bluuebunny/crossref_metadata_2025 huggingface dataset:
A Double-Blind Placebo-Controlled Trial of levetiracetam for Global Severity in Child Autism Spectrum Disorders
Authors: Aliyev N. A. , Aliyev Z. N.
Published: March 2019

Objectives: The effects of levetiracetam and placebo on global severity were compared in Child Autism Spectrum Disorders (ASD). Materials and methods: Childs with ASDs were enrolled in a 12-week double-blind placebo-controlled levetiracetamtrial. Fifty were randomly assigned to levetiracetam (n=50) or placebo (n=50).The mean maximum dosage for levetiracetamwas 950.50±279.19 mg/day Repetitive behaviors were measured with the Clinical Global Impression (CGI) improvement scale. Results: There was a significant treatment-by-time interaction indicating a significantly greater reduction in repetitive behaviors across time for levetiracetamthan for placebo. With overall response defined as a CGI global improvement score of 2 or less, there were significantly more responders at week 12 in the levetiracetamgroup than in the placebo group. The risk ratio was 1.5 for CGI global improvement (responders: levetiracetam, 50%; placebo, 10%). Side effects were not observed. Conclusions: levetiracetamtreatment, compared to placebo, resulted in significantly greater improvement in global severity behaviors, according to CGI rating scale. levetiracetamappeared to be well tolerated movement score of 2 or less, there were significantly more responders at week 12 in the levetiracetamgroup than in the placebo group. Side effects were not observed.
Utility of Ultrasonographically Guided Fine Needle Aspiration Cytology in the Diagnosis of Hepatic Masses
Authors: Saldanha, Dr. Prema , Abdulla Dr. Thahseena
Published: March 2019

Background: With technological advances in imaging, previously inaccessible lesions can now be safely sampled by Fine Needle Aspiration Cytology (FNAC) under radiological guidance. It is also possible to ensure a more accurate diagnostic yield often providing an unequivocal diagnosis in both neoplastic and nonneoplastic conditions. This study was done to assess the role of Ultrasonographic (USG) guided FNAC in the evaluation of hepatic masses. Methodology: USG-guided FNAC was done in patients with hepatic masses. The smears made were stained by the Papanicolaou stain and the cytological features were studied. Relevant clinical data and laboratory investigations which corroborated the diagnosis were recorded. Results: A total of 90 liver aspirates were included in the study. Out of these there were 29 cases of hepatocellular carcinoma. In all the cases except one, the serum alpha fetoprotein levels were found to be elevated. There were 49 cases of metastatic tumors, in which the primary site was not known in 15 cases. The morphology of these secondary tumors was that of an adenocarcinoma. In the remaining 34 cases the primary tumor was found in various organs including the lung, pancreas, stomach, small intestine, breast, ovary, oral cavity and thyroid. There were six non-neoplastic lesions including regenerative nodules, hydatid cyst, tuberculosis, and abscess. In six cases the material was inadequate for definite diagnosis. Conclusion: USG-guided FNAC is a rapid, inexpensive and relatively safe technique for making a cytological diagnosis. A high degree of accuracy due to precise localization of the needle can be achieved and requires close co-operation between the clinician, the radiologist and the pathologist.
Comparison of two Radiometers in the Validation of the Irradiance Emitted in the Light Curing Apparatus of the Faculty of Medical Sciences and Health of Juiz De Fora /SUPREMA
Authors: Miranda Dr. Diogo de Azevedo , Santos Souzai Andressa dos , De Souza Marianna Lessa , Da Costa Paula Bedeschi Roman
Published: March 2019

Introduction: For better clinical execution, the performance of LED light curing agents is gaining space in dentistry. For a better efficiency of the photopolymerizers, the intensity of the light through the radiometers must be validated with the constant periodical maintenance so that the emission of light is within the standards of irradiance established by the manufacturers. Objective: To compare the irradiance measured by two Ecel RD-7 and SDI radiometers, respectively. Method: 8 Bluephase-based photopolymerizers were used when the batteries were fully charged. For each apparatus were measured three readings and then averaged. Results: The exploratory analysis of the data indicated homoscedasticity, that is, there is a significant difference between the variances of the two devices. Conclusion: The Ecel RD-7 radiometer with rechargeable battery presented better results than the SDI radiometer.
Zika Virus: A Current Public Health Challenge in India
Authors: Bhutia Sonam Yangchen
Published: March 2019

Zika virus disease (ZiV), a mosquito borne re-emerging disease in India transmitted by a vector aedes with an agent flavivirus in Brazil 2015 has spread to various parts of the countries where WHO has declared it as a global health concern. India with a favourable climate and geographical location with increase distribution of aedes species can result into increase outbreak of Zika virus diseases along with malaria, japanese encephalitis, chikungunya, dengue and scrub typhus in the future. This review states on current global incidence of Zika, epidemiology, mode of transmission, clinical manifestations, complications, diagnosis, treatment and its preventive measures and the threats and challenges of Zika virus disease in India.
Psychiatric Comorbidity among Non-Injecting Opioid Users
Authors: Sidhu Nittu , Garg Parshotam Dass , Singh Manjit
Published: March 2019

Background - Psychiatric comorbidity is strongly associated with opioid use. The earlier studies have focused on injecting drug users and their associated psychiatric comorbidities, while little attention is made on the other group, non injecting drug users. The aim of the study is to focus on socio-demographic profile and psychiatric co-morbidities among the non injecting opioid users. Material and Methods - The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 150 patients was taken who fulfilled the criteria of opioid dependence using ICD 10 criteria. MINI (Mini International Neuropsychiatric Interview) was applied to study the psychiatric co-morbidity among the non injecting opioid users. Statistical Analysis - Data was analysed using SPSS software version 21.0. Results - The mean age of the subjects was 31.74 ± 8.64 years. The majority of subjects were male, married, employed. Majority of subjects had used the opioids for less than 5 years. Heroin was the most commonly used opioid followed by tramadol followed by synthetic opioids. Anxiety disorders were the most common psychiatric comorbidity followed by depression. Conclusions - There is high prevalence of psychiatric co-morbidity in the non injecting drug users which is often ignored which leads to poor treatment outcome. Hence there is more need for screening and assessment of psychiatric disorders in non-injecting opioid users.
Role of Ultrasonography in Diagnosing Acute Cholecystitis and Correlation with Intra-operative Findings
Authors: Singh Bal Jaskaran , Kapoor Sudershan
Published: March 2019

Background: 90-95% of cases of acute cholecystitis are caused due to gall stones, i.e. calculous cholecystitis. Rest of the 5-10% cases are caused without the presence of stones, i.e. acalculous cholecystitis. Diagnosis of acute cholecystitis involves clinical, laboratory, and radiographic findings especially by ultrasonography. The aim of the study is to evaluate role of ultrasonography in diagnosing acute cholecystitis and correlation with intra-operative findings. Material and Methods: The present study was conducted in the Department of Surgery, Govt. Medical College, Amritsar. A sample size of 50 patients was taken who were diagnosed as cases of acute cholecystitis either clinically or radiologically referred to the department. Results: The mean age of presentation was 54.94 years. It was more common in females than males and more common among married females. On USG abdomen, 92% cases had calculous cholecystitis and 8% had acalculous cholecystitis. Intraoperatively, most common finding was adhesions. It was present in 40 patients (95.24%) and increased wall thickness was present in 37 cases (88.09%). The sensitivity and specificity of ultrasonography in our study was 97.62% and 62.5% respectively. Conclusion: The number of patients presenting with acute cholecystitis is increasing because of the increased awareness. With improved healthcare facilities and newer techniques, complications have declined substantially with reduced mortality and morbidity.
Marijuana: To Use or Not to Use
Authors: Banzal Sonal , Kabadi Dr. Udaya M
Published: March 2019

Several state legislatures legalized marijuana for medicinal and recreational purposes despite federal government’s refusal to decriminalize it. Moreover, usage by over 9 % of population ages  12 years documented by CDC in 2016 may have promoted smuggling across state lines.[1,2]
Knowledge and Attitude on Pain Management among Final Year Nursing and Midwifery Students of Khesar Gyalpo University of Medical Sciences of Bhutan
Authors: . Kuenzang , Pokhrel Hari Prasad , Sherpa Passang Lhamo
Published: March 2019

Pain management is the most important component of nursing care process and it is crucial for nurses to have a good level of knowledge on pain management. A cross-sectional study was conducted among 44 final year General Nursing and Midwifery students at the Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan in May 2016. Independent samples T- test was used to assess the association. The mean (SD) age of the respondents was 22.66 years (1.26). Over two-thirds (81.8%) of the participants had a poor level of knowledge and a majority (90.9%) of them had never been posted to a pain clinic. Over a half of them (56.8%) had negative attitude towards pain management. Independent samples t-test detected a significant difference in the mean knowledge scores between students who regularly used pain assessment scales and those who did not use the scales respectively. The study recommends to include pain management as a standalone module to better equip the nurses with knowledge on pain management. Mandatory posting of the students in pain clinic will provide the students with an opportunity to practice the skills.
Use of Chlorhexidine Solution as an Additional Step in Combination with Conventional and Two or Three Step Adhesive Systems
Authors: Miranda Diogo de Azevedo , Bartocci Ana Paula
Published: March 2019

Adhesion to dental tissues is one of the main lines of research today, mainly the chemical evolution of adhesives, which allowed the restorative procedures to be performed with greater speed and predictability1. Bonding to dentin is a unique form of tissue engineering in which a matrix of demineralized collagen with residual crystals of hydroxyapatite is used as the basis for the infiltration of resinous monomers, forming the hybrid layer. Most adhesive systems currently available on the market produce good initial bond strength values, allowing the clinician to stick to the dental structure without the need for retentive preparation.
Tumor-Infiltrating Lymphocytes in Breast Carcinoma: Immunohistochemical Analysis
Authors: R. Rajhans, MD Dr. Amol R. , Howale Dr. Deepak S.
Published: March 2019

Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, after lung cancer. Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin. In 2017, around 252, 710 new diagnoses of breast cancer are expected in women, and around 40,610 women are likely to die from the disease. Awareness of the symptoms and the need for screening are important ways of reducing the risk. Material and Methods: This retrospective study was carried out in the department of Pathology, DCP Consultant Pathologist Shashwat Hospitals, Pune, a total of 38 retrospective breast carcinoma tissues were obtained from female patients. Representative paraffin blocks and haematoxylin and eosin (HandE)-stained sections were retrieved from the pathology department. The patients' records were reviewed to look for the patient age and the clinical stage of the disease. The stage of the cancer was reported according to the American Joint Committee of Cancer. As tissue and patient data was collected in an anonymous way no written or informed consent was required for the study purpose. Results and Observations: According to data by clinical staging Stage I, Stage II, Stage III and Stage IV were 16 (42.11%), 11(28.95%), 7 (18.42%) and 4 (10.53%) respectively. According to histology Stage I, Stage II, Stage III and Stage IV were 2 (5.26%), 11(28.95%), 24 (63.16%) and 1 (2.63%) respectively. Hand E-stained sections showed that tumour-infiltrating lymphocytes (TILs) were present in 31 of the 38 carcinomas (81.58%). Majority of theTILs were T lymphocytes and was present in all 31 cases. CD4+ cells were seen31 patients and CD 8+ were seen in 25 cases. B cells were seen in 21 cases. TILs were analysed according to the clinical stage of breast cancer, stages III and IV tumors showed significantly higher densities of total lymphocytes, T lymphocytes, and CD4+ lymphocytes as compared to stage II tumors. Lymphocyte immuno phenotypes and the total TILs also showed a high significantly positive correlation between each lymphocyte population/subpopulation and the total TILs. Conclusion: T and B lymphocytes were expressed in breast carcinoma with High prevalence of T lymphocytes CD4+ cells. However larger no of cases are required to confirm the findings and extensive large studies are required.
Pulmonary Complications and Critical Care in Cancer Patients
Authors: Darmi, MD Dr. B. A.
Published: March 2019

Cancer refers to the condition where abnormal proliferation of cells occurs overriding the natural check of cell death.[1] As a normal physiological process, all cells of our body are programmed to die - called as apoptosis.[2] In cancer, the balance between cell proliferation and cell death is disrupted, resulting in uncontrolled division of cells.[3] Hence, apoptosis is an anti-cancer defense of body. In other words, carcinogenesis involves sequential genetic change that transforms normal cells to malignant cells. The cancer cells interfere with normal physiological functions and kill by invading various body organs vital for living. Cancer is a second leading cause of death worldwide, estimated to kill 9.6 million people in 2018.[4] Approximately, every sixth death is caused by cancer.[4] Globally, most common cancers are lung, breast, colorectal, prostate, skin and stomach cancers.
Spontaneous Ureteral Rupture Secondary to Obstructing Stone
Authors: Sudhir, MD Dr. B. K.
Published: March 2019

Rupture of the urinary collecting system with or without perinephric extravasation is a rare occurrence and usually known to occur following an obstructive pathology.[1,2] Here we present a case of distal 6mm calculus in otherwise normal kidney in elderly male, presenting secondary to ureteropelvic junction rupture.
Effect of Exercise and Zoledronic Acid on Lipid Profile and Bone Remodeling in Ovariectomized Rats
Authors: Khashaba, M.B.B.CH. MD. PhD Ahmed Sayed , Al Batati Fawaz Salem , BDS, MSc Abdulrhman Al Saffan
Published: March 2019

Exercise (EXE) and amino-bisphosphonates (BP) are both considered as useful strategies in the prevention of post-menopausal bone loss. Exercise reduces lipid levels, and BP may induce increase in high-density lipoprotein cholesterol (HDL-C). We hypothesized that combined effects of BP and exercise would produce a better improvement of lipid profile. (Dolléans, 2010)

 Non pharmacological prevention of osteoporosis fracture by physical activity and particularly regular exercises (EXE) characterized by impact or loading is currently recommended.The effect of regular exercise on the Lipid profile has been developed in a lot of studies It has been recently demonstrated that increasing steps walked may have beneficial effects on serum lipids and thus may decrease the cardio vascular disease risks. Conversely, physical activity, and more specifically mechanical stress, has been shown to induce an osteogenic effect mediated by osteocytes and osteoblasts. (Howe, 2011)

 Sixty 6-month old Wistar female rats were maintained under the standard environmental conditions of light and temperature, (12 h light: 12 h dark photoperiod, at 24 ±2 oC) with free access to water. They were divided into 3 groups according to methods of induction
Healthcare Associated Urinary Tract Infections in Medicine Wards
Authors: Sawarkar Dr. Mahendra M. , Sawarkar Dr. Shushrut Mahendra
Published: March 2019

Health care associated infections (HCAIs) or hospital acquired infections (HAIs) are infections that occur during hospitalization but they are neither present nor incubating before hospital admission. Rapid advancement in medical technology, injudicious use of antibiotics and better adaptation of organisms to the hospital environment contribute to increase in HAIs. Healthcare-associated urinary tract infections (HAUTIs) are frequently increasing and largely preventable infections affecting the provision of healthcare. Material and Methods: Cases included patients admitted in wards of medicine department. Inclusion criteria: included patients are who were admitted for at least for past 48 hours, or readmitted in less than 14 days after their discharge from hospital. Confirmed HAI was defined as clinical signs and microbiological confirmation; potential HAI: association of several clinical signs with no microbiological confirmation; less potential HAI: a single clinical sign with no microbiological confirmation; no potential HAI: no clinical signs. Sociodemographic data from all the included patients was confirmed from medical records. All clinical history was obtained from the patients. Signs of HAI were observed and recorded. Results: A total of 528 patients were included in the studies who were admitted in the medicine wards. Of the 528 patients 276 (52.3%) were male and 252 (47.7%) were female. 87 patients were diagnosed as HAI patients of which 37 (42.5%) were male and 50 (57.5%) were female. Mean age of HAI patients was 51.3 ± 15.74 while total mean of age was 44.2 ± 24.77. Mean age of male with HAI 49.5 ± 11.99 and female was 52.4 ± 13.47. Of the total 10 culture positive patients with HAI Escherichia coli was isolated in 3 cases, Klebsiella pneumonia, Pseudomonas aeruginosa and Staphylococcus aureus were isolated in 2 cases each. While Acinetobacter spp. was isolated in 1 case. Conclusion: This study shows the prevalence of HAI in Urinary tract infection as 15.3% which was quite high but there is no mortality due to UTI and HAI. Periodic active surveillance over a longer period is required to evaluate the efficacy of preventive measures.
Women with Severe Anemia in Labor: Adverse Clinical Outcomes
Authors: Singh Dr. Ruchika , Gupta Dr. Mamta , Saini Dr. Vandana
Published: March 2019

Background: Severely anemic women in labor is a challenging situation for the obstetrician with increased perinatal and maternal morbidity and mortality. Methods: Evaluation of feto-maternal outcomes in women reporting in labor with severe anemia (group A, n=50) and without anemia (group B,n=50) was done. Results: No maternal mortality and still birth was observed in any of the group. Preterm labor pains, hypertensive disease, occurred more in group A (p value 0.003, 0.037 respectively). Blood transfusion was the commonest intervention required. Congestive heart failure developed (CHF) in 3 women in group A and none in group B. Mean birth weight was more in group B (p value 0.002). Birth asphyxia and NICU admissions were more in group A neonates (p value 0.012, 0.017 respectively). Puerperal morbidity was high in group A women (p value 0.001). Eight women had severe maternal morbidity and 1 woman had near miss event in severe anemia group. Conclusions: Severely anemic women reporting in labor have high maternal and perinatal morbidity.
Trend of Mantoux Positivity in a Tertiary Health Institution in Nigeria: A Secondary Data Analysis
Authors: Edokwe Genevieve , Ojule Inumanye N. , Tobin Alafaka
Published: March 2019

Background: Mantoux test is the most widely used screening test that aid diagnosis of latent tuberculosis infection (LTBI) especially in resource poor countries. This study aimed to determine the seven year trend of Mantoux test result at the University of Port Harcourt Teaching Hospital, Rivers State Nigeria. Methods: A secondary data analysis was carried out on abstracted data from 2011 to 2017 in the Mantoux result register. Descriptive statistics was computed for all categorical variables. Chi-square of trend was used to assess significant differences in positivity. P-value less than 0.05 was considered significant. Results: Using a cut-off point of   ≥10 mm diameter, a total of 5863 clients were screened for TB. Chi square for trends showed statistical significant decreasing proportion of significant Mantoux reaction status among clients over the study period. Conclusion: The study showed a high prevalence of negative Mantoux reaction compared to positive reaction. Trend analysis showed a notable downward plunge of significant Mantoux positivity. The trend was towards continuous reduction in Mantoux test result positivity suggesting a tailing of LTBI in this region.
Expression of Mesothelial Marker Calretinin in Breast Cancer
Authors: Aboobacker Dr. Kalathingal Kamarunisha , Saldanha Dr. Prema
Published: March 2019

Calretinin (CR) is a calcium binding protein of calmodulin superfamily, a widely used marker for mesothelial differentiation. It is also found to be expressed in breast carcinoma. Breast carcinoma is the leading cause of cancer death in women and despite new approaches and advances, it is still difficult to predict the behaviour of the tumour and its prognosis. So there is a need and struggle to identify new markers for prognosis of breast cancer. The study is aimed at evaluating the frequency of Calretinin expression in breast carcinoma and assessing the characteristics of Calretinin positive tumours. Thirty mastectomy specimen of invasive breast carcinoma were analysed histopathologically and for immunohistochemical expression of ER, PR, HER2/neu and Calretinin. In this study 93.33% (28 cases) were of invasive carcinoma, NST and 6.67% were of other subtypes. Patients less than 40 years of age showed low CR expression and patients over 40 showed high CR expression (p = 0.22). Grade 3 tumours showed high CR, grades 1 and 2 showed low CR expression. Lymph node positive cases showed high CR and lymph node negative cases showed low CR. Tumours less than 5cms in size show low CR expression and those over 5cms showed high CR expression (p = 0.38). Negative ER, PR and HER2/neu showed high CR expression. CR expression was high in 54.5% of basal-like subtype and 66.7% of HER2-enriched.CR expression was low in 50% of luminal cases. High Calretinin expression was seen in grade 3, HER2-enriched and basal-like subtypes of breast cancer which may be of considerable prognostic significance.
A Multi-centered Study to Evaluate the Efficacy and Safety of Amitriptyline and Mecobalamine in the Management of Neuropathic Pain
Authors: Kiran Dr. Mayuresh Dilip , Sheikh Shaheen Naseem , Pawaskar Lalit Jeeevan
Published: March 2019

Introduction: Neuropathic Pain (NP) is known as ‘nerve pain’- is a type of chronic pain that occurs when nerve in the central nervous system becomes damage or injured. An FDC of Amitriptyline a neuroanalgesia and Mecobalamine (Vitamin B12) a damage nerve rejuvenator have an important role in management of NP. Methodology: Of 786 registered, 666 patients completed the study. Efficacy assessment was made by reduction in mean VAS score and ≥50% reduction in NP was calculated at conclusion visit and used to determine the corresponding NNT which was calculated by using risk reduction. Safety assessment was made by inspecting the adverse events during trial. Results: Reduction in mean VAS score was from 7.3 (baseline) to 5.6 (day 30) and 3.9 (day 45). Nearly all the patients had experience ≥50% reduction in NP and NNT score of 1.21 which was calculated by using risk reduction parameter at conclusion visit. Overall 236 patients experience adverse events and were of mild to moderate intensity, sedation and drowsiness being dominantly seen. Conclusion: A combination of Amitriptyline and Mecobalamine was efficacious, safe and well-tolerated in management of Neuropathic pain (NP).
Determination of Biofilm Formation between Different Strains of Propionibacterium acnes Using Biofilm Assay
Authors: N. Yusufu, W. , O. Suleiman, H. , Y. Akwa, V. , L. David, D. , A. Taiga,
Published: March 2019

Propionibacterium acnes (P. acnes) a member of the normal flora of the skin has constantly been associated with deep tissue infections especially during medical processes. P. acnes have been isolated in deep tissues and are believed to be an aetiological agent in these infections, contributing to the progression of some of these diseases. The biofilm formation ability between different strains of P. acnes was determined. Ten (10) P. acnes clinical isolates were considered, two (2) from acne vulgaris and eight (8) [two (2) per recA types 1A1, 1B, II and III] from lumber herniation tissues. Semi quantitative biofilm analysis using the microtiter plate assay was used with some modification. The semi quantitative biofilm assay was done in triplicates. The result obtained from the biofilm triplicates from 4 days’ incubation using 3 days’ culture showed that isolates 17(IB), 82(IB) and 55(II) showed very high biofilm production for 2 replicates which implies that they are real biofilm producing isolates. Using overnight cultures, higher biofilm production was witnessed with isolates 1(III), Lesion 7 and 84 (IA1) being the highest biofilm producers. Although with 3 days’ culture, isolate 1(III) could easily be discarded as a-non biofilm producer, while lesion 7 and 84 (IA) has been associated to biofilm formation in 3 days’ culture. The production of biofilms by isolates supports the theory that the ability of P. acnes to form biofilms enables it to attach to medical implants hence causing deep tissue infections.
Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia
Authors: I. Kjaev , D. Milkovski , D. Karadjova , S. Atansova Kjaeva , A. Daneva , J. Kjaeva Nicichka , R. Spasova , G. Kocoski
Published: March 2019

Introduction: Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with gestational hypertension/preeclampsia. Aim: The aim of the study is to show that some of the heart changes in pregnancies complicated with gestational hypertension and preeclampsia are abnormal and further follow up of these patients is needed. Methods: A total of 81 patients were enrolled in the study. The patients were further divided in two groups. Pregnant women with gestational hypertension or preeclampsia (51) and a control group of normotensive pregnancies (30). A total of 3 echocardiograph exam were made, the first upon entry in the study (28 -34 g.w), the second 2 weeks after delivery and the last 6 months after delivery. Results and discussion: We found several statistically significant results that involve the IVS, PWLV, LKM, left chamber hypertrophy and diastolic function. Diastolic dysfunction usually shows up before systolic dysfunction in the evolution of ischemic/hypertensive cardiovascular disease and is of prognostic value in predicting long term cardiovascular morbidity. The changes seen 6 months after delivery on our last control mean that those changes are permanent and need further prevention strategies. Conclusion: From the noninvasive methods echocardiography is the most favorable method in identifying structural changes and functional changes in pregnancies with hypertension. Echocardiography allows fast, reproducible information and is both safe for mother and fetus.
Protein-Energy Intake, Sleep Quality and Quality of Life Before and After Bariatric Surgery: The Malaysian Context
Authors: Poh Yue Tsen , Gee Tikfu , Awang Raflis Ruzairee , Mohd Yusof Barakatun Nisak Binti , Shu Yu Lim , Leng Ang Yeu , Jia Ying Soo , Wei Lee Yu
Published: March 2019

Background: This prospective observational study aimed to determine the impact of bariatric surgery on the protein-energy intake, sleep quality and quality of life (QOL) of bariatric surgery patients in Malaysia.

Methods: The study evaluated 52 morbidly obese patients who underwent bariatric surgery. The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF), Epworth Sleepiness Scale (ESS) questionnaire and three days 24-hour diet recall were used to evaluate the health-related QOL, sleep quality and protein-energy intake of patients. Patients were interviewed before and 3 months after surgery.

Results: The mean age was 42 years and 69.2% of them were female. The mean BMI was 42 kg/m2. Patients with morbid obese had significantly lowered QOL scores, mean intake of 1898 kilocalories and 75 g protein per day before the surgery. The reduction of weight after bariatric surgery showed an increase in QOL score in all areas (P < 0.05) and a decrease on ESS score from 6.3 ± 4.0 to 2.9 ± 2.3 (p < 0.00). The mean intake 3 months after surgery was 718 kilocalories, 39g protein per day.

Conclusion: Bariatric surgery is proven effective in achieving significant weight loss, improving sleep quality and QOL among Malaysian obese patients within 3 months of surgery. However, the newly restricted stomach after bariatric surgery significantly reduces food intake in the first 3 months. Therefore, a more careful follow-up with patients is required.
Efficiency of Multislice Computed Tomography in Diagnosis of Coronary Artery Disease compared to Cardiac Catheterization
Authors: Elhussein Nagwan , Ahmed Rania Mohammed , AL-Thobity Rawan , Al-Qurashi Hadeel , AL-Sulimani Shahad , AL-Turgi Shmookh , AL-Zaidi Wasyf , Al-Sufyani Basma , Kazim Mameedullah
Published: March 2019

Coronary artery disease (CAD) is a leading cause of mortality and morbidity in developed countries, although percutaneous coronary intervention and coronary artery bypass grafting have developed recently, also multislice computed tomography has been accepted tool for diagnosing of (CAD). Objective: To assess the efficiency of multislice computed tomography in diagnosing coronary heart disease compared with cardiac catheterization. Method: This retrospective study was conducted at Alhada Military hospital in Taif City, Saudi Arabia, in radiology and cardiac catheterization departments during period from January to April 2018. The study was done by collecting of 51 patients reports of computed tomography and coronary artery catheterization most of them complain of chest pain. Data was analyzed using statistical package for social sciences program (SPSS) version 21.00. And achieved in tables and graphs in percentages according to the age, gender, patient history, symptoms, CT finding and catheterization finding, from the check list. Results: The most common affected age group was (61-80)y, male were (52.9%), the most complain was chest pain. CT scan positive findings were found to be in (72.5%) of the patients, while the cardiac catheterization diagnosed (CAD) in (68.6%) of the patients, there are statistical significance difference between the CT and cardiac catheterization finding (P=0.00), but there were no statistical significance difference between cardiac catheterization finding with age and gender among study sample. Conclusion: CT scan can accurately diagnose the coronary artery disease, which is an ideal non-invasive technique compared with cardiac catheterization.
Prevalence and Vulnerability to Drug Abuse among Students of High School and Colleges in Riyadh, Saudi Arabia: Cross-Sectional Study
Authors: Khader, Pharm. D, BCPS Khadeejeh , Mohamed, Pharm. D. Alaa , Almesned, Pharm. D. Nahla , Alrukiti, Pharm. D. Nourah , Zayed, Pharm. D. Alaa , Alghamdi, Pharm. D. Beshaier , Al Shehri, Pharm. D. Hind
Published: March 2019

Background: Drug and substance abuse is a significant burden worldwide. This problem affects many families in each community in a way or another. By the end, the misuse of these substances can lead to health associated problems in addition to social, economic, and legal issues. The Students’ susceptibility to drug abuse depends on different factors such as low self-esteem or to gain acceptance. Objectives: To compare the attitude of drug abuse between high school students and college students and to assess the common reasons that led to increase number of abusers. Methods: The study was conducted between February and May 2018 in Riyadh city on colleges and high schools students. A sample of 935 students aged between 15 and 25 years were randomly selected by distributing an online self-administered questionnaire for data collection. Results: The overall prevalence of drug abuse in Riyadh city was 18.94% among high school students (8.07% and 10.87% female abusers) and 24.14% among college students (13.87% male and 10.28% female abusers). A significant relationship was found between abuse and being a male students in college. The prevalence was different for high schools, the most widely abused substance was alcohol (44.5%) followed by Hashish (40.19%). These were used for different reasons the most common was for fun followed by escaping from problems. Conclusion: The study demonstrated that college students have higher prevalence and vulnerability to drug abuse than high school students, with the most commonly used substances being Alcohol and Hashish. According to our findings, the main reasons behind students’ abuse of drugs are due to boredom thus wanting to have fun and having problems so they escape from them by drugs. Due to the prevalence of drug abuse and the various reasons behind it as demonstrated in our study, we believe that parents should be more involved with their children’s lives, students should be encouraged to have hobbies in their spare time and guidance should be provided for them in order to learn how to deal with their problems correctly.
Indications and Complications of Stoma Formations in Emergency Surgery
Authors: Dincer Mürsit , Çıtlak Gamze
Published: March 2019

Introduction: Colorectal cancers are the second leading cause of cancer death in Europe. Colonic emergencies are associated with high morbidity and mortality. The aim of this study was to discuss the ostomy indications, stoma preferences and the early stage results of these operations. Methods: The cases who underwent emergency operation were investigated retrospectively. Demographic characteristics, surgical indications, preferred type of stoma, postoperative early stage complications were analyzed. Results and Conclusion: As a result, the stoma still maintains its importance in colorectal surgery. Frequencies are preferred to minimize morbidity in emergency surgery procedures. The operations at the right time with the right indications are life-saving.
Precision Medicine: Omics-tailored Clinics
Authors: Acuner-Ozbabacan Saliha Ece
Published: March 2019

We are now in a data-driven biomedical era in which the aim of precision medicine is to collect, investigate and interpret the omics data effectively and integratively to be able to implement the results in healthcare with high accuracy. Recent promising applications show that molecularly classifying a disease into subpopulations is beneficial for both patients and drug developers.
The Need for Development of Medical Genetics and Genomics Curriculum for Medical Schools in Saudi Arabia
Authors: Al-Harbi Khalid M.
Published: March 2019

Next generation genomic tools including dense SNP arrays and high throughput sequencing technology have led to the exponential increase in delineating genetic defects in rare as well as common genetic disorders. Advanced genetic tools have found clinical applications in almost all areas of medicine specifically in clinical diagnostic setting. Genomic testing has entered clinical practice and physicians are using genomic information to guide treatment options. Medical schools throughout the world have integrated medical genetics and genomics courses in the curriculum to prepare medical students and future physicians to understand the role of genetic factors in human health and disease. However, in Saudi Arabia, the existing undergraduate curriculum in most of the medical schools is insufficient to prepare medical students to cope with rapidly advancing genomic science. Moreover, the majority of medical schools in Saudi Arabia have no geneticist as an academic staff, and where there are such academician available relatively less teaching time is allocated for them and negligible use is made of their specialized knowledge. Overall in Saudi Arabian medical schools, little genetics teaching is given to medical students. An objective oriented genetic and genomic course need to be integrated in medical school curricula which would subsequently prepare generation of the student who can develop a critical understanding and knowledge of core concepts in medical genetics and genomics.
Cyanoacrylate Vein Glue and Allergy - A Real Problem ?
Authors: Saphenion Dr. Ulf Th. Zierau
Published: March 2019

Vein Glue and allergy - is there a significant risk?

In a few specialist comments and articles by phlebologically active colleagues is repeatedly warned against the emergence of an allergy to the cyanoacrylate used in the vein glue. Reason enough for us to compare our own experience with the use of the vein adhesive with the worldwide specialist literature.
New Technique for Controlling Bleeding in Laparoscopic Liver Resection
Authors: Masoni Luigi , Landi, MD Leandro , Maglio, MD Riccardo
Published: March 2019

Introduction: The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection.

Controlling bleeding during laparoscopic hepatectomy(LH) is technically demanding, but reportedly associated with less estimated blood loss (EBL) than open surgery. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy.

Case presentation: The present study aimed to describe and evaluate hemorrhage control techniques during left lateral partial segmentectomy with use of endoscopic clips.

Conclusion: control of intraoperative bleeding it is the most important aspect in liver resection. we propose a new technique for controlling bleeding in restricted operating spaces.
MARKETING-RESOURCE APPROACH TO CRISIS MANAGEMENT OF A PRIORI UNSTABLE SOCIO-ECONOMIC SYSTEMS
Authors: Gubin Victor Anatolyevich , Khandamova Eva Frizovna , Shchepakin Mikhail Borisovich
Published: March 2019

The article highlights instability of the socio-economic environment of the national economy as a result of asymmetry of marketing behavior of entities, government and business that arises in the process of growing internal and external motivational and resource contradictions between them. There has been substantiated the problem of generating recessionary processes and phenomena in the economy because of the unbalanced motivations of stakeholders to achieve the consensus. The problems of low economic growth are indicated as a result of ignoring the interests of the lower stratification classes and underestimating the impact of the human factor on positive changes in all spheres of society. The generalized characteristic of crisis processes and phenomena in the national economy has been given. The sources of economic growth potential formation have been shown. The results of analyzing the enlarged factor groups that affect economic growth in the national economy and the development of enterprises have been presented. The law of marketing reflection as an instrument of economic development management has been formulated. Strengthening the competitive position of the business sector in unstable economy is noted to require the greater influence of government intervention into the processes of transformations and changes in society and business on the basis of resolving the conflicts between the entities in terms of strengthening the social vector of development. There has been proposed the marketing and resource approach to crisis management in conditions of a priori instability that provides changing the marketing behavior of entities in terms of resource limits and manifestations of the recessionary trends. The model of economic growth management in the socio-economic system as an element of crisis management in conditions of a priori instability has been presented.
FORMING COMPETITIVENESS OF MOTOR TRANSPORT SERVICES AT DIFFERENT HIERARCHICAL LEVELS OF ECONOMIC MANAGEMENT
Authors: Rayushkina Alevtina Anatolievna , Morozova Irina Anatolievna
Published: March 2019

The article considers the problem of competitiveness of motor transport services in the context of hierarchical levels of economic management. Resource, operational and strategic competitive advantages of subjects-operators of the market of motor transport services on nano-, micro-, meso-, quasi-, macro- and megalevel have been allocated. The level of competitiveness of road transport services at a particular time is determined not only by competitive advantages of the subjects-operators of the market of motor transport services, but also by the joint impact of many factors on their activities. Research and analysis of these factors can determine whether they contribute to or hinder the achievement of the higher level of motor transport service competitiveness. There has been carried out the comparative analysis of forming road transport service competitiveness. It has been stated that at all levels of economic management the process of forming the competitiveness of motor transport services is specific. Presented typology of competitiveness of motor transport services at different levels of economic management acts as a methodological approach which contributes to theoretical justification of the concept of “competitiveness of motor transport services”, allows better assessing the activities of competitors. Besides, this approach enables the subject-operator of the market of motor transport services to navigate with greater accuracy for further operation in order to obtain advanced results due to using its competitive advantages. In the conditions of rapid innovative development of integration processes of the world economy, marketing to a large extent determines the level of competitiveness of motor transport services. Thus, the process of developing and realization of marketing strategies for improving competitiveness of motor transport enterprises is very important.
IMPERATIVES OF LABOUR PRODUCTIVITY RISE IN THE RUSSIAN ECONOMY
Authors: Reshetilo Tatiana Vasilyevna , Chernova Tatiana Vasilyevna , Maksimenko Tatiana Sergeyevna , Oleynikova Irina Nickolaevna
Published: March 2019

Policy of sustainable growth that aims to foster wellbeing of the population and to develop competitiveness of the Russian economy should strive to achieving quality and quantity standards. The labor productivity index takes the strategic point in the system of analytical indicators of assessing the efficiency of economic activity of all economic entities, regardless of the level of hierarchy (enterprise, region, country). The analysis of conditions determining the influence of various factors on productivity growth in the Russian economy, both around the country and in the regions-subjects of the Russian Federation has been given. The main reasons for the decline of the labor productivity index have been identified as following: deindustrialization having a pronounced regional character; low level of organization of production, sales and innovation management; insufficient level of investment attractiveness of Russian companies along with the restricted access to external sources of financing; high cost of capital in the domestic financial market, limiting the potential for technological modernization and innovative growth. The dominating factors of productivity growth in conditions of innovative economy have been allocated: structural, technical and technological, organizational, managerial factors and the factor of developing innovative culture, which create cumulative effect of implementing the project approach to adoption of innovative decisions and innovations. The imperative of increased productivity growth has revealed the need to increase the welfare of the population as the main goal of economic development, which determines the development of a specific mechanism for its achievement as a priority direction of state economic policy. Investment and innovative components of the state policy generally determine labor productivity growth, transition to a new technological structure of the Russian economy and bridging gaps between Russia and developed countries.
SUSTAINABLE DEVELOPMENT OF THE ENTERPRISE: ESTIMATION, PROJECT, FUNCTIONAL STRATEGY OF MARKETING MANAGEMENT
Authors: Kalynychenko Maksym Petrovich
Published: March 2019

The concept of sustainable development and the concept of market-oriented management of the enterprise (marketing management) are continuing to develop. Sustainable development of the enterprise is presented as one of the priority functional strategies of marketing management. The incompleteness of the substantiation of conceptual provisions, as well as the development of scientific and methodological framework for the assessment and management of the sustainable development of an enterprise, was the basis for conducting a scientific search in this direction. The main objectives of the study have been defined as evaluating the achieved level of sustainable development of the enterprise on the basis of the improved methods; working out a project for sustainable development of the enterprise; integrating a sustainable development strategy into the system of marketing management of an enterprise to harmonize interests with internal and external stakeholder key groups. It has been substantiated that sustainable development of an enterprise is the process of a conscious choice by a subject of marketing management of the enterprise activities to ensure economic, social and environmental performance by means of preparation and adoption of management decisions through a reflexive influence on the interests of stakeholder key groups and increasing market orientation. Using the method of scientific generalization there have been given methodological approaches to understanding the sustainable development, as well as methodological approaches to assessing the generalized factor of sustainable development of the enterprise and their main contradictions. This fact allowed to improve the methods for assessing the sustainable development of the enterprise, approbation of which established the level of sustainable development of a number of enterprises. There have been presented the main stages and expected results of the approved sustainable development project of NPO Donventilyator LLC. Implementation of the developed functional strategy of sustainable development was carried out on the basis of “Balanced Scorecard” toolkit and controlling for harmonization of marketing management purposes and the interests of key stakeholders.