Teachers' Encounters with Horizon Content Knowledge Investigating Knowledge Sensibilities for Teaching Mathematics

Mathematics education researchers have sought to understand the knowledge that teachers need to teach mathematics effectively. Teachers need to know more than merely knowing how to "do the math" at a particular grade level. However, the research community differs on the nature of that knowledge. The construct of "horizon content knowledge" has emerged in the literature as a promising way to characterize advanced mathematical knowledge (AMK) as it relates specifically to teaching practice. Ball, Thames, and Phelps (2008) and Ball and Bass (2009) propose a kind of knowledge that is neither common nor specialized, that is not about curriculum progression, but is more about having a sense of the broader mathematical environment of the discipline. They call this horizon content knowledge (HCK) and argue that knowledge of the mathematical horizon can support teachers in hearing students' mathematical insights, orienting instruction to the discipline, and making judgments about what is mathematically important. However, operationalizing HCK in practice is still under development. Jakobson, Thames, and Ribeiro (2013) offer an overarching definition of HCK, which foregrounds some inherent characteristics of this knowledge. This dissertation examined cases of teaching and teachers for the purpose of collecting and analyzing examples of HCK in practice, understanding the interaction between teachers’ management of what I call "encounters with mathematics at the horizon" and students’ learning experiences in the classrooms, and to characterize the knowledge resources that teachers draw upon to make sense of the mathematics at the horizon. I identified and articulated a new domain of knowledge resources that the teachers draw upon, called professional practice knowledge (PPK). I define PPK as a form of mathematical knowledge derived from practice and experience. As PPK is knowledge that is shaped by experience, the culture in school, role of leadership, and kind of students’ and parents’ involvement impacts PPK. If PPK is the only resource available to the teacher, then teachers’ explanations of mathematical deductions are often pseudo-mathematical. Pseudo-mathematical descriptions are generated by the teachers in such ways that they do not explain the concept, term, or formula but instead focus on memorization. These center on the visual patterns or syntactic patterns, use colloquial meanings of the mathematical terms, and often have a cue to remember the term, concept, or formula. These explanations can block mathematical access for the students to investigate or build further. However, if PPK remains rooted in other domains of HCK elaborated in the dissertation, teachers are able to manage encounters with HCK in more meaningful ways.PHDEducational StudiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/145790/1/shwetan_1.pd

Study of thyroid hormone profile in women presenting with abnormal uterine bleeding attending gynaecology out patient department, tertiary care centre Raipur

Background: Menstrual disorders pose a huge burden on genecology OPD, accounting for 10-30% of attendance. Women with HMB have a significant impact on physical, emotional, social, professional and family perspectives which leads to decrease in work productivity. Thyroid gland is closely linked with the process of ovarian maturation and endometrial hyperplasia, its dysfunction also causes abnormal uterine bleeding (AUB).Methods: This was an observational cross-sectional study performed at Pt J. N. M. medical college associated with Dr. B.R.A.M. hospital Raipur (C.G.) between 1st January 2020 to 31st December 2020. Total 100 cases between 18-45 years of age with AUB were included routine investigations and ultrasonography done.Results: Majority of AUB cases belong to the more than 39 years (46%), 41% were multiparous. The 20% cases of AUB have hypothyroidism, 2% have subclinical hypothyroidism, 7% have hyperthyroidism. Commonest pattern of bleeding was heavy menstrual bleeding (52%). They 37% cases had leiomyoma of uterus, 17% cases had adenomyosis, and 14% cases had ovulatory dysfunction. The 12 cases having hypothyroidism and 3 cases having hyperthyroidism presented with heavy and prolonged bleeding.Conclusions: There is significant increase in thyroid disorders in cases with AUB as compared to general population. More than one fourth of cases of AUB were having thyroid disorder. Hypothyroidism is 3 times more common than hyperthyroidism. It is suggested that women of any age having AUB should be offered thyroid profile test to detect thyroid disorders. Early detection can provide early diagnosis and treatment.

Comparison of the efficacy of combined epidural anesthesia with general anaesthesia alone to attenuate hemodynamic responses and perioperative analgesia in laparoscopic cholecystectomy patients

Background: The aim of the study was to compare the efficacy of combined GA-Epidural Anesthesia (CEGA) with GA alone to attenuate hemodynamic responses and perioperative analgesia.Method: Authors conducted a prospective, randomized, double blind study, in which 60 patients undergoing laparoscopic cholecystectomy. Group A received (n=30) received GA and Group B (n=30) received combined GA and Epidural Anaesthesia (CEGA). Authors analyzed the effect of combined epidural general anaesthesia as compared to plain general anaesthesia with regard to hemodynamic parameters (heart rate, systolic and diastolic blood pressure), intraoperative anaesthetic requirement (intraoperative requirement of propofol), recovery score and postoperative analgesia (VAS score).Results: Authors found significant decrease in the heart rate, systolic and diastolic blood pressure in response to stress response to pneumoperitoneum in combined epidural general anaesthesia (CEGA) group compared to plain general anaesthesia (GA) group. Total amount of propofol required intraoperatively was less in CEGA group than in GA group. Recovery score and pain score (VAS) score were also compared which were better in CEGA group than in GA group. There were no significant intraoperative and postoperative complications noted in both the groups.Conclusion: Authors concluded that the use of epidural along with general anaesthesia helps in attenuating hemodynamic changes due to stress response to pneumoperitoneum, which results in maintaining stable intraoperative and postoperative hemodynamics during laparoscopic cholecystectomy surgery. Combining epidural to general anaesthesia results in rapid recovery as compared to plain general anaesthesia and also helps in providing good postoperative analgesia

Severe primary hypothyroidism leading to life threatening heavy menstrual bleeding: a case report

Thyroid disorders are one of the leading causes of abnormal uterine bleeding in women of all age groups and in India its prevalence in women is about 26%. Sequelae of thyroid disorders may vary from infrequent menstrual cycle, light menstrual bleeding to even a very severe life threatening heavy menstrual bleeding leading to anemia &shock. It occurs due to anovulation, endometrial hyperplasia and coagulation defects. Thyroid screening is important while investigating all cases of AUB. A 18 year old girl was brought to Dr. Bhim Rao Ambedkar Memorial Hospital Raipur with very severe anemia (Hb: 1.1gm/dl) and grade IV hemorrhagic shock (BP 50/30mm of Hg) but surprisingly pulse rate was normal (80bpm). Her peripheries were cold and clammy. SpO2 -80% on room air, she had facial puffiness and grade III pitting edema over her hands and feet. Her TSH was very high >100 µIU/ml with decreased (T4 - 0.678µg/dl, T3 - 0.359 µg/ml) suggestive of severe primary Hypothyroidism. USG was suggestive of bulky uterus with 14 mm endometrial thickness. Her shock was managed and tablet norethisterone, tranexamic acid, levothyroxine and iron supplements started. Severe hypothyroidism can cause life threatening uterine bleeding. This case is of peculiar interest because of profound hypothyroidism associated with hemorrhagic shock. Early recognition and proper management is important to prevent hazardous complications

Therapeutic role of vegetables in Respiratory Diseases – A critical review from Ayurvedic classics.

The concept of Pathya (wholesome diet) is an unique contribution of Ayurveda, which plays an important role in prevention and management of many diseases. “Shakavarga”, a category under dietetics in classical texts of Ayurveda enlisted different vegetables with their properties and indications in different disease conditions. These vegetables can be prescribed as Pathya (wholesome diet) in clinical practice. In the present review, plants described under Shakavarga, indicated as Pathya in different diseases related to Pranavaha Srotas (Respiratory system) were compiled from 15 different Ayurvedic classical texts. Critical analysis of the compiled data reveals that out of 332 vegetables described under Shakavarga, 44 are indicated in respiratory disease like Shvasa (Dyspnoea/Asthma), Kasa (Cough), Peenasa (Chronic rhinitis) and Hikka (Hiccup). Among them, botanical identity of 42 classical plants has been established and maximum number of vegetables belongs to the family cucurbitaceae (10) followed by solanaceae (4). Some of these vegetables have been reported for their various pharmacological activities related to prevention and management of diseases related to Pranavaha Srotas (Respiratory system). These vegetables are reported for their anti-inflammatory (16), antioxidant (14), anti-allergic (6) and antitussive (3) activities. The observed result may be helpful in use of vegetables as Pathya (wholesome diet) and planning further scientific studies about the efficacy of these plants on prevention as well as management of respiratory diseases

Comparative study of acupressure wristband versus palonosetron for prophylaxis of postoperative nausea and vomiting in elective laparoscopic cholecystectomy under general anaesthesia

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method

Genotypic Distribution and Antimicrobial Susceptibilities of Carbapenemase-Producing Enterobacteriaceae Isolated in Tertiary Care Hospital in South India

Antimicrobial resistance has emerged as a major danger to contemporary medicine around the world. Carbapenems are the highest class of B-lactam drugs which are considered as the most effective and safest antibiotics available. Increasing spread of carbapenemases has been noted across the world which restricts treatment options. The aim of this study was to determine the incidence of carbapenem resistant genotypic pathways in a tertiary care hospital. 130 clinical strains of Enterobacteriaceae were subjected to Kirby-Bauer disk diffusion tests and genotypic methods (PCR) for the identification of the genes NDM, VIM, and OXA-48. Carbapenem resistance was detected in 30% of the isolates by phenotypic methods. These 37 isolates on being subject to PCR showed OXA-48 followed by VIM and NDM as the most frequently isolated genotypes. All isolates had multiple genes encoding carbapenem resistance. Carbapenemases resistance is on the rise and is associated with multi drug resistance pattern. To minimize spread and initiate early appropriate therapy, early detection of carbapenem resistance is essential. Molecular methods remain gold standard for detection

Comparison of Three Phenotypic Methods of Carbapenemase Enzyme Detection to Identify Carbapenem-resistant Enterobacterales

The prevalence of multidrug-resistant gram-negative bacilli has increased worldwide. Critical care areas of most hospitals use carbapenem antibiotics for the empirical treatment of gram-negative bacterial (GNB) infections. In the last decade, there have been reports of the detection of carbapenem-resistant Enterobacterales (CRE). This rise in the spread of CRE presents a great challenge in the treatment of GNB infections and poses a serious threat to global health. To detect the burden of CRE and to characterize CRE, we used three phenotypic methods for the detection of carbapenemase enzymes. Using conventional aerobic bacterial culture methods, 150 Enterobacterales strains were isolated from various clinical samples. Identification of CRE was performed using multiple phenotypic detection methods, such as the Kirby Bauer disc diffusion method for meropenem (10 mcg) using the CLSI 2021 interpretation for meropenem, modified Hodge test (MHT), Carba NP test, and modified carbapenem inactivation method (mCIM) test. A total of 150 Enterobacterales strains were isolated over a period of 1 year. Among these, 66/150 (44%), 63/150 (43%), 64/150 (43%), and 65/150 (43%) were identified as CRE using the Kirby Bauer disc diffusion method, MHT, mCIM test, and Carba NP test, respectively. The sensitivity and specificity of MHT, mCIM, and Carba NP tests within 95% CI were 93.94%/100%, 96.97%/100%, and 98.48%/100%, respectively. The positive and negative predictive values of MHT, mCIM, and Carba NP tests were 100%/95.45%, 100%/97.67%, and 100%/98.82%, respectively. The accuracies of the MHT, mCIM, and Carba NP tests were 97.33%, 98.67%, and 99.33% respectively indicating a high burden of carbapenem resistance in Enterobacterales. Therefore, given the current statistics of carbapenem resistance, use of carbapenem as empiric treatment in the intensive care units of hospitals may not be beneficial. Identification of carbapenem resistance can help in the initiation of appropriate antimicrobial therapy. This study compares the accuracy and efficiency of Carba NP, mCIM, and MHT in detecting carbapenem-resistant Enterobacterales

Comparative Study of Antibacterial Activity between Selected International and Indian Essential Oils against Selected Pathogenic Bacteria

In recent years, the rapid growth in Antimicrobial resistance (AMR) has become a global concern. Essential oils derived from plants that include bioactive components with proven antioxidative and antibacterial activities could be a potential solution to arrest this problem. In this study, antibacterial activities of DoTERRA essential oils such as Onguard, Clove, Teatree, Lavender and Eucalyptus were evaluated with Indian essential oils against clinical pathogenic bacteria. The GC-MS study revealed that cineole, terpinene, eucalyptol, and eugenol were the most prevalent bioactive components in these essential oils. The purity of the essential oils was confirmed with zeta potential and white light absorption spectrophotometer and shows that the Zeta potential of all the essential oils ranges from -51.4 to 0 mV. Using agar well diffusion and Micro broth dilution procedures, the antimicrobial activity of essential oils of clove, lavender, tea tree, eucalyptus, and On-Guard (combined) was assessed against several multi-drug-resistant bacteria. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of essential oils in aqueous and micellar solutions were determined by Micro broth dilution techniques. The most effective antibacterial essential oils were clove, tea tree, and On guard (a blended essential oil with a predominance of Limonene and Eugenol). The current research could result in development of formulas that contain micelle or colloid suspensions of whole essential oils such as clove, On-Guard, or Tea-Tree oil to aid in antimicrobial treatment

Antibiotic Resistance of Clinical Klebsiella Isolates from Tertiary Care Hospital

Klebsiella is a pathogen that causes a significantly high number of community-acquired and hospital-acquired infections, with infections being one of the leading causes of death in ICU patients worldwide due to increasing antibiotic-resistance and a lack of therapeutic options. A total of 230 Klebsiella spp. were collected from various clinical samples. After initial identification, the drug-resistant strain was subjected to standard Clinical Laboratory and Standards Institute methods such as Kirby–Bauer disc diffusion. All isolates were screened and confirmed for ESBL/AmpC β-lactamase/carbapenemase production. The isolated Klebsiella spp. were found to be K. pneumonia (89%), K. oxytoca (6.5%), and K. aerogenes (4.5%). Among the 230 isolates, 80 (34.7%) isolates were found to be ESBL producers via screening; of these, 53 (23.5%) were verified by a confirmatory test. Moreover, 115 isolates (50%) were screened as AmpC producers; of these, 23 isolates (10%) were verified by a confirmatory test. Carbapenemase producers accounted for 69 (30%) isolates, identified by screening; 25 (10.86%) were verified by a confirmatory test. ESBL producers accounted for the majority of Klebsiella spp. isolates, followed by carbapenem and AmpC producing strains