bluuebunny/crossref_metadata_2025 huggingface dataset:
O SUICÍDIO NO ATENDIMENTO CLINICO JUNGUIANO
Authors: De Sena Táina Santos , Franco Aicil
Published: August 2017

A Organização Mundial de Saúde considera o suicídio um problema de saúde pública. Os dados apresentam a média de um milhão de mortes por suicídio a cada ano. O Brasil é um dos dez países que registram os maiores números de suicídio. Por causa destes números, crescendo ao longo dos anos, em 2006, foram criadas as Diretrizes Nacionais de Prevenção do Suicídio pelo Ministério da Saúde. Por ser um tema pouco trabalhado e visível, ele é um desafio para a Psicologia, em todas as suas áreas de atuação e talvez mais desafiador para um psicoterapeuta. O presente trabalho objetiva uma revisão bibliográfica sobre a atuação do psicólogo junguiano frente a um paciente com ideação suicida. A metodologia é uma revisão narrativa constituída na análise da literatura publicada na Biblioteca Virtual em Saúde (BVS), maior base de dados sobre saúde, onde foram extraídas publicações da Scientific Electronic Library Online (SciELO) e Periodícos Eletrônicos de Psicologia (PePSIC). Foram descritores os seguintes termos: Suicídio, Ideação Suicida e Psicologia Analítica. Como resultados obteve-se poucas publicações referentes a este assunto, o que evidencia a falta de estudos sobre o suicídio e sua rara inclusão nos cursos de graduação em Psicologia.
Self-conception of patients with paranoid schizophrenia in remission
Authors: Kosina Nataliia V , Gorban Lada S
Published: August 2017

The article presents a study of the peculiarities of self-conception of patients with paranoid schizophrenia with consideration of gender differences and the period of remission, the relationship of self-conception to other emotional and psychological factors and the peculiarities of protective and coping behavior. The results obtained indicate that, during remission of the examinees, the examined parameters of self-conception are primarily within the normal range, they use different relatively adaptive coping mechanisms most often. The examinees showed a sufficiently high level of resilience, a favorable emotional background and absence of expressed discomfort. In case of positive self-conception, regardless of the period of remission, a high level of involvement, risk taking and resilience, low values of anxiety, hostility and psychoticism are noted. For men, a high level of self-conception is associated with a high level of involvement and resilience and low levels on the scales of psychopathological symptoms. Women with a high level of self-conception are noted for a high level of resilience, willingness to take risks but at the same time they have high expression of various psychopathological symptoms. Thus, the results of the study allow to say to hold a variety of rehabilitation measures. For greater efficiency of these activities, the group can be formed regardless of the period of remission but with considering of characteristics of the self-protective and coping behavior according to gender.
Effective of antiviral therapy of HIV infection and intercurrent diseases in children
Authors: Timchenko Vladimir N , Yastrebova Elena B , Bulina Oksana V
Published: August 2017

The study included 366 HIV-infected children (under-23) and 350 children with perinatal contact with HIV infection (R-75), consisting on the dispensary account in the Department of motherhood and childhood of the Saint Petersburg city AIDS center. The vast majority of children with perinatal HIV receive HAART (95.0%) with high efficacy (undetectable viral load, normalization of CD4 lymphocytes, the absence of clinical manifestations). In the structure of opportunistic viral infections (herpes, respiratory infections) 40.0%, bacterial (bronchitis, tonsillitis, pyoderma, pulmonary tuberculosis) - 28.6%, fungal infections (candidiasis mucous membranes of the oral cavity) and Pneumocystis pneumonia - 31.4%. Complex therapy (etiotropic, pathogenetic, symptomatic) acute respiratory viral infections in children with B-23 and R-75, allows us to achieve in the early stages (6 days treatment) of the regression of the main symptoms of acute respiratory diseases.
Mechanism of neurodevelopment of children with hearing deprivation
Authors: Yuryeva Diana S , Palchik Alexander B , Yuldashev Zafar M , Mashevskiy Gleb A , Ulyanova Anna V , Sablina Yulia V
Published: August 2017

100 children with sensorineural hearing loss, who had confirmed hearing impairment, were examined by routine somatoneurological and surdological survey, as well as standard psychomotor development scales (Alberta Infant Motor Scale (AIMS), Denver Developmental Screening Test (DDST), Griffiths Mental Development Scales (GMDS, GMDS-ER) in the city rehabilitation center for children with hearing and speech pathology. Criterion for inclusion in the study were the following: post-conceptual age of the child had to be not more than 36 months at the time of observation; bilateral or unilateral chronic sensorineural hearing loss or deafness and/or the presence of auditory neuropathy, confirmed by objective methods with modern audiological examinations for the core group; the absence of hearing loss, set by the modern objective methods of audiological examination for the comparison group; assessment of psychomotor and speech development of a child with at least two scales from the selection below. The survey results were analyzed using nonparametric statistical methods. Next Bayesian networks were used as efficient, compact, and intuitive way to represent knowledge related to uncertainty. Patterns of mental development, motor skills, speech and social functions in children with hearing impairment were obtained. The technique, which, depending on the factors affecting the trait under study, can help to predict with certainty the likelihood of various normal and deviant development of the child.
The method of evaluation and prediction of formation of menstrual function of adolescent girls
Authors: Mironova Anna V. , Balasanyan Viktoria G.
Published: August 2017

Timely detection of risk groups at the onset of puberty and menstrual function is key to good physical, sexual, and mental health. Nowadays, many authors work at the problem of identifying risk factors that lead to the disruption of the formation of the reproductive system as well as creat predictive software and maps for the assessment of possible risks of the formation of this system in girls. The paper presents the possibility of predicting the formation of menstrual function in adolescent girls based on prognostic charts. The prognostic chart includes the following criteria: age, health, mother’s social position at the time of pregnancy and childbirth, place of birth and residence, and the transferred diseases of a girl with a group definition of health. Medical examination was performed in 432 girls aged 9-13 years and 11 months. It was revealed that more than half of the girls belong to a group with medium risk of all forms of menstrual dysfunction, requiring the attention of a gynecologist for adolescents. The main components of preventive observation and treatment consisted of gynecological examination, normalization of work and rest, nutrition, sanitation of foci of infection, sedative therapy, vitamin therapy, adaptogens, psychological training, physical therapy, and acupuncture. The chart can be used not only by gynecologists for children and adolescents but also by pediatricians, endocrinologists, and health workers in the school setting.
Correction of hepatic dysfunction in an extensive deep burn model
Authors: Brus Tatiana V , Pahomova Maria A , Vasiliev Andrey G
Published: August 2017

The ongoing increase of burn trauma rates urges elaboration of valid and effective methods of medical aid with actualization of pathogenetically-based intensive therapy. Burn disease is a peculiar nosologic form characteristic of local manifestations as well as critical systemic state with involvement of internal organs and systems with subsequent development of polyorganic insufficiency. Liver lesions in case of burn disease are multiform and often combine with disturbances of other organs yielding polyorganic insufficiency. Desintoxicating, hepatoprotector and organoprotector effects of succine acid - containing medicines used for prevention of hepatic failure were assessed in the present study in a model of extensive deep burn in comparison with standard therapy. The experiments involved 60 mature albino rats (180-200 g). Deep burns involving 20% of body surface caused hepatic dysfunction. Remaxol and Reamberin infusions’ effects were comparatively assessed. To evaluate desintoxicating and hepatoprotector effects of these medicines biochemical analysis of these rats’ blood serum was carried out on the 7th day after infliction of extensive deep burns. Alanine-aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase activity and bilirubin concentration were assessed. Analyzing desintoxicating and hepatoprotector effects of Remaxol and Reamberin upon the morphologic structure of the liver in case of extensive deep burn one must admit these medicines are capable of moderate desintoxicating and hepatoprotector effects.
Neonatal Diabetes Mellitus in the Structure of IPEX Syndrome
Authors: Turkunova Mariia E , Ditkovskaya Liliya V , Suspitsin Evgenii N , Tyrtova Ludmila V , Jelenina Ludmila A , Guseva Marina N
Published: August 2017

This disease is characterized by the onset of primary immunodeficiency, which expresses itself as autoimmune multisystem failure, often clinically manifests during the first year of life; there are only about 150 cases in the world described by now. IPEX syndrome is caused by FOXP3 gene defect, which is a transcription factor that affects the activity of regulatory T-cells responsible for the maintenance of aytotolerance. There are around 70 pathogenic mutations in this gene described so far. Most patients with IPEX-syndrome have a clinical manifestations of the disease in the early neonatal period or during the first 3-4 months of life. For this disease the following clinical triad of manifestations is typical: Autoimmune enteropathy (100%), diabetes mellitus (70%), skin lesions (65%), as in the syndrome structure includes severe developmental delay (50%), thyroid disease (30%), recurrent infections (20%), rarer autoimmune cytopenia (Coombs-positive hemolytic anemia), pneumonia, nephritis, hepatitis, artrit, myositis, alopecia. However, some cases of later manifestations were described (in patients of more than 1 year of age) when patients did not show all clinical and laboratory symptoms typical for severe forms of the disease. Due to the severity of the disease and the high mortality in this group of patients, it is very important to diagnose it early and start therapy timely. The article describes a clinical case of permanent neonatal diabetes mellitus in the structure of IPEX syndrome.
Clinic, diagnosis and treatment of children with dysplasia of the main veins
Authors: Kupatadze Dimitry D , Azarov Mikhail V , Nabokov Victor V
Published: August 2017

Dysplasia of the main veins is one of the little-studied problems of childhood, which often leads to the erroneous diagnosis and the wrong treatment tactics of this defect. In the angiomyrosurgical department of the Federal State Sanitary and Epidemiological Service, there were 270 children with dysplasia of the main veins in the SPbGPMU of the Russian Ministry of Health. The appearance of children with dysplasia of the main veins, in the "classical" version, is very characteristic. The extremity is disproportionately increased in volume and elongated. Smooth or bulging vascular spots are observed on the skin (often outside) as a geographical map, cyanotic (purple, "port wine") color. The pathognomonic sign is the presence of an embryonic vein, the trunk of which is of different length and caliber (from 3 to 25 mm) passes along the outer or anterior-external surface of the limb. Sometimes there is gigantism of feet, macrodactyly, syndactyly. However, the above classic clinical picture, which allows confidently diagnose dysplasia of the main veins, is not always revealed. In this regard, we examined the general, characteristic for the majority of patients factors, and those that are most important in determining the severity of the lesion in the preoperative period are identified. We propose a scheme of rational approach to the examination and treatment of sick children (270 patients), which should help optimize the treatment of patients with this malformation. It is established that the volume and type of surgical interventions depend on the type of defect and severity of the lesion.
Cardiovascular complications of antineoplastic therapy in children
Authors: Kulyova Svetlana A , Semiglazova Tatiana Yu , Zvyagintseva Daria A , Belogurova Margarita B , Ivanova Svetlana V , Okisheva Irina V
Published: August 2017

The improvement of long-term survival in children with malignant tumors is noted in the last five decades. Serious late consequences of the applied therapy including early death, the second tumors, different organ dysfunctions (heart, gonads, liver, lungs) began to come to light with increase in number of cured and follow-up. The article discusses the emergence of cardiotoxicity in children treated with cytostatic and radiation therapy for malignant tumors. Particular attention is paid to the influence of anthracycline antibiotics on the state of the heart muscle. Anthracycline and similar medicines - doxorubicin, rubomycin, idarubicin, mitoxantrone - are an important component of most regimen of chemotherapy in children. Briefly describes the history of the application of this group of drugs in oncology and the study of their effects on heart function. The attention to the pathogenesis of anthracycline cardiotoxicity risk factors for its development, display options, how to identify and mitigate. We describe the clinical manifestations of early and late cardiotoxicity arising after the application of antitumor antibiotics anthracyclines. The article defines the role of chemotherapeutic agents other groups in the development and worsening cardiotoxicity. No less important role in the development of long-term effects of the heart and blood vessels plays radiotherapy. The paper paid attention to cardiovascular dysfunctions that arise in different periods of observation after irradiation of the mediastinum. Finally, recommendations for practitioners on screening, monitoring and treatment of identified diseases of the cardiovascular system in patients cured of childhood malignancies are presented.
Comparative assesment of efficiency application cold atmospheric plasma and biopolymerous coats evaluation of the effectiveness for the treatment of skin burns of iii degree in experiment
Authors: Zinovyev Evgeny V. , Asadulaev Marat S. , Komissarov Igor A. , Shemet Mihail V. , Yudin Vladimir E. , Shabunin Anton S. , Smirnova Natalia V. , Kryukov Artem E. , Lukyanov Sergey A. , Stoyanovskiy Roman G. , Shalonia Tatiana A. , Artsimovich Ilya V. , Kostyakov Denis V.
Published: August 2017

The results of the application of cold atmospheric plasma are discussed in the experimental study. The effectiveness of an experimental wound dressing based on chitosan nanofibers and copolyamide and a commercial wound dressing material based on hyaluronic acid hydrogel in the treatment of third-degree skin burns (ICD-10) is also evaluated. During the first phase of the study, an original method of inflicting thermal burn on the skin of small laboratory animals (rodents) was developed. The temperature of dehaired skin and the temperature of skin heated by resistive electrical element metal plate were obtained through a digital thermometer sensor. The source for the generation of cold atmospheric plasma was made by specialists of St. Petersburg Polytechnic University of Peter the Great. Biopsy material for histological assay was taken 3, 7, 12, 15, 21, and 28 days after treatment. Paraffinic microscopic sectioning was performed with hematoxylin and eosin; after this, microscopic assay was done. The use of cold atmospheric plasma decreases the frequency of purulent complications and also helps reduce the recovery time of the skin by 20% (p < 0.05) but is not sufficient to achieve the result that has been proclaimed after an early escharectomy and replacement of surgical defects by wound dressing materials based on natural polymers. It was demonstrated that the wound dressing based on aliphatic copolyamide and chitosan and hyaluronic acid hydrogel can help significantly accelerate the process of reparative regeneration and histogenesis in the heat-affected zone after escharectomy for up to 14.6%-46% (p < 0.05).
Evaluation of efficiency of different methods of radiation diagnosis in the detection of tuberculosis in children
Authors: Sinitsyna Anastasiya V , Gavrilov Pavel V , Sinitsyn Alexandr V , Michailova Svetlana V , Pribitok Ksenia V , Sinelnikova Elena V
Published: August 2017

An evaluation of the effectiveness of the method of computer tomography in 77 children with suspicion of tuberculosis of the intrathoracic lymph nodes and positive test with recombinant tuberculosis allergen (Diaskintest). Ultrasound diagnosis is conducted with 60 children with a negative test with recombinant tuberculosis allergen (Diaskintest), with indirect signs of increase of intrathoracic lymph nodes, left tracheobronchial region according to traditional radiographic studies (plain radiography, linear tomography). In the first group of the frequency change detection by computed tomography in a group of patients, where it was revealed the changes on the survey radiograph, was almost 2 times more than in the group of patients with normal radiograph. There is a high rate of detection of changes at computed tomography in children with normal x-ray picture according to the classical methods. These changes were regarded as possibly associated with an active tuberculous process and required additional evaluation of clinical and laboratory data physician TB. In 32% of cases, the changes revealed by traditional x-ray, computed tomography has not been confirmed. When conducting sonography in the second group in the left tracheobronchial region was visualized left lobe of the thymus in 100%. Specific changes in the lymph nodes and the pleura was not determined by ultrasound. Thus the thymus simulated increase in intrathoracic lymph nodes. In the evaluation of clinical and laboratory data physician TB specialist, diagnosis of tuberculosis in this group, was not confirmed.
Random Forest
Authors: Rigatti Steven J.
Published: August 2017

For the task of analyzing survival data to derive risk factors associated with mortality, physicians, researchers, and biostatisticians have typically relied on certain types of regression techniques, most notably the Cox model. With the advent of more widely distributed computing power, methods which require more complex mathematics have become increasingly common. Particularly in this era of “big data” and machine learning, survival analysis has become methodologically broader. This paper aims to explore one technique known as Random Forest. The Random Forest technique is a regression tree technique which uses bootstrap aggregation and randomization of predictors to achieve a high degree of predictive accuracy. The various input parameters of the random forest are explored. Colon cancer data (n = 66,807) from the SEER database is then used to construct both a Cox model and a random forest model to determine how well the models perform on the same data. Both models perform well, achieving a concordance error rate of approximately 18%.
Qualidade de Vida de Enfermeiros do Serviço de Atendimento Móvel de Urgência com Dupla Jornada de Trabalho
Authors: Farias Maria Sinara , Ponte Keila Maria De Azevedo , Moraes Marcio Venicio Alcântara de , Sabóia Elaine Cristina Marques
Published: August 2017

Objetivou-se descrever a qualidade de vida de enfermeiros do Serviço de Atendimento Móvel de Urgência com Dupla Jornada de Trabalho. Trata-se de um estudo exploratório e descritivo realizado de julho a agosto de 2015 com enfermeiros do Serviço de Atendimento Móvel de Urgência em Sobral – Ceará. Para coleta das informações foi usado o questionário validado Whoqol-Bref. Os dados foram apresentados, de forma descritiva, e discutidos de acordo com a literatura pertinente sobre o assunto. O estudo mostrou que quase a metade dos profissionais não está satisfeita com a qualidade de suas vidas. Contudo, no domínio físico, se mostraram bem fisicamente, no psicológico se mostraram positivos nos sentimentos negativos, quanto à ansiedade. Nas relações sociais, os enfermeiros estavam satisfeitos e no domínio do meio ambiente, eles demonstraram opiniões divididas entre satisfeitos e insatisfeitos e enfatizaram os riscos que estão sujeitos nas ocorrências. Portanto, o enfermeiro, em qualquer serviço em que atua, merece apoio, respeito e valorização, neste sentido é preciso políticas que promovam saúde, previnam doenças com vistas a melhor qualidade de vida.Palavras-chave: Qualidade de Vida. Cuidados de Enfermagem. Jornada de Trabalho.AbstractThe purpose of this study was to describe the nurses’ life quality at the Double Emergency Mobile Service work shift. This is an exploratory and descriptive study carried out from July to August 2015 with nurses from the Mobile Emergency Care Service in Sobral - Ceará. To collect the information, the validated Whoqol-Bref questionnaire was used. The data were presented descriptively and discussed according to relevant literature on the subject. The study showed that nearly half of professionals are not satisfied with the their lives quality. However in the physical domain, they were physically well, in the psychological, they were positive regarding their feelings and negative when it comes to anxiety. In social relationships, nurses were satisfied and in the environmental domain, they demonstrated divided opinions between satisfied and unsatisfied and emphasized the risks that they are subject in the occurrences. Therefore, the nurse, in any service in which he / she works, deserves support, respect and appreciation, in this sense it is necessary policies that promote health, prevent diseases with a view to a better life quality.Keywords: Life Quality. Nursing Care. Work Shift.
Can liver cirrhosis patients benefit from target controlled infusion of propofol for conscious sedation during endoscopic variceal ligation?
Authors: Li Jun-Xiang , Wu Jun-Chao , Lin Wei-Wei , Wang Xiao
Published: August 2017

Background: The aim of the present study was to evaluate the feasibility of conscious sedation using target controlled infusion of propofol combined with a single dose of fentanyl during endoscopic variceal ligation in patients with liver cirrhosis.Methods: Forty-eight patients with liver cirrhosis scheduled for endoscopic variceal ligation were randomly assigned to deep sedation group (DS group) with intravenous bolus of propofol and conscious sedation group (CS group) with target controlled infusion of propofol, 1 μg/kg fentanyl was intravenously injected in each patient before administration of propofol. Cardiorespiratory parameters were monitored, and the side-effects were recorded. The depth of sedation was assessed by both of the sale of observer′s assessment of alertness/sedation (OAA/S) and the bispectral index (BIS). The quality of sedation/analgesia was evaluated by the endoscopist and patients using Visual Analog Scores (VAS). The recovery level was evaluated with the Aldrete scales.Results: No significant differences were found on demographic data and initial parameters in the two groups. Compared with the CS group, the changes of mean arterial pressure (MAP) and heart rate (HR) and the signs of respiratory depression were significant in the DS group (p<0.05). The recovery time in DS group (16.7±2.7 minutes) was much longer than that in the CS group (9.3±3.0 minutes, p<0.01). There was no difference in Visual Analogue Scale scores for endoscopist’s satisfaction between the two groups (9.2±0.6 versus 9.0±0.6, p>0.05), but a higher degree of satisfaction for patient was found in the DS group (9.3±0.6 versus 7.9±0.7, p<0.01).Conclusions: Conscious sedation with target controlled infusion of propofol combined with a single bolus of fentanyl for endoscopic variceal ligation in patients with liver cirrhosis had better hemodynamic stability, less respiratory depression and shorter recovery time.
Comparative study of transthoracic ultrasound and chest X-ray in the postoperative period of thoracic surgery
Authors: Traslaviña Julián A. , Martínez Manuel M. , Olivera Maria J. , Balsalobre Ramón M.
Published: August 2017

Background: Chest radiography is currently the reference technique in postoperative follow-up of thoracic surgery. However, routine use (almost daily) has been repeatedly questioned. Moreover, transthoracic ultrasound, besides being a useful technique in pleuropulmonary pathology offers additional advantages over the radiograph. The aim of this study is to analyse the diagnostic agreement between radiographic and ultrasound techniques in the postoperative follow-up of thoracic surgery.Methods: Observational, prospective study, in the postoperative period of thoracic surgery, to study the concordance between the ultrasound and radiographic findings. Sixty patients were evaluated during the postoperative period with the two diagnostic tests, first the lung ultrasound of the 2 hemithorax and then the chest radiograph. Each patient had an ultrasound and an X-ray. The sonographer and radiologist have independently assessed the occurrences of pneumothorax, pleural effusion, pulmonary consolidation, and interstitial pattern.Results: The Cohen kappa index for pneumothorax was 0.706 (p <0.001), for pleural effusion 0.588 (p <0.001), for interstitial pattern 0.471 (p <0.001) and for pulmonary consolidation 0.282 (p 0.002).Conclusions: The diagnostic concordance between radiographic and ultrasound techniques in the postoperative period of thoracic surgery is substantial for pneumothorax, pleural effusion and interstitial pattern, and  fair for pulmonary consolidation.
A study on clinical and radiological factors for predicting difficult laparoscopic cholecystectomy preoperatively
Authors: S. Arun Prasath , Rathnakar Surag Kajoor , L. Nagaraja Anekal
Published: August 2017

Background: Laparoscopic cholecystectomy considered as the gold standard treatment for symptomatic gall stone disease has 1-13% conversion rate to an open procedure due to various reasons. Present study aims to predict difficult laparoscopic cholecystectomy preoperatively using clinical and sonological factors.Methods: This is a prospective study done on 190 patients who were posted for laparoscopic cholecystectomy from March 2015 to February 2017. Parameters taken into consideration were: age, number of previous attacks of acute cholecystitis, impacted gallstone, thickness of GB wall, pericholecystic fluid collection, history of upper abdominal surgery and obesity. All surgeries were performed by surgeons with minimum ten years of experience on laparoscopic cholecystectomy and ultrasound of the abdomen was performed by senior radiologists with experience of minimum five years.Results: Out of 190 patients, difficulty was experienced in 48 patients of which conversion to open cholecystectomy was needed for 11 patients. Elderly age, multiple attacks of pain abdomen (>2), palpable GB, impacted gallstone, thickness of GB wall >3 mm, peri-GB fluid collection, adhesions due to previous abdominal surgery and obesity were all found to be independent risk factors leading to difficult laparoscopic cholecystectomy.Conclusions: Though there is no definite scoring system to predict difficult LC, there is scope for further refinement to make the same less cumbersome and easier to handle using the above clinical and radiological factors.
Management of diabetic foot ulcers in a teaching hospital
Authors: Sade Rajkumar , Jatothu Dasharadha , Taruni . , Sade Kirthana , Pyadala Nagababu
Published: August 2017

Background: Diabetic foot ulcers (DFUs) are major public health problem, especially in developing countries. Still now management of diabetic foot ulcer is the major challenge for surgeons.Methods: A prospective study was done at Kamineni Institute of Medical Sciences, Narketpally; from February 2014 to January 2017. All the collected data was analyzed by the SPSS 20.0 software.Results: A total of 350 DFUs patients was included in this study. Among all of them 77.14% were male and 22.86% were female. Most common age group with DFUs was 40-60 years. All the patients had type 2 diabetes mellitus. The majority of patients were presented foot ulcers between 4 weeks to 32 weeks. 18% patients had previous history of DFUs and 11.14% had previous amputation. The forefoot was commonly affected in 48.3% of cases. Neuropathic ulcers were the most common type of DFUs in 50.6% of cases. Wagner's stage 3, 4 and 5 ulcers were the most common at 20.86%, 28% and 22% respectively. 52.86% patients were treated surgically. Lower limb amputation was the most common surgical procedure performed in 60% of cases. The complication rate was (49.7%) and surgical site infection was the most common complication (34.8%). 60% of cultures had polymicrobial growth and Staphylococcus aureus (53.3%) was the most common microorganism isolated. Most of the microorganisms isolated showed multi drug resistance to commonly used antibiotics except for Carbapenems group drugs (sensitivity 100%). The hospital stay was ranged between 15-116 days. Mortality rate was 9.4%.Conclusions: Diabetic foot ulcer is the major cause of morbidity and mortality among patients with diabetes mellitus. A proper education on foot care and appropriate foot ware, good sugar level control and early surgical intervention is needed to decrease the morbidity and mortality among diabetic foot ulcer patients.
The role of ultrasonic guided fine needle aspiration cytology in the diagnoses of renal masses
Authors: Abid Ali Hussein , Mohammad Ehab Jasim , Alani Mohammed Kamal Rasheed
Published: August 2017

Background: FNAC has been widely applied in the diagnosis of tumors and tumor like lesion of the abdomen including the kidney. The aim of this study was to evaluate the outcome of FNAC to a sample of Iraqi patients with kidney tumor.Methods: Patients with clinical, radiological suspicion of renal masses underwent FNAC of the kidney under ultrasound guidance were invited to this study. Those who fulfilled inclusion criteria were recruited. FNAC was done in accordance with stipulated clinical practice.Results: 53 patients with clinical and radiological suspicion of renal mass underwent FNAC of the kidney under ultrasound guidance. The age ranged from 1-2 year to 70 years (mean 44.7 years) with male to female ratio (1.9:1). Around 94.3% had primary renal mass, 1.9% metastatic tumor to the kidney and the rest 3.8% was undiagnosed. Sensitivity was 90% while specificity was 100%.Conclusions: We conclude that FNAC of the renal masses is safe and reliable, and fast diagnostic procedure in the evaluation of patient with renal masses.
Comparative study and outcome of open versus laparoscopic appendectomy: case series of 60 patients
Authors: Sharma Neeraj , Mishra Mayank , Tripathi Alok , Rai Vivekanand
Published: August 2017

Background: Laparoscopic appendectomy combines the advantages of diagnosis and treatment in one procedure with least morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities of daily living sooner than those who have undergone open appendectomy.Methods: This prospective study was carried out in the Department of Surgery, Heritage IMS, Varanasi, from May 2016 to May 2017. All the patients were randomly divided into two groups, Group I (Lap App) and Group II (Open App). All quantitative data was compared by independent sample test. All qualitative data was compared by chi-square test. A p-value <0.05 was considered statistically significant.Results: In present study 19 (63%) patients of open appendectomy and 19 (63%) patients of laparoscopic appendectomy were males. 11 (36%) patients of open appendectomy and 11 (36%) laparoscopic appendectomy were females.Conclusions: This study from May 2016 to April 2017 was done on 60 (30 lap and 30 open) patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Heritage Institute of Medical Sciences. In spite of drawback of the increase in duration of surgery, we conclude that laparoscopic appendectomy is better than the open method for acute appendicitis, with less post-operative pain and reduced duration of analgesics used, with lesser incidences of post-operative complications, shorter duration of hospital stays, early return to normal work.
A prospective cohort study of hypoalbuminemia as risk factor of wound healing in diabetic foot: a study from tertiary hospital in south India
Authors: Edakkepuram Unnikrishnan , P. C. Sheeja , Gopi Ellikunnel Vithon
Published: August 2017

Background: Diabetic foot ulcers is a major complication of diabetes mellitus, and precedes >80% of all diabetes related lower leg amputations. One of the risk factors in non-healing diabetic ulcer is low serum albumin level. The objectives of this study were to study the effect of low serum albumin level in patients with diabetic foot ulcer and to study the factors affecting wound healing in diabetic ulcer.Methods: Prospective cohort study in a tertiary hospital.Results: The mean age among study was 57.8 out of which 68.3% were males and 31.7% were females. 55% patients presented with slough over ulcer, 29.2% patients presented with healthy granulation and 15.8% patients presented with extensive wound infection. Among study group 50% patients had good glycaemic control and 50% patients had poor glycaemic control.Conclusions: Low serum albumin level is one of the attributable risk factor of non-healing ulcers in diabetic foot. Poor glycaemic status is also a risk factor for non-healing ulcer.
A rare case report of bilateral synchronous carcinoma breast
Authors: Shah Bhushan Anil , Yadav Nagendra , Akhil Kandarpa , Alam Firoz
Published: August 2017

Bilateral Breast Carcinoma (BBC) is a rare entity with incidence of synchronous carcinoma being 2-5% of all breast malignancies, which is much less than metachronous carcinoma. Synchronicity/metachronicity are usually associated with local and lymphatic spread and with blood-borne spread to lungs, bones and liver. Moreover, BBC are mostly lobular carcinomas but we report a rare case of Infiltrating Ductal Carcinoma (IDC), medullary type as the primary carcinoma. 56-year-old female who presented with a lump in her right breast for 6 months and lump in her left axilla. There was no e/o palpable lump in her left breast. Trucut biopsy was taken from both the lumps and was s/o infiltrating ductal carcinoma. Different histological subtypes with different grades of tumour in both breasts suggested synchronous primary tumours. Early detection of the contralateral tumour is of utmost importance emphasizing the significance of breast self-examination. Screening tools like MRI have a greater sensitivity compared to Mammography. There are no clear treatment guidelines for bilateral breast cancer. Patients are often treated with bilateral mastectomy, with breast conservative surgery having unclear importance. Meticulous diagnosis and appropriate management help to improve the longevity with an improved quality of life.
Variable relationship of retro-mandibular vein to the facial nerve, a finding during parotid surgery: a rare case report
Authors: Reddy V. Jayapala , Hemachandra T. , Kumar S. Nagesh , Reddy P. V. Ramasubba
Published: August 2017

Studies describing the anatomical relation and variability of facial nerve and retro-mandibular vein were mostly on cadavers. Intraoperative encounter of variable anatomy in parotid surgery is rarely reported in literature. The usual location of retro-mandibular vein is medial to facial nerve as described in many classical text books is around 88%. Here we present a case with variable anatomy of retromandibular vein. A 55-year-old Indian gentleman presented with history of painless swelling in left parotid region for 5 months. On clinical examination, a 3×3 cm swelling probably arising from left parotid gland was felt. Preoperative ultrasonography described it as parotid cyst arising from inferior pole. Fine needle aspiration cytology described it as benign parotid cyst. A superficial parotidectomy was planned and executed. During surgery, the retro-mandibular vein was found crossing the two trunks of the facial nerve laterally (superficial to facial nerve) in between the division of facial nerve trunk and origin of ramifications. Usually retro-mandibular vein runs medial (deep) to the facial nerve trunks. Anatomical variations between facial nerve and retro-mandibular vein are underreported and not given due importance during training. With this article, we want to emphasize the importance of having awareness regarding anatomical variations related to facial nerve and retro-mandibular vein and be prepared to encounter during surgery there by preventing complications. We are reporting the first case from India.
Cholelithiasis in an intrahepatic gallbladder
Authors: G. Chandrasekar , Nagappa Vivek
Published: August 2017

Intrahepatic gall bladder (GB) is an uncommonly encountered condition in clinical practice characterized by ectopic location of GB within the hepatic parenchyma. This condition not only produces difficulty in clinical diagnosis of various GB diseases especially cholecystitis and carcinoma but also in their management including cholecystectomy. An ectopic partial intrahepatic GB can make cholecystectomy hazardous, when indicated. A case of cholelithiasis in an intrahepatic gallbladder with concurrent choledocholithiasis is reported. The patient initially presented with pain over the right upper abdomen. The diagnosis was made during intraoperative laparoscopic cholecystectomy. This article discusses about difficultly faced during cholecystectomy and rarity of the presentation.
Peran Lembaga Keuangan Syariah dalam Pemberdayaan UMKM di Indonesia
Authors: Muheramtohadi Singgih
Published: August 2017

Syariah Financial Institution means that the financial institution is run based on the Islamic teaching that refers to Qur’an and the Sunnah. Practically, it beganin early history of Islam, then was developed into Syariah Financial Institution. So, the purpose of Syariah Financial Institution is not merely for profit orientation. Further, it should be in accordance with Islamic value and the human philanthropy. Most of Syariah Financial Institution’s financing is for business sector and its ability to reach the micro business, that can’t be done by commercial banks. The financing for small business is funded by Islamic institutions due to Grameen Bank effect. Previously, Grameen Bank was built in mid-decade of 1970. The Financing of Syariah Financial Institution, in any sort, including cooperative union or BMT (Baitul Maal wa Tamwil), increased over time in both Institution Revenue and the Financing Rate. According to Financial Service Authority, most of financing of Syariah Banking is for the Micro, Small, Medium Enterprises that is very important for the nation economy, because it is engaged in the real sector of economy. And the other characters of the Micro, Small, medium enterprises in Indonesia are holding the honesty ethics and resistante to the crisis. They are the strengths of UMKM which must be considered to make the decision by the government or the Financial Institutions.Lembaga Keuangan Syariah (LKS) berarti badan yang bergerak di bidang keuangan yang dilandaskan pada ajaran Islam yang bersumber pada al Qur’an dan As Sunnah. Praktek ini sudah terdapat pada sejarah awal Islam, dan asas moralitas Islam dikembangkan dalam bentuk LKS. Sehingga, tujuan dari LKS tidak semata Profit Oriented, melainkan terdapat unsur-unsur keislaman dan kemanusiaan di dalamnya. Lembaga Keuangan syariah sebagian besar pembiayaannya diperuntukkan kepada sektor usaha, dan punya kemampuan untuk menjangkau usaha mikro, Sesuatu yang jarang dilakukan oleh pihak perbankan konvensional. Pembiayaan kepada UMKM ini tidak lepas juga dari pengaruh Grameen Bank sebelumnya, yang telah berdiri sejak medio 1970-an. Pembiayaan Lembaga Keuangan Syarah, baik dalam wujud Bank, Koperasi Simpan Pinjam maupun BMT mengalami peningkatan dari waktu ke waktu. Baik itu dari segi omzet LKS maupun tingkat pembiayaan nya. Berdasarkan data dari Jasa Otoritas Keuangan sebagian besar dari pembiayaan tersebut disalurkan kepada UMKM. Pembiayaan UMKM sangat penting dalam perekonomian nasional, karena bergerak di sektor riil. Karakteristik UMKM adalah sebagai usaha menengah ke bawah, pada umumnya dikelola dengan etika kejujuran masih dipegang kuat, serta relatif lebih kuat ketika dihadapkan pada krisis. Inilah yang jadi potensi UMKM yang harus diperhatikan dalam mengambil keputusan publik, baik itu oleh Pemerintah maupun Lembaga Keuangan (perbankan).
Avaliação do bagaço de cana natural e modificado como potencial sorvente de óleo vegetal
Authors: Guilarduci Viviane Vasques da Silva , Gorgulho Honória Fátima , Martelli Patrícia Benedini , Santos Vanessa Soares dos , Corrêa William Graciliano
Published: August 2017

O óleo e a gordura vegetal residual, utilizados para a preparação de alimentos representam um perigoso poluente para as águas de córregos e rios. Um dos métodos mais utilizados nas últimas décadas para limpeza da água oleosa é a aplicação de biossorventes, pois apresentam facilidade para remoção e recuperação do óleo. Neste sentido, o objetivo deste trabalho foi determinar a influência das modificações do bagaço de cana com anidrido acético (acetilação) e com 3-aminopropiltrietoxisilano (silanização) sob a sorção de óleo vegetal. A modificação das fibras foi avaliada pelas técnicas de espectroscopia no infravermelho com transformada de Fourier (FTIR), análise termogravimétrica (TG), difração de raios X, microscopia eletrônica de varredura (MEV) e análise de área superficial e porosidade. Os resultados obtidos indicaram maior sorção de óleo vegetal para o bagaço de cana modificado com anidrido acético (BCA), 667 mg.g-1, seguido pelo bagaço de cana sem modificação (BCN) com sorção de 576 mg.g-1. O bagaço de cana modificado com 3-aminopropiltrietoxisilano (BCS) apresentou menor sorção, 425 mg.g-1, o que foi atribuído à sua maior hidrofilicidade.Evaluation of natural and modified sugarcane bagasse as sorbent of vegetable oil Abstract: The oil and the residual vegetable fat, used for the preparation of foods represent a dangerous pollutant for the waters of streams and rivers. One of the most used methods in the last decades for cleaning the oily water is the application of biosorbents, since they are easy to remove and recover the oil. In this sense, the purpose of this work was to determine the influence of the modifications of sugarcane bagasse with acetic anhydride (acetylation) and with 3-aminopropyltriethoxysilane (silanization) under sorption of vegetable oil. The BCN and the grafted products were further characterized by FTIR spectroscopy, thermal gravimetric analysis, X-ray diffraction, scanning electron microscopy and analysis of surface area and porosity. The results showed higher sorption of vegetable oil for the acetic anhydride-modified sugarcane bagasse (BCA), 667 mg.g-1, followed by sugarcane bagasse without modification (BCN) with sorption of 576 mg.g-1. The cane bagasse modified with 3-aminopropyltriethoxysilane (BCS) presented lower sorption, 425 mg.g-1, which was attributed to its greater hydrophilicity.
Wewnętrzny punkt widzenia i znaczenie pojęcia wspólnoty komunikacyjnej w metodologii prawoznawstwa (wprowadzenie do problematyki)
Authors: Zirk-Sadowski Marek , Bekrycht Tomasz
Published: August 2017

Tekst zawiera kilka spostrzeżeń dotyczących metodologicznej problematyki prawoznawstwa. Autorzy wskazują w nim na istotną rolę tzw. wewnętrznego punktu widzenia w epistemologii prawa oraz analiz języka prawnego i prawniczego w postawie uczestnika wspólnoty komunikacyjnej.
Klauzula sumienia lekarzy a trudny przypadek prawa
Authors: Rzymkowska Katarzyna
Published: August 2017

Celem tekstu jest próba opisania sytuacji odwołania się przez lekarza do klauzuli sumienia jako trudnego przypadku prawa w rozumieniu Ronalda Dworkina. Tak samo, jak ma to miejsce w trudnym przypadku, klauzula sumienia pozwala lekarzom odwołać się do autonomicznego systemu norm w przypadku niesprawiedliwego wyniku interpretacji norm systemu prawnego. Dzieje się tak dlatego, że sytuacja lekarza jest indywidualna i konkretna, w odróżnieniu od przepisów prawa, co każe uznać klauzulę nie za przyczynę zaistnienia trudnego przypadku, lecz drogę do jego rozwiązania. Ponadto instytucja klauzuli sumienia nakłada na lekarza dodatkowe obowiązki, które motywowane są zasadami prawa, poddanymi procesowi ważenia. Obecna w koncepcji Dworkina postawa interpretacyjna pozwala na rozszerzenie kategorii trudnego przypadku na sprawy niesądowe oraz nierozstrzygane przez sędziów.
Socjologia praw pacjenta – wybrane uwagi, analizy i refleksje
Authors: Kmieciak Błażej
Published: August 2017

Sytuacja prawna pacjenta stała się jednym z kluczowych elementów debaty na temat ochrony zdrowia. Odnosi się ona do szczególnej sytuacji. Pacjent w trakcie spotkania z ekspertem medycznym zmuszony jest często do przedstawienia intymnych informacji dotyczących swojego życia. Prawa pacjenta najczęściej analizowane są pod kątem legalnym, w aspekcie konkretnych ustaw lub rozporządzeń. Warto jednak zaznaczyć, że wspomniane uprawnienia pacjentów „żyją” przede wszystkim na terenie instytucji, takich jak szpitale czy poradnie. Ponadto, nie są one wyłącznie elementem szeroko rozumianego systemu prawa medycznego. Odwołują się do konkretnego spotkania, do jakiego dochodzi pomiędzy pacjentem a ekspertem medycznym. W jaki sposób, wspomnianą relację można odnieść do pojęcia praw pacjenta? Czy istnieją prawa, które w sposób szczególny dotyczą interakcji, do której dochodzi pomiędzy lekarzem a pacjentem? Czy formalna realizacja przepisów wystarczy, by uznać, iż dane prawa są w pełni respektowane? W prezentowanym artykule podjęta zostanie próba udzielenia odpowiedzi na te pytania.
Achieving Sustainable Development through Environment Accounting from the Global Perspective: Evidence from Bangladesh
Authors: Kumar Tapos
Published: August 2017

The study visualizes the link between environment accounting & triple bottom line, quantitative environmental reporting & standard method, voluntary environmental disclosure & legal requirement, size of company & volume of environmental disclosure, material flow analysis & life cycle assessment to achieve sustainable development in Bangladeshi corporation. Therefore, the purpose of the study is to investigate the role of these factors to achieve sustainable development in Bangladeshi corporation. To investigate the role of these factors, ten factors that significantly contribute to achieve sustainable development were determined. A set of closed-minded questionnaire was developed on the basis of these factors to collect the data from employees & employers. Questionnaire was administered by using statistical tools such as matrix, cross tabulation & Paired Samples Tests as a data collection tool and analyses. Research finding shows that sustainability of corporation was associated with the performance of economic, social, and environment. Other factors like quantitative environmental reporting, standard method, voluntary environmental disclosure, legal requirement, size of the company, volume of environmental disclosure, material flow analysis & life cycle assessment were found that they worked as a complement to enhance the performance of economic, social, and environment to achieve sustainable development in Bangladeshi corporation.