bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of matrix nature on the functional efficacy of biomedical cell product for the regeneration of damaged liver (experimental model of acute liver failure)
Authors: Gautier S. V. , Shagidulin M. Yu. , Onishchenko N. A. , Iljinsky I. M. , Sevastianov V. I.
Published: June 2017

Aim. A comparative analysis of the functional efficacy of biomedical cell products (BMCP) for the regeneration of damaged liver based on biopolymer scaffolded porous and hydrogel matrices was performed on the experimental model of acute liver failure. Materials and methods. Matrices allowed for clinical use were employed for BMCP in the form of a sponge made from biopolymer nanostructured composite material (BNCM) based on a highly purified bacterial copolymers of poly (β-hydroxybutyrate-co-β-oxyvalerate) and polyethylene glycol and a hydrogel matrix from biopolymer microheterogeneous collagen-containing hydrogel (BMCH). Cellular component of BMCP was represented by liver cells and multipotent mesenchymal bone marrow stem cells. The functional efficacy of BMCP for the regeneration of damaged liver was evaluated on the experimental model of acute liver failure in Wistar rats (n = 40) via biochemical, morphological, and immunohistochemical methods. Results. When BMCP was implanted to regenerate the damaged liver on the basis of the scaffolded BNCM or hydrogel BMCH matrices, the lethality in rats with acute liver failure was absent; while in control it was 66.6%. Restoration of the activity of cytolytic enzyme levels and protein-synthetic liver function began on day 9 after modeling acute liver failure, in contrast to the control group, where recovery occurred only by days 18–21. Both matrices maintained the viability and functional activity of liver cells up to 90 days with the formation of blood vessels in BMCP. The obtained data confirm that scaffolded BNCM matrix and hydrogel BMCH matrix retain for a long time (up to 90 days) the vital activity of the adherent cells in the BMCP composition, which allows using them to correct acute liver failure. At the same time, hydrogel matrix due to the presence of bioactive components contributes to the creation of the best conditions for adhesion and cell activity which accelerate the regeneration processes in the damaged liver compared to BMCP on scaffolded matrix. Conclusion. A statistically significant difference was found between the functional efficacy of the BMCP studied based on BNCM and BMCH matrices. BMCP based on hydrogel BMCH matrix was more effective for the regeneration of damaged liver.
Dementia and legal determination of capacity
Authors: Delineau Valeska Maria Eboli Bello , Schultz Rodrigo Rizek
Published: June 2017

ABSTRACT One of the consequences of dementia is the possibility of a guardianship proceeding that will deprive patients of legal capacity in taking decisions and managing their own assets. Objective To assess the legal capacity and guardianship proceedings in patients diagnosed with dementia. Methods Ninety-seven patients diagnosed with dementia and seen at a tertiary hospital were evaluated. Results Of these 97 patients, 60 (62%) were female. The mean age of the patients was 77.9 years; average schooling was 5.5 years. The main diagnosis was Alzheimer’s disease (73%): 16 patients were at a mild stage, eight at a moderate stage and 73 at an advanced stage of dementia. Only 28 patients had been legally declared incapable. Conclusion The large numbers of patients at an advanced stage of dementia, and the relatively few patients legally declared incapable show that legal issues in dementia are problematic.
"Mas Ele Diz que me Ama...": Duplo-Vínculo e Nomeação da Violência Conjugal
Authors: Guimarães Fabrício Lemos , Diniz Glaucia Ribeiro Starling , Angelim Fabio Pereira
Published: June 2017

RESUMO O objetivo dessa pesquisa qualitativa foi discutir a aplicação da Teoria do Duplo-Vínculo ao contexto da violência conjugal.Foram consideradostrês critérios de duplo-vínculo: (a) Relacionamento de imenso valor afetivo; (b) Mensagens paradoxais; (c) Impossibilidade de refletir sobre a relação. A estratégia metodológica foi a leitura do livro Mas ele diz que me ama..., aplicação de questionário e reflexão grupal sobre o livro.Participaram da pesquisa 20 mulheres encaminhadas pela justiça. A análise dos títulos atribuídos pelas participantes a sua própria história resultou em quatro categorias que revelaram dimensões da relação duplo-vincular: Ambiguidade de sentimentos; Promessas do parceiro; Constatação da realidade violenta; Perspectiva de nova vida. Essa pesquisa-intervenção facilitou a reflexão das mulheres sobre sua realidade e ofereceu ferramentas para avaliação de riscos da violência.
A cooperação entre a AMI e o Brasil: situações e emergências
Authors: Martins Marco António Baptista , Libório Tânia Sofia
Published: June 2017

Resumo Em uma era global, em que a riqueza e a pobreza interagem por meio das suas potencialidades e vulnerabilidades, enfrenta-se com convicção essa disparidade em nome da cooperação em prol do desenvolvimento sustentável. Neste sentido, as Organizações Não Governamentais (ONGs) possuem um papel promotor para apoiar o desenvolvimento, na medida em que a Fundação de Assistência Médica Internacional (AMI) atua e coopera no desenvolvimento local e comunitário, conduzindo ao progresso do município.
Seleção de profissionais de TI por competências em uma instituição do ensino superior: uma proposta baseada em um modelo multicritério de apoio à decisão
Authors: Gurgel André Morais , Pimenta Iris Linhares , Santos Jhaimes Willian dos , Medeiros Júnior Josué Vitor de
Published: June 2017

Resumo O trabalho teve como objetivo desenvolver e implantar um modelo de apoio à decisão no processo de seleção por competências de profissionais de Tecnologia da Informação em uma instituição do ensino superior. Para isso, foi adotada estratégia de pesquisa-ação e utilizado o método de análise de decisão multicritério (MCDA), a partir da compreensão do processo seletivo e análise das competências para os cargos de Programador e Analista de Suporte, utilizando-se como base a percepção dos avaliadores com relação ao perfil e os resultados dos candidatos nas etapas do processo de seleção. Com isso, desenvolveu-se um modelo multicritério (SMARTER) para estruturar o perfil de competências dos cargos, possibilitando comparações entre os candidatos do processo de seleção, gerando assim resultados mais próximos à estrutura de preferências com relação ao perfil de candidato almejado, estudo relevante pela aplicabilidade do modelo criado, que proporcionou um processo de seleção mais rápido, com uma avaliação mais simplificada, e atendendo ao perfil de cargo requerido. O modelo foi apresentado e aprovado pelos participantes da pesquisa, que são os avaliadores. Os resultados gerados fizeram com que o modelo multicritério contribuísse no apoio à decisão dos avaliadores no processo de seleção dos profissionais de TI, sendo bem avaliado pelos decisores e tornando a avaliação do processo de seleção mais confiável para eles.
E-PROCUREMENT: CONCEITOS, MODELOS E FATORES CRÍTICOS DE SUCESSO
Authors: Grande Márcia Mazzeo , Olhê Enrico Arnaldo , Rodello Ildeberto Aparecido , Gomes Erasmo José
Published: June 2017

RESUMO Este trabalho é uma revisão bibliográfica sobre o tema e-procurement e foi motivada pela importância crescente da atividade de compras para as empresas, pelo aumento do uso da tecnologia da informação na cadeia de suprimentos e pela escassez de trabalhos sobre o tema no Brasil. O objetivo foi compreender as práticas de e-procurement nas empresas, identificando os modelos existentes, as vantagens, benefícios, fatores críticos para a implementação e dificuldades de seu uso. Adicionalmente, foi realizado um balanço das publicações sobre o tema na coleção principal da Web of Science, indicando os períodos onde houveram mais publicações e também os periódicos que mais tem artigos relacionados. Assim, foi possível perceber as tendências sobre as pesquisas no assunto. Ao fim deste trabalho foi também possível chegar a conclusões importantes sobre a função estratégica do e-procurement, uma vez que modifica a maneira como as empresas se inserem na cadeia de suprimentos; o foco atual da tecnologia em compras de materiais indiretos, e uma série de benefícios não financeiros. O trabalho ainda contribui apresentando sugestões de assuntos para condução de pesquisas na área.
TECNOGRAN: TODO PISO SERÁ PALCO. TODA PAREDE, MURAL. E A CIDADE INTEIRA, POESIA.
Authors: Carstens Danielle Denes dos Santos , Vincenzi Ticiana Braga De , Fernandes Bruno Henrique Rocha , Galvão Franciani Fernandes
Published: June 2017

RESUMO Este caso apresenta a Tecnogran, empresa paranaense de revestimentos de alto tráfego atuante no segmento de pisos para supermercados, shopping centers, áreas externas, obras públicas e de acessibilidade. O caso descreve o histórico, as características da organização e do setor, abordando impasses enfrentados pela Tecnogran: pressões por preço e demandas de mercado. A empresa é líder no mercado nacional e, apesar disso, encontra dilemas ao buscar se consolidar como inovadora frente a seus concorrentes. O caso é analisado sob as perspectivas das teorias: Estratégias Genéricas e Vantagem Competitiva Ambiental; Teoria Baseada em Recursos; e Teoria de Recursos, Processos e Valores na Inovação. O caso apresenta também as respostas da empresa: inovações em produtos e serviços, e alterações em processos produtivos para manutenção de sua liderança no mercado nacional. As informações para a elaboração do caso foram obtidas por entrevistas semiestruturadas com os gestores da Tecnogran e por dados secundários, tais como publicações, documentos da empresa e sites. Este caso de ensino poderá ser utilizado nas disciplinas de Administração Estratégica, Gestão da Inovação, Marketing e disciplinas correlatas, em cursos de graduação e pós-graduação com foco em negócios de empresas. Os principais objetivos educacionais são: sensibilizar alunos para perceber as estratégias empresariais; analisar os modelos de gestão em busca de vantagem competitiva; identificar modelos estratégicos organizacionais; assinalar a relação entre competências organizacionais e vantagem competitiva sustentável; e compreender a importância e os desafios da inovação para as organizações.
Cultura participativa: um processo de construção de cidadania no Brasil
Authors: Ventura Carla Aparecida Arena , Miwa Marcela Jussara , Serapioni Mauro , Jorge Márjore Serena
Published: June 2017

Este estudo pretende descrever os elementos – contexto e recursos – que influenciam a participação social em um Conselho Municipal de Saúde (CMS). Trata-se de pesquisa descritiva com abordagem qualitativa. Os dados foram coletados por meio de observação direta da dinâmica do CMS estudado e de entrevistas semiestruturadas com seus membros. A análise dos dados baseou-se na análise temática, visando aproximar as categorias obtidas com as categorias estabelecidas pela OMS sobre as dimensões do contexto e dos recursos que influenciam a cultura participativa, quais sejam: i) políticos conscientes da questão da participação; ii) organização da sociedade civil; iii) estruturas e espaços; iv) recursos; v) conhecimento; e vi) impacto das políticas e práticas anteriores. Como resultado, constatou-se que os componentes são deficientes e a participação popular é ainda precária, e os maiores obstáculos são aqueles relacionados à comunicação entre vários atores e instituições sociais.
Two new species of Bittacidae (Mecoptera) from the Amazon Basin
Authors: Penny Norman D.
Published: June 2017

Abstract Two new species of Bittacidae (Mecoptera) from Humboldt Biological Reserve, Mato Grosso state, Brazil, are described and ecological notes are given.
Anatomia foliar de Bromehaceae da Campina
Authors: Braga Marilene Marinho Nogueira
Published: June 2017

RESUMO Foi feito um estudo anotômico-foliar das seguintes espécies de Bromeliaceae de uma campina da Amazônia Central: Aechmea mertensii, Aechmea setigera, Ananas ananassoides, Streptocalyx poeppigii, Tillandsia adpressiflora e Vriesesea splitgerberi. Por meio de cortes histológicos, epidermes dissociadas e raspagens das superfícies foliares de várias regiões da folha, foram feitas descrições das estruturas foliares acompanhadas de fotomicrografias e desenhos esquemáticos e contagens do número de estômotos e escamomas. A epiderme de todas as espécies apresenta a estrutura típica encontrada no família. O maior número de escamas foi encontrado na região basal da folha em todas as espécies estudadas. Na maioria das espécies existe um relacionamento estrutural entre os estômatos e escamas, o que sugere um relacionamento funcional. A disposição, volume e aspecto dos tecidos variam de espécie para espécie e dentro de uma mesma folha. Todas as plantas apresentam características estruturais que justificam sua presença na campina.
A new species of Liothrips from the Amazonas harmful to Guarana plantations (Insecta: Thysanoptera: Phlaeothripidae)
Authors: Strassen Richard zur
Published: June 2017

Abstract One of the Thysanoptera species collected from Guarana plantations in the Amazonas basin has proved to be hitherto unknown to science and is described as Liothrips adisi n. sp.
Doença cerebrovascular no Brasil de 1990 a 2015: Global Burden of Disease 2015
Authors: Lotufo Paulo Andrade , Goulart Alessandra Carvalho , Passos Valéria Maria de Azeredo , Satake Fabio Mitsuhiro , Souza Maria de Fátima Marinho de , França Elizabeth Barbosa , Ribeiro Antônio Luiz Pinho , Bensenõr Isabela Judith Martins
Published: June 2017

RESUMO: Objetivo: Verificar as tendências temporais das taxas de mortalidade, dos anos de vida perdidos (years of life lost - YLL) e dos anos de vida perdidos devido à incapacidade (years lost due to disability - YLD) motivadas pela doença cerebrovascular no Brasil entre 1990 e 2015. Métodos: Utilizou-se as informações do Global Burden of Diseases 2015 (GBD 2015) para analisar a magnitude e as tendências das taxas de mortalidade e dos anos de vida ajustados por incapacidade (DALY - disability-adjusted life years) nas 27 unidades da Federação, entre 1990 e 2015, pela doença cerebrovascular (CID-10: I-60-69). Os estados brasileiros foram analisados pelo índice de desenvolvimento social (IDS), composto por renda per capita, proporção de escolaridade formal aos 15 anos e taxa de fecundidade. Resultados: Apesar do aumento do número absoluto de mortes pela doença cerebrovascular, a proporção de mortes abaixo dos 70 anos de idade reduziu pela metade entre 1990 e 2015. A aceleração da queda foi maior entre as mulheres, e mais acentuada no período de 1990 e 2005 do que de 2005 a 2015. O risco de morte reduziu-se à metade em todo o país; porém, os estados no tercil inferior tiveram reduções menos expressivas para homens e mulheres (respectivamente, -1,23 e -1,84% ao ano), comparados aos no tercil médio (-1,94 e -2,22%) e no tercil superior (-2,85 e -2,82%). Os anos perdidos por incapacidade também apresentam redução entre os estados, mas de forma menos expressiva. Conclusão: Apesar da redução das taxas ajustadas por idade em todo o país, a doença cerebrovascular ainda apresenta alta carga de doença, principalmente nos estados com menor desenvolvimento socioeconômico.
Mortalidade e anos de vida perdidos por violências interpessoais e autoprovocadas no Brasil e Estados: análise das estimativas do Estudo Carga Global de Doença, 1990 e 2015
Authors: Malta Deborah Carvalho , Minayo Maria Cecília de Souza , Soares Filho Adauto Martins , Silva Marta Maria Alves da , Montenegro Marli de Mesquita Silva , Ladeira Roberto Marini , Morais Neto Otaliba Libanio de , Melo Ana Paula , Mooney Meghan , Naghavi Mohsen
Published: June 2017

RESUMO: Objetivo: Analisar a mortalidade e os anos de vida perdidos por morte ou incapacidade (Disability-Adjusted Life Years - DALYs) por violências interpessoais e autoprovocadas, comparando 1990 e 2015, no Brasil e nas Unidades Federadas, utilizando estimativas produzidas pelo estudo Carga Global de Doença 2015 (GBD 2015). Métodos: Análise de dados secundários das estimativas do GBD 2015, com produção de taxas padronizadas de mortes e DALYs. A principal fonte de dados de óbitos foi o Sistema de Informações sobre Mortalidade, submetido à correção do sub-registro de óbitos e redistribuição de códigos garbage. Resultados: De 1990 a 2015, observou-se estabilidade das taxas de mortalidade por homicídios, com variação percentual de -0,9%, passando de 28,3/100 mil habitantes (II 95% 26,9-32,1), em 1990, para 27,8/100 mil (II 95% 24,3-29,8), em 2015. As taxas de homicídio foram mais altas em Alagoas e Pernambuco, e ocorreu redução em São Paulo (-40,9%). As taxas de suicídio variaram em -19%, saindo de 8,1/100 mil (II 95% 7,5-8,6), em 1990, para 6,6/100 mil (II 95% 6,1-7,9), em 2015. Taxas mais elevadas ocorreram no Rio Grande do Sul. No ranking de causas externas por Disability-Adjusted Life Years (DALYs), predominaram as agressões por arma de fogo, seguidas de acidentes de transporte e em sexto lugar lesões autoprovocadas. Conclusões: O estudo aponta a importância das causas externas entre jovens e homens na morte prematura e em incapacidades, constituindo um problema prioritário no país. O estudo Carga Global de Doença poderá apoiar políticas públicas de prevenção de violência.
Carga de doença por infecções do trato respiratório inferior no Brasil, 1990 a 2015: estimativas do estudo Global Burden of Disease 2015
Authors: Corrêa Ricardo de Amorim , José Bruno Piassi de São , Malta Deborah Carvalho , Passos Valéria Maria de Azeredo , França Elisabeth Barboza , Teixeira Renato Azeredo , Camargos Paulo Augusto Moreira
Published: June 2017

RESUMO: Introdução: Infecções do trato respiratório inferior (ITRi) apresentam incidência e mortalidade significativas no mundo. Este artigo apresenta o impacto das ITRi na carga de doença, segundo as métricas utilizadas no estudo Global Burden of Disease 2015 (GBD 2015) para o Brasil, em 1990 e 2015. Métodos: Análise de estimativas do GBD 2015: anos de vida perdidos por morte prematura (YLLs), anos vividos com incapacidade (YLDs) e anos de vida perdidos por morte ou incapacidade (DALYs = YLLs + YLDs). Resultados: As ITRi foram a terceira causa de mortalidade no Brasil em 1990 e 2015, com 63,5 e 47,0 mortes/100 mil habitantes, respectivamente. Embora o número absoluto de óbitos tenha aumentado 26,8%, houve redução de 25,5% nas taxas de mortalidade padronizadas por idade, sendo a redução mais marcante em menores de 5 anos. Também houve redução progressiva da carga da doença, expressa em DALYs. Discussão: Apesar da redução da carga da doença no período, as ITRi foram importante causa de incapacidade e a terceira causa de mortes no Brasil em 2015. O aumento do número de óbitos ocorreu devido ao aumento e envelhecimento populacional. A redução das taxas de mortalidade acompanhou a melhora das condições socioeconômicas, do acesso mais amplo aos cuidados de saúde, da disponibilidade nacional de antibióticos e das políticas de vacinação adotadas no país. Conclusão: Apesar das dificuldades socioeconômicas vigentes, constatou-se uma redução progressiva da carga das ITRi, principalmente na mortalidade e na incapacidade, e entre os menores de cinco anos de idade.
DYNAMIC CAPABILITIES, CREATIVE ACTION, AND POETICS
Authors: MacLean Donald
Published: June 2017

ABSTRACT Research on dynamic capabilities explores how businesses change enables enterprises to remain competitive. However, theory on dynamic capabilities still struggles to capture novelty, the essence of change. This study argues that a full understanding of strategic change requires us to sharpen our focus on real people and experiences; in turn, we must incorporate other faculties, which almost always operate alongside our logical ones, into our theory. We must pay more attention to the "non-rational" sides of ourselves-including, but not limited to, our imaginations, intuitions, attractions, biographies, preferences, and aesthetic faculties and capabilities. We argue that all such faculties, on the one hand, are central to our abilities to comprehend and cope with complexity and, on the other hand, foster novel understandings, potential responses, and social creativity. This study introduces the possibility of an alternative form of inquiry that highlights the role of poetic faculties in strategic behavior and change.
Primary Dealers' Behavior during the 2007-08 Crisis: Part I, Repo Runs
Authors: Macchiavelli Marco , Iyer Rajkamal
Published: June 2017

This is the first of two notes that empirically document the behavior of U.S. Primary Dealers during the 2007-08 financial crisis. In this note we show that dealers' exposure to risky assets drives the observed repo funding squeeze; moreover, as evident from Lehman's experience, we show that repos become subject to counterparty risk during periods of stress, even when collateralized by the safest assets.
Estimating the Competitive Effects of Common Ownership
Authors: Gramlich Jacob , Grundl Serafin
Published: June 2017

If managers maximize the payoffs of their shareholders rather than firm profits, then it may be anticompetitive for a shareholder to own competing firms. This is because a manager’s objective function may place weight on profits of competitors who are held by the same shareholder. Recent research found evidence that common ownership by diversified institutional investors is anticompetitive by showing that prices in the airline and banking industries are related to generalized versions of the Herfindahl-Hirschman Index (HHI) that account for common ownership. In this paper we propose an alternative approach to estimating the competitive effects of common ownership that relates prices and quantities directly to the weights that such managers may be placing on the profits of their rivals. We argue that this approach has several advantages. First, the approach does not inherit the endogeneity problems of HHI regressions, which arise because HHI measures are functions of quantities. Second, because we treat quantities as outcomes we can look for competitive effects of common ownership on both prices and quantities. Third, while concentration measures vary only at the market-time level, the profit weights also vary at the firm level, which allows us to control for a richer set of unobservables. We apply this approach to data from the banking industry. Our empirical findings are mixed, though they’re preliminary as we investigate irregularities in ownership data (Anderson and Brockman (2016)). The sign of the estimated effect is sensitive to the specification. Economically, estimated effects on prices and quantities are fairly small.
Ukrainisation Tendencies in Luhansk Regional Printed Press of 1920-1930s
Authors: Ulyanova Kateryna
Published: June 2017

The main objective of the study is to carry out a comprehensive analysis of the functioning of Luhansk regional periodicals in the scope of Ukrainisation (indigenization), which was implemented by the Bolshevists in the 1920-30s, and promoted the formation and understanding of Ukrainian national self-identification.

Methods. The synchronous analysis is used to perform a comprehensive characterization of the scientific object at the particular stage of historical development. Since the study is mainly descriptive, core research methods are also descriptive, combined with various methods and procedures of scientific analysis, including comparative historical and retrospective.

Results. The Ukrainisation process in media primarily affected the functioning of periodicals that were massively re-orientated to Ukrainian language. The period of 1920-30s was the most productive. Totally, there were about 100 functioning Ukrainian newspapers. However, they were only formally Ukrainian, when the semantic level of these publications absorbed the negative sides of indigenization processes, including primary focus on masses, which practically meant narrowing the role of journalism to be the ideological service of party and state policy. The course to Ukrainisation was actively supported by the national conscious people of Donbas, including clerisy, coordinated around “Zaboy” / “Literary Donbass” magazine, the only one existing at the time. The activity of the magazine in late 20s – early 30s of XX century effected rising of general cultural level of readers, impacting the modernization of national consciousness of Luhansk people.

Conclusions. The study of indigenization policy and its consequences for printed press in Luhansk region reveals the social nature of journalism in general, emphasizing its creative aspect in gratification of spiritual and cultural needs of East Ukrainian community, associated with protection of Ukraine national interests.
Actual diagnostic and clinical problems in post-term pregnancy in modern obstetrics
Authors: Burkitova Ainura M , Prokhorova Viktoriya S , Bolotskikh Viacheslav M
Published: June 2017

This review is devoted to etiology and diagnostics post-term and prolonged pregnancy. We analyzed the results of studies aimed at the study of diagnostic, pregnancy and complications in childbirth in pregnant women at high risk for post-term pregnancy. When evaluating methods of prenatal training in prolonged and post-term pregnancy most studies showed greatest efficacy in the preparation of the cervix, and the lowest frequency of complications in childbirth when using antigestagens in comparison with other methods of preparing the cervix for childbirth. Despite the long history of the study of this problem, many questions concerning post-term pregnancy, are not fully studied and actual to this day.
A succinct medical safety: periodic safety update reports
Authors: Krishnamurthy Arun Chander Yadav , Dhanasekaran Jayasudha , Natarajan Anusha
Published: June 2017

In the rapidly developing era of advanced of medical sciences, pharmacovigilance plays an important role to put necessary brakes and help the medical fraternity to prescribe in a safe manner. Unanimously PSUR contributes in an essential way to regulate the drug marketing agencies to make sure that biological products which are marketed do not harm the general population by its adverse drug reactions. As we all know that the regulatory agencies like EMA, US FDA, CDSCO etc. are very stringent in approving the drugs, they have framed several rules and imposed strict timelines for reporting the necessary documents pertaining to drugs. Inevitably several new drugs like immunomodulators, anticancer drugs are on the raise which further adds a huge responsibility on the regulatory agencies regarding the risk and benefits of such biological products. Thus, the regulatory agencies have added several new implementation and amendments in the existing rules for the marketing of new drugs as well as already prevailing drugs. Hence, it is of paramount importance for the drug companies to follow the guidelines and abide by the rules of regulatory agencies for the benefit of mankind. However, several factors can impede the process of PSUR like improper data retrieval, inadequate training of resource personnel concerned with the development of PSUR. To overcome such difficulties, the field of advanced technology extended its arms for the regulatory authorities to implement electronic documentation and databases for the development of PSURs. In spite of all these efforts several challenges are to be met in the future in the field of pharmacovigilance. In this review several aspects of PSUR in different countries, necessary processes and format in which it needs to be submitted, pitfalls and ways to overcome such situations have been discussed in brief. Therefore, it is the collective responsibility of both Regulatory agencies and the drug companies to ensure a good quality PSUR is produced with its benefits outweighing the risk of the drug for the suffering human population.
Patient-reported outcomes with medical management of benign prostatic hyperplasia: a prospective study in a tertiary care teaching hospital of rural West Bengal, India
Authors: Mandal Soumitra , Mandal Ananya , Majhi Tapas K. , Mandal Sonai , Gangopadhyay Tanmoy , Das Asoke K.
Published: June 2017

Background: Effectiveness of pharmacotherapy in benign prostatic hyperplasia (BPH) is generally evaluated by clinical measures. Outcome of the treatment from the patient’s perspective however cannot be evaluated which may result communication gap between the patient and the physician. Patient-Reported Outcomes (PRO) studies can bridge this gap. This study was undertaken to evaluate outcomes and to assess the impact of medical management of BPH on general health-related quality of life.Methods: In this prospective, observational study, eligible patients with BPH attending a Urology clinic in a tertiary care rural hospital of West Bengal were enrolled and followed up on third and sixth months from baseline. Symptom assessment of BPH were assessed through International Prostate Symptom Score (I-PSS), BPH Impact Index (BII) and Health Related Quality of life questionnaires. Tools of descriptive statistics were used for analysis of data.Results: In the study population of 66 patients, 50% were treated with monotherapy (alpha blockers) and 50% were treated with combinations (alpha blocker and 5alpha reductase inhibitors). After 6 months of medical management, I-PSS was decreased from 18.86±5.53 to 11.76±3.94 (p <0.001), BII score decreased from 9.65±2.59 to 5.89±2.24 (p <0.001) and VAS score increased from 51.44±10.03 to 54.24±11.38 (p <0.001).Conclusions: We found medical management definitely improved quality of life in BPH patients and significantly decreased symptoms. This study is a step in the direction of development of larger and longer term PRO studies in BPH management.
An experimental study to investigate the effects of venlafaxine and escitalopram on anticonvulsant activity of conventional antiepileptic drugs in mice
Authors: Singh Santosh Kumar , Singh Anamika , Sharma Ashok Kumar
Published: June 2017

Background: Depression is a common psychiatric comorbidity in patients with epilepsy which remains often untreated, due to concern of antidepressant induced seizures. The safety status of selective serotonin reuptake inhibitors (SSRIs) in epileptics is controversial.Methods: Phase I acute effect of venlafaxine and escitalopram on the seizure threshold was studied. Phase II, the acute effects of test ADDs on the effective dose of AEDs viz valproate, phenobarbitone and phenytoin were studied in maximal electroshock (MES). Phase III- same study design as in phase II except that AEDs and ADDs were administered daily for 28 days.Results: Venlafaxine raised the electroconvulsive threshold in a dose dependant manner in phase I, however it was significant at a dose of 25mg/kg. In phase II, a significant reduction in ED50 of valproate was observed when it was co-administered with venlafaxine at dose of 12.5 and 25mg/kg, whereas ED50 of phenobarbitone was significantly reduced at a dose of 25mg/kg. Chronic administration of venlafaxine at 12.5mg/kg daily reduced ED50 of valproate. At 25mg/kg daily ED50 of all the three studied AEDs was reduced, Escitalopram 8mg/kg significantly raised the electroconvulsive threshold value in phase 1, Escitalopram administered in the dose of 8mg/kg reduced the ed50 value of valproate. Escitalopram given in dose of 4 and 8mg/kg reduced the ED50 value of valproate.Conclusions: From this finding, it may be concluded that venlafaxine and escitalopram administered either alone or in combination with AEDs acutely or chronically, exhibit anticonvulsant action.
A questionnaire based study on the knowledge, attitude, practice of staff nurses about pharmacovigilance in a tertiary care hospital
Authors: M. Prema , G. K. Nalini , G. N. Sahana , P. Deepak , Nagaral Jayashree V. , Rathod Geeta , U. S. Nuthan Kumar
Published: June 2017

Background: Adverse drug reactions (ADR) - one of the global problems of major concern leading to morbidity and mortality. Spontaneous reporting of ADR is the cornerstone of Pharmacovigilance (PV) programme and it is important to reduce the risk of drug related harm to the patient. The active participation of healthcare professionals (Doctors, Nurses, Pharmacist) play a major role in the success of Pharmacovigilance. The objective of the study was to assess the knowledge, attitude, practice of Staff Nurses about Pharmacovigilance in a tertiary care hospital.Methods: A Cross sectional, Observational questionnaire based study was carried out using a pre designed KAP questionnaire. Study included 100 staff nurses who were working in Hassan institute of medical sciences (HIMS). The results were analyzed using descriptive statisticsResults: In our study 65% participants knows the correct definition and 48.8% knows the important purpose of Pharmacovigilance and 77.5% aware of existence of ADR reporting system in India. There was huge gap between ADR experienced (53.8%) and ADR reported (21.3%). The determinants of under reporting from our study include Lack of time / overburdened (33.7%) and lack of knowledge about ADR (31.25%).Conclusions: This study showed that majority of participants understand the need for reporting of ADR. In spite of that the reporting rate of ADRs by them is very low. Hence, there is a need to create awareness about the importance of reporting ADR by conducting many Pharmacovigilance programme.
Drug utilization study in ischaemic heart disease in a tertiary care hospital, Mangalore, India
Authors: Zachariah Tittu George , K. Subramanyam , M. Pooja , Kempaller Vinayak J.
Published: June 2017

Background: The study of drug utilization is a component of a medical audit and periodic evaluation need to be done to enable suitable modifications in prescription of drugs to increase the therapeutic benefit and decrease the adverse effects. When new drugs are used additional information on safety and efficacy may be generated. Ischaemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium. Medications for IHD include anti-platelet therapy, nitrates, statins, ACE inhibitors, beta blockers, CCB’s, diuretics.Methods: The study was carried out at cardiology department of K. S. Hegde Charitable Hospital for a period of one year from January 2015, and relevant retrospective data were also collected from hospital records for period pertaining to one year from 1/1/2013.Results: We assessed discharge summaries of 950 patients and found that majority of patients were males than females. The highest number of patients were in the age group of 51-60 years. Polypharmacy has been observed in our study. The average number of days spent by the patients in the hospital was 3.5 days. None of the drugs were prescribed using generic names, all the drugs (100%) were prescribed in brand names only. Common co-morbidities associated with IHD were hypertension and diabetes. Most commonly prescribed drugs for IHD were Aspirin, followed by Atorvastatin, Clopidogrel, and Nitrates.Conclusions: In our study, on analysing the drug prescription data it was observed that there was no statistically significant change in drug utilization between the two years.
Awareness of surgeons and surgical trainees of online web-based techniques for teaching laparoscopic surgery in north Queensland
Authors: Egedovo Alfred , Ho Yik-Hong , Larkins Sarah , Mushuya Chrispen , Ashraf Muhammad , Nyandowe Masimba , Emeto Theophilus I. , Vangaveti Venkat N.
Published: June 2017

Background: For generations, surgical training has followed the example of an apprenticeship model. However, many doctors see this training as insufficient and potentially unsafe for the patient. Web-based simulation training for teaching laparoscopic surgery is not only becoming increasingly popular but is cheaper in comparison to the traditional apprenticeship method. Objective is to assess the educational value of web-based training videosMethods: Data was obtained through questionnaires sent to consultant surgeons and   surgical trainees at three sites in North Queensland. Study invited participants to complete a 24-item questionnaire on knowledge and attitudes. The questionnaires were distributed using online survey monkey software to send emails to the three Government Hospitals.Results: There was a response rate of 11.40%, Consultant surgeons (13/17; 72.20%) and surgical trainees (4/17; 22.20%).  Majority of participant`s sources of learning laparoscopic surgery was from supervisors in operating theatre (64.30%) and online Web-based training video (WBTV; 7.10%), although satisfaction with current web-based training video resources was found to vary widely for a variety of reasons. WBTV were used mainly when required for clinical rotation.Conclusions: There was a response rate of 11.40%, Consultant surgeons (13/17; 72.20%) and surgical trainees (4/17; 22.20%).  Majority of participant`s sources of learning laparoscopic surgery was from supervisors in operating theatre (64.30%) and online Web-based training video (WBTV; 7.10%), although satisfaction with current web-based training video resources was found to vary widely for a variety of reasons. WBTV were used mainly when required for clinical rotation.
A case series of uterine rupture: a continuing cause of maternal and fetal morbidity!
Authors: Choudhary Vinu , Bisu Surendra
Published: June 2017

Background: Uterine rupture is defined as a full-thickness separation of the uterine wall and the overlying serosa. It is a rare peripartum complication associated with severe maternal and neonatal morbidity and mortality. The objective of this study was to review the incidence of ruptured uterus and evaluate associated risk factors, maternal and fetal complications.Methods: 14 case notes were reviewed for every patient with a ruptured uterus for a period of 4 years, from January 2012 to December 2015.Results: 79% patients had uterine rupture while in labour. Three patients were not in labour (two had a spontaneous rupture at 28/40 and 33/40 weeks respectively and for one patient it was found during an elective C/S). Two out of five patients with 2 previous C/S ruptured at 28 and 33 weeks respectively. Two or more C/S were associated with increased risk of pre- labour rupture uterus as highlighted by the three cases.Conclusions: Challenging diagnosis and cases of pre- labour rupture may necessitate pre- pregnancy counselling and antenatal LUS thickness USS in certain cases.
The clinical study of the incisional hernia and its management
Authors: Garg Navdeep , Batra Pooja , Bali Sharadendu
Published: June 2017

Background: Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Incidence of Incisional hernias is 60%. It is the most common complication after exploratory laparotomy followed by LSCS.Methods: Data was collected for 30 cases of incisional hernia according to the proforma which included detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted.Results: Incisional hernia was more common in females with the ratio 1.5:1. The incidence of incisional hernia was highest in the age group ranging from 30-50 years. Most of the patients presented with chief complaint of swelling (100%) followed by pain and swelling (24%). Incisional hernia was more common in patients of previous history of abdominal procedures (explorative laparotomy 53%) followed by gynaecological operations (23%). Out of 30 patients studied, 20 underwent only mesh hernioplasty (67%), 10 underwent sublay mesh hernioplasty (23%).Conclusions: With prosthetic mesh, defects of any size can be repaired without tension. The polypropylene mesh, by inducing inflammatory response sets up scaffolding that in turn induces the synthesis of collagen. Thus, the superiority of mesh repair over suture repair can be accounted for.
Medical expulsion therapy in the management of ureteric calculi: a comparative real-life experience
Authors: Degaonkar Anil S. , Jamdade Pundlik T. , Bhamare Nikhil S. , Shirure Prashant A. , M. S. Manjuprasad , Swami Onkar C.
Published: June 2017

Background: One of the conservative management of ureteric caculi is by medical expulsive therapy by targeting common causes of obstruction such as edema, ureteral spasm and infection which will favour expulsion of calculi. The objective of this study was to assess comparative efficacy and safety of medical expulsive therapy of ureteric calculi.Methods: This was a randomized, prospective, open label, comparative study. Subjects satisfying inclusion and exclusion criteria were randomized into 4 groups tamsulosin, nifedipine, progesterone and control. Medical expulsion of calculi of 6mm to 15 mm size was carried out in 120 patients. Patients were followed up on OPD basis every third day. Calculi expulsion until day 28 as confirmed by abdominal ultrasonography was taken as the end point.Results: Expulsion rate in tamsulosin group was 90%, whereas nifedipine, progesterone group were 83.33% and 70% respectively which was significant compared to control group which was 36.6% (p < 0.005). Expulsion time was also reported to be significantly less in these groups as compared to control group. Therapy related adverse effects were minor and were seen in only 6 patients.Conclusions: Medical expulsive therapy of ureteric calculi of size 6 to 15mm with Tamsulosin, nifedipine and progesterone were safe and efficacious and could be implemented for initial management in selected patients.
Retroperitoneal cystic metastasis from cervical cancer: a rare case report
Authors: V. Shruthikamal , S. Reshma , A. Akmal
Published: June 2017

Cervical cancer accounts for 5% of all cases of cancer diagnosed worldwide. Cervical carcinoma commonly spreads via the lymphatics, with metastases first occurring in the pelvic lymph nodes, and then sequentially spreading to the paraortic nodes.  Retroperitoneal cystic metastases originating from cervical cancer is extremely rare.  In patients undergoing chemoradiation, isolated failure in the lymph nodes is uncommon and is more commonly associated with failure to control the primary tumor.  Study report a case of 62 years old woman with retroperitoneal cystic metastasis from cervical cancer managed with cystojejunostomy along with Roux en y reconstruction and chemotherapy.
Study of tuberculosis in HIV positive children in a tertiary care hospital of Odisha
Authors: Gahan Ajaya Kumar , Champatiray Jyoti Ranjan , Satpathy Saroj Kumar
Published: June 2017

Background: Tuberculosis and HIV have been closely linked since the emergence of AIDS. Worldwide, TB is the most common opportunistic infection affecting HIV seropositive individuals and it remains the most common cause of death in patients with AIDS. HIV infection has contributed to a significant increase in the worldwide incidence of TB. So, an attempt was made in the present study to know the magnitude/extent of tuberculosis, associated clinical patterns, epidemiological factors and outcomes in HIV positive children attending the ART Centre of SCB medical college and hospital, Cuttack.Methods: A tertiary care hospital based prospective study was carried out in 50 children between 6 months to 14 years of age for a period of 2 years.Results: Most of the cases were less than 6 years old. TB was more common in male children than in females. Most cases were from rural areas. Majority belong to Class IV (Upper Lower) and Class V(Lower) socio-economic class. Most had Grade II and Grade III malnutrition as per IAP classification. Definite history of contact and recent infection was present in most. Majority (75%) had pulmonary tuberculosis. Pleural variant was predominant in extra-pulmonary form followed by TB lymphadenitis and disseminated forms. 5% had both PTB and EPTB. Most cases were un vaccinated. Common clinical features were fever, cough, FTT, chronic diarrhoea. Disseminated TB was common in unvaccinated group. Recovery pattern was almost similar in vaccinated and unvaccinated groups. Most of the PTB cases were cured of the disease with only 2 deaths in this group whereas the number of deaths, children going LAMA and development of MDR-TB was more in disseminated forms.Conclusions: Occurrence of TB is high in HIV positive cases. EPTB is common in unvaccinated cases. TB is common in rural and underprivileged children. Drug compliance is poor in disseminated forms. Mortality is high in disseminated forms. Sequele is more in disseminated forms of TB.
Complicated severe acute malnutrition: anthropometric status from Southern Rajasthan, India
Authors: Jain Rupali , Suman Rameshwar Lal , Goyal Suresh , Meghwal B. L. , Meena Suresh Kumar
Published: June 2017

Background: Childhood under-nutrition is an important public health and development challenge in India. Undernourished children have significantly higher risk of mortality and morbidity. Objective of present study was to identify the anthropometric status of complicated Severe acute malnutrition (SAM) in Southern Rajasthan, India.Methods: It was a retrospective study conducted in children admitted at Malnutrition Treatment Centre attached to a tertiary hospital. Basic socio-demographic and anthropometric records of all children between 6 months to 5 years of age were analysed.Results: Out of the total 1554 SAM children admitted in last two years, 855 (55.01%) were males and 699 (44.98%) were females. Mean weight was 6.17±1.59 kg, mean height was 71.65±8.6 cm and Mid upper arm circumference (MUAC) was 10.99±1.53 cm. Among these, 1375 (88.48%) children fulfilled weight for height (WFH) criteria, 919 (59.13%) fulfilled MUAC criteria and 246 (15.83%) had edema. On WFH Zscore analysis, 53% had <-3SD and <-4SD, 19.88% had <-5SD, 9.97% had <-6SD, 3.47% had <-7SD and 1.67% had <-8SD. Also, we observed that lower values of MUAC ranging from <11.5cm to <9cm. MUAC of 11.5-10cm was in 43.43% of children and 15% had MUAC <10cm. Among the children of all age group, we observe that males of 6-24 months of age are more significantly affected as compared to females.Conclusions: The study highlights the fact that extreme grades of malnutrition exist in our area ranging upto Z-score of -8SD and beyond, and is not limited to -3SD and -4SD. Also, males are the more affected of the two sexes in our rural and tribal area setting.
Outbreak investigation of acute diarrheal disease in Palitana urban, Gujarat
Authors: Koria Bharti , Boricha B. P. , Munsi Hirava , Sarvaiya Jatin
Published: June 2017

Background: Clustering of diarrhoea and vomiting cases were reported in Palitana urban on 22 December 2014. Rapid response team was sent from government medical college, Bhavnagar to control the epidemic. Methods: A cross sectional study was conducted in Palitana urban for acute diarrheal disease epidemic investigation. Secondary data obtained from health staff and analysed to have clear picture of epidemic. Necessary actions were taken to control it. Results: Total 390 cases were reported. Out of them 21-30 adult age group was more affected as compared to other age groups. Attack rate of diarrheal disease was more in male population (85.61%) as compared to female population (40.99%).Over all attack rate was 64.19%. Conclusions: It was an acute diarrheal disease outbreak due to mixing of drinking water with polluted water.