bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ISSUE OF ADHERENCE TO TREATMENT OF OBESE PATIENTS IN COMBINATION WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: Shypulin Vadym P. , Melnyk Nataliia G.
Published: June 2020

The aim – to study the effect of adherence to treatment in patients with obesity in combination with NAFLD on the effectiveness of treatment of NAFLD

Materials that methods. 93 patients with obesity 1,2,3 degrees (BMI = 30-44.9 kg \ m2) in combination with NAFLD were examined. The patients were divided into two groups by randomization. They were offered a comprehensive weight loss program consisting of 5 visits over 12 weeks. The comprehensive weight loss program included: a reduction in the energy diet by 500 kcal from physiological daily energy expenditure and a moderate physical activity of 150-200 min per week. The patients of the first group adhered to the comprehensive weight loss program and received pioglitazone 15 mg / day. Patients of the second group adhered only to comprehensive weight loss program. We studied adherence to treatment in two groups of patients using self-report questionnare. The survey on Obesity WGO recommendations was also conducted. All patients underwent anthropometric measurements, laboratory and instrumental examination.

Results. The comparative analysis revealed that patients with obesity and NAFLD in group 1, who followed a comprehensive weight loss program and received pioglitazone at a daily dose of 15 mg, had significantly better adherence rates (70.4%) (p <0, 05) compared with patients in Group 2 (59.6%) who followed only a comprehensive weight loss program. It was found that in patients of group 1, controlled attenuation parameter had a strong negative correlation with the level of adherence to treatment (r = -0,71), compared with patients in group 2, where there was an medium negative correlation (r = -0.56). It was found that the level of adherence to treatment had a medium negative correlation with the number of previous attempts to lose weight (r = -0.52) and the duration of obesity (r = -0.49).

Conclusions. Patients who received pioglitazone 15 mg / day in addition to comprehensive weight loss program were likely to have better adherence rates and, as a consequence, a more significant decrease in steatosis. It is revealed that the level of adherence to treatment depends on the number of previous attempts to lose weight and the duration of obesity.
EXTRAPANCREATIC INFECTION AS A RISK FACTOR FOR ANTIBIOTIC RESISTANCE OF PANCREATIC INFECTIOUS AGENTS IN PATIENTS WITH ACUTE NECROTIZING PANCREATITIS
Authors: Dronov O. , Kovalska I. , Horlach A. , Shchyhel I.
Published: June 2020

Aim of the study To determine the effect of extrapancreatic infection (EPI) on antibacterial resistance of pancreatic infectious agents in patients with acute infected necrotic pancreatitis

Materials and Methods A longitudinal retrospective case-control study was conducted. The Object of the study were the patients with infected acute necrotizing pancreatitis (ANP). The subject of the study was the acquired AMR of pancreatic infection (PI) agents in patients with ANP. The control group included 27 patients who had a positive bacterial culture from sources of PI. 21 patients were included in the risk group, in which the additional source of EPI was recorded. Bacteriological monitoring was conducted in two stages: the primary identification of the agent of PI and the completion of inpatient treatment. Microbiological identification of the pathogen of EPI was performed before the primary determination of the pathogen of PI, and in the interval between stages I and II of the study. According to the results of the resistance profile of PI to AMR, all patients were divided into four clusters: I - patients who identified only antibiotic-sensitive bacterial strains (AMR"-"), II - patients with defined MDR-bacteria (multidrug-resistant), III - patients with XDR-bacteria (extensively drug-resistant), IV - patients with PDR bacteria (pandrug-resistant).

Results The presence of EPI in patients with ANP influences the development of AMRs of PI toward increasing XDR and PDR strains (p=0.008 and p=0.04, respectively). In patients with infected ANP with the EPI, the risk of developing XDR infection was 2.4 times higher than the risk of developing this level of AMR in patients with no EPI (RR-2.4 (95% CI-1.16-4.91), p=0.03). EPI increases the risk of PDR PI by 8 times (RR-8.0 (95% CI-1.04-61.5) p=0.04). For each patient with infected ANP with signs of EPI, the risk of developing XDR strains was 36%, and PDR strains - 25%.

Conclusions The presence of extrapancreatic sources of infection is a risk factor for development of AMR strains of microorganisms that persist in the sources of pancreatic infection. In this category of patients the risk of identification of extensively resistant strains was increased by 2.4-fold (p=0.03) and PDR strains by 8-fold (p=0.04), compared with patients with infected ANP without EPI.
The effect of «pumping wells» procedure on the flow rate of extraction wells
Authors:   Satbayev University, Almaty, Kazakhstan, Yusupov Kh.A. , Omarbekov E.U. ,   Satbayev University, Almaty, Kazakhstan
Published: June 2020

Study of application of «pumping wells» when mining of uranium deposits by in-situ leaching (ISL) to the mine "Karatau" under conditions of high pressure of groundwater character was performed. The operating «Karatau» mine is located in a deserted, inaccessible, sparsely populated area in the southwestern part of the Shu-Sarysuy depression in the territory of the Suzaksky district, Turkestan oblast. The «Karatau» deposit differs from other deposits in that self-pouring of geotechnological wells with a statistical level of +20 m is observed at all sites. The use of traditional technology for such deposit leads to excessive material and labor costs. Therefore, the technology of "pumping wells" is proposed. It is shown that the use of "pumping wells" procedure leads to achieving a uniform flow rate of extraction wells, reduction in the purchase of the cable production costs for the purchase of submersible pumps and wells in the end cap.
Activation of cement clinker with high content of belite
Authors:   Rudny Industrial Institute, Miryuk О.А.
Published: June 2020

The results of studies of cement clinkers with a high content of belite are presented. To obtain clinkers polymineral wastes of enrichment of skarn-magnetite ores were used. To intensify the hardening of cements, a method for activating the silicate phases of clinker (alite and belite) is proposed. Active phases are formed during the synthesis of clinker using a dual-blend technology, which provides an increase in the reactivity of the components of the raw material mixture. Thermodynamic calculations have been carried out, confirming the likelihood of belite formation reactions based on minerals of the raw material mixture. The composition of raw materials blends is justified. To assess the low-melting charge, a basicity coefficient (BC) was introduced and the preferred values of BC = 0.25 – 1.50 were shown. An increase in the activity of alite and stabilization of the active modification of belite provide hardening of the cement stone. The work is aimed at creating resource-saving technologies for Portland cement.
Diversification of uranium production in order to extract associated precious metals
Authors:   Al-Farabi Kazakh National University, Almaty, Kazakhstan, Duisebayeva T.S.
Published: June 2020

Work aimed at diversification of production through the extraction associated with valuable metals in the uranium mines. The peculiarity of this work is the additional processing of spent and existing blocks using the existing production infrastructure for the extraction of associated useful components. Underground leaching technology is well developed for uranium deposits. The technology of underground leaching of associated components differs only in the reagents used, hardware design, etc., but they are fundamentally similar in the method of extraction. Even if there are associated components in the uranium-bearing Sands with a content of less than 1 g/t, up to 0.1 g/t production can be profitable. In this regard, the use of ready-made infrastructure of spent blocks in the uranium field allows us to expect good economic profitability in the future.
Relationship between Consumption of TV Political Programs and Media Malaise in Shaping Political Efficacy among Students
Authors: Mubeen Amber , Saleem Noshina , Latif Faiza
Published: June 2020

This study explores the relationship between consuming Pakistani TV political programs and media malaise to shape external efficacy among University students of Lahore. This study assumed that entrainment and talk shows make students cynical, distrustful and pessimistic; commonly known as media malaise which causes them to affect their external efficacy. Media malaise has been measured with two indicators namely cynicism and political participation. Students of two public sector Universities from Lahore city were taken as population and survey method was applied to get students responses. Data analysis (N=758) shares an interesting result, that there is a positive relationship between consumption of infotainment shows and media malaise, which shows that political programs are making students cynical, distrustful and pessimistic about the political milieu. This hypothesis was also accepted that media malaise effects reduce the external efficacy of students by making them distrustful about the political environment of the country
Interfaith Harmony in Pakistan: An Analysis
Authors: Akbar Muqarrab , Yaseen Hafsa
Published: June 2020

Pakistan is a religious and Islamic state. The religion followed in Pakistan is Islam with a proportion of 98% being a peaceful religion; it protects the rights of every individual without discrimination of any religion. The constitution of Pakistan also protects the rights of every citizen. In this paper, the researchers have tried to figure out the meaning of interfaith harmony and how state policies and state politicians are playing their role in promoting peace and harmony. Quantitative research method is followed by filling the questionnaires by the respondents mostly from the South Punjab region. The sample population was Muslims and Non-Muslims. In the end, researchers evaluated whether interfaith harmony prevails in Pakistan and nonMuslims and whether they can enjoy the same rights as the Muslim citizens of Pakistan.
Pseudo-Galen, Czy to, co znajduje się w łonie, jest istotą żywą?
Authors: Longosz Stanisław , Sawa Robert
Published: June 2020

tłumaczenie traktatu Pseudo-Galena
Mowy o poście Bazylego Wielkiego w łacińskiej wersji Rufina z Akwilei
Authors: Budzanowska-Weglenda Dominika Łucja
Published: June 2020

Posty znane były od wieków, zarówno w świecie grecko-rzymskim, jak i na Wschodzie. Ojcowie Kościoła podkreślali wartość wewnętrzną postów, krytykując pomijanie elementu duchowo-moralnego. Ich traktaty o poście wykazują wzajemną zależność pisarzy, czytali oni bowiem swoich poprzedników, powtarzali ich idee, ale także po swojemu przedstawiali temat postu. Bardzo wyraźnie widać takie działanie w przypadku analizy mów Bazylego Wielkiego i Rufina z Akwilei. Rufin swoje mowy pisał pod wyraźnym wpływem homilii Bazylego. Rufin nie tylko przetłumaczył dwie homilie Bazylego o poście, ale je zinterpretował. Łaciński tekst często bowiem pokazuje, że Rufin pewne wątki z greckiego tekstu znacząco rozwija, a niektóre pomija. Zarówno Bazyli, jak i Rufin zwracają uwagę na moralno-duchowe nastawienie osoby poszczącej oraz podkreślają duchowo-cielesne dobro i pożytek płynący z postu dla samego poszczącego i jego otoczenia. Wzywają do wstrzemięźliwości w piciu alkoholu i do czystości seksualnej.
Symbolika namaszczenia głowy i obmycia twarzy przez poszczącego (Mt 6, 17) w interpretacji patrystycznej
Authors: Nieścior Leon
Published: June 2020

U starożytnych komentatorów spotykamy bogatą refleksję nad zaleceniem namaszczenia twarzy i obmycia głowy podczas postu (Mt 6, 17. Trzymając się istoty przesłania, a więc ewangelicznej zachęty do pokory i wystrzegania się ostentacji w poście, Ojcowie zastanawiają się nad koniecznością w niektórych przypadkach postu publicznego. Kasjodor łączy post odbywany na pokaz ludzki z postawą panien nierozsądnych (Mt 25, 1-13), u których zabrakło oliwy w lampach, czyli uwagi skierowanej na Pana, ponieważ dobre uczynki spełniały dla zdobycia pochlebstw u innych. Obmycie twarzy w Mt 6, 17 oznacza dla naszych autorów szczerość sumienia, a przede wszystkim czystość moralną, polegającą na wyzbyciu się grzechów i wad. Namaszczenie głowy z kolei wyraża radość człowieka wewnętrznego, który pości ze względu na Boga. Ojcowie dostrzegają związek tego namaszczenia z „olejkiem wesela” w Ps 45 (44), 8, którym Bóg namaszcza swego wybranego. Radość postu płynie też z wielu korzyści duchowych, który przynosi post. Namaszczenie olejem miało w świecie biblijnym i starożytnym bogate znaczenie, które przejmują nasi autorzy. Jest ono udziałem w tajemnicy Chrystusa jako Pomazańca Bożego, Arcykapłana i Głowy Mistycznego Ciała. O ile obmycie twarzy oznacza wyzbycie się zła, to u niektórych pisarzy namaszczenie głowy symbolizuje dobre uczynki, a przede wszystkim dzieła miłosierdzia. Skojarzenie z kolei z namaszczeniem atlety przed walką każe rozumieć post jako pewnych zmagań. Przyjemna woń oleju z kolei wskazuje na apostolski charakter chrześcijańskiego umartwienia, które pociąga innych do wiary i naśladownictwa.
Teologia postu w "Hymnach o poście" św. Efrema Syryjczyka
Authors: Uciecha Andrzej
Published: June 2020

W literackim dorobku świętego Efrema są biblijne komentarze, pisane prozą polemiczne refutationes i medytacje, dialogi poetyckie, metryczne homilie (memre) oraz hymny (madrasze). Te ostatnie zasługują na szczególną uwagę, gdyż jak się wydaje ten gatunek literacki był ulubionym narzędziem w hermeneutycznym warsztacie Syryjczyka. Adresatami madrasza nie byli mnisi, czy eremici, bowiem syryjskie chrześcijaństwo orientalne w IV wieku skupiało się z wyjątkową intensywnością na pogłębianiu aspektów ascetycznych chrześcijańskiego życia, takich jak: post, czuwanie, modlitwa nieustanna. To duchowe nastawienie dotyczyło wszystkich ochrzczonych, niezależnie czy duchownych, mnichów, czy świeckich. Oprócz przykładów biblijnych drugim źródłem obrazów w pieśniach De ieiunio jest świat natury, który nie istniałby bez woli Stwórcy. W niektórych fragmentach swoich madrasza O poście Efrem buduje harmoniczną kompozycję  złożoną z tych dwóch wątków, dopełniając sens tekstu biblijnego za pomocą obrazów zaczerpniętych ze świata natury. Klamrą spinającą bogate teologiczne przesłanie zawarte w zwrotkach dziesięciu liturgicznych pieśni jest Chrystus, jako Słowo otwierające skarbnicę Pisma Świętego, jako Pierworodny Syn Ojca, jako jedyny Sprawiedliwy i wzór nad wzorami dla wszystkich ascetów i poszczących. W praktykowaniu postu liczy się dobra wola, dyscyplina w walce z głodem i pożądaniem oraz umiejętność dzielenia się z innymi. Efrem podkreśla znaczenie czynników motywacyjnych i akcentuje oczyszczające działanie postu.
ON THE PERFORMANCE OF OUTDOOR AND INDOOR WI-FI NETWORKS
Authors: Lebedeva N. , Oleynikova O. , Dunaytsev R.
Published: June 2020

Today, Wi-Fi networks can be found almost everywhere: in homes, businesses, hotels, restaurants, transportation, streets, etc. Research subject. In this study, we analyze the performance of outdoor and indoor wireless local area networks. Method. To achieve this goal, the following empirical research methods were used: measurement, experiment, and comparison. Core results. In the first part of the study, experimental data on radio frequency spectrum usage around and inside St. Petersburg State University of Telecommunications are provided. The second part of the study is devoted to the peculiarities of outdoor and indoor Wi-Fi. The effective data rate, retry rate, and noise floor are compared for the 2.4 and 5 GHz frequency bands. Practical relevance. The obtained results can be used for design and optimization of outdoor Wi-Fi networks.
IDENTIFICATION OF MULTIMEDIA CONTENT BASED ON DIGITAL OBJECT ARCHITECTURE
Authors: Zelenov V. , Shustov I. , Kirichek R. , Borodin A.
Published: June 2020

Research subject. The article is devoted to the method of identification of multimedia content based on digital object architecture and a stand which demonstrates the work of the method. Method. The principle of identification data division and injecting data parts in random order to a different area of the file is considered. The analysis of existing solutions is performed. Core results. Stand for identification of multimedia content based on digital object architecture have been developed. This stand can write identifier to the multimedia file and read from it. Practical relevance. The developed stand for identification of multimedia content based on digital object architecture can be used to protect digital content from piracy.
ANALYSIS AND METHODS OF ORGANIZING NODE PART OF THE ACCESS NETWORK
Authors: Bushelenkov S. , Paramonov A.
Published: June 2020

This paper presents results of developing a models and methods for organizing a node part of an optical access network. The object of research is optical cross of the GPON, and the subject of research is models and methods for reducing its resource consumption and increasing other parameters characterizing its functioning. Models and methods are proposed for choosing the type of equipment for optical cable distribution system, as well as a model and method for choosing the structure of switching connections that solve the problem of minimizing the amount of resources.
EVOLUTION OF POSITIONING PROCEDURES IN MOBILE RADIO NETWORKS
Authors: Fokin G.
Published: June 2020

In this paper, we analyze the evolutionary features of positioning procedures in cellular 2G - 4G mobile radio systems. The analysis shows that along with the improvement of the architecture and methods of network positioning, new special mechanisms and procedures for the exchange of data appeared for the collection and processing of primary measurements during location estimation.
ANALISIS BENTUK, MAKNA, DAN NILAI FILOSOFIS PADA DESAIN LOGO KEDATUAN LUWU KE-XL
Authors: Aswan Rifki
Published: June 2020

Penelitian ini berupaya mengungkap makna dan nilai filosofis melalui pendekatan budaya. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Adapun pertanyaan penelitian yang dijawab pada artikel ini yaitu: bagaimana proses penciptaan logo Kedatuan Luwu? dan apa makna dan nilai filosofis yang terkandung dalam logo Kedatuan Luwu? Tujuan penelitian dilakukan untuk mengungkap dinamika proses kreatif penciptaan logo dalam lingkup masyarakat adat, khususnya di Sulawesi Selatan. Kedatuan Luwu melakukan strategi rebranding yang bertujuan memperkuat dan mendekatkan citra kerajaan bagi generasi Bugis dalam suksesi perannya sebagai benteng budaya. Bentuk logo Kedatuan Luwu merupakan akumulasi tanda ikonik dan simbolis yang digunakan masyarakat Bugis dalam struktur kesatuan mallebu ittello (bulat telur). Ikon dan simbol digunakan sebagai perlambangan strukturasi, asal-usul, komponen, ideologi, spiritualitas dan religiusitas, visi-misi, serta karakter ideal wijanna luwu. Nilai filosofis terkandung dalam 3 komponen logo Kedatuan Luwu (payung, singkerru’ mulajaji, dan tanaman labu) merupakan cerminan nilai yang telah diterapkan masyarakat Bugis secara turun-temurun dan dipegang teguh sebagai pedoman hidup. Dimana ketiga nilai filosofis telah mendarah daging bagi masyarakat suku bugis.
KAJIAN KEGAGALAN KAMPANYE PERIKLANAN EXPERIENTIAL SOLIDARITAS SOCIAL DISTANCING COVID-19 MCDONALD’S BRAZIL
Authors: Mansoor Alvanov Zpalanzani
Published: June 2020

Pewaralaba McDonald’s Brazil memublikasikan kampanye experiential solidaritas gerakan social distancing untuk menghambat pandemi Covid-19 pada 20 Maret 2020. Awalnya kampanye tersebut mendapat apresiasi positif, namun muncul sejumlah apresiasi negatif dari netizen media sosial global yang mengakibatkan McDonald’s menarik semua materi kampanye tersebut sambil meminta maaf. Kampanye ini dikaji secara deskriptif eksplanatif sebagai sebuah pembelajaran dalam bidang desain komunikasi visual, khususnya perancangan experiential marketing yang memanfaatkan identitas merek. Didapatkan bahwa strategi kampanye yang disusun melalui sejumlah modul pengalaman relevan dengan alasan rasional yang dibangun, akan tetapi tidak membangun empati atau ada kesenjangan pada aspek emosional. Selain itu terdapat kesenjangan informasi atas layanan dengan ekspektasi serta persepsi masyarakat terhadap merek dan kampanye yang dilaksanakan. Pertimbangan relasi antara pemanfaatan elemen identitas dan merek dengan persepsi dan ekspektasi akan kinerja merek harus disusun dan dipetakan dengan jelas sebelum merancang sebuah kampanye dengan strategi experiential marketing.
El mercado de trabajo a debate
Authors: Redacción Consejo de
Published: June 2020

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Flexibilidad laboral y creación de empleo
Authors: Ortega Victorino
Published: June 2020

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La fecundación "in vitro" y la inseminación artificial humana
Authors: Higuera Gonzalo
Published: June 2020

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PENGARUH PEMBERIAN PUPUK ORGANIK CAIR TERHADAP PERTUMBUHAN DAN PRODUKSI PADI (Oryza sativa L) DI LAHAN GAMBUT
Authors: Melia Aktrinisia, SP. MP dan Zinatal Hayati, SP Deshadiawarman
Published: June 2020

Penelitian tentang pengaruh pemberian beberapa dosis pupuk organik cair terhadap pertumbuhan dan produksi tanaman padi ( Oryza sativa L ) telah dilaksanakan di Desa Pekan Arba, Kecamatan Tembilahan. Kabupaten Indragiri Hilir, Provinsi Riau. Dimulai dari bulan Jili sampai September 2014. Tujuan penelitian untuk mengetahui pengaruh pemberian pupuk organik cair dan untuk meningkatkan dosis yang terbaik terhadap pertumbuhan dan hasil produksi tanaman padi ( Oryza sativa L ). Penelitian menggunakan rancangan acak kelompok (RAK) dengan 5 perlakuan dan 4 ulangan. Perlakuan dosis pupuk organik cair yang diberikan yaitu 25 ml/15 liter air, 50 ml/15 liter air, 75 ml/15 liter air, 100 ml/15 liter air. Parameter pengamatan yaitu tinggi tanaman (cm), umur berbunga (hari), jumlah anakan, jumlah anakan produktif, umur panen (hari), produksi per plot (kg). Data pengamatan dianalisis dengan sidik ragam (DNMRT) pada taraf 5%. Berdasarkan penelitian yangbtelah dilaksanakan dapat disimpulkan bahwa pemberian dosis pupuk organik cair 50 ml/15 liter air menunjukan hasil yang terbaik terhadap pertumbuhan dan produksi padi di lahan gambut.

Kata kunci:

Padi, POC, Tanah Gambut
PENGARUH BERBAGAI DOSIS ABU JANJANG KELAPA SAWIT (AJKS) TERHADAP PERTUMBUHAN DAN PRODUKSI TANAMAN TOMAT (Solanum Iycopersicum L) DI TANAH GAMBUT
Authors: Intan Sari,  Zinatal Hayati Zulkifli.
Published: June 2020

Penelitian tentang pengaruh berbagai dosis Abu Janjang Kelapa Sawit (AJKS) terhadap pertumbuhan dan produksi tanaman tomat (Solanum Iycopersicum L) di Tanah Gambut, dilakukan di Desa Rumbai Jaya, Kecamatan Kempas, Kabupaten Indragiri Hilir, Propinsi Riau. Penelitian berlangsung selama 4 bulan dari september 2014 sampai Desember 2014. Tujuan dari penelitian ini adalah 1) Mengetahui pengaruh pemberian berbagai dosis Abu Janjang Kelapa Sawit (AJKS) terhadap pertumbuhan dan produksi Tanaman tomat di tanah gambut, 2) Mendapatkan dosis Abu Janjang Kelapa Sawit (AJKS) yang terbaik bagi pertumbuhan dan produksi tanaman tomat ditanah gambut.

Penelitian dilakukan menggunakan Rancangan Acak Lengkap dengan 6 perlakuan dan 4 ulangan, yaitu dosis 0 ton/ha, dosis 0,6 ton/ha, dosis 0,9 ton/ha, dosis 1,2 ton/ha dan dosis 1,5 ton/ha. Data hasil penelitian di lakukan perhitungan statistik dengan menggunakan analisis sidik ragam dan jika  terdapat pengaruh yang nyata maka di lakukan uji lanjut Tukey HSD pada taraf 5%. Parameter yang di amati pada penelitian adalah tinggi tanaman, jumlah cabang tanaman, bobot buah pertanaman, bobot buah perbutir, jumlah buah pertanaman dan diameter buah pertanaman.

Hasil penelitian memberikan pengaruh yang nyata pada parameter tinggi tanaman, jumlah cabang tanaman, bobot buah pertanaman dan jumlah buah pertanaman, sedangkan parameter buah perbutir dan diameter buah pertanaman tidak memberikan pengaruh yang  nyata. Hasil penelitian menunjukkan dosis AJKS terbaik adalah 1,5 ton/ha yang terlihat dari parameter tinggi tanaman, jumlah cabang tanaman, bobot buah pertanaman, jumlah buah pertanaman dan diameter buah pertanaman

Kata Kunci : Abu Janjang Kelapa Sawit, Tanah gambut dan Tomat
Eco-friendly synthesis of nano copper and its use in fenton-like reactions for methylene blue degradation
Authors: GÜLTEKİN Demet Demirci , ALAYLI Azize , NADAROGLU Hayrunnisa
Published: June 2020

Copper oxide nanoparticles (CuO NPs) were produced using green synthesis method with Cimin grape extract (Vitis vinifera cv.). The produced CuO NPs were used to remove methylene blue (MB) from water by degradation with Fenton-like reactions. The surface properties of the CuO NPs were determined by FT-IR, SEM and XRD techniques. Experimental parameters for MB removal were selected as: pH: 3 – 11; Temp: 20 - 80°C; initial MB concentration (15 - 50 ml-1), and CuO NPs concentrations (25 - 800 mg ml-1). The best reaction conditions were found to be pH: 7 - 11, temperature: 40 - 45C, interaction time: 120 min, initial MB concentration: 3.125 mg ml-1 and CuO NPs concentration: 25 mg ml-1. Under these conditions, CuO NPs showed a 97.80% efficacy for the removal of MB from wastewater with Fenton-like process. Moreover, this study showed that reagents were reusable, inexpensive, biocompatible, easy to prepare, harmless (CuO NPs, H2O2), and Fenton-like reaction conditions were created.
Bacteriological analysis of donor human milk in milk bank in an Indian setting
Authors: Singh Poonam H , Surana Amita Uday , Chaudhari Vaishali
Published: June 2020

Background: Although human milk banking in India was started in 1984, limited data regarding bacteriological quality of milk are available. Objective: To find bacteriological contamination of milk samples in human milk bank. Methods: Retrospective analysis of milk samples from milk bank for the year 2009-2015 was done. Group A donor mothers were from postnatal or neonatal units of our hospital. Group B mothers were from milk donation camps organized at the community level. All milk samples were plated on blood agar for bacteriological analysis. Pre-pasteurized samples were analyzed for the year 2014-2015 only. Results: Total donor mothers were 3670. 1481 (40%) were from milk donation camp at the community level. 327 (9%) were preterm milk. 2.34% of post-pasteurized samples showed contamination as compared to 9.1% pre-pasteurized milk samples (p=0.002). Group A mothers showed a higher contamination rate as compared to Group B mothers in both pre-pasteurized (p<0.001) and post-pasteurized samples (p=0.006). The most common organisms isolated in pre-pasteurized samples were Gram-positive bacilli (51.89%), coagulase-negative staphylococci (CONS, 44.96%), and Gram-negative bacilli (3%). The most common organisms in post-pasteurized samples were Gram-positive bacilli (88.23%) and CONS (11.76%). No Gram-negative bacilli were isolated from post-pasteurized samples. Conclusion: Contamination rates in our study for both pre- and post-pasteurized samples are quite low as compared to other studies. Community collection of human milk was safe with regard to bacteriological contamination. Holder’s method of pasteurization is effective in reducing contamination.
Neonatal septic arthritis: Clinical profile and predictors of outcome
Authors: Devi R Usha , Bharathi S Mangala , Anitha M
Published: June 2020

Background: Neonatal septic arthritis deserves a special attention due to its subtle signs and symptoms and catastrophic consequences. There is paucity of literature regarding the clinical profile and predictors of outcome in neonatal septic arthritis. Objectives: The objective was to study the clinical profile of neonates admitted with septic arthritis, their clinical and radiological outcomes on follow-up, and factors that predict outcomes. Methodology: Neonates with septic arthritis as assessed by retrospective case sheet review were included. Prospective data collection of clinical and radiological outcomes was done during follow-upvisits. Children with good outcomes (controls) were compared to those with poor outcomes (cases) subsequently to identify the predictors of outcomes using a nested case–control design. Results: Data of 70 neonates admitted with septic arthritis were collected. Single joint involvement was common (75.8%), and hip joint was the most common joint involved. Gram-negative organisms were predominant (72%), and Klebsiella was the most common organism isolated from joint aspirate (36%), followed by Escherichia coli and Staphylococcus aureus. Of 52 babies who turned for follow-up, half had poor outcomes. In univariate analysis,multiple joint involvement (odds ratio [OR] 4.79, [confidence interval (CI): 1.14-20.21]), pre-intervention period ?7 days (OR 92, [CI: 14.06-601.9]), culture positive joint aspirate (OR 3.70, [CI: 1.55-11.86]), and restricted range of joint movements at discharge (OR 83.3, [CI: 9.2-749.9]) were significantly associated with poor outcomes. Pre-intervention period ?7 days (adjusted OR 107.99, [CI: 5.16-2258.8]) and restricted joint mobility at discharge (adjusted OR 139.53, [CI: 9.03-2154.04]) were the independent predictors of poor overall outcome by logistic regression analysis. Conclusions: Long pre-intervention period and restricted joint mobility at discharge were independent predictors of poor outcome in neonatal septic arthritis. We emphasize the importance ofearly diagnosis, prompt referral to tertiary centers, timely surgical intervention, appropriate measures to ensure good joint mobility, and regular follow-up in these neonates to achieve best outcomes.
Risk predictors for the development of retinopathy of prematurity in very low birth weight neonates
Authors: Shreetal Sheena , Sobhakumar S , Rhiju Reshmi , Nair Shreetal Rajan
Published: June 2020

Background: Retinopathy of prematurity (ROP) is an important cause of visual and neurological impairment in premature infants. Identification of risk factors and effective management of the same will help in better outcomes. Information on ROP and its risk factors are limited especially from South India and interventions directed at prevention and treatments have produced only modest results. Methods: The study was of a prospective, unmatched case–control design and was conducted in premature, very low birth weight infants (<34 weeks; <1500 g) admitted to Neonatal Intensive Care Unit in a tertiary care center in South India during an18-month period. The neonates were screened for ROP and subjects who developed ROP were classified as cases and those who did not were categorized as controls. The maternal risk factors studied were the type of delivery, maternal fever, pregnancy-induced hypertension (PIH), gestational diabetes mellitus, cardiac disease, premature rupture of membrane, antepartum hemorrhage, chorioamnionitis, multiple pregnancy, infertility treatment, urinary tract infections, polyhydramnios, and oligohydramnios. The neonatal factors studied were gestational age, birth weight, septicemia, apnea, anemia, hypotension, need for inotropic support, typeand duration of oxygen therapy, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, and phototherapy. Both univariate and multivariate analyses were carried out. Results: A total of 54 cases and 54 controls (1:1) were enrolled into the study. Males dominated the study (63% of cases). Univariate analysis showed gestational age, PIH, birth weight, sepsis, oxygen administration, hypotension and packed cell transfusion as important risk factors for ROP. On binary logistic regression analysis,birth weight (odds ratio: 6.00; p: 0.014), oxygen exposure (odds ratio: 11.05; p: 0.003), and hypotension (odds ratio: 6.85; p: 0.009) were identified as important risk predictors of ROP. Conclusions: The study adds important information to the understanding of risk factors of ROP.
Outcome predictors of severe and very severe pneumonia in children between 2 and 59 months of age admitted in a tertiary care hospital
Authors: Ansari MD Ehtesham , Kumar Ajay , Aggarwal K C , Meena K R , Kamal Murtaza
Published: June 2020

Objective: The objective of this study was to determine the factors associated with outcome (morbidity and mortality) in children aged 2-59 months with severe and very severe pneumonia. Materials and Methods: This is a hospital-based, prospective, observational study conducted in the pediatric department of a tertiary care hospital. Totally 300 children of either sex between 2 and 59 months of age with the WHO-defined severe pneumonia and very severe pneumonia were enrolled in the study. Associations of outcomes and various clinical symptoms were assessed using Chi-square test first and then through logistic regression models. Results: In our study, 86 (28.7%) children stayed in hospital more than 5 days, 113 (37.7%) needed change in antibiotics, 24 (8%) developed complications (5% effusion and 3% pneumothorax), and 31 (10.3%) expired. Multivariate analysis showed that younger age at presentation, household pollution (cooking fuel other than liquefied petroleum gas), and children who did not receive exclusive breastfeeding were prone to develop more severe pneumonia. Head nodding and cyanosis were independent factors significantly associated with mortality on multiple logistic regression. Radiologically proven pneumonia cases required change in antibiotics more frequently and stayed for longer duration in hospital as compared to clinical pneumonia cases. Conclusions: Children with signs of severe respiratory distress such as head nodding, cyanosis and altered sensorium, anemia, decreased or increased total leukocyte count, and hypoxemia have greater risk of mortality. Children with risk factors including overcrowding, indoor air pollution, lack of exclusive breastfeeding and proper immunization, and abnormal chest radiograph are less likely to respond to the first-line antibiotics; therefore, they may be treated aggressively with the second-line antibiotics from the beginning so that their hospital stay may be reduced.
Comparison of 24% sucrose as analgesic during 2nd and 3rd diphtheria-pertussis-tetanus vaccinations with 1st diphtheria-pertussis-tetanus vaccination
Authors: Kavthekar Saiprasad Onkareshwar , Bharati Hemant Pralhad , Kurane Anil Bapurao , Patil Rahul Ravaso
Published: June 2020

Background: International clinical guidelines recommend oral sucrose to be given to relieve procedural pain in neonate. Objective: The aim of this is to study analgesic effect of 24% sucrose beyond neonatal age up to 4 months by comparing its effect during the 2nd and 3rd diphtheria-pertussis-tetanus (DPT) vaccinations with the 1st DPT. Materials and Methods: This prospective study was conducted in 150 healthy infants undergoing for their 1st, 2nd and 3rd DPT vaccination of 50 each and received 24% Sucrose 2 ml 2 min before vaccination. The outcome variables were total duration of cry, first cry, change in heart rate and modified facial coding score (MFCS). The data were analyzed statistically. Results: Mean total duration of cry was significantly longer in 3rd DPT 94.4 (30.12) s and 2nd DPT babies 50.6 (26.14) s than 1st DPT babies 36.3 (25.34) s. Mean duration of the first cry was significantly higher in 3rd DPT 52.1 (13.12) s and 2nd DPT babies 37.3 (15.14) s than 1st DPT babies 18.2 (14.12) s. Mean change, that is, rise in heart rate (beats/min) from baseline was significantly higher in 3rd DPT 16.6 (4.9) and 2nd DPT babies 10.3 (5.2) than 1st DPT babies 3 (2.3) Change in median MFCS at 1 and 3 min was significantly higher with 3rd DPT (3, 2) and 2nd DPT (2, 1) groups as than 1st DPT (1, 0). Longer mean total and first cry, and increase in heart rate was maximum in 3rd DPT group. Conclusion: Nearly 24% sucrose had less analgesic activity in babies receiving 3rd and 2nd DPT vaccination compared to those receiving 1st DPT, and it suggested 24% sucrose had less analgesic effect between 2 and 4 months of age babies.
Assessment of knowledge, attitude and practice of antenatal mothers on child’s immunization in Raichur district, Karnataka
Authors: Ramalingam Revathi , Ajay J , Chetty Sanjeev
Published: June 2020

Objectives: To assess the knowledge, attitude and practice (KAP) of antenatal mothers on child’s immunization and to know the factors affecting the completeness of vaccination and coverage. Design: A questionnaire based cross-sectional study. Setting: Navodaya Hospital, Raichur in the months of June and July 2016. Participants: 200 antenatal inpatients and outpatients mothers. Intervention: A questionnaire comprising 18 questions were administered to the mothers to assess their KAP regarding child’s immunization. Their responses were analyzed using Chi-square test with a value of p<0.05 considered as significant. EPI info version 12 and SPSS 16.0 software were used to analyze the data. Results: Demographic factors of the mother did not have a significant impact on immunization of child. 76.5% of them acquired knowledge regarding through health workers, 60% of the mothers did not know the existence of different types of vaccines, but polio has gained the highest attention of 84% among the diseases. 74% were aware that immunization is free of cost from the government. Responses regarding attitude showed, 96% were willing to get their children vaccinated, 83% felt that the vaccines were harmless, 44% had a fear of side effects due to the vaccines, and 60% of them own an immunization card. Conclusion: The KAP regarding immunization of child in antenatal mothers of Raichur is favorable to the society but fear, lack of awareness and knowledge that prevent the reaching of set targets, can be eliminated by health-care professionals through their timely counseling and interventions in antenatal mothers to achieve completeness and coverage.
Stressors in adolescence: An analytical cross-sectional study
Authors: Ashok Vidhu , Rajan Aswathy , Maben Roshan
Published: June 2020

Objective: To understand the importance of stress in adolescence well-being, to categorize the stressors in them, and to understand the validity of their solutions. Materials and Methods: A prospective study was conducted in 804 students in the age group of 15-17 years from four schools in the city. Study was conducted with the help of “adolescent stress questionnaire” which consisted of 31 questions. An analysis of these answers was done to understand the stressors and other factors. Results: Out of 804 participants,43% (n=342) were females and 57% (n=462) were males. 52% (n=421) were 15-year-old, 32% (n=251) 16 years, and 16% (n=132) were 17-year-old. Academic stress is seen in 74%. No significant differences with gender are seen with the stress. Severe stress isless in children who are 17-year-old than those who are 15-year-old. Mild stress increases with age. Among the study participants, 50.9% (409) children mentioned that they did not get enough time to spend with their friends. Majority of the children were stressed due to studies (p=0.03) more than peer and parent relationship. At the time of break down, they preferred to watch television, listen to music and to use social media (WhatsApp or Facebook) rather than to speak out the matters that stressed them. 33.3% (268) of the adolescents felt that they need help in coping up with their stress. They enjoy what they are doing; though, grades in the school affect them and they feel more time to be spent for studies. Conclusion: Their main stressor was studied; though, a few of them stated that peer/parent/teacher relationships also affect them. Most of the adolescents are able to cope up with stressors in their own way but some of them feel that they need help.
Evaluation of knowledge, perception, attitudes, and practices of pain management of children among pediatric nursing personnel of a tertiary care hospital
Authors: Patnaik Sibabratta , Swain Natabar , Behera Chinmay Kumar , Jain Mukesh Kumar , Nayak Manas Kumar
Published: June 2020

Background: Pain is one of the most misunderstood, under diagnosed and under treated medical problems, particularly in children. If left unaddressed, pain can affect children in ways that will follow them throughout their lives. Nurses play an important role in assessing and managing pain among children during hospitalization. Objective: To evaluate the knowledge, attitude, and practices of pediatric pain management among nursing personnel working in pediatric tertiary care hospital. Materials and Methods: A cross-sectional, self-administered questionnaire-based survey was carried out involving 40 nurses. The questionnaire had 45 items in the domains of personal information, knowledge, and perception toward the pain of pediatric patients, and practices for pain relief. Voluntary participation was ensured and anonymity maintained at all level. Results: The mean age of nurses was 25.53 ± 4.05 years. 90% had a diploma in nursing and 10% were graduates. More than a half (57.5%) of the subjects had experience between 1 and 5 years. The mean score for knowledge was found to be 10.88 ± 2.81 (range 3-16.87%). Most of the participants (87%) thought that children have good pain sensitivity. Only 40% nurses knew about pain scoring system; however, none used pain scoring system in daily practice. None of the nurses were able to answer about the route of administration of morphine for chronic and prolonged pain. Only 44% had shown the correct attitude toward pain in children and 60% participants gave a satisfactory answer regarding practices. Conclusion: Study revealed a deficiency in the knowledge of nurses and their practices regarding pain in children.
Dengue - should we look for confirmation?
Authors: Srigade Vedavyasa , Bingi Koteshwar
Published: June 2020

Background: Children are at great risk of dengue infection and mortality. Pediatric dengue management needs early identification and timely intervention. Objective: Evidence for case management based on clinical diagnosis without waiting for confirmation is aimed at in this study. Methods: Retrospective medical record review of pediatric clinical and confirmed dengue cases was done. Children admitted during 6 months in 2015 at Institute of Child Health, Niloufer Hospital, Hyderabad, were included in the study. 3 demographic, 32 symptom, 24 sign, and 24 investigation data were collected. Proportions of individual findings of the total number of patients in the group were compared between clinical and confirmed dengue groups. Results: Of the 13,750 admissions, 282 serologically confirmed dengue cases, 407 clinical dengue cases, 4 confirmed dengue deaths, and 24 clinical dengue deaths, making a total of 717 patient data were analyzed. Case fatality rate was 4.06% (95% confidence interval: 2.56-5.57). Except 9 out of 83 parameters, no significant differences of proportions between the groups were present. Age <5 years, seizures, altered sensorium, bradycardia, and systolic blood pressure <70 mmHg were significantly associated with increased mortality in dengue on logistic regression. Conclusions: Clinical diagnosis in the light of epidemiology, using acute pain in right hypochondrium, malena, tender hepatomegaly, centrifugal blanchable flushing, and hypotension as definite pointers of dengue avoids vagueness and is sufficient to treat dengue with escalation of fluid therapy as needed and with other supportive measures without waiting for lab support. Currently, available investigations cannot confirm dengue with accuracy in the hour of need, but they should be used for epidemiological purposes.
Enteric appendicitis: An unusual complication of enteric fever
Authors: Sandal Sapna , Verma Sanjay , Malik Muneer Abas
Published: June 2020

We present an 11-year-old boy admitted with fever, loose stools, vomiting, diffuse abdominal pain, and hepatosplenomegaly. Ultrasound and contrast enhanced computerized tomography of the abdomen was suggestive of appendicular lump. Widal done on day 8 showed elevated TO (1:320) and TH titers (1:80); repeat Widal on day 15 was suggestive of increasing titers (TO-1:320, TH-1:160). The patient improved with conservative management with intravenous ceftriaxone and azithromycin. This case highlights that appendicitis could rarely present as a complication of enteric fever in children; which may not always need surgery. In such cases, early initiation of appropriate antibiotics for enteric fever is curative.
Gender outcome in children with disorders of sex development: A cryptic misfortune
Authors: Rahul Aswathy , Saraswathyamma Sobhakumar
Published: June 2020

Background: Disorders of sex development (DSD) are an important cause of management dilemma for a clinician, especially due to the difficulty in assigning a suitable sex to them. Not many studies are reported regarding their gender outcome. Objective: To find out the gender outcome of children with DSD. Materials and Methods: A hospital-based descriptive study was conducted in children with DSD from birth till 12 years of age who were attending pediatric outpatient department and ward and endocrinology clinic of a tertiary care teaching hospital of South India for 1 year. Children with DSD who were registered in endocrinology clinic over the preceding 10 years were called for review. Those came for review were also included. They were analyzed for their assigned gender at birth, etiological diagnosis, current gender role and phenotype, treatment and follow-up patterns. Reinvestigations were done in needed cases. Results: A total of 38 cases were analyzed in the study. Work up could be completed in 92.1% of children. 60.5% cases were diagnosed in infancy, and 18.42% (n=7) of cases were identified above 5 years. Among those who were not assigned any sex at birth, 50% became phenotypic male and 50% became phenotypic female. 25% of the patients, who were assigned male sexat birth, changed to female sex. 100% of 46 XX DSD are being reared as females but only 44.4% of 46 XY patient are being reared as males. Conclusion: Sex assignment in DSD, especially 46 XY DSD, is a great challenge. Sex assignment must be based on a definitive etiological diagnosis, its natural course, gender role, gender identity, external genital structure and reproductive outcome and with proper counseling of the parents. Strict follow-up is inevitable.
Opportunistic screening of at risk asymptomatic adolescent children for prediabetes
Authors: Krishnappa Santosh Kumar , Yashoda H T , Chaitra K M
Published: June 2020

Background: Type 2 diabetes mellitus (T2DM) once considered an adult disease is now being reported in children and adolescents all over the world due to a parallel increase in obesity. Prediabetes is an intermediate stage between no diabetes and diagnosis of DM. Objective: To screen at risk asymptomatic adolescent children for prediabetes state. Methods: A prospective descriptive study was conducted in the outpatient department of a tertiary care hospital in South India. All adolescent children between the age group of 10 and 18 years with evidence of overweight as per the World Health Organization age and sex specific centile charts for body mass index (BMI) were enrolled. The study period was 18-month. Anthropometric and demographic data were collected among these subjects and investigated for oral glucose tolerance test (OGTT), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) as per the designed protocol. Results: Prediabetes was diagnosed in 13% of the study population with a combination of OGTT, FBG, and HbA1c tests. Prediction of prediabetes by OGTT was 10%, HbA1c 5% and by FBS was 3%. Combination of impaired glucose tolerance test with HbA1c had high sensitivity (92%) and specificity (100%). Conclusions: Our study had 13% population with increasing risk of developing T2DM. Further longitudinal studies are required to screen at risk asymptomatic adolescent children for prediabetes.