bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of disease information (Ebola and COVID-19) on the pharmaceutical sector in Russia and USA
Authors: Fedorova E. A. , Afanasyev D. O. , Sokolov A. V. , Lazarev M. P.
Published: July 2021

Objective: identification of the relationship between the news coverage of global diseases and the dynamics of the return on shares of the pharmaceutical sector for Russia and the United States.

Material and methods. The empirical base of the study includes more than 700 thousand tweets on Ebola and COVID-19 in Russian and English, news of the RBC news agency. The sentiment of the text was assessed on the basis of five English and four Russian-language dictionaries, the influence of fundamental and textual variables on the profitability of pharmaceutical companies' shares was carried out using the ARMAX-GARCH econometric model.

Results. It has been proven that the dynamics of the stock index of pharmaceutical companies is explained by fundamental (economic) and sentimental factors. News of any epidemics negatively affects the pharmaceutical sector in the US and Russia, that is, there are no industries that benefit from this situation. Pandemic news affects US pharmaceutical companies more than Russian companies. The effect of news influence depends on the level of spread of the disease. News influences not only at the moment of their publication, but also after: there is a "delayed effect". Ebola news affects the American pharmaceutical market for 2 weeks, and the dynamics of the increase in influence can be traced. News on the COVID pandemic amplifies its impact during 1 week for the Russian pharmaceutical market and for 2 weeks for the US pharmaceutical companies. As for news sources, the elastic network has identified more significant variables based on publications from RBC; therefore, Internet publications generate more publicity, shaping a more significant overall sentiment in the markets.

Conclusion. The models developed in the framework of the study and the economic conclusions obtained have not only theoretical, but also practical significance, and can also be used for further research in this area. It is possible to give recommendations on the practical use of dictionaries to assess the sentiment of the text. In our study, the elastic network method chose the Loughran–McDonald dictionary for evaluating economic texts in English and the EcSentiThemeLex dictionary (designed in R and Python programming environments). Avenues for further investigation may include analysis of other sources of information about the pandemic.
Interdisciplinary Connections in the General Course of Higher Mathematics
Authors: Stepanov M.E.
Published: July 2021

The article discusses the methods of teaching higher mathematics, arising at the modern level of education in our country. The author relies on his experience working at the Faculty of Information Technologies of the Moscow State Psychological and Pedagogical University.
Relationship between thrombophilia status and short-term outcome in young adults with ischemic stroke
Authors: UZUNKÖPRÜ Cihat , BAŞKURT Esra , BEQİROSKİ Tea
Published: July 2021

Purpose: Ischemic stroke is a serious health condition in patients with young adults. This study aims to determine thrombophilia polymorphisms in young patients with ischemic stroke and associations with other risk factors.

Materials and Methods: We evaluated 64 patients with ischemic stroke under 50 years old. Computerized Tomography Angiography, Holter Electrocardiography, Transthoracic Echocardiography, thrombophilia status, and Modifying Rankin Scale (MRS) in baseline and first month findings were recorded. We analysed the association between thrombophilia status and short-term outcome in young adults with ischemic stroke.

Results: 64 patients (38 male, 59.4%) were included in our study. The mean age of the patients were 42.486.73. The thrombophilia status showed that the most frequent polymorphism was MTHFRA1298T mutation (18.8% homozygous, 43.7% heterozygous). The second was MTHFRC677T and the third polymorphism was Factor 5 Leiden mutation, of 21.8% was homozygous and 34.4% was heterozygous mutation. 7.8% of the patients have atrial fibrillation, 17.2% of them have patent foramen ovale, and 7.8% have elevated pulmonary artery pressure (>30 mmHg). Thrombophilia status and PFO were not associated with IS in young adults.

Conclusion: Young patients with ischemic stroke have several thrombophilial polymorphism; however, we did not detect any association with IS. Young patients with ischemic stroke have also many classic risk factors which should be treated appropriately. Patent foramen ovale is another remarkable pathology and more researches are needed to realize its relation with ischemic stroke in young adults.
Effects of chronic illness adaptation on the healthy lifestyle behaviours of patients in internal services
Authors: ASLAN Hakime , ÇETKİN Tülay , DEMİR Rukiye
Published: July 2021

Purpose: This descriptive study investigated the effects of chronic illness adaptation on the healthy lifestyle behaviours of patients in internal services.

Materials and Methods: The research was conducted with 104 inpatients at the Bingöl State Hospital. No sampling method was used in the study. A descriptive information form was utilised to record the patients’ sociodemographic characteristics. The Adaptation to Chronic Illness Scale (ACIS) and the Healthy Lifestyle Behavior Scale-II (HLBS-II) were used to collect the data on their adaptation and behaviour levels.

Results: The patients’ total mean ACIS score was 84.99±12.45, meaning that their adaptation to chronic illness was above average. Moreover, since their total mean HLBS-II score was 130.27±24.50, their adaptation to healthy lifestyle behaviours was moderate. The patients’ adaptation to chronic illness positively affected their healthy lifestyle behaviours (B=1.045), and this result was statistically significant.

Conclusion: Chronic illness adaptation positively influenced healthy lifestyle behaviours.
THE DOCUMENT ANALYSIS OF GRADUATE THESES ON THE SUBJECT OF THREEDIMENSIONAL VIRTUAL ENVIRONMENTS IN TURKEY
Authors: MERCAN Gamze , KÖSEOĞLU Pınar
Published: July 2021

The aim of this research is to examine the postgraduate theses on the subject of three-dimensional virtual environments, which is one of the outputs of rapid developments in the field of information technologies, software industry, and communication on the field of education, based on their demographic characteristics, research topics, research methodology, findings section, discussion and conclusion section, and suggestions section. The method of this research is document analysis, one of the qualitative research methods. The study documents of the research consist of 15 postgraduate theses, 11 master’s, and 4 doctoral theses, which were published in the National Thesis Center of Turkey between January 2010 and August 2020 on the subject of three-dimensional virtual environments. Analytical themes were also used in the analysis of the data obtained in the study in relation to descriptive analysis and descriptive themes obtained as a result of the deductive analysis. As a result of the research, it was found that there were a small number of postgraduate theses on three-dimensional virtual environments in the field of education.
TÜRKİYE’DEKİ DİJİTAL ÖYKÜLEME ÇALIŞMALARININ EĞİLİMİ
Authors: ULU Hacer
Published: July 2021

Araştırmanın amacı, Türkiye’de dijital öykülemeye dayalı yapılan araştırmaların eğilimini belirlemektir. Bu araştırma, dijital öykülemeye dayalı araştırmaların eğilimini sistematik olarak ayrıntılı incelenmesini içeren içerik analizi çalışmasıdır. 49 araştırma çalışmaya dahil edilmiştir. Veriler araştırmacı tarafından geliştirilen form aracılığıyla analiz edilmiştir. Bu form yayın türü ve yıllara göre dağılım, araştırma deseni, çalışma grubu seçimi, kademe, uygulama süresi, veri toplama araçları, kullanılan programlar, veri analiz yöntemleri, geçerlik ve güvenirlik çalışmaları, sonuçlar ve öneriler kategorilerinden oluşmaktadır. Araştırma sonucunda dijital öykülemeye dayalı çalışmaların en fazla makale ve yüksek lisans tezi türünde olduğu, farklı desenlerde tasarlandığı belirlenirken bu çalışmalarda farklı kademelerdeki öğrencilerin çalışma grubu olarak seçildiği, hem nitel hem nicel ölçme araçlarının kullanıldığı tespit edilmiştir. Ayrıca dijital öyküleme yönteminin öğrencilerin akademik başarılarına, bilgi, medya, teknoloji, yaratıcı düşünme, problem çözme, eleştirel düşünme, araştırma yapma, dil becerileri, iş birliği, öz düzenleme, karar verme, iletişim, bilimsel süreç, yabancı dil becerilerine ve hayal güçlerinin gelişimine olumlu yönde etki ettiği ortaya konmuştur.
TÜRKİYE’DE ARTIRILMIŞ GERÇEKLİKLE İLGİLİ EĞİTİM ALANINDA YAPILAN LİSANSÜSTÜ TEZLERİN İNCELENMESİ
Authors: AYDOĞDU Fatih
Published: July 2021

Araştırma artırılmış gerçeklikle ilgili eğitim alanında yapılan lisansüstü tezlerin çeşitli değişkenler açısından incelenmesi amacıyla yapılmıştır. Bu amaç doğrultusunda Yüksek Öğretim Kurulu Ulusal Tez Merkezinden erişilebilen, 2013-2020 yılları arasında artırılmış gerçeklikle ilgili eğitim alanında yapılan 76 tez araştırmaya dahil edilmiştir. Veriler içerik analizi yapılarak çözümlenmiştir. Araştırma sonucunda tezlerin çoğunluğunun yüksek lisans türünde olduğu, tezlerin genel olarak artma eğilimi gösterdiği, 44 üniversite, 6 enstitü ve 21 anabilim dalında yapıldığı, farklı konu alanlarında gerçekleştiği, en çok karma yöntem ve deneysel desenin kullanıldığı, lisans ve ortaokul düzeyinde öğrenim gören öğrencilerin araştırmalara daha çok dahil edildiği belirlenmiştir. Elde edilen bulgular doğrultusunda doktora tez çalışmalarının artırılması, farklı konularda çalışma yapılması, okul öncesi çocukların dahil edildiği çalışmaların yapılması önerilmiştir.
OKUL ÖNCESİ MÜZİK EĞİTİMİNDE TEKNOLOJİ KULLANIMI: ANTALYA İLİNDE NİTEL BİR ÇALIŞMA
Authors: BURAK Sabahat , ÇÖREKCİ Ezgi Düriye
Published: July 2021

Bu araştırmanın amacı, okul öncesi öğretmenleri ve öğretmen adaylarının müzik eğitiminde teknoloji kullanımına yönelik görüşlerini belirlemektir. Bu araştırmanın çalışma grubu 2019-2020 eğitim-öğretim yılında Antalya ilinin Muratpaşa, Konyaaltı, Kepez ilçelerinde özel, devlet ve belediyelere ait okul öncesi kurumlarında görev yapmakta olan okul öncesi öğretmenleri ve 2019-2020 eğitim-öğretim yılında Akdeniz Üniversitesi Eğitim Fakültesi Temel Eğitim Bölümü Okul Öncesi Öğretmenliği bölümü 4. Sınıfta okuyan okul öncesi öğretmen adaylarından oluşmaktadır. Araştırmaya toplamda 104 okul öncesi öğretmeni ve 76 okul öncesi öğretmeni adayı katılmıştır. İçerik analizi aracılığı ile okul öncesi öğretmeni ve öğretmen adaylarının müzik eğitiminde teknoloji kullanımına yönelik görüşleri temalara ayrılmıştır.
ZEKİ ÖĞRETİM SİSTEMLERİ ÜZERİNE YAPILAN LİSANSÜSTÜ TEZLERDEKİ EĞİLİMİN İNCELENMESİ: TÜRKİYE ÖRNEĞİ
Authors: AYDIN Furkan , YURDUGÜL Halil
Published: July 2021

Bu çalışmanın amacı Türkiye’deki yükseköğretimde zeki öğretim sistemleri üzerine bitirilen tezlerin incelenmesi ve araştırmacılara konu ile ilgili bir bakış açısı sağlanmaya çalışılmasıdır. Bu amaç doğrultusunda araştırma konusu “Türkiye’deki zeki öğretim sistemleri üzerine yazılan tezler” olarak belirlenmiş ve Yükseköğretim Kurulu (YÖK) tarafından doktora ve yüksek lisans tezlerinin yayınlandığı “https://tez.yok.gov.tr/” adresinden tarama gerçekleştirilmiştir. Çalışmada 2020 (dahil) yılına kadar yayınlanan ve belirlenen ölçütlere uyan 25 tez incelenmiştir. Tezler ise önceden belirlenmiş 10 ölçüte göre analiz edilmiştir. Bu ölçütler ise yıllara, eğitim seviyesi, içerik, çalışma grupları, öğrenci modelleri, öğrenci karakteristikleri, karar vermede kullanılan algoritmalar, öğrenene sunulan geri bildirimler ve tasarım etkililiğidir. Analiz sonucunda bir yılda en çok tez 2013 yılında yazıldığı, son 5 yılda (2016-2020) ise dört tez yazıldığı tespit edilmiştir. Tezlerin 9’u doktora, 16’sı ise yüksek lisans düzeyindedir. En çok Matematik dersine yönelik ZÖS geliştirilmiştir. Çalışma grubu olarak en çok lisans öğrencileri tercih edilmiştir. Bitirilen tezlerde zeki öğretim sistemleri en çok e-öğrenme kavramıyla birlikte ele alındığı; daha sonra sırasıyla öğrenme alanı, öğrenci modeli, yapay zekâ, uzman sistemler ve uyarlanabilir öğrenme kavramlarıyla birlikteliği tespit edilmiştir. Öğrenci modeli olarak en çok katman modeli kullanılmıştır. Öğrenci karakteristiklerinden en çok bilgi düzeyinin kullanıldığı görülmüştür. Karar vermede en çok kural tabanlı yaklaşımın kullandığı belirlenmiştir. Geri bildirim olarak en çok ipucunun kullanıldığı tespit edilmiştir. Son olarak tezlerin büyük bir çoğunluğunun, tasarım etkililiğinin değerlendirilmediği ya da raporlanmadığı belirlenmiştir. Sonuç olarak ise Türkiye’de zeki öğretim sistemleri üzerine tamamlanan tezlerin belirlenen ölçütler doğrultusunda var olan durumu ortaya konulmuştur.
Analysis of Induction Motor Performance Using Motor Current Signature Analysis Technique
Authors: Syahputra Ramadoni , Purwanto Hedi , Wiyagi Rama Okta , Mustar Muhamad Yusvin , Soesanti Indah
Published: July 2021

This paper discusses the analysis of the performance of an induction motor using the motor current signature analysis (MCSA) technique. Induction motor is a type of electric machine that is widely used in industry. One of the industries that utilize induction motors is a steam power plant (SPP). The role of induction motors is very vital in SPP operations. Therefore, it is necessary to monitor the performance, stability, and efficiency to anticipate disturbances that can cause damage or decrease the life of the induction motor. MCSA is a reliable technique that can be used to analyze damage to an induction motor. In this technique, the induction motor current signal is detected using a current transducer. The signal is then passed on to the signal conditioning and then into the data acquisition device. The important signal data is analyzed in adequate computer equipment. The results of this analysis determine the condition of the induction motor, whether it is normal or damaged. In this research, a case study was carried out at the Rembang steam power plant, Central Java, Indonesia. The results of the analysis of several induction motors show that most of them are in normal conditions and are still feasible to operate.
Inverator Starting Energy Saver Design For Electric Power Efficiency In Water Pumps
Authors: Pasaribu Faisal Irsan , Evalina Noorly , Harahap Partaonan
Published: July 2021

The use of a Water Pump at the initial start is the use of electricity with a large capacity which sometimes faces various kinds of efficiency problems. These problems include an increase in current that occurs in the channel by improving the quality of electric power, especially in the electrical system in the area of the use of the Water Pump, which is expected to be able to improve the quality of electric power. The purpose of the research was to design an inverter starting energy saver as an effort to improve power quality for electricity savings, electric power efficiency in water pumps. This improvement is also expected to be able to reduce the cost of using electricity bills, especially in the use of water pumps. To be able to carry out the improvement of the quality of the electric power, it is necessary to calculate the active power and apparent power when the water pump is used. After performing these calculations, the installation of the inverter starting circuit saver electricity will be used. By carrying out these steps by installing a series of inverters that can improve the quality of electrical power. And by using the inverter circuit starting Energy saver, it is clear that it produces an active power efficiency value of 82% of the active power before using the 272 Watt inverter circuit and active power after using the 223.9 Watt inverter circuit, and also produces an apparent power efficiency value of 83% before using the circuit. inverter 275.18 VA and apparent power after using the inverter circuit 227.94 VA
Sample size calculation for Mann-Whitney U test with five methods
Authors: Zhu Xiaoping
Published: July 2021

Background: Precise sample size estimation plays a vital role in the planning of a study specifically for medical treatment expenses that are expensive and studies that are of high risk.

Methods: Among a variety of sample size calculation methods for the nonparametric Mann-Whitney U test, five potential methods are selected for evaluation in this article. The evaluation of method performance is based on the results obtained from high precision Monte Carlo simulations.

Results: The sample size deviations (from the simulation ones) are performance indicators. The sum of the squared deviations over all scenarios is used as the criterion for ranking the five methods. For power comparisons, the percentage errors (relative to the simulated powers) are used. The effect size and target power both have large impacts on the minimum required sample sizes.

Conclusions: Based on the ranking criterion, Shieh's method has the best performance. Noether's method always overestimates the minimum required sample sizes but not too severe.
Development and evaluation of a culturally tailored education module for type 1 diabetes in a resource-constrained setting: protocol for a mixed-methods study
Authors: Rohilla Latika , Dayal Devi , Malhi Prahbhjot , Bharti Bhavneet , Kaur Sukhpal , Dhandapani Manju
Published: July 2021

Background: Diabetes education is the key to successful diabetes management. There is a need for an education module for type 1 diabetes (T1D) that is culture-specific and suited to resource constraints.

Methods: A mixed-methods study will be conducted, in three phases, to develop and evaluate a culturally tailored diabetes education module for Indian children with T1D and their families. During the first phase, a qualitative study among health professionals and families of children with T1D for need assessment will be conducted. During the second phase, based on the themes from the last phase, an educational module will be developed. The third phase will involve an evaluation of the content, feasibility and effectiveness of the proposed module. The content evaluation will be done using the standardized 'suitability assessment of materials' checklist. For feasibility, a mixed-method approach will be used with iterative cycles of satisfaction scale, semi-structured interview and feasibility and observation checklist. The module will be revised after each cycle till no new changes are suggested. The effectiveness will be assessed by a quasi-experimental controlled trial assessing glycemic control, health-related quality of life, clinically important events and self-management practices in T1D children at baseline and three and six months.

Conclusions: This study aims at development and validation of a novel culturally tailored diabetes education module for children with T1D, suited to their resource constraints. A module designed with the inputs from all stakeholders, and evaluated using iterative cycles, has the potential to suit the dynamic nature of diabetes management in children.

Trial registration: Trial registration number is CTRI/2021/04/032739.
Psychometric properties of quantitative sensory testing focusing on healthy and patients with shoulder pain: a systematic review protocol
Authors: Bilika Paraskevi , Savvoulidou Konstantina , Paliouras Achilleas , Dimitriadis Zacharias , Billis Evdokia , Strimpakos Nikolaos , Kapreli Eleni
Published: July 2021

Background: Quantitative sensory testing (QST) is a battery of non-invasive psychophysical methods to assess the function of somatosensory system. Although the use of QST is widespread and several studies in patients with chronic shoulder pain have used it, the level of evidence for the psychometric properties has not been established. The aim of this protocol is to investigate, through a systematic review, the level of evidence for the psychometric properties of QST in the shoulder.

Methods: For conducting and reporting this review the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines will be used. Nine databases including PubMed, Medline, AMED (via EBSCO), PEDRO, Embase, Web of Science, Scopus, SportDiscus, Google Scholar and Cochrane Library will be searched for the period from their inception until September 2021. Two reviewers (BP and SK) will independently evaluate the retrieved articles (titles and abstracts) and the psychometric characteristics checklist based on the standards from the COSMIN. The modified grading of recommendations assessment, development, and evaluation (GRADE) approach will be used to assess the overall quality of the evidence.

Conclusions: Evaluation of the level of evidence for the psychometric properties of QST in the shoulder is an essential step for evidence-based assessment in clinical practice.

Trial registration: PROSPERO registration number is CRD42021232778.
Clinical research education: a mini-review of the available opportunities for future and current clinical trial managers
Authors: Kopjar Veljko
Published: July 2021

Various for-profit as well as not-for-profit organizations offer educational opportunities for project managers. Often, these are generic (not industry-specific) as the goal is to attract a wide audience of students. Examples include Six Sigma and the Project Management Professional ® program. Although students may be granted an opportunity to research their own industry as part of the curriculum, these programs generally do not focus on clinical research project management skills in particular. Therefore, it can be difficult for Clinical study managers/clinical project managers, and others within the clinical research field, to find appropriate training opportunities. This aim of the study was to provide valuable information on some of the primary available educational opportunities that exist for those entering the clinical research management workforce, or who are otherwise interested in expanding their knowledge in this field.
Evaluation of modified nitrite test for diagnosing urinary tract infection in pediatrics
Authors: Babu N. Aravind
Published: July 2021

Background: Urinary tract infection (UTI) is a common bacterial infection causing illness in children. It may be difficult to recognize UTI in children because the presenting symptoms and signs are non-specific, particularly in younger children. In addition, urine collection and interpretation of urine tests in children are not easy, and therefore, it may not always be possible to confirm the diagnosis unequivocally. The study was conducted to evaluate the value of the modified nitrite test in diagnosing urinary tract infection (UTI) in children.Methods: The study included 150 children of both sexes, aged below 5 years, who were examined due to suspicion of UTI. The efficacy of the modified nitrite test to predict culture positivity was studied.Results: Modified nitrite test was positive in 14 out of the 26 culture-positive urine samples (sensitivity 53.85%). The specificity, positive predictive value, and negative predictive value were 96.77%, 77.78%, and 90.91%. The overall diagnostic accuracy was 89.33%.Conclusions: Modified nitrite test is an effective rapid screening test for diagnosing pediatric UTI.
Evaluation of SpO2, PaO2, FiO2 levels in developing retinopathy of prematurity
Authors: Das Porimal Kumar , Paul Shubhra Prakash , Halim Md Shamim Parvej Ibne , Mamun Mohammad Abdullah Al , Hossain Mohammad Monir , Shirin Mahfuza , Hossain A. H. M. Enayet , Biswas Puspanjali
Published: July 2021

Background: Retinopathy of prematurity (ROP) is a potentially blinding disease affecting the retinas in premature infants. In the treatment procedure of ROP, oxygen inhalation as well as the SpO2, PaO2, FiO2 levels analysis are some major concerns.Methods: This was a prospective COHORT study which was conducted at the special care baby unit (SCABU) and intensive care unit (ICU) of Dhaka shishu (children) hospital, Dhaka, Bangladesh from July 2012 to December 2014. Total one hundred (100) neonates of both sexes were finalized as the study population. Data were processed and analyzed using statistical software SPSS version 17, EPI info 7.Results: We found statistically significant risk for ROP, RR 3.48 (2.61-4.64) but there was no risk associated with FiO2 (24-32) % or 33-40 % in inhaled air. SpO2 (95-99) % was present in 25 (78.13%) of ROP (positive) neonates and 16 (23.53%) in ROP (negative) neonates. The difference was statistically significant (p<0.05) between the groups and RR 4.8 (2.51-9.28) for saturation of 95-99%. Partial pressure of oxygen >150 mm of Hg present in 12 (37.50%) cases of ROP (positive) neonates and 6 (8.82%) in ROP (negative) neonates. The difference was statistically significant (p<0.05) between the groups and RR 2.90 (1.83-4.5) for partial pressure of oxygen (>150) but there was no risk for partial pressure of 70-99 and 100-150 mm of Hg.Conclusions: During oxygen therapy FiO2 value, SpO2 value and more precisely the PaO2 value on neonate should be maintained within a target range.
Assessment of suitability of pediatric index of mortality 2 score for monitoring the outcome of pediatric intensive care unit patients and associated risk factors of mortality in a tertiary care center in South India
Authors: Y. Sreekrishna , E. Adarsh , S. Lavanya T.
Published: July 2021

Background: Pediatric index of mortality 2 (PIM 2) score is an illness severity and scoring systems used for predicting outcome of children admitted to PICU. The objective was to evaluate the usefulness of PIM 2 score in predicting mortality in our PICU, assess whether the model is calibrated to our case mix and to compare the observed and expected death rates by calculating standardised mortality ratio. Methods: It was a prospective observational study done in a tertiary care center from January 2019 to June 2020. Consecutive 120 patients admitted to PICU aged from 1 month to 18 years were enrolled in study. PIM 2 scoring was calculated for the data obtained within 1 hour of admission to PICU. The outcome was recorded as death or discharge. PIM 2 logit score is calculated using software.Results: PIM2 can discriminate between death and survival with area under curve (AUC) of 0.867 with 95% CI (0.729,0.980). PIM 2 predicted death rate was significant (p<0.001). The model is well calibrated with Hosmer- Lemeshow Goodness-of-fit test p=0.961 (p>0.05). The observed death rates are equal to predicted death rates and standardized mortality ratio (SMR) is equal to 1. Conclusions: PIM 2 score predicted mortality correlated well with observed mortality in PICU patients. The model is well calibrated for use in our set up and discriminate well between survivors and   non-survivors.
Effectiveness of an information booklet on knowledge regarding breastfeeding among mothers of under two-years children
Authors: Nag Arpita , Chaturvedi Anjali , Kumari Rina
Published: July 2021

Background: The basic food of infant is mother’s milk. Breastfeeding is the most effective way to provide a baby with a caring environment and complete food. It meets the nutritional as well as emotional and psychological needs of the infant. But there is tendency to replace the natural means of infant feeding and introduction of breast milk substitutes. So, breastfeeding deserves encouragement from all concerned in the welfare of children.Methods: A quantitative evaluative research approach and Quasi experimental one group pre-test post-test design was used. By using purposive sampling technique total 65 mothers of under two years children admitted in selected wards i.e.; pediatric and maternity ward at V.P.I.M.S., Lucknow, were selected to assess the effectiveness of an information booklet on knowledge regarding breastfeeding. Written permission was obtained from the authorities of Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, where the study was conducted.Results: In pre-test the majority of mothers, 50.80% had moderate knowledge, 40.00% of mothers had inadequate knowledge whereas 9.20% of mothers had adequate knowledge. In post-test majority 92.30% mothers had adequate knowledge, 7.70% mothers had moderate knowledge whereas none of the mothers had inadequate knowledge.Conclusions: The study concluded that after the distribution of information booklet on knowledge regarding breastfeeding mothers of under two-years children have gained their knowledge.
Demographic and clinical profile of children with severe acute malnutrition: an experience from nutritional rehabilitation centre in South Kashmir
Authors: Najar Bilal Ahmad , Bhat Mohd Ashraf , Rather Zul Eidain , Sheikh Mushtaq Ahmad
Published: July 2021

Background: Malnutrition is significant contributor of childhood morbidity and mortality in developing countries. More than 1/3rd of world’s severely malnourished children live in India. The aim was to evaluate the clinical-epidemiological profile and co-morbidities of SAM (severe acute malnutrition) children and to recognize socio-demographic risk factors of SAM children.Methods: It was a prospective hospital based case study. The prospective hospital based study was conducted from September 2018 to February 2020 and included children less than 5 years admitted to an paediatrics ward and satisfying the WHO definition of SAM. Data were entered in Microsoft excel sheet and SPSS software version 16 for windows was used for analysis.Results: 112 patients were taken for study. Mean age of admitted children were 16±3 months. Male:female ratio was 1:1.22. SAM is more common in nuclear families (N=67, 59.83%), illiterate mothers (N=72, 62.48%), children with high birth order more than 3 (N=42, 37%) and low socioeconomically status Kuppaswamy IV (N=72, 64.28%).The most common associated infections were acute gastroenteritis (82.14) and respiratory tract infections (54.20%). Hypoglycaemia (14.28) was the most common metabolic complication. The most commonly used supplementary food used was over diluted cow milk (43.67%).Conclusions: The problem of SAM is multifactorial (rural background, low socioeconomic status, maternal illiteracy, incomplete immunization). The findings of this study confirm the association of severe acute malnutrition with appropriate infant and young child feeding practices. NRCS provide life-saving care for children.
A case series of neonatal human parecho-virus encephalitis with a seasonality and endemicity
Authors: Kudukkan Favas , Athoor Bindu , Neliyathodi Fysal , Haweri Sheela P.
Published: July 2021

Human parecho viruses are small, non-enveloped, single stranded RNA viruses within parechovirus genus of the large picornaviridae family. In new-born it can cause gastroenteritis, sepsis and encephalitis. We report case series of parecho-virus encephalitis admitted to a tertiary care centre, Perinthalmanna. Parechoviral encephalitis is an endemic disease seasonally present (May-July) in certain regions of Northern part of Kerala. HPeV are viruses that cause CNS infection in the neonatal period, resulting in white matter lesions that can be visualised with MRI. In a retrospective study, 4 newborn babies of neonatal HPeV encephalitis diagnosed on the basis of clinical and radiological findings with a seasonality were assessed. HPeV encephalitis needs to be in differential diagnosis when neonates and young infants present with seizure and sepsis. HPeV infection must be considered in infants with specific pattern of white matter change but no convincing history of a perinatal hypoxic-ischaemic insult.
Corona virus myocarditis in pediatric age group: a rare manifestation of pandemic
Authors: U. Praveen , Jhadav Datta , Thakare Jitesh M. , G. Reshmi , Krishnan Priyanka
Published: July 2021

Myocarditis is an uncommon disease of adult and pediatric age group, characterized by inflammatory cell infiltrates, myocyte necrosis, or myocyte degeneration due to a myriad of causes and resulting in variable degrees of myocardial dysfunction. Which may be caused by infections, connective tissue disorders, granulomatous diseases, toxic agents or can be idiopathic. Viral infections are the most common etiology accounting for more than 50-60% of cases, particularly enterovirus (Coxsackie virus) and adenovirus groups. The disease is typically sporadic but may be epidemic. Manifestations of myocarditis range from asymptomatic or nonspecific generalized illness to acute cardiogenic shock and sudden death. In our case 10-year-old boy presented with history of fever and cough of 2 days duration. On examination patient found to be having tachycardia and tachypnea without other signs of heart failure. chest x-ray suggestive of bilateral pneumonia, ECG showed features of Myocarditis without any echocardiographic or cardiac enzyme abnormality. Child tested positive for corona virus rapid antigen test. Started on Favipiravir, corticosteroids and managed symptomatically. Child's heart rate normalized over a period of 4 days. Patient subsequently discharged with the advice of follow up echocardiography.
Case report of COVID-19 positive new born with necrotizing enterocolitis (NEC)
Authors: Rajurkar Rajshree , Dangi Chanda , Kela Gunjan
Published: July 2021

COVID-19 caused by SARS-Cov-2 virus has spread rapidly across the world. Children are just as like as adult to become infected with virus but have lesser symptoms and less severity of the disease. Necrotizing enterocolitis is one of the common gastrointestinal emergencies in neonatal intensive care unit. More than 85% of cases of NEC occur among preterm and very low birth weight. Preterm babies are vulnerable to develop NEC because of high incidence of perinatal distress factor, stasis of gut due to autonomic immaturity, poor barrier function of gut or immune defences, lack of feeding with human milk and higher incidence of nosocomial infections. During the current COVID-19 pandemic, no similar finding has been reported in the neonatal population to date. In this review we summarize the case report of two newborns admitted in our NICU who were COVID 19 positive presented to us with symptoms suggestive of necrotizing enterocolitis (NEC) and their outcome based on presence of comorbidity. Our case reports two case of two COVID-19 positive newborns admitted in our NICU with history, examination and investigations suggestive of necrotizing enterocolitis. Early initiation of antibiotics covering bowel flora, bowel rest and resuscitation, similar to our tried and true medical management of NEC, should be considered for initial management to avoid surgical intervention
Impact of estrogen replacement on growth, skeletal maturation, bone density and body composition in a girl with novel aromatase gene mutation
Authors: Agarwal Neha , Shukla Rishi , Bajpai Anurag
Published: July 2021

Aromatase deficiency is a rare autosomal recessive disorder characterized by impaired androgen to estrogen conversion. We report a 13.5-year-old girl initially misdiagnosed as simple virilising 21 hydroxylase deficiency who presented with delayed puberty. Work-up showed aromatase deficiency due to novel mutation in the aromatase gene. Estradiol replacement was associated with increased growth, skeletal maturation, bone density and adiposity. Early estrogen treatment in our case may have prevented metabolic complications and ovarian cysts.
Congenital laryngeal cyst causing respiratory distress in a neonate: a rare case report
Authors: Basak Aniruddha , Dey Debaleena
Published: July 2021

Congenital laryngeal cyst is a rare but responsible of upper airway obstruction which can be potentially life-threatening. The most common symptoms are inspiratory stridor, dyspnea, cyanosis, abnormal voice and difficulty with feeding. It should be differentiated from laryngomalacia. It is diagnosed by flexible fibro-optic laryngoscopy. Surgical options are endoscopic excision, needle aspiration, de-roofing, external laryngo-fissure and lateral pharyngotomy. The best treatment consists in the entire removal of the cyst. This case report described the case of 28 days old neonate with a severe airway distress and stridor caused by a congenital laryngeal cyst which has been managed by de-roofing of the cyst entirely with flexible laryngoscope.
Microalbuminuria as a predictor of cardiovascular morbidity in essential hypertensive patients: research study done at tertiary care centre in Western India
Authors: Parikh Rujuta R. , Gandhi Archana U. , Trivedi Smita K.
Published: July 2021

Background:Small amount of albumin excretion in urine, termed as microalbuminuria, has been postulated to be an indicator of endothelial dysfunction. This study was done to find the prevalence of microalbuminuria in patients with essential hypertension and to study the association of microalbuminuria with cardiovascular morbidity.Methods:This cross-sectional, observational study was conducted at the Department of Internal Medicine, Medical College and SSG Hospital, Baroda; by selecting 60 first time detected essential hypertensive patients, without any significant past or treatment history, attending Medicine outpatient department (OPD) or admitted in different wards at SSG hospital, for various reasons. A detailed history, clinical examination, basic blood investigation, urine albumin to creatinine ratio, electrocardiography (ECG) and 2D echo were done in all patients.Results:In this study, microalbuminuria was found in 24 (40%) cases with prevalence increasing with increasing age. A higher serum cholesterol, serum low density lipoprotein (LDL) and cholesterol/high density lipoprotein (HDL) ratio; left ventricular hypertrophy (LVH), ST-T changes and bundle branch block on ECG; LVH, hypokinesia and diastolic dysfunction on 2D echo; retinopathy on D fundus examination were all associated with higher microalbumin excretion in urine. Microalbuminuria was independent of age, sex, addiction to smoking, alcohol, BMI and severity/stage of hypertension. Thus, irrespective of existing known cardiovascular risk factors, microalbuminuria was associated with signs of cardiovascular morbidity.Conclusions:As a predictor of systemic vascular dysfunction, microalbuminuria can be used to stratify and prognosticate hypertensive patients at a higher risk of developing further vascular complications and they can be screened early for same.
Bugs and bones: a study of 25 cases of infectious spondylodiscitis
Authors: Sukumar Cynthia A. , Rai Shipra , Bhat Shyamasunder N. , Saravu Kavitha
Published: July 2021

Background: Infectious spondylodiscitis (IS) is an illness that presents a diagnostic dilemma. It is often associated with significant neurological morbidity, hence early diagnosis and treatment is crucial. As only a few Indian studies have dealt with IS, our study analyses the unique clinico-epidemiological profile of this disease in India and assesses the current management trends and outcome in these patients.Methods: A retrospective study of 25 cases of microbiologically confirmed IS in a single unit at a tertiary care hospital over an 18-month period (January 2018 to June 2019).Results: A total of 25 cases of IS were considered with a mean age of 49 years. Among the cases of non-tubercular spondylodiscitis (NTS), the organisms isolated were methicillin-resistant Staphylococcus aureus (MRSA), Brucella, Escherichia coli and Citrobacter. The average time taken from onset of symptoms to diagnosis was 3 months in tubercular spondylodiscitis (TS) cases and 5 months in NTS cases. Neurological complications were seen in 32% of the patients. Magnetic resonance imaging (MRI) was the imaging modality used to confirm diagnosis in up to 80% of the patients. Medical and surgical management were required in 84% of the cases.Conclusions: The clinical conundrum in IS primarily due to its atypical presentation. The higher tubercular burden of IS was also confirmed in our study and the time taken to presentation was markedly longer compared to the western data. Therefore, understanding the clinical spectrum of this disease helps overcome hurdles of recurrence and debilitating neurological morbidity.
Vitamin D levels in persons with traumatic spinal cord injury: a multicentre observational study
Authors: Saha Sucheta , Gupt Sandeep K. , Laisram Nonica , Siddique Ummatul , Rahman Simin
Published: July 2021

Background: According to the published literature, Vitamin D deficiency is prevalent in spinal cord injury (SCI). Many studies were done earlier to find out different factors which predispose the SCI population to the risk of vitamin deficiency, but correlation with any such factor is still uncertain. Studies from India are scarce. The present study was conducted in view of this lacuna in existing knowledge in India and in the developing countries, to observe the levels of Vitamin D in traumatic SCI patients admitted for rehabilitation.Methods: In this prospective, observational, multicentre study, all patients admitted consecutively in the three study centres, satisfying the selection criteria were included. The level of 25-OH Vitamin D was assessed by Chemiluminescence procedure. Vitamin D level <20 ng/ml was taken as deficient, 20-29ng/ml as insufficient, ≥30 ng/ml was the optimum and ≥150 ng/ml was taken as toxic level.Results: Among 56 patients of traumatic spinal cord injury who were included in the study, having mean age of 32.32±11.82 years, only 14 (25%) were having optimum Vitamin D level. 25 (45%) subjects were deficient in Vitamin D, whereas 16 (28%) were having insufficient levels. One subject was found to have toxic level of Vitamin D (156 ng/ml). No differences of Vitamin D levels were observed between demographic and clinical groups.Conclusions: Although a high rate of Vitamin D deficiency was encountered in SCI individuals, the role of different factors causing Vitamin D deficiency remains unproven. Also the amount of Vitamin D required to forestall insufficiency is still unknown, indicating a necessity for more studies with well-defined outcome measures.
Serum uric acid, lipid profile and alkaline phosphatase levels in ischemic cerebrovascular accident patients
Authors: Gupta Gaurav , Kishor Saurabh , Kumar Aditya
Published: July 2021

Background: Stroke or cerebrovascular accident (CVA) is noted as the second cause of mortality, especially in the elderly population. Recent studies indicated that higher concentrations of uric acid are involved in various vascular diseases. The findings of previous investigations suggest that, elevated serum alkaline phosphatase (ALP) levels may have a pathophysiological character in the occurrence of atherosclerotic vascular disease (AVD) of the heart and brain. This study evaluated the association between serum uric acid (SUA) levels, serum lipid levels, serum alkaline phosphatase (ALP) levels, and changes in ischemic cerebrovascular accident patients.Methods: All patients with Ischemic cerebrovascular accident age >50 years were included based on their clinical, laboratory, and radiological findings (including computed tomography (CT)/magnetic resonance imaging (MRI)) those admitted in our hospital. As control group 200 healthy individuals matched for sex and age were recruited from the same demographic area.Result: Multiple logistic regression analysis findings proposed four components as significant predictors in ischemic cerebrovascular accident (serum uric acid, serum ALP, LDL and HDL. In this study, it was found, that patients with ischemic cerebrovascular accident had significant difference (p<0.001) in serum uric acid and serum ALP than normal patients (non-ischemic cerebrovascular accident patients).Conclusions: Patients with ischemic cerebrovascular accident had significant difference (p<0.001) in SUA and serum ALP than normal patients (non-ischemic cerebrovascular accident patients). High SUA levels were observed to be associated significantly with ischemic stroke. On the basis of our study design, we cannot clarify that the elevated levels are the risk of ischemic stroke and it requires further studies.
A study on prevalence and pattern of tobacco uses and nicotine dependence among migrant labourers working in Pathanamthitta, Kerala
Authors: U. Prathvimraj B. , A. T. Jubina Bency
Published: July 2021

Background: According to domestic labour migrant report about 2.35 lakh migrant workers continue to arrive every year to Kerala and they are comparatively neglected group in the society and high level of smoking and other modes of tobacco consumption is seen in this population on general observation. Tobacco use is the leading cause of preventable death in the world and linked to 90% of oral cancer in South East Asia and cigarette smokers are 8.6 times higher risk for lung cancer than non-smokers. These are attributed to nicotine and several harmful carcinogens in tobacco products. Objectives were to study the prevalence and pattern of tobacco use among migrant labourers and to assess the associated risk factors among the study participants.Methods: A cross sectional study was done in a district, Pathanamthitta, Kerala among migrant labourers over a period of 2 months using WHO steps questionnaire for tobacco consumption and Fagerstrom test for nicotine dependence.Results: Majority of study participants belonged to age group of less than 25 years. 20.8% of the participants smoked nicotine products but only 1 participant had high dependence. The 75% of participants consumed smokeless tobacco products with 37% of those participants showing high dependence to the products.Conclusions: A field-based study will give an in depth understanding of problems of migrant population including their environment. It will also help in application of health planning and health education at community level.
Use of tamsulosin and dutasteride combination for the management of benign prostatic hyperplasia: a real world practice survey (VELTAM survey)
Authors: Sarkar Sudip
Published: July 2021

Background: Benign prostatic hyperplasia has high prevalence ranging from 8-80% affecting male population. Dutasteride and tamsulosin combination has been found to be more effective as compared to individual monotherapy. However, evidence on real world clinical experience on this combination is lacking. Aim and Objective of current study was to gather the evidence on real world clinical experience from the physicians using the combination of tamsulosin and dutasteride for the management of BPH.Methods: Responses from 1571 physicians who were the current prescribers of tamsulosin with dutasteride combination for the management of BPH were collected in a questioner containing a set of nine questions having multiple choice answers. All the data is expressed as number and percentage.Results: Majority of the physicians considered tamsulosin with dutasteride combination as the gold standard therapy for the treatment of BPH (88.86%). Most common co-morbidities which physician takes in to consideration was cardiovascular (62.61%) followed by asthma (23.04%). While treating BPH patients with cardiovascular co-morbidities, majority of the physician consider drug-drug interaction as significant criteria to decide the therapy (87.83%).Conclusions: Physicians considered tamsulosin and dutasteride combination as the gold standard for the management of BPH with cardiovascular co-morbidity. Tamsulosin and dutasteride combination is the first line choice for the management of BPH in real world practice.