bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth media for V. natriegens v1
Authors: Hoff Josef
Published: October 2018

Media for V. natriegensLB2:Standard LB media (10.0 g/L Tryptone, 5.0 g/L Yeast Extract, 10.0 g/L NaCl) with additional 1.5% NaClLBv2 Salts:Standard LB media (10.0 g/L Tryptone, 5.0 g/L Yeast Extract, 10.0 g/L NaCl) with additional with additional v2 salts (204 mM NaCl, 4.2 mM KCl, and 23.14 mM MgCl2)BHIv2:Brain heart infusion Broth (37 g/L Teknova Brain Heart Infusion Broth Dry Media (Cat. No. B9500) with additional v2 salts (204 mM NaCl, 4.2 mM KCl, and 23.14 mM MgCl2) note: BHI can not be autoclaved together with the salts, they have to be autoclave separate and later on added. Matthew T Weinstock,Eric D Hesek, Christopher M Wilson,Daniel G Gibson Vibrio natriegens as a fast-growing host for molecular biologyNature Methods volume13,pages849–851(2016)
Assessment of the effect of long-term continuous stay in the artificial hypoxic gas-air environment at normal atmospheric pressure on the functional state of the cardiovascular system
Authors: Lyubimov Andrei V. , Ivanov Andrei O. , Bezkishkii Eduard N. , Shakhnovich Pavel G. , Cherkashin Dmitrii V.
Published: October 2018

In the vast majority of clinical cases, hypoxia and hypoxia are considered as negative pathological processes that require urgent correction with subsequent pharmacological support for the restoration of functioning, and in some cases, the structure of the involved organ and system. The loss of full functionality as a result of local or general exposure to the hypoxia is confirmed by numerous studies. However, there are research data showing that subliminal exposure to hypoxia can be used as a positive adaptation factor, which increases the overall health of the body, stamina, and tolerance to physical load. This mechanism is actively used in training athletes of different levels of functional fitness, sports and ages. There is a question of balance of adaptive and damaging properties of hypoxia. Threshold values at which the hypoxic state will have positive adaptive or negative — damaging properties are not clearly defined at the moment. The key criterion for a hypoxic environment is the concentration of oxygen in the inhaled air. At the same time, physiological or pathophysiological response to changes in concentration is purely individual and primarily depends on the parameters of homeostasis. This issue is relevant because clinical manifestations characteristic of the hypoxic state develop in patients with different forms of coronary heart disease. The purpose of our study was an attempt to document the functional changes from the cardiovascular system of healthy individuals with prolonged continuous exposure to artificial hypoxic conditions while maintaining normal atmospheric pressure using standard diagnostic methods that are generally available.
Vasopressin in mechanisms of stress reactions and modulation of emotion
Authors: Belokoskova Svetlana G. , Tsikunov Sergey G.
Published: October 2018

The review presents modern conceptions about the role of the vasopressinergic system in regulating reactions to stress and modulation of emotions in animals and humans. The contribution of vasopressin to activation of the hypothalamic-pituitary-adrenal system in conditions of acute and chronic stress is reflected in the work. It is noted that the activation of vasopressin receptors of type 1 enhances the response to stress, which contributes to the development of psychopathology. It is emphasized that the role of vasopressin receptors of type 2 in the regulation of emotions has been studied little. At the same time, there is evidence that the activation of vasopressin receptors of type 2 in patients with depressive disorders after a stroke is accompanied by effects that are opposite in direction to the effects of activation of vasopressin receptors of type 1. The review examines promising areas of further studies of the involvement of vasopressin receptors of type 2 in modulating stress reactions and emotions. The use of receptor antagonist’s vasopressin of type 1 and receptor agonists of type 2 in the treatment of depressive and anxiety disorders are discussed.
Hyperoxia and hypoxia influence to adaptive processes at muscular work
Authors: Radchenko Aleksander S. , Shabanov Petr D.
Published: October 2018

In this brief review we will state the use of hyperoxia (HO) in sports training. HO training has been recommended by some authors for athletes to increase their performance. Herewith, there is no reliable knowledge about physiology mechanisms that provides the athlete level of growth during long-term training under HO conditions. Concurrently in the last half century, the athletes’ performance in endurance sports has grown remarkably due to natural and artificial hypoxia application in training process of many kinds of sports. Long-term adaptation mechanisms to muscular work under hypoxia conditions are shortly summarized for comparison with HO effects and we emphasized that the prospectivity of searching the ways for regular usage HO to increase athletic performance is too questionable.
Actividad física moderada a vigorosa en educación física y recreo en estudiantes de primaria y secundaria de la frontera México-USA.
Authors: Hall Lopez Javier Arturo , Ochoa-Martínez Paulina Yesica , Macías Castro Raúl Alexis , Zúñiga Burruel Rodrigo , Sáenz-López Buñuel Pedro
Published: October 2018

El objetivo de este trabajo ha sido comparar la actividad actividad física moderada a vigorosa de clases de educación física impartidas por profesores y actividad física de sus estudiantes durante el recreo en primaria y secundaria Mexicali, Baja California. México. Método: Se utilizó como instrumento de evaluación el sistema para observar el tiempo de instrucción de actividad física (SOFIT), el diseño metodológico fue transversal descriptivo comparativo, evaluando 87  clases de educación física (n=75 primaria y n=12 secundaria), seleccionado al azar 4 estudiantes de cada clase (2 hombres y 2 mujeres), el mismo procedimiento se siguió durante los 30 minutos del recreo. En cuanto a los resultados, la igualdad de la varianza se calculó mediante la prueba t Student para muestras independientes resultando una P-Valor=.000 en primaria y .001 en secundaria ambas menores a α≤ 0.05, con un índice de actividad física moderada a vigorosa de las clases de educación física impartidas por profesores en primaria fue de 43.5±18.2 y la realizada por los estudiantes durante el recreo 50.5±10.4, mientras que en secundaria 37.2±11.2 en la clase de educación física y 54.4±3.8 del recreo.  Se concluye que la intensidad de actividad física durante el recreo fue mayor sin instrucción docente en relación a las clases de educación física evaluadas, no cumpliendo estándares internacionales al tener una intensidad moderada a vigorosa por arriba del 50% del tiempo de la clase, por lo anterior es importante retroalimentar de manera constructiva la manera de impartir la clase de los profesores mediante capacitación con estrategias didácticas para involucrar al alumno en actividad física moderada a vigorosa.
Views of first time implementers physical education and sports teachers on health related fitness report card
Authors: Yıldızer Günay , Ektirici Arıkan , Eren Gonca , Özböke Caner , Yılmaz İlker
Published: October 2018

The Health-Related Fitness Report Card (HRFRC) has been implemented first-time by physical education and sports teachers in the 2016-2017 academic year under the leadership of the Ministry of National Education in Turkey. The purpose of this study was to obtain the views of the physical education and sports teachers on the first time implemented HRFRC and the content of the fitness test. Participants were composed of 10 physical education and sports teachers with seniority between 2 and 30 years and actively working in the middle and high schools. Semi-structured in-depth individual interviews and field notes were chosen as the data collection tools. Collected data were analysed using the content analysis method. Identified themes are (1) Benefits of the Practice, (2) Reasons for Not Achieving the Objective of the Practice, (3) Challenges Experienced with the Practice, and (4) Recommendations for the Practice. Teachers emphasized that improving the quality of HRFRC training provided by the government, using standard materials for measurements, changing the time of the implementation, increasing the integration of stakeholders such as a nutritionist, health experts and families into implementation and providing a more confidential atmosphere in the implementation for increasing participation rate and the quality of the HRFRC.
An Analytical Study of reasoning skills according the bloom's taxonomy included in the curriculum of physical education and sport based on competency approach in middle school in Algeria
Authors: Abdelkader Zitouni , Daho Ali , Bloufa Boudjemaa
Published: October 2018

This study aims to reveal the scope of the presence of reasoning skills according to Bloom's taxonomy in the competency indicators included in the physical education and sports curriculum of a secondary school in Algeria. To achieve the objectives of the study, the technique of content analysis was used, and the validity and stability were tested using the Holsti method. The main findings of the study were as follows: the competency indicators contain most of the reasoning skills according to Bloom's taxonomy, as well as, however, neglect the ability to analyze and the low presence of the cognitive aspect of the skills of reasoning according to Bloom's taxonomy in the competency indicators included in the physical education and sports curriculum.
Ertugliflozin: a novel anti-diabetic drug
Authors: Sharma Vikrant , Sharma Sonika , Jaiswal Sanjay , Ghanghas Ravi R. , Bodepalli Durgaprasad , Sharma Ashok Kumar
Published: October 2018

Diabetes Mellitus is a disorder of global proportion. Despite various treatment modalities presently being available, yet the desired glycaemic control and patient outcomes have not been achieved completely. Sodium glucose co-transporter type 2 inhibitors (SGLT2 inhibitors) are one such promising group of emerging drugs in diabetes treatment. Ertugliflozin prevents the reabsorption of glucose by inhibiting sodium-glucose cotransporter-2 (SGLT2) at proximal convoluted tubules. Ertugliflozin is available as 5mg and 15mg tablets. Ertugliflozin has been related to genital mycotic infections and urinary tract infections. Benefits of Ertugliflozin include better control on blood glucose, body weight and blood pressure.
Effect of tooth brushing on color changes of esthetic restorative materials
Authors: Alzayer Fatima , Alawami Roaa
Published: October 2018

Background: The major problem of dental restorative material over time is color changes, and this discoloration is caused by either intrinsic or extrinsic factors. Intrinsic factors include the staining of the material itself caused by changes in the resin matrix and the interface between matrix and fillers.Methods: The study was conducted using resin composite material (shade A2), and four solutions (distilled water, strawberry, pomegranate, and red grape juices). The specimens were distributed into four groups for immersion in one of the four solutions. Authors divided each group into brushing and non-brushing subgroups.Results: When immersed in water, shade was changed from A2 to A3.5 and A4 (light to dark) in brushing group and no overall change was noticed in non-brushing group. However, there was statistically significant difference between the two groups.Conclusions: All types of juices caused distinct color change. However, brushing caused more color change as compared to specimens with no brushing.
A study on milk adulteration of Savar Upazila in Bangladesh
Authors: Moonajilin M. Sabrina , Saiful Islam M. , Paul Ratna
Published: October 2018

Background: Milk adulteration has become a serious concern. Some of the adulterants in milk have serious adverse health effects. This study was designed to assess consumer awareness about milk and determine formalin and melamine in milk.Methods: The study involved a laboratory-based investigation and a survey was conducted to assess consumer awareness about milk adulteration from January 2018 to June 2018. Total 10 samples were collected from local market purposively. 2 adulteration tests were conducted to detect formalin and melamine in samples. 10 brands of milk from 8 companies were collected from different markets of Savar and tested at BCSIR as per Bangladesh Standards. On the other hand; a survey was conducted to assess consumer awareness about milk adulteration. A pre tested semi structured questionnaire, was used to collect the information. Statistical analysis was done by using Excel.Results: We found the concentration of formaldehyde and melamine in all 10 analyzed products below the level of detection. The majority (55.9%) of the respondents knew that there is a law in the country that deals with milk adulteration; among them 41.7% thought that the reduced mobile court activity is reason for unchanged milk adulteration situation and insufficient penalty is also a major factor (45%). Only (55.9%) respondents consider water is main milk adulterant and 31.8% know about Chemicals. The majority of the respondents 87.8% strongly agreed that milk adulteration has harmful effects on health.Conclusions: These findings may be helpful for the concerned government regulatory bodies to monitor the quality of the commercial milk in the market.
Quality of life of low back pain patients following self back care intervention
Authors: Rahman Robin M. Ashikur , Ziaul Islam M. , . Akhiruzzaman , Morshed M. Shariar
Published: October 2018

Background: Low back pain is the major health problem which is experienced by people at any stage of lifetime. The study was conducted to assess the quality of life (QOL) of low back pain (LBP) patients following self back care intervention.Methods: A quasi-experimental study was carried out among adult (18-59 years) LBP patients. A self-back care intervention was applied to compare QOL of low back pain patients before and after intervention by using SF-20 scale.Results: The study showed that mean (±SD) age was 37.41 (±10.63) years and majority (52.7%) of the LBP patients was female. The study revealed that LBP was common among married housewives and mean duration of LBP was 3.59 (±3.52) years. Majority (55.4%) of the patients had poor QOL before intervention but after self back care intervention most (83.9%) of them had average QOL. Mean (±SD) score of QOL after intervention (57.83±8.74) was significantly (t, p˂0.001) higher to before intervention (49.30±11.31). It was also found that mean QOL score with long duration of LBP (50.526±6.844) was significantly (ANOVA, p˂0.001) lower than QOL with short duration of LBP (65.137±9.538). The study also found that when severity of pain increased, mean QOL score significantly (ANOVA, p˂0.001) decreased after intervention. Mean QOL score significantly correlated with duration of LBP (r=-0.382 p˂0.01). Linear regression of mean QOL and duration of LBP before intervention were R2=0.146 and after intervention were R2=0.214.Conclusions: Self back care is an effective intervention to improve QOL of LBP patients. So encouraging health education measures regarding self back care.
Infant and young child feeding practices in two provinces of Afghanistan: results from two rounds of large country-lot quality assurance sampling surveys
Authors: Shinwari Ibrahim , Aminee Ahmad Wali , Warvadekar Kirti , Gupta Payal , Chaudhery Deepika Nayar , Raut Manoj Kumar
Published: October 2018

Background: As per NNS 2013, about 58% of the infants aged 0-5 months were exclusively breastfed. The data also shows that only 41% infants 6-8 months of age were introduced solid, semi-solid and soft foods. Further only 28% of children aged 6-23 months received foods from four or more food groups during last 24 hours preceding the survey. Suboptimal IYCF practices are therefore considered to be an important contributor to the high rates of under nutrition in Afghanistan. The program monitoring at two time points was conducted to inform the program about the current status of the program activities and any course correction required. It was also meant to inform the government and other stakeholders on the feasibility of program strategies in improving IYCF practices and recommendations for scale-up programs.Methods: The program monitoring was performed before and after the (IYCN) program roll out in Wardak and Laghman provinces of Afghanistan. To understand and monitor the status of process and program indicators, a Large Country-Lot Quality Assurance Sampling (LC-LQAS) study design was adopted.Results: Minimum acceptable diet was observed to be 54% (95% CI: 46%, 61%) in the second round, which was 44% (95% CI: 35%, 53%) in the first round.Conclusions: Minimum acceptable diet among the children of age group 6-23 months was found to be consistently doing well in both the rounds. LC-LQAS was found to be an apt method to estimate the IYCN indicators at time points with low resource use.
Effectiveness of a health education intervention on the knowledge, attitude and practices of teachers regarding physical and psychosocial health of adolescents in Amritsar, Punjab
Authors: Kaushal Pushapindra , Singh Tejbir , Padda A. S. , Deepti S. S.
Published: October 2018

Background: Adolescents undergo the transition period of adolescence with little knowledge of body’s impending physical, physiological and psychological changes. After parents, teachers have maximum opportunity to support and educate adolescents. This study attempts to study effectiveness of health education on knowledge, attitude and practices of teachers regarding physical and psychosocial health of adolescents.Methods: The study was started with 155 teachers (teaching class 9th -12th) who willingly participated from 50 senior secondary schools of Amritsar district. After taking informed consent, teachers filled a pretested questionnaire which was followed by an interactive session on adolescent health. To study impact of health education, they were again administered same questionnaire after a period of 3 months. Statistical analysis was on Microsoft Excel, Chi square test, SPSS.Results: Maximum 74 (47.7%) teachers were aware of psychosocial problems of adolescents as compared to the physical and sexual problems. Only 11 (7.1%) teachers had adequate knowledge about changes occurring during adolescence. Majority 125 (80.6%) of teachers had no knowledge regarding height and weight gained during adolescence and more than 2/3rd [110 (71%)] of teachers were unaware of daily calorie and protein requirements. Only 28 (18.1%) had adequate knowledge about drug abuse. After intervention significant favourable changes were observed in their knowledge, attitude and practices regarding most of above mentioned topics.Conclusions: Overall knowledge of teachers in most aspects of adolescent health was found to be low, however significant favourable changes were observed after health education was provided to them.
Vaccines for adults: a review of recent literature
Authors: Ahmed Mahir , Alorinan Bayan , AlYemni Abdullah , Albakri Mohammed , Alahmari Mohamme , Hassan Ayan , Alrahili Abdulaziz , Alfawzan Abdullah , Alazzouni Abdulrahman , Alansari Abdulaziz
Published: October 2018

Vaccinations in adults and older patients are of special importance due to two main reasons: physiological and anatomical alterations in the body as it ages, making diseases more serious and possibly fatal, and so that adult individuals have a decreased immunological response when they are exposed to infections. Major adult vaccination includes influenza, pneumococcal pneumonia and meningitis, pertussis, tetanus, diphtheria, and hepatitis. In this study, our aim was to understand the recent updates on adult immunization and their efficacy in disease prevention. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: adult vaccination, adult immunization, influenza, pneumococcal pneumonia and meningitis, pertussis, tetanus, diphtheria, preventive measures, infection prevention. Several communicable diseases that affect the elderly population which can cause significant morbidity and mortality along with excessive costs on the health care system are easily preventable with the use of vaccination. Therefore, using vaccines to prevent these diseases should be updated and encouraged by all family health care practices.
Follow up and complications of knee replacement surgery
Authors: Fakeih Elaf , Basnawi Mohammed , Alshardi Waleed , Albakheet Shaher , Mandura Marwan , Alateeq Abdullah , Al Arbash Mohammed , Algamdi Saleh , Alzayer Mohammed , Owaidah Hamza
Published: October 2018

Total knee surgical replacement is considered to be an extremely cost-effective surgery in the field of orthopedics. It is estimated that over four million patients in the United States have undergone a total knee replacement, and more than half a million patients undergo this operation annually. In this review, we will discuss the risks of possible complications, methods for their prevention, and ideal follow up for patients who underwent total knee replacement surgery. We did a systematic search for prostatitis using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). The terms used in the search were: total knee replacement, knee arthroplasty, complications, management and follow up. Despite having an overall favorable safety profile, total knee replacement therapy can have associated morbidities. Overall mortality following a total knee replacement therapy is extremely low and is about 0.08%. Possible complications include cardiovascular events like arrhythmias, heart failure, myocardial infarction, deep venous thrombosis, pulmonary embolisms, and fat embolisms. Other more common complications are prosthetic infection, which is the most common early complication, and aseptic loosening, which are the most common late complications.
Triage for low income countries: is ESI truly the way forward?
Authors: Siddiqui Emaduddin , Daniyal Muhammad , Khan Muhammad Abdul Raffay , Siddiqui Saif ul Islam , Siddiqui Zain ul Islam , Farooqi Walid
Published: October 2018

A triage desk at the doorstep of an emergency department (ED) is to “sort, select or prioritize” presenting patients as per their clinical needs. Many triage systems exist globally, however, the need and/or practical applicability of any triage is dictated by the hospital system and setting. In low-income/developing countries, the triage system must be capable and proficient enough to pair the right patient with the most appropriate management. Ineffective and/or in-efficient triage leads to overcrowding, delays, inappropriate resource utilization and patient dissatisfaction. A sizeable proportion of triage systems rely on three to five levels/tiers. Five level triage systems, such as the Australian Triage System (ATS) and the Canadian Triage Acuity Scale (CTAS), to name a few, are widely used worldwide. Based on door-to-physician time, these systems not only allow the institution to monitor and meet the timelines recommended by the institution policies, but have also been identified as an effective triage tool hence widely adopted in hospitals of developed countries. However, both ATS and CTAS are time-consuming and require skilled and qualified nursing staff to process it. On the other hand, the ESI (Emergency Severity Index) scale which is also a 5-level triage system, categorizes patients based on resource requirement and severity of the patient’s condition. Although ESI is in the developing phase, it is proving to be nurse-friendly and reliable in both intra and inter-rated conditions. The aim of this paper is to critically analyze the merits and pitfalls of the ESI system, in addition to proposing further modifications, in order to fulfill the needs of a developing country.
Evidence of bacterial biofilms in chronic rhinosinusitis: factors affecting and the impact on prognosis
Authors: Gogia Vivek , Vaid Lakshmi , Singh P. P. , Saha Rumpa
Published: October 2018

Background: The aim of the study was to study the evidence of bacterial biofilms in chronic rhinosinusitis (CRS) and its effect on disease prognosis by correlating between symptom score, computed tomography (CT) score and endoscopy score.

Methods: 40 samples of bacteriologically positive CRS patients were studied and data analyzed using SNOT-20 questionnaire, nasal endoscopy scores and CT grading. Functional endoscopic sinus surgery was done in all CRS patients to clear blockage and ensures patency of osteomeatal complex. Postoperative evaluation continued at 2 weeks, 1 month and 3 months. A comparison made between preoperative and postoperative SNOT-20 and endoscopy scores of patients with and without biofilms.  

Results: Patients with biofilm forming bacteria have significantly poor preoperative and postoperative SNOT-20 score and endoscopy score as compared to bio-film negative patients; however the quality of life improved in both the groups.

Conclusions: Biofilms play a potential role in postoperative prognosis of patients undergoing FESS. Further studies and research is required for assigning them as a definite proprietor for CRS.
The accuracy of free-hand cup positioning: a CT based measurement in a South Indian hospital
Authors: Sengodan Vetrivel Chezian , Marimuthu S. , Ramasamy Raghupathy
Published: October 2018

Background: In total hip arthroplasty, the restoration of normal hip center in acetabular reconstruction encourages the normal bio mechanics. The impingement, dislocation, and implant wear have increased the interest in accurate component placement in arthroplasty. This study is to determine the accuracy of the free hand technique in the acetabular cup placement in relation to native acetabulam using CT scan images.

Methods: This study was done in the Coimbatore Medical College and Hospital from June 2015 to March 2016. Twenty patients who have undergone total hip replacements were subjected to CT scan of pelvis preoperatively and postoperatively. The acetabular cup version and the inclination were measured and analyzed statistically.

Results: The mean acetabular version was 17.5◦±6.5◦ and the inclination was 46.6◦±9.3◦ pre operatively. Post operatively the mean acetabular version was 26.3◦±17.3◦ and the inclination was 41.7◦±10.9◦. With reference to the component version it ranged from 12.5˚ of retroversion to 62.5˚ anteversion with a mean of 26.3◦±17.3◦. The component inclination ranged from 15.6◦ to 58.4◦ with a mean of 41.7◦±10.9◦. On combining component version and inclination, only (50%) was within the safe zone.

Conclusions: Based on the CT finding acetabular version and inclination differs from individual to individual. During acetabular cup placement in total hip arthroplasty using free hand technique, our study shows that that inclination is better achieved and the anteversion is over targeted in most of the cases.
Functional outcome of arthroscopic reconstruction of anterior cruciate ligament tear using peroneus longus tendon autograft
Authors: Khajotia B. L. , Chauhan Shakti , Sethia Rajendra , Chopra B. L.
Published: October 2018

Background: The objective of the study was to evaluate the functional outcome of arthroscopic reconstruction of ACL tear using triple layered PLT autograft and to study its effect on ankle stability.

Methods: The study included 25 patients. The range of age was 18-42 years. Pre-op clinical tests and MRI was done to confirm tear. Reconstruction was done arthroscopically. Physiotheraphy protocol was fixed for all patients. Final outcome was assessed at 6 months using IKDC score and ankle stability was assessed by grading muscle power (MRC grading) with the normal side as control.

Results: IKDC score was normal or near normal in 21 patients and only 4 patients were rated as abnormal or severely abnormal. Mean IKDC Score was 83.53. Stability of the ACL was assessed using the Lachman test: normal in 18 cases (72%), 1+ laxity in 5 cases (20%), 2+ and 3+ in 1 case (4%) each. Pivot shift was negative in 15 cases (60%), Pivot glide was seen in 9 cases (36%) and gross pivot shift was seen in 1 patient. Partial meniscectomy of the medial meniscus was performed in 5 patients. No patient experienced ankle dysfunction however 2 patients had pressure pain in the region of the graft harvest.

Conclusions: PLT graft is similar to the native ACL both in terms of thickness and strength. It can be an appropriate autograft option for ACL reconstruction without compromising ankle function and avoiding potential complications of hamstring and BPTB autograft obtained from the knee region.
Effect of teriparatide in fracture healing of intertrochanteric fracture: a prospective study
Authors: Singhal Sanjeev K. , Aggarwal Naresh , Sharma Ajay
Published: October 2018

Background: Intertrochanteric fracture is a relatively common and serious medical issue in geriatric trauma result in serious health problems and decrease health related quality of life. Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture-healing. The purpose of the present prospective, randomized, controlled study was to evaluate the effect of teriparatide on the course of intertrochanteric fracture-healing.

Methods: Forty patients of intertrochanteric fractures who underwent surgical intervention between June 2016 and May 2017 were enrolled in this prospective study and followed for minimum of six months. Group A included patients who received only calcium supplementation; patients in Group B received teriparatide along with calcium supplementation postoperatively.

Results: The mean time to fracture healing was between 8-12 weeks for the treatment group, compared with 12-16 weeks for the control group. There was also significant effectiveness with regards to Parker and Palmer mobility score at 6 months.

Conclusions: Postoperative use of teriparatide for 6 months appears to be an effective adjunct therapy in the treatment of patients with intertrochanteric fractures. However, because of the limited power of the study a large-scale cohort study is still required for determining the efficacy of teriparatide.
A hospital based cross sectional study on synovial fluid analysis among patients with different types of knee joint disorders at a tertiary care hospital
Authors: Gandra Arvind
Published: October 2018

Background: Patients presenting with knee joint disorders are subjected to variety of investigations which are often inconclusive. Instead if they are subjected for synovial fluid analysis, they will be benefited. The objective of the study was to study synovial fluid analysis among patients with different types of knee joint disorders at a tertiary care hospital.

Methods: A hospital based cross sectional study was carried out among 30 patients attending the outpatient Department of Orthopedics and suffering from knee joint pain of either left or right or both the sides. Present study was carried out over a period of two years from January 2011 to December 2012 at Department of Orthopedics, Global Hospitals, Secunderabad. All patients were examined in detail and subjected to all necessary investigations.

Results: Males were more than females. The most common joint disease in the study population was tubercular synovitis in 20% of the cases. The most common condition among males was osteoarthritis while there was no such case in females. Rheumatoid arthritis was most common in females while there was no such case in males. Polymorphs were seen in all cases except osteoarthritis and villonodular synovitis. On biochemical analysis of synovial fluid it was found that gouty arthritis did not have proteins. Proteins were minimum in the synovial fluid in case of osteoarthritis while maximum range was found in cases of tubercular arthritis and rheumatoid arthritis.

Conclusions: Synovial fluid analysis is very important to understand the etiopathogenesis of knee joint diseases. Our study showed that synovial fluid of the knee joint analysis was very informative in the diagnosis and proper management of the patients presenting with knee joint disorders.
A clinico-epidemiological study of melasma
Authors: Kumar Akshy , Sharma Mukul
Published: October 2018

Background: Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin.

Methods: The proposed study is an epidemiological cross sectional study which was carried out in the department of dermatology in a teaching institute from October 2007 to September 2008 at Pramukh Swami Medical College, Karamsad, Gujarat. A total of 60 patients were enrolled for the study over a period of one year.

Results: The main age group affected was 30-39 years i.e. 48.33% patients. 50 patients were females.18 patients had a positive family history of melasma. 12 patients had a positive history of using OC Pills. Malar region was the commonest affected area found in 52 patients followed by Centro-facial in 31 and least involvement was seen in forehead region in 24 patients. 20 patients reported association of occurrence of the lesions with pregnancy, 09 patients reported sunlight to be the offending agent.

Conclusions: Females were affected more commonly during their late third decade of life. Although we did not find the exact cause of melasma, we noticed that sun-exposure, pregnancy, and taking of oral contraceptive pills could precipitate or exacerbate the melasma.
A comparative study of the efficacy and safety of oral apremilast versus oral methotrexate in patients with moderate to severe chronic plaque psoriasis
Authors: Shetty Vinma H. , Goel Saumya , Murali Babu Amita , Eram Hafsa
Published: October 2018

Background: Psoriasis is a chronic, inflammatory systemic disease. Methotrexate acts by inhibiting dihydrofolic reductase enzyme. Apremilast is an oral PDE4 inhibitor approved by US Food and Drug Administration for treatment of psoriasis.

Methods: This is hospital based comparative study conducted from February 2018 to August 2018. Seventy patients above 18 years of age with chronic plaque psoriasis were divided into 35 patients in each group and were treated with oral Apremilast (30 mg twice daily) and oral methotrexate (15 mg per week in three divided doses with a 12-hour interval between doses and tab folic acid on methotrexate free days) and were evaluated every 4 weeks for a period of 16 weeks and followed-up at 24th week. Outcome was assessed on basis of psoriasis area-and-severity index score (PASI), psoriasis disability index (PDI) and clinical photographs.

Results: % of improvement in Group-A patients (76.8%) after 16 weeks of treatment was relatively more (p<0.05) as compared to group B (71.5%). At the end of 16 weeks PASI score in methotrexate group was statistically significant (p<0.05) as compared to group B, PDI became 17.90±3.87 in group A and was statistically significant (p<0.05) as compared to group B which was 20.34±2.98. Side effects observed were comparatively less in group A patients.

Conclusions: On comparing the two drugs, methotrexate was comparatively better tolerated and had better efficacy and safety. More studies are required to further prove the efficacy of Apremilast in treatment of psoriasis.
Analysis of cases of dermatological referrals and their systemic correlation in a tertiary care hospital in Gangtok: a prospective study
Authors: Sharma Rukma Lall , Sharma Rekha , Zaman Forhad Akhtar
Published: October 2018

Background: Practice of dermatology in a teaching hospital is not merely limited to inpatient and out patients’ management but also boost up the clinical knowledge of young medical graduates and medical students. Many dermatological diseases might be directly or indirectly associated or related with the primary diseases for which the patient is admitted in the hospital or it may also be the dermatological manifestation of systemic diseases.

Methods: The aim of the study was to analyze the type of dermatological diseases referred from the indoor patients of various departments and to identify its relation to systemic diseases. Consecutive sampling was applied on 297 referrals of indoor patients from various other specialties with dermatological disease.

Results: Out of 297 referrals majority, 145 were from the department of medicine and only one, the least number, from Gastroenterology. Maximum number of cases that encountered was the viral infection with 39 cases. 128 patients had dermatological manifestations of primary diseases or directly or indirectly related to it and the rest 169 fell in unrelated group.

Conclusions: Dermatological referrals from other specialties was noted to be an eye opener to the no dermatologist and beneficial to the patients in terms of providing proper guidance and evidence based treatment avoiding unnecessary investigations. This also emphasizes the need for a proper training of young non dermatologists.
Correlation of serum calcium levels with severity of psoriasis
Authors: Chaudhari Sunil , Rathi Sushil
Published: October 2018

Background: Recently it has been observed that psoriasis can be successfully controlled by use of vitamin D. This has attracted the curiosity into research on psoriasis and vitamin D as well as role of calcium supplements in the control of psoriasis. Studies have shown that psoriasis risk factor is hypocalcemia. The objective of the study was to analyse serum calcium levels in patients of psoriasis and correlation with severity of psoriasis in comparison with control subjects without psoriasis.

Methods: This study recruited 80 subjects, of psoriasis (age and sex control subjects without psoriasis) attending Skin and STD department, Government Medical College Amritsar, Punjab. Both patients and controls studied during period of 2 year from June 2015 to May 2017.

Results: Serum calcium levels were significantly lower in psoriasis patients than in controls. Serum calcium levels values in patients of mild severity (PASI <10), moderate severity (PASI: 11-20) and severe (PASI >21) were 9.00±0.20, 8.93±0.24 & 8.98±0.22 respectively.

Conclusions: Serum calcium levels were found lower in psoriasis patients and there were no correlation with severity of psoriasis. Hypocalcemia is a risk factor of psoriasis.
THE IMPORTANCE OF MORPHOLOGICAL-CLINICAL CONSISTENCY: THROUGH THE REVIEW OF GASTRIC BIOPSIES IN NORTH-EASTERN ANATOLIA REGION IN TURKEY
Authors: Demirtaş Rabia , Erdoğan Durmuş Şenay , Yarıkkaya Enver
Published: October 2018

OBJECTIVE: In our study we aimed to make a generallyreview of gastric biyopsies in North-Eastern Anatoliaregion in Turkey such as; percentages of malignancy ordysplasia, reasons of re-biopsy recommendations andresults of second biopsies if taken.MATERIAL AND METHODS: 1840 gastric biopsies whichexamined by 3 pathologists at 2 centers were analyzedretrospectively. Percentages of malignancy or dysplasia,cases which were recommended for re-biopsies, reasonsof recommendations and results of re-biopsies wereexamined. In the results of the second biopsies, dysplasia,malignancy and gastritis were accepted as a significantresult.RESULTS: The mean age of our cases was 52.9 ± 16.6 years(range: 18-95 years). 1012 (55%) patients were femalesand 828 (45%) patients were males. In 90 out of 1840cases, biopsies were taken for suspect of malignancy,clinically. 35 of 90 cases were reported as malignancy. In61 out of 1840 cases re-biopsy were recommended. Reasonsof recommendations for re-biopsy categorized inthree groups: suspect of malignancy- clinically, suspectof malignancy- morphologically, insufficient (superficial)biopsies. 12 (46.2%) of 26 cases which were taken secondbiopsies were reported as malignancy and gastricdysplasia. Only in 2 (7.6%) of 26 cases the results wereinsignificant (insufficient biopsy).CONCLUSIONS: Endoscopic findings provide informationabout the diagnosis but are not pathognomonicwhich also need histological confirmation. Closeworking relationship and a good dialogue between thepathologist and the gastroenterologist is essential forclinical-morpological consistency, morphological-clinicalconsistency and final diagnosis.
TEK BİR TRAVMAYA BAĞLI GELİŞEN İZOLE PERİFERİK SİNİR NÖROPATISI: İKİ OLGU SUNUMU
Authors: Akpınar Çetin  Kürşad , Çalık Murat , Aytaç Emrah
Published: October 2018

Muskulokutanöz sinir brakiyal pleksus lateralkordundan ayrılır. Biceps braki ve brakiyalis gibikasları innerve eder. Ulnar sinir ise brakiyal pleksusunmajor terminal dalıdır. Ulnar sinirin terminaldalı derin ulnar motor daldır. Hipotenarkasları innerve eder. İzole travmatik sinir hasarıoldukça nadir görülmektedir. İzole travma nedeniylesinir hasarı gelişmesi nadir bir durumdur.Biz bu yazıda atrofi ve ağrısız güçsüzlük yakınmasıylabaşvuran iki izole sinir hasarı olgusu(65 yaşında kadın ve 40 yaşında erkek) sunduk.Olgularımızdaki muskulokutanöz ve derin ulnarmotor dal nöropatisinin tek bir travmadan kaynaklandığınıdüşünmekteyiz. Yapılan elektrodiagnostiktestler, izole muskulokutanöz ve derinulnar motor sinir nöropatisini göstermiştir.Manyetik rezonans görüntüleme ve elektrofizyolojikçalışmalar bu hastalıkların ayırıcı tanısındafaydalıdır. Literatürde izole muskulokutanözve derin ulnar motor sinir hasarının, tek bir travmanedeniyle oluştuğunu bildiren çok az sayıdaolgu sunumu vardır.
DİSTROFİK EPİDERMOLİZİS BÜLLOZADA LAPAROSKOPİK APENDEKTOMİ: MİNİMAL İNVAZİV GİRİŞİMİN AVANTAJLARI
Authors: Arslan Alıcı Çiğdem , Arda M.surhan , İlhan Hüseyin , Köse Aydan Ayşe , Tokar Baran
Published: October 2018

Distrosfik epidermolizis bülloza (DEB), bül oluşumunundermoepidermal bileşkenin dermalyüzünde, bazal laminadaki ayrılma nedeniylegeliştiği bir Epidermolizis Bülloza (EB) tipidir.Bu hastalarda travma ile oluşan mekanik büllerinaçılması enfeksiyona neden olabilir. DEBolan olgularda cerrahi girişim, özellikle batıncerrahisi gerekirse insizyon ve cerrahinin gereğioluşacak büllerin enfekte olmaması için gerekliözenin gösterilmesi gerekir. Bu makalede,bilgilendirilmiş onam formu alınan, DEB tanısıolan perfore apendisit nedeni ile laparoskopikapendektomi yapılmış olan 16 yaşındaki hastasunulmuştur. Cerrahi öncesi ve sırasındaki girişimlerinciltte en az travma ve enfeksiyonunaneden olacak planla gerçekleştirilmesi; özellikledaha az invaziv olan laparoskopik yaklaşımıntercih edilmesi bu ve benzeri olgularda komplikasyonlarıazaltabilecek yaklaşım şeklidir.
İKİ PERİNATAL HİV OLGUSU VE LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ
Authors: Yılmaz Fatma Hilal , Gültekin Nazlı Dilay , Sündüz Uygun Saime , Altunhan Hüseyin
Published: October 2018

Dünya genelinde hâlihazırda yaklaşık 37 milyonkişide bulunan kazanılmış immün yetersizlik virüsü(HIV) giderek daha fazla sayıda insanı etkilemekteve bu nedenle, önemli bir sağlıksorunu olarak kabul edilmektedir. Türkiye iseHIV’in az görüldüğü ülkeler arasında yeralmaktadır. Çocukluk çağı HIV olgularının%90’ından perinatal yolla geçiş sorumludur veantiretroviral profilaksi ile geçiş riski %1’inaltına düşürülmüştür. HIV enfeksiyonununmortalite ve morbiditesi düşünüldüğü vakitkoruyucu tedavinin komplikasyonları gözealınabilir fakat olası toksisite yönündenhastaların yakın izlemi gerekmektedir. HIVolgularının engellenmesi büyük oranda perinatalsürecin doğru yönetimiyle mümkündür.Burada HIV pozitif annelerden doğmuş olan ikiolgu incelenmiş ve literatür eşliğinde perinatalyönetim süreci gözden geçirilmiştir.
Obesity in Children and Adolescents and the Factors Responsible for it: A Case Study among Children of Some Affluent Families
Authors: Urmi Atika Farzana , KC Bhuiyan
Published: October 2018

The present analysis is based on data regarding the level of obesity amongst 662 children and adolescents of 560 families. These were the families of students of American International University – Bangladesh. The children and adolescents were classified by the level of obesity which was measured by percentiles of BMI.

It was observed, that among 662 children and adolescents 465 were in the underweight group. Obesity and severe obesity were observed among 9.1% children and adolescents. Among the obese and severe obesity group, 53.3% killed their time while watching television, which is not a scheduled healthy activity and another 26.7% utilized the time playing sports and games, which is a planned and scheduled healthy activity. Obesity and severe obesity were associated with killing time in doing unhealthy activity. Among the obese and severe obesity group of children 31.7% were diabetic patients. Diabetes and level of obesity were significantly associated [ = 8.75, p-value = 0.033]. Among obese and severe obese groups, around 42% were habituated in taking restaurant food and these two characteristics were also significantly associated with food habit of the children [ = 94, p-value = 0.000]. Some socioeconomic factors of parents, viz. parent’s education, father’s occupation, and income of the families were also associated with level of obesity.

The logistic regression analysis showed that all the variables, except the variable mother’s occupation, were significantly related to the variation of the level of obesity of children. For underweight children family income had a significant impact on their level of obesity.
Phytochemical Properties and Antimicrobial Activity of Natural Colorant Extracted from Mesocarp and Exocarp of Cocos nucifera
Authors: Hassan Rodiah Mohd , Zulrushdi Nur Asma Fhadhila , Yusoff Aziah Mohd , Ibrahim Nurhafizah , Nor Norakma Mohd
Published: October 2018

Phytochemical analysis was carried out on the natural colorant extracted using the microwave-assisted extraction which performed at a microwave power of 300 watts for 2 minutes. The pigment compound was extracted from mesocarp and mesocarp of Cocos nucifera by using 0.1 M NaOH as extracting agent. The qualitative analysis that was carried out for these natural colorants confirmed that flavonoids, terpenoids, cardiac glycosides and phenol/tannins were present in both plant parts (mesocarp and exocarp) tested whereas alkaloids, saponins, steroids and anthraquinone were not detected. Quantitative analysis showed that tannin content was significantly (p < 0.05) higher (134.82 mg TAE/g) in the mesocarp extract compared to the exocarp extract (33.90 mg TAE/g). The amount of flavonoids was low in both extracts (mesocarp: 15.48 mg QE/g and exocarp: 28.45 mg QE/g, respectively). The antimicrobial study discovered that the mesocarp and the exocarp extract were not effective as antibacterial agents.
Maternal Education Household’s Wealth and Child Mortality in Rural Nigeria
Authors: Waheed M Ashagidigbi , Oluwatosin B Adewumi , Kehinde O Olagunju , Adebayo I Ogunniyi
Published: October 2018

Poverty, maternal literacy and child mortality has been a policy issue in Nigeria, most especially in rural areas.Studies have established their individual effects on households. However, the need to establish the link between the three welfare indicators is of great economic and social importance. The study aimed at investigating the linkage and effect of maternal education and household wealth on incidence of child mortality in rural Nigeria. The study made use of data obtained from the 2013 Nigeria Demographic and Health Survey (NDHS2013). Logit, probit and Principal Component Analysis models were the analytical techniques adopted. The findings revealed that mothers residing in the north-west recorded the highest percentage of no formal education (54%). Also, asset deprivation (poverty rate) is 63%, though higher in the northern divide than in the south. About 44 percent of the rural households recorded child mortality, with north-west households having the highest. The results revealed that maternal education improves households’ wealth; also, households with low level of maternal education and wealth index have the likelihood of recording higher child mortality rate in rural Nigeria. If the Sustainable Development Goals of ending extreme poverty, achieving good health, and ensuring gender equality in relation to female education are to be achieved, maternal human capital development and households’ welfare improvement should be the areas of focus in rural Nigeria.