bluuebunny/crossref_metadata_2025 huggingface dataset:
PULSATILE DRUG DELIVERY SYSTEM: A FORMULATION APPROACH FOR TREATMENT OF DISEASES
Authors: SOWMYA PASHAM , DP VENKATESH , NAYEK SUJIT
Published: May 2020

location at a particular time. Some of the conditions under which pulsatile drug delivery system is positive include duodenal ulcer, cardiovascular disease, arthritis, asthma, diabetes, neurological disorder, cancer, hypertension, and hypercholesterolemia. Pulsatile drug delivery systems are essentially time-controlled drug delivery systems in which the lag time is regulated independently of environmental factors such as pH, enzymes, gastrointestinal motility, etc. The theory justification for the use of pulsatile release is for drugs where a continuous release of drugs is not needed, i.e. a zero-order release. Drug administration in chronopharmacotherapy is coordinated with biological rhythms to achieve full therapeutic effect and minimize harm to the patient. This drug delivery system is designed to distribute drugs in accordance with body clock. The pulse must be designed in such a way as to achieve a total and rapid release after the lag time.

Pulsatile drug delivery is therefore one device that provides strong promises of benefit to patients suffering from chronic conditions such as arthritis, asthma, hypertension by delivering medication at the right time, right place and in appropriate quantities. In recent pharmaceutical applications involving pulsatile delivery; multi-particulate dosage forms (e. g. pellets) over single-unit dosage forms are gaining more popularity. On the basis of methodologies, various pulsatile technologies have been developed, including ACCU-BREAKTM, AQUALON, CODAS ®, PRODAS ®, SODAS ®, MINITABS ®, DIFFUCAPS ®, OROS ® etc.
EFFECT OF AMLODIPINE ON ENTEROPATHY INDUCED BY INDOMETHACIN IN RATS
Authors: ANNOUF YARA , AL-LAHAM SHAZA , AL-SHATTI EYAD
Published: May 2020

Objective: Non-steroidal anti-inflammatory drugs (NSAIDs) have become well known for causing gastroduodenal mucosal damage. In addition, they are also known to affect the small intestine in humans. Amlodipine is a third-generation dihydropyridine-type calcium channel blocker; it can inhibit inflammatory cytokines and enhance antioxidant defenses. The aim of this study was to evaluate the effect of Amlodipine on indomethacin-induced enteropathy in rats.

Methods: Enteropathy was induced by subcutaneous indomethacin (Indo) prepared in 5 % sodium bicarbonate administrated at a dose rate of 9 mg/kg for two days at 24h intervals. Amlodipine (10 mg/Kg body weight po) was administrated for seven consecutive days beginning 24 h after the first Indo injection. Rats were sacrificed under ether anesthesia on the 8th day. The small intestinal injury was assessed by body weight loss, small intestine weight/length ratio, macroscopic damage, histological study, as well as by biochemical measurement of reduced glutathione (GSH), lipid peroxides and superoxide dismutase (SOD) activity in the small intestine tissue.

Results: The results showed that Amlodipine didn't decrease body weight loss, it decreased small intestine weight/length ratio, macroscopic and microscopic small intestinal damage scores caused by administration of Indo. It also increased SOD activity and decreased lipid peroxidation. The effect on the level of GSH wasn't observed. No statistical significance was observed when previous findings were compared to Indo induced enteropathy group (p>0.05).

Conclusion: Amlodipine didn't produce an obvious enhancement in enteropathy induced by Indo in rats.
Chemical Characterization and Sensory Relationships of Beef M. longissimus lumborum and M. gluteus medius Steaks After Retail Display in Various Packaging Environments
Authors: Ponce Jacqueline , Brooks J. Chance , Legako Jerrad F.
Published: May 2020

Volatile compounds, carbonyls, non-heme iron, and thiobarbituric acid reactive substances (TBARS) were measured in both raw and cooked beef samples to determine the effects of muscle and packaging type on beef flavor development. All paired strip loins and top sirloin butts were packaged under vacuum and aged for 14 d postmortem. After initial aging, all subprimals were fabricated to produce M. gluteus medius (GM) or M. longissimus lumborum (LL) steaks. At 14 d postmortem, steaks were randomly assigned to 1 of 5 package types: high-oxygen modified atmosphere lidded trays (80% O2/20% CO2 [“HIOX”]), carbon monoxide modified atmosphere lidded trays (0.4% CO/30% CO2/69.6% N2 [“CO”]), rollstock (forming and non-forming films [“ROLL”]), vacuum packaging without retail display (“VAC”), and traditional overwrap (“OW”) remained under vacuum prior to retail display. Steaks were stored in darkness an additional 7 d prior to display. At 21 d postmortem, HIOX, OW, CO, and ROLL packages were displayed for 48 h under continuous fluorescent lighting, while VAC steaks remained in dark storage. Packaging and muscle type impacted (P < 0.05) quantities of multiple volatile flavor compounds, including alcohols, n-aldehydes, esters, furans, hydrocarbons, sulfur-containing compounds,and ketones in both raw and cooked samples. Volatile compounds related to lipid oxidation were more (P < 0.05) prominent in HIOX packaging. Package type (P < 0.05) and muscle (P < 0.05) had an impact on raw-steak TBARS, although package type did not influence (P > 0.05) cooked-steak TBARS. The GM possessed greater (P < 0.05) TBARS values than the LL in both raw and cooked samples. Package type had no effect (P > 0.05) on carbonyl and non-heme iron content although these analyses differed among muscles (P < 0.05), with the GM being greater (P < 0.05) than the LL. These results indicate that the development of lipid oxidation that occurs during storage and display was muscle and packaging specific. Therefore, to maintain flavor, quality packaging systems should be selected on a muscle-specific basis.
Ketamina, un nuevo agente terapéutico para la depresión
Authors: Pérez-Esparza Rodrigo , Kobayashi-Romero Luis Fabián , García Mendoza Ana María , Lamas-Aguilar Reyna Minerva , Vargas Sosa Melissa , Encarnación-Martínez Melissa , González-Manríquez Luz Andrea , Eternod-Rodríguez Silvia Alejandra , Maltos-Gómez Fernanda , Vargas-Valencia Karen Marisel , Fonseca Pérez-Amador Alan
Published: May 2020

Major depressive disorder affects about one in every 10 people in Mexico and is one of the first 5 causes of disability worldwide. Current treatment options are limited and only act upon some factors associated in its physiopathology. Moreover, the effects on depression are not immediate, which is a great limitation in obtaining a benefit over disability caused by this disorder and impedes a rapid action in the scenario of suicidality. Recently, ketamine (an anesthetic) has shown to have antidepressant properties by acting in the glutamate neurotransmission system (while no other current treatment acts on this level). It offers benefits in depressive symptoms in a matter of hours and has proven to be useful in patients that do not benefit from current therapeutic options. Recently, it has been approved for the treatment of depression. However, there are still many questions about its antidepressant mechanisms of action, safety, side effects, among others. Key words: Depression; antidepressants; ketamine.
Muerte fetal por negligencia médica
Authors: Gomez Fröde Carina Xochil , De Anda Aguilar Leticia
Published: May 2020

Los especialistas de la CONAMED nos presentan un interesante caso con la finalidad de describir cuáles son las situaciones y eventos adversos que pueden ser corregidos y con ello evitar más muertes fetales
El ultrasonido, de la cabecera del paciente al aula
Authors: Vázquez Reyes José Manuel , Millán-Hernández Manuel , Ramírez Terán Oscar Andrés , Fernández Saldívar Fabián , Cortés Algara Alfredo , González Ramírez Pedro Alberto , Rodríguez Molina Víctor Manuel
Published: May 2020

In recent years, ultrasound at the patient’s bedside has exponentially grown. Its application has been observed in the operating room, intensive care units, emergency rooms, first-level care and even in field work. It is so versatile that it facilitates diagnosis, improves patient monitoring and supports invasive procedures, all in a safe and effective manner. It has been used as a didactic tool in medical education that helps create a link between basic sciences and clinical application. Ultrasound is one of the most versatile instruments in contemporary medicine, hence, more training and research in the subject is a must and a priority.
Key words: Point-of-care ultrasonography; insonation; medical education; anatomy; physiology
Calorie Restriction and Intermittent Fasting: Impact on Glycemic Control in People With Diabetes
Authors: Ganesan Kavitha , Habboush Yacob , Dagogo-Jack Samuel
Published: May 2020

Intermittent fasting has been suggested as an option for managing overweight and obesity. The purpose of this article is to present a balanced review of the practice of intermittent fasting and its impact on glycemic control in people with diabetes.
Factors Beyond Carbohydrate to Consider When Determining Meantime Insulin Doses: Protein, Fat, Timing, and Technology
Authors: Evert Alison B.
Published: May 2020

For many years, carbohydrate counting has been a popular strategy for determining mealtime insulin doses for people with diabetes who are on a multiple daily injection regimen or continuous subcutaneous insulin infusion. This approach assumes that only carbohydrate-containing foods and beverages affect postprandial glucose levels. However, many studies have indicated that the fat and protein content of a meal can play an important role in delaying postprandial hyperglycemia and should be considered when trying to optimize postprandial glucose levels. This article reviews research on making insulin dose adjustments for high-fat and high-protein meals, as well as the timing of mealtime insulin doses.
Student’s Self Esteem and Cyber-bullying Behavior in Senior High School
Authors: Haura Azzah Tahani , Ardi Zadrian
Published: May 2020

Cyberbullying behavior is a phenomenon that often happens among social media users, especially students. The behavior of cyberbullying is a continuous attack on victims by using communication media as a platform. One aspect that can influence a person to do cyber bullying is self-esteem. The purpose of this study is to see the relationship between self-esteem and cyberbullying behavior. This study uses descriptive correlational method with a quantitative approach. This study uses a simple random sampling technique by considering sampling using the G*Power application with a total sample are 100 (n = 100). Data analysis using descriptive analysis and correlation test analysis by using product-moment correlation. The findings of this study indicate that self-esteem related to cyberbullying behavior.
Analisa Penggunaan Sensor Proximity LJC 18 A3-B-Z/Bx Sebagai Salah Satu Sensor Prototype Cucimobil Otomatis
Authors: Abdul Rozaq Imam , Noor Rohman Mohammad
Published: May 2020

Saat ini mobil pribadi banyak digunakan masyarakat indonesia sebagai salah satu alat transportasi. Makin pesatnya perkembangan dunia otomotif, memberikan peluang usaha bagi jasa perawatan mobil. Salah satu peluang dalam usaha bagi perawatan mobil adalah dengan cara mendirikan car wash (cucian mobil). Berdasarkan permasalahan diatas maka timbulah ide untuk membuat prototype alat cuci mobil otomatis dan membutuhkan sensor yang dapat digunakan sebagai penanda posisi mobil yaitu sensor Proximity LJC 18 A3-B-Z/Bx. Metode yang digunakan dalam penelitian ini adalah dengan Metode Research and Development (RnD) yaitu dengan cara menganalisis 2 buah sensor proximity LJC 18 A3-B-Z/Bx dengan berbagai parameter. Parameter yang digunakan dalam menganalisis sensor adalah bahan atau material yang dapat dideteksi dan jarak yang dapat dideteksi oleh sensor. Hasil dari pengujiaan sensor proximity LJC 18 A3-B-Z/Bx yang pertama dapat mendeteksi material Plat besi, Besi, Dempul, Fiber, Kaca, Kayu, Plastik, Karet, Mobil Mainan dan jarak yang dapat dideteksi oleh sensor proximity LJC 18 A3-B-Z/Bx yang  pertama adalah 2mm, sedangkan pengujian sensor proximity LJC 18 A3-B-Z/Bx yang kedua dapat mendeteksi material Plat besi, Besi, Dempul, Fiber, Kaca, Kayu, dan jarak yang dapat dideteksi oleh sensor proximity LJC 18 A3-B-Z/Bx yang  pertama adalah 1 mm sehingga yang akan digunakan dalam prototipe alat cuci mobil otomatis adalah sensor proximity LJC 18 A3-B-Z/Bx yang pertama.
UNAPREĐENJE PROCESA SKLADIŠTENJA U PREDUZEĆU DOO UNIPROGRES
Authors: Simić Nemanja
Published: May 2020

U ovom radu predstavljeni su osnovni pojmovi vezani za logistiku i skladište. Primenom Išikava dijagrama identifikovani su svi uzroci koji utiču na kvalitet usluge preduzeća DOO Uniprogres. Proces skladištenja je identifikovan kao najvči uzrok i za njega je dat predlog za unapređenje u vidu magacinskog softvera.
PERFORMANSE PORESKOG SISTEMA ŠVAJCARSKE, FRANCUSKE I RUSIJE
Authors: Aranđelović Tamara , Perović Veselin
Published: May 2020

Porezi predstavljaju najznačajniji oblik javnih prihoda jedne države na osnovu kojih država prinudno uzima novčana sredstva od subjekata i sredstva prikupljena na ovaj način služe za zadovoljavanje finansijskih potreba države i ostvarivanje drugih ciljeva kao što su ekonomski, socijalni, kulturni, ekološki, obrazovnii sl. Istraživanje u ovom Master radu ima za svrhu prvenstveno da upozna a zatim i pokaže značaj javnih prihoda u vidu poreza, kroz performanse poreskih sistema. Istraživanje se zasniva na analizi performansi poreskih sistema tri države i to Švajcarske, Francuske i Rusije, kroz praktične primere vođenja poreske politike. Osnovni zadatak ovog rada jeste da se sa teoretskog aspekta sagleda značaj finansijskog stanja i ključnih indikatora zemalja u funkciji vođenja poreske politike.
UNAPREĐENJE PROCESA SKLADIŠTENJA U PREDUZEĆU PROMIST D.O.O
Authors: Drpa Jasmina
Published: May 2020

Predmet rada jeste istraživanje problema u poslovanju preduzeća „Promist d.o.o“, kako bi se u odnosu na date probleme predložile mere za njihovo smanjenje ili sprečavanje. Dijagramom UZROCI – POSLEDICA došlo se do svih uzroka problema u poslovanju. Kao najveći problem javlja se nedostatak skladišnog prostora, a uzrok tome jeste način skladištenja. Daljom analizom predložene su mere za unapređenje.
KARAKTERISTIKE I ANALIZA FAKTORA INOVATIVNOSTI U USLUŽNIM PREDUZEĆIMA
Authors: Ivezić Nikola
Published: May 2020

Теma rada jeste prikaz inovacija, nji­hov značaj, karakteristike i analiza faktora inovativnosti sa posebnim osvrtom na uslužna preduzeća; merenje ino­vativnosti putem inovativne balansirane tabele rezultata, kao i određivanje ključnih faktora promene u preduzeću Pollini.
KANCELARIJA ZA UPRAVLJANJE PROJEKTIMA – ISTRAŽIVANJE UTICAJA NA ORGANIZACIONE I PROJEKTNE PERFORMANSE
Authors: Rakić Jovanka , Morača Slobodan
Published: May 2020

Rad se bavi procesom upravljanja projektima usklađenim sa organizacionim ciljevima na strateškom nivou i pozicioniranjem kancelarije za upravljanje projektima u organizaciji. Rad se može sagledati iz dva dela. Teorijski deo predstavlja osnove upravljanja projektima u kompanijama i potrebu uspostavljanja organizacione jedinice za centralizovano upravljanje projektima (PMO). Opisane su uloge, funkcije i modeli PMO, kao i uslovi za njeno uspešno funkcionisanje. Praktični deo sadrži studiju slučaja organizacije koja je nedavno implementirala kancelariju za upravljanje projektima. Ovaj rad daje određen uvid u načine utvrđivanja njene vrednosti.
IMPLEMENTACIJA LEAN ALATA U KOMPANIJU ,,UNIVEREXPORT”
Authors: Milanović Branko
Published: May 2020

Ovaj rad opisuje inicijativa da se u kompaniji počne sa uvođenjem lean-a. U radu je opisan jedan logistički centar, i njegova potreba za uvođenjem  i primenom lean alata. Primenom određenih alata kroz praktične primere, teži se postizanju određenih rezultata za unapređenje logističkog sistema, i njegovog skladišta prevashodno.
ANALIZA METODOLOGIJE UPRAVLJANJA INOVACIONIM PROJEKTIMA U OBLASTI ENERGETSKE EFIKASNOSTI
Authors: Pekez Rade
Published: May 2020

U radu su date teoretske podloge u oblasti inovacija, upravljanja projektima i upravljanja inovacionim projektima, a potom je predstavljen jedan inovacioni projekat iz prakse sa posebnim osvrtom na analizu primenjene metodologije upravljanja projektima i utvđen je stepen inovativnosti projekta. Potom su postignuti rezultati upoređeni sa sličnim projektom koji predstavlja primer dobe prakse a implementiran je na teritoriji Republike Hrvatske. Na kraju je predložen set mera koje je potrebno preduzeti kako bi predstavljeni projekat bio održiv i postigao bolje rezultate.
OCENJIVANJE UTICAJA ŽIVOTNOG CIKLUSA MIKROTALASNE PEĆNICE NA RADNIKЕ
Authors: Jakovljević Marina , Agarski Boris
Published: May 2020

Istraživanje u okviru rada realizovano je u tri celine. Prvi deo pruža teoretske osnove ocenjivanja životnog ciklusa sa aspekta socijalnih uticaja, kao i metodu za ocenjivanje uticaja životnog ciklusa na radnika (WE-LCA). U drugom delu rada primenjena je WE-LCA meto­da, kako bi se procenili uticaji životnog ciklusa mikro­talasne pećnice na radnike. Dobijeni rezultati prikazani su tabelarno i grafički i ukazuju na verovatnoću nastanka fatalnih povreda, raka, psiho-socijalnih oboljenja, pore­mećaja funkcije centralnog nervog sistema, oboljenja sluha, alergenih i nealergenih oboljenja disajnih puteva, kožnih oboljenja, oboljenja vezanih za skeletnu musku­laturu i mišiće i ostalih povreda.
LOKALNA GEODETSKA MREŽA-PROJEKAT I REALIZACIJA
Authors: Živanović Stefan
Published: May 2020

Ovaj rad se sastoji iz nekoliko delova u kojima je u teoretskom smislu opisan projekat lokalne geodetske 2D mreže uz osvrt na metodu najmanjih kvadrata i njena realizacija na praktičnom primeru.
УВОЂЕЊЕ И РАЗВОЈ КАТАСТАРСКИХ ЕВИДЕНЦИЈА НА ПОДРУЧЈУ ПОЛИТИЧКЕ ОПШТИНЕ РОГАТИЦА
Authors: Mitrović Jelena Savo , Marinković Goran Dušan
Published: May 2020

Овај рад је резултат истраживања на тему катастарске евиденције у Републици Српској, са посебним освртом на ток развоја катастарских евиденција у општинама Рогатица и Фоча. С обзиром да је тежња катастра прелазак на јединствену евиденцију, основни циљ истраживања био је анализа стања досадашње евиденције као основе за даљи развој.
PROJEKAT GEODETSKE MREŽE TUNELA „ČORTANOVCI”
Authors: Popadić Slaven
Published: May 2020

U ovom radu data je teorijska osnova metodologije projektovanja tunelskih geodetskih mikro­mreža. Praktičnim dijelom rada predstavljena je reali­zacija plana opažanja za geodetsku mikromrežu tunela „Čortanovci”, kao i prethodna analiza tačnosti same mikromreže sa proračunom poprečnog i podužnog pro­boja tunela.
UTICAJ PARAMETARA MATRIKSA NA UKLANJANJE BISFENOLA A IZ PROCEDNIH DEPONIJSKIH VODA PRIMENOM FOTOKATALITIČKE DEGRADACIJE
Authors: Simeunović Uroš , Novaković Mladenka , Mihajlović Ivana , Petrović Maja
Published: May 2020

Bisfenol A predstavlja hormonski disruptor sa potencijalno kancerogenim dejstvom koji se nalazi pretežno u polikarbonatnoj plastici i epoksi smoli. Velika količina otpada sa sadržajem bisfenola A svakodnevno se odlaže na deponije komunalnog otpada. U okviru rada ispitano je uklanjanje poznate koncentracije bisfenola A iz laboratorijski sintetisanog uzorka i realnog uzorka procedne vode. Upoređivanjem rezultata ocenjen je uticaj prirodnog okruženja procedne deponijske vode na efikasnost uklanjanja bisfenola A primenom fotokatalitičke degradacije.
ANALIZA PROCENE RIZIKA ZA RADNO MESTO VATROGASAC-SPASILAC I MERE ZA POBOLJŠANJE USLOVA PROCESA RADA
Authors: Laban Mirjana Đorđe
Published: May 2020

Тема овог рада је процена ризика за радно место ватрогасац-спасилац према Киннеy метои, која је рађена на основу података из МУП-а, Центра за ванредне ситуације у Новом Саду и на основу статистичких података који прате ово радно место. Анализиране су потенцијалне опасности и штетности са којима се један ватрогасац-спасилац (ватрогасац вођа спасилачке груpe) сусреће сваког дана на свом радном месту, као и како оне утичу на његов живот и здравље, и које су то мере које треба спровести да би се спречио и умањио ризик којем је свакодневно изложен.
UPRAVLJANJE POŽARNIM RIZIKOM KOD SKLADIŠTENJA SEMENA ULJARICA
Authors: Ostojić Nikola
Published: May 2020

Požarne opasnosti u toku prerade i skladištenja uljarica (suncokreta, soje, uljane repice) mo­gu biti izražene ukoliko nije primenjena adekvatna pre­ventivna zaštita. Veliki rizik postoji od samozagrevanja i samopaljenja mase semena uljarica tokom skladištenja u silosima usled neadekvatnog i nestručnog vođenja tehnološkog procesa. Budući da samoupala može rezultirati tinjajućim požarima koji su izuzetno teški za gašenje, razumevanje i sprečavanje ovog procesa ima veliki značaj.  Cilj ovog rada je da se objasne uticajni faktori na početak i intenzitet inicijalnih procesa. Na eksperimentalnom primeru u laboratoriji utvrđeni su  fizičko-hemijski parametri i minimalne temperature paljenja semena sa ciljem pronalaženja ključnih uzroka nastanka požara u uljnoj industriji i predstavljanja rešenja za smanjenje rizika nastanka požara.
UTICAJ REAKTIVNOSTI PREDUZEĆA NA EFIKASNOST I EFEKTIVNOST KRIZNOG MENADŽMENTA
Authors: Arsić Darko
Published: May 2020

Ovаj rаd rаzmаtrа odnos između reaktivnosti preduzeća i efikasnosti i efektivnosti kriznog menadžmenta u njemu. Definisana je i razjašnjena efikas­nost i efektivnost preduzeća kao i reaktivnost preduzeća tj. osetljivost na promene okruženja, dok je kontrolabil­nost atribut sposobnosti preduzeća da kontroliše situaciju kreiranjem organiziacionih uslova (resursa), kao što su fleksibilnost tehnologije, ljudskog resursa, organizacije, organizacione kulture i informacionih sistema.
TIPOLOGIJA LIČNOSTI U SVOJSTVU UMETNIČKOG STVARANJA
Authors: Milojković Jelena
Published: May 2020

Rad „Tipologija ličnosti u svojstvu umetničkog stvaranja“ bavi se istraživanjem i analizom grane popularne psihologije koja se tiče psihologije ličnosti i uticajem tipologije ličnosti na umetničko stvaralaštvo. Rad se fokusira i pobliže predstavlja karakteristike INFJ-T tipa ličnosti, ispituje načine na koje on reaguje na nadražaje i prikazuje kako kako ih procesuira.
RAZVOJ MERNO – UPRAVLJAČKOG SISTEMA BEZBEDNOSTI VOŽNJE ZASNOVANOG NA CAN KOMUNIKACIJI U REALNOM VREMENU
Authors: Jelić Dušan
Published: May 2020

U radu je prikazan problem koji se javlja kada dođe do srčanih tegoba vozača u toku vožnje automobila, kao i praktično realizovan merno upravljački sistem koji sprečava mogućnost saobraćajne nesreće. Takođe opisana je CAN komunikacija koja se koristi. Na kraju su dati rezultati i mogućnosti proširenja rada.
Add-on tiotropium versus step-up inhaled corticosteroid plus long-acting beta-2‐agonist in real-world patients with asthma
Authors: Chipps Bradley , Mosnaim Giselle , Mathur Sameer K. , Shaikh Asif , Khoury Samir , Gopalan Gokul , Palli Swetha R. , Lamerato Lois , Casciano Julian , Dotiwala Zenobia , Settipane Russell
Published: May 2020

Background: A step-up approach (increasing inhaled corticosteroid [ICS] dose and/or add-on treatment) is recommended for asthma that is uncontrolled despite ICS plus long-acting beta-2‐agonist (LABA) combination treatment. Understanding the impact of different treatment
options on health outcomes can help guide treatment decision-making. Objective: To compare the effectiveness of add-on tiotropium 1.25 µg (two puffs once daily) versus an increased ICS plus LABA dose in a real-world cohort of patients with asthma initiated on ICS
plus LABA. Methods: De-identified data from patients ages ≥12 years and with asthma who were initiated on ICS plus LABA, and then had tiotropium added (Tio group; index date) or an ICS plus LABA dose increased (inc-ICS group; index date) were collected from two medical
and pharmacy claims data bases (2014‐2018). To account for population/group differences, propensity score matching was performed. The primary end point was the exacerbation risk after the index date. Secondary end points included exacerbation rates 6 and 12 months postindex, health-care
resource utilization, costs, and short-acting beta-2‐agonist (SABA) refills 12 months postindex. Results: Overall, 7857 patients (Tio group, 2619; inc-ICS group, 5238) were included. The exacerbation risk was 35% lower in the Tio group than in the inc-ICS group (hazard
ratio 0.65 [95% confidence interval, 0.43‐0.99]; p = 0.044). Exacerbation rates in the Tio group also were significantly lower within 6 and 12 months postindex (64% and 73%, respectively). All-cause and asthma-related emergency department (ED) visits were 47% and 74% lower, respectively
(p < 0.0001 for both), and all-cause and asthma-related hospitalizations were 48% (p < 0.01) and 76% (p < 0.001) lower, respectively, in the Tio group. Also, significantly fewer patients in the Tio group versus the inc-ICS group required SABA refills (56% versus 67%, p < 0.0001).
Conclusion: Add-on tiotropium significantly decreased the risk and rate of exacerbations, decreased all-cause and asthma-related ED visits and hospitalizations, and reduced SABA refills compared with increasing the ICS plus LABA dose. The findings supported the use of add-on
tiotropium for patients with uncontrolled asthma taking ICS plus LABA.
Volatility, Global Proxy Index, V-A-R: Empirical Study on Pakistan And China Stock Exchanges
Authors: Arslan Muhammad , Ahmed Wajid Shakeel , Akhter Mansoor
Published: May 2020

This study postulates that propose global proxy index is a significant conduit to evaluate the shocks in volatile stock markets i.e. PSX and SSE, alike. The two separate models i.e. Log-GARCH (1, 1) and ARMA-GARCH (1, 1) have been used along with the value at risk (V-a-R) @ 5% criteria for choosing best-fitted model. The study results showed Log-GARCH (1, 1) model proves to the best. This study results are not driven by political-level risks and thus independent study can be conducted to evaluate the detrimental consequences on investment opportunities under volatile environments.
What Motivates Teachers to Stay Faithful to the Teaching Profession?
Authors: Carls Kathryn Medina
Published: May 2020

This descriptive research inquired on the motivational factors that made teachers stay faithful to the teaching profession. There were 18 teacher–participants from the public and private basic education and secondary school of the City Schools of Dasmarinas. The qualitative part was done through triangulation and was participated by 18 teachers or significant others whose responses shed light on the prime question: ”what made teachers stay faithful to the teaching profession” asked through- narrative inquiry. However, in the journey of searching for the best motivational factors, some weak areas were discovered that paved the way to the formulation of an effective framework of analysis that would help address the not so strong points that hamper teaching effectiveness. Findings revealed that as to personal attributes, the teacher-participants served their schools for more than 6 years; working at their best always; recognition and prestige matters a lot for them; remuneration/ and other benefits were essential for them and equally important was, whatever they will be getting after retirement; with very satisfactory teaching performance; undoubtedly satisfied of the teaching profession, and did find teaching as a stable job. Conversely, there were some factors that teacher-participants were not so happy about and so the framework of analysis was formulated striking the balance between the strong and weak points. The framework has a universal C that stands for competence. C serves as the overall environment of the school with the strong motivational factors under its umbrella that must be sustained/fostered for the teachers to stay faithful to the teaching profession such as prestige and recognition; accountability and remuneration and other benefits. For the teacher-participants, these factors were all significant. The same factors motivated them to stay dedicated to the teaching profession. However, there were found motivational factors considered weak points that hamper teaching effectiveness and forwarded the following recommendations: (a) strengthen the policy on workload reduction and preparation time for learning materials hence, reduce stress; (b) provision for recreational activities that can foster greater camaraderie among employees; (c) provision for a more objective criteria on selection of teachers to participate in seminars funded by the school which must be related to the discipline they teach; (d) review seminar re-echo policy; offer strategic career development plans deemed needed for teachers’ continual improvement; and (e) provision for scholarships programs that can further enhance the potentials of teachers. Toward the end, this study hopes to open doors of improvement and encouragement that could add more flavor to the noblest profession.
Analysis of the challenges of small-scale farmers’ access to labor in North Central Nigeria
Authors: Akintobi O.S
Published: May 2020

The study analyzed the challenges experienced by small-scale farmers’ in accessing human labour in North Central Nigeria. Multi-stage random sampling technique was used for sample selection while questionnaires were used for data collection. A total of 1,750 farmers were randomly interviewed. Data were analyzed using descriptive statistics and one-way factorial analysis of variance and mean separation was done at 5% probability level. Result revealed small scale farmers perceived a lack of access to human labour for agricultural activities in the zone while mean separation showed Niger state has the highest access to labour while Abuja and Kwara states are the least state with access to labour. High cost of labour, lack of fund and scarcity of labour are the major challenges experienced by the farmers in accessing labour for agricultural production. Based on the findings, the research concluded that small scale farmers do not good access to labour while facing serious challenges which has resulted into increased cost of production for the small-scale farmers. The study recommends among others that combine hiring should be encouraged among farmers for the adoption of expensive labour saving technologies/ implements.
Pattern of cervical biopsy results in cases with cervical cytology interpreted as higher than low grade in the background with atrophic cellular changes
Authors: Li Yilan , Shoyele Olubunmi , Shidham Vinod B.
Published: May 2020

Objective:

The cytomorphological changes associated with atrophic cellular pattern (ACP) in cervical cytology smears may mimic high-grade squamous intraepithelial lesion (HSIL). Due to this, there may be higher chances of cytomorphological overinterpretation in cases with ACP. Estrogen therapy (ET) (topical or systemic) would reverse the changes related to atrophy and repeat Pap smear after ET should correct the false positives. This approach would minimize the unindicated invasive interventions. However, performing immediate biopsies following “higher than low-grade squamous intraepithelial lesion (LSIL) (atypical squamous cells-cannot exclude HSIL, low-grade squamous intraepithelial lesions-cannot exclude HSIL, and HSIL) interpretations” in such cases, is a general trend. Pap smears with “higher than LSIL interpretations” in association with ACP over a period of 10 years were selected.

Materials and Methods:

A total of 657,871 cases over 10 years were reviewed, of which 188 Pap smears interpreted as higher than LSIL interpretations with ACP were selected randomly for this study.

Result:

Of these 188 cases, 67 underwent biopsies which were reviewed and compared with 67 biopsies performed for “higher than LSIL interpretation” cases without ACP. The follow-up biopsy material was reviewed including elective p16 immunohistochemistry with other clinical details including high-risk HPV test results as indicated.

Conclusion:

The findings demonstrated that Pap smears with ACP have higher false positives due to tendency for cytomorphologic overinterpretation as compared to non-ACP group.
Utility of coping mechanisms in children with learning disabilities to arrive at the similimum: A case series
Authors: Tamboli Madhavi Prashant , Dhawale Kumar M.
Published: May 2020

Objectives:

In India, learning disabilities (LD) constitutes about 10–20% of scholastic problems in children. The standard way of treating these children is through remediation. An extra-mural Research Project supported by the Department of AYUSH (2008–2011) comprised a single blind, case–control study conclusively proved the value of homeopathy intervention in the treatment of LD. It is difficult to locate the characteristics in the written expressions of LD. This paper, explores through the use of a case series the most appropriate method, of identifying and incorporating the characteristic coping techniques used by these children to deal with their disability into the totality. The totality, thus erected, is processed through the use of various repertorial or nonrepertorial approaches.

Materials and Methods:

Detailed case histories of the children diagnosed with LD including data from the caregiver/s and the child were studied. The evolutionary behavioural expressions of the children were noted and analysed to derive the coping mechanisms utilized. These contributed to the characteristics which in turn defined the approach to the totality and further the similimum.

Results:

Incorporation of coping mechanisms with expressions at the mental and physical level was invaluable in leading to the similimum. The results indicated a significant change not only in the expressions of the LD but also in a better adaptation of the child to the environment.

Conclusion:

Identifying and valuing the coping mechanisms are of value in arriving at the similimum in children with LD.
Role of ABO blood type in delayed cerebral ischemia onset and clinical outcomes after aneurysmal subarachnoid hemorrhage in an ethnic minority urban population
Authors: Unda Santiago René , Vats Tarini , Ramos Rafael De la Garza , Cezaryirli Phillip , Altschul David J.
Published: May 2020

Background:

In recent years, the role of ABO blood type moved into focus through the discovery of different hemostaseologic properties with importance in many diseases including subarachnoid hemorrhage (SAH). However, the role of ABO blood type in delayed cerebral ischemia (DCI) onset, clinical progress, and outcome after SAH is to date largely unexplored. Our aim was to explore the role of ABO blood group in DCI and clinical outcomes after aneurysmal SAH (aSAH).

Methods:

A retrospective analysis was made with data collected from patients who presented aSAH at our single- academic center from 2015 to 2018. We included demographic, clinical, and imaging variables in the univariate analysis and in the subsequent multivariate analysis.

Results:

A total of 204 patients were included in this study. About 17.9% of “O” type patients developed a DCI while DCI was reported in only 8.2% of non-O type patients (P = 0.04). “O” type was an independent risk after in the logistic regression after adjusting for significant factors in the univariate analysis (OR=2.530, 95% CI: 1.040- 6.151, P = 0.41). Compared to “non-O” type patients, “O” type patients had a trend to have poorer outcomes at discharge (25.5% vs. 21.3%, P = 0.489) and at 12–18 months (21.1% vs. 19.5%, P = 0.795). However, there were no significant differences.

Conclusion:

Our study evidenced that patients with “O” blood type have higher risk of DCI onset after aSAH. Although these findings need to be confirmed, they may aid to improve DCI prevention and outcome predictions.
Hirayama disease – Early MRI diagnosis of subacute medullary ischemia: A case report
Authors: Galletta Karol , Gaeta Michele , Alafaci Concetta , Vinci Sergio , Longo Marcello , Grasso Giovanni , Granata Francesca
Published: May 2020

Background:

Hirayama disease (HD) is a rare, benign, and self-limiting motor neuron disorder that results in selective motor impairment of the C7-T1 myotomes. It is characterized by progressive, unilateral, or bilateral asymmetric muscle atrophy of the distal upper extremities and myelopathy.

Case Description:

A 23-year-old male presented with bilateral atrophy of the thenar/hypothenar eminences/ interosseous muscles, plus left-hand weakness. The cervical MRI documented subacute ischemic damage of the distal cervical cord. To rule out a tumor and reduce questionable cord compression, the patient underwent a C5–C6 anterior cervical discectomy and fusion (ACDF) immediately followed by a laminectomy with durotomy and to obtain a spinal cord biopsy. When the histology confirmed focal cord ischemia consistent with HD, it was clear that both operations were unnecessary.

Conclusion:

Establishing the diagnosis of HD is based on clinical findings and MRI/flexion MR features which include the demonstration of an increased T2-weighted intramedullary cord signal, enlargement of the posterior epidural space, and segmental spinal cord atrophy. The presence of HD should be recognized as a “nonsurgical entity,” and conservative nonsurgical management should be employed.
Anterior sacral meningocele complicated by rectothecal fistula and rectorrhea: A Case report and review of the literature
Authors: Rahimizadeh Abolfazl , Ehteshami Saeed , Rahimizadeh Ava , Karimi Mona
Published: May 2020

Background:

Anterior sacral meningocele (ASM) is a rare congenital anomaly. It is characterized by herniation of the dura through a defect in the anterior sacrum. Rarely, however, it may extend to the rectal area through a rectothecal fistula with or without rectorrhea.

Case Description:

Here, we present a case of ASM associated with a rectothecal fistula and rectorrhea. Surgical closure of the ostium of the cyst through a posterior approach resulted in long-term improvement

Conclusion:

An ASM with both rectothecal fistula and rectorrhea is extremely rare.
Retro-odontoid pseudotumor (pannus) with Forestier’s disease presenting with severe tetraparesis: A case report and literature review
Authors: Bamps Sven , Roosen Gert , Put Eric , Plazier Mark , Vanvolsem Steven , Wissels Maarten , Donkersloot Peter , Duyvendak Wim
Published: May 2020

Background:

A retro-odontoid pannus is often associated with inflammatory diseases. It can also have a noninflammatory cause due to chronic atlantoaxial instability.

Case Description:

Here, we report a patient with diffuse idiopathic skeletal hyperostosis and a severe noninflammatory retro-odontoid pannus who rapidly improved after posterior craniocervical decompression and arthrodesis.

Conclusion:

Transoral resection of the pannus, followed by posterior stabilization, is a common treatment for this condition. The pannus can, however, also reduce after posterior stabilization alone (e.g., craniocervical decompression).
Recurrent dysphagia after lower posterior cervical fusion
Authors: Ishikawa Yoshinori , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Kudo Daisuke , Shimada Yoichi
Published: May 2020

Background:

Although dysphagia following posterior craniocervical fixation is well known, the incidence after mid-lower posterior cervical fixation is not well described. Here, we presented a case of recurrent dysphagia in a 72-year-old male following C3–T3 posterior cervical fixation and discussed its etiology.

Case Description:

A 72-year-old male sustained a cervical fracture in a fall; he was neurologically intact. The cervical/thoracic MR and CT studies documented ankylosing spondylitic changes in the cervicothoracic spine, a C5/6 disc herniation, and a C7 vertebral fracture. He underwent posterior cervical C3 to T3 fusion without decompression. For the 1st postoperative day, he complained of dysphagia without hoarseness, and fiberoptic endoscopy revealed poor esophageal mobility. For the next 6 postoperative years, he continued to require repeated attempts at the dilation of the esophageal entrance but remained reliant on a feeding tube.

Conclusion:

Posterior cervical fixation restricts cervical motion and may restrict expansion of the esophageal duct leading to permanent postoperative dysphagia requiring continued feeding tube utilization.
Relying too much on upfront radiosurgery: Indolent course misinterpreted as effectiveness of radiosurgery in a case of skull base chondrosarcoma
Authors: Malik Puneet , Sahoo Sushant Kumar , Gupta Kirti , Salunke Pravin
Published: May 2020

Background:

Skull base lesions are still considered surgically challenging and primary gamma knife radio surgery (GKRS) is gaining popularity. However the effectiveness of GKRS may be overrated especially in lesions with indolent course.

Case Description:

We report a case of chondrosarcoma, mimicking a trigeminal schwannoma treated with upfront radio surgery. Relatively lower dose was administered in view of proximity to the brainstem. The patient was asymptomatic and the size of the lesion remained static for over a decade. This was misinterpreted as effectiveness of GKRS. The lesion grew after a decade necessitating surgery.

Conclusion:

With popularity of upfront GKRS, suboptimal but maximal safe radiation dose is usually prescribed for lesions close to critical structures like brainstem. In these cases the long indolent natural course of the pathology, as in the case of chondrosarcoma may be misconstrued as success of radiosurgery. An extended follow up beyond this static period is necessary before concluding its effectiveness.
Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority
Authors: Ahn Jae-Min , Oh Hyuk-Jin , Oh Jae-Sang , Yoon Seok-Mann
Published: May 2020

Background:

Pituitary apoplexy is syndrome of sudden onset of headache, visual loss, pituitary dysfunction, and altered consciousness. Pituitary apoplexy followed by acute cerebral ischemia is extremely rare. Here, we introduced the case of successful surgical resection of pituitary adenoma which induced acute cerebral ischemia.

Case Description:

A 78-year-old man with a known pituitary macroadenoma presented with decreased consciousness and left hemiparesis. Magnetic resonance image (MRI) and computed tomography (CT) showed large pituitary macroadenoma with hemorrhage and diffusion-perfusion mismatch of right internal carotid artery (ICA) territory. Conventional angiography was done and severe stenosis of bilateral ICA and prominent flow delay of left ICA were noted at paraclinoid segment. Microscopic tumor mass removal with transsphenoidal approach was performed. Final pathological diagnosis was pituitary adenoma with apoplexy. Immediately after surgery, his symptoms were disappeared. Follow-up image studies revealed much improved perfusion in right ICA territory and patency of bilateral ICAs.

Conclusion:

Direct compression of ICA is rare complication of pituitary apoplexy, which caused cerebral ischemia. Conventional angiography should be necessary for accurate diagnosis and prompt surgical decompression should be the treatment of choice.
Comparative study of transferring frozen embryo with short culture vresus overnight culture and also assess prevalence rate of psychological distress amongs infertility patient
Authors: Brij Raj Singh  , Akash More  , Ranjit S. Ambad  , Nandkishor Bankar  , UjwalGajbe  , Ajinkya S. Ghogare
Published: May 2020

Frozen embryo transfer is a procedure which is widely preferable technique to transfer of embryos obtained in assisted reproductive technology. The transfer of cryopreserved embryos transfer which is less expensive than the second fresh cycle, fertility treatment costs, can get an increased implantation rate, and an increased rate of pregnancy. The primary negative emotional reaction to both infertility and assisted reproductive therapy is typically either anxiety or depression. To compare serum β-hCG value in fresh frozen-thawed embryo transfer with overnight cultured frozen-thawed embryo transfer. And prevalence rate of psychological distress. 52 FET Cycles performed in between June to December 2018 among these embryos transfer 36 were performed within 1 hour after thawing and 16 were performed after overnight incubation. We observed that patient in 1 hour incubation has higher β-hCG level than overnight culture patients and there is worse psychological status in infertile women and nearly half of our infertile sample (51.9%) displayed mild to extreme depressive symptoms. Obstetricians should consider that reducing the mental and social issues will lead to greater happiness and productivity. If psychiatry disorders are chronic, it can affect adversely.
Nanoparticulate targeted drug delivery systems - A Review
Authors: Sindhuja Devaraj  , Ganesh GNK
Published: May 2020

Nanoparticulate drug delivery system are the rapidly developing system, and nanoparticles are present in the size range of 1-100nm. Nanoparticles composed of various thermal, electrical, and optical property. Nanoparticles offers the potential advantages over the traditional dosage forms it is ascribable to the properties of nanoparticles. Nanoparticulate drug delivery system ensures the site-specific delivery of a drug(Targeting drug delivery) and aids in improving the efficacy of the new as well as old drugs and has the potential in crossing the various physiological barriers and also improves the therapeutic index of the drugs and increases the patient compliance. The objectives of this review is to classify the nanoparticles based on the different groups, surface properties of nanoparticles, describe the strategies of drug targeting, the necessity of nanoparticles their general method of preparation, different methods used in characterization, self- assembly and mechanism of drug release in a systemic manner. The potential advantages and limitations of various nanoparticulate drug delivery systems are also discussed elaborately.
Nutrition and corona virus: Plan a diet in a pandemic
Authors: Suchitra M R  , Parthasarathy S
Published: May 2020

The corona virus pandemic is causing the worst ever health disaster in the recent decades. Continuously newer drugs are being tried for the same with variable success. There has been much talk about one’s immunity and the corona survival.  There are a lot of traditional food items which can increase the immunity with an additional benefit of some antiviral properties. Citrus fruits, sitaphal, apple papaya are among the fruits. Vegetables including broccoli, onion, garlic and green leaves are a few vegetables. Nuts, ginger, turmeric, pepper, egg yolk, shell fish, mushroom are some of the miscellaneous dietary supplements which have both properties. In a pandemic scenario, diet and nutrition can be an important supplement to pharmacy to counter viruses. We have tried to give complete menu for a day with such properties.  The major hiccup may be the non-availability of certain foods. Hence, we have also suggested many alternate recipes to tackle this problem. This sample menu and their alternatives are being given for a normal adult. Needy changes should be contemplated according to age, sex, body mass index and daily physical activities.