bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with uncertainty in small business budgets by sensitivity analysis
Authors: MacMillan I. C.
Published: October 2022

n lnherente probleem van standaardbegrotings is dat hulle nie die uitwerking of implikasies van afwykings van die begroting weergee nie. 'n Sensitiwiteitsontleding van die begroting sal aan die organisasie addisionele inligting verskaf wat sal aantoon waar die organisasie die gevoeligste is vir fluktuasies in die beramings soos weergegee in die begroting. Aan die einde van die artikel behoort die leser, volgens die skrywer, in staat te wees om so 'n sensitiwiteitsanalise uit te voer. Aan die hand van so 'n analise kan bestuur doeltreffender vasstel hoe en waar die aandag van die verskillende bestuursvlakke toegespits moet word.
The Trade Practices Act - What's in it for business
Authors: Van der Merwe Sandra
Published: October 2022

Die skryfster van hierdie artikel is 'n senior lektrise aan die Nagraadse Bestuurskool van die Universiteit van Stellenbosch. Sy is van mening dat die Wet op Handelspraktyke nie as 'n skok gekom het nie. Niemand kan dit ontken nie dat die tyd aangebreek het vir wetgewing om 'n beter balans in bedingingsmag in die mark te weeg te bring - om die belange van die verbruiker te beskerm asook om maatskappye te vrywaar van onetiese handelspraktyke deur sommige van hulle mededingers. Die artikel is geskryf as 'n gids vir bestuur. Die bedoeling is nie om die Wet wetlik te interpreteer nie.
Wanted: Consumer information - Does the Trade Practices Act fit the bill?
Authors: Van der Merwe Sandra
Published: October 2022

Hierdie artikel, die tweede in 'n reeks van twee artikels oor die Wet op Handelspraktyke handel oor die Wet in verhouding tot verbruikers, en verbruikersweerstand. Die eerste artikel, "9The Trade Practices Act—What's in it for Business?" wat in die vorige uitgawe van Bedryfsleiding/Business Management gepubliseer is, het oor die Wet self gehandel en die implikasies wat dit vir die sakewêreld inhou. Die skryfster voel dat die twee artikels tesame gelees, 'n gebalanseerde siening weergee.
The importance of the effective management of physical distribution
Authors: Staude Gavin E.
Published: October 2022

Hierdie artikel vestig die aandag op die rol wat fisiese distribusiebestuur speel in enige organisasie wat betrokke is by die vervaardiging of bemarking van produkte. Te lank, se die skrywer, is fisiese distribusiebestuur as 'n aspoestertjiefunksie behandel; 'n lastige aktiwiteit wat uitgevoer moet word sodra die produk verkoop is. lndien dit egter doeltreffend bestuur word, word al hoe meer erken, kan fisiese distribusie n bydrae lewer tot die skepping van 'n vraag. Dit is op hierdie gebied wat kliëntebehoeftes onbevredig gelaat word. Daarbenewens is fisiese distribusie 'n terrein wat aansienlike kostebesparings kan meebring indien sisteembeginsels en die totale kostebenadering toegepas word. Om hierdie twee voordele te verkry, nl. groter verkope en/of kostedoeltreffendheid, vereis egter onvermydelik organisatoriese aanpassings waar die algehele fisiese distribusie-aktiwiteit onder een departement of een bestuurder ressorteer.
Interface/Koppelvak: Nuutverkose Raad van SAVB
Authors: Office Editorial
Published: October 2022

No abstract available.
Book Review: Investments
Authors: Neuland Ernst W.
Published: October 2022

No abstract available.
Interfaces/Koppelvakke: Boekresensie
Authors: Roux N. J.
Published: October 2022

No abstract available.
The limits of job enrichment
Authors: Orpen Christopher E.
Published: October 2022

"Posverryking" is 'n belangrike onlangse ontwikkeling in die bedryfsielkunde wat daarop gerig is om werknemer-bevrediging en produktiwiteit te verhoog. Hierdie benadering geniet tans bale aandag en word deur sommige bestuurders as 'n wondermiddel gesien, en deur ander as 'n tegniek wat tot mislukking gedoem is. Die redes vir uiteenlopende ervaring met die benadering word ontleed, en die vereiste omstandighede vir die toepassing daarvan word bespreek. 'n Oorsig word ook gegee van die teoretiese agtergrond en van navorsing in die Verenigde State en in Suid-Afrika, om die invloed van posverryking op sowel werknemer-bevrediging as produktiwiteit te meet. Individuele, kulturele en omstandigheidsverskille kan die doeltreffendheid van die tegniek sterk beinvloed, en hierdie faktore moet veral in die Suid-Afrikaanse omstandighede deeglik in ag geneem word voordat duur posverryking-skemas aangepak word.
Utilizing the other half: World trends in the employment of women
Authors: Smit Truida
Published: October 2022

Die aantal vroue in Suid-Afrika wat bestuursposisies beklee, het in slegs agt jaar verdriedubbel. Hierdie toename word beskou teen die agtergrond van die wêreldwye toename van vroue in die werksituasie en veral in bestuursloopbane. Redes vir hierdie toename sluit in 'n groter bewuswording onder sowel mans as vroue van die loopbaanpotensiaal en prestasiebehoeftes van vroue; ekonomiese druk; die stygende aantal vroue wat gesinshoofde is; en die behoefte aan bekwame menslike hulpbronne. Ten spyte van die menigte probleme en vooroordele waarvoor die bestuursvrou te staan kom, beweeg 'n groeiende groep vroue opwaarts in nie-tradisionele loopbane, en maak hulle so ook die pad oop vir nog meer vroue om hulle hydrae te maak in belang van sowel hulle werkgewers en die ekonomie, as hulleself.
Economic costs of discrimination and segregation in U S society
Authors: Lombard B. Urban
Published: October 2022

Alhoewel hierdie studie nie 'n uiteensetting is van diskriminerende praktyke in die Suid-Afrikaanse arbeidsmark en die sosiale koste daaraan verbonde nie, vorm Becker se teorie van diskriminasie en Thurow se empiriese ontleding daarvan 'n deeglike grondslag, en kan dit dien as 'n uitstekende raamwerk vir soortgelyke ondersoeke in Suid-Afrika. Die doel van hierdie studie is om die ekonomiese koste van die diskriminasie wat swartmense in die arbeidsmark in die Verenigde State teenkom, te ontleed en te definieer. 'n Duidelike onderskeid word getref tussen openlike en bedekte diskriminasie-optrede in die indiensnemingsproses. Van die teoretiese ontleding en van navorsingsresultate op hierdie gebied is dit duidelik dat daar geen eenvoudige, direkte of objektiewe kriteria is vir die meet van die sosiale effekte van diskriminasie nie. 'n Poging word aangewend om 'n samestelling van mannekrag-beleidstellinge uiteen te sit, wat nodig sal wees om diskriminerende praktyke wat deur swart werknemers ondervind word, doeltreffend te bekamp.
A short note on questionnaire form design and the limits of human processing capacity
Authors: Clarke H. G.
Published: October 2022

Navorsers maak dikwels met die beste bedoelings die fout om die mens se kapasiteit om inligting te prosesseer, uit die oog te verloor. Die gemiddelde individu kan, volgens studies deur George A Miller, '2,5 stukkies' inligting gelyktydig behartig. Die stuk verwys ook na ander navorsing wat duidelik aantoon dat die mens se vermoë om inligting te prosesseer en tussen prikkels te onderskei, afneem soos die aantal prikkels toeneem. Hierdie begrip in verband met die mens se reaksie teenoor stimuli is van belang vir bemarkers, en ook veral vir navorsers wat vraeboë opstel. 'n Te groot verskeidenheid prikkels of alternatiewe kan dikwels resultate verswak.
Export policies of the South African Government
Authors: Meyer W. N.
Published: October 2022

n Uiteensetting word gegee van ontwikkelings in Suid-Afrika se uitvoerbeleid sedert 1962, die jaar toe die Regering besluit het om 'n stelsel van ekonomiese ontwikkelingsbeplanning in te stel, tot en met 1976/77. Die tydperk word in twee fases ingedeel: 1962 tot 1971, toe dit toenemend duideliker geword het dat positiewe optrede nodig is om uitvoer te bevorder; terwyl die tweede fase verwys na die posisie nadat die Kommissie van Ondersoek oor Suid-Afrika se Uitvoerhandel in 1971 sy werksaamhede begin het. In die sewentigerjare het daar besliste veranderings in die uitvoerhandel ingetree. Beter koordinasie is bevorder tussen die verskeidenheid van staats- en semistaatsliggame wat op verskillende maniere in uitvoerbevordering betrokke is; die Nasionale Produktiwiteitsinstituut het 'n groot bydrae gemaak om produktiwiteit (en so ook mededingendheid) in vervaardigingsbedrywe met uitvoerpotensiaal te bevorder; en uitgawes deur die Departement Handel aan subsidies en uitvoerbevordering het geweldig toegeneem. Uitvoer het dan ook sowel in waarde as in volume bestendig gestyg ten spyte van die resessie in die Weste in die middel-sewentigs.
Management of Bronchomalacia in Infants Post-Cardiac Surgery Using Synchronized Nasal DuoPAP
Authors: Kumar Alok , Praveen M , Tiwari Nikhil , Ramamoorthy H. Ravi , Joshi Ankur , Parikh Badal
Published: October 2022

Background:

Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseases. The conventional treatment options include positive pressure ventilation with or without tracheostomy, surgical correction of external compression and airway stenting.

Aim:

To use “synchronized” nasal Dual positive airway pressure (DuoPAP), a non-invasive mode of ventilation as an alternative treatment option for bronchomalacia to avoid complications associated with conventional treatment modalities.

Study Design:

Prospective observational study conducted in Army Hospital Research and Referral from Jul 2019 to Dec 2020.

Material and Methods:

We diagnosed seven cases of TBM post-cardiac surgery at our institute, incidence of 4.2%. Four infants were diagnosed with left sided bronchomalacia, 2 were diagnosed with right sided bronchomalacia and one with tracheomalacia. Those infants were managed by “synchronized” nasal DuoPAP, a first in ventilation technology by Fabian Therapy Evolution ventilator (Acutronic, Switzerland).

Results:

All seven infants showed significant improvement with synchronized nasal DuoPAP both clinically as well as radiologically. None of the infant required tracheostomy and discharged to home successfully.

Conclusion:

The synchronized nasal DuoPAP is a low cost and effective treatment option for infants with TBM. It could be attributed to synchronization of the breaths leading to better tolerance and compliance in paediatric age group.
C–Reactive Protein Kinetics after Cardiac Surgery
Authors: Santonocito Cristina , Sanfilippo Filippo , De Locker Isabelle , Chiarenza Federica , Giacomo Cucuzza , Njimi Hassane , George Shane , Astuto Marinella , Vincent Jean-Louis
Published: October 2022

Background:

Recognition of postoperative infection after cardiac surgery is challenging. Biomarkers may be very useful to recognize infection at early stage, but the literature is controversial.

Methods:

We conducted a retrospective study at two large University Hospitals, including adult patients undergoing cardiac surgery (excluding those with preoperative infections, cirrhotic or immunocompromised). We evaluated the kinetics of C-Reactive Protein (CRP) and White Cell Count (WCC) during the first postoperative week. Primary outcomes were CRP and WCC changes according to the development of postoperative infection. In order to evaluate the influence of cardiopulmonary bypass on biomarker kinetics, we also studied CRP and WCC changes in patients without postoperative infection and undergoing on- vs off-pump coronary-artery bypass grafting.

Results:

Among 429 included, 45 patients (10.5%) had evidence of postoperative infection. Patients with postoperative infection had higher CRP and WCC values than those without infection, with between-groups difference becoming significant from postoperative day 2 for CRP (120.6 ± 3.6 vs. 134.6 ± 7.9, P < 0.01), and from postoperative day 3 for WCC (10.5 ± 0.5 vs. 9.9 ± 0.2, P = 0.02). Over the postoperative period, CRP and WCC showed significant within-group changes regardless of development of postoperative infection (P < 0.001 for both). We found no differences in CRP and WCC kinetics between patients undergoing on- vs off-pump procedure.

Conclusions:

During the first week after cardiac surgery, CRP increases one day earlier than WCC in patients developing postoperative infections, with such difference becoming significant on the second postoperative day. In not infected patients, use of cardiopulmonary bypass does not influence CRP and WCC kinetics.
The Use of Cerebral Oximetry in Cardiac Surgery
Authors: Chiong Xin Hui , Wong Zhen Zhe , Lim Siu Min , Ng Tyng Yan , Ng Ka Ting
Published: October 2022

High prevalence of cerebral desaturation is associated with postoperative neurological complications in cardiac surgery. However, the evidence use of cerebral oximetry by correcting cerebral desaturation in the reduction of postoperative complications remains uncertain in the literature. This systematic review and meta-analysis aimed to examine the effect of cerebral oximetry on the incidence of postoperative cognitive dysfunction in cardiac surgery. Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception until April 2021. All randomized controlled trials comparing cerebral oximetry and blinded/no cerebral oximetry in adult patients undergoing cardiac surgery were included. Observational studies, case series, and case reports were excluded. A total of 14 trials (n = 2,033) were included in this review. Our pooled data demonstrated that patients with cerebral oximetry were associated with a lower incidence of postoperative cognitive dysfunction than the control group (studies = 4, n = 609, odds ratio [OR]: 0.15, 95% confidence interval [CI]: 0.04 to 0.54, P = 0.003, I
2 = 88%; certainty of evidence = very low). In terms of postoperative delirium (OR: 0.75, 95%CI: 0.50–1.14, P = 0.18, I
2 = 0%; certainty of evidence = low) and postoperative stroke (OR: 0.81 95%CI: 0.37–1.80, P = 0.61, I
2 = 0%; certainty of evidence = high), no significant differences (P > 0.05) were reported between the cerebral oximetry and control groups. In this meta-analysis, the use of cerebral oximetry monitoring in cardiac surgery demonstrated a lower incidence of postoperative cognitive dysfunction. However, this finding must be interpreted with caution due to the low level of evidence, high degree of heterogeneity, lack of standardized cognitive assessments, and cerebral desaturation interventions.
The Use of Ketamine as an Induction Agent for Anesthesia in Pulmonary Thromboendarterectomy Surgery
Authors: Salaunkey Kiran , Jenkins David , Roscoe Andrew
Published: October 2022

Pulmonary thromboendarterectomy (PTE) surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The induction of anesthesia in patients with severe pulmonary hypertension (PHT) can be challenging, with a risk of cardiovascular collapse. The administration of ketamine in patients with PHT is controversial, with some recommendations contraindicating its use. However, ketamine has been used safely in children with severe PHT. We present a retrospective case series of adult patients with severe PHT presenting for PTE surgery, using intravenous ketamine as a co-induction anesthetic agent.
Combination of Low-Dose Spinal Anesthesia and Epidural Anesthesia as Anesthetic Management in Patient with Uncorrected Double Outlet Right Ventricle (DORV) Underwent Cesarean Section
Authors: Hartono Ruddi , Ramadhani Dendy D. , Isngadi Isngadi
Published: October 2022

Pregnant patients with uncorrected Double Outlet Right Ventricle (DORV) undergoing cesarean section are challenging for anesthesiologists. We present a case of a 24-year-old woman with a gestational age of 30–32 weeks with DORV, ventricular septal defect, pulmonary hypertension, and stage C functional class III heart failure who was successfully managed using a combination of low-dose spinal anesthesia bupivacaine 0.5% 7.5 mg with adjuvant fentanyl 50 mcg and epidural ropivacaine 0.2%, and fentanyl 50 mcg TV 10 cc given 30 minutes after the birth of her baby. Hemodynamics was stable after low-dose spinal anesthesia and until the end of the operation.
VASOplegia is Predicted by Preoperative Platelet-LEucocyte conGlomerate Indices in Cardiac Surgery (VASOPLEGICS)
Authors: Magoon Rohan , Kashav Ramesh C. , Shri Iti , Dey Souvik , Walian Ashish , Kohli Jasvinder K.
Published: October 2022

Background:

Post-cardiotomy vasoplegia syndrome (VS) is often linked to an exaggerated inflammatory response to cardiopulmonary bypass (CPB). At the same time, the prognostic role of platelet-leucocyte indices (PLIs) and leucocyte indices (LIs), (platelet-lymphocyte ratio [PLR], systemic immune-inflammation index [SII = platelet × neutrophil/lymphocyte], aggregate index of systemic inflammation [AISI = platelet × monocyte × neutrophil/lymphocyte], and neutrophil-lymphocyte ratio [NLR], systemic inflammation response index [SIRI = monocyte × neutrophil/lymphocyte), respectively] has been recently described in diverse inflammatory settings.

Methods:

The retrospective study was conducted to evaluate the VS predictive performance of PLIs and LIs in 1,045 adult patients undergoing elective cardiac surgery at a tertiary care center. VS was defined by mean blood pressure <60 mmHg, low systemic vascular resistance (SVRI <1,500 dynes.s/cm 5/m2), a normal or high CI (>2.5 L/min/m2), and a normal or reduced central filling pressure despite high-dose vasopressors.

Results:

About 205 (19.61%) patients developed VS postoperatively. On univariate analysis, age, diabetes, dialysis-dependent renal failure, preoperative congestive heart failure (CHF), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, ejection fraction, NLR, PLR, SII, SIRI, AISI, CPB, and aortic cross clamp (ACC) duration, packed red blood cell (PRBC) transfusion, and time-weighted average blood glucose predicted VS. Subsequent to the multivariate analysis, the predictive performance of EuroSCORE II (OR: 3.236; 95% CI: 2.345–4.468; P < 0.001), CHF (OR: 1.04; 95% CI: 1.02–1.06; P = 0.011), SII (OR: 1.09; 95% CI: 1.02–1.18; P = 0.001), AISI (OR: 1.11; 95% CI: 1.05–1.17; P < 0.001), PRBC (OR: 4.747; 95% CI: 2.443–9.223; P < 0.001), ACC time (OR: 1.003; 95% CI: 1.001–1.005; P = 0.004), and CPB time (OR: 1.016; 95% CI: 1.004–1.028; P = 0.001) remained significant. VS predictive cut-offs of SII and AISI were 1,045 1045×109/mm3 and 137532×109/mm3, respectively. AISI positively correlated with the postoperative vasoactive-inotropic score (R = 0.718), lactate (R = 0.655), mechanical ventilation duration (R = 0.837), and ICU stay (R = 0.757).

Conclusions:

Preoperative elevated SII and AISI emerged as independent predictors of post-cardiotomy VS.
Serum Gamma Glutamyltransferase (GGT) in Coronary Artery Disease
Authors: Singh Kunal K. , Kapoor Aditya , Khanna Roopali , Sahu Ankit , Kapoor Vishwas , Kumar Sudeep , Garg Naveen , Tewari Satyendra , Goel Pravin
Published: October 2022

Background:

There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma-glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied.

Aim:

To assess GGT in patients with angiographically documented CAD.

Methods and Results:

Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10–269 U/L). The levels of GGT progressively increased in those with single/double or triple-vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0–22, 23–32, and ≥ 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0–17.65, 17.66–56.65, ≥56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score ≥ 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX ≥ 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772).

Conclusions:

In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.
A comparison of the success rate of radial artery cannulation between the ultrasound-guided and conventional palpation techniques in elderly patients undergoing cardiothoracic surgery
Authors: Chanthawong Sarinya , Tribuddharat Sirirat , Sathitkarnmanee Thepakorn , Suwongkrua Thanaporn , Silarat Suparit , Plengpanich Pathawat
Published: October 2022

Background:

Ultrasound-guided (USG) radial artery cannulation against the standard palpation technique increases the first attempt rate in both pediatric and adult patients. The objective of this study was to evaluate the benefits of USG versus the palpation technique in improving the first attempt rate in elderly patients.

Methods:

The patients over 65 years of age were randomized to the USG or Palpation group. The radial artery identification in the USG group was performed with the aid of the Sonimage HS 1. In the Palpation group, the radial artery was identified by manual palpation. The operators were cardiothoracic anesthesiologists. Overall success was defined as cannulation completed within 10 min.

Results:

Eighty patients (40 in each group) were recruited. The respective first attempt and overall success rate for the USG group were similar to the Palpation group (P > 0.999 and P = 0.732). The time to the first attempt and overall success were also similar (P = 0.075 and P = 0.636). The number of attempts, number of catheters used, and failure rates were similar between the groups (P = 0.935, P = 0.938, and P = 0.723). The number of successful cannulations within 10 min was similar for both the groups as categorized by the radial artery diameter (P = 0.169).

Conclusions:

The USG did not increase the first attempt or overall success rate of radial artery cannulation in the elderly patients undergoing cardiothoracic surgery. The time to first attempt and overall success were similar between both the groups. The number of attempts and number of catheters used were similar between both groups.
Randomized Control Study of Nebulized Colistin as an Adjunctive Therapy in Ventilator-Associated Pneumonia in Pediatric Postoperative Cardiac Surgical Population
Authors: Bharathi K. S. , Bhat Ananda , Pruthi Gegal , Simha Parimala P.
Published: October 2022

Background:

Ventilator-associated pneumonia (VAP) with multidrug-resistant (MDR) gram negative organisms is a common problem in intensive care unit (ICU). Aerosolized antibiotics enhance the efficacy of systemic antibiotics when added as adjuvants.

Aim:

The primary objective of the study was to compare the clinical and bacteriological outcome of patients with VAP who were administered intravenous (IV) antibiotics alone with those patients who were treated with adjunctive nebulized colistin (NC) along with IV antibiotics. The secondary objective was to study the occurrence of any adverse events during colistin nebulization.

Settings and Design:

The study was a prospective, randomized, double-blinded controlled study conducted at a tertiary-care teaching institution.

Materials and Methods:

Ninety-eight children from surgical ICU aged less than 12 years who were diagnosed with VAP due to gram negative bacteria following cardiac surgery were chosen and divided randomly into two groups. The experimental group (NC group) was treated with systemic antibiotics along with NC, whereas the control group (NS group) was administered systemic antibiotics with nebulized normal saline (NS). Clinical and bacteriological outcomes were noted. Statistical analysis was done using SPSS Version 20.0 software. The patient characteristics were compared using independent Student's t test and Chi-square test.

Results:

There was a statistically significant reduction in the duration of mechanical ventilation, postoperative ICU and hospital stay (P < 0.05) in the NC group compared with the NS group.

Conclusion:

Aerosolized colistin may be considered as an adjunct to systemic IV antibiotics in pediatric patients with VAP due to gram negative bacteria susceptible to colistin.
Nocturnal Frontal Lobe Epilepsy Presenting as Sleepwalking Episodes and Restless Leg Syndrome-Like Symptoms
Authors: Jith Arya , Mathew Kathleen Anne , Jain Kudrat
Published: October 2022

Nocturnal frontal lobe epilepsy (NFLE) is characterized by seizures with complex motor behaviors arising mainly during sleep. Varied clinical presentations and nonspecific electroencephalogram findings make it difficult to distinguish NFLE from other nocturnal paroxysmal events such as nonrapid eye movement (NREM) parasomnias and restless leg syndrome (RLS). Here, we present a case of NFLE, which had a complex clinical presentation resembling features suggestive of RLS and NREM parasomnia and posed a diagnostic challenge. Initiation of carbamazepine as the anti-epileptic led to rapid resolution of symptoms.
Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure
Authors: Kim Sua , Hwang Jinwook , Kim Je Hyeong
Published: October 2022

Although the routine use of alkali buffer is not recommended in patients with respiratory acidosis, some patients may benefit from its administration. A 42-year-old man was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemodiafiltration (CVVHDF) due to necrotizing pneumonia and emphysematous cystitis with Klebsiella pneumoniae. Although the sweep gas flow rate of the VV-ECMO was gradually reduced, he failed to wean off VV-ECMO due to respiratory acidosis, followed by tachycardia and tachypnea on the 63rd day of VV-ECMO. Therefore, we mixed sodium bicarbonate in the replacement fluid of CVVHDF for 5 days to avoid an intolerable decrease in blood pH after discontinuing the VV-ECMO sweep gas. When the serum bicarbonate concentration was >30 mmol/L and pH was maintained at >7.30 with a PCO2 of >60 mmHg, VV-ECMO was finally decannulated. Sodium bicarbonate buffer through the replacement of CVVHDF fluid facilitated VV-ECMO weaning in a patient with hypercapnic respiratory failure.
Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia
Authors: Alsheikh Sultan , Alorainy Walid , Alkahthlan Husam , Alamri Khalid , Neel Lina , Alrumaihi Nouf , Alshahrani Fatma , Soliman Mona
Published: October 2022

Background:

Medical students have an important role to provide training to other medical students and health workers, and to volunteer when there is a shortage in health care personnel. The aim of the study was to evaluate the knowledge of medical students in six medical colleges in Riyadh, Saudi Arabia, about the coronavirus-19 (COVID-19) pandemic.

Materials and Methods:

An online survey was distributed to undergraduate medical students from August to October 2021. A total of 261 medical students participated in the study. The survey composed of 26 questions that evaluated students' knowledge about the COVID-19 pandemic in terms of symptoms, modes of transmission, diagnosis, management, and prevention.

Results:

Two hundred and sixty-one medical students participated in the study with an overall response rate of 31.37%. Around half of the respondents (54%) being from 1st to 4rd medical years 81 (31.03%) and 60 (22.99%), respectively. The students' knowledge regarding COVID-19 was investigated in different domains. The mean knowledge score of the protection and prevention of the disease was the highest with a (mean = 79.85%) followed by the knowledge of the ways of the disease transmission (mean 71.31%). 140 (53.64%) of the participants knew how to properly diagnose COVID-19, while (48.35%) were able to identify the different possible symptoms that can be seen in COVID-19-positive individuals (47.32%) knew the different lines of treatment according to the case severity.

Conclusions:

The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the COVID-19 pandemic.
Erosive Pustular Dermatosis of the Scalp
Authors: Aithal Sowmya S. , Shilpa Kanathur , Revathi T. N.
Published: October 2022

Erosive pustular dermatosis of the scalp is a chronic cutaneous condition presenting with areas of erosions and pustules, healing with scarring and alopecia. We report three such cases presenting with pus-filled lesions of the scalp with nonspecific pathological changes. This condition is often misdiagnosed and shows a poor response to antibiotics. Clinical suspicion is of primary importance for early diagnosis and proper treatment.
Alopecia Areata Complicated by Plica Neuropathica
Authors: Agarwal Shail , Vijay Atul , Sharma Manoj Kumar , Jain Akshay Kumar
Published: October 2022

Plica neuropathica is a rare scalp condition, which is manifested as a compact mass of scalp hair. Previously, it has been found to be associated with a variety of dermatological disorders. We report a case of 15-year-old female presenting with alopecia areata associated with plica neuropathica.
Vitamin D Levels in Alopecia Areata and Other Alopecias
Authors: Tran Patrick Thanh , Chen Alessandra , Yi Lynn , Goh Carolyn
Published: October 2022

Recent research has associated alopecia areata (AA), an autoimmune disorder, with deficiency of Vitamin D, which regulates immune processes. This retrospective study compared Vitamin D levels in AA patients to those of other alopecia diagnoses and nonalopecia controls. When compared to controls, patients with AA or other alopecia diagnoses did not demonstrate lower Vitamin D levels. However, when compared to other alopecia diagnoses, AA patients had a statistically significantly higher proportion of patients with Vitamin D deficiency and a lower mean Vitamin D level. Our findings suggest a greater association between lower Vitamin D levels and AA compared to other alopecia diagnoses. Further prospective studies investigating Vitamin D levels and supplementation in AA patients are needed to further elucidate this association and its potential relevance.
Comparative Efficacy of Injection Triamcinolone Acetonide given Intralesionally and through Microneedling in Alopecia areata
Authors: Arora Astha , Bhalla Mala , Thami Gurvinder Pal
Published: October 2022

Introduction:

Alopecia areata (AA) manifests as patchy hair loss and intralesional corticosteroid (ILCS) is usual therapeutic choice in limited disease. Microneedling is used for uniform delivery of topical agent to relatively larger areas may prove to be more efficacious than traditional ILCS. The present study prospectively compared microneedling to traditional intralesional delivery of triamcinolone acetonide (TA).

Materials and Methods:

Prospective randomized comparative study in 60 patients of AA restricted to scalp not requiring systemic treatment randomly divided into two equal groups. Group 1 patients underwent microneedling with local application of injectable TA and Group 2 patients were given injectable TA intradermally for a total of three sessions at 3 weeks interval.

Results:

A mean regrowth of 66.36% in Group 1 and 69.75% in Group 2 at week 9 was seen which was comparative with no significant statistical difference between the two groups (P = 0.664). Thirteen patients achieved 100% regrowth at week 9 in Group 1 and 16 patients achieved 50%–99% regrowth in Group 2.

Discussion and Conclusions:

ILCSs have been cornerstone in the treatment of limited AA, but depth of injecting drug cannot be controlled, microneedling whereas is an effective drug delivery system and also causes release of growth factors. In this study, injectable TA used intralesionally and topically with microneedling had nearly similar efficacy in causing regrowth of hair with microneedling resulting in a more uniform but less dense regrowth of hair with lesser adverse effects.
Analysis of ‘enhanced-view totally extra-peritoneal’ (eTEP) approach for ventral hernia: Early results
Authors: Mishra Atul , Jabbal Harmandeep Singh , Nar Amandeep Singh , Mangla Rochan
Published: October 2022

Introduction:

Laparoscopic ventral hernia repair is undergoing a paradigm shift with the introduction of numerous new techniques to improve the outcomes. Enhanced-view totally extra-peritoneal (eTEP) is a novel approach for the repair of ventral herniae introduced by Belyansky et al. The key innovation lies in placing the mesh in a large retrorectus–pre-peritoneal space contrary to the widely practiced intra-peritoneal placement. This approach can be easily coupled with a component separation in the form of transversus abdominis release (TAR) for large herniae. We conducted a midterm analysis of ‘eTEP’ approach to ventral hernia at a high-volume tertiary care centre and present our results of over 3 years of employing this technique.

Methodology:

A retrospective study of 150 cases of ventral hernia repaired using eTEP approach from January 2018 to February 2021 at a tertiary care centre by a team of three surgeons. The procedures were performed by a single team of three members headed by the first author.

Results:

Out of total 150 cases, incisional hernia occurred in 73 cases (48.7%), primary hernia occurred in 48 cases (32%) and recurrent hernia in 29 cases (19.3%). Although the majority of incisional (87.7%) and recurrent (79.3%) ventral hernias occurred in female, the incidence of primary ventral hernia was equal at 24 cases in both genders. The majority of the cases (80.7%) underwent eTEP RS procedure, and the rest were W3 hernias, which were managed by including a component separation in the form of eTEP TAR. The operating time for eTEP TAR (222.24 min ± 32.56) compared to eTEP RS (124.33 ± 23.68) was significantly longer. The mean length of stay was significantly shorter for primary hernias (3.75 days ± 1.62) compared to recurrent (5.21 days ± 2.51) and incisional hernias (4.36 days ± 2.19) (F = 4.376) (P = 0.014). The peri-operative period was uneventful in majority of the cases. We experienced a seroma rate of 5.8% in our series. At follow-up of 1 year, 3.3% of patients complained of discomfort/bulge in the upper abdomen. There were no other surgical site occurrences (SSO) in the form infection, posterior rectus sheath disruption and skin necrosis. We observed no recurrences till date with a minimum follow-up of 1 year.

Conclusion:

eTEP approach to ventral hernia is a promising abdominal wall reconstruction technique. It is safe and offers good functional outcomes with restoration of abdominal wall dynamics. It is a reproducible and safe technique for tackling various types of ventral hernia. It is specifically useful in managing unusual lateral hernias, incisional and recurrent hernias with ease.
Sad fetus syndrome
Authors: Kintanar Alan O. , Estuart Darleen SJ , Lasala Lynette L.
Published: October 2022

Sad fetus syndrome is a rare gestational trophoblastic disease wherein a hydatidiform mole coexists with a live fetus. We report a case of a 40-year-old G4P2 (2012) with 29 weeks gestational age who came in with vaginal bleeding and labor pains. A previous ultrasound done at 16 weeks of gestation showed a live fetus, a normal placenta, and a focal multicystic uterine mass. The beta-human chorionic gonadotropin level was 1,500,000 mIU/mL. She delivered a live preterm female fetus weighing 900 g by partial breech extraction. The placenta was grossly normal. Postpartum hemorrhage secondary to uterine atony was encountered and a total hysterectomy with bilateral salpingectomy was performed. Cut section of the specimen revealed molar tissue at the anterofundal area with evidence of gross myometrial invasion. The histopathologic finding was consistent with a diagnosis of partial hydatidiform mole. This paper describes the incidence, pathology, clinical presentation, diagnosis, treatment, and postpartum course of this rare condition.
Uses of Authentic Assessment Tools: Implications towards Competence Acquisition among Undergraduate Prospective Science Teachers in Tanzania
Authors: Nyinge Baraka
Published: October 2022

The study was concerned with the uses of authentic assessment tools in higher education institutions, particularly portfolios and practical work. The study employed the mixed method research approach with the explanatory sequential research design. The sample for the study involved 231 third year undergraduate prospective science teachers who were selected randomly and 6 instructors who were purposively selected from two higher learning institutions. Data was collected by using a questionnaire and a semi-structured interview. The findings indicated that authentic assessment tools namely portfolios and practical works were used both formatively and summatively though summative use was dominant. Portfolios were found to be minimally used both for formative and summative purpose. Findings from interview indicated that awareness on the formative uses of authentic assessment tools among instructors was minimal since summative use of such tools was observed to be dominant. It is concluded that the use of authentic assessment tools ranged from formative to summative, though summative was more dominant. Therefore it is recommended that there should be policy on the authentic assessment in higher education institutions to guide the effective use in both summative and summative aspects.
Primary School Teachers’ Preparation and Use of Lesson Plans in Igunga District, Tanzania
Authors: H. Halala Remigius , Jacob Seni Abdallah
Published: October 2022

This study examined teachers’ frequency of preparation and use of lesson plans. The study location was Igunga District of Tabora Region in Tanzania. Mixed approach and explanatory research design were used and a total of 69 respondents were sampled. Among them, 60 were teachers from four purposely selected primary schools, four were head teachers and five were school quality assurance officers. Data was collected through a questionnaire, an interview schedule and document. Analysis of data was done through the thematic approach and the descriptive statistics. The established that not all teachers prepared the lesson plans; there were those who prepared frequently, those who prepared occasionally and those who did not prepare at all.  It is also concluded that not all teachers used the prepared lesson plans in the classrooms during teaching and learning process. There were those who used lesson plans frequently, those who used lesson plans occasionally and those who did not use the lesson plans at all in the teaching and learning process. The researchers therefore recommended that teachers should be given more in service training on the preparation of lesson plans and they should be closely capacitated for them to refrain from teaching without prerequisite guiding documents including lesson plans. Head teachers as internal quality assurers and the DSQAOs as external quality assurers should closely supervise teachers to fulfill this crucial role as professional teachers.  Educational leaders at district and national levels should ensure effective preparation and use of lesson plans to teachers through close monitoring and facilitating teachers with all necessary tools for the preparation of lesson plans.
Monitoring and Evaluation Challenges and Approaches by Non-Governmental Organizations in Musoma, Tanzania
Authors: Mathayo Reinfrida , Kinyina Alen
Published: October 2022

This study sought to establish the monitoring and evaluation challenges and approaches by Non-Governmental organizations in Musoma, Tanzania using the cross-sectional quantitative study design.  The approval to conduct this study was sought from the Ethical Committee Board of the Open University of Tanzania. The permission to collect data was further obtained from particular organizations and the respondents gave their consent before the data collection. A total of 44 respondents from 11 organizations were involved as respondents. Data was cleaned and analyzed by using the Statistical Package for Social Science (SPSS) Version 24 in frequencies and percentages. The result oriented approach was the most common used approaches. Other approaches such as Logical Framework, Reflexive and Constructivist approach were utilized depending on the need and nature of the project being implemented. An insufficient fund, inadequate skilled M&E experts and varying reporting requirements from multiple donors are challenges facing the majority of NGOs during implementation of monitoring and evaluation. The authors recommend the use of available experts in monitoring and evaluation to train the employees on the proper selection of the M&E approaches depending on the project needs. The authors also recommend the employees to utilize the available free online courses and trainings that do not require funds to improve their skills in monitoring and evaluation.
Development and Performance Evaluation of a Rubber and Canvas Strip Fingers Defeathering Machine
Authors: Bello R. S. , Saliu M. O. , Nebo E. U. , Ayodele A. A.
Published: October 2022

Human labour requirement in poultry products processing has continued to increase and more demanding, especially defeathering which is faced with faced challenges such as lacerations and hygiene in handling. To solve these challenges, mechanical defeathering proffered a solution, which further posed a problem of equipment cost and efficiency of operation. This paper investigated a developed a low-cost axial-loading (horizontal) defeathering with dual fingers for small and medium-scale poultry processors. This study reported the development of a defeathering machine which comprises of an axial defeathering drum with strip fingers, which flaps on the carcass to pluck off feathers in motion. The machine is electrically powered with a defeathering power requirement of 0.304 kW and at a power rating of 0.269 kW. The performance evaluation carried out with a broiler, cockerel and layer birds at a soaking temperature of 80 degree Celsius for an average time of 1 minutes showed that the efficiency and the effectiveness of the machine varies with respect to the quality of cleaned carcass produced. It was also observed that it takes the machine about 60 seconds to completely defeather a broiler of 2.4 kg weight, 70 seconds to defeather an old layer breed of bird of about 1.2 kg weight and 105 seconds to defeather a 1.3 kg weight of local chicken. However, test carried out on local birds showed that the machine was less effective defeathering local chicken at low temperature, because of the toughness of the skin. Comparatively, canvass (leather) fingers have the highest defeathering efficiency while rubber strip fingers produced the least defeathering efficiency. Therefore, canvas (leather) strip finger performed better than rubber strip fingers.
Agricultural Co-Operatives and Training of Male and Female Farmers on Improved Rice (Oryza sativa) Production Techniques in Ini Local Government Area, Akwa Ibom State, Nigeria
Authors: Etim G. J. , Asuquo L. E. , Osu S. R.
Published: October 2022

This study assessed the extent to which agricultural cooperatives carryout the training of male and female farmers on improved rice (Oryza sativa) production techniques in Ini Local Government Area of Akwa Ibom state, Nigeria using research questions for 2,500 (male and female) rice farmer cooperative members in the study Area. Data analysis for 1600 completed questionnaire collected revealed that male and female farmers were not efficiently trained by agricultural cooperatives on improved rice production techniques. Moreso, there were no significant difference on the extent of carrying out the training of male and female farmers by agricultural cooperatives on improved rice production techniques in Ini Local Government Area. It is recommended among others that Agricultural cooperatives should organize periodic training sessions for rice farmers through the use of facilities and demonstration in the farm. The Government, through The Ministry of Agriculture should encourage and support agricultural cooperatives by providing materials and adequate funding to enable them perform their primary assignment creditably.
Effect of Sublethal Concentration of Malathion Insecticide on Innate Immune System, Immune Function and Hemocytes of Adult Drosophila melanogaster
Authors: Bindhani B. , Maity S. , Chakrabarti I. , Saha S. K.
Published: October 2022

Invertebrate organisms mostly have innate immune system. Hemocytes are the immune cells of the innate immunity in invertebrates. Our study was designed to observe the effect of malathion insecticide on the innate immune system, immune function and hemocytes of Drosophila melanogaster. A hemocytometer was used for total count of hemocytes which showed a reduced percentage of live cells (from 91.63% to 44.57%) due to the treatment. For differential count, the hemolymph was spread as a smear on a clean grease free slide. It was observed that the plasmatocyte count considerably decreased under the effect of malathion (from 78% to 44.66%). Lamellocytes also showed a decline in their number (from 18.33% to 12.61%). But, a trivial increase (from 3.67% to 3.98%) in crystal cell count was recorded. Our result suggests that malathion has mostly negative effect on hemocytes. This study could help in understanding of insect defense mechanism against such hazardous chemicals. Additionally, the function of human macrophages is analogous to the function of plasmatocytes. Hence, this work could possibly aid us in studying the response of human immune cells against organophosphates like malathion.
A Treatment Option or Source of Bacterial Pathogen Transmission? The Case of Herbal Mixture in Nigeria
Authors: Inoma I. I. , Evbuomwan L.
Published: October 2022

Herbal mixture such as agbo, has been used in recent years in Nigeria to treat various sicknesses including malaria, typhoid, dysentery and cholera. However, the bacteriological quality and safety is of paramount importance spurring the argument whether it is treatment option or sources of pathogen transmission. Hence this study was conducted to investigate the bacteriological analysis of agbo herbal preparations. Samples of herbal mixture were purchased from five different markets (Uselu, New Benin, Oba, Santana and Ogida Markets) in Benin City, Edo State, Nigeria. Bacteriological analysis was carried out using pour plate isolation method. Identification of isolated bacteria was based on their cultural, morphological, biochemical and molecular techniques. Antibiotic sensitivity pattern was carried out using disk diffusion method. The plasmid profile of multiple drug resistance bacterial genes isolated was also analyzed. Bacteriological analyses showed that the total bacterial counts (TBC) of all the test herbal samples obtained from the various markets ranged from 0.04 x 104 to 1.13 x 104cfu/ml. Eight bacterial species were identified and they include; Bacillus cereus, Bacillus subtilis, Escherichia coli, Lactobacillus casei, Serratia marcescens, Micrococcus varians, Pseudomonas aeruginosa and Staphylococcus aureus. The least occurring bacterial isolates were Serratia marcescens and Pseudomonas aeruginosa (5.26%) while the highest occurring was Bacillus cereus (21.05%). Isolated bacteria were resistant to commonly used antibiotics. Plasmid profile revealed presence of plasmid genes in the bacterial isolates. Since applications of herbal medicines for curative purposes is on the increase, there is need to monitor and ensure its bacteriological quality before distributing to final consumers.