bluuebunny/crossref_metadata_2025 huggingface dataset:
Liming and biofungicide for the control of clubroot in cauliflower1
Authors: Santos Carlos Antônio dos , Amaral Sobrinho Nelson Moura Brasil do , Costa Evandro Silva Pereira , Diniz Caio Soares , Carmo Margarida Goréte Ferreira do
Published: October 2017

ABSTRACT Clubroot, caused by Plasmodiophora brassicae, is a disease that limits the cauliflower cultivation and is difficult to control. This study aimed to evaluate the efficiency of liming combined with the use of Trichoderma harzianum-based biofungicide for the control of clubroot in cauliflower. In a field experiment, the use of the biofungicide in combination with the application of calcined limestone doses (0 Mg ha-1, 1.0 Mg ha-1, 2.0 Mg ha-1 and 4.0 Mg ha-1) was evaluated. Subsequently, in a greenhouse, the biofungicide combined with liming with quicklime (2.54 Mg ha-1) was tested, and cyazofamid and water were tested as controls. The disease severity and attributes related to root and plant development were analyzed. In the field experiment, the healthy root volume and fresh weight, total root dry weight and inflorescence fresh weight and diameter were all significantly increased, while the diseased root volume, in response to the limestone doses, was reduced. The biofungicide reduced the root growth and inflorescence fresh weight. In the greenhouse, liming increased the healthy root volume and fresh weight, as well as total root dry weight, and reduced the disease severity. No significant difference was observed between the biofungicide and the control (water), which were inferior to cyazofamid. The biofungicide was not efficient in controlling the disease and did not favour the growth of cauliflower plants, either alone or combined with liming. Liming reduced the disease severity and increased the cauliflower root growth and yield.
Mayoral quality and municipal performance in Brazilian local governments
Authors: Avellaneda Claudia N. , Gomes Ricardo Corrêa
Published: October 2017

Abstract We test the influence of managerial quality on organizational performance using a panel data set on 827 (out of 853) Brazilian municipalities of the state of Minas Gerais over a six-year period (2005-2010). The intra-country and intra-state comparison controls for potential institutional, historical, and cultural variables. Local managerial quality is assessed in terms of mayoral education and experience (public and reelection), and municipal performance is operationalized as property tax collected per capita and property tax collected as a percentage of total revenue. The study covers the four years of the 2005-2008 mayoral administration and the first two years of the 2009-2012 administration. After testing the effect of political, economic, and ideological factors and controlling for other municipal factors, we find, contrary to our expectations, that mayoral quality fails to explain variance in property tax collection. Rather, political factors (legislature support and electoral cycle) seem to be more strongly correlated with municipal property tax collection. Specifically, municipalities in which the mayor enjoys more partisan support on the city council tend to collect more property tax. Moreover, compared to the first three years of mayoral administration, in the last year of mayoral administration – that is, during the mayoral election year – municipalities tend to reduce their property tax collection.
Why microfinance institutions exist: lending groups as a mechanism to enhance informational symmetry and enforcement activities
Authors: Marconatto Diego Antônio Bittencourt , Cruz Luciano Barin , Moura Gilnei Luiz de , Teixeira Emidio Gressler
Published: October 2017

Abstract In this paper, we focus on the economic motivation for the existence of microfinance institutions (MFIs). In doing so, our study contributes to the debate regarding why MFIs exist and, especially, what mechanisms are used to address the risks associated with their operation. In examining the reasons why some individuals are regarded as “non-bankable”, we lay out the basic economic logic that motivates the exclusion of this population from formal credit markets. Next, we show how the lending group methodology overcomes the credit dilemma which sustains and increases the exclusion of the poorest from these formal credit sources. Through this, we point out the microfinance founding mechanisms: the increase of both informational symmetry and enforcement capacity of MFIs through the enhancement of their screening, monitoring and enforcement activities. We also highlight the importance of context and gender for the success of lending groups. Finally, we analyze these mechanisms in the Brazilian context.
O FORTALECIMENTO DA IDENTIDADE CAMPONESA: REPERCUSSÕES DO PROGRAMA NACIONAL DE EDUCAÇÃO NA REFORMA AGRÁRIA NOS ESTADOS DO CEARÁ, MINAS GERAIS E PARANÁ (1998-2011)
Authors: Esmeraldo Gema Galgani Silveira Leite , Molina Mônica Castagna , Antunes-Rocha Maria Isabel
Published: October 2017

RESUMO: O artigo discutiu os resultados da II Pesquisa sobre o Programa Nacional de Educação na Reforma Agrária (PRONERA), em sua fase qualitativa, focalizando as repercussões de seus cursos na trajetória de egressos residentes em nove assentamentos localizados nos Estados do Ceará, Minas Gerais e Paraná. Foram realizadas entrevistas narrativas junto a egressos dos três estados sendo problematizadas à luz do método analítico do materialismo dialético. Observaram-se repercussões nas dimensões pessoal (ampliação dos níveis de escolaridade e de atuação socioprofissional) e coletiva (escola mais próxima da realidade camponesa e do setor produtivo) e possibilidades de compreensão de identidade camponesa que sinaliza para resistências e lutas nos territórios de produção e reprodução de vida.
CICLOS DE FORMAÇÃO HUMANA COM COMPLEXOS DE ESTUDO NAS ESCOLAS ITINERANTES DO PARANÁ
Authors: Sapelli Marlene Lucia Siebert
Published: October 2017

RESUMO: O Movimento dos Trabalhadores Rurais Sem Terra (MST) é resultado de processos de luta pela Reforma Agrária que, desde o início, esteve atrelada a outras lutas, especialmente pela educação. O objetivo desse trabalho é analisar o processo de formulação da proposta dos Ciclos de Formação Humana e a posterior incorporação dos Complexos de Estudo nas escolas itinerantes do Paraná. Produzimos a pesquisa a partir do estudo de bibliografias específicas e de análise documental. Na primeira parte, explicitamos a concepção de alguns autores acerca da natureza e da especificidade da escola capitalista, e analisamos a formulação da proposta dos Ciclos de Formação Humana e a incorporação dos Complexos de Estudo. Na segunda parte, apresentamos elementos da avaliação dos quatro primeiros anos de implementação da proposta.
ESTRATEGIAS ALTERNATIVAS DE EDUCACIÓN EN LAS LUCHAS DE LOS PUEBLOS ORIGINARIOS EN MÉXICO
Authors: Baronnet Bruno
Published: October 2017

RESUMEN: Los procesos de construcción de autonomías en territorios rurales e indígenas reorientan las prácticas de aprendizaje en función de luchas campesinas, culturales y ambientales. Dentro y fuera de las escuelas está en juego el reconocimiento otorgado a diferentes valores y conocimientos locales y científicos ligados a luchas que generan estrategias educativas para la autonomía indígena y la sustentabilidad de la producción en el campo en México. El análisis socio-antropológico examina las experiencias educativas de pueblos mayas zapatistas en el Sureste, de campesinos indígenas en el Sur de Oaxaca y de comuneros de Cherán en Michoacán, como producto de estrategias alternativas ante el Estado y las amenazas al territorio.
Mathematical modeling for the management of the carrying capacity of aquaculture enterprises in lakes and reservoirs
Authors: Bueno Guilherme Wolff , Bureau Dominique , Skipper-Horton James Owen , Roubach Rodrigo , Mattos Flávia Tavares de , Bernal Francisco Ernesto Moreno
Published: October 2017

Abstract: Flooded areas of reservoirs and artificial lakes have been increasingly used for fish production; however, the waste generated by aquaculture has become a concern for the sustainable development of this activity. One of the main strategies adopted by management and regulatory agencies is the use of hydrodynamic models that calculate the carrying or nutrient load capacity of a particular water body and the effect of fish farming. These models are precise in the development of optimal strategies for feeding and waste calculation. This review paper addresses this topic and describes the methodology developed for the analysis and simulation of the carrying capacity for fish production, based on the integration of the Fish-PrFEQ nutritional bioenergetic model and the hydrodynamic model of Dillon & Rigler. This methodology allows evaluating the real contribution of aquaculture waste and assists in the planning and management of aquaculture in these aquatic environments, besides enabling and encouraging producers and the aquaculture industry to use fish food with better nutritional quality and lower environmental impact.
Adherence of private health system hospitals to dissemination of outcomes according to the Global Reporting Initiative (GRI) model
Authors: Machado Junior Celso , César Robson Danúbio da Silva , Souza Maria Tereza Saraiva de
Published: October 2017

ABSTRACT Objective To verify if there is an analogy between the indicators of the Global Reporting Initiative adopted by hospitals in the private healthcare system. Methods Documentary research supported by reports that are electronically available on the website of the companies surveyed. Results The organizations surveyed had a significant adherence of their economic, social and environmental indicators of the model proposed by the Global Reporting Initiative, showing an analogous field of common indicators between them. Conclusion There is similarity between the indicators adopted by companies, but one of the hospitals analyzed had a greater number of converging indicators to Global Reporting Initiative.
Rheology of self-consolidating concrete in hot weather conditions
Authors: Al-Martini Samer , Al-Khatib Mohammed I.
Published: October 2017

The rheological properties of fresh concretes incorporating various supplementary cementitious materials (SCMs) in binary and ternary blends were investigated as a function of mixing time, temperature and SCM dosage. Two types of SCMs were tested: silica fume and fly ash. Ordinary Portland cement concrete mixtures were designed with a constant water to cementitious materials ratio of 0·36 and incorporating a fixed dosage of polycarboxylate-based high-range water-reducing admixture. Self-consolidating concrete (SCC) mixtures were continuously mixed for up to 110 min using a drum mixer at different ambient temperatures (25, 30, 35 and 40°C). Rheological testing was performed using a BT2-type concrete rheometer. The relative yield stress was found to have an exponential correlation with the slump flow. The relationship between the relative yield stress and relative viscosity was investigated. The aim of this study was to gain understanding into the contribution of SCM type and dosage to mitigate the harsh effects of hot temperature and prolonged mixing on the rheology of green SCC mixtures. The findings of this study are of practical significance that can provide realistic recommendations on the use of SCMs in hot weather conditions.
BTEX contamination of Bengaluru aquifers, Karnataka, India
Authors: Rao Sudhakar M , Joshua Rita Evelyne , Arkenadan Lydia
Published: October 2017

Leakage from underground storage tanks (USTs) in petrol filling stations is a recognised pathway for contamination of aquifers by benzene, toluene, ethylbenzene and xylene (BTEX) compounds. Bengaluru City, India, partially depends on groundwater for potable water and has a specific climatic condition of wet and dry seasons. Hence, the influence of temporal rainfall variations on possible BTEX contamination of groundwater from leaky USTs was examined by testing tube-well samples located at petrol filling stations and their vicinities in Bengaluru City during pre- and post-monsoon periods. Groundwater samples were collected from tube wells located at petrol filling stations or their vicinities during post-monsoon (September 2015–January 2016) and subsequent pre-monsoon (March–April 2016) periods. Variations in BTEX concentrations during post- and pre-monsoon periods highlighted the influence of season on BTEX concentrations in the aquifer, as higher BTEX concentrations were generally observed in groundwater samples during post-monsoon than pre-monsoon. The results of the study show that BTEX contamination of Bengaluru aquifers from leaky USTs in petrol filling stations is not extensive as only 5% of groundwater samples showed benzene presence in excess of the permissible limit, while toluene, ethylbenzene and xylene compounds were below permissible limit in all the 124 groundwater samples.
Comparison of direct shear and simple shear responses of municipal solid waste in USA
Authors: Fei Xunchang , Zekkos Dimitrios
Published: October 2017

Although large-size simple shear (SS) testing of municipal solid waste (MSW) may arguably provide a more realistic estimate of the shear strength (τ ) of MSW than the most commonly used direct shear (DS) testing, a systematic comparison between the shear responses of MSW obtained from the two testing methods is lacking. In this study, a large-size shear device was used to test identical MSW specimens sampled in USA in DS and SS. Eight DS tests and 11 SS tests were conducted at vertical effective stresses of 50–500 kPa. The stress–displacement response of MSW in SS testing was hyperbolic and a maximum shear stress was reached, whereas a maximum shear stress was not reached in most DS tests. The τ, effective friction angle (ϕ ′) and cohesion (c ′) of MSW were obtained from DS and SS tests by using a displacement failure criterion of 40 mm. τ in SS testing was found to be equal to or lower than τ in DS testing with ratios of τ between 73 and 101%. SS testing resulted in higher ϕ ′ but lower c ′ than DS testing. The shear strength parameters were lower than those obtained in previous studies from DS tests at 55 mm displacement.
An experimental appraisal of composite joint components
Authors: Rodrigues Monique Cordeiro , de Andrade Sebastião Arthur Lopes , de Lima Luciano Rodrigues Ornelas , da Silva Vellasco Pedro Colmar Gonçalves , Ramires Fernando Busato
Published: October 2017

The component method incorporated in Eurocodes 3 and 4 is one of the most accepted models for composite semi-rigid beam-to-column joint design. This method explicitly considers the contribution of the components with the most relevant composite action, such as reinforcing bars, concrete and shear connectors. This was the main motivation to further improve the assumptions employed in the structural response of composite joints to surpass the current limits of its adoption in hogging moment regions. However, in hogging moment regions the concrete slab is not under compression forces, leading to extensive concrete cracking, which can influence the actual structural joint response. An alternative set-up, namely, pull-out tests, was developed to better represent composite joints where tension forces act in the concrete slab. The overall results served as the main basis for a better understanding of some of the components present in composite joints, enabling a better formulation for their design capacities. The present paper focuses on a series of pull-out tests that presented failure modes associated with a tensile reinforcing bar rupture or anchorage capacity. The test results enabled a better understanding of the reinforcing bar failure modes and their relevance over the global beam-to-column joints' structural response.
PENDAYAGUNAAN REAKTOR TRIGA 2000 BANDUNG UNTUK IRADIASI TELURIUM OKSIDA DALAM PEMBUATAN RADIOIODIDA-131 (131I) BEBAS PENGEMBAN BERDASARKAN KOLOM RESIN AMBERLIT
Authors: Alfathia Dara , Hastiawan Iwan , Setiawan Duyeh
Published: October 2017

Saat ini metode yang sering digunakan dalam pembuatan radioiodida-131 (131I) bebas pengemban (carrier-free) yaitu radioisotop tanpa tambahan pengemban (non-carrier-added radioisotopes) adalah menggunakan metode pemisahan distilasi basah atau distilasi kering. Kelemahan metode distilasi diantaranya membutuhkan peralatan yang rumit dan kemungkinan besar terjadi kontaminasi akibat penguapan serta pelepasan 131I. Untuk mengatasi kelemahan metode distilasi dan supaya pengerjaannya sederhana, dikembangkan pemisahan berbasis kolom berisi resin penukar ion (Amberlit). Metode teknik pengocokan terhadap perilaku pertukaran radioiodida-131 dan telurium-130 dalam resin penukar ion di media larutan asam dan basa serta parameter-parameter yang berpengaruh terhadap proses pemisahan seperti kapsitas tukar ion, koefisien distribusi (Kd), waktu kontak dan massa resin Amberlit akan dipelajari. Berdasarkan hasil penelitian didapatkan nilai kapasitas tukar ion 1,15 meq/gram berat basah resin,  Kd 130Te dan 131I pada pelarut NaOH 2 M dengan waktu kontak 20 menit adalah 47 mL/g dan 113 mL/g. Persen yield pemisahan 131I diperoleh sebesar 60,70 ± 0,09 % dengan menggunakan resin amberlit sebanyak 2 gram. Radioisotop dalam bentuk kimia Na131I  memiliki kemurnian radiokimia sebesar 95,27 ± 0,06 % dan kemurnian radionuklida sebesar 99,5 ± 0,02 %. Hasil uji kualitas Na131I berupa larutan jernih, pH 7, kadar Pb<40 ppm, kadar Te<10 µg/mL, kadar reduktor 0,2844 mg/0,1 mL Na131I.
Expression and purification of the recombinant protein rRmLTI-BmCG-LTB v1
Authors: Guimarães Csordas Bárbara , Casquero Cunha Rodrigo , Valério Garcia Marcos , Silva da Silva Sérgio , Leivas Leite Fábio , Andreotti. Renato
Published: October 2017

This work describes the construction of a multi-antigen chimera composed of two R. (B.) microplus antigens (RmLTI and BmCG) and one Escherichia coli antigen (B subunit, LTB). The immunogenic regions of each antigen were selected and combined to encode a single polypeptide. The gene was cloned and expressed in E. coli system.
Revisiting the Antecedents of Social Entrepreneurial Intentions in Hong Kong
Authors: Ip Ching Yin , Wu Shih-Chia , Liu Huei-Ching , Liang Chaoyun
Published: October 2017

This study examined how empathy, moral obligation, social entrepreneurial self-efficacy, perceived social support, and prior experience with social problems are associated with social entrepreneurial intentions. Through a survey, a sample of 252 Hong Kong students was used for analyses. Factor analyses supported that the antecedents of social entrepreneurial intentions could be divided into dimensions of empathy, moral obligation, social entrepreneurial self-efficacy, perceived social support, and prior experience with social problems. Multiple regression analysis results indicated that perceived social support was the most prominent antecedent of social entrepreneurial intentions, followed by moral obligation, empathy, and prior experience with social problems. Notably, moral obligation was revealed to be negatively associated with social entrepreneurial intentions.
Born of fire: In search of volcanoes in U.S. national parks, four striking examples
Authors: Walkup Laura C. , Casadevall Thomas J. , Santucci Vincent L.
Published: October 2017

Geologic features, particularly volcanic features, have been protected by the National Park Service since its inception. Some volcanic areas were nationally protected even before the National Park Service was established. The first national park, Yellowstone National Park, is one of the most widely known geothermal and volcanic areas in the world. It contains the largest volcanic complex in North America and has experienced three eruptions which rate among the largest eruptions known to have occurred on Earth. Half of the twelve areas established as national parks before the 1916 Organic Act which created the National Park Service are centered on volcanic features. The National Park Service now manages lands that contain nearly every conceivable volcanic resource, with at least seventy-six managed lands that contain volcanoes or volcanic rocks. Given that so many lands managed by the National Park Service contain volcanoes and volcanic rocks, we cannot give an overview of the history of each one; rather we highlight four notable examples of parks that were established on account of their volcanic landscapes. These parks all helped to encourage the creation and success of the National Park Service by inspiring the imagination of the public. In addition to preserving and providing access to the nation's volcanic heritage, volcanic national parks are magnificent places to study and understand volcanoes and volcanic landscapes in general. Scientists from around the world study volcanic hazards, volcanic history, and the inner working of the Earth within U.S. national parks. Volcanic landscapes and associated biomes that have been relatively unchanged by human and economic activities provide unique natural laboratories for understanding how volcanoes work, how we might predict eruptions and hazards, and how these volcanoes affect surrounding watersheds, flora, fauna, atmosphere, and populated areas.
Effect of the combined preparation Terzhinan® on microorganisms isolated from the urogenital tract of women. In vitro experiment
Authors: Savicheva Alevtina M. , Spasibova Elena V.
Published: October 2017

Introduction. The study is in vitro experiment, aimed to determine antibiotic susceptibility of microorganisms isolated from the urogenital tract of women to the combination of substances included in the preparation Terzhinan.

Methods. In total, 516 microorganism strains isolated from the vagina of reproductive age women have been tested: Candida spp. (n = 83), bacteria of the family Enterobacteriaceae (n = 138), Streptococcus agalactiae (n = 72), Enterococcus spp. (n = 147), Staphylococcus spp. (n = 37), Actinomyces urogenitalis (n = 7), Gardnerella vaginalis (n = 27), Atopobium vaginae (n = 5). Suspensions of each strain in a volume of 0.5 ml (0.5 according to McFarland) were applied onto culture medium (Muller-Hinton Agar or 5% Blood Muller-Hinton Agar). Furthermore, serial dilutions of Terzhinan were applied with a calibrated loop onto three sectors. Petri dishes were then incubated at 37 °С for 24 h. The results were evaluated visually, by measuring growth inhibition zones.

Results. The majority of Candida albicans isolates were susceptible (S) to the preparation, using both undiluted and diluted (10 and 100 times) preparation. Terzhinan without dilution and in the dilution 1:10 was 100% effective against all tested bacteria of the family Enterobacteriaceae. Susceptibility of gram positive bacteria to the antibiotics included in Terzhinan, was 74.1%. All isolates of staphylococci, including Staphylococcus aureus, were susceptible. The frequency of susceptible strains of Streptococcus agalactiae and Enterococcus spp. was 70%. All clinical isolates of Gardnerella vaginalis and Atopobium vaginae were susceptible to the combinations of antibiotics included in the preparation Terzhinan, which is in agreement with data on its high efficiency in the treatment of bacterial vaginosis.

Conclusions. In in vitro experiment, the combined preparation Terzhinan showed high activity against major groups of microorganisms isolated from the vagina including pathological conditions, such as bacterial vaginosis and vulvovaginitis of different etiology.
Treatment of infertility in women with polycystic ovary syndrome using assisted reproductive technology
Authors: Danielyan Roza M. , Gzgzyan Alexander M.
Published: October 2017

The article recent data concerning the pathogenesis, diagnostic criteria and hormonal disorders in the polycystic ovary syndrome are presented. A sequential step-by-step treatment of this disease is also described. Pаrticulаr аttention is pаid to the treаtment of infertility in women with PCOS using аssisted reproductive technology.
The use of suggestive methods, including hypnotherapy, in obstetric practice
Authors: Vishnevskaya Ekaterina E.
Published: October 2017

Labor pain leads to various undesirable clinical and psychological complications. The mental aspect of pain is actively being studied, as well as non-drug methods of influence. Expedient is the use of psychological preparation of women for childbirth and the use of the analgesic effect of hypnosis on the stage of preparation to labor and during childbirth.
Pharmacokinetic study of rational regimen of oral clindamycin in comparison with doxycycline in mild cases of acne vulgaris
Authors: Arivazhagan N. , Kumar R. Saravana , Kumar R. Arbind
Published: October 2017

Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. It is a common skin disorder affecting both boys and girls in the adolescent age group and also extends into the post adolescent age group. From time immemorial, various remedies have been suggested and followed by Ayurvedic, Siddha, Unani practitioners and native healers present in various parts of the world. In this study an attempt has been made to evaluate the efficacy of a low dose oral Clindamycin in Acne vulgaris and the results of the study have been presented in ensuing chapters.Methods: The Prospective, Randomized Controlled, Single blind study was conducted in Out Patient Section, Department of Dermatology, tertiary care teaching hospital September 2016 to May 2017 for Total six weeks. Drug administration - four weeks. Follow up - two weeks mostly drug used Capsule Clindamycin 50mg. Capsule Doxycycline 100 mg. Benzoyl Peroxide 5% topical cream.Results: The objective of the study is not only to find out the efficacy of a low dose of 50 mg Clindamycin given orally, but also to find out if this efficacy is obtained without producing the adverse effects for which the administration of Clindamycin is hesitated the ant-microbial, Cap. Doxycycline and Cap. Clindamycin act in acne vulgaris by their effect on the Propionibacterium acne. These antibiotics decrease the population of Propionibacterium acne which in turn leads to the inhibition of the bacterial lipases and this is followed by a decrease in concentration of free fatty acids. This produces less tissue inflammation and acne.Conclusions: This study proves the safety and efficacy of low dose of oral Clindamycin in acne vulgaris, and such low doses can also be tried for other infections where the causative organism responds to Clindamycin.
Prescribing pattern of drugs in alcohol dependence in a tertiary care hospital
Authors: Dube Upasana , H. Shwetha , P. Shanmukananda , R. Veena D. , Kumar Ashok
Published: October 2017

Background: Alcohol dependence is one of the more serious public health issues in the world. It not only affects health but is also a social and economic burden. Pharmacotherapy is the main stay of treatment along with behavioural therapy for alcohol addiction. The present study was done to analyse the prescribing pattern of drugs used in alcohol dependence.Methods: The present study is a retrospective study which was carried out in the Department of Psychiatry, Dr. B.R. Ambedkar Medical College, Bengaluru from March 2016 to August 2016. Demographic, disease and treatment details were collected and entered in the case proformas. The results were analyzed using descriptive statistics.Results: A total of 125 prescriptions were analyzed. The most common age group was between 30-60 years with a male predominance (95.2%). 72% of patients were treated for alcohol dependence whereas 28% who had other co morbidities like psychosis and depression were treated appropriately. The most commonly prescribed drugs were Vitamins (74.4%), Benzodiazepines (BZDs) (56.8%), anti-craving drugs (52%), antipsychotics (20%) and anti-depressant drugs (8%). Lorazepam (45.6%) and Baclofen (46.1%) were the most common drugs prescribed among BZDs and Anti-craving drugs respectively. For affective disorders Olanzapine (36%) was the commonest drug prescribed.Conclusions: This study reveals that alcohol dependence is accompanied by other co-morbidities like psychosis, depression and anxiety. Combined therapy of Vitamins, BZDs, Anti-craving drugs along with Antipsychotic or Antidepressant drugs have been prescribed to the patients. Newer anti-craving drugs like Baclofen, Acamprosate and Naltrexone have also been prescribed.
Oral clonidine: an effective adjuvant in functional endoscopic sinus surgery
Authors: Ray Amit Kumar , Ghosh Dastidar Anjana Basu , Hembrom Bani P. M.
Published: October 2017

Background: A comparative study to evaluate the efficacy of intravenous Dexmedetomidine as a hypotensive agent in comparison to oral Clonidine in Endoscopic Nasal Surgery or Functional Endoscopic Sinus Surgery (FESS).Methods: Forty patients ASA I or II scheduled for Endoscopic Nasal Surgery were equally randomly assigned to receive either dexmedetomidine 1μg/Kg over 10 min before induction of anesthesia followed by 0.5μg/Kg/h infusion during maintenance (Group D), or oral Clonidine (Group C) 2µg/kg with minimal water 1 hour prior starting of surgery. Rescue bolus doses of Propofol (10mg/dose) were given to maintain mean arterial blood pressure (MAP) between (50-70mmHg). General anesthesia was maintained with Isoflurane 1%-2%. The surgical field was assessed using Average Category Scale. Hemodynamic variables (MAP and HR) were recorded at 10 minutes interval.Results: Both group C and group D reached the desired MAP (50-70mmHg) with no intergroup differences in HR but a statistically significant lower MAP was noticed in group C. The quality of the surgical field in the range of MAP (50-70mmHg) were 2-3 as per average category Scale with significantly lower score in Group C. Mean intraoperative propofol consumption was significantly higher in group D than C group.Conclusions: Both Dexmedetomidine or oral clonidine with isoflurane are safe agents for controlled hypotension, but oral clonidine provides lower MAP and better surgical field. Compared with Dexmedetomidine, oral clonidine offers the advantage of less consumption of propofol.
Evaluation of efficacy and tolerability of nitrofurantoin versus ciprofloxacin in patients of urinary tract infection: a comparative study
Authors: Kaur Rajneet , Kumar Vijay , Singh Harjinder , Walia Geeta , Sehgal Arshiya
Published: October 2017

Background: UTIs are one of the most common infectious diseases encountered in out-patient departments on day to day basis. Nitrofurantoin and Ciprofloxacin are most commonly used antibiotics in the treatment of UTI. The present study was done to compare the efficacy and tolerability of nitrofurantoin and ciprofloxacin in patients of urinary tract infection.Methods: This prospective, open, randomized, parallel group, comparative study was conducted on 60 patients presenting with acute/uncomplicated or recurrent urinary tract infection in the outpatient Department of Urology, Rajindra Hospital attached to Govt. Medical College, Patiala, Punjab. They were divided into two groups, Group I and Group II of 30 cases each. Group I patients were put on Nitrofurantoin and Group II patients were put on Ciprofloxacin. Initially 100 patients were enrolled but only those who showed growth of uropathogens on baseline urine culture or those who completed the treatment were included in the study. The primary outcome measure was microbiological eradication on post treatment urine culture.Results: The age range of the patients in Group I and Group II was 19 to 68 years (43.40±14.58 years) and 20-60 years (39.77±13.49 years) respectively. The total no. of males and females who participated in this study were 32 (53.33%) and 28 (46.66%) respectively. The most common uropathogen associated with uncomplicated UTI was E. coli (80%), other organisms detected were Klebsiella species (16.67%), Staphylococcus aureus (3.33%) and Providencia (3.33%). Post treatment urine culture results showed significant difference between two groups, 5 patients (16.67 %) in case of Group I and 14 patients (46.67%) in case of Group II showed growth of micro-organisms post treatment. P-value comes out to be 0.017 which is significant.Conclusions: In this era of super bugs, nitrofurantoin is more efficacious than ciprofloxacin in the treatment of UTI. E. coli was found to be major organism causing UTI. Ciprofloxacin is less effective due to increasing antibiotic resistance among uropathogens. Both the drugs were well tolerated, no major significant adverse effects were encountered.
Evaluation of indoor prescriptions of depression in psychiatry department of a tertiary care hospital in North India
Authors: Randhawa Gurpreet Kaur , Singh Navyug Raj , Kundu Prithwijit , Prabhakar Swati
Published: October 2017

Background: Depression is one of most common psychiatric illnesses affecting the human population and poses significant economic burden to society. Prescription for depression usually involves multiple medications sometime irrationally prescribed.Methods: Present study involved evaluation of 65 indoor prescriptions of patients diagnosed with depression from Psychiatry Department in a tertiary care hospital. The prescriptions were evaluated on basis of WHO Core Indicators for writing a good prescription. The demographic characteristics of the patient population were studied. Number of drugs prescribed per prescription and the average number per prescription were calculated to assess polypharmacy. The cost involved in treatment using latest market data from drug information source and the rationality of prescriptions were also evaluated.Results: 80% of the prescriptions were not in accordance with the WHO Core Indicators. An average of 2.415±1.102 medications were prescribed per prescription indicating polypharmacy. Insignificant difference was observed in cost per prescription per month of medicines when compared with lowest priced products available in market.Conclusions: Polypharmacy was found in most prescriptions and monotherapy was instituted in five prescriptions only, with clonazepam as the most prescribed antidepressant drug. Majority of prescriptions did not conform to WHO core indicators for prescription writing.
A prospective double blind randomized comparative study of safety and efficacy of Tapentadol versus Tramadol in post-operative orthopaedic patients
Authors: Gedela Vasavi , Gururaj Sashank
Published: October 2017

Background: Pain following surgery is an unwanted effect which is to be relieved for the better outcome of surgery and anaesthesia. The study was conducted to compare the efficacy and safety of Tapentadol with Tramadol for post-operative pain relief in orthopaedic surgeries.Methods: After approval of IEC, patients of either sex aged between 18-55 years who had undergone orthopaedic surgeries at Government General Hospital, Kakinada between February 2013 to January 2015 were selected for study. It is a prospective double blind randomised active controlled parallel group comparative study. Sample size is 80 who fulfilled all criteria but there are 6 who discontinued drug in Tramadol group, so 74 were analysed. Written informed consent was taken from all patients, screening, pre anaesthetic evaluation done. Tablet Alprazolam 0.5mg was given at 9PM on previous day of surgery. Both Tramadol and Tapentadol were given 100mg orally 6th hourly. Pain intensity was analysed by visual analogue scale. Sedation was assessed with Modified Wilson sedation scale. Safety and tolerability was assessed by side effects reported by patients. Patients were assessed at 0, 2, 4, 6, 8, 10, 12, 18, 24, 30, 36, 42 and 48 hours post-operatively.Results: Pain reduction was higher in Tapentadol group on chi square test where p value is less than 0.001.Conclusions: Both Tramadol and Tapentadol are effective in treatment of post-operative pain. The pain reduction was higher in Tapentadol group on chi-square test where p value is <0.001. So, we can conclude from our study findings that Tapentadol is efficacious compared to Tramadol in reducing Post-operative pain. Both the drugs were well tolerated by the patients.
Adverse drug reaction monitoring of antitubercular drugs at tertiary care medical college hospital: prospective study
Authors: Revanna Shubha , Harish Chinmayi Kaggere , Amol Gramle
Published: October 2017

Background: To study the socio-demographic profile of patients receiving DOTS and to estimate the prevalence of adverse drug reaction and casualty in patients receiving DOTS.Methods: This is a self reporting prospective study , trained personnel instructed patients about treatment and possible adverse drug reaction and patient telephone number was noted and pamphlet with information about possible ADR’S and containing contact number of the staff in-charge was distributed among the patients and they were instructed to contact staff if any mild or severe ADR’S was noticed and also staff in-charge himself contacted patients regularly for update of neglected ADR’S and noted information was tabulated ,analyzed using and frequency table with percentage and chi-square test of significance was calculated and causality was assessed using Noranjo scale and severity using modified Hartwig and Siegal scale.Results: The commonest ADRs received were gastritis in 32 (20%) patients, followed by myalgia in 25 (15.6%) and fatigue in 21(13.12%) patients. Major adverse events included chest pain, joint pain, edema, blurring of vision and mental depression. It was surprising that none of the patients reported with any untoward skin reactions. In a small sample of 64 subjects, 160 ADRs were noted and among the ADRs there by received, the statistically significant value obtained was only with that of gastritis (p= 0.025).Conclusions: Incidence of fatal ADR’s in DOTS is none with extremely low incidence of severe ADR’s with only mild to moderate ADR’S reported DOTS is relatively safe in treatment of tuberculosis.
A study on cardiac troponin t in early diagnosis of myocardial injury due to perinatal asphyxia and its comparison with other modalities
Authors: Tamilarasu N. , Kumaravel K. S.
Published: October 2017

Background: Perinatal Asphyxia is a multi-system disorder and its effects are not limited to central Nervous System. MODS determine the early outcome of asphyxiated neonate. Cardiac impairment occurs in about 25% of neonates with asphyxia. Often cardiac impairment is overlooked due to the lack of sensitive diagnostic test.Methods: A hospital based prospective analytical study performed over 50 Asphyxiated neonates admitted in our NICU from September 2016 to January 2017 myocardial dysfunction was evaluated using clinical, electrocardiography, echocardiography and cardiac troponin-T card test.Results: In the present study, among the 50 neonates 32 had clinical evidence of myocardial injury. Troponin T card test has the highest sensitivity of about 84.37%, positive predictive value of 93.1% and negative predictive value of 76% in diagnosing myocardial injury in contrast to ECG and ECHO. In terms of Specificity ECHO has the highest specificity of about 94.4% when compared to ECG and Trop T. Among all the diagnostic modalities used in this study, Troponin T best predicts the severity and outcome of Perinatal asphyxia. Conclusions: Troponin T card test is a valuable tool for early detection of myocardial injury due to perinatal asphyxia. In resource limited setting where the accessibility to 12 lead ECG, ECHO, and aid of cardiologist are not available, Trop T card test will serve as an effective handy screening tool in diagnosing myocardial injury
Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India
Authors: Thaddanee Rekha , Khilnani Gurudas , Shah Nupur , Khilnani Ajeet Kumar
Published: October 2017

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI).Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal.Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% - 23.5%), Cephalosporins (11.7% - 52.9%), Fluoroquinolones (5.8% - 11.7%), Co-trimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics.Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.
A study of clinical and laboratory profile of febrile children presenting with thrombocytopenia
Authors: Nair Bindu T. , Sharma Kuldeep , Paimode Sandeep D.
Published: October 2017

Background: A large number of acute febrile illnesses have an infectious aetiology and many of them are associated with thrombocytopenia. The objective was to study the clinical and laboratory profile of febrile children with thrombocytopenia, associated clinical complications and assess the relationship between platelet levels and severity of disease.Methods: The study was carried out in 180 children up to the age of 18 years, seen in Out Patient Department as well as those admitted in the wards of Department of Paediatrics of a 999 bedded hospital in North India from July 2016 to June 2017.Results: The commonest causes of thrombocytopenia in our study were Viral Fever (other than dengue and chikungunya) 27.78% (50), followed by Dengue 22.2% (40), enteric fever 12.22% (22), chikungunya 11.11% (20), malaria 8.33% (15), septicaemia 5.55% (10), ITP 5.55% (10), haematological malignancy 1.67% (03) and megaloblastic anaemia 1.11%(2). Bleeding manifestations were present in 19.45 % of patients and the commonest sites were skin and mucous membranes. Bleeding manifestations were seen most commonly in children with a platelet count less than <20,000/μl.Conclusions: Viral fevers (non-specific) followed by dengue and chikungunya were the most common causes of fever with thrombocytopenia.
Pediatric appendicitis score in the diagnosis of childhood appendicitis: a validation study
Authors: Parveen Kambalabettu Zohara , Avabratha K. Shreedhara , Shetty Kishan
Published: October 2017

Background: Pediatric appendicitis score (PAS) is a scoring system which includes symptoms, physical examination and laboratory tests in children suspected to have appendicitis. The objectives of this study were to analyze the diagnostic value of Paediatric Appendicitis Score and to aid early diagnosis of appendicitis.Methods: A prospective study was done in a Medical College hospital, in Mangalore in children aged between 4-16 years, admitted during study period June to December 2016, with right Iliac fossa pain, suspected to have appendicitis. Data from the children including demographic details, clinical features, laboratory investigations and ultrasound done were recorded in proformas after consent from parents. The PAS score was applied to them. If PAS was between 4-6, PAS scoring was repeated after 6 hours. Investigations done were noted. If child was taken up for surgery, histopathology report of the biopsy specimen was collected. The decision to operate or manage conservatively was taken up by the treating pediatric surgeon. PAS score was compared with ultrasound and biopsy report.Results: Sixty children were included in the study. Anorexia, emesis, migration pain, cough tenderness and leukocytosis were the features most consistently seen in appendicitis. Initial PAS were comparable to the repeat scores. Ultrasound showed presence of appendicitis in 88.3% of the children. Ultrasound showed appendicitis in all children with PAS ≥7. Twenty-six children out of 60 underwent surgery. Out of 20 children with PAS ≥7.15 (75%) were taken up for surgery and biopsy showed appendicitis. Biopsy was done in 26 children, of whom 58.1% had PAS ≥ 7. These findings were statistically significant. Conclusions: Paediatric appendicitis score is a valuable tool in diagnosing childhood appendicitis.
Dynamization of external fixator is single stage definitive procedure for open fractures both bone leg
Authors: Singh Ajeet , Kumar Rakesh , Ranjan Rajni , Mahajan Avijit
Published: October 2017

Background: Open fracture both bone leg is a common fracture present in orthopaedic causality. Treatment consists of I. V. antibiotics, debridement and external fixator. Judicious selection of the patients on basis of Gustilio and Anderson classification leads to external fixator as a definitive and single stage procedure with dynamization. It reduces the risk of infection at time of definitive procedure and number of hospital stay and surgery.

Methods: In school of medical sciences and research, We treated 68 patients with open both bone fracture (Gustilio and Anderson type 2 and 3b) with debridement and external fixator. All patients underwent dynamization depending upon fracture pattern. Majority of our cases were road traffic accident involving male. Average duration of union was 22 to 26 weeks. There was no need for any major plastic surgery procedure. Removal of external fixator and Patellar tendon brace (PTB) was given for the period of 4 to 6 weeks at the time of clinical and radiological union.

Results: Eighty eight percent of our cases united well. This reduces the burden of secondary definitive procedure, infection and cost of treatment. So careful selection of the patients and dynamization of external fixator hold the place for definitive surgical option for open both bone fractures.

Conclusions: External fixator is simple effective surgical procedure for open fractures both bone leg. Staged dynamization of external fixator add in the better union with functional outcome and cost effective. 