bluuebunny/crossref_metadata_2025 huggingface dataset:
N.I. Kuskov. - The case of the absence of the left kidney in combination with a bifid uterus. - (Collected Works. Doctors of St. Petersburg. Maryinsky Hospital. Issue II, St. Petersburg., P. 80).
Authors: Kakushkin N.
Published: December 2020

In the corpse of a consumptive woman, 46 years old, in place of the left kidney was only the adrenal gland of normal structure. The right kidney is enlarged, parenchymal inflamed. Heart is small, 230 grm. vѣsom. Two uterus, as if spliced ​​by their necks over a length of 2.3 cm. Does the stigma have only one hole? for the canal of the right uterus, and resembles the stigma of the giving birth uterus. The size of the right uterus is normal, its left corner is rounded. This uterus has one round ligament, one wide and solitary appendages. The fallopian tube comes from the left corner. A thin fold of the peritoneum goes from the back surface of this uterus to the rectum, the same fold goes from the left edge to the left uterus. The left uterus is smaller in size, with a narrow cavity. She has two round ligaments and one wide ligament. There are no appendages. Densely augmented with old connective tissue to the rectum.
I. Yurasovskiy. - A case of blistering skid. - (Med. Review, 1895, No. 17, p. 411).
Authors: Kakushkin N.
Published: December 2020

A 26-year-old woman giving birth, after a 2-month stop in blood, immediately after the fall of the patient, bleeding occurred, continuing without interruption for three weeks. At the same time, a growing tumor was found in the lower abdomen. 3 months have passed since the stopping of the correct menstruation, between the dark the bottom of the uterus was felt 11/2 of the finger above the navel. The uterus is soft, equally enlarged. The presence of the fetus is not detected. t t подla subfebrile. Under anesthesia, a rapid expansion of the cervical canal and removal of the contents of the uterus with a finger was performed. This content consisted of rather small bubbles, weakly connected to each other. It weighed 21/2 to 3 pounds. The microscope discovered the presence of a falling membrane with mucous degeneration of villi. The patient recovered quickly.
M. Kalmykov. - A case of incorrect births with twins. - (Protocol. General Donskikh doctors for 1894, the tenth year, Novocherkassk, 1895. Appendices, p. 84).
Authors: Kakushkin N.
Published: December 2020

The patient's first child (8-raga, 42 years old), gave birth safely. Then the attempts stopped. The patient, with the umbilical cord sticking out of the vagina, was engaged in the usual chores around the house. Only on the 4th day after the birth of the first child, the author saw the patient and, stating the presence of a living fetus in the uterus, burst the bubble. Despite the contractions, the presenting part, the buttocks, did not drop. Then the author undertook a manual extraction of the fetus, but met a strong obstacle in the release of the legs thrown upward: there was a spasm of the upper and middle sections of the uterus. All the same it was possible to free the legs. Extracted live fruit; squeezed out 2 small separate after. The author attaches to the article, not devoid of interest, a description of the situation in which he has to work as an obstetrician.
Dr. John D. Malcolm. - Illustration of some Modes of Death from Ovariotomy. - (Lancet., 1895, 12 / v, p. 93) .— Some causes of death after ovariotomy.
Authors: Ginzburg M.
Published: December 2020

Dr. Malcolm reported to the Royal Society of Medicine, London, a list of all cases of death that had occurred in his practice after ovaryotomy with the results of autopsies that clarified the causes of the death. (Such a report, I believe, is instructive, since there are a number of successful cases of this operation. Ref.).
Dr. James Murphy. — Abdominal Section during Pregnancy .— (Lancet., 1895, 19 / i, p. 148). - Gluttony during pregnancy.
Authors: Ginzburg M.
Published: December 2020

A 22-year-old woman with a left ovarian cyst, which caused her considerable pain, considering herself to be 2 months pregnant, turned to Dr. Murphy for advice; he did not find a reason for the immediate production of the operation. After a short time, the patient suddenly developed a collapse, a liquid was felt in the abdomen. Murphy immediately made a cut in the abdomen with chloroform, at which up to 20 ounces of liquid blood had escaped from the last day, and rinsed the peritoneal cavity with boron solution. The uterus turned out to be enlarged, the tubes and ovaries were healthy, but near the right ovary, a bleeding place was found in the ruptured pseudo-membrane, by which the ovary was attached to the Douglas space. When the pregnant uterus was lifted up, the membrane ruptured and gave profuse bleeding, probably not long before the operation. After bandaging the bleeding membrane, the operation is over; recovery is smooth. Pregnancy continued and the patient was destroyed in time by a living child.
Dr. O'Sullivan. - (Melbourne, Australia). Cases (50) of abdominal Section. - (The Australasian Medical Gazette, 1895 15 April., P. 154). - 50 wounds (with notes on some issues of gynecological surgery).
Authors: Ginzburg M.
Published: December 2020

O'Sullivan has performed a number of large gynecological surgeries in recent years. The outcomes of the operations were very favorable, but the numbers of recovery are not shown.
Tuz Stresi Altındaki Hıyar Bitkilerinde Ekzojen Askorbik Asit Uygulamalarının Fotosistem II Aktivitesi Üzerindeki Etkileri
Authors: TOKSOY Sezen , DOĞRU Ali
Published: December 2020

Tuz stresi (100 mM NaCl) altındaki Beith Alpha hıyar (Cucumis sativus L.) çeşidinde ekzojen askorbik asit uygulamasının fotosistem II aktivitesi üzerindeki etkileri klorofil a floresansı tekniği yardımıyla araştırılmıştır. Tuz stresi hıyar yapraklarında fotosistem II’nin hem donör hem de akseptör bölgesindeki elektron hareketlerini inhibe etmiştir. Ayrıca tuz stresinin hıyar bitkisinde aktif reaksiyon merkezi miktarını ve kinonA ile plastokinonun indirgenme yeteneğini azalttığı, indirgenmiş reaksiyon merkezlerinin birikimini ve termal disipasyon enerjisini artırdığı belirlenmiştir. Askorbik asit uygulaması ise hıyar bitkilerinde tuz stresinin fotosistem II’nin donör ve akseptör bölgesindeki elektron hareketleri üzerindeki olumsuz etkisini ortadan kaldırmıştır. Ek olarak askorbik asit uygulaması hıyar yapraklarındaki aktif reaksiyon merkezi miktarını ve kinonA ile plastokinonun indirgenme yeteneğini artırırken, indirgenmiş reaksiyon merkezi miktarını ve termal disipasyon enerjisini azaltmıştır. Sonuç olarak askorbik asidin hıyar yapraklarında tuz toleransını artırdığı ve bu yaklaşımın tarımsal amaçlarla kullanılabileceği söylenebilir.
A New Myxomycetes record (Myxogastria) from Turkey: Didymium listeri Massee
Authors: BABA Hayri , SEVİNDİK Mustafa
Published: December 2020

Myxomycetes called Plasmodial slime moulds, or true slime molds are eukaryotic microorganisms. They live in a variety of ecosystems. Genus Didymium Schrad. (family Didymiaceae) is a myxomycete taxon containing calcareous peridia (order Physarida) and non-calcareous capillitium. Didymium listeri Massee were recorded in this study for the first time from Turkey. D. listeri sporocarp was found in the laboratory by moist chamber culture. In addition, the description, distribution, photograph and identification key of the taxon were presented.
Özel Güvenlik Sektöründe Çalışanların Örgütsel Politika Algıları ile İşten Ayrılma Niyetleri Arasındaki İlişkiye İş Doyumlarının Aracılık Etkisi
Authors: BENLİGİRAY Serap , DEMİRCİ Uğur
Published: December 2020

Bu araştırmanın temel amacı özel güvenlik sektöründe çalışanların iş doyumlarının, örgütsel politika algıları ile işten ayrılma niyetleri arasındaki ilişkiye etkisini tespit etmektir. Araştırmanın evrenini Antalya’da çalışan özel güvenlik görevlileri oluşturmaktadır. Yapılan analize tesadüfi örneklem kullanılarak uygulanan anket sonrasında ulaşılan 996 gözlem birimi dahil edilmiştir. Araştırmada Ferris ve Kaçmar (1992) tarafından geliştirilen Örgütsel Politika Algısı Ölçeği; Scott ve arkadaşları (1999) tarafından geliştirilen İşten Ayrılma Niyeti Ölçeği ile Weiss ve arkadaşları (1967) tarafından geliştirilen Minnesota İş Doyum Ölçeği kullanılmıştır. Araştırma sonuçlarına göre iş doyumunun örgütsel politika algısı ile işten ayrılma niyeti arasındaki ilişkide kısmi aracı etkiye sahip olduğu tespit edilmiştir.
A Study on the Relationship between Ethical Climate Perception and Innovative Work Behavior in Health Workers
Authors: TOKMAK Mutlu
Published: December 2020

This study aims to reveal the relationship between ethical climate perception and the innovative work behaviors of health workers. Besides, the effects of ethical climate perception sub-dimensions on innovative work behavior were tried to be introduced in the study. In order to realize the objectives determined in the study, field research was conducted in a public hospital in Ankara. 280 public health workers participated in the study. The data obtained from the research were subjected to descriptive statistics analysis, correlation analysis, and multiple linear regression analysis. According to the results of the analysis, it is determined that there is a 21% statistically significant and positive relationship between the ethical climate perception and innovative working behavior levels of healthcare workers. Among the ethical climate perception sub-dimensions, benevolence and independence dimensions were found to be positively related to innovative work behavior. A 10 percent deviation in the innovative work behaviors of health workers is explained by ethical climate perception sub-dimensions. It was concluded that "benevolence" and "independence", the ethical climate sub-dimensions, affected the innovative working behavior by 17% and 23%, respectively. On the other hand, "laws, and codes", "rules", and "instrumental" dimensions were not found to have a statistically significant effect.
Cinsel İstismara Maruz Kalan Türk Vatandaşı ve Mülteci Çocukların Durumu
Authors: KARATAŞ Kasım , ASLAN Harun , ÖZTÜRK Aslıhan Burcu , ALBAYRAK Hande
Published: December 2020

Çocuğa yönelik cinsel istismar, çocuk ve aile ile kapsamlı bir sosyal hizmet müdahalesi yapılmasını gerektirmektedir. Bu araştırmada, çocuğa yönelik cinsel istismarın bildirimi sonrasında hazırlanan adli görüşme raporları, sosyal inceleme raporları ve koruyucu-destekleyici tedbir kararları uygulama raporlarını içeren dosyalar üzerinden cinsel istismara maruz kalan Türk vatandaşı ve mülteci çocuklar ile ilgili durum değerlendirmesi yapmak amaçlanmıştır. Betimleyici araştırma modeli çerçevesinde nicel araştırma yöntemi ile tasarlanan araştırmada, Aile, Çalışma ve Sosyal Hizmetler Bakanlığı Ankara İl Müdürlüğünde bulunan toplam 207 farklı dosyada yer alan 181 çocuk hakkında elde edilen bilgiler taranmıştır. Belge incelemesi yöntemi ile elde edilen verilerin, araştırmacılar tarafından oluşturulmuş SPSS 23 programında veri tabanı üzerine işlenerek istatistiksel analizi yapılmıştır. Analiz sonucunda elde edilen bilgiler, çocukların ve ebeveynlerin uyruklarına göre sosyo-demografik bilgiler, çocukların uğradığı cinsel istismara dair bilgi, çocukların bazı risklere açık olma durumu ve cinsel istismara müdahale süreci başlıkları altında çözümlenmiştir. Belirlenen sorunların çözümüne yönelik olarak çocuk koruma alanında sosyal hizmet müdahalelerine ilişkin öneriler dile getirilmiştir.
Jeokültür ve Dünya Sistemi: Wallerstein’ı Yanlış mı Anladık?
Authors: AKSU EREKER Fulya , ÖZER Utku
Published: December 2020

Jeokültür kavramı, özellikle Soğuk Savaş Sonrası dönemde genel olarak Uluslararası İlişkiler literatüründe, özel olarak da jeopolitik ve dış politika çalışmalarında oldukça sık kullanılan bir kavram haline gelmiştir. Bununla birlikte kavramın bu çalışmalarda ilk kez Immanuel Wallerstein tarafından “Dünya Sistemleri Analizi” kapsamında tanımlandığı ve kavramsallaştırıldığı şekliyle kullanıldığını söylemek olanaklı değildir. Wallerstein’in kavramsallaştırmasında jeokültür dünya sisteminin meşruiyet sağlayıcı ideolojisini tanımlamak üzere kullanılmaktadır, dolayısıyla sistemik bir fenomendir. Oysa jeokültürü tekil devletlerin dış politikalarının bir aracı anlamında kullanmak, Wallerstein’ın kavramsallaştırmasıyla örtüşmemektedir. Bu çalışmanın temel amacı Wallerstein’ın kendisinin ortaya koyduğu bir kavramın Uluslararası İlişkiler literatüründe ancak bağlamından çıkarılarak yaygın şekilde kullanılabiliyor olmasının nedenlerini anlamaktır. Bu amaçla çalışmanın ana eksenini Wallerstein’ın jeokültür kavramsallaştırmasını anlama çabası oluşturmaktadır. Bu doğrultuda çalışmanın temel argümanı, kavramın içeriğinin değiştirilerek Uluslararası İlişkiler’in ana akım yaklaşımlarına uygun hale getirildiğidir.
İstanbul’da Kayıt Dışı İstihdamın Sosyo-Demografik Belirleyicileri
Authors: BAŞOL Oğuz , YALÇIN Esin Cumhur
Published: December 2020

Çalışanların sosyal güvenlik kurumuna hiç bildirilmemesi ya da eksik bildirilmesi olarak tanımlanan kayıt dışı istihdam; zaman, ekonomi, düzenleme ve sosyal koruma boyutlarıyla bireylere zarar vermektedir. Bu bağlamda mevcut araştırma, İstanbul’da kayıt dışı istihdamı etkileyen sosyo-demografik özellikleri tespit etmeyi amaçlamaktadır. Araştırmada 2017 yılı TÜİK Hanehalkı İşgücü Anketi mikro veri seti kullanılmıştır. Örneklem olarak İstatistiki Bölge Birimleri Sınıflamasında (İBBS 2. düzey) TR10 İstanbul bölgesi, 15-64 yaş arası ve özel sektörde aktif çalışanlar seçilmiştir. Örneklem hacmi bu kısıtlar altında 13930 çalışandan oluşmaktadır. Araştırmada kayıt dışı çalışmayı etkileyen sosyo-demografik değişkenleri belirlemek amacıyla iki model tahmin edilmiştir. İlk modelde cinsiyet, yaş grubu, eğitim durumu, medeni durum ve işyerinde çalışan sayısı; ikinci modelde ek olarak çalışma şekli bulunmaktadır. İlk model sonuçlarında, kadınların, gençlerin, düşük eğitim düzeyine sahip olanların, evli, dul/boşanmışların ve küçük işletmelerde çalışanların kayıt dışı istihdam edilme olasılıklarının daha yüksek olduğu görülmüştür. İkinci modelde ise, gençlerin, düşük eğitim düzeyine sahip olanların, dul/boşanmışların, küçük işletmelerde çalışanların ve yarı zamanlı olanların kayıt dışı istihdam edilme olasılıklarının daha yüksek olduğu tespit edilmiştir.
Comparison of Machine Learning Methods in Prediction of Financial Failure of Businesses in The Manufacturing Industry: Evidence from Borsa İstanbul
Authors: AKSOY Barış , BOZTOSUN Derviş
Published: December 2020

In this study, Artificial Neural Networks (NN), C5.0 Classification Algorithm, Classification and Regression Trees (CART) analyses were used to predict the financial success/failure of 126 businesses that are operating in the BIST (Borsa İstanbul) Manufacturing Industry Sector. The data contains the years 2006 to 2009. In the study, 25 quantitative variable and 4 qualitative variable were used. The overall classification accuracy from the highest to the lowest of 3 years prior to successful-failure year (for 2006) is 84.21% for CART, 81.58% for ANN and 76.32% for C5.0, respectively. The overall classification accuracy from the highest to the lowest of 2 years prior to successful-failure year (for 2007) is 86.84% for CART, 84.21% for ANN, 78.95% for C5.0, respectively. The overall classification accuracy from the highest to the lowest of 1 year prior to successful-failure year (for 2008) is 92.11% for CART, 92.11 for ANN and 86.84% for C5.0, respectively. ANN and CART models are notable in terms of their ability to predict upcoming financial failure of unsuccessful businesses with 100% classification accuracy from a year ago. The prediction of the financial success/failure by the three models obtained in the study more than one, two and three years ago shows that the models used in this study can be included in the model used by those concerned.
Almanya ve Türkiye’de Karşılaştırmalı Olarak Bakım Hizmetleri: Türkiye’de Bakım Sigortası Kurulmasına Yönelik Bir Öneri
Authors: KOCABAŞ Fatma , KOL Emre
Published: December 2020

Nüfusun yaşlanması, bütün ülkeler açısından önemli bir sorun olarak karşımıza çıkmaktadır. Yaşlı nüfusun oranı, doğum oranlarındaki azalma ve ortalama yaşam süresinin uzamasına bağlı olarak giderek artmaktadır. Türkiye için de, diğer tüm ülkelerde olduğu gibi nüfusun yaş yapısı ile ilgili yapı/durum önemlidir. Günümüzde ülkemizde de yaşlı nüfus giderek artmaktadır. Dolayısıyla yaşlanmaya bağlı olarak bakıma muhtaç olan kişi sayısı gelecek yıllarda artış gösterecek ve buna bağlı olarak yaşlandığında kendine bakamayacak yaşlılar için yapılacak sağlık ve sosyal güvenlik harcamaları ile bakım hizmetlerine duyulan ihtiyaç giderek artacaktır. Yaşlılar ve engelliler başta olmak üzere bakıma muhtaç kişilerin ihtiyaç duyduğu bakım hizmeti, insan sağlığı ve ülke ekonomileri açısından hayati bir önem taşımaktadır. Ayrıca bakım hizmetinin ekonomik maliyetlerinin yanında bu hizmeti yerine getirecek nitelikli insan gücünün de varlığı gerekmektedir. Bakıma muhtaç kişiler, gereksinimlerini karşılayacak nitelikli insan kaynağının olmayışı, gelir yetersizliği ve yoksulluk nedeniyle ihtiyaçları olan bakım hizmetlerine erişememektedirler. Bu bağlamda bakım sigortasına duyulan ihtiyaç giderek artmaktadır. Bakıma muhtaçlık da bir sosyal risk olması nedeniyle bu riske karşı da sosyal güvencenin sağlanması gerekmektedir. Ülkemizde sosyal güvenlik hukuku alanında şu an yürürlükte olan 5510 sayılı Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu kapsamında düzenlenen sigorta kollarına baktığımızda bakım sigortasının bulunmadığı görülmektedir. Bu çalışmada, konu ile ilgili literatür ve Almanya uygulaması dikkate alınarak bakım sigortası kurulmasının ülkemiz bakımından önemi ve gerekliliği ortaya konulmuştur.
Bad Vibes: Images of Communication, Emotional Balance and Health in East German Television, 1970s-1980s
Authors: Schnädelbach Sandra
Published: December 2020

Analysing health education films from the German Democratic Republic broadcast on TV during the 1970s and 1980s, this paper explores how emotions were framed as health risks and how this framing corresponded with socialist ideas on communication and media theory. I argue that television offered an ideal medium for updating traditions of social hygiene and that it served as a means to the socialist concept of “emotional education”. Television and public health met in highlighting socialist ideas on social interaction: health education aimed at cultivating trust to reduce organic diseases. At the same time, creating trust and intimacy was one of the main promises of the new medium, a function bolstered by its location in the home. To achieve these, they turned to the emotional effects of the spoken word.
Association of Gakko Soji and Littering Behavior by Examining Environmental-Efficacy: A Comparative Study between Japanese School and Indonesian School
Authors:   University of Indonesia Department of Environmental Health, Depok, Indonesia, Syakura Fatimah , Tomita Naohiro , Madani Nya' J.
Published: December 2020

Waste management has been one of the major problems in Indonesia. Besides the inadequate waste management system, it is also due to the lack of awareness about waste disposal that leads to littering. Littering does not only occur in low educated community, but also occurs in educational institutes. This research aims to investigate the association of the presence of gakko soji in school curriculum to the development of anti-littering attitude. The study is conducted by measuring the environmental efficacy as one of the psychological determinants of littering attitude. The result shows that the average score of environmental efficacy is higher among Indonesian students than Japanese students, but both average scores are still in the same category. Another finding is that the score variation is lower with the students who have experienced gakko soji. The result indicates the presence of probability that gakko soji provides uniform environmental education to students.
Innovative Assessment Practice to Improve Teaching and Learning in Civil Engineering
Authors:   Middle East College, Sultanate of Oman, Farrag Siham G.
Published: December 2020

The professional skills are essential for engineering student along with conceptual knowledge. The main objective of this paper is to explore an innovative assessment practice that was implemented to enhance teaching and learning for an undergraduate student in Civil Engineering. The practice was developed to increase students’ engagement, and encourage collaboration and critical thinking to achieve sustainable learning. Emerging technology and e-tools were the key of improve this practice. The practice was evaluated through students’ performance during the semester, and through the analysis of student’s feedback, peer review and external feedback. Generally, the feedback demonstrated the effectiveness of this practice in improving students’ understanding of the subject area and their academic performance. The total satisfaction was more than 90% and showed students’ satisfaction with the pedagogy adopted. The results showed a significant improvement in students’ performance in both internal and external marks. The final exam average increased by 20% and the total average increased by 15.4 % from the previous semester. This paper highlights the importance of linking learning and assessment as a core part of the teaching and learning process.
Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital
Authors: Pathy Shuchisuta P. , Pandey Sachchidanand , Rath Bhabagrahi , Dash Rinu Rani
Published: December 2020

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.
Comparative study of safety and efficacy of pregabalin, gabapentin and amitriptyline in management of neuropathic pain
Authors: Kancherla Nagaraju , Babu G. Chitti , Singh Hukum , Khandelwal Mayank , Sharma Nitika , Kuma Masuram Bharath
Published: December 2020

Background: Neuropathic pain has a significant negative impact on the patients’ quality of life. Now a day’s anticonvulsants and antidepressants drugs are often used as first-line drugs for the treatment of neuropathic pain. The present study aims to evaluate the safety and efficacy of gabapentin, amitriptyline, and pregabalin in patients of severe neuropathic pain not controlled by simple analgesics.Methods: A total of 360 patients diagnosed with cases of chronic lumbar radiculopathy based on symptoms, clinical examination, X-ray, and magnetic resonance imagining (MRI) scan of the lumbosacral spine, were randomized into three groups. Group A patients received pregabalin 75 mg, Group B patients received gabapentin 300 mg, and Group C patients received amitriptyline 10 mg, respectively. Pain intensity was measured at the baseline, after 1 month and after 2 months with the Numeric pain rating scale (NPRS). Adverse drug reaction reported by the patient or observed by the clinician during the study was reported using the adverse drug reaction (ADR) reporting form.Results: At baseline, the mean±SD of NPRS score in Group A was 8.42±1.48, in Group B and Group C were 8.53±1.94 and 8.33±1.26 respectively with an F-value of 0.843 and p value of 0.584, which was not statistically significant. At 1 month, the mean±SD of NPRS score in Group A was 7.23±1.58, in Group B and Group C were 7.43±2.03 and 7.99±2.10 respectively with F-value of 1.58 and p value of 0.085 which was not statistically significant. At 2 months, the mean±SD of NPRS score in Group A was 4.38±2.72, in Group B and Group C were 4.74±2.86 and 6.32±2.31 respectively with F-value of 5.53 and p value of 0.002 which was statistically significant.Conclusions: Pregabalin has the advantages in terms of the NPRS score over gabapentin and amitriptyline. Gabapentin has fewer reported adverse effects and hence better patient compliance on long term use. Amitriptyline is more cost effective than pregabalin which is an important factor to keep in mind while treating patients.
Evaluation of analgesic activity of levofloxacin in adult albino rats
Authors: S. Prasanna Kumari , K. Latha , A. Meeradevi
Published: December 2020

Background: Levofloxacin is a fluorinated quinolone antimicrobial used in the treatment of various bacterial infections and was active against both gram positive and gram negative bacteria. Levofloxacin is an optically active isomer of ofloxacin. Apart from its antibacterial action, it also exhibit antinociceptive properties. This study was conducted with the aim to evaluate the analgesic activity of Levofloxacin in albino rat in comparison with aspirin.Methods: Thirty adult albino rats weighing 150-250 gm were obtained from central animal house. The animals were divided into five groups of six animals each. Group I served as control received normal feed and water. Group II served as standard received tablet aspirin 100 mg/kg (oral) and Group III, IV, V served as test T1, T2, T3 and received tablet levofloxacin 10 mg/kg, 20 mg/kg and 40 mg/kg (oral), respectively. The analgesic effect of levofloxacin was evaluated using Eddy’s hot plate and tail flick methods and compared with standard analgesic aspirin. The values obtained were expressed as mean±SD. Statistical analysis of difference between groups were carried out using one-way analysis of variance (ANOVA). Probability p<0.05 was taken as the level of statistical significance.Results: Levofloxacin at 40 mg/kg showed statistically (p<0.05) elevation in pain threshold and a higher antinociceptive activity in comparison to control and standard groups.Conclusions: In the present study, levofloxacin has showed promising results as an analgesic when compared to the control and standard groups. It may be a lead compound for identifying newer adjuvant analgesic agents.
Efficacy and tolerability of vitamin C as an add on therapy to standard antihypertensive regimen
Authors: Singh Vivek , Sourav Ujjwal
Published: December 2020

Background: In both developing and developed countries, elevated arterial blood pressure is perhaps the most significant public health issue. It is widespread, often asymptomatic, readily observable, typically easily treatable and, if left untreated, frequently leads to lethal complications. According to the Framingham report, the prevalence of hypertension in the white suburban population is almost one-fifth of those with blood pressure >160/95 mm Hg, while almost half of those with blood pressure >140/90 mm Hg. Aim and objectives were to estimate the efficacy of vitamin C as an add-on therapy to the antihypertensive regimen.Methods: The prospective comparative study was undertaken in mild to moderate hypertensive patients to find out the efficacy and tolerability of vitamin C as an add-on therapy to the standard anti-hypertensive regimen in the reduction of blood pressure and C-reactive protein levels. This study was done at the Saraswathi institute of medical sciences, Hapur, UP.Results: For Systolic BP as well as DBP, at baseline there was non-significant difference among all the four group with p value 0.28, whereas at all the visit at 1, 3 and 6 month there was significant difference among the four group with p value<0.01, <0.001 and<0.001.Conclusions: There was significant addon benefit of vit C when added with standard antihypertensive regimen.
Anti-fungal activity of Carica papaya leaf extract against candida albicans and its synergy with fluconazole: an in-vitro study
Authors: M. Nilofer Noorie , G. Chenthamarai
Published: December 2020

Background: In this study objectives were to evaluate the antifungal activity in increasing concentrations of ethanolic extract and aqueous extract of Carica papaya against Candida albicans and to assess the synergistic activity of ethanolic extract of Caricia papaya with flucanazole as a potential antifungal.Methods: The aim of the study was to evaluate the antifungal activity in increasing concentrations, 500 µl/ml, 750 µl/ml and 1000 µl/ml of ethanolic extract and aqueous extract of caricia papaya against Candida albicans and the synergistic activity with Fluconazole was assessed by observing the zone of inhibition in agar disc diffusion assay and by observing the turbidity in minimum inhibitory concentration (MIC) assay.Results: It was observed that ethanolic extract of Carica papaya leaf showed significant antifungal activity in higher concentration of 1000µg/ml with zone diameter of 11.97±0.15 mm in disc diffusion assay and MIC of 350 µg/ml. The ethanolic extract of Carica papaya leaf with fluconazole showed synergistic activity with zone diameter of 13.6±0.45 mm in disc diffusion assay and MIC was 125µg/ml, whereas the standard drug Fluconazole’s zone of inhibiton was 12.83±0.9 in disc diffusion and MIC was 500 µg/ml.Conclusions: From this study, we can safely conclude that the Carica papaya leaf extract has a significant antifungal property and exhibit synergistic effect when used with fluconazole.
Pharmacological investigation of Thespesea populnea bark extract for analgesic activity
Authors: J. K. Jayakumar
Published: December 2020

Background: Pain is an unpleasant and distressing common problem with profound impact on individuals and society. Existing treatment modalities used for pain management are either less effective or exhibits several side effects. The aim of current study is to investigate the analgesic activity of stem bark extract of Thespesea populnea for pain management.Methods: Thirty Swiss albino were divided into five groups including control, standard and three tests groups (different doses of Thespesea populnea bark extract). Groups were investigated for analgesic activity using hot plate induced paw withdrawal, acetic acid induced writhing and formalin induced paw licking models.Results: Findings of hot plate model revealed that, percent increase in reflex latency of paw licking response in mice for test drug (10 mg/kg), attained peak effect of 136% at 180 minutes, whereas for standard pentazocine peak effect of 125% was attained at 180 minutes. In acetic acid model, the maximum percent inhibition in number of writhings for the test drug (30 mg/kg) was 68% and for standard diclofenac, it was 80%. In formalin model, percent inhibition in licking response in early and late phases for test drug (30 mg/kg) were 81% and 91% and for standard diclofenac it was 56% and 94% respectively. It was thus depicted that analgesic activity of test drug was significantly more than the standard in early phase and equivalent to standard in late phase.Conclusions: It was concluded that Thespesea populnea bark extract at a dose of 10 mg/kg showed potential peripheral and central analgesic activity.
Fulminant Guillain Barre syndrome with recurrent lung collapse
Authors: Kolleri Hasif , Fardan Mohammed , Priya A. , Chander K. Arun
Published: December 2020

Fulminant Guillain-Barré syndrome (GBS) is a rapidly progressive form of polyneuropathy in which patients demonstrate eventual flaccid quadriplegia and an absence of brainstem function. Most patients present initially with a mild upper respiratory or gastrointestinal illness and have non-diagnostic cerebral imaging studies. Here we report the case of child aged 7 who was admitted initially with complaints of weakness of lower limbs lasting for 4-5 hours. He had difficulty in standing and walking, associated with pain in both lower limbs. Flaccid weakness rapidly progressed over 12 hours to involve both upper limbs along with difficulty in swallowing and nasal regurgitation of feeds. He was intubated and mechanically ventilated for respiratory failure. Over the period of time, after confirmation with all the test reports and symptoms, other differential diagnoses were ruled out and fulminant GBS was considered and hence plasmapheresis was started. Over the period of 3 months his muscle power slowly improved. During discharge, he was able to lift limbs against minimal resistance, turn sideways on bed, sit up with minimal support and likewise stand with support.
Recent advances in pain management
Authors: Baskaran Priyadarsini , Karthikeayan Venkatraman , Natarajan Anusha
Published: December 2020

Pain is one of the most common complaints for which patients approach physicians. In spite of this there is a huge unmet need for developing medications for pain that are safe and efficacious. Owing to the heterogeneity of clinical pain and complex pathophysiology, target identification for drug development is difficult. Preclinical models have also proven unreliable for the development of novel analgesics. Recent advances in understanding the physiology of nociception has enabled the development of novel analgesics including abuse deterrent opioids, drugs targeting several receptors, ion channels and enzymes. This review will attempt to cover the physiology of nociception focusing on the novel targets, the challenges in development of novel analgesics and give an overview of the recently developed drugs and those in the pipeline for the management of pain.
A recent review on 2019 novel coronavirus outbreak
Authors: Shaji Bipin , Suresh Abisri , Vasanth Nimitha , Stanly Sharon Mary
Published: December 2020

SARS-CoV2, a single-stranded RNA virus that can cause a wide array of clinical manifestations ranging from mild to severe (respiratory failure). The spread of SARS-CoV2 has now become uncontrollable leading to a pandemic. The infection is usually transmitting through cough droplets and sneeze. The main clinical manifestations of the disease are similar to common respiratory tract infections and may become fatal after the development of symptoms such as severe dyspnea, low PaO2/FiO2 (fraction of inspired oxygen) ratio, and severe decline in blood oxygen saturation. Current diagnostic tools employed at the moment include time-consuming NAAT (nucleic acid amplification test). Recent investigations and researches are aimed at rapid serological testing. Real-time reverse transcription-polymerase chain reaction (rRT- PCR) is the standard method of testing, using respiratory samples obtained by the nasopharyngeal swab. Medications such as darunavir, ribavirin, remdesivir, interferon, and lopinavir/ritonavir combination therapy were used for the management of the infection. Social distancing, use of protective masks, isolation of the infected persons and maintaining personal hygiene helps in the prevention of the disease.
Assessment of thyroid function among children with epilepsy receiving anticonvulsant monotherapy: a hospital based prospective study
Authors: Rahman Ushuf , Islam Munshi Safikul
Published: December 2020

Background: Data on influence of antiepileptic drugs (AED) on thyroid profile in children is limited and is still controversial. This study aimed to investigate the effects of valproate, levetiracetam, phenobarbitone and oxcarbazepine monotherapy on thyroid function in children after one year of therapy.Method: A total of 106 children (39 girls and 67 boys) with new onset and controlled epilepsy treated with valproate (n=52), phenobarbitone (n=12), oxcarbazepine (n=14) and levetiracetam (n=28) were enrolled in the study. Serum thyroxine (T4, T3) and thyroid-stimulating hormone (TSH) level were measured before and at one year of therapy.Results: At baseline average T4, T3 and TSH concentrations were not different between the drug groups. Except levetiracetam all antiepileptics increased TSH after one year of therapy and there was significant difference in TSH increment in valproate treated patients compared to other anticonvulsants. All anti-epileptics except levetiracetam was found to decrease T4 and T3 after one year of therapy but there was no significant difference among the groups, unlike TSH. Sodium valproate was the most frequently used antiepileptic drug. None of children had any symptoms of hypothyroidism, only 3% had signs of hypothyroidism which included goitre on examination. Out of various seizure disorders generalised tonic clonic type was most common (47.5%) followed by atypical febrile seizure (23%).Conclusions: All antiepileptic drugs studied except levetiracetam had varying degrees of deleterious effects on thyroid function.
Effectiveness of an instructional module regarding first-aid of pediatric emergencies on knowledge among mothers of 1-6 years children
Authors: Arti Km , Kumari Rina , Koonwar Sciddhartha , Charan Anugrah
Published: December 2020

Background: The first aid is given to preserve and protect life, prevent further injury or deterioration of the victim, and help to promote recovery. The objectives of the study were to assess the pre- test knowledge scores regarding first aid of pediatric emergencies among mothers of 1-6 years children, to evaluate the effectiveness of an instructional module regarding first aid of pediatric emergencies on knowledge among mothers of 1-6 years children, to find out the association between the post-test knowledge scores of mothers with their demographic variables.Methods: Quasi-experimental with one group pre-test post-test design was used for 48 mothers at pediatric medical ward, surgery ward and trauma emergency KGMU, Lucknow and   purposive   sampling   technique   was   used.   Self-structured knowledge questionnaires on first aid of pediatric emergencies were used. Based on the objectives and the hypotheses the data were analyzed by using various statistical tests.Results: The result reveals that the overall score was 13.17 in pre-test and 20.13 in post- test after distribution of Instructional module to mothers 22 (45.83%) had good knowledge and 26 (54.17%) had average knowledge regarding first aid of selected conditions of pediatric emergencies. Paired ‘t’ test showed that there was a significant improvement between pre-test and post-test scores with a 't' value of -24.639, p<0.05.Conclusions: The study findings revealed that the Instructional module regarding first aid of Pediatric Emergencies was effective in improving knowledge of mothers of 1-6 years children.
Correlation of vitamin D level with its related biochemical parameters and impact of different treatment regimens on their correction
Authors: Gupta Amit , Kumar Sachin
Published: December 2020

Background: Vit D is a fat-soluble vitamin that is produced when ultraviolet rays from sunlight strike the skin and trigger vit D synthesis. Aims and Objectives of the study were to find out the correlation of vit D level with its related biochemical parameters and impact of two different treatment regimens on their correction. Methods: A total of 107 patients were followed up out of which 89 were vit D deficient and rest were vit D insufficient. Results: Mean age of the patients was 6.11±4.49 and males comprised 66%. Mean BMI of children included in group A, B and C was 19.40±2.69, 19.60±3.18 and 20.95±3.72 kg/m2 respectively. Vit D levels at baseline had a significant inverse correlation with ALP (r=-0.27, p value=0.008).  Before and after comparison of mean serum calcium levels revealed significant improvement in both the treatment groups. Severity of vit D deficiency, at baseline, 9.10, 77.30 and 13.60% of patients had vit D levels of less than 5, 5 to 15 and more than 15 for group A respectively. In group B at baseline, 6.70, 71.10 and 22.20% of patients had vit D levels of less than 5, 5 to 15 and more than 15 respectively.Conclusions: Present study found that 60,000 IU/week and dose of 2000 IU/day for infants or 5000 IU/day for 1 to 18 years of age, along with 500 to 800 mg oral calcium for 6 to 8 weeks can result in correction of vit D deficiency.
A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre
Authors: Yelamali B. C. , Mirji Gangadhar S. , Rajput Mirnalini
Published: December 2020

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.
Bicytopenia/pancytopenia in children - clinico etiological profile and importance of bone marrow evaluation in a tertiary care centre
Authors: Wadhwa Lalita , Chirla Suman , K. Maheshwari , Wadhwa Puneet
Published: December 2020

Background: Peripheral cytopenia is a common hematological problem in our day-to-day clinical practice resulting from various diseases ranging from transient infection induced bone marrow suppression to life threatening hematological malignancies. The objective of this study was to know the clinicoetiological profile,hematological analysis and importance of bone marrow evaluation of bicytopenia/pancytopenia in children in a tertiary care teaching hospital.Methods: This was a retrospective, observational study, conducted in pediatric department, NRIIMS, Visakhapatnam, Andhra Pradesh from May 2019 to May 2020. All children in the age group of 1-18yrs of age admitted with new onset bicytopenia/pancytopenia who underwent hematological analysis and bone marrow examination in our hospital were included in this study. Children with bicytopenia/ pancytopenia evaluated outside/treated in other hospitals were excluded from our study. Data was obtained from bone marrow biopsy register from pathology department, admission register of pediatric ward and hospital medical records.Results: Out of the 31 children studied, males were (54.8%), females were (45.2%).11-18 years of age were (51.6%), 1-5 years of age were (38.7%). Fever (77.4%), pallor (74.1%), hepatosplenomegaly (41%) was the most common clinical feature noted in these patients. ALL (52.3%), followed by ITP (9.52%) was the most common etiology for bicytopenia. Aplastic anaemia (40%), megaloblastic anaemia (20%) were most common etiology noted for pancytopenia. Bicytopenia (67.7%) was more common than pancytopenia (32.2%).Peripheral smear examination picked up only 11 out of 14 cases of haematological malignancy, identified by bone marrow examination. Most common bone marrow finding noted was ALL (38.7%), followed by hypocellular bone marrow (22.5%).Conclusions: When there is high index of clinical suspicion and peripheral smear is unable to pick up these cases, it is advisable to do bone marrow examination at the earliest for early confirmation.
Predictors of mortality in extramural very low birth weight neonates: a prospective observational study
Authors: Meshram Rajkumar M. , Gedam Ruchi A. , Garg Shivangi , Kadu Kalyani S. , Chakraborty Madhabika R. , Kumar Swaroop B.
Published: December 2020

Background: Over the past few decades, the burdens of very low birth weight (VLBW) preterm infants are increasing due to advances in obstetrics and perinatal services. Objectives of the study were to assess predictors of mortality of extramural VLBW neonates.Methods: Prospective one year cohort study was undertaken on VLBW neonates fulfilling the inclusion criteria at a tertiary institute. Maternal and neonatal demographic data were analyzed.Results: Male to female ratio was 1.26:1. One hundred and thirty seven (74.9%) neonates had birth weights from 1000-1499 g while 46 (25.1%) had birth weights <1000 g (ELBW) and 90% were preterm. One hundred and sixty five (90.2%) neonates were admitted in early neonatal period. Anaemia was the commonest maternal illness and preeclampsia/eclampsia was the most common obstetric complication. Respiratory distress, temperature instability and lethargy were common clinical presentations. Respiratory distress, sepsis and perinatal asphyxia were common diagnoses on admission. Mortality rate in VLBW neonates was 59.6% and respiratory distress was the commonest cause of death. Male gender (p=0.01), home delivery (p=0.04), vaginal delivery (p=0.05) and positive septic screen (p=0.003) had significantly higher mortality while mode of delivery (aOR 0.27 CI 0.086-0.83 p=0.02) and positive septic screen (aOR 4.0 CI 1.67-9.84 p=0.002) were independent risk factors for mortality.Conclusions: In extramural VLBW neonates, male gender, home delivery, vaginal delivery and positive septic screen had significantly higher mortality whilst mode of delivery and positive septic screen were independent risk factors for mortality.
Characteristics of patients with rapid eye movement-related obstructive sleep apnea: a retrospective review of 52 patients at a tertiary care center
Authors: Hawari Muhannad , Jamil Mohamad Gayath , Hemideh Sanaa , Alharbi Ayman
Published: December 2020

Background: The term “rapid eye movement (REM)-related obstructive sleep apnea (OSA)” is commonly used to describe sleep disordered breathing that occurs exclusively in REM sleep. The prevalence of REM-related OSA ranges from 10% to 36%. Despite the presence of reports describing the features of REM-related OSA, there is still much more to be known about it.Methods: In this study we did retrospective review of 734 patients who had a diagnostic sleep study in a sleep lab at a tertiary center between January 2014 and August 2016 were reviewed.Results: We found that hypertension was found in the charts of 50 patients, 36 of them were diagnosed with hypertension and on medical therapy (72%), 11 patients (out of 50) had diabetes (22%) and 9 (out of 49) had dyslipidemia. 2 patients (out of 49) had Ischemic heart disease (4%), 1 patient (out of 49) had stroke (2%) and 3 patients (out of 49) had arrhythmias (6%). 8 patients (out of 49) had thyroid disease (16%).Conclusions: In conclusion Most patients had mild REM related OSA and most did not have subjective EDS. Hypertension was the most common comorbidity among our patients.