bluuebunny/crossref_metadata_2025 huggingface dataset:
El inventario como determinante en la rentabilidad de las distribuidoras farmacéuticas.
Authors: Asencio Cristobal Luis Roberto , González Ascencio Edwin , Lozano Robles Mariana
Published: April 2017

En el mundo competitivo en que se desenvuelven los negocios, es necesario desarrollar mecanismos de control interno que permitan a las empresas reducir sus costos para obtener mayor utilidad. El presente trabajo tiene por objetivo analizar el control de inventarios, contextualizado en el sector de distribución farmacéutica de la provincia de Guayas-Ecuador, a fin de determinar su incidencia en los costos y en la rentabilidad de las empresas. La metodología a seguir para realizar un diagnóstico contable a profundidad, se sustenta en métodos y técnicas científicas (observación, entrevistas y encuestas) aplicadas en una empresa distribuidora farmacéutica, en la esfera del manejo de inventarios, siendo esta investigación exploratoria y descriptiva. Los resultados obtenidos, presentan los principales inconvenientes del control de inventarios en la distribución farmacéutica, que se centran en la carencia de mecanismos de control, asociado con el tiempo de rotación. Estos resultados servirán de referentes para futuras investigaciones, considerando otros factores de la conducción de inventarios en las empresas comercializadoras, que permitan diseñar sistemas de control contable para contribuir a optimizar los costos de comercialización de este sector, resaltando la necesidad del uso crítico y reflexivo de la teoría contable a lo largo del proceso investigativo, para presentar el siguiente trabajo.
La influencia de la pobreza en el crecimiento económico de Brasil, período 2000-2014
Authors: León Serrano Lady Andrea , Cevallos Gamboa Washington , Quito Vera Álvaro
Published: April 2017

Brasil es la séptima mayor economía del mundo y encabezó la lista de los países que redujeron la pobreza en un 87% en los periodos 2006-2010. Sin embargo los niveles de Producto Interno Bruto no fueron alentadores. Ante estas afectaciones, el presente trabajo tiene como objetivo principal determinar la influencia de la pobreza en el crecimiento económico y deuda externa de Brasil (período 2000-2014). El método aplicado se basa en la aplicación de modelos econométricos de Regresión Lineal Simple y Multivariado, utilizando datos de la Comisión Económica para América Latina y El Caribe y del Ministerio de Finanzas de Brasil. Los resultados del modelo lineal simple afirman una fuerte correlación inversa de pobreza con desempleo y deuda externa medidos por el coeficiente de determinación en 0.4533 y 0.7808 respectivamente, que representa ser aceptable para el modelo y una débil relación con Producto Interno Bruto e inflación. La aplicación del modelo multivariado evidencia un excelente ajuste de explicación de las variables independientes y pobreza con un nivel estadístico F igual a 17.64. Los resultados determinan que los porcentajes de Producto Interno Bruto e inflación no inciden en los niveles de pobreza, el crecimiento económico no es afectado mayormente, mientras que los cambios en el endeudamiento externo y tasa de desempleo afectan a la pobreza.
Guará, o craque que não foi: ficção e história na biografia esportiva
Authors: Silva Marcelino Rodrigues da
Published: April 2017

Tendo como pano de fundo o debate mais amplo sobre as fronteiras entre a literatura e a história, o artigo pretende discutir a presença do discurso biográfico no jornalismo e na cultura esportiva brasileira. Para isso, lança mão de referências teóricas sobre a narrativa e a biografia, colhidas tanto no campo dos estudos literários quanto no dos estudos históricos. Do trabalho dos historiadores, vem a percepção do caráter narrativo das representações do passado, bem como a reflexão sobre as diferentes formas de articular as trajetórias individuais focalizadas pela biografia e as experiências coletivas visadas pela historiografia. Do campo literário, são trazidas para o debate discussões sobre a ficção e suas relações com a realidade, as ligações entre biografia e outras formas literárias e o conceito de “ficção biográfica”, por meio do qual se evidencia a dimensão ficcional das narrativas biográficas e se questiona a tradição heroica da biografia histórica. Busca-se, desse modo, construir uma perspectiva analítica a partir da qual seja possível compreender melhor os sentidos e as funções da escrita biográfica na constituição do imaginário esportivo. Como exemplo das possibilidades abertas por essa perspectiva, são brevemente analisados alguns textos de caráter biográfico sobre a trajetória de Guará, jogador do Clube Atlético Mineiro nos anos 1930 que despontou para o estrelato e teve sua ascensão dramaticamente interrompida por um violento choque com o destino.
Garrincha sob a ótica do herói: uma análise de “Alegria do Povo” e “Estrela Solitária”
Authors: Marques José Carlos , Rosa Bruno Navarini
Published: April 2017

O presente estudo tem por objetivo analisar as narrativas presentes no documentário Garrincha, alegria do povo (1963, direção de Joaquim Pedro de Andrade) e a biografia Estrela solitária – um brasileiro chamado garrincha (1995, Ruy Castro), estabelecendo uma comparação entre as trajetórias do futebolista Mané Garrincha retratadas nestas duas obras e a estrutura da Jornada do Herói de Joseph Campbell, um dos mais renomados estudiosos da mitologia universal. As reflexões propostas visam analisar a possibilidade de enquadramento do atleta no âmbito do mito, o que se dá pela verificação da passagem de Garrincha pelo núcleo Separação–Iniciação–Retorno do monomito, percurso padrão da aventura mitológica do herói, uma figura predestinada a superar desafios e a realizar feitos grandiosos.
Muito mais do que bonecos: um estudo do filme “Um time show de bola”, de Juan José Campanella, e do conto “Memorias de un wing derecho”, de Roberto Fontanarrosa
Authors: Santos Maria Angélica Amâncio , Santos Luis Fernando Amâncio
Published: April 2017

O objetivo deste artigo é analisar determinadas escolhas do diretor Juan José Campanella, em seu processo de transposição do conto “Memorias de un wing derecho” (1985), de Roberto Fontanarrosa, para o filme Um time show de bola (Metegol, Argentina/Espanha/EUA/Reino Unido, 2013). Nesse intuito, emprega-se a teoria relativa ao processo de adaptação, como o trabalho de Jeanne-Marie Clerc e Monique Carcaud-Maccaire, além de dados extraídos de periódicos atuais e de estudos acerca dos efeitos do futebol sobre a sociedade. Esta pesquisa pretende também refletir sobre a transformação do jogador em “garoto-propaganda” e sobre as diferentes relações estabelecidas entre o futebol, o cinema e o sistema de estrelato – ou star system.
Então, de onde vem a força que os faz continuar correndo? Condições diaspóricas e rostidades olímpicas em Chariots of Fire, de Hugh Hudson
Authors: Santana Jorge Alves
Published: April 2017

Em 1917, o Barão Pierre de Coubertin sintetiza, em seus escritos doutrinários, que uma das finalidades mais nobres do Olimpismo “é, por excelência, a glorificação da juventude”. Em 1924, Paris sedia a VIII Olimpíada dos tempos modernos, na qual o lema “Citius, Altius, Fortius” continua a oscilar entre a vontade individual da vitória e as articulações pragmáticas dos países em busca de vitórias coletivas e colaborativas. Neste breve estudo, dado o seu quadro inicial, acompanharemos a já clássica narrativa fílmica Chariots of fire (Carruagens de fogo – 1981), de Hugh Hudson, no que ela nos oferece da caracterização da delegação britânica, presente nos Jogos Olímpicos de 1924. Esse grupo de jovens atletas, bem como suas equipes de apoio, é representado de modo tensionado em sua formação multicultural, com ênfase nos substratos marcados por dois atletas diaspóricos: o “Escocês Voador” e o judeu filho de um financista de Londres. Refletiremos, pois, sobre essas duas linhas de força político-cultural, entre outras, responsáveis pela conformação da tradição e da rostidade dialética de uma nacionalidade heterogênea e contraditória que terá presença constante e vitoriosa em vários Jogos Olímpicos modernos.
"ABC Futebol Clube" e o versátil jogo de Mário Alex Rosa
Authors: Belúzio Rafael Fava
Published: April 2017

Resenha de ABC Futebol Clube, de Mário Alex Rosa.
Literatura e futebol no espaço fronteiriço: a construção de uma identidade provisória no conto "Empate", de Aldyr Garcia Schlee
Authors: Ourique João Luis Pereira , Maciel Alexandre Antonio Ramos
Published: April 2017

Este ensaio parte do entendimento da fronteira como um lugar culturalmente autônomo e com raízes identitárias que o particularizam. Em consequência, também é evidenciada a questão do pertencimento, a exemplo do que aqui é tratado, em que a semelhança entre Jaguarão e Rio Branco – cidades que fazem fronteira entre Brasil e Uruguai – é muito maior que entre a primeira e a metrópole mais próxima, assim como ocorre em tantos casos similares. Partindo desse princípio é que este trabalho analisa o conto intitulado “Empate”, integrante da obra Contos de futebol, do escritor Aldyr Garcia Schlee. O livro é composto por onze narrativas, numa relação com o número de atletas que formam uma equipe de futebol, tendo sido publicado originalmente no Uruguai, com o título de Cuentos de futbol, e depois traduzidos para o português pelo próprio autor para ganhar sua edição brasileira. A análise e interpretação se amparam na relação entre literatura e sociedade a partir dos estudos de Antonio Candido e nas reflexões sobre o futebol e sobre o imaginário que perpassa a identidade cultural no espaço fronteiriço.
Bioequivalence study of two oral amoxicillin formulations (Biocillin® and Atcomox 87%®) in broiler chickens
Authors: Aboubakr Mohamed , Elbadawy Mohamed
Published: April 2017

Background: The present study was designed to assess the comparative bioequivalence of Biocillin® and Atcomox87%® in healthy broiler chickens after oral administration of both products in a dose of 20 mg amoxicillin base/kg.b.wt.Methods: Twenty-four broiler chickens were divided into two groups. The first group was designed to study the pharmacokinetics of Biocillin®, while the 2nd group was designed to study the pharmacokinetics of Atcomox87%®. Each broiler chicken in both groups was injected intravenously with 20 mg amoxicillin pure standard/kg.b.wt. After 15 days both groups taken orally Biocillin® and Atcomox87%®, respectively. Blood samples were obtained from the wing vein and collected immediately before and at 0.08, 0.16, 0.25, 0.5, 1, 2, 4, 8, 12 and 24 hours after a single intravenous or oral administration.Results: Amoxicillin in both products obeyed a two compartments open model following I.V. injection. The disposition kinetics of Biocillin® and Atcomox87%® following oral administration of 20 mg amoxicillin base/kg.b.wt. revealed that the maximum blood concentration [Cmax] were 10.79 and 10.30 μg/ml and attained at [tmax] of 0.90 and 0.86 hours, respectively. The mean systemic bioavailability of amoxicillin in Biocillin® and Atcomox 87%® after oral administration in healthy chickens was 64.15 and 65.54%, respectively.Conclusions: Atcomox 87%® is bioequivalent to Biocillin® since the ratios of Cmax, AUC0-24 and AUC0-∞ (T/R) were 0.95, 0.91 and 0.90 respectively. These are within the bioequivalence acceptance range. Biocillin® and Atcomox87%® are therefore bioequivalent and interchangeable.
Aqueous extract of Lannea microcarpa attenuates dextran sulphate-induced paw oedema and xylene-induced ear oedema in rodents
Authors: Antwi-Adjei Meshack , Owusu George , Ameade Evans P. K.
Published: April 2017

Background: Lannea microcarpa Engl. and K. Krause (Family Anacardiaceae), a tropical tree is used traditionally used in Africa for both medicinal and non-medicinal purposes. Folkoric uses of the plant include wound healing, conjunctivitis, stomatitis and gingivitis among others. Inflammatory reactions are involved in several diseases which this plant is traditionally used to manage. This study was therefore aimed at investigating the antiinflammatory effects of the aqueous extract of Lannea microcapa.Methods: Oedema was induced in the right hind paws of Sprague Dawley rats (200-250g, 12 weeks old, n=5) using dextran sulphate solution whiles ear oedema was induced in ICR mice (25-30g, 6 weeks old, n=5) using xylene solutions. Aqueous extracts of ALM (30, 100 and 300mg kg-1) were administered in a set of rats and mice for both prophylactic and therapeutic studies. In the dextran sulphate-induced paw oedema, rats (200-250g) were treated orally with ALM (30, 100 and 300 mg kg-1) for both prophylactic and therapeutic studies. The paw thickness of the rats was measured before and after dextran sulphate injection at an hourly interval for 5 h. For xylene-induced ear oedema, ICR mice (25-30g) were given the same doses of the ALM and the ear weight of mice were measured after 2 h.Results: In the dextran sulphate-induced paw oedema, the ALM reduced the mean maximal paw oedema significantly (P ≤0.05) to 36.392±9.207% and 26.050±3.396% at 100 and 300 mg kg-1 (prophylaxis) and 32.192±5.670%, 31.398±6.921% and 31.593±5.841% at 30, 100 and 300 mg kg-1 (therapeutic) in dose dependent manner when compared to the control respectively. Similarly, the ALM dose dependently showed a significant (P ≤0.05) reduction of percentage mean oedema in xylene-induced ear oedema by 43.56%, 59.63% and 68.07% at 30, 100 and 300 mg kg-1 when compared to the control respectively.Conclusions: Aqueous extract of Lannea microcapa (30 -300 mg kg-1) caused significant reduction of oedema in both dextran sulphate-induced paw oedema and xylene-induced ear oedema.
A study of cutaneous adverse drug reactions in the outpatient department of Dermatology at a tertiary care center in Gujarat, India
Authors: Chavda Dinesh A. , Suthar Satish D. , Singh Shradhanand , Balat Jayesh D. , Parmar Sailesh P. , Mistry Suresh D.
Published: April 2017

Background: The data for adverse cutaneous drug reactions (ACDRs) is limited in Gujarat. The ACDRs are one of the frequent ADRs and cause of significant morbidity and mortality in patients of all areas of healthcare today. They are responsible for significant number of hospital admissions. Thus, the present study emphasises on the need and importance of an effective pharmacovigilance programme.Methods: A prospective study was undertaken in a 183 cases tertiary care teaching hospital of India. Male to female ratio, most common class of drug, individual drug causing ACDR, common types of ACDRs Parameters were studied. Other Parameters like Causality, preventability and severe or non-severe reactions were analyzed.Results: Majority of the patients (48%) with CADR belonged to the age group 25-44 followed by 45-64 (28%). Most frequent adverse cutaneous drug reactions reported were Urticaria (40%), Maculopapular rash (25%) & Fixed drug eruptions (21%) in decreasing order of frequency. Majority of reactions (96%) were Bizarre/Unpredictable in nature. As a group, antimicrobials (46%) were most frequently associated with CADR followed by NSAIDs (31%) and antiepileptics (11%).  Most of the reactions (93%) were mild-moderate and probable (77%) in nature. Approximately 60% of ACDRs reported in this study were preventable.Conclusions: There was slight male preponderance except acneiform eruptions. Cotrimoxazole being the most common offending drug then after Ibuprofen, Phenytoin among the anti-inflammatory, analgesics, antiepileptics class. Causality assessment resulted in high score 77% of probable category.
Knowledge, attitude and practices of pharmacovigilance among the postgraduate and undergraduate medical students in a tertiary care hospital in Central India
Authors: Kulmi Mohit , Reddy Pooja , Dhakre Shilpi , Shinde Meghna , Goyal Chhaya
Published: April 2017

Background: Adverse Drug Reactions (ADRs) are one of the underestimated causes of morbidity and mortality. Monitoring of these ADRs is at the core of any pharmacovigilance program. ADR monitoring suffers from lack of reporting from health care personnels. Unless we know the current knowledge, attitude and practices of the budding doctors it’s difficult to design corrective measures to improve reporting. The present study was designed to assess the knowledge, attitude and practices of pharmacovigilance and ADR reporting among undergraduate and postgraduate medical students.Methods: This was a questionnaire-based, observational study. The questionnaire had six questions each pertaining to knowledge, attitude and practices of pharmacovigilance and ADR reporting. Factors discouraging ADR reporting were also studied. Descriptive statistics were carried out and one-way ANOVA was applied to find the statistical difference between the groups.Results: A total of 288 subjects were approached for the study of which 229 agreed to participate. It was observed that the knowledge of the participants regarding ADR reporting and pharmacovigilance was satisfactory. 68% of respondents felt that educational programmes have a positive effect on ADR reporting. 15% of respondents admitted of having reported an ADR. The mean scores of knowledge, attitude and practices of ADR reporting were considerably higher in postgraduates as compared to undergraduates (p-value <0.05).Conclusions: The study concluded that participants of study were aware of the importance of ADR reporting but it did not reflect in their practices. There is a need to create awareness and to educate these future physicians about Pharmacovigilance.
A study on incidence of adverse drug reactions with commonly prescribed drugs and causality assessment in Silchar Medical College and Hospital
Authors: Laskar Jahirul Islam , Chakravarty Pinaki , Dewan Babul
Published: April 2017

Background: Present study was carried out to assess the incidence of adverse drug reactions (ADRs) and assessment of causality, severity with reported suspected ADRs.Methods: A prospective observational study was conducted over a period of one year in inpatients and out patients hospitalization due to ADRs, at Silchar Medical College & Hospital, Silchar, Assam. WHO–UMC Probability scale was used for causality assessment. Reported ADRs were classified according to Wills and Brown classification and assessed for severity using scale developed by Hartwig et al. All data were calculated by ‘Descriptive statistics’ analysis as percentage of patient population who encountered ADRs.Results: A total of 192 suspected ADRs were reported and Overall incidence of ADRs during the study period was found to be 0.41% of which 0.22% of ADRs had lead to hospital admissions and 0.19% of ADRs occurred during the hospital stay. Most common drug class associated with ADRs were Antimicrobials [101(52.6%)], which was found to have mostly affected the Skin system followed by NSAIDs [24(13.54%)], Haematinics [21(10.93%)]. Severity of the ADRs were found to be moderate [79(41.14%)], followed by [71 (36.97%)] ADRs which were severe and [42(21.87%)] which were mild.Conclusions: Present study revealed that, more awareness about the importance of Pharmacovigilance have to be provided among the health care professionals by way of ADR bulletins, seminars and workshops. Also, more studies need to be conducted in Indian population to know the exact prevalence of ADRs in Indian hospitals.
Awareness and knowledge of diabetes mellitus among diabetic patients in Puducherry, India
Authors: V. Benil , B. Dheepan Nayagam
Published: April 2017

Background: Diabetes prevalence is high in India and the numbers are increasing every year. Many patients are aware that they have diabetes only when they develop one of its complications. Since there is a paucity of literature on the level of awareness and knowledge about diabetes, this study was done.Methods: It is a cross-sectional study conducted on diabetic patients attending Sri Lakshmi Narayana Institute of Medical Sciences and Hospital, Puducherry over a period of two months, using questionnaire. The demographic data were analyzed using descriptive statistics. Quantitative data were expressed as percentages.Results: Among 104 diabetics, 60%, 49% and 66% of the patients answered high sugar intake as the cause of diabetes, loss of vision as its complication and diet control as the important measure of treatment of diabetes respectively. Only 30.67% of the patients were aware of the name of the medicine they consume.Conclusions: Awareness and knowledge about diabetes were less in our study populations. Hence it is important to extend the diabetic health programs in mass campaigns to improve their knowledge.
A study on awareness of pharmacovigilance and determinants of underreporting of adverse drug reactions by health care professionals and general practitioners
Authors: R. Priyadharsini , TAR Raja , M. Dhayaguruvasan
Published: April 2017

Background: Health care providers/professionals (HCPs) play a critical role in ADR surveillance. Only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information.Methods: This was a prospective questionnaire-based study. Structured questionnaire was issued to HCPs before and after the conduct of Pharmacovigilance awareness program and scores given to each question was analyzed statistically.Results: Of the 69 participants, 46.4% were nurses, 40.6% were residents of a tertiary health care facility and 13% were general practitioners in Pondicherry. The response rate was found to be 62.7% and 100% both before and after the awareness program respectively. Creation of awareness amongst HCPs is the most important factor (77%) influencing spontaneous reporting.Conclusions: Our study suggests that HCPs were aware of the concept of ADR but the majority did not know how and where to report. Thus, creation of awareness amongst HCPs is the most important determinant influencing spontaneous reporting of ADRs.
Cementless bipolar hemiarthroplasty for displaced fracture neck of femur with modular hydroxyapatite coated stem in elderly with cardiopulmonary co-morbidities
Authors: Bhat Towseef Ahmad , Ali Zameer , Gulzar Amara , Mirza Furqaan
Published: April 2017

Background: Bipolar hemiarthroplasty is one of the common procedures done for fracture neck of femur in elderly.  Debate about Cemented or cementless is still on. Cementing increases perioperative mortality by causing significant hemodynamic changes or embolization. Patients with cardiopulmonary complications are at higher risk of cementing complications. We report our series of 31 cases of fracture neck of femur with cardiopulmonary diseases operated over 2 years with modular cementless bipolar hemiarthroplasty.Methods: 31 elderly patients with cardiopulmonary co-morbidities (age=75 to 97 years) with displaced femoral neck fractures were operated between January 2011 to December 2013. Cementless bipolar hemiarthroplasty using hydroxyapatite coated stem was done by single surgeon using same implant in all the patients through anterolateral approach. Clinical and radiological follow-up was done with mean follow up of 54 months (36-72 months).Results: Total 31 cases with cardiopulmonary comorbidities were operated. The average follow up was 54 months. No intraoperative mortality was seen. 3 patients had splitting of femur during canal preparation. 1 patient died due to cardiac arrest in the post-operative period. 1 patient had surgical site infection. 3 patients had hemodynamic abnormalities and 1 patient had significant limb length discripency (1.5 cm). 2 patients died in the follow up because of comorbidities.  27 patients reached to pre-injury status with average harris hip score of 86 at final follow up.Conclusions: Cementless bipolar hemiarthroplasty with hydroxyapatite coated stem is a good option for femoral neck fractures in elderly patients with cardiopulmonary complications without risking the harmful effects of cementing.
Fetal kidney length as a parameter for determination of gestational age from 20th week to term in healthy women with uncomplicated pregnancy
Authors: Peter Monalisa , Nayak Ajit Kumar , Giri Prajna Paramita , Jain Manju Kumari
Published: April 2017

Background: Accurate assessment of gestational age is pivotal to give quality maternity care. Ultrasonographic fetal biometry is the most widespread method used to establish GA. Sonographic biometric parameters commonly used are Crown rump Length (CRL), Biparietal diameter (BPD), Head circumference (HC), Abdominal circumference (AC) and Femur length (FL). Fetal Kidney Length (FKL) is one of nontraditional parameter and more accurate method of GA estimation than BPD, FL, HC and AC after 24th week of gestation. This study evaluates role of FKL in estimation of GA and compared its accuracy with other established biometric indices.  Methods: Present study is a cross sectional study and includes healthy women who were certain of their LMP with prior regular menstrual cycles with uncomplicated pregnancy between 20 weeks of gestation to term. Maximum length of anyone single fetal kidney is measured from upper pole to lower pole at least thrice and mean of the measurements was taken. The data has been analyzed in SPSS-21 version and Microsoft word, excel have been used to generate graphs, tables etc.Results: Linear regression equation showed kidney length could predict gestational age with an accuracy ±9.048 days and predictability when combined with other biometric indices was ±8.299 days.Conclusions: The study shows good correlation between gestational age derived from FKL and gestational age from established biometric indices like BPD, HC, AC, and FL.FKL can be combined with the other four biometric indices to give a fair estimation of gestational age.
A descriptive analysis of extended matching questions among third year medical students
Authors: Vuma Sehlule , Sa Bidyadhar
Published: April 2017

Background: With changes in teaching methods in medicine, assessment tools have also evolved in order to be valid, reliable, practical, analyzable and not time-consuming. After questions of reliability and practicality when using free response short answer questions, we replaced them with extended matching questions (EMQs). Previous analysis of the same group of students, in the same time period, showed high reliability and discrimination with standard multiple choice questions (MCQ). Objective was to describe the efficiency of Extended matching questions (EMQ) in third-year medicine coursesMethods: Castler-Rock Integrity programme, item analyzed reports of EMQ results over a three-year period were analyzed. There were 25EMQ items in each course, each year, with 9 option answers.Results: The Kuder Richardson-20 reliability mean ranged from 0.447 to 0.674. Spearman-Brown split half-reliability coefficient mean ranged from 0.443 to 0.685. Spearman-Brown prophecy reliability formula mean from 0.614 to 0 837. The Guttman split-half reliability coefficient mean ranged from 0.441 to 0.718. The difficulty mean ranged from 0.491 to 0.719. The Corrected point bi-serial coefficient ratio mean was 0.118 to 0.255. The number of items with all-functioning distractors ranged from 16% to 40%, and the total number of non-functioning distractors ranged from 14.5% to 28%.Conclusions: EMQs showed reliability, though lower than with the MCQs previously analyzed. This may be due to the much smaller numbers hence increasing numbers of EMQs should be considered. There was a high number of functioning distractors. Poor distractors should be revised.
Factors influencing the work performance of Mitanins (ASHA) in Bilaspur district, Chhattisgarh, India: a cross sectional study
Authors: Baghel Ashish , Jain Kamlesh K. , Pandey Sachin , Soni Gopal Prasad , Patel Anubha
Published: April 2017

Background: The Mitanin programme is a community health volunteer programme which was initiated by the Government of Chhattisgarh, India in 2002. The Mitanin programme further progressed to lay foundation for the Accredited Social Health Activists (ASHA) programme by the National Rural Health Mission. There is robust indication that the Community health workers could significantly contribute towards the betterment of health outcomes. The objective of the study was to study the factors influencing the work performance of Mitanins in Bilaspur district, Chhattisgarh, India.Methods: A community based cross sectional study was carried out among 180 Mitanins selected through multistage random sampling in Bilaspur district, Chhattisgarh, India during March to August 2015. A predesigned, pretested questionnaire was used for data collection.Results: Regarding counselling to pregnant mother on maternal and child health about (65.6%) Mitanins were having knowledge and out of these prevalence of its practice was found to be (75.4%). Their less knowledge for content of responsibility significantly affected their practices in community. Other major factors influencing their work performance are better training sessions (37.8%), support from health staff (65.6%), drug kit refilling (80%), and fewer hurdles in receiving incentives (85.6%.Conclusions: Less knowledge of the work component, less cooperation from health staff, delay refilling of drug kit, incentive oriented practices, delayed and inadequate payment of incentives for Mitanins influences the work performance.
Activities of daily living amongst inmates of home for aged in Nagpur, Maharashtra, India: a cross sectional study
Authors: Jadhao Ashok R. , Ghongte Pravin R. , Ughade Suresh N.
Published: April 2017

Background: Although persons of all ages may have problems performing the Activities of Daily Living (ADL), prevalence rates are much higher for the elderly (65 years and over) than for the non-elderly. Elderly population face many problems. They become economically dependent on family for their basic needs and health care. Due to nuclear family norm, there is no place for elderly parent who feel alone and insecure. The study was undertaken to assess activities of daily living and reasons for admitting in home for aged amongst them. Objectives of present study were to assess the activities of daily living (ADL) and to identify the reasons for admitting in home for aged, in two homes for aged in Nagpur city, Central India.Methods: A cross sectional study was undertaken in two homes for aged namely Panchvati Vridhashram, Umred road and Home for aged, Untakhana, Nagpur, Maharashtra, India. Total 176 study subjects had consented for participation in study.Results: Mean age of study subjects was 73.47±6.06 year ranging from 61 to 90 years. Proportion of female inmate was 55.11%. Around one-fifth of study subjects (19.32%) were illiterate. Significantly more illiterate study subjects were of female gender (chi- square=5.78, d.f.=1, P=0.016). Mean duration of stay in home for aged was 5.29±3.29 years with the range of 9 months to 17 years. Number of study subject’s dependent for at least one ADL was 37 (21.02%). Amongst dependents 32 (18.8%) inmates were partially dependent with ADL score of 1-5 and only 5 (2.85%) inmates were totally dependent with ADL score of 6-12. The proportion of inmates with dependency for at least one activity of activities of daily living increases as the age increases. Positive liner trend was observed between age and dependency (r=0.1971, P=0.0087).Conclusions: Prevalence of ADL dependency was 21.02% among the inmates of home for aged. Dependency for activities of daily living increases with increase in age. Major reasons for admission to the home for aged were - no one to look after, strained relation with family members and economic constraints. There is need for economic assistance through social security to economically dependent inmates.
Osteosynthesis distal tibial metadiaphyseal fractures with intramedullary nailing versus plating
Authors: Vashisht Deepak , Daroch Manjit S. , Sreen Sanjeev , Rathi Kuldeep
Published: April 2017

Background: The management of the tibial fracture remains controversial despite advances in both non-operative and operative care. Plates and intramedullary nails are two well-accepted and effective methods, but each has been historically related to complications. The present study was conducted to compare the results of displaced extra-articular distal tibia meta-diaphyseal fractures OTA/AO Type 42A- C (distal) and 43-A treated with intramedullary nailing versus plating with respect to union of fracture, early Restoration of function, the axial alignment and Complications, if any.Methods: In this study 30 patients of extra-articular distal tibia fracture AO type 42 A-C (distal) and 43 A were randomly selected and 15 were operated with intramedullary nailing and remaining 15 with plating. The patients were regularly followed up for a period of 9 months with radiological and clinical examination. Final assessment was done by Tenny and Wiss clinical assessment criteria.Results: In Interlocking group, average time for union was 20.33 weeks in Interlocking nail group compared to 23.21 weeks in plating group which was significant (p value 0.011). Also, the average time required for partial and full weight bearing in the nailing group was 7.2 weeks and 13.2 weeks respectively which was significantly less as compared to 9.33 weeks and 16.64 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in Interlocking group as compared to plating group.Conclusions: In present study ILN showed better outcome as it offers advantage in terms of mean operating time, less invasive surgery, hospital stay, partial and full weight bearing time and union time.
Bacteriological profile of urinary tract infections at a tertiary care hospital in Western Uttar Pradesh, India
Authors: Singh Vijay Prakash , Mehta Abhishek
Published: April 2017

Background: This prospective study was intended to identify the bacterial pathogens causing urinary tract infections and their antimicrobial resistance patterns in a tertiary care teaching hospital of Western Uttar Pradesh, India.Methods: Clean-catch mid-stream urine samples were collected from patients symptomatic for UTI. Samples were cultured aerobically on CLED agar and strains having significant growth (>105cfu/ml) were further processed for identification using standard microbiological techniques and their antimicrobial susceptibility pattern evaluated by Kirby Bauer disk diffusion as per CLSI guidelines.Results: Out of the 2250 urine samples processed, 750 showed significant growth on aerobic culture. Thus, the prevalence of UTI in the population was 33.3%. E. coli was the commonest isolate (33.3%) followed by S. aureus (20 %), Klebsiella spp. (13.3%), Coagulase Negative Staphylococci (13.3%), Enterococcus spp. (6.7%), Pseudomonas spp. (6.7%) and Candida spp. (6.7%). Amongst these isolates, Gram negative bacilli have shown a high susceptibility to imipenem, levofloxacin, nitrofurantoin, linezolid and amoxyclav and Gram positive organisms towards levofloxacin, nitrofurantoin, linezolid, vancomycin and amikacin.Conclusions: This study has shown nitrofurantoin and fluoroquinolones to be the most effective drugs for the empirical therapy of UTI in our region. The study of antimicrobial susceptibility pattern of UTI in a particular area can guide the clinicians in the rational choice of antibiotic treatment so that misuse of antibiotics can be prevented.
Interrater reliability of client categorization system as a psychiatric status rating scale in measuring psychiatric patients’ health status
Authors: Nurjannah Intansari , Nurmasari Putri , Nugraha Irwan Tri , Katan Diki Yuge , Hariyadi Ki
Published: April 2017

Background: Reliable instrument is needed by nurses to measure patient’s status. This study aimed to determine the interrater reliability of client categorization system instrument used in psychiatric setting.Methods: Data was collected two periods in a year by twelve raters. They used the CCS to simultaneously gauge the condition of 30 patients for 98 measurements. Data was analyzed using the Cohen’s-Kappa formula and percent agreement.Results: The analysis showed that the Cohen-Kappa values of interrater reliability were 0.59 which can be categorized as moderate (accepted, if value >0.41) and percent agreement value was 77.78% indicated acceptable.Conclusions: The CSS has moderate and acceptable category of interrater reliability and can be recommended for use in clinical practice.
Kikuchi Fujimoto lymphadenitis- an uncommon entity in the surgical outpatients: a case report
Authors: Panchal Anuradha , Gautam Raj , Mahadik Abhishek , Chougle Qurratulain , Shaffi Mohammed Zeba
Published: April 2017

Kikuchi Fujimoto lymphadenitis is a benign self-limiting disease with subacute necrotizing lymphadenopathy of unknown cause. The clinical, histopathological and immunohistochemical features point to viral etiology hence delaying diagnosis commonly. Clinicians and pathologists awareness of this disorder may prevent misdiagnosis and inappropriate treatment. We describe here a case of a young woman admitted under our care with fever and cervical lymphadenopathy. Cervical lymph node biopsy revealed the rare clinical disorder of Kikuchi Fujimoto lymphadenitis which is not thought of as a primary cause of lymphadenopathy in the Indian subcontinent where tuberculosis is widely prevalent.
Cervical spine intramedullary cysticercosis in a young adult - a case report and literature review
Authors: Hedaoo Ketan , Garg Sunil , Thanvi Sharad , Agay Ashuvi Kunjan , Nagocha Vallabh , Rao Meenakshi
Published: April 2017

Neurocysticercosis, is the most common central nervous system parasitic infestation worldwide, but spinal involvement by neurocysticercosis is relatively rare. Here we report a case of 18-year-old male patient with intramedullary cysticercosis caused by Tenia soleum in cervical spinal cord. MRI revealed expansile illdefined intramedullary mass at C4 and C5 vertebral level which believed to be a tumor instead, rather than a cysticercosis preoperatively. surgery was performed to decompress the spinal cord. Histopathological examination of removed lesion confirmed it as cysticercosis.
Clinical profile and outcome of dengue fever in a paediatric tertiary care centre
Authors: Moinuddin Md Khaja , Sahana Devadas Sahana Devadas
Published: April 2017

Background: A study of different presentation and outcome of dengue fever in tertiary care centre.Methods: the observational cross sectional study was carried out from June to October 2016 in Bowring and Lady Curzon hospital attached to Bangalore Medical College and Research Institute. Included patients from 1 to 18 years of age who presented with febrile illness. WHO classification and definitions were used to classify disease as dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Clinically, haematological and biochemical findings were recorded till discharge.Results: during study period,142 patients presented with typical features of dengue fever, male being 86 (60%) and female being 56 (40%). Among 142 cases 64 cases were probable dengue, 50 cases were dengue with warning signs and 28 cases were had severe dengue. Fever (100%) was the most common clinical presentation followed by vomiting (70%), body ache (43%), abdominal pain (23%), headache (12%) and rashes (5%). Laboratory findings included thrombocytopenia, leucopenia and elevated liver enzymes. 126 (88%) cases were discharged in clinical stable conditions, (8%) were died during course of treatment and 8 cases left against medical advice.Conclusions: fever with vomiting and thrombocytopenia were most common presentation of dengue fever, appropriate clinical diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as long correct and timely interventions instituted.
Study of C - reactive protein in neonatal sepsis
Authors: Mehrotra Gunjan
Published: April 2017

Background: Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. Neonatal sepsis in newborn is characterized by paucity of signs and symptoms and is due to invasion and spread through the body of non-pathogenic/ pathogenic & Gram positive / negative organism. It is subtle disease, the general characteristic of bacterial infection in neonatal period are influenced more by response of the infant than the causative organism. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP) for evaluation of neonatal sepsis in tertiary care hospital.Methods: Neonates with clinical suspicion of sepsis were prospectively studied out from June 2006 to January 2008. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS.Results: Of 50 neonates studied, 34 (68%) had positive CRP while 31 (62%) had positive blood culture. The sensitivity, specificity, positive and negative predictive values of CRP were 90.32%, 42.10%, 71.79% and 72.72% respectively.Conclusions: The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value.
Clinical profile and outcome of snake bite in children
Authors: Meshram Rajkumar M. , Bokade C. M. , Merchant Saira , Bhongade Swapnil
Published: April 2017

Background: Snake bite is generally considered to be a rural problem and has been linked with environmental and occupational condition is a neglected public health problem. This study was conducted to ascertain clinical profile, complication and outcome of snake bite in pediatric population. Methods:Retrospective observational study was done in paediatrics wards and Paediatric Intensive care unit of tertiary care institute. A medical record files of 80 patients of snakebite, between the periods of January 2011 to February 2016 were recovered from Medical Record and Statistics Section of Institute. Files were analyzed for demographic data; variables included site of bite, time of bite, type of primary treatment and treatment provider, and type of snake poison, common symptoms suggestive of hematotoxicity, myotoxicity and neurotoxicity.Results: Out of total 80 patients, 58.75% were male and most of snake bites were seen in age group of 6-12 years. Clinically 57.5% patients were presented with signs and symptoms of envenomation and most of them were bitten during the months of June to September. All bites were nonprovocative and in 57.5% lower limb was the commonest site of bite. A 77.5% patient were primarily treated by medical personnel, 56.25% patients were received treatment within 1 hour of bite and hospitalized within 6 hours of bite. Coagulation failure was commonest complication (58.33%) followed by hypotension (25%) in vasculotoxic snake bite and respiratory paralysis (68.18%) in neuroparalytic bites. Renal replacement therapy was required in 5%, blood/blood product transfusion in 11% patients and case fatality rate was 11.25%.Conclusions: The most vulnerable to snake bites are boys aged more than 5 years. There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.
Outcome of premature babies with RDS using bubble CPAP
Authors: Arora Vivek , Gediya Sandip G , Jain Rupali
Published: April 2017

Background: Respiratory distress syndrome (RDS) contributes significantly to mortality and morbidity. Continuous positive airway pressure (CPAP), when applied to premature infants with RDS, re-expands collapsed alveoli, splints the airway, reduces work of breathing and improves the respiration. Objectives: To ascertain the immediate outcome of preterm infants with RDS on Bubble CPAP and identify risk factors associated with its failure.Methods: This was a prospective analytical study and inborn preterm infants (gestation 28 to 34 weeks) admitted to the NICU with RDS were included in the study. All the spontaneously breathing infants were stared on bubble CPAP and different variables were recorded. Those in whom CPAP failed were given surfactant and mechanical ventilation.Results: 170 neonates were enrolled in the study. 52 (30.5%) babies failed CPAP. The predictors of failure were; partial or no response to Antenatal Steroids (ANS), white-out on the chest X-ray, Silverman Anderson scoring >6 or FiO2 > 0.4 after 15-20 minutes of CPAP, extreme prematurity. Other maternal and neonatal variables did not influence the need for ventilation. Rates of mortality and duration of oxygen requirement was significantly higher in babies who failed CPAP. No baby had chronic lung disease.Conclusions: Infants with no or partial exposure to antenatal steroids, white-out chest X-ray and those with higher FiO2 requirement after initial stabilization on CPAP are at high risk of CPAP failure (needing mechanical ventilation). Bubble CPAP is safe for preterm infants with RDS; it decreases need of surfactant and mechanical ventilation.
Mother’s knowledge, attitude and practice regarding prevention and management of diarrhoea in children in Southern Odisha
Authors: Padhy Sadasiba , Sethi Rajesh Kumar , Behera Narendra
Published: April 2017

Background: Diarrhoeal infections are the fifth leading cause of death worldwide and continue to take a high toll on child health. The objective of the study was toassess and compare mothers’ knowledge, attitude and practice regarding prevention and management of diarrhoea in children.Methods: A hospital based observational study was carried out in the Department of Paediatrics, M.K.C.G. Medical College. Data collected from mothers by questionnaire method.Results: Diarrhoea is more common in less than 2 years of age with males are affected more than females and more cases are seen from rural areas. Diarrhoeal diseases are more common in the lower educated group and low socioeconomic status families with prevalence of overcrowding. 47% mothers had knowledge about diarrhoea, 52% about the aetiology and 58% about risk factors of diarrhoea. Regarding role of breastfeeding in diarrhoea 48% mothers had good knowledge and regarding adverse effects of bottle feeding 56% mothers were aware. In this study only 34% of mothers were aware of assessment of danger signs and dehydration and 27% about treatment of dehydration. 33% mothers had good knowledge on sanitary latrine and safe drinking water uses in prevention and treatment of diarrhoea. Regarding preparation of ORS only 19% mothers had good knowledge, 65% mothers had average knowledge.Conclusions: Among mothers’ knowledge about diarrhoea along with the importance of breastfeeding and the adverse effects of bottle feeding is significantly lacking. Also, the knowledge about assessment, management and practices about diarrhoeal diseases among mothers is significantly less.
Clinical study of the correlation of foot length and birth weight among newborns in a tertiary care hospital
Authors: S. Gowri , V. Kumar G.
Published: April 2017

Background: Gestational age and birth weight are the two most useful parameters for assessing maturity of the newborn. Major causes of neonatal mortality are diseases associated with low birth weight babies (LBW). It has been shown that foot length measurement is particularly valuable in premature babies who are so ill that conventional anthropometric measurements cannot be carried out due to the incubator and intensive care apparatus. Methods: The cross-sectional study was conducted in the department of pediatrics Sri Siddhartha Medical College Hospital, Tumkur, India. The birth weight in grams and length of the foot were documented in centimeters. Data was collected using standard proforma.Results: A total of 600 neonates were studied of which, males were 54.67 % (328) and females were 45.33 % (272). The neonates weighing less than 2.5 kg had a mean foot length of 6.94. The mean foot length for neonates weighing between 2.5 to 3.5 was 7.68. The mean foot length for neonates weighing more than 3.5 kg was 8.2cm. The correlation coefficient of birth weight with foot length was maximum in low birth weight babies (r= 0.94).Conclusions: The foot length is an efficient screening tool in identifying low birth weight babies. Foot length is a simple, quick and reliable anthropometric measurement which can be used as a proxy measurement to birth weight especially in sick and pre-term neonates receiving intensive care.