bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of EGFR mutation subtypes in lung adenocarcinoma : A multi-center Korean study v2
Authors: Yoon Hee-Young , Ryu Jeong-Seon , Kim Dojin , Yong Lee Sung , Choi Juwhan , Ju Ryu Yon , Hwa Lee Jin , Hyun Chang Jung
Published: October 2019

Background: Adenocarcinoma is the most common type of non-small cell lung cancer (NSCLC). Some causative genetic mutations, including deletion of exon (E) 19 and point mutation of E 21, are known to have a favourable prognoses due to sensitivity to tyrosine kinase inhibitors (TKIs); however, the prognoses of other uncommon mutations are unclear. The goal of this study was to analyse the clinical significance of epidermal growth factor receptor (EGFR)mutation subtypes in lung adenocarcinoma. Methods: We retrospectively reviewed 1021 subjects (mean age: 66.8 years, female: 41.7%) who were diagnosed with advanced (stage III–IV) lung adenocarcinoma, had EGFR mutation data, and did not undergo surgery from five medical institutes between 2010 and 2016. Subjects were classified according to EGFR mutation status, particularly for exon-specific mutations. Results: The median follow-up period was 13.3 months. EGFR positivity was 38.1%, with the incidence of mutations in E 18, 19, 20, and 21 being 3.6%, 51.2%, 3.3%, and 41.9%, respectively. The EGFR positive group survived significantly longer than the negative group (p<0.001), and there was a significant difference in survival among the four EGFR subtypes (p=0.004): mutation in E 19 showed a better survival probability compared with the other subtypes (p<0.001), whereas mutation in E 21 showed a poorer prognosis (p=0.008). Multivariate analysis showed that mutation in E 19 was the only significant factor that lowered mortality rate (HR:0.415, p=0.001), while mutations in E 18, 20, and 21 were not significant. Amongst EGFR-positive cases, TKI non-responders had a significantly higher proportion of E 21 mutations compared with TKI-responders (p=0.047). Conclusion: In advanced EGFR-mutant lung adenocarcinoma, mutations in E 19 predict good prognoses, while the presence of mutations in E 18, 20, and 21 did not significantly affect survival. Unlike previous reports, mutations in E 18 and 20 were not worse factors than mutation in E 21.
Structuralization and Incubation v2
Authors: Armero H Laura , Troncone Clemente Claudia
Published: October 2019

The interaction between an aptamer and his target depends on the tertiary structure of the aptamer, to attempt to always have the same structure for all the rounds, we forced the aptamer population to achieve the most thermodynamic stable structure. Once all the sequences are structuralized, we can incubate the library with our target.
A progressão continuada no ensino fundamental: relato de experiência docente na disciplina de Ciências
Authors: Da Silva Rosineide Nascimento
Published: October 2019

Este artigo surge da insatisfação com a política de progressão continuada, implantada em escolas como a política de aprovação automática. Seria a aprovação automática o viés para a melhoria da educação no Brasil ou seria apenas uma forma de política paliativa de atraso educacional? O objetivo deste estudo é relatar uma experiência docente quanto a prática compulsória da “aprovação automática”, na disciplina de Ciências, em seis turmas de uma escola de ensino fundamental no município de Craíbas-AL. Assim, foram realizados levantamentos bibliográficos sobre o tema e analisada a experiência prática de vivência em sala de aula. Percebeu-se que essa política de progressão/aprovação continuada/automática tende a mascarar os resultados de baixas frequências e baixos rendimentos escolares dos educandos, visando o aumento de índices educacionais que não retratam, necessariamente, a qualidade do ensino-aprendizagem. Conclui-se que, ainda há um longo caminho para se alcançar a garantia do padrão de qualidade na educação brasileira.
Alteração da atividade locomotora de populações de traça-das-crucíferas Plutella xylostella L. 1758 (Lepidoptera: Plutellidae) sobre área tratada com o inseticida metilcarbamato de oxina
Authors: Silva Filho José Gomes da , Melo Iuri Andrade de , Farias Thiago Izaquiel de , Tschoeke Lucas Felipe Prohmann , Franco Junior Cícero Luiz Franco , Badji César Auguste
Published: October 2019

Os insetos herbívoros tem desenvolvido uma série de respostas comportamentais para os inseticidas utilizados nos sistemas agrícolas. O presente estudo teve por objetivo averiguar alterações comportamentais de populações de traça-das-crucíferas expostas a áreas tratadas com o inseticida Metilcarbamato de oxina. Populações de Plutella xylostella provenientes dos municípios de Camocim de São Félix–PE (CSF), Sairé–PE (SR), Lajedo–PE (LJ) eduas populações de laboratório: Recife–PE (RCF) e Viçosa–MG (VÇS) foram expostas a resíduos secos do inseticida, em doses crescentes. Estas populações tiveram os parâmetros comportamentais analisados (Distância de caminhamento (DC),Tempo de caminhamento (DC), Velocidade Média (VM), Número de paradas (NP) e Tempo de Repouso (TR)). Em relação a DC, as populações de SR, CSF, LJ e VÇS não apresentaram padrão claro de redução ou aumento da DC. A população de RCF não apresentou alteração da DC e diferiu estatisticamente entre áreas estudadas. Em relação ao parâmetro TC, a população de SR apresentou aumento deste parâmetro, RCF diminuiu e as demais populações não demonstraram padrão definido. Para o Parâmetro VM, se verificou redução desta nas populações de SR e CSF, e aumento da VM na população de RCF. Para a variável do TR, as populações de LJ, VSÇ e CSF não apresentaram padrão definido, logo, a população do RCF aumentou e SR reduziu tal parâmetro. As alterações resultantes das respostas comportamentais dos insetos a áreas tratadas com inseticidas contribuem para uma menor eficácia de controle desempenhada pelos inseticidas, uma vez que estes vãos se exporem menos a concentrações letais.
Agrotóxicos no Semiárido de Alagoas: agricultura químico-dependente e suas contradições
Authors: Lima Lucas Gama , Miranda Anderson Ribeiro , Lima Érica Franciele da Silva , Santos José Rodolfo da Silva , Nascimento Jefferson Araújo
Published: October 2019

RESUMO: Os agrotóxicos integram o modelo químico-dependente vigente na agricultura brasileira e é parte da complexa totalidade capitalista em que as megacorporações agroquímicas gozam de enorme centralidade. As linhas que seguem têm como objetivo analisar as contradições subjacentes à agricultura dependente de agrotóxicos no Semiárido de Alagoas, oferecendo um aporte reflexivo a partir de dados e informações de destacada relevância. O fenômeno dos agrotóxicos se materializa de maneira desigual no Semiárido de Alagoas e tem resultado em agudas contradições socioambientais. A pesquisa conseguiu identificar uma expressiva incidência de intoxicação humana e riscos de contaminação das águas e dossolos com os ingredientes químicos usados nas plantações. Ademais, constatou-se a sujeição da renda da terra camponesa ao capital por meio da compra/venda regular de variados agrotóxicos. No texto são veiculados dados primários e secundários levantados ao longo da investigação, através de visita de campo a algumas das comunidades situadas às margens do Canal do Sertão e do rio Moxotó, Mesorregião do Sertão, porção oeste do Semiárido, e coletados por meio de consultas a diversos órgãos do Estado.PALAVRAS-CHAVE: pesticidas, capital, renda da terra
Caracterização dos paradigmas e entraves no processo de transição para o sexto ano do Ensino Fundamental
Authors: Lins Maria Adelina Cavalcante Botelho
Published: October 2019

O presente trabalho de pesquisa tem a finalidade de trazer uma reflexão sobre a transposição do aluno do quinto para o sexto ano do ensino fundamental. Esta passagem manifesta sentimentos e comportamentos inerentes ao ser humano, porém, inadequado ao âmbito escolar. Os alunos passam a conviver com um novo contexto escolar e, com professores que adotam posturas diferentes em relação aos dos anos anteriores. Assim, virá momentos de dificuldades, alegrias e tristezas, fragilidade no desempenho escolar, incertezas e inseguranças. São raros os professores que possuem entendimento e compreensão desses sentimentos, gerados diante das incertezas para enfrentar os novos desafios. Na obtenção das informações, adotou-se uma abordagem qualitativa de cunho bibliográfico e, observações in loco nas escolas do ensino fundamental, existentes em Tamandaré (PE). Diante do entendimento adquirido, foi constatado que a chegada do aluno ao sexto ano traz momentos difíceis de adaptação, pois psicologicamente ele sofre, muitas vezes pela impaciência e as posturas diferenciadas dos novos professores. Tal fato provoca temor e ansiedade nos alunos, pois de forma bastante precoce, estão iniciando no mundo dos adultos. 

Palavras-chave: transição, alunos do 6º ano, ensino fundamental, incompreensão dos professores.
ENTEROPARASITOS EM MANIPULADORES DE MERENDA ESCOLAR EM CUITÉ, PARAÍBA
Authors: Andrade Júnior Francisco Patricio de , Alves Thiago Willame Barbosa , Pontes Edson Douglas Silva , Barbosa Vanessa Santos de Arruda
Published: October 2019

O presente estudo teve como objetivo avaliar a prevalência de enteroparasitos e as variáveis epidemiológicas associadas à infecção parasitária em manipuladores de merenda escolar de Cuité-PB. As amostras fecais foram analisadas pelo método de centrífugo-sedimentação simples e houve aplicação de questionário semiestruturado em manipuladores de merenda escolar de 12 escolas do município de Cuité. Foi utilizado o teste qui-quadrado e as variáveis foram analisadas a partir do Software Statistical Package for Social Sciences.Dos 57 manipuladores de merenda escolar analisados, 78,9% estavam infectados por enteroparasitos/enterocomensais. Endolimax nana foi a espécie mais prevalente (53,4%). Em relação à caracterização da amostra, 100% dos infectados eram do sexo feminino, 48,9% possuíam baixa escolaridade, 53,3% tinham renda familiar de até um salário mínimo e 60% tinham entre 20-49 anos, ademais 40% dos infectados estavam bi/poliparasitados. Diante da alta prevalência são necessárias melhorias sanitárias, educacionais, no treinamento em boas práticas de manipulação, bem como a realização periódica do EPF.
ATUAÇÃO DAS UNIVERSIDADES PROMOTORAS DE SAÚDE NA PREVENÇÃO DE NEOPLASIAS DO COLO DO ÚTERO
Authors: Dantas Karen Fernanda de Deus , Abdalla Tamara Fadoni Sahyun , Yamaguchi Mirian Ueda , Silva Tânia Maria Gomes , Bernuci Marcelo Picinin
Published: October 2019

Estudo descritivo de corte transversal realizado com mulheres (n= 61) que atuam no setor de limpeza de uma instituição de ensino superior privada no município de Maringá-PR. O objetivo foi avaliar a percepção delas sobre a prevenção da neoplasia do colo do útero. Foram aplicados questionários semiestruturados, elaborados com base nas informações do Instituto Nacional do Câncer. Verificou-se que 8,20% das funcionárias nunca realizaram o preventivo (grupo NR); 26,23% realizaram há mais de dois anos (grupo R+2); 65,57% há menos de dois anos (grupo R-2). Para NR, 20% reconhecem o HPV como fator necessário para o câncer, 43,75% para NR, e 40% para R+2. Para NR, 60% reconhecem que o preventivo auxilia no diagnóstico, 70% para R+2, e 80% para R-2. Para R+2, 25% reconhecem que toda mulher entre 25 e 64 anos de idade deve fazer o exame, e 7,5% para R-2. Para R+2, 12,5% têm hábito de realizar exames rotineiramente, e 30% para R-2. Conclui-se que a adesão ao exame preventivo é intuitiva e o conhecimento sobre a doença é limitado, ressaltando a necessidade de educação em saúde.
MORBIDADE HOSPITALAR, ASSOCIADA AO APARELHO CIRCULATÓRIO EM SANTO ANTÔNIO DE JESUS - BAHIA
Authors: Costa Carlos Alberto Soares da
Published: October 2019

O objetivo do estudo foi comparar o número de óbitos, associados às doenças do aparelho circulatório, no município de Santo Antônio de Jesus (SAJ) em relação à capital do Estado da Bahia, Salvador (SSA). Estudo retrospectivo baseado nos dados do Censo (2005 – 2014). Resultados: SAJ: apresentou 90.985 residentes, sendo 42.965 (48%) do sexo masculino e 48.020 (52%) do sexo feminino. 87,15% das pessoas residem na zona urbana e maior parte destas está na faixa etária de 30-39 e 40-49 anos; 97,71% das pessoas trabalham no município. SAJ (vs. SSA) apresentou menor número de óbitos (p
Diyalojik Paydaş İletişimi İçin Twitter Kullanımı
Authors: ÇETİNTAŞ H. Buluthan
Published: October 2019

Konuşma, anlaşma ve uyum sağlama anlamına gelen diyalog, örgütsel iletişim çabalarının temelini oluşturmaktadır. Aslında tüm iletişim stratejileri diyalog kökenlidir ve diyalojik iletişimle kurum için değer yaratmak amaçlanmaktadır. Kent ve Taylor (1998), diyalojik iletişim kavramını, bir işletmenin ve paydaşlarının etkileşimli olarak iletişim kurabilecekleri bir araç olarak ortaya koymuştur. Buradaki temel düşünce, paydaşlar arasında bir anlayış ve anlam geliştirmek, onları belirli örgütsel hedeflere teşvik etmektir. Çalışmanın amacı, işletmelerin paydaşları ile diyalog oluşturmasını ve ilişkiler geliştirmesini incelemek, diyalojik iletişim uygulamalarının etkinliğini belirlemektir. Bu kapsamda İstanbul Sanayi Odasının İSO 500 listesinde yer alan 100 işletme örneklemi oluşturmaktadır. Diyalojik iletişim için en uygun sosyal medya aracı olan Twitter, uygulama alanı olarak seçilmiştir. Belirlenen işletmelerin Twitter hesaplarına ulaşılmış ve bu hesaplar incelenmiştir. Değerlendirmeye uygun olan 77 işletmenin Twitter hesabından toplam 770 mesaj alınmış ve mesajlar, içerik analizine tabi tutulmuştur. İçerik analizinde Kent ve Taylor (1998) tarafından geliştirilen kodlama şemasından yararlanılmış ancak şemada çeşitli düzenlemeler yapılmıştır. Elde edilen sonuçlara göre işletmelerin Twitter’ın diyalojik iletişim özelliklerinden faydalanmadığını ve bu özellikleri kullanmadığını söylemek mümkündür.
İlköğretim, Kamu Eğitim Harcaması ve Ekonomik Büyüme
Authors: MAMMADOV . Rza , GÜMÜŞ Erdal
Published: October 2019

Bu araştırmanın amacı ilköğretim eğitimi, finansmanı ve ekonomik büyüme arasındaki ilişkiyi incelemektir. Çalışmada kişi başına düşen reel GSYİH, ilköğretim kademesine kayıtlı öğrenci sayıları ve öğrenci başına reel kamu eğitim harcaması kullanılmıştır. Araştırmada PISA kapsamında 30 ülkenin 1998-2015 verileri kullanılmıştır. Yöntem olarak panel ekonometrisi kapsamında eşbütünleşme, uzun dönem ilişki tahmincileri için DOLS ve FMOLS testlerine yer verilmiştir. Araştırmadan elde edilen bulgulara göre, ilköğretim eğitimi, finansmanı ve ekonomik büyümenin birlikte hareketliliği söz konusudur. Bu hareketlilik uzun dönemde beşeri sermayenin yayılımına katkı sağlamaktadır.
Karl Popper’in Platon Eleştirisinin Epistemolojik ve Politik Kökenleri
Authors: ERDEM Ekin
Published: October 2019

Karl Raimund Popper (1902–1994), bilim felsefesine kazandırdığı yanlışlanabilirlik ilkesi ve siyaset felsefesinde geliştirdiği açık toplum kavramıyla 20. Yüzyıl’ın en etkili düşünürleri arasında yer almaktadır. Popper’in epistemoloji alanında Hegel’in diyalektik idealizmine, siyaset felsefesinde ise sosyalizme ve kolektivizme yaptığı eleştiriler, kendisinin ilk alanda neo-pozitivizmin, ikinci alanda ise neo-liberalizmin önemli bir temsilcisi olarak algılanmasına neden olmuştur. Ne var ki Popper’in idealizme yönelttiği eleştirilerin temeli La Mettrie tarzı bir materyalizme, David Hume tipi bir ampirisizme ya da Comte-Durkheim ekolünden bir pozitivizme dayanmadığı gibi, sosyalizm ve kolektivizme yönelttiği eleştiriler de kaynağını John Locke, Adam Smith ya da Friedrich von Hayek gibi klasik liberal teorisyenlerden almamaktadır.  Popper’in her iki alandaki eleştirilerinin hedefinde bulunan düşünür, ilk büyük sistematik filozof olan Platon’dur (M.Ö.427–347). Popper, idealizme ve sosyalizme kökten cephe almaktan çok, Platon’un sisteminden kaynaklandığını düşündüğü objektif idealizme ve topyekûn toplum mühendisliğine karşı çıkmıştır. Buna karşılık düşünürün temel görüşlerinin, Platon’un da içinden çıkmış olduğu Sokratik geleneğin eleştirel ve bireyci bir yorumuna dayandığı söylenebilir.
Made to Order: Using Gubernatorial Executive Orders to Promote Health in All Policies
Authors: Gakh, JD, MPH Max
Published: October 2019

The Health in All Policies (HiAP) approach presents different and often complementary avenues to address the social determinants of health. But at its core, HiAP relies on collaborations to make health a governmental priority across sectors. In the United States, HiAP efforts can involve multiple levels of government and strategies that may vary in formality. In some states, state-level HiAP efforts may be advanced by gubernatorial executive orders (GEOs). GEOs are often used to promote health. GEOs may be powerful in the HiAP context because of their potential to manage the different sectors that comprise state government and thereby address the social determinants of health. By synthesizing the relevant literature and providing illustrative examples of HiAPpromoting GEOs, this review explores how, why, and whether to use GEOs for HiAP. It demonstrates that GEOs may advance HiAP with or without using a HiAP label, along different steps in the policymaking cycle, and by addressing common HiAP challenges. Champions of HiAP should therefore examine the possible utility of GEOs to promote state-level HiAP efforts.
The Long Road to the “All” of HiAP
Authors: Calloway Erik
Published: October 2019

The objective of health in all policies (HiAP) is straightforward: integrating health and equity considerations into policies across all sectors of government will transform systems and environments in ways that support healthier, more equitable outcomes. However, pursuing that objective is complex and achieving those outcomes takes time.
This article examines three communities (Minneapolis, MN, Seattle, WA, and Richmond, CA) which have been pursuing HiAP long enough to achieve meaningful policy, systems, and environmental change. We identify when and how each community employed five key strategies for effectively adopting and implementing HiAP. And we present policies each community has adopted with examples of outcomes these initiatives have achieved. The purpose of this assessment is to set realistic expectations for how long it may take to achieve HiAP and to identify themes that could help other communities realize this level of progress more quickly and efficiently.
Based on our assessment of these communities, we conclude that it is not uncommon for it to take ten years or more to integrate health and equity into a substantial and coordinated set of policies across government agencies and departments. However, we also see that each step taken toward HiAP makes subsequent steps easier. And as more policies include health and equity concerns, the entire system does become more effective at improving health and equity outcomes. Finally, we show that that integrating health and equity across a range of plans and policies does shape decisions, lead to actual community transformation, and improve community health outcomes.
Role of vitamin D3 supplementation in allergic rhinitis: an outpatient department based prospective analytical observational study
Authors: Hembrom Rabi , Ghosh Souvik , Paul Swarnali , Maiti Ramnarayan , Mandal Sekhar , Das Subhayan , Tamang Bina
Published: October 2019

Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06±1.01 in Test group and 13.93±1.01 in Control group and the Post treatment ASS score was 2.65±1.12 and 6.06±0.87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement.
Analysis of drug promotional literature and its abidance to WHO guidelines
Authors: Jindal Meenakshi , Choudhary Priya , Sharma Rajeev K.
Published: October 2019

Background: Drug promotional literature (DPL) is used by the pharmaceutical companies for promotion of their drug. It is the commonest source for providing information about the drug to the physician. According to WHO promotional literature should be reliable, truthful, informative, balanced and up to date.Methods: Study was conducted in Department of Pharmacology, Muzaffarnagar Medical College. 200 drug promotional literatures like advertisements published in medical journal, package insert of medicinal products and brochures were collected and analysed according to WHO criteria.Results: Total 200 promotional literatures were analysed. 100 promotional literatures were from the medical journal, 50 were package inserts of medicinal products and 50 were medicinal brochures. On assessing DPL using WHO criteria, all DPL mentioned brand names and dosage form (100%). Most of them published the generic name (98.5%), therapeutic uses (78%), side- effects (75%), dosage regimen (70%), contraindication (62.5%), warnings (55%), drug interaction (54%), precaution (50%), reference to scientific literature (45%), name of manufacture and distributor (99%), address of manufacturer and distributor (50%). Out of 200 DPL only 151 DPL contain references to scientific literature, 88 DPL references were retrievable and 63 were non retrievable.Conclusions: Our study shows although pharmaceutical companies are trying to adhere to the WHO criteria it is not fulfilled. As DPL are an important source of seeking information by the medical practitioner who rely on them to impart treatment to the patient, strict steps to regulate fulfilment of the WHO criteria should be taken by the government and authorities.
Materanal and neonatal outcomes of triplet gestation in a tertiary care centre: a retrospective study
Authors: Sharma Neeraj , Kumari Deepika , Prasad Sonal , Srivastava Akanksha
Published: October 2019

Background: A significant rise in triplet pregnancy rate has occurred recently. This rise is of concern, as these infants are frequently reported as a risk factor of adverse outcome. The aim of this study was to retrospectively study the outcomes of triplet births.Methods: A retrospective study was undertaken to analyze the clinical data of all patients with triplet gestation admitted to the labour room of Dr. Baba Saheb Ambedkar Hospital, Delhi to study the maternal and fetal outcomes. Authors retrospectively observed and analyzed the database to examine triplet gestations delivered between January 2014 and December 2018.Results: Over the five-year study period, there were total 44,011 deliveries. Out of these, there were 35 (0.079%) triplet pregnancies. Of all the triplet pregnancies studied 80% resulted from ovulation induction and assisted reproductive technology. The mean gestational age at delivery was 31.6±3.0 weeks, and the mean birth weight was 1,594±460 gm. The most common maternal complications were Preterm labour in 32 pregnancies (92%), anemia in 17 (49%), pre-eclampsia in 11 (31%), post-partum hemorrhage in 8 (22%). Of the total deliveries neonatal complications included Respiratory distress syndrome in 44 (42.2%), Hyperbilirubinemia in 41 (39%), Intrauterine growth restriction in 19 (18.1%). The perinatal mortality rate was 10.5%.Conclusions: Higher order pregnancies are associated with maternal and neonatal complications. These high risk women need more care and the neonates require intensive care and monitoring after birth, most commonly due to prematurity and low birth weight.
Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome
Authors: Samyal Poonam , Thakur Rama , Rao Rohini , Chauhan Gian , Kaushik Sharad , Chandel Anu B.
Published: October 2019

Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.
Successful management of a patient with sudden loss of vision and eclampsia complicated by posterior reversible encephalopathy syndrome
Authors: Vaswani Babita , Gopal Sriram , Satia Meena
Published: October 2019

Reversible visual disturbances in patients with eclampsia may be due to either retinal detachment or retinal arteriolar vasospasm or thrombosis of the central retinal arteries or PRES (posterior reversible encephalopathy syndrome). Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness may occur in 1% to 15% of patients with eclampsia. Reporting herewith a case of reversible cortical blindness in the setting of severe preeclampsia complicated with eclampsia.
Chronic uterine inversion associated with uterine leiomyoma misdiagnosed as cervical fibroid: a case report
Authors: Kochar Swati , Nama Ankur , Khajotia Santosh , Suthar Neha
Published: October 2019

Chronic inversion of uterus is a rare clinical entity which is usually associated with obstetrics complication and rarely with gynaecological disorder like fibroid present at fundus of uterus. We here present a case of 40-year-old female P3L3 with chronic inversion of uterus with fundal fibroid which present with 3year history of abnormal vaginal bleeding. Ultrasonography and MRI revealed cervical fibroid. Due to AUB secondary to cervical fibroid decision of hysterectomy was taken. On laparotomy chronic uterine inversion was present which was corrected by haultain’s procedure. Then hysterectomy was done. Histopathology report suggestive of uterine leiomyoma at fundus of uterus. Chronic uterine inversion associated most commonly with fundal submucous leiomyoma. Other causes are leiomyosarcoma, endometrial carcinoma, cervical carcinoma, rhabdomyosarcoma, mixed mullerian sarcoma. It is an extremely rare gynaecological condition and can be misdiagnosed as cervical fibroid, advanced cervical malignancy or other causes of AUB in females. It could be labelled as gynaecological near miss so a high index of suspicion is necessary for it’s diagnosis.
A comparative study of phonetogram parameters among female trained Hindustani classical singers, untrained singers and non-singers
Authors: Bandhopadhyay Ankur , Chaterjee Indranil , Dey Sanghamitra
Published: October 2019

Background: Vocal sound is based on the complex yet co-ordinated interaction of phonatory system, resonatory system and respiratory system. Phonetography is a practicable and readily accessible method to investigate and map the quantitative potentialities of vocal output. The objectives of the present study were to determine the phonetogram of trained (Hindustani classical) singers, untrained singer sand non-singers elicited from singing as well as speech task to see if statistically significant differences were present which may indicate an effect of training.

Methods: 90 female subjects between the ages 20-45 (mean age 34.2 years for trained subjects, 26.3 years for untrained subjects and 25.8 years for non-singers) divided into three groups each group consisting of 30 subjects. For the singing task, the individuals had to phonate |a| at habitual level by traversing through eight musical scales. In the speech task, the subjects were asked to count from one to twenty in Bengali at habitat level and at Sustainable cohorts of intensity. This was recorded using phonetogram software Dr. Speech (version 4). The parameters considered were fundamental frequency, intensity, semitones and area.  

Results: The study revealed that in both tasks singing and non-singing task for all three groups in all the four parameters of phonetogram significant differences were seen (p=0.000) at 95% level of confidence.

Conclusions: The present study depicted the phonetographic profile of a genre of trained singers and tracked out the parameters on which differences are pronounced between a trained and untrained singer and non-singer.
Primary tubercular otitis media: a rare case report
Authors: Sharma Vishal , Bhagat Sanjeev , Sahni Dimple , Sharma Dinesh
Published: October 2019

Tubercular otitis media is a rare presentation of tuberculosis. High index of suspicion is required for diagnosis. We present a rare case of tubercular otitis media presenting as post auricular swelling with no evidence of pulmonary or any other foci of tuberculosis. Diagnosis was made on the basis of acid fast bacilli seen in fine needle aspirate. Anti-tubercular drugs were initiated and patient responded well to treatment.

 
A study of functional outcome after osteosynthesis of intercondylar fracture of distal humerus in adults with pre-contoured locking compression plate system
Authors: Ojha Ankur , Singh Shashi Kant Kumar
Published: October 2019

Background: Intra-articular fracture of distal humerus is considerable cause of morbidity in adults. The new pre-contoured LCP system provides better angular stability in fixation of inter-condylar distal humerus fracture.

Methods: A prospective study of 25 patients with distal humerus fracture treated with pre-contoured double plate system is conducted in Department of Orthopaedics, RIMS, Ranchi between April 2017 to March 2018. These patients were followed up 3 weekly in first 3 months, then 6 weekly in next 6 months, then at every 3 month interval. Clinical and functional outcome was evaluated on the basis of Mayo elbow performance score (MEPS).

Results: 24 fixed elbows were reviewed at a follow-up period of 1 year. Results obtained were graded on the basis of MEPS, 21 patients (87.5%) were graded excellent to good, fair in 2 patients (8.3%) and poor in 1 case (4.1%). Average time interval between surgery and admission was 9 days (average 4-14 days). All the fractures as well as the olecranon osteotomies united by 10-16 weeks (12.56 weeks). Superficial wound infection and transient ulnar nerve palsy was reported in 3 (12.5%) and 1 (4.16%) respectively and was managed conservatively. 1 patients did not reported in follow up.

Conclusions: We conclude that osteosynthesis with pre contoured dual plating of closed intracondylar distal humerus fractures provide good fixation and early rehabilitation, leading to high rate of bone union and minimal soft tissue damage.
Etiological pattern of problems in an orthopaedics outpatient department of a tertiary care center
Authors: Jagiasi Jairam D. , Ubale Tushar , Marfatiya Harsh , More Abhijit , Sahu Dipit
Published: October 2019

Background: Outpatient orthopaedics department of a tertiary care hospital sees large number of patients. However, the funds and resources are limited and have to be judiciously distributed. This study aims to study the etiological pattern of different patients that present to the outpatient department (OPD).

Methods: Nine consecutive OPD’s data was studied for the etiology of the different diagnosis of new patients presenting to the OPD. Etiology of various diagnoses was studied as a percentage of the total patients.

Results: Trauma of upper limb and lower limb formed a higher percentage of the total patients. Degenerative spine was more common than traumatic spine.

Conclusions: Traumatic conditions of the lower and upper limb make up majority of the cases. Degenerative spine is more common than the traumatic etiology.
A study on conservative management on paediatric bone forearm fractures in tertiary care hospital in Cuddalore district
Authors: . Manikandarajan , Raj Dinesh
Published: October 2019

Background: Diaphyseal fractures of the radius and ulna are common in the pediatric population. The standard management for pediatric forearm fractures remains conservative management with closed reduction and immobilization with an above elbow plaster cast. Though the fracture unites readily, malunion is very common. Stiffness of joints, compartment syndrome is other complications of conservative management with plaster cast Forearm fractures are common in the pediatric population. These fractures are mostly managed conservatively by means of closed manual reduction and casting. The aim of this study was to reiterate the importance of conservative management in both bone forearm fractures in the pediatric population.

Methods: This was a prospective study from a tertiary level trauma center on 70 children up to 14 years of age with both bone forearm fractures from June 2018 to June 2019, cases were obtained from medical records. Data were collected and confirmed by plain X-ray films and medical records.

Results: All fractures achieved union at the final visit. More than 90 of diaphyseal forearm fractures achieved exceptional radiological and clinical outcomes and almost no case had a significantly poor outcome. There were significantly reduced angulation deformities before and after treatment (p<0.05).

Conclusions: Nonsurgical treatment as a model of management by means of closed reduction and casting is a very well accepted method of treating pediatric diaphyseal forearm fractures. 
Ludzka rybonukleaza Dicer – struktura i funkcje biologiczne
Authors: Koralewska Natalia , Ciechanowska Kinga , Pokornowska Maria , Figlerowicz Marek , Kurzyńska-Kokorniak Anna
Published: October 2019

Rybonukleaza Dicer jest znana przede wszystkim z kluczowej roli, jaką odgrywa w proce­sie biogenezy krótkich regulatorowych RNA: miRNA oraz siRNA. Badania prowadzone w ostatnich latach znacząco wzbogaciły wiedzę dotyczącą funkcji pełnionych przez Dicer. Wykazano, że Dicer jest zaangażowana w metabolizm zróżnicowanej puli RNA, m.in. tRNA i snoRNA, usuwanie potencjalnie cytotoksycznych cząsteczek RNA oraz utrzymywanie sta­bilności genomu. Co więcej, podczas apoptozy, w następstwie cięcia proteolitycznego przez kaspazy, fragment Dicer staje się deoksyrybonukleazą i bierze udział w degradacji genomo­wego DNA. Odkrycie mechanizmu pasywnego wiązania RNA przez Dicer oraz jej aktywno­ści opiekuńczych wobec kwasów nukleinowych wykazało, że Dicer może dodatkowo pełnić funkcje niezwiązane z hydrolizą kwasów nukleinowych. W tym artykule podsumowujemy aktualny stan wiedzy na temat struktury i funkcjonowania ludzkiej rybonukleazy Dicer, uwzględniając kanoniczną rolę enzymu w biogenezie miRNA oraz nowo odkrywane obsza­ry jej aktywności.
Prosthodontics Specialization Programs Around the Globe
Authors: Farid Farzaneh , Arastouei Sepideh , Saker Jamal
Published: October 2019

Statement of Problem: Prosthetic treatments account for more than half of the all provided dental services, as well as the highest number of lawsuits in some countries. The quality of Prosthodontics postgraduate programs has profound effect on the improvement of provided patient health care and reduction of patient complaints.
Goal: The goal of this study was to survey different universities around the globe for the duration and subjects of Prosthodontics specialty programs, the title of degree awarded and the programs that are offered in conjunction with other disciplines.
Methods and Materials: This study surveyed Prosthodontics specialty programs offered by different universities available on their websites, and reviewed published research on this subject using search engines such as Google, Pubmed and Medline. The published Accreditation Standards for the program and minimum requirements for achieving competency after completion of the program was reviewed.
Result: The results of survey showed that prosthodontics specialty is not recognized by all countries. In 42 universities surveyed, the duration of program ranged from two to four years. The title of awarded degree varied in different universities. In some universities, prosthodontics and other disciplines were integrated in one program. Few universities offered additional subjects like photography, geriatrics and pain in their educational curriculum.
Conclusion: The core subjects of the programs seemed identical. However, programs differ in duration, title and extra subjects.
Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014
Authors: Hashemi Hamid Mahmood , Sharifi Reza , Hasheminasab Mahboube , Mortazavi Mostafa
Published: October 2019

Purpose: Maxillofacial infections (MIs) commonly occur in patients of all ages, representing a life-threatening challenge when reaching deep facial spaces. The epidemiologic studies of MIs and their characteristics are very important and beneficial for both patients and clinicians. Therefore, the aim of this prospective study was to determine the annual incidence, etiology, risk factors and complications of MIs in all patients who were admitted to the department of oral and maxillofacial surgery of the Shariati hospital during a 1-year period.
Material and methods: The demographic data, levels of some serum markers on day of admission, such aserythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), bandemia, serum albumin, predisposing factors for each patient referred for treatment of MI were recorded by one researcher in November 2013 to November 2014. The linear regression test was used to evaluate whether there was a relationship between the amount of changes in ESR, CRP and albumin levels and age of the patients, pregnancy, gender and severity of infection. Panoramic radiography as well as axial and coronal CT scans with soft tissue window were performed for all cases, except pregnant participants. The origin of MIs, including odontogenic, pathologic and foreign body, was identified for each patient.
Results:During the study period, a total of 157 patients (87 female, 70 male), with an age range of 3 to 74 years (mean, 23.5±13.2 years), were admitted to the department of maxillofacial surgery. Regardless of the gender, the most frequent cause of MIs was odontogenic sources (128 cases, 81.5%). The most common affected area was the buccal space with 106 positive cases (67.5%). The most common teeth responsible for maxillofacial fascial space infection were mandibular third molars. A positive association was found between CRP and ESR levels and the severity of infections. Serum albumin and ESR levels were significantly reduced and increased in the patients with severe infection and pregnant patients, respectively.
Conclusion: The results of this study indicated that odontogenic origins were the main cause of MIs and the most common involved space was the buccal space. Diabetes mellitus was the most commonly found systemic disease among the participants of this study. The findings of this study suggest that dentists should consider that the most appropriate treatment of odontogenic infections involves surgical intervention and selection of a suitable antibiotic as an adjunct.
Middle and Lower Facial Soft Tissue Changes after Maxillary Advancement through Conventional or High Le Fort I Osteotomy: A Case Series Study
Authors: Foroughi Ramin , Khakbaz Oveis , Maneshi Mehrdad
Published: October 2019

Introduction
Maxillary advancementis applied extensively for malocclusion class III correction.This procedure is done using one of the two methods, Conventional or High.
Maxilla moves in both vertical and horizontal and only in the horizontal directions in Conventional and High method respectively, so expecting a difference in facialsoft tissue changes. In present study is a case series that describes this issue.
Materials and Methods: The cases included 30 patients with class III malocclusion due to maxillary deficiency, whom underwent Le Fort I osteotomy for maxillary advancement in Shahid Beheshti Hospital in Babol, Iran during 1995 to 1995. According to surgical technique, the cases were placed in group 1 (Conventional) or group 2 (High). Maxillary advancement and changes in hard and soft tissue of the middle and lower facial regions where measured through tracing on the lateral cephalometry. Intra-group and inter-group statistical comparisons were done using SPSS20 software at significance level as 0.05. Result: The pre-surgical mean size of SNA, SNB, nasolabial and mentolabial angles was similar in two groups. In all patients, after surgery, SNA angle size was increased and SNB، nasolabial and Mentolabial angles size were decreased. The mean value of these change was similar in two groups. In group 2, the displacement of point A ‘(mean difference: 1.30 mm) and Labrale Superius (mean difference: 1.40 mm) were significantly more than group 1. The amount of displacement of SN (mean difference: 1.30 mm), Labrale Inferius (mean difference: 0.88 mm) and Pogonion (mean difference: 0.23 mm) points in group 2 was higher than that of group 1, but this difference was not statistically significant. Conclusion: It is needed strong evidence for decision about selecting High or Conventional approach maxillary advancement in terms of facial aesthetic aspects. So, further studies with larger sample sizes and cohort or quasi-experimental design is suggested
Nutrition and Foods for Skin Health
Authors: Akalın Gülsüm , Selamoglu Zeliha
Published: October 2019

Various medicinally uses of the natural foods as well as edibility of them caused attraction a huge attention for several pharmacological activities include antioxidants, antibiotics and antineoplastic activity. Aging is a major risk factor in the change of convert skin structure and function might also directly affect skin appearance. Age-related disorders in the skin health are a consequence of the accumulation of cellular damage and reduced activity of protective stress response pathways leading to low-grade systemic inflammation and oxidative stress. There is increasing evidence that consumption of a variety of phenolic compounds present in natural foods may lower the risk of serious health disorders because of their antioxidant activity, amongst other mechanisms. This mini review reports the importance of the natural foods and nutritional status in the maintenance of healthy skin in human.
Ventricular Septal Rupture Secondary to Myocardial Infarction Post Fibrinolytic Therapy: A Case Report
Authors: Peetha Ankitha , Farheen Shaik Nahida , Ayela Spandana
Published: October 2019

Myocardial infarction can be complicated by Ventricular septal rupture which is a rare fatal grim mechanical complication of MI which is a surgical emergency due to its incredibly high mortality rate. We depict a case of Anterior wall MI which was complicated by Ventricular septal rupture post fibrinolytic therapy.
AUTODIDACTIC FOR PARENTS OF CHILDREN STUDYING IN MULTI-ETHNIC SCHOOL ENVIRONMENT
Authors: L. Grigoryevа Elena , V. Lebedkina Maria , A. Musin Oleg , N. Germanov Gennadij , R. Bajmurzin Al'bert
Published: October 2019

Purpose: The article is aimed at describing a model of self-education of primary school children's parents and the results of its testing in a primary school in a multi-ethnic educational space. The leading technology of organizing self-education for parents of primary students and formation of their methods of auto-didactics is the technology of poly directional pedagogical counseling.

Methodology: The following methods of measuring the effectiveness of the offered program were used: SWOT - analysis of educational problems of primary school children in a multi-ethnic educational organization, analysis of research data on related topics, pedagogical modeling, studying students' work, observation, and survey methods with graphical interpretation of the data.

Result: The result of the study was a unique model of inclusion of primary students’ parents in the educational space of a multi-ethnic school. In accordance with the authors' model, an awareness program was launched for parents of primary school children.

Applications: The research materials can be useful for primary school teachers, for parents of primary students, as well as for specialists in the system of additional education in working with multi-ethnic children groups, as well as for social teachers in working with migrant families to build a non-conflict educational environment.

Novelty/Originality: The originality of the study lies in the development of a model for the inclusion of parents of younger schoolchildren in the educational space of a multi-ethnic school through parental self-education organized by school teachers.
A Course Proposal on Office Spirometry and Peak Flowmetry Usage for Family Physicians and Evaluation of its Effectiveness
Authors: KAYA Abdulkadir , TASTAN Kenan
Published: October 2019

Aim: The diagnosis, treatment, and follow-up of chronic
obstructive pulmonary disease (COPD) ‎and asthma are crucial in family
practice. However, the utilization of pulmonary function tests in Turkey is not
sufficient and also the interpretation ‎of spirometric test results is not
adequate due to lack of knowledge.‎ This study aimed to provide a course on
using office spirometry and peak flowmetry for family physicians and helping
them become competent in approaching the respiratory system.

Methods: A course with unique content was developed and
administered to family physicians. A 20-item test covering the educational
content was applied to the participants before and after each course. Oral and
written feedback was taken from the participants to evaluate the course
program.

Results: 115 family physicians joined the study. Pre-test and
post-test scores were 40.39±12.8% and 75.22±11.12%, respectively. Primary
outcome of the study was the difference in the mean test scores before and
after the trainings, which revealed significant (p<0.001).

Conclusion: Extending this kind of courses to all family physicians
might be useful in facilitating the diagnosis of respiratory diseases, enabling
more conscious diagnoses, and possibly more efficient utilization of the health
resources, leading to better health outcomes.