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A Methodology to Detect Distributed Denial of Service Attacks
Authors: ASLAN Ömer
Published: April 2022

Distributed denial of service (DDoS) attacks is one of the most destructive cyber attacks which target the availability of the system when legitimate users try to access the system. Not only computers, but also the growing number of smartphones as well as Internet of Things (IoT) devices are affected by DDoS attacks. There is no well-known system which effectively stops or prevents DDoS attacks. Designing an effective DDoS detector with high accuracy with low computational overhead is still a very challenging task. In this paper, a methodology, which is used to detect and classify the types of DDoS attacks, is proposed. Our methodology is divided into three parts: pre-processing, feature selection, and classification. First, pre-processing is performed to eliminate some features which are not suitable for our model. Second, most significant features are selected by using Information Gain, Gain Ratio, Correlation Coefficient, and Relief. We declined the number of features from 87 to 20. Finally, various classifiers are used to detect DDoS attacks from the bening ones. The proposed methodology is performed on the CIC-DDoS2019 dataset. The experimental results show that the proposed methodology performed pretty well when it is compared to leading methods in the literature.
Eğitim İçerikleri için Sezgisel Metin Bölütlemeye Dayalı Çoklu Etiketleme Stratejisi: M.E.B. Sanat Tarihi Kitabı için Bir Durum Çalışması
Authors: KAYAHAN Selcan , GÜNEL Korhan , NURİYEV Urfat
Published: April 2022

Bu çalışmada, eğitim içeriklerinden otomatik öğretim kavramlarının tespit edilerek, metnin anlamsal bütünlük arz eden ve birbiriyle çakışan metin bloklarına bölütlenmesi ve metin blokları içindeki paragrafların öncelik derecesine bağlı olarak birden fazla öğretim kavramı ile etiketlendirilmesine amaçlanmıştır. Çalışmada T.C. Millî Eğitim Bakanlığı’na bağlı okullarda okutulan Sanat Tarihi kitabı kullanılmıştır. Kitap üzerine doğal dil işleme ve sezgisel kümeleme yaklaşımları uygulanmış ve dokümanın her bir paragrafının hangi öğretim kavramıyla ilişkili olduğunun belirlenmesi hedeflenmiştir. Hedef doğrultusunda, ayrıştırılan metin bloklarını temsil eden öznitelik vektörleri çıkartılmış ve bu öznitelik vektörleri üzerine Temel Bileşen Analizi uygulandıktan sonra Parçacık Sürü Optimizasyonu (Particle Swarm Optimization, PSO) yaklaşımı ile kümeleme işlemi gerçekleştirilmiştir. Bununla birlikte, önerilen sistemin başarım oranlarının belirlenmesi için bölütlendirilmiş metin blokları alan uzmanı tarafından kitap içinde sunulan öğretim kavramları ile eşleştirilmiştir. Ardından uzman görüşleri ve sistem çıktıları karşılaştırılarak ağırlıklandırılmış ortalama karesel hata değeri hesaplanmıştır. Elde edilen sonuç, eğitim içeriklerinin birden fazla öğretim kavramı ile etiketlenmiş metin bloklarına ayrıştırılabileceği konusunda umut vermektedir.
Makine Öğrenmesi Yaklaşımı ile Acente Kredi Riski Hesaplama
Authors: KIRCA Serkan , CANATAN Güldeniz , GÜNEŞ Vedat
Published: April 2022

Ekonomik trendlerin hızla dijital süreçlere uyum sağladığı günümüzde finans sektöründe risk analizi ilgili kurumların sahip oldukları değerler, birlikte çalıştıkları paydaşlar ve faaliyet gösterdikleri sektörler için büyük önem arz etmektedir. Risk analizi herhangi bir anda müşterinin ya da çalışılan firmanın risk potansiyelini ölçümleyebilmek adına son derece önemli bir çalışma olup, sadece finans sektöründe değil, diğer sektörlerde faaliyet gösteren şirketlerin de değerlendirmesi gereken bir çalışma haline gelmiştir. Riskini önden bilme gayreti şirket finansal durumunu doğru yönetmek adına emek yoğun bir çaba haline dönüşmüştür. Bununla birlikte veri merkezli çalışmaların arttığı günümüzde risk değerlendirme çalışmaları da veri analitiği teknolojileri ile zenginleşmekte ve eskiye nazaran daha iyi sonuçlar üretmeye başlamışlardır. Geniş bir ekosistem ile müşterilerine hizmet vermeye gayret eden sigorta şirketleri risk konusunda iki temel alanda; müşterinin ve kendisine bağlı faaliyet gösteren acentelerin, risk değerlerini hesaplamak için veri merkezli analitik süreçler geliştirmektedir. Sigorta şirketleri için risk analizleri son derece önemli olup, finansal riski belirlenen müşteri ya da acenteye göre iş akışlarında kurallar tanımlamakta veya yaptırımlara varan aksiyonlar alabilmektedirler. Acente ağı sigortacılık sektörü için gelirlerin %70’i anlamına gelmektedir. Yapılan hesaplamalar sonucunda her bir acentenin sigorta şirketi için ifade ettiği finansal risk değeri tahminlenmiştir. Çok riskli bulunan acenteler bütün portföyün yaklaşık %0,2’si kadardır. Bu çalışmada acente risk değerlendirme süreci makine öğrenmesi yöntemleri kullanılarak hesaplanmıştır ve uygulanan faaliyetler paylaşılacaktır.
Video Görüntülerinde Gerçek Zamanlı Yüz Tanıma ve Zaman İşaretleme için Yeni Bir Derin Öğrenme Modeli
Authors: GÖZE Hüseyin , YILDIZ Oktay
Published: April 2022

Video görüntülerinde gerçek zamanlı yüz tanıma ve görüntü akışı içerisinde etiketlenmesi birçok alanda yüksek öneme sahip bir konudur. Son yıllarda, video görüntülerinde gerçek zamanlı yüz tanıma problemlerinde derin sinir ağları başarılı bir şekilde kullanılmaktadır. Ancak video görüntülerinde yer alan küçük ölçekli yüzlerin tespiti ve aynı zamanda model yanıt süresinin düşürülmesi karşılaşılan önemli zorluklardır. Gerçekleştirilen bu çalışmada, video görüntülerinde gerçek zamanlı yüz tanıma ve zamanın tespiti için yeni bir derin öğrenme modeli önerilmiştir. Yapılan deneysel çalışmalarda önerilen Evrişimli Sinir Ağı tabanlı modelin MTCNN, OPENCV-CNN, HOG+SVM, SSD-CAFFEMODEL modellerine göre daha yüksek performansa ve daha yüksek doğruluk oranına sahip olduğu gösterilmiştir.
Hair Removal and Lesion Segmentation with FCN8-ResNetC and Image Processing in Images of Skin Cancer
Authors: AKYEL Cihan , ARICI Nursal
Published: April 2022

Skin cancer is quite common. Early detection is crucial for the treatment of skin cancer. Methods based on computer technology (deep learning, image processing) are now increasingly used to diagnose skin cancer. These methods can eliminate human error in the diagnostic process. Removing hair noise from lesion images is essential for accurate segmentation. A correctly segmented lesion image increases the success rate in diagnosing skin cancer. In this study, a new FCN8-based approach for hair removal and segmentation in skin cancer images is presented. Higher success was achieved by adding ResNetC to FCN8. ResNetC is a new model based on ResNet. Two datasets were used for the study: ISIC 2018 and PH2. Training success was 89.380% for hair removal and 97.050% for lesion segmentation. 3000 hair masks were created as part of the study to remove hair noise in the lesion images.
Bireysel Müşteriler için İnternet Hizmeti Sağlayıcısının ve İnternet Paketi Seçiminin Çok Kriterli Karar Verme Teknikleri ile Belirlenmesi
Authors: KIZIL Fahrettin , GÜRBÜZ Feyza
Published: April 2022

İnternet kullanımının artmasıyla birlikte Türkiye’de onlarca internet servis sağlayıcı (İSS) şirketi kurulmuş, buna paralel olarak da İSS’lerin müşterilerine sunduğu paket seçenekleri de artmıştır. İnternet kullanıcıları, seçeneklerin çokluğu nedeniyle İSS’ler tarafından sunulan hizmetlerin kalitesi ile sunulan paketleri karşılaştırmakta ve karar vermekte zorlanırlar. Çoğu internet kullanıcısı diğer kullanıcıların deneyimlerine ve tavsiyelerine dayanarak bir İSS ve paket seçer. Nihayetinde en uygun İSS ve internet paket seçimi bireysel kullanıcılar için çözülmesi gereken önemli ve yaygın bir karar problemi haline gelmiştir. Bu çalışmada Türkiye’deki bireysel müşteriler için 6 adet İSS ve bu İSS’lerin 51 adet internet paket seçiminin, çok kriterli karar verme (ÇKKV) teknikleri ile belirlenmesi amaçlanmış ve sıralama/seçim işlemi için ÇKKV tekniklerinden olan AHP, SWARA, SAW ve WASPAS kullanılmıştır. Çalışmada sonucunda; SWARA yöntemde “bağlantı hızı”, AHP yönteminde ise “maliyet” en önemli kriter olarak belirlenmiştir. SWARA ve AHP ile belirlenen kriter ağırlıkları kullanılarak WASPAS ve SAW yöntemleri ile bulunan sıralama sonuçlarına göre; TürkNet-TR1 paket seçeneği her iki durumda da ilk sırada yer almıştır. Bununla birlikte SWARA ile yapılan marka imajı sıralaması en iyiden en kötüye; Superonline, Türk Telekom, Vodafone Net, D-SmartNet, TürkNet ve Millenicom şeklinde belirlenmiştir.
Öğrenme Yönetim Sistemi Log Kayıtlarının Akademik Başarı Tahmininde Kullanılması
Authors: YAVUZARSLAN Mithat , EROL Çiğdem
Published: April 2022

Dünyada ve ülkemizde eğitim alanında dijitalleşme eğilimi arttıkça Öğrenme Yönetim Sistemleri (ÖYS) kullanımı da yaygınlaşmaktadır. Öğrenciler bu ortamlarla girdikleri etkileşimlerde kayda değer miktarda veri üretmekte ve bu veri üzerinde yapay zekâ algoritmaları kullanılarak öğrenme sürecini anlamaya dönük modeller geliştirilebilmektedir. Söz konusu modeller geliştirilirken eğitim ve öğrenme ortamına ait her türlü veri bu kapsama girebildiği gibi özellikle ÖYS’ler içerisindeki öğrenmeye harcanan zaman ve ders içeriğine erişim sıklığı gibi değişkenleri ölçmeye yarayan log (etkileşim) verisi öğrenme sürecinin anlaşılması bakımından büyük imkânlar barındırmaktadır. Bu çalışmada 2020 Bahar yarıyılı içerisinde açılan Temel Bilgisayar Uygulamaları dersine kayıtlı 93 öğrencinin 10 haftalık süre boyunca kullanmış oldukları Moodle tabanlı ÖYS içerisinden elde edilen log verisi üzerinde akademik başarı tahmini amacıyla KNN, Naive Bayes, SVM, CART ve C5.0 sınıflandırma algoritmaları uygulanmıştır. Elde edilen log dosyaları her bir öğrenci için ders ortamıyla olan etkileşimlerini ifade eden oturum açma sayısı, geçmiş konulara bakma sayısı, toplam ve ortalama görüntüleme sayısı, toplam ve ortalama oturum süresi, ödev materyalleri indirme sayısı, ödev deneme sayısı, ödeve harcanan zaman, sınav odaklı çalışma, eğitmene gönderilen mesaj sayısı, video sayfalarında geçirilen zaman ve yüklenen ödev sayısı özniteliklerine dönüştürülmüştür. Oluşturulan veri setinin dengesiz olmasından dolayı ayrıca yukarı örnekleme, SMOTE yöntemi ile sınıf örneklerini yakınlaştırma ve SMOTE yöntemi ile yukarı örnekleme yöntemleri kullanılarak 3 ayrı veri seti üzerinde de sınıflandırma algoritmaları uygulanmıştır. Çalışma sonucunda tüm veri setlerinde %80 üzeri sınıflandırma başarısına ulaşıldığı görülmüştür. En yüksek sınıflandırma başarıları SMOTE ile yukarı örnekleme uygulanan veri setinde negatif sınıfa ait örneklerin düşük miktarı ve benzer varyasyonların türetilmesi sebebiyle %100 başarı gösteren KNN algoritması göz ardı edildiğinde %97 başarı oranıyla CART ve SVM algoritmaları ile elde edilmiştir. Diğer yandan, Naive Bayes algoritmasının sonuçları daha güvenilir sayılabilecek olan rastgele alt örnekleme yöntemiyle en yüksek başarıyı gösterdiği görülmüştür. Sonuç olarak, ÖYS log kayıtlarının akademik başarı tahmininde kullanılabileceği görülmüş ve bulgular ilgili literatür ışığında tartışılmıştır.
Revealing the Reflections of the Pandemic by Investigating COVID-19 Related News Articles Using Machine Learning and Network Analysis
Authors: BAYRAM Ulya
Published: April 2022

Social media data can provide a general idea of people’s response towards the COVID-19 outbreak and its reflections, but it cannot be as objective as the news articles as a source of information. They are valuable sources of data for natural language processing research as they can reveal various paradigms about different phenomena related to the pandemic. This study uses a news collection spanning nine months from 2019 to 2020, containing COVID-19 related articles from various organizations around the world. The investigation conducted on the collection aims at revealing the repercussions of the pandemic at multiple levels. The first investigation discloses the most mentioned problems covered during the pandemic using statistics. Meanwhile, the second investigation utilizes machine learning to determine the most prevalent topics present within the articles to provide a better picture of the pandemic-induced issues. The results show that the economy was among the most prevalent problems. The third investigation constructs lexical networks from the articles, and reveals how every problem is related through nodes and weighted connections. The findings exhibit the need for more research using machine learning and natural language processing techniques on similar data collections to unveil the full repercussions of the pandemic.
Estimation by ANN of Luminous Efficacy of Lamps Used for Lighting
Authors: OK DAVARCI Züleyha , ŞAHİN Mustafa , AKAR Onur
Published: April 2022

The increase in energy production costs, and the increasing demand for energy have made energy saving necessary. Energy saving in lighting is able to be actualized by providing economically the same level of light without decreasing the illumination quality. A good lighting is possible by directing required amount of light to spaces desired to be lit. For a good lighting, efficiency factor is a significant measure. By adjusting the luminous efficacy in lamps, the electric energy to be consumed by the lamps is able to be minimized. The electric energy consumed for producing luminous energy will be less at the extent of greatness of luminous efficacy. In this study, the luminous efficacy of lamps of different brands were estimated by the use of data regarding voltage rating, power rating, and total luminous rating of lamps. According to the results of the analysis made by the developed ANN model, the luminous efficacy of lamps of different brands were estimated with an accuracy rate of above 98%. Regarding the lighting systems to be developed, the selection of lamps will be made based on their ability to provide economically the same level of light without decreasing the lighting quality, and to provide the required luminous efficacy for increasing the luminous efficacy.
Application of the Early Care Program Based on the Early Start Denver Model for Children with ASD
Authors: Starikova O.V. , Dvoryninova V.V. , Balandina O.
Published: April 2022

Currently, there are no standards for early care in Russia, and therefore the introduction of successful foreign practices of work with young children is relevant. The article presents the experience of implementing an early care program for children with ASD. Presented program developed and tested during 6 months of 2020 in the Center for Mental Health of the Privolzhsky Research Medical University in 2020. The program was established on the basis of the Early Start Denver Model program for children with ASD. The study involved 19 children from 1 to 4 years old with a diagnosis of autism. For 6 months, all children were engaged in the developed program. Frequency of the program — 2—3 hours in a week, parents were also trained. As a result of the dynamic assessment of skills according to the RCDI-2000, the rates of target skills in the Denver model showed improvement in all areas of child development. For example, as a result of classes, 9 children (47.4%) demonstrated positive dynamics in the development of social skills, their “age” in this area improved by the end of the project from 3 to more than 20 months. 12 children (63.2%) showed an improvement in the development of speech skills in the range from 1 to more than 28 months. The results of the dynamic assessment based on repeated diagnostics of the list of target skills of the Denver model demonstrate an improvement in children’s skills in all areas of age development. The greatest changes in indicators are detected in the areas of receptive communication (improvement of skills by an average of 40%), games (an increase of 30%), cognitive skills (an increase of 30.5%), household skills (an increase of 33%). That is, the effectiveness of the developed training program has been proven. A low-intensity early care program based on the Denver model is promising for use in public educational and social institutions involved in the early care system.
Development of the Mathematical Representations in Children with ASD. Practical Case
Authors: Kudacheva N.I.
Published: April 2022

The process of teaching children with autism spectrum disorders and mental disorders requires well-prepared environment and organization of the behavior of children. Additionally, this process requires teachers to make efforts to apply special working methods, adapt teaching materials and socialization measures. Currently, preschool educational institutions develop inclusive groups rapidly. The case of teaching a 6-year-old non-verbal boy with ASD to elementary mathematical concepts by the special teacher of a preschool educational institution in is presented. Guided by the principle of gradualness, the teacher included the child in group of normotypical peers. Using motivational techniques, prompts, modeling, the teacher normalized the boy’s behavior. To form elementary mathematical concepts, the teacher developed a step-by-step work plan. This plan involved implementation of PECS alternative communication system and the NUMIKON multi-sensory manual. NUMIKON helps to motivate and educate the child, develops sensory skills, communication, consolidate and generalize the acquired skills. As a result of application of presented training block the child gives 90% of the correct independent answers (according to the protocols of classes). Observations of the child in the preschool educational institution and a survey of parents showed that the frequency of episodes of undesirable behavior has decreased, the child is willingly included in the group of normotypical peers.
Development Augmented Reality (AR) Learning Media for Pencak Silat Course at Faculty of Sports and Science Universitas Negeri Padang
Authors: Nelson Sonya , Darni Resmi , Haris Fahmil
Published: April 2022

Learning activity must contain aspects of practicality, attractiveness and could motivate student, to facilitate the implementation of learning. Interesting learning media and effective also very necessary for students in the pencak silat course at the sports science faculty which contains practical and theoretical material.  It should be considered in the selection of media, namely learning objectives, effective, easy to obtain, flexible use and able to visualize something abstract into reality. One of the developments of learning media that is currently still new is learning media using Augmented Reality (AR). AR is a technology application that can present virtual objects in virtual 3D in real form and presented in real time, then be able to present abstract concepts more real. The purpose of this research is to produce pencak silat learning media in terms of practicality aspects, attractiveness and validity. The research development model uses Borg and Gall, with the following stages: (1) Data collection; (2) Planning (3) Development; (4) Design Validation (5) Design Revision (6) Product Trial (7) Product Revision (8) Usage Trial (9) Product Revision (10) Mass production. The results of the study according to the results of expert validation on the development of Augmented Reality-based pencak silat learning media showed very good results and were suitable for use as learning media. The average acquisition of validation results by experts is 91.8%. Student responses to the use of this media in learning pencak silat were very good with scores in the small group trial of 89.97% and the large group trial of 87.15%. Conclusion hfinal result this finding in the form of learning media Augmented Reality in martial arts courses that are valid, practical and effective.
E7 ÜLKELERİNDE İNSANİ GELİŞMİŞLİK ENDEKSİ: KADIN FAKTÖRÜ
Authors: BATU AĞIRKAYA Melahat
Published: April 2022

Toplumların iç dinamiklerden kadının emeğinin ekonomideki rolü küreselleşen dünya ekonomilerinde kalkınma anlayışını insanı odaklı bir anlayışa doğru kaydırmıştır. Kalkınma perspektifinde kadın işgücünün önemi her geçen gün artmaktadır. Kadınların ekonomik yaşama daha fazla katılmaları, büyüme ve aile içindeki konumlarının iyileşmesi, sağladıkları katma değerin yanı sıra aynı zamanda kalkınmışlığında gereğidir. Türkiye’nin de aralarında bulunduğu E7 ülkeleri (Brezilya, Çin, Hindistan, Endonezya, Meksika, Rusya) özelinde insani gelişme endeksi üzerinde ekonomik özgürlükler, kadın iş gücü ve onların aldıkları ücret durumlarının kalkınma üzerindeki etkisini belirlemek önem arz etmektedir. Bu amaçla çalışmada 1995-2019 arası dönemi için E7 ülkeleri insani gelişmişlik düzeyi üzerinde ekonomik özgürlüğün, kadın iş gücünün ve kadın iş gücü ücretlerinin etkisi Panel DOLS ve Panel FMOLS yöntemleri ile belirlenmeye çalışılmıştır. Ülkeler bazında değişkenlik göstermekle birlikte, panel bazda ekonomik özgürlüğün insani gelişmişlik üzerindeki etkisi negatif, kadın iş gücünün ve kadına verilen ücretlerin etkisi ise pozitiftir
TÜRKİYE’DE BANKALARIN KULLANDIRDIĞI TİCARİ ÖZELLİKLİ KREDİLER VE İKTİSADİ BÜYÜME İLİŞKİSİ
Authors: ÖZ Mehmet
Published: April 2022

İktisadi büyümenin belirleyicileri klasik okuldan beri tartışma konusudur. İktisadi büyüme üzerinde ilk tartışmalar sermaye birikimi üzerinden gerçekleşmiştir. Schumpeter (1911) ile finansal gelişmenin iktisadi büyümeyi olumlu yönde etkilediği görüşü ortaya çıkmıştır. Literatürde finansal gelişime iktisadi büyümeyi sağlıyorsa arz öncüllü hipotez olarak adlandırılmaktadır. Diğer taraftan Robinson (1952) iktisadi büyümenin finansal gelişmeye yol açtığını ileri sürmüştür. İktisadi literatürde İktisadi büyümeden finansal gelişmeye doğru bir ilişkinin varlığı söz konusu olması halinde, talep takipli hipotez olarak isimlendirilmektedir. Aynı zamanda literatürde finansal gelişme ve büyüme arasında çift yönlü etkileşimin olduğunu ve hiçbir etkileşimin olmadığını ortaya koyan hipotezlerde vardır. Bu hipotezler üzerinden finansal sistemin iktisadi büyüme ile etkileşimi de literatürde geniş bir şekilde inceleme konusu yapılmıştır. Finansal sistem geliştikçe tasarruf sahiplerinden yatırımcılara doğru fon akışının hızlanması beklenmektedir. Finansal gelişme göstergesi olarak bankacılık sektörü büyüklükleri ve sermaye piyasası kapitalizasyonu verilerinden yararlanılmaktadır. Literatürde Türkiye için bankacılık sektörünü temsilen çok sayıda gösterge kullanılmasına rağmen ticari özellikli kredileri finansal gelişme göstergesi olarak ela alan çalışma tespit edilememiştir. Dolayısıyla bu çalışmada bu eksikliği gidermek için ticari özellikli krediler verileri kullanılmıştır. Bu çalışmanın amacı Türkiye ekonomisinde 2005:Q4-2020:Q4 döneminde meydana gelen finansal gelişim ile iktisadi büyüme arasındaki ilişkiyi analiz etmektir. Çalışmada yöntem olarak Engle ve Granger eşbütünleşme testi uygulanmıştır. Test sonuçlarına göre finansal gelişime ile gayri safi yurt içi hasıla serileri arasında eş bütünleşme ilişkisi bulunmuştur. Hata düzeltme modeli bulguları finansal gelişimden iktisadi büyümeye doğru tek yönlü nedensellik ilişkisinin olduğu görülmektedir. Elde edilen bu ampirik bulgular arz öncülü hipotezi doğrulamaktadır. Sonuçta finansal kaynaklar, finansal aracılar ve bankacılık kesimi vasıtası ile ticari kredilere yönlendirilmesi zaman içinde iktisadi büyümeye dönüştüğü gözlemlenmektedir.
Adiponectin: A novel prognostic marker for rheumatoid arthritis: A case control study in a tertiary care hospital in central India
Authors: Patel Ashish , Solanki Neha , Manyal Rohit , Dubey Sanjay , Sharma Shiv Shankar , Verma Rajesh
Published: April 2022

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by symmetrical synovitis, progressive damage to the articular cartilage and the subchondral bone, pain, fatigue, and disabilityRecognition of RA as early as possible is important, because a significant proportion of the patients develop irreversible joint damage shortly after disease onset & risks associated with its treatment. The adiponectin is an active participant in the regulation of physiological and pathological processes, inflammatory process as mediator. This study was done to compare the progression of rheumatoid arthritis in conjunction with changes in levels of adiponectin and to evaluate its role as a prognostic marker.

Analyse serum adiponectin level to evaluate its potential role to assess disease severity in patients of rheumatoid arthritis & compare its level in normal healthy control subjects.

This study was conducted in MY Hospital, Indore. We enrolled 50 cases of confirmed rheumatoid arthritis patients of 20-70 years age group and 50 age and sex matched apparently healthy controls. Both cases (n=50) and controls (n=50) were assessed for haematological tests and biochemical tests, lipid profile, uric acid, CRP & adiponectin. The data were expressed as mean ± SD and analysed by using SPSS version 20. P-value of < 0.05 was accepted as statistically significant.

The mean age of the cases was 44.74 ± 13.10 and that of controls was 42.26 ± 8.09. Maximum number of study patients were in the age group of 31-40 years & women. The rheumatoid arthritis group was divided into subgroup according to DAS28 Score. Out of 50 cases, 2 patients (4.0%) had remission, 2 patients (4.0%) had low disease activity, 30 patients (60.0%) had moderate disease activity and 16 patients(32.0%) had high disease activity. The mean CRP in the rheumatoid arthritis group was 21.56 ± 25.46 mg/dL while in the control group was 11.09 ± 7.95 mg/L. The difference was found to be statistically significant (p<0.05).The mean ESR in the rheumatoid arthritis group was 21.26 ± 8.88 mm/hour while in the control group was 15.70 ± 5.40 mm/hour. The difference was found to be statistically significant (p<0.05).The mean adiponectin level in the rheumatoid arthritis group was 30.13 ± 13.04 µg/ml while in the control group was 17.08 ± 8.69 µg/ml. The difference was found to be statistically significant (p<0.05).The mean adiponectin level was highest in the high disease activity subgroup and lowest in the low disease activity subgroup.

In our study we concluded that patients of rheumatoid arthritis have raised level of adiponectin & CRP as compared to normal healthy control group. Adiponectin might be better marker for RA compare to CRP & ESR. Also higher levels of adiponectin were observed in patients with severe disease. Therefore, adiponectin might be used for screening which will help in predicting disease progression.
Neurological soft signs in autism spectrum disorder
Authors: Malviya Juhi Anil , Gawande Sushil , Faye Abhijeet , Kirpekar Vivek , Bhave Sudhir , Tadke Rahul
Published: April 2022

Autism spectrum disorder (ASD) is a phenotypically heterogeneous group of neurodevelopemental syndromes characterized by impairments in social communication and restricted & repetitive behavior. Neurological soft signs (NSS) are minor neurological abnormalities that aren’t a part of any fixed/transient neurological disorders. The most common NSS in ASD are motor incoordination, difficulty sequencing motor tasks & sensory disintegration.

22 participants of ASD satisfying the inclusion and exclusion criteria were assessed for NSS, using a semi structured performa & Heidelberg manual for neurological soft signs. The data was tabulated and analysed statistically.

The mean age of the participants was 11.63 years with 82% males & 18% females. 100% participants had dysdiadochokinesia (82% -adiadochokinesia), errors in the finger-nose test(71% unable to perform), right-left confusion (39% -making gross errors), difficulty in tandem walking(70% -significant balance problems), difficulty in fist-edge-palm (54% unable to complete task) & ozeretski test (78%- unable to perform). 94% had difficulty in pronation-supination (56%-failed to complete exercise).89% of the participants had difficulty in finger –thumb opposition (63%- unable do it).

NSS are present in a significant amount of patients of ASD & such patients should be assessed for the full spectrum of NSS.
Evaluation of serum Vitamin D level in Vitamin D supplemented 9 to 12 months old children in a tertiary care hospital
Authors: Saha Sudip , Mondal Tanmay , Saha Pradip
Published: April 2022

Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Indian context, it has been reported to be present in majority of children in spite of wide availability of sunlight. Our objective was to evaluateSerum Vitamin D Level in Vitamin D Supplemented 9 to 12 Months Old Children in a Tertiary Care Hospital.

A cross sectional study was conducted in the patients aged 9 months to 12 months attending Out Patient Department and Ward of Tertiary care mother and child hospital, Department. of Paediatrics between April, 2019 to March, 2020.Blood sample was collected and analysed by the Electrochemiluminescence Immunoassay (ECLIA) with the help of HITACHI Elecsys Cobas E411 to estimate 25-OH-D level after getting proper consent.

The study done among 100 Vitamin D Supplemented 9 to 12 Months Old Children in a Tertiary Care Hospital resulted standard error 0.0952 and standard deviation 0. 9522. The children who had regularly taken vitamin D3 at 400IU/day since birth showed minimum vitamin D3 level at 22.34ng/ml and maximum vitamin D3 level found is 98.18ng/ml with a mean value of 40.67ng/ml that is sufficient.

In our study we have found that if children are given vitamin D3 regularly since birth at 400IU/day the attain desired serum vitamin D3 level irrespective of the brand/preparation.
Renal functions in term neonates with weight loss of more than 10% in early neonatal period - A cross sectional study
Authors: Edbor Anjali , Dua Himanshu
Published: April 2022

Normally neonates lose 5-7% of their birth weight in the first week of life. Inadequate breastfeeding resulting from different factors may result in dehydration and excessive weight loss. Hypernatremic dehydration leading to acute kidney injury (AKI) is a well-known complication of lactational insufficiency in exclusively breast-fed babies progresses from pre-renal to intrinsic renal injury, if persistent. Acute kidney injury (AKI) is a complex disorder which has a clinical manifestations ranging from mild dysfunction to complete anuric kidney failure.

To evaluate renal function tests (RFT) in term neonates with more than 10% weight loss within 7 days of life.

To determine the frequency of acute kidney injury in term neonates with more than 10% weight loss within 7 days of life.

1:To determine type of acute kidney injury (Prerenal, Renal); 2: Assess the percentage of dehydration in terms of percentage of weight loss (more than 10%, more than 15%); 3: Assess type of dehydration (hypernatremic, isonatremic, hyponatremic); 4: To assess type of dehydration with acute kidney injury.

A hospital based prospective study was conducted on term neonates in a tertiary care hospital for period of 12 months from July 2019 to June 2020. Daily weight of all the neonates was recorded using electronic weighing machine. 103 new-borns presenting with weight loss of more than 10 % of birth weight within 7 days of life were enrolled as per convenient sampling technique without any bias. Neonates with congenital anomalies of kidney, sepsis, birth asphyxia and diabetes insipidus were excluded. Neonates were assessed by performing renal function test as a marker of dehydration.

One hundred and three neonates with weight loss of more than 10% were enrolled in the study. Among them, 88 (85.4%) had prerenal AKI and 15 (14.5%) had renal AKI; 68(66%) neonates had dehydration of 10-15% while, 35 (34%) had dehydration of more than 15%. Most of the neonates 75(73.4%) had hypernatremic dehydration while 25(25%) and 3(1.5%) had isonatremic and hyponatremic dehydration respectively. 69, 16 and 3 neonates with prerenal AKI had Hypernatremia, isonatremia and hyponatremia respectively while 5 and 9 neonates with renal AKI had Hypernatremia and isonatremia respectively. None of the neonate had renal AKI with hyponatremia.

: Hypernatremia is severe enough to cause prerenal AKI progressing to renal AKI in exclusively breast-fed babies without any associated comorbidities. Training of mothers, care givers and doctors and weight monitoring of breast-fed babies to identify at risk neonates is important in early diagnosis.
Elevated high sensitivity c-reactive protein in patients with subclinical hypothyroidism: A case control study
Authors: Dasmohapatra Deepak Kumar , Panda Anuradha , Dash Aditya Narayan , Ekka Babita
Published: April 2022

Inflammation in subclinical Hypothyroidism (SCH) imposes a significant cardiovascular risk. The aim of the present study was to assess the elevated levels of high sensitivity C-reactive protein (hs-CRP) in SCH patients.

In this study, 50 cases of SCH and 50 cases of euthyroid were selected. The complete history of the subjects were taken and demographic , biochemical parameters like age, BMI, thyroid profiles, lipid profiles and hsCRP were estimated.

The mean TSH levels were significantly (p<0.05) elevated in SCH cases as that of the controls (8.56± 1.76 vs 2.28± 0.65 μU/ml). Further, hs-CRP level was significantly (p<0.05) higher in SCH cases as that of the controls (2.93 ±0.87 vs 1.16 ±0.45 mg/l). Meanwhile, lipid profiles were also elevated in SCH cases as that of the controls. Coefficient correlation analysis showed significant association between TSH and hs-CRP.

Thus, increased level of hs-CRP in SCH highlights the inflammatory status and thus associated with the development of cardiovascular diseases in SCH.
Factors affecting long term outcome in acute cervical spinal cord injury
Authors: Rajamohan B. , Rao P. Narasinga
Published: April 2022

Spinal cord injuries are most commonly caused by motor vehicle accidents. The next frequent causes are falls and acts of violence, Sports-related spinal cord injuries. Drastic reduction in the mortality & morbidity was noticed with the better management of pressure sores, urinary tract infections and respiratory problems with the advent of modern rehabilitative methods.

To study clinical factors affecting long term outcome in acute cervical spinal cord injury patients,

A 2-year study Conducted between 2015-2017, 33 patients with acute cervical SCI were included in the study, admitted in the department of Neurosurgery, Osmania General Hospital.

Maximum number of patients were in ASIA grade B 11/33 (33.33%), Neurological improvement-All patients improved in ASIA grade ‘D' and none in ASIA grade 'A'. Percentage improvement in cord edema group was 52% and contusion group was 0%. Percentage of improvement in less than forty years age group was 45%: and more than forty years age group was 46.1%. Percentage of improvement in early surgery group was 60% and in the late surgery group was 33.33%.

Functional improvement in transfer, self-care and mobility was seen maximum in ASIA grade C. Amongst them, the 'transfers' function scored the maximum.
Parental beliefs and practices in childhood asthma – A hospital based cross-sectional study
Authors: Panda Abinash , Panda Sadhana
Published: April 2022

Childhood asthma represents a significant burden, not only in terms of morbidity and reduced quality of life but also in terms of healthcare costs, as reflected by the high rates of unscheduled emergency department visits, hospitalization, and school absenteeism. Parents play a key link in asthma management and adherence to treatment regimen in the early years of childhood before children can manage their asthma independently. However, some parents have misconceptions regarding asthma and its medication, which could in turn influence children’s control of asthma.

To find out the effect of parental beliefs and practices with respect to their knowledge about etiology, folk beliefs, home remedies, alternative therapies, etiology and pharmacotherapy in childhood asthma influence the pharmacotherapy and outcome of asthma management.

The hospital based cross sectional study was carried out on a convenience sample of 82 parents of children, 5-14 years of age and clinically diagnosed with asthma of any form in the Department of Pediatrics, F.M. Medical College & Hospital, a tertiary care teaching hospital in Balasore town in the eastern part of India. The parents’ beliefs and practices were captured with the help of a pre-designed and validated questionnaire. Descriptive analytical statictics was used to analyse the demographic data. Chi square test was used to find out the association of beliefs, use of home remedies, folk beliefs and alternative therapies and the use of prescribed asthma medications as per standard reference. GraphPad Prism free trial version 7.0 was used for statistical analysis. Statistical significance was taken at a level of p ≤ 0.05.

Majority of the children were in the age group of 10-14 years with a male predominance. Most of the primary care givers less than 40 years age and literate, 30 (36.6%) having more than two children and a family history of asthma. The common beliefs were that asthma was chest allergy, of hereditary origin. Exposure to dust, indoor smoke believed to be a significant potential triggering factor for asthma attack The participants (68.2%) believed that inhaled steroids had more side effects lead to dependency also believed using inhaler only when serious. Domiciliary treatment was preferred. 𝛽-agonist were the commonest medications.

Parental beliefs and practices have a predominant role in the management of asthma in children. In order to enhance the level of perceptions among caregivers, education should include knowledge about asthma and its management, as there might be misperceptions about the use of inhalers and the safety of inhaled corticosteroids.
Hyperprolactinemia in patients with high TSH levels with both clinical and subclinical hypothyroidism
Authors: Sahu Jyotindra Kumar , Ravikant M , Thakur Amar Singh
Published: April 2022

Hyperprolactinemia is the most common endocrine disorder involving hypothalamic–pituitary axis. This results from multiple causes such as medications, hypothyroidism, and pituitary disorders. Hyperprolactinemia and hypothyroidism are closely interrelated conditions. The present study aimed to estimate serum prolactin levels and determine the prevalence of hyperprolactinemia in newly diagnosed subclinical and clinical hypothyroid patients and correlation between TSH and prolactin levels in subclinical and clinical hypothyroid patients.

This study was conducted in the Department of Biochemistry, in collaboration with Department of Medicine, Department of Obstetrics and Gynecology, LATE BRKM Government Medical College, Jagdalpur, Chhattisgarh, India. Total of 138 patients presenting to Department of Medicine for various thyroid related problems were involved in this study. The newly diagnosed cases of primary hypothyroidism were included in this study. The demographic, physical and clinical history was taken from all the study subjects.

In the present study, serum prolactin levels were significantly increased in subclinical (28.7 ± 6.4 ng/mL) and clinical hypothyroidism (15.02 ± 4.2ng/mL) compared to controls. Hyperprolactinemia was observed in 11 (22.9%) patients in subclinical hypothyroidism and 4 (8.3%) in clinical hypothyroid patients. In the subclinical hypothyroidism and clinical hypothyroidism, the serum TSH levels were (17.01 ± 8.2 μU/l, 7.3 ± 2.0 μU/l respectively) significantly increased than the controls. In the clinical hypothyroidism and subclinical hypothyroidism, the serum free T3 (fT3) levels were (5.6 ± 0.68 pmol/l, 2.54 ± 0.43 pmol/l respectively) significantly increased than the controls. In the clinical hypothyroidism and subclinical hypothyroidism, the serum total T3 (T3) levels were (1.27± 0.24 nmol/l, 0.59±0.12 nmol/l respectively) significantly increased than the controls.

The study results may conclude that, prolactin regulation is altered, in patients with clinical and subclinical hypothyroidism. Thyroid functions tests ought to be conducted in patients with hyperprolactinemia prior to performing further tests.
Correlation of platelet indices with the spectrum of acute coronary syndrome and extent of coronary artery disease
Authors: Mohanty Nirmal Kumar , Satpathy Chhabi , Routray Satyanarayan , Dash Bijay
Published: April 2022

Platelets have a major role in acute coronary syndrome and their activation is a hallmark of this. Troponin I, Troponin T and Creatine Kinase enzymes are not enough sensitive at an early stage of acute coronary syndrome. Platelet indices can be detected earlier, inexpensive, widely available and easily recordable in most clinical laboratories, thus could be a better marker in these patients. The primary objective of this study is to determine the correlation between platelet indices and spectrums of acute coronary syndrome or the number of vessels involved.

This is a prospective observation study conducted in a tertiary care teaching hospital of eastern India over a period of six months where 125 patients were non-randomly selected with a diagnosis of acute coronary syndrome who underwent coronary angiogram and reports correlated with platelet parameters.

A total of 100 patients were finally evaluated. Only platelet large cell ratio and platelet-crit were significantly higher in ST elevated myocardial infarction group compared to the unstable angina group. Across all the spectrums of acute coronary syndrome or extent of coronary artery disease there was a strong positive correlation within platelet distribution width, mean platelet volume and platelet large cell ratio, which was also very significant. Similarly total platelet count had a strong positive and very significant correlation with platelet-crit in the above groups.

Increase platelet large cell ratio and platelet-crit seems to be independent risk factors for development of ST elevated myocardial infarct than unstable angina. Thus they could serve as simple but important early biomarkers for predicting development of ST elevated myocardial infarction compared to unstable angina in acute coronary syndrome patients.