bluuebunny/crossref_metadata_2025 huggingface dataset:
Manajemen Metode Bernyanyi Dalam Meningkatkan Kecerdasan Siswa Di Pos PAUD Anyelir 31 Jember
Authors: Rizal Syaiful , Muawanah Muawanah
Published: August 2022

ABSTRACT
The learning objective is to optimize the overall development of the child and involve interactive communication. One way to implement the above is by providing the most effective and effective learning methods for singing students. Singing has many benefits, one of which is the development of intelligence possessed by children. Of the 9 intelligences, 3 intelligences can be achieved through intelligence methods that have kinesthetic intelligence, musical intelligence, and linguistic verbal intelligence of children. The purpose of this research is to see how the school management is implementing the singing method. Type of research Field research (field research) which is then described qualitatively. The results of the study can be concluded that the singing management of Pos PAUD Anyelir 31 covers: a) planning management as stated in the learning tools and the planning stage of the singing method (determining goals, determining material, selecting models). b) implementation management, including learning media or teaching materials to be delivered, dividing children into small groups, guiding children in the implementation of singing and overcoming problems or obstacles that often occur during singing. c) management evaluation of management and recorded management.
Keywords: Singing Method, Intelligence, Students
 
ABSTRAK
Tujuan pembelajaran adalah untuk mengoptimalkan perkembangan anak secara menyeluruh serta terjadinya komunikasi interaktif. Salah satu cara mengimplementasikan hal diatas yakni dengan memberikan metode pembelajaran yang paling efektif dan efesien bagi siswa  yakni dengan bernyanyi. Bernyanyi memiliki banyak mamfaat salah satunya terbangunnya kecerdasan yang dimiliki oleh anak. Dari 9 kecerdasaan, 3 kecerdasaan bisa dicapai melalui metode bernyanyi yakni kecerdasan kinestetik, kecerdasan musikal, dan kecerdasan verbal linguistik anak. tujuan dari penelitian ini adalah untuk mengetahui bagaimana managemen yang dilakukan sekolah dalam hal implementasi metode bernyanyi. Jenis penelitian Field Research (penelitian lapangan) yang kemudian dideskripsikan secara kualitatif. Hasil penelitian dapat di simpulkan bahwa managemen bernyanyi Pos PAUD Anyelir 31 melingkupi : a) managemen perencanaan yang tertuang pada perangkat pembelajaran dan tahap perencanaan metode bernyanyi (menetapkan tujuan, menetapkan materi, memilih model). b) managemen pelaksanaan diantaranya menyiapkan media pembelajaran atau bahan ajar yang akan disampaikan, membagi anak dalam suatu kelompok kecil, memandu anak dalam pelaksanaan bernyanyi serta mengatasi problem atau hambatan yang sering terjadi waktu pelaksanaan bernyanyi. c) managemen evaluasi yakni penilaian proses dan penilaian sikap yang didokumentasikan.
Kata Kunci : Metode Bernyanyi, Kecerdasan, Siswa
Konsep Pendidikan Anak Usia Dini Dalam Pandangan Psikologi Al-Qurâ€™an Dan Hadits
Authors: Hasyim Badrun Fawaidi
Published: August 2022

ABSTRAK
Penelitian ini melakukan penganalisaan dengan tujuan mendeskripsikan terhadap aspek pendidikan anak usia dini (AUD) dan mendapatkan konsep pendidikan anak usia dini dalam pandangan psikologi dan al-Qurâ€™an Hadits. Sedangankan jenis penelitian library research, teknik pengumpulan data menggunakan dokumentasi, setelah data terkumpul lalu dianalisis dengan analisis deskriptif dan content analysis. Hasil temuan penelitian ini menunjukkan bahwa Pertama: konsep pendidikan anak dalam perspekstif psikologi memiliki empat dimensi utama yaitu, fisik, psikis, spiritual, dan sosio kultural. Pradigma pola pendidikan anak usia dini (AUD) harus sesuai dengan kondisi psikolog anak artinya  melalui pendekatan gaya Autoritatif. Kedua: mendidik dengan pandangan al-Qurâ€™an dan hadits, dapat menjadikan anak dapat bertumbuh kembang secara optimal baik secara fisik maupun mental, dalam artian anak dapat tumbuh menjadi pribadi yang matang baik secara intelektual, emosional, maupun spiritual berlandaskan islam dan iman. Psikologi dalam pandangan al-Qurâ€™an dan Hadits yaitu menjembatani kegiatan belajar dalam mentrasfer ilmu pengetahuan supaya agar lebih memperhatikan psikologi dari masing-masing individu anak usia dini (AUD), karena hal ini sangat menetukan keberhasilan orang tua atau pendidik dalam mentransfer ilmu yang diberikan kepada anak-anaknya.
Kata Kunci: Pendidika AUD, Psikologi, Al-Qurâ€™an dan Hadits.
NEUROANATOMIA COMO VEÍCULO ESTRATÉGICO EM MARKETING
Authors: Abreu Rodrigues Fabiano de , Antonio de Sousa Campos Eduardo , Aline Silva de Paula Jennifer
Published: August 2022

Este artigo tem como objetivo discutir a estratégia em marketing sob o olhar da neuroanatomia. Discute-se a importância dos neurotransmissores da felicidade, em especial, a dopamina, sendo o neurotransmissor mais fácil de modular com técnicas de marketing. O conhecimento do cérebro e o mapeamento de personalidades por meio dos transtornos é significativo. É possível conseguir resultados promissores com a tríade: preço baixo, justo e alto. Também é considerado 4 fatores de interação com o consumidor: Interatividade, experimentação, conexão e recompensa. O conjunto deste estudo vai ao cerne da estratégia do consumidor. Há margem para novas pesquisas envolvendo os outros neurotransmissores da felicidade.
Identification and characterization of Ethyl gallate from Ethyl acetate fraction of Phyllanthus emblica fruit, and invitro free radical scavenging activity
Authors: Balaji G. , Sangaraju Rajendra , Sinha Sukesh Narayan , Shashikala P.
Published: August 2022

Phyllanthus emblica fruit has a rich source of polyphenolic compounds and is widely used due to its medicinal properties. A portion of the ethyl acetate fraction (EAF) from 70% methanol extract (70% ME) showed greater 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) scavenging activities. Moreover, EAF has more polyphenol content than 70% ME. The EAF was subjected to a dry silica gel column eluted successively with a mixture of chloroform: ethyl acetate: formic acid (2.8: 2.4: 0.4ml) as a mobile phase solvent system, and to afford various fractions. EAF and isolated fraction-1 of ethyl gallate (EG) showed a unique pattern of EG standard chromatogram in thin layer chromatography (TLC) analysis. EAF and isolated fraction-1 real time (R.T) of the peaks were unique compared with those of the standard chromatogram in high-performance liquid chromatography (HPLC) analysis. This chromatogram fraction was collected from isolated fraction-1 at the same R.T time by multiple HPLC analysis. The collected fraction from HPLC was injected into Mass spectroscopy (MS) and it showed a molecular ion at m/z 197 corresponding to C9H10O5. The substance was identified as EG based on the results mentioned above.
A Rare Case of Oligodendroglioma in Sacrococcygeal Mature Teratoma Diagnosed in Preterm Infant
Authors: Jeong Mun Hui , Jeong Seong Hee , Hwang Chung Su , Cho Yong-Hoon , Byun Shin-Yun , Lee Narae
Published: August 2022

Sacrococcygeal teratoma is the most common congenital tumor in neonates, and is reported in approximately 1/35,000 to 1/40,000 live births. Oligodendroglioma is a rare central nervous system tumor that is usually found in the cerebral hemisphere of young and middle aged adults. When associated with a teratoma, it is mainly identified in ovarian teratoma in adolescents and adults. We describe a rare case of a preterm infant with oligodendroglioma in a mature sacrococcygeal teratoma. The male neonate was born at a gestational age of 30 weeks with a protruding mass in the sacrococcygeal region. Pelvic magnetic resonance imaging showed a sacrococcygeal teratoma of approximately 11 cm comprising fat components and skeletal structure, that extended from the anterior part of the sacrum to the abdominal cavity. Radical resection was performed at 36 days of age. Macroscopically, the resected intra-abdominal mass had the characteristics of a cystic lesion, and the intrapelvic mass was a predominantly solid mixed cystic-solid lesion. Histologically, this solid lesion in the intrapelvic mass was composed of mature glial tissue, which comprised as a proliferation of monotonous cells with small and round nuclei, surrounded by a perinuclear halo (“fried egg” appearance). Additionally, these cells were immunohistochemically positive for glial fibrillary acidic protein. These findings confirmed the diagnosis of oligodendroglioma in sacrococcygeal mature teratoma. After the treatment, no recurrence was observed during the follow-up period, and no additional intervention was required. However, the patient is undergoing treatment for voiding dysfunction caused by a neurogenic bladder.
Comparison of Satisfaction Levels between COVID-19 and Non-COVID-19 Patients in the Emergency Department
Authors: AKYOL Pınar Yeşim , ACAR Hüseyin , KAYALI Ahmet , BİLGİN Serkan
Published: August 2022

Background: Patient satisfaction in the emergency department is an indicator of the quality of healthcare service provided. The increased workload and stress of healthcare workers due to the ongoing pandemic can affect the quality of patient care and thus patient satisfaction. This study compares the satisfaction levels of COVID-19 and non-COVID-19 patients in the emergency department.

Tools and Methods: In this prospective, observational survey study, the brief emergency patient satisfaction scale (BEPSS) was used to establish the satisfaction levels of patients.

Results: Satisfaction levels were significantly higher, while waiting times were quite shorter for COVID-19 patients than for non-COVID-19 patients. The triage categories had no effect on the satisfaction of non-COVID-19 patients, while satisfaction levels were significantly lower in patients with green triage tags than in those with yellow and red triage tags among the COVID-19 patients.

Conclusion: The satisfaction levels of COVID-19 patients were higher than those of non-COVID-19 patients. The short waiting times for COVID-19 patients in the emergency department have a significant impact on patient satisfaction.
Sosyal Ağ Bağlantılarının Bireysel Performans Üzerindeki Etkisi: Akademisyenler Üzerine Bir Çalışma
Authors: Sözen H. Cenk , Fayganoğlu Pınar
Published: August 2022

Sosyal bir varlık olan insanın örgüt içerisinde sergilediği pek çok davranış, onun sosyal olarak geliştirdiği ve üyesi olduğu ağ bağlantılarından etkilenmektedir. Bu çalışmanın amacı, aktörün örgüt içerisinde sahip olduğu sosyal ağ bağlantılarının, yönetim ve örgüt araştırmaları yazınında pek çok davranış değişkeninin öncülü sayılabilecek bireysel performans üzerinde etkisi olup olmadığını ortaya koymaktır. Yazında, olumlu ve olumsuz sosyal ağ bağlantılarını birlikte ele alan bütüncül bir çalışmanın olmayışı çalışmanın özgünlüğünü oluşturmakta olup, çalışmanın gerek metodolojisinin gerekse kuramsal alt yapısının yazına katkılar sağlayacağı değerlendirilmektedir. Çalışmanın sosyal ağını Ankara ilinde faaliyet gösteren bir üniversiteye bağlı fakültede çalışan 37 akademisyen oluşturmakta olup, çalışma kapsamında ilk olarak aktörlerin UCINET programı ile ağ düzeneği ortaya çıkartılmış, ardından üniversitenin kendi belirlediği kriterler çerçevesinde aktörlerin düzenli olarak ölçülen bireysel performans skorları ile ağ analizinden elde edilen bulguların SPSS programı aracılığıyla ilişkisini ortaya koymak amacıyla korelasyon ve regresyon analizleri yapılmıştır. Bahse konu analizler neticesinde, oldukça dikkat çekici sonuçlar elde edilmiştir. Buna göre, olumlu sosyal ağ bağlantılarına sahip merkezî konumdaki aktörün başka bir ifadeyle, ağ düzeneğinde en çok sevilen aktörün, performans skorlarının düşük olduğu tespit edilirken; en çok olumsuz sosyal ağ bağlantısına sahip aktörün bireysel performans olarak en yüksek skora sahip aktör olduğu saptanmıştır.
Euoplos eungellaensis, sp. nov. (Idiopidae), a new golden trapdoor spider from central-eastern Queensland
Authors:   Queensland Museum, Wilson Jeremy D. , Harvey Mark S. ,   Western Australian Museum, Rix Michael G. ,   Queensland Museum
Published: August 2022

The golden trapdoor spider genus Euoplos Rainbow, 1914 is endemic to Australia, and currently contains 23 species. In eastern Australia, the genus is known to occur from southern Victoria to the Cape York Peninsula of northern Queensland, however, all described species in the genus are from the southern part of this distribution– all species north of the Tropic of Capricorn are currently undescribed. Here, wetake the first step in rectifying this by describing Euoplos eungellaensis, sp. nov. from the rainforest of the Clarke Range in central-eastern Queensland. We provide diagnostic characters for both males and females, as well as information on burrow morphology.
Physico-Chemical Quality Of Drinking Water From Various Sources In Abia State, Nigeria
Authors: Okereke Eric E. , Obasi Kalu O. , Amadi Chinasa A. , Ede Okorie A. , Aronu Cecilia , Abonyi Isaiah C. , Nwankwo Chidiebere J. , Eze Peter , Amadi Agwu N.
Published: August 2022

The majority of Nigerians lack access to a safe drinking water source, making sustainable and equitable access to safe drinking water a challenge. The current study was designed to evaluate the physicochemical quality of drinking water from various sources in 24 randomly selected communities throughout Abia State, Nigeria. These communities were selected from 8 Local Government Areas within the 3 senatorial zones of Abia State. Using sterile universal containers, water samples were  collected from the major drinking water sources in the selected communities. On-site evaluation of the pH, electrical conductivity (EC), total dissolved solids (TDS) and temperature of the water samples was carried out using a  HI9813-6 pH/EC/TDS/Temperature meter.  The pH values of the water samples from all sampled communities ranged between 4.1 and 5.9, and the acidic pH levels of the water samples were not within the Nigerian Industrial Standard's (NIS) approved range of 6.5 - 8.5. Furthermore, the water sources in the selected communities were found to have ambient temperatures ranging from 25.8 - 31.8oC. The average electrical conductivity (0.04 µS/cm) and total dissolved solids (36.4 mg/L) of water samples from all senatorial zones studied were both within acceptable limits of 1000 µS/cm and 500 mg/L respectively. Although the other parameters (temperature, EC and TDS) evaluated in this study were within acceptable limits for drinking water physicochemical quality, this study emphasizes the importance of effective water treatment, safe distribution to households, and continuous monitoring and quality assessment of drinking water sources in Nigeria.
Drug Information Services Utilization In Nigeria From 1980-2020: A Narrative Review Of Related Studies
Authors: Okoye Ijeoma , Onyebuchi Ogbonna
Published: August 2022

The functioning and utilization of Drug Information Services (DIS) are reviewed in other climes with several studies on the subject matter and measures are taken for quality control of the information output from the Drug Information Centers (DICs). Although some studies assessed the drug information (DI) needs of healthcare professionals and their attitude towards DIS, there still exists the need to provide an overview of the state and extent of DIS and related studies in Nigeria as a means of creating awareness and promoting possible interventional measures. This study presented an overview of Drug Information Services and utilization in Nigeria and generated information for intervention and policy making.  This study reviewed the state of drug information services and their utilization in Nigeria using narrative review of relevant literature. The literature search was conducted on computerized databases. Search terms were used singly, in combination,and truncation to select and synthesize articles. The studies selected included those written in the English Language, carried out in Nigeria, with clear study design and properly stated year of publication which fell within the stated years of 1980 to 2020. The data obtained were subjected to descriptive statistics of frequency and percentage. The data was also subjected to comparative assessment using the Oxford and Scottish Benchmarks for Study Standard.  Selection of articles gave rise to 41 articles that met the criteria. They were used for the study. The highest number of articles were cited in the Southwest (26.83%). This was followed by the southeast (24.39%). While the north-central had the highest number (12.20%)of articles cited in the north, the least number of articles was found in the north-east (2.44%). There were no articles on DIS and its utilization cited before the year 2000(0%) while the highest number of studies (90.24%) were carried out between 2011 and 2020. The studies fell within the lower half of the Oxford and Scottish benchmarks for the hierarchy of studies and study standards. Drug information Services and utilization in Nigeria are still at their primary stage. Most of the studies carried out were in the south-west and south-east. The leading study design carried out were cross-sectional descriptive surveys which fell within the lower half of two standard benchmarks (Oxford and Scottish) for the hierarchy of studies.
Not-ordered quasi-distance measures of generalised trapezoidal hesitant fuzzy numbers and their application to decision making problems
Authors: DELİ İrfan , ÇELİK Elif Özge
Published: August 2022

As an extension of the trapezoidal fuzzy number, the generalised trapezoidal hesitant fuzzy number is an effective mathematical tool for handling uncertainty and vagueness in decision-making problems. Considering that the quasi-distance measure has a strong ability to process and analyse data, we initiated some novel quasi-distance measures to measure the strength of the relationship between generalised trapezoidal hesitant fuzzy numbers in this paper. Moreover, based on the proposed measures, a new multi-criteria decision-making approach is proposed to address uncertain real-life situations. Finally, a practical application of the proposed approach is also illustrated to demonstrate the effectiveness and applicability.
Long-term results of two different techniques in patients with supracardiac partial anomalous pulmonary venous connection via right thoracotomy approach. A prospective study
Authors: Nuriyev Rashad , Hasanov Elnur , Mirzazade Faiq
Published: August 2022

Aim: This study compared outcomes following the double-patch and Warden procedures for correcting partial anomalous connection of the right pulmonary veins to the superior vena cava via right thoracotomy approach.
Material and Methods: Hundred patients, aged <18 years old, and with partial anomalous connection of the right pulmonary veins to the superior vena cava were randomly selected into double-patch method (n=50) and Warden procedure (n=50) groups. The median follow-up was 31.5 (range, 10-45) months. The primary endpoint was sinus node dysfunction at the mid-term follow-up period.
Results: No early or late mortality occurred. In the early postoperative period, sinus node dysfunction was observed in 32.4% and 7% of cases after double-patch technique and the Warden procedure, respectively (risk ratio, 6.15; 92% confidence interval, 1.45-26.35; p=0.02). At follow-up, sinus node dysfunction remained in two (5%) patients after double-patch correction. All patients had normal sinus rhythm after the Warden procedure. No early or late pacemaker implantation occurred in either group. No patients had significant pulmonary veins or superior vena cava stenosis.
Conclusion: The double-patch technique and Warden procedure both showed best mid - term consequences without mortality. The Warden procedure was linked with less sinus node dysfunction in the early postoperative period than the double-patch technique. There was no significant various differences in sinus node dysfunction at the mid-term follow-up.
CABG outcomes in patients with postinfarctional ventricular septal rupture
Authors: Aliyev Ramil
Published: August 2022

Aim: Postinfarctional ventricular septal rupture (Post MI VSR) is the most fatal complication of the myocardial infarction. The mortality rate in modern and in-time surgical management is varying between 10 and 40%; the survival rate is 88% in the first year. The issue of CABG (coronary artery by-pass grafting) is still the subject of great discussion. In order to clarify this issue, we decided to analyze the short- and long-term outcomes of CABG in our patients with Post MI VSR.
Material and Methods: In our research we analyzed 90 patients with IHD (ischemic heart disease), complicated with Post-MI IVS rupture (Post -MI IVSR). Most of the patients with Post MI VSR were over 60 years old. The Post MI VSR within first days after acute myocardial infarction (AMI) was detected in 10 patients; up to 3 days – in 6 patients; up to 7 days – in 3 patients; from 7 to 29 days – in 4 patients. The time of IVS rupture after AMI was varying from 1 to 29 days (5.5±7.6 дней). All patients were distributed into groups depending on the hospitalization time after AMI.
Out of 83 patients underwent reconstruction after Post MI VSR, 79 (95.2%) required CABG. Two- or three-vessel lesions were detected in 67 (80.7%) patients. Cumulative mortality in CABG group was 19.7%, whereas in the group without accompanied CABG – 20%. The long-term outcomes were followed from 1- to 8 years, averagely in 18 patients (28.6%).
Results: The decompensation of heart failure and relapse of coronary symptoms during follow-up up to 3 years was observed in 6 (33.3%) patients, during follow-up from 3 to 8 years – in 3 (25%) out of 12 patients. The repeated revascularization was conducted in 5 patients.
Conclusion: Our results are showing the benefits of CABG in patients with Post MI VSR, which requires mandatory coronary angiography in pre-op period.
Long-term outcomes of cabg with intra-aortic balloon pump support
Authors: Aliyev Rafiq
Published: August 2022

Analyzed literature data concerning late outcomes of CABG with intra-aortic balloon pump (IABP) support in high-risk patients with acute coronary syndrome. MEDLINE, EMBASE, Scopus, The Benchmark Counterpulsation Outcomes Registry, Cochrane registry of Controlled Trials, and reference lists of relevant articles were searched. Results of surgery were matched with: 1).suitable option and time of surgery; 2).initial risk profile of patients; 3).tactic strategy, and timing of IABP connection; 4).leading risk predictors of in-hospital, and late results of surgery.
Is there a relationship between thyroid hormone change and postoperative arrhythmia in patients undergoing coronary bypass surgery? A prospective randomized controlled trial
Authors: Donmez Koksal , Akca Baris , Erdil Nevzat
Published: August 2022

Aim: Several factors are known to be associated with arrhythmias after cardiac surgery. This paper examines the changes in thyroid hormones after cardiac surgery and the relationship with arrhythmias.
Material and Methods: A random sample of euthyroid patients scheduled for isolated coronary artery bypass surgery were recruited for a randomized prospective study. Patients were divided into two groups based on developing a new-onset arrhythmia (NOA) or atrial fibrillation (NOAF) after surgery (Group 2, n=18), and patients without NOA or NOAF after surgery were included in Group 1 (n=66). Blood samples for free triiodothyronine (fT3) and free thyroxin (fT4) levels were collected preoperatively and at the time of arrival to intensive care unit (D0), 24th hour (D1), 48th hour (D2), 72nd hour (D3) and 96th hour (D4).
Results: Arrhythmia was detected in 21.43% of patients. Twelve patients had NOAF and six patients had ventricular NOA. The postoperative second day was the most common day for arrhythmia. fT3 values were lower than preoperative values in both groups. When intra-group decreases were compared, the fT3 value decrease was more prominent in the arrhythmia group and fT3 regression at the D2 term (p=0.036) was especially significant. Postoperative fT4 values were higher than preoperative values in both groups. When intra-group raises were compared, fT4 values increased in both groups. This raising was more significant in the arrhythmia group and the fT4 rise at D1 term (p=0.022) was especially important.
Conclusion: The decrease of fT3 values in the arrhythmia group (Group 2) was greater. This is more prominent on the postoperative second day, which is the most common day for arrhythmia after cardiac surgery. There is a rise in fT4 values and this is higher in the arrhythmia group. These relatively high values may be mimicking hyperthyroidism and may be considered a predisposition for arrhythmia and atrial fibrillation.
Comparison of tibial nailing by suprapatellar approach with a normal bend nail vs infrapatellar approach with a high tibial bend nail
Authors: Nair Vinod , Pareek Rajesh , Sharma Jaiman , Jani Chiranjivi , Bhatnagar Aastha
Published: August 2022

Background
Fractures of Diaphysis of tibia are among the most common diaphyseal fractures, with a bimodal age distribution. These are also notorious for going into delyed or non union, the preferred mode of fixation for these is the Intramedulllary nailing. We have compared the two approaches of the same, the supraptellar as well as infrapatellar approach.
Methods
Patients were divided into 2 groups, randomly, one group undergoing tibial diaphyseal intramedullary nailing via the conventional infrapatellar approach and the other undergoing via the suprapatellar approach. Post operative knee function was assessed using TegnerLysholm Scale.
Results
Mean TegnerLysholm knee score was 84.80 ±9.829 and 87.07±11.10 in infrapatellar and suprapatellar group respectively. When mean Tegner Lysholm knee score was compared in suprapatellar group and infrapatellar group using t test, it was found to be statistically insignificant.
Conclusions
we conclude that there was no difference in tibial fracture healing, alignment, knee pain and functional disability.
Key Words : Suprapatellar, Infrapatellar, Tegner Lysholm, Intramedullary, Nailing.
Appropriateness of antimicrobial doses in patients with Chronic kidney disease
Authors: KUMAR ALOK , Khrime Dorchhom
Published: August 2022

INTRODUCTION
Antimicrobials are commonly prescribed to hospitalized CKD patients. Studies showed that antibiotic dose was adjusted in 40 – 62% prescriptions in CKD patients. Dose adjustment according to eGFR can reduce toxicity in these patients. It can also save extra cost due to excessive dosing. There is limited data regarding drug dose errors in CKD from developing countries.
AIM
Aim of the study was to evaluate the extent of dose adjustment according to eGFR in CKD patients at our institute. We also looked for adverse effects related to excessive doses in patients.
MATERIAL AND METHODS
The study was conducted from July 2020 to March 2022. The study cohort comprised of 254 CKD patients admitted in various department and nephrology department was consulted . Investigators screened the records of patients. Patients were included in study on basis of inclusion and exclusion criteria. Descriptive statistics was used to present the results.
RESULTS
Patients received total 626 antimicrobials with mean of 2.46 per patient. About 539 antimicrobial drugs needed modification of doses but no adjustment was done in 55.28% prescriptions. Beta lactum antibiotics were most prescribed antibiotics. Only 51 % of patients received appropriate dose in beta lactum group. Amoxicillin clavulanate dosage were inappropriate in 75.28% patients followed by cefepime (57.4%), ceftizoxime (44.82%) and Piperacillin tazobactam (31.7%). Most patients (86.66%) on colistin received inappropriate doses. Patients on vancomycin and amikacin also received inappropriate dose adjustments in ˃ 65% patients. Fluconazole dose was adjusted in 61.8% cases while only 14% patients received adjusted dose of acyclovir. Adverse drug reactions due to inappropriate doses were observed in 19 patients
CONCLUSION
We found drug dose errors of antimicrobials in 55% cases. Antibiotic dose adjustment had been observed 40-60% in different studies. It would be appropriate to increase awareness about dose adjustment in CKD patients among physicians.
Clinical Profile of Thyroid Malignancies: A 10 year Retrospective Study in a Tertiary Care Centre in Eastern India
Authors: Mohanty Arun , Ethiraj Suraj
Published: August 2022

Background: Thyroid cancer is the most common endocrine malignancy. The incidence of which is on the rise in the last 2 decades. The incidence of this disease varies uniquely with age, sex and ethnicity. This epidemiological study was conducted to study the frequencies and patterns of thyroid neoplasm for last 10 years in East Indian population.

Methods: This retrospective study was conducted in a tertiary care center of Eastern India from January 2011 to December 2020 on all patients diagnosed with thyroid cancer. The clinical profile of all patients were analysed in the study

Result: Out of the total 2007 thyroid cases, 310 (15.4%) were diagnosed as thyroid malignancy. Of which 83.5% were papillary carcinoma, 10% follicular carcinoma, 2.5% medullary variety, 3.5% anaplastic type and 0.3% lymphoma. There was female preponderance with the approximate female to male sex ratio of 3:1. There was also a distinct age distribution, with papillary and follicular carcinoma being common in younger age, medullary in middle age group and anaplastic in the elderly. A total of 295 patients underwent thyroidectomy for malignancy in the last 10 years. The incidence of postoperative complication of recurrent laryngeal nerve injury is 2.4% and hypocalcemia is 4.1%.

Conclusion: Understanding the clinical profile of thyroid malignancies aides in preoperative suspicion of various types of malignancy. Papillary carcinoma thyroid is the most common malignancy, with each subtype having a unique age of presentation.
Study of fetomaternal outcomes in a tertiary care hospital related to liver disorders during pregnancy
Authors: Behuria Sasmita , Panda Swarupa , Jena Sushanta , Mohanty Minakshi
Published: August 2022

Introduction: Pregnancy-related liver diseases are significant medical conditions with a poor prognosis that present a challenge to both obstetricians and hepatologists. Around 3% of pregnancies worldwide and 3-5% of pregnancies in India are impacted by it. Numerous symptoms, including a yellowish discoloration of the sclera, black urine, anorexia, nausea, vomiting, and stomach pain, can be present. Hyperemesis gravidarum, preeclampsia, eclampsia with liver dysfunction, hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, intrahepatic cholestasis of pregnancy (IHCP), and acute fatty liver of pregnancy are among the specific liver illnesses associated with pregnancy.
Methods: This prospective observational study was carried out at the SCB Medical College and Hospital in Cuttack, Department of Obstetrics and Gynecology. On the basis of the inclusion criteria, 85 prenatal cases were prospectively investigated. Those who underwent a thorough history and examination, clinical symptoms suggestive of liver disorders, all available LFTs, including LDH, as well as some more conclusive tests to help identify the underlying cause, were then monitored up until delivery in terms of the outcome for the maternal and the foetus.
Results: There were 0.86% cases of hepatic problems during pregnancy. In the study group, 76.5% of cases appeared in the third trimester of pregnancy, 72.9% of cases were primigravida, and 90.59% of cases were between 20 and 30 years old. 76.4% of the participants in this study had a liver condition unique to pregnancy, of which 32.9% had pre-eclampsia, 11.7% had eclampsia, and 11.7% had HELLP syndrome. 16.4% had ICP, 2.3% had AFLP, and 1.1% had hyperemesis gravidarum. Morbidity was 34.12% and maternal mortality was 10.58%. Preterm 21.1%, stillbirth 38.82%, live birth 61%, and IUGR 24.7%. In 28.57% of cases, NICU admission is necessary.
Conclusion: Poor outcomes for the maternal and the foetus are linked to abnormal liver function during pregnancy. Many pregnant women and their unborn children can be saved by routine prenatal screenings, liver problem diagnosis, and treatment.
Evaluation of patients whose HCV serology was investigated in our hospital between 2010-2018
Authors: Tunay Havva , Demirturk Nese
Published: August 2022

HCV infection is commonly asymptomatic, most people infected with HCV are not aware that they are infected, and most of those who receive a diagnosis also currently cannot reach treatment. Our study, it was aimed to appreciate the rate of anti-HCV-positive patients and the awareness and knowledge of patients about their hepatitis C follow-up or treatment. In this study, we evaluated 56.115 patients who were screened for anti-HCV tests retrospectively. The patients who have positive HCV RNA tests with anti-HCV tests and without having HCV RNA test results were attempted to reach by phone. Anti-HCV positivity was determined in 708 (1.3%) patients. The mean age of 708 patients (Female, n=415;58.6%, and male, n=293;41.4%) was 63 years. Anti-HCV was positive in 708 patients, HCV RNA test was positive in 324 (45.8%) patients and negative in 163 (23.0%) patients. In 221 (31.2%) patients with positive of anti-HCV tests. The distribution rates of the requesting HCV RNA test in departments were: 41.8% in the infectious department, 39.4% in the internal department, 18.8% in the surgery department. Among 324 patients, 65 of them were phoned. Among 65 patients, 14 of them were being treated in another center, 11 of them were treated in our hospital. Among 221 patients who were not tested for HCV RNA 74 of them were phoned. Among 74 patients, 16 of them were being treated in another center and 7 of them were treated in our hospital. We found that the knowledge of physicians about HCV screening and treatment is low in the eradication of HCV. This situation emerged as the most important limitation of the study. Therefore, education programs about the notification of the HCV cases to the doctors for diagnosis and treatment may be beneficial.
Epidemiological and complication assessments of patients with ventriculoperitoneal shunts
Authors: Kiyak Veysel , Deniz Fatih , Oksuz Erol , Demir Ozgur , Demir Osman
Published: August 2022

This study aims to examine patients with ventriculoperitoneal shunts (VPS) used prevalently in the treatment of hydrocephalus epidemiologically, identify complications and present what can be done to reduce complications. Thirty-three patients who underwent ventriculoperitoneal shunt placement surgery between 2019 and 2021 at the neurosurgery department of a university hospital were examined retrospectively in terms of their epidemiology and complications using the hospital data. The most frequently observed complaint at admission was clouding loss of consciousness. There were significant differences between the patients who received revision operations after the first year following their surgery, which is the most frequently encountered period, and those who had revision operations within the first year (p<0.001). There were no significant differences between the patients who underwent revision operations and those who did not, in terms of the examined variables (p>0.001). In VPS surgery, which has frequent usage in the treatment of hydrocephalus, shunt dysfunction is usually caused by obstruction and infection. Some precautions can be taken to reduce the rates of these complications. Preoperative antibiotic use, the completion of the surgery in the shortest time possible, limiting entries and exits for the operating room, touching parts of the shunt as little as possible, and using neuro-navigation if possible are among the precautions that can be taken to minimize complications. To reduce mortality and morbidity rates, avoid unnecessary economic losses and prevent patients and their relatives from experiencing this stress, it is highly important to comply with these methods.
Efficacy of high dose chemotherapy in adult patients with relapsed or refractory ewing sarcoma
Authors: Aykan Musa , Keskin Gul , Ornek Ece , Topal Alper , Koseoglu Caglar , Dumludag Aysegul , Erturk Ismail , Karadurmus Nuri
Published: August 2022

Background: A rare condition in adults, Ewing sarcoma (EWS) has no standard treatment during the relapse–refractory period. In our study, we aimed to identify the treatment-related side effects of high-dose chemotherapy (HDC) and salvage autologous stem cell transplantation (ASCT) in adult patients with relapsed or refractory EWS and their survival rates.
Materials and Methods: In a retrospective study, we recorded the clinical characteristics of patients with relapsed or refractory EWS treated with HDC in the hospital’s patient registry to determine their objective response rate (ORR), progression-free survival (PFS), 6-month PFS rate, overall survival (OS), 6-month OS rate, transplantation-related mortality (TRM) and treatment-related side effects.
Results: In our sample of 29 patients (72.4% male), the mean age was 26.41 years (SD = 9.35). The most common primary tumour site was the lower extremities (31%), 69% of patients had lung metastases, and 48.1% had undergone surgical resection, adjuvant radiotherapy and chemotherapy. The ORR to HDC was 31%. Median PFS (IQR) was 5.35 (6.79) months (95% confidence interval = 4.23–8.28), whereas the 6-month PFS rate was 38.9%. Median OS (IQR) was 9.46 (14.45) months (95% confidence interval = 8.52–15.82), whereas the 6-month OS rate was 68.1%. Mortality from HDC or other causes occurred in five patients within the first 100 days after ASCT. Grade 3 febrile neutropenia and thrombocytopenia were present in all patients until engraftment following ASCT.
Conclusion: Amongst adults with relapsed or refractory EWS, HDC has successful survival and response rates and a manageable side-effects profile.
The effect of nursing care satisfaction on pain and anxiety levels of patients undergoing orthopedic surgery in the early postoperative period
Authors: Gunes Huseyin , Bulbuloglu Semra , Kapikiran Gurkan , Saritas Serdar
Published: August 2022

In our study, we aimed to examine the effect of nursing care satisfaction on the pain and anxiety levels of patients who underwent orthopedic surgery. This descriptive study was conducted with the participation of patients who underwent surgery in the orthopedic clinic of a training and research hospital, and they were in the early postoperative period. Patient information form, Newcastle Satisfaction with Nursing Scale and State-Trait Anxiety Inventory were used in data collection. In this study, we found that 41.2% of the orthopedic patients were between the ages of 36 and 50, and 60.4% of them were women. Both nursing care satisfaction and anxiety levels were found to be higher in women than men (p<0.05). The highest satisfaction rate was found among patients aged 18-35 years old, and the highest anxiety level was found in patients over the age of 66. In our study, we found that higher anxiety levels increased pain intensity, and a high level of nursing care satisfaction could be seen in various pain and anxiety levels. Our study showed that nursing care satisfaction was affected by pain and anxiety in patients who underwent orthopedic surgery. In addition, it showed that pain and anxiety trigger each other. Clinicians should be aware of the negative effects of pain and anxiety on postoperative recovery. Strategies to increase nursing care satisfaction should be developed.
New onset liver test elevations with biological treatments in patients with rheumatological diseases
Authors: Araz Filiz , Tufan Muge
Published: August 2022

To identify the incidence and characteristics of liver enzyme elevations following initiation of biological treatments in patients with rheumatological diseases. Patients with rheumatological diseases taking biological treatments were analyzed retrospectively for new onset liver test abnormalities. Disease type, duration of treatment, concomitant medications, hepatitis b status and laboratory tests were recorded. Elevation of transaminases was defined as grade 1 if ALT elevation was 2–3 times the ULN, grade 2 if ALT ≥3xULN and grade 3 if ALT was ≥5xULN. RUCAM score was used to assess likelihood of causal association between liver toxicity and biological treatments. A total 418 patients were included. 46 (11%) patients had grade 2 ALT elevation. Mean treatment duration to ALT elevation from baseline was 200.5±255.4 and 67.3±54.0 days for patients with grade 2 and grade 3 ALT elevation, respectively (p:0.001). DMARDs use and the type of the biological agent used were not different for patient with grade 2 ALT elevation or not. 29 (6.9%) patients had RUCAM score of 3-5, thus possibly having DILI. No patient had RUCAM score of six or higher. Mild and transient enzyme elevations are relatively frequent with biological treatments. But, likelihood of causal association between liver toxicity and these therapies is usually low. Concurrent medications should be reviewed cautiously in each issue.
Chest computed tomography and COVID-19 RT-PCR: The tale of two diagnostic tests in a resource-limited setting
Authors: Ozturk Reyhan , Tazegul Gokhan
Published: August 2022

Herein, we aimed to report the association between coronavirus disease 2019 (COVID-19) real-time polymerase chain reaction (RT-PCR) and computerized chest tomography (CT), along with hospitalization and mortality in rural secondary care, resource-limited hospital setting, without the capabilities to conduct RT-PCR or report chest CT results in-house. We included patients admitted to the COVID-19 outpatient clinic between August 2020 and January 2021. COVID-19 RT-PCR was the standard for diagnosis. Chest CT scans were categorized into negative, suspicious, or positive rather than using the COVID-19 Reporting and Data System (CO-RADS) system; and pneumonia was classified into mild, moderate, and severe, rather than using the global CT involvement score (CTIS), as provided by outsourcing. Of 954 outpatients admitted, 382 (40%) were RT-PCR positive, and 472 (49.5%) had pneumonia on chest CT. The sensitivity of the chest CT scans for RT-PCR positivity was 62.04%, and specificity was 58.92%. Cohen’s kappa between the RT-PCR and chest CT results showed fair agreement (K=0.205, p=0.0001). Hospitalization and death rates were higher in the RT-PCR positive patient population (p=0.001 and 0.0001). In cases with negative CT scans for pneumonia, the death rates were higher in the RT-PCR positive population (p=0.025, chi-square test). RT-PCR and chest CT had a fair agreement, and the sensitivity and specificity of chest CT scans for RT-PCR positivity were low. Death rates were higher in RT-PCR positive, initial chest CTs negative patients, which underlines the importance of obtaining RT-PCR results in a resource-limited setting to identify patients with a higher risk for mortality.
Evaluation of snake bites at an emergency department
Authors: Gokcek Kemal , Alatas Omer
Published: August 2022

This study aimed to explore the epidemiology, clinical stage, treatment modality, complications and prognosis of cases presenting to the emergency department with a complaint of snakebite. Snakebite patients admitted to the emergency department between January 2012 and January 2021 were analyzed retrospectively. We retrieved epidemiological-demographic data of patients, procedures carried out in the emergency room, biochemical tests, final outcomes of inpatients, treatments administered during hospitalization, and complications. A total of 123 snakebite cases were detected in the emergency department medical records from this period. 16 cases were excluded from the study, and the remaining 107 cases were examined retrospectively. 15.9% (n=17) of snakebite cases were categorized as stage 0. Local symptoms were observed in all stages, except for five patients; systemic complications were observed only in advanced stages. The most common local complication was pain (n=99, 91.6%), while the systemic complication rate was 8.4% (n=9)Antivenom therapy was not administered to 14 (13.1%) patients, but it was applied to a total of 93 (86.9%) patients, with 74 (69.9%) receiving it in our center and 19 (17.8%) in external health centers. Antibiotherapy was administered to 93 (96.6%) of the patients, immobilization to 42 (39.3%), erythrocyte suspension to 1 (0.9%), fresh frozen plasma to 2 (1.8%), and 1 (0.9%) fasciotomy. No adverse outcomes were observed at 6-month or 1-year follow-up. Complications should be evaluated based on the type of toxin and clinical stage, and then appropriate treatment should be commenced without any delay. This approach should reduce or prevent the development of complications.
Risk factors and prognosis in patients with suprachoroidal hemorrhage
Authors: Dursun Ozer , Ozer Omer , Vatansever Mustafa , Dinc Erdem
Published: August 2022

The aim of the present study is to evaluate the risk factors and prognosis after treatment in patients followed up for suprachoroidal hemorrhage (SCH). Six eyes of 6 patients who were followed up and treated for SCH between May 2016 and December 2021 were included in this study. All patients' risk factors, treatment, visual acuity and the anatomical result were evaluated separately. While 4 (66.7%) of the patients were male and 2 (33.3%) were female, the mean age of the patients was 72.5±12.5 years. There was a history of hypertension in 2 patients and a history of glaucoma in 3 patients. Surgery was performed under general anesthesia in 5 patients and under local anesthesia in 1 patient. While intraoperative SCH development was observed in four patients, SCH developed in 2 patients during the postoperative period. While hemorrhage drainage and pars plana vitrectomy were combined in one patient, 5 patients received only medical treatment. In the follow-up period, two patients had no perception of light, and one of these patients underwent evisceration. Perception of light was positive in one patient and anatomical integrity was preserved. The visual and anatomical results to be obtained from patients with SCH vary according to the severity of the situation, and very encouraging results cannot be obtained. The main strategy here is to prevent the development of SCH, and for this purpose, optimal precautions should be taken before, during and after surgery.
Inflammatory markers in the prognosis of gastric cancer
Authors: Cakcak Ibrahim , n Yusuf , t Beliz , Kayabas Merve , Cansiz Sila
Published: August 2022

We aimed to investigate whether these parameters can determine the prognosis of gastric cancer. In our study, patients who applied to Trakya University School of Medicine, Department of General Surgery for surgical treatment with a diagnosis of gastric cancer between January 2015 and March 2021 were evaluated, retrospectively. In this study, we have 219 consecutive gastric cancer patients who applied for surgical treatment between January 2015 and March 2021. There are 156 (71.2%) male patients and 63 (28.7%) female patients. The mean age is 65.6±11.2. 158 (72%) of our patients were over the age of 60. When each TNM stage was compared with each other, a statistically significant difference was found in the NLR, PLR, PNI, SIRI, and SII parameters. There was a statistically significant difference between the GPS when we compare the early stage and the advanced stage cancer. In our study, we showed that high SIRI, SII, NLR, PLR, and GPS as inflammatory and nutritional markers and low PNI value may be negative predictive factors for prognosis in gastric cancer patients.