bluuebunny/crossref_metadata_2025 huggingface dataset:
USAGE OF THE NEW INFORMATIONAL TECHNOLOGIES IN PERSONALIZATION OF RELATIONS WITH CUSTOMERS OF TOURISM ENTERPRISES
Authors: Basyuk Daria , Pohuda Natalia , Prymak Tatyana
Published: May 2019

Purpose: scientific substantiation of new ways to improve personalized interaction with tourist companies' clients based on the use of modern Internet technologies.

Methods. A theoretical synthesis of scientific sources concerning of usage of Internet technologies in the framework of relations with clients (I. Reshetnikova, S. Ilyashenko, E. Pan, P. Gumble, R. Johnson and D. Ford, S. Melnichenko, M. Boyko, V. Lukyanov, G. Munin, Yu. Pravyk). An analysis of the activities of domestic and foreign tourist enterprises regarding the personalization of relations with clients shows that at the present stage there is a tendency to switch from a strategy of concentrated marketing to a strategy of personalization, where each client is offered an individualized service complex.

Results. Personalizing relationships with clients for the tourism industry is an extremely important factor in the development and profit making, since communication in tourism involves close interaction with consumers and their individual requests and wishes. Ukrainian companies that implement the principles of personalization often face the lack of scientifically based methods for preparing and adopting managerial decisions using modern information technologies.

As a result of the scientific search, there have been offered various innovative ways and means of optimizing the work of tourism company managers for personalized interaction with customers through Internet technologies, which include modern analytics services, information collection and processing, as well as tools that allow the creation of personalized emails, promotional advertisement, content, etc.

The scientific novelty lies in the complexed integrated differentiated assessment of the use of IT-technologies for the formation of personalized relations of a tourism enterprise with customers.

The practical significance. The integrated implementation of modern personalized marketing tools ensures effective and long-lasting relationships with customers, which is the key to the successful operation of the company's tour in the market.
APPLIED GASTRONOMIC DOSSIER OF THE RIGHT-BANK POLISSYA
Authors: Nesterchuk Inna
Published: May 2019

In the article, an audit of gastronomic proposals for the territory of the the Right-bank Polissya study was carried out in order to attract and promote local autochthonous dishes and food traditions.

Goal. The substantiation of the theoretical and methodological approach to the issues of promotion of local food and wine through a retro-innovative perspective. Therefore, the creation of immersive ethno-gastronomic experience requires an innovative approach, starting with the inventions of traditional dishes and recipes, but without the risk of loss of authenticity.

Method. Based on the retro-innovative approach and field research, we tried to ensure the synergy of gastronomic tourism through a range of variables: promotion and advertisement of local cuisine as a resource of a particular region; development of a universal product tour, which includes gastronomic tours; the experience gained about the unique places that make the impression of an "attractive kitchen"; culinary events tied locally.

Results. The research results of the region announce a large traditional heritage in which the autochthonous cuisine becomes a link between the pleasure of experience for the tourist and the advertisement of the area. A key factor is the transformation of the general tourist product into a unique experience, thanks to gastronomic routes that will improve local infrastructure and contribute to the development of the economy in the region.

Scientific novelty. Knowledge of food and wine of the Right-bank Polissya will become the main motivating factor for visiting this destination. In light of these changes, it is necessary to adopt a new approach to the promotion of gastronomic tourism – a new way of thinking.

Practical significance. Gastronomy in recent years has become one of the main motivations for visiting geographic areas, in particular, the Right-bank Polissya. In fact, tourists demand new experiences that stimulate other feelings, besides the sight: gastronomic tourism can stimulate other sensations such as taste and smell. Gastronomic tourism demonstrates great potential for tourism product and creates new opportunities for development of other economic events.
COMMUNICATIVE, ITS ROLE IN THE DEVELOPMENT OF TOURISM ON THE EXAMPLE OF IVANO-FRANKIVSK REGION
Authors: Kovalska Lesia , Tkachenko Tetiana , Kovalska Angela
Published: May 2019

Aim: The purpose of the article: To analyze the current state of the transport network development, the index of transport communication, the dynamics of the number of users of mobile communication services, on the example of Kyivstar Company in Ivano-Frankivsk region. Determine the role of transport and mobile networks in promoting and enhancing the development of tourism on the basis of multifunctionality, mutual permeability and complementarity of various elements of socio-economic systems.

Methods – the study of communicative and its role in the development of tourism on the example of the Ivano-Frankivsk region is based on the combination of methods of sectoral and territorial analysis.

In particular, a systematic approach is used for the study using comparative methods, statistical analysis, analytical analysis, etc.

This methodology includes an analysis of the conditions and factors of tourism development within the administrative unit of Ukraine based on statistical data of indicators (types of vehicles and connections, number of arrivals / departures of passengers, directions of tourist flows from / to Ivano-Frankivsk region, etc.).

Results – the article analyzes the impact of transport and mobile networks on the development of the tourism industry, for example, Ivano-Frankivsk region. The emphasis is placed on the index of transport communicativeness of the Ivano-Frankivsk region. The analysis of migration monitoring with the help of Kyivstar telecommunication operator was carried out, namely: citizens' migration in Ivano-Frankivsk, duration of their stay, geography of their arrivals. In comparison with the statistical indicators of the state of tourism development, external (country) and internal (oblast) donors of tourists are determined. The influence of communicativeness on the current state of the tourism industry is substantiated.

Scientific novelty – for the first time, on the basis of sectoral-territorial analysis the state of development of the tourism industry through the prism of transport and mobile networks has been analyzed.

The results of the research may form the basis for writing course papers, theses, preparation of lecture-practical material, monitoring of the national tourism market.

Practical significance – materials of the publication, conclusions can be used during the educational process, preparing training for the national tourism industry, the practical activities of tour companies, to popularize the western region of Ukraine, on the example of Ivano-Frankivsk region on the external and internal tourist markets.
EVALUATION OF QUALITY LEVEL TOURISM SERVICES AND DIRECTIONS OF GROWTH TOURIST POTENTIAL OF THE CITY PEREYASLAV-KHMELNYTSKY
Authors: Samoilenko Natalia , Bondar Nataliіa , Sharan Larisa , Hubenia Vyacheslav
Published: May 2019

Goal. The purpose of the article is to analyze the prospective opportunities for improving the tourist potential of the city Pereyaslav-Khmelnitsky. Method. The methodical basis of the work is the works of domestic scientists in the field of tourism, scientific periodicals, Internet resources, statistics of the Main Department of Statistics in Кviv Oblast, etc., which reflect the characteristics of the state of the tourist and recreational industry of the region Results As a result of the research, the tourist potential of the city Pereyaslav-Khmelnitsky has been analyzed. Were proposed the directions of development of the city. They will ensure the preservation of historical monuments, improvement of service and infrastructure, and the popularity of the city. In turn, this will increase the number of tourists that visit the city and improving the tourism potential in general. Scientific novelty. The main problems of tourism development in the city Pereyaslav-Khmelnitsky are determined, and suggestions on increasing the tourist potential are given. Practical significance. The coverage of tourism development problems in the city Pereyaslav-Khmelnitsky and the methods of their solution will increase the attractiveness of the city for sponsors and entrepreneurs. Increasing the tourist potential of the city will contribute to a larger flow of funds for the overall development of the city and the region.
Familia y redes sociales: un binomio controvertido
Authors: Dans Álvarez de Sotomayor Isabel , Muñoz Carril Pablo César , González Sanmamed Mercedes
Published: May 2019

Las redes sociales poseen una gran importancia en la vida de los adolescentes y la labor de las familias resulta imprescindible para aprovechar las posibilidades que ofrecen y frenar los peligros que suscitan. En este estudio se analizan, a través del método de encuesta, las opiniones de 1144 alumnos de cuarto de educación secundaria sobre la mediación parental en el acceso y uso de las redes sociales. Tras análisis descriptivos y no paramétricos, los resultados revelan que los menores se inician en el uso de redes sociales a través de su grupo de amigos, constatándose la escasez de medidas de control familiar frente al uso de este tipo de herramientas. Asimismo, el acceso y tiempo de conexión a las redes sociales guardan relación con el rendimiento escolar y el género. También se identifican diferencias importantes en cuanto a la percepción que familias, docentes y alumnado tienen sobre las redes sociales, siendo estos últimos los que manifiestan una visión más positiva. Entre las conclusiones cabe señalar la necesidad de que las familias desarrollen medidas educativas adecuadas que propicien que los menores realicen un uso responsable y seguro de las redes sociales.
Risk of developing gestational diabetes in women after assisted reproductive technologies
Authors: Arzhanova Olga N. , Rulyova Anna V. , Paykacheva Yulia M. , Ivanova Alina O. , Nichiporuk Natalya G.
Published: May 2019

Hypothesis/aims of study. Gestational diabetes mellitus (GDM) is one of the leading causes of perinatal morbidity and mortality. The use of assisted reproductive technologies (ART) is an independent risk factor for the development of GDM. Among other risk factors are overweight, diabetes burdened heredity, previous GDM, previous birth weight more than 4 kgs, stillbirth, miscarriage in history, glucosuria, polyhydramnios in this pregnancy, age over 30 years, polycystic ovary syndrome. The most significant risk factor for GDM is excess weight before pregnancy. The aim of this study was to investigate the risks of GDM in patients after ART.
Study design, materials, and methods. 342 case histories of women with single pregnancy for the period 2014–2017 were studied on archival material. The main group consisted of 234 women with single pregnancy after ART. The comparison group comprised 108 medical records of fertile women with a history of single pregnancy that occurred spontaneously. The exclusion criteria in the comparison group were pregestational diabetes mellitus and severe extragenital pathology.
Results. The incidence of GDM was significantly higher in the group of women in whom pregnancy occurred after ART compared to the comparison group (15.4 ± 0.4% and 5.5 ± 0.4% respectively). In the main group, patients were more likely to have overweight, extragenital pathology and pregnancy complications.
Conclusion. The increase in the frequency of GDM among patients after ART is probably associated with late reproductive age, initially negative somatic background at the time of entry into the IVF protocols, as well as long-term hormone therapy during pregnancies after ART, starting from early terms.
Somatic features and reproduction characteristics of patients with perinatal fetal death
Authors: Bezhenar Vitaliy F. , Ivanova Lidia A. , Frederiks Elena V. , Anashkina Raisa I.
Published: May 2019

Aims of study. The current analysis was undertaken to determine risk factors for perinatal losses and assess the possibility of their prediction.
Study design, materials and methods. We analyzed 307 cases of perinatal death in obstetric facilities of the Leningrad region (main group). 357 women who gave birth to living children who lived 7 days of the perinatal period represented the control comparison group. A retrospective analysis was carried out based on medical hospital records: an examination of events during pregnancy, childbirth, postpartum, and early infancy, as well as afterbirth study findings and autopsy reports.
Results. We performed a retrospective analysis of the social (3 factors), somatic (28 factors), and reproductive (15 factors) statuses of patients with perinatal losses in order to try to assess the possibility of identifying risk groups and predicting perinatal and fetal mortality.
Conclusion. The predictors of perinatal mortality were determined, namely features of social status (absence of a marriage record and a permanent job, low level of education), somatic status (diabetes, cardiovascular pathology, arterial hypertension, chronic hemocontact infections), and reproductive status (late menarche, early sexual debut, previous infectious genital pathology, childbirth at a young age, etc.).
Amniotic fluid composition and its role in perinatal pathology
Authors: Mochalova Marina N. , Mudrov Viktor A. , Mudrov Andrey A.
Published: May 2019

Amniotic fluid composition reflects vital processes in the fetus, which determines its diagnostic value. This composition varies under pathological conditions of the fetus and uteroplacental complex. The aim of the study was to investigate the role of amniotic fluid composition in perinatal pathology. This systematic review summarizes and critically analyzes foreign and domestic research data obtained from 1977 to 2018. Determining the role of amniotic fluid composition will optimize the management of pregnancy and childbirth.
Expressive Writing: A Self-Care Intervention for First Year Undergraduates
Authors: Kennison Monica , Lamb Connie , Ponder Judy , Turner Lisa , Karpinski Aryn C. , Dzurec Laura C.
Published: May 2019

Background: As incoming students grapple with stress and traumatic experiences at alarming rates, faculty and institutions are increasingly promoting resilience and self-care activities. Expressive writing (EW) may be an underutilized self-care practice for addressing students' stressful or traumatic experiences.Aim: This pilot study aimed to describe the effects of an expressive writing (EW) intervention on participants' mental and physical health and stress levels.Methods: The study design was mixed methods. The convenience sample of 32 undergraduate participants were assigned, every other one, to either an EW intervention group who wrote about a stressful or traumatic experience (n = 18), or a neutral writing (NW) group (n = 14) who wrote about trivial topics. Data regarding sample characteristics, cortisol level, quality of life, and impact of the EW intervention were collected via a demographic survey, the SF-36v2® Health Survey (Maruish, 2011), salivary sampling and exit survey, respectively.Results: Comparison of SF-36v2® pre- to post-test demonstrated higher gains in mental health in the experimental group, relative to the control group. Fourteen (44% of total group) reported that they would recommend EW to a friend to help with stressful or traumatic experiences.Conclusions: EW may support first year undergraduates' self-care related to addressing past or current stressful or traumatic situations.
Cross-sectional study of effect of adiposity and hypertensive states on airway dynamics
Authors: Gautam Kunal Kishor , Saxena Deepak , Kanchan Arvind , Ahmad Nisar , Saini Rahul , Mujeeb Naushi
Published: May 2019

Background: Adiposity and hypertensive states are major burden for community. It causes many health-related issues, including problems related to respiratory system. It is proposed that pulmonary functions can be affected in obese hypertensive and obese normotensive adults compared to non-obese normotensive adults. The objective of the study was to find out the effect of adiposity and hypertensive states on the airway dynamics.Methods: About 30 male obese normotensives and 30 male obese hypertensive subjects were selected as study participants. 30 age-controlled non-obese, normotensive males were selected as controls. All participants were in the age group of 40 to 60 years. The pulmonary functions measured were FVC, FEV1, FEV1% and PEFR. All the participants performed 3 attempts of spirometry and maximum among the three recordings were used for analysis. ANOVA followed by Post hoc analysis to find out any significant differences between these groups. Spearman’s rank correlation was used.Results: There was a statistically significant differences in BMI between the group I and group II and III. There was a significant difference in SBP and DBP between obese normotensive (group II) and obese hypertensive (group III) subjects. There were significant decline in % predicted values of PFT parameters, on comparing obese normotensive and obese hypertensive when compared to non-obese normotensive participants. There were statistically significant negative correlations between age and FEV1 as well as BMI and PEFR.Conclusions: There was a significant decrease the pulmonary functions in obese normotensive and obese hypertensive adults in comparison to non-obese normotensive adults. It can be concluded that body weight and adiposity as well as high blood pressure creates deleterious effect on airway dynamics.
Correlation of serum parameters with disease severity, exacerbations and hospitalizations in patients with Non-cystic fibrosis bronchiectasis
Authors: Kallarakal John Sonia , A. Fathahudeen , Mallan K. G. R. , D. Manjula V.
Published: May 2019

Background: The factors essential to define the severity and the prognosis of subjects with NCFB have not been sufficiently assessed. A prospective observational study was conducted to assess the serum parameters, their correlation with BSI (bronchiectasis severity index) and FACED (FEV1% predicted, age, chronic colonization by pseudomonas aeruginosa, extension by radiological assessment and dyspnoea) score in assessing disease severity and respiratory hospitalizations in patients with NCFB.Methods: About 76 clinically stable patients diagnosed as NCFB were included. Data extraction was done using structured proforma. The BSI and FACED scores were calculated. The serum parameters albumin, CRP (C-reactive protein), ANC (Absolute neutrophil count) and Hb (hemoglobin) levels were estimated. The number of exacerbations and hospitalizations during the 6 months follow up period were recorded.Results: The mean value of the serum parameters albumin, CRP, absolute neutrophil count (ANC) and Hb were 3.86 (95% CI 3.77- 3.95), 19.61 (95% CI 15.53 -23.68), 8632.95 (95% CI 7258.5-10068) and 12.3 (95% CI 11.84- 12.74) respectively. There was strong negative correlation between serum albumin and the BSI and FACED score. The mean exacerbations and hospitalizations during the 6 months follow up period were 3.3 (95% CI 2.93-3.65) and 1.14 (95% CI 0.85-1.44) respectively.Conclusions: The serum albumin level exhibited strong correlation and was identified as a variable associated with the BSI and FACED scores. Further studies in this direction are needed for use of serum parameters in severity assessment.
Knowledge, awareness and practice of cervical cancer screening among ever married rural women of Ganjam District, Odisha: a community based cross-sectional study
Authors: Kar Monali , Karmee Nivedita , Satapathy Durga M.
Published: May 2019

Background: India accounts for 25% of total deaths from cervical cancer. Screening for cervical cancer reduces mortality by early detection and treatment. So, a study was conducted among rural women of Ganjam district with the objective to know knowledge, attitude and practice of cervical screening among them.Methods: A community based cross sectional study was conducted from January to February 2019 among ever married women of more than 30 years of age residing in villages of Chhatrapur block of Ganjam district. Sample size was calculated to be 280 by formula Z2pq/l2. Multistage random sampling and PPS method were used to select participants. A semi-structured questionnaire was used to collect data and all data were analysed in SPSS.Results: Among 280 participants, though 70.7% had heard about cervical cancer, only 32.5% knew that there are tests for screening. Only 13.2% of participants said that Pap smear test was to be taken regularly. However, majority didn’t know who should undergo screening test and what age tests should be started. Main source of information for them was health worker (39%). Only 14.6% had any type of cervical screening in their lifetime. The main reason for not going for screening was ignorance (53.9%) followed by thinking tests are not needed unless any symptoms appearedConclusions: Proportion of participants with proper knowledge and awareness regarding cervical cancer screening was low which led to poor uptake of screening. So, awareness regarding cervical cancer screening should be increased. Health camps and education programs should be conducted regularly.
Effect of brimonidine on central corneal thickness in normal tension glaucoma patients
Authors: V. Neethu K. , V. Latha N. , K. Praveena K.
Published: May 2019

Background: Brimonidine is a potent ocular hypotensive agent widely used in glaucoma treatment. A reduction in central corneal thickness can lead to an underestimation of intraocular pressure by Goldmann applanation tonometry and vice versa. The aim of this study is to determine whether brimonidine has an effect on central corneal thickness.Methods: 30 eyes of patients who attended the Ophthalmology OPD between the time period October 2017 and June 2018 who were newly diagnosed with normal tension glaucoma with no history of any systemic illness or not on any medication were included. Each patient underwent a complete ophthalmic evaluation including fundus examination, visual field assessment, intraocular pressure, central corneal thickness measurement by pachymetry before as well as 1 month and 6 months after starting treatment with 0.2% topical brimonidine twice daily.Results: Administration of brimonidine 0.2% resulted in an increase in central corneal thickness from 525±21 µm before starting brimonidine to 528±21 µm (p<0.05) after 1 month and 535±20 µm (p<0.001) after 6 months. It also resulted in a reduction in intraocular pressure from an initial value of 16±2 mmHg before starting brimonidine to 14±2 mmHg (p<0.05) and 13±2 mmHg (p<0.05), 1month and 6 months after starting treatment, respectively.Conclusions: The data presented in this study show that topical administration of 0.2% brimonidine twice daily results in a significant increase in central corneal thickness in patients with normal tension glaucoma.
Angiographic anatomy of the coronary sinus venous system in adult Kashmiri population
Authors: Samoon Sayma , Mohiuddin Khalid , Itoo Mohammad Saleem , Dar Khurshid Ahmad , Zargar Parvez Ahmad , Andrabi Syed Manzoor Ali
Published: May 2019

Background: Knowledge of the coronary sinus venous anatomy is an important factor because of its relevance in electrophysiological procedures such as chronic resynchronisation therapy, mapping and ablation of arrhythmias. The advent of advanced invasive and interventional cardiac treatment and management tools for common disorders like heart failure has made understanding of coronary sinus anatomy necessary. The aim was to study the angiographic anatomy of coronary sinus and its tributaries in adult Kashmiri population and provide anatomical basis for cannulation of coronary sinus and its tributaries.Methods: Authors analysed the levophase angiogram of 150 subjects undergoing routine coronary angiography in the right anterior oblique and left anterior oblique view with the necessary caudal or cranial angulations.Results: The coronary sinus was formed by the union of GCV+LMV in 93.3% of subjects and by the union of GCV+PLV in 6.7% of subjects. The GCV and the MCV were the most consistent tributaries present in all the subjects. The mean length of CS was 71.70±9.7 mm when it was formed by GCV+LMV and 70.18±14.98 mm in case of GCV+PLV. The diameter of the CS ostium was 8.48±1.21mm. The mean diameter of GCV was 2.90±1.24 mm, MCV was 2.76±1.08 mm, LMV was 2.23±0.51 mm and the PLV was 2.25±0.53 mm. The opening angle of GCV was obtuse in all the cases, MCV drained at an acute angle in 62% subjects and LMV draining angle was acute in 31.33% cases. The valve of the CS was present in 32.7% subjects and absent in 67.3% subjects. The tortuosity was absent in 75.3%. The distance between CS ostium and the ostium of the vein ideal for lead implantation was between 10-40 mm in 76% subjects.Conclusions: The basic knowledge of coronary sinus and its tributaries play a significant role during electrophysiological procedures. The data obtained from the study can be utilised by interventional cardiologist for cannulation of coronary sinus in Kashmiri population.
Cefepime/tazobactam as a new treatment option for multidrug resistant gram negative bacilli
Authors: Agarwal Roshni , Agarwal Vaibhav , Tewari Anjali , Upadhyay Parwati
Published: May 2019

Background: Every time an antibiotic is used, whether appropriately or not, the probability of the development and spread of antibiotic resistant bacteria is increased. Thus, multidrug resistant bacteria particularly ESBL (Extended spectrum β­lactamase), Amp C and carbapenemases producing gram negative bacilli have emerged as a major health problem all over the world. Considering new treatment options as a carbapenems sparing and resistance prevention modality, this study was aimed to know the in vitro susceptibility pattern of Cefepime/Tazobactam (CPM/TZ) in comparison to other β-Lactam/ β-Lactamase inhibitors (BL/BLI) and carbapenems against GNB.Methods: A prospective study was conducted on all clinical samples received for a period of about 1 year. Identification and susceptibility of all isolates was done by Vitek 2 Compact system. Susceptibility of CPM/ TZ was done by disc diffusion method on the basis of CLSI guidelines. Both fermenters (E. coli and Klebsiella pneumoniae) and non-fermenters (Acintobacter baumanii and Pseudomonas aeruginosa) were included in the study.Results: Out of 550 GNB isolates the most common was E. coli (61.8%), Acintobacter baumanii (16%), Klebsiella pneumoniae (14.9%) and Pseudomonas aeruginosa (7.3%). Cefepime/tazobactam had a much higher susceptibility of 68% compared to cefepime (28%). Among the BL/BLI combinations tested cefepime/tazobactam (68%) showed the maximum percentage of susceptibility followed by cefoperazone/sulbactam (61.5%) and piperacillin/tazobactam (57.6%). Amongst all GNB isolates cefepime/tazobactam (68%) sensitivity was very much comparable to imipenem (71.8%) and meropenem (69.6%).Conclusions: CPM/TZ exhibited the best in vitro activity in comparison to the other BL/BLI. This new combination of cefepime/tazobactam appears to be a promising alternative therapeutic option to carbapenems. Clinical studies are needed to confirm this in vitro study result.
Incidence of HIV infection in eastern Uttar Pradesh: HIV counseling and testing services record based retrospective study
Authors: Singh Amresh Kumar , Gaur Vivek , Kumar Ankur , Pandey Jayesh , Upadhyay Vandana
Published: May 2019

Background: India has approximately 2.4 million of people living with HIV and out of these two thirds live in rural areas. This study may yield significant data to understand epidemiology of HIV/AIDS in this region that would help in designing techniques for effective implementation to prevent this infection.Methods: The present study was a comprehensive retrospective hospital-based investigation of the HIV infection in eastern Uttar Pradesh, India based on a large number of clinical samples at HCTS centre, representing different geographic regions and has been functional since 2002, conducting HIV tests, counselling of patients as well as maintains proper records.Results: A total of 444 HIV positive clients were registered in this retrospective study. The male and female ratio among all positive clients was 1.67:1 and the most common age group for both the genders was 35-49 years. Among 444 HIV positive clients, HIV-TB co-infection found in 72 (16.21%) cases. Out of 444 clients, 177 (40%) and 167 (38%) found extremely immunocompromised with low CD4 cells count in range between of 0-100 cells/mm3 and >100-350 cells/mm3 respectively. Mortality was seen in 72 (16%) out of 444 HIV positive clients.Conclusions: There is an urgent need of information, education about this disease and by providing suitable occupation or to make them aware, which will markedly help in preventing the spread of HIV pandemic in this geographical region.
Attitude and awareness on importance of breastfeeding among childbearing women in a rapidly developing country
Authors: Vamegh Motahareh H. , Karkout Rami A. , Shihan Hadeel A. , Kaouas Mujtaba C.
Published: May 2019

Background: Health authorities in United Arab Emirates passed a law giving all the mothers the right to breastfeed their children even during the working hours. The objective of this study is designed to explore the degree of awareness among mothers in childbearing period on breastfeeding importance and practices.Methods: A cross sectional explorative questionnaire-based survey included 400 mothers from multi health centres in 3 emirates of United Arab Emirates as follows: Abu Dhabi 100 samples, Dubai 100 samples and Sharjah 200 samples, who were in their childbearing period and had a minimum of one child during the study period between July 2016 and November 2016.Results: Total 54.5% of mothers were above 30 years of age. 48% were local and 52% were non-local. 80% were familiar with the advantages of breastfeeding. 84.8% believed that exclusive breastfeeding up to 6 months is important and 41% had breastfed their children exclusively. 76% had the skin-to-skin contact with their baby and 43.5% had started breastfeeding within the first hour after birth, of them, 10% had delivered by caesarean section.  82% were roaming in with their baby during hospital stay and 81% had practiced demand breastfeeding. 89.9% of mothers had received the support they needed for breastfeeding from hospital staff. 56% had not used pacifier during the hospital stay and 56% had used bottle-feeding. 55% of mothers were employed, 72% of them had the intention to continue exclusive breastfeeding for a minimum of 6-month period.Conclusions: Attitude and awareness on breastfeeding are encouraging. Educational efforts, workshops and public awareness should be enhanced and maximized.
Comparing retrograde urethrography readings with intraoperative findings in urethral stricture
Authors: Kelkar Tanvi Subhash , Joshi Anil
Published: May 2019

Background: Urethral strictures are relatively common in men with most patients acquiring the disease due to injury or infection. The present study was conducted to assess the accuracy of retrograde urethrography (RGU) in diagnosing urethral strictures in patients presenting with lower urinary tract symptoms.Methods: All male patients presenting with lower urinary tract symptoms and referred for retrograde urethrogram to the Department of Radiodiagnosis, Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from November 2018 till January 2019 were included. The parameters of RGU were compared with intra-operative findings as gold standard to calculate the operating characteristics of RGU.Results: The present study included 42 patients, mean age 54.9±11.2 years. Grade I urethral stricture was observed in 42.8% and 26% had grade II stricture. Bulbar stricture was the most common location. The common presenting complaints were increased frequency (50%) and dribbling micturition (40.4%). Approximately one tenth of all patients had a history of trauma. RGU was 100% sensitive and 66.7% specific in detecting strictures of less than 2 cm. Overall accuracy of RGU in detecting urethral strictures of less than 2 cm was 83.3%.Conclusions: RGU is a reliable means for establishing the diagnosis of a suspected urethral stricture and also provides accurate staging information with regard to stricture number, length, location, and coexistent urethral pathology.
Role of diffusion weighted MR imaging in differentiating benign from malignant prostate lesions
Authors: . Sachin , Chaturvedy Kirti , Gehlot R. N. , Sihag Prateek , Kumari Suman , Jangir Anil Kumar , Jakhar Mohit , Purohit Ravindra , Singh Tejinder Pal
Published: May 2019

Background: The purpose of the study was to determine the diagnostic accuracy of diffusion weighted MR imaging and to propose a cut off ADC value in differentiating benign from malignant prostatic lesions considering histopathology as gold standard.Methods: It is a descriptive type of observational study done on 40 patients with clinical suspicion of prostate carcinoma and elevated PSA level more than 4ng/ml. The patients underwent Multiparametric prostate MRI and ADC values were calculated using ADC maps.Results: Of the 40 cases included in the study histopathology revealed a diagnosis of abscess (1), chronic prostatitis (2), BPH with chronic prostatitis (4), BPH (12), and malignancy (21). The mean and standard deviation (SD) of ADC values for the abscess (0.59), CP (0.83+0.16), BPH with CP (0.94+0.22), BPH (1.14+0.14) and malignancy (0.72+0.15) (x10-3mm2/s) were found in our study. The mean ADC value of malignant lesion was lower (0.727+0.149) as compare to benign lesion (1.034+0.216) and this difference was found to be statistically significant with p<0.001. By using ROC curve, ADC cut off value was calculated as 0.92 x 10-3mm2/s and sensitivity, specificity at this cut off value of ADC were 95.24% and 73.68% respectively. The PPV, NPV, diagnostic accuracy of at this cut off value of ADC were 80%, 93.33%, 85% respectively.Conclusions: Our study shows that DWI with ADC calculation helps in differentiation of Benign from Malignant prostatic lesions with high accuracy and this quantitative analysis should be incorporated in routine MRI evaluation of prostatic lesions
Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India
Authors: . Puran , Kardam Narendra Kumar
Published: May 2019

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed   tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.
Investigation of formation variation of portal vein with multidetector computed tomography
Authors: Bolatli Gunes , Ulusoy Mahinur , Koplay Mustafa , Acar Musa , Zarasiz Ismail
Published: May 2019

Background: To determine the types, frequency and clinical implications of formation of variations of portal vein with routine abdominal multi detector CT.Methods: MDCT images of 265 patients without any pathology were evaluated. Types and frequencies of formation variations of portal vein were determined.Results: Portail vein formation variations were observed in 186 (70.15%) of our study population. Normal portal vein was detected in 79 (29.8%) images. These variations were classified according to frequency. Normal anatomic structure was determined as type 1. Type 1 was observed in 79 (29.8%) images. As type 2 variation, left gastric vein flows into splenic vein instead of portal vein (60.75%). The type 3 of portal vein variation as uniting of superior mesenteric vein, inferior mesenteric vein and splenic vein at the same trunk to form portal vein was determined 9.43%.Conclusions: This study, which was performed to determine the anatomical variations of portail vein, makes the type 2 variation rate higher than the other studies. This information is different from the classical anatomy information. In addition, we are able to make the radiologists and surgeons highly capable of both recognition and functionality of the results.
Irritable bowel syndrome, endometriosis and polycystic ovary syndrome: is there a link?
Authors: Ramji Ashwath Narayan
Published: May 2019

Chronic pelvic pain is a common yet difficult problem to manage, plaguing the gynecologist as well as the gastroenterologist and general surgeon. Highlighted by increased visceral hypersensitivity, endometriosis and irritable bowel syndrome (IBS) are the most common causes or chronic unrelenting pelvic pain. Recently, the similarities between the two conditions has begged the question as to whether there is any common denominator between the two conditions and their likely co-existence and mismanagement. Further, the association of polycystic ovary syndrome (PCOS) in this cohort remains definitively uncharacterized. This report details a young female patient with the triad of POCS, IBS and endometriosis presenting with chronic pelvic pain.
Alcohol use and its correlates in suicide attempters in a rural tertiary care teaching hospital in south India
Authors: P. Sreelatha , G. Haritha , S. S. R. Ryali V. , P. Janakiraman
Published: May 2019

Background: The relationship of alcohol and suicide is well documented. The interactions of alcohol use and suicide are complex. Neurobiological, genetic, psychological, social, cultural, and environmental factors are postulated to influence the outcome Aim was to find the frequency of alcohol use in suicide attempters and evaluate the association of alcohol use and its correlates in subjects who use alcohol to facilitate the attempt.Methods: It is a cross sectional observational study set in rural background in south India. Consecutive referrals of suicide attempters (n=175) were selected for the study. Details regarding the socio-demographic profile, suicide related details like lethality, intent, suicidal ideation, previous attempts, and alcohol related details like frequency, quantity and age at onset of alcohol consumption were recorded. Statistical significance of various socio demographic and clinical variables in correlation with use to facilitate attempt were analyzed. Logistic regression was used to determine the predictors in this at risk group of suicide attempters.Results: Over 43.43% of suicide attempters consumed alcohol. Intentional alcohol use prior to attempt to facilitate the attempt group constitutes about 18.29 %. High suicide intent and previous suicide attempt emerged as risk factors when alcohol was used to facilitate the attempt.Conclusions: Determinants, which increase the risk of suicide with alcohol use in rural south India, were identified.
Evaluation of laboratory request forms submitted to clinical pathology department in tertiary health care hospital
Authors: Manoharan Kavitha , Manoharan Hemavathi , Sharma Chetna
Published: May 2019

Background: Laboratory diagnostics is the fast-growing field which contributes 70% of clinical diagnosis. Laboratory information has a profound impact on patient diagnosis. Research has demonstrated most of the laboratory errors occur in the pre-analytical phase. Incorrect and incomplete filling of information on the laboratory request forms can significantly impact the quality of laboratory results, and it affects patient outcome and resources. We, therefore, evaluated the extent of incomplete laboratory forms in our center.Methods: The study was a retrospective study conducted on all request forms received over 1 month from June 15, 2018, to July 15, 2018, in the Clinical Pathology Department of ESI hospital, Coimbatore, during working hours were analyzed for the frequency of incomplete data.Results: Only the patient’s name appeared in all the forms. Consultant in charge of requesting laboratory tests (99%) was the most omitted parameter. No clinical details or location/ward details of the patient was provided in 90.7% and 7% of the cases. Age and gender did not appear in 21.9% and 22%, respectively. Date of request, doctor’s signature, and hospital number were missing on 8.4%, 27.6%, and 4.4%, respectively.Conclusions: The study has demonstrated the level completion of laboratory request forms was suboptimal. This may be responsible for many pre-analytical errors. There should be closer interaction between clinicians and laboratory physician to improve the quality of laboratory services and resource management.
A comparative study of salivary and serum calcium and alkaline phosphatase in patients with osteoporosis
Authors: Bairwa Bijender Kumar , Sagar Mamta , Gupta R. C. , Gupta Madhuri
Published: May 2019

Background: This study was undertaken to investigate the changes in salivary and serum calcium and alkaline phosphatase in osteoporosis patients. The objective was to compare the change in serum levels with those in saliva.Methods: The study was conducted in the department of biochemistry, National Institute of Medical Sciences and Hospital, Shobha Nagar, Jaipur, Rajasthan, India. Subjects were selected from department of orthopedics, National Institute of Medical Sciences and Hospital, Shobha Nagar, Jaipur, Rajasthan, India. At the same time one hundred adult osteoporosis patients confirmed by DEXA were taken. Calcium and alkaline phosphatase were measured in serum and saliva of each patient. The data obtained was statistically analyzed.Results: Serum calcium has strong positive correlation with salivary calcium (r=0.726) while serum ALP and salivary ALP had weak positive correlation (r =0.453).Conclusions: Saliva can be used to measure calcium level instead of serum as it is non-invasive, quick and easy method.
Is vitamin C able to reduce hyperuricemia
Authors: S. Hantono
Published: May 2019

Hyperuricemia is defined as high levels of blood uric acid, the product of purine metabolism, which can form uric acid crystals and lead to become gout. Gout is a systemic disease that results from chronic elevation of uric acid levels above the threshold point and form the deposition of monosodium urate (MSU) crystals in tissues, mainly in and around the joints forming tophi. The impact of gout and its associated conditions can cause deformity, morbidity and mortality. Vitamin C is shown to has beneficial effect in lowering serum uric acid level in hyperuricemia patients with unknown mechanism. But it is still debatable whether using or not using and the dose of vitamin C because giving large doses also had no effect on serum uric acid concentration, uric acid excretion and clearance by the kidney, and even can cause adverse effects.
A case of abdominal tuberculosis: a challenging diagnosis
Authors: Thirupathi Siraveni , P. Chinnaiyan , Chandrababu Sujeetha
Published: May 2019

Tuberculosis continues to intimidate the human race since traditional for an extremely long time not only due to its effects as a medical ailment, but also it impacts as a social and economic burden. Tuberculosis is a major health problem in developing countries. Abdominal tuberculosis is most common extra pulmonary tuberculosis. Tuberculosis can suspect in endemic countries like India, and can have various presentations and complications, it can mislead the diagnosis. Here, this case it involves small bowel, large bowel and peritoneum with different presentation.
Avaliando o Desempenho e Custos da Graduação das Instituições Federais de Ensino Superior
Authors: Bielschowsky Carlos Eduardo
Published: May 2019

As instituições federais de ensino superior (IFES) vêm sendo taxadas como ineficientes nas atividades de ensino de graduação, cujos principais argumentos são o alto custo médio anual por aluno, altas taxas de evasão e que boa parte de seus alunos pertencem às classes mais favorecidas. Este é o foco principal das críticas frequentemente realizadas na mídia e por agências internacionais, tais como o jornal O Globo e o Banco Mundial, posto que em suas demais atividades de ensino de pós graduação, pesquisa e extensão seu papel tem sido, de maneira geral, reconhecido: até porque respondem, juntamente com as demais universidades estaduais, por 83,8% do total de alunos pós-graduados de todas as IES e realizam a maior parte da produção científica do país. As IFES também são reconhecidas pela importância de suas atividades de extensão, tais como o atendimento à população de seus hospitais universitários, seu protagonismo na formação continuada de professores da educação básica e a importância e excelência de seu ensino técnico e de seus colégios de aplicação. No presente trabalho mostramos que essas críticas ao ensino de graduação das IFES não procedem, que o gasto anual por aluno de graduação das universidades federais é equivalente àquele das IES privadas, que sua taxa média de diplomação é 9,7% superior àquela das universidades privadas e que a maioria de seu concluintes tem renda familiar inferior a 4,5 salários mínimos, sendo que apenas 12% pertencem famílias com renda superior a 10 salários mínimos. Além disso, mostramos, com base no resultado de seus alunos nos exames Enade do ciclo 2015 a 2017, que a qualidade média dos cursos das IFES é bem superior àquela das IES privadas.
Case of Cardiorespiratory Arrest following Removal of Cervical Cerclage
Authors: M Raheem , R Orefice
Published: May 2019

We report a case of cardiorespiratory arrest following the removal of a cervical suture in a non-labouring woman.
The European Higher Education Area: A road to the future or at way’s end?
Authors: Bergan Sjur
Published: May 2019

The goal of the Bologna Process was to develop a European Higher Education Area within a decade. The goal and the process proved to be attractive, new countries steadily applied for accession, and the Bologna Process has brought about substantial reforms. At the same time, the drive and optimism of the early years has given way to more measured optimism and even a sense of disillusion as we approach the 20th anniversary of the Bologna Declaration. The article outlines six phases in the development of the European Higher Education Area and then looks at some of the main challenges the EHEA faces as it approaches its third decade. Structural reforms have been the hallmark of the EHEA, and in this area the main challenges concern implementation rather than the development of new structures even if some policy challenges also remain. In the run-up to the 2018 Ministerial conference, EHEA faced a bitter debate on the character of the EHEA itself, linked to the questions of how to foster implementation of commitments undertaken and what it means to be a voluntary process. The fundamental values on which the EHEA builds are now threatened in some EHEA members, the role of the EHEA in a global context, and its relevance and governance constitute other challenges.Received: 08 April 2019Accepted: 29 April 2019Published online: 29 May 2019