bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of CRM on employee performance in banking industry
Authors: Yapanto Lis M. , Diah Ahyar Muhammad , Kankaew Kannapat , Dewi Anita Kusuma , Dextre-Martinez William Rene , Kurniullah Ardhariksa Zukhruf , Villanueva-Benites Luis Augusto
Published: April 2021

The relationship between the organization and its clients is the life of every enterprise, whether it is a multinational corporation of several billion employees and a multi-million-deposit business or sole traders with a handful of daily customers. The relationship between the organization and its traditions is the key concern. Between these two cases, consumer relationship management (CRM) is the same in theory and may differ significantly. Both the company and consumers have some factors to meet, such as the desires and expectations of all sides, before forming a contract. We need to earn a profit to succeed and to improve clients expect excellent support, better goods and reasonable pricing. The implementation of a CRM program will impact consumer service and customer knowledge for various purposes. Likewise, adopting a CRM strategy would definitely affect consumer loyalty and awareness. CRM guarantees that consumers are happy and strengthens ties between the company and its clients. Such practices improve the partnership between customers and sales representatives. The study carried out the quantitative approach in the delivery of the questionnaire to more than 100 bank customers. In concise and inferential statistics, the data were handled using the SPSS statistical method. Data indicates that the strong relationship between consumer loyalty and customer happiness of CRM technologies occurs and the stronger the overall customer satisfaction score, the larger the volume of CRM technology deployed.
The effect of competency management on organizational performance through supply chain integration and quality
Authors: Tarigan Zeplin Jiwa Husada , Mochtar Jenny , Basana Sautma Ronni , Siagian Hotlan
Published: April 2021

Synergy is built by manufacturing companies with suppliers and customers in the supply chain to improve organization performance. The research provides simultaneous testing of competency management, supply chain integration, supply chain quality, operational capability as a strategy to improve company performance. Collecting data for medium and large manufacturing companies in Indonesia are performed by sending a questionnaire link via email and WhatsApp. 625 respondents received the questionnaires and 152 respondents filled them with a response rate of 24.32%. Data analysis were performed using partial least squares to test the hypotheses and found that competency management had a direct impact on supply chain integration (0.598), supply chain quality (0.387) and operational capability (0.346). Supply chain integration affects increasing supply chain quality (0.428), operational capability (0.619) and organizational performance (0.255). Supply chain quality impacts increasing operational capability (0.260) and does not significantly affect organizational performance (0.018). The operational capability of a manufacturing company has an impact on improving organizational performance (0.584). Practical contribution is that managers who manage the supply chain must continue to enhance skills and knowledge and supply chain components in quality for increased performance.
Supply chain management and logistic presentation: Mediation effect of competitive advantage
Authors: Kankaew Kannapat , Yapanto Lis M , Waramontri Rojanard , Arief Sjamsul , Hamsir Hamsir , Sastrawati Nila , Espinoza-Maguiña Marcos Rosamel
Published: April 2021

Supply chain management (SCM) practices have become strategic resources and capabilities for enhancing both competitive advantage logistic performance (ORGPER). However, it is not clear how SC Practices influence logistic performance in the agribusiness context. However, the mechanism of SCMPs effects is not yet understood since extant literature has produced mixed results. Hence, this study sought to test the impact of mediation of the competitive advantage of relations between SCMP and Reperform the point of view of Kenya's dairy supply chain. The study examined four estimates that were tested using partial minimum square structural equation modeling (PLS-SAME) techniques to work out the purpose of the study. Across-departmental survey design has been used to collect preliminary data from109 dairy cooperatives in thirteen major dairy producing counties in Kenya. The results reveal that SCM practice has a positive and significant effect on CA(P=0.730) and ORGPER (P=0.237). In addition, THERE is a positive, statistically significant effect on THECAORGPER (P=0.522). Further results show that CA mediates the relationship between SCMP and ORGPER. Consequently, the study concludes that SCMPs first generate CA, which in turn enhances ORGPER in a logistic sense. Theoretically, the study provides insights on the resource-based view theory as well as a conceptual framework for its validation. Similarly, the study informs managers and policymakers in knowing specific SCMPs to focus on to enhance CA and ORGPER of the dairy cooperatives in Kenya.
The effect of competitive strategies on company performance with supply chain management as moderating variables in Indonesian manufacturing corporations
Authors: Hermawan Dadang
Published: April 2021

Dry Port, a supply chain company, strives to bring its workers up to speed in the current VUCA world. The study explores the degree to which ambidexterity affects agility, which can impact organizational effectiveness. The structural equation model with multilevel simulation used to test the research hypothesis. The study indicates that ambidexterity is an influential factor to agility, and that ambidexterity is also an impactful factor to agility and organizational effectiveness. Furthermore, there is also evidence that the power of agility contributes to greater organizational effectiveness, and also that ambidexterity has an impact on organizational effectiveness through workforce agility. To achieve organizational effectiveness in dry port business, mobile devices and social network technology are functional enablers of ambidextrous activities that can allow staff to be agile in handling dry port business tasks.
Statistical Software Applications and Statistical Methods Used In Community Medicine and Public Health Research Studies
Authors: Joshi Krishna P , Jamadar Deepak C
Published: April 2021

Background: The utilization of software in statistical methods and tools has increased very much in last two decades. The easily availability of statistical application software on internet, made easy to analyse, interpretation and conclude the study variables.

Aim and Objectives: To know the statistical software applications and various statistical methods used in the community medicine and public health research studies.

Materials & Methods: A cross sectional retrospective study, We had included online community medicine and public health journals of four years (2017 to 2020).By cluster sampling method were used and each cluster includes articles of four different year, 400 randomly selected research articles were downloaded & reviewed. The data was analysed by using SPSS version 23.

Results: 400 articles were reviewed. 317 (79.25%) were used Ms-Excel software followed by 261 (65.25%) descriptive statistics and 145(36.25%) SPSS and 143 (35.75%) applied cross sectional study design. 91 (22.75%) applied chi-square test, 77(19.25%) applied ANOVA test. 59(14.75%) t-tests. Only 41(10.25%) articles were reported with confidence intervals.

Conclusion: The current study reveals, Microsoft excels, and SPSS and R-programming were more frequently using software in the community medicine and public health, whereas descriptive statistics, chi-square tests, t-tests and non-parametric tests were commonly using statistical methods.
Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain
Authors: Berger Amnon A. , Liu Yao , Mosel Luke , Champagne Kristin A. , Ruoff Miriam T. , Cornett Elyse M. , Kaye Alan David , Imani Farnad , Shakeri Asadollah , Varrassi Giustino , Viswanath Omar , Urits Ivan
Published: April 2021

Context: Neck pain is a common phenomenon and affects a large segment of the population. Chronic neck pain, lasting more than 3 months, likely occurs in 10% - 30% of patients with acute neck pain and affects up to 288 million cases globally, carrying a significant cost in terms of quality of life, disability, and healthcare dollars. Here we review neck pain background, acupuncture and the evidence that exist to support acupuncture use in chronic neck pain. Results: Neck pain not only affects quality of life directly, but also contributes to depression, job dissatisfaction and reduced productivity. Unfortunately, neck pain is strongly linked to office and computer work and is likely to continue increasing in prevalence. Traditional treatments, such as analgesics, physical therapy, exercise, and non-invasive therapy bring some relief, and invasive therapy is indicated if anatomical pathologies exist. Acupuncture is a form of integrative medicine, originally described and practiced in traditional Chinese medicine and now expanded to include methods including acupressure, dry needling, and others. Traditionally, it focused on restoring the patient’s flow of Qi by puncturing specific points along the meridians. It has previously been shown to be effective in other forms of chronic pain and disability. Clinical trials studying acupuncture for neck pain have shown significant reduction in both pain and associated symptoms. These therapies are reviewed in this text. Conclusions: Neck pain is a common and significant global problem. Acupuncture, dry needling, and cupping were all shown to be effective in alleviating pain both immediately after treatment, as well as provide long-lasting relief. These treatments are generally safe and inexpensive and should be considered as part of a multimodal approach for the treatment of neck pain. More head-to-head studies will provide better data to support a choice of a specific treatment over another.
Episiotomy and Its Complications
Authors: Soleimanzadeh Mousavi Seyed Hosein , Miri Mina , Farzaneh Farahnaz
Published: April 2021

Objectives: This study aimed to evaluate the frequency of episiotomy and its early complications in natural vaginal delivery in the maternity ward of Ali Ibn Abitaleb (AS) Hospital in Zahedan from 2014 - 2016. Methods: In this cross-sectional study, which was conducted in 2017, the archives of women who gave birth between 2014 - 2016 were reviewed. Data were collected using information forms and analyzed by SPSS software. Results: Of 418 women were reviewed, the episiotomy rate was 54.5%; there was a significant association between parity and mother age with episiotomy rate. Moreover, 24-hour pain frequency, perineal rupture rate, hematoma rate was significantly higher in the episiotomy group. First- and fifth-minute Apgar of the neonates in the episiotomy group was significantly lower. Conclusions: In overall, the episiotomy rate was 54.5%, and there was a significant association between parity and mother age with episiotomy rate.
Hesse’s Steppenwolf
Authors: Sipiora Michael P. ,   Philosophy Documentation Center
Published: April 2021

The psychological character of Herman Hesse’s Steppenwolf is explored by way of a detailed analysis of the novel’s comic genre. This reading of Steppenwolf contextualizes its celebrated portrayal of the crisis of modern life within a story of “healing” (Hesse, 1974, p. viii) informed by the comic vision of “faith, hope, and love in a fallen world” (Cowan, 1984, p. 9). The novel’s innovative sonata-like structure (Ziolkowski, 1965) and the extensive use of double perception, along with the employment of classic comic action, themes, and stock characters are discussed. In the work’s comic vision, the dichotomies (flesh/spirit, subject/object, inner/outer) that plague the Steppenwolf give way to humor and imagination as preferred responses to the soul’s alienation and homelessness.
The Meaning of Feeling
Authors: Soffer Joshua ,   Philosophy Documentation Center
Published: April 2021

Current approaches in psychology have replaced the idea of a centralized, self-present identity with that of a diffuse system of contextually changing states distributed ecologically as psychologically embodied and socially embedded. However, the failure of contemporary perspectives to banish the lingering notion of a literal, if fleeting, status residing within the parts of a psycho-bio-social organization may result in the covering over of a rich, profoundly intricate process of change within the assumed frozen space of each part. In this paper I show how thinking from this more intimate process may transform current views of metaphor, the unconscious, and the relation between affect and cognition.
Don DeLillo’s The Body Artist
Authors: Kontoulis Cleopatra , Kitis Eliza ,   Philosophy Documentation Center
Published: April 2021

Don DeLillo’s The Body Artist portrays a world inhabited by characters whose unified, other-proof subjectivity crumbles around them to reveal the basic fibres of the biological, organicist body as this is mutated across bodies and projected across images. Such sameness and connection are primarily played out in the language and the style used. The paper examines linguistic techniques such as the use of logical conjunction (e.g., and) and causal connectives, such as because, which instead of signaling causality, constantly rephrases the same as an expanded other, thus effectively subverting our common sense perceptions. In this context, the absence of representational means of identity resulting in the redefinition of Lauren’s subjectivity on a broader biological plane also reconciles her to the grief felt at her husband’s death.
Productive Strife
Authors: Rivers Nathaniel , Tirrell Jeremy ,   Philosophy Documentation Center
Published: April 2021

This article posits that Andy Clark’s model of distributed cognition manifests socially through the agonism of human activity, and that rhetorical theory offers an understanding of human conflicts as productive and necessary elements of collective response to situation rather than as problems to be solved or noise to be eliminated. To support this assertion, the paper aligns Clark’s argument that cognition responds to situated environmental conditions with the classical concept of kairos, it associates Clark’s assertion that language structures behavior (Being There 195) with the long-held rhetorical stance that language is constitutive, and it examines the online encyclopedia Wikipedia as an enactment of what Clark and rhetorical theorists claim about productive agonism and the litigious nature of identity and cognition.
What Do I Love When I Love My Patient?
Authors: Fratoni Mark ,   Philosophy Documentation Center
Published: April 2021

This essay examines the implications of Jacques Derrida’s complex engagement with negative theology for the field of psychotherapy. Negative (or apophatic) theology is a long tradition which emphasizes God’s absolute otherness. This essay explores Derrida’s attempt in The Gift of Death to translate this theological language into the language of human intersubjectivity. John Caputo, the most renowned American interpreter of Derrida’s writings on religion, calls for a “generalized apophatics,” an application of apophatic thought to fields outside of religion. Caputo bases his exhortation on Derrida’s assertion that “every other is wholly other.” This essay is a preliminary attempt to sketch the outline of an apophatic psychotherapy, with an emphasis on Derridean themes such as the impossible, the secret, and translation.
The Indeterminable Gender
Authors: Stoller Silvia ,   Philosophy Documentation Center
Published: April 2021

What kind of ethics can we consider in the framework of feminist phenomenology that takes poststructuralist feminism into account? This seems to be a difficult task for at least two reasons. First, it is not yet clear what ethics in poststructuralist feminism is. Second, phenomenology and poststructuralism are still regarded as opposites. As a phenomenologist with strong affinities to poststructuralism, I want to take on this challenge. In this paper, I will argue that phenomenology and poststructuralism share the idea of the “indeterminable.” If this idea is applied to the topic of gender, we can speak of an “indeterminable gender.” Moreover, phenomenology and poststructuralism support an ethical attitude toward genders inasmuch as they both avoid making problematic determinations. My goal is to explore what the so-called “indeterminable gender” is and to illuminate the ethical implications of this concept.
Faking Orgasms and the Idea of Successful Sexuality
Authors: Kalman Hildur ,   Philosophy Documentation Center
Published: April 2021

In the Nordic countries, at a time when women have only recently won the right to their own bodies and to a sexuality of their own and for themselves, women nevertheless fake orgasms. Moreover, a common question posed to the Swedish Association for Sexuality Education (RFSU) deals with lack of desire. Not only are women faking and complaining of lack of desire, but men as well. It seems that contemporary ideals surrounding sexuality converge with quests for not only pleasure and love, but also for fitting in and experiencing what is conceived of as normal and “successful” sexuality. This essay examines the contemporary and prevalent phenomenon of faked orgasms from the perspectives of feminist theory and phenomenology.
Hempel’s Raven Revisited
Authors: Bollhagen Andrew ,   Journal of Philosophy Inc.
Published: April 2021

The paper takes a novel approach to a classic problem—Hempel’s Raven Paradox. A standard approach to it supposes the solution to consist in bringing our inductive logic into “reflective equilibrium” with our intuitive judgements about which inductive inferences we should license. This approach leaves the intuitions as a kind of black box and takes it on faith that, whatever the structure of the intuitions inside that box might be, it is one for which we can construct an isomorphic formal edifice, a system of inductive logic. By popping open the box we can see whether that faith is misplaced. I aim, therefore, to characterize our pre-theoretical, intuitive understanding of generalizations like “ravens are black” and argue that, intuitively, we take them to mean, for instance: “ravens are black by some indeterminate yet characteristic means.” I motivate and explicate this formulation and bring it to bear on Hempel’s Problem.
Quality-Space Functionalism about Color
Authors: Berger Jacob ,   Journal of Philosophy Inc.
Published: April 2021

I motivate and defend a previously underdeveloped functionalist account of the metaphysics of color, a view that I call ‘quality-space functionalism’ about color. Although other theorists have proposed varieties of color functionalism, this view differs from such accounts insofar as it identifies and individuates colors by their relative locations within a particular kind of so-called ‘quality space’ that reflects creatures’ capacities to discriminate visually among stimuli. My arguments for this view of color are abductive: I propose that quality-space functionalism best captures our commonsense conception of color, fits with many experimental findings, coheres with the phenomenology of color experience, and avoids many issues for standard theories of color such as color physicalism and color relationalism.
Populism and Cosmopolitanism as a Unitary Structure of Global Systemic Process
Authors: Friedman Jonathan ,   ProtoSociology Project
Published: April 2021

Populism is discussed here in terms of the larger global systemic matrix in which it occurs. It is suggested that it is not, as has been claimed so often, recently, somehow related to what is labelled as right-wing extremism. It is an expression of an aspiration to sovereignty, control over one’s conditions of existence and its links to either left or right are based on that aspiration. And, of course, right and left are themselves terms that have shifted or even been inverted over the past 30 years. The core argument is that populism and cosmopolitanism form a complementary opposition that has emerged as a product of the hegemonic decline of the West.
No Going Back?
Authors: Tormey Simon ,   ProtoSociology Project
Published: April 2021

This paper takes up the challenge posed in recent commentary concerning the nature or ontology of populism. I suggest that we need to take a sociological approach that seeks to locate populism within the wider processes and tendencies associated with late modernity in order to fully capture not only what populism is, but also why we are seeing a greater prevalence of populism around the world. I locate populism in relation to fve dominant tendencies: The decline of traditional authority structures; the rise of individualisation; the growth of bureaucracy and complexifcation; the intensifcation of globalisation and the emergence of a new media ecology. These processes together are creating enormous strains on representative democracy, lead­ing to “democratic grievance”. Those who are represented become uncoupled from their own representatives, leaving a vacuum which is increasingly flled by populist initiatives. Populism thus needs to be read as a symptom of an intensifying crisis of democracy, as much as a cause of it.
Populism and Worldwide Turbulence
Authors: Robertson Roland ,   ProtoSociology Project
Published: April 2021

This contribution consists in an attempt to make sense of one central aspect of the present worldwide turbulence, one which might well be called the contemporary, perfect, global storm. A pivotal problem that will be interrogated is the issue of the circumstances that have produced this phenomenon in most parts of the world, although it should be emphasized that the term populism is, more often than not, applied to the Western world rather than the East or, for the most part, the global South. However, this reservation does not amount to a severe caveat, since all the contemporary signs are that what is here called populism is sweeping across the entire world as a whole, even though it is not necessarily given this name in non-Western regions. To this generalization it should be added that there are, rather obviously, parallels to what has become known as populism in the West. Examples of this are anarchism in nineteenth century Russia and the movement known as the Long March under the leadership of Mao Zedong in the years 1934 and 1935 particularly, as well as al Qaeda and its various offshoots.
Globalization, Cosmopolitanism and 21st Century Populism
Authors: Roudometof Victor ,   ProtoSociology Project
Published: April 2021

The contemporary debate on 21st century populism centres on a term (“populism”) that can be flled with multiple meanings. It provides the social sciences with a “meta-concept” that offers coherence to disciplinary discourses. In the 21st century, globalization and cosmopolitanism are often viewed as an irresistible force by intellectuals, with advocacy of cosmopolitanism becoming commonplace. For the most part, the academic community has only belatedly and reluctantly decided to address the electoral success of political parties that reject the political consensus of the post-1989 “New World Order”. In sharp contrast to the intellectuals’ stance, the empirical evidence suggests that it is localism (and not cosmopolitanism) that has been on the rise in recent decades. Glocalization is connected to the formation of varied collective responses and representations, thereby giving rise to the mutually defined pair of cosmopolitanism and localism. The cosmopolitanism–localism binary relationship is a result (or outcome) of glocalization. However, the majority of social-scientifc perspectives do not give proper consideration to the notion of “local”. The notions of localization and de-globalization as part of post-Great Recession trends are discussed. The extent to which these can rectify shortcomings in current theorizing is explored.
The impact of the employer brand on the corporate reputation of hotel companies
Authors: Ognjanović Jasmina
Published: April 2021

Employees are one of the key resources involved in building of corporate reputation. The efficiency of employees is reflected in the corporate reputation and depends on the development of the employer brand. The concept of the employer brand is aimed at building the image of attractive employer in the labor market and implies providing functional, psychological and economic benefits for potential and current employees. The aim of this paper is to examine the interdependence of the employer brand dimensions and the corporate reputation of the observed hotels in the Republic of Serbia. The research involved the application of correlation analysis, regression analysis and non-parametric tests to check the differences between groups. In the paper are observed three dimensions of the employer brand: functional-economic value, social value and interest value. It is proved and the presence of a positive and statistically significant correlation between the dimensions of the employer brand and the corporate reputation of the observed hotels. Based on the processed data, the influence of the dimensions of the employer brand on the corporate reputation of the hotel has been proven, with the strongest influence on the social value and functional-economic value. Non-parametric tests did not reveal a statistically significant difference in the level of development of the employer's brand dimensions between different categories of hotels.
The value of customer involvement in new product development for company
Authors: Gligorijević Mirjana , Rusić Jovan
Published: April 2021

Modern companies are facing much tougher competition than before. In the past, companies were competing, mostly with other companies locally. Now companies can offer their products to customers beyond the local market. Globalization presents a huge chance for companies to grow by an increase in the market size, but as the market size grows, the same happens with the competition. If a company wants to endure, a company is under pressure to innovate, and including customers can affect new product development. The goal of this paper is to determine if including consumers in new product development can affect faster and better quality new product development processes and increase new product value for the company. This analysis should provide us with an answer to the question, should we include consumers, and if we should, when? The results of this paper could act as a guide for managers in developing new products.
The determinants of purchasing private label products
Authors: Marković Ivana , Rabasović Biljana , Vićentić Mlađen
Published: April 2021

A private label is developed by a retailer with the aim to achieve the largest possible market share, to suppress manufacturer's brands, to increase the margin and to gain consumer loyalty. The subject of this paper is to analyze the determinants of purchasing private label products. The aim of this paper is to examine whether the economic situation perception, price sensitivity, quality perception and the sense of "smart shopping" have an impact on the purchase of a private label products. Data were collected by personal interview method, via online survey 260 respondents were examined, and hypotheses were tested by regression analysis. The obtained results indicate that the price sensitivity and the smart shopping feeling have a positive statistical impact on the private label purchase, while in the case of the two remaining observed variables: perception of economic situation and quality, this impact is not statistically significant. The study is original while it identifies which determinants shape consumer behavior when it comes to buying a private label. As such, it can be useful for retailers to successfully develop and manage their own branded products.
An Integrated System for Continuous Assessment and Examination Management in Schools and Colleges
Authors: Mgbeafulike Ike , Chekwube Ezechi
Published: April 2021

The technological advancement in IT has brought about the need for computer usage in all areas of human life and endeavors, education sector also. The traditional method of conducting exams is often characterized by questions leakages, human errors when marking the scripts of students and recording of students’ scores. This work, Integrated System for Continuous Assessment and Exam Management was, therefore, born out of the will to solve the problems plaguing the conventional (paper-based) examination system by providing a campus-wide service for e-assessment devoid of dishonest conduct and equally enhances quick feedback. The developed system which uses a combination of HTML,PHP,MySQL reduces the proportion of workload on examination, grading and reviewing on the part of examiners. The system also enables the release of exam results in record time and without errors. Thus, this system can serve as a solution for mass education evaluation and offers many features that cannot be implemented in paper-based system.
Detection of Atypical Pathogens in Community Acquired Pneumonia by Indirect Immunofluorescence Assay
Authors: Guchhait Partha , Devi Doddarangappa Rangaswamy Gayathri , Indumathi VA , Deepak TS
Published: April 2021

Introduction: Community Acquired Pneumonia (CAP), as the name suggests, is acquired at the community level, and symptoms usually develop within 48 hours. There are two types of CAP, namely, typical and atypical. Typical pneumonia is usually caused by bacteria such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Atypical pneumonia is caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Coxiella burnetii, as well as respiratory viruses, such as Adenovirus, Respiratory Syncytial Virus (RSV), Influenza viruses A and B, and Parainfluenza viruses 1,2,3, among others. Typical and atypical CAP can be distinguished by the absence or presence of extrapulmonary symptoms. Aim: To elucidate the proportion of atypical respiratory pathogens that cause CAP in a tertiary care hospital setting. Materials and Methods: This was a cross-sectional study that was conducted at the Department of Medicine, Chest Medicine and Microbiology of MS Ramaiah Medical College, Bengaluru, Karnataka, India. The study included 202 patients, aged 18 years and above with clinical and radiological features of CAP. Indirect Immunofluorescence Assay (IFA) was carried out to detect the pathogens. Results: The prevalence of atypical pathogens was 33.17% among all CAP patients. Atypical pneumonia was more prevalent in males and in the age group of >61 years. The most common pathogens included Mycoplasma pneumoniae (12.38%) followed by Legionella pneumophila (9.90%) and influenza A (5.94%). Typical pneumonia was primarily caused by Streptococcus pneumoniae (9.9%), followed by Klebsiella pneumoniae (1.49%), Staphylococcus aureus (1.49%), and Haemophilus influenzae (0.49%). Mixed infections occurred in 16 patients. Conclusion: Active screening for CAP is needed in all wards and Intensive Care Units (ICU), as more patients with CAP are increasingly being admitted to ICU. Data on the proportion of atypical CAP will help to use antibiotics prudently for a better prognosis, thereby preventing the emergence of antibiotic resistance.
Efficacy of Peptone Glycerol Broth in Long-term Storage of the Bacterial and Yeast Cultures
Authors: Lavanya J , Manjula SR , Chitra A Gomathi , Chaithanya Venkata , Sivaramakrishnan Ramya
Published: April 2021

Introduction: Bacterial isolates and control strains stocking is an integral part of clinical microbiology laboratories. This is an essential step in maintaining quality. Preserving the strains without altering the character is an essentiality. There are different stock culture preparations studied in past showing varied level of performance. Aim: To evaluate the performance in terms of longevity and phenotypic character preservation of Peptone Glycerol Broth (PGB) in comparison to Brucella Glycerol Broth (BGB) and Skim Milk (SKM). Materials and Methods: The present study was a prospective analytical study. Three quality control strains and seven clinical isolates with different types of resistance were stocked in triplicates with cryobead based peptone broth with 15% glycerol, Brucella Broth (BB) with 15% glycerol and 10% SKM and stored at -80°C. Isolates were revived in monthly pattern, quarterly pattern and once after 10 months to assess the variations in viability and loss of phenotypic properties arising out of repeated freeze thaw and contaminations. Viability was assessed by time taken to produce observable confluent growth on revival. Metabolic characters and antibiotic susceptibility testing were compared before and after stock revival at intervals. Results: The phenotypic characters like metabolic features and antibiotic susceptibility were preserved with all three preparations both with repeated freeze thaw and single freeze thaw at the end of 10 months. PGB and BGB had a 100% revival rate of stored isolates with a confluent growth at 24 hours in comparison to 93.56% with SKM. Conclusion: Cryobead preparation of peptone broth-15% glycerol can be used as an effective preparation for stock culture maintenance of non-fastidious bacteria and yeast.
Concomitant Mucormycosis with Aspergillosis in Patients with Uncontrolled Diabetes Mellitus: A Case Series
Authors: Singh Arpana , Mohanty Aroop , Jha Shweta , Gupta Pratima , Kaistha Neelam
Published: April 2021

Fungal infections are life threatening especially in presence of immunosuppression or uncontrolled diabetes mellitus mainly due to their invasive potential. Mucormycosis of the oculo-rhino-cerebral region is an opportunistic, aggressive, fatal and rapidly spreading infection caused by organisms belonging to Mucorales order and class Zygomycetes. The organisms associated are ubiquitous. Aspergillosis is a common clinical condition caused by the Aspergillus species, most often by Aspergillus fumigatus (A. fumigatus). Both fungi have a predilection for the immunosuppressive conditions, with uncontrolled diabetes and malignancy being the most common among them. Mucormycosis is caused by environmental spores which get access into the body through the lungs and cause various systemic manifestations like rhino-cerebral mucormycosis. Here, a case series of such concomitant infections of Aspergillus and Mucor spp from Rishikesh, Uttarakhand, India is reported.
Keratoconus: Available Treatment Options
Authors: Twinkle Choksi , Sahdev Saroj , Pawar Rajendra
Published: April 2021

Treatment of keratoconus has evolved substantially over years. Treatment modalities are aimed at stabilization of progressive ecstasia with least invasive approach. Mainstay of treatment has shifted from keratoplasty - (penetrating or lamellar) to less invasive techniques like corneal collagen cross linking, intrastromal corneal ring segments and topography-guided PRK. Recently Bowman Layer Transplantation has evolved as a less invasive, promising option in patients with advanced progressive form of disease.
Evaluation Of Hundred Consecutive Cases Of Optic Disc Oedema At A Tertiary Care Centre In North-West Rajasthan
Authors: Pensiya Maya , Kochar Anju , Ali Nawab , Khan Arif
Published: April 2021

Purpose:

This study aimed at evaluation of patients diagnosed as optic disc oedema in terms of demographics, aetiology and clinical presentation.

Methods:

This prospective, noninterventional hospital based study was conducted between January 2018 and November 2019. 100 cases of disc edema were included by consecutive sampling and comprehensive examination was done including BVCA, pupillary reaction, colour vision, detailed slit lamp examination, intraocular pressure, fundus examination, fundus photograph. CSF manometry, Lumbar Puncture, CT and MRI scan and OCT for RNFL assessment were performed as and when required.

Results:

The most common cause of the disc edema was papilloedema (54%) followed by optic neuritis (18%); optic neuropathies (9%); pseudopapilledema (7%); diabetic papillopathy (5%). Most common age group affected was 21-40 years (39%). Our study population had Male to Female ratio of 1:1.1. Bilateral disc edema was 3.5 times more common than unilateral presentation. Space occupying lesions were found to be most common cause of Papilledema. Decreased vision and headache was main symptom reported by majority of patients.

Conclusion:

From this study it was concluded that papilledema and optic neuritis should be considered in the differential diagnosis of patients with optic disc swelling. Bilateral disc swelling Could be due to papilledema, the first investigation should be urgent magnetic resonance imaging (MRI) plus magnetic resonance venography (MRV) to exclude a brain tumor or dural venous sinus thrombosis. With newer imaging technique like OCT, it is possible to differentiate pseudo from true optic disc oedema, also to recognise the aetiology.
Factors Affecting Retinal Screening Among Patients With Diabetes In India
Authors: Karishma Goyal , Rambharos Goyal , Gautam Lunia
Published: April 2021

Aim -

to identify various factors affecting diabetic retinopathy (DR) screening rate and measures to overcome the barriers.

Methods -

Patients visiting the eye OPD were enrolled in this study from January 2017 to December 2018. A total of 2242 patients participated in this study. A questionnaire was prepared to conduct the survey. Excluding patients (82) with missing responses for more than three questions, a final sample of 2160 participants yielded.

Results -

Although 71.16% of participants reported that their physician suggested DR exam, only 54.16% were screened during the past 2 years. Majority of them gave reason that they didn’t know about the necessity of screening. Knowledge about DR, treatment of DR, risk factors of DR, and knowing the appropriate frequency to have an eye checkup for early detection of DR were significantly associated with receipt of a DR in the past 2 years (all P < 0.05).

Conclusion -

Lack of awareness came out as major factor to be addressed. Information about the relationship between diabetes and retinopathy and concerns about damage to vision should be considered to promote DR screening
Topical Anaesthesia For Cataract Surgery: Patient's And Surgeon's Perspective
Authors: Rewri Parveen , Choudhary Anjali , Pandey Surya Mani , Singhal Aparna , Chaudhary Priyanka , Kumar Sanjeev
Published: April 2021

Aim:

The study aimed to find factorsʼ determining satisfactory experience from patientʼs as well surgeonʼs perspective in cataract surgery under topical anesthesia

Methods:

In this prospective study, we recruited consecutive patients of senile cataract willing to undergo cataract surgery under topical anesthesia. Using a validated score system, patients comfort and cooperation was quantified. Demographic and ocular factors affecting the comfort level and cooperation were analyzed.

Results:

A total of 530 patients, with mean (±SD) age 61±9 (range 41-90), underwent cataract surgery under topical anesthesia between September and November 2019. Of all the participants, 429 (81%; 95% Confidence Interval (CI):77-84) were not aware about injection less topical anesthesia for cataract surgery. The average comfort and cooperation score were 4.56±0.67and 4.54±0.73, respectively. The average duration of surgery was 8.33±3.24 (range: 4-25) minutes.

Conclusion:

The acceptance for topical anesthesia for cataract surgery is high, in both patientʼs and surgeonʼs perspective. Patientʼs satisfaction and cooperation depends on several socio-demographic and psychological factors.
Clinical Response To Switch From Ranibizumab To Aflibercept In Wet Age-Related Macular Degeneration
Authors: Weerasinghe Bhagya , Gupta Chandni , Levene Yasmin , Shankar Jai
Published: April 2021

Introduction:

To assess whether switching from Ranibizumab to Aflibercept conferred benefit in visual acuity (VA) and central macular thickness (CMT) in patients with wet age-related macular degeneration (AMD).

Methods:

Mean change in VA and CMT was assessed in wet AMD patients 6 months prior and 6 months after switch from Ranibizumab to Aflibercept, between July 2014 and November 2016.

Results:

90 eyes were switched from Ranibizumab to Aflibercept. VA improved in 11 eyes, 65 reported no change and 14 showed deterioration. Improvement in VA was not statistically significant (p>0.05). CMT improved in 24 eyes, 64 showed no change and in 2 there was deterioration. This improvement was statistically significant (p<0.01). Sub-analysis into patients that had switched to Aflibercept after 6 (28 patients) or >6 (62 patients) Ranibizumab injections showed no significant difference between these groups for VA or CMT change.

Conclusion:

Although there seemed to be an improvement in the CMT with Aflibercept, this did not translate as a statistical improvement in VA. Switching earlier to Aflibercept did not show any significant benefit in either VA or reduced CMT within the first 6 months. Our research however, requires extension as the benefits may be seen over a longer period of time. In conclusion, some patients with sub-optimal response to Ranibizumab may benefit from switching to Aflibercept.
Heart and Brain behind E-Learning amidst COVID19 Pandemic
Authors: Ramakrishnan Reshma , Agrawal Mamta , Gandhi Priyanka , Shrivastava Saurabh , Choudhary Ayushi , Hussain Syed Faraaz
Published: April 2021

Introduction:

COVID-19 pandemic presented us with a window to introduce digital learning in ophthalmology. We conducted this study to understand the repercussions of change of traditional learning and commence E-learning as an educational channel to medical students in the field of Ophthalmology and analyse the response of the students to the pristine method of education in this pandemic.

Aim:

To determine the effect of COVID19 lockdown on ophthalmic medical education in a private medical college in Navi Mumbai.

Settings and Design:

A cross-sectional study done by recruiting undergraduates and BSC optometry students of a private medical college as the subjects, after obtaining ethical approval from the instituteand informed consent from the students.

Methods and Material:

A random sample of 322 undergraduate medical students; 151 from 7th semester, 151 from 5th semester and 20 from Third year Optometry were surveyed by a questionnaire. The Statistical Package AQ6 for the Social Sciences software used for statistical analysis.

Results:

70% students The response of 70% students was responded that online lectures covered all the important topics of curriculum and learning through phone was easier. Less than 45% students of 7th semester responded that online teaching should not remain a part of academic teaching when college reopens. The response of 112 students of 7th semester responded was that their parents complained about overusage of gadgets in this COVID19 pandemic. The response of 219 students was that they utilized COVID19 lockdown in a creative and constructive way apart from E-learning. Conclusion: E-learning can be an excellent appurtenance to traditional learning and hence enhance spread of medical knowledge worldwide.
Acute Foreign Body Reaction And Corneal Abrasion Secondary To Impacted Human Hair In Tarsus
Authors: Raini Atif Rahman
Published: April 2021

Eye injury due to foreign body is the most common cause of ocular emergency. Hair as a foreign body is very much common due to plant, pet's ad caterpillars. But human hair impacted in tarsus is very rare. Our case is unique as in the way where we found a hair which is probably human in origin and was impacted in the tarsus. We initially missed the hair end but later meticulous high magnification slit lamp examination after eversion of the eyelid, we were able to locate the hair end as tiny black spot. This indicate the importance of eversion of the upper eyelid and slit lamp examination in higher magnification.
Spontaneous absorption of the lens: A case report
Authors: Dandekar Prajakta
Published: April 2021

Spontaneous absorption of the natural lens is rare. A fifty-six-year-old lady came to the Eye Dept with a chief complaint of gradual, painless and progressive diminution of vision in the left eye since last ten years. Undilated anterior segment examination revealed a mature cataract, and on dilatation an opaque calcified anterior lens capsule in the centre and translucent capsule with calcified spots in the peripheral part was visible. Neodymium-doped Yttrium Aluminum Garnet (Nd YAG) laser capsulotomy of the anterior capsule allowed us to examine the posterior segment. No nucleus or lens particle found in the posterior segment. Ultrasound B scan also revealed absent nucleus. After anterior vitrectomy, we implanted IOL through a 6mm scleral tunnel. Postoperatively, the patient's vision improved to 6/6. Unrecognised capsular tears with unnoticed ocular inflammation can lead to spontaneous lens absorption as in our case evident from the capsular calcification.
Recalcitrant bilateral shield ulcer in vernal keratoconjunctivitis
Authors: Madan Siddharth , Beri Sarita , Virmani Prachi , Khan Sarah
Published: April 2021

Allergic conjunctivitis is frequently encountered in general practice and in the specialist pediatric clinics. Though these cases are well managed in specialty allergy clinics yet a rare and severe manifestation in the form of bilateral shield ulcer can be potentially blinding and comes with management challenges. The pathobiology is driven by multiple inflammatory mediators which contribute to the recalcitrant nature of these noninfectious indolent ulcers. A seven-year-old boy presented with a recent onset photophobia with other characteristic ocular manifestations of vernal keratoconjunctivitis. Grade three shield ulcer in both the eyes was managed with both medical and surgical arms. Medical immunomodulation was achieved with topical steroids, topical immunomodulators along-with copious lubrication of the ulcer. Surgical intervention included a permanent tarsorraphy in the left eye and debridement of the plaques over the ulcer base in both the eyes. Aggressive follow-up and step wise management approach resulted in promising results without any recurrence.
Rhino-Orbital Mucormycosis and Aspergillosis in A Child With Thalassemia Major on Deferoxamine Therapy
Authors: Madan Siddharth , Beri Sarita , Chakravarti Arunabha , Jain Rajesh , Maheshwari Rahul
Published: April 2021

Rhino-orbital mucormycosis and aspergillosis is a rare potentially fatal opportunistic infection caused by saprophytic fungi. Mucormycosis is described almost exclusively in patients with compromised immune systems or metabolic abnormalities like poorly controlled diabetes. Iron overload states predispose to invasive mucormycosis. Coexistance of mucor and aspergillus is rarely observed and no case has been reported in a child with thalassemia major on deferoxamine therapy. Our patient developed unilateral blindness secondary to invasive fungal infection causing orbital cellulitis. Her journey over seven years of treatment and rehabilitation is described.