bluuebunny/crossref_metadata_2025 huggingface dataset:
Penerapan Outdoor Learning dengan Media Klinometer Terhadap Aktivitas dan Kemampuan Komunikasi Matematis Siswa
Authors: Fajriah Noor , Soraya Selfina
Published: February 2018

This study aims to explain about students’ activities, mathematical communication skills, students’ achievement and students' responses toward the implementation of outdoor learning using clinometers through utilization of schoolyard as a learning resource on the topic of trigonometry in SMA Global Islamic Boarding School (GIBS). The method employed in this study is quasi-experimental with one shot case study. The subject of this study includes 25 female students who are in 10 grade of natural science class. The data are collected through observation, written tests, and questionnaire. Data gained are analyzed using descriptive statistic. The result indicates that: 48% of students’ activities are in the category of active and very active; the average improvement of student’s mathematical communication skills is in the high category; there are 80% of students’ achievements passed the minimum mastery criteria; the students’ responses are satisfied with the learning experience through the implementation of outdoor learning.
Profil Berpikir Fungsional Siswa SMP dalam Menyelesaikan Masalah Matematika Ditinjau dari Perbedaan Jenis Kelamin
Authors: Siregar Ardianto Pandapotan , Juniati Dwi , Sulaiman Raden
Published: February 2018

This research was conducted at 2 students of SMPK Anak Bangsa Surabaya grade VIII. Subjects were selected based on the basic of equal mathematics ability. Data was collected using provision of problem-solving and task-based interview. Data was analysed using data reduction steps, data presentation, and conclusions. Meanwhile, to obtain valid research data in this study, researchers used time triangulation. The results indicated that in the number 1 problem of identifying patterns, the subjects of men and women tend to have similarities in stating what is known and asked the question, but the male students are more specific to explain the magnitude of the difference between the first quantity Followed by increased differences in other quantities. Related activities determine the relationship between two quantities, male subjects and women subject tend to have similarities in how to determine the relationship between two quantities that is by trial and error using existing mathematical operations.It can be concluded that the functional way of thinking both subjects is relatively the same. It's just that the male subject is more specific in finding the difference between the two quantities and finding the correspondence relationship between the quantities
Pembelajaran Pecahan dengan Menggunakan Manik Susun
Authors: Pertiwi Kiki Rizkiah , Zulkardi Zulkardi , Darmawijoyo Darmawijoyo
Published: February 2018

This study aimed to design a learning path which can help students to understand fractions based on Pendidikan Matematika Realistik Indonesia (PMRI) approach. The subject is 30 students of 4th grade of PP Qodratullah Langkan. Method of this research is design research, Hypothetical Learning Trajectory (HLT) developed from learning activity series using context stacked beads. The implementation of this research in 3 stages: preparing the design experiment, conducting the learning (the design experiment), and retrospective analysis in order to contribute to Local Instruction Theory support to students in studying fractions. The designed Hypothetical Learning Trajectory (HLT) is then compared to Actual Learning Trajectory (ALT) students during the learning to analyze whether students learn or not from what has been designed in the learning sequence. A retrospective analysis of the implementation of learning suggests that the use of the stacking bead context can help students understand fractions.
Profil Berpikir Siswa SMP dalam Menyelesaikan Masalah Matematika Ditinjau dari Kemampuan Matematika
Authors: Isroil Ahmad , Budayasa I Ketut , Masriyah Masriyah
Published: February 2018

This study has aims to describe the profile of junior high school students’ Thinking in Solving math problems. The subjects of this research are three students of high, medium and low in mathematical ability. Thinking profile of students described as follows: Understanding the problem, students received information by reading problems, then they recalled, processed, and stored information. Devising a plan, students processed, stored, and recalled information. Carrying out the plan, students recalled, processed, and stored information. Looking back, students stored information by performing a repletion of steps looking back.
Nienaruszalność unijnego systemu wartości jako żywotny interes Unii Europejskiej – krytyczna analiza mechanizmu egzekucji postanowień art. 2 Traktatu o Unii Europejskiej
Authors: Prostak Rafał
Published: February 2018

The inviolability of the European Union’s values is of vital interest to the Union. The list of these values is laid down in article 2 of TEU, while Article 7 lays down the mechanism of their enforcement. The terms and conditions for using Article 7, and anxieties about possible outcomes, have led this article to be dubbed the nuclear option. Its nature prompted the European Commission (EC) to adopt a more practical tool – the New Framework to Strengthen the Rule of Law (2014). Responding to the prolonged constitutional crisis in Poland, the EC has now for the first time invoked its framework to evaluate the conditions of rule of law in a particular Member State.This article presents a critical analysis of the mechanism enabled by Article 7 and the tool created by the EC. The analysis proves that Union’s instruments established to enforce respect for its values are ineffective, which limits its ability to properly respond to the violation of these values and effectively secure the vital interests of the European Union as well.
Reef fishes of the Anchieta Island State Park, Southwestern Atlantic, Brazil
Authors: Souza Gabriel Raposo Silva de , Gadig Otto Bismark Fazzano , Motta Fabio dos Santos , Moura Rodrigo Leão de , Francini-Filho Ronaldo Bastos , Garrone-Neto Domingos
Published: February 2018

Abstract This paper presents a checklist of the reef fish fauna of the Anchieta Island State Park, a no-take zone in which no extractive activities are allowed, in Ubatuba, Southeastern Brazil. Data was obtained between 2011 and 2013, mainly through underwater observations with snorkelling and SCUBA, and secondarily using scientific fishing (trawling). Published and unpublished data were also verified and compiled. A total of 103 reef fish species, distributed in 78 genus and 50 families was recorded. Haemulidae was the richest family (n=7 species), followed by Epinephelidae (n=6), Pomacentridae, Carangidae and Tetraodontidae (n= 4 each). Haemulon was also the most speciose genera (n=5), followed by Stegastes, Acanthurus and Mycteroperca (n=3 each). Sixty-nine species (67%) are included in global and regional Red Lists. Twenty-five species (24.2%) are within the categories Critically Endangered (CR), Endangered (EN), Vulnerable (VU) and Near-Threathened (NT). The network of Marine Protected Areas in Southeastern Brazil is still incipient, and the considerable number of threatened species in the Anchieta Island State Park clearly indicates the importance of the study area for the conservation of coastal and reef fishes.
Mammals of a restinga forest in Mataraca, Paraíba, northeastern Brazil, and its affinities to restinga areas in Brazil
Authors: Campos Bruno Augusto Torres Parahyba , Feijó Anderson , Brennand Pamella Gusmão de Goés , Percequillo Alexandre Reis
Published: February 2018

Abstract The Restinga forests are plant formations associated to the Atlantic Forest which still have not been much studied in terms of their mastofauna. The objective of the present work was to list for the first time the mammal species found in a Restinga on northeastern Brazil and show the similarities on species composition to other areas of the same environment and of Atlantic Forest. Our records were based on several complementary approaches: field survey, interviews, and museum collections. Subsequently, we performed similarity analysis between Restinga areas along Brazil and Atlantic Forest areas. We found a total of 30 species of mammals distributed in 28 genera, 16 families and 7 orders for Restinga of Mataraca. Species richness was similar to other Restinga areas and similarity analyzes pointed out that Restingas are more closely related to adjacent Atlantic Forest areas than to other Restingas in the country. This suggests that Restingas do not exhibit an autochthone fauna, but rather a faunal subsample of neighbor Atlantic Forest. Therefore, conservations policies for the Restinga habitat depends not only on actions focused on this habitat, but on initiatives that encompass nearby Atlantic Forest remnants, allowing the connectivity between these habitats.
Density and diversity of filamentous fungi in the water and sediment of Araçá bay in São Sebastião, São Paulo, Brazil
Authors: Doi Sonia Assami , Pinto Aline Bartelochi , Canali Maria Carolina , Polezel Daiane Raquel , Chinellato Roberta Alves Merguizo , Oliveira Ana Julia Fernandes Cardoso de
Published: February 2018

Abstract Araçá Bay, located in the city of São Sebastião, São Paulo, Brazil, is a protected area of substantial complexity. It represents the last remaining mangrove swamp preserve between the cities of Bertioga and Ubatuba on the northern coast of São Paulo State. This mangrove swamp has specific physical and chemical properties, and it shelters a wide variety of life, including fungi. These microorganisms are present in a variety of species with different morphophysiological features, and they have the ability to produce enzymes of biotechnological importance. The goal of this study was to quantify, isolate, and identify filamentous fungi in water and sediment samples from the Araçá Bay mangrove swamp in São Sebastião. Two samplings were performed in the summer and two were performed in the winter. The samples were collected from intertidal zones, and dissolved oxygen (DO), temperature, salinity, and pH were measured in situ. The spread plate technique was used to inoculate the samples collected on plates with a potato dextrose agar (PDA) medium. A total of 208 colonies (68 from water samples and 140 from sediment samples) were isolated, and they were identified based on their morphological characteristics. Filamentous fungus density was higher in the sediment than in the water, and the samplings performed in the winter revealed a higher density than those performed in the summer. Though some of the environmental parameters were not ideal for fungal development, a high quantity of growth was nevertheless observed. When the isolated colonies were analyzed, the greatest diversity and species richness were found in the summer samples. The genera identified in all of the samples were Aspergillus, Penicillium, Cladosporium, and Fusarium. The pathogenic species found from these genera were Aspergillus fumigatus, A. terreus, Penicillium citrinum, and P. chrysogenum. These species are also able to produce enzymes that offer a variety of applications. The fungal community described herein represents the diversity found in this mangrove swamp during the period studied. Many of the fungus species found are pathogenic and may be useful due to their ability to produce specific enzymes applicable in the biotechnological and pharmaceutical industries.
Stress-state dependency of small-strain shear modulus in silty sand and sandy silt of Ganga
Authors: Prashant A. , Bhattacharya D. , Gundlapalli S.
Published: February 2018

This study explores the effect of stress state on small-strain modulus (Gmax) in the naturally occurring Ganga sand and silt using bender elements during a series of carefully performed undrained triaxial tests. Unlike previous studies with drained shearing or testing of dry samples, the undrained shearing is chosen here to decouple the effects of void ratio and stress state on the small-strain stiffness. The results from undrained shearing of anisotropically and isotropically consolidated medium dense sand specimens are compared by keeping the same relative density and matching the initial mean effective pressure. The measured Gmaxvalues show stress path dependency – that is, it is a function of both mean effective stress and deviatoric stress. This behaviour of Gmaxis captured well by a non-linear isotropic model following the energy conservation principle, which incorporates the effect of both mean effective stress and deviatoric stress. The stress–strain response of soil provides some interesting observations, such as the strain hardening occurs mostly at constant effective stress ratio and the stress ratio at phase transition varies with the effective confinement. Experiments with varying silt content in the sand indicate that higher fines content results in slightly lower Gmaxvalues, mainly due to the lower values of mean effective stress and deviatoric stress during undrained shearing.
Using tactile pressure sensors to measure dynamic earth pressures around dual-row walls
Authors: Madabhushi Srikanth S. C. , Haigh Stuart K.
Published: February 2018

Following the destructive 2011 Tohoku earthquake and tsunami, dual-row retaining walls are being employed in Japan to protect coastal areas from these natural hazards. Dynamic centrifuge tests are conducted to investigate the system behaviour, in particular the earth pressures generated. High-frequency tactile pressure sensors can measure the dynamic earth pressures. By directly measuring the stresses generated during earthquake events invaluable insight can be gained into the dynamic behaviour. However, the processing and interpretation of the raw output can be challenging. This paper describes a processing scheme that can be used to reduce the apparent scatter in the data. This is applied to the earth pressure data collected using the system developed by Tekscan. The calibration and sensitivity correction process is detailed, with attention to the limitations of the assumptions made in the proposed method. The variation of the processed earth pressures with time is considered to better understand the wall behaviour. The distribution along the wall is considered at several instants to gain further insight. To help verify the earth pressure measurements, equilibrium-based methods are used to investigate the consistency between the recorded earth pressures and the outputs from other instruments that directly measure the wall response.
FEN BİLİMLERİ DERSİ ‘MADDENİN DEĞİŞİMİ’ ÜNİTESİ İLE İLGİLİ BAŞARI TESTİ GELİŞTİRME: GEÇERLİK VE GÜVENİRLİK ÇALIŞMASI
Authors: SARAÇ Hakan
Published: February 2018

Araştırmanın amacı, beşinci sınıf Fen Bilimleri dersi ‘Maddenin
Değişimi’ ünitesine yönelik bir başarı testi geliştirmektir. Bu amaçla ilk
olarak kazanımlar belirlenmiş ve bu kazanımlara uygun 55 sorudan oluşan madde
havuzu hazırlanmıştır. Fen eğitimi alanında uzman görüşlerine başvurularak soru
sayısı 30’a düşürülmüştür. Hazırlanan 30 soruluk test 2014-2015 eğitim öğretim
yılında 230 tane beşinci sınıf öğrencisine uygulanmıştır. Başarı testinin
geçerliği ve güvenirliği incelenmiştir. Başarı testinin kapsam geçerliği için
belirtke tablosu hazırlanmıştır. Öğrencilerin testte yer alan sorulara
verdikleri cevaplar doğrultusunda madde analizi yapılarak, her bir maddenin
ayırt edicilik ve güçlük indeksleri ayrı ayrı hesaplanmıştır. Soruların madde
ayırt edicilik ve güçlük indeksleri arasında bağımsız gruplar t- testi
sonuçlarına da bakılmıştır. Madde analizi sonucunda 2 madde testten çıkarılmış
ve 28 sorudan oluşan ‘Maddenin Değişimi’ ünitesi başarı testi oluşturulmuştur.
Testin ortalama güçlüğü 0.501, ortalama ayırt ediciliği 0.488 olarak
hesaplanmıştır. Başarı testinin güvenirlik analizinde, Kuder Richardson-20
tekniği kullanılmıştır. Hesaplanan güvenirlik katsayısı (r) 0.714 olarak tespit
edilmiştir. Araştırmadan elde edilen
bulgular doğrultusunda önerilerde bulunulmuştur.
Treatment of Myopia – Current Status and Recent Advances
Authors: Grzybowski Andrzej ,   Department of Ophthalmology, Poznań City Hospital, Poland; Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
Published: February 2018

The incidence of myopia is increasing and represents a major global economic and social burden. In addition to its disadvantages in terms of vision, myopia increases the risk of myopic macular degeneration, retinal detachment, glaucoma and cataract and is a leading cause of visual impairment and blindness worldwide. Pharmacological, environmental and optical interventions have been used to try to slow the progress of myopia. While spectacles and contact lenses have a long history in controlling accommodative responses, they do not slow progression. In an expert interview conducted at EURETINA 2017, Andrzej Grzybowski of the Institute for Research in Ophthalmology, Poznan, Poland discusses the current status of myopia and its treatment, as well as discussing new technologies aimed at delaying progression of the condition.
Advances in Retinal Disease Treatment and Diagnosis 2017
Authors: Parodi Maurizio Battaglia ,   Department of Ophthalmology, Ospedale San Raffaele, University Vita-Salute, Milan, Italy
Published: February 2018

Retinal disease is a major cause of poor vision especially in the ageing population, and age related macular degeneration is the main cause of vision loss in the developed world. Early recognition of the signs and symptoms of retinal disease can help prevent ophthalmologic complications and vision loss. It is unsurprising, therefore that retinal imaging and treatment of retinal disease is an active area of research. Founded in 2000, the European Society of Retina Specialists (EURETINA) is Europe’s premier organisation for dissemination of research on retinal disease. In this expert interview, European Ophthalmic Review’s Editor-in-Chief, Maurizio Battaglia Parodi, of the University Vita-Salute, Milan, Italy, discusses the highlights of the 17th EURETINA Congress in Barcelona, Spain on 7–10 September 2017, as well as the year’s other major advances in retinal imaging technology and retinal disease.
Progress in Modern Cataract Surgery – New Steps and Algorithms for Precise Measuring and Intraocular-lens Calculations
Authors: Hengerer Fritz H ,   Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany, Auffarth Gerd U ,   Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany, Conrad-Hengerer Ina ,   Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany
Published: February 2018

In standard cataract surgery, one of the major goals is to reach target refraction. Based on keratometry measurements, axial length and anterior chamber depth, most of the intraocular lens calculation formulae are suitable to achieve this aim. Further evaluation of corneal refractive parameters like anterior and posterior corneal surface by Scheimpflug devices led to a significant enhancement of precision in astigmatic and post-refractive surgery cases.
Update on Presbyopia-correcting Drops
Authors: Karanfil Feyza Çalis ,   Yuksek Ihtisas University, Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey, Turgut Burak ,   Yuksek Ihtisas University, Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
Published: February 2018

Presbyopia causes diminishing of vision-targeted life quality and occupational performance for most people over 40 years old. It affects the ability to perform visual tasks at near distance such as book reading, handcrafts, stitching, cooking and surgical operation. Although there are some treatment modalities such as surgery, the use of near-glasses and contact lenses for presbyopia, topical drug treatment for pharmacological control of presbyopia is currently a very popular and attractive nonsurgical option. In this review, we tried to summarise the presbyopia drop treatment.
Karadeniz Ekonomik İşbirliği Örgütü Ülkelerinde Enerji Tüketimi ve Ekonomik Büyüme İlişkisi: Panel Nedensellik Analizi
Authors: ÖZTÜRK Yrd. Doç. Dr. Zafer , ÖZ Arş. Grv. Damla
Published: February 2018

 Karadeniz Ekonomik İşbirliği Örgütü 1992 yılında Türkiye öncülüğünde kurulmuştur. On iki üyesi olan bu oluşumun temel amacı hem ekonomik hem de politik ilişkileri küresel ve bölgesel düzeyde artırmaktır. Enerji havzası ve koridoru üzerinde bulunan bu ülkelerde sanayi sektörünün temel girdilerinden biri olan enerji ile ekonomik büyüme arasındaki ilişkinin analizi uygulanacak enerji politikalarını da etkileyecektir. Bu çalışmada Karadeniz Ekonomik İşbirliği Örgütü’ne üye ülkelerde ekonomik büyüme ile enerji tüketimi arasındaki ilişki panel nedensellik metoduyla analiz edilmiştir. Bu amaçla, Konya (2006) tarafından geliştirilen yatay kesit bağımlılığını ve modeldeki değişen varyanslı hata terimi durumlarını hesaba katan panel SUR nedensellik testi kullanılmıştır. Çalışmada Dünya Bankası veri tabanı WDI’dan elde edilen yıllık kişi başına reel GSYH ve kişi başına enerji tüketimi verileri kullanılmıştır. Veriler 1992-2011 yılları arasını kapsamaktadır. 
Gallbladder Disease in Type-2 Diabetes Mellitus Patients
Authors: Chhabra Ajay , Grover Suparna , Vij Anil , Singh Amrit Pal
Published: February 2018

Background: Diabetes mellitus is a modern epidemic which leads to various complications over a period of time. Autonomic neuropathy is one such complication which may lead on to gallbladder dysmotility and gallbladder stones.

Objectives: To determine the incidence of gallbladder disorders in patients of type 2 diabetes mellitus and to find out the incidence of autonomic dysfunction in type 2 diabetes mellitus and correlate it with presence of gall bladder disorders.

Material and Methods: The present study was conducted in 50 cases of type 2 diabetes mellitus and 25 healthy age and sex matched normal individuals were taken as controls. The cases as well as the controls underwent ultrasonographic examination for gall bladder volume, wall thickness, intraluminal mass and contraction in response to fatty meal. Data thus collected was compared and analysed statistically by using students ‘t’ test and chi- square test.

Results: Mean postprandial gallbladder volume was 20.56±8.87 cm3 in diabetics with ANP with gallstones, 26.16±1.24 cm3 in diabetics with ANP with dysmotility 13.0±6.26 cm3 in diabetics with gallstones without ANP, 12.14±4.88 cm3 in normal diabetics and 13.60±5.95 cm3 in controls. The percentage contraction post fatty meal was calculated from these values and found to be 24.73±14.64% in diabetics with ANP with dysmotility, 26.38±17 .04% in diabetics with ANP with dysmotility, 43.48±8.45% in diabetics with gallstones without ANP, 56.84±9.02% in normal diabetics and 57 .64±9.92% in controls.

Conclusion: Incidence of gallbladder disease is much higher in type 2 diabetics (40%) as compared to normal healthy adults (4%). It was concluded that diabetics with ANP had significantly impaired gallbladder emptying. Poor control of diabetes, hypercholesterolemia and diabetic autonomic neuropathy are important risk factors for the development of gallbladder disease.
An Ascending Aortic Haemodynamic Comparison Between Normotensive and Hypertensive Subjects
Authors: Narayana Vijay Kumar , Sharma Rajeev , Murthy Niranjan
Published: February 2018

Background: Systemic hypertension, a common disorder with potentially serious complications, exerts ill effects through structural and functional modifications of arterial wall. Haemodynamics play an important role in the development of atherosclerosis. Local hemodynamic temporal pressure and wall shear stress are important for understanding the mechanisms leading to various complications in cardiovascular function.

Objectives: Since we could not find such a study in literature involving Indian population, this prompted us to investigate and establish the relationship between the blood pressure and the ascending aortic pulse wave parameters in normal individuals and compare the same with hypertensives.

Material and Methods: A case control study was done in a tertiary care hospital involving 25 hypertensive parents and further compared with 25 normotensive subjects of same age group acting as control. The GE ̶ P 100 Doppler echocardiography machine was used to study acceleration time, deceleration time, ejection time, ejection fraction, peak flow velocity and pressure gradient in hypertensives and compared the same with age matched normotensive. Also ascending aortic diameter was mapped at the annulus.

Results: The results of our study confirmed our assumption that in hypertensive the ascending aortic haemodynamic parameters are abnormal and both systolic and diastolic blood pressure does exert a statistically significant influence on the Doppler parameters of ascending aorta. The acceleration time, deceleration time, pressure gradient and ejection time showed statistically significant increase in hypertensives when compared to normotensive. At the same time the ejection fraction and the ascending aortic diameter showed a statistically significant decrease than normotensive.

Conclusion: We would conclude to say that the Doppler parameters of ascending aortic blood flow are abnormal in hypertensives. This altered haemodynamics may lead to further ill effects by way of altered peripheral haemodynamics. This Doppler evaluation of ascending aortic blood flow can be developed as a clinical tool for evaluating hypertensives and assessing the benefit of treatment of hypertension.
Effect of Atorvastatin on E.C.G Changes in Coronary Artery Disease
Authors: Singh Harmanjit , Gupta Anita , Bajaj Vijay , Gill Bakhshish Singh , Singh Jasbir
Published: February 2018

E.C.G is the most widely used test for both the diagnosing and estimating the prognosis of CAD. ST segment and T wave changes are most commonly evaluated parameters of E.C.G. Atorvastatin have found to decrease ischemic events apart from its hypolipidemic effect. The main objective of this open prospective randomized, controlled study was to evaluate the effect of addition of atorvastatin to conventional antianginal treatment on ST segment and T wave changes on E.C.G. The study was conducted for duration of 2 months in 30 patients of CAD (15 in each group). Group A was started on conventional antianginal treatment and group B was started on Atorvastatin 20 mg once a day at night in addition to conventional treatment. The ECG changes were recorded after 15, 30, 45 and 60 days using 12 lead E.C.G. At the end of the study, no significant difference was found in E.C.G changes between the group A and group B. A slight improvement in ST segment changes in group B patients was observed but the effect was statistically not significant. So, addition of atorvastatin to conventional antianginal treatment did not have a significant effect on reversal of ischemic changes on ECG in patients of CAD.
Recent and Emerging Trends in Pharmacotherapy of Neuropathic Pain
Authors: Singh Jasbir , Sehgal Vijay , Singh Harmanjit
Published: February 2018

Neuropathic pain is a type of chronic pain caused by a lesion or disease of the somatosensory nervous system. The pathophysiology of neuropathic pain is very complex, not fully understood and different from that somatic pain. It has a deleterious effect on health related quality of life, and leads to increased health-care costs and its management is extremely difficult. The response to currently available treatments is less promising, so newer agents with better efficacy and safety are needed. Currently tricyclic antidepressants and anticonvulsants like gabapentin and pregabalin are considered as the 1st line drugs but these are not able to produce complete relief. Various recent drugs are: high dose capsaicin patch, topical lidocaine, botulinum toxin A, lacosamide, Selective Serotinin Reuptake inhibitorss, NMDA antagonists. Certain new targets like endocannabinoid system and various neurotrophic factors like BDNF, NT3, NT4, and GDNF are undergoing preclinical and clinical trials and their role in the treatment of neuropathic pain is still emerging.
Restoring Esthetics by Immediately Loaded Implant Placement
Authors: Jurel Sunit K. , Gupta Durga Shanker , Agrawal Himanshi , Singh Raghuwar D. , Aggarwal Kaushal Kishore
Published: February 2018

The replacement of a single missing anterior tooth with an implant-supported crown is a demanding therapy. This report describes a treatment in which an anterior maxillary implant was immediately restored with a provisional restoration. During the provisional phase, an optimal emergence profile was created by adjusting the provisional restoration. An impression was made with an individually fabricated impression post for an accurate reproduction of the established emergence profile and, finally, a screw-retained all-ceramic crown was placed. By implementing this protocol, an optimal definitive result could be achieved, together with immediate patient satisfaction.
Changing Paradigm of Doctor Patient Relationship-Issues of Cost, Communication, Compassion, Consumerism or More?
Authors: Jerath Amitabh M. , Singh Ravinder
Published: February 2018

Ilhealth is always considered an uninvited guest and so is the pain of spending for it. For something that is unexpected and unwelcome, a negative sentiment gets tagged with it at the very start itself. It someone falls sick, there is a feeling of victimization by the force unknown. These are the pack of emotions with which a patients walks into hospital surrounded by anxious, restless attendants and most of the anxiety and disturbed look is borne out of the forced eventuality of accompanying their own kin. Another pertinent cause is the loss of the working days which are not easy to afford in the present era of cut throat competition. And not to lag behind is the constant prayer buzzing in their mind wishing a quick discharge and slim as a Barbie doll hospital bill.
A Drug Utilisation Study of Antihyperglycaemic Agents in a Rural Tertiary Care Hospital
Authors: CDM Naidu , A Vardhan , MA Bankar , S Sharma , VS Raghuvanshi , S Reddy
Published: February 2018

Background: Diabetes mellitus is an emerging non communicable, life style disease. The aim was to evaluate the drug utilization pattern of anti-diabetic drugs in diabetic outpatients and monitor the adverse drug reactions (ADRs) associated with anti-diabetic therapy.

Materials and methods: A prospective observational study was carried out in adult diabetic patients from the Department of General Medicine of a rural tertiary care hospital in October 2013- December 2014 after obtaining written informed consent from the patient and approval from institutional ethics committee. Demographic data, drug utilization pattern, cost of the antidiabetic drugs along with defined daily dose was calculated. ADRs due to anti-diabetic drugs were summarized.

Results: A total of 450 patients were enrolled in the study of which there was male preponderance and majority belong to geriatric age. The most common comorbidity was hypertension. Insulin was most commonly prescribed drug during hospital stay and metformin at the time of discharge. Of the combination therapy dual therapy of metformin and glimipiride was most preferred. The total antihyperglycaemic drug consumption was 15.65 DDD/100 bed days. 67 ADR were reported of which the most common was hypoglycaemia.

Conclusions: The study showed insulin and metformin were the most commonly used drugs. The prescribing trend also appears to be moving towards combination therapy particularly two drug therapies. The most commonly reported ADR was hypoglycaemia.
Neonatal Sepsis-Culture Positive Sepsis Vs Clinical Sepsis
Authors: Ghosh Purbasha , Misra Rabindra Nath , Paul Retina
Published: February 2018

Background: The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important.

Objectives: To find out the risk factors associated with neonatal sepsis, to isolate&identify the pathogens from various clinical specimens and to find out antimicrobial susceptibility of the pathogens.

Material and methods: Blood culture, sepsis screen, haematological&biochemical markers, cerebrospinal fluid (CSF) study, radiology, MRSA (methicillin resistance Staphylococcus aureus) surveillance were carried out in this study. Some samples were processed in BacT/ALERT-3D system (BioMerieux ) and identified by VITEK-2 (BioMerieux). Epi Info Software system was used to calculate statistics.

Results: One seventy (65.9%) were culture positive and 88 (34.1%) were culture negative out of 258 clinically suspected cases. Methicillin sensitive Staphylococcus aureus (MSSA) 66 (38.82%) was the commonest organism. Among 88 culture negative cases, 38(43.2%) babies were two or more sepsis screen tests positive, 40(45.5%) culture negative babies were with risk factors and 5(5.7%) had radiological evidence of pneumonia.

Conclusion: The clinical diagnosis of it remains difficult as the symptoms are nonspecific. So, blood culture is mandatory. Other diagnostic tests also help in this situation. Blood culture is still the "Gold standard" for the diagnosis of septicaemia in neonates, but culture negativity cannot exclude the sepsis as a whole.
Hoarseness Due to Penicillium Marneffei Infection-An Unusual Presentation
Authors: Bhagyabati Devi S. , Chanu Keisham Jaya , Birendra Singh Ksh
Published: February 2018

Penicillium marneffei is a dimorphic fungus causing infection mainly in immunocompromised individuals, especially those with HIV infection. Penicillium marneffei is an important opportunistic pathogen of HIV infection in South East Asia including Manipur. Common clinical manifestations are fever, cough, weight loss, generalised lymphadenopathy, and papulonodular eruptions. We report an unusual case of HIV patient with Penicillium marneffei infection presenting as hoarseness.
Impacted Maxillary Third Molar: Report of Two Cases
Authors: Borisov Tsvetanov Tsvetan , Stamenov Nicola
Published: February 2018

The aim of this case report was to review two cases of patients with impacted maxillary third molars. Both were symptomatic and presence of pathology clinically and radiographically. Surgical extraction of these third molars with accessible positions requires a bone removal. Moreover, it contains a high risk of displacement of the third molars into the maxillary sinus. The postoperative period for both cases was without complications.
Pattern of Variations in Superficial Palmar Arch and its Clinical Importance
Authors: Rapotra Megha , Sharma Anshu , Sharma Mahesh
Published: February 2018

Background: Superficial palmar arch (SPA) is an important arterial anastomotic arcade which is the dominant vascular supply to the majority of the palmar muscles.

Objectives: Keeping the importance of these variations in mind this study was designed to find out the pattern of superficial palmar arterial arches.

Materials and Methods: A total of 40 adults upper limbs of unknown sex were observed for the variations in the pattern of superficial palmar arches on right and left side and were compared with the previous data.

Results: A complete superficial palmar arch was encountered in 72.5% (n=29/40) of specimens and an incomplete SPA was observed in 27.5% (n=11/40) of specimens.

 Conclusion: Knowledge of the variations in the arterial supply of hand is essential in advent of microvascular surgery for revascularisation, replantation and composite tissue transfers.
Perforation Repair Using Biodentine:A Nobel Approach
Authors: Mukherjee Mridusmita , Shekhawat Krutika
Published: February 2018

Root perforations are one of the many consequences of compromised endodontic procedure. It not only poses a significant problem in treatment outcome but also greatly affects the prognosis if not repaired in time. If it occurs, it allows microbial invasion and inflammation in the non-invated area of operation. So, choice of restorative material should be such that it closes the pathway of communication between the root canal system and its associated tissues. It should possess all the good qualities of an ideal orthograde or retrograde filling material. The following note describes a case report of a young boy with failed root canal treatment performed earlier with its steps of management.
Seroprevalence of Dengue Infection in a Tertiary Care Hospital in Assam
Authors: Goswami Liza , Runumi Chowdhury , Rasul Elmy S.
Published: February 2018

Background: Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue in India has dramatically expanded over the last few decades, with rapidly changing epidemiology. Dengue is emerging as major public health concern in northeast India and spreading with increased morbidity.

Objective:This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam during the period 2013-2016.

Methods: A retrospective study was done from the year 2013 to 2016. A total of 340 serum samples received in the department of microbiology FAAMCH, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests were performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity.

Results: Out of 340 samples tested, 68 were positive either by NS1 antigen or for IgM antibody ELISA tests. These comprised all age groups of both sexes with higher incidence of cases in young males aged 26– 60 years.

Conclusion: From this study, it is apparent that dengue surveillance and control should be enhanced by wider use of laboratory testing to confirm dengue as a cause of fever of unknown origin, especially during the local dengue transmission season.
Retromandibular Approach for Subcondylar Fractures: A Prospective Study
Authors: Tripathi Geeta Mishra , Sharma Divashree , Dixit Sourabh , Bhat Atul , Yadav Lal Singh , Sharma R. J.
Published: February 2018

Background: Condylar fractures accounts for 25-50% of all mandibular fractures. It can be extracapsular or intracapsular, nondisplaced, displaced, deviated, or dislocated from the disc.

Objective: To evaluate the retromandibular transparotid approach for open reduction & internal fixation of subcondylar fractures for post-operative occlusal status, stability of fixation & postoperative complications.

Material and Methods: The prospective study was performed on 24 patients (18 male and 8 females) sustaining 26 subcondylar fractures who were treated surgically utilizing retromandibular transparotid incision.

Results: The most common etiology of injury was road traffic accidents in 62.5% patients. Satisfactory anatomic reduction and occlusion was achieved in all patients. The incidence of transient facial nerve injury was 16.67%. The facial nerve returned to normal function in 3 months in all the 4 affected patients.

Conclusion: The incision provides easy visualization of the subcondylar region from the posterior edge of the ramus to the sigmoid notch, allows the perpendicular placement of screws to the fracture site, with minimal post operative complications and satisfactory esthetic results.
Enfermagem e odontologia: perspectivas para a integração no cuidado ao paciente crítico
Authors: Cruz Ronny Anderson de Oliveira , Araújo Angela Amorim de , Moreira Thiago Pelúcio
Published: February 2018

Este artigo tem como objetivo refletir sobre as práticas interdisciplinares que advém dos processos de integração entre a enfermagem e a odontologia no cuidado e manutenção da higiene bucal do paciente crítico, o que tem contribuído para o estabelecimento de condutas padronizadas. Apresenta abordagem reflexiva, fundamentada a partir de revisão integrativa nas bases de dados Scielo, Pubmed e Bireme no período de 2000 a 2014, onde foram encontrados encontrando 113 artigos. Após a aplicação dos critérios de inclusão e exclusão restaram 6 artigos. Evidências fundamentam a necessidade de melhorar a integração entre estas categorias profissionais neste nível de cuidado com vistas a contribuir com a diminuição dos efeitos danosos que a falta ou a inadequada higienização oral possam trazer, bem como o aumento das complicações infecciosas com o intuito de otimizar a qualidade da assistência prestada.

Nursing and dentistry: prospects for integration in critical care patient
Abstract: This article aims to reflect on the interdisciplinary practices that comes from the integration processes between the nursing and dental care and maintaining oral hygiene critical patients, which has contributed to the establishment of standardized behaviors. It features reflective approach, based from integrative review in Scielo databases, Pubmed and Bireme from 2000 to 2014, where they were found finding 113 articles. After applying the criteria of inclusion and exclusion remaining 6 articles. Evidence underlying the need to improve the integration of these professional categories at this level of care in order to contribute to the reduction of harmful effects that the lack or inadequate oral hygiene can bring as well as the increase in infectious complications in order to optimize quality of care.
Role of Effective Internal Control Structure in Achievement of Targeted Success in Businesses
Authors: Turedi Hasan , Celayir Duygu
Published: February 2018

Due to economic relations evolving over time, technology and changing business environments, the way in which one of the management functions, “control”, is executed has undergone a number of changes. Accordingly, the management of a business has become unable to control operations directly, making it a necessity for businesses to obtain timely and reliable data for a number of purposes, including protecting assets, and eliminating or minimizing errors and frauds. Internal control structures, formed within the business to serve this purpose, have become more relevant in terms of protecting business assets, identifying the way operations are executed and ensuring execution of operations at the desired level of efficiency. Internal control is defined as a structure in businesses which is directed by board of directors, managers and employees, aims to ensure effectiveness and efficiency of operations, reliability of the financial reporting system, and compliance with laws, and is designed to provide reasonable assurance in these aims. Depending on the position they assume, officials at every level have responsibilities in the context of ensuring effective and efficient execution of the internal control structure in businesses, and accordingly, of corporate management, and attaining expected goals. This study will examine development of an effective internal control structure in terms of attaining expected success by businesses and the impact thereof on the business.
An Empirical Study of Institutional Investor and Enterprise Innovation
Authors: Min Cheng
Published: February 2018

Innovation is the driving force of social and economic development, and a decisive factor in enhancing national competitiveness. In recent years, more and more countries have taken innovation to a strategic height. Chinese institutional investors have an increasing share of the overall ownership and make a remarkable improvement in the market position. Based on an increasingly significant role in the capital market, they actively intervene in the management of the enterprise, focusing on long-term improvement of corporate performance. Correspondingly, Institutional investors can also affect the level of technological innovation by participating in corporate governance. This study analyzes the mechanism of institutional investment affecting the technological innovation of enterprises, and takes an empirical test of institutional investors on the impact of technological innovation. The results show that the overall ownership of institutional investors has a significant positive impact on corporate R&D expenditure. This paper proposes that the future policies should still be oriented toward the development and support of institutional investors, and give further play to their efforts to promote technological innovation of enterprises.
Impact of Government Debt on Economic Growth in Kenya: A Critical Literature Review
Authors: Murungi Silveria Mukwandiga , Okiro Kennedy
Published: February 2018

The study examined the impact of government debt on economic growth through extensive review of relevant theoretical and empirical literature. Governments borrow to cover budget deficits. The debt is obtained either from the domestic market or from external sources. Government debt by Greece proved to be bad for the economy while government debt by USA which has the highest debt in the world proved to be manageable. This led to the need to examine the impact of government debt on economic growth in Kenya. The major theories examined included Adolph Wagner’s law of increasing state activity, the debt overhang theory, crowding out theory and the Ricardian equivalence theory. The main objective of the critical literature review was to review the literature done on the impact of government debt on economic growth while the specific objectives were to examine the impact of government debt on economic growth, to investigate the effects of macroeconomic variables on the relationship between government debt and economic growth, to establish the effects of regulatory reforms on the relationship between government debt and economic growth, and to review the joint effect of macroeconomic variables and regulatory reforms on government debt and economic growth. The majority of the findings from the literature reviewed on government debt indicated that there was an impact of government debt on economic growth; some showed a positive economic growth while others showed a negative economic growth.
Disadvantages of the Replacement Ratio Indicator with Calculation of a New Variant of This Indicator: A Case Study of Czech Republic
Authors: Stipek Vladimir
Published: February 2018

This article deals with the analysis of the replacement ratio (an indicator of the relation between the average wage and the average pension). This was carried out on the basis of the analysis of pensioners’ consumer baskets and their expenditures. It proposes a more appropriate concept of the so-called real replacement ratio. The replacement ratio is often used for longterm (intergenerational) comparisons of the standard of living of pensioners. Also, the weaknesses of this indicator make such comparisons insufficiently informative. On the other hand, the so-called real replacement ratio takes into account the impact of significant cost items and cost items whose price is rising. As a result, this provides only a comparable standard of living without contributing to the improvement of living standards, for example through consumption expenditures. Examples of these significant cost items are housing, healthcare or transport. As illustrated by the paper, before 1989, the level of these costs was considerably lower, which is not taken into account by the average values of the non-adjusted replacement ratio. The replacement ratio calculated in the usual manner was 41.56% in 2016 and decreased to 33.7% with the use of the real replacement ratio concept.