bluuebunny/crossref_metadata_2025 huggingface dataset:
A INTERDISCIPLINARIDADE NO PROCESSO DE INCLUSÃO: A FORMAÇÃO DO EDUCADOR ESPECIAL NA PERSPECTIVA DA GESTÃO DO CONHECIMENTO
Authors: Negrini Tatiane , Forno Letícia Fleig Dal
Published: December 2017

Este artigo tem como objetivo investigar a relação da formação de profissionais da Educação Especial e a interdisciplinaridade quanto à inclusão. Definindo-se a interdisciplinaridade como uma variável relevante no atendimento educacional especializado, bem como, pertencente ao desenvolvimento da gestão do conhecimento no contexto escolar. Por meio de uma abordagem qualitativa e da análise de conteúdo foram estudadas cinco ementas de disciplinas de um curso de Educação Especial, de descrições presentes em políticas públicas acerca do papel e das ações do educador especial, bem como, da descrição de três educadoras especiais acerca das suas percepções da interdisciplinaridade em sua formação. Observou-se que a interdisciplinaridade faz-se presente nas relações da prática educacional do educador especial, quanto ao modo de percepcionar às intervenções pedagógicas, e em relação ao modo de organizar e desenvolver o planejamento do atendimento e da avaliação dos alunos com necessidades educativas especiais.
LOGÍSTICA AGROINDUSTRIAL: UMA REVISÃO SISTEMÁTICA NOS ANAIS DE CONGRESSO DA SOBER
Authors: Filippi Amanda Cristina Gaban , Guarnieri Patricia , Farias Josivânia Silva
Published: December 2017

O objetivo deste artigo é analisar o conteúdo de trabalhos relacionados à logística agroindustrial publicados nos anais do Congresso da SOBER no período de 2005 a 2015, considerando que este é o principal evento da área de agronegócio no país. Para isto, foi realizado um trabalho descritivo e qualitativo, cujo procedimento técnico utilizado foi a revisão sistemática da literatura, seguindo o protocolo de Cronin, Ryan e Coughlan (2008). Os dados foram analisados por meio da análise de conteúdo (BARDIN, 1977). Os resultados explicitaram problemas metodológicos, descrição e explicação insuficiente de materiais e métodos utilizados nos artigos, mas também possibilitaram algumas sugestões de trabalhos futuros, sugestões de técnicas e procedimentos metodológicos para estudos em logística agroindustrial e objetos que podem ser abordados futuramente. Este artigo contribui com a ampliação do conhecimento da direção dos estudos nesta área e, assim, poderá sinalizar uma agenda para estudos futuros.
CARACTERIZAÇÃO DE BIOMASSA RESIDUAL DE FÁBRICA DE PAPEL-CARTÃO PARA APROVEITAMENTO ENERGÉTICO
Authors: Schirmer Waldir Nagel , Ferreira Italo Tadeu Machado , Ribeiro Camilo Bastos , Pavanello Guilherme Pozzobom , Machado Gilmara de Oliveira , Rodrigues Paulo Rogério Pinto
Published: December 2017

Um dos problemas da indústria de papel e celulose é a disposição de resíduos sólidos em aterros industriais, pela escassez de áreas disponíveis para esta finalidade e ao impacto ambiental gerado. Uma das formas de avaliar o potencial energético de materiais celulósicos residuais é pela determinação do seu poder calorífico. Esta pesquisa teve como objetivo caracterizar os resíduos celulósicos de uma fábrica de papel-cartão por análise imediata e análise elementar, para estimar o poder calorífico e avaliar o potencial de aproveitamento energético na combustão misturada com cavacos na fornalha de caldeira. Foram analisados os combustíveis normalmente queimados na caldeira de biomassa para geração de vapor: cavacos de madeira de pinus, cascas de madeira de pinus e os resíduos gerados na fabricação de papel-cartão: fibras e fiapos de madeira da fabricação de pasta mecânica de madeira, fibras da estação de tratamento de efluentes - ETE e cinzas da caldeira. Os resíduos celulósicos fibras da ETE, fibras e fiapos de madeira apresentaram potencial para utilização energética, desde que submetidos a processo de secagem para redução da umidade e aumentar o poder calorífico. As cinzas da caldeira tem poder calorífico residual podendo ser reaproveitadas na combustão com cavacos de madeira.
HEDGE COM COMBINAÇÃO DE ATIVIDADES AGROPECUÁRIAS
Authors: Xavier Karine Diniz , Fernandes Kellen Cristina Campos , Figueiredo Reginaldo Santana , Oliveira Neto Odilon José de
Published: December 2017

O objetivo deste estudo foi desenvolver hedge por meio da combinação de diferentes atividades agropecuárias de modo a oferecer ao produtor rural e usuários em geral, um instrumento para mitigação do risco no mercado agropecuário. Tal instrumento se refere a uma tabela com diferentes portfólios compostos por diferentes atividades agropecuárias, acompanhados de seu risco e retorno operacional mensal, além das alocações ótimas dos recursos financeiros e da área da propriedade rural para cada atividade. Para alcance do objetivo da pesquisa, foi utilizada a teoria do Portfólio de Harry Markowitz (1952) com a elaboração da matriz de correlação entre os retornos das atividades em estudo e o modelo de programação linear, que possui como função objetivo a equação que visa minimizar o risco de um portfólio proposta pelo mesmo autor. Os resultados oferecem portfólios com a combinação de duas, três, quatro, cinco e seis atividades agropecuárias. Foi possível verificar que o Portfólio 1, composto pelas atividades milho e soja, apresentou maior nível de retorno operacional mensal, 15,70%, para um risco de 2,79%. O Portfólio 6, formado pelas atividades tomate e bovinocultura de corte, oferece o menor nível de risco quando comparado aos outros portfólios, 0,35%, para um retorno operacional mensal de 3,33%. A escolha do melhor portfólio é feita pelo usuário levando em consideração o nível de risco que ele está disposto a enfrentar.
COISA JULGADA COMO DESAFIO PARA A CONCREÇÃO DA TUTELA JURISDICIONAL COLETIVA ADEQUADA
Authors: Silveira Sebastião Sergio , Guimarães Leonardo Aquino Moreira
Published: December 2017

O instituto da coisa julgada, como garantia fundamental e indutor do princípio da segurança jurídica, tem como função conferir estabilidade às decisões judiciais. No âmbito da tutela individual ele é de existência secular. Não obstante, no âmbito da tutela coletiva, por ser ainda de incidência recente, vem provocando debates e dificuldades. Para falar sobre as implicações da coisa julgada nas ações que veiculam direitos metaindividuais, faz-se mister, à míngua de uma disciplina legal específica, socorrer, mutatis mutandis, às feições e ao regime jurídico da coisa julgada nas relações processuais intersubjetivas. Diante da tendência de “massificação” dos conflitos, e por corolário, da “dessubstantivação dos interesses”, a depender da espécie de direto coletivo envolvido e da sentença prolatada, a coisa julgada produzirá efeitos cambiantes. O estudo acerca da expansão da coisa julgada nas ações coletivas é o objeto do presente trabalho.
A REGULAÇÃO DO DIREITO DO CONSUMIDOR NO COMÉRCIO ELETRÔNICO
Authors: Hanashiro Wagner Seian , Nava Leandro Caldeira , Barreto Junior Irineu Francisco
Published: December 2017

As relações entre direito e internet adquirem status estratégico, uma vez que as novas relações sociais, interpessoais e interinstitucionais exigem uma nova reflexão sobre paradigmas, teorias e aplicação da legislação vigente. Dentre as transformações sociais recentes, que afetam o direito, destaca-se a ampliação dos negócios em meio eletrônico (e-business) e do comércio eletrônico (e-commerce). Este artigo teve como objetivo analisar a regulamentação do Código de Defesa do Consumidor e sua eficácia para solucionar conflitos provocados em transações realizadas pela internet. Em termos metodológicos, resulta de pesquisas e análises doutrinárias e jurisprudenciais, e apresenta como foco estudar o comércio eletrônico (e-commerce) na perspectiva da garantia dos direitos do consumidor. Esse direito, constitucionalmente garantido aos cidadãos brasileiros, muitas vezes não é tutelado de forma plena pelo Estado, o que força a necessidade de procedimentos administrativos e ações judiciais. A pesquisa conclui com a necessidade de fortalecer as instituições consumeristas, bem como proporcionar o desenvolvimento saudável das relações na sociedade da informação, evitando prejuízos aos cidadãos.
O PRINCÍPIO DA INIMPUTABILIDADE DA REDE E A REMOÇÃO DE CONTEÚDO DOS PROVEDORES DE APLICAÇÕES DA INTERNET
Authors: Faustino André , Fujita Jorge Shiguemitsu
Published: December 2017

Este artigo analisa o princípio da inimputabilidade da rede, parte integrante do decálogo da internet do Brasil e a remoção de conteúdo dos provedores de aplicação de internet, prevista no Marco Civil da Internet, buscando compreender tais conceitos, estabelecendo a possibilidade de relação entre eles. Para tal finalidade, a pesquisa analisa os provedores de serviços de internet, o pensamento que influenciou a construção do conceito de inimputabilidade da rede e os sistemas existentes para a remoção de conteúdo de aplicações de internet existentes no Brasil, bem como a legislação americana e europeia que serve de base para esse instituto. O artigo conclui que é possível relacionar a inimputabilidade da rede com a remoção de conteúdo, pois o primeiro não significa isenção absoluta de responsabilidade, em que o segundo serve como medida de controle e correção de possíveis ilícitos praticados por terceiros dentro dos provedores de aplicação de internet.
A PESSOA COM DEFICIÊNCIA E A SUA INCLUSÃO NO ENSINO SUPERIOR BRASILEIRO
Authors: Ferreira Gláucia Cristina , Motta Ivan Dias da
Published: December 2017

A relevância dos direitos da personalidade conforme suas prerrogativas são advindas dos direitos fundamentais do ser humano, porque os direitos da personalidade vêm definidos como direitos essenciais, considerados como o conteúdo mínimo necessário e imprescindível da personalidade humana. Com a atuação do Poder Público busca-se garantir os meios de acesso à educação e comunicativos básicos a todos os cidadãos, incluindo acesso à acessibilidade, somadas às políticas públicas de qualidades e atuação judiciária consciente das obrigações em matéria de direitos humanos. Assegurar o acesso à educação é promover inclusão social, acabando com os grupos fechados, integrando entre si, todos numa mesma comunidade. No trabalho de ajudar as instituições de ensino no país em relação à acessibilidade, com os pressupostos do Sinaes (Sistema Nacional de Avaliação da Educação Superior), pode-se entender o processo da educação inclusiva, que no momento tem se representado um desafio para a educação superior.
O SISTEMA INTERAMERICANO E O DIREITO DA CRIANÇA EM PRESTAR DECLARAÇÕES NO PROCESSO PENAL: GARANTIAS PARA RECONHECIMENTO DE SUA PERSONALIDADE
Authors: Ribeiro Daniela Gonçalves Menengoti , Ávila Gustavo Noronha de , Zavattaro Mayra dos Santos
Published: December 2017

O presente artigo investiga a efetiva garantia do direito da criança ofendida de prestar declarações no Processo Penal. A problemática centra-se no reconhecimento da oitiva da criança como um direito, e não como um dever. Esse pressuposto encontra respaldo no entendimento jurídico pátrio, nas convenções internacionais e nos julgados do órgão jurisdicional do Sistema Interamericano de Proteção aos Direitos Humanos. Sendo, pois, um direito, a violação desta garantia dos infantes enseja o acionamento dos mecanismos internacionais de proteção para a efetivação de seus direitos de personalidade previstos na Convenção Interamericana de Direito Humanos (Pacto de San Jose da Costa Rica). O trabalho utiliza o método dedutivo de abordagem e a pesquisa bibliográfica, documental e jurisprudencial como procedimento.
Культурное пространство: аксиологический аспект
Authors: Касаткин Петр Игоревич
Published: December 2017

В статье рассматривается концепт «культурное пространство», дается его авторская трактовка и понимание. В современных культурологических исследованиях данный концепт имеет противоречивое и не вполне четкое определение, что заставляет концептуализировать и уточнить его.

Под культурным пространством понимается пространство ценностей, продуцирующих содержание духовной и материальной культуры общества. Мировое культурное пространство есть пространство гетерогенное, состоящее из множества национальных культур, основанных на своих ценностях. Таким образом, в качестве культурного индикатора  предлагается рассматривать именно ценности,  а сами ценности понимать как базис культуры.

Ценности действуют в качестве структурирующего механизма в различных культурных пространствах и одновременно определяют границы этих пространств. Автор отмечает необходимость рассматривать аксиологическую проблематику в рамках общефилософской проблемы целого. В этой связи кумулятивистский подход в анализе аксиологического измерения социальной жизни дополняет существующие исследования о роли ценностей в структурировании социального. 

Автор делает вывод о том, что культура выступает в бытии в двух основных ипостасях: с одной стороны, она есть механизм (код), структурирующий общество, задающий ему направление движения и развития, с другой — совокупность духовно-материального творчества общества. Кроме этого, культура как феномен находит свое социальное воплощение в качестве культурного пространства, гетерогенного по своей сути. 
Семиотическое пространство культуры Русского Севера
Authors: Михайлова Лариса Владимировна
Published: December 2017

Семиотическое пространство культуры Русского Севера включает Валаамский и Соловецкий архипелаги, а также топонимы, характеризующие духовное и материальное бытие Спасо-Преображенских монастырей, природные объекты, флору и фауну региона. Актуальность исследования обусловлена возрастающим интересом к духовно-нравственному, историко-культурному и ландшафтному пространству Русского Севера, духовность которого определяется фундаментальной ролью Соловецкого и Валаамского православных монастырей. Целью данной статьи является определение культурно-исторического, топонимического и ландшафтного пространств Русского Севера. Задачи исследования — соотнести духовную культуру северных монастырей с материальной и природной культурой Русского Севера; выявить роль мирских названий культурных ландшафтов Валаамского и Соловецкого монастырей.

В статье представлены результаты эмпирического исследования геокультурного пространства Валаамского и Соловецкого монастырей. Для определения семиотического пространства Соловков и Валаама использованы методы сбора информации, лингвистического анализа выявленных в ходе полевых исследований и из различных источников названий географических объектов, расположенных на островах Валаамского и Соловецкого архипелагов; использован синтез различных подходов: философских, исторических, географических, религиозных, литературных. Исследование топонимии Валаама русского происхождения проводилось в 2000–2012 гг. и опубликовано в научных статьях и в монографии «Валаам: Град Земной — Град Небесный» (Михайлова, 2013). В данной статье впервые публикуется классификация топонимов, характеризующих природу Валаама. Следующим шагом нашего исследования является изучение семантики и структуры компонентов топонимов, описывающих хозяйственно-экономическую деятельность Соловецкого монастыря. Полевые, архивные и другие исследования проводились автором на островах Соловецкого архипелага в 2012–2016 гг. и опубликованы в научных статьях и в монографии «Преображение Русского Севера» (Михайлова, 2015). Классификация топонимов островов Соловецкого архипелага, представленная в данной статье, более полно отражает различные виды деятельности Соловецкого монастыря, его историю и природу. На основе собранного топонимического материала автор впервые проводит также сравнительный анализ семиотического пространства Соловков и Валаама.

Семиотическое пространство Русского Севера характеризуют названия природных объектов, расположенных на островах Валаамского и Соловецкого архипелагов, а также топонимы, описывающие культурное пространство, хозяйственно-экономическую деятельность Спасо-Преображенских монастырей. Топонимы, созданные разными поколениями людей, раскрывают гармонию рукотворного и природного ландшафтов, дополняют культурный образ монастырей Русского Севера.
Культурные константы и экология культуры
Authors: Кузнецова Татьяна Федоровна
Published: December 2017

Статья посвящена анализу особой роли культурных констант в экологии культуры. Эта роль видится автору в том, что культурные константы составляют то ядро культуры — и мировой, и региональной, и национальной, — которое подлежит сохранению как культурное наследие.

Выдвигая данное положение, автор исходит из тезаурусного подхода к мировой культуре, а именно из представления о том, что экология культуры представляет собой не понятие, а концепт. Его логическая сторона непосредственно сопровождается сторонами образными и эмоциональными, что позволяет экологии культуры выступать в ключе ценностного отношения субъекта к его миру и ставить ее в связь «своего» и «чужого». Такое понимание характерно для субъектной организации гуманитарного знания.

Тезаурусный подход, как показано в статье, выступает применительно к экологии культуры в методологической роли и одновременно на эмпирическом уровне закрепляет многообразие повседневности, выделяя и фрагменты вечного, и фрагменты преходящего в повседневности жизненного потока.
Эпизод с привратником в «Макбете» в свете «Ада» Данте и средневековых мистерий
Authors: Микеладзе Наталья Эдуардовна
Published: December 2017

В статье анализируется эпизод со стуком в ворота и «адским» привратником в трагедии Шекспира «Макбет» (II, 2–3) в нескольких взаимно дополнительных ракурсах. Первый исследуемый смысловой план задан контекстом песни 33 «Ада» Данте (эпизод с братом Альбериго, свидетельствующим о прижизненном разъединении души и тела предателя) и позволяет говорить об утрате души Макбетом сразу после убийства Дункана. Второй план эпизода отсылает шекспировского зрителя к персонажам и ситуациям популярных средневековых мистерий о заговоре против Христа (Иуда Искариот, Привратник, Пилат и его жена). Наконец, третий план данного эпизода намечает тему Второго пришествия и установления Царства Божия, т. е. в нем проглядывает сюжет грядущего финала «Макбета».

Шекспировский зритель должен был узнать в качестве прообраза для героев и ситуаций трагедии сумму знакомых по Библии, мираклям и мистериям сюжетов и перенести их моральный смысл на историю шотландского узурпатора Макбета. В первую очередь он напоминает о Люцифере и Иуде и показывает падение души предателя в преисподнюю. В статье также доказывается отсутствие в рассматриваемом эпизоде следов сюжета средневековых народных пьес о сошествии Христа в Ад (Harrowing of Hell), которые традиционно отмечаются учеными последних двух веков.
Дизайнерское профессиональное сообщество: особенности конструирования
Authors: Манторова Анна Владимировна
Published: December 2017

В статье рассматривается специфика образования и функционирования профессионального сообщества дизайнеров. Сравнительно молодая профессия дизайнера развивается, растет ее значимость в современном социокультурном пространстве. Но в настоящее время российский дизайн имеет крайне нестабильное положение и до сих пор находится в поиске собственной национальной модели. Возникший в 1920-е годы в противовес традиционному станковому искусству, он возродился в функционализме 1960-х, но к концу XX в. постепенно растворился в западных заимствованиях. Однако это не помешало дизайну выделиться в отдельную профессию. В статье представлены результаты исследования профессионального сообщества дизайнеров с точки зрения социального конструирования.

Процесс конструирования в данном случае отличается тем, что он основан на контактах поверхностного характера: человек не имеет возможности знать абсолютно всех представителей данного профессионального сообщества. Это, в свою очередь, позволяет рассматривать его, во-первых, как воображаемое сообщество, во-вторых, охарактеризовать действительную форму данной социальной общности, в чем и заключается научная новизна исследования. Воображаемое сообщество, по Андерсону, имеет ряд специфических признаков, которые были обнаружены в дизайнерской среде. В их число входит ментальный образ сходства, язык, пространственно-временные координаты и формирование сообщества вокруг высшего центра.  Интерес также представляет выявление данного организующего центра, определяющего основную стратегию развития профессии дизайнера в России. Автором проводится контекстуальный анализ интернет-ресурсов (тематических форумов и групп в социальных сетях, публикации Вячеслава Глазычева и Артемия Лебедева) с целью определения организующей формы профессионального сообщества и специфики ее функционирования. 
New Developments in Mechanical Ventilation
Authors: Ouellette Daniel R ,   Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, US
Published: December 2017

Positive pressure ventilation was developed in the 1950s as a way to treat respiratory failure due to ventilatory insufficiency. While lifesaving, mechanical ventilation, especially when prolonged, can be associated with a host of complications. Current advances focus on strategies to liberate patients from the ventilator. New guidelines have been published to aid practitioners in this area.
Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions
Authors: McClure Rebecca , Villani Anthony
Published: December 2017

Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti‐inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well‐designed, longer‐term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.
Regulación legal de la robótica y la inteligencia artificial: retos de futuro = Legal regulation of robotics and artificial intelligence: future challenges
Authors: Santos González María José
Published: December 2017

Cuanto mayor sea la inteligencia artificial de los bots, robots y androides mayor será su autonomía y en consecuencia tendrán menor dependencia de los fabricantes, propietarios y usuarios. Es un hecho que la nueva generación de robots convivirá con los humanos y la legislación debe adaptarse y regular cuestiones de gran importancia jurídica cuáles son: ¿quién asume la responsabilidad de los actos u omisiones de los robots inteligentes?, ¿cuál es su condición jurídica?, ¿deben tener un régimen especial de derechos y obligaciones?, ¿qué soluciones vamos a dar a los conflictos éticos relacionados con su conducta? y por último, ¿deben establecerse medidas mínimas organizativas, técnicas y legales para minimizar los riesgos de seguridad a los que está expuesta la tecnología asumiendo que su desarrollo no debe verse como una amenaza sino como una oportunidad y que los robots pueden estar interconectados?. La regulación es un aspecto clave para la existencia de una sociedad más segura y pacífica y por ello debe estar adaptada a como es a día de hoy la humanidad y como queremos que sea en un futuro.The greater the artificial intelligence of bots, robots and androids, the greater its autonomy and consequently they will depend less of factories, owners and users. It is a fact that the new generation of robots will coexist with human. For this reason, legislation should order questions of great legal importance such as: Who takes responsibility for the acts or omissions of intelligent robots? Should it exist a special regime of rights and obligations?, what solutions will we give to ethical conflicts related to their behavior? Finally, Should we establish the minimum organizational, technical and legal measures to minimize the security risks that the technology is exposed assuming that its development should not be a threat as a threat but as an opportunity and that, the robots may be interconnected?. Regulation is a key aspect for the existence of a more secure and peaceful society and therefore it must be adapted to how humanity is today and how we want society is in the future
Study of drug utilization and antimicrobial prescription pattern of indoor paediatrics cases in tertiary care hospital
Authors: Bamel Vivek Virbhan , Shahani Savita Ramesh , Mohanty Nimain C.
Published: December 2017

Background: Infectious disease represent a major cause of mortality and morbidity in India. Pattern of use of antibiotics need to be studied separately as they vary from adult, however there is limited data is available, Therefore the aim of our study is to observe the drug utilization and antimicrobial prescription pattern and drug utilization in department of pediatrics at our tertiary care hospital.Methods: This was a prospective observational study carried out among indoor patients admitted to paediatric ward after obtaining approval by Institutional Ethics Committee. Written informed consent obtained from a parent or legal guardian of participants.Results: 100 patients were enrolled. The maximum number of antibiotics were prescribed from cephalosporin class (75; 43.6%) out of which ceftriaxone (42;56%), Cefixime (20;26.6%), cefotaxim (11;14.6%), cefpodoxime (3;4%), cefazolin (1;1.33%). The majority of cephalosporins were prescribed in Gastrointestinal tract infections (60.66%) followed by respiratory (27.2%) and least in cvs (2.66%), secondly higher group of antimicrobial prescribed was from Aminopenicillin class accounting of (36; 21.9%) which includes amoxiclav (35;97.2%), ampicillin (1;2.7%) and other beta lactamase (3;1.7%) consisting meropenem (2;66.7%), piperacillin with tazobatcam (1;33.3%). The majority of aminopenicillin were prescribed in respiratory tracts infections and very less in other systems. Miscellaneous drugs used in respiratory conditions were bronchodilator, systemic steroid and nasal decongestant; in CNS disorders antiepileptic and diuretics; in cardiovascular disease NSAID, inotropic, antihypertensive, diuretics; in genitourinary tract infections alkalizing agent and steroid and in GIT disorders minerals, rehydration fluids, antispasmodic probiotic were used.Conclusions: We conclude that commonly prescribed drugs were from 3rd generation cephalosporins followed from extended spectrum penicillin with β lactmase inhibitor. Majority of the antimicrobials are used empirically.
A study on pattern of initial and acquired drug resistance for isoniazid and rifampicin in A.F.B. positive sputum smears of pulmonary tuberculosis patients at a Medical College in North Eastern Uttar Pradesh, India
Authors: Tiwari Ravi K. , Haider Jamal , Shukla Amitabh D. , Gupta Prem P.
Published: December 2017

Background: Despite availability of good quality anti-tubercular drugs and its administration through Directly Observed Therapy Short Course (DOTS) strategy of Revised National Tuberculosis Control Programme (RNTCP), tuberculosis remains a major cause of morbidity and mortality in India. The emergence of drug resistance necessitates the timely detection of susceptibility of anti-TB drugs. This can help in appropriate modification in treatment strategies.Methods: A total of 50 patients of pulmonary TB with AFB positive sputum smears attending the OPD of TB and Chest department of B.R.D. Medical College, Gorakhpur were included. Patients were grouped based on history into new (cat-I) and previously treated patients (cat-II). Cat-II patients were further subdivided into defaulter, treatment failure and relapse groups. The culture and DST of AFB positive sputum smears of these patients was done in VersaTREK™®. At the end of study, patients were grouped according to age, sex, category and drug sensitivity pattern for Isoniazid (INH) and Rifampicin (RIF) viz mono resistance (resistance to either INH or RIF) or multi drug resistance (M.D.R.) and the resultant data were analysed.Results: Of the total 50 patients included in this study, 18 (36%) patients were sensitive to both the drugs INH and RIF, of which 11 (22%) were of cat-I and 7 (14%) of category-II. Twenty-two (44%) patients were resistant to INH only of which 8 (16%) were of cat-I and 14 (28%) of cat-II. One (2%) case of cat-I showed resistance to RIF only, while M.D.R. type of resistance is seen in 1 (2%) patient of cat-I and 8 (16%) patients of cat-II. Pattern of resistance to both INH and RIF together (i.e. M.D.R. type) showed significant difference between cat-I and cat-II.Conclusions: Most of the patients showing resistance to INH, RIF or both INH and RIF (M.D.R.) belonged to category-II (previously treated) patients.
Evaluation of an appraisal regarding the establishment of Drug Information Service Center in the medical institution
Authors: Bavane Dattatray Sampatrao , Ramoji Prashanth Chary , Gursale Santosh , Bhavsar Rahul , Nanaware Subhash
Published: December 2017

Background: India has an exploding drug market in generic and brand name products with variable cost. Many doctors tend to rely on pharmaceutical representatives for their prescribing information. Now it is agreed that the major objectives of DISC are to provide a rational basis for choosing and using drugs skilfully to relieve patient’s ailments. This is becoming more and more important as the practicing doctors is now confronted with so called “newer drugs” at such a great pace that even a full- time pharmacologist sometimes finds it difficult to keep abreast of their merits and demerits. The DISC provides the knowledge of number of drugs for practical application while prescribing. To provide healthcare professionals and patients with immediate access to accurate, concise and unbiased information on drug therapy problems.Methods: This is randomized study is to be conducted to determine the opinions of doctors, medical students, nurses, patients, other non-medical staff and general public as a patient representation from our institute campus regarding necessity of drug information. They are provided written feedback forms to be filled. The drug information service center (DISC) routinely responds to queries/inquiries regarding various drug related information. A structured eleven points questionnaire containing both open and close ended questions is prepared for opinion poll in feed-back form.Results: Large majority of the health and non-health professionals of opinion poll are in favour of reforms &innovations. They also suggested their own suggestions regarding the refreshing the subjects.Conclusions: It is essential to create awareness of the services provided by the DISC among physician’s pharmacists, nurses and consumers so that they should come forward to utilize these services.
Initial GCS and laboratory findings of patients with TBI are associated with the GOSE and mortality rate at one year
Authors: Paydar Shahram , Bordbar Elahe , Taghipour Mehdi , Khalili Hosseinali , Jafari Mehran
Published: December 2017

Background: To evaluate the relationship between presenting Glasgow Coma Scale (GCS) or laboratory data of patients with TBI and Extended Glasgow Outcome Scale (GOSE) and final outcome (deceased, survived) at one year.Methods: 74 patients (59 males and 15 females; mean age ±SD of 40±19years) who presented with TBI were entered into the study, and their GCS and laboratory data were recorded. After one year, GOSE level and final outcome were evaluated with 11 yes/no questions obtained from the patients or their first-degree relatives.Results: The patients with lower GCS on admission or day six, significantly had lower GOSE. Moreover, the lower the GCS in the first week of admission, the poorer the final outcome. Among laboratory data, the base deficit (BD) level of -6 or worse on admission was an indicator of mortality at one year. Hypernatremia was the only laboratory factor which predicted poor GOSE after a year. Furthermore, patients with serum hypernatremia, hyperkalemia, or high PTT levels on the first week of admission had poor final outcome.Conclusions: Presenting GCS and metabolic derangements are reliable indicators of long-term outcome and GOSE at one year.
Prescribing patterns in systemic hypertension and pharmaco-economics (cost effectiveness and cost minimisation analyses) of the commonly prescribed antihypertensives in a district hospital in Enugu State, Southeast Nigeria
Authors: Umegbolu Emmanuel I.
Published: December 2017

Background: Prescribing patterns in systemic hypertension vary from place to place. Studies have shown that cost could be one of the factors responsible for non-adherence to treatment among hypertensive patients. Nigerian pharmacoeconomics studies have not provided a general guide on cost-effective prescribing for hypertensive patients in the country. The aim of the study was to examine the prescribing patterns, do cost effectiveness and cost minimisation analyses of the commonly prescribed antihypertensives, and determine if cost is a major reason many of the hypertensive patients of the District Hospital are usually lost to follow up.Methods: 5267 adult (≥18 years) non-antenatal patients’ cards of 2016 were reviewed for hypertension. Examination of the prescriptions, cost-effectiveness and cost-minimisation analyses of the commonly prescribed antihypertensives were done.Results: 12.6% of the patients were hypertensive. 73% of these hypertensive patients were treated pharmacologically. 40.8% adhered to treatment. 73% of the adherent ones responded to treatment. Amlodipine was the most expensive prescribed antihypertensive (N22). Amiloride-hydrochlorothiazide with the largest cost effectiveness ratio (CER) (9) was the most cost effective of all the combinations. Lisinopril- hydrochlorothiazide (N17) was preferable to the triple combination of lisinopril-amlodipine-hydrochlorothiazide (N39), and amlodipine-hydrochlorothiazide (N32) in cost minimisation.Conclusions: Cost of drugs probably had played a significant role in non-adherence to treatment among hypertensive patients in the District Hospital in 2016, since moduretic with the largest CER (9) and nifedipine with the greatest BP reduction when combined with hydrochlorothiazide (56/22 mm Hg) were rarely prescribed.
Clinical profile and the outcome of corrosive injury of GI tract
Authors: Velayudham Rajendran , S. Senthilkumar , Karthikeyan R. K.
Published: December 2017

Background: Corrosive substances are common household substances that can be ingested either accidentally or intentionally with suicidal intent. The present study was conducted to analyse the clinical profile of 50 cases of corrosive injury of GI tract and to analyse the outcome of 50 cases of corrosive injury of GI tract.Methods: The Cross-sectional study was conducted on 50 cases admitted in the toxicology ward in Rajiv Gandhi Government General Hospital, madras medical college, Chennai over a period of six months. Patients with history of corrosive ingestion presenting within 24 hours of ingestion subjected to Upper GI endoscopy within 24 hours of admission. Patients presenting after 24 hours, with respiratory distress, suspected perforation either radiologically clinically and normal findings in Upper GI endoscopy were excluded. The patients were serially followed and were subjected for a re-look upper GI endoscopy after 6 weeks and the findings were compared.Results: Corrosive ingestion was more common in the age group 20-30 years and more common in males. Acid ingestion was almost twice as common as alkali ingestion. Suicidal ingestion was the most common circumstance of consumption and associated with higher grade of injury. Patients with ingestion of more than 50 ml had higher grades of injury and also were at higher risk of strictures. The spectrum of injury to the GI tract revealed esophageal injury of grade II b to be the most common finding with the duodenum being spared in majority of the cases.Conclusions: In our study, Patients with ingestion of more than 50ml had higher grades of injury and also were at higher risk of strictures. While the lesser grade injuries (0, I, IIa) were associated with complete recovery with no sequelae, the more severe grades (IIb and IIIa) were associated with higher incidence of strictures especially the circumferential lesions.  Oesophageal strictures are commonly associated with suicidal corrosive ingestion. All patients with corrosive ingestion should be subjected to early UGIE and after 6 weeks to identify stricture formation.
Nutritional status of older adults in a community in Pathanamthitta district of Kerala
Authors: Abraham Jacob , N. Navaneetha , Johns Felix , Aiyappan Rajalakshmy , M. Mili , Shibu Priyanka , Mathew Elsheba
Published: December 2017

Background: India is said to be shifting from an undernourished to over nourished population with advances in health, economy and medical care. But there is paucity of information regarding nutritional status of older adults in the country, who are socially and economically insecure. Hence the present study attempts to assess the nutritional status of people above 60 years of age, and to find the factors associated with it.Methods: A cross sectional study was conducted among 129 people aged above 60 years, residing in Pathanamthitta district, Kerala. Mini Nutritional Assessment tool (MNA) was used to classify the respondents as having ‘normal nutrition’ (score 23.5 and above), ‘at risk of malnutrition’ (17-23.5), ‘malnourished’ (<17). A 24-hour dietary recall was done to calculate per day calorie intake and compare with Recommended Daily Allowance (RDA). The results were interpreted as adequate or deficient. Descriptive statistics, chi-square and spearman’s correlation were done to find relationship between various sociodemographic variables, MNA status, BMI and calorie intake.Results: Females constituted 75.2%; 81.4% were unemployed; 62% belonged to rural area. Nutritional assessment showed 41.9% to be having normal nutrition, 46.5% at risk of malnutrition, and 11.6% malnourished. Caloric intake was less than the RDA in 89.1%. There was no association between calorie intake per day and MNA status. Education (p=0.025), place of residence (p=0.021), marital status (p=0.003), and family income (p=0.031) were factors significantly influencing nutritional status in elderly. There was significant correlation between MNA status and BMI (p<0.001, r=0.329).Conclusions: Malnutrition was seen in 11.6% of older adults in this study and another major proportion was at risk of malnutrition. Better nutritional status was significantly associated with good education, urban residence, married state, and higher family income. Dietary intake was inadequate among older adults. 24-hour dietary recall reflected nutritional status of only the malnourished.
Bilateral superficial cervical plexus block combined with general anaesthesia for thyroid surgery-a comparative study of intraoperative haemodynamic status and safety
Authors: Velayutham Nedumaran , . Selvaraju , . Shanmugavelu
Published: December 2017

Background: When general anaesthesia is employed for a surgery, the hemodynamic changes are intense during intubation, intraoperative stress and extubation. Hence, in the present study, by employing Bilateral Superficial Cervical Plexus Block using 0.5% Bupivacaine prior to skin incision, assessment of hemodynamic effects during intraoperative period is done. The aim of the study was to compare the intra operative hemodynamic status and the safety of bilateral superficial cervical plexus block with general anesthesia in thyroid surgerie.Methods: Bilateral superficial cervical plexus block was performed in patients undergoing simple thyroid surgery using normal saline in 29 control group patients and 0.5% Bupivacaine in 29 study group patients. Intraoperative hemodynamic status was monitored in both the groups using parameters such as heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure.Results: Hemodynamic parameters are not altered during the intraoperative period in the study and control group.Conclusions: Bilateral Superficial Cervical Plexus Block with bupivacaine did not alter the intraoperative hemodynamic parameters.
Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh
Authors: Bajjou Tahar , Reggad Ahmed , Hilali Farida , Elkochri Safae , Laraqui Abdelilah , Touil Nadia , Lahlou Amine Idriss , Sekhsokh Yassine , Mahassine Fattouma
Published: December 2017

Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus.
Imaging in phenytoin induced neurotoxicity: a case series
Authors: Arora Manali , Kumar Boruah Deb , Thakker Vishal , Bhanwra Sangeeta
Published: December 2017

Phenytoin is a commonly used anti-epileptic drug for various types of seizure disorders except for absent seizures. Long term dose dependant neurological side effects of phenytoin therapy include cerebellar atrophy, cerebral atrophy and brain stem atrophy. Skull hyperostosis, gum hypertrophy and megaloblastic anemia are other known effects of Long term therapy. We present four cases depicting clinical and neuroimaging findings of Phenytoin induced Toxicity.
Hypertension and occupational stress among high school teachers of Dibrugarh district
Authors: Chetia Dipankar , Gogoi Gourangie , Baruah Rupali
Published: December 2017

Background: Hypertension is an important public health problem. High blood pressure is one of the leading risk factors for premature deaths. Job strain can impact blood pressure directly through neuro-endocrine mechanisms. Teaching in school especially at the secondary school level has been identified as one of the most stressful professions. The present study was conducted to estimate the prevalence of hypertension and its association with occupational stress among high school teachers of Dibrugarh district. Methods: A community based cross sectional study among all government high school teachers of Dibrugarh district was done. All high school teachers in the age group ≥21 years to <60 years of both sexes were included. The sample size was calculated to be 335 using the formula, n=4pq/d2. Results: Out of the 335 study participants, 45.4% were hypertensive while the remaining 54.6% were non-hypertensive. Study participants who had stress as a problem had highest prevalence of hypertension (84.6%). The association between prevalence of hypertension and occupational stress of the study participants was observed to be statistically significant as (p<0.05). Conclusions: From the findings of the study it was concluded that the prevalence of hypertension among high school teachers of Dibrugarh district was high (45.4%). The prevalence of hypertension was found to be significantly associated with occupational stress.
Prevalence of depression in PLHA attending ART centre of Assam medical college and hospital, Dibrugarh
Authors: Kotoky Manas Jyoti , Gogoi Gourangie
Published: December 2017

Background: Depression is a common mental health disorder encountered in people living with HIV/AIDS. Depression has a strong impact on the daily chores in the lives of those suffering from HIV/AIDS and their ability to cope with the disease and has a special role to play in adherence to antiretroviral therapy. This study was undertaken to assess the prevalence of depression in PLHA attending the ART centre of AMCH. Methods: A cross sectional study was carried out on 54 patients attending the ART centre. They were interviewed using a predesigned and pretested proforma with prior consent. Depression was assessed using the MDI-4 scale and data was analysed using SPSSv16. Chi square test was done to see the association. Results: Majority (85%) of the respondents were male. Prevalence of depression was found in 55.6% of the respondents. Alcoholic history was found in 54% and smoking in 24% (p<0.05). Most were educated below 10th grade (66.6%) (p<0.05). Most of them (83.3%) disclosed their status to their family members. Conclusions: The prevalence of depression is very high in PLHA. To diagnose depression and to treat at the earliest will go a long way in improving their quality of life.
Comparison of perceived stress among medical and engineering students of Karpaga Vinayaga Educational Group, Kancheepuram District, Tamil Nadu
Authors: D. C. Vidya , N. Swetha , D. Thirunaaukarasu , H. Gladius Jennifer , E. Karthikeyan
Published: December 2017

Background: Doctors and engineers are experiencing stress from their student life. There are very few studies from South India, which have looked into comparison of perceived stress among medical and engineering students. Hence, this study was attempted with an objective to estimate the overall prevalence and to compare the perceived stress, and to know associated factors influencing stress, among medical and engineering students of Karpaga Vinayaga Educational group, Kancheepuram district, Tamil Nadu. Methods: A cross sectional study was conducted in Karpaga Vinayaga Educational Institute, Tamil Nadu, from June to September 2016. Based on simple random sampling, students from medical and engineering college were selected. After obtaining informed consent, a self administered questionnaire was administered. The data was analysed in SPSS version 18.0. Results: Out of 560 study subjects, 135 (24.2%) had low stress, 390 (69.6%) had moderate stress and 35 (6.2%) severe stress. Stress was associated with personal problems OR=2.29 (95% CI: 1.19-4.39), sleep disturbance OR=4.12 (95% CI: 1.57–10.7), difficulty in understanding the subject OR=2.32 (95% CI: 1.19–4.53), difficulty in time management OR=2.47 (95% CI: 1.40–4.35) and home sickness (p=0.001) in medical students whereas among engineering students, stress was associated with personal problems OR=2.01 (95% CI: 1.02–3.92), sleep disturbance OR=2.14 (95% CI: 1.1–4.1) and difficulty in time management OR=2.6 (95% CI: 1.48–4.58). Conclusions: The overall prevalence of perceived stress was 75.8%. The prevalence of perceived stress among medical students was 76.8% as compared to 75% of engineering students. Among medical and engineering students, stress was associated with personal problems, sleep disturbance and difficulty in time management.