bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical awareness of risk factors of cardiovascular diseases in different types of hospitalized patients (part 2)
Authors: Pogosova N. V. , Yufereva Y. M. , Ausheva A. K. , Sokolova O. Y. , Melik-Oganjanyan G. Y. , Karpova A. V. , Arutyunov A. A. , Kalinina A. S. , Vygodin V. A.
Published: October 2019

Objective. To study medical awareness of cardiovascular risk factors (RFs) in different types of hospitalized patients (pts). Methods. A total of 150 pts from neurological, endocrinological and cardiac units one of Moscow city hospital were enrolled into the survey (50 pts in each unit). The pts were interviewed during the I-II days of the hospitalization. A special questionnaire was developed in‑ cluding socio-demographic and clinical indicators, open questions on the awareness of traditional cardiovascular RFs and their target values. Results. Pts of three units did not differ in gender and age. The range of diagnoses corresponded to the profile of the unit. The survey revealed an extremely low awareness of major cardiovascular RFs of pts in all 3 units: almost none of them pointed to elevated cholesterol (0%, 4% and 0%, respectively) and blood pressure (2%, 2% and 0%) respectively) as RF of cardiovascular diseases. The pts of the three units most often referred to stress (64%, 56% and 66%, respectively) and unhealthy diet (50%, 56% and 64%, respectively) as the main cardiovascular RFs. On average, pts in three units correctly indicated only 2 RFs. Conclusion. The survey revealed a low awareness of cardiovascular RFs in different types of medical pts, including cardiac pts, at time of hospital admission.
A prospective observational study on incidence of adverse drug reactions in a tertiary care teaching hospital: a pharmacovigilance study
Authors: Kalyani S. Sre Akshaya , Srihitha Pendota , Abhinay Sharma Katnapally , Dharanija Porandla , Bheemreddy Sandeep Kumar
Published: October 2019

Background: An adverse drug reaction (ADRs) is determined as response to a drug that is noxious unintended excludes therapeutic failures, overdose, drug abuse, noncompliance, and medication errors. The main aim of the study is to detect, understand and report ADR’S.Methods: This study is prospective observational study conducted for 6 months in in-patient setting in a tertiary care hospital. Naranjo’s, WHO causality scale, Siegel scale, Schumock and Thornton scale are used to assess ADR. Graph Pad Prism and SAS software’s are used.Results: Data was collected from a total of 1000 patients of which 121 (12.1%) patients were effected with 150 ADRs. Among 121 patients AdrAd was 60.66% and AdrIn was 39.33%. Of 121 patients 97 patients with single ADR, 28 patients with 2 ADRs, 10 patients were with three ADRs. ADR onset divides acute (10%), Latent (39%) and sub-acute (51%). ADR occurred are recovered (54%), Recovering (13%). Naranjos scale interprets definite (0.9%), probable (50.9%), possible (42.97%). According to WHO scale certain (2.7%), unlikely (2.7%), possible (38.84%). Hartwig and Siegel scale results are mild (12.4%), moderate (66.12%) and severe (12.4%). Schumock and Thornton preventability results are definitely (25.45%), probably (68.18%) and not preventable (6.36%).Conclusions: Every health care professional should be aware of the Pharmacovigilance principles and also should be aware of suspected ADR reporting form of PVPI. By applying the above scales it is easy for health care professionals to assess an ADR.
Use and inappropriate use of proton pump inhibitors in hospitalized patients
Authors: Gupta Yadvendra , Bhandari Sudhir , Govil Anurag , Gupta Rahul , Goyal Jaswant , Goyal Barkha , Chandalia Saloni
Published: October 2019

Background: The discovery of Helicobacter pylori infection in etiology of peptic ulcer disease and proton pump inhibitors (PPI) in management of upper gastrointestinal diseases had been the milestones in medical science. PPI are currently being both overused and misused. In countries like India, where over 500 branded formulations of PPI are available, probability of misuse and abuse increases exponentially. The aim of the study was to find out inappropriate use of PPI, among hospitalized patients.Methods: In order to find answer to the research question a cross sectional study was conducted in indoor patient of a tertiary care private hospital at Jaipur, Rajasthan. Patients of either sex, aged 18 years or above belonging to rural and urban communities were participating in study. The sample size was 500.Results: It was noted that Inappropriate PPI use was observed in most of the hospital admitted patients (78%). Most common diagnosis among inappropriate PPI use was dengue fever (due to increased number of dengue cases during study period), followed by cerebrovascular accidents and urinary tract infection. Most common indication for appropriate PPI use was stress ulcer prophylaxis, again in dengue case (due to cardinal manifestation of thrombocytopenia).Conclusions: Almost all patients were once prescribed PPI after admission and discharged on PPI (99.2%). Thus, we recommend evidence-based prescription of PPI, to reduce side effects and excess cost.
Determinants of cervical cancer screening via Pap smear among female staff in a tertiary hospital in Niger-Delta of Nigeria
Authors: Awoyesuku Peter A. , Altraide Basil O. , Mac Pepple Dagogo A.
Published: October 2019

Background: Cervical cancer remains a leading cause of death among women in the developing world, with poor prognosis attributed to lack of awareness about the disease and its prevention. Hospital workers’ attitude and practice to such an issue might positively or negatively influence people they come into contact with. This study is to assess the determinants of cervical cancer screening via Pap smear among Female Staff in a Tertiary Hospital in Nigeria.Methods: A hospital-based cross-sectional study was conducted between September and November 2015. A structured self-administered questionnaire was used to collect data from 265 female hospital workers on socio-demographic characteristics (age, parity, educational level and occupational category) and awareness and utilization of Pap smear test. The data obtained were analyzed using SPSS version 20.0.Results: Of the 265 respondents, only 40 (15.1%) had Pap smear test done at least once previously. Bivariate analysis of socio-demographic factors and Pap smear test uptake among the respondents was statistically significant for younger maternal age ≤35 years, not being married, higher educational level, professional occupation category and awareness of Pap smear. However, only maternal age, marital status and awareness of Pap smear remain statistically significant after multivariate analysis.Conclusions: Uptake of Pap smear test as a screening test for cervical cancer is low among female hospital workers. Identified determinants of cervical cancer screening via Pap smear test were younger age ≤35 years, not being married, higher educational level, professional occupational category and awareness of Pap smear.
A study on awareness about temporary contraceptive methods among women in reproductive age group
Authors: Karthikeyan Sharan Kumar , Kalimuthu Kohila
Published: October 2019

Background: This study focuses on the awareness about temporary contraceptive methods among women in reproductive age group (15-45 years). The temporary contraceptive methods are barrier method, hormonal methods and intrauterine method. The need to study the awareness of temporary contraceptive among women is important to avoid Abortion, MTP and to reduce maternal mortality. The purpose of this study is to assess the awareness of temporary contraceptive methods among women within the reproductive age group of 15 to 45 years in the community. Explore women's understanding, interpretations of contraceptives. Suggestions to improve Birth control and enhance maternal, child health programmes.Methods: Cross-sectional descriptive study (samples were drawn from relevant population and studied once) conducted among the outpatients visiting the obstetrics and gynaecology department of Saveetha Medical College and Hospital. The study was conducted from 15th April 2019 to 14th July 2019 using pretested questionnaire by interview method.Results: The study shows 72% of women were aware of condoms and 92% of women were aware about sterilization method. 38% of the women who participated in the study belonged to the age group (36-45) and maximum usage of temporary contraceptives was found among this age group. We observe 56% of the women were aware that these contraceptives can be obtained at the government hospitals and 7% of the women were not aware where to get these services. 48% of the women got information about contraceptives from health personnel.Conclusions: The success of family planning programs can only be achieved by increasing the awareness of various contraceptives available. It is necessary that supplies of contraceptives are accessible, available and affordable to the general public with ease. Awareness can be improved by expanding health care facilities to peripheral areas.
Endometrial osseous metaplasia in a case of abnormal uterine bleeding
Authors: Gautam Himleena , Goswami Alaka , Goswami Papari , Kathar Kamal Kumar
Published: October 2019

Endometrial osseous metaplasia is an uncommon pathology with varied clinical symptoms. Its pathogenesis is not exactly known and has a benign course. Here we present a case of a 42-year-old female with abnormal uterine bleeding who did not respond to medical management. On ultrasonography, suspected endometrial calcification was seen. Patient opted for hysterectomy and the biopsy report showed endometrial osseous metaplasia. Thus, in this case of menometrorrhagia and dysmenorrhoea, the cause was found to be osseous metaplasia.
Gossypiboma: a surgical menace
Authors: Shah Nitin H. , Joshi Aditi V. , Shah Vaishali N.
Published: October 2019

Gossypiboma is a rare yet devastating complication. It may be a sequela to any kind of surgical procedure, however intra-abdominal surgeries are commonly implicated as the cause for this entity. In chronic cases, it may even lead to severe morbidity. We report a case of gossypiboma post vaginal hysterectomy, diagnosed and treated successfully by laparoscopy.
A retrospective clinical study and management of ingested Indian currency coin found in the oesophagus among paediatric age group
Authors: M. S. Sudhakar Rao , Karade Deepak
Published: October 2019

Background: Foreign body ingestion is a common event in children and carries significant morbidity and mortality. Indian currency coins are found to be the common ingested foreign bodies hence, to be treated accordingly.

Methods: A 7 years retrospective review of 133 children diagnosed, admitted and managed for “ingested Indian currency coin” between January 2011 to December 2017 in the Department of Oto-rhino-laryngology and Head and Neck surgery, Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India. A plain radiograph of the relevant views of neck and chest were taken to identify the foreign body.  

Results: There were 80 (60.2%) males and 53 (39.8%) females, ranging in age from 6 months to 15 years. Most of the patients 98 (73.7%) presented within 12 hours of the coin ingestion. 109 patients presented with one or more symptoms, common being vomiting 83 (62.4%). Coin was located mostly at the cricopharynx 111 (83.5%). Coin removal was possible using Macintosh laryngoscope and Magill’s forceps in 106 (79.7%) patients, and 27 (20.3%) patient’s required rigid oesophagoscope.

Conclusions: Indian currency coin ingestion is commonly found in cricopharyngeal area of the oesophagus among preschool age group. The duration of retention of the foreign body, procedural time, hospital stay of the patient, diameter of the coin in both the genders have no impact on clinical outcome on retrieval of them.
Total knee arthroplasty at Gaza Strip Palestine: compliance and retrospective comparative study
Authors: Afana Hatem B. , Dhair Rafat F.
Published: October 2019

Background: In Gaza Strip, arthroplasty only performed at our center. This study is to assess the compliance and improve current practices.

Methods: Study is based on medical records review of all patients underwent total knee arthroplasty (TKA) between January 2016 and December 2017.

Results: Forty eight TKA were performed on 41 patients. Neuraxial anesthesia used in 43 operations (30 spinal, 13 epidural). Tranexamic acid used in 20 operations and those show less frequently decrease in hemoglobin level after surgery and for blood transfusion. Simultaneous bilateral TKA used in one patient. Drain used in 26 operations, 2 of them had infection. No one started physiotherapy at same day surgery, this may be due to repeat doses of Epidural anesthesia, performed surgeries before weekend and using the drain. Delayed physiotherapy is associated with prolong hospitalization and increase suspicion of deep venous tthrombosis. The result from our retrospective comparative study was similar to guidelines.

Conclusions: We concluded that there is overall good management of TKA in our hospital according to the best available evidence. We recommend to use the international guidelines like the American Academy of Orthopaedic Surgeons (AAOS) guidelines as a standard guidelines to our Hospital, and increase awareness of our staff to the good practice guidelines. Emphasize the important elements that we have shorten of good practice as listed in the discussion. 
Descriptive study of outcome of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of weight bearing long bones
Authors: Sen Abhijit , Kulkarni Chandan , Meena Ashok
Published: October 2019

Background: Infected non-union of tibia and femur is a debilitating disorder for patient as well as challenging task for treating surgeon. Conventionally treatment of infected non-union is a two staged procedure. But antibiotic cement-impregnated intramedullary nailing (ACIINs) is a single staged and cost-effective procedure. Hence we intended to study the outcome of ACIIN use in infected non-union of tibia and femur.

Methods: This is a hospital based prospective case series type of descriptive study conducted in Department of Orthopedics, SMS Medical College and Hospital, Jaipur. We studied 35 cases of infected non-union of femur and tibia fracture with interlock nail in situ. All patients were treated with interlock nail removal, debridement and freshening of sclerosed bony ends and fixation with ACIIN. All were followed for at least 6 months for infection control and bony union and final results were evaluated by Paley’s bony criteria and functional criteria.

Results: Infection was controlled in 94.28% cases. Bony union was achieved in 88.57% cases (19 femur and 12 tibia). Average duration for bony union was 7.3 months for femur and 8 months for tibia. According to Paley’s criteria for bony outcome and functional outcome 65.71% and 51.43% had shown excellent outcome respectively.

Conclusions: ACIIN is a good modality for treatment of infected non union of tibia and femur in terms of infection control and bony union and has a good functional outcome when bone gap is less.
Locking plate for displaced proximal humerus fractures-outcomes and complications: a prospective study
Authors: Rathod Avinash , Balaji Gopisankar , Patro Dilip
Published: October 2019

Background: The management of unstable proximal humerus fractures is controversial as many fixation techniques have evolved over the years claiming to be a better fixation device compared to the other.

Methods: 23 patients with closed displaced proximal humerus fractures were included in this study. All patients underwent open reduction and internal fixation with proximal humerus locking plate through either delto-pectoral or deltoid splitting approach. Standard shoulder rehabilitation program was used in all cases. Functional and radiological outcome were assessed at follow-up.

Results: The mean constant-Murley score achieved at 6 months was 66. Complications were reported in a total of 7 patients including 3 varus malunion, 1 valgus malunion, 2 screw penetration into the joint and 1 nonunion with implant breakage.

Conclusions: The proximal humeral locking plate seems to be an adequate device for the fixation of displaced proximal humerus fractures as 83% of our study population had good/moderate functional outcomes.

 
Antynowotworowe właściwości probiotycznych bakterii jogurtowych
Authors: Karwowska Zuzanna , Szemraj Janusz , Karwowski Bolesław T.
Published: October 2019

Komensalna mikroflora jelit odgrywa kluczową rolę w utrzymaniu homeostazy w ludzkim organizmie. Drobnoustroje wpływają między innymi na przemianę energii i wchłanianie składników odżywczych, regulują pracę układu immunologicznego oraz pomagają chronić organizm gospodarza przed patogennymi mikroorganizmami. Skład mikroflory jelitowej występuje w łatwej do zaburzenia równowadze, a wszelkie jej zmiany wywołane dietą, stresem, otyłością, chorobami układu pokarmowego czy przyjmowaniem leków, mogą prowadzić do prozapalnych odpowiedzi immunologicznych i zapoczątkowania procesów chorobowych, w tym nowotworowych. Utrzymanie homeostazy mikroflory jelit jest zatem niezwykle istotne dla zdrowia człowieka. W celu jej przywrócenia najczęściej stosowane jest przyjmowanie preparatów zawierających odpowiednie kultury bakterii tj. probiotyków. W związku z faktem, iż jogurty stanowią źródło bakterii probiotycznych, ich regularne spożycie stanowić może mocny punkt w profilaktyce różnego rodzaju chorób w tym cywilizacyjnych jak i nowotworowych. Artykuł ten stanowi przegląd literatury dotyczącej zastosowaniabakterii jogurtowych w profilaktyce chorób nowotworowych. Zagadnienia poruszone w artykule dotyczą charakterystyki bakterii jogurtowych, dobroczynnego wpływu probiotyków na zdrowie człowieka, antynowotworowych właściwości bakterii jogurtowych oraz ich metabolitów tj.: immunoregulacji, zapobiegania infekcjom bakteryjnym, utrzymania połączeń komórkowych w jelicie i przeciwnowotworowej aktywności metabolitów bakteryjnych.
Rokitnik zwyczajny (HippophaĂŤ rhamnoides L.) jako skarbnica witaminy C
Authors: Urbaniak Sandra , Kaźmierczak-Barańska Julia , Karwowski Bolesław T.
Published: October 2019

Sea buckthorn is a plant rich in numerous biologically active compounds, such as: vitamins, flavonoids, carotenoids or unsaturated fatty acids, which have a beneficial effect on human health. This plant deserves a special interest, due to the stable vitamin C. Importantly, sea buckthorn maintain its properties even after cooking or drying. Sea buckthorn juice can successfully replace the lemon in the daily diet.The aim of this article is to approximate the health-promoting properties of sea buckthorn resulting from the high content of compounds with an antioxidant properties, particularly vitamin C, which in the case of sea buckthorn is characterized by high stability.
Comparative study of articaine and lidocaine for third molar surgery
Authors: Shahnaseri Shirin , Mohammadi Navid , Tamizifar Alireza , Mousavi Seyed Amir
Published: October 2019

Background: This study aims to compare the anesthetic efficacy, postoperative pain, hemorrhage & dry sock incidence of articaine 4% versus lidocaine 2% in inferior alveolar nerve block during impacted lower third molar surgery.
Method: A prospective randomized study was conducted on 20 subjects planned for elective surgical removal of bilateral impacted mandibular with similar difficulty indices. A single operator performed all surgeries on basis using 4% articaine or 2% lidocaine as an anesthetic agent and with the same concentration of vasoconstrictor (epinephrine 1:100,1000). Latency, duration of anesthetic effect, intra and post surgical pain experiences, hemorrhage & dry socket occurrences were evaluated with respect to the type of anesthetia. A visual analog scale was used to score pain.Data were analyzed by descriptive statistics, repeated measures ANOVA, Wilcoxon and McNemar’s test (a=0.05).
Results: Latency, Intra & Postoperative pain and hemorrhage showed clinical differences in favor of articaine, though statistical significance was not reached. In turn, the mean duration of anesthetic for articain was much extended and showed statistically significant difference. Dry socket incidence consisted of two occurrences (5 %) and those two only occurred in Lidocain group.
Conclusion: although 4% articaine offers better pharmacological performance than 2% lidocaine, both articaine and lidocaine have demonstrated adequate, negligible differences and acceptable clinical profiles. For this reason, their use in oral surgery should remain of the professional preference who will evaluate their use base on the necessary surgical time.
Intraosseous lipoma of the mandible: A rare case report
Authors: Razmara Farnoosh , Mosavat Farzane , Keshani Forooz
Published: October 2019

The lipoma is 5% of benign tumors and 25 to 50% of soft tissue tumors. It most occurs in the upper trunk area, neck and the extremities. But it is rare in the oral and maxillofacial area. It is a benign lesion composed of fat mature adipose tissue that Separated with fibrous septa and surrounded with a thin fibrous capsule. Jaw Intraosseous lipoma is very rare, and its prevalence has been mentioned in articles 1.0%. The case of this manuscript was a 33-year-old woman who referred to an orthodontic specialist with a complaint about the tooth crowding and requesting orthodontic treatment. Based on clinical, radiography and histopathology finding, a diagnosis of intraosseous lipoma of the mandible was made.
Inhaler Refill Adherence among Patients with COPD/Asthma at a General Hospital in Northern Peninsular Malaysia
Authors: Chern Ang Wei , Mahdzan Mahirah , Mohmad Rashila
Published: October 2019

Background: Most adherence studies are based on self-report measures. There are limited studies on medication refill adherence (MRA) conducted in Malaysia, especially on bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). The study aimed to investigate the MRA for inhalers with fixed dosing indicated for BA or COPD, prescribed from paediatric and medical clinics in Hospital Tuanku Fauziah and the factors that may affect MRA of COPD/BA inhalers.
Methods: A cross-sectional study was conducted on repeat prescriptions (fixed-dose inhalers dispensed as the units of analysis) collected from 1st January 2015 to 31st December 2015 from the specialist clinic pharmacy. Descriptive analysis was conducted based on satisfactory MRA which was set as the dispensed refill of inhalers covering 80-120% of the prescribed treatment time. Logistic regression analysis was used to explore each variable (diagnosis, gender, ethnicity and age) in relation to MRA: overall satisfactory MRA (≥80% MRA) with undersupply (<80% MRA) as the reference group.
Results:  Out of the repeat prescriptions analysed (N=199), the majorities were COPD (N=118; 64.3%), male (N=122; 61.4%), Malay (N=175; 88.0%), and aged 60-69 years old (N=56; 28.3%). 44.5% of repeat prescriptions (N=57) for COPD showed satisfactory MRA, compared to only 25.4% (N=18) in BA. Repeat prescriptions for fluticasone/salmeterol accuhalers showed the highest satisfactory MRA at 18.1% (N=36). Diagnosis, gender and ethnicity did not significantly influence the overall MRA while age marginally influenced the overall MRA.
Conclusion: More than half of the repeat prescriptions for BA and COPD inhalers showed undersupply and oversupply: patients may not be compliant nor using the inhaler correctly.
Vitamin D Deficiency and Oral Mucositis in Hematopoietic Stem Cell Transplantation: A Cross-Sectional Observation
Authors: Raoufinejad Kosar , Pezeshki Shahrzad , Chahardouli Bahram , Hadjibabaie Molouk , Jahangard-Rafsanjani Zahra , Gholami Kheirollah , Rajabi Mehdi , Vaezi Mohammad
Published: October 2019

Backgrounds: One of the most frequent complications of high-dose chemotherapy regimen before hematopoietic stem cell transplantation (HSCT) is oral mucositis (OM). Vitamin D (VD) has well-known immunoregulatory, anti-inflammatory, and antioxidant properties.This study aimed to evaluate the association of pre-HSCT VD levels with OM as well as neutrophil and platelet engraftments in patients with multiple myeloma, Hodgkin’s and non-Hodgkin’s lymphoma after autologous HSCT.
Methods: A sample of 71 patients was enrolled after obtaining informed consent. Serum samples were collected in the morning prior to the administration of conditioning regimen to measure the 25-OH-D. OM was examined daily during hospital stay. The World Health Organization (WHO) scale was used for scoring the OM. Absolute neutrophil count and platelet count were determined daily from transplantation until engraftment.
Results: Patients aged 18-65 years. Mean length of hospital stay was 15.8±5.7 days. OM was detected in 44/71 (62.0%) of patients. Mean time to the engraftment of neutrophils and platelets were 11.8±4.0 and 17.2±7.3 days, respectively. Mean level of 25-OH-D was 17.5±14.0 ng/ml. VD deficiency (<20 ng/ml) was diagnosed in 51/71 (71.8%) of patients. No association between the 25-OH-D levels and incidence of OM (P=0.69) or OM grade 3-4 (P=0.46) was found. No significant correlations were detected between the 25-OH-D and engraftment time of neutrophils (P=0.46) or platelets (P=0.17).
Conclusions: The prevalence of VD deficiency was high among adult HSCT patients at the time of transplantation. No association was found between the pre-HSCT VD level and OM or engraftment time.
Rituximab Utilization Evaluation with Focused on Available Evidence for Off-Labeled Indications
Authors: Farasatinasab Maryam , Aghabeigi Sohrab , Ramezaninejad Soodeh , Amouzegar Atefeh , Ghanbari Behrooz , Pakdaman Nashmin , Motamed Mohammadreza , Almasi Simin , Rezaie Nader , Nasiripour Somayyeh , Sabzghabaei3 Forough , Basi Ali
Published: October 2019

Background: To investigate the on-labeled and off-labeled indications of rituximab according to available evidence and the cost benefit of using this expensive drug.
Methods: This retrospective cross-sectional study was conducted between August 2016 and August 2017 at a teaching hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Patients’ demographic data and disease, indication for rituximab use, its dosage and treatment regimen and previous and concurrent treatments was assessed. The collected data were compared with the current criteria for the pattern of rituximab use. The last version of Lexicomp® acquired by Wolters Kluwer was used as the reference for on-labeled and off-labeled indications of the prescribed drug and its dosage. Level of evidences for applied indications and cost has also been evaluated.
Results: A total of 85 patients received rituximab during the study period. The most frequent reasons for rituximab prescription were: multiple sclerosis (50.58%), systemic sclerosis (10.58%), rheumatoid arthritis (7.05%) and Idiopathic inflammatory myopathies (4.70%).Rituximab was used in 8 (9.4%) cases according to on-labeled indications. There was level C evidence for rituximab use in off-labeled indications in 47 (55.29%) cases according to available evidences which accounts for the highest calculated cost.
Conclusion:Based on our results, rituximab was frequently administrated for off-labeled indications most of which are not supported by established levels of evidence. The total cost was higher for level C evidence indications of off labeled rituximab than for indications with a higher level of evidence (A and B). So, strong evidence is necessary for decision making regarding its effectiveness and its cost benefit.
J Pharm Care 2019; 7(1-2): 14-20.
Drug Utilization Evaluation of Two Broad-Spectrum Antimicrobials: Cefepime and Piperacillin/Tazobactam in a Teaching Hospital in Tabriz, Iran
Authors: Saleh Parviz , Hamishekar Hadi , Naeimzadeh Farnaz , Mikaili Sara , Owaysee Osquee Hamid , Rezaee Haleh
Published: October 2019

Background: The inappropriate use of antibiotic leads to microbial resistance, nosocomial infections and increased hospital costs. The present study was designed to evaluate DUE (Drug utilization evaluation) of cefepime and piperacillin-tazobactam drugs consumption patterns. Methods: This study was a descriptive and cross–sectional which performed 2014 on 140 hospitalized patients in Sina hospital Tabriz, Iran. Demographic data, duration of prescription, dose, dosage adjustment in renal impairment and accompanied prescribed antibiotics were extracted from medical files. UpToDate and American Hospital Formulary Service (AHFS) drug information 2012 were considered as standards of rational prescribing. Data analysis was performed by SPSS 18 software. Results: In 77.4% and 90% of the prescribed doses of cefepime and piperacillin-tazobactam for patients with guideline. The most common antibiotic administered with cefepime was ciprofloxacin (37 cases). In 21 patients, cefepime dosage should have been adjusted according to renal impairment, whereas it has done only in 16 (22.9%) patients. Culture was done in 60 (85.8%) cases. In 22(31.4%) patients, the result of culture was negative. Drug dosage and indication were appropriate in 34 (48%). The most common antibiotic administered with Piperacillin/tazobactam was vancomycin (45 cases). In 9 patients, Piperacillin/tazobactam dosage should have been adjusted according to renal impairment and it has done. Culture was done in 53 (75.8%) cases. In 9(12.8%) patients, the result of culture was negative. Conclusion: The results showed that there was an injudicious use of cefepime and piperacillin/ tazobactam at our hospital, evidenced by the significant number of inappropriate empiric prescriptions and drug modifications
Assessment of Prescriptions Patterns and Drug Use across the Kurdistan Region
Authors: Tawfeeq Rawaz , Tahssen Obied Tarin , Ommar Aram
Published: October 2019

Background: Errors in drug prescriptions are the most common preventable medication errors encountered in clinical practices worldwide. The purpose of this study is to examine the pattern of prescriptions and drug use in the Kurdistan region and to determine whether prescription patterns are based on rational therapeutic considerations. Methods: A cross sectional-observational study was conducted in the Kurdistan region of Iraq over a period of five months. A total of 1000 prescriptions were selected randomly from different pharmacies and data obtained from each prescription. In these prescriptions a total of 2878 medications were prescribed. After collection, excel software was then used to perform calculations. Results: The average number of drugs per prescription was calculated to be 2.8. Drugs prescribed by generic name were 27% and more than 98 percent of prescriptions were handwritten. The duration of therapy was mentioned in 56.5% of prescriptions. However, the dose and dosage form of medications were recorded 62% and 87.3% respectively. The percentage of prescriptions containing a signature was 88.1%. Furthermore, the percentage of antibiotics, supplements, non-steroidal anti-inflammatory drugs and other painkillers were prescribed at a rate of 51.8%, 44.2%, 31.8%, and 21.8% per prescription. Conclusion: Whilst observing the data we can conclude that the rate of drugs written per prescription is much higher than the suggested World Health Organization (WHO0 average. Prescribing errors are one of the most common preventable causes of medication errors and the use of electronic prescriptions may play a huge role in ameliorating this fact.
Vitamin B12 Yetersizliğine Yaklaşım
Authors: SEZGİN Yılmaz
Published: October 2019

Hayvansal gıdalarda bulunan vitamin B12; insan vücudunda iki enzim sisteminde kofaktör olarak görev alır. Vitamin B12 fizyolojik etkilerinin çoğunluğunu homosistein metiyonin döngüsüne sağladığı katkı yoluyla gösterir. Vitamin B12 yetmezliği çoğunlukla emilim mekanizmaları ile ilişkili bozukluklardan kaynaklanır ve öncelikle nörolojik ve hematolojik hastalıklar olmak üzere pek çok hastalıkla ilişkilendirilir. Ölçüm belirsizliğinin geniş olması nedeniyle serum vitamin B12 seviyesinin tespit edilmesinin yanında homosistein seviyesine de bakılması gereklidir. Son olarak vitamin B12 yetersizliğinde paranteral tedavi yaklaşımı daha doğru bir yöntem olarak kabul görmektedir.
CARTÕES MESADA PARA CRIANÇAS E JOVENS: UMA PEDAGOGIA AOS MOLDES DO TEATRO NEGRO?
Authors: Vilela Souza Lucas Vitor , Hennigen Inês
Published: October 2019

Neste artigo, analisamos redes discursivas que perpassam a disponibilização de cartões mesada às crianças e aos jovens na atualidade. Seu estudo é pertinente e relevante, pois tais discursos produzem certa forma de educar e de lidar com dinheiro/finanças. Conceitos foucaultianos, como poder microfísico e governamentalidade, constituem nossa base teórica, e recorremos à perspectiva cênica do Teatro Negro para pensar a pedagogia implicada. Tomamos como material de análise a oferta de cartões mesada veiculada nos sites do Banco do Estado do Rio Grande do Sul, da Caixa Econômica Federal e da incorporadora Visa. As análises mostraram que se enuncia uma associação direta entre cartões mesada e a educação financeira. Dentre outros aspectos, discutimos como a decisão dos pais de adotá-los para seus filhos, estimulando assim a familiarização com operações e dinheiro virtuais, pode estar relacionada à busca do incremento do chamado capital humano, que requer toda ordem de investimentos educacionais. As problematizações que lançamos não repousam sobre nenhum saudosismo, visam contribuir para se pensar uma educação num âmbito que não seja meramente instrumental, mas que articule questões como consumo, finanças, renda etc. Nesse sentido, entendemos ser fundamental romper com a “elegância cultural” que naturaliza a posse do dinheiro, lançando luz sobre esta zona “sombreada” que são as fontes e formas de obtenção do dinheiro pessoal/familiar. Nossa aposta é no sentido de trazer pontos de tensionamento quanto à governamentalidade neoliberal e seus efeitos subjetivos.
Nowe trendy gospodarcze a reguła domniemania zawarcia umowy o pracę
Authors: Gersdorf Małgorzata
Published: October 2019

Artykuł odnosi się do różnych podstaw zatrudnienia. Autorka wyraża przekonanie, że innowacyjność gospodarki wymaga zwiększenia udziału zatrudnienia zadaniowego, a do tego bardziej przystają stosunki cywilnoprawne. W tym kontekście sprzeciwia się koncepcji domniemania zawarcia umowy o pracę.
DETERMINATION OF THE QUANTITATIVE CONTENT OF LIPIDS IN A BIOLOGICAL MATERIAL BY THE METHOD OF IR SPECTROSCOPY
Authors: Bel’Skaya L. V. , Sarf E. A. , Solomatin D. V.
Published: October 2019

A modification of the Folch method has been proposed for the quantitative determination of lipids in biological material, in which, after extraction of lipids with a chloroform / ethanol mixture, lipids are determined using IR spectroscopy. The bands corresponding to the stretching and deformation vibrations of the methyl and methylene groups of lipids and fatty acids were selected as analytical absorption bands: 1396, 1458, 2853, and 2923 cm- 1. These bands do not intersect with the absorption bands of proteins and nucleic acids, thus avoiding the stage of preliminary cleaning of lipids from non-lipid impurities. A multifactor regression model was constructed, which allows experimental data to be described with an error not exceeding 12%.
DIAGNOSIS OF GIARDIOSIS IN CHILDREN: RESULTS OF A RETROSPECTIVE COHORT STUDY
Authors: Kimirilova Olga Gennadievna , Kharchenko G. A.
Published: October 2019

Giardiasis in children remains an urgent problem, the importance of which is determined by the endemicity for many countries and regions, polymorphism of the clinic, which causes difficulties in clinical diagnosis of this pathology. The report presents the results of the diagnostic significance of methods of laboratory diagnostics giardiase: microscopy of native and stained with Lugol solution preparation fecal enzyme-linked immunoassay (ELISA) for the presence of antibodies of class IgM and IgG antibodies to the antigens of Giardia in the serum and antigen of G. Lamblia in feces, polymerase chain reaction (PCR) - detection of Giardia DNA in feces obtained during the examination of 160 patients with giardiasis children aged 3 to 14 years. The results of our study suggest that the most informative methods of diagnosis of giardiasis in children is coproscopy (specificity - 96.2%, sensitivity - 98.1%), PCR coprofiltrate. (specificity - 85%, sensitivity 82.5%), determination of antigen in feces by ELISA (specificity - 87,5%, sensitivity - 60%). With high specificity of the blood ELISA method (90%), the sensitivity of the method is only 27.5%. It should be recognized that the «gold standard» diagnosis of giardiasis remains microscopy of native and stained with a solution of Lugol preparation of feces with a three - time study at intervals of 2-3 days.
MOLECULAR-GENETIC MONITORING AS THE BASIS OF MODERN EPIDEMIOLOGICAL SURVEILLANCE OF TICK-BORNE INFECTIONS
Authors: Shutikova A. L. , Leonova G. N. , Lubova V. A.
Published: October 2019

Molecular genetic monitoring of natural focal of tick-borne infections in the epidemic season of 2018 revealed infectiousness of ixodid ticks causative agents of tick-borne encephalitis (0.58% of cases), Lyme disease (31% of cases), human monocytic ehrlichiosis (1.6% of cases) and granulocytic anaplasmosis (3.9% of cases) is registered and also co-infections of ticks by these infections (2.9% of cases) is revealed in natural and anthropourgic foci (B. burgdorferi s.l.+A. phagocytophilum, B. burgdorferi s.l.+E. chaffeensis/E. muris and B. burgdorferi s.l.+tick-borne encephalitis virus). The major epidemiological importance of ticks of the species I. persulcatus is found, their share being 87,6%. The majority of patients being bitten by a tick were from the southern and southeast areas of Primorye. Contamination of ticks with Borrelia was revealed not only in I. persulcatus, but also in ticks of the Haemaphysalis and Dermacentor. The infectiousness of ticks of B. burgdorferi s.l. (42,3%), tick-borne encephalitis virus (7,7%) and A. phagocytophilum (15,4%) was highest on Russky Island.
The Use of Advertisements as Learning Materials to Enhance Critical Thinking Ability of Elementary Students
Authors: Han Kyoo-Hoon , Kim Jieun
Published: October 2019

This study devised an approach utilizing advertisements for cognitive education, particularly training to foster critical thinking ability of elementary students and conducted a field experiment to verify its educational effect. Fourteen sessions of the critical thinking education were performed over one semester geared toward elementary students in the fifth and sixth grades. Results indicated that students who received critical thinking education using advertisements made statistically significant improvements in both critical thinking skills and critical thinking dispositions, compared to students who did not receive this education. These results demonstrate that education using advertisements as learning materials can help elementary students to improve their critical thinking ability. We discussed several implications of our results for educational practice as well as directions for follow-up studies.
The role of intra- and interpersonal relations in the process of diagnosis and treatment
Authors: Stanisławska-Kubiak Maia , Warchoł-Biedermann Katarzyna , Skommer Maria , Mojs Ewa , Wójciak Rafał W.
Published: October 2019

There is an increasing tendency to adopt biopsychosocial approach to teaching how to care for patients. Participation in Balint’s groups is used to train students in communication and building relations with patients. Aim: To identify positive and negative aspects of participation in Balint’s groups, which are a part of compulsory training for students.Methods: 70 medical students, who took part in the study, filled in a questionnaire specifically developed for students participating in Balint’s group. The questionnaire consisted of three open questions. The answers were collected and then analyzed by way of qualitative analysis of text and factorial analysis Results: The results suggest that Balint’s method can be difficult for medical students because they have not practiced  building therapeutic relations with patients. Nevertheless, most students benefit from training in terms of personal development, awareness of mechanisms influencing patients – doctor communication and satisfaction with participation in classes.    Conclusion:  Balint’s Workshops is a useful method of teaching which influences medical student’s self – reflection because they become aware of the necessity of personality development.
Effectiveness of Efflux Pump Inhibitors as Biofilm Disruptors and Resistance Breakers in Gram-negative (ESKAPEE) Bacteria
Authors: Reza Akif , Sutton J. Mark , Rahman Khondaker Miraz
Published: October 2019

Antibiotic resistance represents a significant threat to the modern healthcare provision. The ESKAPEE pathogens, in particular, have proven to be especially challenging to treat, due to their intrinsic and acquired ability to rapidly develop resistance mechanisms in response to environmental threats. The development of biofilm has been characterised as an essential contributing factor towards antimicrobial-resistance and tolerance. Several studies have implicated the involvement of efflux pumps in antibiotic resistance, both directly, via drug extrusion and indirectly, through the formation of biofilm. As a result, the underlying mechanism of these pumps has attracted considerable interest due to the potential of targeting these protein structures and developing novel adjunct therapies. Subsequent investigations have revealed the ability of efflux pump-inhibitors (EPIs) to block drug-extrusion and disrupt biofilm formation, thereby, potentiating antibiotics and reversing resistance of pathogen towards them. This review will discuss the potential of EPIs as a possible solution to antimicrobial resistance, examining different challenges to the design of these compounds, with an emphasis on Gram-negative ESKAPEE pathogens.
Selection of Target Nutrients for the Nutritional Standards of School Lunches in Korea
Authors: Kim Meeyoung , Kim Dongwoo , Yoon Jihyun
Published: October 2019

The purpose of this study was to select target nutrients to be included in the nutritional standards of school lunches in Korea. The dietary intake data of children and adolescents aged 6-17 years old from the Korea National Health and Nutrition Examination Survey Ⅵ were analyzed for eight groups based on gender and age (6-8, 9-11, 12-14, and 15-17 years old). First, the usual intake of the 3,091 subjects was estimated and assessed to identify nutrients with insufficient or excessive intake prevalence. Along with the nutrients identified by the assessment, the energy and nutrients prioritized in the meal planning procedure of the 2015 Dietary Reference Intakes for Koreans were the initial candidates: energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, phosphorus, sodium, and iron. Phosphorus was excluded due to little evidence of clinical symptoms caused by insufficient intake. Sodium was excluded because reliable data on added salt were not available among the school lunch recipes in Korea. Therefore, energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, and iron were selected to be included in the nutritional standards of school lunches in Korea.
The Effects of the Justice System on the Mental Health of Plaintiffs and Defendants
Authors: Clemente Miguel , Padilla-Racero Dolores
Published: October 2019

This study aimed to assess the psychological effects of being processed by the justice system, either as a plaintiff or as a defendant. The sample consisted of 360 subjects, 32.8% defendants and 52.2% plaintiffs, residents in the Autonomous Community of Galicia (NW Spain). A lot of psychological test were administered. The results indicated significant differences between plaintiffs and defendants. The former were more pessimistic about the future, used poor strategies for protecting health, and had less empathy. In contrast, defendants had a more negative outlook on life, and in general more psychosomatic symptomology. Thus, both defendants and plaintiffs suffered health problems. Moreover, the group with the longest exposure to litigation had the worst deteriorated health. In conclusion, defendants were more pessimistic about the future, used poor strategies for protecting their own health, and showed less empathy. Likewise, plaintiffs had a more negative outlook on life, and on the whole presented more psychosomatic symptomology. Thus, both defendants and plaintiffs presented health problems. Moreover, the comparison between litigants and non-litigants showed health was more deteriorated in the former, but only in a few specific variables.
Optimal Sensing for Fish School Identification
Authors: Weber Pascal , Arampatzis Georgios , Novati Guido , Verma Siddhartha , Papadimitriou Costas , Koumoutsakos Petros
Published: October 2019

Fish schooling implies an awareness of the swimmers for their companions. In flow mediated environments, in addition to visual cues, pressure and shear sensors on the fish body are critical for providing quantitative information that assists the quantification of proximity to other swimmers. Here we examine the distribution of sensors on the surface of an artificial swimmer so that it can optimally identify a leading group of swimmers. We employ Bayesian experimental design coupled with two-dimensional Navier Stokes equations for multiple self-propelled swimmers. The follower tracks the school using information from its own surface pressure and shear stress. We demonstrate that the optimal sensor distribution of the follower is qualitatively similar to the distribution of neuromasts on fish. Our results show that it is possible to identify accurately the center of mass and even the number of the leading swimmers using surface only information.
Precision in Biostratigraphy: Evidence For a Temporary Flow Reversal in the Central American Seaway During Or After the Oligocene-miocene Transition
Authors: Fraass Andrew J. , Leckie R. Mark , Lowery Christopher M. , DeConto Robert
Published: October 2019

The Oligocene-Miocene Transition (OMT) was a time of significant oceanic, climatic, and biotic change, but there is still a great deal we do not understand about its effects, particularly in terms of ocean circulation. The Central American Seaway (CAS) was an important ocean gateway at this time; recent fully coupled modeling results have suggested a possible temporary reversal of surface flow, from westward to eastward, during the OMT. Such a flow reversal would have altered numerous oceanographic properties and the dispersal of marine taxa. Here, we find a mismatch in the timing of the Atlantic vs. Pacific first appearances of the tropical mixed layer planktic foraminifer Paragloborotalia kugleri, a key zonal marker for the OMT. The first appearance ages for P. kugleri from fourteen ocean drilling sites vary from ∼23.2–23.05 Ma in the Pacific to ∼23.05–22.7 Ma in the Atlantic. Key requirements for including a site in this compilation are: 1) sampling resolution; 2) independent non-biostratigraphic chronology, such as magnetostratigraphy or orbital tuning; and 3) a preference for shore-based biostratigraphic analyses rather than shipboard estimates. Although we explore alternative explanations, we conclude that, given the restricted nature of the CAS gateway, timing of dispersal, and results from previous modeling efforts, CAS flow reversal is the most parsimonious explanation for the delayed first appearance of P. kugleri in the Atlantic relative to the Pacific. We suggest that after originating in the tropical Pacific, P. kugleri was initially blocked from dispersal into the Atlantic by westward surface circulation through the CAS during the latest Oligocene. During the OMT, circulation reversed and Pacific surface water flowed through the CAS into the Atlantic, allowing P. kugleri to disperse into the Atlantic. Previously published ocean-climate simulations suggest that the cause of this reversed flow may be related to the progressive constriction of Tethys and opening of the Drake Passage at the time of the OMT, compounded by a short-lived glaciation event in Antarctica and possible change in meridional temperature gradient and prevailing wind patterns in the tropics.