bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment
Authors: Natarajan Girija , Shankaran Seetha , Nolen Tracy L. , Sridhar Amaanti , Kennedy Kathleen A. , Hintz Susan R. , Phelps Dale L. , DeMauro Sara B. , Carlo Waldemar A. , Gantz Marie G. , Das Abhik , Greenberg Rachel G. , Younge Noelle E. , Bliss Joseph M. , Seabrook Ruth , Sánchez Pablo J. , Wyckoff Myra H. , Bell Edward F. , Vohr Betty R. , Higgins Rosemary D.
Published: July 2019

OBJECTIVE:

Among extremely preterm infants, we evaluated whether bevacizumab therapy compared with surgery for retinopathy of prematurity (ROP) is associated with adverse outcomes in early childhood.

METHODS:

This study was a retrospective analysis of prospectively collected data on preterm (22–26 + 6/7 weeks’ gestational age) infants admitted to the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers who received bevacizumab or surgery exclusively for ROP. The primary outcome was death or severe neurodevelopmental impairment (NDI) at 18 to 26 months’ corrected age (Bayley Scales of Infant and Toddler Development, Third Edition cognitive or motor composite score <70, Gross Motor Functional Classification Scale level ≥2, bilateral blindness or hearing impairment).

RESULTS:

The cohort (N = 405; 214 [53%] boys; median [interquartile range] gestational age: 24.6 [23.9–25.3] weeks) included 181 (45%) infants who received bevacizumab and 224 (55%) who underwent ROP surgery. Infants treated with bevacizumab had a lower median (interquartile range) birth weight (640 [541–709] vs 660 [572.5–750] g; P = .02) and longer durations of conventional ventilation (35 [21–58] vs 33 [18–49] days; P = .04) and supplemental oxygen (112 [94–120] vs 105 [84.5–120] days; P = .01). Death or severe NDI (adjusted odds ratio [aOR] 1.42; 95% confidence interval [CI] 0.94 to 2.14) and severe NDI (aOR 1.14; 95% CI 0.76 to 1.70) did not differ between groups. Odds of death (aOR 2.54 [95% CI 1.42 to 4.55]; P = .002), a cognitive score <85 (aOR 1.78 [95% CI 1.09 to 2.91]; P = .02), and a Gross Motor Functional Classification Scale level ≥2 (aOR 1.73 [95% CI 1.04 to 2.88]; P = .04) were significantly higher with bevacizumab therapy.

CONCLUSIONS:

In this multicenter cohort of preterm infants, ROP treatment modality was not associated with differences in death or NDI, but the bevacizumab group had higher mortality and poor cognitive outcomes in early childhood. These data reveal the need for a rigorous appraisal of ROP therapy.
Twelve Tips for Tweeting as a Residency Program
Authors: O'Glasser Avital , Desai Sima S. , Cooney Thomas G.
Published: July 2019

This article was migrated. The article was not marked as recommended. Physicians have dramatically increased social media use in recent years. Twitter has been heralded as a means to connect a broader learning community, engage with colleagues, initiate mentorship and sponsorship, and to amplify trainees. A residency program-linked Twitter account affords unique opportunities to champion residents while promoting the program and its affiliated faculty and institutions. However, while the scholarship of Twitter usage is expanding, the current literature specific to residency programs is limited. We draw from our experience tweeting as an internal medicine program to share more broadly applicable advice. With these practical tips, creating, maintaining, and sustaining a residency program twitter account can be feasible, fulfilling, and successful.
Modelling the long-term hydro-mechanical behaviour of a bentonite pellet/powder mixture with consideration of initial structural heterogeneities
Authors: Mokni Nadia , Molinero Guerra Agustín , Cui Yu-Jun , Delage Pierre , Aimedieu Patrick , Bornert Michel , Tang Anh Minh
Published: July 2019

The aim of this paper is to investigate the long-term hydro-mechanical behaviour of a highly heterogeneous MX80 bentonite pellet/powder mixture (80/20 in dry mass), which is one of the candidate sealing materials in deep geological repositories. In spite of the operational advantages related to the use of the mixture, structural heterogeneities resulting from the installation process constitute a matter of concern and require special approaches to describe adequately the material behaviour during hydration. In this study, a double structure formulation taking into account the initial structural heterogeneity of the material as well as damage to pellets upon wetting is proposed. The formulation is applied to the modelling of a 1/10 mock-up of Sealex large-scale tests. Hydraulic and mechanical parameters are determined from an extensive laboratory programme carried out on a single pellet of bentonite and on the pellet/powder mixture. To ensure an adequate analysis of the test, the initial heterogeneous structural distribution of the material is determined by image analysis of microfocus X-ray computed tomography observations. The model allows the anisotropic swelling behaviour of the mixture to be satisfactorily reproduced when accounting for the spatial variation of the material's initial porosity. In particular, the long-term (decade) hydro-mechanical behaviour of the mixture can be well described. Detailed analysis of the modelling results demonstrates the existence of dry density gradients at the long term and their influence on swelling pressure anisotropy.
The effect of duloxetine on ECoG activity of absence-epilepsy model in WAG/Rij rats
Authors: AYGÜN Hatice
Published: July 2019

Aim: Many

epidemiological studies have found a high

incidence of depression and anxiety in people with epilepsy. Duloxetine is a selective

inhibitor of serotonin and norepinephrine reuptake (SNRI) and commonly prescribed in a patient with major depressive

disorder. The aim of this study was to investigate

the effect of duloxetine on the WAG/Rij rat in an experimental rat model

of absence-epilepsy.

Methods: WAG/Rij

rats were randomly assigned into 5 groups with 7 animals in each group. Tripolar

electrodes were placed on the skull to

perform electrocorticography (ECoG) evaluation. Then, following the recovery

period, ECoGs were recorded at 09:00 am for 3 hours every day. Subsequently, duloxetine (1, 5, 10

and 30 mg/kg) was injected

intraperitoneally (i.p). After

the treatment program, ECoG recordings were taken for 3 hours. And then all

animal anxiety-like behavior by using the

behavioral test, open field test (OFT) was performed after duloxetine (1,5,10

and 30 mg/kg) treatment. The total number and

the total duration of the spike-wave

discharges (SWDs) were

calculated offline. The

number of squares crossed (locomotor activity) and the duration of grooming

episodes were analyzed in OFT. 

Results: The doses of duloxetine (1 mg/kg) did not alter ECoG and OFT parameters. The 5, 10 and 30 mg/kg doses of duloxetine decreased the total number and the total duration of

SWDs, (p<0.05) and increased the number of squares crossed when

compared to with control group (p <0.05) without changing duration of

grooming episodes (p> 0.05). Intraperitoneal administering of 1 mg/kg

duloxetine did not show any statistically

significant change in regard to the number and duration of SWDs.

Conclusions: In the present study, duloxetine reduce

dose-dependent absences-like seizures and

anxiety-like behavior.
LAPAROSKOPİK HİSTEREKTOMİ ÖNCESİ MEKANİK BARSAK HAZIRLIĞI YAPILMALI MIDIR?
Authors: YALCİN Yakup
Published: July 2019

Giriş

Laparoskopik
histerektomi jinekolojik operasyonlar içinde sık uygulanan cerrahi bir
prosedürdür. Laparoskopik histerektomi öncesi yapılan mekanik barsak hazırlığı açısından
farklı görüşler bulunmaktadır. Biz bu çalışmada, benign jinekolojik patolojiler
nedeniyle yapılacak laparoskopik histerektomi öncesi mekanik barsak hazırlığı
yapılmasının gerekli olup olmadığını incelemeyi amaçladık.

Gereç ve Yöntem

Çalışmada, benign
jinekolojik nedenlerle Haziran 2017 ve Haziran 2018 tarihleri arasında
laparoskopik histerektomi ameliyatı yapılan 63 hastanın verileri retrospektif
olarak analiz edilmiştir. Hastaların 24’ünde barsak hazırlığı yapılmadığı
39’unda ise mekanik barsak hazırlığı yapıldığı tespit edilmiştir. Hastaların
yaş, parite, vücut kitle indeksi, geçirilmiş cerrahi öyküsü, histerektomi
endikasyonları, operasyon süresi, uterus ağırlığı, hastanede yatış süreleri,
intraoperatif ve postoperatif komplikasyonları karşılaştırılmıştır.

Bulgular

Hastaların demografik
verileri incelendiğinde yaş, parite, vücut kitle indeksi ve geçirilmiş pelvik
cerrahi öykü arasında fark yoktur (p>0.05). Histerektomi endikasyolarına
bakıldığında myoma uteri, ilaca dirençli menometroraji, adneksiyal kitle,
servikal displazi ve kronik pelvik ağrı arasında istatistiksel anlamlı fark
izlenmemiştir. Operasyon süresi, barsak hazırlığı yapılan hastalarda barsak hazırlığı
yapılmayan hastalara göre istatistiksel anlamlı olarak daha kısa bulunmuştur
(p<0.05). Perioperatif ve postoperatif komplikasyonlar açısından
bakıldığında fark bulunmamıştır (p>0.05).

Sonuç

Literatürde
benign jinekolojik nedenlerle histerektomi yapılan hastalar için mekanik barsak
hazırlığının gerekip gerekmediği hakkında farklı görüşler mevcuttur. Bizim
calışmamızda mekanik barsak hazırlığı yapılmasının perioperatif ve postoperatif
komplikasyon oranını değiştirmediği fakat operasyon süresini anlamlı derecede
kısalttığı görülmüştür. Bundan dolayı uygun hastalara operasyon öncesi barsak
hazırlığı yapılması faydalı olabilir.
GEBELİKTE DEMİR VE FOLAT EKSİKLİĞİ ANEMİSİNDE KANITA DAYALI GÜNCEL YAKLAŞIMLAR
Authors: BİLGİN Zümrüt , DEMİRCİ Nurdan
Published: July 2019

Özet:Anemi,
gebelikte en yaygın hemotolojik bir sorundur. Dünyadaki gebe kadınların %38.2'sinin
anemik olduğu, tahmin edilmektedir. Türkiye’de üreme çağındaki kadınlarda anemi
sıklığının %20 ile %39.9 arasında değiştiği belirtilmektedir. Gebelik
dönemindeki anemiler edinsel ve kalıtsal olmak üzere iki grupta değerlendirilir.
Gebelikte sıklıkla edinsel yetmezlik anemilerinden olan demir eksikliği ve daha
az sıklıkla da folik asit eksikliği anemisi oluşur. Demir eksikliği anemisi (DEA)’nin en temel nedeni;
gebelik öncesinde demir düzeyinin düşüklüğü, gebelikte absorbsiyonun artması
ile artan gereksinimdir. Demir eksikliği anemisinin tanısı için öncelikle hemoglobin
(Hb) ve serum ferritin düzeyi ölçülür. Gebelikte en düşük Hb değeri 1. ve 3. trimesterde <11 gr/dL,
2. trimesterde <10,5 gr/dL’olmalıdır. Gebelikte anemi; annenin
hastalanma ve ölüm riskinde artışla (%20-40 oranında), fetüste ise intrauterin büyüme
geriliği,  düşük doğum ağırlığı, erken
doğum ve perinatal mortalite riskinde artışla ilişkilidir. Maternal ve fetal
komplikasyonların önlenmesi için gebe kadınlara demir ve folat desteği
verilmesi önemlidir. Demir eksikliği anemisinde oral demir tedavisi birinci basamak tedavi olarak verilir. Oral
tedavi yanıtsızlığı, tedaviye uyum sorunu, çok düşük hemoglobin değerleri ve
hızlı demir replasmanına ihtiyaç duyulması gibi durumlarda intravenoz (İV)
demir tedavisi tercih edilmektedir. Bu derlemede gebelikte demir
ve folat eksikliği anemisinde kanıta dayalı güncel yaklaşımların incelenmesi
amaçlanmıştır.
A rare case report: Herlyn-Werner-Wunderlich syndrome (HWWS) seen with primary amenorrhea and cervical agenesis
Authors: TOPDAĞI Yunus Emre , TOPDAGİ YİLMAZ Emsal Pinar , KAYA TOPDAGİ Seray , KUMTEPE Yakup
Published: July 2019

The classic triad of Herlyn-Werner-Wunderlich syndrome
includes blind hemivagina,uterine didelphys and ipsilateral renal agenesis.Herlyn-Werner-Wunderlich
syndrome is a variant of Mullerian duct anomalies.Clinical presentation of the
Herlyn-Werner-Wunderlich syndrome is usually accompanied by severe dysmenorrhea
secondary to hematometrocolpos beginning with menarche and palpable pelvic
mass.Early diagnosis and treatment are important in protecting the patient's
fertility and preventing complications in the long term.In this study,when a
13-year old patient from the pediatric age group was being investigated for the
pelvic mass,HWWS confirmed by MRI was identified.After the patient and his
family were informed,and their consent was taken,the diagnostic laparoscopy was
performed.Subsequently,after hematometra was removed by paravaginal repair,her
complaints were resolved.The patient was followed up regarding fertility and
endocrine functions,and a second operation could be performed in accordance
with her age.This syndrome should be kept in mind in pediatric and adolescent
patient groups who are investigated for severe dysmenorrhea, primary amenorrhea
or pelvic mass.
Exchange Rate Dynamics and Monetary Spillovers with Imperfect Financial Markets
Authors: Akinci Ozge , Queralto Albert
Published: July 2019

We use a two-country New Keynesian model with financial frictions and dollar debt in balance sheets to investigate the foreign effects of U.S. monetary policy. Financial amplification works through an endogenous deviation from uncovered interest parity (UIP) arising from limits to arbitrage in private intermediation. Combined with dollar trade invoicing, this mechanism leads to large spillovers from U.S. policy, consistent with the evidence. Foreign monetary policies that attempt to stabilize the exchange rate reduce welfare, and may exacerbate exchange rate volatility. We document em- pirically a link between UIP deviations and measures of credit market frictions, as predicted by the model.
Creating a Book Club with a Critical Approach to Foster Literacy Practices
Authors: Chaves Barrera Camila , Chapetón Claudia Marcela
Published: July 2019

This paper reports the pedagogical experience of creating a book club to foster the reading of short stories from a critical literacy perspective at a high school in Bogotá, Colombia. The Book Club arose as an after-school program where students, who were interested in the proposal, were free to join. First, the paper presents the fundamental concepts that guided the implementation. Then, it describes the central elements of the pedagogical experience: context, curricular platform, procedures, and activities. The final discussion centers on the role of a critical literacy approach that encouraged participants to go beyond concerns about the grammatical and linguistic aspects of the foreign language to focus on meaning-making. Also, to concentrate on responding and transacting with the texts while engaging in dialogic interactions that allowed them to share background knowledge, life experiences, social and individual issues of their realities and interests, and most importantly, enjoy the act of reading in a foreign language as it was seen as a social-situated practice.
Effects of Reading Strategy and Dictionary Instruction in an Undergraduate Foreign Language Reading Comprehension Group
Authors: Lopera Medina Sergio Alonso
Published: July 2019

This article reports the effects of the integration of dictionary use and the reading strategy approach in a foreign language reading comprehension course. A case study was used as a research method, and three instruments helped gather data: a reading comprehension test, field notes, and an interview. Fifteen undergraduate students from a public university in Medellin, Colombia, participated in the study. Improvement in reading, metacognitive awareness, and selective use of dictionary were found as part of positive effects. In contrast, tiredness appears to be as the negative effect. Conclusions suggest that both the reading strategy approach and the selective use of dictionary are a good combination to integrate into a foreign language reading course.
La investigación sobre deserción universitaria en Colombia 2006-2016. Tendencias y resultados
Authors: Rodríguez Urrego Marcela
Published: July 2019

Este artículo recoge los resultados más relevantes de una revisión documental de 28 investigaciones realizadas en Colombia entre el 2006 y el 2016, sobre deserción en educación superior. Esta revisión fue el punto de partida de una investigación sobre la deserción en la Licenciatura en Educación Comunitaria de la Universidad Pedagógica Nacional. Los resultados se presentan en seis apartados: 1) caracterización de la muestra en la que se tipifican los estudios revisados, según su metodología y objeto de investigación; 2) consideraciones generales sobre la deserción, donde se evidencia la concepción de deserción que sirve de punto de partida de los estudios; 3) conceptualización de la deserción, en donde se explicitan los conceptos centrales de los estudios revisados y los problemas asociados a una deficiente conceptualización; 4) factores asociados, en el que se reportan los modelos de deserción utilizados en los análisis estadísticos; 5) presenta de manera sucinta los resultados de las investigaciones empíricas con relación a la deserción en las unidades académicas o conjuntos de ellas estudiados, y 6) un aparte final con resultados y reflexiones referidos a la retención, permanencia y prevención de la deserción.
NEBNext dA-Tailing Module (NEB #E6053) v1
Authors: England Biolabs New , Teffera Menna
Published: July 2019

The NEBNext dA-Tailing Module has been optimized to efficiently incorporate a non-templated dAMP on the 3 ́ end of a blunt DNA fragment (1). 3 ́-dA DNA tailing prevents concadamer formation during subsequent ligation steps.DNA tailed with the NEBNext dA-Tailing module may be ligated to adaptors or cloning vectors with complementary dT overhangs. The NEBNext dA-Tailing Module is provided as a master mix to maximize efficiency and convenience in DNA sample preparation workflows. The NEBNext dA-Tailing Module has been validated by sequencing with the Il- lumina Genome Analyzer II (Illumina, Inc.) in conjunction with the NEBNext End Repair Module, NEBNext Quick Ligation Module and Phusion® High-Fidelity PCR Master Mix. For larger volume requirements, customized and bulk packaging is available by purchasing through the OEM/Bulks department at NEB. Please contact OEM@neb.com for further information.
Evaluation of Light Curing Units and Dentists’ Knowledge About Photo Polymerization Techniques in Sulaimani Governmental Dental Clinics
Authors: Mahmood Mohammed , Faraj Bestoon
Published: July 2019

Objective: To measure the output intensity of light curing units (LCU) in governmental dental clinics of the Sulaimani governorate. To evaluate practitioners’ knowledge on light cure application.

Methods: Ninety-four dental units and eighty-eight dentists in the Sulaimani governorate were included in this research. Output intensity and diameter of tips of the dental LCU devices were measured. Two survey questionnaires were filled, one for the LCU and its maintenance, the other for evaluating the knowledge, attitude, and practice of the dentists. 

Results: Output power intensity results ranged from 50-2000W, with an average of 993W. The output intensity of 78% of the tested devices was found to be acceptable regarding the manufacturer instruction of the radiometers used (every intensity below the given range that given in the Result section is regarded as unusable or non-acceptable). The range of age in service of the devices was 1-12 years with a mean of 4.7 years. The average restorations performed in a week by a device was 17.8. Dentists had poor knowledge, attitude, and practice towards the maintenance of the LCU devices. 51% of the dentists were quite satisfied with the devices. 48.9% of the dentists reported that they don’t have an idea of LCU intensity.

Conclusions: Devices should be checked regularly for output intensity, light bulb efficiency, and composite build up. Dentists express poor knowledge, maintenance, and attitude toward LCUs. Educational programs are advisable and recommended.
Generating Drift‐Free, Consistent, and Perfectly Spectrum‐Compatible Time Histories
Authors: Yang Lanlan , Xie Wei‐Chau , Xu Weiya , Ly Binh‐Le
Published: July 2019

The focus of this article is on generating spectrum‐compatible acceleration, velocity, and displacement time histories for seismic analysis and design of engineering structures. If a generated acceleration time history is integrated to obtain the corresponding velocity and displacement time histories, it has been found that there are usually drifts in the resulting processes. Such drifts are due to overdeterminacy in the constants of integration. Baseline correction, although widely used, is not a suitable remedial measure to remove drift because it distorts the frequency content and renders the corrected processes no longer mutually consistent.

The objective of this article is to develop an efficient and accurate method for generating drift‐free, consistent, and spectrum‐compatible time histories, which are essential properties for these time histories to be used as seismic input in time history analysis. To ensure drift‐free and consistent behavior, the eigenfunction method is applied to expand the time histories in eigenfunctions of a sixth‐order ordinary differential eigenvalue problem. The influence matrix method considering the influence of one frequency component on all others is capable of achieving perfect spectrum compatibility which has never been accomplished.
Pengaruh aktivitas fisik terhadap kapasitas memori kerja pada pelajar SMA
Authors: Rizvialdi Rizvialdi , Sidarta Nuryani
Published: July 2019

LATAR BELAKANG

Memori Kerja merupakan salah satu bagian dari fungsi eksekutif otak yang dinilai sangat penting untuk menunjang kemampuan proses belajar siswa sekolah. Penelitian menunjukan bahwa prevalensi anak dengan kapasitas memori kerja yang rendah adalah sekitar 15%, dan 80% anak tersebut mengalami kesulitan akademik. Hasil penelitian menunjukan hubungan kuat antara aktivitas fisik dengan fungsi kognitif otak, terutama memori kerja. Penelitian lain memperlihatkan korelasi lemah antara aktivitas fisik dengan fungsi kognitif otak. Oleh karena itu, peneliti ingin melihat kembali hubungan antara aktivitas fisik dengan kemampuan memori kerja khususnya siswa SMA di Jakarta

METODE

Penelitian ini menggunakan studi analitik observasional dengan desain cross-sectional (potong-silang). Teknik pengambilan sampel pada penelitian ini menggunakan teknik non random consecutive sampling yang melibatkan siswa SMAN 54 Jakarta. Jumlah responden yang didapat adalah sebanyak 56 siswa. Pengambilan data menggunakan instrumen kuesioner IPAQ untuk intensitas dan frekuensi aktivitas fisik serta WISC-IV mengukur indeks memori kerja. Analisis data dilakukan dengan uji korelasi Gamma. 

HASIL

Terdapat korelasi antara intensitas aktvitas fisik dengan indeks memori kerja (r=0.487; p=0.023). Selain itu juga terdapat hubungan antara frekuensi aktivitas fisik dengan indeks memori kerja (r=0.220; p=0.458).

KESIMPULAN

Terdapat korelasi positif antara intensitas aktivitas fisik dan kemampuan memori kerja pada pelajar SMA. Hal ini berarti bahwa semakin tinggi intensitas aktifitas fisik yang dilakukan oleh seorang siswa maka semakin tinggi pula kemampuan memori siswa tersebut.
İNTERNET BANKACILIĞINDA E-HİZMET KALİTESİNİN ANALİZİ ÜZERİNE BİR ARAŞTIRMA
Authors: BAŞARAN Ümit , AKSOY Filiz
Published: July 2019

Bu çalışmada internet bankacılığında e-hizmet kalitesi
bileşenlerinin hangi değişkenlerden meydana geldiği araştırılmakta ve bu
bileşenlerin müşterilerin genel e-hizmet kalitesi algısı üzerindeki etkileri belirlenmeye
çalışılmaktadır. Bununla birlikte, internet bankacılığında genel e-hizmet
kalitesi, müşteri memnuniyeti, tekrar satın alma niyeti ve ağızdan ağıza
iletişim değişkenleri arasındaki ilişkiler incelenmektedir. Bu amaçlarla kota
örneklemesi yöntemiyle seçilen ve internet bankacılığı kullanan 875 tüketici
üzerinde anket uygulaması gerçekleştirilmiştir. Elde edilen veriler
çerçevesinde çalışmanın hipotezleri yapısal eşitlik modellemesi ile analiz
edilmiştir. Çalışma bulguları e-hizmet kalitesi bileşenlerinin bilgi kalitesi,
estetik, işlem süreci, uygunluk, hizmet çeşitliliği, fiyat teklifleri,
kişiselleştirme, işlem doğruluğu, hizmet seviyesi, iade politikaları, güvenlik
ve gizlilik değişkenlerinden oluştuğunu göstermektedir. Genel e-hizmet kalitesi
üzerinde işlem doğruluğu, gizlilik, estetik, işlem süreci, güvenlik, bilgi
kalitesi, kişiselleştirme ve fiyat teklifleri değişkenlerinin etkili olduğu
tespit edilmiştir. Genel e-hizmet kalitesi, müşteri memnuniyeti, tekrar satın
alma niyeti ve ağızdan ağıza iletişim değişkenleri arasında yüksek etkili
ilişkiler saptanmıştır. Elde edilen bu bulgulardan yola çıkılarak literatüre ve
uygulamaya yönelik birtakım çıkarım ve önerilerde bulunulmaktadır.
İÇ GİRİŞİMCİLİĞİN YENİ ÜRÜN GELİŞTİRME ÜZERİNDEKİ ETKİSİNDE TAKIM YENİLİK İKLİMİNİN ARACI ROLÜ
Authors: ASLAN Hüseyin , YILDIZ Bülent
Published: July 2019

Bu çalışmada
imalat firmalarında iç girişimciliğin takım yenilikçi iklimi ile yeni ürün
geliştirme faaliyetleri üzerindeki etkisi araştırılmıştır. Ayrıca iç
girişimciliğin yeni ürün geliştirme üzerindeki etkisinde takım yenilikçi
ikliminin aracılık rolü test edilmiştir. Bu amaçla gıda sektöründe faaliyet
gösteren ve Türkiye’nin ilk 500 sanayi firması içerisinde yer alan bir gıda
firması çalışanlarından elde edilen veriler ile araştırma yapılmıştır. 157
çalışandan anket ile elde edilen veriler yapısal eşitlik modeli ile analiz
edilmiştir. Analiz neticesinde iç girişimciliğin yeni ürün geliştirmeyi pozitif
yönde anlamlı olarak etkilediği bulgusuna ulaşılmıştır. İç girişimciliğin takım
yenilikçi iklimini pozitif yönde anlamlı olarak etkilediği tespit edilmiştir.
Takım yenilikçi ikliminin de yeni ürün geliştirmeyi pozitif yönde anlamlı
olarak etkilediği bulgusu elde edilmiştir. Yapılan Sobel testi sonucunda ise iç
girişimciliğin yeni ürün geliştirme üzerindeki etkisinde takım yenilikçi
ikliminin kısmi aracılık rolü bulunduğu bulgusuna ulaşılmıştır.
BANKALARIN FİNANSAL YAPISININ KARLILIK ÜZERİNDEKİ ETKİSİ: ÖZEL SERMAYELİ MEVDUAT BANKALARI ÜZERİNE BİR İNCELEME
Authors: KILIÇ Meltem
Published: July 2019

Bu çalışmada, Türkiye’nin Bankacılık
Sektöründe faaliyet gösteren özel sermayeli mevduat bankalarının karlılık ve
finansal yapıları arasındaki ilişki incelenmiştir. Bu kapsamda Türkiye Bankalar
Birliğine kayıtlı 8 özel sermayeli mevduat bankasının 2011-2017 yılları
arasındaki yıllık mali tablolarından elde edilen finansal yapı ve karlılık
göstergeleri arasındaki ilişki panel veri analizi ile incelenmiştir. Çalışmada
bağımlı değişken olarak aktif karlılık ve net faiz marjı kullanılırken,
bağımsız değişken olarak toplam kredi, öz sermaye, mevduat ve banka büyüklüğü
kullanılmıştır. Çalışmanın sonucunda, toplam kredi/aktif toplam ile öz sermaye
oranının aktif karlılık ve net faiz marjı üzerinde pozitif etkisinin olduğuna
ulaşılmıştır. Toplam mevduat/aktif toplamı oranının aktif karlılık üzerinde
etkisinin olmadığı, net faiz marjı üzerinde ise negatif etkisinin olduğu tespit
edilmiştir. Aktif büyüklüğün ise aktif karlılık üzerinde pozitif, net faiz
marjı üzerinde negatif etkisinin olduğu tespit edilmiştir.
Study of clinical efficacy, safety and tolerability of low cost branded generic antiepileptic drugs in children and adolescents
Authors: Parekh Neha Vijay , George Ruth Susan , Dharmadhikari Adhiraj , Srivastava Kavita , Panda Bijoy Kumar
Published: July 2019

Background: Generic substitution is preferred to reduce healthcare costs and improve patient adherence. The review of literature showed that physicians all around the world were not comfortable in prescribing generic medications due to the lack of evidence on their safety and efficacy.Methods: A prospective study was conducted over a period of one year in Pune. The patients were categorized on their age and were assessed for the clinical effectiveness data (no. of breakthrough seizures and seizure free days) and safety data (no. of ADR episodes). The mean number of patients controlled and the frequency of adverse events at the 3rd and 6th month were calculated.Results: Authors assessed 150 newly diagnosed pediatric epileptic patients who received anti-epileptic drug monotherapy for at least 6 months, out of which 46 (30.66%) received Oxcarbazepine and 104 (69.33%) received Sodium Valproate. At the end of 3 months of therapy 140 (93.33%) patients were seizure free and 145 (96.66%) patients were seizure free at the end of  6 months. Adverse effects were observed in 14 (30.43) patients on oxcarbazepine and 26 (25%) patients on sodium valproate. The most common adverse effect was weight gain in 34 (22.66%) patients with both the AEDs.Conclusions: Seizure control was achieved in majority of the patients. In addition to the seizure control, the frequency of adverse effects was few and tolerable by the patients when prescribed with low cost branded generics.
Knowledge, attitude and practice among consumers about adverse drug reaction reporting
Authors: Patel Jeet J. , Shah Megha K. , Patel Prakruti P. , Gandhi A. M. , Desai Mira K.
Published: July 2019

Background: Background: Adverse Drug Reaction (ADR) reporting by consumers is quite low in India. Assessing knowledge and attitude of consumers regarding ADR reporting and observing practice of ADR reporting among them can help explore probable causes for underreporting of ADRs by consumers.Methods: This was a cross-sectional study conducted in a tertiary care teaching hospital using investigator-administered questionnaire and interviewing indoor patients of Surgery, Medicine, Obstetrics & Gynaecology and Dermatology departments. The questionnaire was prepared to assess knowledge, attitude and practice of consumers about ADR reporting. Data was analysed using mean, standard deviation and percentages.Result: A total of 820 consumers of medicines were included. It was found that 32.2% consumers were not aware that a drug can produce adverse effects. After being explained about adverse drug reactions, 94.6% consumers felt that adverse drug reactions should be reported. However, 98.8% consumers were not aware of Pharmacovigilance Programme of India. After consulting about consumer reporting programme, majority of respondents (96.1%) felt that the direct consumer reporting programme helps reporting of ADRs. Moreover, 93.7% of consumers were willing to use it to report ADRs in future. Consumers preferred the Telephonic method with a Toll free number for ADR reporting followed by informing a health care professional.Conclusion: Poor knowledge and awareness about ADR reporting is the major factor for low to nearly absent ADR reporting by consumers in India.
A study on the efficacy and adverse effects of methotrexate in psoriasis patients in a tertiary care centre
Authors: S. Yesodha , G. Sujatha , J. Arunkumar
Published: July 2019

Background: Psoriasis is a common, chronic and recurrent inflammatory disease of the skin. Methotrexate has been used in patient with psoriasis, a folic acid antagonist interfering with purine pathway and the mechanism of action in psoriasis is immune modulation and anti-inflammation. So, this study aims at monitoring the efficacy and adverse effects of methotrexate in south Indian patients with psoriasis attending a tertiary care hospital.Methods: It is a prospective, observational study conducted for a period of one year in subjects of either sex having psoriasis. Methotrexate was initiated in a single weekly oral dose of 5mg to 25mg. The efficacy was evaluated using psoriasis Area and Severity Index (PASI) score in all patients before starting methotrexate therapy and the end of first month, third month and sixth month of therapy. Adverse reaction was monitored.Results: All 40 psoriasis patients after treatment with methotrexate therapy showed improved  skin lesions by falling PASI scoring at the end of first, third and sixth month of treatment. None of the patients in our study had pulmonary toxicity, life threatening adverse effects which required hospitalization.Conclusions: Use of methotrexate in the treatment of psoriasis in this study was found to be safe and highly efficacious and caused minimal adverse effects and it was well tolerated.
Drug utilization study of psychotropic drugs in psychiatry out-patient department of a tertiary care hospital in Kerala: a geriatric perspective
Authors: S. I. D Shaikh Ubedulla , V. Niloofar
Published: July 2019

Background: Geriatrics tend to be the largest consumers of prescribed drugs exposing them to various drug interactions and adverse drug reactions. Present study is an attempt to assess the drug utilization pattern of psychotropic drugs among the geriatrics in psychiatry out-patient department (OPD) of a tertiary care hospital in Kerala.Methods: Prescriptions of patients diagnosed with psychiatric illness and being prescribed at least one psychotropic drug were collected. Prescriptions of male and female patients of age more than 60 years were sorted and analysed separately according to WHO core prescribing indicators.Results: 18% prescriptions were of geriatric population. Depressive disorders (38.89%) were the most common psychiatric disorder encountered. Out of 291 drugs prescribed in geriatrics, 237(81.44%) drugs were psychotropic drugs. Among the total psychotropic drugs prescribed, antipsychotics (39.24%) were the most commonly prescribed class of drugs. Average number of psychotropic drugs per prescription was 2.19, drugs prescribed by generic name were 2.06% and the drugs prescribed from NLEM (2015) were 41.77%. 86.11% of prescriptions contained more than one drug and 33.33% of prescriptions contained FDCs.Conclusions: Prescription analysis using WHO prescribing indicators showed some deviations from the standard which can be improved. A trend of polypharmacy was noted in this study. Prescribing using generic name and prescribing from NLEM was low as compared to the other reference studies. Proper strategies taken to overcome the inadequacies pointed out by this study can ensure the rational use of medicines.
A study on pattern of adverse drug reaction in an adverse drug reaction monitoring centre of a tertiary care hospital in South Kerala, India
Authors: Rajan Ajay , T. Ramani P. , Raj Sabitha
Published: July 2019

Background: Adverse drug reactions (ADR) are rated as fifth leading cause of death and accounts for approximately 5% of all hospital admissions. Under reporting of ADR from healthcare professional is considered as the contributing factor for increased morbidity and mortality. India has taken well appreciated step to launch Pharmacovigilance Programme of India (PvPI) to safeguard heath care of Indian population. This study looks into the detailed analysis of ADR reported to adverse drug reaction monitoring centre (AMC), Government Medical College, Trivandrum to assess its pattern, causality, severity and seriousness of ADR. Primary objectives of this study are the pattern of adverse drug reactions reported to ADR monitoring centre (AMC) and secondary objective is to assess causality, severity.Methods: A record based descriptive study was conducted in the ADR monitoring centre of government medical college, Trivandrum, Kerala from September 1st  2016 to February 2017(6 months). The data were collected from the all reported case records/ ADR report form of CDSCO. The details of the various adverse drug reactions were identified and analysed to find the pattern of adverse drug reactions including distribution of age, gender, causal drug group, system organ class. Also, an attempt is made to do causality assessment using WHO UMC scale and severity by using Heart wig Seigel Scale.Results: Out of 320 ADR cases, majority of reports were due to cutaneous manifestations. Most common ADRs were erythema, induration, and rash, itching. Females were 56% and males were 44%. Majority cases were of adult age group. Causality 91.88% were probably related, 75.6% were mild reaction. 25% of cases were serious. 77.5% were recovered. Antibacterial implicated 25(7.8%) followed by anti-epileptics 24 (7.5%) ADR.Conclusions: The pattern of adverse drug reactions reported to this AMC is comparable to the studies done in other parts of country. A strong need for streamlining of ADR monitoring system and reporting reemphasized by this study, which will promote the ADR reporting in healthcare professionals.
A prospective observational study to assess compliance and factors influencing compliance with antiepileptic drugs among patients with epilepsy
Authors: Singh Paramjit , Gupta Kanchan , Singh Gagandeep , Kaushal Sandeep
Published: July 2019

Background: The primary treatment for epilepsy is Antiepileptic drug (AED) therapy. Non-compliance to AEDs can result in break-through seizure, emergency department visits, hospitalizations, fractures, head injuries and increased mortality. Thus, compliance to AEDs is crucial to be studied. Objective is to study compliance and factors influencing compliance with AEDs among patients with epilepsy.Methods: This observational study was conducted in 105 patients with epilepsy on AED therapy in community in Ludhiana (Punjab) after approval from Institutional Ethics Committee. Demographic data and drug history was collected. Monthly follow up for 6 months was done by paying home visits and data regarding type, dose, frequency of administration of AED was recorded on a semi-structured performa. Pill count was done by recording number of pills dispensed and number of pills remaining with patient. Response to Morisky’s Medication Adherence Scale (MMAS) was also recorded. Results were correlated with patient demographics, type, frequency and number of AEDs.Results: Out of 105 patients, 65 were males and 40 were females. Fifty-four patients were non-compliant with both pill-count and MMAS. Non-compliance was high in first month and decreased gradually. Poly-therapy, lower socio-economic status and multiple dosing regimens were most commonly associated with non-compliance.Conclusions: Under-dosing was more common among non-compliers, which explains the high reporting of forgetfulness to take medicine in MMAS. Both pill count and MMAS are effective non-invasive tools to study compliance.
Prescribing pattern and pharmacoeconomic analysis of antidiabetic drugs
Authors: Goyal Pardeep Kumar , Arora Shalini , Mittal Naveen , Mahajan Bharti , Kaushal Sandeep
Published: July 2019

Background: Diabetes Mellitus is a worldwide growing problem causing threat to patient's health because of its association with various complications and comorbidities. It is a chronic disease requiring lifelong medication which further adds to the economic burden. The objective of this study was to evaluate the prescribing pattern and to do pharmacoeconomic analysis of prescribed antidiabetic drugs.Methods: This observational cross sectional study was conducted for 12 months duration in Outpatient Pharmacy of tertiary care hospital. Prescriptions with antidiabetic drugs were captured and evaluation of prescribing pattern along with pharmacoeconomic analysis of antidiabetic drugs was done.Results: A total of 611 prescriptions with antidiabetic drugs were analyzed. There were total 4034 drugs in all prescriptions with a mean of 6.6 drugs per prescription. 4.28% of drugs were prescribed by generic name and 58.9% of prescribed drugs were from essential drug list. Dual drug therapy was prescribed in maximum number of patients (42.2%) followed by monotherapy (28.8%). More commonly prescribed class of antidiabetic drugs was biguanides as monotherapy (n=119) and its combination with sulfonylureas was prescribed maximally among dual drug therapy (n=158). Cost of monthly therapy for antidiabetic drugs prescribed as monotherapy was least with Biguanides (₹ 98.89/ month) whereas combination of biguanides and thiazolidinediones was least expensive among dual drug therapy (₹ 216/ month).Conclusions: Biguanides was the most common prescribed class of antidiabetic drugs among monotherapy and its combination with sulfonylureas was most prescribed as dual drug therapy and both of these therapies were economical.
Evaluation of prescription pattern and quality of life in postmenopausal osteoporosis: a cross sectional study
Authors: Agrawal Siddharth Pravin , Patel Suhani V. , Malhotra Supriya , Patel Pankaj R.
Published: July 2019

Background: Osteoporosis (OP) is a silently progressing metabolic bone disease that results in loss of mineralized bone and subsequent fractures with minor trauma. Fracture related pain and physical inability to perform activities of daily living can lead to psychological consequences that impair Quality of Life (QoF). However, much less is known about Indian scenario. Hence, our study becomes imperative. Aim of this study to the drug utilization pattern and to analyze Quality of life of postmenopausal women suffering from osteoporosis.Methods: An analytical cross-sectional study was done on 91 post-menopausal osteoporotic women. Drug utilization pattern was evaluated. Pre-validated QUALEFFO-31 questionnaire was administered to each patient to record patient’s perceived QoL. Scores were calculated according to the algorithm. Higher scores indicated poor QoL. The collected data was analyzed with SPSS software (version 23)and p value ≤0.05 was considered as statistically significant.Results: The mean age group of presenting patients was 56.2±6.6 years. All the patients received Calcium and vitamin D supplements and non-steroidal anti-inflammatory drugs for pain relief. But only 33% of the patients received any one of the bisphosphonates (BP). For analysis, patients were grouped into Group-1(n=60) who did not and Group-2 (n=31) who did receive a BP. QOL analysis showed that pain domain was affected the most. Also, patients in Group 2 reported worse score in all the domains in comparison to Group 1 (P<0.05). It is likely that BP might need more time to show considerable effect or because it was added only to those patients who already had more complaints and could afford the high cost.Conclusion: BP in spite of being the drug of choice for OP is used less commonly in India. OP causes pain and physical debilitation with detrimental effect on mental health. Longer duration prospective studies are needed to study the association of QoL and use of BP in OP patients.
Drug Utilization pattern of psychotropic medicines in tertiary care centre of Bastar Region, Chhattisgarh, India
Authors: Agrawal Ratna , A. Marium K. , Sharma Raj Kumar , Sharma Sanat Kumar , Jaiswal Mahendra Kumar
Published: July 2019

Background: With the changing lifestyle, the incidence of psychiatric illness is increasing day by day. And the mental illnesses not only affect the social and personal life but also adds additional economic burden affecting quality of life of the person. So, proper diagnosis and management of psychiatric illnesses is utmost important. So, keeping this in mind, the present study has been conducted to evaluate drug utilization pattern of psychotropic medicines in tertiary care centre of Bastar region.Methods: After obtaining approval from Institutional Ethics Committee, present study was conducted in 237 patients for a period of 3 months from February 2019 to April 2019. The data of patients attending psychiatry OPD was collected in a structured case record form. The data were analysed using graph pad prism version 6.0.Results: Out of total 237 patients, males 136(57.38%) outnumbered females 101 (42.62%). The major psychiatric illness reported was schizophrenia (45.99%) followed by bipolar affective disorder (16%) and generalized anxiety disorder (14.35%). Average number of psychotropic drugs per prescription was 1.74±1.02. The percentage of drugs prescribed from state Essential drug List (EDL) was 93.05%.Conclusions: Overall, the principles of rational prescribing was tried to be maintained, as polypharmacy has been avoided and most of the drugs were prescribed from the state EDL. The use of generic drugs should be increased to make prescriptions more rational and to cut down the cost of the therapy which may be helpful in increasing the quality of life of the patients.
The comparative effects of Itopride and Levosulpiride orally used in patients suffering from Non-ulcer dyspepsia
Authors: Ranjan Ashish , Chandra Akash , Kumar Deepak
Published: July 2019

Background: Itopride and Levosulpiride both comes under the group of Prokinetic drugs. These drugs are used for the treatment of non-ulcer dyspepsia, heart burn, nausea and vomiting. Both drugs act on dopaminergic D2 receptor as antagonist and increases the concentration of acetylcholine so that gastric peristalsis will be increase and that time pressure at lower oesophageal sphincter will be increase thus gastric motility increases and there will be good gastro-duodenal co-ordination.Method: This study has to conduct on patients with complains of non-ulcer dyspepsia attended Medical outdoor and department of pharmacology of SKMCH Muzaffarpur, Bihar, India. The total 60 patients have to include in the study, which have to randomly divide in two groups. Group A (itopride) comprising of 30 patients and Group B (Levosulpiride) comprising of 30 patients. Patients have to randomly allocate to receive one tablet of itopride hydrochloride, 50 mg three times daily before meal and one tablet Levosulpiride of 75 mg three times daily before meal. Authors have to enroll the patients at the interval of two weeks and continue it upto 3 months.Results: Study did not found any remarkable change in biochemistry profile. Only QT prolongation changes were found in two patients, but no serious cardiac toxicity was observed with patient receiving Levosulpiride. Neither QT prolongation nor serious cardiac toxicity was observed with itopride hydrochloride therapy.Conclusions: In present study, efficacy of Itopride was comparable to Levosulpiride in relieving the symptoms of non-ulcer dyspepsia. Both the drugs were clinically and biochemically well tolerated. QT prolongation changes were found in two patients, but no serious cardiac toxicity was observed with patient receiving Levosulpiride. Itopride does not show cardiac toxicity and any changes in ECG.
Drug utilisation study in medicine outpatient department at Ashwini Rural Medical College, Kumbhari, Solapur, India
Authors: Bhalerao Pramod P. , Waghmare Chandrakant S.
Published: July 2019

Background: Drug utilization studies are used to analyze different aspects of the use of drugs and to implement methods of improving therapeutic quality. This study was conducted to study drug prescription pattern in Medicine Outpatient Department (OPD) in Ashwini Rural Medical College, Kumbhari. Methods: Six hundred prescriptions were screened & analyzed as per the study parameters at Medicine OPD of Ashwini Rural Medical College, Kumbhari. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Doctor details and patient details like age, sex and address were analyzed. Also, groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed.Results: Most common group of drugs prescribed by physicians were Analgesics (21.84%), followed by Drugs for Peptic ulcer (17.92%) and Multivitamins/multimineral (14.70%). The average number of drugs prescribed per patient was 2.38. The incidence of Polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, etc.Conclusions: Authors conclude that most of the prescriptions which were analyzed at Ashwini Rural Medical College Hospital, Kumbhari, were according to the standard norms of WHO prescriptions and also most of the drugs prescribed were from the list of essential drug list. But still there is scope for improvement in prescription pattern.