bluuebunny/crossref_metadata_2025 huggingface dataset:
Entre Exu e Ogum: políticas do sagrado no teatro de Abdias do Nascimento
Authors: Lima Rainério dos Santos
Published: January 2020

Resumo Estudo crítico das determinantes míticas na caracterização das personagens e na composição da ação em Sortilégio II, drama de Abdias do Nascimento. O teatro de Abdias obedece a paradigmas de composição da cena que não se baseiam mais na organicidade sintagmática da fábula, mas, apresentando os complexos e paixões de Emanuel, busca uma organização descontínua e paradigmática, para dar conta da vida de uma única e dominante subjetividade em cena. Em Sortilégio II, essa configuração teatral pós-catástrofe é ideal para tecer os processos rememorativos de Emanuel, na tentativa de projetar no presente da cena o passado traumático do personagem, marcado pela violência social, pelos complexos raciais e pelas contraditórias relações eróticas com Ifigênia e Margarida. Na peça, além das definições estruturais da ação, o sagrado afro-brasileiro e a mitologia dos Orixás são importantes modulações culturais que interferem nas relações de poder entre os agentes e nos processos de subjetivação que acometem Emanuel. Uma rede social e simbólica que, sob a tutela de Exu e Ogum, concorre para a libertação e deificação do personagem. Por meio do reconhecimento da cultura negra, do pertencimento étnico-racial e do sacrifício mítico, Emanuel deixa o mundo racista dos homens para habitar o Orún, o plano divino dos Orixás.
História da assistência hospitalar em São Paulo: a subvenção do Estado às misericórdias paulistas
Authors: Silva Márcia Regina Barros da
Published: January 2020

Resumo O artigo analisa como as santas casas de misericórdia do estado de São Paulo foram subvencionadas pelos governos municipais, provincial e estadual na passagem do século XIX para o XX. Para tanto, são discutidas as dotações orçamentárias realizadas de 1838 a 1915, com o fim de avaliar o repasse e a ampliação de verbas nesse ínterim. É possível notar que foi criada uma rede de assistência fortemente apoiada pelo Estado, mas efetivada pela assistência filantrópica. Essa rede de atendimento hospitalar permanece com o mesmo formato até pelo menos o primeiro terço do século XX, contexto em que se incluíam as misericórdias criadas pelo interior do estado paulista.
Riqueza, pobreza e infância: o reformismo ilustrado português e a utilidade dos expostos
Authors: Franco Renato
Published: January 2020

Resumo Em meados do século XVIII, a associação entre “gente” e “riqueza” reemergiu como uma tópica relevante para a literatura da razão de Estado, em que, por extensão, sedimentou-se um conjunto de controvérsias a respeito das melhores formas de aproveitar os enjeitados como população útil. Tanto na América quanto na Europa, a ênfase em torno da utilidade dos expostos indicava uma inflexão que secundarizou os significados religiosos do auxílio às crianças em favor dos interesses do Estado. Este artigo analisa os sentidos das reformas da assistência aos expostos em um período de aumento global dos índices de abandono e, em simultâneo, de endividamento de boa parte das instituições de acolhimento.
O traço do personalismo das instituições assistenciais: doadores, doações e projeção social no Ceará oitocentista
Authors: Oliveira Cláudia Freitas de
Published: January 2020

Resumo No Brasil oitocentista evidenciou-se a emergência de instituições assistenciais. Por meio delas, os estados provinciais projetaram membros das elites políticas e econômicas nomeando-os grandes benfeitores. Homens de notoriedade local desempenharam papel na construção de determinados espaços asilares por meio de práticas que ratificaram seu prestígio social não apenas entre seus pares e para sua época, mas também para a memória e a história das instituições às quais estavam vinculadas. O artigo problematiza a construção de três instituições assistenciais no Ceará: Asilo de Mendicidade, Colônia Orfanológica Cristina e Asilo de Alienados São Vicente de Paula, cuja tônica discursiva e ações filantrópicas estavam inseridas no cenário da grande seca de 1877-1879.
A Comissão Nacional de Bem-estar Social: planejamento estatal e política social, 1951-1954
Authors: Oliveira Samuel Silva Rodrigues de
Published: January 2020

Resumo O artigo analisa a criação da Comissão Nacional de Bem-estar Social no segundo governo Vargas (1951-1954). A partir das mensagens presidenciais e do acervo privado de Alzira Vargas do Amaral Peixoto, contextualiza o momento de fundação do órgão e suas conexões com órgãos internacionais de planejamento da política de assistência social.
O Grace Memorial Hospital e a Missão Presbiteriana norte-americana no Brasil: fontes para a história da assistência à saúde, 1955-1971
Authors: Silva Maria Elisa Lemos Nunes da , Batista Ricardo dos Santos
Published: January 2020

Resumo Apresenta aspectos da história e do acervo documental do Grace Memorial Hospital, instituição criada em 1926 na antiga cidade de Ponte Nova, atual Wagner, na Chapada Diamantina (BA), pelo médico e missionário presbiteriano norte-americano Walter Welcome Wood. O corpus documental está sob guarda da Universidade do Estado da Bahia, campus II, Alagoinhas, desde o encerramento definitivo das atividades do hospital, e constitui-se em fonte de pesquisa para diferentes áreas de estudo, especialmente para a história da assistência à saúde no Brasil. Os documentos auxiliam as análises sobre a incidência de doenças, tratamentos médicos e outros cuidados com a saúde em uma população que não tinha acesso a outras instituições que atuassem nesse âmbito.
Saturated Cost Partitioning for Optimal Classical Planning
Authors: Seipp Jendrik , Keller Thomas , Helmert Malte
Published: January 2020

Cost partitioning is a method for admissibly combining a set of admissible heuristic estimators by distributing operator costs among the heuristics. Computing an optimal cost partitioning, i.e., the operator cost distribution that maximizes the heuristic value, is often prohibitively expensive to compute. Saturated cost partitioning is an alternative that is much faster to compute and has been shown to yield high-quality heuristics. However, its greedy nature makes it highly susceptible to the order in which the heuristics are considered. We propose a greedy algorithm to generate orders and show how to use hill-climbing search to optimize a given order. Combining both techniques leads to significantly better heuristic estimates than using the best random order that is generated in the same time. Since there is often no single order that gives good guidance on the whole state space, we use the maximum of multiple orders as a heuristic that is significantly better informed than any single-order heuristic, especially when we actively search for a set of diverse orders.
Spatio-seasonal variations in the faecal bacterial community of Zulu sheep grazing in communally managed rangeland
Authors: Xulu Thembinkosi G. , Ezeokoli Obinna T. , Gupta Arvind K. , Mienie Charlotte , Bezuidenhout Cornelius C. , Kunene Nokuthula W.
Published: January 2020

The adaptation of Zulu (Nguni) sheep (Ovis aries) to environmental stress and survival under extensive conditions makes them uniquely important to rural Nguni farmers of South Africa. Here, the faecal bacterial community of five Zulu sheep populations managed under extensive conditions across summer and winter seasons was investigated in order to understand the influence of prevailing seasonal factors. Bacterial operational taxonomic units (OTUs)/species (at 97% 16S rRNA gene similarity) in Zulu sheep faeces were more diverse in winter than in summer at most (80%) sites and varied between seasons at specific sites. Firmicutes was the most abundant phyla in both summer and winter seasons, while the relative abundance of Actinobacteria reduced in 80% of sites from summer to winter. The genera (or family) such as Akkermansia, Eubacterium coprostanoligenes group, Intestinibacter, R-7 group (family Christensenellaceae), Ruminococcus, Ruminoclostridium, Treponema and UCG-005 (family Ruminococcaceae) were relatively more abundant and belonged to a ‘core microbiome’ of Zulu sheep faeces. Between seasons, Acinetobacter, Jeotgalicoccus, Methanobrevibacter, Phascolarctobacterium and Planomicrobium were differentially abundant. Overall, results suggest increased richness and diversity of bacteria from summer to winter which may be related to spatio-seasonal variations in grazing management, forage types and availability. This observation serves as baseline evidence, justifying further controlled studies investigating, amongst other factors, effects of forage type and availability across seasons on ruminal microbiota of Zulu sheep grazing in communally managed rangelands.

Significance:

Spatio-seasonal dynamics in the bacterial community of Zulu sheep faeces suggest differences in forage type and availability across sites potentially influence faecal bacteria of Zulu sheep.

The study provides a basis for further controlled studies investigating the influence of environmental factors on rumen and faecal microbiomes of Zulu sheep.

Open data set: 

https://www.ncbi.nlm.nih.gov/sra/?term=PRJNA356736
PlOsOne_Araneda_DeVolder_study protocol v1
Authors: De Volder Anne
Published: January 2020

Abstract Using functional magnetic resonance imaging, we monitored the brain activity of 12 blind subjects and 12 control subjects, studied blindfolded, matched for age, gender, and musical experience. They were involved in the detection of rhythmic sequences ("beat") versus irregular ("no beat") composed of sounds or vibrotactile stimulations. Differences in cerebral activity between the two groups, in both sensory modalities, were observed in the occipital brain areas as well as in the heteromodal cerebral regions, including the parietal and frontal brain areas, which were recruited only in the early blind group. These results highlighted that early blindness induced brain differences in the brain network dedicated to perception of rhythm, with a participation of visual occipital brain areas. We concluded that, in the early blind, the visually deprived cortex switches its input modality from vision to audition and vibrotactile sense to perform a temporal processing task, regardless of the input modality, supporting the concept of metamodal organization of the brain.
MojoSort™ Whole Blood Human CD8 Nanobeads Whole Blood Column Protocol v1
Authors: Li Sam
Published: January 2020

BioLegend MojoSort™ nanobeads work in commonly used separation columns, based on our internal research as well as validation by external testing by academic labs. This simple protocol consists of following the MojoSort™ protocol to label the cells with pre-diluted MojoSort™ reagents and using the columns as indicated by the manufacturer. Note: Due to the properties of our beads, it may be possible to use far fewer beads that with other commercial suppliers. We recommend a titration to find the best dilution factor. However, as a general rule, dilutions ranging from 1:3 to 1:20 for the Nanobeads can be used. Please contact BioLegend Technical Service (tech@biolegend.com) if further assistance is needed.
US POLICY AND DEMOCRACY CHALLENGES IN LATIN AMERICA AND THE CARIBBEAN
Authors: Tkach Anatoly
Published: January 2020

Formulation of the problem: In the article management problems are examined Geographic proximity has ensured strong linkages between the United States and Latin America and the Caribbean, based on diverse U.S. interests, including economic, political, and securityт concerns. The United States is a major trading partner and the largest source of foreign investment for many countries in the region, with free-trade agreements enhancing economic linkages with 11 countries.
Purpose of the research: The region is a large source of U.S. immigration, both legal and illegal; proximity and economic and security conditions are major factors driving migration. Curbing the flow of illicit drugs has been a key component of U.S. relations with the region for more than three decades and currently involves close security cooperation with Mexico, Central America, and the Caribbean. U.S. support for democracy and human rights in the region has been long-standing, with particular current focus on Cuba, Nicaragua, and Venezuela.
The article analyzes the priorities of Administration of President Trump ordered U.S. withdrawal from the proposed Trans-Pacific Partnership trade agreement, which would have increased U.S. economic linkages with Mexico, Chile, and Peru. President Trump criticized the North American Free Trade Agreement (NAFTA) with Mexico and Canada as unfair, warned that the United States might withdraw, and initiated renegotiations; ultimately, the three countries agreed to a United States-Mexico-Canada Agreement in late September 2018. The proposed agreement, which requires congressional approval, largely leaves NAFTA intact but includes some updates and changes, especially to the dairy and auto industries. Administration actions on immigration have caused concern in the region, including efforts to end the deportation relief program known as Deferred Action for Childhood Arrivals (DACA) and Temporary Protected Status (TPS) designations for Nicaragua, Haiti, El Salvador, and Honduras. President Trump unveiled a new policy in 2017 toward Cuba partially rolling back U.S. efforts to normalize relations and imposing new sanctions.
GRAFİK VE ANİMASYON DERSİNE YÖNELİK TUTUM ÖLÇEĞİNİN GELİŞTİRİLMESİ
Authors: Çelik Berkay , Gündoğdu Kerim
Published: January 2020

Bu
çalışmada, öğrencilerin meslek lisesi bilişim teknolojileri alanı 11.sınıf
düzeyinde okutulan Grafik ve animasyon dersine ilişkin tutumlarını belirlemeye
yönelik bir ölçek geliştirilmesi amaçlanmıştır. Çalışmada ilk olarak özellikle
meslek lisesi bilişim teknolojileri alanında okutulan derslerin öğretim
programları, ders kitapları incelenmiş ve literatürde grafik ve animasyon
konulu çalışmalar incelenmiş ve grafik ve animasyon dersine yönelik tutumu
ölçen toplam 36 taslak madde yazılmıştır. Taslak ölçek maddeleri uzman kanısına
(n=8) sunulmuş ve 36 maddelik taslak ölçek 24 maddeye düşürülerek deneme formu
hazırlanmıştır. Elde edilen form meslek liselerinin 12. Sınıfında okuyan 298 öğrenciye
uygulanmıştır. Açımlayıcı faktör analizinde madde faktör yüklerine bakılarak 5
madde elenmiştir. Ölçekte yer alan 19 maddeye ilişkin faktör yükleri 0.53 ile
0.81 arasında değişmektedir. Doğrulayıcı
faktör analizi sonucunda elde edilen karşılaştırmalı uyum indekslerinden
(RMSEA) = 0.062 ve (RMR) = 0.044 olarak hesaplanmıştır. Ölçümlerin cronbach
alfa güvenirlik katsayısı 0,87’dir. Elde edilen bulgular ölçeğin güvenilir ve
geçerli bir ölçme aracı olduğunu göstermektedir.
NEW GENERATION CHAOTIC SCENES: THE CHAPMANS AND YELLIN
Authors: Asmaz Ayşenur Ceren
Published: January 2020

Regardless
of the art discipline to which it belongs or the material used, the artwork
always hosts the presentation of a scene. These scenes may include figures, the
serenity of nature, or the imaginary structure of dreams. The images and colors
used can be elements that make the viewer feel happier or more depressed. But
the only thing that does not change is the existence of a scene that the artist
presents to the audience. In this context, it is not surprising that the
understanding of consumption and motion, which dates back to the twenty-first
century, takes place in chaotic scenes with positive or negative effects. A new
generation of chaotic scenes that try to be defined through the example of Jack
& Dinos Chapman brothers and Dustin Yellin, who differentiate themselves
from their contemporaries and present their approaches to this chaos in
different ways; has gained a solid place in contemporary art and has been
diversified by being supported by other artists. This interaction, which
accelerated with the change and development of classical techniques and mediums
used to create artworks, it seems that to continue to connect with the audience
for a long time.
Changing a Language Person in Learning a Foreign Language
Authors: Oltuszyk A.B.
Published: January 2020

The article is devoted to the actual problem of the formation of a secondary linguistic personality when teaching a foreign language, including Russian as a foreign language. In it, the author summarizes the results of a survey conducted among students of higher educational institutions of Russia and Poland. As a research task, the influence of the foreign language being studied on the formation of a linguistic personality was considered.
From the Editors
Authors: Kędra-Kardela Anna , Kędzierska Aleksandra , Kowalczyk Andrzej Sławomir
Published: January 2020

.
Comparative study of pathological lesions of liver in autopsy cases
Authors: Simon K. Ankita , Dantkale Sunita , Shinde Samruddhi
Published: January 2020

Background: Liver is a site for plethora of diseases among which many become symptomatic while others usually either go undiagnosed or are concealed by other prominent diseases. As said about liver to be the custodian of milieu interior most of the silent liver diseases are diagnosed only on autopsy examination. Aims and objectives was to study various pathological lesions of liver in medicolegal and clinical autopsy cases and to corelate liver diseases with age and sex. Retrospective cross-sectional observational study of 649 medicolegal and clinical autopsies conducted within 2 years of duration (January 2017 to December 2018).Methods: Out of all 649 autopsies conducted in our hospital all liver specimens along with other organs viscera were collected and formalin fixed. After gross examination sections from the liver were submitted for tissue processing and then stained with haematoxylin and eosin stain.Results: The most common pathology found in our study was fatty change (11.1%) followed by venous congestion (4.3%), hepatitis (3.5%), cirrhosis (2.2%), tuberculosis/ granulomatous hepatitis (0.6%), chronic hepatitis (0.3%), malignancy (1%), miscellaneous (2%) and normal (72.4%). Maximum cases were in 21-30 years of age group with male preponderance.Conclusions: Autopsy examination of liver is an effective tool to identify silent liver diseases. Use of autopsy findings along with other investigative techniques.
A study of femoral bicondylar angle in Udaipur, India zone
Authors: Shrivastava Bhavana , Mehta Rupali , K. Prabhakaran , Jain L. K.
Published: January 2020

Background: Human body consists of 206 bones; among which femur. The thigh bone is considered as the biggest and strongest bone of the body. The bone contains a femoral bicondylar angle which helps in maintaining the balance and certain movements of the body. Those movements are essential to stand upright and erect; therefore, helps in balancing the posture of the body. Bicondylar angle shows various gestures and characteristics essential for describing the necessary ailments of the human skeleton. Thus, the present study is designed with an aim to measure and compare the bicondylar angle of femur both in males and females in Udaipur, Rajasthan, India zone.Methods: Totally, 96 bones were studied- 48 males and 48 females’ bones in 2 years duration. The study was carried out in the Department of Anatomy of Geetanjali Medical College and Hospital and R.N.T. Medical College. The bicondylar angle was measured with a suitable apparatus comprising of compass, Digital Vernier Calliper, scale and protector (Figure 1) along with osteometric board. Bicondylar angle of male and female bone was calculated using SPSS software.Results: The study shows that the bicondylar angle of left femur was greater than right femur in both the genders, but their side differences was statistically insignificant (p>0.05).Conclusions: Hence, the bicondylar angle of female is larger than in comparison to males and these results can put emphasis/light on the orthopaedic clinicians and surgeons to know the etiology of osteometric diseases.
C-reactive protein/albumin ratio as a predictor of 28 day mortality in patients with sepsis
Authors: T. Hamsa B. , V. Srinivasa S. , A. Raveesha
Published: January 2020

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis remains a major cause of morbidity and mortality worldwide. Important biomarkers that can be used as prognostic markers in sepsis are C Reactive Protein (CRP) and serum Albumin levels. CRP levels markedly elevate in response to infection whereas albumin levels decrease in response to acute phase infection. We want to ascertain the value of CRP/albumin ratio as an independent predictor of 28-day mortality in sepsis patients.Methods: A prospective study was conducted including 150 patients satisfying the criteria for sepsis according to SOFA score of more than 2. Initial CRP/Albumin ratio was assessed to determine its significance in assessing the 28-day mortality, primary end point of our study. Secondary end points assessed were length of ICU stay, need for inotropic support, need for ventilator support and renal replacement therapy.Results: In the analysis of CRP/Albumin ratio as a predictor of 28-day mortality, patients were followed up from day of admission till 28 days to assess primary outcome. Among study subjects survivors were 92 in whom mean CRP/ALB ratio was 0.1197 and non survivors were 58 patients with mean CRP/ALB ratio was 0.0426. p-value <0.001, there was statistically significant difference found between survivor and Non-Survivor with respect to CRP/Albumin ratio. In assessing secondary outcome statistically significant association was found for need for ventilator and inotropic support, whereas it was insignificant in assessing need for dialysis and length of ICU stay.Conclusions: CRP/albumin ratio, which indicates the extent of residual inflammation, could be used as a prognostic marker in predicting mortality in patients with sepsis and septic shock.
Modified hematological sepsis score: an easy and cost effective measure to combat neonatal septicemia
Authors: Varughese Pearl Mary
Published: January 2020

Background: Early diagnosis of neonatal sepsis continues to be a problem because of subtle and non-specific clinical features. Blood culture is the gold standard, but it takes several days and is expensive. The hematological scoring system (HSS) consisting of different blood parameters could be an effective and simple method to help diagnose and treat neonatal sepsis. Aim of the present study was undertaken to highlight the importance of HSS in the early diagnosis and evaluation of neonatal septicaemia.Methods: This was a prospective study done in a peripheral hospital in Kerala. The inclusion criteria involved all inborn babies above 34weeks gestation. Exclusion criteria involved babies with congenital anomalies, congenital heart diseases, pathological jaundice, birth weight less than 2kg and babies requiring NICU admission, 550 babies were included in the study. Cord CRP and 48 hours CRP was taken. At 48 hours, blood samples were also taken for Total count (TC), Absolute Neutrophil Count (ANC), Platelet count, and peripheral smear. Blood culture was taken for babies suspected to have sepsis and started on antibiotics. The screening parameters were assessed for individual performance and in combination.Results: Individually, though parameters like TC, ANC, 48 hrs CRP and platelet count had excellent sensitivity (100%) and NPV (100%), their specificity was low 65%-82%. Degenerative changes showed sensitivity 94.1%, specificity 91% and NPV 99.8%. HSS score >5 and >6 had better specificity and NPV.Conclusions: HSS scoring can be used to safely exclude neonatal sepsis, thus avoiding unnecessary antibiotic exposure in newborns and undue worry for parents.
Study of onychomycosis
Authors: Nayak Sarita Kumari , Krishna P. Bala Murali , Lakshmi N.
Published: January 2020

Background: Onychomycosis is one of the most common fungal nail infections caused by Dermatophytes, Non-Dermatophytic Molds (NDM) and Yeast. Though it is not life-threatening, can cause pain, discomfort, and disfigurement. It decreases the nail growth rate. Objectives: This study was carried out to document the clinico-mycological pattern and antifungal susceptibility pattern of onychomycosis.Methods: The study group included 130 consecutive patients with suspected fungal nail infections, attending Dermatology outpatient department of King George Hospital, Visakhapatnam, Andhra Pradesh during November 2012 to August 2014. The nail clippings of the patients were collected and subjected to KOH mounts for direct microscopy and fungal culture and antifungal susceptibility tests.Results: Onychomycosis was common among males (66.92%) than females (33.08%) with highest incidence was in age group 31-40 years (41.37%). Finger or toenails were exclusively involved in 32.18% and 55.18% patients respectively while these were involved concurrently in the rest of the 12.65% patients. Distal and lateral subungual onychomycosis seen in 64.36% of the patients was the most common clinical type. KOH and culture positivity were recorded in 56.92% and 48.46% cases respectively. Dermatophytes (50.58%) were predominant isolate followed by NDM (27.58%) and yeast (21.84%). Clotrimazole and ketoconazole were most effective antifungals against dermatophytes. For NDM, itraconazole, nystatin and amphotericin B and for yeast fluconazole and itraconazole were effective.Conclusions: The present study gives an insight about the aetiological agents causing onychomycosis and their anti-fungal susceptibility pattern in this region. Thus, it can help in taking adequate control measures to prevent it.
Comparison between caudal epidural block and popliteal nerve block for postoperative analgesia in children undergoing foot surgery: a randomized controlled trial
Authors: Bumer Tailang , Kashyap Lokesh , Arora M. K. , Batra R. K. , Prasad Ganga , Mohan V. K. , Khan Shah Alam
Published: January 2020

Background: Pain following surgery in children cause discomfort, restlessness and agitation in the postoperative period which may result in an increased incidence of nausea, vomiting and maladaptive behavioural changes. Regional anaesthesia is commonly used as an adjunct to general anaesthesia for perioperative analgesia in children as part of a multimodal approach of pain relief. This study is to compare between caudal epidural block and popliteal nerve block for postoperative analgesia in children undergoing foot surgery.Methods: A prospective randomized single blind study was carried out on 30 children aged 1-12 years of either sex undergoing foot surgery. Patients were randomly assigned into caudal epidural block group and Popliteal nerve block group, 15 children each. Both groups receive 1 ml/kg of 0.25% bupivacaine. Foot surgery was carried out under general anesthesia along with regional block for all children. After completion of surgery, children were shifted to PACU and HR, BP, SPO2 were monitored. Patient was discharged from PACU after CHEOPS (1-5 years) or VAS (6-12 years) <4. Parental satisfaction, sedation score, PONV, and any other side effects were recorded.Results: Demographic data and baseline vital signs were comparable between two groups. Statistically significant difference (p=0.025) in number of attempts in giving block in group A (1.20±0.41) than group B (1.80±0.86). The mean postoperative pain scores, CHEOPS and VAS were comparable in both groups.Conclusions: Both caudal epidural block and popliteal nerve block provides comparable and adequate analgesia in children undergoing elective foot surgery.
Evaluation of 2 mm locking plates for treating mandibular fractures
Authors: Sharma Amit , Sharma Kopal , Panwar Vasim Raja , Kamal Neel , Gurjar Manish
Published: January 2020

Background: The progressive development in the trauma management has now paved way to the use of miniplates for the treatment of mandibular fractures. We present a case series of twenty-five patients treated with miniplates for the mandibular fractures.Methods: The study was done on twenty-five patients diagnosed clinically and radiographically with mandibular fractures and attending the outpatient department of Oral and Maxillofacial surgery of a tertiary care hospital in Jaipur city. The selected cases were treated by open reduction and internal fixation under general anesthesia. 2.0-mm titanium locking mini plates were used as a method of internal fixation. The patients were evaluated for the location, type and number of fractures, time required for adaptation and fixation of single four hole 2.0-mm locking plate, complications during surgery, pre and post-surgical occlusal relationship, adequacy of reduction on postoperative radiograph and any post-surgical complications requiring a secondary surgical intervention.Results: Majority were in the age group of 21-30 years (72%) with a mean age of 26.6 years. Among these, there were 23(92%) male and 2(8%) female patient. Maximum (28%) patients were of symphysis and angle fracture followed by symphysis and condylar (25%), while only 2% cases were of Para symphysis and condylar. The mean time taken for single plate adaptation and fixation was 11.34 minutes for symphysis fracture, 14.12 minutes for parasymphysis fracture, and 11.56 minutes for body fracture and 18.90 minutes for angle fractures.Conclusions: The locking miniplates in mandibular fractures is efficacious enough to appreciate early recovery of normal jaw function, uneventful healing and good union at the fracture site with minimal weight loss due to early reinstatement of masticatory function.
Efficacy and safety of thrombolytic therapy in prosthetic valve thrombosis
Authors: S. Purushotama T. , K. Sathish , K. Santhosh , S. Ravindranath K. , N. Manjunath C.
Published: January 2020

Background: There is limited data available about the effectiveness of thrombolysis in prosthetic valve thrombosis (PVT). Therefore, this study aimed to evaluate the efficacy and safety of thrombolytic treatment in PVT patients.Methods: This was an observational study conducted at a tertiary-care centre in India between March 2013 and April 2014. Total of 56 patients with either recurrent PVT or with confirmed left-sided PVT was included in the study. Thrombolytic therapy was administered as an intravenous infusion of streptokinase or urokinase, initially at a loading dose of 2.5L IU/hour over 30 minutes, followed by 1L IU/hour for 48–78 hours depending upon the clinical and 2D-Echo observation. Primary endpoint was considered as the occurrence of a complete clinical response. Secondary endpoint was considered as a composite of death, major bleeding or embolic stroke.Results: Mean age of the patients was 37±13 years. Most of the patients presented with NYHA-II (51.7%), III (39.2%), and IV (8.9%) symptoms. Mitral and aortic valve thrombosis were observed in 40(71.4%) and 11(28.6%) patients. Forty-nine (73.3%) patients were treated with streptokinase. Whereas, rethrombosis patients were treated with urokinase [6(16%)] and tenecteplase [1(1.3%)]. Two (3.6%) patients died, 1(1.8%), 1(1.8%), 2(3.6%), and 1(1.8%) patient had peripheral embolism, central nervous system bleeding, stroke, and embolic complications.Conclusions: Thrombolytic therapy can be used as the first-line treatment for thrombolysis in PVT patients. All PVT patients can be treated with streptokinase unless specific contraindications exist. Urokinase or tenecteplase is an alternative thrombolytic agent in rethrombosis patients.
Coronary anomalies and anatomical variants detected by coronary computed tomographic angiography in Kashmir, India
Authors: Rafiq Suhail , Mohiuddin Irshad , Nazir Imran , Faizan Malik
Published: January 2020

Background: Coronary Artery Anomalies (CAAs) presenting in adulthood are rare and associated with adverse cardiac events, including sudden cardiac death. Coronary artery anomaly is the second most common cause of Sudden Cardiac Death (SCD) in young athletes. Cardiac Computed Tomographic Angiography (CTA) is a readily available non-invasive imaging modality that provides high-resolution anatomical information of the coronary arteries. Multi-detector row CT is superior to conventional angiography in deﬁning the ostial origin and proximal path of anomalous coronary branches.Methods: This was a prospective study included 186 patients who underwent coronary CTA from December 2018 to November 2019 in Government medical College, Srinagar on a 256 slice CT. The indications for coronary CTA were an equivocal, or non-diagnostic stress test, atypical chest pain, suspected anomalous coronary, as well as the evaluation of cardiac cause of syncope.Results: Ramus intermedius was the most common anatomical variant seen in 25 patients (13.4%). The prevalence of coronary anomalies in this study was 5.66% including myocarding bridging. The most common anomaly was high take off of coronary artery from sinotubular junction accounting for 1.6%.Conclusions: Coronary Computed Tomographic angiography is much superior in detecting coronary artery anomalies than invasive coronary angiography because of the absence of soft tissue information like as is needed in myocardial bridging. Proper knowledge of the anomalies and their clinical significance is highly important in planning treatment and easing hardships of cardiologists in dealing with them.
Demonstrate observe assist perform versus video assisted teaching in teaching deep tendon reflexes to medical students: a comparative study
Authors: S. Sundeep , Pillai Swapna K.
Published: January 2020

Background: Clinical examination of Deep tendon reflexes is a skilled technique that should be taught in an interesting way. Newer teaching learning methods like Video assisted teaching can be utilized  to facilitate self-directed and long term learning  and to cultivate enhanced interest in the study.Method: Among 120 students are divided into 6 groups.  Each group is divided into two batches of 10 members each. 6 batches are taught deep tendon reflexes separately by DOAP.  6 batches are taught deep tendon reflexes separately by video assisted teaching. At the end of teaching and 2 weeks later, each batch is  assessed by OSCE . Objective Structured Clinical Examination checklist marks are systematically entered in an excel sheet and was analysed using unpaired t-test .The perception to each teaching learning method was assessed by feedback Questionnaire using  Likert Scale.Results: On comparing between the effectiveness of video assisted teaching and clinical demonstration of the examination of deep tendon reflexes , students taught by video assisted teaching scored higher marks in the evaluation after two weeks, which was statistically significant. Regarding perception, students favoured both teaching methods for their effectiveness. For clarifying doubts, students favoured DOAP method. For reproducibility and better retaining of memory, students favoured video assisted teaching.Conclusion: Video assisted teaching was equally effective as DOAP in teaching deep tendon reflexes to medical students. For reproducibility and better retaining of memory, Video assisted teaching was perceived better as reflected in the better mean scores two weeks after the teaching sessions.
Curse of the technology-computer related musculoskeletal disorders and vision syndrome: a study
Authors: Pandey Rahul , Gaur Shikhar , Kumar Rakesh , Kotwal Narendra , Kumar Sanjeev
Published: January 2020

Background: Computer Related Musculoskeletal disorders and Vision Syndrome (CRMSKVS) is defined as symptoms due to prolonged use of Visual Display Terminal (VDT).Methods: A cross-sectional observational study was done among office-workers working on computer terminal. A self-reported questionnaire was distributed and Musculoskeletal (MSK) and visual symptoms in the preceding 12 months (01 October 2017 to 30 September 2018) were taken as dependent variable. Multivariate analysis was done to identify the determinants of CRMSKVS.Results: Responses from 1193 subjects were included in the study. CRMSKVS was present in 489 cases (40.98%; males - 37.5%, females - 58.29%).  The main MSK symptoms were pain/stiffness in neck (40.98%), shoulder (38.99%), lower back (35.6%) and elbow/wrist/hand/fingers (23.1%). The ocular symptoms were excessive watering (39.6%), pain (24.99), irritation (18.6%), burning/itching sensation (29.8%), redness (40.7%), blurring of vision (13.2%) and headache (40.9%). Female gender (OR-1.498(1.262-1.778)), long duration of working hours (OR-2.77(2.399-3.214)), poor break duration (OR-2.59(2.172-3.089)), excessive smart phone use (OR-2.071(1.834-2.338)), poor posture (OR-3.883(3.282-4.592)), inappropriate distance of computer screen (OR-2.173(1.829-2.582)), low height of screen (OR-1.936(1.527-2.454)), distance of keyboard (OR-3.161(2.528-3.953)) and distance of mouse (OR-5.785(3.932-8.512)) were identified as significant determinants of CRMSKVS.Conclusions: CRMSKVS is an emerging pandemic which needs urgent attention by medical and administrative authorities. The device factors, personal factors, environmental and ergonomic factors are the modifiable risk factors for CRMSKVS.
Study of the correlation of epicardial adipose tissue with left ventricular mass and left ventricular mass index in patients with essential hypertension
Authors: Goswami Sourabh , Keswani Prakash , Chaturvedi Neeraj , Sharma Shrikant , Sharma Ramji
Published: January 2020

Background: Epicardial Adipose Tissue (EAT) is recognized to be a cardiovascular risk factor. In addition to providing fuel to heart, it plays a pivotal role in the pathogenesis of atherosclerosis though the secretion of adipokines. This study aims to find the correlation of EAT with Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI) in patients with essential hypertension. Increasing LVM and LVMI are predictors of poor cardiovascular outcome. So, if we find a positive correlation, we can say that measurement of epicardial fat in essential hypertension may help us identify high risk hypertensive patients.Methods: This study was carried out in SMS Hospital, Jaipur, after approval from the Ethics Committee. 100 consecutive eligible patients were included in the study after application of inclusion and exclusion criteria and taking proper informed consent. After history, examination and routine laboratory investigations, all patients underwent transthoracic 2D and Doppler echocardiography. EAT thickness, LVM and LVMI were measured and correlated using Spearman correlation coefficient.Results: The mean LVM was 139±42.12 g and mean LVMI was 35.76±11.28 g/m2.7. The spearman correlation coefficient (r) was calculated to be 0.691 between EAT and LVM and 0.677 between EAT and LVMI, indicating strong positive correlation between EAT and both LVM and LVMI. This implies that as; EAT increases, LVM and LVMI increases significantly.Conclusions: Thus, authors have found that EAT is positively correlated with LVM and LVMI. So, we can say that increase in EAT may lead to adverse cardiovascular outcome in patients with essential hypertension.
Ultrasound evaluation of biopsy proven malignant breast mass
Authors: Barman Geetanjali , Bujarbaruah Kabita , Choudhury Binoy Kumar , Kataki Amal Chandra
Published: January 2020

Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy.
Clinico hematological profile of pancytopenia in pediatric patients: an institutional experience in North Himalayan region of India
Authors: Rawat Anil , Mamgain Varun , Chandra Smita , Kalra B. P.
Published: January 2020

Background: Pancytopenia is a common clinical pattern with an extensive differential diagnosis, but literature search shows only limited studies of pancytopenia in Pediatrics patients in Uttarakhand state of India. The present study was therefore conducted to study the spectrum of pancytopenia with bone marrow and haematological profile in Pediatrics patients in this north Himalayan state of India.Methods: Prospective observational study was conducted in the Department of Pediatrics in the teaching institute situated in Uttarakhand state of India over a period of 12 months. The study included all the patients of pancytopenia below 18 years of age who underwent bone marrow examination after written informed consent.Results: The study included total 50 pediatrics patients of pancytopenia with male to female ratio of 1.38:1. The mean age of patients was 10.58±4.94 with median age of 12 years. Mean hemoglobin was 5.31±2.09 g/dl, total leukocyte count was 2492.68±941.76/mm3, platelet count was 34724±26423/mm3, mean corpuscular volume was 90.95±16.65 fl, mean corpuscular hemoglobin was 30.11±6.07 pg, mean corpuscular hemoglobin concentration was 33.06±1.65% and reticulocyte count was 1.21±1.10%. Nutritional deficiency (28%) was the most common cause for pancytopenia followed by aplastic anemia (24%). Megaloblastic anemia was the commonest cause of nutritional deficiency anemia (71.42%) with pancytopenia.Conclusions: Pancytopenia is an important presentation in Pediatrics population with the most common cause being nutritional anemia and aplastic anemia. Megaloblastic anemia is the commonest cause of nutritional anemia with pancytopenia. The clinicians should be aware of spectrum of pancytopenia with clinical and haematological presentation in Pediatrics patients of this region so as to avoid unnecessary work ups and delay in treatment.
Awareness and sources of the digital transactions schemes: a cross sectional study in a rural block of Jabalpur, Madhya Pradesh, India
Authors: Tomar Shashi Prabha , Dangwal Nipun , Kasar P. K.
Published: January 2020

Background: India is a developing country and is on the road of rapid progress, in every aspect. So, to further boost the development process, India joined many other developing countries and showed an intent to promote a cashless economy. However, this penetration is not much in the rural areas which constitute the building blocks of the country. Awareness regarding digital transaction schemes of government of India is imperative to success of such schemes. Hence, the current study for assessing the awareness of the digital transaction schemes and finding out the sources in their implementation will help cater these issues.Methods: A  descriptive cross sectional study was conducted among 60 respondents belonging to different age groups, socio economic strata and with different education status, to explore the awareness and acceptance percentage of respondents in rural block Paragraph  in relation to digital transaction schemes and methods and the their sources of information. Study was done in three-month duration from1st July 2018 to 30th September 2018.Results: It was found that the awareness for mobile banking among all the age groups was  a massive 93.36% while that of the Digital Dakiya scheme is a meagre 8.30%.It was inferred from the study that social interaction  was the major information source (51%) and there was a significant association between the use of mobile banking and younger age of the individual.Conclusions: Awareness among the older population and rural females is lesser as compared to counterparts and was massive for mobile banking. Disparity about awareness the of schemes points that overall usage needs to be promoted.
Sheehans syndrome: the hidden nemesis
Authors: Ghosh Labani M. , Leuva Alpa
Published: January 2020

Sheehan’s syndrome is the name given to postpartum hypopituitarism, usually precipitated by massive uterine haemorrhage and hypovolemic shock during or after childbirth resulting into pituitary injury in varying degrees. Most cases are diagnosed very late in life and the first presentation may be a life-threatening situation like shock or cardiorespiratory collape. This hidden nemesis in women compromises their quality of life and may result into mortality if not suspected early. In this article we present 3 patients who presented in the ICU in a state of complete cardio-respiratory collapse and later discharged in full health.
Which mesh should be used to repair abdominal wall defect in peritonitis? An experimental study
Authors: Alakuş Hüseyin , Göksu Mustafa
Published: January 2020

Background: In this study, following the Bogota bag closure of abdominal wall defects created in a rat peritonitis model, the short-term efficacy of polypropylene (PP) mesh (Prolene®, Ethicon), PP Mesh+Seprafilm®, polytetrafluoroethylene (PTFE) mesh [Infinit® Mesh (Gore)] and expanded PTFE (ePTFE) [Dualmesh®plus(Gore)] in the permanent repair of the defects was investigated.Methods: 64 rats were used. The rats were randomized into four groups, each consisting of 16 subjects: PP mesh (Group 1), PP mesh+Seprafilm (Group 2), PTFE mesh (Group 3), and ePTFE mesh (Group 4). Laparotomy was performed and abdominal wall defects were created. Contamination of the peritoneal cavity was induced, and closure was undertaken using a Bogota bag. After three days, the Bogota bag was removed, and materials were placed. At the end of the follow-up period, the rats were sacrificed. Mortality, grade of adhesion, surgical site infection (SSI), and tensile strength were evaluated.Results: Mortality was calculated as 6.3%, 50%, 25%, and 0% for Groups 1, 2, 3, and 4, respectively (p=0.002). Adhesion was observed at a rate of 61.1% in Group 1 and 38.9% in Group 2 (p=0.621). There was no adhesion in Groups 3 and 4 (p=0.001). The rate of SSI was 68.8% in Group 1, %75% in Group 2, and 100% in Groups 3 and 4 (p=0.022). Tensile strength was 2196±193.6 g/cm in Group 1 and 1906±142.1 g/cm in Group 2 (p=0.258).Conclusions: We argue that PP mesh is a suitable prosthesis for the permanent repair of contaminated abdominal wall defects despite the increased adhesion risk.
Role of low-lying pubic tubercle in the development of inguinal hernia
Authors: Jakhar Diwan Singh , Singh Joginder , Kumar Ashok , Jajra Dharmveer , Lodha Sanjay
Published: January 2020

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.