bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Business Performance Using Data Envelopment Analysis and Grey Relational Analysis
Authors: Škrinjarić Tihana , Šego Boško
Published: October 2020

Financial ratios are used in a variety of ways today. Empirical research is getting bigger, with a special focus on predicting business failure, the strength of a company, investment decision making, etc. This chapter focuses on two methodologies suitable to deal with many data to evaluate business performance. They are data envelopment analysis and grey relational analysis. The empirical part of the chapter conducts an empirical analysis with the aforementioned two approaches. Firms are ranked based on their performances and detailed interpretations are obtained so that managers within businesses can get useful information on how to utilize such an approach to modelling. This study implicates that using the two mentioned approaches can be useful when making investment decisions based on many data available for the decision maker. This is due to the methodology being suitable to handle big data and correctly quantifying the overall financial performance of a company.
Use of Data Analytics to Increase the Efficiency of Last Mile Logistics for Ecommerce Deliveries
Authors: Nagpal Gaurav , Bishnoi Gaurav Kumar , Dhami Harman Singh , Vijayvargia Akshat
Published: October 2020

With the increasing share of digital transactions in the business, the way of operating the businesses has changed drastically, leading to an immense opportunity for achieving the operational excellence in the digital transactions. This chapter focusses on the ways of using data science to improve the operational efficiency of the last mile leg in the delivery shipments for e-commerce. Some of these avenues are predicting the attrition of field executives, identification of fake delivery attempts, reduction of mis-routing, identification of bad addresses, more effective resolution of weight disputes with the clients, reverse geo-coding for locality mapping, etc. The chapter also discusses the caution to be exercised in the use of data science, and the flip side of trying to quantify and dissect the phenomenon that is so complex and subjective in nature.
Computer-Aided Diagnosis of Knee Osteoarthritis From Radiographic Images Using Random Forest Classifier
Authors: Pavithra D.  , Vanithamani R.  , Justin Judith
Published: October 2020

Knee osteoarthritis (OA) is a degenerative joint disease that occurs due to wear down of cartilage. Early diagnosis has a pivotal role in providing effective treatment and in attenuating further effects. This chapter aims to grade the severity of knee OA into three classes, namely absence of OA, mild OA, and severe OA, from radiographic images. Pre-processing steps include CLAHE and anisotropic diffusion for contrast enhancement and noise reduction, respectively. Niblack thresholding algorithm is used to segment the cartilage region. GLCM features like contrast, correlation, energy, homogeneity, and cartilage features such as area, medial, and lateral thickness are extracted from the segmented region. These features are fed to random forest classifier to assess the severity of OA. Performance of random forest classifier is compared with ANFIS and Naïve Bayes classifier. The classifiers are trained with 120 images and tested with 45 images. Experimental results show that random forest classifier achieves a higher accuracy of 88.8% compared to ANFIS and Naïve Bayes classifier.
Healthcare Conversational Chatbot for Medical Diagnosis
Authors: Jagtap Rohan , Phulare Kshitij , Kurhade Mrunal , Gawande Kiran Shrikant
Published: October 2020

Medical services are basic needs for human life. There are times when consulting a doctor can be difficult. The proposed idea is an AI-based chatbot that will provide assistance to the users regarding their health-based issues. The state of the art in the aforementioned field includes extractive bots that extract the keywords (i.e., symptoms from the user's input) and suggest its diagnosis. The proposed idea will be a conversational bot, which unlike the QnA bot will take into consideration the context of the user's whole conversation and reply accordingly. Thus, along with symptom extraction, the user will get a better experience conversing with the bot. The user can also normally chat with the chatbot for issues like if the user is not emotionally sound. For example, the bot will console the user if he/she is feeling stressed by recognizing the emotional health of the user.
Sickle cell avascular necrosis: Prevalence and clinical profiles in a tertiary hospital northwestern Nigeria
Authors: Awwalu Sani , Hassan Abdulaziz , Kusfa Ibrahim U. , Waziri Aliyu D. , Ibrahim Ismaila N. , Yahaya Garba
Published: October 2020

Acute painful crises are the hallmark of Sickle Cell Anaemia (SCA). However, chronic daily pain also occurs in SCA patients with a high frequency. Avascular Necrosis (AVN) of the femur is an important cause of chronic pain and adversely affects their quality of life. The aim is to determine the prevalence of AVN among SCA patients in Zaria and describe some of its clinical and laboratory features. A cross-sectional study of 58 SCA patients in steady state. Data on gender, age, presence of radiologically diagnosed AVN, number of pain crises, blood transfusions in the previous 12 months and laboratory parameters were collated. Data were analyzed using JASP version 0.11.1.0. A critical level of α of 0.05 was set. Females constituted 40 out of 58 (69.0%) of the study participants. The median age was 23 (19.8, 28.0) years. AVN was present in 6 out of 58 (10.3%). There was no relationship between gender and AVN (FET, p=1.00, OR=0.889 95% CI 0.147, 5.359). There was no age difference between patients with AVN and those without AVN (29.92 vs 29.45, MWU=153.500, p=0.956). Patients with AVN had lower mean rank HCT levels (24.08 vs 30.13, MWU=123.500, p=0.414), higher pain episodes (31.67 vs 29.25, MWU=169.000,p=0.747), number of blood transfusions (33.42 vs 29.05, MWU=179.500, P=0.549) and platelets (34.00 vs 28.98, MWU=183.000, p=0.499) compared to those without AVN. Avascular necrosis is common among SCA patients in Zaria. These patients have more blood transfusions and bone pain episodes compared to those without AVN.
High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation
Authors: Destro Francesca , Selvaggio Giorgio , Marinoni Federica , Pansini Andrea , Riccipetitoni Giovanna
Published: October 2020

Primary Obstructive Megaureter (POM) is a common cause of hydronephrosis in children with spontaneous resolution in most cases. High-Pressure Balloon Dilatation (HPBD) has been proposed as a minimally invasive procedure for POM correction in selected patients. The aim of the paper is to review our experience with HPBD in patients with POM. We performed a retrospective study in a single Centre collecting data on patients’ demographics, diagnostic modalities, surgical details, results and follow-up. In particular, the endoscopic aspect of the orifice permitted the identification of 3 patterns: adynamic ureteral segment, stenotic ureteric ring and pseudoureterocelic orifice. We performed HPBD in 30 patients over 6 years. We had 23 patients with adynamic distal ureteral segment (type 1), 4 with stenotic ring (type 2) and 3 with ureterocelic orifice (type 3). In 3 patients (10%) the guidewire did not easily pass into the ureter requiring ureteral stenting or papillotomy. Post-operative course was uneventful. Five patients (3 pseudoureterocelic) required open surgery during follow-up. HPBD for the treatment of POM is a safe and feasible procedure and it can be a definitive treatment of POM. Complications are mainly due to double J stent and none of our patients had symptoms related to vescico-ureteral reflux. The aspect of the orifice, identified during cystoscopy, seems to correlate with the efficacy of the dilatation: type 1 and 2 are associated with good and excellent results respectively; type 3 do not permit dilatation in almost all cases requiring papillotomy. HPBD can be performed in selected patients of all paediatric ages as first therapeutic line. The presence of a pseudoureterocelic orifice or long stenosis might interfere with the ureteral stenting and seems associated with worse outcomes.
Investigating the Effect of Hyoscine and Dexamethasone on Cervical Preparation in Primigravid Women with Term Pregnancy: A Double-blind Randomized Clinical Trial
Authors: Shabanian Sheida , Danesh Azar , Najafi Saba
Published: October 2020

ABSTRACT

Objective:

Pregnancy outcomes are an important factor in women’s quality of life, and negative experiences have adverse effects on the overall health of the mother and the family. This study was designed and implemented to compare the effects of two drugs, hyoscine and dexamethasone, on cervical ripening and effacement during childbirth.

Methods:

This study was a double-blind randomized clinical trial of 150 patients divided into three groups. The researchers, in the early stage (latent) of labor, gave 8 mg of dexamethasone intravenously to the first group, 20 mg of hyoscine butyl bromide to the second group, and 8 mg of dexamethasone along with 20 mg of hyoscine butyl bromide to the third group.

Findings:

Among the quantitative variables studied (length of labor induction, duration of active stage, first stage and second stage of labor, placental expulsion time, 5- and 10-min Apgar and Bishop score), active stage duration (P = 0.000) and 5-min Apgar (P = 0.042) had statistical differences among the three groups. In addition, the type of delivery (P = 0.003) and the percentage of fetal distress (P = 0.001) in the studied groups had a statistically significant difference, and also, in the third group, the cesarean rate was less than the other two groups.

Conclusion:

Simultaneous injection of hyoscine and dexamethasone in primiparous women can reduce the duration of the active stage of labor without obstetric complications, so its use in the latent stage is suggested.
Editorial
Authors: Tumwine James K
Published: October 2020

Nil.
Presentation and outcomes of early and late onset neonatal sepsis in a Nigerian Hospital
Authors: Ogundare Ezra , Akintayo Akinyemi , Aladekomo Theophilus , Adeyemi Lateef , Ogunlesi Tinuade , Oyelami Oyeku
Published: October 2020

Background: Neonatal Sepsis remains a major cause of morbidity and mortality in neonates despite great advances in antimicrobial therapy and life support measures.Objectives: To compare the aetiology, risk factors, presentation and outcomes of care between early onset neonatal sepsis (EOS) and late onset neonatal sepsis (LOS).Methods: Bacterial isolates were identified using blood cultures and antibiotic susceptibility testing was done using disc diffusion method. The risk factors, clinical presentation, laboratory findings and neonatal outcomes of the babies with EOS were compared with LOS. Statistical significance was set at P <0.05.Results: Neonatal Sepsis was responsible for 16% of Special Care Baby Unit (SCBU) admissions. Of the 72 babies with sepsis, 56 (77.8%) had EOS as against 16 (22.2%) who had late-onset sepsis. Low birth weight (p=0.01) and perinatal asphyxia (p=0.01) were significantly associated with EOS while for LOS, delivery outside the health facility (p=0.01) was the only significant risk factor. Respiratory distress was more significantly observed in EOS (p = 0.01). Neonatal deaths occurred in 32% of babies with EOS while all babies with culture positive LOS survived.Conclusion: Early onset neonatal sepsis is associated with high likelihood of neonatal mortality. Unsupervised delivery, birth asphyxia and low birth weight are risk factors associated with neonatal sepsis. Efforts to ensure supervised hospital delivery and improvement in neonatal resuscitation may reduce the incidence of neonatal sepsis and its attendant complications.Keywords: Onset neonatal , Nigerian Hospital.
Magnitude and factors associated with anti-malarial self-medication practice among residents of Kasulu Town Council, Kigoma-Tanzania
Authors: Mwita Stanley , Meja Omary , Katabalo Deogratias , Richard Catherine
Published: October 2020

Background: Anti- malarial self-medication practice in Africa is very common. It is considered as an alternative way for people who cannot afford the cost of health care services. This study was conducted to assess the magnitude and factors associated with anti-malarial self-medication practice among residents of Kasulu Town Council.Materials and methods: The study was a descriptive cross sectional study. Two hundred and eighty consenting respondents were selected by systematic random sampling and interviewed with the aid of a semi structured questionnaire to assess anti-malarial self- medication practice. A p value of less than 0.05 was considered statistically significant, at 95% confidence interval.Results: Prevalence of anti-malarial self-medication was (69.6%). Majority of the respondents (83.1%) reported that, they did not get better after self- medication. About 36% of the respondents metioned time taken in health facilities as the main factor for self- medication.Conclusion: This study revealed that, self-medication practice is very common among community members in Kasulu district. The main reasons identified for self-medication was long time taken to get treatment in health facilities.Keywords: Anti-malarial, Self- medication, Practice, Kasulu, Tanzania.
Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study
Authors: Bellazreg Foued , Guigua Ahmed , Ferjani Asma , Hattab Zouhour , Boukadida Jalel , Ach Koussay , Letaief Rached , Hachfi Wissem , Letaief Amel
Published: October 2020

Objective: To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs).Methods: We conducted a cross-sectional study in patients with DFIs hospitalized in a Tunisian teaching hospital. Superficial specimens were collected for all patients, and intra-operative specimens were collected in operated patients. The specimens were processed using standard microbiology techniques. Antimicrobial susceptibility testing was carried out according to the protocol established by the European Committee on Anti-microbial Susceptibility Testing. Intra-operative and superficial specimens were considered correlated if they isolated the same microorganism(s), or if they were both negative.Results: One hundred twelve patients, 81 males and 31 females, mean age 56 years, were included. Superficial samples were positive in 77% of cases, and isolated 126 microorganisms. Among the positive samples, 71% were monomicrobial. The most frequently isolated microorganisms were Enterobacteriaceae (53%), followed by streptococci (21%) and Staphylococcus aureus (17%). Nine microorganisms (7%) were multi-drug resistant. Intra-operative samples were positive in 93% of cases. Superficial specimens were correlated to intra-operative specimens in 67% of cases. Initial antibiotic therapy was appropriate in 70% of cases. The lower-extremity amputation and the mortality rates were 41% and 1%, respectively.Conclusion: In our study, DFIs were most frequently caused by Enterobacteriaceae and superficial specimens were correlated to intra-operative specimens in only two thirds of cases. Clinicians should emphasize on the systematic practice of intraoperative specimens in all patients with DFIs treated surgically, while well-performed superficial specimens could be useful for prescribing appropriate antibiotic therapy in other patients.Keywords: Diabetic foot infections, superficial specimens, intra-operative specimens.
Socio-demographic correlates of postpartum psychological distress among apparently healthy mothers in two tertiary hospitals in Enugu, South-East Nigeria
Authors: Odinka Paul , Odinka Jaclyn , Ezeme Mark , Ndukuba Appolos , Amadi Kennedy , Muomah Rosemary , Nwoha Stanley , Nduanya Ujunwa
Published: October 2020

Background: Postpartum depression and anxiety could cause poor mother-infant relationship that could impair infant growth and cognitive development. Psychiatric assessment has not been part of periodic evaluations in postnatal clinics. Some apparently well, but high-risk mothers continue to live with psychological distress, without treatment to relieve their burden.Objectives: The study assessed the prevalence of postpartum anxiety and depression, their co-morbidity, and socio-demographic predictors, within 6 - 14 weeks postpartum among nursing mothers in two tertiary hospitals in Enugu, South-East Nigeria.Methods: A cross-sectional study that was carried out at the postnatal and children’s welfare clinics of two tertiary hospitals in Enugu, South-East Nigeria. Hospital Anxiety and Depression Scale, Social Support Scale and Socio-demographic Questionnaire were used for the study. Correlations and multiple regressions were used to test for associations and risk factors. Results: Occurrence rate for anxiety and depression were 30.1% and 33.3% respectively with a co-morbidity rate of 22%. Low social support and multigravida predicted risk factors for postpartum psychological distress, while a higher number of children alive predicted a decrease in the risk for postpartum psychological distress.Conclusion: The study supports service planning and the development of strategies to reliably identify women at high-risk, for effective treatment.Keywords: Postpartum Psychological Distress, Socio-demographic, Correlates, Apparently Healthy, Mothers, South-East Nigeria.
Prevalence and associated factors of hypertension in Amhara regional state city and its’ surrounding rural districts: a community-based cross-sectional study
Authors: Tesfaye Tadesse Dagget , Temesgen Worku Animaw , Kasa Ayele Semachew , Yismaw Yeshaneh Seyoum
Published: October 2020

Background: Nowadays, among non-communicable diseases hypertension is a growing public health important disease both in developed and developing nations. Objective: The aim of this study was to determine the prevalence and associated factors of hypertension in Amhara Regional State city and its’ surrounding rural districts, Ethiopia. Method: Community-based cross-sectional study was conducted in the urban and rural communities living in Amhara Regional State city and its’ surrounding rural districts administrations in 2015. The WHO Stepwise approach was used for data collection.Result: A total of 1405 subjects participated and the response rate was 95.5%. The overall prevalence of hypertension was 11.4% either previously diagnosed or undiagnosed and was higher in older ages. Whereas the prevalence of hypertension was 13% for urban and 10% for rural residents. Nearly half of them (46.3%) were newly diagnosed. A family history of hypertension, being underweight, overweight, obese, and raised fasting blood sugar were found to be significantly associated with raised blood pressure.Conclusion: One among every three (37.4 %) and one among every nine study participants were found to have pre-hypertension and hypertension respectively.Keywords: Prevalence of hypertension, blood pressure, Bahir Dar.
Late ART Initiation among adult HIV patients at university of Gondar Hospital, NorthWest Ethiopia
Authors: Anlay Degefaye Zelalem , Tiruneh Bewket Tadesse
Published: October 2020

Introduction: Late initiation of anti-retroviral therapy (ART) is associated with low immunologic response, increase morbidity, mortality and hospitalization. Therefore, this study aimed to assess the prevalence and factors associated with late ART initiation among adult HIV patients in NorthWest Ethiopia.Methods: Retrospective cross-sectional study was conducted among 412 HIV patients who started ART between January/2009 and December/2014. Simple random sampling technique was used to select patient records. Data were collected by using pretested and structured extraction tool. Binary logistic regression model was fitted to identify factors associated with late ART initiation.Result: A total of 410 participants were included for analysis after excluding 2 participants with incomplete data. The prevalence of late ART initiation was 67.3%. Age between 35-44 years(AOR=3.85; 95%CI:1.68-8.82), duration between testing and enrollment to care<1year (AOR=2.19;95%CI:1.30-3.69), secondary education (AOR=2.59; 95%CI 1.36-4.94), teritary education(AOR=3.28; 95%CI 1.25-8.64), being unmarried(AOR=1.88; 95%CI 1.13-3.03), bedridden and ambulatory patients (AOR=4.68 95%CI:1.49-14.68), other medication use before ART initiation(AOR=2.18; 95%CI 1.07-4.44), starting ART between 2009-2010 (AOR=5.94; 95%CI 2.74-12.87) and 2011-2012(AOR=2.80; 95%CI 1.31-5.96) were significantly associated with late ART initation at p-value <0.05.Conclusion: The prevalence of late ART initiation was high. Strengthening the mechanisms of early HIV testing and linkage to care are recommended to initiate treatment earlier.Keywords: Associated factors, Late ART initiation, Ethiopia.
Acute human cytomegalovirus infection among voluntary blood donors in the Lake Victoria zone blood transfusion centre: should it be considered in screening?
Authors: Tebuka Erius , Fulgence Ruharara D , Msemwa Bertrand , Silago Vitus , Mshana Stephen E , Mirambo Mariam M
Published: October 2020

Background: Despite blood transfusion being a lifesaving option, it may be associated with blood borne infections including human cytomegalovirus(HCMV). The World Health Organization recommends screening of blood products for HCMV before transfusion to pregnant women, neonates and immunocompromised patients. However, this is not routinely practised in many resource limited countries.Objective: This study aimed at determining seroprevalence of specific HCMV IgM antibodies among volunteered blood donors at the Lake Victoria zone blood transfusion centreMethods: A total of 228 sera from volunteered blood donors were analyzed using HCMV IgM µ capture enzyme linked immunosorbent assay as per manufacturer’s instructions. Data were analyzed by STATA version 13Results: The median age of the study participants was 19 interquartile range (IQR): 18-23 years. The seroprevalence of specific HCMV IgM antibodies was found to be 23/228 (10.1%, 95% confidence interval (CI): 6-14. None of the factors was found to be associated with HCMV IgM seropositivity among blood donors.Conclusion: One out 10 blood donors in the Lake Victoria zone blood transfusion centre is acutely infected with HCMV. There is a need to consider screening of HCMV before blood transfusion particularly in resource limited countries where HCMV is endemic.Keywords: Human cytomegalovirus, Tanzania, blood transfusion.
Atazanavir / ritonavir versus Lopinavir / ritonavir-based combined antiretroviral therapy (cART) for HIV-1 infection: a systematic review and meta-analysis
Authors: Molla Tigabu Bereket , Doyore Agide Feleke , Mohraz Minoo , Nikfar Shekoufeh
Published: October 2020

Background: This systematic review and meta-analysis was conducted to evaluate the safety and effectiveness of Atazanavir/ritonavir over lopinavir/ritonavir in human immunodeficiency virus-1 (HIV-1) infection.

Methods: Clinical trials with a head-to-head comparison of atazanavir/ritonavir and lopinavir/ritonavir in HIV-1 were included. Electronic databases: PubMed/Medline CENTRAL, Embase, Scopus, and Web of Science were searched. Viral suppression below 50 copies/ml at the longest follow-up period was the primary outcome measure. Grade 2-4 treatment-related adverse drug events, lipid profile changes and grade 3-4 bilirubin elevations were used as secondary outcome measures.

Results: A total of nine articles from seven trials with 1938 HIV-1 patients were included in the current study. Atazanavir/ritonavir has 13% lower overall risk of failure to suppress the virus level < 50 copies/ml than lopinavir/ritonavir in fixed effect model (pooled RR: 0.87; CI: 0.78, 0.96; P=0.006). The overall risk of hyperbilirubinemia is very high for atazanavir/ritonavir than lopinavir/ritonavir in the random effects model (pooled RR: 45.03; CI: 16.03, 126.47; P< 0.0001).

Conclusion: Atazanavir/ritonavir has a better viral suppression at lower risk of lipid abnormality than lopinavir/ritonavir. The risk and development of hyperbilirubinemia from atazanavir-based regimens should be taken into consideration both at the time of pre- scribing and patient follow-up.

Keywords: Atazanavir; Atazanavir/ritonavir; lopinavir/ritonavir; viral suppression.
Experiences of people affected by rabies in Ethekwini district in the province of Kwazulu-Natal, South Africa
Authors: Mduduzi Hadebe Jeffrey , Nokuthula Sibiya Maureen
Published: October 2020

Background: South Africa is one of the countries in Africa adversely affected by rabies, a notifiable disease which can be fatal. Fatalities can be prevented if health care is sought timeously and people are educated about the disease. The Province of Kwa- Zulu-Natal, in particular, has had rabies outbreaks in the past which have led to loss of many lives and devastation of entire families.

Objective: The aim of the study was to explore the experiences of people affected by rabies in the eThekwini district of Kwa- Zulu-Natal, South Africa.

Methods: The study was guided by a qualitative, exploratory, descriptive design. The sample was purposively selected, and a semi-structured interview was used to collect data from people affected by rabies in the eThekwini district. Data saturation was reached after 12 participants were interviewed. Data was analysed by using Tesch’s eight steps of thematic analysis.

Results: The themes included family stability and support structures, exposure to risk factors and risky practices, factors that hindered participants from seeking health care assistance, limited knowledge about rabies and the effects of rabies.

Conclusion: It was evident that participants experienced many challenges during their rabies exposure. Individuals, who were directly affected by rabies through contact with rabid animals, were expected to take responsibility for their own lives.

Keywords: Rabies; South Africa; qualitative research.
Abdominal volume index: a predictive measure in relationship between depression/anxiety and obesity
Authors: Hadi Said , Momenan Mehrnaz , Cheraghpour Kasra , Hafizi Nadia , Pourjavidi Niloufar , Malekahmadi Mahsa , Foroughi Mona , Alipour Meysam
Published: October 2020

Background: Obesity is a risk factor for mood disorder (such as depression and anxiety). We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index (AVI), as new indices of obesity to evaluate the relationship between obesity and depression/anxiety.

Methods: This cross sectional study was conducted on 307 overweight and obese women (249 females, 58 males) 20-60 years in Iran in 2017-2018. The anthropometric measures including weight, waist circumference, hip circumference, body fat and derived values of body mass index, waist–hip ratio, AVI and ABSI were evaluated. HADS questionnaire for depression and anxiety completed.

Results: Prevalence of depression was 36.1% in women; men 24.1%; overweight 28.1%; obese 36.5 % and central obesity 33.7%. Anxiety was apparent in 27.1% of overweight 30.3 % obese and 29.6% central obesity. People with depression and anxiety had higher WC, BF and AVI. ABSI had no significant correlation with depression/anxiety. The odds of depression (1.06; 95% CI, 1.02-1.12) and anxiety (1.06; 95% CI, 1.01-1.11) were elevated with increase AVI.

Conclusion: Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety.

Keywords: Abdominal volume index; anxiety; depression.
Prevalence of insulin resistance and identifying HOMA1-IR and HOMA2-IR indexes in the Middle Black Sea region of Turkey
Authors: Kevser Demir Ayşe , Şahin Şafak , Uzun Kaya Süheyla , Bütün İlknur , Çıtıl Rıza , Önder Yalçın , Taşlıyurt Türker , Demir Osman , Deveci Köksal , Kutlutürk Faruk
Published: October 2020

Background: Insulin resistance (IR) is one of the most important etiological risk factors in the development of diabetes. How- ever, there is no clear data regarding the prevalence of IR in the country.

Objective: This study evaluates the prevalence of IR and identifies the optimal threshold values for the HOMA indexes in Turkey.

Methods: This cross-sectional, population-based survey includes 2013 participants aged 20–84 years. The values of the anthro- pometric measurements and laboratory analysis were recorded. The 90th percentile in the non-obese and non-diabetic population was accepted as cut-off values for IR.

Results: The optimal threshold values for IR were 2.46 in HOMA1-IR and 1.40 in HOMA2-IR. Using the HOMA2-IR method, the overall prevalence of IR was 33.2%. The IR prevalence was higher in women (35.6%) compared to men (30.1%) [p=0.008]. There was a higher IR prevalence in men living in urban areas (p=0.001), not in women. The multivariate logistic regression analysis showed that gender, serum glucose level, serum levels of triglycerides and high-density lipoprotein cholesterol, body- mass index and income status were associated with insulin resistance.

Conclusion: The cut-off values of HOMA1-IR and HOMA2-IR were determined in this study and we believe that these find- ings will be helpful to clinicians in the fight against health problems such as diabetes.

Keywords: Insulin resistance; HOMA; diabetes mellitus.
Comparative study of hypercoagulability change in steady state and during vaso-occlusive crisis among Sudanese patients living with sickle cell disease
Authors: Abdelgadir Mohamed Elmigdad , Mohamed Elgari Mamoud , Mohammed Babker Asaad , Ali Waggiallah Hisham
Published: October 2020

Background: Sickle cell disease (SCD) is an inherited blood disorder that affects red blood cells. (SCD) is characterized by re- current vaso-occlusive crisis (VOC).

Material and methods: This was a descriptive cross sectional study conducted through the period from July 2015 to July 2017 in which a total of seventy two blood specimens were collected in 'EDTA' and citrated vacutainers from Sudanese patients with SCD attending "Fath Elrhman Albasheer" Centre. Both sexes' with different ages were included. Among these samples 49 (68.1%) were in steady state while the remained 23 (31.9%) were in VOC. All samples were tested for coagulation profile

Result: There was increase in fibrinogen and D-dimer levels in most patients 67% and 71%, respectively. Significant increase in D-dimers was observed in patients with (VOC) compared with steady state (P. value = 0.006). Protein S was significantly in- creased in males in comparison with females P. value = 0.017. The results of prothrombin time (PT), international normalized ratio (INR) and thrombin time (TT) were within normal range.

Conclusion: Significant increase in levels of D-dimer during VOC indicating abnormal coagulation and fibrinolysis activation. Reduced levels of natural anticoagulants proteins C and S can be consider as predictive markers indicate hepatic dysfunction in patients with SCD.

Keyword: SCD; VOC; hypercoagulability; Sudanese patients.
Preliminary national report on cystic fibrosis epidemiology in Tunisia: the actual state of affairs
Authors: Hamouda Samia , Hadj Fredj Sondess , Hilioui Sonia , Khalsi Fatma , Ben Ameur Salma , Bouguila Jihene , Boussoffara Raoudha , Besbes Habib , Ajmi Houda , Mattoussi Nadia , Messaoud Taieb , Mehrezi Ahmed , Hachicha Mongia , Boughamoura Lamia , Taher Sfar Mohamed , Gueddiche Neji , Abroug Saoussen , Ben Becheur Saida , Barsaoui Sihem , Tebib Neji , Samoud Azza , Gandoura Najoua , Tinsa Faten , Boussetta Khadija
Published: October 2020

Aim: To establish a preliminary national report on clinical and genetic features of cystic fibrosis (CF) in Tunisian children as a first measure for a better health care organization.

Methods: All children with CF diagnosed by positive sweat tests between 1996 and 2015 in children’s departments of Tunisian university hospitals were included. Data was recorded at diagnosis and during the follow-up from patients’ medical records.

Results: In 12 departments, 123 CF children were collected. The median age at diagnosis was 5 months with a median diag- nosis delay of 3 months. CF was revealed mostly by recurrent respiratory tract infections (69.9%), denutrition (55.2%), and/ or chronic diarrhea (41.4%). The mean sweat chloride concentration was 110.9mmol/L. At least one mutation was found in 95 cases (77.2%). The most frequent mutations were Phe508del (n=58) and E1104X (n=15). Fifty-five patients had a Pseudomonas Aeruginosa chronic colonization at a median age of 30 months. Cirrhosis and diabetes appeared at a mean age of 5.5 and 12.5 years respectively in 4 patients each. Sixty-two patients died at a median age of 8 months. Phe508del mutation and hypotrophy were associated with death (p=0.002 and p<0.001, respectively).

Conclusion: CF is life-shortening in Tunisia. Setting-up appropriate management is urgent.

Keywords: Cystic fibrosis epidemiology; Tunisia.
Knowledge, sexual behaviours and risk perception of sexually transmitted infections among students of the polytechnic, Ibadan, Oyo state
Authors: M Oharume Irikefe
Published: October 2020

Background: Current evidence shows that the surge of sexually transmitted infections (STIs) is of public health importance. In Nigeria, about 3 million cases of STIs are reported annually with the highest rates observed among young people.

Objective: This study was designed to investigate the knowledge, sexual behaviours and risk perception of STIs among students of the polytechnic, Ibadan.

Method: The study was a descriptive cross-sectional survey which involved the use of a four-stage sampling technique to select 401 students across the five faculties of the institution.

Results: Among the students interviewed, few (18.7%) had good knowledge of STIs with overall mean knowledge score of 5.9±3.6. Majority (65.3%) were sexually active in the last 12 months; while 26.7% had multiple sex partners in the last six months. Only 23.1% of single sexually active students used condom regularly. Few (14.2%) of the students considered themselves to be at risk of contracting STIs. However, there were significant associations between knowledge and risk perception of contracting STIs; and between having multiple sex partners and the risk perception of contracting STIs.

Conclusion: These results emphasise the need to provide students with more information about STIs with the aim of positively influencing their self-perceived risk and sexual behaviour.

Keywords: Knowledge; sexual behaviours; risk perception; STIs; polytechnic; Ibadan; Oyo state.
Awareness and uptake of human papilloma virus vaccines among female secondary school students in Benin City, Nigeria
Authors: Ezeanochie Michael , Olasimbo Peter
Published: October 2020

Background: There is no Government endorsed HPV vaccine immunisation program in Nigeria. The Vaccine has been available at the University of Benin Teaching Hospital (UBTH) in Benin City for more than 7 years.

Objectives: The aim was to evaluate awareness about HPV, the prevalence of HPV immunisation and its associated factors among the study population.

Methods: A cross-sectional study using interviewer-administered questionnaires among 215 females attending secondary schools in Benin city, Nigeria. Participants were selected using multi-stage stratified sampling. The primary outcome measure was HPV immunisation of the girls.

Results: The majority of the participants were between 14 to 18 years (58.6%). Almost all the participants (>97%) had not heard of HPV, HPV Vaccines and Cervical cancer. In addition, 2 (0.9%) persons correctly identified that the virus can be transmitted sexually while only 1 person (0.5%) had received the HPV vaccine. The respondents all agreed that they needed to be enlightened about HPV, HPV vaccines and Cervical cancer. Majority (49.3%) of the girls suggested that this could be done through the mass media (49.3%) or their parents (32.1%).

Conclusion: HPV immunisation, knowledge of HPV vaccines and Cervical cancer among the study population was very low. We recommend interventions in Schools to increase knowledge about cervical cancer and HPV vaccines.

Keywords: Human papilloma virus; vaccines; cervical cancer; Nigeria.
INFLUENCE OF WATER EXCESS OR DEFICIENCY ON LEAF NUTRIENT CONTENT AND PLANT GROWTH IN SUGARCANE AND OTHER CROPS
Authors: Samuels George
Published: October 2020

INFLUENCE OF WATER EXCESS OR DEFICIENCY ON LEAF NUTRIENT CONTENT AND PLANT GROWTH IN SUGARCANE AND OTHER CROPS
LOSSES CAUSED TO SEED OF TEPHROSIA VOGELII HOOK F. BY THE LIMA-BEAN POD BORER
Authors: Stone Eric G. , Freyre Rubén H.
Published: October 2020

LOSSES CAUSED TO SEED OF TEPHROSIA VOGELII HOOK F. BY THE LIMA-BEAN POD BORER
Effect of Two Cutting Heights, Four Harvest Intervals and Five Nitrogen Rates on Yield and Composition of Congo Grass under Humid Tropical Conditions
Authors: Vicente-Chandler José , Silva Servando , Abruña Fernando , Rodríguez José A.
Published: October 2020

The effect of cutting to heights of 2 and 6 inches from the ground, of harvesting every 30, 45, 60, and 90 days, and of applying 0, 200, 400, 600, and 800 pounds of nitrogen per acre yearly on yields and composition of Congo grass, were determined under humid tropical conditions over a 2-year period. Congo grass produced higher yields when cut to a height of 2 inches than when cut to 6 inches, at all harvest intervals and nitrogen rates. The following discussion is therefore limited to results obtained with low cutting. Yields of Congo grass increased, but crude; protein content of the forage decreased with increasing length of harvest interval. Harvest interval did not markedly affect protein yields. Phosphorus and potassium content of the forage decreased with increasing length of harvest interval but the calcium and magnesium content were not affected. Lignin content of the forage increased with increasing length of harvest interval. Yields of Congo grass increased with nitrogen application up to 600 pounds per acre yearly at all harvest intervals and during seasons of both fast and slow growth. Protein content of the forage and protein yields increased with nitrogen rates up to 800 pounds per acre yearly. Recovery of fertilizer nitrogen in the forage averaged about 60 percent at the 600-pound nitrogen rate. Dry matter and phosphorus content of the forage decreased with increased nitrogen fertilization. Nitrogen fertilization did not affect the calcium, magnesium, or potassium content of the forage. Much lower yields were produced during the shorter days and cooler, drier winter months. With close cutting every 45 to 60 days and 600 pounds of nitrogen applied per acre yearly, Congo grass produced about 30,000 pounds of dry forage (65 tons of green forage) containing 9.5 percent protein, or enough cut forage to feed over five 600-pound steers per acre. With high cutting every 30 days, which may approximate yields under grazing management, Congo grass fertilized with 400 pounds of nitrogen per acre yearly produced about 16,000 pounds of dry forage per acre yearly containing 9.7 percent of protein.
Effect of the Rootstock on Certain Fruit Characters of the Chironja
Authors: Pérez Agripino , Bosque Lugo Ramón
Published: October 2020

Chironja trees grafted on native grapefruit, sour orange, and Cleopatra mandarine rootstock were planted on Alonso clay and Coto clay at Adjuntas and Isabela Substations, respectively. Only native grapefruit and sour orange rootstocks were compared at Isabela. The experiments were conducted for the purpose of determining the possible effect of the three rootstocks on fruit weight, peel weight, number of seeds and segments (carpels) per fruit, and refractometer readings of the fruit (Brix) harvested from the grafted chironja trees. The most important results obtained were: Trees at Adjuntas grafted on grapefruit rootstock yielded heavier chironja fruits in 1962 and 1963, and a heavier peel in 1963, than those grafted on sour orange or Cleopatra mandarine rootstocks. In 1962, peel weights of chironja fruits from trees grafted on sour orange exceeded those obtained from trees grafted on mandarine rootstock. Fruits from chironja trees at the Isabela experiment grafted on sour orange rootstock had a significantly higher Brix than those from trees grafted on grapefruit rootstock, but no significant differences occurred among the other characters studied. No significant differences were found between chironja fruits from trees grafted on any of the three rootstocks as far as number of seeds and segments (carpels) per fruit, suggesting that rootstock species does not affect these characters. These studies suggest in general that the fruit from chironja trees grafted on grapefruit rootstock is larger, but less sweet, than fruit from trees grafted on either sour orange or Cleopatra mandarine rootstocks.
Autoimunidade como manifestação paraneoplásica
Authors: Machado Maria Cecília Mathias , Harada Guilherme , Castro Junior Gilberto de
Published: October 2020

No contexto das complexas manifestações clínicas de natureza reumatológica observadas nos pacientes com câncer, os autores revisam as manifestações paraneoplásicas que se manifestam como fenômenos de autoimunidade. Estas se caracterizam por sintomas e/ou sinais causados por hormônios e/ou citocinas produzidas por células neoplásicas ou como consequência de mecanismos imunológicos humorais ou celulares em resposta ao câncer. Podem estar relacionadas a um tumor ainda oculto e que podem ser diagnosticadas simultânea, anterior ou posteriormente ao diagnóstico da neoplasia. Tais manifestações costumam ser raras, e geralmente se apresentam em articulações, fáscias, músculos, vasos ou ossos. São discutidos aspectos de diagnóstico, fisiopatologia e tratamento de algumas síndromes mais comuns na prática clínica como poliartrites, osteoartropatia hipertrófica, síndrome RS3PE, miosites e osteomalácia induzida por tumores. Os pacientes com apresentações atípicas de manifestações autoimunes e com pouca resposta à terapia preconizada devem ser investigados para afastar neoplasias malignas. Apesar de sua raridade, o reconhecimento de padrões clínicos distintos de paraneoplasias é essencial para clínicos e reumatologistas, pois permite um diagnóstico oportuno de câncer, a possível reversão de sintomas e o início de terapias com potencial de cura ou melhora da qualidade de vida.
Unitermos. Câncer. Síndromes paraneoplásicas. Imunoterapia. PD-1. Anticorpos monoclonais.
Hydrocephalus and Dandy- Walker Malformation: a review
Authors: Dastoli Patricia Alessandra Dastoli , Nicácio Jardel Mendonça , Da Costa Marcos Devanir  Silva , Suriano Italo Capraro , Da Silva Marcia Cristina , Cavalheiro Sergio
Published: October 2020

Introduction: Dandy Walker malformation (DWM) is characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle leading to an increase of the posterior fossa and superior dislocation of the lateral sinus, tentorium and torcula. Although it is the commonest posterior fossa malformation, its pathogenesis is still not fully understood, making the differential diagnosis with other posterior fossa malformations difficult and as a result the choice of therapeutic strategy.
Material and methods: An extensive review of the literature relating to Dandy Walker malformation was performed. Historical, genetic, embryologic, epidemiologic, clinical and radiological presentation, treatment and prognosis were revised.
Conclusion: The correct diagnosis of Dandy Walker malformation can be made through careful interpretation of magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) flow studies.  The choice of hydrocephalus treatment depends on whether there is aqueduct stenosis.  And, although ventriculoperitoneal (VP) shunts have been the treatment of choice for many years, neuroendoscopic techniques such as endoscopic thirdventriculostomy and stent placement are being frequently performed lately.
Economic Effects of Inward Foreign Direct Investment in Myanmar
Authors: Soe Thet Mon
Published: October 2020

This paper aims to examine the effects of inward foreign direct investment (FDI) on economic growth and domestic investment at the regional-level and sectoral-levels of Myanmar economy, by applying a panel vector-autoregressive model framework. The major research questions are twofold: whether inward FDI causes economic growth or economic growth attracts inward FDI, and whether inward FDI crowds in or crowds out domestic investment. The main findings are summarized as follows. In the regional level analysis, there is a difference in the FDI-economic growth relationship between the FDI-intensive region and the FDI-less-intensive one. In the FDI-intensive region, the bidirectional FDI-economic growth relationship is found, supporting the both hypotheses of FDI-driven growth and growth-driven FDI, while the FDI-driven growth effect is larger than the growth-driven FDI one. In the FDI-less-intensive region, on the other hand, FDI deteriorates economic growth whereas economic growth still induces FDI. The difference in the FDI-economic growth relationship between the regions might come from the gap in agglomeration effects. In the sectoral level analysis, the crowd-in effect of FDI on domestic investment is found in the non-oil and gas sectors, since the FDI in the oil and gas sector has less linkages to domestic investment.
Interdisziplinäre Funktionstherapie 2.A.
Authors: Dapprich Jürgen
Published: October 2020

Diagnostik und Therapie unter Einbeziehung des gesamten Körpers

Die 2. Auflage dieses erfolgreichen Buches weist den Weg von der lokalen Betrachtung des craniomandibulären Systems hin zur interdisziplinären Diagnostik und Therapie mit Einbeziehung des ganzen Körpers. Nicht nur ca. 80% aller Kopf-, Nacken- und Rückenschmerzen werden von einer CMD ausgelöst, sondern auch Symptome im ganzen Körper.

Die Sensibilität für diese Zusammenhänge zu wecken, zu erkennen und zu behandeln ist Ziel der hier vorgestellten interdisziplinären Therapie.

Aus der Praxis für die Praxis

Hochwertige Abbildungen zum besseren Verständnis

Schritt-für-Schritt-Anleitung
Bewegungstherapie bei psychischen Erkrankungen
Authors: Hölter Gerd
Published: October 2020

Psychische Erkrankungen erfolgreich mit Bewegung behandeln

Die Anwendung von Maßnahmen der Bewegungsförderung bei psychischen Erkrankungen ist seit der Antike bekannt. In Deutschland gehören seit ca. 50 Jahren unterschiedliche Bewegungstherapien zur ambulanten und stationären Standardbehandlung bei vielen psychischen Erkrankungen, wobei heutzutage die Spanne der Intervention von der Physio- bis zur Körperpsychotherapie reicht.

Fachpersonen aus Allgemeinmedizin, Psychiatrie, Psychotherapie und Bewegungstherapie erhalten umfassende theoretische Informationen und anwendungsbezogene Konzepte zu einer Form der Bewegungstherapie, die eng mit der Bewegungs- und Sportwissenschaft verbunden ist.

- Körper, Leib und Bewegung - eine Begriffsklärung

- Bewegungstherapie auf sport- und bewegungswissenschaftlicher Grundlage

- Diagnostik, Indikation, Intervention, Evaluation

Bewegungstherapie bei:

- Affektiven und Persönlichkeitsstörungen

- Schweren psychischen Erkrankungen

- Essstörungen

- Abhängigkeitserkrankungen

Bewegungstherapie in der Kinder- und Jugend sowie der Gerontopsychiatrie