bluuebunny/crossref_metadata_2025 huggingface dataset:
Satisfacción del usuario externo con la atención en establecimientos del Ministerio de Salud de Perú y sus factores asociados
Authors: Hernández-Vásquez Akram , Rojas-Roque Carlos , Prado-Galbarro Francisco Javier , Bendezu-Quispe Guido
Published: December 2019

Objetivos. Estimar la satisfacción con la atención en salud recibida en los establecimientos del Ministerio de Salud (MINSA) en el Perú y determinar sus factores asociados en adultos peruanos. Materiales y métodos. Estudio analítico de corte transversal empleando datos de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza (ENAHO) 2018. La satisfacción con la atención en salud recibida fue calificada como: muy mala, mala, buena, y muy buena. Se describieron las características de la población en estudio mediante frecuencias y proporciones ponderadas. Para determinar los factores asociados a la satisfacción con la atención recibida, se estimó un modelo logístico ordinal generalizado. Resultados. Se incluyó un total de 14 206 adultos (población expandida: 7 684 602) que reportaron haber sido atendidos en algún establecimiento de salud del MINSA. A nivel nacional, el 74,3% de usuarios reportó una satisfacción con el servicio recibido como «bueno o muy bueno». Padecer una enfermedad crónica, tener una lengua materna nativa o vivir en aglomeraciones poblacionales mayores a 2000 personas se asoció con una menor satisfacción con la atención recibida. Vivir en la selva se asoció con un reporte de mayor satisfacción con la atención. Conclusiones. Tres de cada cuatro usuarios externos califican como buena o muy buena la atención recibida en establecimientos del MINSA. Existen subgrupos poblacionales con una menor satisfacción de la atención recibida. Incidir en la mejora de la satisfacción de estos usuarios mejoraría la calidad de la atención en el MINSA, el mayor prestador en salud en Perú.
Supervisión de ensayos clínicos en hospitales del Seguro Social de Salud del Perú: enfoque administrativo y regulatorio
Authors: García-Mostajo Jorge A. , Rivera Fulton P. , Álvarez-Arroyo Violeta , Catacora-Villasante Manuel , Acosta Joshi
Published: December 2019

El objetivo del estudio fue describir las características de los ensayos clínicos (EC) supervisados por el Instituto de Evaluación de Tecnologías en Salud e Investigación en EsSalud entre el 2015 y 2018 y las principales observaciones de las supervisiones realizadas. Se realizó un estudio descriptivo de 82 ensayos clínicos supervisados entre 2015 y 2018. La mayoría de los ensayos clínicos fueron estudios de fase III (81,7%), la vía de administración más frecuente de los productos de estudio fue oral (47,6%) y la mayoría fueron patrocinados por la industria farmacéutica (96,3%). Las observaciones más frecuentes fueron las relacionadas al contrato de estudio (83,8%), al pago por concepto de overhead (57,3%) y a la falta de documentos regulatorios (47,6%). Estos hallazgos permiten la identificación de oportunidades de mejora en la regulación y gestión de la investigación.
Aclaración sobre endogamia editorial en la Revista Peruana de Medicina Experimental y Salud Pública
Authors: Alarco J. Jhonnel , Arroyo-Hernandez Hugo
Published: December 2019

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Instrucciones para los autores (versión 2020)
Authors: Instituto Nacional de Salud, Perú Rev Peru Med Exp Salud Publica,
Published: December 2019

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Birleştirilmiş SWARA-COPRAS Yaklaşımını Kullanarak Trüf Mantarı Yetiştirilmesi için Bölge Seçimi
Authors: YÜCENUR G.nilay , ŞENKAN Çağla , KARA Güzide Nur , TÜRKER Özge
Published: December 2019

Trüf mantarı, gerek
sahip olduğu oldukça yoğun aromatik tadı ve gerekse de besin değeri ile Dünya
genelinde gurme şeflerin aradığı ve sıklıkla kullandığı bir lezzettir.
Özellikle doğal ve doğaya dönük beslenmenin hızla yayıldığı son yıllarda
oldukça zor yetişen trüf mantarları verilen emek karşılığı alınan ekonomik
değer ve ithalat avantajı açısından da ülkelerin en önemli tarım ürünlerinden
biri olmaya adaydır. Bu çalışma kapsamında, Türkiye’de kurulması planlanan trüf
mantarı yetiştirme alanının hangi ilde kurulması ile ilgili çok kriterli bir
model önerilmiştir. 10 kriterden ve 3 alternatif ilden oluşan model, son
yıllarda kullanım alanını genişleten iki farklı çok kriterli karar verme
yönteminin entegrasyonu ile çözülmüştür. Çözümün ilk aşamasında alternatiflerin
değerlendirilmesi için önerilen 10 kriterin ağırlıklarının belirlenmesinde
uzmanların kriterleri önem sırasına göre sıralamalarına dayanan Adım Adım
Ağırlık Değerlendirme Oran Analizi (Step Wise Weight Assessment Ratio Analysis
/ SWARA) yöntemi kullanılmış, bu yöntemle elde edilen kriter ağırlıklarına göre
alternatifler Karmaşık Oransal Değerlendirme (Complex Proportional Assessment /
COPRAS) yöntemi ile değerlendirilmiştir. Çalışma, konusunda uzman kişilerin
görüşlerini alarak yetiştirilmesi oldukça zor olan trüf mantarının yetiştirilme
şartlarının incelenmesini sağlamış ve en doğru alternatif sıralamasının elde
edilmesine yardımcı olarak tarım konusunda yatırım yapacak olan girişimcilere
ve ülke yönetimine yol göstermiştir.
Epoxy Based Metal And Metal Oxide Doped New Composite Neutron And Gamma Radiation Moderator Material
Authors: AYGÜN Bünyamin
Published: December 2019

In this
study, five different composite shield materials were developed and
produced.  Epoxy resin based different
proportions, materials such as [chromium oxide (Cr2O3),
lithium florür (LiF), nickel oxide (NiO), bismuth oxide (Bi2O3),
manganese oxide (MnO), copper oxide (CuO), titanium oxide (TiO2),
cobalt oxide (CoO), gadolinium oxide (Gd2O3), selit (CaWO4),
iron oxide (Fe2O3), lead oxide (PbO)] were used on
production. The GEANT4 code of the Monte
Carlo simulation program was used in determining mixing ratios. The total
macroscopic cross section, mean free path and transmission neutron number were
determined for fast neutron radiation by using GEANT4 simulation code. The mass
attenuation coefficient and half-value layer (HVL) were calculated for gamma
radiation by using WinXCom software. Experimental absorbed dose measurement was
carried out and in these measurements 241Am-Be neutron source with
74 GBq activity which average neutron energy is approximately 4.5 MeV and BF3
gas detector were used.  Both simulation
and experimental measurements were compared with paraffin, conventional
concrete. It was found that the new composite shielding material absorbed
radiation much better than these reference materials. It has been suggested
that this new radiation shielding composite material can be used in areas such
as nuclear medicine, transport and storage of radioactive waste, nuclear power
plants and as shield material for both neutron and gamma radiation.
Anlam Çözümleme Modelleri İle Geliştirilen Türkçe İşaret Dili Çeviri Sisteminin Nesnelerin İnterneti Üzerinden Web Ortamında Uygulaması
Authors: FIRAT Yelda , UĞURLU Taşkın
Published: December 2019

Günlük
hayatta insanlar; duygularını, düşüncelerini ve yaşantılarını dili kullanarak
ya da kullanmaksızın çevrelerindeki insanlara aktararak iletişime geçerler. Dilsel
ve işitsel yetisi olmayan kişiler ise çevreleriyle bu iletişimi işaret dilini kullanarak
gerçekleştirirler. İşaret dili ise, engelli kişilerin hem kendi aralarında hem
de bu dili bilen engelsiz kişilerle jest, mimik ve vücut hareketleriyle anlaşmalarını
sağlayan bir dil olarak tanımlanır. Bu anlamda Nesnelerin İnterneti üzerinden
anlam çözümlenme modelleri ile web (ağ) ortamında çalışmasına yönelik
geliştirilen bu çalışma, duyma ve konuşma bozukluğu olan kişilerle işaret
dilini bilmeyenler arasındaki iletişimi sağlayan bir Türkçe İşaret Dili Çeviri
Sistemidir. Gerçekleştirilen bu sistemle; işaret dilini gösteren el
hareketleri, derinlik kamerasıyla yakalanmış, MQTT (Message Queuing Telemetry
Transport /Sıralı Telemetri Mesaj İletimi) sunucusuna gönderilmiştir. Gönderilen
bu görüntüler Üç Boyutlu Modelleme ve Hareket Analizinde kullanılan yapay sinir
ağları algoritmaları ve makine öğrenmesi yöntemleri ile analiz edilmiştir. Analiz
edilen görüntülerden elde edilen sözcüklerin gerçek anlamları ise, Biçimsel
Kavram Analizi Teorisi ile hazırlanan tematik rollerden oluşan gerçeklik
modelleriyle bulunmuştur. Gerçek anlamları bulunan bu kelimeler, içinde geçtiği
cümle ile birlikte lokal ağ ortamında yayınlanmıştır. Böylece, engelli bir kişi
aynı veya farklı mekanlarda yer alan kişi veya kişilerle iletişim kurabilmiştir.
Kesir Dereceli PID Denetleyici Kullanarak İçten Yanmalı Motorlarda Otonom Termal Yönetim Sistemi Tasarımı
Authors: KALELİ Ali Rıza
Published: December 2019

Bu çalışmada, kesir dereceli PID (FOPID) tipi
kontrolcülerin içten yanmalı motorlarda bağımsız soğutma sistemi için tasarımı
gerçekleştirilmiştir.  Önerilen kontrol
stratejisinde kontrolcü parametrelerinin belirlenmesinde doğrusal olamayan
optimizasyon tekniği kullanılmıştır. Otonom motor soğutma şeklinde
isimlendirilen bu sistem, geleneksel sisteme göre optimal ısı yönetimi bakımından
üstün bir performans sağlar. Tasarımda öncelikle soğutma sisteminin
matematiksel modeli elde edilmiştir. Sonrasında soğutma sistemi bileşenleri
için önerilen kontrol stratejisi hem sabit ve hem de geçici motor çalışma
koşulları için test edilmiştir. Sabit çalışma koşullarında kontolcü sayesinde
motor çıkış sıcaklığını izeleme hatası 0,0248 ve değişken
koşullarda ise sıcaklık izleme hatası ise 2,108 elde edilmiştir.
Farklı İstinat Duvar Tiplerinde Aktif Toprak Basınçlarının Sayısal Analizi
Authors: KAMİLOĞLU Hakan Alper , ŞADOĞLU Erol , YILMAZ Fatih
Published: December 2019

Dayanma yapılarının tasarımında yatay toprak basıncı
dağılımı önem arz etmektedir. Birçok çalışmada, dayanma yapısına etkiyen aktif
toprak basınç dağılımı nonlineer olarak kabul edilir. Toprak basınç dağılışı
ile ilgili çok sayıda çalışma olmasına karşın, Duvar boyutlarının yatay toprak
basıncı dağılışı üzerine etkilerini irdeleyen az sayıda çalışma bulunmaktadır.
Bu çalışmada, duvar şeklinin aktif yanal toprak basınç dağılımı ve aktif
kırılma yüzeyleri üzerine etkisi incelenmiştir. Bu nedenle çeşitli tip dayanma
duvarlarına gelen yanal toprak basınç dağılışları ve oluşturdukları kırılma
yüzeyleri numerik olarak irdelenmiştir. Yapılan çalışma kapsamında, çeşitli
eğimlerdeki ağırlık tipi dayanma duvarları, farklı topuk uzunlukları ve eğime
sahip ters T biçimli dayanma duvarları göz önüne alınmıştır. Yapılan çalışma
sonucunda yanal toprak basınç dağılışının duvar tipine göre değiştiği
belirlenmiştir. Buna ek olarak duvar eğimi ve topuk uzunluğunun kırılma
yüzeyleri ve yanal toprak basınç dağılışı üzerinde etkili olduğu görülmüştür.
Kolorektal Kanser Nedeniyle Ameliyat Edilen Hastaların Değerlendirilmesi
Authors: ÇİMEN Orhan , KURNAZ Eray , KESKİN ÇİMEN Ferda , EDEN Arif Onur
Published: December 2019

Kolorektal kanserler gastrointestinal sistemde en sık
görülen malign lezyonlardır. Kanserden ölümlerin en sık üçüncü sebebi
durumundadır. Erken evrelerde tanı almaları durumunda mortalite ve morbiditesi
daha düşüktür, cerrahi olarak kür sağlanma şansı daha fazla olmaktadır.
Erzincan Binali Yıldırım Üniversitesi Mengücek Gazi Eğitim Araştırma
Hastanesi’nde 2013-2018 yılları arasında kolorektal kanser nedeniyle ameliyat
edilen 86 hasta çalışmaya dahil edildi. Hastaların en
sık başvuru semptomları rektal kanama, anemi, kilo kaybı, karın ağrısı ve
dışkılama alışkanlığında değişikliklerdi. Kolorektal kanserlerde en önemli
prognostik faktör tanı anındaki tümör evresidir. Geç teşhis morbidite ve
mortalitede artışa neden olmaktadır. Ortaya çıkan semptomların hasta tarafından
önemsenmesi, hekim tarafından gerekli tetkiklerin vaktinde yapılması ve bu
konuda toplumsal bilincin arttırılması sayesinde tümörün erken tanısının
sağlanabileceği kanaatindeyiz.
Grand Canonical Monte Carlo Modeling of Anesthetic Xe Separation from Exhale Gas Mixtures Using Metal Organic Frameworks
Authors: GURDAL Yeliz
Published: December 2019

Xe
has been shown to be a promising candidate for anesthetic applications.
However,  its high price prevents its
usage in clinical industry. An alternative approach is to recover Xe from
anesthetic exhale gas mixture and recycle it to the inhale gas stream.
Although, many membranes and/or adsorbents have been proposed for recovering
anesthetic Xe, using metal organic frameworks (MOFs) for adsorption based
separation of  anesthetic Xe exhale gas
mixtures has been newly studied. MOFs have 
tunable pore sizes, large surface areas, and high porosities which
make them potential candidates for gas separation applications. Currently,
very little is known about anesthetic Xe recovery  performances of MOFs. We theoretically
investigate adsorption based separation of single component and binary
mixtures of CO2, Xe, and N2 in three MOFs, namely  CECYOY, SUDBOI, and ZUQPOQ. Single
component and binary adsorption isotherms and adsorption selectivities are
calculated using Grand Canonical Monte Carlo simulations for each MOF in
order to characterize their performances as adsorbents. Results suggest that
while MOFs prefer adsorption of CO2 for  CO2/Xe
mixture,  Xe adsorption is favorable in
the case of Xe/N2 mixture. While SUDBOI shows significantly large
CO2 adsorption selectivity for CO2/Xe mixture,  ZUQPOQ has the largest adsorption
selectivity for Xe/N2 mixture.
Therapeutic effects of anthocyanin-rich Hibiscus sabdariffa L. extract on body mass index, lipid profile and fatty liver in obese-hypercholesterolaemic rat model
Authors: Noordin Liza , Wan Mohamad Noor Wan Nurul Izzati , Safuan Sabreena , Wan Ahmad Wan Amir Nizam
Published: December 2019

Background: Hibiscus sabdariffa L. or Roselle, is one of the most common flower plants cultivated worldwide. Traditionally, it is claimed to reduce weight and cholesterol level. The aim of this study was to evaluate the effects of anthocyanin-rich Roselle aqueous extract on the physical, biochemical and histological changes in obese-hypercholesterolaemic rat model.Methods: Thirty Sprague-Dawley male rats were divided into five groups (n=6 per group). Group 1 is normal control (NC) rat that was fed with normal diet. The remaining rats (Group 2-5) were fed with commercial high-fat diet (HFD) for 6 weeks to induce obese-hypercholesterolaemic (OH) rat. After induction, the OH rats were divided into 4 groups: OH-Untreated group, OH-ARTE; OH treated with 300 mg/kg Roselle aqueous (anthocyanin-rich) and 1% trifluoroacetic acid extract (ARTE), OH-Orlistat; OH treated with 37 mg/kg orlistat and OH-Atorvastatin; OH treated with 10 mg/kg atorvastatin. After the 3 weeks intervention period, all rats were sacrificed. Body mass index, lipid profile and liver enzymes were evaluated. The liver section was subjected to hematoxylin and eosin staining for histopathological evaluation.Results: This study showed that 3 weeks administration of ARTE significantly reduced BMI, improved levels of lipid profile and liver enzymes, and histopathological changes of liver when compared to OH-untreated rats. The results were also comparable to the standard drugs.Conclusions: This study suggested that Roselle extract constitutes an effective and safe alternate treatment for obesity and hyperlipidaemia.
Ameliorative potentials of aqueous extracts of leaf and stem of Ipomoea involucrata on selected biochemicals in experimental diabetic rats
Authors: Ogunka Nnoka Charity Uchechi , Okolo Lucky Uche , Uwakwe Augustine Amadikwa
Published: December 2019

Background: Diabetes mellitus is a chronic metabolic disorder characterized by derangements in carbohydrate, protein and lipid metabolisms, due to deficiency in insulin secretion and action. This research evaluates the ameliorative potentials of aqueous extracts of leaves and stem of Ipomoea involucorata on selected biochemicals in experimental diabetic rats.Methods: Diabetes mellitus was induced by single intraperitoneal injection of 150 mg/kg body weight of alloxan and the animals were orally administered with gilanil (4 mg/kg) for positive control, 100, 200 and 300 mg/kg bw aqueous extract of leaves (groups 4-6) and stem (groups 7-9) of Ipomoea involucrata once daily for 21 days. Biochemical parameters were analysed using standard methods.Results: The median lethal dose was established at 648 mg/kg (leaves) and 547 mg/kg (stem). The negative group (untreated) showed significant increase in glucose concentration compared to the other groups. After 2 to 3 weeks there was significant (p<0.05) decrease in glucose concentration of the extract and glibenclamide (positive group) treated groups when compared with the negative group. Diabetes control rats showed significant (p<0.05) high serum lipid profile (except for high density lipoprotein), liver enzymes/ indices and renal indices when compared with non-diabetic control rats. However, these alternations were reversed with the positive group and the groups treated with aqueous extracts of both samples. The differences observed in the electrolytes were not significant in all groups.Conclusions: The results suggest that aqueous extract of leaves and stem of I. involucrata is considerably safe and a potential therapy for management of complications associated with diabetes mellitus.
Evaluation of antianxiety effect of cinnamaldehyde in swiss albino mice
Authors: Churihar Ritesh , More Sapna A. , Mishra Pooja S. , Vyas Savita , Tanwani Hemant
Published: December 2019

Background: Cinnamon is one of the best known spices used as an herbal medicine. Cinnamaldehyde (CNM) the volatile oil, which was present in the essential oil of the bark, is the important constituents of cinnamon. Cinnamon has been investigated for its various effects like peptic ulcer protection, antioxidant property, inhibition of tau aggregation, anti-inflammatory activity, effect on cardiovascular system, anti-nociceptive activity, hepato-protective effects, hypolipidemic and antidiabetic activites. The present study was aimed to evaluate the anxiolytic effect of CNM per se and its interaction with diazepam in swiss albino mice.Methods: Anxiolytic activity was evaluated by elevated plus maze method. A group of 36 healthy mice of either sex weighing 20-30 grams were divided at random into six groups (n=6). CNM and diazepam were dissolved in tween twenty 20% to maintain uniformity of the solvent and given orally. Group I was given twenty 20% (10 ml/kg, p.o.), group II diazepam (0.5 mg/kg, p.o.), group III diazepam (1 mg/kg, p.o.), group IV cinnamaldehyde (100 mg/kg, p.o.), group V cinnamaldehyde (200 mg/kg, p.o.), group VI cinnamaldehyde and diazepam (100 mg/kg and 0.5 mg/kg, p.o.).Results: Cinnamaldehyde per se showed no anxiolytic effect at any dose (p<0.05). The standard drug diazepam has shown significant anxiolytic activity on elevated plus maze. Whereas combination of diazepam 0.5 mg/kg and cinnamaldehyde 100 mg/kg showed significant increase in the time spent in open arms as compared to all groups (p<0.05).Conclusions: CNM per se did not show any effect on anxiety but enhanced the action of diazepam when co-administered.
Sociodemographic and drug prescription pattern in patients with rheumatoid arthritis in a tertiary care teaching hospital
Authors: Kairi Vijoy Sankar , Barman Sarajita
Published: December 2019

Background: Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease that affects mainly the small joints of the hands and feet. RA is widely prevalent throughout the world.Methods: A prospective and observational study was carried out on 44 patients for 6 months. Patients of either sex, aged between 18 to 70 years diagnosed with rheumatoid arthritis were screened and recruited in the study. Patients were diagnosed on the basis of clinical assessment and the lab parameters assessed were rheumatoid factor and anti-CCP (anti-cyclic citrullinated peptide antibody). Prescriptions were analyzed for socio-demographic details and drug prescribing pattern.Results: Out of 44 patients, 36 (81.82%) were females, 8 (18.18%) were males. Maximum occurred 19 (43.18) between 31 to 40 years of age. Out of 19 (43.18%), females were 16 (36.36%), males were 3 (6.83%). 39 (88.63%) were from rural and 5 (11.37%) from urban area, 21 (47.73%) illiterate, 15 (34.09%) primary educated, 7 (15.91%) secondary educated, 1 (2.27%) educated above higher secondary, 4 (9.08%) unemployed, 2 (4.55%) students, 19 (43.18%) housewives, 7 (15.91%) agricultural workers, 7 (15.91%) non-agricultural outdoor workers and 5 (11.37%) non-agricultural indoor workers. Most common co-morbidity was hypertension 28 (63.63%). Anti-CCP was positive in 38 (86.36%). All of the patients 44 (100%) received disease-modifying anti-rheumatic drugs (DMARDs). Majority of the patients were prescribed with triple DMARDs combination 30 (68.18%).Conclusions: We observed that female were dominant over the male with male: female ratio of 1: 4.5. Prescriptions pattern was primarily based on DMARDs.
Assessment of quality of life of type-2 diabetes mellitus patients in tertiary care teaching hospital in North India
Authors: Parashar Aditya , Jha K. K. , Kumar Arun , Tomer Sheetal Singh , Yadav Dharmendra Singh , Imran Haidar
Published: December 2019

Background: Quality of life (QoL) is a standard indicating a person’s life in better condition as compared to a diseased person or patient. Diabetes itself is not a dangerous disease if managed properly, but it becomes life-threatening after a certain time period because of the patient’s poor interest in disease management and treatment adherence. Diabetes mellitus is an endocrine system disorder that invokes lack of insulin secretion in the bloodstream. The study was conducted to assess the QoL of type-2 diabetes mellitus patients with QoL instrument.Methods: Questionnaire based cross-sectional, prospective study was conducted at Teerthanker Mahaveer Hospital, Moradabad, for a duration of 6 months from January - June 2019, on 196 patients of type-2 diabetes mellitus.Results: On an average 56.5% people have accepted that due to the diabetic condition their working proficiency is decreased. 80.3% of patients have accepted that they were facing problems due to diabetic symptoms. Similarly, 84% of patients have accepted that the ongoing treatment was quite expensive than their expectations. Finally, the last section of the patient’s emotional/mental satisfaction showed that 49.7% of patients were very satisfied with their family support while 13.7% of patients were not satisfied.Conclusions: QOL instrument for Indian diabetes patient’s instrument helped to evaluate the patient’s physical strength, psychological strength of the patient during disease condition, the response provided from the family members and relatives, the economical status of the patient and its effects on their living.
Evaluation of prescribing pattern and rationality of fixed dose combinations in patients of general medicine department
Authors: Joshi Nupuri , Falke Anvita , Saji Sajin , Diwan Arundhati , Raut Asawari
Published: December 2019

Background: Fixed dose combinations are widely used in India, they are either irrational or prescribed irrationally. Moreover, the government has recently banned over 300 fixed dose combinations (FDCs) because of a lack of therapeutic justification. This study was conducted to study the prescribing pattern of FDCs in a tertiary care teaching hospital and to highlight the rationality of FDCs, and adverse drug reactions (ADRs) associated with them.Methods: In the present prospective observational study, a total of 500 inpatients were evaluated for prescribing pattern, cost analysis, and adverse drug reactions (ADRs) of FDCs. The FDCs were assessed for their rationality. The ADRs and severity were assessed using the WHO causality scale, Hartwig severity scale respectively.Results: Out of total 103 FDCs, 58 were approved, 86 were rational and 17 were irrational. 5 FDCs were banned and irrational. 48.54% of rational FDCs had rationality score from 7 to 9. The most commonly prescribed FDCs belonged to the anatomic therapeutic and chemical class of respiratory system, followed by the in younger age group and cardiovascular FDCs in the elderly. The 886 ADRs occurred in 500 patients with a mean of 1.81±1.9. Banned FDCs contributed to 76 ADRs. According to causality and severity assessment, most of the ADRs were possible (62.53%) and mild (70.77%) respectively.Conclusions: Although FDCs were rational in most cases but banned FDCs were also prescribed. As these FDCs were associated with ADRs, monitoring of patients is necessary. Knowledge and attitude of healthcare professionals can be assessed through awareness programs.
Adverse drug reactions observed in treatment of gastro intestinal and respiratory tract infections: a prospective analysis
Authors: Kodam Laxmipathi , Tamma Naveen Kumar , Marupaka Janardhan , Karedla Srinivasu
Published: December 2019

Background: The aim of the study was to observe common adverse drug reactions in treatment of gastro intestinal and respiratory tract infections in a tertiary care hospitals.Methods: A prospective observational study was conducted by Departments of Pharmacology for a period of one year from prescriptions and case sheets of medical record section. Adverse drug reaction reporting forms and alert cards were used for reporting.Results: The drugs most commonly used for gastrointestinal tract and respiratory diseases are tablets norflox 400 mg, norflox-tz, taxim 200 mg, IV amikacin and iv amoxicillin (500 mg) and clavulanic acid (125 mg) combination. Systems affected by use of above drugs were skin and gastrointestinal tract. Urticaria on skin, abdominal pain, itching in genital area, ulcer on oral mucosa are the common adverse drug reactions observed.Conclusions: Drugs used for common gastrointestinal tract and respiratory tract infections alert cards should be issued to patients when prescribing and adverse drug reactions should be reported to higher centres. Brand names causing adverse reactions should be monitored regularly and their further usage should be based on signals from other centres. All tertiary care hospitals should have antimicrobial guidelines policy to reduce adverse drug reactions.
A study to assess the completeness of informed consent documents for biomedical research on human participants submitted to the institutional ethics committee of a tertiary care hospital
Authors: Anandabaskar Nishanthi , Vimal Mourouguessine , Dongre Amol Rambhau , Kagne Rajendrakumar Nivaratirao
Published: December 2019

Background: Informed consent is an essential pre-requisite for research on human participants. However, many studies have shown that informed consent documents (ICDs) are incomplete and lack many of the essential elements. The objective of the study was to assess the completeness of ICDs submitted to an institutional ethics committee (IEC) against the Indian Council of Medical Research (ICMR) ethical guidelines for biomedical research on human participants.Methods: This is a retrospective cross-sectional study. The ICDs submitted to the IEC during the period from January 2015 to December 2017 were reviewed for completeness, with the help of a checklist which is based ICMR ethical guidelines for biomedical research on human participants 2006.Results: A total of 212 ICDs were reviewed during the study period. More than 50% of the ICDs have clearly explained many of the essential elements like nature and purpose of the study (62.3%), voluntary participation (98.6%), procedures (68.9%), risks (71.2%), benefits (92.9%), alternative treatments (60.7%), maintaining confidentiality (99.1%), no loss of benefits on withdrawal from the study (87.8%) and contact details of principal investigator (99.5%). However, the other essential elements of the ICD are either not mentioned or not clearly explained.Conclusions: This study has shown that although majority of the ICDs submitted for review by the IEC have mentioned many of the essential elements, some of the elements like contact details of Chairman of IEC, future use of sample, compensation for trial related injury and provision of counseling for consent of genetics testing have not been stated.
Drug utilization study in medicine intensive care unit in tertiary care hospital
Authors: Athawale Siddharth Suryakant , Kulkarni Madhuri D.
Published: December 2019

Background: The medical intensive care unit (MICU) is a setting were patients who are critically ill are admitted and thus usually receive a large number of drugs of different pharmacological classes due to life threatening illnesses which may be fatal. The various drugs used in MICU and there clinical outcome was investigated in this study.Methods: Patients admitted between January 2017 to June 2018 in Medicine ICU of GMC Aurangabad were included in this study.Results: Total of 351 prescriptions was analyzed from the medicine intensive care unit. Out of 351 patients 243 (69.23%) were male, while 108 (30.77%) were female. The mean age of the patients admitted in MICU was 42.78±18.14 years. The most common type of patients admitted in MICU have the diagnosis of organophosphorous poisoning (25.36%), followed by cerebrovascular accident (15.95%), pneumonitis (10.26%), snake bite (7.12%), chronic kidney disease (5.98%), diabetic ketoacidosis (5.70%) and seizure disorder (3.42%). The most common drugs used were ranitidine (99.71%) and ondansetron (99.43%). Among antibiotics cephalosporins were most commonly used, ceftriaxone (39.03%), cefotaxim (40.46%), cefoperazone and sulbactum (24.22%). Other antibiotics most commonly used were metronidazole (61.25%), amoxicillin and potassium clavulanate (26.78%), piperacillin and tazobactum (11.68%), meropenem (11.40%).Conclusions: In conclusion, we found that in MICU utilization rate of gastroprotective (ranitidine), antiemetic (ondansetron) and antibiotics (cephalosporins) was high. The present study provides valuable insight about the overall pattern of drugs used in medicine intensive care unit.
Women post menopause: assessment of quality of life and socio-demographic correlates
Authors: Raj Purnima , Deshmukh Namita , Borkar Avinash
Published: December 2019

Background: Menopause can have psychological, physical, and vasomotor symptoms along with sexual dysfunction, Current health care model fail to recognize that these symptoms profoundly affect a woman’s personal and social functioning and ultimately her quality of life. Hence, this study aims to assess the Quality of life of post-menopausal women and finding out socio-demographic factors affecting quality of life.Methods: A cross-sectional study in an urban slum area was undertaken and 105 females between 45-65 years of age were interviewed using menopause-specific quality of life (MENQOL) questionnaire.Results: The mean age of these study participants was 54.13±4.05 (45-62) years. Out of 105 post-menopausal women included in the study, 20% were illiterate, 26.7% had completed education up to Secondary school level. Total MENQOL scores ranged from 62-148 and total mean score was 101.3±23.44.Conclusions: Menopause affected not only physical health of a woman but also affects psychosocial aspect of life and this was well evident from the present study where MENQOL scores were higher indicating poor quality of life after menopause. Ageing, lower education, lower socio-economic status, unemployment and no spouse support were contributing to the poor quality of life.
Ethambutol induced optic neuritis: a case series
Authors: N. Sruthi , M. Anuradha
Published: December 2019

Ethambutol is one of the first line chemotherapeutic agents used in the treatment of tuberculosis used both in the intensive and continuation phase according to the new Revised National Tuberculosis Control Program guidelines. Patient acceptability is rather good with this drug as it produces comparatively lesser adverse effects. The most important and serious side effect reported is optic neuritis, resulting in loss of visual acuity, color vision and field defects. The incidence of optic neuritis is generally directly proportional to the dose and duration of ethambutol therapy. Here we report four cases of ethambutol induced optic neuritis in patients on fixed dose combinations (FDC) of ethambutol, isoniazid, pyrazinamide and rifampicin who presented in Ophthalmology OPD in a span of 2 months, between June and July 2019. Contradictory to the rare occurrence of ethambutol induced optic neuritis this comparatively higher incidence of optic neuritis is alarming. We observed that the presentation of ethambutol induced optic neuritis can vary and dose of ethambutol along with other factors can also contribute to it. So proper pre-treatment evaluation, dosage adjustment, periodic monitoring and early detection have a significant role in prevention and treatment of ethambutol induced optic neuritis.
Factors influencing the uptake of pulse vitamin A supplementation among children in a rural area in India: a cross sectional study
Authors: Ramani Vinod K. , Lakshman Anand
Published: December 2019

Background: The change in strategy of India’s National Program for the prevention and control of nutritional blindness due to Vitamin A deficiency during 2006, aims for all children aged 9 months to 5 years to receive biannual pulse dose of Vitamin A with a total nine mega doses of Vitamin A. Micronutrient initiative (MI) was providing technical assistance to the State Health department of Karnataka in implementing the new bi-annual strategy, in partnership with UNICEF during the period 2006 to 2010.Methods: During July 2006, the Investigator evaluated its coverage in Gulbarga district. This study assessed the factors influencing the uptake of pulse Vitamin A supplementation (VAS) among children from impoverished background. Using oral questionnaires, a total of 30 Parents (Mothers) of these children, 12 childcare workers (AWWs), 12 peripheral health workers (ANMs) were interviewed regarding barriers towards implementing this Program and assessment of the facilities (12 Anganwadi centres) were conducted.Results: Only 28% of the facility had some IEC display regarding VAS. 75% of ANMs were aware that either green leafy vegetables or fish or fruits are the main source of micronutrients. A similar number of ANMs knew that Vitamin A deficiency causes night blindness, >90% of AWW had informed parents about the program during the monthly mother meetings. <20% of parents were aware of the current pulse VAS program and a similar number were aware of the next round of supplementation.Conclusions: Regular interaction with families, monitoring the activities of field level health workers and supportive supervision will enable uptake of VAS Program. Future action should prioritize sub-district level units – blocks and villages, with higher concentration of poor households.
Knowledge and perceptions regarding immunization among mothers of under five children: a community study from South Kerala
Authors: N. Navaneetha , Abraham Sherin Billy , Thomas Thushara , Mary Rose , . Bhuvanendu , Abbas Hilal
Published: December 2019

Background: Immunization coverage is undisputedly the most effective health status and outcome indicator.  Though India is effectively organizing vaccination campaigns, a large majority of children are often left out. Strong anti-vaccination propaganda is influencing the decision of parents. This study was initiated in the context of vaccine-preventable disease outbreak rising recently in Kerala to assess the knowledge and practices of mothers of children less than five years regarding immunization.Methods: A cross sectional study was conducted among 140 women with children less than 5 years. Sample was drawn from the rural and urban field practice areas of a tertiary care teaching hospital. A pilot tested interviewer administered questionnaire was used to assess the knowledge and practices of immunization among mothers of under-five children. Chi-Square test was used to find the association between dichotomous variables.Results: In the study group 96.4% of the children were fully immunized. Mean score on knowledge regarding immunization among the study population was 6.45 (SD=1.84). Majority (89%) of the mothers agreed on the importance of vaccination. More than half (57.1%) had heard of anti-vaccination campaign and 24.3% were influenced by it at one time or the other. Higher knowledge score was associated with mothers residing in urban area, better occupation of mother and educational status of father. Age of child, sex, religion, type of family did not influence knowledge level. Factors influencing the perceived importance of vaccination are better occupation of father, higher education status of father and mother.Conclusions: Vaccination was perceived significant for child’s health. Immunization coverage in the study population was high. The level of knowledge regarding immunization among the study population was poor. Anti-vaccination campaign has influenced the population at one time or the other.
A study of mortality and morbidity profile of electrolyte imbalance in critically ill children with special importance to mechanical ventilation
Authors: V. Kishore S. , Routray Mrutyunjay , Champatiray Jyotiranjan , Satpathy Saroj Kumar
Published: December 2019

Background: Electrolytes imbalance is not uncommon in critically ill children. The outcome of critically ill child is dependent on various factors like the underlying disease, fluid and nutrition, which are responsible for electrolyte homeostasis in tandem with renal function and many others. In this study authors look into morbidity and mortality associated with dyselectrolytemia with special importance to children on mechanical ventilation.Methods: This prospective observational study was conducted in the PICU, SVPPGIP (SCB MC and Hospital), Cuttack during the period November 2015 to October 2017. Includes children admitted to PICU (Based on consensus guidelines for PICUs in India, Indian Society of Critical Care Medicine (Pediatric Section) and Indian Academy of Pediatrics (Intensive Care Chapter).Results: Mortality distribution in electrolyte abnormality patients is 27.9% (around 3 times higher than normal electrolyte patients). 25% hyponatremic patients and 31.25% hypernatremia patients expired, 30.76% hypokalemia patients, 32.72% hyperkalemia patients expired. Morbidity distribution in electrolyte imbalance population was 85.27%, with more than 7 days of stay in PICU. Amongst the mechanical ventilated patient, 54.23% patients having potassium disturbances were associated with significant mortality and morbidity. No such significant relation exists between mechanical ventilation and dyselectrolytemia of sodium and calcium.Conclusions: Early recognition with a thorough understanding of common electrolyte abnormalities and their prompt management definitely pose an implication on the final outcome of the patient. Aggressive and strict adherence to correction of in particular to potassium before weaning is necessary for successful weaning from ventilator.
Association of screen time with physical activity and BMI in middle school children at Tamil Nadu, India
Authors: Kumar S. Santha , Shirley S. Alph
Published: December 2019

Background: The objective of this study was to find the association of screen time with physical activity and BMI in middle school children in the age group of 11 to 13 years in Tamil Nadu, India.Methods: This cross-sectional observational study was conducted among 139 middle school children aged 11 to 13 years at the state of Tamil Nadu, India from June 2019 to August 2019. Data regarding screen time and physical activity were collected from the children using a predesigned questionnaire and anthropometric measurements done. The data collected were analyzed with suitable statistical methods using SPSS 25 software.Results: Of the 139 children, 46(33.1%) were 11 years, 48(34.5%) were 12 years and 45(32.4%) were 13 years old. 74(53.2%) were male and 65(46.8%) were female. Majority of the study subjects (52.5%) had an average daily screen time of >120 minutes followed by 61 to 120 minutes (28.8%) and ≤60 minutes (18.7%). Of the 139 children studied, only 31.7% (44 children) followed the WHO recommendations of moderate to vigorous physical activity of at least 60 minutes per day, 57.5% of the children had normal BMI, 10.8 % had thinness, 25.2% were overweight and 6.5% were obese. Physical activity was found to decrease with increasing screen time, and this was found to be statistically significant. No statistically significant correlation between screen time and BMI was found. There was statistically significant correlation between physical activity and BMI.Conclusions: There is a significant correlation of screen time with physical activity in this study. Urgent measures need to be taken to decrease screen time and promote a healthy lifestyle.
Retinopathy of prematurity: study of incidence, risk factors and outcome in level 3 neonatal intensive care unit in a tertiary care centre
Authors: Rachamadugu Uma Devi , Devana Sravani , Sandanala Srikanth
Published: December 2019

Background: Advancing technology in antenatal and neonatal care has resulted in better survival of preterm neonates in developing countries in the past few decades. This has resulted in an apparent increase in the incidence of Retinopathy of Prematurity (ROP), which is the most important cause of preventable blindness in infants.Methods: A prospective clinical study was done for 18 months in 400 preterm babies less than 34 weeks of Gestational Age (GA) or less than 1750 gm of Birth Weight (BW). ROP screening was performed. The babies who developed any stage of ROP were taken as cases and the babies who did not have ROP were taken as controls. Statistical analysis was performed using SPSS software (Version 20.0). p value <0.05 was taken as statistically significant.Results: Four hundred babies were thus examined. The overall incidence of ROP in the study group was 10.25% (41 babies). Out of them, 38 babies (92.6%) had stage-1 ROP and 3 babies (7.31%) had stage-2 ROP. three babies (7.31%) required laser treatment. Risk factor analysis revealed that gestational age at birth, low birth weight, need foroxygenation, RDS, clinical sepsis, HIE, AKI, NNS, resuscitation, apnea.Conclusions: Screening should be intensified in the presence of risk factors like resuscitation, oxygen requirement, apnoea and prolonged hospital stay, which can reduce the incidence of severe stages of ROP as shown by this study.
A prospective observational study of associated anomalies in hirschsprung’s disease
Authors: Patole Monali Madhukar , Patole Mandar Madhukar , Paul Subhasish
Published: December 2019

Background: Hirschsprung’s Disease (HSCR) is the commonest congenital gut motility disorder and is characterized by the absence of ganglion cells in a variable length of the distal gut. According to literature , HRSCD may be associated with a chromosomal abnormality or other congenital anomalies in approximately 20% of cases HSCR appeared to be a multifactorial malformation with low, sex dependent penetrance and variable expression according to the length of the a ganglionic segment, suggesting the involvement of one or more gene (s) with low penetrance. So far, eight genes have been found to be involved in HSCR. This frequent congenital malformation now stands as a model for genetic disorders with complex patterns of inheritance. The objective of this study was to collect and study personal and family history and any information regarding known associated anomalies in patients diagnosed as Hirschsprung's disease.Methods: Here author present a series of 89 consecutive HSCR patients who were admitted or attended the Pediatric Surgery OPD of in a tertiary care Government medical college, who were evaluated for associated malformations with the help of available non-invasive investigation.Results: Congenital heart diseases and Down’s syndrome were the two most common associated anomalies. Genitourinary anomalies, Limb anomalies and central nervous system anomalies were other associated anomalies. Conclusions: This study confirmed the underestimation of certain associated anomalies in Hirschsprung patients, such as CNS anomalies. Based on the results of this study, in addition to meticulous general examination author suggest performing cardiologic assessment in patients diagnosed with Hirschsprung’s disease based on clinical features and according to the standards of care adopted for the general population.
A study on correlation between screen time duration and school performance among primary school children at Tamil Nadu, India
Authors: Kumar S. Santha , Shirley S. Alph
Published: December 2019

Background: In recent times, one of the factors implied in poor school performance in children is increasing screen time. Objective of the study was to find the association of screen time duration with school performance among primary school children in the state of Tamil Nadu, India.Methods: This cross-sectional observational study was conducted among 134 primary school students at the state of Tamil Nadu, India from June 2019 to August 2019. Data regarding screen time were collected from the parents and school performance from teachers using a predesigned questionnaire. The data collected were analyzed with suitable statistical methods using SPSS 25 software.Results: Of the 134 children, 72(53.7%) were male and 62(46.3%) female children. 52(38.8%) were in the age group of 6 to 7 years, 47(35.1%) in the age group of 8 to 9 years and 35(26.1%) in the age group of 10 to 11 years. Majority of the children (56.7%) had an average daily screen time of >120 minutes followed by 61 to 120 minutes (29.1%) and ≤60 minutes (14.2%). Based on composite academic performance, 23(17.2%) children were categorized as having poor academic performance, 71(52.9%) as average and 40(29.9%) as good academic performance. There was no statistically significant correlation of screen time duration with composite academic performance and academic performance in mathematics, science and language. (p Value >0.05).Conclusions: There was no significant correlation between screen time duration and school performance in primary school children in this study. Further studies are required to find the influence of screen time on various domains of learning and on long term cognition and educational achievement.
Hernia of the umbilical cord: a clinical spectrum
Authors: Patole Monali Madhukar , Patole Mandar Madhukar , Paul Subhasish
Published: December 2019

Background: Hernia of the umbilical cord is a rare clinical entity which presents with hernia of the small bowel into the proximal part of the umbilical cord. This is sporadically associated with other congenital malformations. This is usually poorly identified and mistakenly termed as ‘omphalocele minor. Inadvertent clamping of the cord in these cases leads to iatrogenic bowel wall injury. The aim of this study is to present a spectrum of cases presenting with umbilical cord hernia in a tertiary care Govt medical college, along with demography, intra operative findings, associated malformations and postoperative outcome and 1 year follow up.Methods: This is an ambispective study on neonates who attended the Outpatient Department (OPD) or Emergency department. The babies were evaluated by age, birth weight, gender, any gross clinical malformation. They were also evaluated intraoperatively for any associated anomalies. Post-surgery the babies were followed up until 2 years of age in pediatric surgery OPD of the same institute and outcome was recorded.Results: Out of 90 babies, 88 babies (97.77%) had body weight more than 2.5 kg, and rest 2(2.22%) had bodyweight of 1.5kg and 1.8 kg. Regarding content of contents of umbilical cord hernia, out of 87 patients, 43 patients (49.42%) had ileal loop as, 32 patients (36.78%) had ileum with Meckel’s diverticulum, 6 patients (6.39%) had cecum with appendix.Conclusions: Most of this study cases had ileal loops as content of the hernial sacs, and 36.78% cases had Meckel’s diverticulum associated, which is a remnant of Vitello intestinal duct. Prompt identification of the condition and early intervention and adequate post-natal care are affective to prevent long term morbidity.