bluuebunny/crossref_metadata_2025 huggingface dataset:
Probabilistic Slope Stability Analysis: A Case Study
Authors: HUVAJ Nejan , OĞUZ Emir Ahmet
Published: July 2018

Probabilistic slope stability
analyses are becoming more and more popular to evaluate the safety level of
slopes and the associated risk and reliability, especially in the recent years.
Probabilistic approach can take into account the uncertainties and natural variability
in material properties, as well as in environmental factors, by using various statistical
distribution fuctions (such as normal, lognormal etc.) for random variables. It
is already noted by various researchers that, a slope with a deterministic
factor of safety larger than 1.00 using average values of soil parameters may
have a significant level of probability of failure, if the material properties
are unknown, or contain significant uncertainty/variability. In this study,
a well-documented landslide case study is used to demonstrate the importance of
probabilistic approach in slope stability; to investigate the effects of
considering variabiliy in material properties; and to compare deterministic and
probabilistic slope stability analyses results. Deterministic limit
eqilibrium, probabilistic limit equilibrium and probabilistic finite element
analyses are conducted for Lodalen landslide in Oslo, Norway and the results
are compared with each other. The factor of safety, the probability
of failure and the most critical failure surface are investigated with and
without statistical cross-correlation of soil’s shear strength parameters. The
results of this study can provide further insights into the comparison of
deterministic and probabilistic approaches in slope safety.
REGULARITIES OF FORMATION AND DEGRADATION OF THE MICROSTRUCTURE AND PROPERTIES OF NEW ULTRAFINE-GRAINED LOW-MODULUS Ti–Nb–Mo–Zr ALLOYS
Authors: Kolobov Yu. R. , Golosova O. A. , Manokhin S. S.
Published: July 2018

Regularities of the formation of ultrafine-grained (UFG) and submicrocrystalline (SMC) structures in new nickel-free low-modulus Ti–Nb–Mo–Zr titanium β alloys under the action of plastic deformation were studied. Temperature-time ranges of the development of dynamic recrystallization processes under the simultaneous action of temperature and plastic deformation were determined. The recrystallization diagram of II type of the Ti–28Nb–8Mo–12Zr alloy was constructed and analyzed. It was shown using scanning electron microscopy and electron backscatter diffraction method that the UFG structure with an average grain size of no more than 7 μm and high fraction of high-angle grain boundaries is formed in the investigated alloys as a result of longitudinal rolling followed by annealing for quenching. It was found that the formation of the UFG structure leads to a significant increase in the strength and plastic characteristics of these alloys. The regularities of the formation of UFG and SMC structures in the titanium β alloys Ti–28Nb–8Mo–12Zr and VT30 widely used in industry under the action of plastic deformation by the helical rolling method were studied. It was shown that the helical rolling of the VT30 alloy leads to the formation of the homogeneous UFG state as opposite to the developed Ti–28Nb–8Mo–12Zr β alloy where this method causes structure softening with micropores and microcracks formed in the central region. It is possible to form a nanostructured state with an average grain size of about 100 nm in Ti–Nb–Mo–Zr titanium β alloys using high-pressure torsion method.
Acuerdos comerciales de Colombia: Impactos en balanza comercial e inversión extranjera directa
Authors: Cruz Negrete Juan David
Published: July 2018

Objetivo: Este estudio tuvo como objetivo determinar el impacto generado por los acuerdos comerciales suscritos entre Colombia y doce (12) países observados, tomando en cuenta, por un lado, el año de suscripción de los acuerdos y, por otro, el período comprendido entre 2014 y 2016. Método: El análisis del impacto generado, se realizó a través del método mixto, ya que se consideraron contrastes de datos, el enfoque analítico de los resultados, y la revisión bibliográfica del tema. Resultados y discusiones: Se observó que los acuerdos comerciales de Colombia han generado atracción de Inversión Extranjera Directa (IED) encontrándose ahora mayores ingresos de inversión en comparación con la fecha de suscripción de los mismos; de otra parte, el intercambio comercial arrojó una balanza comercial negativa, explicada por crecientes niveles de importaciones y el estancamiento de las exportaciones. La revisión literaria de la temática arrojó diversos argumentos, entre estos se destaca: que la IED puede generar impactos positivos y negativos en materia de economía y desigualdad social; y que para comprender la balanza comercial, se debe identificar la situación en infraestructura interna de los países. Conclusiones: Se determinó que Colombia debe fortalecer su sistema productivo, diversificando el mercado interno, mejorando la infraestructura logística y añadiendo innovación y tecnología a bienes y servicios; así se el país se consolidará como destino de inversión internacional y los flujos de exportaciones se incrementarán.
Áreas susceptibles del arbitraje tributario en el contexto Venezolano: Una visión estratégica
Authors: Villasmil Milagros Del Carmen , Romero Villasmil Francisco , Hernández Gracia Tirso , García Cali Ernesto
Published: July 2018

Objetivo: Este trabajo se realizó ante todo con la intención de identificar el direccionamiento estratégico procedimental para las áreas susceptibles del arbitraje tributario en el contexto venezolano. Método: Se trata de un estudio de tipo descriptivo, no experimental, de campo, bajo el enfoque positivista, en el que se utilizó como técnica para la recolección de la información la entrevista y la observación, considerando una población de diez (10) sujetos de las oficinas de recaudación municipal del Estado Zulia. Resultados y Discusiones: Los resultados se obtuvieron mediante un proceso de estadística inferencial, a través del Anova, t de student y regresión lineal, quedando claro que las administraciones tributarias de los municipios glocales muestran un panorama propicio en relación a su gestión estratégica, en aras de mantener un escenario favorable que propicie el direccionamiento estratégico del procedimiento de las materias susceptibles para el arbitramiento, y este permite dirimir así las controversias. Conclusiones: El procedimiento antes descrito conduce a la administración tributaria al cobro inmediato del crédito fiscal, facilitando su recaudación y evitando ulteriores procedimientos contenciosos, constituyéndose en una estrategia empresarial en sus procesos legales.
La capacidad dinámica de aprendizaje
Authors: Garzón Castrillon Manuel Alfonso
Published: July 2018

Este artículo presenta una revisión de la literatura sobre capacidades dinámicas de aprendizaje. Empieza por determinar los antecedentes del tema en las organizaciones, realizando para ello una aproximación al concepto de capacidad dinámica de aprendizaje; a la evolución del concepto de capacidad dinámica de aprendizaje, y a las dimensiones de la capacidad dinámica de aprendizaje. Sobre esto último se identificaron tres categorías: la Capacidad de Adquisición de Conocimiento (KAC), con seis dimensiones: crisis y problemas, los clientes, unidades especializadas, la competencia, la experiencia y los practicantes, la tecnología; y la historia; la segunda categoría es la Capacidad de Generación de Conocimiento (KGC), también con seis dimensiones: competencias, la estructura, comunidades de práctica, comunidades de aprendizaje, comunidades de compromiso y la memoria organizacional. La tercera categoría es la Capacidad de Combinación de Conocimiento (KCC), que presenta dos dimensiones: la cultura organizacional para el AO y el clima Organizacional para el AO.
General Aiptasia husbandry - Weis Lab v1
Authors: Weis Lab OSU
Published: July 2018

This protocol describes how Aiptasia stocks are cared for in the Weis lab. The protocol was last updated in 2018. Most students and postdocs tha have been in the Weis lab have contributed to this protocol in some form or another, and they are too numerous to list.
General Aiptasia husbandry - Pringle lab v1
Authors: Lab Pringle
Published: July 2018

This protocol describes the basic steps neccessary to maintain and propagate Aiptasia as they are done in the Pringle lab.
Characteristics of electrophysiological activity of the cerebral cortex in children with arthrogryposis
Authors: Blagoveschenskiy E. D. , Agranovich O. E. , Kononova E. L. , Baindurashvili A. G. , Nazarova M. A. , Shestokova A. N. , Gabbasova E. L. , Nikulin V. V.
Published: July 2018

Background. Arthrogryposis is one of the most severe congenital abnormalities of the musculoskeletal system characterized by 2 or more contractures of the large joints, muscle and anterior grey column pathology. One of the main problems making selfcare limited or impossible for the patients is an absence of the active movements in the joints of the upper extremities which can be restored through autologous transplantation from the various donor areas. Processes of the rehabilitation after these operations are associated with neuronal remodeling in the central nervous system both in the spinal cord and the brain, in the cortial regions in particular.

The objective is to evaluate possible reflection of arthrogryposis in the amplitude and neurodynamical characteristics of the electroencephalogram (EEG) in children.

Materials and methods. Electrophysiological characteristics of the cerebral cortex in children with arthrogryposis and healthy children of the same age were examined. Such EEG characteristics as power and long-range temporal correlations (evaluation of the neuronal activity dynamics) in ranges of 4–8, 8–12, and 12–16 Hz were measured. The results were evaluated in accordance with clinical scales.

Results. Data analysis has shown that children with arthrogryposis have significantly decreased EEG power in all of the studied ranges compared to healthy children. Additionally, a significant correlation between EEG power and the level of restoration of motor functions in the upper extremities after autologous transplantation of various muscle groups in the position of the biceps was observed. The obtained results reflect correlation between the electrophysiological parameters of the cerebral cortex and processes associated with arthrogryposis pathology. However, neurodynamical parameters in children with arthrogryposis are similar to those in healthy children. The results allow to state that arthrogryposis is reflected through decreased electrical activity of the cerebral cortex in 4–16 Hz range with preservation of neurodynamic characteristics typical for disease-free children.

Conclusion. In this study, a significant difference in EEG power in 4–8, 8–12, and 12–16 Hz ranges between children with arthrogryposis and healthy children was demonstrated. However, there was no difference in such an important neurodynamical characteristic as longrange temporal correlations. It is possible that decreased amplitude of EEG rhythms in children with arthrogryposis is caused by their lower motor activity in general.
Evaluation of methylation status of the 5’-promoter region of C9orf72 gene in Russian patients with neurodegenerative diseases
Authors: Shpilyukova Yu. A. , Fedotova E. Yu. , Pogoda T. V. , Abramycheva N. Yu. , Vetchinova A. S. , Zakharova M. N. , Illarioshkin S. N.
Published: July 2018

Background. Hexanucleotide repeat expansion in the C9orf72 gene is the most significant cause of a large number of neurodegenerative diseases: frontotemporal degeneration (FTD), amyotrophic lateral sclerosis (ALS), Parkinson’s disease (PD), etc. Several studies have shown the relationship with the neurodegenerative process for full (>40 GGGGCC copies) and intermediate (13–20) repeats expansion. Methylation of the C9orf72 gene can play an important role in the pathogenesis of FTD and ALS, but the mechanism has not been sufficiently studied.

The objective is to investigate the status of methylation of the 5’-promotor region of the C9orf72 gene in patients with neurodegenerative disorders having full or intermediate expansion of GGGGCC-repeats.

Materials and methods. We investigated the methylation status of the 5’-promoter region of full C9orf72 expansions in FTD/ALS patients (n = 12), of intermediate expansions in Parkinson’s disease patients (n = 8) and of non-expanded alleles in healthy controls (n = 8). Methylation status was determined via sequencing of amplified fragments of bisulfite-converted DNA.

Results. We identified two cases (sibling) with the hypermethylation of the 5’-promoter region in the full C9orf72 expansions group. Patient A. (65 years old, male) had an atypical ALS presentation: an onset with head tremor, a long duration of ALS symptoms (9 years at this time), and cognitive impairments with a temporal lobes atrophy. The patient’s sister had a similar clinical phenotype. There were no cases of the promoter hypermethylation in the intermediate and control groups.

Conclusion. This is the first data on the 5’-promoter region C9orf72 gene methylation in Russian population. The frequency of the promoter methylation in this group was 9.1 % that consistent with previous studies in other populations. Atypical clinical presentation may indicate a modifying effect of methylation in this area on the ALS phenotype.
Ten years of progress: Analytic review of the first decade of journal functioning
Authors: Glagolev Mikhail V. , Sabrekov Aleksandr F. , Filippova Nina V. , Lapshina Elena D.
Published: July 2018

The analytic review of work of the scientific journal «Environmental Dynamics and Global Climate Change» (EDGCC) over the 10 years since the first publishing is presented here. Statistical (science metrical) data were summarized to reveal what papers were most interesting and useful for readers.Two-year impact factor (IF) of the journal increases persistently. During last five years it shows five-fold increase reaching a certain level among other Russian journals of the respective category. Number of EDGCC authors (special issues were not considered) does not vary substantially: 10-16 authors are published in EDGCC each year (among the first authors – from 4 to 10). The Hirsch index also increases stably during all years of publication showing that authors with higher qualification start to submit their papers to the journal. 26 scientific journals were selected randomly among those where authors of EDGCC publish their papers to compare science metrics of EDGCC with other journals (based on 2016 data). Two-year IF based on Russian Science Citation Index of 70% of these journals was lower than IF of EDGCC. The half-live of EDGCC papers is close to the average value for our ensemble. The EDGCC mean Hirsch index was higher than Hirsch index of 63% of all journals selected for our study. The value of probability of citation after reading was the highest for the test sample. Bibliometric parameters of ten most cited EDGCC papers were also analyzed here. Based on provided analysis following recommendations on improving EDGCC as scientific journals have been formulated: translation of papers into English, selection of manuscripts relevant to the journal topic, increasing the number of theoretical papers, improving the quality of experimental papers. Discussion section reviewed in a usual manner seems to be optimal decision to provide future development of the journal. New referee questionnaire modified according to the recommendations above for improvement of manuscripts quality is attached in appendix.
Functional disorders of maxillofacial region in children with cerebral paralysis
Authors: Danilova M. A. , Bronnikov V. A. , Zalazaeva E. A.
Published: July 2018

Aim. To reveal the peculiar features of functional disorders in maxillofacial region among children with cerebral paralysis.

Materials and methods. While carrying out complex neurological, stomatological and logopedic examination of 120 patients (age 3 to15 years) with the above mentioned diagnosis, the following was assessed: the course of speech development (first words, phrases), state of general, fine and speech motor activity, speech sounding, status of speech apparatus.

Results. The data on frequency and structure of functional maxillofacial disorders in children with cerebral paralysis were obtained. Thus, dysfunction of swallowing was detected in 32,5 % of cases. In 53,33 % of cases from the total number of the examined patients, there was revealed the impaired chewing function in the form of slow chewing process, which occurred in 100,0 % of cases among children with double hemiplegia. Impaired speech development in the form of pseudobulbar dysarthria (spasticoparetic, spasticorigid) and anarthria was diagnosed in 82 (68,33 %) persons, speech development corresponded to age in 38 (31,67 %) children.

Conclusions. The obtained data on peculiar features of functional maxillofacial disorders, observed among children with different clinical variants of spastic cerebral paralysis forms, should be used in practical health care for planning treatment-and-prophylactic measures at rehabilitation centres.
On problems and algorithm of prescribing combined medicinal preparations, containing small quantities of narcotic drugs and psychotropic substances
Authors: Porseva N. Yu. , Soloninina A. V. , Rostova N. B.
Published: July 2018

Aim. To analyze the regulating documents and work out the algorithm of prescribing combined medicinal preparations, containing small quantities of narcotic drugs, psychotropic substances, their precursors and other pharmacological active substances.

Materials and methods. The normative documents, regulating the order of prescribing and selling combined medicinal preparations, containing narcotic drugs, psychotropic substances and their precursors were analyzed.

Results. Some normative documents to regulate the order of prescribing combined medicinal preparations, containing narcotic drugs and psychotropic substances, present problems. To simplify the procedure of prescribing such medicinal preparations, there was suggested an algorithm, explaining: the choice of prescription form; conditions of prescribing combined medicinal preparation by trade name; terms of prescription validity and possibilities of their prolongation; regulated possibilities for exceeding norms of prescribing medicinal preparations and order of their registration.

Conclusions. The suggested algorithm of the order of prescription will promote observation of requirements of the existing normative acts.
Grounding of using treatment-and-rehabilitation complex for patients with occupational lumbosacral radiculopathy
Authors: Shaikhlislamova E. R. , Karimova L. K. , Gallyamova S. A. , Urmantseva F. A. , Iskhakova D. R. , Alakaeva R. A.
Published: July 2018

Aim. To ground and estimate the efficiency of using nonmedicamentous methods of treatment in patients with occupational radiculopathy of lumbosacral level.

Materials and methods. Sixty seven patients, diagnosed occupational lumbosacral radiculopathy, were examined; patients’ neurological status, manifestation of pain syndrome by 10-score visual analog scale and neuromuscular state by stimulation electroneuromyography data prior to and after treatment were assessed.

Results. Treatment-and-rehabilitation complex included magnetic-laser therapy, acupuncture, combined with curative gymnastics. By the completion of treatment, positive dynamics regarding nearly all neurological states, including reduced manifestation of painful sensations, increased volume of active movements in the lumbar spine, decreased hyperesthesia rate and hypoesthesia intensity in the zone of injured roots, decreased occurrence of Lasegue test was observed. Dynamics of electroneuromyographic parameters was expressed by improved conduction of nerve impulses through the peripheral low extremity nerves and roots L4, L5, S1 of cerebrospinal nerves.

Conclusions. Application of the offered complex provided positive effect by the end of treatment in 82.3 % of cases.
Potential Predictors for HPV Vaccination Completion Rates
Authors: Sachdev Arushi , Sekhon Kerman
Published: July 2018

Background

Human papillomavirus (HPV) is the most common sexually transmitted pathogen; its ease in transmission significantly contributes to its prevalence within the population. While most HPV infections are asymptomatic, a subset of infections cause genital warts, cervical cancer and various anogenital cancers. Accordingly, the vaccine Gardasil has been designed to prevent HPV infection and its associated sequelae. While Gardasil is effective against over 75% of cervical cancers, recent studies have demonstrated its limited adoption. In 2010, only 49% of females between the ages of 13-17 had received at least one dose. Moreover, Gardasil is a three-dose vaccine, and consequently, female patients that initiate the vaccination series often do not complete it in its entirety.

Methods

Data obtained from researchers at the Johns Hopkins Medical Institutions (JHMI) was used to determine which socioeconomic factors influence a female’s likelihood of vaccination completion. The dataset consisted of female patients between the ages of 11-26 that had received at least one of the Gardasil vaccine doses from a JHMI clinic in Baltimore, USA, between the years 2006 and 2008. First, three logistic regression models were run with vaccination regimen completion, one shot completed and two shots completed as the dependent variables. Then, three LASSO logistic regression models were run to find relationships that were not influenced by model overfitting. The two regression methods were compared to determine if different results could be achieved.

Results

For the logistic regression, findings revealed that black females (P = 0.006881), females between the ages of 18-26 (P = 0.000483), and females that visited urban clinics (P = 0.004582) are at an increased risk of incomplete vaccinations. In contrast, females that were treated by obstetrician-gynecologists (P = 0.006269) had increased compliance with the Gardasil vaccination regimen compared to women that visited other healthcare professionals. For the LASSO logistic regression, the model that penalized the most for overfitting showed that black females have a higher likelihood of only receiving one shot.

Conclusions

Due to the retrospective nature of the data, no causation can be established. However, these correlations shed light on what female populations should be studied further and potentially targeted to improve Gardasil vaccination completion rates. Moreover, the differences in vaccination completion rates can, in turn, aggravate the existing disparities in cervical cancer risk among females.
PSİKOLOJİK SÖZLEŞME İHLALİNİN YENİLİKÇİ DAVRANIŞA ETKİSİ: ÖRGÜTSEL SESSİZLİĞİN ROLÜ: SAVUNMA SANYİİNDE BİR UYGULAMA
Authors: KÖKSAL Kemal , EROĞLUER Kemal , YAPAR Hakan
Published: July 2018

Yenilikçi davranış, işyerinde ürün ve uygulamalara
ilişkin yeni fikirlerin üretilmesi olarak tanımlanabilir. Psikolojik sözleşme
ise çalışan davranışlarının önemli bir belirleyicisidir. Psikolojik sözleşmenin
ihlaline yönelik bir algı, çalışanlarda olumsuz tutum ve davranışlara neden
olabilmektedir. Çalışanların psikolojik sözleşmelerinin ihlal edildiğine
yönelik algıları, psikolojik ve güvenliğe ilişkin endişelerinden dolayı sessiz
kalmalarına neden olmaktadır. Bu çalışmanın amacı, psikolojik sözleşme
ihlalinin yenilikçi davranışa etkisi ve bu ilişkide örgütsel sessizliğin
aracılık rolünü incelemektir. Araştırma verileri, savunma sanayiinde faaliyet
gösteren iki farklı firmada çalışan toplam 213 kişiden elde edilmiştir.
Ölçeklerin yapı geçerliliği doğrulayıcı faktör analiziyle; değişkenler
arasındaki ilişkiler ve aracılık etkisi korelasyon ve regresyon analiziyle
incelenmiştir. Analiz sonuçları psikolojik sözleşme ihlalinin çalışanların
yenilikçi davranışını olumsuz olarak etkilediğini ve örgütsel sessizliğin bu
ilişkide tam aracılık etkisine sahip olduğunu göstermektedir. Araştırma
bulgularının uygulamaları ve gelecekte yapılabilecek çalışmalar için öneriler
tartışılmıştır.
GIDA SEKTÖRÜNDE YENİ ÜRÜN GELİŞTİRME: KONYA’DA BİSKÜVİ, ÇİKOLATALI VE ŞEKERLİ MAMULLER ALT SEKTÖRÜ ÜZERİNE BİR UYGULAMA
Authors: ÖZTÜRK Derya , ONURLUBAŞ Ebru
Published: July 2018

Günümüzde
imalat işletmeleri, teknolojik yenilikler, ürün ömrünün kısalması ve müşteri
beklentilerindeki hızlı değişim gibi sorunlarla karşı karşıyadır. Rekabet
ortamında hızlı değişimin yaşandığı bu durum, işletmelerin pazardaki
yenilikleri yakından takip etme zorunluluklarını ortaya çıkarmıştır. Bu
bağlamda çalışmanın amacı, gıda sektöründe faaliyet gösteren öncü bir firmanın X markasının yeni
ürün geliştirme sürecinin incelenmesidir. Bu amaçla çalışmada, Konya’da bisküvi, çikolatalı ve şekerli mamuller
üreten bir firmanın ürün geliştirme sürecine katkı sağlayan 110 firma
personeline yüz-yüze anket uygulanmıştır. Elde edilen verilerden frekans
analizi ile durum tespiti yapılırken, yeni ürün fikri oluşturmada etkili olan
faktörler ve yeni ürün bulma teknikleri demografik değişkenlere göre ki-kare
testi ile karşılaştırılmıştır. Araştırma sonuçlarına göre,  katılımcıların %50,9’u yeni ürün fikri oluşturmada
hedef pazarı dikkate aldığını ifade ederken, yeni ürün fikri oluşturmada etkili
olan faktörlerin personelin çalışma yıllarına göre değişim gösterdiği
belirlenmiştir. Katılımcıların %66,4’ü müşteri analizini yeni ürün bulma
tekniği olarak gösterirken, yeni ürün bulmada kullanılan tekniklerin ise firmada
çalışma yıllarına ve personelin işletmedeki pozisyonuna göre değişim gösterdiği
bulunmuştur.
A comparative study of impact on cognitive function between diabetic and non-diabetic patients in a tertiary care hospital
Authors: Patel Dharnaben A. , Patel Dhruv J. , Kantharia N. D.
Published: July 2018

Background: Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia, polyuria, hyperlipidemia etc, resulting from defects in insulin secretion, insulin action or both. It affects various organs of the body including the brain. Cognitive function is the thinking process of the brain. In any chronic disease evaluation of cognitive function is justified as it may affect various common day to day activities.Methods: It is a prospective, observational and non-interventional study. Thirty diabetic patients who were recently started on insulin i.e. within 7 days were enrolled in the study based on inclusion and exclusion criteria. Thirty non diabetic healthy individuals served as a control. Cognitive function was accessed by Adenbrooke’s Cognitive Examination (ACE III) at the time of enrollment.Results: The results were analysed using paired t-test. Attention, Memory and Visiospatial ability was significantly reduced in diabetic patients compared to control. Verbal fluency and language was also reduced but the change was not significant. Total ACE III score was significantly reduced in diabetic patients compared to control.Conclusions: Cognitive function is significantly reduced in Diabetic patients recently started on insulin. Hyperglycemia could be the possible reason of cognitive decline. Proper understanding of the natural history of Diabetes and the pathogenesis of cognitive decline as well as control of Diabetes can help to prevent development of cognitive dysfunction.
A comparative study of antihyperglycemic effect of Gymnema sylvestre and metformin in streptozotocin induced diabetic rats
Authors: Mulkalwar Sarita , Shah Aadil S. , Kataria Pallav , Gupta Tanya , Tilak A. V. , Sharma Bhagyashree
Published: July 2018

Background: Diabetes mellitus (DM) is a metabolic disorder that has the phenotype of hyperglycemia. According to World Health Organization (WHO) there were 65.1 million diabetics in India in 2013, International Diabetes Federation estimates this to increase to 190 million by 2035. Although a number of drugs are available for treatment of DM, their cost and safety profile are major concern. Medicinal plants are used by clinicians for treatment of diabetes. Gymnema sylvestre (GS) extract has been reported to increase insulin levels in diabetic rats. This study was designed to compare the antihyperglycemic effect of Gymnema sylvestre with metformin.Methods: Diabetes was induced in Sprague-Dawley rats using streptozotocin 45mg/kg. Methanolic extract of Gymnema sylvestre 120mg/kg p.o. prepared using Soxhlet apparatus.Results: GS extract reduced blood glucose levels but not statistically significant. GS extract increased HDL and triglycerides, reduced both serum ALT and AST but no statistical significance seen. Metformin significantly increased serum urea, which was not seen in GS extract group. GS extract showed regenerative changes in pancreas, liver and kidney.Conclusions: The study investigation demonstrates that methanolic extract of GS possesses antihyperglycemic and hypolipidaemic activity and so it can be considered as a promising natural remedy in a prediabetic state and in mild hyperlipidaemia to prevent its progression. Increase in β cell regeneration activity could be a probable mechanism of action. However, further long term clinical studies are recommended to define its possible role in diabetes mellitus and hyperlipidaemia. Role of GS as a potential hepatoprotective agent also needs further evaluation.
The study of clinical profile and assess the outcome of preterm infants diagnosed to have clinically significant PDA
Authors: Mallick Bhabagrahi , Nayak Sarthak R. , Tripathy Subrat Ku.
Published: July 2018

Background: Patency of ductus arteriosus is vital for fetal survival. Ductus often fails to close in premature infants called patent ductus arteriosus (PDA). Our objective is to find the clinical profile and assess the outcome of preterm infants diagnosed to have clinically significant PDA.Methods: 20 infants diagnosed as PDA clinically and confirmed by echocardiography. Symptomatic infants initially treated with fluid restriction and frusemide. Non responders treated with per rectal ibuprofen with dose of 10 mg/kg stat followed by 5 mg/kg x 2 doses at 24 hour intervals. Failure to ductal closure followed by similar second course of ibuprofen. Echocardiography repeated after 72 hours of each therapy. Surgical ligation of ductus was carried after failure to drug therapies. Secondary outcomes during hospitalization were documented.Results: PDA was diagnosed in seventeen infants during first week and three after seven postnatal day. Mean gestational age and birth weight were 31±2 weeks and 1466±378grams respectively. Three babies responded well to fluid therapy. Thirteen infants out of seventeen had ductal closure after first course and two to second course of ibuprofen. Two had undergone surgical treatment. Six infants detected with sepsis, five with intraventricular hemorrhage and retinopathy of prematurity. Two developed bronchopulmonary dysplasia. Pulmonary hemorrhage and NEC were found in one each. Two babies died.Conclusions: PDA is inversely related to gestational age and birth weight. Prostaglandin synthase inhibitors are essential in ductal closure. Surgical ligation is reserved for medical therapy failure. Co-morbidities in PDA are less in well treated babies.
A study on antimicrobial agents utilization pattern using anatomical therapeutic chemical / daily defined dose system and adverse drug reaction pattern in the intensive care unit of a tertiary care teaching hospital in North Eastern state of India
Authors: Ray Debasis , Datta Smita
Published: July 2018

Background: Successful use of antibiotics has brought a revolutionary change in the management of infectious diseases but has also resulted in its irrational use. Indiscriminate use of anti-microbial agents (AMAs) has been well-documented in the ICUs where polypharmacy is a common phenomenon, thus increasing the risk of Adverse Drug Reactions (ADRs). It is extremely imperative to evaluate the prescribing pattern of antimicrobials for enabling suitable modifications in prescribing patterns; to increase the therapeutic benefits and for optimizing the health care services.Methods: With the objective to assess the prescription patterns of AMAs and the rationality of their use this observational study was undertaken in the Intensive Care Unit of a Tertiary Care Hospital for two months.Results: Of the total 127 patients, 80 (62.99%) were male and 47 (37.01%) were female at an average age of 51.3±18.3 years. 102 (80.31%) patients received AMAs at average of 1.71±0.99 and 25 (19.69%) didn’t. Betalactam antibiotics were the most frequently (72.99 %) prescribed class. Meropenem was the most commonly prescribed (41 occasions) agent. The length of stay in ICU per patient was 4.42±3.49 days. 41.63% patients had more than two morbidities. No AMAs were prescribed in generic name. In 28 (27.45%) patients the AMAs prescribing were irrational.Conclusions: The high utilization rates of costly AMAs and irrational prescriptions are matters of great concern and need to be urgently addressed by use of guidelines, surveillance and antibiotic restriction policies and sensitization programs at all level of healthcare.
Study of efficacy of ischemia reversal program (IRP) in ischemic heart disease (IHD) patients with VO2max and Duke’s treadmill score
Authors: Sane Rohit , Sugwekar Varada , Nadapude Aarti , Hande Archana , Depe Gayatri , Mandole Rahul
Published: July 2018

Background: Number of people dying from IHD has increased from 0.61 million in 1990 to 1.13 million in 2010, which is a disturbing fact. According to report by World Health Organization, India would be spending a whopping 237 billion US dollars, owing to direct spending on health care and indirectly due to loss of productivity due to IHD. Ischemia Reversal Program (IRP) is a combination of Panchakarma and allied therapy. This study was conducted to evaluate the effect of IRP on VO2max, Duke’s treadmill score, systolic blood pressure (SBP), diastolic blood pressure (DBP), and dependency on conventional therapy in IHD patients.Methods: This observational study was conducted in January 2017, wherein the data of IHD patients (inducible ischemia on stress testing) who attended out-patient departments (OPDs) at Madhavbaug clinics in Maharashtra, India were identified. Data of patients who were administered IRP (60-75 minutes) with minimum 7 sittings over 90 days (±15 days) were considered. Variables were compared between day 1 and day 90 of the IRP.Results: Out of 38 enrolled patients, 25 were males while 13 females. There was significant improvement in Duke’s score with  subjects at moderate (50%) and high (31.6%) risk at baseline were significantly decreased to low (52.6%) and moderate (47.4%) after the 90th day of therapy.  IRP also showed significant improvement in VO2max by 9.11 (from 20.29±6.72 to 29.40±6.71; p<0.001), SBP by 5.78 (from 128.78±17.40 to 123±12.23, p<0.03), DBP by 4.76 (from 80.53±8.10 to 75.76±6.85, p<0.005). Dependency on concomitant medicines was reduced.Conclusions: IRP was effective in IHD; it had dual benefits, i.e. anti-ischemic effect, as well as reducing the dependency on allopathic medicines.
Frequency of gross total resection in intra-axial brain tumors with help of neuronavigation
Authors: Irshad Muhammad , Manzoor Ch Ali , Aamir Muhammad
Published: July 2018

Background: Neuronavigation has become a ubiquitous tool in the surgical management of brain tumors. Neuronavigation is most useful as an adjunct to other brain-mapping techniques such as awake mapping and electrocorticography in the resection of lesions within eloquent motor and language areas. Neuronavigation is also commonly used in skull base tumors, especially for planning an operative trajectory in regions containing vital neurovascular structures and may be used for cerebrovascular surgery. The current study was planned to determine the frequency of gross total resection in intra-axial brain tumors with the help of neuronavigation.Methods: This cross-sectional study was carried out in the Department of Neurosurgery, Nishtar Medical College and Hospital, Multan, from September 2014 to March 2015. After approval from institutional ethical committee, seventy-seven patients fulfilling the inclusion criteria were selected from the patient admitted in the Neurosurgical Department through the Out-Patient Department and patients referred from other departments.  After thorough counseling with the patient and his/her relatives, informed consent for procedure was taken.Results: Total 78 patients were included in the study. Out of these 78 (100%), 41 (52.6%) were male and 37 (47.4%) were female. As concern to the outcome variable (gross total resection), out of 78 (100%), in 61 (78.2%) patients gross total resection was present. On cross tabulation it was further clarified that in male patients’ gross total resection present in 32 patients and absent in 9 patients. Similarly, in female patients gross total resection present in 29 patients and absent in 8 patients. P value was 0.747.Conclusions: Conclusion of present study is that neuronavigation is a useful technique in for better gross total resection of intra axial brain tumors.
Correlations between clinical features and CD4 cell count in HIV patients with tuberculosis
Authors: K. Bariha P. , C. Karua P. , M. Tudu K.
Published: July 2018

Background: The correlation between tuberculosis and HIV is evident from the higher incidents of tuberculosis estimated 5-8% per year among HIV infected person with lesser CD4cell count. The high seroprevalence with tuberculosis in occurrence among AIDS patients.Methods: 100 HIV positive patients with tuberculosis who were admitted to medicine department and who visited to ARTS center were taken up for study for period of two years from December 2014 to 2016. Type of study is a observational comparative cross sectional study The investigation for HIV and TB were done as per NACO and WHO recommendation ELISA test CD4 cell counts AFB staining chest X-ray FNAC Mountoux test pleural fluid analysis Ascitic fluid analysis CSF fluid analysis USG of thorax CT scan of thorax.Results: It is seen that the maximum number of patients belong to the age group 31-40 years male 40 (40%) and female 4(4%) the common occupation in the study group was driver 36 (36%) the common constitutional symptom was weight loss physical examination reveal underweight (BMI <16-18.5) 54 (54%) among the study extra-pulmonary TB 63 (63%) X-ray chest finding pleural effusion found in 21% of patients CD4 cell counts 200-500 /µl was seen maximum number of patients.Conclusions: The CD4cell counts is important investigation in HIV and TB patients it is main investigation to know prognosis of HIV also important for initiation of ARV drugs.it is evident from this study the decrease the CD4cell counts there is increase the incidence of tuberculosis.
A prospective study of electrocardiographic and echocardiographic changes in patients with cerebrovascular accidents
Authors: Devarapu Chandrababu , S. Lokesh
Published: July 2018

Background: Cerebrovascular accident also called as stroke is defined as the sudden onset of neurological deficit that can be attributable to a focal vascular cause. Many studies in the past have demonstrated the fact that neurological abnormalities produce Electrocardiographic changes without any underlying cardiac lesions. Present study is done to analyze different changes in Electrocardiogram and echocardiographic patterns in the cases of cerebrovascular accidents and to assess whether these different changes have got any prognostic significance in these patients.Methods: In this study 100 patients of acute stroke admitted between May 2011 to August 2012 in Vydehi institute of medical sciences and research centre were considered and subjected to CT scan of brain, Electrocardiogram and 2D echocardiography within 24 hours of admission. Follow-up was done within the hospital to know the prognosis of all the patients.Results: Out of 100 patients majority of them had ischemic stroke accounting for 80% and remaining 20% of patients had haemorrhagic stroke. Abnormal Electrocardiographic changes were seen in 64% patients and 58% patients showed abnormal Echocardiography. ECG changes seen are Tachycardia, QTc prolongation, T wave inversion, ST depression, U waves and Bradycardia. Commonly seen echocardiographic changes were LV dysfunction, mitral valve abnormality, aortic valve abnormality. Overall mortality in patients with abnormal ECG was 28.12% compared to 11.11% in patients with normal ECG and it was statistically not significant. Overall mortality in patients with abnormal 2D echocardiography was 31.03% compared to patients with normal 2D Echocardiography which was 4.76% and it was statistically significant.Conclusions: From this study we conclude that ECG abnormalities in stroke patients do not have any prognostic significance. But LV dysfunction has prognostic significance in predicting mortality in cerebrovascular accident.
Study of lipid levels in diabetes mellitus with special reference to diabetic retinopathy
Authors: C. M. Shyam Sundar , Jearth Vaneet
Published: July 2018

Background: Diabetic retinopathy is a very common, potentially preventable, long term, microvascular complication of diabetes mellitus and leading cause of visual disability and blindness. It is considered hallmark of generalized microangiopathy occurring in diabetic patient. The present study was designed to study the lipid levels in patients of diabetes mellitus and further analyse the data with reference to occurrence of diabetic retinopathy.Methods: It was a case control study of 30 cases consisting patients with diabetic retinopathy and 30 controls with diabetes and no diabetic retinopathy. Fasting lipid profile, FBS, PPBS, HbA1C and BMI were measured in all subjects.Results: 34 males (57%) and 26 (43%) females were recruited in the study. The mean duration of diabetes was 8.5±5 yrs. The average HbA1C was 8.2±1.3 in Diabetic Retinopathy (DR) group and 7.5±0.9 in patients with no Diabetic Retinopathy (NDR). 21 (70%) patients in DR group had dyslipidaemia, whereas 13 (43.3%) patients in NDR had dyslipidaemia, average cholesterol was 188.30±46.48 mg/dl in patients with DR, 182.50±34.74 mg/dl in patients without DR.Conclusions: Dyslipidaemia was found to be more common in patients having Diabetic Retinopathy than in those without DR and the association was statistically significant. Mean cholesterol levels were found to be higher in cases and mean HDL level was found to be higher in controls but the relationship was not found to be statistically significant. No association was found between other lipid fractions and retinopathy.
Relative importance of inflammatory markers in deciding infection versus inflammation
Authors: Chakrabartty Subroto , Sardar Ajit , Ghosh Aniruddha , Barman Santanu
Published: July 2018

Background: Fever is the commonest presentation of pediatric patients attending emergency departments of all children’s hospital. The cause of fever may be acute bacterial infections or primary vasculitic disorders like Kawasaki disease or inflammation due to non-bacterial infections. The objective was to compare the performance of the four biomarkers ESR, CRP, Procalcitonin and IL-6 in predicting a diagnosis of sepsis/infection and find out a definite cut off value for the statistically most significant one.Methods: The authors conducted this prospective observational study at the indoors of a pediatric tertiary care referral center in India to find out a biomarker which can differentiate between infection and inflammation (vasculitis) in children admitted with fever and finally diagnosed as infection or inflammation (vasculitis).Results: Among ESR, CRP, Procalcitonin and Interleukin-6, only IL-6 showed statistical significance in differentiating infection from inflammation (vasculitis) analysed using the Receiver Operating Characteristic (ROC) curve and Mann-Whitney U test, sensitivity and specificity.Conclusions: IL-6 level 27 pg/mL or less at the time of admission indicates an infectious etiology while level more than this indicates towards a vasculitic cause.
Evaluation of complications and factors associated with multi-organ dysfunction in malaria: a cross sectional study
Authors: Dev Nishanth , Sankar Jhuma , Lall B.
Published: July 2018

Background: Prevalence of complications in malaria continues to grow even with reducing number of malaria cases. Complications associated with malaria can involve multiple organs. There is paucity of literature on factors associated with multi organ dysfunction in different types of malaria.Methods: Our aim was to study the clinical profile of complications in different types of malaria with specific focus on multi-organ dysfunction (MODS). In this cross-sectional study confirmed cases of malaria were enrolled.Results: Plasmodium vivax malaria was the predominant type seen in 74.1% cases. The overall prevalence of thrombocytopenia was 61.5%, hepatic dysfunction 58%, cerebral malaria 16.1%, Hypoglycemia 7.5%, bleeding 34.5%, acute respiratory distress syndrome (ARDS) 5.7% and acute kidney injury (AKI) 49.4%. Hypoglycemia was significantly higher in mixed malaria (0.025, p = 0.025). Hepatic dysfunction and hyperbilirubinemia were significantly higher in mixed malaria (p=0.001). Mortality was seen in mixed malaria (p = 0.007). Only those with mixed malaria died (13%). Patients with MODS had higher prevalence of rashes (p <0.0001) and cerebral malaria (p = 0.000). Serum levels of urea, creatinine, Bilirubin, Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) were significantly higher in patients with MODS (p<0.0001 for all variables). On evaluating factors associated with multi-organ dysfunction presence of cerebral malaria [OR: 6.4 (95% CI): 2.4 to 17.4; p<0.0001], type of malaria (Vivax or Falciparum or both) [1.77 (1.03 to 3.03); p=0.0038], and hypoglycemia [4.4 (1.08 to 17.8); p=0.038] were statistically significant on multivariate analysis.Conclusions: The present study demonstrates the factors associated with multi organ dysfunction and its impact on clinical outcome in different types of malaria.
Occurrence of high altitude cerebral edema (hace) and high altitude pulmonary edema (HAPO) simultaneously at 12000 ft: a rare phenomen
Authors: Kumar Dharmendra , Rath T. K. , Verma L. C.
Published: July 2018

High altitude cerebral edema (HACE) and High altitude pulmonary edema (HAPO) are the most dreaded complications related to high altitude. Authors managed a case of HACE and HAPO simultaneously set at unusually low height (1200 ft) in a patient. The altitude was not too much to develop these comorbidities as studied earlier. Relationship with altitude was immaterial in our case. However, rapid ascent without proper acclimatisation, young and tender age, male sex and smoking were associated contributing factors. He was managed with standard protocol and descent to lower altitude.
Kyasanur forest disease: a rare viral hemorrhagic disease in India
Authors: Dhaka Rohit , Verma Ramesh , Kumar Raj , Dhankar Mukesh , Bhalla Kapil , Agrawal Ginni
Published: July 2018

Kyasanur forest disease (KFD) is a rare hemorrhagic disease in India and isolated in monkeys in the Kyasanur Forest of the Shimoga district, Karnataka State in India in 1957. KFD is a zoonotic disease and endemic in southern part of India. KFD Virus commonly infects the black faced langur monkey (Semnopithecus entellus). No evidence for human-to-human transmission. Large domestic animals (cows, goats, sheep) that become infected are thought be important only for sustaining tick population. When monkeys come in contact with the infected ticks, they get infected, amplify and disseminate the infection creating hot spots of infection. The people who pass through the forest are bitten by the infected nymphs of H. spinigera, which are highly anthropophilic. Local villagers staying in and around the forest area frequently visit the forest for collection of fire woods, grass  and get infected through tick bites. The incubation period is 3-8 days and patients presented with following symptoms like chills, frontal headache, bodyache, and high fever for 5-12 days. There were 466 human cases during initial outbreak and 181 more the following year and has caused epidemic outbreaks of haemorrhagic fever affecting 400 to 1000 people per year since then, with mortality rate of 4 and 15%.  In 2012, 9 persons were found positive for KFD, in Theerthahlli taluk of district Karnataka. There is no specific treatment for KFD but a timely supportive therapy reduces the mortality in human being.