bluuebunny/crossref_metadata_2025 huggingface dataset:
Erkek Çocuklarda Denge Düzeyi, Biyomotor Beceriler ve Fiziksel Aktivite İlişkisi
Authors: ÜNVER Evrim , DEMİRCİ Necip , KONŞUK ÜNLÜ Dr.hande , CİNEMRE Doç. Dr. Şükrü Alpan
Published: August 2019

Bu çalışmanın amacı, erkek çocuklarda denge
düzeyini belirleyen sensör sistemlerin biyomotor beceriler ve fiziksel aktivite
(FA) düzeyi ile ilişkisini araştırmaktır. Çalışmaya, Ankara ilinde eğitim gören,
44 erkek çocuk (Yaş=9.59 ± 0.76 yıl) katılmıştır. Araştırmaya katılan
katılımcıların boy uzunluğu ve vücut ağırlığı ölçümlerinden oluşan
antropometrik ölçümler gerçekleştirilmiştir. Katılımcıların sensör sistem
seviyeleri; BIODEX Biosway portatif denge sistemi ile modifiye edilmiş sensör
entegrasyon denge testinde (m-CTSIB); sabit zeminde gözler açık, sabit zeminde
gözler kapalı, hareketli zeminde gözler açık ve hareketli zeminde gözler kapalı
olacak şekilde dört farklı ölçüm yöntemi kullanılarak tespit edilmiştir. Her
test 30sn uygulama 10 sn dinlenme sürelerinden oluşan test protokolü ile
uygulanmıştır. Biyomotor beceri düzeylerinin belirlenmesi için kuvvet testi
olarak plank testi, 505 yön değiştirme testi, 20m sprint koşu testi ve ayak
bileği dorsifleksiyon eklem hareket ranjı testi uygulanmıştır. FA ölçümleri beş
okul günü boyunca okul saatleri süresi içinde GT3X-BT Actigraph akselerometre
aracılığı ile gerçekleştirilmiş ve Orta-Yüksek Şiddetli Fiziksel Aktivite
(O-YŞFA) değerleri elde edilmiştir. Değişkenler arasındaki korelasyon düzeyleri,
parametrik varsayımların yerine geldiği değişkenler için Pearson korelasyon
katsayısı (r) ile; parametrik varsayımların yerine gelmediği değişkenler için
Spearman sıra korelasyon katsayısı (rho) ile incelenmiştir.  Elde edilen veriler SPSS 23.0 istatistik paket
programı ile değerlendirilmiştir. Çalışmanın bulgularında yalnızca 505 yön
değiştirme testi ile görsel sensör sistemin primer olduğu denge skoru arasında
istatistiksel olarak anlamlı bir ilişki düzeyi elde edilmiştir (rho=0,394;
p<0,05). Sonuç olarak, görsel sensör sistem haricinde diğer sensör sistemler
ile biyomotor beceriler ve FA düzeyi arasında istatistiksel olarak anlamlı bir
ilişki düzeyi elde edilememiştir.
Impacto do treinamento físico combinado em indivíduos com linfoma: relato de casos
Authors: Lima Fernanda Godoy , Maresti Julia Rego , Coelho Vitória Helena Maciel , Pardi Guilherme Rocha , Oliveira Leonardo Rodrigues , Ruas Gualberto
Published: August 2019

Introdução: Os benefícios da atividade física na população geral estão bem estabelecidos, gerando melhora da qualidade de vida e diminuição significativa do risco de desenvolver doenças cardiovasculares e metabólicas. A perda da massa muscular com redução da força muscular e do desempenho físico é um problema relevante em indivíduos com câncer. O exercício físico com fim terapêutico constitui um valioso instrumento da reabilitação para estes pacientes. Objetivo: Descrever o impacto do treinamento físico combinado em dois pacientes com linfoma. Casuística e Métodos: Descreve-se o caso de dois pacientes com linfoma, sendo um do sexo masculino, com 30 anos de idade, com linfoma tipo Hodgkin e outro do sexo feminino, com 29 anos de idade com linfoma tipo não Hodgkin. Em ambos os pacientes foram avaliados o hemograma, as variáveis respiratórias, a capacidade física funcional, força de preensão palmar, funcionalidade e teste de repetições máximas antes e após treinamento físico combinado. Resultados: O treinamento físico combinado demonstrou melhora nas variáveis respiratórias, na capacidade física funcional, na força muscular global e na funcionalidade dos pacientes com linfoma. Conclusão: É possível concluir que o treinamento físico combinado pode trazer benefícios nos aspectos físicos e funcionais dos pacientes em tratamento oncológico. Sugere-se que o treinamento físico combinado seja incluído na reabilitação destes pacientes.
Avaliação da Síndrome de Burnout entre estudantes do último ano de um curso de medicina do Brasil
Authors: Prado Monique Sâmara Freire Máximo , Norte Nathalia Marques , Carvalho Iracema Gonzaga Moura de , Sousa Ivone Félix de , Almeida Rogério José de
Published: August 2019

Introdução: Estudantes de medicina estão cada vez mais suscetíveis ao desenvolvimento de agravos relacionados à saúde mental. Um importante agravo que deve ser investigado durante a formação médica é a Síndrome de Burnout. Sintomas próprios da síndrome, como a exaustão emocional, muita das vezes não são reconhecidos com tal, podendo agravar o quadro já instalado no estudante. Objetivo: Avaliar a ocorrência da Síndrome de Burnout no período de formação profissional dos graduandos do último ano de um curso de medicina. Casuística e Métodos: Trata-se de um estudo transversal analítico com abordagem quantitativa realizada por meio de questionário sociodemográfico e pelo Instrumento de avaliação de Burnout “Maslach Burnout Inventory for students (MBI-SS)”, aplicados aos acadêmicos do último ano de um curso de medicina da cidade de Goiânia, Goiás, Brasil. Foi confeccionado um banco de dados, sendo realizadas análises descritivas, teste t de Student e o teste de análise de variância (ANOVA). Resultados: Foram pesquisados 81 estudantes do último ano do curso de medicina, sendo 42% do sexo masculino e 58% do sexo feminino. Um total de 67,9% tinha idade entre 21 e 25 anos, eram solteiros (95,1%), com baixo envolvimento religioso (38,3%) e praticavam atividade física regularmente (71,6%). Os escores da escala MBI-SS foram respectivamente: exaustão emocional (4,21±1,063), descrença (3,02±1,402) e satisfação pessoal (4,28±0,885). As análises demonstraram que aqueles que participaram de iniciação científica tiveram uma melhor satisfação pessoal (4,73±0,78) e menor escore em relação à descrença (3,43±1,27). Aqueles que tiveram experiência de doença grave pessoal apresentaram escore mais alto em exaustão (4,50±0,71). Conclusão: Os alunos pesquisados não apresentaram escores que indicam a ocorrência da Síndrome de Burnout. Os escores apresentaram-se moderados em exaustão emocional e descrença, mas altos em satisfação pessoal, não caracterizando assim a síndrome neste grupo de alunos. Diante da relevância dos resultados apresentados, é importante que as instituições de ensino voltem sua atenção à questão da prevalência da Síndrome de Burnout em acadêmicos de medicina.
Uso do eculizumab na síndrome hemolítico urêmica atípica associada a comprometimento da função renal: revisão integrativa
Authors: Lima Janielle Ferreira de Brito , Teixeira Etenilde Dias dos Santos , Linhares Laíla Silva , Barros Eremilta Silva , Rolim Isaura Letícia Tavares Palmeira
Published: August 2019

Introdução: a Síndrome Hemolítico Urêmica é uma doença rara e grave que se define pela anemia hemolítica microangiopática não imune, trombocitopenia e insuficiência renal aguda. Objetivo: identificar informações disponíveis na literatura acerca do uso do eculizumab no tratamento da síndrome hemolítico urêmica atípica com comprometimento da função renal associado. Material e métodos: trata-se de uma revisão integrativa realizada nas seguintes bases de dados: Literatura LatinoAmericana e do Caribe em Ciências da Saúde e Medical Literature Analysis and Retrieval System Online. O estudo foi norteado pela seguinte questão: O que há na literatura acerca do uso do eculizumab no tratamento da SHUa com comprometimento da função renal? Para busca de artigos foram utilizados três descritores em português, inglês e espanhol. O recorte temporal foi de 2007 à 2017. Resultados: Inicialmente foram localizados dez artigos e após a aplicação dos critérios de inclusão e exclusão foram selecionados sete deles. Todos os artigos relatam melhora da função renal logo no início da terapia e não há consenso quanto a indicação de descontinuação do uso do eculizumab nesses pacientes, mesmo nos casos onde houve completa remissão da patologia. Conclusão: Ainda são poucos os estudos sobre o uso do eculizumab. Estudos dessa natureza tem relevante contribuição para o avanço da terapia em casos raros como a SHUa, tendo em vista que o uso do anticorpo pode aumentar a sobrevida e melhorar a qualidade de vida de pessoas acometidas com a doença.
Perfil dos pacientes acompanhados pelo SIS-HiperDia em um estado do nordeste brasileiro
Authors: Soeiro Vanessa Moreira da SIlva , Coimbra Liberata Campos , Aquino Dorlene Maria Cardoso de , Goiabeira Yara Nayá Lopes de Andrade , Viana Lucian Da Silva , Ramos Érica Luzia De Abreu
Published: August 2019

Introdução: Atualmente a hipertensão (HAS) e o diabetes (DM) configuram-se como um importante problema de saúde pública internacional, com elevadas morbidade e mortalidade em diversas nações. O maior ônus aos sistemas de saúde do mundo relaciona-se ao conjunto de doenças crônicas não transmissíveis, no qual se insere a hipertensão e o diabetes melittus, implicando em prejuízos para os doentes, suas famílias e para a sociedade. É, portanto, imperioso conhecer as características dos acometidos por essas enfermidades. Objetivo: Caracterizar indivíduos com hipertensão e diabetes mellitus cadastradas no SIS-HiperDia no estado do Maranhão. Material e Métodos: Estudo observacional, descritivo, quantitativo, utilizando dados do SIS-HiperDia de 2002 a 2012. Resultados: As mulheres foram o grupo de maior representatividade dentre os cadastrados, bem como aqueles pertencentes à faixa etária de 60 a 79 anos. Na análise das complicações e fatores de risco, o AVC e o sedentarismo foram, respectivamente, os mais referidos. Conclusão: observou-se maior prevalência de hipertensão e diabetes mellitus entre as mulheres, em idades avançadas. Faz-se necessário implementar ações de saúde que visem assistir essa população alvo, bem como estratégias que auxiliem na redução das complicações e fatores de risco associados a essas doenças crônicas não transmissíveis.
Diagnóstico de esclerose sistêmica em pacientes com hipertensão pulmonar inicialmente considerada idiopática
Authors: Brito Kemps Hostalacio , Bertazzi Glauce Rejane Leonardi , Michelini Lupo Cristiano , Iwamoto Juliana , Perez Borim Mariana , Tamelini Paula
Published: August 2019

Introdução: A Hipertensão Arterial Pulmonar está associada a uma ampla gama de doenças, sendo comum nas doenças do tecido conjuntivo. Porém, um dos maiores desafios diagnósticos em relação à Hipertensão Arterial Pulmonar inclui doenças do tecido conjuntivo clinicamente não identificadas ou tardiamente evidenciadas, principalmente Esclerose Sistêmica. Objetivos: Relatar casos de Hipertensão Arterial Pulmonar secundária à Esclerose Sistêmica que inicialmente foi classificada como Idiopática. Materiais e métodos: Estudo observacional analítico transversal no qual sete pacientes com diagnóstico de Hipertensão Arterial Pulmonar Idiopática foram avaliados quanto ao quadro clínico, exame físico, pesquisa de autoanticorpos e capilaroscopia periungueal na busca de critérios que os classificassem como Esclerose Sistêmica. Resultados: Todos os pacientes preencheram os Critérios Classificatórios para Esclerose Sistêmica ACR/EULAR 2013, sendo que Fenômeno de Raynaud, telangiectasias e positividade de autoanticorpos estiveram presentes em 100% dos casos. A maioria dos pacientes apresentava Esclerose Sistêmica forma cutânea limitada. Conclusões: A determinação do diagnóstico de Hipertensão Arterial Pulmonar secundária à Esclerose Sistêmica é fundamental, pois tais pacientes têm menor sobrevida quando comparados aos casos Idiopáticos. A presença de Fenômeno de Raynaud tem grande relevância no diagnóstico dos pacientes com Hipertensão Arterial Pulmonar associada à Esclerose Sistêmica.
Editorial
Authors: Alonso Orfa Yineth Galvis
Published: August 2019

Neste primeiro número de 2019, a revista Archives of Health Sciences, com diagramação reformulada,  presenta uma nova coleção de dezessete artigos de várias disciplinas da área da saúde. No volume, cujos artigos contam com autores brasileiros de todas as regiões do país, há um foco em estudos originais. Como exemplos desses artigos selecionados pela equipe editorial, podem ser mencionados estudos que indicam a necessidade de reforço e de geração de estratégias para a prevenção de doenças de impacto social e epidemiológico significativos (tais como a sífilis gestacional e congênita1 e hipertensão arterial em crianças2) e estudos com pacientes idosos, um que aponta efeitos benéficos da terapia de Pilates3 e outro que avalia o risco de queda e o medo de cair4. Além desses, é possível encontrar ainda estudos com um foco em metodologia, como a análise de índices prognósticos de sobrevivência, em pacientes queimados, que demonstra a capacidade de discriminação dos mesmos5.
Somados aos estudos acima mencionados, também foram selecionadas revisões da literatura, dentre as quais se encontram um estudo na área da imunologia sobre o sistema do complemento, que descreve um apanhado interessante sobre doenças associadas à deficiência desse sistema6 e outro que mostra o importante efeito de terapias complementares e lúdicas com uso da arte, no cuidado de enfermagem em saúde mental7. Adicionalmente, também foram selecionados relatos de casos, como o de pacientes com hipertensão pulmonar, inicialmente considerada idiopática, apresentando o processo de avaliação e reclassificação do diagnóstico para hipertensão pulmonar secundária a esclerose sistêmica8.
Aproveito para destacar e agradecer o excelente trabalho da equipe de editores e revisores, que ao longo dos últimos meses se dedicaram de forma exaustiva para o sucesso deste volume.
Desejo uma excelente leitura.
STANDARD OF PRMS-SPE: METHODICAL ASPECTS, RESULTING ACCOUNTING AND POSSIBILITY OF APPLICATION TO GEE OF OIL AND GAS SUPPLIES IN UKRAINE
Authors: Rudko G. , Mykhailiv I.
Published: August 2019

The article gives detailed description of PRMS-SPE, as one of the leading international systems for the evaluation of hydrocarbons supplies and resources. Their category and classes are distinguished by the degree of beds studying, expected economic effects from their exploitation and state of present wells. The calculation of gas deposit supplies after the criteria of PRMS – SPE was carried out. The comparison of the results that was conducted with the requirements of minerals supplies and resources Classification of the earth crust state fund was made. This Classification defined methodical principles of calculation, recording, and control of minerals inventories in Ukraine. The calculated volumes of hydrocarbons in the certain measure comparable in general size, howeve, are redistributed in different groups and categories. Reporting on supplies/resources of these two standards cardinally differs, that is determined by differences in approach to the selection of categories and establishment of bordersunder which the calculation of supplies is conducted.
Hyperglycaemia lowering activity and hypoglycaemic risk assessment of Sarenta, an Ivorian traditional herbal remedy
Authors: Irié Geneviève A. N’guessan , Tako Ange A. , Effo Etienne K. , Kouakou Landry S. , Kouakou Gisèle N. Siransy
Published: August 2019

Background: Diabetes remains a major public health problem for which traditional medicine is a better therapeutic alternative for low-income populations, including African populations. The aim of this work was to evaluate the effect of Sarenta, an herbal preparation used in Ivorian traditional medicine as anti-diabetic, on hyperglycaemia and on basic glycaemia.Methods: Hyperglycaemia lowering activity was led in rats receiving glucose at 5 g/kg body weight by gavage after oral pre-treatment with either Sarenta at 125, 206 or 209.5 mg/kg b. wt., either glibenclamide at 10 mg/kg b. wt., or physiological saline solution. Hypoglycaemic risk was assessed by administering the same doses of Sarenta to native i.e. NaCl-treated rats. For both tests, blood glucose was measured before any substance was administered and then every hour for 4 hours.Results: After 4 hours, Sarenta at 206 mg/kg b. wt. and 209.5 mg/kg b. wt. significantly reduced the induced hyperglycaemia in rats by 33.87% and 37.39%, respectively. The degree of the hyperglycaemia lowering effect of the remedy at these two doses was not significantly different from that of glibenclamide. In addition, Sarenta at 209.5 mg/kg b. wt. resulted in a significant reduction of basic blood sugar to 29.78% four hours after administration.Conclusions: The remedy Sarenta has a hyperglycaemia lowering activity that could partially justify its traditional use in the treatment of diabetes. However, considering its hypoglycemic effect, precautions should be taken when using this traditional medicine.
Drug utilization pattern among geriatrics according to anatomical therapeutic chemical and defined daily dose classification in a tertiary care hospital
Authors: Reddy T. Muneswar , Prasad Thammi Setty Durga , Hemalatha Allikesam , Chanukya Vanam , Sirisha Bandi Lakshmi
Published: August 2019

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.
Effect of herbal combination of triphala and garcinia cambogia extracts on anthropometric measurements and lipid profile in high fat diet induced obesity in rats
Authors: A. N. Vijay Kumar , Thawani Vijay
Published: August 2019

Background: Obesity, occurring at epidemic rates globally, is a major risk factor for DM and CVD. Despite advances in understanding its pathogenesis, the pharmacotherapy for obesity remains limited for achievable weight loss, safety and tolerability of the medicines. Almost all approved medications for long term use in obesity treatment result in health issues. Due to the ADRs associated with many antiobesity drugs, the drug trials have focused on screening herbal medicines that are reportedly used in the treatment of obesity and which have minimal side effects.Methods: In this study rats were divided into eight groups of six rats each. In the first approach, the rats were first made obese by feeding HFD for three weeks. In the second, treatment with the herbal extracts was given simultaneously with the HFD to the experimental rats. Rat were fed HFD for six weeks along with treatment of herbal extracts and the effect on their body weight, daily food intake and lipid-profile were evaluated.Results: Results showed that rats fed HFD for a six week period, supplemented with herbal preparations of triphala and G. cambogia presented with significant reduction in body weight, energy intake, and improved the lipid-profile as compared to the rats fed with HFD group.Conclusions: Our findings suggest that triphala and G. cambogia can counter the effects of HFD intake and have the potential for use as antiobesity agents with desirable body weight, food intake, fluid intake, and lipid-profile modulating properties.
Effect of quercetin on histamine induced gastric ulcers in male guinea pigs
Authors: Narayanamurthy Uma , Jayachandran Ranjani , Ramarajan Sudar Codi , Kumarappan Manimekalai
Published: August 2019

Background: Peptic ulcer disease is the most prevalent gastrointestinal diseases caused by an imbalance between gastric stimulant or aggressive factors and the mucosal defensive factors. The defence of flavonoids against the tissue oxidative stress is being proved in various animal models for wide pharmacological effects. The aim of the present study is to evaluate the anti-oxidant effect of quercetin in histamine induced gastric ulcers.Methods: Male guinea pigs were divided into 4 groups (n=6). Group I includes normal control. Group 2, 3 and 4 were induced gastric ulcers with histamine as intraperitoneal (IP) injection. Group 2 serves as the gastric ulcer control. Group 3 and Group 4 are pre-treated with quercetin 200 mg/kg per orally (PO) and ranitidine 100 mg/kg PO respectively 45mins before histamine injection. After 4 hours of histamine injection, the animals were sacrificed to collect blood samples and stomach tissue for estimation of plasma and tissue antioxidant levels.Results: On estimation of antioxidant levels both in plasma and stomach tissues the SOD and CAT levels increased in the Group 3 and 4 significantly and also a significant reduction in MDA levels were noted in the Group 3 and 4 compared to the gastric ulcer control group.Conclusions: Hence, with flavonoids quercetin utilization in histamine induced gastric ulcers, the antioxidants showed comparative levels with ranitidine treatment groups. So a permanent cure for the chronic gastric ulcers could be proved in further studies as this is the milestone, tough to achieve in general clinical practice.
Assessment of Morus alba (mulberry) leaves extract for anti-psychotic effect in rats
Authors: Rayam Sriharsha , Kudagi Babasaheb Laxmansing , Buchineni Madhavulu , Pathapati Rama Mohan , Immidisetty Mallikarjuna Rao
Published: August 2019

Background: Morus alba commonly known as white mulberry has been widely cultivated to feed silkworms. This widely grown plant has been in use by tribals of this country for ailments such as asthma, cough, bronchitis, edema, insomnia, wound healing, diabetes, influenza, eye infections and nose bleeds. Various parts of morus alba linn are used as an cardioprotective, hepatoprotective anti-inflammatory, hypoglycemic, free radical scavenging activity and neuro-protective agent. In this study, anti-psychotic property of M. alba leaves extract (MAE) was evaluated by Haloperidol induced catalepsy model in rats.Methods: In this study Haloperidol induced catalepsy model was used to evaluate antipsychotic effects in rats. Haloperidol (1 mg/kg) was injected intraperitoneally to rats (n=6) pretreated with vehicle (0.5 mg/kg, i.p.) or MAE (100, 200 and 400 mg/kg, i.p).Results: In control treated animals, haloperidol produced the maximum catalepsy at 90 min 212.66 ±10.23. In animals treated with MAE at dose of 100 mg/kg, 200 mg/kg and 400 mg/kg significantly potentiated haloperidol induced catalepsy at each time interval, in a dose dependent manner. At dose 100, 200 and 400 mg/kg, animals treated with MAE showed maximum cataleptic score of 228.33±12.29, 265.66±7.33 and 274.16±8.86 respectively at 120 min (p<0.001).Conclusions: Results indicate that the MAE have anti-psychotic effects in haloperidol induced catalepsy model in rats.
Evaluation of dose dependent analgesic response by extracts of Myristica fragrans on albino wistar rats: an experimental study
Authors: Zaheer Imran , Rahman Syed Ziaur , Khan Rahat Ali , Parveen Mehtab , Sharma Priyamvada
Published: August 2019

Background: The objective of the study was to evaluate analgesic activity of ethanolic extract, methanol and benzene fraction of Myristica fragrans on wistar albino rats.Methods: The present study was carried out in the department of pharmacology JNMC AMU and F.H. Medical College, Agra. The analgesic activity was evaluated by employing the Eddy’s hot plate method and tail flick response method. In both the tests, Rats of either sex weighing 150-200 g were used. The total number of animals n=36 were allocated to six groups. Each group consist of six animals each. The response noted in animals that were tested by hot plate method was reaction time for licking/biting of both the paws before and after administration of control & test drugs. However in Tail flick test, the pain threshold response was recorded before and after administration of control & test drugs. The statistical analysis was done by using one-way ANOVA. The data is expressed as Mean±SEM. P<0.05 was considered to be statistically significant.Results: Ethanolic extracts and methanol fraction of M. fragrans showed statistically significant (p<0.001) increase in reaction time for licking/biting in hot plate method. On the contrary a significant increase in pain threshold was also recorded in tail flick response test. It is interesting to note that no significant degree of analgesia related to any dose of benzene fraction was observed.Conclusions: The present study reveals the dose dependent significant analgesic activity of the extracts of M. fragrans i.e. ethanolic extracts and methanol fraction in both the test. However, the degree of analgesia was recorded significantly higher in groups received higher doses of extracts of M. fragrans.
Assessment of prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators
Authors: Singh Kamaldeep , Bhutani Garima , Rani Seema , Saini Rahul
Published: August 2019

Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.
Antidiabetic activity of Manomani chooranam aqueous extract on female wistar albino rats
Authors: J. V. Sabari Anandh , Kumarappan Manimekalai , Shanmuganathan Padmavathi , Vinayagam Subha , . Iyyankannu , Narayanamurthy Uma
Published: August 2019

Background: The aim of the present study was to evaluate the antidiabetic potential of Manomani chooranam (MMC), an indigenous polyherbal siddha formulation in Streptozotocin (STZ) induced diabetic female Wistar albino rats.Methods: Aqueous extract of MMC was prepared. Wistar albino rats were divided into six groups (n=6). Group 1 was kept as normal control, Group 2, 3, 4, 5 and 6 were induced diabetes. After induction, the group 2 was kept as diabetes control; Group 3 received the standard drug metformin (100 mg/kg), whereas Groups 4, 5 and 6 were treated with the aqueous extract of MMC at 500 mg/kg, 1000 mg/kg and 1250 mg/kg doses, respectively for the 21 days. Blood sugar was estimated at the end of each week. At the end of the study, rats were sacrificed and the pancreas was analyzed for histopathological changes. Data expressed as mean±standard error of the mean. Statistical analysis was done using one-way ANOVA followed by post hoc Tukey's test. p<0.05 considered statistically significant.Results: The groups which received aqueous extract of MMC at 500 mg/kg, 1000 mg/kg and 1250 mg/kg showed a significant decrease in the mean blood sugar level when compared to normal level. The groups which received MMC shows significant reduction in blood sugar level in comparison with standard drug metformin 100 mg/kg.Conclusions: The aqueous extract of MMC was able to decrease the elevated blood sugar levels in dose dependent manner.
Methotrexate induced ventricular arrhythmia as a medication error: a case report
Authors: Shah Shailja S. , Gupta Sapna , Vala Jasvin , Malhotra Supriya D. , Patel Pankaj
Published: August 2019

Methotrexate (MTX) is the most widely used drug in clinical practice for long term treatment of connective tissue disorders. As this drug has narrow therapeutic index, if it goes unmonitored can lead to life threatening complications. Herein we are describing the case of a patient who presented with ventricular arrhythmia, due to failure to execute MTX therapy in the prescribed frequency and took daily dose of MTX which was meant to be taken as a weekly dose pointing to failure of patient education or patient comprehension regarding MTX and finally succumbed due to cardiogenic shock. We concluded this causality as probable/likely category according to WHO-UMC causality categories.
Anti-thrombotic effect of Zingiber officinale (ginger) in sprague dawley rats
Authors: Shadrack Kipyegon , Faraj Alkizim , Alex Muriithi K. , Kenneth Ngure
Published: August 2019

Background: The prevalence of thrombotic diseases is rising globally. Presently, stroke and ischemic heart disease account for 25% of all deaths. Use of anti-thrombotic drugs have proven effective in prevention of these ailments but might not be affordable especially in developing countries. They are also associated with undesirable side effects. This study sought to determine the anti-thrombotic effect of ginger since it is affordable, accessible and is widely used as a food enhancer and a medicinal herb.Methods: The current study employed an in-vivo experimental study design. Three groups Sprague dawley rats (N=5) were given different doses of methanolic extract of ginger for 30 days. Two other groups (N=5) which served as controls received 5% dimethyl sulfoxide and aspirin for the same duration. Measurement of bleeding time, platelet count, prothrombin time, activated partial thromboplastin time and thrombin time was done to assess the anti-thrombotic property.Results: There was a statistically significant difference in bleeding time (P=0.03) across the groups investigated. There was however no significant difference across the groups in platelet count, prothrombin time, activated partial thromboplastin time and thrombin time (P=˃0.05).Conclusion: This study demonstrates that methanolic extract of ginger possesses an anti-thrombotic property probably through inhibition of platelet function. Regular consumption of ginger may therefore confer protection against thrombotic diseases.
Artificial intelligence and dichotomy on benefits and challenges: what do healthcare providers say?
Authors: Singh Bharat , Kashyap Surekha , Grover Ankita
Published: August 2019

Background: In a developing country like India, with a vibrant information technology (IT) sector, employing Artificial Intelligence (AI) should be carefully weighed before its introduction in healthcare with relation to perception of healthcare providers (HCP's/Doctors).  Methods: This qualitative study was conducted in medical college and affiliated hospital in India. Initially a pilot study was conducted for reliability and internal consistency of questionnaire. Thereafter, pre-tested questionnaire was distributed to 153 healthcare providers and their responses were analyzed on SPSS version 20.0 (IBM) to identify the demographic and job-related differences in their perception regarding the benefits and challenges of using AI in healthcare.Results: Most of respondent were agreed upon the benefits of using AI in healthcare and most cited benefits were speedy decision making, better resource utilization and improvement in staff satisfaction. Similarly most cited challenges were lack of training on AI enabled machines, lack of skilled technical support, high cost of AI and data privacy issue. Further, Age and Job experience were significantly associated with benefits like timely and speedy decision making, improvement in the patient and staff satisfaction respectively. Furthermore, Age, Department, Job experience, Job profile were significantly associated with challenges like high cost of AI, lack of skilled technical support, lack of training in AI enabled machines and lack of trust in AI among patients.Conclusions: Significant challenges of using AI in healthcare with demographic and job related variable based on the results of this research paper need to be resolved first in order to overcome the initial resistance in employing AI in healthcare.
Hypertension and Diabetes as a risk factor for dementia: a cross sectional study
Authors: Yahya Arshad , Shamim Robina , Anand Kuljeet S.
Published: August 2019

Background: A relation between possible cardiovascular risk factors (hypertension and diabetes) and dementia has been studied in the past and an association has been documented, in spite of some studies pointing to the contrary. Our purpose is to analyze the relation between these risk factors and dementia and add some information to the existing concept and will try to conceptualize the pathogenesis of dementia.Methods: This was a cross sectional study. Patients were recruited from amongst those presenting to our department by convenient consecutive sampling method after taking consent. Five hundred patients of different types of dementia were enrolled. Hypertension was diagnosed using JNC7 criteria. World health organization (WHO) diagnostic criteria were used to diagnose diabetes mellitus. The open Epi software version 3 was used to find the absolute values after preparing 2×2 table. Continuous quantitative data were analyzed using chi square test. Odds ratio and Risk ratio were also calculated. For all statistical tests, a p Value less than 0.05 was taken to indicate significance.Results: Study provides the strong positive association of hypertension (HTN) and diabetes mellitus (DM) with vascular dementia (VaD) but the relationship of these risk factors were not positively correlated with other dementia. Conclusions: Positive association of these risk factors with vascular dementia were found but not with the other types of dementia.
Study of intranasal midazolam versus intranasal ketamine as a premedication in children undergoing surgical procedures
Authors: Marathe Himanshu , Chhajwani Sunil
Published: August 2019

Background: Usage of premedication in children undergoing surgery is almost imperative and various medications have been used with varying success. The present study was aimed at comparison of intranasal midazolam and intranasal ketamine as a premedication in children by assessing acceptability of the drug by patients, ease at parent separation, level of sedation at the time of induction and facilitation of intravenous cannulation.Methods: In this comparative observational study, 60 eligible participants were randomly divided into two groups of 30 each on the basis of preanaesthetic medication received: those intranasal midazolam group and intranasal ketamine group. At 30 minutes after intranasal dose, sedation, separation from parents and intravenous cannula acceptance was evaluated on four point score scale. Children were constantly observed for occurrence of possible adverse effects and the same were duly noted.Results: The two groups were similar with respect to age, gender and body weight distribution. Twenty four patients (80%) in both ketamine and midazolam groups were observed to become drowsy, while 6 patients (20%) in ketamine group were asleep, compared to 0 patients in midazolam group (p=0.024). Thirteen (43.3%) patients from midazolam group had poor parenteral separation, as compared to 0 patients from ketamine group. And Comparison of intravenous cannula acceptance revealed the acceptance to be good in 26 (86.7%) patients in ketamine group as compared to 10 (33.3%) patients in midazolam group (p<0.001).Conclusions: Ketamine when given in a dose of 5 mg/kg via intranasal route is better than midazolam given in a dose of 0.2mg/kg intranasally, as a premedication in children.
Cystatin C based eGFR - for early detection of diabetic kidney disease
Authors: Shelke Sudarshan N. , Tele Jyoti S.
Published: August 2019

Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria.  50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR  measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.
Association of mood disorder and modifiable life-style risk factors in medical students: a cross-sectional study
Authors: Titoria Reena , Mohandas Anu , Gupta Garima
Published: August 2019

Background: Bipolar disorder is one of the common chronic serious mental illness affecting 7 billion people in the world associated with significant morbidity which goes unrecognized. After extensive literature search, it was found that there is paucity of studies from the Indian setting that have addressed the issue of bipolar disorder.Methods: The present study was carried out to screen for bipolar disorder among medical undergraduate students and its correlates.  Due to non-availability of many studies from India, the proportion of 50% was taken as prevalence to calculate the sample size. With 95% confidence interval and 8% absolute error, a sample size of 126 was calculated using Epi Info. Study tools used were a semi structured questionnaire on socio-demographic profile of participants, Global Physical Activity Questionnaire (GPAQ) and Mood Disorder Questionnaire (MDQ). MDQ is a self-reporting screening instrument for bipolar disorder having a Cronbach’s alpha coefficient of 0.83. Data was analyzed using chi-square test with p value <0.05 considered statistically significant.Results: The study included 87.3% males and 12.7% females with mean age 21.26±1.23 years. Out of 126 participants, 17 (13.5%) were screened positive for bipolar disorder. Factors found to have statistically significant association with bipolar disorder were number of siblings, type of family, migration status of family, living in hostel, body mass index and physical activity of the participant.  Conclusions: The results suggest that medical students constitute a vulnerable group and there are certain risk factors other than academic stressors which predispose a medical student to mental illness.
Unusual complications of hypospadias repair: diagnosis and management
Authors: Saran Rama Kishan , Mirdha Kiran , Saran Sanya , Takhar Rajendra Prasad
Published: August 2019

Background: Epidermal inclusion cyst, smegma stones and urethral calculi of the penis are rare and may result as a late complication of hypospadias repair. This study reported the presentation and management of these late complications.Methods: A prospective observational study included male patients aged more than 6 years of age, who had undergone hypospadias repair 3-15 years back and presented with slow growing, non-tender, mobile, firm to hard swelling. Histopathological and radiographic examination were done and surgery was used for management of epidermal inclusion cyst, urethral calculi and smegma stone. Patients were followed up for one year, postoperatively.Results: Out of 15 patients, two (13.3%), four (26.7%) and nine (60%) patients were diagnosed with smegma stones, epidermal inclusion cyst and urethral calculi, respectively. The median (range) age of patients was 17 (8-30) years. Patients were presented with slow growing, non-tender, mobile swelling measuring from 1 cm x 3 cm to 2 cm x 1.5 cm. The average size of epidermal inclusion cyst, and urethral calculi was 2 cm x 2.5 cm x 1.5 cm, and 2 cm x 3 cm, respectively. Treatment were complete excision of cyst and removal of smegma stones by surgery and urethral calculi by dorsal urethrotomy. All patients had an uneventful postoperative period and were asymptomatic up to one year of follow-up.Conclusion: Results suggest that these complications can be managed with complete excision and surgical removal and care must be taken while performing the hypospadias repair to avoid these unusual late complications in patients.
An evaluation of hyperbaric ropivacaine with magnesium as an adjuvant in lower abdominal surgeries among the north Indian subjects: a double-blind randomized trial
Authors: Saxena Sulekha , Kumar Kuljit , Gupta Rajni , Agrawal Avinash
Published: August 2019

Background: An evaluation of intrathecal hyperbaric ropivacaine without adjuvant and with adjuvant magnesium for lower abdominal surgeries.Methods: This was a prospective, randomized, double-blind study conducted among the patients aged 18 to 60 years planned for lower abdomen surgeries under spinal anaesthesia and ASA grade I or II. Patients were randomly allocated to two groups (30 in each): ropivacaine Group (R group): spinal anesthesia with 3ml of 0.6% hyperbaric ropivacaine (18mg )+ 0.5ml NS. hyperbaric ropivacaine + Magnesium Group (R+M group ):   spinal anesthesia with 3ml of 0.6% hyperbaric ropivacaine (18mg) + 0.5ml magnesium sulphate (50 mg).  All the patients scheduled for operation were given oral tablets ranitidine 150 mg and Alprazolam 0.25mg in the night before surgery.Results: There was no significant difference in the basic characteristics between the groups. The mean HR, MAP and SpO2 in both the groups decreased over the periods as compared to baseline. However, the trend of HR over the periods remains similar in both R and R+M groups. The bromage levels were significantly (p=0.0001) higher among the patients of Group R compared with R+M.  The 2 segment sensory regression (min), Sensory regression S2 (hr), motor recovery (hrs) and long term mobilization after spinal anesthesia were significantly (p=0.0001) lower among the patients of Group R compared with R+M. The complications were lower in Group R+M than R.Conclusions: Magnesium may be more suitable drug in surgeries in which muscle relaxation has greater value in lower abdominal surgeries.
Comparison between the results of proximal femur nail anti-rotation and cemented bipolar hemiarthroplasty in treatment of intertrochanteric fractures in Sanglah Hospital in 2016
Authors: Dusak Wayan Suryanto , Simanjuntak Herryanto Agustriadi , Putra I Gusti Ngurah Paramartha Wijaya
Published: August 2019

Background: Hemiarthroplasty is now being considered as a primary treatment for comminuted unstable type of IT fracture in elderly on the grounds that it allows early mobilization and full weight bearing. Recently popular modality is fourth generation of intramedullary nails like the Proximal Femoral Nails. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure.Methods: A Forty patients, having Intertrochanteric fractures treated with PFNA or cemented BH at our institution between April 2016 and April 2017. The primary outcomes measures were postoperative complication and hip function. The secondary outcome measures were intraoperative blood loss, transfusion rate, surgical time, postoperative haemoglobin and hospital stay.Results: Seventeen patients in PFNA group and 23 patients in BH group were included for analysis. There were no significant differences between the two group regarding to the Harris Hip Score at 6 months follow up. Significant differences were found between PFNA and BH group in comparison of intraoperative blood loss (p < 0.001), length of stay (p = 0.006), surgical time (p < 0.001), postoperative transfusion (p < 0.001), and decrease of hemoglobin (p=0.001).Conclusions: These findings indicate that PFNA has obvious advantages over the BH in treatment of intertrochanteric fractures in case of surgical trauma and postoperative complication.
Health problems in geriatric population of age group ≥70 years in rural Kerala, India: a cross sectional study
Authors: M. Sarin S. , K. Jayasree A.
Published: August 2019

Background: The proportion of elderly population is increasing considerably world over. The health and socio-economic issues of this section is to be considered separately and in depth insights about them is needed for formulating elderly friendly health policy. This study intends toidentify the important health concerns of elderly population above the age group of 70 years in a rural area in North Kerala, India.Methods: It is a community based cross-sectional descriptive study involving all individuals above the age group of 70 years in a randomly selected panchayath ward from rural North Kerala. The data regarding demography, socioeconomic aspects, medical history, access to health care and treatment of chronic illnesses were collected through interview of study participants by a trained health care volunteer using a pre-validated questionnaire.Results: A total of 93 individuals above the age group of 70 years were included in the study out of which 63% were females and 37% males. In the study population 55.9% of the elderly were widowed and 87.1 % were staying along with their children. Almost 75% of the elderly received social welfare pension from government agencies and 14.3% received service pensions. 67.74% of the study population were hypertensive and 35.56% were diabetic. Other health issues included arthritis, coronary artery disease, chronic kidney disease, genito urinary symptoms and cerebrovascular accident.Conclusion:  The study provide valuable insights into the health and social issues of elderly in Kerala and points to the importance of formulating an elderly friendly health policy in the state.