subject and the degree of coherence of the structural organization of the main metacognitive parameters was verified in this study. Using diagnostic and experimental techniques of the study of metacognitive processes and qualities (G. Shraw, R. Dennison, M. Grant, D. LaCosta, R. Dixon, S. Haltch, D. Everson, Z. Tobias), in combination with the author’s methods of structural-psychological analysis, in particular method for determining structural indices of the matrices of intercorrelations, we discovered and interpreted new features and regularities of dynamics of development of metacognitive processes and personality traits in the course of professionalization. It is revealed that professiogenetic restructuring of the parameters of the cognitive sphere are carried out simultaneously on two complementary levels (analytical and structural), and the most important transformations take place at the structural level. In the course of professionalization, the integrativity of basic metacognitive parameters significantly increases alongышву with reduction of their divergence (differentiation). We substantiates the position, according to which mechanisms of the integration plan and resulting synergistic effects, leading to expansion of cognitive and metacognitive potential of the subject, are the main tool of discovered transformations.
Health representations of children and adolescents
Authors: Bovina I.B. , Dvoryanchikov N.V. , Dany L. , Aim M. , Milekhin A.V. , Gayamova S. , Yakushenko A.V.
Published: April 2018

The key question in this article is how children and adolescents understand health. This period attracts a particular interest because the social practice towards health and illness as well as attitudes towards risk and risk behaviour are formed at that time. The productivity of the theory of social representations applied to the field of health and illness is discussed. The exploratory study in groups of children and adolescents on the representations of health and illness is presented here. A total of 633 subjects (333 children (aged 8 years old) and 300 adolescents (aged 13 years old) participated in a study. The study is based on the structural approach of the theory of social representations. The opposition «health»—«illness» is important in case of representations of health in children; its importance is decreasing with age. The key elements of the representation of health in adolescents are the actions to maintain health. The representation in case of children is less shared than in case of adolescents.
Green tea moisturizer improves skin hydration in elderly
Authors: Tjandra Oentarini , Wijayadi Linda J , Rumawas Marcella E
Published: April 2018

BACKGROUNDDry skin is a major skin health problem in elderly. Green tea, which has an antioxidant effect, has recently been used as an active ingredient in moisturizing creams; yet the effect has not been well studied. This study compares the skin hydration effect of green tea and vitamin E moisturizer among elderly.METHODSThis quasi-experimental study involved 60 elderly living in Tresna Werda Budi Mulia 4 Social Institution, Jakarta. Using the Runve HL 611 skin analyzer, skin capacitance was measured prior to experiment and every following week during the 5-week application of green tea and vitamin E skin moisturizer on both forearms. The consecutive measurement data was analyzed using Generalized Estimating Equation to compare the relative changes in skin hydration between the two moisturizer groups over 5 weeks of intervention. RESULTSThe green tea moisturizer showed more significant increases in skin hydration level than the vitamin E moisturizer at all measurement sites on right arm and proximal left arm (p= 0.021), and medial and distal left arm (p= 0.034). Skin hydration levels significantly changed over time at proximal (p=0.021), medial (p=0.006) and distal (p=0.006) right arm, and medial left arm (p=0.021). A parallel trend of skin hydration improvements for both moisturizer groups indicated no correlation between the moisturizer type and the duration of usage (p >0.05) in all measurement locations. No side effects were observed during application period in both groups.CONCLUSIONRoutine use of moisturizer containing green tea may improve skin hydration in elderly.
Aqueous IR Bagendit rice leaf extract decreases reticulocyte count in lead-exposed rats
Authors: Santosa Budi , Sunoko Henna Ria , Sukeksi Andri
Published: April 2018

BACKGROUNDLead acetate may inhibit the enzyme aminolevulinate dehydratase (ALAD) resulting in decreased heme synthesis (and consequently in anemia) but in increased number of reticulocyte cells. IR Bagendit paddy leaf water extract has a high metallothionein protein content which acts to bind to lead. The study objective was to determine whether aqueous IR Bagendit rice leaf extract dosage variations prior to lead exposure decreases reticulocyte count in lead-exposed rats. METHODSThe study was of randomized post test only control-group design involving a sample of 28 rats, that were randomized into 4 groups consisting of 1 control group and 3 treatment groups, daily administered with aqueous IR Bagendit rice leaf extract of respectively 0.2; 0.4; 0.8 mg using a feeding tube up to week 13. Lead exposure was also given using a feeding tube to both control and treatment groups at a dose of 0.5 g/kg BW/day, up to week 13. The reticulocyte count was then examined using supravital brilliant cresyl blue staining. The reticulocyte count was determined per 1000 erythrocytes and then converted into a percentage. Kruskal Wallis test followed with Bonferroni test was conducted to figure out the differences between groups. RESULTSMean reticulocyte count decreased significantly, starting from the control group up to the third treatment group (15.48 ± 3.41; 12.25 ± 03.28; 10.45 ±1.47; 9.10 ± 2.35 average per unit) (p=0.02). The Bonferroni test showed that the reticulocyte count was significantly decreased in the third treatment group (p=0.004). CONCLUSIONAqueous rice leaf extract significantly decreases reticulocytes in rats exposed to lead.
Knowledge and perception towards pharmacovigilance and adverse drug reactions reporting among medical students at a teaching hospital in South India
Authors: J. K. Akshay , Kumar K. H. Hemanth
Published: April 2018

Background: Pharmacovigilance and adverse drug reactions monitoring has become an integral part to ensure patient safety. Targeting the younger doctors for sensitization towards pharmacovigilance is the key to ensure practice of ADR reporting in clinical practice. The objective of the study is to understand and assess the knowledge and perception of students towards pharmacovigilance and adverse drug reactions reporting.Methods: The study included undergraduate medical students of second, pre-final and final years of Mysore Medical College. A validated and standardized KAP based questionnaire was distributed to all students. Willingness to answer and complete the questionnaire was considered as consent.Results: The questions were statistically analysed individually and compared. Q1-Q10 compared knowledge towards pharmacovigilance, Q11-Q20 on the attitude and Q21-Q23 on the practice of ADR reporting. 325 questionnaires were distributed of which only 280 consented (second year - 114, pre-final - 98, final - 68). 112(49.1%), 137(69.9%) and 79(58.1%) of the three groups respectively knew what pharmacovigilance and ADR is. 79.8%, 76.5% and 75% knew who can report ADRs while 18.4%, 32.7% and 33.8% did not know what ADRs to report. 73(64.1%); 93(81.6%), 18(18.4%); 69(70.4%), 13(19.1%); 37(54.4%) knew the existence of AMC in the institute and the PvPI respectively. More than 92% agreed that ADR reporting is necessary. Majority (>90%) agreed that PV and ADR reporting should be taught to all health care students while 28%, 30% and 54% said that it was not well covered in their curriculum.73(64%), 51(52%) and 63(93%) were not familiar with the ADR reporting form.Conclusions: Pharmacovigilance and ADR reporting needs to be made compulsory, have better, interesting ways to learn and understand it, so that the students can practice it with confidence in their clinical practice.
Comparative prospective randomized open label trial of synbiotic (bifilac) as an add on therapy with standard treatment in patients with aphthous ulcer
Authors: G. Sasikala , Sivaraman Malar , Dutta Trayambak , K. R. Dhanasekar
Published: April 2018

Background: To trial the safety, efficacy and rapidity of response to a lozenges containing synbiotic in patients with minor aphthous ulcer.Methods: A total of 60 patients were enrolled for the trial after obtaining IEC approval and randomly allocated into two groups. Control “Group A” was administered with conventional treatment i.e., zytee and B complex for 2 weeks and trial “Group B” was administered with Bifilac along with conventional treatment for 2 weeks. The results of this trial were analyzed both subjectively and objectively.Results: Comparing with control group, where standard treatment was used with analgesics and B-complex, the trial group showed a quick relief of pain and helped in reducing mean size of ulcer.Conclusions: This trial was done with synbiotic lozenges in minor aphthous ulcers and it proved to be better alternative for them. Moreover, synbiotics have no adverse effects.
Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital
Authors: Bhatia Amit , Kalra Juhi , Kohli Saurabh , Kakati Barnali , Kaushik Reshma
Published: April 2018

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents.
In-vitro study of formulation and evaluation of nanosuspension of tamoxifen
Authors: M. Reddy Somasekhar , N. Sriganth Navispaul , S. Kumar Chandra , C. Gursale Santosh , V. Ragavan Vijay
Published: April 2018

Background: Nanosuspension technology has been developed as a promising candidate for efficient delivery of hydrophobic drugs. It could maintain the required crystalline state of the drug with reduced particle size, leading to an increased reporting on dissolution rate and therefore improved bioavailability.Methods: In this paper, we report on the preparation of Tamoxifen nanosuspension by high-pressure homogenization (HPH). The aim is to obtain a stable nanosuspension with an increased drug saturation solubility and dissolution velocity. The morphology and particle size distribution of the modified nanosuspensions were characterized by the means of several analyses that included: transmission electron microscopy (TEM), polarized light microscopy (PLM), scanning electron microscopy, differential scanning calorimetry (DSC) and powder X- ray diffractometry (XRD).Results: HPH was employed to produce aqueous drug nanosuspensions with fine solubility and dissolution properties, which render the produced particles stable up to one month. In addition, the prepared nanosuspensions possessed a high drug-loading efficiency (10%). The recoded zeta potential values (≈ -27 mV) indicated that the prepared nanosuspensions possess a higher degree of long-term stability. TEM data showed narrow size distribution with average size 322.7 nm. Morphologically, as indicated from results, the produced nanosuspensions have a homogenous distribution even after redispersion, indicating the stability of the product.Conclusions: It was possible to obtain Tamoxifen nanosuspensions with fine solubility and dissolution properties. Nanosuspensions possessed a high drug- loading (10%), which could reduce the dosage administration and gastrointestinal side effects. HPH can be employed to produce aqueous drug nanosuspensions that are stable up to one month. Aqueous nanosuspension can be converted to dry nanocrystals by lyophilization which offer superior physicochemical properties.
Efficacy and safety of prucalopride in the treatment of chronic constipation
Authors: Kanaki Anand R. , Kanaki Asharani A. , Singanal Sharanabasappa
Published: April 2018

Background: Chronic constipation is a common condition that significantly impacts health care utilization, productivity, and quality of life. Laxatives are commonly used, although often insufficient in restoring normal bowel function or providing adequate relief. There remains a significant need for the development of novel agents to optimize treatment of this condition. Prucalopride, a selective, high-affinity 5-hydroxytryptamine 4 receptor agonist, stimulates gastrointestinal and colonic motility and alleviates common symptoms of chronic constipation. Here authors are evaluating efficacy and safety study of this drug in chronic constipation patient.Methods: This is a prospective observational study where chronic constipation patient treated with prucalopride 2 mg daily once were enrolled during 6 month period. Data at one week and four weeks were observed along with adverse effects. Efficacy assessed by the number of Spontaneous Complete Bowel Movements (SCBMs) per week recorded by patient diaries. Patients were defined as responders when they had a mean of three or more SCBMs per week over the whole treatment period. The primary efficacy end point was proportion of responders after 1 week and after 4 weeks of treatment.Results: A total of 43 patients diagnosed with chronic constipation and treated with prucalopride were included in study. The proportions of patients in the present study with at least three SCBMs per week (responders) were 44.2% (19 out of 43 patients) at 1 week and 46.5% (20 out of 43 patients) at 4 weeks. Treatment was well tolerated with minimal side effects. Common adverse effects reported in our study were gastrointestinal disorders like diarrhea, nausea and abdominal pain and nervous system disorders like headache and dizziness.Conclusions: Prucalopride is effective, has a good safety profile, and is well tolerated in chronic constipation treatment.
Comparison of drug information in package inserts with standard medical textbook of pharmacology
Authors: Jain Amit , Jindal Amita , Bansal Nagma , Arora Hobinder
Published: April 2018

Background: Accurate and reliable drug product information is important for the safe and effective use of medicines. But there are variations in the quantity and quality of information mentioned in different drug information sources and a single credible benchmark is lacking. This study was carried out to compare the presentation and completeness of clinical information in package inserts (PIs) marketed by pharmaceutical companies in India with standard medical textbook of pharmacology.Methods: Out of eighty five PIs of different drugs, only 55 were found eligible to be included in this study after applying inclusion and exclusion criteria. These PIs and medical textbook were analysed for quantitative and qualitative drug information and were compared using Chi square test of two proportions. The p value of 0.05 was used as cut off to evaluate statistical significance.Results: Quantitatively medical textbook was significantly better statistically in context of treatment of overdose and references. No statistically significant difference was observed in relation to information related to mechanism of action (MOA) and pharmacokinetics (Pk). After qualitative analysis, medical textbook was significantly better statistically in context of size and readability, references related to adverse drug reactions (ADRs) and indications and pictures. No statistically significant difference was observed in context of dosing interval, frequency of doses and pharmacokinetic parameters.Conclusions: PIs can be used as a reliable source of drug information by health care professionals in addition to other sources like medical textbooks.
Hepatoprotective activity of ethanol extract of Pavetta Indica Linn leaves
Authors: Valte Varkung , Singh M. Premchand , Raleng Indira , R. K. Losica
Published: April 2018

Background: Traditionally, the bark of Pavetta Indica Linn., in decoction or pulverized, is administered, especially to children, to correct visceral obstructions. The decocted leaves are used externally to alleviate the pains caused by hemorrhoids. The root, pulverized and mixed with the ginger and rice-water, is given in dropsy. A local fomentation with the leaves is useful in relieving the pain of piles. Paracetamol (PCM) toxicity generates free radicals and raised serum enzyme levels-SGPT, SGOT, Alkaline Phosphatase and S. Albumin. It causes necrosis, congested vessels, multifocal area of fatty changes nuclear disintegration, sinusoidal dilation, kuffer cell hyperplasia. The reverse is considered as the index of hepatoprotective activity. The present study is being taken up to screen hepatoprotective action of P. Indica Linn.Methods: The acute liver damage in albino rats was induced by per oral administration of a single dose of 2000mg/kg b.w. PCM suspension in 0.5% Carboxy methyl cellulose (CMC) and chronic liver damage by giving the same dose of PCM on the 7th day. The hepatoprotective activity was monitored biochemically by estimating S. transaminase, S. bilirubin and S. Protein on the 8th day of experiment.Results: Ethanol extract of P. Indica inhibited PCM induced liver toxicity in albino rats at 100mg/kg and 200mg/kg b.w as assessed by the biochemical values.Conclusions: Ethanol extract of “P. Indica” exhibited significant hepatoprotective activity.
Comparative study of impact of marketing strategies of pharmaceutical houses on prescription practices of doctors rural vs urban
Authors: Gupta Shallini , Khajuria Kanika , Khajuria Vijay , Kumar Niraj
Published: April 2018

Background: Indian pharmaceutical market is fast going and there is a stiff competition amongst them as single product is marketed by different brand names. The pharmaceutical houses adopt different strategies to influence the physician to promote their products. These strategies are known to influence the prescription behaviour of physician, which may have variable impact among rural and urban doctors. Aim of the study was to compare the impact of marketing strategies of pharmaceutical houses on prescription practices of rural and urban doctors.Methods: The current crossover study was conducted among urban and rural doctors. A questionnaire consisting of 17 questions was presented to the doctors and their responses regarding different aspects of marketing strategies was recorded. Comparison between two groups was done using unpaired t-test.Results: Different strategies had impact on prescription pattern of doctors working in rural and urban institutions. All 17 parameters were affected similarly except e-mailing where urban doctors were more influenced (p=0.005).Conclusions: Present study indicates marketing strategies by different pharmaceutical houses do influence prescription pattern of physicians. Both urban and rural doctors were similarly affected except e- mailing which had more impact on urban doctors.
A concurrent parallel study to compare the efficacy and safety of oral iron chelators, defrasirox and defriprone in patients of beta thalassaemia major
Authors: Gupta Pankaj , Gupta Mamta , Nyati Prem , Raipurkar Swati P. , Tripathi Suraj , Thora Sharad
Published: April 2018

Background: This study was planned to evaluate all the cases of β thalassaemia major, already receiving one of the oral iron chelators for a comparison among the efficacy, safety and economy of deferasirox and deferiprone to establish the better option in an Indian scenario.Methods: We identified two groups of patients: 38 treated with deferasirox and 35 treated with deferiprone. Laboratory parameters such as serum ferritin, creatinine, SGPT, Hb, CBC and urine were recorded at the time of inclusion and at 1, 3 and 6 months after the inclusion. The primary outcome variable was serum Ferritin level at the start and at the end of study. Serum ferritin level was carried out by microparticle enzyme linked immunoassay.Results: Before the study, the mean hemoglobin level was 7.32±1.50mg/dL ranged from 4 to 10.8 in deferasirox group and 7.54±1.15mg/dL ranged from 5.5 to 8.8 in deferiprone group. At the time of inclusion, study population was characterized by a mean serum ferritin value of 4735.11±450.01 SE in deferasirox and 4315.97±340.75 SE in deferiprone group. After one month the mean serum ferritin increases to 4578.66±371.96 in deferasirox and 4388.82±316.16 in deferiprone group. After three month the mean serum ferritin reduces to 4295.60±377.37 in deferasirox and 3988.88±349.84 in Deferiprone group.Conclusions: Thus, we conclude that deferasirox and deferiprone are well tolerated, have few adverse effects and almost have a comparable effect in lowering of the patient's serum ferritin level. Deferiprone is more cost effective but needs a strict control on compliance owing to requirement in three divided doses per day.
A comparative study on quadrupedal and non-quadrupedal head position on recovery from chronic maxillary sinusitis in a tertiary hospital of Rohtas district, Bihar, India
Authors: Kumar Sujeet , Rai Tarkeshwar , Aslami Ahmad Nadeem , Alwa Bhaskar
Published: April 2018

Background: Chronic rhino-sinusitis (CRS) is diagnosed in cases when symptoms are present for more than 12 weeks. Rhino-sinusitis manifests itself with a sudden onset of two or more symptoms, one of which is either nasal blockage or nasal discharge (anterior or posterior nasal drip). Position of maxillary ostia is high on their supero-medial walls, which may be suboptimal for natural drainage. Human maxillary sinuses exhibit better passive drainage through their ostia when tilted anteriorly to mimic a quadrupedal head position. Objective of this study is to evaluate the result and advantage of both quadrupedal and non-quadrupedal head position on recovery on CRS.

Methods: This study consists of 100 patients which consists of group 1 (quadrupedal) and group 2 (non-quadrupedal head position), of CMS in whom assess the result based on the overall Quality of Life and CT scan findings after 6 weeks treatment with medical treatment.  

Results: The significant difference between the two groups was the group 1, had more males as compared with group 2.The scoring form used for CT scans reflected the Lund-Mackay staging system. Each maxillary sinus was scored separately and total scores were determined for right and left sides. No statistically significant differences in the scores were noted between the 2 groups at baseline and there were significant differences after 6 weeks of treatment.

Conclusions: CRS significantly impacts patients quality of life. From an analysis of quality of life and CT score, this study confirmed that quadrupedal head position significantly improved recovery from CMS. This study thus indicated that quadrupedal head position can be valuable adjuvant therapy for patients with CMS. 
Epistaxis in children: a clinical study
Authors: N. Ponraj Kumar , S. Rajasekar , V. J. Vikram
Published: April 2018

Background: Epistaxis is a common condition among children. Most cases are due to vascular fragility in the nasal vestibule aggravated by digital trauma. Epistaxis is rare below 2 years. 30% of children of all children between 0-5 years, 56% aged between 6-10 years, 64% of those aged between 11-15 years have had at least 1 episode of epistaxis in their lifetime.

Methods: A retrospective analysis was done on 56 patients of nasal bleed, at Institute of child health and Hospital for children / Madras Medical College, Chennai, between June 2015 - June 2016. The records of children were analysed. All the patients under went blood investigation. The statistical analysis was done for the age group.  

Results: There were 56 cases of nasal bleed enrolled in our study, out of which 35 were boys and 21 girls. The most common age group was between 6-10 years accounting for 27 cases. In laterality of nasal bleed right side was common. The most common site in nostril noted was from little’s area of nasal septum in 27 cases. The most common cause was idiopathic in 15 cases. Most of the cases were managed conservatively.

Conclusions: Epistaxis is a common clinical condition among the paediatric age group. In all cases, ENT examination should be done to rule out nasal pathology or foreign body in nasal cavity and haematology workup is necessary. Majority of nasal bleed stops with digital pressure.
Anterior reconstruction of spine by posterior approach in cases of unstable thoracolumbar burst fractures
Authors: Tiwari Anurag , Thora Ankit , Mohindra Mukul , Sharma Amit , Sural Sumit , Dhal Anil
Published: April 2018

Background: The purpose of this study is to evaluate neurological, functional and radiological outcome of the anterior reconstruction of spine by posterior approach in cases of unstable thoracolumbar burst fractures.

Methods: Ten patients with acute unstable burst fractures at thoracolumbar junction (T-11 to L-3) with partial or complete neurological deficit in the age group of 18-50 years with McCormack’s score six or more and thoracolumbar injury severity score (TLISS) five or more were included. Neurological status, Japanese Orthopaedic association score (JOA score), visual analogue scale (VAS), angle of kyphotic deformity, McCormack’s score and TLISS score were evaluated.

Results: The mean duration of surgery was 282 minutes. The mean blood loss was 1885 ml. Five patients with neurologic deficit recovered an average of 1.40 ASIA grades at last 24 months’ follow-up. The JOA score improved from -6 preoperatively to 11 at 24 months follow up. The mean kyphotic angle was 19 degrees preoperative improved to -0.6o postoperatively. Visual analogue score improved from 6.1 to 1.7.

Conclusions: The familiar posterior approach is a safe and reliable surgical approach for reconstruction of all the columns of spine. It has the advantage of doing anterior decompression and reconstruction with posterior instrumentation in single stage, reducing the operative time and blood loss. It reduces the morbidity of anterior approach (isolated or two staged) in the hands of an average orthopaedic surgeon.
A estrutura de capital de empresas de pequena dimensão em Portugal: uma abordagem segundo as teorias do Trade-off e da Pecking-order
Authors: Camfield Claudio Eduardo Ramos , Freitas Guilhermina Maria da Silva , Correia Marco Rafael Fernandes , Serrasqueiro Zélia
Published: April 2018

Resumo: No corrente estudo analisaram-se os fatores explicativos das decisões de estrutura de capital das Pequenas Empresas (PEs) portuguesas, dado a estrutura de capital destas ter um interesse relevante ao nível econômico-social geral. Neste trabalho centrou-se na teoria Pecking-order (POT) e na teoria do Trade-off, considerando-as mutuamente explicativas e complementares, para avaliar o papel de um conjunto de fatores divididos em três níveis: os internos à empresa, os ligados ao mercado e os ligados ao sistema fiscal. Com base em uma amostra de 2.329 PEs portuguesas, os dados foram sujeitos a uma regressão multivariada. Os resultados obtidos mostram que a rentabilidade, a liquidez e a idade têm um impacto negativo e significativo no endividamento, evidenciando a importância dos princípios da teoria Pecking-order para as decisões de estrutura de capital das empresas portuguesas de menor dimensão. O relacionamento positivo entre a variável dimensão da empresa e o endividamento dá algum suporte à importância da teoria do Trade-off em contexto das decisões de estrutura de capital das pequenas empresas.Palavras-chave: Teoria Pecking-order. Teoria do Trade-off. Endividamento. Portugal. The small firms’ capital structure in Portugal: an approach to the Trade-off and Pecking-order theories Abstract: The present study analyzes the explanatory factors of the capital structure decisions of the Portuguese Small Companies (PEs), given that the capital structure of these companies has a relevant interest in the general economic-social level. This paper focuses on the Pecking-order (POT) theory and the Trade-off theory, considering them mutually explanatory and complementary, to evaluate the role of a set of factors divided into three levels: the internal to the company, market and the tax system. Based on a sample of 2.329 portuguese PEs, data were submitted to a multivariate regression. The results obtained show that profitability, liquidity and age have a significant impact on indebtedness, evidencing the importance of the principles of the pecking-order theory for the capital structure decisions of smaller portuguese firms. The positive relationship between the firm's variable size and indebtedness supports the importance of Trade-off theory in the context of the capital structure decisions of the companies analyzed.Keywords: Pecking-order theory. Trade-off theory. Debt. Portugal.
Testando a relação nível de serviço versus preço por meio do Laboratório de Logística
Authors: Bouzada Marco Aurelio Carino
Published: April 2018

Resumo: Será que empresas que oferecem nível de serviço logístico mais elevado alcançam mesmo maiores receitas e incorrem em custos maiores, como prega a teoria? Nesta pesquisa teve-se como objetivo testar a relação entre nível de serviço, preço de venda e alguns indicadores de desempenho das empresas gerenciadas por participantes de um Jogo de Logística. Para testar a questão de pesquisa foram realizadas sete análises de correlação. O principal resultado foi a constatação do impacto do nível de serviço nos custos e na receita e do preço de venda na receita e no resultado total. Esses achados empíricos foram comparados às conclusões teóricas encontradas na literatura. Foi possível concluir que as discordâncias com a teoria não caracterizam, necessariamente, que os resultados experimentais estão refutando os teóricos, apenas indica que os participantes do Jogo não estão, de maneira geral, atendendo às sugestões da teoria.Palavras-chave: Jogos de Empresas. Logística. Laboratório de Logística. Nível de Serviço Logístico. Preço. Testing the relationship between service level and price through the Logistics Laboratory Abstract: Do companies that offer higher level of logistics service achieve higher revenues and have to deal with higher costs, as the theory says? This research aimed to test the relationship among service level, sales price and some performance indicators of companies managed by participants of a Logistics Business Game. To test the research question, seven correlation analyzes were performed. The main results were the verification of the impact of the service level on costs and revenue and the impact of the sale price on revenue and total result. These empirical findings were compared to the theoretical conclusions found in the literature. It was possible to conclude that the disagreements with theory do not imply that the experimental results are refuting the theoretical ones; they only indicate that the participants of the Game are not, in general, attending to the suggestions of the theory.Keywords: Business Games. Logistics. Logistics Laboratory. Logistical Service Level. Price.
A inovação organizacional como vantagem competitiva: um estudo sobre a agroindústria orgânica brasileira
Authors: Coti-Zelati Paolo Edoardo , Miniussi Adriana , Araújo Davi Lucas Arruda de , Queiroz Mauricio Jucá de
Published: April 2018

Resumo: Nesta pesquisa teve-se como objetivo identificar a influência da inovação sobre a vantagem competitiva da indústria agroalimentar orgânica brasileira. Buscou-se criar aderência entre a revisão bibliográfica levantada e a pesquisa empírica nas estratégias de inovação e vantagem competitiva no setor. A tendência do mercado globalizado aponta perspectivas favoráveis para as indústrias de alimentação orgânica, por essa razão, as indústrias perceberam a necessidade de reestruturar-se para atender à demanda, enquanto o mercado agroalimentar vem buscando formas de agregar valor ao seu produto e obter lucros. Quanto à metodologia, foi realizada uma pesquisa de natureza exploratória com 83 gestores de empresas do setor agroalimentar orgânico. Obteve-se como resultado que a inovação exerceu influência positiva sobre a vantagem competitiva dos produtos orgânicos e que as empresas devem focar em inovações para gerar vantagem competitiva.Palavras-chave: Inovação. Competitividade. Agronegócios. Produtos orgânicos. Organizational innovation how competitive advantage: a study on brazilian organic agroindustry Abstract: This research aimed to identify the influence of the innovation process in the competitiveness of brazilian organic agrifood industry, we sought to create adhesion between the literature review and empirical research raised the strategies of innovation and competitiveness in the sector. The trend of the globalized market indicates favorable prospects for industries Organic food, for this reason the industries have realized the need to restructure to meet the demand, the food industry has been searching for market differentiation looking to add value to your product and make a profit. As for methodology, exploratory research with 83 managers of companies in the organic agrifood sector, the result was that innovation had a positive influence on the competitiveness of organic products and the theoretical foundation joined the conducted research was conducted showing that companies should focus on innovations to generate competitive advantage.Keywords: Innovation. Competitive. Agribusiness. Organic products.