bluuebunny/crossref_metadata_2025 huggingface dataset:
Ação popular ambiental enquanto instrumento de promoção da sustentabilidade nas contratações públicas
Authors: Gomes Magno Federici , Soares Igor Jotha
Published: January 2019

A sustentabilidade ambiental é princípio vinculante nas atividades administrativas desde a promulgação da Constituição da República de 1988 (CR/1988). No entanto, depois de inserido no art. 3° da Lei nº 8.666/1993 pela Lei nº 12.349/2010, a sustentabilidade é premissa cogente nas contratações públicas. Nessa senda, a ação popular, como medida de controle do ato administrativo, pode viabilizar a implantação das licitações sustentáveis. É o que este artigo se propõe a investigar. Adota-se o método analítico e interpretativo, bem como pesquisa descritiva e de levantamento bibliográfico. Conclui-se que é possível ação popular ambiental para implantação da sustentabilidade nas licitações.
Caso Margarida Maria Alves: uma demonstração do desafio brasileiro à proteção multinível de direitos humanos
Authors: Soares João Gabriel , Arruda Paula
Published: January 2019

O presente artigo objetiva discutir a proteção multinível de direitos humanos em relação ao caso Margarida Maria Alves, cuja repercussão histórica, social e política é bastante conhecida como um movimento de resistência às elites econômicas da região do brejo paraibano. Neste sentido, vê-se que ainda não houve resposta satisfatória ao caso, havendo denúncia das violações a direitos, garantias e liberdades ao Sistema Interamericano de Direitos Humanos, cuja admissibilidade foi realizada pela Comissão, ainda sem julgamento meritório. Por fim, dentro de uma análise propositiva, argumenta-se um pressuposto diálogo entre os diferentes níveis e propõe-se a realização de uma relação precedente à decisão anteriormente proferida pela Corte Interamericana sobre direitos dos trabalhadores no Brasil.
ATATÜRK DÖNEMİ TÜRKİYE-SURİYE İLİŞKİLERİ VE HATAY SORUNU (1920-1938)
Authors: AKDENİZ Sedat
Published: January 2019

Yavuz Sultan
Selim döneminde Osmanlı sınırları içerisine dahil edilen Suriye bölgesi, 1.
Dünya savaşında önce İngilizler, sonra da Fransızlar tarafından işgal
edilirken, 1918 Mondros ateşkes anlaşması ile Osmanlı bu bölgeyi kaybetmiştir.
İtilaf devletleri arasında yapılan gizli anlaşma Sykes-Picot ile Fransız
mandasına bırakılmıştır. 1946 yılında bağımsızlığını kazanana kadar
Fransızların himayesinde kalmıştır. Kurtuluş savaşından sonra Suriye ile Sınır
meseleleri, Suriye’de kalan Türkler gibi sorunlar meydana gelmiştir. En önemli
Sorun ise Hatay Sorunu’ dur. Türkiye, Hatay meselesini sürekli gündemde
tutmuş,  Hatay’ın Türkiye’ye verilmesi
için mücadelesini sürdürmüştür. Bu çalışmada, Atatürk Döneminde Türkiye- Suriye
ilişkileri daha çok Suriye ile yapılan anlaşmalar ve özellikle Hatay meselesi
geniş olarak ele alınmıştır.
TAVŞAN SÖZCÜĞÜNÜN ETİMOLOJİSİ ÜZERİNE
Authors: SARITİKEN Hakan
Published: January 2019

Türkçenin en eski metinlerinden itibaren takip edebildiğimiz tavşan
sözcüğünün oldukça farklı alanlarda, hem kendi anlamıyla hem de benzetme
yoluyla birçok anlamda kullanıldığını görmekteyiz. Eski Türkçe ve Orta Türkçe
dönemlerinde kendi anlamıyla kullanılması yanında, On iki hayvanlı takvimde
“Tavışgan Yılı” kullanımı ile karşımıza çıkan tavşan sözcüğünün, benzetmeler
yoluyla spor terimi anlamında da kullanıldığını görmekteyiz. Günümüzde ise
Türkçe Sözlükte, Derleme Sözlüğünde ve Tarama Sözlüğünde çeşitli alanlardaki
kullanımlarına rastlamaktayız. Benzetme ve somutlaştırmalar yoluyla bir takımyıldızına,
birçok bitkiye, birçok hastalığa ad olarak; astronomi, botanik, tıp alanlarında
kullanılırken, spor, coğrafya gibi birçok alanda tavşan sözcüğünü görmek
mümkündür. Tavşan sözcüğünün kökeni ile ilgili birçok değerlendirme
yapılmıştır. Tuncer Gülensoy; taw-(sıçramak, zıplamak) rı- ş- gan şeklinde
olduğunu ifade eder. Eski Türkçede kullanılan tabış- fiiline -gan eki
getirilerek yapıldığı görüşü yanında, Eski Uygur Türkçesinde “gürültü şamata”
anlamında kullanılan “tavış” isminden türetildiği görüşlerine rastlamaktayız.
Makalede öncelikle tavşan sözcüğünün Türkçenin tarihi metinlerinde ve Türk
lehçelerinde nasıl ve hangi anlamlarda kullanıldığı ortaya konulurken sözcüğün
kökeni üzerinde daha önce ortaya atılan görüşlere yer verilecektir. Son olarak tavşan
sözcüğünün; “Düzleştirme, tepme, yere vurma” anlamındaki “tab”  isim kökünden iki farklı şekilde türetilmiş
olabileceği görüşü ortaya konmaya çalışılacaktır.
R.1308 (M.1892/1893) TARİHLİ ERZURUM VİLAYET SALNAMESİ’NE GÖRE BAYEZİD SANCAĞI
Authors: KARASU Mehmet Kerem , KARASU Demet
Published: January 2019

Bayezid Sancağı,
Osmanlı egemenliğine girdiği 1514 senesinden itibaren, gerek İran ve gerek
Rusya ile münasebetlerde sahip olduğu jeostratejik konumu ve ayrıca önemli
ticaret yollarının kesiştiği bir konuma sahip olmasından dolayı Osmanlı
Devleti’nin doğuya açılan en önemli sancaklarından birisi olmuştur. Osmanlı
Devleti 1847 yılından itibaren devlet yıllıkları olan salnameleri tutmaya
başlamıştır. Vilayet salnamelerinin hazırlanmasında ilk örneği İbrahim Halet
Bey’in yayımladığı “fihrist-i salname-i Halep” adlı eser örnek alınarak 1866
yılında ilk eyalet salnamesi olan Salname-i Vilayet-i Bosna yayımlanmıştır.
Vilayet salnamelerinde, Osmanlı Devleti’ne bağlı vilayetlerin yıllık olarak
idari taksimatı ve teşkilatı, görevli memurları, maarif kurumları, kısa tarihi,
coğrafi yapısı, eski eserleri, nüfusu, zirai ve ticari üretimi, gibi pek çok
konuya yer verilmektedir. Bu yönüyle vilayet salnameleri, 19. yüzyılın
ortasından itibaren merkez ve taşra teşkilatı hakkında önemli bilgiler veren
çok değerli ana kaynaklardır. Bu çalışmada, R.1308 Erzurum Vilayet
Salnamesi’nin verdiği bilgiler ışığında, Ağrı Dağı’nın eteğinde bulunan Bayezid
Sancağı ile ona bağlı olan Karakilise, Tutak, Eleşkirt ve Diyadin kazaları
idari, sosyal, ekonomik, coğrafi ve demografik açılardan ele alınmaya
çalışılacaktır. Böylece XIX. yüzyılın son çeyreğinde bölgenin genel vaziyeti
ortaya çıkarılarak geniş bir perspektiften yerel tarih incelemesi yapılmış
olacaktır. Osmanlı tarihinin en önemli dönemlerinden biri olan Sultan II.
Abdülhamid döneminde Rus ve İran sınırlarının kesişim noktasındaki bir sancağın
fotoğrafı çekilmiş olacaktır.
TEK PARTİ DÖNEMİNDE CHP’NİN TAŞRA ÖRGÜTLERİNDE GÜÇ VE İKTİDAR MÜCADELESİ: MARAŞLI KADIZÂDE AİLESİ
Authors: AYDIN Tülay
Published: January 2019

Tek Parti
Döneminde tek parti mantığına uygun olarak yürütülen merkez-çevre ilişkilerinde
taşradaki parti merkezleri, yerel güçlerin merkeze ulaşma konusundaki en önemli
noktalarını teşkil etmekteydi. Bu dönemde kırsal yapıya uygun olarak taşranın
siyaset yapıcıları da bir nevi kitlelerin liderliğini üstlenen eşraf temsilcileri
olmuştu. Şehrin ve yörenin ileri gelenleri üstlendikleri hami rolü ile taşrada
siyasetin tek temsilcisi durumuna gelmişti. Parti örgütlerini kendi
sosyo-ekonomik güçlerini bütünleyen bir siyasi kanat olarak kullanan bu yerel
güçler, parti merkezine hoş görünmek ve mevcut siyasi ve toplumsal gücünü
garantiye almak için ciddi mücadeleler vermişlerdir. Kitlelerin mecburi
sessizliği karşısında, rakip görülen yerel güçler arasındaki bu mücadeleler,
bir siyasi rant elde etme aracına dönüşmüştür. Birçok taşra kentinde olduğu
gibi Maraş’ta da büyük ve zengin aileler elinde yürütülen parti siyaseti, çoğu
zaman derin uyuşmazlık ve anlaşmazlıklara sebep olmuştur. Bu dönemde Maraş’ta
yerel siyasetin temel yapıcısı konumunda bulunan Kadızâde ailesi, rakipleri
tarafından sürekli eleştiri altında tutulmuş ve parti merkezinin irdelemesi sonucu
iktidardan düşürülmüştür. Tek Parti Döneminin bir taşra kentindeki parti
idaresini ele geçirme mücadelesini ele alan bu çalışmada; kırsal bir kent
yapılanmasına sahip olan Maraş’ın CHP teşkilatında ortaya çıkan parti
mücadeleleri ve bunun alt yapısında yer alan sosyo-kültürel sebeplerin
irdelemesi yapılacaktır. Bu perspektifkten hareketle çalışmanın asıl dayanağını
parti müfettiş raporları oluşturmuştur. Tek Parti Döneminde CHP’nin taşradaki
parti teşkilatlarının yapısal durumunu ve örgütlenme açısından bir tahlilini
sunan parti müfettişlerinin teftiş raporları, taşra kentlerindeki
sosyo-ekonomik durumu ve parti örgütlerindeki iç mücadelelerinde bir
fotoğrafını sunmaktadır. Kadızâde ailesi örneği üzerinde yapılan bu makale
çalışması ile tek parti idaresinde partinin taşra örgütü içinde meydana gelen
çekişmelere, bu çekişmelerin yapısal sebeplerine, tek parti idaresi altında
parti merkezi ve parti örgütlerinin ilişki ağının niteliğine, taşrada siyaseti
yürüten ve olgunlaştıran temel etmenlerin neler olduğuna değinilecektir.
Çalışmanın varmayı beklediği temel sonuç ise parti mücadelelerinin tek parti
idaresinin tek ve en kudretli siyasi mekanizmasında yer edinebilmek amacıyla
gerçekleştirildiği tespiti olacaktır.
Riesgo cardiovascular y su relación con el estilo de vida en los estudiantes de la Facultad Ciencias de la Salud de una Universidad Privada Lima, 2017
Authors: Zhunaula Guamán Tania , Huzco Rutti Charo Nátali
Published: January 2019

Objetivo: Determinar el riesgo cardiovascular y su relación con el estilo de vida en estudiantes de la Facultad de Ciencias de la Salud de una Universidad Privada de Lima, 2017. Materiales y métodos: Estudio de tipo cuantitativo, descriptivo, correlacional y transversal. Participaron 183 estudiantes seleccionados por muestreo no probabilístico, se aplicó la encuesta “Estilo de vida saludable” y unaficha de datos antropométricos. Resultados: El 67.3% son mujeres y el 100% son solteros. El 85.2% comprenden una dispersión de edad entre 18 a 23 años y 49.2% son de la costa. Con respecto a la condición laboral, 77.6% son dependientes y 50.3% son de cuarto año. En las dimensiones de estilo devida se encontró que el 48.6% mantiene una condición física y deporte poco saludable. El 50.8% son saludables en recreación y manejo de tiempo libre. En consumo de drogas, alcohol y tabaco el 85.8% son muy saludables. El 66.1% en la dimensión de sueño son saludables. El 56.3% se mantienen saludablesen hábitos alimentarios. En autocuidado y cuidado médico 55.7% son poco saludables. No se evidenció relación estadísticamente significativa entre RCV y el estilo de vida saludable (p=0.234). Los hábitos alimenticios tienen relación estadísticamente significativa con el RCV (p= 0.012). Conclusiones: El 82% de los estudiantes son saludables y 54%, presentó un riesgo cardiovascular moderado. No se encontró correlación estadísticamente significativa (p=0.234) entre RCV y estilo de vida, sin embargo, si se encontró correlación entre RCV y hábitos alimenticios (p=0.012).
REKTUM KANSERİNDE NEOADJUVAN KEMORADYOTERAPİ SONRASI RADYOLOJİK VE PATOLOJİK YANIT PREDİKTÖRLERİNİN DEĞERLENDİRİLMESİ
Authors: ÖZKAN Emine Elif , EROĞLU Hasan Erol , KARAHAN Nermin , ŞENGÜL Süreyya
Published: January 2019

Amaç: Bu çalışmada lokal ileri evre rektum tümörlü olgularda preoperatif
kemo-radyoterapi (KRT) sonrası klinik, radyolojik patolojik özelliklerin radyolojik
ve patolojik yanıt ile korelasyonunun araştırılması amaçlandı.

Gereç
ve Yöntem: Çalışmada Ocak 2012
ve Mayıs 2017 tarihleri arasında endoskopik biyopsi ile rektum kanseri tanısı
alan ve kliniğimizde neoadjuvan (KRT) uygulanan 26 hasta retrospektif olarak
değerlendirildi. Hastaların tedavi öncesi endoskopik bulguları (dentat çizgiye
uzaklık, çevresel tutulum, ülserasyon), radyolojik tümör boyutu, Pozitron
Emisyon tomografi (PET) de görülen kitle boyutu, lenf nodu pozitifliği, standart
uptake değeri (SUV) düzeyi ile tedavi sonrası radyolojik ve patolojik yanıt
düzeylerinin ilişkisi araştırıldı. Patolojik regresyon düzeyi modifiye Ryan
skorlaması ile değerlendirildi.

Bulgular: Hastaların 19’u erkek 7’si kadın olup median yaşları 61
(40 – 83) idi. Olgularımızın medyan pelvik radyoterapi dozu 4500 cGy (3600 –
5040) tümöre yönelik boost dozu ise median 900 cGy (360 – 900) idi. Biri ileri
yaşta diğeri ise kardiak morbiditesi olan iki hastanın dışında tüm hastalara
radyoterapi eş zamanlı kapasitabin uygulandı. Kemoterapi sonrası yanıt tüm
hastalarda RECIST kriterlerine göre değerlendirildiğinde 1 hasta tam yanıtlı, 10
hasta stabil, kalan 15 hasta ise parsiyel yanıtlı olarak değerlendirildi. Tedavi
sonrası opere edilen 22 hastanın 11’ine abdominoperineal rezeksiyon (APR)
15’ine ise low anterior rezeksiyon (LAR) uygulandı. Radyoterapi sonrası
operasyona kadar geçen süre median 42 gün (15 – 194) olarak hesaplandı. Tedavi
öncesi PET CT de lenf nodu pozitif olan hastaların 11 inde patolojik lenf nodu
saptanmadı. Buna karşın başlangıçta lenf nodu görülmeyen 5 hastanın 1 inde
postop lenf nodu (+) idi. Endoskopide görülen tümörün çevreselliği,  lokalizasyonunun anal verge’den 5 cm ve daha
fazla olması ve radyolojik yanıt varlığı sfinkter koruma açısından anlamlı
bulunurken (sırasıyla p: 0,03, p:0,019 ve p:0,022), radyolojik yanıt üzerinde
incelenen hiçbir faktörün prediktif etkisi saptanmadı. Hastalar risk gruplarına
göre değerlendirildiğinde radyolojik ve patolojik yanıt üzerinde anlamlı bir
etki saptanmadı. 

Operasyon sonrası 1 hastada patolojik tam yanıt saptandı.
Regresyon skoru değerlendirilen 17 hastanın 2’sinde skor 3, 10’unda 2, 5
hastada ise 1 olarak değerlendirildi.

Sonuç: Tümörün çevresel yayılımı,  lokalizasyonunun anal verge’den 5 cm ve daha
yüksek olması ve radyolojik yanıt varlığı sfinkter koruma açısından anlamlı
bulunurken (sırasıyla p: 0,03, p:0,019 ve p:0,022), radyolojik yanıt üzerinde
incelenen hiçbir faktörün prediktif etkisi saptanmadı.
THE MULTIPLE ROLES OF EXHIBIT LEARNING IMPACT ASSESSMENTS IN A SCIENCE CENTRE
Authors: Monteiro Paulo Henrique Nico , Barriault Chantal , Bizzo Nelio
Published: January 2019

Visitor’s engagement with an exhibit could be considered as an important learning indicator and predictor. Based on this idea, Barriault and Pearson (2010) proposed an assessment framework, which has been constantly used by a Canadian Science Centre - Science North for different areas and proposes since 2005. This paper presents and analyses this experience as well as discuss some features of this framework as accuracy, feasibility and adaptability for other contexts. Documental analysis and interviews with Science North science staff and directors were held in order to deeply understand how this assessment method has been used at this Science Centre over these 10 years. All interviewees pointed that data collected through this method has been used to make changes in an exhibit in order to improve visitor's engagement, in floor-staff training programmes, as an important information for international partnerships and sales and, more recently, as a Centre's management indicators. In addition, all respondents  stressed the accuracy and feasibility as strengths of the tool as far as data collected is easy to understand and "make sense" for all staff. Science North's experience shows that collecting and analysing learning data can play an important role in providing useful findings for different areas of a science centre, and could be an important way to improve visitor’s experience at the museum.
PENSANDO A AMIZADE NO MUNDO VIRTUAL
Authors: Barreto Maria Cristina Rocha
Published: January 2019

A virtualização das relações faz repensar as coordenadas espaciais e temporais como algo que deve ser constantemente problematizado. Várias pessoas possuem amigos que nunca viram pessoalmente, mas que cultivam essa relação por muito tempo, comunicando-se apenas pela internet. Declaram-se amigos pela sintonia, pelo ombro dado, pela presença constante apesar da ausência física. Evidencia-se então que as relações de amizade não dependem da presença física, já que consistem na consideração e afeição de um indivíduo pelo outro, e de uma conexão afetiva duradoura. Este trabalho tem o objetivo discutir algumas transformações assumidas pelas relações de amizade entre alguns jovens brasileiros, com idades entre 15 e 17 anos, a partir da utilização da internet e dos dispositivos móveis como meio de aproximação e troca de experiências.
UKRAINIAN GREEK CATHOLIC CHURCH IN THE SECOND HALF OF THE 20TH CENTURY: THE ANALYSIS OF MODERN HISTORIOGRAPHY
Authors: Pshenychnyi T.
Published: January 2019

Ukrainian Church History is a great field for scientific research. The 20th century was a kind of test for the survival and self-determination of Ukrainian churches. Through the spread of general pressure on the Ukrainian national movement, a repression mechanism was introduced against the Institute of the Church as an integral part of the social life of Ukrainian people in the Soviet Union. A characteristic feature of the anti-church campaign in the Ukrainian SSR was the introduction of a “new” model of social relations, built on the principles of atheism and godlessness. The only legal national church until March 1946, which opposed this path, was the Ukrainian Greek Catholic Church. In the second half of the 20th century its clergy, while in an unlawful position in the USSR, remained in the center of the Ukrainian resistance movement against the Soviet system.
The article presents the modern view of domestic and foreign scholars on the history of the Ukrainian Greek Catholic Church in the second half of the 20th century. On the basis of a broad historiographic base, an attempt was made to show the place of the UGCC in the Ukrainian national movement, its influence on the democratization of social processes in the second half of the 1980s, and others. Thanks to the works of foreign historians, the relevance of church issues in the study of socio-political processes in the USSR is shown. According to some scholars, ignoring this it is impossible to understand the phenomenon of the national movement itself, including in the western regions of the Ukrainian SSR.
Recognition of facial expressions during step-function stroboscopic presentation
Authors: Barabanschikov V.A. , Korolkova O.A. , Lobodinskaya E.A.
Published: January 2019

We studied the perception of human facial emotional expressions during step-function stroboscopic presentation of changing mimics. Consecutive stages of each of the six basic facial expressions were pre sented to the participants: neutral face (300 ms) — expression of medium intensity (10—40 ms) — intense expression (30—120 ms) — expression of medium intensity (10—40 ms) — neutral face (100 ms). Alternative forced choice task was used to categorize the facial expressions. The results were compared to previous studies (Barabanschikov, Korolkova, Lobodinskaya, 2015; 2016), conducted using the same paradigm but with boxcar-function change of the expression: neutral face — intense expression — neutral face. We found that the dynamics of facial expression recognition, as well as errors and recognition time are almost identical in conditions of boxcar- and step-function presentation. One factor influencing the recognition rate is the proportion of presentation time of static (neutral) and changing (facial expression) aspects of the stimulus. In suboptimal conditions of facial expression perception (minimal presentation time of 10+30+10 ms and reduced intensity of expressions) we revealed stroboscopic sensibilization — a previously described phenomenon of enhanced recognition rate of low-attractive expressions (disgust, sadness, fear and anger), which has been previously found in conditions of boxcar-function presentation of expressions. We confirmed the similarity of influence of real and apparent motion on the recognition of basic facial emotional expressions.
The dynamics of some health indicators in adult patients with cystic fibrosis, observed in the research institute of pulmonology in 2003-2018
Authors: Krasovskiy S. A. , Amelina E. L. , Gorinova U. V. , Chernyak A. V. , Afanasjeva M. V. , Krilova N. A. , Shumkova G. L. , Zonenko O. G. , Tatarskiy A. R.
Published: January 2019

Background: Evaluation of the main clinical and functional indicators and their relationship with the treatment and diagnostic care at different time periods can contribute to the development of further effective medical strategies and globally lead to improved care for cystic fibrosis patients.
Aim: An assessment of the dynamics of some clinical and functional indicators in adult CF patients, who have been observed ed Research Institute of Pulmonology during the last 15 years(2003–2018).
Methods: The comparative analysis was performed on the data of adult patients with cystic fibrosis, observed at 31.12.2003 and at the end of October of 2018. The group of patients in 2003 consists of 80 and in 2018 — of 667 patients. The comparative analysis between the groups was carried out according to the following indicators: age, survival, lung function, nutritional status, proportion of infection with pathogenic microflora, identification of mutations in the cystic fibrosis gene and diagnosis in adult patients.
Results: An increase in patient’s age, survival rate, the proportion of identified mutations in cystic fibrosis gene and infection of Burkholderia cepacia complex in the group of patients in 2018 was revealed. There were no differences in the state of lung function, nutritional status, the ratio of the living and dead patients and proportion of patients diagnosed in adulthood between groups.
Conclusion: The progress in the treatment through the introduction of modern methods and therapeutic programs leads to improved survival and an increase in the number of adult patients with cystic fibrosis.
Inhalation beta-2-agonists in cardiorespiratory pathology: pro-or anti-inflammatory effects?
Authors: Nistor S. Yu. , Smolyakova E. V. , Klimova A. A. , Rvacheva A. V. , Zykov K. A.
Published: January 2019

Currently, the increase in comorbid pathology, including patients with bronchoobstructive and cardiovascular diseases remains an urgent problem. Therefore, there is a need not only for new approaches in the tactics of management and treatment of patients with combined cardiorespiratory pathology, but also a more complete understanding of the impact of existing bronchodilator therapy on comorbid pathology and the pathophysiological changes taking place in order to create a new approach to the diagnosis and selection of effective and optimal treatment. The article provides a review of the literature on the impact of beta-2-agonists on pro- and anti-inflammatory mechanisms in patients with bronchial obstruction, including cardiovascular disease.
Bioplásticos de origen bacteriano: los poli-hidroxialcanoatos
Authors: Luengo José María
Published: January 2019

En esta revisión se analizan diferentes aspectos relacionados con unos biomateriales muy interesantes, denominados genéricamente poli-hidroxialcanoatos o, de forma abreviada, PHAs. Estos compuestos son poliésteres de origen bacteriano que poseen propiedades y características muy similares a losplásticos de origen petroquímico, razón por la que nos referiremos a ellos como bioplásticos. A lo largo del artículo, se describe su estructura química, sus propiedades, las rutas responsables de su biosíntesis y de su degradación, asícomo sus múltiples aplicaciones clínicas, farmacológicas, medioambientales y, en suma, biotecnológicas.
A study of drug utilisation pattern in patients of chronic kidney disease at a tertiary care hospital
Authors: Kamath Latha , G. Hema N. , S. Himamani
Published: January 2019

Background: Chronic kidney disease (CKD) is a major public health issue and widely prevalent non-communicable disease in India. CKD has a complex pharmacotherapy and it inevitably requires poly-pharmacy. CKD patients require to take medications for a lifelong period, which makes it very important to study the prescribing trends on a regular basis. The main objective of the study was to analyse current prescribing trends in the management of CKD patients and to know whether the prescribing rationality was maintained.Methods: After Institutional Ethics Committee approval, a prospective         Cross-sectional study was carried out at Nephrology department of a tertiary care hospital for a period of six months from 1st June 2017 to 30th November 2017. Patients diagnosed with CKD by treating Nephrologist were included and their prescriptions were analysed to study the prescribing patterns.Results: A total of 120 cases were analysed during the study, of which 81.7% were males and 18.3% were females. Analysis of WHO core drug prescribing indicators showed that the average number of drugs prescribed per patient was 5.13, percentage of drugs prescribed by generic name was 30.03%, percentage of patients with an injection prescribed was 16.6%, percentage of drugs prescribed from essential medicine list was 65.8% and percentage of patients prescribed with an antibiotic was 10.8%. Antihypertensive drugs (39.9%) were the most commonly used drugs, followed by, calcium salts (12.01%), multi-vitamins (7.6%), oral iron supplements (6.8%), erythropoietin (6.3%) and ulcer protectives (6.1%).Conclusions: Maximum number of drugs were prescribed from cardiovascular class of drugs. Calcium channel blockers and diuretics were the commonest group of antihypertensives prescribed. The principle of rational prescribing was followed.
A prospective evaluation of efficacy and safety of topical bromfenac 0.09% over topical flurbiprofen 0.03% after cataract surgery
Authors: Hebbar Sahana K. , P. Deepak , G. K. Nalini , C. V. Kavitha , G. N. Sahana , Nagaral Jayashree V.
Published: January 2019

Background: Different medications are used to reduce pain and inflammation after cataract surgery. Hence this study was taken up to compare the efficacy and safety of topical bromfenac 0.09% over topical flurbiprofen 0.03% in reducing anterior chamber inflammation and pain after cataract surgery.Methods: Total of 100 patients who underwent uneventful cataract surgery with posterior chamber intra ocular lens (IOL) implantation were randomly allocated to receive bromfenac 0.09% and flurbiprofen 0.03% topically from first post-operative day onwards for 6 weeks. Assessment of anterior chamber inflammation and pain was done by slit lamp and visual analogue scale respectively on each follow up days. Analysis was done by unpaired t test and Fischer’s exact test.Results: The response to treatment was earlier in bromfenac group for all the inflammatory changes (significant difference was found on day 7, p<0.05) except for corneal edema where both the groups showed similar response. On 7th day after surgery, 72% patients in flurbiprofen group and 12% in bromfenac group had pain (score1), while on the 14th day none in the bromfenac group complained of pain whereas 4% in flurbiprofen group still had pain. Both the drugs were safe and no clinically serious adverse effects were observed in either of the groups.Conclusions: This study showed both the medications, topical bromfenac 0.09% and topical flurbiprofen 0.03% effective and safe in reducing pain and anterior chamber inflammation after cataract surgery but the response was earlier with bromfenac 0.09%.
A comparative study of the efficacy of amisulpride and olanzapine in patients with schizophrenia attending the outpatient Department of Psychiatry in a tertiary care hospital, Silchar, Assam, India
Authors: Yashin Ali N. , Roy Dolly , Ghosh Prosenjit
Published: January 2019

Background: Schizophrenia is one of the most commonly encountered psychiatric disorders. It is characterized by impairment in perception or expression of reality, leading to occupational and social dysfunction. Now a day’s mainstay of treatment of schizophrenia is by using atypical antipsychotics. Amisulpride and olanzapine are atypical antipsychotics which are commonly used in treatment of schizophrenia. The current study is undertaken to assess the efficacy of amisulpride which is a relatively newer antipsychotics against existing antipsychotic olanzapine.Methods: This was designed as a single-blind, prospective, parallel-group, observational study. Eighty adult patients of either sex were randomized to receive standard doses of the two drugs orally for 12 weeks, with follow up at 4 and 8 weeks. Effectiveness was assessed by change in the score of Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) score during the treatment period. Data were entered in Microsoft excel and statistical analysis were done using graph pad and p value <0.05 considered to be statistically significant.Results: Out of 80 adults patients 76 patients were evaluated by dividing into two groups, 38 patients were included in each group. Final BPRS score was less for olanzapine as compared to amisulpride (p<0.001). Improvement in CGI score is more in olanzapine group than amisulpride group which became statistically significant from 8th weeks onwards.Conclusions: Both amisulpride and olanzapine are very effective in controlling the symptoms of schizophrenia which is evident by significant decrease in BPRS, CGI-S and CGI-I score, but efficacy of amisulpride is still inferior to olanzapine.
Self-medication practices among medical and nursing students in Tripura, India: a mixed-method study
Authors: Karmakar Nabarun , Chakraborty Tamal , Datta Anjan , Nag Kaushik , Datta Shib Sekhar
Published: January 2019

Background: In developing countries like India, self-medication is a common practice because of costly clinical services and easy availability of medicine from pharmacies. There is an increase trend of self-medication among different health professional students apart from general people. This study aims to assess self-medication practice among medical and nursing students in Tripura, India.Methods: This cross-sectional study was conducted among undergraduate medical and nursing students of Tripura Medical College and Tripura College of Nursing, of Tripura for two months (January- February 2018). A pre-tested, semi-structured schedule was used to collect the required information. The collected data was entered in SPSS version 16.0, represented in proportions and p <0.05 was considered as statistically significant.Results: Overall 353 (88.3%) students of both courses practiced self-medication; prevalence was more among medical (91.5%) than nursing students (85%). Main source of information among medical students were books (90.2%) while 56.5% nursing students replied friends and/or seniors as primary source. Majority (53%) respondents took self-medication for headache (79.2% medical vs 72.4% nursing students) followed by fever (77.6% medical vs 52.4% nursing). Less than half of the respondents (48.5% medical vs 46.5% nursing students) believed that self-medication was harmful; maximum nursing students (71.5%) believed that self-medication is self-care as compare to medical students (56.5%).Conclusions: The study found wide practice of self-medication among students, inappropriate use of which may cause serious health hazards. Promoting education regarding self-medication and making healthcare system available can reduce self-medication practices substantially.
Predictors of hypertension in Oman
Authors: Anwar Sanam , Moslhey Ghadeer J. , Aleem Bushra , Rashid Hajir H. , Alrashdi Asma S.
Published: January 2019

Background: According to the Oman World Health Survey in 2008, the prevalence of hypertension in Oman is about 40%. Hypertension is associated with old people, male gender, smoker and impaired glucose tolerance. The objective of the study was to find out the important predictors of hypertension in Oman.Methods: A cross sectional study in Omani adults more than 18 years of age was conducted.  Blood pressure was measured and participants were classified as having hypertension. Height and weight was measured and body mass index was used to classify obesity by WHO guidelines. Multiple logistic regression was used to find the predictors of hypertension.Results: Increase in age and body mass index were found to be important covariates of hypertension. People in the age group of 30 to 50 years were at high risk of hypertension (OR 1.6, p<0.05); likelihood increased to three times in more than 50 years age group (p<0.01) in univariate analysis. Overweight had almost 2 times (p<0.05) and obese had five times (p<0.01) more likelihood of hypertension than normal weight people. People with less education had more likelihood of hypertension. Smokers (OR 2.9, p<0.01) and males (OR 1.5, p<0.05) were at a higher risk of hypertension than non-smokers and females in multivariate analysis. Percentage accuracy of classification was 67.4%.Conclusions: Age more than 50 years, male gender, BMI more than 30 and smoking were important predictors of hypertension in the study population.
Multidrug resistant, extensively drug resistant and pan drug resistant gram negative bacteria at a tertiary care centre in Bhubaneswar
Authors: Pattnaik Dipti , Panda Subhra Snigdha , Singh Nipa , Sahoo Smrutilata , Mohapatra Ipsa , Jena Jagadananda
Published: January 2019

Background: Multidrug resistance has emerged as a challenge in health care settings. Again increasing prevalence of multidrug resistant (MDR), extensively drug resistant (XDR) and pan drug resistant (PDR) gram negative bacteria is making the condition more critical because of limited options of antibiotics, increasing morbidity, mortality and hospital stay of the patients. The present study is carried out with an aim to estimate the prevalence of MDR, XDR, PDR gram negative bacteria in a tertiary care hospital.Methods: Total of 912 gram negative bacterial isolates obtained from various samples of indoor patients in a tertiary care hospital, were studied over a period of six months. The bacteria were identified by conventional methods. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method. Minimum inhibitory concentration (MIC) of antibiotics for the resistant isolates were detected by Vitek-2 automated method. MDR, XDR and PDR were determined according to the definitions suggested by European Centre for Disease Prevention and Control (ECDC), and Centers for Disease Control and Prevention (CDC). Prevalence of extended spectrum beta lactamase (ESBL) producers was estimated.Results: Out of 912 isolates, prevalence of MDR, XDR and PDR were 66.12%, 34.32% and 0.98% respectively. Prevalence of MDR and XDR were higher in ICUs than clinical wards (p<0.0001). Prevalence of ESBL producers was 48.4%.Conclusions: The study highlights increased prevalence of multidrug resistant and extensively drug resistant strains in our hospital. Stringent surveillance, proper implementation of hospital infection control practices and antimicrobial stewardship will help in limiting the emergence and spread of drug resistant strains.
Health problems among IT professionals in Chennai city, Tamil Nadu
Authors: Vyas Smita
Published: January 2019

Background: Increasing technological advantage lead to the higher health disadvantages to IT professionals who spent most of the time working in front of the computer. They are experiencing many neural, visual and musculoskeletal ailments. The present study was done with the aim to limelight the health issues among IT employees in IT Park, Chennai.Methods: This cross-sectional quantitative survey related to health issues among IT professionals was done on 417 employees of Chennai IT Park during the period from January 2018 to May 2018. The predesigned questionnaire included socio-demographic and health related issues. It was sent to the employees through various media including Facebook messenger, LinkedIn private messaging and email. The data was analyzed and presented in number and percentages and the related associations were analysed by Chi square test.Results: The prevalence of pain in eye was the major visual problem noticed in 157 (38%) patients and the rate of incidence was similar in both males and females. About 50% of the participants had pain/stiffness in lower back. Feeling nervous ness is the related stress condition experienced by the respondents (49%). Other health correlated issues noticed among the participants was headache (40%). The prevalence rate of these factors was higher in males compared to females.Conclusions: The study concluded that IT professionals face several health issues in terms of visual, musculoskeletal and stress problems in Chennai IT Park.
Internet addiction and ADHD, are they significantly related?
Authors: Piplani Shobhit , Bhushan Shashi , Tekkalaki Bheemsain V.
Published: January 2019

Background: There has been marked rise in use of internet over the last decade, with increasing internet use people are more prone to psychological disorders. This has markedly hit the population of young adults as they are the ones who maximum use internet. These users are also prone to develop Attention deficit hyperactive disorder(ADHD) and other behavioural problems.Methods: The study was conducted by the Department of Psychiatry, 900 (design effect=2) students were randomly selected (620 from Medical College and 280 from Dental College). Out of 900, 618 students answered the questionnaire completely which included Young’s Internet Addiction Test (IAT) and the Adult ADHD Self-Report Scale (ASRS-v1.1). Subjects who came positive for ASRS were asked to undergo a test for DSM-V. Independent t-test was used to assess the outcomes and p<0.05 was considered significant.Results: The mean age of the participants were 20.03±1.45 years. It was found that people from age group 19-20 were addicted the most (240 students), coming next were from age group 21-22 (162 students). The prevalence rate of self-reported ADHD symptoms using the ASRS screener was 20.2%. Out of these ADHD suspects 39(31.45%) were moderately addicted and 73(58.87%) were mildly addicted, and this association was found to be statistically significant (p<0.001).Conclusions: Thus, with modernization it is seen that internet use has dramatically increased, which has various kinds of behavioural, psychological, mental effects on one's life. Moreover, students who were more addicted to internet were found to be more susceptible to ADHD.
A cross sectional study to assess awareness regarding rabies amongst medical students of Rajindra hospital, Patiala, Punjab
Authors: Singh Aman Dev , Rochwani Ritu , Sagar Ishan , . Riya , Jain Ankur
Published: January 2019

Background: Rabies is a preventable enzootic endemic disease in India, it is a viral disease caused by Lysavirus causing acute inflammation of brain in humans and other warm blooded animals. It is typically transmitted through bites from infected animal. Human rabies deaths are almost entirely preventable through prompt delivery of post-exposure prophylaxis (PEP) to victims of bites by rabid animal. Appropriate knowledge regarding rabies and its prevention among medical students is very important to prevent rabies deaths. The aims and objectives of the study were to assess awareness regarding rabies amongst medical students.Methods: This was a cross sectional study which was conducted in month of April 2018. There were total of 496 students, we could obtain the information from 373 students as the questionnaire was given during a theory class and some of the students were absent. A pretested, structured questionnaire was administered to assess their knowledge about rabies, classification and management of bite wounds, including different vaccination schedules, site and dose. The data was entered using Microsoft excel and statically analysed by Epi Info 7.Results: Almost all (97.32%) students knew that rabies is a fatal disease and 78.02% knew that dog was the primary transmitting animal. Only 41.29% students were aware that head, neck and face to be the danger site of bite. Almost all 98.6% students were aware about washing the wound with soap and water as the primary first aid measure following dog bite whereas 0.27% said suturing as first aid measure.Conclusions: Awareness of medical students regarding cause of rabies and its fatality were good but they had less awareness about the danger sites of animal bite.
Pregnant women with severe anemia reporting in labor: prevalence, socio-demographic and obstetric determinants
Authors: Singh Ruchika , Gupta Mamta , Saini Vandana
Published: January 2019

Background: Severely anemic women reporting in labor remains one of the most important challenging situation for the obstetrician as well as for the mother and her family due to its adverse feto-maternal outcome. Various socio-demographic and obstetric conditions need to be explored which are important to tackle them, for primary prevention of anemia. The aim and objectives of the study were to estimate prevalence of severe anemia in pregnant women reporting in labor in a tertiary hospital of Delhi and to evaluate various socio-economic and associated obstetric factors associated.Methods: This is a hospital based, prospective, case contol study. Hemoglobin was estimated at the time of labor room admission. Fifty consecutive antenatal women with severe anemia (Group A) and 50 non-anemic women (Group B) were enrolled in early labor. Socio-demographic and obstetric factors, were recorded and analyzed.Results: Prevalence of severe anemia was estimated to be 2.23%. Determinants of severe anemia were found to be socio-economic status (p value 0.001), education (p value 0.001), rural living (p value 0.016), calorie intake (p value 0.001), BMI (p value 0.046), booking status of pregnancy (p value 0.001), gravida (p value 0.024), inter-conception interval (p value 0.002) and regular iron-folic acid intake (p value 0.001).Conclusions: Primary prevention of anemia by targeting these factors at the community/state/ national level, by the policy makers is important. Early booking and screening for anemia in antenatal clinics, providing iron supplements to anemic women for secondary prevention of severe anemia is recommended so that no woman reports with severe anemia in labor.
Awareness regarding medical ethics in health care practice among the resident doctors in a tertiary care hospital of the sub-Himalayan region: a cross sectional study
Authors: Parashar Anupam , Chauhan Nidhi , Gupta Rahul , Kumar Vineet
Published: January 2019

Background: Bio-ethics i.e. health care ethics is a set of moral principles, beliefs and values that guide us in making choices about medical care. This novel study was carried out with an objective of assessment of knowledge regarding the medical ethics among the resident doctors of Indira Gandhi Medical College, Shimla Himachal Pradesh.Methods: This descriptive analytical cross-sectional study was conducted at Indira Gandhi Medical College (IGMC), Shimla, Himachal Pradesh among the resident doctors using predesigned, structured, self-administered anonymous close-ended questionnaire. We analyzed the data using Stata software version 12.Results: There were a total of 61 study participants, who consented to participate, of which more than half were females (52.5%). The mean age of the study participants was 28.6±0.63 years. Regarding the source of knowledge about medical ethics most of the study participants had acquired the information during their experience at their workplace (42.6%). A majority of the male participants disagreed that confidentiality while providing the health care services should be abandoned (54.3%). More than 90% of the study participants agreed that incorporation of medical ethics is necessary in undergraduate curriculum.Conclusions: Incorporation of a formal structured teaching on medical ethics in the undergraduate curriculum is the need of the hour. Besides research work, the medical ethics committee in the institution should also act as the guiding hands to address the grievances faced by the doctors during medical practice.
Prevalence of non communicable disease risk factors among male to female transgenders: a cross sectional study
Authors: Shenoy Vaishnavi Venkat , Vaishnavi P. , Rajan Thulasi , Eswaran Cowshik , Subramaniam Sudharshini
Published: January 2019

Background: Non communicable diseases are responsible for a high proportion of deaths and disabilities. The major risk factors attributed to this are smoking, heavy alcohol drinking, inadequate fruit, and vegetable consumptions, and physical inactivity. While there are data available to understand the prevalence of non-communicable risk factors among men and women, there is no data among transgender community. Hence this study was conducted to assess the prevalence of NCD risk factors among the male-to-female transgender community.Methods: This cross sectional study was conducted among 54 transwomen who had been registered with two social welfare organizations for transgender community in Chennai. The risk factor was assessed using WHO STEPS instrument.Results: Among the transwomen, 16.7% were currently smoking tobacco, while 18.5% were using smokeless forms of tobacco. Alcohol consumption was observed in 44.4% of the population. 62.9% of them were not involved in any kind of exerting physical activity for recreation. 25.9% had undergone hormone supplementation for gender affirmation. Prevalence of obesity was 20.4% in the study population. The prevalence of hypertension, diabetes and hypercholesterolemia was 11.1%, 5.6% and 7.4% respectively.Conclusions: High Prevalence of certain risk factors such as smokeless tobacco usage, alcohol consumption and hormone supplementation were seen among the male-to-female transgender community compared to the general population. Targeted interventions must be made so that specific attention is given to the transgender community in various NCD programs by the government. They must also be supported and accepted by every member of this society.
Exclusive breast feeding reduces diarrhoeal episodes among children: results from a cross-sectional study among the mothers of under-five children in Kolkata
Authors: Banerjee Nibedita , Chakraborty Arup , Lahiri Arista , Biswas Kalidas
Published: January 2019

Background: Breast feeding is of utmost importance for optimal child growth. This study aims to determine the knowledge on breast feeding among the mothers of under five children and to find out the association between the proportion of exclusive breast feeding and the incidence of diarrhoeal disease.Methods: An institution based cross sectional descriptive study was conducted among ninety (90) mothers of under five children who attended the immunization clinic of a tertiary care hospital with the help of a pre-designed, pre-tested, semi-structured schedule. Mothers were selected by systematic random sampling and interview done after obtaining written consent.Results: The mean age of the respondent mothers were 25.78 years. Among them 77.8% were staying in the nuclear family with the mean education up to 8th standard, 94.4% of home maker. The mean education of fathers was 9th standard with majority (77.8%) occupied either in service or in other occupation. Average no of children per family was 1.3. Majority of mothers’ younger children (66.7%) were male. Majority (66.7%) mothers had heard the term colostrum and 88.3% knew that colostrum has anti-infective property and nutritionally superior. Sixty (66.67%) mothers had exclusively breast fed their children. Out of not exclusively breastfed children 36.67% experienced diarrhoea.Conclusions: Though majority mothers knew about breastfeeding, yet the proportion not having proper knowledge was high. The statistical analysis showed exclusive breast feeding to be highly protective against developing diarrhoeal episodes. In order to generate better breastfeeding practices, addressing the knowledge gap is needed.