bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solvent extraction and spectroscopy identification of bioactive compounds from medicinal shrub Tamarix gallica
Authors: Elamin Moussa Mohammed 
Published: November 2020

This research is interested in chemical valorization of the medicinal shrub called Tamarix gallica. The phytochemical study of the extracts of this plant showed that it is rich in phenolic compounds especially the flavonoids. The liquid-liquid extraction by n-butanol and acetate of ethyl of the leaves allowed to us the extraction of the secondary metabolites of class of the flavonoids.The identification of the isolated flavonoids is made by the spectroscopy methods: UV, IR, NMRH, from where we extracted some structures of flavonols class. Keywords: Tamarix gallica, chemical valorization, flavonoids, extraction, spectroscopy analysis, chromatography methods.
The Effect of 14 Days of Coenzyme Q10 Supplementation on Muscle Damage and Fatigue Indices Following a Bout Exhausting Exercise Activity in Passive Men
Authors:   Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran., Khanvari Touhid , Sardari Faramarz ,   Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urumia University, Urumia, Iran., Rezaei Babak ,   Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.
Published: November 2020

Background and Aim: Exercise aerobic is associated with increased creatine kinase and blood lactate immediately after exercise, leading to increased muscle damage and undesirable changes in many cellular markers including serum creatine kinase. In such situations, consuming nutrients and supplements such as coenzyme Q10 may prevent metabolic stress damage by increasing buffering power. However, comprehensive studies have not been performed on the effects of this nutrient on the index of muscle injury and fatigue caused by exercise. Methods & Materials: For this purpose, 20 inactive volunteer men were randomly divided into two groups of 10-person Coenzyme Q10 supplement (2.5 mg/kg body weight) and quasi-drug (2.5 mg/kg body weight Dextrose). All subjects participated in the Bruce test exercise contract after 14 days of supplementation. Blood sampling was performed in four stages including baseline, after supplementation, immediately after exercise and two hours after exercise. Creatine kinase, lactate and cortisol indices of both groups were measured during these four stages. Data were analyzed by means of standard deviation and repeated measures ANOVA, Bonferroni post hoc and Independent T-test using SPSS V. 17 at the significant level of 0.05. Ethical Considerations: This article has been approved by the ethics committee of Tabriz School of Medical Sciences with the ethics code IRCT 201203104663N8. Results: The results showed that 14 days of Coenzyme Q10 supplementation had a significant effect on cortisol level (P<0.05). In addition, one session of exhausting aerobic activity increased creatinine kinase and lactate (P<0.05). On the other hand, creatinine kinase did not differ significantly after exercise (P>0.05). Conclusion: According to the results of the present study, 14-day supplementation of Coenzyme Q10 may reduce the cellular damage induced by exhaustive aerobic activity in inactive men and prevent an increase in blood lactate levels.
Analyzes of Life World of a Young Girl With Myasthenia Gravis: Qualitative Case Study
Authors:   Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran., Khodabakhshi-Koolaee Anahita , Pourebrahimi Mohammad ,   Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Published: November 2020

Background and Aim: Myasthenia Gravis (MG) is a neuromuscular disorder and auto-immune disease that is associated with symptoms of fluctuating muscle fatigue and dysfunction of the neuromuscular junction system. This disease greatly affects various aspects of the patient's life and impacts the person's perception of the quality of life. The aim of this study was to explain and analyze life experiences with myasthenia gravis disease in a young girl. Methods & Materials: This report is a qualitative case with interpretive phenomenological approach that examines the life experiences of a young girl with myasthenia gravis in 2019. Data were collected through semi-structured interviews and analyzed using Van Manen's phenomenological approach. Ethical Considerations: This study was registered in the Research Ethics Committee of Khatam University (Code: 3299/100/P/98). Results: Thematic analysis indicated that myasthenia gravis disease affects all aspects of person's life world. These four aspects include living and feelings with time, body, space, and others. Eventually, three interrelated themes emerged from the patient's perception of the world around her, including physical weakness, future ambiguity, and frustration. Conclusion: The present study shows a clear image and understanding of the problems of living with MG in a young girl. The phenomenological world of mixed by physical weakness, ambiguity in the future, and frustration that indicating the suffering and distress that the patient experiences following the illness. The results of this study contribute to the awareness of health and rehabilitation specialists in the field of work and research in myasthenia gravis as a neurological disease.
Investigating the Causes of Death in the Injured of Traffic Accidents Referred to Vali-Asr Hospital in Arak, Based on Oral Autopsy and Forensic Autopsy
Authors:   Department of Forensic Medicine, School of Medicine, Aral University of Medical sciences, Arak, Iran., Jamalian Mohammad , Eslamdost Mohsen ,   Department of Forensic Medicine, School of Medicine, Aral University of Medical sciences, Arak, Iran., Rezaee Ali ,   Department of Forensic Medicine, School of Medicine, Aral University of Medical sciences, Arak, Iran., Alizadeh Shabanali ,   Department of Surgery, School of Medicine, Aral University of Medical sciences, Arak, Iran.
Published: November 2020

Background and Aim: The deaths caused by traffic accidents are one of the three leading causes of death in Iran. Considering that all deaths from traffic accidents in the forensic organization are undergoing autopsy and also in the treatment centers under oral autopsies, the cause of death is determined, we determined that the cause of reported death from oral autopsy and medical autopsy Compare the law. Methods & Materials: In this descriptive study, patients who were admitted to the forensic medical center during the year 1395 admitted to the Vali-e-Asr Hospital in Arak, were referred. The causes of death in Vali-asr Hospital were evaluated and compared with the outcome of the forensic oral hearing. Ethical Considerations: This study ethcally approved by the ethics committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.226). Results: In this study, 109 patients (1.33%) died from a total of 8153 patients with traffic accidents referred to Valiasr hospital in Arak. Of these, 68.8% were male and 31.2% were women. The Mean±SD age of the patients died was 44.03±22.43 years. Also, 59.6% of the dead died during the first 24 hours of the accident. The most common cause of death, according to the results of oral autopsy, was “multiple injuries,” accounting for 49.5% of the patients in 45 patients. Conclusion: Abundance of deaths among patients with road traffic accidents and they referred to Valiasr hospital, which was 1.33%. According to the existing standards and considering that the mortality rate in this center is less than 1.5%. It seems that the level of service delivery in this center is favorable.
PENINGKATAN KETERAMPILAN MENULIS NASKAH DRAMA DENGAN MENGGUNAKAN MEDIA SHORT FILM PADA PESERTA KELAS VIII DI SMP NEGERI 3 JOMBANG TAHUN PELAJARAN 2018/2019
Authors: Affandi Ali Nuke 
Published: November 2020

Students think that writing skill is difficult because students determine to be difficult to convey their thoughts, ideas, or opinions into a piece of writing. To deal with this problem, it is very necessary to have a media to facilitate students to convey thoughts, ideas, or opinions into a writing. The lack of instructional media used by teachers in the teaching and learning process also causes a sense of laziness and limited ideas on students to take a theme and make it to a complete drama script. This study aims to improve students’ writing skill of drama scripts for VIII B students at SMPN 3 Jombang by using instructional media in the form of short film. Learning by using the short film as media is a mean for teaching writing drama scripts by utilizing listening activities and writing important things in the film being watched. Then this activity is developed into drama scripts according to the elements, structure and rules of drama.The research method used in this study is a classroom action research conducted for two cycles, namely cycle I and cycle II. Each cycle has four steps including planning, implementing, observing and reflecting. This research uses analysis techniques in the form of qualitative descriptive analysis.Based on the result of the study, the use of Short Film as a media improve the students’ writing skill of drama scripts in the eighth grade students of SMPN 3 Jombang. The media has improved students’ writing skill at each stage of the cycle, this can be seen from the improvement in the average value of students during pre-cycle, cycle I and cycle II. In the pre-cycle stage, the average value of students gets 66.75. In the first cycle, it has increased the average value to 73.25 and in the second cycle, it has also increased to 84.5.
Chlamydia Trachomatis Infection and Ectopic Pregnancy
Authors: Sima Septian , Abdullah Nusratuddin , Arifuddin Sharvianty , Irinta Trika , Tessy Telly 
Published: November 2020

Objective: To determine the relationship of Chlamydia trachomatis infection in patient with ruptured ectopic pregnancy through examination of endocervical swabs, tubal tissue using Polymerase chain reaction (PCR) and Enzyme linked immunoabsorb and assay (ELISA) serum IgG antibodies Specific to Chlamydia trachomatis.Method: This study was an observational analytic study with a cross sectional study design. In this study, there were 50 participants consisting of 25 ruptured ectopic pregnancy patients and 25 non-ruptured ectopic pregnancy patients who underwent treatment at Dr.Wahidin Sudirohusodo Hospital as well as networking hospitals at the Universitas Hasanuddin in Makassar City.Results: The results showed that Chlamydia trachomatis infection in patients with ruptured ectopic pregnancies was found to be 84% positive in tubal tissue, 72% with endocervical swabs and 64% with serum examination. There was a significant relationship between chlamydial tracheal infection obtained through examination of tubal tissue, endocervical swab and specific serum IgG in patients with ruptured ectopic pregnancy (p <0.001).Conclusion: Based on the results of the study, it can be concluded that Chlamydia trachomatis infection can significantly affect the occurrence of ruptured ectopic pregnancy.Keywords: Chlamydia trachomatis, endocervical swab, ruptured ectopic pregnancy, serum IgG, tubal tissue.

Abstrak
Tujuan : Untuk mengetahui hubungan infeksi Chlamydia trachomatis pada pasien penderita Kehamilan Ektopik Terganggu (KET) melalui swab endoserviks dan jaringan tuba menggunakan pemeriksaan Polymerase Chain Reaction (PCR) dan Enzyme linked immunoabsorb and assay (ELISA).Metode : Penelitian ini merupakan studi analitik observasional dengan desain studi potong lintang. Pada penelitian ini terdapat 50 orang partisipan yang terdiri atas 25 orang pasien kehamilan ektopik terganggu dan 25 orang pasien non-kehamilan ektopik terganggu yang menjalani pengobatan di RSUP Dr.Wahidin Sudirohusodo serta RS jejaring Universitas Hasanuddin di Kota Makassar.Hasil : Hasil penelitian menunjukkan bahwa infeksi Chlamydia trachomatis pada pasien dengan kehamilan ektopik tergangu didapatkan sebesar 84% positif di jaringan tuba, 72% dengan swab endoserviks dan 64% dengan pemeriksaan serum. Terdapat hubungan yang signifikan antara infeksi klamidia trakomatis yang didapatkan melalui pemeriksaan jaringan tuba, swab endoserviks maupun serum IgG spesifik pasien kehamilan ektopik terganggu (p<0,001).Kesimpulan : Berdasarkan hasil penelitian, dapat disimpulkan bahwa infeksi Chlamydia trachomatis secara signifikan dapat mempengaruhi terjadinya kehamilan ektopik terganggu.Kata kunci : chlamydia trachomatis, jaringan tuba, kehamilan ektopik terganggu, swab endoserviks, serum IgG
A Preliminary Study: The Effectiveness of CO2 Laser Therapy for Stress Urinary Incontinence
Authors: Moegni Fernandi , Chan Nadir , Santoso Budi I. , Surya Raymond , Tanamas Leonardo 
Published: November 2020

Objective: To evaluate the role of fractioned CO2 laser intravaginal as a non-invasive treatment for relieving stress urinary incontinence (SUI) symptoms.Methods: This was a prospective, quasi-experimental study in patients with SUI. The patients were treated through three different sessions in a month apart by the fractioned CO2 laser Femilift©, produced by Alma Lasers. The patients fi lled and completed questionnaires about continence assessment, quality of life, and sexuality before and after therapy based on PISQ-12 and ICIQ-UI questionnaire. Perineometry was performed to prove the outcome.Results: Twenty women were enrolled. At 4 weeks following the third treatment, there was a signifi cant improvement for continence assessment (7.70 ± 4.38 to 4.50 ± 2.88; p < 0.001), quality of life and sexuality (28.13 ± 7.06 to 33.13 ±7.80; p < 0.001), and vaginal perineometer results (37.20 ± 17.24 to 48.80 ± 16.72; p = 0.009).Conclusions: Fractioned CO2 intravaginal laser has a role in improving SUI symptoms.Keywords: fractioned CO2 laser, stress urinary incontinence, vaginal rejuvenation.
AbstrakTujuan: Untuk mengetahui efektivitas terapi laser CO2 terfraksi intravaginal sebagai terapi non-invasif untuk mengurangi gejala inkontinensia urine (IU) tipe tekanan.Metode: Penelitian ini merupakan studi prospektif, quasieksperimental pada pasien dengan inkontinensia urin (IU) tipe tekanan yang mengikuti terapi laser CO2 terfraksi intravaginal tiga sesi berbeda, dengan jarak satu bulan menggunakan laser CO2 terfraksi Femilift© dari Alma Lasers. Subjek mengisi kuesioner mengenai penilaian kontinensia, kualitas hidup dan kehidupan seksual sebelum dan sesudah terapi (kuesioner PISQ-12 dan ICIQ-UI). Selain kuesioner, pemeriksaan perineometri juga dilakukan pada beberapa subjek penelitian untuk membuktikan efektivitas terapi.Hasil: Dua puluh subjek ikut dalam penelitian ini. Penilaian pada minggu keempat setelah sesi terapi ketiga, menunjukkan peningkatan yang signifi kan pada penilaian kontinensia (7.70 ± 4.38 ke 4.50 ± 2.88; p < 0.001), pada kualitas hidup dan kehidupan seksual (28.13 ± 7.06 ke 33.13 ±7.80; p < 0.001), dan pada hasil perineometri (37.20 ± 17.24 ke 48.80 ± 16.72; p = 0.009).Kesimpulan: Terapi laser CO2 terfraksi intravaginal menunjukkan kecenderungan untuk mengurangi gejalainkontinensia urine (IU) tipe tekanan.Kata kunci: inkontinensia urin tipe tekanan, terapi laser CO2 terfraksi intravaginal, vaginal rejuvenation.
Medical Undergraduates’ Perceptions on Medical Humanities Course in Nepal
Authors: Helen Amanda Douglas , Subedi Madhusudan , Gongal Rajesh 
Published: November 2020

Background: Medical humanities is taught in medical schools in the western countries, partly to address the lack of compassion within healthcare. It seeks to develop understanding of human experiences relating to disease, disability and death, through humanities, arts and social sciences. In 2018, Patan Academy of Health Sciences Nepal introduced an eight-week medical humanities course for new medical students. This study aims to evaluate the course from the student participants’ view, exploring their perceptions and experiences.
Methods: A mixed method study was used to assess the perceptions of 65 students who completed a semi-structured survey, comprising eight items, with five point- Likert scale and three open response questions. Quantitative data was analysed with results expressed as mean, standard deviation and percentage. Qualitative data was coded and analysed thematically.
Results: The students’ perception of the course was strongly positive where 98.5% agreed or strongly agreed it was enjoyable and interesting (items 1,2) and should be continued (item 9). 97% agreed or strongly agreed it made them think differently (item 5) and 96.9% that it was relevant to future careers (item 6). 96.9% agreed or strongly agreed the course helped them understand doctor’s caring roles (item 10) and 92.3% believed it will make them better doctors (item 11). Three themes emerged from open response questions related to perceptions- enjoyable and interesting, positive personal impact and valuable and important.
Conclusions: The students had positive perceptions of the medical humanities course, recognizing its’ impact, importance and its value in medical education. Its expansion in the undergraduate curriculum should be considered.
Keywords: Evaluation;medical humanities; Nepal; perceptions;students
Strategies to reduce the use of low-value medical tests in primary care: a systematic review
Authors: Takada Toshihiko , Heus Pauline , van Doorn Sander , Naaktgeboren Christiana A , Weenink Jan-Willem , van Dulmen Simone A , Hooft Lotty 
Published: November 2020

BackgroundIt is recognised that medical tests are overused in primary care; however, it is unclear how best to reduce their use.AimTo identify which strategies are effective in reducing the use of low-value medical tests in primary care settings.Design and settingSystematic review.MethodThe databases MEDLINE, EMBASE, and Rx for Change were searched (January 1990 to November 2019) for randomised controlled trials (RCTs) that evaluated strategies to reduce the use of low-value medical tests in primary care settings. Two reviewers selected eligible RCTs, extracted data, and assessed their risk of bias.ResultsOf the 16 RCTs included in the review, 11 reported a statistically significant reduction in the use of low-value medical tests. The median of the differences between the relative reductions in the intervention and control arms was 17% (interquartile range 12% to 24%). Strategies using reminders or audit/feedback showed larger reduction than those without these components (22% versus 14%, and 22% versus 13%, respectively) and patient-targeted strategies showed larger reductions than those not targeted at patients (51% versus 17%). Very few studies investigated the sustainability of the effect, adverse events, cost-effectiveness, or patient-reported outcomes related to reducing the use of low-value tests.ConclusionThis review indicates that it is possible to reduce the use of low-value medical tests in primary care, especially by using multiple components including reminders, audit/feedback, and patient-targeted interventions. To implement these strategies widely in primary care settings, more research is needed not only to investigate their effectiveness, but also to examine adverse events, cost-effectiveness, and patient-reported outcomes.
Implementing PROMs in routine clinical care: a qualitative exploration of GP perspectives
Authors: Litchfield Ian , Greenfield Sheila , Turner Grace M , Finnikin Samuel , Calvert Melanie J 
Published: November 2020

BackgroundThe recently announced long-term plan for the NHS is based on a model of person-centred care, which relies on the sustained engagement of patients, shared decision making, and capability for self-management. For a primary care service under increasing pressure from an ageing and chronically ill population, Patient Reported Outcome Measures (PROMs) appear capable of supporting many of the requirements for person-centred care, yet little is known of the circumstances of their current implementation or how their use might be optimised.AimTo begin the conversation about how successfully PROMs have been integrated into primary care and how their use might be supported.Design & settingA qualitative investigation of the perspectives of GPs exploring the use of PROMs as part of routine clinical care in England.MethodSemi-structured telephone interviews were conducted with GPs from across England. The data were analysed using the Consolidated Framework for Implementation Research (CFIR).ResultsA total of 25 interviews were conducted and GPs described the potential benefit of PROMs in a range of circumstances, but also voiced concerns about their reliability and their potential to constrain consultations. Their flexibility meant they had the potential to be incorporated into existing care processes but only with the requisite logistical support.ConclusionAreas that need to be addressed include the creation of a compelling body of evidence of the benefit of PROMs, appropriate training for staff and patients, and a coherent implementation strategy from policymakers and funding bodies.
Evaluation of winter pressures on general practice in Manchester: a cross-sectional analysis of nine GP practices
Authors: Millwood Sinead , Tomlinson Peter , Hopwood Jon 
Published: November 2020

BackgroundThe Nuffield Trust’s report on NHS winter pressures highlights a lack of data for primary care, with a consequential focus on secondary care. An increase in data is required on the scale of the winter demand on primary care, so the need for investment in this area can be clearly seen.AimTo quantify seasonal variation in workload in primary and secondary care.Design & settingAnalysis of data for nine GP practices in Greater Manchester with a patient population of 75 421.MethodDescriptive and comparative analyses were performed for winter and summer periods in 2018–2019. Data were obtained from the North of England Clinical Support Unit (NECSU) via the Rapid Actionable Insight Driving Reform (RAIDR) toolkit, and EMIS Enterprise clinical audit tools.ResultsAccident and emergency (A&E) attendances increased by 4% (P = 0.035) during winter with no difference in the number of hospital admissions (P = 0.668). The number of problems (defined as separate diagnoses or causes for a GP consultation, for example, chest infection or medication request) seen in general practice increased by 61% (P<0.001) in winter compared to summer, as did the number of GP consultations, which was also 61% (P<0.001). Respiratory diagnoses saw the greatest seasonal variation accounting for 10% in winter compared with 4% in summer (P<0.001). Self-referral accounted for 66% of all A&E attendance and increased by 16% in winter. GP referral accounted for 7% in winter and 6% in summer (P = 0.002).ConclusionGeneral practice observed a greater seasonal increase in presenting patients compared with secondary care. Any winter pressures strategy should target both respiratory illness and patients who self-refer to A&E. Transferring 50% of self-referrals in Manchester to GP appointments would achieve a £2.3 million cost saving. Increasing provision in primary care requires funding and increased appointments, but more importantly improved patient opportunities to easily access timely advice and assistance.