bluuebunny/crossref_metadata_2025 huggingface dataset:
EXTRACTION AND EVALUATION OF OIL FROM GREEN ALGAE CLADOPHORA GLOMERATA BY HEXANE/ETHER MIXTURE
Authors: Yusuff Adeyinka Sikiru , Ewere Donatus
Published: May 2020

The overall aim of this study was to grow green algae Cladophora glomerata, extract oil from it, and characterize the extracted oil to gain insight into its physicochemical properties. The effects of parameters affecting the solvent extraction process, temperature, time and biomass particle size were investigated at a fixed solvent ratio of 4:1 hexane to ether. An optimization of oil separation from algae biomass via the solvent extraction method was studied. The obtained results showed that at the extraction temperature of 60 oC, extraction time of 2.5 h, and the particle size of ≤0.6 mm, the maximum oil yield was 18.3% from the process. The functional group analysis revealed the presence of alkane, esters, carboxylic acid, and unsaturated groups on the extracted oil, while the result from the fatty acid profile analysis confirmed the dominance of oleic acid. The physicochemical properties of the extracted algal oil conformed to the ASTM standard.
Cuban Literature in the Age of Black Insurrection
Authors: Pettway Matthew
Published: May 2020

Juan Francisco Manzano and Gabriel de la Concepción Valdés (also known as Plácido) were perhaps the most important and innovative Cuban writers of African descent during the Spanish colonial era.Both nineteenth-century authors used Catholicism as a symbolic language for African-inspired spirituality.Likewise, Plácido and Manzano subverted the popular imagery of Neoclassicism and Romanticism in order to envision black freedom in the tradition of the Haitian Revolution.African religious knowledge subverted official Catholic dogma about redemptive suffering that might free the soul but leave the body enchained.Rather, Plácido and Manzano envisioned emancipation through the lens of African spirituality, which constituted a transformative moment in the history of Cuban letters.
Matthew Pettway examines how the portrayal of African ideas of spirit and cosmos in otherwise conventional texts recur throughout early Cuban literature and became the basis for Manzano and Plácido’s antislavery philosophy.Cuban debates about freedom and selfhood were never the exclusive domain of the white Creole elite.Pettway’s emphasis on African-inspired spirituality as a source of knowledge and a means to sacred authority for black Cuban writers deepens our understanding of Manzano and Plácido not as mere imitators but as aesthetic and political pioneers.
Visible Cities, Global Comics
Authors: Fraser Benjamin
Published: May 2020

The story of comics is also the story of the modern city. Visible Cities, Global Comics thus makes urban contribution to an interdisciplinary phase in comics studies. Striking a balance between descriptive, historical, analytical and theoretical modes, Fraser’s research monograph explores representations of the city in a selection of comics from across the globe. First, this book brings insights from urban theory to bear on specific comics texts; and second, it uses comics texts to elucidate themes of urbanism, architecture, planning and the cultures of cities in works from the 18th through the 21st centuries. Throughout, close readings of comics by artists from a range of locations—Argentina, Belgium, Brazil, Canada, China, England, France, Holland, Japan, Norway, Spain, Switzerland, the United States, and Uruguay—contribute to an exploration of larger urban themes. Chapters include “The Modern City Streets” (ch. 1), “The Passions of Everyday Urban Life” (ch. 2), “Urban Planning, Built Environment and the Structure of Cities” (ch. 3), “Architecture, Materiality and the Tactile City” (ch. 4), and “Danger, Disease and Death in the Graphic Urban Imagination” (ch. 5). Fraser’s writing presumes no previous knowledge of either urban theory or the ninth art. Readers are introduced to names, places, historical events, urban thinkers, and formal elements of the comics medium with which they may not be familiar. In the process, each chapter introduces readers to specific comics artists and texts and investigates a range of matters pertaining to the medium’s spatial form, stylistic variation, and cultural prominence.
Transcribing Petrarch’s Genres in the Late Fourteenth Century: An Ongoing Conversation with the Observations from MSS Cologny Bodmer 131 and Gambalunga SC-Ms. 93
Authors: Benghi Giulia
Published: May 2020

In spite of its apparent ‘betrayal’ of Petrarch’s visual poetics due to its one-column layout, the copy of the Rerum vulgarium fragmenta contained in MS Cologny Bodmer 131 documents a way of employing common graphic devices that still shows awareness of the graphological distinctions among the five genres of the Fragmenta, and yet unavoidably slips in occasional errors deriving from the loss of Petrarch’s original mise en page. Gambalunga Sc-Ms. 93, in its first unit, reproduces the same choices of organization of the genres, and often even the same errors, demonstrating its derivation from the same antegraph as the Bodmer manuscript. The two copies, both from the end of the fourteenth century, provide evidence that such transcriptional choices were already consolidated shortly after the death of the poet, suggesting that scribes of the earliest copies of the Rvf did not follow the formats of their holograph.
Application caching strategy based on in-memory using Redis server to accelerate relational data access
Authors: Zulfa Mulki Indana , Fadli Ari , Wardhana Arief Wisnu
Published: May 2020

Utilization of an in-memory database as a cache can overcome relational database latency problems in a web application, especially when using a lot of join queries. This study aims to model the academic relational data into Redis compatible data and analyze the performance of join queries usage to accelerate access to relational data managed by RDBMS. This study used academic data to calculate student GPA that is modeled in the RDBMS and Redis in-memory database (IMDB). The use of Redis as an in-memory database can significantly increase Mysql database system performance up to 3.3 times faster to display student data using join query and to shorten the time needed to display GPA data to 52 microseconds from 61 milliseconds.
Iluzivní postupy ve vzpomínkových textech Ignáta Herrmanna
Authors: Změlík Richard
Published: May 2020

Studie je zaměřena na vzpomínkové knihy Ignáta Herrmanna, zejména na problematiku hranice mezi non-fikčním a fikčním vyprávěním. Herrmann svoje knihy vzpomínek koncipoval jako faktuální vyprávění, nicméně v některých jeho částech lze pozorovat zvláštní narativní techniky, jež fikcionalizují vyprávění. Naším cílem je tyto části detekovat a analyzovat na pozadí nejen ostatního Herrmannova faktuálního vyprávění, ale také ve srovnání s fikčním u Jana Nerudy.
Modular Organization ofCis-regulatory Control Information of Neurotransmitter Pathway Genes inCaenorhabditis elegans
Authors: Serrano-Saiz Esther , Gulez Burcu , Pereira Laura , Gendrel Marie , Kerk Sze Yen , Vidal Berta , Feng Weidong , Wang Chen , Kratsios Paschalis , Rand James B , Hobert Oliver
Published: May 2020

Here, Serrano-Saiz et al. describe the cis-regulatory logic of how neurotransmitter identity is imposed onto individual, distinct neuron types...

We explore here the cis-regulatory logic that dictates gene expression in specific cell types in the nervous system. We focus on a set of eight genes involved in the synthesis, transport, and breakdown of three neurotransmitter systems: acetylcholine (unc-17/VAChT, cha-1/ChAT, cho-1/ChT, and ace-2/AChE), glutamate (eat-4/VGluT), and γ-aminobutyric acid (unc-25/GAD, unc-46/LAMP, and unc-47/VGAT). These genes are specifically expressed in defined subsets of cells in the nervous system. Through transgenic reporter gene assays, we find that the cellular specificity of expression of all of these genes is controlled in a modular manner through distinct cis-regulatory elements, corroborating the previously inferred piecemeal nature of specification of neurotransmitter identity. This modularity provides the mechanistic basis for the phenomenon of “phenotypic convergence,” in which distinct regulatory pathways can generate similar phenotypic outcomes (i.e., the acquisition of a specific neurotransmitter identity) in different neuron classes. We also identify cases of enhancer pleiotropy, in which the same cis-regulatory element is utilized to control gene expression in distinct neuron types. We engineered a cis-regulatory allele of the vesicular acetylcholine transporter, unc-17/VAChT, to assess the functional contribution of a “shadowed” enhancer. We observed a selective loss of unc-17/VAChT expression in one cholinergic pharyngeal pacemaker motor neuron class and a behavioral phenotype that matches microsurgical removal of this neuron. Our analysis illustrates the value of understanding cis-regulatory information to manipulate gene expression and control animal behavior.
Molecular epidemiology of cryptosporidiosis in pre-weaned cattle calves in Egypt
Authors: Abu El Ezz N. M. T. , Khalil F. A. M. , Abd El-Razik K. A.
Published: May 2020

The aim of this study was to throw more light on the genetic diversity of Cryptosporidium parvum isolates originating from pre-weaned cattle calves in Egypt using multilocus gene analysis. Cryptosporidium parvum (C. parvum) is a global zoonotic protozoan causing severe acute diarrhoea in humans and different animals. In this study, 172 diarrhoeic faecal samples collected from pre-weaned cattle calves at Giza and Sharkia governorates of Egypt were screened by modified Ziehl-Neelsen acid-fast microscopy for detection of Cryptosporidium oocysts. From them, 79 (45.9%) samples were positive for this test. Molecular characterisation using nested PCR showed a high sensitivity and accuracy in the verification of all C. parvum isolates. Sequence and phylogenetic analysis of five isolates confirmed three buffalo and two cattle variants of C. parvum. Moreover, there was a high homology between present isolates with others from different governorates of Egypt and also with that of Latin America that may be due to the introduction of live animals from these countries to Egypt. In conclusion, this study demonstrates some features of Cryptosporidium transmission in cattle in Egypt and addresses the probable role of cattle calves in zoonotic cryptosporidiosis. More consideration should be focused on the role of the imported livestock in the transmission of the disease.
Comparative evaluation of electrocardiographic effects of different doses of medetomidine and xylazine in calf-camels (Camelus dromedarius)
Authors: Samimi A. , Sakhaee E. , Iranmanesh F.
Published: May 2020

This experimental, prospective, randomised, and blinded study aimed to perform comparative evaluation of electrocardiographic (ECG) effects of different doses xylazine and medetomidine in dromedary calves after intravenous (IV) administration. A total of twenty five clinically and paraclinically healthy male dromedary calves aged 15±2 weeks and weighing 95±5.5 kg were assigned randomly to five different groups (four experimental and one control). Groups XL and XH received a low (0.2 mg kg-1) and high (0.4 mg kg-1) dose of xylazine hydrochloride and groups ML and MH received a low (10 µg kg-1) and high (20 µg kg-1) dose of medetomidine hydrochloride once, IV. Finally, the control group (C) received normal saline in the same manner. ECG indices were evaluated on post treatment 0, 5, 10, 15, 30, 60, 90, 120 min, and 24 h. There was no significant difference in heart rate (HR) in all experimental groups at T90. HR was significantly lower after high doses than after low doses of medetomidine and xylazine at T120. HR was significantly lower in XH than in other groups of study at T24. At T90 QRS amplitude in XH was statistically lower than in control and XL groups. Analysis of P wave duration revealed that in MH and XH it was significantly longer than in ML, XL and control at T5. Duration of P wave in control group was significantly shorter than in all experimental groups from T10 to T90. RR interval duration was significantly shorter at T5 and T10 in control group compared to experimental groups. At T120, RR interval duration in MH and XH was considerably longer than that in ML, XL, and control. Compared with control group, cardiac arrhythmia scores were significantly lower than in all experimental groups from T5 to T60. At T90 and T120 in MH and XH, cardiac arrhythmia scores were significantly higher than those of XL, ML, and control. According to our findings, using low dose of medetomidine (10 µg kg-1) and xylazine (0.2 mg kg-1) was suggested in comparison with high dose of medetomidine (20 µg kg-1) and xylazine (0.4 mg kg-1) in dromedary calves with cardiac diseases in the field.
Behavior of scientific production on severe acute respiratory syndrome
Authors: Cheng Cezar , Machado Daniel Aragão , Silva Roberto Carlos Lyra da , Louro Thiago Quinellato , Garcia Andrea dos Santos , Silva Carlos
Published: May 2020

Objective: To analyze the dispersion of journals and scientific collaboration on Severe Acute Respiratory Syndrome, available on the Web of Science. Methods: Bibliometric study that analyzed the production of documents available on the Web of Science, from 1989 to 2020. Results: 1623 documents were retrieved, distributed in 538 journals. The average production per year was 55.9. The average production per author was 1.73. The Nursing category contributed 17 (1.04%) documents, with Virology being the largest contribution 324 (19.96%). China led the ranking with 640 publications (39.43%). Conclusion: The data presented demonstrate the high level of interest of the scientific community in the subject. It was possible to identify 82 authors composing an Elite group of Authors, whose productivity was 66.1%. The United States, China and Saudi Arabia are the countries that most formed Collaboration Networks.
Application of Chitosan-Encapsulated Orange Oil onto Footwear Insock Leathers
Authors: Yılmaz Buket , Karavana Hüseyin Ata
Published: May 2020

The purpose of this study was to devise an antibacterial treatment for footwear insock leathers. Orange oil-loaded chitosan microparticles were utilised for this purpose. Emulsion formulations with different ratios were prepared, and from these formulations microparticles were manufactured using a spray drying technique. Microparticles obtained in this way were applied to the insock leathers using a finishing process. Successful encapsulation was confirmed by ultraviolet-visible (UV-vis) spectrophotometry, Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM) techniques. The microparticles exhibited highly spheroid shape with a size range of 3–5 μm. Microparticle encapsulation efficiencies ranged from 79.41% ± 3.36% to 86.60% ± 1.13%. After performing microbiological tests and in vitro release studies on the insock leathers, it was determined that the prepared microparticles are able to perform core material delivery. Also, successful microparticle application resulted in these leathers acquiring antibacterial properties. The products and process are biodegradable, nontoxic and biocompatible.
Parental Anxiety Levels of Patients Admitted to Pediatric Emergency Clinic Due to Febrile Convulsion
Authors: TÜRE Esra , KILIÇ Ahmet , UZUN Necati , YAZAR Abdullah , AKIN Fatih
Published: May 2020

Aim: This study aims to determine the anxiety levels of the parents of patients admitted to the pediatric emergency clinic due to febrile convulsion, and to evaluate factors that may affect anxiety levels. In addition, it is aimed to investigate the effect of the febrile convulsion on parents' behavior and emotional status in order to improve our attitude towards parents in the future.
Materials-Methods: The study was done at Necmettin Erbakan University Meram Medical Faculty Faculty Hospital Pediatric Emergency Department between February 2017 and September 2018 with febril convulsion and fever were included in this study. The patients were evaluated in two groups as those with febril convulsion and those who complained of fever only. The State-Trait Anxiety Inventory was used to determine the level of anxiety of parents.
Results: Of the patients included in the study, 323 (48.6%) were admitted with febril convulsion and 341 (51.4%) with fever complaints. When compared to the mean of the state anxiety score and the trait anxiety score between the groups, it was found that the mean of the state anxiety score was statistically higher in the febrile convulsion group than the non-seizure fever group (p=0.001), while the trait anxiety score was also high in the febril convulsion group, but no statistical significance was found between the non-seizure fever group (p>0,05). When the anxiety level of parents was examined according to the number of seizures of the patients in the febril convulsion group, it was found that the parents of patients with their first seizures were statistically significantly higher than their parents with multiple seizures (p=0.007, p=0.001). No statistical significance was found between the education level of the parents and their anxiety scores (p> 0.05).
Conclusion: Parents of patients who have applied to health institutions with a fever complaint, providing fever and febrile convulsion training, explaining the first interventions to the patient who has a seizure, and raising awareness of the families reduce parents' worries and fears.
Conceptualization of the concept of "business" in the process of teaching a foreign language in a non-linguistic university
Authors: Morozova Anna L. , Kostyukova Tat’yana A.
Published: May 2020

The problem of conceptualization of the lexeme "business" in the process of teaching a foreign language is considered on the example of MGIMO Odintsovo branch (Moscow region). Authors present a study of the conceptualization of the content of education in the process of learning foreign language by students of nonlinguistic training directions in the conditions of implementation of the current Federal state educational standard of higher education 3++ (bachelor's and master's levels) implemented in the educational process of educational institutions of the Ministry of foreign Affairs of the Russian Federation. The methods of working with the concept are described and the algorithm of work is developed, which was successfully tested on the basis of the Institute. The materials of the proposed study, which were made by the national corpus of the English language, authentic textbooks and educational sites, are analyzed. These materials allow students to comprehensively and comprehensively study the concept of "business", and teachers to update the content of education. The communicative orientation of the process of learning a non native language contributes to a comprehensive analysis of this concept from the point of view of the native culture and the culture of the studied language. Proposed basic principles of designing of educational process of the subject: 1) study of the first semester of practice-oriented interpretation in order to fit the specifics of the concept; 2) dialogical process of practicebased communication in a second language in the study of the concept; 3) implementation of scientific-research work of students based on the application of the original literature. The developed algorithm involves the use of various forms of active work of students on the development of the concept: individual, pair and group. The algorithm includes three stages of work: construction of associograms, fixing the concept space and comparison. It is established that the proposed form of work with the concept is aimed not only at the development of educational motivation of students, but also to improve the level of foreign language proficiency of students and foreign language communicative competence.
The effect of hemostasis by electrocoagulation versus suture on endometrioma recurrence and pregnancy rates after laparoscopic cystectomy in endometriomas
Authors: YILDIZ Şükrü , KAYA Cihan , ALAY İsmail , EKİN Murat , YAŞAR Levent
Published: May 2020

Purpose: The aim of this study was to assess the effect of hemostasis by electrocoagulation versus suture on endometrioma recurrence and pregnancy rates after laparoscopic cystectomy in uni/bilateral endometriomas. Materials and Methods: Forty-six primary infertile patients wishing to conceive without any assisted reproductive treatments, between 18 and 42 years, with uni/bilateral endometriomas were retrospectively analyzed. Laparoscopic cystectomies were performed by the stripping method. Ovarian hemostasis was obtained either by suturing (n = 23) or by bipolar electrocoagulation (n = 22). Cyst recurrence was evaluated by postoperative ultrasound scan. Pregnancy was confirmed by serum Beta-human choronic gonadotropin (B-hCG) levels if the patient presented with menstrual delay. Results: The mean of age of the patients was 31.62±6.55 years old. There was no significant difference between study groups regarding age, body mass index (BMI), preoperative endometrioma size, or pre/post-operative hemoglobin/hematocrite (Hb/Htc) levels. The recurrence rate was higher in the electrocoagulation group than the suturing group; however, the difference was not statistically significant. The spontaneous pregnancy rates were also similar between study groups. There was no significant difference between study groups considering unilaterality or bilaterality of endometriomas. Conclusion: Our preliminary data show that an operation on ovarian endometriomas-either electrocoagulation or suturing-may not affect endometrioma recurrence or spontaneous pregnancy rate.
Bağırsak stomalı hastaların stomaya uyumlarını etkileyen faktörler: ilişkisel çalışma
Authors: AKIL Yasemin , TAYLAN Seçil
Published: May 2020

Amaç: Bu çalışma, bağırsak stoması olan hastaların stomalarına uyumlarının tanımlayıcı, hastalık ve cerrahi özellikleriyle olan ilişkisini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Çukurova Üniversitesi Balcalı Hastanesi Stomaterapi ünitesine başvuran bağırsak stoması olan 128 hasta ile yürütülen çalışma tanımlayıcı-ilişkisel tiptedir. Araştırma verileri Bağırsak Stoması Olan Bireylere Yönelik Soru Formu, Ostomili Bireylere Yönelik Uyum Ölçeği ve Başa Çıkma Yolları Envanteri ile toplanmıştır. Bulgular: Stomalı hastaların Ostomili Bireylere Yönelik Uyum Ölçeği (OBYUÖ) toplam, kabul etme, kaygı/endişe, sosyal uyum, öfke alt boyutlarından sırasıyla 58.61±14.12, 23.98 ±8.43, 15.84±3.44, 12.53±4.73, 6.25±2,077 puan almışlardır. Stepwise Multıble Doğrusal Regresyonda ileostomisi olma, kadın olma, ileri yaşta olma, bekar olma, stoma sonrası çalışma yaşamına dönme, sorunları ile baş etmede duygusal baş etme yollarını kullanma ve kendi stoma bakımını yapamamama durumu ile yetersiz-kötü stoma uyum sürecinin ilişkili olduğu belirlendi. Sonuç: Stomalı hastaların stomaya uyum puanlarının düşük ve stomaya uyum sağlama destekleyici yöntemlere gereksinimleri olduğu sonucuna ulaşılmıştır.
Anxiety and prenatal attachment levels in pregnancy and influencing factors
Authors: ÖZDEMİR Kevser , ÇEVİRME Ayşe , BAŞKAYA Yasemin
Published: May 2020

Purpose: The aim of this study was to determine the anxiety and prenatal attachment levels of pregnant women, examine certain related factors and evaluate the relationship between anxiety and prenatal attachment. Materials and Methods: The study is a cross-sectional study conducted on pregnant women applying to the pregnancy polyclinic of Sakarya Education and Research Hospital. The study group consisted of 502 pregnant women. Beck Anxiety Scale and Prenatal Attachment Inventory were used to determine the anxiety level of the prenatal attachment level, respectively. Results: Mean age of women participating in the study was 28.07±4.71 years (min:18, max:40). The mean scores of the pregnant women in the Beck Anxiety Scale and Prenatal Attachment Inventory were determined as 15.10±9.37 and 44.31±9.45, respectively. A negative medium level relationship is found between the points obtained in the Beck Anxiety Scale and the Prenatal Attachment Inventory. Conclusion: Anxiety disorders experienced during pregnancy have a negative impact on the maternal and fetal health and weaken the prenatal attachment.
Psöriatik artrit hastalarında otoimmun tiroid hastaliği sıklığı ve anti TNF-a tedavisinin etkisi
Authors: KARAOĞULLARINDAN Ümit , TARHAN Emine , ÖRÜK Güzide Gonca
Published: May 2020

Amaç: Bu çalışmada psöriatik artrit (PsA) hastalarında tiroid hastalığı sıklığı ve anti-TNF tedavinin otoimmun tiroid hastalığına olan etkisi araştırılmıştır..Gereç ve Yöntem: Romatoloji polikliniğinde PsA tanısıyla takip edilen 95 hastanın tiroid stimülan hormonu (TSH), triiyodotironin (sT3), tiroksin (sT4), antitiroglobulin (Tg) ve anti-tiroid peroksidaz (TPO) retrospektif olarak incelendi. Çalışmaya, verileri eksiksiz olan ve tiroid hastalığına yol olan sekonder nedeni olmayan 66 adet PsA (F / M: 43/23) ve 35 sağlıklı kontrol (F / M: 25/10) alındı. Tüm olgulara endokrinoloji uzmanı tarafından tiroid ultrasonografisi yapıldı.Bulgular: PsA hastalarından 38 tanesi hastalık modifiye edici antiromatizmal ajan (DMARD) tedavisi (Grup 1; ortalama yaş: 43.94 ± 9.81) ve 28 hasta anti-TNF-α tedavisi (Grup 2; ortalama yaş: 42.25 ± 11.48) alıyordu. Grup 3 sağlıklı kontrollerden oluşuyordu (yaş ortalaması: 40,52 ± 8,34). Tüm grupların ortalama anti-TPO değerleri ve anti-Tg değerleri arasında anlamlı farklılıklar gözlendi.Sonuç: PsA hastalarında otoimmün tiroid bozuklukları kontrol grubundan daha sık gözlendi. DMARD alan PsA hastalarında anti-TNF-α tedavisi alan hastalardan daha sık otoimmün tiroid bozuklukları görüldü. Bu durum tiroid bozukluklarının patogenezinde TNF-α nın rolü olabileceğini gösterdi.
Mukopolisakkaridozlu hastalarda vitamin B12 düzeyleri
Authors: KOR Deniz , BULUT Fatma Derya , ŞEKER Berna , KILAVUZ Sebile , ÖNENLİ MUNGAN H. Neslihan
Published: May 2020

Amaç: Bu çalışmada farklı tiplerinde değişen oranlarda multisistemik tutuluma, nörolojik bulguların da eşlik ettiği mukopolisakkaridozlu hastalarda, serum vitamin B12 düzeylerinin de klinik seyir üzerine etkisi araştırılmıştır.Gereç ve Yöntem: Bu çalışmaya enzim düzeyi ve mutasyon analizi ile mukopolisakkaridoz tanısı konulan 114 hasta çalışmaya dahil edildi. Bu hastalardan periyodik takipleri sırasında sistemik ve nörolojik değerlendirmeye ek olarak serum vitamin B12 düzeyleri ölçüldü. Vitamin B12 düzeyi <300 pg/ml eksiklik olarak kabul edildi.Bulgular: Ortalama serum vitaminB12 seviyeleri 399,4 ± 258,5 pg/mL idi. Hastaların 53’ünde (%46,5) serum B12 seviyesi 300 pg/ml'nin altındaydı. Mukopolisakkaridozlu çocuklarda serum B12 vitamini düzeyi, literatürdeki sağlıklı çocuklardan önemli ölçüde düşüktü. Erkeklerde vitamini B12 eksikliği kızlara göre istatistiksel olarak anlamlı derecede fazlaydı. Tipler arası değerlendirmede MPS tip II tanılı hastalarda vitamin B12 düzeyindeki düşüklüğün anlamlı olarak diğer alt gruplardan daha yüksek olduğu görüldü.Sonuç: Mukopolisakkaridozlu hastalarda etiyopatogenezi net olmamakla birlikte, vitamin B12 seviyesi sağlıklı ve kronik hastalığı olan diğer bireylerden daha düşük bulunmuştur. Vitamin B12 eksikliği hastalığın doğal seyrinde ki büyüme geriliği ve nöromotor fonksiyon etkilenmesini daha da arttıracağı için, çalışmamız sonucunda mukopolisakkaridozlu hastalarda vitamin B12 düzeyinin de rutin monitorizasyonunun gerekliliği ortaya konulmuştur.
Akut inme hastalarında Sofia katater ile direkt aspirasyon yönteminin sonuçları
Authors: ÖNAL Yılmaz , VELİOĞLU Murat , DEMİR Uğur , ERCAN Volga , YAKUPOĞLU Ezgi , KARAKAŞ Hakkı M.
Published: May 2020

Amaç: Bu çalışmada akut iskemik inme hastalarında 6F Sofia katater ile direk aspirasyon yönteminin (ADAPT) etkinliği ve güvenirliğinin gösterilmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmamıza Mart 2017-Temmuz 2019 tarihleri arasında, akut inme nedeniyle başvuran ve ön sistem büyük damar okluzyonu saptanarak Sofia katater ile ADAPT uygulanan 117 hasta dahil edildi. Tandem okluzyonlar ve arka sistem inmeler çalışmaya dahil edilmedi. İşlem sonrası başarılı açıklık oranları, post-operatif kanama komplikasyonları ve hastaların 90. gün modified Rankin Scale (mRS) skorları değerlendirildi. Bulgular: Hastaların 86’sında (%73.5) okluzyon orta serebral arterde (MCA), 31’inde (%16.5) internal karotis arter (ICA) tepe kısımdaydı. Açıklık oranları Thrombolysis in Cerebral Infarction (Tici) skorlamasına göre değerlendirildi. Başarılı rekanalizasyon (Tici ≥ 2b) %83.7, 90. gün iyi klinik sonuç (mRS 0-2) %43.5 olarak bulundu. Semptomatik kanama ise hastaların %7.69’unda görüldü. ADAPT ile başarılı açıklık sağlanamayan ve ek olarak stentretriever kullanılan 32 hastada başarılı açıklık %59.3 idi. %15.3 hastada mortalite izlendi.Sonuç: Sofia, hastaların birçoğunda okluzyon seviyesine kadar ilerleyebilmesi, kost-efektif olması ve ADAPT ile yüksek başarılı açıklık oranları sağlaması ile endovasküler inme tedavisinde etkili ve güvenli bir şekilde kullanılabilir
Drug utilization of antibiotics in post-operative cesarean section inpatients in tertiary care hospital: a prospective observational study
Authors: B. Srinivasa , Kotinatot Basavaraj C.
Published: May 2020

Background: The aim of this study is to evaluate the pattern and rational use of antibiotics in post-operative caesarean section (CS) inpatients in tertiary care teaching hospital, BIMS Belagavi.Methods: This cross sectional prospective observational study was conducted from December 2019 to February 2020, prior permission from institutional ethics committee was taken. Detailed data of post-operative caesarean section (CS) inpatients including age, diagnosis, line of management, complications and any adverse effects if occurred during the study was collected and entered in a specially designed proforma and MS word excel and analyzed by descriptive statistics like percentage.Results: Total 100 post-operative caesarean section inpatients were involved in the study. Most common indication for C-section was cephalopelvic disproportion. Average no of antibiotics per prescription was 3.32. Most commonly prescribed antibiotic was cefotaxime (27.71%) followed by gentamycin (25.90%) and metronidazole (24.59%). Majority (90%) of patients who admitted for ≤3 days (66%) had received combination antibiotic i.e., cefotaxime, metronidazole and gentamycin. IV fluids (21.21%) and analgesics (13.13%) were most frequently prescribed concomitant drugs. Majority (97.8%) of patients received parenteral preparation. 306 antibiotics (92.17%) used were from national model list of essential medicines (NLEM) and 332 antibiotics (100%). used were by generic name. Polypharmacy was 7.92.Conclusions: Cefotaxime was the most frequently prescribed antibiotic. Most of the antibiotics prescribed was rationally from NLEM and were by generic name.
Medication errors reported in a tertiary care private hospital in Eastern India: a three years experience
Authors: Bhowmick Subhrojyoti , Jana Shubham , Bandyopadhyay Adrija , Kundu Debarati , Banerjee Meena , Das Anupam , KarPurkayastha Sujit
Published: May 2020

Background: Medication errors (MEs) can cause significant harm to patients. The MEs identified through reporting processes currently report only a fraction of the actual number of MEs. Data about MEs is limited in India, especially from eastern and north-eastern parts of India. The objective of this study was to analyse the various types of Medication errors reported in a tertiary care private hospital in Eastern India. The aim was to determine the various factors associated with these errors and steps to be taken to reduce the MEs in this healthcare setup.Methods: We carried out a prospective passive surveillance study over the course of 3 years (2016-2018) on 50,822 admitted patients after obtaining approval from the Institutional Ethics Committee. A detailed root-cause analysis was performed for every reported error by a team of healthcare quality professionals and clinical pharmacists along with a clinical pharmacologist followed by appropriate preventive and corrective actions.Results: In our study, a total number of 88 medication errors were reported from a sample size of 50,822 (0.0017%). 61 of the reported MEs were administration errors (69.3%). Higher preponderance of medication errors was seen in male patients (53.1%) in comparison to female patients (46.9%).Conclusions: In this study gross under-reporting of MEs were observed which is in line with previously published studies in India. The reasons reported for gross under-reporting can function as an effective tool to ensure improved reporting of MEs and implementation of mitigation strategies.
Evaluation of TOPS score as predictor for outcome in sick newborns
Authors: Sheth Nirali Maheshbhai , Pandya Nimisha
Published: May 2020

Background: Multiple parameters have been developed to prognosticate the outcomes of critically ill newborns admitted in NICUs. The objective of this study is to predict the outcome of newborns admitted in NICU using a simple but efficient score, TOPS score, involving alteration of physiological parameters. Aim of this study was to evaluate role of TOPS score in predicting mortality in sick neonates.Methods: The variables assessed under TOPS score on arrival for all subjects were: Temperature, Oxygen Saturation, Perfusion and blood glucose reading <45 mg/dl. All affected neonates were given treatment as per NICU protocol and outcome was assessed in terms of mortality or discharge using TOPS score. It was prospective study conducted at NICU, Department of Pediatrics, GMERS medical college and general hospital, Gotri, Vadodara. Study population was all admitted neonates aged <28 days at NICU.Results: Mean age of presentation of all cases was 2.8±3.58 days. Hypothermia on admission was observed in 63.3% cases. 40.8% cases had hypoxia. 26.5% neonates recorded poor perfusion. Mortality observed in hypoxic group was 51.7% followed by hypothermic group (46.9%). Highest strength of association was found for poor perfusion, mortality (87.5%) and OR-33.406.  TOPS score was observed to be statistically significant (X2 value is 63.27, p < 0.05) as predictor of mortality. Thus, mortality rate increased with increasing no. of altered TOPS parameters. Regression analysis showed three factors (hypothermia, hypoxia, prolonged CRT) which are consistently associated with p value ≤ 0.05 for each variable and can be used to predict mortality.Conclusions: All parameters in TOPS score are physiologically important and each parameter carries an independent risk associated with mortality. It is important to note that multiple parameters affected increases the risk. TOPS score is a simple, basic and effective tool to guide about the condition of new born at admission and outcome. of neonatal mortality.
Clinical profile and outcome of patients admitted to pediatric intensive care unit in a tertiary care teaching hospital of Puducherry, India
Authors: K. Maheswari , Sharma Neha
Published: May 2020

Background: This study was undertaken to know about the clinical profile and outcome of patients admitted in paediatric ICU in a tertiary care teaching hospital.Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to paediatric ICU of Sri Venkateshwara Medical College Hospital and Research Centre Puducherry from Jan 2019 - Dec 2019 (12 months).Results: As about 424 patients were admitted paediatric ICU. 79 patients were excluded from the study. Remaining 345 PICU patients were analysed. According to the age distribution of patients, it showed that < 1year were (25.2%), 1-5 years were (44.3%), > 5years of age were (30.4%). There was a female preponderance (58.8%), males were (41.1%). Patients from rural area were 243 (70.4%) and 102 (29.5%) from urban area. Clinical profile showed that pneumonia was the most common diagnosis (8.4%) for admission in PICU. This was followed by bronchiolitis (6.9%), enteric fever in (6.6%), febrile seizures (6.3%), poisoning (6.0%), renal problems (5.7%), occult bacteremia (5.5%), unknown bite (5.2%), acute severe asthma (4.9%), sepsis (4.6%), severe gastritis (4.3%), clinical dengue (3.7%), seizure disorder (3.4%), croup (3.1%), traumatic head injury (2.8%), wheeze associated LRI (2.6%), acute otitis media (2.3%), migraine (2.0%), meningitis (1.7%), CHD with complications (1.7%), severe anaemia with CCF (1.4%), acute urticarial (1.4%), foreign body (1.1%), electric shock (1.1%), scorpion sting (0.8%), viral hepatitis (0.8%), clinical malaria (0.8%), nephrotic syndrome with complications (0.5%), scrub typhus (0.2%) and (0.2%) was angioedema. The outcome noted was, (87.8%) were discharged, (10.7%) patients went against medical advice, (1.4%) patients were referred at parent’s request.Conclusions: Respiratory illness, infectious diseases, neurological problems and poisoning are the most common cause for PICU admissions. But seronegative dengue cases, electric shock, reemergence of scrub typhus, are being increasingly diagnosed. So, emphasis is therefore placed on high index of suspicion for this type of conditions. We also recommend better manpower and infrastructure to improve the outcome of patients admitted to PICU.
Correlation of neonatal gestational age with foot length and right nipple to umbilicus distance
Authors: Keshwani Ajay K. , Suroshe Swati S.
Published: May 2020

Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.
West syndrome: clinic etiological profile, and response to treatment in Western India
Authors: Nawaz Shah , Gajre Mona P. , Adhikari Arpita , . Shagufta
Published: May 2020

Background: Information on the profile of infants with West syndrome in developing countries is limited. This study was done to determine clinico-etiological profile and clinical response of infantile spasms to various medications in children with west syndrome in a developing country.Methods: It was a retrospective cohort study from January 2017-january 2020 done in a tertiary care hospital in western India. Records of 39 children with west syndrome who visited this pediatric neurology division during study period were analysed. 6 were excluded in view of incomplete data. Detailed history, examination, investigations and medications given were noted. Follow up records were assessed to look for long term control of spasms, relapse rates after cessation, or progression to other seizure types.Results: Mean age at onset of infantile spasms was found to be 8.12 months (1 - 36 months).  Mean lag time to treatment was 5.35 months. Etiology was found in 69.7% children with perinatal causes being most common. With oral prednisolone, 54.5% had complete cessation of spasms, and with ACTH also 54.5% had complete spasm cessation. Favourable clinical response at 6 months follow up was found in 8 (47.05%) of the 17 children. Surprisingly, lag time (p=0.381) and symptomatic etiology (p=1.00) did not have any significant impact on outcome.Conclusions: This study highlights the developing country perspective of west syndrome. Increased lag time, different etiological profile and poor outcome are the challenges. High dose prednisolone is a good first line alternative treatment option in resource poor settings.
Is mean platelet volume the earliest diagnostic marker of neonatal sepsis: a prospective case control study
Authors: Pandian Ramkumar , Kugonally Gopal , R. Lakshmipathy S. , . Sunitha
Published: May 2020

Background: Neonatal sepsis is the third leading cause of neonatal mortality after prematurity and intrapartum related complications worldwide. The literature regarding the use of Mean platelet volume as a diagnostic tool in neonatal sepsis is scanty.Methods: Prospective case control study in a district hospital. Neonates > 30 weeks gestation admitted to NICU during the study period were included. Neonates who did not have any risk factors for sepsis and did not have a positive blood culture or elevated CRP were categorized as group 1. Neonates who were admitted with risk factors of sepsis but did not have a positive CRP or blood culture positivity were categorized as group 2. Neonates who were admitted as probable sepsis and subsequently developed blood culture or CRP positivity were categorized as group 3.Septic workup was done for all the subjects at admission and at 72 hours after admission. Newborn with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 20.0.Results: Total 240 Neonates were included in the study. Elevation of MPV in neonates with sepsis was seen as early as the first sample whereas CRP elevation was seen only on Day 3. Cut off value for Mean Platelet Volume (MPV) was found to be 10.15fl with sensitivity of 84% and specificity of 74%.Conclusions: MPV can be used as a earliest diagnostic marker for prediction of neonatal sepsis and mortality. It can facilitate early initiation of treatment without any additional exposure.
Chronic intestinal pseudo-obstruction in newborn: a case report
Authors: Osman Mahmoud M. , Sherif Ahmed Hassan , Alissa Mohammed Saleh , Hamid Suzan Abdel , Alatar Adel Abdelsalam
Published: May 2020

Chronic intestinal pseudo-obstruction (CIPO) is a rare and serious disorder of the gastrointestinal tract motility with the primary defect of impaired peristalsis. Symptoms are consistent with a bowel obstruction, although mechanical obstruction cannot be identified. It is a rare differential diagnosis for neonatal intestinal obstruction. Herein we report a case of neonate with non-resolving intestinal pseudo-obstruction, presenting since birth as progressive abdominal distention. The diagnosis was made by exclusion of mechanical causes of intestinal obstruction via thorough imaging studies.
A case report of leukoencephalopathy with vanishing white matter disease
Authors: Navya Bommidi , Kondle Vamshi Krishna , Uppal Komal
Published: May 2020

Vanishing white matter disease (VWM) is one of the most prevalent inherited childhood leucoencephalopathies. Childhood ataxia and diffuse central nervous system hypomyelination are the common findings. The disease is characterized by chronic progressive and episodic deterioration with ataxia, spasticity and optic atrophy. VWM is caused by mutation in any of the five genes encoding the subunits of eukaryotic translation initiation factor eIF2B. The disease has an autosomal recessive mode of inheritance. The cause of the disease is unknown. Authors are reporting an 8 year old male child presented with complaint of difficulty while walking since one month and history viral fever was present one month back. MRI revealed bilateral symmetrical periventricular T2 hyperintensities with T1 hypointensities. Perivenular sparing was seen and molecular analysis shown eIF2B4 mutations confirmation of vanishing white matter disease. No specific treatment is available and advised to avoid stress and triggers.
Two cases with pycnodysostosis in a family: a case report
Authors: Reddy K. Venkataramana , Soren Chapay , Geethika M. , Malathi V.
Published: May 2020

Pycnodysostosis (Greek, pycnos - density, dys - defect, ostosis - bone) is a rare inherited disorder of the bone, first described by Maroteaux and Lamy. Pycnodysostosis is an autosomal recessive disorder, with incidence estimated to be 1.7 per 1 million births. Clinical presentation of this disorder include short stature, dolichocephalic skull, frontal bossing, obtuse mandibular angle, dysplastic clavicles, and short hands and feet, diffuse osteosclerosis, acro-osteolysis along with the finger and nail abnormalities. The main oral aspects are midfacial hypoplasia, a grooved palate, and dental abnormalities include double row of teeth, delayed eruption of permanent dentition, multiple caries. Pathological fractures of the bones occur due to sclerosis. Radiologically, skull bones appear thickened with open fontanels which look like ‘lakes of bones’, hypoplasia of facial bones, generalized osteosclerosis, open fontanels and cranial sutures, non pneumotization of paranasal sinuses, and fractures commonly in lower limbs.
Parasitic twin with major cardiac defect: a case report
Authors: Ghosh Arindam , Prasad Akshay , Kundu Tanusree , Lakra Priya Shalini , Saha Kaushik
Published: May 2020

Parasitic twins are an extremely rare form of asymmetrical conjoined monochorial monoamniotic twins where one of them has a mostly intact body that is able to survive and which is referred to as ‘autosite’, while the counterpart, referred to as ‘parasite’, is only rudimentarily developed being physically attached to and nourished by the other twin. Our case is a baby boy with Single Ventricle Heart defect with a thoraco-abdominal mass (epigastric heteropagus twin) attached to the anterior abdominal wall near the umbilicus with minimal visceral sharing. The twins had two external genitalia both in host and parasite micturating separately. After high risk surgery the parasite could be separated completely from the host and postoperative recovery was uneventful.
An analysis of percutaneous balloon mitral valvotomy: a tertiary care centre study
Authors: Thota Prem Kumar , Dake Rajesh
Published: May 2020

Background: The prevalence of rheumatic heart disease (RHD) has markedly decreased in several countries but is still present in underdeveloped and developing countries, 33 million people around the world affected by RHD. Percutaneous balloon mitral valvotomy (PBMV) or valvotomy via femoral cut down using a balloon dilating catheter used in a small number of patients` as an alternative to surgical mitral commissurotomy.Methods: A retrospective, observational study included 37 patients who were diagnosed to have severe mitral stenosis between October 2017 and October 2019 were included in the study. Primary endpoint was considered as in-hospital mortality and secondary endpoint was considered as 6 months clinical outcomes. All patients were evaluated clinically by the same investigator who performed PBMV.Results: The mean age of the study population was 36.6±11.37 years. There was a female predominance 27 (72.97%) patients. Out of total patients; an optimal result was achieved in 33 (89.19%) patients, 1patient developed pericardial effusion and for 3 (8.1%) patients wire cannot be crossed. Although the mitral valve area calculated by cardiac catheterization increased significantly from immediately before 1.003±0.12cm2 to immediately after PBMV 1.73±0.23cm2 there was a no significant decrease in the mitral valve area at 6 months follow-up 1.66±0.22cm2 by Echocardiography.Conclusions: PBMV is an effective treatment for acquired mitral stenosis, as demonstrated by the immediate hemodynamic results in 37 consecutive procedures. PBMV is effective therapy with good midterm results for selected patients with mitral stenosis.