bluuebunny/crossref_metadata_2025 huggingface dataset:
Marine bacteria from the Gulf of California with antimicrofouling activity against colonizing bacteria and microalgae
Authors: Sánchez-Rodríguez Diana Elizabeth , Ortiz-Aguirre Ismael , Aguila-Ramírez Ruth Noemí , Rico-Virgen Erika Guadalupe , González-Acosta Bárbara , Hellio Claire
Published: October 2018

One way of reducing the input of pollutants into the marine environment is to enforce the use of non-toxic antifouling paints in marine protected areas. Thus, the purpose of this study was to detect marine microorganisms that secrete inhibitory substances against bacteria and microalgae to avoid biofouling on man-made structures in La Paz bay, B.C.S., Mexico. The inhibitory potential of 125 bacteria was evaluated against biofilm-forming bacteria. Crude extracts were obtained with methanol and ethyl acetate from 16 bacterial strains that exhibited antagonistic and antibacterial activity in a preliminary screening. Antibacterial and antimicroalgal assays were performed using crude extracts, the minimum inhibitory concentration (MIC) was determined. The highest activity against bacteria and microalgae was found in two strains, Shewanella algae and Staphylococcus sp. The results of this study suggest that extracts of bacteria from the Gulf of California with antimicrobial properties against biofilm-forming bacteria can also prevent the adhesion of microalgae, which may control the development of biofilm formation and, as a consequence, biofouling.
Subnicho etario y aspectos de la biología reproductiva de Parachondria neglectus (Littorinimorpha: Annulariidae) en Manzanillo, Cuba
Authors: Sariego Frómeta Sandra , Sariego Tamayo Orlando Ramón , Marin Morán Jorge Erick , Lopes de Simone Luiz Ricardo
Published: October 2018

In the present research, the temporal dynamics of age-related subniche and some aspects of the reproductive biology of a Parachondria neglectus population, located in Manzanillo-Granma-Cuba, were characterized. Thirty expeditions were performed from December 2013 to February 2015. The comparisons between the length (t = 8.05, P = 0.007) and biggest diameter (t = 6.24, P = 0.0001) of the shells of truncated juveniles and the shells of full juveniles showed significant statistical differences, indicating that both groups represent two kinds of different ages. The comparison between the biggest diameter of the shells of truncated adults and the shells of full adults (t = 1.50, P = 0.16) showed that both groups represent the same kind of age in the population. The existence of significant statistical differences between the length (t = 19.45, P = 0.0003) and the biggest diameter (t = 13.19, P = 0.006) of the females’ shells and the males’ shells verify the sexual dimorphism in the species, proving to be the females of bigger dimensions in relation to the males. The whitish circular spot in the shells is a valid external morphological characteristic to differentiate the adult females already mated in previous occasions from the rest of the members of the population. The reproductive period was from July to December 2014. Copulations were observed from July to October 2014 and they were associated to conditions of abundant precipitations and high temperatures of summer. The recruitment period took place from September to December 2014.
Population structure and reproductive cycle of the commercial sea cucumber Holothuria mexicana in Belize
Authors: Rogers Arlenie , Hamel Jean-François , Mercier Annie
Published: October 2018

The population and reproductive biology of the commercial sea cucumber Holothuria mexicana (Ludwig, 1875) was studied in Southern Belize (Caribbean Sea), including the sex ratio, size at sexual maturity and reproductive cycle, as well as the size structure among habitats located inside and outside protected areas. Individuals found inside marine protected areas were consistently larger than individuals found outside these boundaries. The male:female sex ratio was 1.1:1.0 with a unimodal size distribution composed mainly of sexually mature individuals (87 %). Size at sexual maturity was established to be ~10 cm based on measures of gamogenetically mature individuals during the peak of the gametogenic maturity period. Juveniles and small adults measuring ≤ 15 cm (13 %), were collected exclusively in sandy and muddy areas of seagrass habitats associated with mangroves. Larger adults were commonly found on hard substrates in both seagrass-associated and coral-reef-associated habitats. Based on histology and gonad indices, the first sign of early gametogenesis was detected in August in both sexes. Gametes developed and matured throughout the colder months between November and February. Decreases in gonad index in both years suggest annual spawning, starting in March-April 2014 (single major event) and March-April and July-August 2015 (two smaller events) for both males and females. The spawning periods were correlated with warmer or increasing temperatures, low rainfall and increasing or high chlorophyll-a concentrations. These data will hopefully guide management and protection of the natural populations of H. mexicana, which are already suffering from overfishing in Belize and neighboring countries.
‘Something that stretches during sex’
Authors: Milles Karin , Holmdahl Jessica , Melander Ida , Fugl-Meyer Kerstin
Published: October 2018

Although there is no scientific proof of a breakable membrane in the vagina, virginity controls are causing great suffering to women worldwide, and hymen (re) constructions are carried out in many countries. The hymen is called mödomshinna 'virginity membrane' in Swedish, which can reinforce the idea of a breakable membrane. In their work against female sexual oppression the Swedish Association for Sexuality Education launched a new term, vaginal corona. The aim of our study is to evaluate this initiative. By conducting a survey directed at youths and health professionals at youth clinics in Stockholm, we were able to show that knowledge of the new word had spread and that changes in the oppressive cultural beliefs connected to virginity and female sexuality in part can be connected to the word. The study thus supports the claim that initiatives aimed at changing vocabulary can be effective in changing cultural concepts. Feminist language activism initiatives are thus usable as part of feminist political work to promote women’s sexual rights and gender equality.
A Phase Ib, Open-Label Study of Dalantercept, an Activin Receptor-Like Kinase 1 Ligand Trap, plus Sorafenib in Advanced Hepatocellular Carcinoma
Authors: Abou-Alfa Ghassan K. , Miksad Rebecca A. , Tejani Mohamedtaki A. , Williamson Stephen , Gutierrez Martin E. , Olowokure Olugbenga O. , Sharma Manish R. , El Dika Imane , Sherman Matthew L. , Pandya Shuchi S.
Published: October 2018

Lessons Learned

Patients with hepatocellular carcinoma (HCC) often have limited therapeutic responses to the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor sorafenib, which is standard of care in advanced HCC. Targeting the activin receptor-like kinase 1 (ALK1) and VEGF pathways simultaneously by combining the ALK1 ligand trap dalantercept with sorafenib may result in more effective angiogenic blockade and delay tumor progression in patients with advanced HCC. Although the combination was generally well tolerated, there was no additive antitumor activity with the combination of dalantercept plus sorafenib in patients with advanced HCC. No complete or partial responses were observed, and overall survival ranged from 1.9 to 23.3 months. These results suggest that, in this patient population, further development of the possible limited benefits of combination therapy with dalantercept plus sorafenib is not warranted.

Background

Targeting the activin receptor-like kinase 1 (ALK1) and vascular endothelial growth factor (VEGF) pathways may result in more effective angiogenic blockade in patients with hepatocellular carcinoma (HCC).

Methods

In this phase Ib study, patients with advanced HCC were enrolled to dose-escalation cohorts, starting at 0.6 mg/kg dalantercept subcutaneously every 3 weeks plus 400 mg sorafenib orally once daily, or to a dose expansion cohort. The primary objective was to determine the safety and tolerability and the dalantercept maximum tolerated dose (MTD) level. Secondary objectives were to assess the preliminary activity and the association of pharmacodynamic biomarkers with tumor response.

Results

A total of 21 patients were enrolled in the study. Five patients received 0.6 mg/kg dalantercept in the first dose escalation cohort. Based on the initial safety results, the dose level was de-escalated to 0.4 mg/kg in the second cohort (n = 6). The MTD was identified as 0.4 mg/kg and used for the dose expansion cohort (n = 10). At this dose level, the combination was generally well tolerated. Overall survival ranged from 1.9 to 23.3 months, and the best overall response was stable disease.

Conclusion

The addition of dalantercept to sorafenib did not improve antitumor activity in patients with HCC. The dalantercept program in this population was discontinued.
Effects of fly ash on Portland limestone cement under sulfate attack at low temperature
Authors: Wu Meng , Zhang Yunsheng , Ji Yongsheng , Liu Guojian , She Wei , Yang Lin , Sun Wei
Published: October 2018

The effects of type-F fly ash (FA) on the performance of Portland limestone cement (PLC) under sodium sulfate or magnesium sulfate attack at 5°C were evaluated. The degree of damage to the ternary blended cement exposed to 5 wt% sulfate solutions was assessed based on the evolution of the blended cement's appearance, compressive strength and volume. The sulfate product compositions from the blended cement under sulfate attack were analysed by Fourier transform infrared spectroscopy and quantitative X-ray powder diffraction. The results indicated that the PLC containing 40 wt% type-F FA was more resistant to sulfate attack than the control specimen without FA with similar mechanical properties, which was tested at a low temperature. The PLC containing 20 wt% type-F FA showed few effects in terms of improved resistance to sulfate attack. Analysis suggested that active aluminium in the FA glassy phase weakened the blended cement's resistance to sulfate attack because more ettringite was easily formed during the attack, which might accelerate thaumasite formation by means of the woodfordite route at low temperature. Therefore, the effects of type-F FA containing high contents of aluminium phase on the sulfate attack of PLC at low temperature need to be carefully evaluated and studied.
Bazı nohut çeşit ve hatlarının verim ve verim unsurları bakımından değerlendirilmesi
Authors: GÜNGÖR Hüseyin , DUMLUPINAR Ziya
Published: October 2018

Bu araştırma 2015-2016 yetiştirme sezonunda,
Kırklareli-Lüleburgaz koşullarında, 36 adet hat ve 24 adet standart çeşit
kullanılarak, Augmented deneme desenine göre yürütülmüştür. İncelenen bütün
özellikler yönünden genotipler arasındaki farklılıklar önemli bulunmuştur.
Ortalama tane verimi standart çeşitlerde 107.8 kg da-1,
hatlarda 150.3 kg da-1 olmuştur. Standart çeşitler
arasında en yüksek tane verimi 160 kg da-1 ile Azkan
çeşidinden, en düşük tane verimi 56.4 kg da-1 ile Akçin 91
çeşidinden elde edilmiştir. SMN 13 hattı en yüksek (254.2 kg da-1)
tane verimine sahip olmuş, en fazla tane verimi sağlayan standart Azkan
çeşidinden %58 daha fazla tane verimi sağlamış ve yöre koşulları için ümitvar
bulunmuştur. Yüz tane ağırlığı yönünden SMN 02 (45.3 g), bitkide tane
sayısı yönünden SMN 13 (45.3 adet bitki-1), bitkide bakla
sayısı yönünden SMN17 (47.3 adet bitki-1) ve bitkide
toplam dal sayısı yönünden SMN 82 (15.7 adet bitki-1)
hatları öne çıkmıştır. Biplot analizine göre, PC1 ve PC2 (sırasıyla, %34.9 ve
22.0) toplam varyasyonun %56.9’sını oluşturmuştur. İlk bakla yüksekliği, bitki
boyu, bitkide toplam dal sayısı, yüz tohum ağırlığı, bitkide tane sayısı,
bitkide bakla sayısı ve tane verimi gibi özellikler olumlu karakterler olurken,
çiçeklenme gün sayısı ve fizyolojik olgunlaşma süresi gibi özellikler olumsuz
yönde karakterler olmuşlardır. Çağatay, Er-99, Azkan, Eser-87, Aziziye-94,
Akça, SMN60 ve Aksu çeşitleri en stabil genotipler olurken, Aydın-92, Cevdetbey
98 ve Diyar-95 bitki boyu, ilk bakla yüksekliği ve toplam dal sayısı bakımından
yüksek değerler almışlardır. Tane verimi, bitkide bakla sayısı ve bitkide tane
sayısı bakımından ise SMN13 ve SMN17 genotipleri öne çıkmıştır.
Is there a relationship between Vitamin D level and socio-economic and education factors in Central Anatolia in Turkey?
Authors: BALBALOGLU Ozlem , INANDİKLİOGLU Nihal
Published: October 2018

Purpose: In
our study, we wanted to investigate the relationship between vitamin D [25(OH)D]  deficiency and socio-economic and education
factors in adult female patients in Yozgat
province in Turkey.Material method: A retrospective examination was made
of the records of female patients with low levels of vitamin D who presented at
the Physical Medicine and Rehabilitation Polyclinic with complaints of pain
between November 2016 and December 2017. Demographic data of the patients (age,
place of residence, education level, occupation, duration of complaint) and 25(OH)D
levels were recorded. The patients were separated into 3 groups according to
the 25(OH)D levels. Demographic data were compared
according to the groups.Result: A
total of 173 female patients were included in the study with a mean age of
37.52±5.5 years (range, 25-49 years). Education and duration of complaint were
significantly correlated with vitamin D levels (respectively p <0,05 ,r =
0,183, p <0,001, r = -0,249).

Conclusion: This
study showed a significant correlation between vitamin D level and educational
level, duration of the complaints.
Fertilite Hemşireliğinde Güncel Uygulamalar: Dünya’dan Örnekler
Authors: Aluş Tokat Merlinda , Fata Sevcan
Published: October 2018

Son
yıllarda infertilitenin tedavi ve bakımında psikososyal yaklaşımlar giderek
önem kazanmaktadır. Ülkemizde bu konuda önemli gelişmeler olsa da, kurumlarda psikososyal
yaklaşımlar çok sistematik ve belli standartlar doğrultusunda
uygulanmamaktadır. Dünya’da fertilite sorunu olan çiftlerle çalışan bazı
kurumlar tedaviyi destekleyen benzer hemşirelik girişimlerini kurum politikası
haline getirmiş ve her çifte uygulamaktadır. Royal College of Nursing (RCN)’de
fertilite hemşireleri tanı ve tedavi sürecinde çiftlere düzenli psikososyal
destek girişimleri uygulamaktadır. Boston In Vitro Fertilizasyon (IVF) merkezinde
hemşireler fertilite desteği alan çiftlere tedavi ile paralel beyin-beden
programı uygulamaktadır. Canada’da International Federation of Gyneacologic and
Obstetrics (FIGO) tarafından sağlık profesyonellerinin fertilite sorunu olan
çiftlerde yaklaşımda izleyecekleri sistematik basamaklar geliştirilmiştir. Bunun dışında bazı kurumlarda
hemşireler hipnofertilite ve fertilite yogası gibi yöntemler de uygulamaktadır.
Bu gibi standartların bulunması çiftlerin kendilerine özgü bakım almasını
sağlayacaktır.
Endometrial Polipler ile Normal Endometriumda Estrogen ve Progesteron Reseptörlerinin Karşılaştırılması
Authors: YÜKSEK Şahin , SAKİN Önder , KARS Bülent , ÇIKMAN Muzaffer Seyhan , ANĞIN Ali Doğukan , ŞİMŞEK Engin Ersin
Published: October 2018

AMAÇ: Endometrial poliplerin patogenezi halen tam
olarak bilinmemektedir. Bu araştırmada amacımız endometrial poliplerdeki
steroid reseptörlerini incelemektir.YÖNTEM: Bu
araştırmada Şubat 2008 ile Aralık 2011 tarihleri arasında hastanemizde histeroskopik polipektomi
yapılan 28 hastanın poliplerine ve sağlam endometrium dokularına ait östrojen
ve progesteron reseptörleri immunohistokimyasal olarak boyandı. Boyanma
skorları kuvvetli boyananlar için 3 pozitif, orta boyananlar için 2 pozitif ve
zayıf boyananlar için 1 pozitif olarak kaydedildi.BULGULAR: Östrojen reseptörleri
endometriyal polip glandında 1 (%3.6) hastada zayıf, 17 (%60.7) hastada
kuvvetli boyandı.  Stromasında ise 5
(%17.9) hastada zayıf,  12 (%52.8)
hastada kuvvetli olarak boyandı. Polipin hemen yanındaki endometrial dokunun
glandında 13 (%46.4) hastada zayıf, 5 (%17.6) hastada kuvvetli boyandı.
Stromasında ise 14 (%50.0) hastada zayıf, 3 (%10.7) hastada kuvvetli boyandı.Progesteron
reseptörleri için endometriyal polip glandında zayıf boyanma olmadı. Kuvvetli
boyanma 27 (%96.4) hastada görüldü. Stromasında da zayıf boyanma olmadı.
Kuvvetli boyanma 25 (%89.3) hastada görüldü. Endometriyal polipin hemen
yanındaki endometrium dokusunun glandında 4 (%14.3) hastada zayıf, 18 (%64.3)
hastada orta, 6 (%21.4) hastada kuvvetli boyandı. Stromasında ise 3 (%10.7)
hastada zayıf, 18 (%64.3) hastada orta, 7 (%25.0) hastada kuvvetli
boyandı. 

SONUÇ: Bulgularımız steroid
reseptörlerinin endometrial poliplerin gelişimi üzerine olan önemini destekler
niteliktedir. Bu reseptörlere yönelik geliştirilecek tedaviler hem poliplerin
gelişiminin önlenmesinde, hem tedavisinde, hem de sebep olduğu şikâyetlerin
engellenmesinde faydalı olabilecektir.
Hypogastric artery ligation for obstetrical haemorrhage: cohort analysis of a single surgeon experience
Authors: KAHRAMANOĞLU İlker , AZEMİ Aslı , TURAN Hasan , DEMİRKIRAN Fuat
Published: October 2018

IntroductionHypogastric artery ligation (HAL) is a life-saving procedure for severe postpartum haemorrhage (PPH). It should be performed as fast as possible when needed. In this study, a single surgeon’s experience in HAL for controlling PPH was presented.MethodsCases in whom HAL performed in emergency setting by the same surgeon in between 2015 and 2018 were included in this retrospective cohort study. The technnique of the procedure was the same for all cases. Data were extracted from hospital’s records.ResultsA total of 6 patients were included into the analysis. Indications for HAL were as follows: uterine atony in 3 (50%) cases, placenta previa in 2 (33.3%) cases and ablatio placenta in one case (16.7%). There were no intraoperative complication. The success rate of HAL was 83.3%, as one of the 6 patient underwent re-laparotomy. Within a median follow-up time of 13 months, only one patient attempted to concieve and succeeded.ConclusionHAL is an effective procedure for the management of PPH. Entering to the retroperitonneum directly over the hypogastric artery may fasten the procedure.
Seismic analysis of concrete arch dams considering hydrodynamic effect using Westergaard approach
Authors: Karabulut Muhammet , Kartal Murat Emre
Published: October 2018

Earthquake response of arch dams should be calculated under strong
ground motion effects. In this study, three-dimensional linear response of an
arch dam is investigated. Different ground motion effects and also foundation
conditions are considered in the finite element analyses. For this purpose, the
Type 3 double curvature arch dam was selected for numerical examples. All
numerical analyses are carried out by SAP2000 program for empty reservoir
cases. According to numerical analyses, maximum horizontal displacements and
maximum normal stresses are presented by dam height in the largest section.
These results are evaluated for five different elastic foundation conditions.
The selected foundation conditions of the all models have different sandstone
material parameters. Furthermore, near-fault and far-field ground motion
effects on the selected arch dam are taken into account by different
accelerograms obtained from the Loma Prieta earthquake at various distances.
Community acceptance challenges of renewable energy transitions: A tale of two solar parks in Limpopo, South Africa
Authors: Nkoana Elvis Modikela
Published: October 2018

Severe problems of climate change, inequality, poverty, and unemployment have compelled the South African government to pass legislation that introduced programmes aimed at achieving energy security, promoting economic development, and realising environmental protection. The Renewable Energy Independent Power Producers Procurement Programme objective is to increase the share of renewable sources in the national energy mix, deliver jobs and economic empowerment for black communities (Africans, Coloureds, and Indians) and cut harmful greenhouse gas emissions. Independent power producers (IPPs) must demonstrate that their projects contribute to job creation and broad-based black economic empowerment during the bidding process. To date, studies suggest that IPPs are missing this government target. This study investigated this phenomenon through face-to-face interviews with key informants involved in the IPP process at two solar parks in Limpopo province. Qualitative content analysis was used to analyse and interpret the field notes. Findings reveal that the process of involving local communities in the governance of the IPP process is highly fragmented, leaving room for powerful stakeholders to thrive over vulnerable community members. The lack of monitoring by the government IPP office enables a prominent not-for-profit organisation to abscond from its responsibility of setting up a community trust for the benefit of local residents. Also, limited skills in the local communities mean that young people are employed in low-paying construction jobs that end after project commissioning. Lack of awareness and knowledge about IPP commitments made during the bidding process are responsible for the ‘wait and see’ approach of local leaders and community members. In the short-term, awareness and capacity-building interventions for local leaders and community members are urgently required to conscientise beneficiaries. It is imperative to create a participatory governance framework that prioritises vulnerable stakeholders as a long-term solution.
Wind energy in South Africa: A review of policies, institutions and programmes
Authors: Mukonza Chipo , Nhamo Godwell
Published: October 2018

South Africa is promoting renewable energy such as wind power to address the objectives of both energy security and sustainable development. This paper reviews the nature of policies, institutional set-up and programmes in place to upscale especially onshore wind energy uptake, as reflected in publicly available documents. It shows that South Africa has put in place critical policies, institutions and programmes for wind energy uptake. Among key policy documents and policies are the White Paper on Energy (1998), Renewable Energy White Paper (2003), Energy Act of 2008, and National Climate Change Response White Paper (2011). There is also the Integrated Energy Plan, the Integrated Resource Plan (2010, revised 2013) and Environmental Impact Assessment Guidelines for Renewable Energy Projects of 2015. Key institutions noted include the South African National Energy Development Institute, the South African Renew-able Energy Council and the South African Wind Energy Association. The main programme is the Renewable Energy Independent Power Producers Procurement Programme, which resulted in more than 30 installed wind energy projects. Overall, wind energy promises to be among the viable and acceptable technologies in the renewable energy sector in South Africa.
El concepto de “remanente” en los escritos de Elena de White
Authors: L. Martines Carmelo
Published: October 2018

La investigación pretende presentar un estudio diacrónico del concepto de “remanente” en los escritos de Elena de White. Dada la actual discusión sobre el tema, su aporte es importante para corregir y evaluar las diver- sas posturas que se exponen.
“Traed los diezmos al alfolí”: Entendiendo Malaquías 3:10
Authors: Asmat David , Iparraguirre Joel
Published: October 2018

Malaquías 3:10 es uno de los textos del Antiguo Testamento que es conocido por su apelación a los diezmos. Sin embargo, este texto ha sufrido una gran variedad de interpretaciones debido a la interpolación del método histórico-crítico. Con el fin de analizar Malaquías 3:10 a través del idioma en el que fue escrito —el hebreo—, el presente estudio (1) mostrará el contexto histórico y la estructura literaria de Malaquías, (2) luego presentará el significado original de verso seleccionado en su contexto, y (3) buscará su correcta aplicación para el creyente actual.
Señor, ¿por qué rechazas mi ofrenda? Entendiendo Jeremías 14:12
Authors: Pacheco Cavero Jonathan , Hanco Torres Jesús
Published: October 2018

El presente artículo muestra que los sacrificios y ofrendas que uno realiza a Dios, no hacen que Él cambie de opinión en cuanto a lo que Él ya ha ordenado. Además, se analiza por qué Dios no acepta todas las ofrendas que sus hijos realizan. Asimismo, se analiza en Jeremías 14:12 en base a los dos aspectos esenciales que deben acompañar a todo cristiano al momento de ofrendar o diezmar. El texto será dividido en oraciones, las cuales son analizados para su desarrollo respectivo.
Drug susceptibility testing v1
Authors: Doulla Basra
Published: October 2018

This SOP describes the susceptibility testing of Mycobacterium tuberculosis and other members of the M. tuberculosis complex (M. africanum and M. bovis are the most frequent) to anti-TB drugs on Löwenstein–Jensen medium using the proportion method. To perform, Drug sensitivity testing (DST) of Mycobacterium tuberculosis cultures on LJ medium, is standard economic variant of 1% Proportion method for Drugs-Streptomycin, Isoniazid, Rifampicin and Ethambutol.
Sputum specimen processing for culture procedure v1
Authors: Doulla Basra
Published: October 2018

This SOP describes methods of specimen processing and other laboratory procedures for purposes of culturing Mycobacterium tuberculosisculture on solid or liquid media. It describes the procedure for the culturing test that detects the capacity for bacterial growth on solid culture media containing p-nitrobenzoate, which is used for the identification of Mycobacterium tuberculosis. Because suspensions with high concentrations of viable, infectious bacteria are handled, strict compliance with safety and protection measures is mandatory. The procedure must be carried out in a laboratory meeting the WHO standards for biosafety level 3 with access restricted to authorized personnel only.
Sonoelastrografi ile fokal pankreas kitleleri; fokal pankreatit mi? Pankreatik adonakanser mi?
Authors: METİN Melike Ruşen , TAHTACI Mustafa
Published: October 2018

Giriş ve Amaç: Ultrasonografi
pankreas kitlelerinde kullanışlı bir yöntem olmakla birlikte özellikle kuyruk
lokalizasyonundaki lezyonların görüntülenmesinde sınırlılıkları vardır ve fokal
pankreatik lezyonların benign-malign ayırıcı tanısına katkısı sınırlıdır. Bunun
yanı sıra çok kesitli bilgisayarlı tomografi ve manyetik rezonans görüntüleme yöntemleri
ile de zaman zaman pankreas kanseri-fokal pankreatit ayırıcı tanısında bazı
güçlükler yaşanmakta ve bazen biyopsiye ihtiyaç duyulmaktadır.Bu çalışmada kesitsel
görüntüleme yöntemleri ile fokal pankreatit-pankreas kanseri açısıdan optimal
ayırıcı tanı yapılamayan hastalarda transabdominal ultrasonografi ve eş zamanlı
sonoelastografi tetkiki yapılarak sonoelastografinin ayırıcı tanıya katkısı
araştırıldı. Gereç ve Yöntem: Bu çalışmada 2013-2017 tarihleri
arasında hastanemizde histopatolojik olarak 52 pankreas kanseri ve 14 fokal
pankreatit tanısı alan hastanın sonoelastografi bulguları karşılaştırıldı. Bulgular: Pankreatik
adenokanser hastalarının yaş ortalaması istatistiksel anlamlı olarak fokal
pankreatit hastalarından yüksekti. Yine adenokanser hastalarında ortalama serum
alfa-fetoprotein seviyesi fokal pankreatit hastalarına oranla anlamlı olarak
yüksekti. Fakat lezyonların çaplarında ve sonoelastografide elde edilen gerinim
indeksi değerlerinde her iki grup arasında istatistiksel olarak anlamlı fark
saptanmadı. Ayrıca adenokanser ve fokal pankreatit arasında renkle kodlanma tipleri
açısından anlamlı fark elde edilmedi.

Sonuç: Sonoelastografi, mükemmel duyarlılıkla görüntülenen
benign ve malign kitleler arasındaki karekterizasyon ve farklılaşmayı
artırabilecek ümit verici bir tekniktir. Fakat bu aşamada pankreatik
adenokanser ile fokal pankreatit arasındaki fark açısından henüz sonoelastografinin
özgüllüğü düşüktür.
Comparison of impact of undergraduate teaching program to assess the knowledge and attitude towards pharmacovigilance and adverse drug reporting among undergraduate medical students at a teaching medical institute in South India
Authors: Kumar K. H. Hemanth , Akshay J. K.
Published: October 2018

Background: Pharmacovigilance has become an important tool to ensure the safety of patient in recent years. To ensure right practice of pharmacovigilance, proper understanding is very essential and the medical colleges with the undergraduate teaching program become a vital platform to educate and train the medical students towards pharmacovigilance. This study compares the impact of teaching program of the undergraduate curriculum in assessing the knowledge and attitude of the undergraduate medical students towards pharmacovigilance.Methods: The study includes 158 undergraduate medical students of second year being trained in pharmacology at Mysore Medical College. A validated and standardized questionnaire was distributed to all the students twice, once during their 3rd term (pre-sensitization) and the second time during their 5th term (post sensitization). Willingness to answer and complete the questionnaire was considered as consent.Results: The pre and post sensitization questionnaires were analyzed individually. A decrease from 114 to 90 students (15.19 % decrease) willing to complete the questionnaire was seen. The mean total knowledge score was 6.37±1.90 during the pre-test as compared to 6.35±1.78 in the post test analysis. An overall increase was seen with the knowledge of ADRs and pharmacovigilance. Only 18.4% knew of the presence of an ADR monitoring center in the institute pre-test which increased to 64.4% post sensitization. 81.6% answered rightly the type of ADRs that needs to be reported as compared to the 67.3% pre-sensitization. The overall attitude towards ADR reporting was seen to be in the right direction, with 71% saying that pharmacovigilance covered adequately in the curriculum. Voluntary reporting attitude increased from 74.6% to 88%. 70% of the students feel ADR reporting as a professional obligation, while only 54% felt so pre-sensitization.Conclusions: Pharmacovigilance should be included in the curriculum with more hours dedicated to teaching. Various interesting methods should be implemented to train and made aware of its importance to ensure patient safety on a global scale.
Anti-microbial sensitivity and resistance of organisms in blood-culture samples from prolonged fever cases: evidence from a tertiary care hospital in West Bengal, India
Authors: Ghosh Somanjana , Lahiri Arista , Bera Siddhartha , Bandyopadhyay Soumyajyoti
Published: October 2018

Background: Currently there is a rise in resistance to anti-microbials which is a matter of concern in treatment of systemic infections. Blood culture is considered “gold standard” in diagnosis of suspected systemic infection. The susceptibility to antibiotics thereafter determine the future course of treatment. The current study aims to find out the sensitivity and resistance pattern of the blood culture isolates.Methods: A cross-sectional study was performed on the blood culture samples sent within 24hours of admission of the adult patients reporting fever for 7 days or more with no history of consumption of any antibiotics within last month. Total 134 blood samples were analysed. The proportion of sensitivity and resistance to anti-bacterial agents was calculated among those samples which showed growth in the culture. Background information of the patients in terms of age, sex and religion were also noted.Results: Mean age of the patients was 39.33 (±12.19) years. Overall 47.76% were female patients and remaining were male. Among the Hindu patients majority were male while among Muslims majority were female. Of the total number of blood cultures examined 46.27% showed growth of bacteria. Staphylococcus aureus was the most frequently found bacteria isolated in cultures, followed by coagulase negative Staphylococcus and Pseudomonas. Of the frequently used antibiotics, higher sensitivity was seen with vancomycin, amikacin, netilmycin, imipenem, gentamicin. High resistance was observed in use of antibiotics like cefixime, amoxicillin-clavulanic acid and azithromycin.Conclusions: High level of resistance to several commonly used advanced antibiotics warrant judicial and evidence-based use of these drugs.
Effect of trimethoprim-sulfamethoxazole vs. norfloxacin on fecal E. coli resistance pattern and efficacy in patients receiving prophylaxis for spontaneous bacterial peritonitis
Authors: Dutta Siddhartha , Chawla Shalini , Srivastava Siddharth , Loomba Poonam , Roy Vandana
Published: October 2018

Background: Spontaneous Bacterial Peritonitis (SBP) is an infection of ascitic fluid. It is highly mortal and recurrent condition, so prophylaxis with Norfloxacin (NOR) or Trimethoprim-sulfamethoxazole (TMP-SMX) seems to play an important role in the prevention of further episodes of SBP. Aims of the study were to assess the effect of TMP-SMX/NOR on the sensitivity pattern of fecal E. coli after long term prophylaxis in Spontaneous Bacterial Peritonitis (SBP) and to compare the efficacy of TMP-SMX and NOR in prophylaxis of SBP.Methods: An interventional, prospective, open label, single center study conducted in Maulana Azad medical college, New Delhi, India. 52 patients of SBP or with high risk of SBP were screened and finally 39 patients were recruited. Stool sensitivity testing of fecal E. coli was done and they were divided into TMP-SMX group(n=18) and NOR group(n=21) according to sensitivity. After 45±3 days (7 weeks) their stool sample was re-examined for change sensitivity pattern of E. coli. Efficacy variables like any episode of SBP, fever (FEV) resolution of ascites (ASC), bacteremia (BACT), extraperitoneal infection (EPI), liver transplantation (LT) or death (D) were noted throughout the period of 24 weeks.Results: Resistance developed in 60% vs. 48% in TMP-SMX vs. NOR group(p=0.46) after 45 days of prophylaxis. By the end of 24 weeks, Incidence of SBP (29%vs. 25%, p>0.99), episodes of FEV(P=0.60), EPI(p>0.99), ASC(p>0.99) and death (14% vs. 16%, p>0.99) were almost similar in both the groups (TMP-SMX vs. NOR) respectively.Conclusions: Both TMP-SMX and NOR showed same degree of resistance and found equi-efficacious when administered as long-term prophylactic therapy in SBP. TMP-SMX can be a suitable as well as cost effective alternative to NOR for the prophylaxis of SBP.
A questionnaire based study to evaluate the knowledge, attitude and perception towards pharmacovigilance among doctors in rural hospital, Jammu, India
Authors: Gupta Shallini , Khajuria Kanika , Khajuria Vijay , Kumar Niraj
Published: October 2018

Background: Monitoring and reporting of adverse drug reactions (ADRs) is very important to minimize or prevent drug caused harm. Thus, pharmacovigilance deals with it and ensures the patient safety. However, most of pharmacovigilance centers are concentrated in the urban tertiary care hospitals and contributes the maximum reports of ADRs. Participation of the rural health workers is equally important towards the success of pharmacovigilance.Methods: The study was conducted using a pre-validated questionnaire among forty doctors in rural Sub district hospital Akhnoor, Jammu after approval of the institutional ethical committee of Government Medical Jammu. The questionnaire consisted of 16 questions (7 related to knowledge, 4 related to attitude, and 4 related to practice and one question pertained to under reporting). The responses were recorded, and data obtained was analysed and presented as number and percentage.Results: Total 66.6% doctors gave correct response regarding the definition of pharmacovigilance and purpose of pharmacovigilance was given by 76.6% of doctors. 70% agreed that ADR reporting is a professional obligation for them. 80% responded that health care professionals are responsible for reporting ADRs. 63.3% of them were aware of a pharmacovigilance programme of India. A total of 96.6% doctors agreed that reporting of ADR is necessary and 93.3% were of the view that pharmacovigilance should be taught in detail. Majority of doctors have experienced ADRs in patients and 36.6% have seen the ADR reporting form. However, only 10% have ever reported ADR to a pharmacovigilance center. No remuneration (50%), lack of time to report ADR (30%), belief that a single unreported case may not affect ADR database (10%), and difficulty to decide whether ADR has occurred or not (10%) were important causes for under reporting of ADRs.Conclusions: Current study has shown that majority of the doctors have good knowledge and attitude about pharmacovigilance. However, under reporting is still a major concern among rural doctors and efforts are needed to address this problem of under reporting by conducting CMEs on regular basis.
Knowledge, attitude and practices about complementary feeding among mothers of children aged 6 to 24 months in tertiary care centre of Kumaun region, India
Authors: Chand Ramesh , Kumar Ashok , Singh Nutan , Vishwakarma Soniya
Published: October 2018

Background: Well-being of child is directly related to the nutritional status of the baby. Malnutrition rate increases between 6 and 18 months- the period of complementary feeding. Complementary feeding is the introduction of semisolid or solid food in infant who is on breast feeding, when mother’s milk is no longer enough to meet the nutritional needs. Understanding the social beliefs, knowledge, attitude and practices about complementary feeding among mothers is an important step prior to designing an intervention strategy to prevent malnutrition in children. Aim of the study was to assess the knowledge, attitude and practices regarding complementary feeding among mothers.Methods: Prospective study including 200 mothers with children between 6 to 24 months of age in GMC Haldwani, from December 2017 to May 2018.Results: Present study shows 60.5% mothers initiate their breast milk soon after delivery. The initiation of complementary food at the age of 8 months, 6 month and 4-5 months were 64 (32%), 104(52%) and 32 (16%) respectively. 68% mothers did not properly clean their children hands and utensils before feeding Use of janam ghutti 64% and dilution of cow milk 79% was the major part of complementary feeding.Conclusions: Mother’s knowledge regarding timing of complementary feeding is inadequate and practices are inappropriate. Majority of them are not aware of the current recommendations. It is essential to give accurate information and education about complementary feeding to prevent malnutrition and improve the health status of children.
Assessment of breastfeeding position and attachment (ABPA) in a tertiary care centre in Chennai, India: an observational descriptive cross-sectional study
Authors: Aswathaman Nalini , Sajjid Mohamed , Kamalarathnam C. N. , Arasar Seeralar A. T.
Published: October 2018

Background: Effective breastfeeding becomes an art with experience. Correct position and attachment is the first step necessary for exclusive breast feeding. However, studies assessing correct position and attachment for breastfeeding in South India are sparse. Hence our study aimed to assess the percentage of mother infant dyads with correct breastfeeding position and attachment along with factors influencing them in a Tertiary care Hospital.Methods: A descriptive cross-sectional study was conducted among the stable dyads in Institute of Obstetrics and Gynaecology using quasi random sampling. 101 dyads were observed for correct position, attachment and effective suckling using WHO B-R-E-A-S-T feed observation form and were scored. Data was analyzed using SPSS software with chi square test, univariate logistic regression and spearman correlation test.Results: Among the 101 dyads, only 30.7% of them had good or average position, 52.47% had good or average attachment and 62.3% had effective suckling at breast. There was significant correlation between breast problem in mother with incorrect position and poor attachment. NICU stay and breast problems were significantly associated with poor attachment. Effective suckling improved significantly as gestational age matured and in infants who had no NICU stay.Conclusions: Practical demonstration on how to hold infants in correct breastfeeding position and drilling with key points for correct position and attachment as soon as possible after delivery will go a long way for promoting exclusive and effective breastfeeding by learning correct technique. Rechecking after counselling will reinforce this learned art.
Derivation of MUAC cut-off to identify undernourished 1-6 months old infants
Authors: D. Ramamani , E. Suganya
Published: October 2018

Background: Under nutrition is the major public health problem in our country. There are numerous anthropometric methods, one of which is mid upper arm circumference (MUAC). MUAC cut-off classify the nutritional status of the children aged between 6-60 months. However, there is no specific cut-off for MUAC to identify the undernourished infants aged between 1-6 months. With the above background study was planned with the following objectives. Objectives of this study were to classify the nutritional status of 1-6 months aged infants using WLZ classification and to derive a cut off value for Mid upper arm circumference, to define under nutrition/wasting among 1-6 months aged infantsMethods: The cross-sectional study was carried out among 706 infants aged between 1-6 months. Nutritional status was assessed using WLZ. Various MUAC was tested against WLZ of <-2, in order to identify the cut-off below which, the infant will be considered undernourished.Results: Mean age of the participants was 96±55 days. Mean weight, length and mid upper arm circumference was 4.75±1.02 kg, 58.51±4.47 cm and 12.15±3.01cm respectively. MUAC cut-off <13.5 cm has yielded highest youden index, accuracy and sensitivity of 0.36, 0.79,99% respectively. The total area under ROC curve is 0.707 [95% CI: 0.66, 0.74; p<0.0001], having a good diagnostic accuracy and it is statistically significant.Conclusions: A MUAC cut-off value below 13.5 cm, among 1-6 months aged infants will be considered to be undernourished.
Lifestyle of school going adolescents in Mumbai, India: a cross sectional study
Authors: Patil Shalaka P. , Almale Balaji
Published: October 2018

Background: Adolescents, as defined by World Health organization, constitute individuals in between the age group of 10 to 19 years. Children, youth and young people are the other groups which have ages which overlap with the adolescent age group. The hormonal changes at this age are responsible not only for physiological growth but also emotional and cognitive changes. Lifestyle in this age group may have lasting and, in many cases, lifelong implications. We conducted this cross-sectional study to holistically analyse lifestyle of school adolescents in Mumbai.Methods: This was a cross sectional study conducted in the in a tertiary care medical college. The students belonging to an English medium co-education school of a metropolitan city were included in this study on the basis of a predefined inclusion and exclusion criteria. A culturally acceptable questionnaire was structured in simple language and used in this study. Demographic data was asked. All questions were closed ended and requiring specific response the questionnaire was subjected to critical evaluation by experts from the field of Public Health Pediatrics, high school teachers, heads of schools, experts from Social justice and law input from the experts were incorporated in the questionnaire. Statistical analysis was done using SSPE 22.0 Software.Results: A total of 538 adolescents were studied in this cross-sectional study. There were 270 boys (50.18%) and 268 (49.82%) girls with a M:F ratio of 1:0.95. Mean age of the studied cases was found to be 12.4±1.44 years. Majority of the adolescents were found to be residing in buildings (66.36%) and average family size was found to be 5.63±3.34 members Majority of the boys and girls (66.92%) were not having any knowledge about HIV/AIDS.7.06% adolescents were found to have suicidal or homicidal thoughts. 93.31% adolescents liked to come to school and 83.83% claimed to be obedient.Conclusions: This cross-sectional study highlights the fact that adolescents have a significant amount of psychosocial problems. Important amongst these included inclination towards substance abuse, suicidal or homicidal thoughts and ignorance about HIV/AIDS. Strategies to tackle these issue needs to be devised so as to tackle these problems faced by adolescents.
Incidence and risk factors associated with hypoglycemia in the first 48 hours of life in Small for Gestational Age Neonates
Authors: S. Alph Shirley , T. Antony Leo Jerry , R. Shiji
Published: October 2018

Background: Hypoglycemia is one of the important problems encountered in small for gestational age (SGA) neonates.  The incidence and risk factors associated with hypoglycemia in the first 48 hours of life in Small for Gestational Age (SGA) Neonates was investigated in this study.Methods: Capillary Blood Glucose was screened by glucostix at 1, 2, 6, 12, 24, and 48 hours of age in 100 SGA neonates fulfilling the inclusion and exclusion criteria.Results: The overall incidence of hypoglycemia in SGA neonates in the study was 24%. The incidence of hypoglycemia was significantly higher in preterm SGA neonates (37.50%) when compared to term SGA neonates (17.65%).  The incidence of symptomatic hypoglycemia was 9%. Maximum incidence of hypoglycemia was noted at 2 hours of life. Of the 24 SGA neonates with hypoglycemia, 33.33% had one episode of hypoglycemia, 45.83% had two episodes of hypoglycemia, 12.50% had three episodes of hypoglycemia, 8.33% had four episodes of hypoglycemia. None of the SGA neonate had more than four episodes of hypoglycemia. Early initiation of enteral feeding was significantly associated with decreased incidence of hypoglycemia in SGA neonates. There was no significant correlation between incidence of hypoglycemia in SGA neonates and gender of the baby, parity of mother, mode of delivery and type of IUGR.Conclusions: It is recommended to monitor all SGA neonates especially preterm SGA for hypoglycemia and ensure early initiation of enteral feeding in all SGA neonates.
Proteinuria due to increased dose of deferasirox in a pediatric patient with thalassemia major: case report
Authors: Sarbay Hakan , Kara Mehtap Akbalik
Published: October 2018

Deferasirox is an iron chelator that used in B-thalassemia in worldwide. Nephrotoxicity is one of the common side effects of the deferasirox. Nephrotoxicity can be seen in the form of nephritis and tubulopathy. A 6-year-old male whose ferritin levels were above 3500 ng/mL is reported in this article. Deferasirox was increased from 30 mg/kg/day to 40 mg/kg/day because of the high levels of ferritin. In complete urinalysis of the patient after 3 weeks later +3 protein was detected, and spot urine protein/creatinine ratio was 2.5. In patient without symptoms and findings, deferasirox was discontinued. In his follow-ups, no proteinuria was detected in the complete urinalysis at the second week after the drug treatment was discontinued.
Hybrid Filters To Damp Harmonic Resonance In Power Transmission Systems
Authors: Encarnação Lucas F. , Merçon Alexandre G. , De Almeida Hélio H. , Van Emmerik Emanuel L. , Aredes Maurício
Published: October 2018

Problems related to harmonic propagation in transmission systems have been noticed in the last years. Passive filters, commonly used to attenuate noncharacteristic harmonics in HVDC systems, stay at risk of disconnection from the system due to overcurrents. One of the possible solutions to solve the problem of high harmonic levels would be the use of pure active filters. However, this alternative may be very expensive due to the high power of the transmission systems. This paper relates to a comparative study on two different topologies of hybrid filters to damp harmonic resonance in power transmission systems. The first one combines a smallrated active filter in series with passive filters, limiting overcurrents, when existent, or improving the quality factor of the filter when the passive filters work under its nominal current. The second one consists of an active filter in parallel with passive filters, compensating all eventual overcurrent in these. Simulation results with the two proposed topologies present the efficiency of, and the differences between, the hybrid filters in power transmission systems.