bluuebunny/crossref_metadata_2025 huggingface dataset:
PhD on Track – designing learning for PhD students
Authors: Austrheim Gunhild , Rullestad Tove , Gullbekk Eystein
Published: May 2018

Three years ago we started the project "Information Management for Knowledge Creation". The project was initiated to create online information literacy modules for PhD students. The result of our endeavours, PhD on Track, will be launched in May 2013. The initial stage of the project was mapping out the information behaviour of PhD students, as well as what services they require from the library through a literature review and a focus group study. The findings of these inquiries formed the knowledge base from which we developed our information literacy modules. Our paper will focus on the interaction between content production and user testing when creating PhD on Track. Methods:User testing has been employed throughout the production stage. We have tested navigation and organisation of the web site, content and usability. The project team have conducted expert testing. Analysis:The results from our user testing have played an important part in decisions concerning content production. Our working hypothesis was that the PhD students would want an encyclopaedic website, a place to quickly find answers. However, the user tests revealed that PhD students understood and expected the website to be learning modules. Conclusions:The PhD students in the tests agreed that a site such as this would be useful, especially to new PhD students. They also liked the design, but had some qualms with the level of information. They preferred shorter text, but with more depth. The students would likewise have preferred more practical examples, more illustrations and more discipline specific information. The current content of PhD on Track reflects the feedback from the user testing. We have retained initial ideas such as one section for reviewing and discovering research literature and one section for publishing PhD research work. In addition, we have included more practical examples to indicate efficient workflows or relevant actions in context. Illustrations proved a challenge for the production team. How do you illustrate copyright or the process of getting published? The project team sees user testing as an essential part of content development. Though PhD on Track certainly mirrors the research support efforts of the academic libraries behind it, by involving the users throughout the production we have tried to make sure it is a highly relevant and qualitatively sound resource for the PhD students. "Information Management for Knowledge Creation" is a collaborative project ran by the libraries at the Bergen University College, the Norwegian School of Economics, and at the Universities of Bergen, Oslo and Aalborg. The project is funded by the Norwegian National Library.
Heyelan tetikleyici faktörlerine bağlı mekânsal hassasiyet değerlendirmesi
Authors: CİHANGİR Mehmet Emin , GÖRÜM Tolga , NEFESLİOĞLU Hakan Ahmet
Published: May 2018

Kelkit Çayı Vadisi heyelan yoğunluğu bakımından Türkiye ortalamasının üzerindedir. Bu vadi yamaçlarının üst kesimlerinde yapısal düzlüklerin bulunduğu alanlarda kış aylarında biriken kar ilkbahar aylarında aniden erimektedir. Eriyen kar, bu düzlüklerin önündeki eğimli yamaçlarda su çıkışlarına neden olmakta ve büyük katastrofik heyelanları tetiklemektedir. Gözlem ve literatür araştırmaları sonucunda bu tetiklenmenin kış aylarında vadideki bazı yamaçlarda karın uzun süre tutunması, ilkbaharda güneş radyasyonuna bağlı eridikten sonra sızması ve akışa geçmesiyle gerçekleştiği tespit edilmiştir. Bu etkinin yüksek olduğu yamaçlarda heyelan hassasiyetinin de yüksek olduğu bilinmektedir. Tetikleyici faktör bakımından yamaç hassasiyetini belirlemek çalışmanın amacını oluşturmaktadır. Bu amaçla çalışma alanı 3600 fiziki yamaç ünitesine bölümlenmiştir. Bu ünitelerin tutunma, sızma ve akış hassasiyetini belirlemek için, uzman görüşütarafından etken faktörler ve etki derecelerinin belirlendiği M-AHP yöntemi kullanılmıştır. Tutunma modeli için çok çözünürlüklü vadi taban düzlüğü indeksi, yükselti ve bakı, sızma modeli için solar radyasyon, Topoğrafik Nemlilik İndeksi (TNİ) ve Hidrolojik Toprak Grubu (HTG), akış modeli için ise eğim, rölyef ve HTG parametreleri kullanılmıştır. Tutunma, sızma ve akış için en yüksek kararın alındığı yamaç üniteleri belirlenerek ana tetikleyici kar erimelerinin mekânsal hassasiyet üzerinde etkisi ortaya konulmuştur. Elde edilen sonuçlarda birden fazla modelin çıktısının en yüksek (örn. tutunma-sızma-akış) değerini taşıyan yamaçlarda mekânsal hassasiyetin daha yüksek olduğu tespit edilmiştir. Bu yamaçların özellikle kuzey blokta heyelanların başlangıç bölgelerine karşılık geldiği ortaya çıkmıştır. Heyelana elverişli zemini hazırlayan “tutunma-sızma” yamaçlarının ise eski heyelan içlerine, “sızma-akış” yamaçlarının ise özellikle kuzey yamaçlar olmak üzere heyelanların transfer zonlarına karşılık geldiği tespit edilmiştir. Kuzey yamaçlarda sızmanın yüksek olmasından kaynaklı su içeriğinin fazla olması bu yamaçlarda heyelanın tektiklenmesine neden olmaktadır. Bunun dışında çalışma alanının güney bloğunda ise “tutunma-akış”ın etkin olduğu yamaçlar bulunmaktadır.
CRIMINALITY IN LATGALE IN THE REFLECTION OF THE NEWSPAPER “LATGOLAS WÒRDS” (1919–1921)
Authors: Strods Kaspars
Published: May 2018

After the end of the Latvian War of Liberation (1918–1920) and the liberation of Latgale from the Bolsheviks, everyday life started to improve gradually, however, due to various objective circumstances (the geographical position – the border with the Soviet Russia, the presence of various criminal elements, relocation of refugees and several socio-economic factors such as unemployment, poverty, etc.), the region was still highly criminal. Processes and events including criminal offenses occurring in the territory of Latvia were reflected in various state and regional newspapers. The largest regional newspaper was “Latgolas Wòrds”, published by the Latgalian Christian Farmers’ Union, which eventually became an independent source of information for a large part of the population of Latgale. The aim of the study is to identify the main trends of criminality in the territory of Latgale as reflected in the newspaper “Latgolas Wòrds” (1921–1921). The content of publications under analysis indicates that there were various crimes committed (including murder, robbery, theft, etc.); the selected publications also reveal the overall socio-economic situation in the region during this period. The rapid spread of crime in the rural areas testifies to the socio-economic problems experienced by the population of Latgale (unemployment, devastated farms, the overall food deficit, etc.). Similarly, the publications outline the social portrait of criminals: among them there were socially disadvantaged people (rural population, etc.) and servicemen of different armies. Active or passive participation of certain social groups (soldiers, police officers, etc.) in committing crimes indicates not only certain problems in the activities of the Latgalian security institutions, but also in the general trends typical of the Latvian state on the whole. It should be noted that the news displayed in the newspaper can hardly be perceived as an opinion of the general public, but rather as an interpretation of events by a certain group or its representatives.
Cranial measurements and pattern of head shapes in children (0-36 months) from Sokoto, Nigeria
Authors: MUSA Muhammad A. , ZAGGA Abdullahi D. , HAMİD OON Ahmed
Published: May 2018

Purpose: This study investigated the pattern of head shapes in children using cranial index values. Material and Methods: Cranial length, cranial width and cranial index of 210 normal growing children (100 males and 110 females) aged 0 - 36 months old seen at the Institute of Child Health Center, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria over the period of one year were determined using standard cranial landmarks and procedures. The pattern of head shapes was determined using the cranial index values obtained from the study participants. Results: The overall mean and standard deviation values for cranial length, cranial width and cranial index were 13.79±1.79 cm, 10.95±1.39 cm and 79.49±3.42 respectively. A statistically significant increase was observed in the cranial width values of males when compared to that of females. Meanwhile, there was no statistically significant difference observed in the mean cranial length and mean cranial index values between the sexes. As per the present study, the predominant head shape type in males was Mesocephaly (31.90%) and in females, Brachycephaly (26.19%) while the least observed head shape pattern was Hyperbrachycephaly (1.42%) in males and Dolicocephaly (0.47%) in females. Conclusion: Cranial parameters evaluated in this study are good indicators of skull and brain growth, thus can be of clinical importance in determining the timing and etiology of brain insults, especially in the first three years of postnatal life.
Test-retest reliability of muscle strength evaluations in healthy ballet students
Authors: Yücel Ahmet Hilmi , Ayvazoğlu Seda , Polat Sema Özandaç , Kabakcı Ayşe Gül
Published: May 2018

Purpose: The aim of this study is to investigate the test-retest reliability of muscles strength measurements performed with Nicholas Manual Muscle Tester (NMMT) in healthy ballet subjects.Materials and Methods: The study group consisted of 10 healthy ballet students aged between 10-11 years. Muscle strength evaluations of lower extremity were made to determine the physical performance level using NMMT. Moreover, every measurements were performed three times with NMMT. Results: NMMT measurements were found as reliable for lower extremity muscle strength in clinical measurements. These reliability of NMMT scores were found as between 0.634 and 0.991. Conclusion: In this paper, we think that NMMT measurements for lower extremity muscles can be used as reliable in clinical measurements and the identification of problems including lower extremity, evaluation of the training and treatment effectiveness of ballet students
Çocukluk çağı santral sinir sistemi tümörleri: 60 olgunun retrospektif analizi
Authors: Yağcı Küpeli Begül , Ökten Ali İhsan , Gezercan Yurdal , Uluç Şebnem , Menteş Selahattin
Published: May 2018

Amaç: Bu çalışmada hastanemizde malign santral sinir sistemi (SSS) tümörü tanısı ile izlenmekte olan hastaların klinik, cerrahi ve patolojik özelliklerinin ve izlem sonuçlarının retrospektif olarak değerlendirilmesi amaçlandı.Gereç ve Yöntem: Ocak 2013 ile Ocak 2016 arasında hastanemizde malign SSS tümörü tanısı alan 18 yaş altındaki hastalar çalışmaya dahil edilerek demografik bilgileri, başvuru anındaki yakınmaları, tanı yaşı, tanıda kullanılan yöntemler, tümörün lokalizasyonu, tedavi modaliteleri, tedavide görülen komplikasyonlar ve hastalık durumları kaydedildi.Bulgular: Hastanemizde izlenen SSS tümörü olan 60 çocuk hastanın yaşlarının 10 ay ile 17 yaş arasında değiştiği, ortanca yaşın 8 yıl olduğu saptandı. 21 hastada medulloblastom, 19 astrositom, 6 ependimom, 4 glioblastoma multiforme, 3 beyin sapı gliomu, 2 supratentorial primitif nöroektodermal tümör, 2 optik gliom, 2 glionöronal tümör, 1 desmoplastik infantil gangliogliom tanısı kondu. Cerrahi uygulanmayan 3 beyin sapı gliomu ve 2 optik gliomlu hasta dışındaki 55 hastanın 53’üne gros total kitle eksizyonu yapıldığı, 2’sine ise subtotal kitle eksizyonu yapıldığı saptandı. İzlem süreleri 1 ay-36 ay arasında değişmekte olan hastalardan 11’inde hastalık rekürrensi olduğu, bunların da 8’inin progresif hastalık nedeniyle kaybedildiği gözlendi. 37 olgu ise hastalıksız olarak izlemde idi.Sonuç: Çocukluk çağının malign SSS tümörleri, lösemilerden sonra en sık görülen malign tümörler olup, sağkalım tümör biyolojisi, yerleşim yeri, yaygınlığı ve tedavi modaliteleri ile yakından ilişkilidir. Tedavide cerrahi önemli role sahiptir. Adjuvan kemoterapi ve/veya radyoterapi kararı hasta ve hastalık ile ilişkili risk analizi yapılarak multidisipliner yaklaşım ile verilmelidir.
Serebral Palsi’de Tedavi Yöntemleri Olarak Yüzme ve Su İçi Terapi
Authors: POLAT Sema , KABAKCI Ayşe Gül , İNCE Gonca , YÜCEL Ahmet Hilmi
Published: May 2018

Yaşamın erken dönemlerinde ortaya çıkan, gelişmekte olan beyinde lezyon ve anormallikler nedeniyle oluşan bir grup postür ve hareket bozukluğu olarak tanımlanan serebral palsi, çocukluk çağında en çok görülen problemlerden biridir. Ayrıca, bazı komplike bulgulara sahip serebral palsili hastalarda çeşitli fizik tedavi uygulamaları gün geçtikçe önemli bir yer tutmaktadır. Çalışmanın amacı kısaca serebral palsiyi ele aldıktan sonra su içi egzersizlerinin serebral palsi üzerine etkisini araştıran çalışmaları incelemektir.
Odontojenik Enfeksiyonlar ve Yayılım Komplikasyonları
Authors: ÖZTÜRK Kübra , DELİLBAŞI Ertan Ali
Published: May 2018

Baş boyun bölgesindeki enfeksiyonların bir numaralı nedeni odontojenik orjinlidir yani diş ve çevre dokuları kaynaklıdır. Odontojenik enfeksiyonların çeşitli nedenleri olmakla birlikte bölge anatomisinde enfeksiyonların yayılımını önleyecek pek çok faktör vardır. İhmal edilen enfeksiyonlar ya da yetersiz tedaviler bu enfeksiyonların önemli anatomik lokalizasyonlara yayılımı ile sonuçlanmaktadır. Gelişen tanı ve tedavi yaklaşımlarına rağmen baş ve boyun enfeksiyonları diş hekimleri açısından komplike vakalar olmayı sürdürmektedir. Baş ve boyun enfeksiyonlarında multidisipliner yaklaşımla tedavi planlaması yapmak ve bölge anatomisi ve yayılım yollarını iyi bilmekle doğru tedaviyi uygulamak mümkün olacaktır. Bu derlemede odontojenik enfeksiyonların oluşum nedenleri, yayılım yolları ve oluşabilecek ciddi komplikasyonları sunulması amaçlanmıştır.
DESTİNASYON REKABETÇİLİĞİ ENDEKSİ ÖNERİSİ
Authors: Burnaz Ersin , Ayyıldız Hasan
Published: May 2018

Boş
zamanların artması, iletişim ve ulaşım imkânlarının gelişmesi ve ekonomik
imkânların elverişli hale gelmesi sonucunda her geçen yıl daha fazla insan
seyahat edebilir hale gelmiştir. Bu durum ülke ekonomilerinin elde ettiği
turizm gelirinin de artmaya devam ettiğini göstermektedir. Ülkeler, daha fazla
ziyaretçi çekebilmek için birbirleriyle rekabet etmektedirler. Özellikle
Türkiye gibi gelişmekte olan ülkelerde turizmin ekonomiye katkısı oldukça
önemli olduğundan illerin kendi turizm potansiyellerini bilmeleri ve buna göre pazarlama
faaliyetlerini planlamaları zorunludur. Bu çalışmada destinasyonların rekabet
güçlerini etkileyen faktörlerin açıklandığı, literatürde yaygın olarak
kullanılan modeller, ortak özellikleri dikkate alınmak suretiyle
birleştirilerek destinasyon rekabetçiliği endeksi (DRE)
oluşturulmuştur. Çok sayıda kriterin etkilemiş olduğu bir konu olan destinasyon
rekabetçiliğinin ölçümünde çok kriterli karar verme yöntemlerinden (AHP,
TOPSIS, PROMETHEE, MOORA) yararlanılmıştır. Türkiye için geliştirilen destinasyon
rekabetçiliği endeksi 81 ilden elde edilen verilerle test edilmiş, elde edilen
sıralamalar ile gerçekleşen turizm performansı (GTP) sıralamaları arasında
yüksek bir korelasyon elde edilmiştir. Bu durum geliştirilen DRE’nin
açıklayıcılığının yüksek olduğunu göstermektedir.
PANEL VERİ ZARFLAMA İLE OECD ÜLKELERİNİN 2008 KÜRESEL KRİZİ ÖNCESİ VE SONRASI KAYNAK KULLANIM ETKİNLİKLERİNİN ARAŞTIRILMASI
Authors: EREN Miraç , AGHABAYOVA Aytan
Published: May 2018

Ekonomik
büyüme ülkelerin önemli amaçlarından biridir. Kaynak kullanım etkinliğinin temel hedefi ise ekonomik büyüme ve
kalkınmadır. Nitekim kaynak kullanımında
etkinlik, sürdürülebilir kalkınmanın en önemli bileşenlerinden biridir.
Çalışmada, 2006-2016 dönemleri arasında OECD ülkelerinin ekonomik büyüme
etkinliklerini gözlemleyebilmek için Neo-Klasik üretim fonksiyon değişkenleri
baz alınarak, statik veri zarflama analizi (VZA) ve panel VZA modelleri
kurulmuştur. Böylece 2008 küresel krizi de göz önüne alınarak, ülkelerin
etkinsiz yönetimsel faaliyet göstermesinden mi yoksa dezavantajlı durum içerisinde
olmalarından dolayı mı kaynak kullanımında etkinsiz oldukları
araştırılmaktadır. Bunun yanısıra, 2008 krizi öncesi ve sonrası ayrı ayrı
değerlendirilerek krizin ekonomik büyüme üzerindeki etkisi tartışılmaktadır.
Cure from the rhizomes: the medicine behind the Indian saffron Curcumin
Authors: S. Sujatha , R. Priyadharshini , V. Shwetha , B. K. Yashoda Devi , T. Pavan Kumar , Azmi Rizwana
Published: May 2018

Indian system of medicine has always focused on cure from the nature. Plant products from the Indian household have been used as medicine to cure myriad of ailments since ancestral times. Curcumin is a polyphenol, an active ingredient found in turmeric. In Southeast Asia, turmeric has been used as a coloring, flavoring and as a therapeutic agent. The use of turmeric to treat ailments dates back to the times of Charaka and Shushrutha. It has been widely used as an antiseptic for cuts, burns, and bruises, and as an antibacterial agent. Modern medicine has begun to understand its importance in recent times. Unfortunately its poor solubility, limited absorption and enhanced metabolism limits its bioavailability for its extended therapeutic use. Integration of nanotechnology in drug design and development has led the way to development of nanocurcumin with improved pharmacological properties. A precise understanding of effective dose, safety, and mechanism of action is required for the rational use of turmeric in the treatment of human diseases. This review focuses on the molecular actions of curcumin and its possibility to be used as a therapeutic agent in conditions affecting oral mucosa.
Study on the knowledge of pharmacovigilance among medical students
Authors: Patchva Lakshmi Deepika
Published: May 2018

Background: Pharmacovigilance is the science and activity relating to the detection, assessment, understanding and prevention of adverse effects or any other drug–related problems. The ultimate aim of pharmacovigilance is to ensure safe and rational use of medicines, once they are released for general use in the society. The most important outcome of pharmacovigilance is the prevention of negative consequences of pharmacotherapy. So, the present study primary objective is to assess awareness of pharmacovigilance among medical students and to evaluate the knowledge of pharmacovigilance at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinaoutpally (A.P.), a tertiary care teaching hospital.Methods: A cross-sectional study will be carried out using a pretested questionnaire. The questionnaire will be designed to assess the knowledge regarding pharmacovigilance. The medical students (Final MBBS and Interns) were included in the study during the study period. Only the participants who will give their consent will be included in the study. Results will be calculated by proper statistical analysis.Results: The current study was conducted in a medical college Dr. PSIMS and RF, which included a total of 180 medical students 75% final years, 25% interns. Most of them (89.8%) accepted that reporting ADR is necessary and pharmacovigilance should be taught in detail to healthcare professionals.Conclusions: This study demonstrated that knowledge of pharmacovigilance among medical students is improving gradually, but unfortunately the actual practice of ADR reporting is still deficient among students.
Formoterol versus montelukast as add on therapy to low dose budesonide in persistent asthma: effect on lung function
Authors: Krishnan Divya G. , Keloth Anukesh Vasu
Published: May 2018

Background: Choice between LABAs and LTRAs as add on drugs to low dose ICS in persistent asthma remains unclear due to limited data on the comparative efficacy of these two groups of drugs. The aim of this study was to compare the effects of formoterol and montelukast on lung function, when added to low dose Budesonide in persistent asthma.Methods: This was an institution based randomized open label study. 72 asthmatics satisfying selection criteria of the study were randomized to receive either inhaled budesonide and formoterol (FB group) or inhaled budesonide and oral montelukast (MB group) for 12 weeks. PEF value at end point was primary efficacy measure. Secondary efficacy measures were PEF values measured at the end of 1, 4 and 8 weeks and the end point value of FEV1.Results: Both the groups showed significant improvement in the lung function tests. However inter-group comparison showed that PEF value at end point of FB group was significantly greater than that of MB group (81.94%vs 63.82%, p<0.05). Notable observation was that the superiority of the FB group with respect to PEF values was maintained from the first week itself. FB group also had significantly better results than MB group for FEV1 (67.88% vs 64.88%, p<0.05).Conclusions: In the present study, formoterol was found to be superior to montelukast in improving lung function when added to low dose budesonide in persistent asthma.
Socio-demographic correlates of unmet need for family planning among rural women of Haryana, India
Authors: Singh Srishti , Kalhan Meenakshi , Malik J. S. , Jangra Anuj , Sharma Nitika , Singh Srijan
Published: May 2018

Background: The continuously growing population not only hampers the socio-economic development but the health of mothers and newborns. Progress made in improving social development in addition to strengthening the ongoing family planning programme will contribute towards the future pace of fertility and decline in unmet need. Objective of present study to assess the unmet need for family planning and role of socio-demographic factors among rural women.Methods: The present study was community based cross-sectional study conducted in rural area of Haryana from September 2015 to August 2016 among 500 currently married women (18-49 years).Results: The unmet need for family planning was 19.2% (4.8% spacing and 14.4% limiting).  Education, occupation and SES were significantly associated with unmet need for family planning. The commonest reason for not using contraception among those with unmet need was fear of side-effects (37.5%) followed by in-laws disapproval (21.9%).Conclusions: The unmet need for family planning was high. Women education and empowerment by protecting their health, wellbeing and rights, including their reproductive rights would prove to be beneficial.
Cholesterol levels: the prognostic significance in ICU patients
Authors: A. Jeyasuriya , A. K. Badrinath , Nagalingam Saranya
Published: May 2018

Background: The aims of the study were to monitor the total cholesterol levels at different time intervals in ICU patients and to analogize the values with the outcome of disease, to study the prevalence of hypocholesterolemia among ICU patients and to assess the trend of hypocholesterolemia among various diseases.Methods: Present study populace consists of 55 patients admitted in ICU.  For these patients, lipid profile was done on the day of admission and day-3 of admission. The total cholesterol levels done on day 1 and 3 were compared with disease outcome.Results: The mean cholesterol value among 33 survivors on day 1 was 120.76(±18.54) and day 3 was 145.30 (±55.65) with p value of 0.019, that is statistically significant. As the total cholesterol value increases during the period of ICU stay, it proves to be an  early prognostic indicator of disease outcome. The patients showing increasing trend of total cholesterol levels has increased chances of survival. Similarly, HDL value among 33 survivors on day 1 was 31.70 (±3.98) and day 3 was 36.39 (±11.98), with p value of 0.033, that is statistically significant and also, the mean LDL value among 33 survivors on day 1 was 68.25 (±17.14) and day 3 was 78.78 (±24.74), with p value of 0.009, which was also found to be statistically significant. The mean cholesterol value among 22 non-survivors on day 1 was 131.64 (±15.24) and day 3 was 122.09 (±26.23), the mean HDL among 22 non-survivors on day 1 was 33.14 (±3.79) and day 3 was 31.32 (±4.23).Conclusions: Present study’s intend of monitoring the total cholesterol level was successfully demonstrated that it can be used as prognostic tool in ICU patients. The increasing trend in total cholesterol level indicates better prognosis of disease outcome. Similarly, the increasing trend in HDL and LDL levels also can be used as prognostic tool to determine the survival rate of patient.
A study of subclinical hypothyroidism treated with alternate day fixed dose thyroxine therapy
Authors: Jhavar Dharmendra , Naredi Mohit
Published: May 2018

Background: Subclinical hypothyroidism (SCH) is a biochemical diagnosis wherein free T4 is within normal range while serum TSH value >5mIU/L. We aimed to study effects of alternate day fixed dose thyroxine therapy on this subset of patients with a 3month follow up of various clinical and biochemical parameters.Methods: It was an interventional trial. Fifty consecutive consenting participants with SCH aged 18-45 years were started on alternate day 50µg thyroxine and were observed for 3 months for changes in body mass index, blood pressure, serum cholesterol, serum triglyceride, serum TSH, T3 and T4 levels.Results: Forty four out of fifty participants had initial TSH levels between 5-10 µU/mL and at the end of 3 months, 58% of these (n=29/44) shown improved thyroid profile as their TSH fell to the target 2-4 µU/mL. Seven participants’ (n=7,14%) turned into iatrogenic hyperthyroidism as their T3 and T4 levels rose above normal and TSH levels fell to below 1 µU/mL. Another 7 participants (n=7,14%) showed increased T3 and T4 levels (n=3, n=4 respectively) above normal range with TSH still within normal range. One patient (n=1,2%) had persistently raised TSH levels. Out of 6 participants (n=6,12%) who had initial TSH>10 µU/mL, 3 participants achieved normal TSH with alternate day therapy (n=3,6%) while 3 participants did not achieve euthyroid status (n=3,6%). Authors observed decrease in cholesterol levels (initial=183.18±52.96 mg/dL, final=170.04±42.13 mg/dL, p<0.05). It lead to reduction in weight (initial BMI=24.11±5.69, final=23.33±5.30, p<0.05).Conclusions: Authors found that treatment of SCH with alternative day thyroxine therapy is effective in normalizing TSH values. Its dose needs to be titrated according to TSH levels to avoid side effects. It decreased cost of therapy resulting in good compliance in noncompliant patients and reduced pill burden helped the patients in adhering to the therapy.
A prospective study of pattern of hepatic dysfunction in dengue fever patient in coastal Andhra Pradesh, India
Authors: Acharya Anand , Satyanarayana P. V. V. , Subrahmanyam Vijjapu
Published: May 2018

Background: DENV (dengue viral infection) is a non-hepatotropic RNA virus, but hepatic involvement is common. High level of viremia is associated with involvement liver and other organs. Present study is a prospective study which is aimed to know about the, pattern of hepatic involvement in dengue patients admitted in General Medicine Dept Konaseema Institute of Medical Science.Methods: This is a prospective hospital-based study conducted in the Department of General Medicine Konaseema Institute of Medical Science Amalapuram Andhra Pradesh, from December 2015 to December 2017. During two year of study period 126 clinically and serologically positive patients of Dengue fever, Dengue haemorrhagic fever and Dengue shock syndrome, classified as per the, definition of national vector borne disease control programme Govt. of India.Results: Mean value of total bilirubin was 0.8 mg/dl in DF patients, 0.96mg/dl in DHF patients and 1.08mg/dl in DSS patients. Mean value of AST was 77.44(IU/L) in DF group, 112.32 IU/L in DHF group and 486.28 in DSS group. In DF group mean ALT in DHF group was 94.36 (IU/L) and it was 386.42 IU/L in DSS group. Mean value of serum albumin was 3.97 gm/dl in DF group, 3.65 gm/dl in DHF group and 3.49 gm/dl in DSS group. Serum globulin mean value was 2.98mg/dl in DF group, 2.86 gm/dl in DHF group and 2.69 gm/dl in DSS group. Serum alkaline phosphate level was also increased in all the groups, mean value of ALP was 118.46 IU/L in DF group, 164.32 IU/L in DF group, 164.32 IU/L in DHF patients and 342.42 IU/L in DSS group.Conclusions: The pattern of hepatic involvement of liver in dengue fever varies as per the severity of disease. In milder case of dengue fever liver function test was normal but there was hepatomegaly was present commonly but in severe form of disease pattern of hepatic involvement varies from tender hepatomegaly to significant increase in liver enzyme.
A study on outcome of malaria and acute gastroenteritis induced acute kidney injury requiring hemodialysis
Authors: Gupta Swarna , Gupta Punit , Jain Vishal
Published: May 2018

Background: Acute kidney injury previously known as acute renal failure, is characterized by the sudden impairment of kidney function resulting in the retention of nitrogenous and other waste products normally cleared by the kidneys.   Acute Kidney Injury is usually manifested as multiorgan failure syndrome and extracorporeal support may also target fluid overload and heart failure, extracorporeal CO2 removal for combined kidney and lung support, albumin dialysis for liver support. Haemodialysis is more effective than peritoneal dialysis for management of Acute Kidney injury as Peritoneal dialysis is associated with clearance limitation and difficulties with fluid removal and is thus rarely used in adults in developed countries.Methods: The study was conducted in the Department of Medicine, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur (CG), India, from 2010 to 2012. All patients of both the sexes who were diagnosed as a case of Acute Kidney Injury due to Acute Gastroenteritis and Malaria and who were advised for Hemodialysis were included in the study. In our study, 32 patients of Acute Kidney Injury were included. The criteria used for AKI in the study was RIFLE criteria. Hemodialysis was done in all the cases. Quantitative variables are reported as means±SD and qualitative variables as percentage. Factor(s) determining outcome of AKI were tested by univariate analysis using “fisher’s exact test”. All variables with a P value <0.05 in the univariate analysis were defined statistically significant.Results: Out of 32 patients of Acute Kidney Injury in our study, 50% (n=16) were of Malaria associated AKI cases and other 50% (n=16) patients were of Acute Gastroenteritis associated AKI in which 87.5% males,12.5% Females were of Malaria and 75% male,25% Female were in AGE associated AKI. Maximum number of patients presented with features of AKI within first 3days of disease onset i.e. 56.25% (n=9) of malaria patients and 68.75% (n=11) of AGE patients. Mortality due to MOD was more common in Malaria patients as compared to AGE patients. AGE associated AKI patients had different level of deranged SOFA score.Conclusions: Acute kidney injury due to acute gastroenteritis differs from other causes of AKI by frequent occurrence of hypokalemia. Early diagnosis and prompt management can restore the kidney function.
Corneal thickness and endothelial cell density in diabetic and non- diabetic patients: a hospital based comparative study
Authors: G. Nagaraj , Desai Anasuya Sangaraj , Jayaram Nagesh
Published: May 2018

Background: Diabetes mellitus is associated with structural changes in corneal endothelial cells and their thickness. The present study was done to compare the endothelial cell density (ECD), central corneal thickness (CCT) and morphology in diabetic and non-diabetic patients.Methods: A cross-sectional study was conducted at Minto Ophthalmic hospital, BMC and RI Bangalore for a period of 20 months (October 2013 - May 2015). A total of 200 study subjects, 100 diabetics and 100 non-diabetic age matched controls were selected, and complete timed ophthalmic evaluation was performed. Specular microscopy was performed on all patients for endothelial cell count assessment and corneal thickness was measured by Pachymeter. The data was analyzed and represented using descriptive statistics. ‘t’ test was used for comparing the two groups.Results: The mean endothelial cell density in diabetic group was significantly lower (2438.73±250.23cells/mm2) compared to non-diabetic group (2599.88±168.16cells/mm2) (p<0.0001). The mean Central corneal thickness in diabetic group was significantly higher (518.40±28.13 μm) compared to control group (490.14±24.31 μm) (p<0.001). The Co-efficient of variation percentage of the diabetics was higher than the non-diabetics but this difference was not statistically significant (P>0.05). The hexagonality percentage was significantly lower in diabetic group compared to the controls suggesting less pleomorphism in the diabetic group.Conclusions: The study concludes that the endothelial cell density was lower and central corneal thickness was higher in diabetic patients compared with the non-diabetics. The altered endothelial morphology was significantly seen in the form of pleomorphism (hexagonality) but polymegathism was not significantly altered.
Efficacy and safety of pregabalin versus amitriptyline in patients with painful diabetic neuropathy
Authors: Daniel Sujit R. , Badyal Dinesh K. , Jacob Jubbin J. , Kaur Jasleen
Published: May 2018

Background: Painful diabetic neuropathy is a common complication of long standing diabetes mellitus. Amitriptyline is commonly used to treat painful diabetic neuropathy. Pregabalin has been shown to be effective in the treatment of painful diabetic neuropathy with lesser adverse effects. Sustained release (SR) of pregabalin has the advantage of once daily dosing and a better patient compliance. Hence, this study was planned to compare the efficacy and safety of pregabalin-SR with amitriptyline in painful diabetic neuropathy.Methods: It is a prospective, open labelled, randomized controlled study. A total of 80 patients diagnosed with painful diabetic neuropathy based on Diabetic neuropathy symptom score and Michigan neuropathy screening instrument, were randomized into two groups to receive amitriptyline and pregabalin SR. Amitriptyline was started at 25mg OD and pregabalin SR 75mg OD for 6 weeks with optional dose titration. Patients were assessed for pain relief by using visual analogue scale and an overall improvement in their general condition by patient’s global impression of change scale. Adverse drug reactions were recorded on each follow up.Results: All patients had significant improvement in pain relief in both the treatment groups. The median VAS (visual analogue scale) score was slightly higher in pregabalin SR group (25 vs 22) however it was not statistically significant. Intergroup comparison did not show any significant differences between the treatment groups. Good and moderate pain relief were noted in 37(92.5%) and 3(7.5%) patients on amitriptyline and 36 (90%) and 4 (10%) patients on pregabalin SR respectively. The common adverse effects reported in amitriptyline group were drowsiness (27.5%) and dry mouth (17.5%) and in pregabalin-SR group were drowsiness (15%) and dizziness (5%). No serious adverse event was reported in either of the groups.Conclusions: In patients with painful diabetic neuropathy both amitriptyline and pregabalin-SR are equally effective in alleviating pain and improving the patient’s general condition, but pregabalin-SR has the advantage of fewer adverse effects and convenient dosage timing.
Assessment of serum cardiac troponin-I over serum CPK-MB in early diagnosis of acute myocardial infarction (AMI)
Authors: Kumar Santosh , Patil Sachin
Published: May 2018

Background: The early mortality rate from AMI is 30% with about half of them occurring within 1hour of disability. Although the mortality rate after admission for AMI has declined by 30% over the past decades, approximately 1 of every 25 patients who survive the initial hospitalization die in the first year after AMI. The gold standard for diagnosis of MI has been an elevated serum level of creatinine kinase – myocardial band (CK- MB), the cardiac-specific isoenzyme of CK. However, elevated CK-MB may not detect all myocardial necrosis. In patients who die suddenly after severe or silent episodes of ischemia, autopsies frequently reveal micronecrosis that was not reflected in routine CK-MB measurements. The present study was undertaken to know that serum Cardiac Troponin-I is more sensitive marker than serum CPK-MB in early diagnosis of acute myocardial infarction (AMI).Methods: The study was carried out in tertiary care hospital in Gulbarga. The study was undertaken with an aim to study that serum cardiac troponin-I (cTnl) is more sensitive than serum CK-MB in early diagnosis of acute myocardial infarction (AMI). The study was conducted on patients admitted with history of chest pain suggestive of AMI as diagnosed by WHO criteria to medicine ward of Basaveshwar Teaching and General Hospital, Gulbarga. The period of study was from June 2012 to June 2014. The sample size included 100 patients with history of chest pain suggestive of AMI, selected by simple random method.Results: Our results revealed that cardiac troponin I was more sensitive (62%) than CK-MB in overall cases admitted in between 6-24 hrs from the onset of chest pain. Maximum number (41%) of AMI patients were affected on the anterior wall followed by Inferior wall of AMI. 11 percent were affected with Antero lateral wall wereas 5 to 6 percent were affected with anteroseptal and global acute and right ventricular AMI was seen among 2 percent of patients. Anterior wall AMI was the significantly affected site with AMI (ʎ2:12.5, P:0.0004). The maximum number of acute myocardial infarctions were ST elevation myocardial infarctions. 28% of cases where CKMB is normal, the cTnI detects the AMI cases indicating its sensitivity.Conclusions: Cardiac troponin-I (cTnI) was more sensitive serum marker than CKMB in the early diagnosis of acute myocardial infarction (AMI). Anterior wall was the most significantly affected site of AMI. In the future, further improvements in analytical performance may open additional diagnostic windows.
Nephro protection property of double blockade versus single blocked of RAAS in delaying the progression of CKD
Authors: Gupta Arvind , Narain Upma , Dabu Romar
Published: May 2018

Background: Dual renin angiotensin aldosterone system blockade using angiotensin receptor blockers in combination with angiotensin converting enzyme inhibitors is reported to improve proteinuria in non-diabetic patients.Methods: A prospective observational study was done on 810 non-diabetic chronic kidney disease patients during July 2012 to August 2014 to compare the nephro protection property of double blockade and single blocked of renin angiotensin aldosterone system in delaying the progression of chronic kidney disease.Results: At the end of 24 months urinary protein excretion rate of group I and group III were compared by using student t-test and p value (0.0001) was found significant. Similarly, on comparing group II and group III, p value (0.003) was again significant. Mean arterial blood pressure of group I and group III were statistically significant (<0.0496) while comparing group II and group III, p value (0.0419) was again significant.Conclusions: The study concludes that the use of double renin angiotensin aldosterone system blockade therapy is more effective than monotherapy at reducing albuminuria and proteinuiria, and in decreasing blood pressure at the same time not causing significant deterioration in glomerular filtration rate. Newer potassium lowering therapies can effectively and safely correct hyperkalemia and maintain normokalemia in patients receiving background treatment with renin angiotensin aldosterone system blockade. However, the use of new potassium binders for cardiovascular and renal risk reduction with combined renin angiotensin aldosterone system blockade therapy will require phase III trials.
Are older drivers getting the information they need from their health care provider?
Authors: Huseth-Zosel Andrea L.
Published: May 2018

Background: The number of drivers aged 65 or older is expected to increase, creating a significant public health issue. Health care providers (HCPs) can provide counseling to their older patients to assist with continuing to drive safely. The goal of the current study was to determine the frequency with which older drivers recall having had received driving-related information from their HCP.Methods: Current and former drivers aged 65 or older in the upper Midwest were surveyed about whether a HCP had provided information to them about driving issues.Results: Of the 59 completed responses for former drivers, less than 15% reported having received information from their HCP on driving issues prior to stopping driving. Of the 775 completed responses for current drivers, 0.7% of respondents aged 65 to 74, 0.4% of respondents aged 75 to 84, and 7.0% of respondents aged 85 or older recalled their HCP ever having provided them with information about safe driving habits, or been told they should limit or discontinue their driving.Conclusions: Few adults aged 65 or older are receiving information related to driving safety from their HCP. HCP conversations are an important part of normalizing the transition through the stages of driving cessation, and may assist older adults get prepared, both emotionally and logistically, for the time when they have to stop driving. Additional research on HCP provision of driving safety information to older adults is needed.
Relationship between levels of nutrients and habitual coffee consumption and the incidence of anemia in former leprosy patients
Authors: Ginting Sadar , Sidabutar Sondang , Renaldi Sihombing Eka Saudur
Published: May 2018

Background: Former leprosy patients are a group of people that are at risk of anemia. Anemia in the former leprosy can be caused by daily food consumption and coffee drinking behavior. This study aimed is to determine the relationship between the levels of nutrients and habitual coffee consumption and the incidence of anemia in the former leprosy patients.Methods: Design of this study is cross sectional. There were 115 former leprosy patients, all of whom were selected as subjects for this study. The nutrient consumption data were obtained through filling out 24-hour food recall forms; the coffee drinking habit was obtained through questionnaire; and the incidence of anemia were obtained through Hb level examination by using Digital Acute Check. The data obtained were analyzed with Chi-Square statistical test and binary logistic regression.Results: Protein intake (p value 0.003), iron intake (p value 0.001), and habitual coffee consumption (p value 0.035) have significant relationship with the incidence of anemia. While energy intake (p value 0.833) and Vit. C intake (p value 0.516) have no significant relationship with the incidence of anemia in former leprosy patients. Iron intake is a dominant factor affecting the occurrence of anemia in former leprosy patients.Conclusions: Nutrient consumption is lower than the recommended dietary allowance, especially iron. The daily coffee consuption can inhibit iron absorption. Thus, it appears that insufficient levels of protein and iron, and the consumption of coffee are the factors that affect the occurrence of anemia in the former leprosy patients.
Assessment of prevalence of hypertension in an urban population: a cross sectional study in Indore city
Authors: Modiwala Ashfaq , Deshpande Ajit , Wavare R. R. , Kantharia S. L.
Published: May 2018

Background: Hypertension is growing rapidly to epidemic levels in the developing countries, that’s why described by some clinicians as a ‘silent killer’. The objective of the study was to study the prevalence of hypertension among adults in urban area of Indore city.Methods: A community based survey was conducted among the 375 residents of urban population of Indore.Results: In our study 157 subjects were found to be hypertensive with the prevalence of 41.9%. Where; new cases of hypertension were found to be with prevalence of 15.7%. Out of which males were 44 (20.3%). Whereas, previously diagnosed 98 (62.4%) subjects were on anti-hypertensive medication and 59 (37.6%) newly diagnosed subjects who did not know they were having hypertension.Conclusions: The prevalence of hypertension in study subjects was 41.9%. 15.7% subjects didn’t know that they were having hypertension. 31.6% of hypertensive subjects were on irregular medication. It was found that lack of awareness, negative attitude of people for practicing modifiable risk factors associated with hypertension.
Depression and its determinants among hypertensive subjects from the primary health care centres at Tirunelveli district, Tamil Nadu
Authors: . Dhandayuthapani , . Sunitha , . Rathinavel , M. Prakash , Sendhilkumar Muthappan
Published: May 2018

Background: Depression among elderly persons has become a serious health problem. Despite an increasing number of research studies exploring prevalence of depression among hypertensive patients in high income countries, limited data is available from low and middle income countries particularly in India. People with chronic diseases are more likely to have depression than those without any chronic diseases.Methods: This was across-sectional study. Totally 496 subjects were selected from 4 different Primary Health Centres (PHCs) who attended outpatient department during the study period. The patient health questionnaires (PHQ-9) were used to estimate the prevalence of depression among hypertensive subjects. Basic demographic and behavioral details were also collected. This study was carried out from April to August in 2016 in Tirunelveli district, Tamilnadu, India.Results: The study show 5.8% of subjects had no depression, 42.1% subjects with mild depression, 45.3% had moderate and 6.6% had high depression among hypertensive subjects. Totally 94% hypertensive subjects had depression.Conclusions: The high depression has found more in male, employed, illiterate, non-vegetarian, drinkers, and smokers subjects then compare to other subjects.
Clinico-epidemiological profile of eclampsia patients admitted in an urban tertiary care hospital of West Bengal: a record based study
Authors: Maji Baisakhi , Samanta Sumana , Banerjee Sreetama , Mullick Tanjib Hassan , Saharay Sudhanshu , Sarkar Debjit
Published: May 2018

Background: Eclampsia is a multi–system disorder with complex pathogenesis, causing 12% of global maternal deaths. It is a major public health problem specially in developing countries, contributing to maternal and perinatal morbidity as well as mortality. Majority of them are preventable if managed timely, promptly and with expertise. The objectives of the study were to identify the incidence of eclampsia in R G Kar Medical College and Hospital as well to identify the determinants of feto-maternal outcome.Methods: A retrospective, record-based cross-sectional study was conducted in an urban tertiary care teaching hospital. There were 354 pregnant women with eclampsia admitted and delivered during the study period which was 1st January-31st December’2015. Complete enumeration was done to get the sample for the study. Data were retrieved from eclampsia registers and log books of delivery kept in the labour room and hospital record section. After wards it was analysed with the help of SPSS 20.0 version to get different inferential statistics.Results: Incidence of eclampsia in that hospital in 2015 was18.4/1000 deliveries. Almost 72% patients had ante-partum eclampsia and rest had post-partum eclampsia. Emergency caesarean section was the most common (62.14%) mode of delivery. Perinatal mortality was found in 5.6% of the eclampsia patients. Majority (65%) of the babies delivered belonged to low birth weight. Muslim patients and the patients of gestational age more than 36 weeks had unfavourable outcome.Conclusions: There is need to educate and encourage the general public for antenatal care and institutional delivery. Along with this the socio-economic, cultural and educational status are to be uplifted for the improvement of the present scenario regarding eclampsia in our country.