bluuebunny/crossref_metadata_2025 huggingface dataset:
Bayesian inference for the fitting of dry matter accumulation curves in garlic plants
Authors: Macedo Leandro Roberto de , Cecon Paulo Roberto , Silva Fabyano Fonseca e , Nascimento Moysés , Puiatti Guilherme Alves , Oliveira Ana Carolina Ribeiro de , Puiatti Mario
Published: September 2017

Abstract: The objective of this work was to identify nonlinear regression models that best describe dry matter accumulation curves over time, in garlic (Allium sativum) accessions, using Bayesian and frequentist approaches. Multivariate cluster analyses were made to group similar accessions according to the estimates of the parameters with biological interpretation (β1 and β3). In order to verify if the obtained groups were equal, statistical tests were applied to assess the parameter equality of the representative curves of each group. Thirty garlic accessions were used, which are kept by the vegetable germplasm bank of Universidade Federal de Viçosa, Brazil. The logistic model was the one that fit best to data in both approaches. Parameter estimates of this model were subjected to the cluster analysis using Ward’s algorithm, and the generalized Mahalanobis distance was used as a measure of dissimilarity. The optimal number of groups, according to the Mojena method, was three and four, for the frequentist and Bayesian approaches, respectively. Hypothesis tests for the parameter equality from estimated curves, for each identified group, indicated that both approaches highlight the differences between the accessions identified in the cluster analysis. Therefore, both approaches are recommended for this kind of study.
Contribution of roots and shoots of Brachiaria species to soybean performance in succession
Authors: Balbinot Junior Alvadi Antonio , Santos Julio Cezar Franchini Dos , Debiasi Henrique , Yokoyama Anderson Hideo
Published: September 2017

Abstract: The objective of this work was to evaluate the effect of roots and straw of palisade grass (Urochloa brizantha) and Ruzi grass (U. ruziziensis), used as cover crops in autumn-winter, on soybean performance. Seven treatments were evaluated in a randomized complete block design, with four replicates: fallow, during autumn-winter; straw of U. ruziziensis or U. brizantha 'BRS Piatã', distributed in plots kept under fallow in the winter, without roots; plots only with roots of U. ruziziensis or U. brizantha, without straw; and plots with straw and roots of U. ruziziensis or U. brizantha. The grass species were planted during the 2014/2015 crop season, and treatments were evaluated at the end of the 2015/2016 crop season, without drought during the soybean cycle. The oil and protein contents of soybean grains were not affected significantly by the treatments. However, the cultivation of grass species during autumn-winter increased soybean grain yield in comparison with fallow. Grass root effects are more expressive than those of straw. The combined presence of roots and straw confers a better performance to soybean than the isolated presence of roots or straw.
Digital soil mapping and its implications in the extrapolation of soil-landscape relationships in detailed scale
Authors: Wolski Mario Sergio , Dalmolin Ricardo Simão Diniz , Flores Carlos Alberto , Moura-Bueno Jean Michel , Caten Alexandre ten , Kaiser Douglas Rodrigo
Published: September 2017

Abstract: The objective of this work was to test the extrapolation of soil-landscape relationships in a reference area (RA) to a topographic map (scale 1:50,000), using digital soil mapping (DSM), and to compare these results to those obtained in similar studies previously conducted in Brazil. A soil survey in a 10 km2 RA, using conventional mapping techniques (scale 1:10,000), was made in order to map a 678 km2 physiographically similar area (scale 1:50,000) using DSM. The decision tree technique was employed to build a predictive extrapolation model based on soil classes and eight terrain attributes in the RA. The validation of DSM by application of field observation points resulted in a 66.1% global accuracy and in 0.36 kappa index. The most representative soils in the area were correctly predicted, whereas the less representative and less frequent soils in the landscape (and consequently with reduced sampling) had their prediction compromised. The RA proportion, which equals 1.5% of the total area, is a limiting factor in the formulation of soil-landscape relationships to precisely represent the mapped area by DSM.
Contemporary groups in the genetic evaluation of Nellore cattle using Bayesian inference
Authors: Silva Delvan Alves da , Silva Fabyano Fonseca e , Ventura Henrique Torres , Junqueira Vinícius Silva , Silva Alessandra Alves da , Mota Rodrigo Reis , Lopes Paulo Sávio
Published: September 2017

Abstract: The objective of this work was to evaluate the criteria for the formation of contemporary groups (CGs) in the genetic evaluation of body weight at weaning in Nellore cattle. A total of 713,474 records from 3,066 herds located in Midwestern and Northern Brazil were used. Data were obtained from the genealogical registry of zebu breeds of the Brazilian association of zebu breeders. Data structures were defined based on the number of standard deviations (SDs) for outlier removal (±2.0, ±2.5, ±3.0, and ±3.5) and on the minimal number of animals per CG (3, 7, and 15). Genetic evaluation was performed with an animal model using Bayesian inference. Data structures with ±3.5 SDs and CG with at least 15 animals presented the highest additive genetic variance (82.65±2.93), and those with ±2.0 SDs and CG with at least 3 animals showed the lowest one (60.23±1.96). The proper formation of CGs results in better-quality data archives, allowing to obtain more trustable estimates for the genetic parameters. Better selection responses are obtained when the following criteria are adopted for the removal of outliers: 2.5, 3.0, and 3.5 standard deviations and a minimum of 15 animals per contemporary group.
Grupos de Ajuda Mútua para Cuidadores: Informais de pessoas com demência: no sentido de um helping ethos comunitário
Authors: Ribeiro Óscar , Almeida Rosa , Barbosa Cristina , Duarte Natália , Brandão Daniela
Published: September 2017

Resumo No âmbito das intervenções comunitárias que são promovidas conjuntamente por entidades da área da saúde e do social, as intervenções grupais desenvolvidas para cuidadores informais de pessoas com demência têm se instituído como um importante tópico de investigação e objeto de reflexão profissional. O presente estudo tem como objetivo expor o funcionamento de um conjunto de Grupos de Ajuda Mútua (GAM) enquanto respostas de continuidade no apoio a cuidadores informais de pessoas com demência que participam em Programas Psicoeducativos. Partindo de um Projeto de Intervenção Comunitária realizado na zona Norte de Portugal (Projeto Cuidar de Quem Cuida), o estudo descreve cinco GAMs ocorridos em municípios diferentes e implementados/dinamizados por agentes de desenvolvimento local. São apresentados os seus objetivos e principais características de funcionamento enquanto resposta de continuidade. Os resultados revelam a sua importância para os cuidadores, nomeadamente para a dinamização/ manutenção de redes de apoio social informal no âmbito das escassas respostas especificamente destinadas para esta população, bem como para o papel fundamental dos seus agentes dinamizadores (técnicos de saúde e/ou da ação social). Conclui-se pela relevância dos GAMs enquanto iniciativa comunitária de entreajuda e de suporte ativo e continuado para cuidadores informais de idosos com demência.
Significados do câncer de mama para mulheres no contexto do tratamento quimioterápico
Authors: Machado Márcia Xavier , Soares Daniela Arruda , Oliveira Shirley Batista
Published: September 2017

Resumo O significado imprimido ao processo saúde/doença/cuidado da mulher com câncer de mama localiza-se em um complexo de interações entre características socioculturais, comportamentais e biológicas e a ação singularizada de cada mulher na construção da experiência desta enfermidade. Objetiva-se compreender com este trabalho o significado que o câncer de mama tem para as mulheres portadoras e em tratamento quimioterápico. Estudo descritivo, exploratório com abordagem qualitativa, no qual participaram 18 mulheres em tratamento quimioterápico em uma Unidade de Alta Complexidade em Oncologia, em Vitoria da Conquista-BA. A coleta ocorreu por meio de entrevista semiestruturada, durante os meses de julho a setembro de 2016. A análise temática dos dados evidenciou cinco categorias analíticas: Negação da condição de doença; Sentimentos expressos frente à doença; Aproximação com a finitude da vida; Impacto na autoimagem e coping religioso/espiritual. As significações das mulheres com câncer de mama acerca desta condição são complexas, mas sua compreensão pode contribuir para a realização de práticas de cuidado que não se restrinjam às abordagens de cunho biológico, tecnicista e reificador, mas sim práticas de cuidado mais integrais e efetivas.
Relações e conflitos no âmbito da saúde suplementar: análise a partir das operadoras de planos odontológicos
Authors: Neumann Daniela Garbin , Finkler Mirelle , Caetano João Carlos
Published: September 2017

Resumo Este estudo de abordagem qualitativa teve como objetivo compreender as relações e conflitos entre operadoras odontológicas, beneficiários e prestadores, além da interface com a Agência Nacional de Saúde Suplementar (ANS) e com o Sistema Único de Saúde (SUS). A coleta de dados foi realizada mediante a aplicação de questionários aos representantes das operadoras, seguida de análise documental e de entrevistas semiestruturadas. A análise por meio da triangulação dos dados permitiu observar como principais resultados: que a lógica de redução de custos orienta as ações das operadoras e se reflete nas relações com beneficiários, prestadores e ANS; que é frágil a interface com o SUS; que há resistência à ampliação de coberturas; e que o crescimento do mercado é acompanhado de grande concentração. Não se pode ignorar a pujança da saúde suplementar na odontologia, mas é preciso discutir criticamente o papel do Estado, tanto como regulador deste mercado, quanto como indutor de um modelo de atenção à saúde bucal com maior qualidade e resolutividade.
Internação compulsória de pessoas em uso de drogas e a Contrarreforma Psiquiátrica Brasileira
Authors: Azevedo Américo Orlando , Souza Tadeu de Paula
Published: September 2017

Resumo Este artigo desenvolve uma reflexão crítica ao atual movimento ligado às iniciativas de Internação Compulsória (IC) como abordagem e proposta de tratamento às pessoas em uso de drogas, em um contexto de novos desafios que se apresentam à continuidade da Reforma Psiquiátrica Brasileira (RP). Analisamos o dispositivo da IC enquanto produtor de regimes de visibilidade, percebendo que a sua prática e legitimação com a população usuária de crack estão associadas a elementos de atualização de movimentos históricos presentes desde o século XIX, conforme apresentado por Foucault, movimentos esses de articulação entre os poderes jurídico e médico, produzindo práticas que se legitimam através da apropriação dessa população como o novo sujeito Anormal sobre o qual se pretende intervir. Essa manobra abre também brechas para utilização de mecanismos referentes à IC presentes na lei da RP desvinculados de outros termos, principalmente os que buscam preservar e sustentar os direitos das pessoas que são assistidas pelas políticas de saúde mental, contrariando os aspectos progressistas contidos em sua origem. Consideramos as iniciativas de intensificação dos processos de IC expressões de ação do biopoder, com relevância na produção de políticas e de subjetividades contemporâneas de resistência à continuidade e ampliação da Reforma Psiquiátrica Brasileira.
Análise bibliográfica da produção em saúde sobre adolescentes cumprindo medidas socioeducativas de privação de liberdade
Authors: Arêas Neto Nilo Terra , Constantino Patrícia , Assis Simone Gonçalves de
Published: September 2017

Resumo Este estudo teve por função analisar a publicação de artigos científicos da área da saúde sobre adolescentes cumprindo medidas socioeducativas de privação de liberdade no Estado do Rio de Janeiro, Brasil. Realizou-se revisão sistemática integrativa nas bases de dados entre os anos de 2000 e 2015: Scopus (67 artigos), Scielo (73 artigos), Portal BVS (50 artigos) e Pubmed/Medline (13 artigos), totalizando 218 documentos. Após descartes por duplicação e não preenchimento dos critérios de inclusão, permaneceram no acervo 42 documentos, que foram analisados. Foi realizada categorização temática: caracterização do adolescente em conflito com a lei (15 documentos); conceitos, legislação e histórico das medidas socioeducativas e ações institucionais para adolescentes privados de liberdade (8); saúde (9); representação social do adolescente em conflito com a lei (5); e relação familiar (5).Um total de 57,1% dos artigos foram publicados entre 2010 e 2015, especialmente em periódicos de psicologia e saúde pública, em sua maioria com metodologia qualitativa e publicados por pesquisadores das regiões Sudeste e Sul do Brasil. Após análise dos resultados, constatou-se uma maior ênfase aos trabalhos sobre a saúde mental da população estudada em contraponto a uma escassez quase total de estudos sobre a saúde física. Também se pode observar na literatura especializada que a precária assistência e a promoção da saúde do adolescente privado de liberdade constituem desafios complexos e multifatoriais, seja pela dificuldade de articulação da rede de saúde no atendimento ao adolescente institucionalizado, seja pela persistência da lógica punitiva nos estabelecimentos destinados à socioeducação.
O sentido da relação trabalho e saúde para os assistentes em administração de uma universidade pública federal no Estado de Minas Gerais
Authors: Faria Renata Mercês Oliveira de , Leite Isabel Cristina Gonçalves , Silva Girlene Alves da
Published: September 2017

Resumo O objetivo deste estudo foi analisar o sentido da relação trabalho e saúde para os assistentes em administração de uma instituição pública de ensino superior no Estado de Minas Gerais. O trabalhador do setor público é considerado privilegiado por ter emprego estável, como se também não estivesse submetido a condições de trabalho que levam ao sofrimento e adoecimento. Para aproximação desse universo, na presente pesquisa de cunho qualitativo, adotou-se a técnica de grupo focal, e as informações coletadas foram interpretadas à luz da análise de conteúdo. Como resultados, destacamos a importância das relações interpessoais, da transparência e participação na gestão e do reconhecimento através da valorização dos esforços dos trabalhadores para resolver os problemas. O engajamento no trabalho foi outra característica marcante e distancia-se da visão difundida socialmente do servidor público. A limitação do poder de ação no desenvolvimento das atividades e a falta de comunicação entre os setores prejudicam os processos de trabalho, já que não se conclui o serviço da maneira desejada. Tais elementos devem tornar-se foco no processo de vigilância da relação trabalho e saúde, como estratégicos na organização social dos ambientes de trabalho no sentido de ampliação da saúde institucional e da qualidade dos serviços prestados.
Percepções de profissionais sobre o aprendizado de estudantes de graduação na Atenção Básica
Authors: Codato Lucimar Aparecida Britto , Garanhani Mara Lúcia , González Alberto Durán
Published: September 2017

Resumo Buscou-se compreender as percepções de profissionais que atuam em Unidades Básicas de Saúde (UBS) em relação à formação do estudante de graduação nesse espaço existencial. Pesquisa de natureza qualitativa com abordagem fenomenológica hermenêutica apoiada no referencial de Martin Heidegger, realizada na região metropolitana de um município de grande porte do sul do Brasil, realizada com oito profissionais, um de cada categoria, (fisioterapeuta, farmacêutico, médico, cirurgião-dentista, enfermeira, agente comunitário de saúde, auxiliar de enfermagem e auxiliar de odontologia) que possuíam maior tempo de atuação no acompanhamento de estudantes em UBS. Para os profissionais pesquisados, a participação de estudantes em UBS agrega valor à sua formação por tratar-se de meio para ampliação da compreensão do processo saúde-doença e de suas possibilidades de cuidados. A formação na UBS mostrou-se dependente da postura ativa, do envolvimento e da criatividade do estudante, do vínculo que o docente estabelece com o campo. Também se desvelou ligada à abertura e disposição das pessoas que coexistem com os estudantes na UBS. A formação do estudante na UBS é percebida como algo não linear e previsível, depende de iniciativas individuais, as quais são dependentes da compreensão e dos modos de ocupação das pessoas envolvidas, que incluem interesses e escolhas.
Perfil dos usuários de crack na mídia brasileira: análise de um jornal e duas revistas de edição nacional
Authors: Zanotto Daniele Farina , Assis Fátima Büchele
Published: September 2017

Resumo Este artigo é uma pesquisa documental com abordagem qualitativa, resultado de uma tese de doutorado, que buscou analisar o perfil dos usuários de crack apresentado por reportagens de um jornal e duas revistas de edição nacional, nos últimos cinco anos. O material encontrado foi submetido à análise textual discursiva. Para acessar o objeto de estudo, nossa base teórica contou com os autores Michel Foucault, Erwin Goffman, Howard Becker e John Thompson, buscando desnaturalizar as maneiras como os discursos sobre os usuários de crack são colocados pela mídia. Os resultados evidenciaram que o discurso veiculado pelos meios de comunicação estudados constrói no senso comum um perfil negativo sobre o usuário de crack, permeado por preconceito e estigma. As reportagens são transmitidas de forma sensacionalista e higienista, dando ênfase ao enfrentamento aos usuários e não somente à droga em si. Conclui que o discurso apresentado é capaz de materializar as representações da classe dominante sobre os usuários de crack e de refletir na forma em que a sociedade convive com eles. Entende-se como classe dominante aquela representada pelo modelo biomédico de cuidado em saúde mental.
ABORDAGENS PARA CLASSIFICAÇÃO DO ESTÁDIO SUCESSIONAL DA VEGETAÇÃO DO PARQUE NACIONAL DE SÃO JOAQUIM EMPREGANDO IMAGENS LANDSAT-8 E RAPIDEYE
Authors: Sothe Camile , Liesenberg Veraldo , Almeida Cláudia Maria de , Schimalski Marcos Benedito
Published: September 2017

Resumo: A classificação remota dos diferentes estádios sucessionais da vegetação ainda constitui um desafio devido à similaridade espectral destas classes. Este artigo tem o objetivo de avaliar o desempenho de imagens Landsat-8 e RapidEye para a classificação do estádio sucessional da vegetação em um fragmento de Floresta Ombrófila Mista, localizado no Parque Nacional de São Joaquim- SC. Para isto, três grupos de variáveis gerados a partir de cada imagem foram avaliados, sendo: (1) composto somente pelas bandas espectrais puras; (2) composto pelas métricas texturais GLCM geradas a partir das bandas espectrais; e (3) composto pelas variáveis dos dois grupos anteriores, além de dois índices de vegetação no caso da imagem Landsat-8, e três índices para a RapidEye. Cada grupo foi testado com os classificadores florestas randômicas (Random Forest- RF), máquinas de vetor de suporte (Support Vector Machine - SVM) e máxima verossimilhança (Maxver). Todos os experimentos alcançaram resultados satisfatórios, com índice Kappa variando de 0,66 a 0,88 e acurácia de usuário e produtor superiores a 50%. O melhor resultado alcançado foi com a imagem Landsat-8, grupo 3, associado ao algoritmo RF. A medida de importância das variáveis obtida com o algoritmo RF mostrou que as métricas texturais média, contraste e dissimilaridade destacaram-se na classificação para ambas as imagens
ANÁLISE DOS MÉTODOS DE POSICIONAMENTO E DOS PARÂMETROS DEFINIDORES DA QUALIDADE DE UM LEVANTAMENTO BATIMÉTRICO
Authors: Nakao Laís Thie Hasuda , Krueger Cláudia Pereira
Published: September 2017

Resumo: O método de posicionamento a ser empregado em um levantamento batimétrico algumas vezes é questionado, quanto a sua precisão horizontal e vertical. De forma geral, tem sido utilizado nesses levantamentos o posicionamento da embarcação por meio do GPS Diferencial (DGPS). Mediante consulta de literatura, poucas investigações no que concerne à precisão e acurácia destes métodos têm sido realizadas principalmente quando tais levantamentos ocorrem em reservatórios. Dessa forma, o presente trabalho teve como intuito verificar as precisões e acurácias para o posicionamento da embarcação por meio dos métodos DGPS, Posicionamento por Ponto Preciso (PPP) e de Posicionamento Relativo Cinemático (MPRC). Todos os resultados gerados neste trabalho foram inseridos em um Sistema de Informação Geográfica (SIG), no qual foi observado que o resultado mais preciso foi obtido pelo MPRC. No entanto, também é possível utilizar o serviço online do IBGE-PPP para processar os dados para o posicionamento da embarcação obtendo uma precisão inferior ao metro. Conclui-se que todos os métodos investigados para o posicionamento da embarcação atenderam as especificações da Resolução Conjunta ANEEL/ANA nº 03, de 10 de agosto de 2010 (BRASIL, 2010). Contudo, é importante que o usuário atenda aos requisitos mínimos necessários para cada método de posicionamento.
DETERMINATION OF GEO-INFORMATION CHARACTERISTICS IN THE USER INTERACTION WITH A SYSTEM FOR BETTERMENT TAX CALCULATION
Authors: Ramos Gustavo Dias , Sluter Claudia Robbi
Published: September 2017

Abstract: In this paper, we present some results of research work that seeks to determine how the characteristics of geoinformation should be considered and included in the design of users' interfaces for a geoinformation system. Through well-known techniques of requirements engineering, we collected and documented the information obtained from potential users of a geoinformation system designed to be used for calculation of betterment taxes. Furthermore, we analyzed the users’ requirements to determine the characteristics of geoinformation in this particular case of tax calculation. We try to define how those geoinformation characteristics can be included in the requirements specification and how to consider them to help designing better geoinformation systems interfaces.
TENDENCY OF UTERINE NEOPLASM MORTALITY IN WOMEN IN SOUTHERN BRAZIL v1
Authors: C. Vargas Adriana , A. Gravena Angela , R. Rosseto Rosana , Andrade Luciano , R.N Vissoci João , E.L. Consolaro Marcia , Dalva B.C. Carvalho Maria , M. Pelloso Sandra
Published: September 2017

The aim of this study was to analyze the trend in mortality from uterine neoplasms and their risk factors, specified by the International Classification of Diseases - 10th Edition (ICD-10): C53, C54 and C55. This is an ecological study of a cross-sectional cohort and time series of deaths from uterine cancer that were recorded on the death certificates of 147 women residing in Maringá-PR from 2004 to 2014. Deaths attributed to malignant neoplasms of the cervix, unspecified (C53.9) were the most common among these women. There was an increasing trend in mortality rates from cancer of the uterus. The behavior of age groups showed an increase in women over 65 years of age. Overall, 71.5% of the women had less than 8 years of education, and 60.5% had no partner. It was also found that the health unit in Vardelina had the highest number of deaths, corresponding to 0.73% of the population. The percentage of the total deaths in the city was 0.15%. These data indicate that women in lower social strata have less access to health services and less information regarding primary prevention and the effective treatment of uterine cancer.
Pharmacoeconomic evaluation in cost of illness in type 2 diabetes mellitus patients in a tertiary care hospital
Authors: Bagle Tushar R. , Vare Vijay A. , Nimgade Alankar , Hire Rohankumar C. , Sharma Yogesh , Kshirsagar Prasita
Published: September 2017

Background: India is expected to bear the burden of world’s greatest increase of diabetes population. This burden needs to be considered in terms of costs.Methods: Cross-sectional study was done in type 2 diabetes mellitus 100 patients that attended Medicine OPD. Prior to enrollment Institutional Ethics Committee permission was taken. Written Informed consent was taken. Demographic information related to Education, Occupation and Income was taken down. Also Information related to diagnostic tests and medications were documented. Inclusion criterion were 18-70 years of either gender diagnosed by Physicians in OPD as type 2 diabetes, willing to participate and have followed in OPD for at least one year. The Exclusion criterion was Critically ill or unconscious patients and Pregnant women. Direct and indirect costs were calculated.Results: The average age was 56.31±10.50 years. The average fasting blood glucose was 120.65±22.70mg/dl. The average cost per month for investigations was 159.74±128.06. Annual visit to OPD was 13.06±7.35. Time loss per visit was 5.62±1.29 hours and of accompanying person was 6.55±3.87 hours. There were 2 from Lower and 63 from Upper Lower socioeconomic class. There were 41 patients having diabetic complications. The indirect cost was around 5838.51 and direct cost was around 19925. Total cost per annum per patient was around 32361.27 INR.Conclusions: There is need for strategies to reduce the cost burden. There is also needed to design financial systems for diabetes related nationwide health programs.
Comparative efficacy of agomelatine versus sertraline in major depressive disorder in Himalayan region of India
Authors: Mehta Anil Kumar , Gupta D. D. , Kumar Ramesh , Sood Atal
Published: September 2017

Background: Depression, a major common affective disorder which carries excess mortality through suicide. Among various drug classes available SSRI’s are usually a choice, but many patients show inadequate response, residual symptoms or discontinue medication due to intolerable side effects. Disturbances of circadian rhythm function are an etiopathogenic hallmark of depression. The degree of circadian misalignment correlates with the severity of depression and circadian abnormalities may partially be a consequence of alterations in behavior and sleep patterns that accompany depression. Agomelatine an agonist acts on MT1 and MT2 receptors and antagonist of 5HT2c receptors contributes to its resynchronization of circadian rhythms, enhancement of dopaminergic and adrenergic input to the frontal cortex, induction of hippocampal neurogenesis, and ultimately, to its antidepressant effect.Methods: The study was randomized, prospective, comparative and interventional regarding the efficacy of therapy. Hundred consenting patients of MDD attending psychiatry OPD were screened for possible enrollment into group A(Agomelatine) and group B(Sertraline). Patients were assessed by semi-structured case recording form, DSM-IV- TR Criteria for major depressive episode, Hamilton Rating Scale for Depression (HAM-D) and Clinical Global Impressions for severity (CGI-S) at baseline and CGI for improvement (CGI-I), every two weeks interval and final assessment at 8 weeks.Results: Socio-demographic parameters like age and sex distribution, marital status, locality, family type, educational status, occupation and socio-economic class were comparable between two groups. Similarly baseline HAM-D and CGI-S values between the two groups were statistically non-significant. HAM-D, CGI-S and CGI-I values at eight weeks among the two groups were also statistically non-significant but in all three sertraline had decreased the values to a greater extent and showed a trend towards improvement.Conclusions: Both groups had shown significant decrease in scores of all scales i.e. HAM-D, CGI-S, and CGI-I at the end of 8th week as compared to baseline scores, indicating that the uses of agomelatine and sertraline have resulted in significant improvement in symptoms of patients of MDD and reinforcing there efficacy in treatment of MDD. No statistical difference was observed between two groups.
Evaluation of immediate reactions to β lactam antibiotics using a comprehensive diagnostic protocol
Authors: Bhagwat Bhanuja , H. V. Anuradha
Published: September 2017

Background: β lactam antibiotics are commonly prescribed groups of antibacterial drugs for various infections however the prevalence of its allergic effects is not clear in our country, hence the need for an effective diagnostic protocol to determine immediate hypersensitivity reactions. The objective was to formulate a diagnostic protocol for evaluating immediate drug hypersensitivity to β lactam antibiotics.Methods: A prospective study was conducted at a tertiary care hospital. Adults who were prescribed any class of β lactam antibiotic were included. Non irritating concentrations of the antibiotic as per The European Network on drug Allergy were used. A strict three step diagnostic algorithm with skin prick test followed by intradermal test and drug provocation test, with 20 minutes observation period between each step, to determine cutaneous allergic reactions was followed.Results: The most commonly prescribed drug was cefazolin, followed by ceftriaxone, and cefoperazone + sulbactam combination. The culprit drugs were ceftriaxone in 4 (4.7%) patients, followed by piperacillin + tazobactam combination in 3 (3.5%), amoxicillin + clavulanic acid in 2 (2.3%) and 1 (1.1%) each for cefotaxime and cefepime + tazobactam combination. No patients were positive for skin prick test; 2.4% were positive for intradermal test and 10.6% were positive for drug provocation test.Conclusions: This diagnostic protocol is apt to adequately diagnose immediate reactions to β lactam antibiotics and henceforth can be used effectively in India. However, the skin prick test may be excluded but the intradermal test and drug provocation test is crucial to identify these immediate reactions.
The role of antioxidants and free radicals in the healing effects of Bacopa monniera on acetic acid-induced colitis in rats
Authors: Sharma Himanshu , Chauhan Saurabh , Singh Punya Pratap , Goel Raj K.
Published: September 2017

Background: The aim to study and elucidate the healing effects of ethanolic extract of dried whole plant of Bacopa monniera against experimental colitis in rats.Methods: Bacopa monniera whole plant extract was administered orally, once daily for 14 days, to rats after induction of colitis with acetic acid. We studied its effects on: faecal output, food and water intake, and body weight changes and also examined colonic mucosal damage, inflammation and status of antioxidants: superoxide dismutase, reduced glutathione; free radicals: nitric oxide, lipid peroxidation on 15th day of the experiment. Antibacterial activity of the extract was also studied using in vitro procedures. Statistical comparison was performed using either unpaired ‘t’ test or one -way analysis of variance (ANOVA) and for multiple comparisons versus control group was done by Dunnett’s test.Results: Bacopa monniera whole plant extract decreased colonic mucosal damage, inflammation, faecal output and increased body weight in acetic acid induced colitis. It also showed antibacterial activity and enhanced the antioxidant but decreased free radicals. Acute toxicity study indicated no mortality or other ANS or CNS related adverse effects even with ten time effective dose indicating its safety.Conclusions: Bacopa monniera whole plant extract is safe, effective and could be beneficial as a complementary agent in treatment of ulcerative colitis.
A cross sectional study of knowledge, attitude and practices related to fixed dose combinations use among clinicians and resident doctors at a tertiary care teaching hospital in India
Authors: Belhekar Mahesh N. , Patel Tejal C. , Pandit Prasad R. , Bhave Kiran A.
Published: September 2017

Background: In the year 2016, Government of India had banned 350 fixed dose combinations (FDCs) for the safety and efficacy purpose. The present study was conducted to assess the knowledge, attitude and practices of the clinicians and residents about the use of FDCs at a tertiary care hospital.Methods: A questionnaire based study was conducted at a tertiary care hospital after getting approval from institutional ethics committee. A pre-validated questionnaire comprising of 30 items was distributed to 100 participants. The questionnaire focused on the prescribing behaviour, knowledge on therapeutic efficacy, advantages and limitations of FDC use, clinician perception regarding FDC use and the strategies to improve the awareness about the regulatory updates of the marketed drugs.Results: Total 52/100 clinicians responded. Out of these, 88% prescribed FDCs in their practice, 62% prescribed FDCs only after ensuring therapeutic efficacy and 50% prescribed WHO approved FDCs. 64% were aware of the recent ban on some FDCs by DCGI. Internet was the most common source of latest updates on the regulatory status of the drug, as stated by 55% clinicians. All clinicians agreed that efforts are needed to ensure that prescribers remain up to date about the post-marketing regulatory status of the drugs.Conclusions: Even though many clinicians prescribe FDCs regularly, they appreciated the step of banning some FDCs; however, the clinicians need to be trained to update themselves regularly. The source and relevance of these updates should be taught to the undergraduate students during their training period which can be reemphasized during post graduate training period.
A Study of drug utilization and clinical outcomes in indoor patients of hypertensive disorders of pregnancy
Authors: Gaidhankar Smita L. , Ramanand Jaiprakash B. , Kadam Parashram G. , Zende Ajitkumar M. , Bhosale Rama R. , Puram Nitin N.
Published: September 2017

Background: Hypertensive disorders of pregnancy are an important determinant of drug use during pregnancy. The aim of study was to assess the clinical outcome and evaluate drug utilization according to WHO core drug prescribing indicators in hypertensive disorders of pregnancy.Methods: This prospective, observational study in a tertiary care hospital was conducted in 150 pregnant women with hypertensive disorders of pregnancy from January 2014 and December 2014 who fulfilled the inclusion criteria. Antepartum and intrapartum care and the maternal and perinatal outcome were noted. The data was analyzed to evaluate clinical outcome and drug utilization according to WHO core drug use indicators.Results: Gestational hypertension was most common among hypertensive disorders of pregnancy seen in 62/150 (41.3%) women. The most common symptom was headache (48%) while sign noted was edema (69%). A total of 66% women had preterm delivery and 42% babies weighed less than 2.5 kg. Average number of drugs per encounter was 9.7. Percentage of drugs prescribed by generic name and from essential drug list was 64% and 79% respectively. The most commonly used drugs were vitamins and minerals prescribed in 100% patients followed by antihypertensive drugs (92%). The most common antihypertensive used were calcium channel blockers and anticonvulsant was magnesium sulphate.Conclusions: There was increased maternal and perinatal morbidity and operative intervention among pregnant women with hypertensive disorders of pregnancy. Most of the drugs were used appropriately and were in accordance with standard guidelines. The important problems identified were inappropriate use of antimicrobials, use of sublingual nifedipine and use of brand names in 1/4th of prescriptions.
Assessment of knowledge about post exposure prophylaxis of HIV among medical, nursing and paramedical students in hospital and laboratory practice
Authors: A. Dulcie Celia , S. Mohamed Thajudeen , B. Meenakshi , J. Ezhil Ramya
Published: September 2017

Background: India has 2.1 million of people living with HIV, and places in third-largest population of people infected with the HIV after South Africa and Nigeria. It is thus important for health care providers including medical, nursing and paramedical students to have adequate knowledge on PEP for HIV to protect themselves prior to starting their life long career.Methods: Cross-sectional study was conducted among 200 medical, nursing and paramedical students in Tirunelveli medical college from December 2016 to February 2017. A pre-designed questionnaire was used to collect data. Results were summarized in percentages and presented in tables.Results: A total of 96 (48%) males and 104 (52%) females responded in the study. Though many (87%) had heard about PEP, just 31 (15.5%) had received formal training on PEP for HIV. Only 81 (40.5%) knew the ideal PEP regimen and 88 (44%) knew the correct drug regimen. The majority 196 (98%) considered PEP was important and significant 178 (89%) considered themselves to be at risk of acquiring HIV at work, with 46 (23%) having experienced an exposure in the past. Of those exposed, only 21 (45.7%) received PEP.Conclusions: This study shows that knowledge, attitude and practice towards PEP for HIV is inadequate. A formal PEP training centre with proper guidelines is recommended for medical, nursing and paramedical students.
Effect of silybin in 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) induced parkinsonism in mice
Authors: Justin Shajil Anand , Gobalakrishnan Senthil , Asirvatham Sylvia Santhakumari
Published: September 2017

Background: Parkinson disease (PD) is a major neurological disorder known since ancient times. Though drugs are available for therapy, still effective drug targeting the etiopathogenesis is always going on.Methods: After obtaining permission from animal ethics committee, the mice were divided into four groups of eight each (normal control, experimental control with normal diet only, silybin 300mg/kg, silybin 600mg/kg). At the end of 55 days the mice were subjected to overnight fasting followed by plasma and liver biochemical analysis.Results: The mice treated with 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) developed motor dysfunction and behavioural changes similar to PD, which was tested with rotarod test, photoactometer test and hang test which revealed the impaired performance, hypo-locomotion and impaired neuromuscular strength respectively. Treatment with silybin reversed the motor dysfunction significantly (p≤0.001) in a dose dependent manner. Biochemical analysis measured the oxidant (TBARS, SOD, CAT) and antioxidants (GPx and GSH) which revealed the oxidant activity of MPTP and antioxidant activity of silybin. Histopathological evaluation showed the cytoprotective effect of silybin.Conclusions: Silybin by its antioxidant property has a neuroprotective activity both in motor activity and behaviourally in the MPTP induced Parkinson disease in mice. Hence present study offers a conclusive evidence that silybin is a neuroprotective. Diet supplemented with silybin can protect against neurodegenerative disorders and prevent the progression of neurodegeneration.
Knowledge, awareness and attitude towards rational use of medicines by community pharmacists in and around Coimbatore, India
Authors: K. Bhuvaneswari , D. Jeyalakshmi , A. Umamaheswari
Published: September 2017

Background: Achievement of goals of rational use of medicine (RUM) in the community is not possible without participation of community pharmacists. Pharmacists must know that they are the main tool to educate and spread information on rational use of medicine in the community. This background enabled this study to observe the knowledge, awareness and attitude of the community pharmacists towards the rational use of medicine. Aim and Objectives were to assess the knowledge and awareness among community pharmacists about rational drug use in and around Coimbatore.Methods: It was a cross sectional observational study using a preformed questionnaire. Study participants were 215 Community Pharmacists (those are registered pharmacist running standalone pharmacy stores not affiliating to any institutions /hospitals/not a part of a large chain of stores) inside (115 Pharmacist) and around (100 Pharmacist) Coimbatore city. Questionnaire was given to them and results were analyzed and expressed in percentage at the end of the study.Results: Comparing the awareness about RUM in the community pharmacists in and around Coimbatore was found with the results which was almost equal or less in terms of dispensing medicines without prescription, issuing medicines to outdated prescription, educating the public about ADR etc.Conclusions: This study ensure the need of the community pharmacist participation for the development of a clear educational policy on promoting rational use of medicine involving all segments of health care system to ensure the community benefit and safety.
A comparative study of epidural tramadol with epidural pentazocine for postoperativeanalgesia in patients undergoing lower abdominal surgeries
Authors: M. K. Yadhuraj , P. Somasekharam , D. M. Vinay , U. K. Akhil Rao
Published: September 2017

Background: To evaluate and compare the efficacy of epidurally administered Tramadol. Hydrochloride and Pentazocine Lactate in providing post operative pain relief for lower abdominal and lower limb surgeries. To compare the side effects between epidural tramadol and pentazocine. Design of the study was a prospective randomized study.Methods: The study population consisted of 100 patients aged between 18-65 years posted for various elective lower abdominal and lower limb surgeries requiring neuraxial anaesthesia at M.V.J. Medical College and Research Hospital, Hoskote, Bangalore. The study population was randomly divided into 2 groups with 50 patients in each sub group. Group T: Administered 50mg Tramadol, diluted to 10ml with Normal saline, epidurally (n = 50) Group P: Administered 0.3mg/kg Pentazocine, diluted to 10ml with Normal saline, epidurally (n = 50). Patient was monitored on various parameters including duration of action, hemodynamic variables, and side effects.Results: In group administered 50mg Tramadol epidurally, the mean time to onset of analgesia was 4.36±2.23 mins and the mean time to onset of analgesia in the group administered pentazocine was 4.84±2.24 mins, with a p value of 0.286, which is not considered significant. In tramadol group, the analgesic period averaged 7 hours 20 minutes, while the duration of analgesia in group P averaged 6 hours 43 minutes, with a p value of 0.475, which is not considered significant. It was also observed that 0.3mg/kg of pentazocine produced marginally higher incidence of bradycardia, dizziness, drowsiness.Conclusions: With these results, we conclude that epidural tramadol 50mg gives longer lasting and more profound analgesia with lesser side effects when compared to 0.3mg/kg of pentazocine.
Low current Cd4+T cell count: prediction, for persistent herpetic gingivostomatitis in HIV-positive patients under antiretroviral therapy
Authors: Narendra S. K. , Sahani N. C. , Das Upendra , Tripathy S.
Published: September 2017

Background: Oral viral lesions associated with HIV infection are important since they affect the quality of life of the patient and are useful markers of disease progression and immunosuppression. The purpose of this study was to correlate the persistence of herpetic gingivostomatitis lesions with the current CD4+ T cell count for adherence of HIV-infected individuals to anti retroviral therapy (ART) and antiviral therapy.Methods: 302 HIV +ve patients developing oral ulcers were included in this study. The herpes simplex viral infections associated with the oral manifestations were detected through Immuno histochemical staining. The quantitative analysis of oral ulceration was done by using mucositis index.CD4T cell count was correlated with clinical manifestations of extensiveness of oral ulcers, acute febrile condition and other constitutional symptoms during follow up of cases for the treatment with anti viral therapies.Results: Association of herpes simplex viral infections was found in 72 out of 302 HIV+ ve cases. All the HSV +ve patients developed extensive oral mucsal lesions during the 1st week. Extensive lesions developed within 7 days in patients with CD4 count <200 due to HSV infection, remained more or less unchanged in the oral cavity up to 90 days although they were receiving antiretroviral and antiviral therapies. In HIV + patients with CD4 count >500, manifestation of mucosal ulcers due to acute herpetic gingivostomatitis was limited to a period of 1 to 2 weeks. Patients with CD4 count >200 <500 did not follow a definite pattern.Conclusions: Persistent oropharyngeal mucosal ulcers along with acute febrile condition due to herpes simplex virus infection are associated with low CD4 T cell count in HIV + patients under antiretroviral therapy.
Evaluation of propranolol, flunarizine and divalproex sodium in prophylaxis of migraine
Authors: Bhat Majid F. , Sidhu Harpreet S. , Goyal Manoj
Published: September 2017

Background: Preventive treatment has an important role in the management of migraine. Propranolol and flunarizine have been used for more than two decades while, open-label, controlled studies suggest divalproex sodium may also be efficacious for migraine prevention. The objective of the study to compare efficacy and safety of propranolol, flunarizine and divalproex sodium in patients for migraine prophylaxis.Methods: Following approval from IEC a 12-week randomized, open, comparative study was carried out at the outpatient department of Medicine. Patients between 18 to 65 years, with history of 3 to 12 migraines a month (IHS) for six months were included. Patients were divided into three groups of 30 patients to receive - propranolol 20 to 160mg/day; flunarizine 5 to 10mg/day or divalproex sodium 250 to 750mg/day, for three months.Results: Total 90/116 patients completed the study. No significant differences were found between the groups with regards to mean age or other baseline migraine features. All the drugs significantly decreased the frequency, duration and severity of migraine (P<0.001). There is no statistically significant difference between propranolol, flunarizine and divalproex sodium for any of the efficacy parameters. All the three treatments were well-tolerated and safe.Conclusions: All the three study drugs were equally effective with an acceptable tolerability profile, Divalproex sodium group showed more side effects, none of which were serious. However, further studies with larger number of patients and longer duration of treatment are recommended.
Antiproteinuric effects of cilnidipine and amlodipine as add on therapy in hypertensive patients with chronic renal disease: a comparative study
Authors: Maheswari Y. Nisha , Meenakshi B. , D. M. V. Ramasubramanian , Ramya J. Ezhil
Published: September 2017

Background: Cilnidipine is a dual blocker of L type and N type calcium channel and dilates both afferent and efferent arterioles. Hence it increases renal blood flow and reduces glomerular pressure ultimately reducing proteinuria. Thus, it may exert renoprotective effects. The present study was designed to compare the antiproteinuric effects of cilnidipine and amlodipine in hypertensive patients with chronic kidney disease as add on therapy to patients on losartan.Methods: This is a randomized, open label, prospective, parallel group study conducted in the out patient Department of Nephrology. The trial enrolled Diabetic CKD patients with hypertension and with spot urine protein creatinine ratio (PCR) ≥0.2 who were being treated with T. Losartan 50mg/day for >2 months. The subjects were then randomly assigned to 2 groups to receive either cilnidipine 10-20mg/day (Group A-46) or amlodipine 5-10mg/day (Group B- 50). The drugs were given for a duration of 6 months for each patient. The dose of losartan (50mg/day) was not adjusted throughout the study.Results: After 6 months, a significant reduction in systolic and diastolic blood pressure was seen in both the groups. The decrease in urinary protein creatinine ratio was significantly higher in cilnidipine group rather than amlodipine group. Thus, cilnidipine exerted greater antiproteinuric effect than amlodipine.Conclusions: Cilnidipine has antihypertensive effect equivalent to amlodipine but addition of cilnidipine rather than amlodipine to losartan decreased urine protein excretion in diabetic chronic kidney disease patients.