bluuebunny/crossref_metadata_2025 huggingface dataset:
ON SURFACE FRACTURE OF RAIL HEADS
Authors: O. P. Datsyshyn  , H. P. Marchenko  , A. Y. Glazov
Published: September 2017

Purpose. The formation of crack-like defects in rails of railway tracks is a serious problem for engineering practice because of the danger of creating emergency situations. The purpose of this work is to establish theoretically the characteristic angle of propagation of surface cracks in the rail heads of railway rails, which is basic in the formation of typical surface contact fatigue damages, such as pitting, «checks» and «squat». It is also necessary to find the conditions for determining this angle. Methodology. The investigations were carried out on the basis of the method of singular integral equations. The rail damaged by the surface crack was modeled with a half-plane with an edge cut, and the action of the wheel on the rail by unidirectional repeated translational movement along the edge of the half-plane of the Hertzian contact forces with the tangential component. The problem of determining the stress intensity factors in the vicinity of the crack tip in the rail head was reduced to a system of two real singular integral equations which were solved numerically by the Gauss-Chebyshev mechanical quadrature method. The complexity of the problem consists in the fact that the boundaries of the contact areas and the opening of the crack faces are unknown beforehand and they change when the model contact forces move. These boundaries were determined simultaneously with solving the integral equations of the problem from additional conditions by the iteration method. Findings. The presence of the characteristic angle of propagation of mode II surface cracks in the rail head has been established theoretically and the conditions for its determination have been put down. The results obtained are in good agreement with engineering and experimental data. Originality. For the first time, the values of the characteristic angle were theoretically determined, under which at the initial stage, the surface contact fatigue cracks propagate in the head of the railway rail under the action of the wheels. Conditions for determining this angle have been also put down. Practical value. The received data are of great importance for engineering practice, since they reveal the nature of surface contact fatigue defects under various operating conditions and allow to predict their contact strength and durability.
CREATION OF IT-ORIENTED ONTOLOGICAL FRAMEWORK FOR THE PURPOSE OF MAKING EDUCATIONAL PROGRAMS ON THE BASE OF COMPETENCIES
Authors: G. M. Korotenko  , L. M. Korotenko  , A. T. Khar
Published: September 2017

Purpose. Taking into account the expansion of computing application scopes there is a need to identify the links and features of the constantly emerging professional competencies of the new sections of computing knowledge to improve the process of forming new curricula. Methodology. Authors propose the new approach aimed to build specialized knowledge bases generated using artificial intelligence technology and focused on the use of multiple heterogeneous resources or data sources on specific educational topics is proposed. As a tool, ensuring the formation of the base ontology the Protégé 4.2 ontology editor is used. As one of the modules of the developed system of semantic analysis, which provides access to ontology and the possibility of its processing, the Apache Jena Java framework should be used, which forms the software environment for working with data in RDF, RDFS and OWL formats, and also supports the ability to form queries to Ontologies in the SPARQL language. The peculiarity of this approach is the binding of information resources of the three-platform presentation of the disciplinary structure in the context of identifying the links of professional competencies. Findings. The model and structure of the IT-oriented ontological framework designed to ensure the components convergence of the university three-platform information and communication environment are developed. The structure of the knowledge base ontology-basis, describing the main essence of the educational standards of the "Information Technologies" branch is formed. Originality. Within the framework of design and formation of the knowledge sector disciplinary structure "Information Technologies" in the context of the competence approach to education, the architecture of the competence descriptors of semantic analysis system is proposed. It implements the algorithm for integrating the ontological and product models of knowledge representation about the subject domain. Practical value. The proposed approach allows systematizing the content, structure and connections of the information technologies field components for adjusting the range of competences formed in the development of educational programs for training IT specialists at the University, taking into account the growth of the field of computing.
WAYS TO MANAGE HEATING INERTIA
Authors: Biloshytskyi E. V.
Published: September 2017

Purpose. The research paper proposes to estimate the effect of heat inertia of the water heating system, in transient operation modes, on the temperature condition in the passenger car, as well as to offer technical solutions intended to reduce the heating system inertia effect and to maintain a stable temperature condition in the passenger car premises in transitional modes of the heating system. Methodology. The author developed the method for controlling the heat transfer of heating system pipes with the help of regulating casing. To control the heating system and the heat transfer of heating pipes, two types of temperature control sensors were used in the passenger car: certain sensors interacted with regulatory casings, while the others interacted with high-voltage tubular heating element control devices. To assess the efficiency of heat interchange regulation of heating pipes and the heating system control, with installed regulating casings, the operation of the heating system with regulating casings and two types of sensors was mathematically modelled. Mathematical modelling used the experimental test data. The results of experimental tests and mathematical modelling were compared. Findings. Currently in operated passenger cars, control of heating appliances is not constructively provided. Automatic maintenance of the set temperature in a passenger car is limited to switching on and off of high-voltage tubular heating elements. The use of regulating casings on heating pipes allows reducing the effects of heat inertia and maintaining stable thermal conditions in a passenger car, using the heating system as a heat accumulator, and also provides the opportunity to realize an individual control of air temperature in the compartment. Originality. For the first time, the paper studied the alternative ways of regulating the temperature condition in a passenger car. Using of the heating system as a heat accumulator. Practical value. The regulation of the heat transfers of the heating pipes by regulating casings allows reducing the effect of thermal inertia of the heating system on the temperature condition in a passenger car, implementing individual adjustment of air temperature in a compartment within 40% of the power of the heating pipe section, using the heating system as a heat accumulator.
CONSTRUCTION THE BRIDGE PIER AS PARAMETRIC OBJECT USING AUTODESK REVIT
Authors: K. I. Hladka  , N. P. Bocharova
Published: September 2017

Purpose. The work is aimed to solve the following tasks: 1) to investigate the possibilities of Autodesk Revit to create parametric objects; 2) to create an information model of the bridge pier with the possibility of changing the model size without changing geometry of the object; 3) to trace the complexity and feasibility of using parametric models when designing the elements of bridges. Methodology. The studies were carried out using spatial modeling in the Autodesk Revit system. The ratio of the parameters of the object was set, the relationship between individual geometric elements was determined and the changes that were made to the model with the change of the specified parameters were checked. Findings. Support model of two types has been created: for railway bridges and for road bridges. Both types of models change the dimensions and the number of constituent elements in accordance with the entered parameters. The performed work confirms the possibility of creating information parametric models of complex form and the expediency of using them in the design of bridges and not only. Originality. Creation of information models is a modern and relevant topic. But both in the literature and in Internet resources, parametrization is considered on the example of simple objects. The model proposed in the article consists of several dependent geometric bodies; therefore, it opens the topic of objects parameterization more fully and in detail, in comparison with the existing sources. As for the creation of parametric models of the bridge elements - such information is not found in the literature, that is, it is proposed for the first time. Practical value. Parametrization of spatial models allows significantly to accelerate and simplify the process of designing any objects due to the use of typical parametric models in many projects. Especially it concerns the design of bridges, since the standard elements for them, such as support or span are not yet presented in software products. Designing the bridges as a flat contour, in comparison with the use of spatial information models, is a long and inefficient process, besides it does not allow visualization, which is a necessary component of any project.
Crossrail project: commercial aspects of works contracts for London’s Elizabeth line
Authors: Morrice David , Hands Megan
Published: September 2017

Choosing the right commercial arrangements between the client and contractors was critical to successful delivery of the £14·8 billion Crossrail project to deliver the Elizabeth line east–west railway across London. This paper explains how delivery organisation Crossrail Limited used the NEC3: Engineering and Construction Contract to procure £6·5 billion of main works packages from a wide range of major contractors. The objective was to ensure a fair balance of risk and reward, to allow changes to be accommodated and to enable programme challenges to be addressed as they arose. The paper also deals with the client’s approach to commercial management during the course of the 6 year programme, through to final settlement of accounts with contractors.
An assessment of statistically based relationships between critical state parameters
Authors: Llano-Serna M. A. , Farias M. M. , Pedroso D. M. , Williams D. J. , Sheng D.
Published: September 2017

Reliability-based design (RBD) has been proved effective in the application of probability theory to research and practice in geotechnical engineering. However, the limited field and laboratory information makes it difficult to build robust predictions. This note shows some statistical relationships that may help with additional information in this area. Descriptive statistics are performed in the note followed by demonstrations of the close relationship between deformabilty parameters. The strong correlation between the slope of the critical state line and the earth pressure coefficient at rest is found. The applicability of the statistical relationships is also examined using RBD. Numerical analysis of oedometer tests demonstrates how RBD can consider the influence of the uncertainty of the critical state parameters.
Quantification of infection of fungi by endohyphal bacteria v1
Authors: Baltrus David , Elizabeth Arnold A. , E. Gallery Rachel
Published: September 2017

Protocol established to quantify the levels of reassociation between endohyphal bacteria and various fungi. Strains are grown separately and then mixed and co-cultured. Fungal hyphae are broken apart to release bacterial cells, and bacteria are dilution plated.
Cleansing among Czech Journalists after World War II and a Comparison with the Situation in France and the Netherlands
Authors: Cebe Jan
Published: September 2017

After the end of World War II Czechoslovakia was faced with the task of punishing its Nazi collaborators. Besides sentencing traitors by the special people’s courts, Czech journalists themselves also started the cleansing among their own ranks. The cleansing committee of the Czech Journalists’ Union investigated some 400 journalists and imposed some sort of penalties on more than 200 people. The article also presents a brief a comparison with the situation in France and the Netherlands. The cleansing among Czech journalists was very rigorous, even in comparison to other European countries. In contrast to Western countries, and due to the subsequent political developments, the journalists punished were often prohibited from resuming their profession.
The Rocky Road towards Professional Autonomy: The Estonian Journalists’ Organization in the Political Turmoil of the 20th Century
Authors: Lauk Epp
Published: September 2017

This article attempts to explain the relationships between journalists, politics and the state from the perspective of collective autonomy, that of the professional organization of journalists. The case of Estonian Journalists’ Union demonstrates the complexity and historical contingency of professional autonomy of journalism. The development of the Estonian journalists’ organization occurred as a sequence of transformations from the Estonian Journalists’ Association to the Estonian Journalists’ Union to the Soviet type journalists’ union, and lastly to an independent trade union. This sequence was disrupted by several fatal breakdowns that changed not only the character of the association, but also professional values, the whole occupational ideology and the conditions of the existence of journalism as a profession in Estonia.
Journalists’ Associations as Political Instruments in Central and Eastern Europe
Authors: Lauk Epp , Nordenstreng Kaarle
Published: September 2017

This editorial provides the overall context for the five cases—three national and two international—covered in this thematic issue. While the cases are from Central and Eastern Europe (CEE), they highlight fundamental questions of journalism everywhere, including contradictions between freedom and control, professionalism and politics, individual and collective. The associations of journalists serve as very useful platforms to study these questions, especially at historical turning points when the whole political system changed, as happened twice in CEE after World War II.
Old Romanian pluralized mass and abstract nouns
Authors: Pană Dindelegan Gabriela
Published: September 2017

The analysis of a rich old Romanian corpus shows that the ‘pluralization’ of mass and abstract nouns is extremely frequent in old Romanian. The semantic effects of pluralization are similar for mass and abstract nouns, consisting in the creation of denotative and/or connotative semantic variants. Of the plural endings, –uri is specialized for the pluralization of mass nouns in Daco-Romanian. The evolution of the ending –uri illustrates the specific process by which a grammatical (plural) morpheme is converted into a lexical morpheme (the so-called ‘lexical plurals’). ‘Lexical plurals’ have isolated occurrences in other Romance languages, but they have not reached the spread and regularity they display in Romanian.
Substantive masive și abstracte pluralizate în româna veche
Authors: Pană Dindelegan Gabriela
Published: September 2017

În urma examinării unui corpus bogat de limbă română veche, autorul ajunge la concluzia că fenomenul ‘pluralizării’ substantivelor masive și al celor abstracte este extrem de frecvent în româna veche. Efectele semantice ale pluralizării sînt asemănătoare pentru masive și abstracte, constînd în apariția unor varietăți semantice denotative și/sau conotative. Din ansamblul desinențelor de plural, dacoromâna și-a specializat una (desinența –uri) pentru pluralizarea masivelor. Evoluția desinenței –uri evidențiază un proces special, de convertire a unui semn gramatical (de plural) într-unul lexical (așa-numitele ‘plurale lexicale’). Deși ‘pluralele lexicale’ apar, izolat, și în alte limbi romanice, nicăieri nu au luat extinderea și regularitatea din română.
Desinența de plural –le și interferențe între morfologia flexionară și cea derivațională
Authors: Croitor Blanca
Published: September 2017

În articol sînt descrise situațiile în care desinența de plural –le are valoare derivativă, de formare a unor substantive la plural, de genul feminin. Ea face parte din două sufixe cu care se derivă substantive la plural, –ale și –ele (ambele cu sufixe dezvoltate). În unele formații împrumutate sufixele au fost atașate etimonului pentru a le încadra în sistemul morfologic românesc, iar alte formații au fost create în limba română. Unele formații neologice cu –ale au fost împrumutate, fiind analizabile în română. Sînt inventariate formațiile cu aceste sufixe (și cu cele dezvoltate), în principal pe baza DA, DLR, DI și MDA. În articol se fac și observații privind vechimea sufixelor și a formațiilor, productivitatea, raportul cu eventualele forme de singular (acolo unde există) și sînt descrise cîteva aspecte teoretice.
The descendants of Lat. ipse in Romanian
Authors: Vasilescu Andra
Published: September 2017

The Latin demonstrative ipse had different evolutions across the Romance languages, with Romanian being the one that preserved most of the source-language uses and enriched them with new ones. This article describes the evolution of the forms and functions of îns1, îns2/ins, îns(ă)3, însul, nusul, dînsul, adins, însuși, and of the bound focal particle –și in Romanian. The analysis is based on a rich corpus of old Romanian and non-standard regional varieties of modern spoken Romanian. The most significant phenomena in old Romanian compared to Latin are the proliferation of forms, the preservation of the old uses and the emergence of new ones, semantic enrichments, and a large number of lexical-functional synonymies. During the old Romanian period, the form–function correlations gradually changed, syntactically conditioned variants and differential prepositional object marking emerged, new meanings developed as contextual effects of the focal prototype, the syncretisms with the reflexive and reciprocal pronouns were limited, and the textual deictic was grammaticalized as an adversative conjunction. In modern Romanian, the number of ambiguities has decreased and register differences have appeared. The evolution of the Latin ipse in Romanian illustrates a case of poligrammaticalization and polimorfism, which is not singular in the history of the neo-Latin idioms.
The auxiliary of the Romanian conditional: semantic and functional arguments concerning the reconstruction of a disputed grammaticalization process
Authors: Zafiu Rodica
Published: September 2017

This paper aims at demonstrating the explanatory advantages of the old hypothesis concerning the origins of the auxiliary of the Romanian analytic conditional (aș + infinitive) as deriving from the imperfect tense form of the verb (a) vrea ‘(to) want’ < *volere (< VELLE). The grammaticalization process, reconstructed through the comparison with the other Romance languages and by relating it to typical directions of the linguistic change, presupposes intermediary semantic phases (the future-in-the-past value, the hypothetical value which is mostly counter-factual), whose traces may be found in the first Romanian (translated) texts, but which have been generally considered a consequence of the simple loan translation from the language source. The uses of the conditional with a reduced auxiliary (aș, ai, etc. + infinitive) are related to those (co-occurring in the old texts) of the conditional with a recognisable auxiliary (vrea ‘wanted’ + infinitive), for which the value specific to the first grammaticalization stage is still strong—that of a future-in-the past. The text also puts forth an explanation for the atypical forms within the paradigm of the conditional auxiliary—aș(i), ar(ă)—through the overlap between the forms of the imperfect and the simple past of the verb (a) vrea ‘(to) want’.
Auxiliarul de perfect compus o din graiul moldovenesc. Diacronie și sincronie
Authors: Botez Mădălina , Dragomirescu Adina
Published: September 2017

Scopul acestui articol este acela de a analiza auxiliarul de perfect compus o din graiul moldovenesc. Analiza este precedată de o discuție despre originea, datarea, localizarea și evoluția formei o în limba română pînă în secolul al XIX-lea. Deși conform bibliografiei și atlaselor lingvistice, forma o este generală în Moldova, studiul nostru de corpus va arăta că alături de forma o se folosesc, sub influența limbii standard, și formele a și au, și că există o tendință de specializare a formei o pentru contextele cu cliticizare multiplă.

Analiza noastră—care contribuie la înțelegerea interfeței fonologie-morfologie—poate fi extinsă la studiul altor varietăți teritoriale ale românei.
Some notes on the realizations of the direct object in the old language
Authors: Nicula Paraschiv Irina
Published: September 2017

In the present article, we aim to analyse some constructions with the direct object realized as a personal or animate noun in the old language in order to emphasize certain syntactic features which have been only partially preserved or even eliminated from the modern language. On the one hand, we point to the construction with a bare direct object, which is recorded quite extensively in the context of wider range of selecting verbs than in the present-day language, on the other, we focus on the p(r)e-marking variation in the context of personal nouns with a specific / non-specific reading, as well as on the competition between the direct object generic singular and plural (pre sărac(ul) ‘DOM poor.DEF’ vs pre săraci ‘DOM poor.M.PL’ / săracii ‘poor.M.PL.DEF’).
Note asupra unor realizări ale obiectului direct în limba veche
Authors: Nicula Paraschiv Irina
Published: September 2017

Scopul acestui articol este de a analiza anumite construcții cu obiect direct realizat prin nume personal sau animat în limba română veche pentru a evidenția unele particularități de construcție, care fie nu s-au păstrat, fie au fost restrînse considerabil în limba modernă. Semnalăm, pe de o parte, tiparul cu obiect direct nedeterminat, care se înregistrează destul de extins în contextul unei clase mai largi de regenți decît în limba actuală și, pe de altă parte, variația în marcarea prin p(r)e a expresiilor nominale personale, cu citire specifică sau nonspecifică, precum și între singular și pluralul generic obiect direct (pre sărac(ul) vs pre săraci/săracii).
(Pseudo)cleft constructions in old Romanian
Authors: Gheorghe Mihaela
Published: September 2017

The article examines the syntactic and semantic features of cleft sentences in Old Romanian (OR) as compared to Modern Romanian (MR). The clefting strategy in MR can only produce pseudo-cleft constructions (identifying structures with free relative clauses headed by ce, or relative clauses with an antecedent; the focalized constituent follows the relative clause and the copula; the reversed pattern is also possible: the focalized constituent is placed before the copula and the relative clause). The analysis of an OR corpus showed that cleft constructions were quite frequent, but the patterns were more diverse than in MR: besides cleft and pseudo-cleft constructions, OR also employed hybrid constructions, that amalgamate the features of the prototypical clefts.
The interjection in old Romanian texts
Authors: Manu Magda Margareta
Published: September 2017

The paper tries to identify the special problems posed by the study of interjection based on the examination of a corpus of texts from the old Romanian (1600–1780), referring to texts from modern Romanian. We have watched how certain interjectional formations have acquired, through diachronic expansion, new grammatical, semantic and pragmatic values.

The structure of the paper is the following: the introduction (§1) summarizes the author’s position on the status of the interjection category at a morphosyntactic, semantic and pragmatic level (§1.1) and on the relation between different linguistic structures and their grammaticalization / pragmaticalization process (§1.2). The second section (§2) refers to the specific routes followed by the evolution of the various categories of the analysed interjections, from the old Romanian to the modern Romanian: the presentatives adecă, iată, ni (§2.1), the hortatives haide, ni (§2.2), the addressing particles bre, măi (§2.3), the connectors with demarcation signal function adevăr, amin (§2.4). The third section (§3) has as objective the description of a species of delocutive derivation, illustrated in Romanian by the lexicalized semantic variants of the secondary interjection Doamne!. The study concludes with several final considerations regarding the results of the research (§4).
Research in Indian CSIR Laboratories: A Bibliometric Study
Authors: Mukherjee Bhaskar
Published: September 2017

India is perhaps unique amongst developing countries in having established a distinct science identity since last few centuries. The Council of Scientific and Industrial Research (CSIR) is an autonomous body established in 1942 with the aim of providing strong S&T base for the industry, strategic sectors and advancement of fundamental knowledge. The present study is to understand the quality and quantity of research output and current state-of-the-art of CSIR laboratories using publications output data as reflected in Web of Science and Scopus. The study points out that during 2010 to 2015, although the yearly output has increased from 3940 papers to 5531 papers, the growth rate is neither linear nor exponential. The scientists of the laboratory attach more weight to foreign journals rather than Indian journals having SCI impact factor within the range of 2.0 to 4.0. The authorship trend is completely slanted towards co-authorship and CSIR is assisting considerable financial support for conducting research. The citation analysis of CSIR publications reveals that, a total of 30011 articles published during 2010-2015, received 251212 citations during 2010-2016 with an average rate of 7 citations per article. Almost 10% articles did not receive any citation and 62% articles received citation in the range of 1 to 10.
Analysis of Usage of Electronic Resources by the Department of Science and Technology (DST) Institutions in India
Authors: Adhikari Saumen
Published: September 2017

In the digital era, research scientists are predominantly dependent on electronic resources (e-resources) to fulfill their information needs. Consortia have facilitated access to numerous electronic information resources in S&T institutions. The DST, Government of India supports 20 autonomous R&D institutions that have access to information resources through a consortium. This paper studies the electronic resource use pattern by DST institutes. Institutional downloads are given and the leading publishers relevant to the institutions are listed. Finally, for better utilization of e-resources, an information filtration model has been proposed.
Non-operative treatment of acute appendicitis in selected patients
Authors: Agaoglu Nazim , Ulusahin Mehmet
Published: September 2017

Background: Surgical approach for acute appendicitis (AA) is a standard live saving treatment method. The purpose of this study was to assess the feasibility, initial safety and success rate of non-operative treatment of AA in selected patients.Methods: Selected AA patients were enrolled in this prospective study (non-operative treatment). This was based on IV antibiotic therapy and followed up with oral antibiotic. Patients who declined to participate or excluded were managed with appendectomy and considered as controls. The primary goal of the study was to determine the feasibility, initial safety, early and late success rates of non-operative management. Secondary outcomes include hospital length of stay and charge, days of missed works and return to normal activity at home of patients treated non-operatively in comparison to appendectomy group.Results: In non-operative group (36 patients), 7 patients failed to response and managed by appendectomy with early success rate of 80.5%. Three patients experienced recurrent attacks of AA were managed with appendectomy. Late success rate was 72.2%. In appendectomy group (53 patients) one patient with adenocarcinoma of the colon detected during surgery and in ten patients the appendix was perforated. One patient died due to generalized peritonitis. In non-operative group length of stay and hospital charge were lower but only days to resume home activities and days of missed work were shorter and statistically significant as compared to appendectomy group.Conclusions: This study confirms the feasibility, safety and optimum success rate of non-operative treatment of early AA in selected patients.
Diagnostic value of C-reactive protein and neutrophil-limphocyte ratio in perforated appendicitis at Hasan Sadikin Hospital Bandung
Authors: Rudiman Reno , Ruchimat Tommy , Ferdinand Yohanes
Published: September 2017

Background: The diagnosis of appendicitis depends on the subjective criteria of clinical examination. However, distinguishing acute perforated appendicitis (local peritonitis) and non-perforated is often difficult especially in the elderly population that usually not clinically specific unless it has developed into generalized peritonitis. Between the non-perforated acute appendicitis and perforate should be distinguished because of different surgical approaches. C-reactive protein (CRP) and neutrophil-lymphocyte ratios are known to be associated with various conditions such as malignancy, heart disease, and inflammation, including acute perforated appendicitis. This examination not only is cheaper, but also feasible and available in peripheral hospitals compared to other supports such as ultrasound or CT scan, but this examination has not been routinely used so the purpose of this study is to examine the diagnostic accuracy of both laboratory parameters so as to assist a surgeon to determine whether the case of appendicitis has been perforated or not and can provide information to patients and the families about the diseases and surgical techniques to be performed.Methods: This study used cross sectional analytic in two groups, appendicitis with and without perforation group to know the value of sensitivity, specificity, positive predictor value, negative predictor value, from CRP and RNL in both groups.Results: Of the 46 patients who met the inclusion criteria, the mean age of patients with perforated appendicitis was 33.73±17.101, male sex counted 26 patients (56.5%) and women 20 patients (43.5%). Based on ROC curve analysis, CRP = 76,65 and RNL = 8,825 were obtained, and sensitivity, specificity, positive guess, negative prediction and accuracy value for CRP were 88.0%, 71.4%, 78 %, 5%, 83.3% and 80.4%; While for RNL of 64.0%, 80.9%, 80.0%, NDN, and 71.7%.Conclusions: CRP and RNL have a strong diagnostic value and is moderately strong in cases of perforated appendicitis.
Difficulties in resuscitating adult skeletal injury and trauma: a systemic review
Authors: Al-ajmi Turki Abdullah S. , Salah Al-hussain Abdullah , Fuad Al-Abdulqader Mohammed
Published: September 2017

Background: Trauma resuscitations are complicated, high-risk, and time-sensitive actions that need the coordination of different specialists arriving from multiple areas in the hospital. This systematic review aimed to understand the main key challenges of trauma resuscitations using a broad search in various database.Methods: A systematic review of published articles between the years 2000 and 2016 was conducted using different electronic databases such as PubMed, Medline and Embase to identify studies evaluating trauma resuscitations challenges. Different keywords were used in this study to recognize relevant articles. The titles of all articles were scanned in the first stage. Irrelevant articles were omitted and the abstracts of the rest articles were reviewed in the second stage. Finally, the full text of all articles which met the inclusion and exclusion criteria were reviewed and a data extraction sheet was made to summarize all the articles. Data were analyzed descriptively.Results: Twenty studies were reviewed including; RCT (3 studies), QRCT (5 studies), and descriptive study (12 studies). The results showed that there are four main trauma resuscitation challenges including pre-hospital challenges, error-related challenges, equipment and technical challenges, and finally general challenges.Conclusions: Trauma resuscitation is one of the most critical aspects of emergency care. It is necessary to promote resuscitation care and focus on patient outcomes in terms of mortality and more importantly, functional outcomes. Considering these main factors affecting trauma resuscitation will improve patients’ outcomes and help those who are engaged in providing services.
Prevalence of Helicobacter pylori in peptic ulcer perforation
Authors: John Binni , P. Mathew Bipin , Chandran C. Vipin
Published: September 2017

Background: Helicobacter pylori have an important role in the pathogenesis of peptic ulcer disease. The aim of the present study was to observe the prevalence of H. pylori in peptic ulcer perforation cases and the rationale of H. pylori eradication therapy post operatively and to investigate factors associated with peptic ulcer.Methods: This cross-sectional study was conducted at the Department of general surgery, Government Medical College, Kottayam for a period 20 months from March 2012 to October 2013 after getting approval from institutional ethics committee. A total of 113 patients were participated in the study after meeting inclusion criteria. After getting written consent from the patients with perforated peptic ulcer, resuscitation and laparotomy was performed in the emergency department. H. pyloriinfection was confirmed by histopathological examination by Giemsa staining. Based on the histopathological report, the prevalence of H. pylori infection in the patients was assessed and was given appropriate H. pylori eradication regimen.Results: The mean age of presentation of the patients was 52.81±14.5 years. Male to female ratio was 4.14:1. Out of 113 cases, 67 cases (59.3%) had duodenal ulcer perforation while 46 cases (40.7%) had gastric ulcer perforation. Of them 53(46.9%) cases were positive H. pylori positive. No significant association was found between the incidence of H. pylori infection in peptic ulcers with smoking, hypertension, diet intake, NSAIDS intake. In our study association between H. pylori and diabetes mellitus (p=0.02) found to be significant which can be further investigated.Conclusion: According to our study the prevalence of H. pylori infection in perforated peptic ulcer disease is 47% which must be considered as significant. Hence all the patients undergoing laparotomy for peptic ulcer perforation should be investigated for H. pylori infection and if positive we must start the anti H. pylori regimen for them, which is more cost effective.
Comparative study on efficacy of fistulotomy and Ligation of intersphincteric fistula tract (LIFT) procedure in management of fistula-in-ano
Authors: G. Vinay , K. S. Balasubrahmanya
Published: September 2017

Background: Fistula-in-ano is one of the most common benign anal conditions in daily surgical practice. Present study aims at comparing the efficacy of open fistulotomy and ligation of intersphincteric fistula tract (LIFT) procedure based on its post-operative outcomes.Methods: A comparative study was carried out among 50 subjects attending Department of Surgery, K. R. Hospital, Mysuru over a period of 10 months. Subjects of either sex diagnosed with anal fistula were included in the study. Patients with recurrent fistulas, Crohn’s disease, anal or distal rectal cancers were excluded from the study. Descriptive statistics, unpaired t-test, Fischer exact chi-square test were used to analyse the results.Results: The mean age group of the study subjects was 44.6±8.34 and 41.3±9.71 years among fistulotomy and LIFT procedure group respectively. The gender distribution showed a higher number of males (38) as compared to females (12). There was 23 inter-sphincteric, 2 trans-sphincteric fistula in fistulotomy group and 22 inter-sphincteric, 3 trans-sphincteric fistula in LIFT group. The average operative time for fistulotomy was significantly shorter at 19.6 minutes, compared with 28.4 minutes for LIFT procedure. Wound infection detected in 1 (4%) and 2 (8%) subjects in fistulotomy and LIFT groups, respectively. 1 (4%) subject among fistulotomy group developed anal incontinence. The average healing time for fistulotomy was 8 weeks compared to 3 weeks for LIFT procedure. Total 3 (12%) subjects developed recurrence in LIFT procedure, but no recurrence was observed in fistulotomy group.Conclusions: LIFT procedure is effective and sphincter saving technique for fistula in ano with shorter healing time and lower incidence of postoperative anal incontinence, as compared to open fistulotomy.
A comparative study between aloe vera gel dressing and conventional dressing in chronic wounds
Authors: Athavale Virendra S. , Khandalkar Shivmurti N. , Mahawar Megha , Shetty Iresh , Lad Aditya
Published: September 2017

Background: The aim of this study was to evaluate the effectiveness and rate of healing of Aloe vera gel in treatment of chronic wounds, to compare the effectiveness of Aloe vera gel with conventional dressing (normal saline and povidone iodine) and to assess the percentage reduction of wound healing with Aloe vera gel dressing.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 months (from January 2017 to March 2017) and is a prospective and comparative randomized type of study using 50 cases (Group A and Group B, 25 each). The study was approved by the Institute’s Ethics Committee.Results: Data analysis showed that at the end of 4 weeks, mean surface area in Group A is reduced to 4.58 cm2 from 9.79 cm2 which is higher than that in the control group. Also, the average rate of healing in Aloe vera gel is more than control group. Percentage reduction in ulcer surface area was calculated to be much more in Group A as compared to Group B.Conclusions: The study concluded that Aloe vera gel is highly effective in treatment of chronic ulcers and stimulates the growth of wound healing. Thus, reducing the hospital stay. Apart from being efficacious in wound healing, Aloe vera gel is safe product. No allergic reactions/infections were associated with Aloe vera gel. Aloe vera gel not only heals faster but is also cost effective.
Diagnostic value of serum bilirubin in appendicular perforation
Authors: M. N. Mallikarjuna , Uday Utpala
Published: September 2017

Background: Hyperbilirubinemia has been well documented in relation to acute appendicitis. This study tries to establish the diagnostic value of this parameter in determining the severity of acute appendicitis.Methods: This is a prospective analytical study conducted on 100 patients with acute appendicitis. All patients were subjected to clinical evaluation and investigations; including liver function tests. The diagnosis was confirmed peri-operatively and postoperatively by histopathological examination. The data was compiled and analysed.Results: The incidence of complicated appendicitis was found to be 18%, defined as evidence of gangrene, or microscopic or gross perforation on histopathological examination. Among these total serum bilirubin (TSB) was raised in 17 cases (17%) and statistically significant correlation was established by p-value <0.001. The mean of TSB level was higher in perforated appendicitis than in cases of acute appendicitis (0.57±0.26 mg/dL; range 0.1-1.2 versus 1.68±1.09 mg/dL; range 0.8-4.8 mg/dL). TSB was shown to have specificity of 96.4%, sensitivity 88.2%, PPV 83.3% and NPV was 97.6%. The diagnostic accuracy of raised bilirubin for diagnosis of appendicular perforation was calculated to be 95.0%. The rise in bilirubin was mixed in type (both indirect and direct). There could not be established any correlation between the liver enzymes and appendicitis or its complications.Conclusions: This study ascertains the predictive value of serum bilirubin in acute appendicitis patients as an indicator of severity. Raised bilirubin in the setting of acute appendicitis identifies higher probability of appendicular perforation.
Esophageal atresia and Tracheoesophageal fistula with associated anomalies in a tertiary care hospital of north India
Authors: Prasad Jagdeesh
Published: September 2017

Background: Esophageal atresia (EA) with or without Tracheoesophageal fistula (TEF) has been described as the epitome of pediatric surgery and the management of these neonates require high degree of skill, manpower and tertiary care. This clinical study was undertaken to identify the EA and TEF cases along with the pattern of associated anomalies causing mortality in Varanasi .Methods: This prospective study included 53 patients of EA with TEF who underwent primary esophageal anastomosis. Their clinical profile, time of presentation, various associated anomalies, sex distribution, and their effect on mortality and morbidity were observed.Results: Mortality was high (41.64%) among patients who reached the tertiary centre late i.e. >24 hours. The incidence of low birth weight babies is approximately 75% and mortality rate increased with low birth weight. Almost 2/3 of patients had clinical or radiological evidence of pneumonia. The mortality was very high in severe pneumonia 66.7% as compared to 15% patients without pneumonia. Septicaemia and leak were most common complications. The mortality in septicemic patients is high (77.8%). The overall incidence of associated anomalies was 47%. Early surgical intervention improved the survival of EA with TEF with major GIT associated anomalies. The overall survival rate was 60.37% and mortality was 39.67%.Conclusions: Although we have improved a lot in managing these cases of EA with TEF, but we have to do much more to achieve our goal of near 100% survival.
Prospective studies on clinical outcomes of Lichtenstein’s tension free inguinal hernioplasty under local anaesthesia
Authors: Brar Navjot , Singh Amanjot , Bajwa Rajbir
Published: September 2017

Background: Inguinal hernia may be generally defined as a protrusion of viscus or part of a viscus though inguinal canal. The only way recommended to treat inguinal hernias now a day is to perform tension free Lichenstein repair. In this study, we have done a prospective study on clinical outcomes of lichtenstein tension free inguinal hernioplasty under local anaesthesia in Department of General Surgery, Sri Guru Ram Dass Hospital and Research, Sri Amritsar from 15 August 2014 to 15 February 2017, a period of 2 and half years.Methods: A prospective study was conducted in patients admitted in wards with inguinal hernia from General Surgery Outpatient Department. The series consisted of 60 patients between 15 to 74 years.Results: It is found that no recurrence has yet occurred in 2½ years follow up and it is well accepted specially in older age group (55 -74 years).Conclusion: The methods of Lichtenstein’s tension free inguinal hernioplasty under local anaesthesia is safe, simple, effective, economical, and without any side effects such as hypotension, nausea, vomiting, urinary retention, and spinal headache.
Oral premalignant lesions: a clinicopathological study
Authors: Jagtap Sunil Vitthalrao , Warhate Pranita , Saini Neerav , S. Jagtap Swati , Chougule P. G.
Published: September 2017

Background: A significant number of oral cancer cases present initially with precursor lesions. If detected earlier in disease course it will reduce the morbidity and mortality. The objective of this study was to evaluate the clinical presentation and various histopathological types of premalignant lesions.Methods: This is descriptive, observational, analytical type of study of five-year duration. The detail clinical presentation, relevant investigation and histopathological study on biopsy tissue stain with H and E was done and the data is analysed.Results: During study period, 173 cases having oral lesions were observed. Among these 38 cases showed oral premalignant lesions. The most common age group affected was in between 50 to 59 years. The male predominance was noted. Male to female ratio was 1.9:1. The location of the lesions were buccal mucosa (55.26%), tongue (26.31%), gingiva (7.90%), alveolus (5.26%), lip (2.6%), retromolar area (2.63%) was noted. The common etiological factor observed was tobacco chewing. On histopathological features, cases were of leukoplakia 68.41%, oral lichen planus 13.16%, oral submucous fibrosis 7.90%, actinic cheilitis-7.9%, and oral erythroplakia 2.6%.Conclusions: In this study, various oral premalignant lesions were observed. Their clinical and histopathological evaluation was done. Oral leukoplakia was most common lesion in the present study. Buccal mucosa was the most common site. Tobacco chewing habit was the common risk factor observed. Early detection of premalignant oral lesion is of utmost importance to prevent further morbidity as these lesions further progress to oral cancer.
Study of the pattern and management of blunt chest injuries in rural setup
Authors: Sharma Kuldeep , Pradeep Tated Sushrut , Ashokrao Hatkar Ashish
Published: September 2017

Background: Trauma is recognized as a serious public health problem. In fact, it is the leading cause of death and disability in the first four decades of life and is the third most common cause of death overall. Trauma may lead to short or long-term disability. Objective was to study the pattern of chest injuries with resultant underlying damage, in rural set up.Methods: The present study was carried out among 500 cases of age group 15 to 75 years, all religions and both sexes. All patients received in the Emergency Room (ER/Casualty) were immediately attended and history, primary survey and resuscitation were done simultaneously. X ray chest-erect position was taken and subsequent management either operative or non-operative was done according to clinic-radiological findings. After discharge, patients were followed on OPD basis till the time they return to the normal activity.Results: Majority of patients (31%) were from 55 to 65 years of age group and were male (64.2%). Vehicular accident was the commonest (56.8 %) cause of injury. Vehicular accidents were the most common cause of chest injuries. In vehicular accidents two-wheeler riders were the common victims (55.28%). Assault was 2nd most common mode of injury. Among those patients who sustained chest trauma had average VAS 6 (49.2%) followed by 4 (45%). Majority of patient were treated conservatively (93.6%).Conclusions: The most active age group and males were affected with commonly vehicular accidents. They mainly suffered chest injuries.