bluuebunny/crossref_metadata_2025 huggingface dataset:
PERBEDAAN CUSTOMER SERVICE EXPERIENCE PADA GENERASI Y DAN GENERASI Z DALAM MELAKUKAN PEMESANAN ONLINE FOOD DELIVERY MELALUI APLIKASI GO-FOOD
Authors: Wijaya Viany Revita , Warouw Grace Irene , Thio Sienny
Published: November 2019

ABSTRAKPenelitian ini bertujuan untuk mengetahui customer service experience dari generasi Y dan generasi Z serta melihat apakah terdapat perbedaan pada dua generasi tersebut dalam melakukan pemesanan online food delivery melalui aplikasi GO-FOOD yang dilihat dari faktor psikologis dan faktor fungsional. Penelitian kuantitatif digunakan dalam penelitian ini dengan menyebarkan kuesioner kepada 145 responden generasi Y dan 128 responden generasi Z di Surabaya. Selanjutnya, data diolah dengan menggunakan analisa statistik deskriptif dan independent sample t-test untuk mengetahui apakah terdapat perbedaan signifikan dari dua generasi tersebut dalam melakukan pemesanan makanan secara online. Hasil penelitian menunjukkan bahwa hanya “trust” dan “value for money” yang merupakan sub-variabel dari faktor psikologis yang memiliki perbedaan yang signifikan antara generasi Y dan Z. Kata Kunci : Customer service experience, generasi Y, generasi Z, online food delivery. DIFFERENCES IN CUSTOMER SERVICE EXPERIENCE BETWEEN GENERATION Y AND GENERATION Z IN ORDERING FOOD SERVICE DELIVERY USING GO-FOOD APPLICATION  ABSTRACTThis research aims to investigate customer service experience of generation Y and generation Z and to examine differences between the two generations in ordering online food delivery using GO-FOOD application from the perspective of psychological dan functionality factor. Quantitative research was employed in this paper by distributing questionnaires to 145 respondents of generation Y and 128 respondents of generation Z in Surabaya. Then, data was processed using descriptive statistics analysis and independent sample t-test in order to investigate whether there is a significance difference between the two generations in ordering online food delivery. The result of this research shows that only “trust” and “value for money” which are sub-variables of psychological factor have significantly difference between generation Y and generation Z.Keywords : Customer service experience, online food delivery, x generation, y generation
DESIGNING CORAL REEF TRANSPLANTATION PROGRAM WITH LOCAL COMMUNITY IN FORM OF MARINE ECOTOURISM TOUR PACKAGE
Authors: Wirakusuma Reiza Miftah , Sukirman Oman , Waliyudin Ridwan Taufik , Putra Rifki Rahmanda
Published: November 2019

ABSTRAKSejak 1990 Pangandaran telah berkembang menjadi salah satu tujuan wisata utama di Jawa Barat yang memfokuskan pengembangannya pada wisata bahari. Perkembangan itu menarik banyak wisatawan dan berdampak pada kondisi ekosistem laut. Terumbu karang secara perlahan dirusak oleh kegiatan wisatawan, limbah plastik dan polusi, sehingga kejernihan air terdegradasi. Program ini dilakukan untuk menganalisis tingkat kerusakan terumbu karang dan kesiapan masyarakat dalam membudidayakan terumbu karang, serta menyediakan pelatihan kepada masyarakat sehingga model transplantasi akan dihasilkan. Subjek dari pelatihan ini adalah komunitas nelayan di Kecamatan Pananjung. Pelatihan disampaikan dalam tahapan: 1) identifikasi kondisi terumbu karang di Perairan Cagar Alam; 2) analisis kesiapan dan kemampuan masyarakat dalam mengembangkan budidaya terumbu karang, dan 3) pelatihan dalam budidaya terumbu karang bagi masyarakat. Sasaran dari kegiatan ini adalah untuk meningkatkan kualitas lingkungan perairan dan meningkatkan pengetahuan masyarakat setempat melalui pelatihan dalam budidaya terumbu karang. Ketika transplantasi siap, masyarakat setempat akan dapat mengembangkan usaha pariwisata mandiri, berdasarkan konservasi dan meningkatkan ekonomi masyarakat, sehingga membantu pemerintah dalam mewujudkan wisata bahari yang berkelanjutan.Kata Kunci: Ekowisata, Transplantasi Terumbu Karang, Wisata Bahari. ABSTRACTSince 1990 Pangandaran has developed into one of the main tourism destination in West Java which focuses its development on Marine Ecotourism. The development drawn high number of tourists and impacted the condition of the marine ecosystems. The coral reefs were slowly being damaged by tourists activities, plastics waste and pollution, thus the clarity of the water was degraded.This Program was conducted to analyze the level of damage to coral reefs and community preparedness in cultivating coral reefs, as well as providing training to the community so that the model of transplantion would be generated. The subjects of this training were fishermen communities in Pananjung Subdistrict. The training was delivered in the stages of: 1) identification of the condition of coral reefs in the Nature Reserve Waters; 2) analysis of community readiness and ability in developing coral reef cultivation, and 3) training in coral reef cultivation for the community. The target of this activity is to improve the quality of the aquatic environment and increase the knowledge of local communities through training in coral reef cultivation. Whenever the transplantation is ready, the local community will be able to develop an independent tourism business, based on water conservation, and improve the economy of the community, thus helping the government in realizing a sustainable marine tourism.Keywords: Coral Reef Transplantation, Ecotourism, Marine tourism.
THE HALAL-NESS HOSPITALITY ON HALAL TOURISM, CASE STUDY OF HALAL RESTAURANT IN BANDUNG, INDONESIA
Authors: Andrianto Tomy
Published: November 2019

ABSTRAK Sejak 2015 Pariwisata Halal di Indonesia terus tumbuh dari ke-6 pada 2015, ke-3 pada 2017 dan tempat pertama pada 2019. Indonesia berfokus pada pengembangan pariwisata halal dengan menargetkan wisatawan Muslim internasional dan domestik termasuk standar sertifikat halal untuk industri restoran . Tujuan utama dari penelitian ini adalah untuk memahami keramahan halal pada implementasi pariwisata halal. Dua tujuan sekunder dari penelitian ini, pertama, untuk mengidentifikasi keramahan halal di restoran halal dan yang kedua untuk memahami persepsi manajemen dan wisatawan lokal tentang sertifikasi halal. Penelitian ini mengamati tiga sampel restoran di Bandung, Indonesia dan mewawancarai manajemen restoran dan wisatawan lokal selama Oktober - Desember 2017. Analisis konten berdasarkan tiga dimensi kualitas layanan yaitu atmosfer, kualitas makanan dan layanan digunakan. Akhirnya, penelitian ini mengungkapkan bahwa manajemen restoran lokal mengabaikan kualitas layanan halal, tetapi dianggap sangat penting untuk manajemen restoran rantai. Pelancong lokal menjelaskan bahwa sertifikat halal tidak penting untuk restoran lokal, tetapi suatu keharusan untuk restoran berantai. Nilai perusahaan dan diferensiasi produk adalah faktor kunci lain dari keramahtamahan halal untuk restoran halal. Keywords: Atmosfir Halal, Halal-ness hospitality, Pengunjung Lokal, Restaurant Halal, Sertifikat Halal.ABSTRACTSince 2015 Halal Tourism In Indonesia continues to grow from 6th in 2015, to 3rd in 2017 and the first place in 2019. Indonesia focuses on developing halal tourism by targeting both international and domestic Muslim traveller including the standardized of the halal certificate for the restaurant Industry. The main aim of this research is to understand the Halal-ness hospitality on the implementation of halal tourism. Two secondary objectives of this research, firstly, to identify the Halal-ness hospitality on halal restaurant and secondly to understand the perception of the management and local traveller about halal certification. This study observes three sample restaurants in Bandung, Indonesia and interviews the restaurant management and local traveller during October – December 2017. Content analysis based on three dimensions of service quality i.e. atmosphere, quality of food and services were used. Finally, this study reveals that the local restaurant management ignored the quality of halal-ness services, but considered highly important for a chain restaurant management. The local traveller describes that halal certificates not crucial for local restaurants, but a must for chain restaurants. Corporates' value and differentiation of products were other key factors of the halal-ness hospitality for halal restaurants. Keywords: Halal Restaurants, Local Travelers, Halal-ness hospitality, Halal Atmosphere, and Halal Certificate
Az állam szerepe a városi terek fogyasztás-központú „újratermelésében”
Authors: Nagy Gábor , Nagy Erika
Published: November 2019

A városi terek fogyasztásközpontú átalakítása, a folyamat szereplői és viszonyrendszereik a társadalmi-térbeli egyenlőtlenségek kritikai megközelítésű kutatásának fontos kérdéskörévé vált az utóbbi két évtizedben. A fogyasztás dinamikus társadalmi viszonyrendszerként történő értelmezéséből kiindulva – amellyel egyszerre ragadható meg a fennálló társadalmi struktúrák működése, kulturális logikája, és az egyén (mint fogyasztó) ezekre adott válasza – az állam piaci szabályozó-ellenőrző szerepét, pontosabban ennek és társadalmi-térbeli egyenlőtlenségeket „termelő” mechanizmusait mutatjuk be a magyarországi (posztszocialista) átmenet és „perifériás” kapitalizmus kontextusában. Koncepciónkban az állam a piaci szereplők közötti viszonyok alakítója szabályozók és intézményi gyakorlatok révén, amelyek lenyomatai az állam működését formáló társadalmi/hatalmi-térbeli viszonyoknak. Az állam fogyasztáshoz kapcsolódó, egyenlőtlenségeket „termelő” szerepe több térbeli léptékben és dimenzióban is megragadható, tanulmányunkban azonban a városi terekben zajló folyamatokra koncentrálunk. Elemzésünk empirikus része győri esettanulmányra épül, amelynek során kvalitatív módszerekkel próbáltuk feltárni a helyi állam és a többi szereplő viszonyát. A tanulmányban a mellett érvelünk, hogy (i) a fogyasztás szervezeti és térbeli kereteit alakító szabályozás alapvetően a városi gazdaságok/terek fogyasztásközpontú átalakítása irányába hatott, az ebben résztvevők körét a piaci szelekcióra „bízva”; ii) az előbbi folyamatok eredményként kialakult koniktusok egyrészt lassan és inkonzisztens módon formálódó állami szabályozás, és a mögötte húzódó, tőke/állam kapcsolatok metszetében, másrészt a központi állam/lokális állam változó viszonyrendszerében értelmezhetők; (iii) a városi terek fogyasztásközpontú átrendeződésében fölfedezhető a (perifériás kapitalizmusra jellemző) függőségi viszonyok bonyolult rendszere, ami a „sikeresnek” tekintett városok helyi szereplőinek mozgásterét is behatárolja.
Design Implications of Model-Generated Urban Data
Authors: Jankovic Ljubomir
Published: November 2019

The staggering complexity of urban environment and long timescales in the causal mechanisms prevent designers to fully understand the implications of their design interventions. In order to investigate these causal mechanisms and provide measurable trends, a model that partially replicates urban complexity has been developed. Using a cellular automata approach to model land use types and markets for products, services, labour and property, the model has enabled numerical experiments to be carried out. The results revealed causal mechanisms and performance metrics obtained in a much shorter timescale than the real-life processes, pointing to a number of design implications for urban environments.
Miejsce kreatywności w Krakowskiej Koncepcji Wychowania Muzycznego
Authors: Kalarus Anna
Published: November 2019

W artykule zostanie przedstawiony dorobek krakowskich naukowców zaangażowanych w poszukiwanie skutecznych metod nauczania muzyki w szkolnictwie ogólnokształcącym. Ośrodek krakowski powstał z inicjatywy Zofii Burowskiej w połowie lat 70. XX wieku. Członkami
zespołu zostali pracownicy akademiccy ówczesnej Wyższej Szkoły Muzycznej i Wyższej Szkoły Pedagogicznej. Przyjęto założenia programowo-metodyczne, których podstawą jest metoda solmizacji relacyjnej, wywodząca się z angielskiej metody Tonic-solfa Johna Curwena oraz koncepcji Zoltána Kodálya. Istotną rolę w Krakowskiej Koncepcji Wychowania Muzycznego pełni kreatywność, która wraz z pozostałymi formami aktywności muzycznej wspomaga
rozwój ogólny i muzyczny dziecka. Przedmiotem, rozważań autorek artykułu są również kwestie weryfikacji skuteczności koncepcji, która nastąpiła w wyniku przeprowadzenia badań empirycznych w szkołach podstawowych. Zebrany materiał badawczy dostarczył wielu spostrzeżeń
istotnych dla zmodyfikowania procesu dydaktyczno-wychowawczego. W podsumowaniu zostaną ujęte również problemy, jakie występują w realizacji koncepcji we współczesnej szkole.
MUZYKA KAROLA SZYMANOWSKIEGO W PERCEPCJI I DZIAŁANIACH TWÓRCZYCH DZIECI NA ETAPIE WCZESNEJ EDUKACJI
Authors: Majzner Rafał
Published: November 2019

Aktywność twórcza dzieci w wieku przedszkolnym i wczesnoszkolnym może przybierać różne formy i być wywoływana za pomocą określonych środków. Wśród czynników pobudzających wyobraźnię, a tym samym inspirujących własną twórczość dzieci, wymienia się między innymi muzykę. W artykule przedstawiono wyniki badań nad percepcją muzyki Karola Szymanowskiego przez dzieci. Analizie poddano ich prace plastyczne i wypowiedzi inspirowane wybranymi utworami kompozytora. przeprowadzone analizy skłaniają do wniosku, że dzieci są otwarte na doświadczenia muzyczne z wykorzystaniem muzyki klasycznej i chętnie podejmują się działań twórczych na bazie słuchanych utworów muzycznych.
TAM I Z POWROTEM – AKTUALNE WALORY POZNAWCZE MUZYKI HIPISOWSKIEJ
Authors: Michalak Marcin
Published: November 2019

Celem artykułu jest przegląd twórczości muzycznej określanej „hipisowską” w kontekście jej współczesnych walorów poznawczych. retrospektywę zespołów, wykonawców i utworów muzycznych poprzedzono krótką charakterystyką amerykańskiego i polskiego
ruchu hipisowskiego z lat 60. i 70. XX wieku. Przeglądu wybranych przykładów twórczości muzycznej z tego okresu dokonano pod kątem ich walorów muzycznych, tekstowych, wizualnych (okładki płyt, występy sceniczne), przywołując także sylwetki twórców oraz tło społeczno-kulturowe epoki. W podsumowaniu podjęto próbę przeniesienia wyodrębnionych walorów muzyki hipisowskiej na grunt edukacyjny z odniesieniami do współczesnej edukacji artystycznej, obywatelskiej, a także – pedagogiki krytycznej czy nauczania do twórczości.
Estetyczny wymiar natury. Perspektywy badawcze
Authors: Żukowska Anna Marta
Published: November 2019

Artykuł traktuje o estetycznym wymiarze natury i jej oddziaływaniu na człowieka. Autorka przybliża pojęcie „natury”, przedstawia charakterystykę postaw wobec niej zajmowanych, ukazuje też zasięg oddziaływania środowiska naturalnego na człowieka. W dalszej części tekstu koncentruje się na percepcji estetycznej natury. W świetle przedstawionych refleksji
zarysowuje perspektywy badawcze dotyczące oddziaływania relacji człowiek – środowisko naturalne na percepcję estetyczną natury.
Animacja kultury lokalnej jako inicjatywa instytucjonalna
Authors: Nycz Edward Janusz
Published: November 2019

Artykuł podejmuje zagadnienie przekształceń we współczesnej kulturze, która odchodzi od tradycyjnych wartości. globalizm i dominacja kultury popularnej mają konsekwencje w preferencjach i zachowaniu mieszkańców społeczności lokalnych. Negatywne aspekty indywidualizmu w kulturze mogą być równoważone poprzez działalność placówek kultury w najbliższym miejscu zamieszkania. W tekście ukazana jest działalność kulturalna
i animacyjna w odbiorze społecznym w niedużej gminie miejsko-wiejskiej. na uwagę zasługuje animowanie i formowanie przez lokalne placówki w pracy kulturalno-oświatowej kapitału
społecznego mieszkańców.
Editor's Note
Authors: M Daniel , Shanahan Daniel
Published: November 2019

No abstract available.
A prospective observational study of prescription pattern in a tertiary care teaching hospital of Jharkhand
Authors: Kumari Abha , Kumar Keshav , Gari Manju , Pallavi Kumari , Choudhury Subhankar
Published: November 2019

Background: Prescription error and irrational prescribing are the avoidable problems imposed on health care delivery system from prescriber side which must be addressed. Periodic prescription audit helps to curtail the error and irrational prescribing.Methods: A prospective observational study was conducted on patients visiting various Outpatient Department of RIMS, Ranchi, Jharkhand on all working days at 11:00 AM to 12:00 PM from 1 August 2018 to 31 July 2019. Various aspects of collected prescriptions were analyzed by using World Health Organization (WHO) prescribing indicators.Results: In this study, out of 700 prescriptions collected, 76 were excluded. Out of total 624 patients analyzed, 382 (61.28%) were male and 242 (38.72%) were female. 48 (7.69%) patients belonged to ≤18, 464 (74.36%) to 19-64 and 112 (17.95%) to ≥65 years of age group. Tablet (71%) was the most common dosage form. None of prescriptions were having registration number of the doctor. 242 (38.78%) prescriptions did not have a diagnosis duly written. The total no. of drugs prescribed in 624 prescriptions was 2176. Only 32 (5.13%) prescriptions were found to have medicines prescribed in block letters. Antibiotics (29%) were the most common class of drugs prescribed. Average number of drugs per prescription was 3.47. Only 48 (2.20%) drugs were prescribed by their generic name while total of injectables prescribed were 102 (4.68%). Total number of drugs from NLEM was 848 (38.97%). 196 (9.00%) drugs were fixed-dose combination.Conclusions: In our study, we found deficiencies in various parts of prescriptions. Prescribing pattern was not in accordance with WHO recommendation for prescribing practice.
A 12 week prospective clinical evidence of empagliflozin efficacy in uncontrolled type 2 diabetes mellitus treated with metformin and a sulfonylurea
Authors: Puli Keerthana , Vanjari Nikhil Kumar
Published: November 2019

Background: The main aim of the study is to evaluate the efficacy of empagliflozin 10 mg once daily over 12 weeks as add-on therapy to metformin plus sulfonylurea in patients with type 2 diabetes mellitus with inadequate glycemic control.Methods: It is a prospective, observational, study conducted in patients of Sri Badhrakali Diabetic Center located in Warangal, Telangana, India. The efficacy of empagliflozin 10 mg was assessed by measuring the change in the glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI) at the baseline and 12 weeks, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and after 24 hours of treatment.Results: In the present study, the addition of empagliflozin to metformin and Sulfonylurea therapy for 12 weeks provided 0.87 % reduction in HbA1c. The mean changes of FPG from baseline to 12-week is -26 mg/dl. At 24 hours empagliflozin significantly reduced blood pressure with mean changes of SBP and DBP -4.147 and -1.526 mmHg respectively. The mean changes in BMI from baseline to week 12 is -0.638 kg/m2.Conclusions: Empagliflozin 10 mg provided ancillary reduction in HbA1c outside of metformin and sulfonylurea. Controlled body weight, HbA1c, blood pressure decreases diabetes progression, decreased risk of diabetic complications and reduced risk for cardiovascular disorders.
Analysis of prescription pattern of antihypertensive medication and adherence to Beers criteria in geriatric department of a tertiary care hospital in Mysuru
Authors: Priyanka C. A. , K. Jayanthi M. , Periera Pratibha , Raj Ranjith
Published: November 2019

Background: The objective of the present study was to evaluate the prescription pattern of anti-hypertensive drugs and adherence to Beers’ criteria in geriatric department of JSS Hospital, Mysuru.Methods: An observational, prospective, cross-sectional study was carried out in geriatric department. The basic demographic information and prescriptions of geriatric patients were studied. Descriptive analysis was used to present the results, prescriptions were analysed and checked for adherence to Beers’ criteria.Results: Out of 485 patients, 82.68% received monotherapy, 15.87% received 2-drug combination therapy and 1.4% received 3-drug combination therapy. Among patients receiving monotherapy, angiotensin receptor blockers (49.06%) was the commonest antihypertensive class of drug prescribed. Telmisartan (38.96%) was the commonest drug prescribed. Among 2-drug combination therapy angiotensin converting enzyme inhibitor and Calcium channel blockers were combined commonly. In 3-drug combination therapy angiotensin converting enzyme inhibitor, beta blockers and diuretics were combined commonly. 99.3% of prescriptions were adhered to 2015 American Geriatrics Society Beers criteria.Conclusions: Almost 82% of the patients were treated with monotherapy. The trends in prescribing of anti-hypertensives were in favor of conventional ones such as Angiotensin receptor blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, diuretics, beta blockers and centrally acting alpha agonists. 99.3% of prescriptions were in accordance with the American Geriatrics Society 2015 Updated Beers criteria.
A pharmacoepidemiological study of prescription patterns of β2 sympathomimetic bronchodilators in exacerbation of non-severe asthma in tertiary care hospitals, not needing hospitalization
Authors: Hazra Moumita
Published: November 2019

Background: Arformoterol, the (R, R) enantiomer of the racemic (R, R / S, S) diastereomer, formoterol, is a short and long acting β2 agonist bronchodilator. Levosalbutamol, the (R, R) enantiomer of racemic diastereomer (R, R / S, S) salbutamol, has a greater affinity for the β2 receptor. Occupation of β2 receptors by agonists result in the activation of the Gs-adenylyl cyclase-cAMP-PKA pathway, followed by phosphorylative events leading to bronchial smooth muscle relaxation. The aim of this pharmacoepidemiological study was to analyse the prescription patterns, and prescription content analysis, of arformoterol, levosalbutamol, formoterol or salbutamol, in non-severe asthma exacerbation in tertiary care hospitals, not needing hospitalization.Methods: It was a multi-centre, retrospective, observational and analytical study of 100 asthmatic patients’ hospital medical records, treated with 3 doses of arformoterol, levosalbutamol, formoterol or salbutamol nebulization, followed by peak expiratory flow rates (PEFR) measurement at the baseline and 6 minutes, after each dose; along with adverse effects recording. The number of prescriptions of 100 patients was recorded, the percentage of prescriptions was calculated, and the prescription content analysis was done.Results: PEFR of the patients showed significant increase after the first, second and third doses of bronchodilator nebulisation, with negligible adverse effects. Salbutamol was most commonly prescribed (45 prescriptions, 45%), followed by levosalbutamol (35 prescriptions, 35%), formoterol (15 prescriptions, 15%) and arformoterol (5 prescriptions, 5%). All aspects of prescription content analysis showed 100% completeness.Conclusions: Arformoterol was more effective, but equally safe, as compared to levosalbutamol, formoterol and salbutamol. Prescription frequency of salbutamol was followed by levosalbutamol, formoterol and arformoterol. Prescription content analyses showed 100% completeness.
Pattern of drug use among the geriatric patients: a prospective, observational and hospital based study
Authors: Jonnalagadda Ramya , Kumar Ajay
Published: November 2019

Background: The world’s population continues to grow at an unprecedented rate. With the advances in medical therapeutics have contributed to health gains and increase in life expectancy. So strategies to improve prescribing are essential so as to ensure that the medications available to manage concurrent disease states are prescribed appropriately. This study is undertaken to identify patterns of drug use in treating elderly patients and assessment of polypharmacy among the geriatric age group.Methods: The study was approved by institutional ethics committee of Rangaraya Medical College, Kakinada. The study was conducted as a hospital based study in different departments in Government General Hospital during period from January 2016 to December 2016 at Government General Hospital with a total of 549 patients among outpatient and inpatients.Results: Polypharmacy is unfortunately very common in India and some other countries. In the present study average number of drugs prescribed per patient was 4.66.Conclusions: With ever increasing therapeutic options, escalating proportions of older people worldwide, the prescription pattern among them matters a lot. Also as this group of patients are vulnerable, taking necessary care and reviewing the past drug history will have a major role and increase the betterment of the geriatric age group.
Audit of prescriptions from the department of general medicine based on the WHO core prescribing indicators at Sapthagiri hospital, Bangalore
Authors: K. Navya Teja , Hazra Piyali , Padma L.
Published: November 2019

Background: As medical students start their clinical training, more effort goes in the direction of proper diagnosis and appropriate methods of treatment, leading to improper training in prescription writing causing prescription errors. Physicians should also be encouraged to prescribe unbranded generic medicines which are available at a cheaper price with a comparable bioavailability of drugs and not have a misconception of being less efficacious.Methods: A cross-sectional observational study was carried out over a period of 2 months (September to October 2018). Around 256 prescriptions were randomly collected from general medicine out-patient department. Informed consent was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics and compared with the derived standard values for WHO prescribing indicators.Results: The analyzed data showed an average of 2.23±1.03 drugs per prescription. 23% of the prescriptions had at least one drug prescribed by generic name, 25% of prescriptions contained an antibiotic and 31% of prescriptions had an injection. The percentage of drugs prescribed from NLEM (National list of Essential Medicines) was only 57% as compared to the recommended 100%. Additional only 22.4% of the total number of FDCs prescribed were from NLEM.Conclusions: The average number of drugs per prescription was slightly high, indicating polypharmacy. Brand name prescribing dominates as doctors are still reluctant to use generic names being doubtful of the efficacy. Regular prescription audit with reporting might help to bring awareness among doctors to follow the recommended guidelines and minimize prescription errors.
Contraceptive practices and awareness: a survey among nursing staff at a tertiary care hospital
Authors: Kumari Snigdha , Dhingra Mansi , Ahmed Syed Nawaz
Published: November 2019

Background: India is the second most populous country in the world next to China. Increasing the contraceptive awareness and practice and proper implementation of family planning services are the major tool for improving the health of the population along with stabilizing it. Knowledge and contraceptive practice in the Nursing personnel can positively or negatively influence the population coming in contact with them. Objective of this study was to investigate the knowledge and practice of contraceptive methods among the nursing staff at a tertiary care set up.Methods: Tertiary care set up, cross sectional study. This was a cross sectional study conducted over a period of three months. Fifty staff nurses under the age of 49 years were interviewed through a pre-designed questionnaire regarding knowledge and use of contraceptive methods.Results: Contraception was practiced in 88 percent of the staff nurses. Barrier method of contraception was the most commonly used form of contraception. Permanent method of contraception was opted in 14 percent of cases. Fifty-seven percent of the females were aware of emergency contraception. Twenty-eight percent of females had used emergency contraception in the past.Conclusions: A high percentage of nursing staff was practicing some form of contraception; however, the use of permanent methods and hormonal methods remains low. Only half of study population was aware of post coital methods of contraception with only 28 percent having used it in the past.
Study of fetomaternal outcome in twin pregnancy
Authors: Rami Bijal D. , Kaul Somika
Published: November 2019

Background: Twin pregnancy being one of the causes of high-risk pregnancy is associated with both maternal and fetal complications. This study aims at analysing the fetal and maternal outcome in such cases. All cases were studied according to their parity, maternal age, fetal presentation, mode of delivery and gestational age.Methods: This prospective study was conducted at one of the tertiary care teaching institutes over a period of one year from January 2018 to December 2018. Out of a total number of 7295 deliveries, 130 were twin pregnancy. It included all women admitted in labour room with clinical or ultrasound diagnosis of twin pregnancy after 20 weeks of gestation.Results: In the present study incidence of twin pregnancy was 1.78%. We observed the highest incidence of twins in the age group of 20-29 years. The least incidence was below the age of 20 years. Incidence of twin pregnancy in our study in primipara was 47.7% and in multipara was 52.3%. Most of the patients (43%) delivered at 32-36 weeks of gestation. Maternal complications were noticed as anemia in 29.2% patients, pregnancy induced hypertension in 55.4% patients, post-partum hemorrhage in 4.6% patients, polyhydramnios in 3.1% patients, premature rupture of membranes in 8.5% patients, gestational diabetes in 0.8% patients and urinary tract infection in 2.3% patients. Majority of the patients delivered vaginally (60.8%), others by lower segment cesarean section (LSCS). In this study 95.8% babies were low birth weight. There were 34 neonatal deaths (13%).Conclusions: Twin pregnancy is a high-risk pregnancy associated with significantly increased maternal morbidity, neonatal morbidity and mortality. Such pregnancies require good antenatal care, early detection of maternal and fetal complications and timely referral to a centre well equipped for management of such cases.
The effect of caffeine ingestion in prevention of post-operative ileus after caesarean section: a randomized controlled trial
Authors: Nadim Amr A. , Ghanem Reda M. , Benyamine Madonna G. , Abdallah Fady N. , Abbas Ahmed M.
Published: November 2019

Background: Caesarian section (CS) has become more prevalent than the vaginal delivery in Egypt. Many complications could occur after an abdominal surgery. One of the commonest but yet serious complications is the postoperative ileus that can possibly be prevented by caffeine ingestion. The aim of the study is to assess the value of caffeine ingestion in promoting intestinal motility and prevention of postoperative ileus after CS.Methods: This is a randomized controlled trial that was conducted on 560 cases who were recruited from emergency unit and inpatient wards in Ain Shams University maternity hospital. The patients were divided into two groups where the intervention group received caffeinated coffee while the other group received decaffeinated coffee.Results: There was statistically significant difference between the two groups regarding the bowel function after CS (p <0.05). The intervention group had improved intestinal functions after the CS. Patients from the intervention group had audible intestinal sound sooner than the control group. In addition, they passed flatus and were able to tolerate food in less time.Conclusions: Consuming caffeinated coffee after CS contributes significantly to faster restoration of intestinal function. Coffee is a popular drink and can be used to decrease the incidence of postoperative ileus-related complications.
A prospective study of endometriosis and its outcome at tertiary care centre
Authors: Ninama Shilpa , Rami Bijal D.
Published: November 2019

Background: This study was conducted to detect various presenting clinical features, type and severity of pelvic endometriosis according to revised American fertility society classification. Objective of this study was to assess outcome of endometriosis after medical and surgical treatment in form of pregnancy, reduction of symptoms like dysmenorrhoea, dyspareunia and others.Methods: This prospective study conducted at one of tertiary care teaching institutes for period of 3 years from January 2011 to December 2013. A total number of 100 patients of pelvic endometriosis were examined and divided according to Revised American Fertility Society Classification on bases of severity, type and clinical features and laparoscopic findings. After 1 year of follow up, outcome assessed after completion of medical and surgical treatment in form of pregnancy, reduction of dysmenorrhoea and dyspareunia and other symptoms.Results: This study showed most affected patients (46%) belongs to 26-30 years of age group, dysmenorrhoea was the most common presenting symptoms in 76% patients. Most common site affected (52%) was ovaries. Laparoscopy was done in 86% patients. Most patients (44%) were benefited with fulguration of endometriotic nodules. 62% of patients were given oral contraceptive pills or progesterone pills after definitive surgery as freely available in Governmental setup and fewer side effects as compared to Danazol and GnRH analogues. 40 patients became pregnant after medical and surgical treatment, where 60 patients had reduced dysmenorrhoea and 20 patients had reduced dyspareunia.Conclusions: Laparoscopy is gold standard diagnostic as well as therapeutic tool in pelvic endometriosis as it can rule out other causes of infertility without interfering normal anatomy.
A study on patterns of needle - stick injuries among gynaecologic and general surgeons in open surgery
Authors: Chadha Abhinav , Verma Ashok , . Sapna
Published: November 2019

Background: An estimated 3,84,000 percutaneous injuries are reported by HCW in hospitals in the United States each year, placing them at risk of exposure to HIV, HBV, or HCV. Suture needles have been identified as the most frequent cause of injury. They are involved in as many as 44% of such injuries. This study is designed to note the NSI in major gynaecological procedures and surgical procedures using conventional method (CM) versus (VS) use of HK.Methods: Study was conducted over a period of 12 months from January 2017 to December 2017. 60 patients were included in this study and were divided into 2 groups A and B with 30 patients in each group. Group A was major surgery performed by conventional method; Group B was major surgery performed by using harmonic knife. NSI in two groups were studied and analyzed.Results: Most of the operated patients were between 41-50 years age group. 16.6% procedures were emergency and 83.3% were elective. NSI in conventional surgery was 63.3% in the surgeon and 33.3% with harmonic knife. There were 13.3% NSI in first assistant in conventional surgery and 23.3% in harmonic scalpel group. No such injuries were reported by second assistant in either group. Injuries were more in non-dominant hand in either groups in the surgeon and first assistant.Conclusions: It is concluded that NSI are common in surgeons and first assistant. Such injuries are more in non-dominant hand and in procedures where there is little exposure like vaginal hysterectomy. Use of innovative technologies like harmonic scalpel may be useful.
Value of p53 and estrogen receptors immunohistochemical staining in endometrial carcinoma
Authors: Opric Dejan , Suskic Amer , Suskic Sanela Halilovic , Nikolic Gorana , Filipovic Isidora
Published: November 2019

Background: Since there are many articles dealing with estimating prognostic and diagnostic value of ER and p53, using different, usually complex ICH interpretation methods, we wanted to evaluate significance of p53 and ER ICH positivity in endometrial carcinoma, using easily applicable criteria that would help pathologists and clinicians to be sure in ICH findings noted in the report.Methods: This paper deals with data of the patients treated for endometrial carcinoma in Public Hospitals in Travnik, gynecological department in the period from 1st January 2013 to 1st January 2019. The study included 97 women with endometrial carcinoma, with ages ranging from 42 to 90 years (mean of 64 years). Sample consisted of 72 cases (74.2%) of endometrioid and 25 cases (25.8%) of non-endometrioid carcinoma.Results: p53 expression was observed in 13.8% carcinomas of the endometrioid type and in 68% carcinomas of non-endometrioid type, while estrogen receptors were more frequently observed in tumors of the endometrioid type (61%) in contrast to non-endometrioid type (28%). Among 72 cases, those with grade I expressed estrogen receptors (26 out of 34 cases - 72%) more frequently than those with grades II and III. Frequency of p53 positivity was significantly higher at higher grades (grade I - 5.8%, grade II - 11.5%, grade III - 71.4%). Stage I carcinomas showed p53 staining less frequently (22.2%) that carcinomas diagnosed at later stages (31.5%).Conclusions: Using 80% nuclei stained as threshold for p53 positivity, we concluded that p53 is marker of high-grade endometrial carcinomas: high grade endometrioid and non-endometrioid carcinomas. Using 1% of cells as threshold for ER positivity, we confirmed that ER are common in endometrioid type carcinoma, in contrast to non-endometrioid type. Although observed, higher frequency of ER in tumors with lower grade and stage was not statistically confirmed in our study population.
A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery
Authors: Thakur Jitender , Gupta Bharti , Gupta Amit , Verma Ravinder Kumar , Verma Anita , Shah Payal
Published: November 2019

Background: Caesarean section is most frequently performed surgery worldwide. Patients experience moderate to severe pain in the first 48 hours post-operatively. Aim of this study was to evaluate the efficacy of dexmedetomidine and dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block for postoperative analgesia in patients of caesarean section.Methods: A total 120 ASA I and II patients undergoing elective and emergency caesarean section under subarachnoid block were randomly divided into three groups B, BDM, BDX to receive bupivacaine alone or dexmedetomidine or dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block. Postoperatively, the patients were evaluated for pain level at rest and on movement with a 10 cm visual analog scale (VAS) pain score (0 = no pain and 10 = worst pain), time to demand of first analgesic request, number of analgesic requirements, nausea or vomiting, sedation and patient satisfaction at 0 hours and at 2, 4, 6, 12, 18, and 24 hours.Results: VAS score was significantly higher in group B in comparison to BDM and BDX, and higher in BDX in comparison to group BDM. Mean duration of analgesia was significantly higher in group BDM in comparison to group B and BDX. Total number of rescue analgesic demands were significantly lower in group BDM in comparison to group B and BDX. Sedation score and satisfaction score was higher in group BDM as compared to group B and BDX.Conclusions: Addition of dexmedetomidine and dexamethasone as an adjunct to bupivacaine reduces postoperative pain, prolongs analgesia, decreases demand for additional analgesics and provides better maternal satisfaction as compared to plain bupivacaine group in TAP block in patients undergoing caesarean section under subarachnoid block. Among dexmedetomidine and dexamethasone, dexmedetomidine had prolonged analgesia as compared to dexamethasone group.
Ormeloxifene versus combined oral contraceptive pills to control blood loss in cases of dysfunctional uterine bleeding
Authors: Gupta Ankita , Raj Rishika
Published: November 2019

Background: Dysfunctional uterine bleeding is one of the most often encountered gynecologic problems causing anemia, reduced quality of life and unnecessary hysterectomies. A prospective study was conducted on women with DUB to study the effect of ormeloxifene versus combined oral contraceptive pills in controlling blood loss in them.Methods: 100 Women with DUB were enrolled randomly in three groups. After baseline assessment each patient in group A was treated with iron tablets, containing 100 mg elemental iron and folic acid 1.5 mg, for three months and were termed as control group. Group B patients were treated with ormeloxifene in dose of 60 mg twice a week for twelve weeks. Group C patients were treated with combined oral contraceptive pills for twenty- one days starting from third day of their LMP. The treatment was continued for three consecutive cycles. The efficacy of the studied drugs was analyzed by comparing the baseline and post treatment PBAC score, haemoglobin level and endometrial thickness, using appropriate statistical tests.Results: Ormeloxifene was more effective than only iron or combined oral contraceptive therapy in controlling menstrual blood loss (79.11% versus 58.57%). There was a reduction in endometrial thickness in group receiving ormeloxifene as well as in the group receiving combined oral contraceptive pills (p=0.486), however this was statistically not significant.Conclusions: Ormeloxifene was significantly better than combined OCP in reduction of menstrual blood flow in cases of DUB. It has better compliance and marked improvement in subjective symptoms as compared to OCP.
Study of the sexual and reproductive health of young women with visual impairment
Authors: Joshi Prajakta Ganesh , Joshi Ganesh Arun
Published: November 2019

Background: Census figures in 2011 have depicted that half of the visually impaired in India are women and a third of these females are in reproductive age group. This study was undertaken to identify the gynaecological health problems of the visually impaired young women and impart them necessary health education.Methods: All young visually impaired women attending composite regional centre for persons with disabilities, Bhopal during one day were offered consultation by gynecologist. Their needs and clinical findings were recorded.Results: There were 15 young women in the age range of 19 to 27 years participating in the study. This was their first ever visit to gynecologist. More than half of them reported that menstrual hygiene was taught to them by their mother, a third by peers, and one participant each reported that sister, aunt, and teacher helped them learn it. The cramping pain and warmth of discharge per vaginum helped them identify the onset of menses. Primary dysmenorrhea was the commonest complaint for which they relied on rest and over the counter available medicine.Conclusions: This study highlights the need of the inclusion of the visually impaired girls in adolescent reproductive and sexual health education with appropriate teaching learning material. Access to a gynecologist for the visually impaired shall be ensured through camps on regular basis and referral on individual need basis.
Role of hysterolaparoscopy in the evaluation of female infertility in a tertiary care centre
Authors: Parihar Bharti Choudhary , Gowri S.
Published: November 2019

Background: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. Inability to conceive bears a social stigma which causes societal repercussion and personal suffering. The advent of hysterolaparoscopy have redefined the evaluation and treatment of infertile women. Study aimed to assess the role of hysterolaparoscopy in the evaluation of female infertility.Methods: This prospective observational study was done in the department of obstetrics and gynaecology, Gandhi Medical College, Sultania Zanana Hospital, Bhopal, during the period between 1st December 2016 to 30th November 2017. 104 infertile patients either with primary or secondary infertility were included after thorough evaluation.Results: Out of 104 infertile patients, 82(78.8%) women had primary infertility and rest 22(21.1%) women had secondary infertility. In primary infertility group, most common laparoscopic finding was PCOD in 24(29%) women and in secondary infertility group, tubal blockage was seen in 9(40%) women. The most common pathology seen in hysteroscopy was submucous fibroid in 6(7.3%) women with primary infertility, whereas in secondary infertility group, synechiae was found in 2(9%) patients and septum was seen in 1(4.5%) patient. Out of 104 patients, 33 (31.7%) patients underwent various interventions. The most common intervention was ovarian drilling for PCOS in 21(63.3%) patients followed by hysteroscopic cannulation in 5(15.5%) patients.Conclusions: Hysterolaparoscopy is a very useful tool that can detect various structural abnormalities in multiple sites like uterus, tubes, ovaries and peritoneal cavity in the same sitting. When done by experienced hands and proper selection of patients, hysterolaparoscopy can be considered as a definitive investigative procedure for evaluation of female infertility.
Sublingual versus vaginal use of Misoprostol for induction of labor
Authors: Bansal Mamta , Sharma Indu , Lagoo Jyoti , Jadhav Harish
Published: November 2019

Background: Induction of labor is one of the great challenges for obstetric care provider. Misoprostol is used for induction of labor by various routes with the advantages in being cheap and stable at room temperature and widely available even in resource-poor settings.Methods: A randomized controlled study was conducted in the obstetrics and gynecology department of Govt. Medical College and associated Maharani Hospital, Bastar, Chhattisgarh, India over a period of 1.75 years from September 2014 to May 2016. Study has comprised of 200 pregnant women admitted in the department for induction of labor fulfilling the inclusion and exclusion criteria. Data was collected and analyzed by SPSS 16.0. z-test and chi-square test to compare the safety and efficacy of both the routes of misoprostol use for IOL.Results: There were insignificant differences in number of doses required for induction with satisfactory maternal and neonatal outcome but shorter (12 hours) induction delivery interval with sublingual Misoprostol induction. Most of the cases of both the groups were delivered by vaginal route (86% and 62%) within 12 hours of induction(58% and 42%) yet significant (p value < 0.001) number of cases had undergone caesarean in group of vaginal misoprostol administration (29%) with major indications of meconium stained liquor (3% and 12%) and non assuring fetal heart rate (1% and 10%).Conclusions: Although both the routes of induction by Misoprostol are well tolerated by the women with satisfactory neonatal outcome, sublingual Misoprostol has an added advantage of quicker delivery, less caesarean and ease of administration indicates better safety and effectiveness.