bluuebunny/crossref_metadata_2025 huggingface dataset:
Automatic procedure for analysis and geometry definition of axisymmetric domes by the membrane theory with constant normal stress
Authors: RABELLO F. T. , MARCELLINO N. A. , LORIGGIO D. D.
Published: August 2016

Abstract This paper presents an automatic procedure using the membrane theory of shells to analyse and define geometries for axisymmetric domes subjected to its own weight, varying its thickness and bend radius, to obtain constant normal stresses along the structure. The procedure offers a great advantage over the analytic solution of the problem and usual shell numerical methods when one wants to determine the dome geometry with constant stresses, since the presented procedure has the goal stress as input value for obtaining the geometry, as opposed to the usual numerical methods, where the reverse occurs. An example clarifies the differences between a spherical dome with constant thickness and a dome subjected to constant stress. The convergence of the method for a specific material weight and stress for a dome are also presented.
Target-Site Resistances to ALS and PPO Inhibitors Are Linked in Waterhemp (Amaranthus tuberculatus)
Authors: Tranel Patrick J. , Wu Chenxi , Sadeque Ahmed
Published: August 2016

It is generally expected that, in the case of multiple herbicide resistance, different resistance mechanisms within a weed will follow Mendel’s law of independent assortment. Research was conducted to investigate anecdotal observations suggesting that target site–based resistances to inhibitors of acetolactate synthase (ALS) and protoporphyrinogen oxidase (PPO) did not follow independent assortment in common waterhemp. Cosegregation of the two resistances was observed in backcross lines (population sensitive to both herbicides as recurrent parent). Specifically, whereas 52% of backcross plants were resistant to a PPO inhibitor, this percentage increased to 92% when the backcross plants were preselected for resistance to an ALS inhibitor. Molecular marker analysis confirmed that the corresponding genes (ALSandPPX2) were genetically linked. When data from all plants analyzed were pooled, the genetic distance between the two genes was calculated to be 7.5 cM. The two genes were found to be about 195 kb apart in the recently published grain amaranth genome, explaining the observed genetic linkage. There is likely enough recombination that occurs between the linked genes to prevent the linkage from having significant implications in terms of resistance evolution. Nevertheless, documentation of the happenstance linkage between target-site genes for resistance to ALS and PPO inhibitors in waterhemp is a reminder that one should not assume distinct resistance mechanism will independently assort.
Ordem e caos: um conceito alternativo de mercado
Authors: Oliveira Édivo De Almeira , Barbosa William , De Freitas Clailton Ataídes
Published: August 2016

Mesmo constituindo-se um dos pilares de funcionamento do sistema capitalista, é bem verdade que o conceito de mercado não é consensual entre as distintas abordagens do pensamento econômico, dado as diferentes premissas e axiomas que fundamentam suas análises. Isto posto, o presente trabalho objetiva fornecer uma concepção holística e mais pragmática do mercado a partir dos conceitos de ordem espontânea, taxas naturais e expectativas racionais articulados com a Teoria do Caos. Com base nesses fundamentos teóricos conclui-se que o mercado é uma ordem espontânea evolutiva, repleta de relações não-lineares e formada por agentes autointeressados que, mediante processo de aprendizagem social, complexificam e aprimoram os padrões institucionais, culturais e técnicos que configuram o próprio mercado no transcorrer de um tempo dinâmico.
Benefícios de um plano de remuneração estratégico para uma empresa de médio porte
Authors: Guerra Rodrigo Marques de Almeida , Pereira Lidiane Friderichs , Camargo Maria Emília
Published: August 2016

Este estudo tem o objetivo de identificar benefícios de um plano de remuneração estratégica para funcionários da área de produção de uma empresa de médio porte do segmento plástico. O instrumento de coleta de dados foi desenvolvido sob a ótica da Participação nos Lucros e Resultados (PLR), tendo sido adaptado do modelo de Wood Jr. e Picarelli Filho (1999) e Della Rosa (2000). Além disso, foram realizadas entrevistas semiestruturadas com gestores da empresa investigada. Para tanto, aplicou-se uma pesquisa qualitativa de caráter exploratório, por meio da estratégia de pesquisa estudo de caso. Os principais resultados do estudo foram os seguintes: diminuição da rotatividade e absenteísmo; aumento da retenção de funcionários; melhor satisfação e desempenho dos empregados; e maior engajamento da equipe.
Conselhos gestores de políticas públicas sob o enfoque da teoria das organizações: aproximações teórico-conceituais
Authors: Gandra Pimenta Magalhães Fernanda Gabriela , De Almeida Mendes Wesley , Alves da Silva Tarrara
Published: August 2016

Este estudo realiza aproximações teórico-conceituais entre teoria organizacional e conselhos, propondo um aprofundamento das diferentes perspectivas do objeto. São apresentadas interfaces entre o objeto e teoria, seguida das aproximações entre os mesmos e as temáticas da teoria das organizações. Busca demonstrar pelos pontos de interseção apresentados, a contribuição dos estudos organizacionais para o entendimento desse objeto. Concluiu-se que as diferentes perspectivas apresentadas são complementares, indicando que os conselhos, instâncias permeadas por conflitos de poder e questões culturais, constituem-se nova forma organizacional que é implementada via redes de parcerias entre sociedade e Estado. Infere-se também que a institucionalização dos conselhos abarca de um novo momento e forma de gestão pública, desenvolvida sob a lógica da ação racional substantiva e paradigma humanista.
A Comparative Study of Rio de Janeiro and Johannesburg
Authors: Sanchez Sandra Siomara
Published: August 2016

In the early twentieth century, two cities exhibited social unrest and social conflict. In Johannesburg, South Africa, the seeds for apartheid were sewn as an influx of workers came to nourish the country's mines. In Rio de Janeiro, the rise of a global economy fostered immigrant communities. This paper analyzes the causes of early twentieth century social unrest as a result of the urbanization of both of these cities, and compares and contrasts both spatial and economic factors. It also investigates the labor landscapes in both cities as a supplement to these changes.
BAKING AND BASEBALL IN INDONESIA: REALIA IN TEACHING AMERICAN CULTURE IN INTENSIVE ENGLISH PROGRAM FOR UNIVERSITY FACULTY/STAFF
Authors: Anderson Roger
Published: August 2016

In this reflection, the author reports on his experience teaching English through American culture to Indonesian university educators during three week intensive programs in Indonesia. The author implemented culturally meaningful activities based upon the use of realia, or objects that connect language and on-the-ground reality of native speakers for the foreign language learner. Baseball, baking, the card game Uno, and poetry proved to be successful vehicles for learning. Additionally, emailing between the class and the author’s contacts in North America provided participants with “case studies” of real Americans/native speakers of English. Such interactions with actual Americans may provide a useful contrast/compliment to the stereotypical images of Americans disseminated by mass media. Lastly, while the teaching of English and American culture overseas may be controversial to some, this reflection argues that the careful selection of pedagogies can facilitate mutually enriching exchanges. Insights into appropriate realia, subsequent activities, and teaching considerations in Indonesia may be gleaned from this reflection by pedagogues and practitioners alike. 
TEACHING ENGLISH WITH PICTURE BOOKS: CURRENT CHALLENGES AND POSSIBLE SOLUTIONS IN ENGLISH EDUCATION IN JAPAN
Authors: Kochiyama Arisa
Published: August 2016

The council for revitalization of education has submitted a proposal to Prime Minister Shinzo Abe for educational reforms to make English language courses compulsory in the fifth and sixth grades. The majority of elementary school teachers are now worried and lacking in confidence to teach English, as they feel they are ill-equipped for their new role as language instructors. According to Keith Schoch’s article Picture Books across the Curriculum, picture books deserve a place in the upper elementary and middle school grades for a number of reasons: If chosen with consideration for the interests of the students and used in ways that are appropriate for learners, picture books can provide valuable opportunities of language-rich experiences and interactions. Thus, the present study firstly describes and analyses some of the challenges facing English education in Japan by relating to its wider social setting. Secondly, the study analyzes how teachers perceive they can promote language learning in their EFL classrooms through the medium of picture books. Thirdly, the study discusses the merits of using picture books in the upper elementary and middle school English education from the viewpoint of English language learning, and then investigates topics and themes of a picture book which illuminate some universal aspects of human condition. 
CORPUS RESEARCH ON HEDGES IN LINGUISTICS AND EFL JOURNAL PAPERS
Authors: Wang Shih-Ping
Published: August 2016

There has been a considerable rise of studies on hedges that can help authors to reduce commitment and negotiate the meaning between the reader and the writer. This study examines hedging devices based on corpus-based analysis of 750 research articles (4,831,500 running words) extracted from 15 leading journals in linguistics and EFL areas. The Wordsmith Tools 5.0 was used for identifying hedging devices. Both Hyland (1998a) and Varttala (1998) were integrated into a framework to identify functions of hedging devices. The results reveal that the modal auxiliary hedging (44.9%) is more than other types; the noun category is the least (2.17%). However, the use of different syntactic features (personal or impersonal) when combined with epistemic lexical terms appeared to influence different interpretations of lexical hedging mainly regarding the politeness strategy. Additionally, it is authors' responsibility for hedging their own propositions. Learners should know the rules of hedges to distinguish real facts and findings from researchers' biased views and conclusions, and to use these markers accurately in their own works. The current study is useful for EFL learners, as it discusses many types of hedge for familiarizing students with appropriate use of hedging. 
LITERATURE-BASED EXTENSIVE READING ACCOMPANIED BY READING LOGS: A CASE FOR DEVELOPING CRITICAL THINKING SKILLS OF ENGLISH LITERATURE STUDENTS
Authors: Khonamri Fatemeh , Farzanegan Masoumeh
Published: August 2016

This study attempted to examine the effects of an ER program accompanied by reading logs on the degree of critical thinking skills of sophomore English literature students at the University of Mazandaran. Two groups of English Literature majors formed the two experimental groups of the study in which only the former kept guided reading logs, while the latter group only read extensively. Participants were also divided by their proficiency in reading into two groups of high and low achievers to compare the differences, if any, in the critical thinking skills observed. The results of the Independent t-test indicated no significant difference between the groups regarding their critical thinking ability (sig= .900). Thus, it was concluded that although both groups showed a little progress after the treatment, the difference was not statistically significant whereupon to conclude that reading logs may not drastically affect learners' critical thinking development. 
ISLAMIC MAGAZINE ARTICLES TO ENHANCE STUDENTS’ READING SKILL AND BUILD THEIR CHARACTER VALUES
Authors: Munir Munir , Hartono Rudi
Published: August 2016

This present study examined the use of Islamic magazine articles as authentic materials in teaching reading comprehension for the students of English Education Department of IAIN Batusangkar, Indonesia. This idea is based on the belief that students can be motivated and challenged to read if the selected materials pertain to their prior knowledge and experiences. In addition to this, using Islamic magazine articles as essential sources of information can positively expose students to real language. This study used qualitative research. This research was conducted to the third semester students. Observation and interview were used to collect data from 58 students who learned reading comprehension in the classroom. The research findings showed that the use of Islamic magazine articles empirically enhanced the students’ reading performance and built their character values. Based on these findings it is recommended that lecturers of reading comprehension subject should be able to exploit up-to-date articles to be used as lesson materials in teaching reading comprehension at the English education department in order to avoid boredom in reading texts. 
HUMAN RESOURCE MANAGEMENT MODEL TO CREATE SUPERIOR PERFORMANCE
Authors: Yuniarsih Tjutju , Sugiharto Mochammad Dudih
Published: August 2016

This research is motivated by the empirical conditions related to poor performance of human resources in various institutions in Indonesia. This research focuses on the uneven gains of competitive human resources due to workers’ characters which still prioritize routines and the fact that quality-oriented work culture has not been strongly established.. The solution offered is a model of human resource management that emphasizes the interaction between personal and situational factors that are directed at the creation of improved performance and productivity, as stated in behaviourist theory. Based on the above explanation, the aim of this second year research is to measure the effects of the two previously mentioned factors on performance. The research adopted quantitative approach with explanatory survey method. First year research was focused on an exploration with inductive approach to map the determining factors for variables that will build a model of human resource management in achieving superior performance. Second year research used explanatory survey, combining multiple regression analysis techniques to test the causal relation between variables, while the third year research will use Research and Development method to test the hypothetical model. The subjects of this research were employees in educational institutions (Indonesia University of Education and Bandung State Polytechnic ), banks (West Java-Banten Bank and Indonesian People’s Bank), business institutions (Advent Hospital), and government institutions (Local Government Agencies in Bandung). The size of the samples was taken proportionally from each work unit by using proportionate random sampling. The number of units of analysis was 239 respondents determined by Solvin formula. The instruments of this research consisted of questionnaires, interview guide, and documentary study. The instruments were validated by expert judgment. The data were processed with the aid of SPSS version 21 and AMOS to find the causal relationship between variables, and regression analysis to identify variables forming superior performance. Based on the findings, it can be concluded that all personal aspects and situational aspects were proven to have significantly positive effects and contributions to create superior performance. The hypothetical model developed in this first and second year research will be tested in the next year’s research.
«Багратионовы волки»: Черниговский кавалерийский полк от Полтавы до Мукдена
Authors: Гуларян Артем Борисович
Published: August 2016

В статье восстановлена история Черниговского кавалерийского полка, в который входили два разных соединения, существовавшие в различное время, с интервалом в 60 лет. Но новый Черниговский полк, история которого связана с городом Орлом, свято хранил память о предшественниках, героях Полтавы и Отечественной войны 1812 г., соблюдая традиционную для русской армии преемственность.

Подготовлено на основе доклада автора на Всероссийской научной конференции «Военная история России», которая прошла в Московском гуманитарном университете 25 апреля 2016 г.
Корпус офицеров Русского Генерального штаба в Первую мировую войну 1914–1918 гг. в оценке ее участников
Authors: Некрасов Олег Георгиевич
Published: August 2016

В статье рассматривается служба офицеров русского Генерального штаба накануне и во время Первой мировой войны, сложные и противоречивые оценки «мозга армии» представителями строевой массы офицерства, сильные и слабые стороны корпуса ученых офицеров.

Подготовлено на основе доклада автора на Всероссийской научной конференции «Военная история России», которая прошла в Московском гуманитарном университете 25 апреля 2016 г.
The successful use of bipolar radiofrequency ablation (coblation) in treatment of a lymphatic malformation affecting the upper airway
Authors: Koh Lynn H. , Tan Henry KK
Published: August 2016

Lymphatic malformations of the head and neck region frequently involve the upper aero digestive tract. Patients with these lymphatic malformations may present in early infancy with sudden airway compromise. This necessitates early intervention with intubation or tracheostomy for airway stabilization. The etiology and pathogenesis of lymphatic malformations is still unclear, and a wide array of treatment modalities has been proposed. We present a case report of a neonate with a lymphatic malformation involving the upper airway, and discuss how the patient was initially stabilized with a tracheostomy, following which he underwent a series of staged procedures, including bipolar radiofrequency ablation, which eventually led to successful decannulation.
Topical corticosteroid abuse on face: a clinical study of 100 patients
Authors: Bains Pooja
Published: August 2016

Background: Prolonged and uninterrupted use of topical corticosteroids on face is globally prevalant and this misuse has reached monstrous proportion in India. The topical corticosteroid abuse leads to various local adverse effects on face which are difficult to treat. The aim of this study was to ascertain the magnitude, demographics, cause and adverse effects of TC abuse on the face in the dermatology out-patient department.

Methods: A total of 100 patients with history of topical corticosteroid abuse on face for a minimum period of one month were enrolled in this study.

Results: In our study, majority of the patients were females (76%) and the most common age group was 21-30 years with 49% patients. The duration of application was <6 months (45%) in majority of patients. Most common topical corticosteroids abused were betamethasone valerate in 49% and clobetasol propionate in 40% cases.
Conclusions: Topical corticosteroid abuse on face is quite common with varied presentation. There is need to take urgent remedial steps and increase awareness about this problem in general population.
La legitimidad de la reforma fiscal: autoridades tributarias y contribuyentes en el mercado de la ciudad de Veracruz, 1875-1889
Authors: Sánchez Hidalgo Hernández Dora
Published: August 2016

Uno de los retos más difíciles para instrumentar la reforma fiscal del siglo xix en México fue transitar del cobro de los derechos municipales (de mercado y consumo) a los de patente. Las tensiones entre la ley y la realidad generadas por esta transformación tributaria parecían haber convencido a los defensores más aguerridos de la reforma de su inviabilidad. El caso de la ciudad de Veracruz ayuda a explicar cómo fue gracias a las tensiones entre la ley y la praxis cotidiana que los regidores del Ayuntamiento consiguieron regular la recaudación en los mercados urbanos, con base en los derechos de patente. Los procesos de negociación entre autoridades tributarias, contribuyentes y el gobierno estatal permitieron crear los mecanismos tributarios basados en el “giro”, con los que se legitimó la reforma fiscal federal desde el ámbito local.

 
La construcción del primer sistema de abasto de agua en red en la ciudad de Aguascalientes, 1896-1899
Authors: Gómez Serrano Jesús
Published: August 2016

Este artículo se refiere a la construcción en la ciudad de Aguascalientes del primer sistema de abasto en red de agua potable, que se inscribe en el marco del programa de modernización que experimentaron muchas ciudades de la provincia mexicana durante el porfiriato. A partir de una valoración de los problemas que tenía el antiguo sistema de abasto en línea, se reseña la intervención del gobernador Rafael Arellano quien promovió su reforma integral e ideó el esquema con que se financiaron las obras. La intervención resultó muy afortunada, pues el abasto de agua mejoró en forma exponencial, el Ayuntamiento retuvo el control del sistema, las obras fueron hechas sin necesidad de contratar deuda y se contó con un excedente que permitió, por primera vez en la historia de la ciudad, mercedar agua a particulares. En diálogo crítico con diversos autores, se problematiza el tema en el contexto de los procesos históricos de largo aliento, como el crecimiento urbano, la industrialización, la modernización de diversos servicios, el cambio tecnológico, el fortalecimiento del Estado y las relaciones entre el gobierno estatal y el Cabildo.
To Study the Clinical Profile of Neonatal Sepsis and the Sensitivity of Various Markers of Sepsis Screen
Authors: Sonawane Sagar , Suryawanshi Milind , Patil Priyanka , Sonawane Ravindra , Tolani M. K.
Published: August 2016

Objective: To study the clinical profile of Neonatal Sepsis & the sensitivity of various markers of sepsis screen. Material & Methods: This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture & Sensitivity was done with conventional non–automated method using Herley’s Broth. Result: Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) & Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).
Use of Oil as a Lubricant makes Lacrimal Sac Massage Efficient in Congenital NasoLacrimal Duct Obstruction (CNLDO)
Authors: Pawar Prachi , Patil Aruna , Patel Mihir , Shah Saurabh
Published: August 2016

Introduction: Congenital NasoLacrimal Duct Obstruction (CNLDO) is a frequent entity in the paediatric age. CNLDO has a 20% to 30% incidence rate out of which only 1% to 6% become symptomatic.1 The 4% of premature infants are affected with CNLDO.2 The management of failed Crigler's Sac massage is probing, secondary probing, external DCR and with or without intubation is well known to all. To avoid the sequelae of CNLDO, cure of CNLDO is mandatory. Hence the aim of the study is primary cure for CNLDO by using specific treatment of Crigler's Sac massage with Oil is emphasised. Method: This study was about 140 eyes and in each group, 70 eyes were enrolled with lost to follow up considerations. Patients had been selected and randomised alternatively when visited ophthalmology OPD. The CNLDO patients were selected from the age group ranged 1 to 9 months. Follow up of all patients was taken every month up to 15 months of age. Each and every patient from both the groups had to complete the formality of clinical consultation, doctors counselling to parents specially mothers explaining the procedure of sac massage and taking a live demonstration by mother/ parent hence confirming the proper technique to be followed at home. Results: In group A, Standard Crigler's Method was used only on 54 eyes out of enrolment of 70 eyes. In group B, Standard Method with add on therapy of oil massage had been given to 66 eyes out of 70. In group B, cure rate was found in 60(91%) which was significantly differing from the cure rate of group A 30(56%) by Standard Crigler's Method at P<0.001. Complications were found in 20 eyes in group A and in group B only one patient showed complication unrelated to the treatment of CNLDO used by the patients in this group. No significant difference was seen in the sex distribution in relation to CNLDO at P>0.05. Conclusion: The primary need of Crigler's Sac Massage using Oil has given the importance towards good compliance and success of curing CNLDO.
To Study the Role of Zinc Supplementation on Growth of Low Birth Weight Infants
Authors: Sonawane Ravindra , Patil Suhas , Gulati Lalit , Sonawane Sagar
Published: August 2016

This was a randomized controlled trial undertaken to study the role of zinc supplementation on growth of low birth weight infants (b.wt≤2500 gm). Out of 120 LBW infants, 23 were excluded due to loss of follow up. The remaining 97 LBW eligible neonates were randomized in to 2 group (zinc & control group), zinc group were given zinc supplementation at a dose of 2 mg/kg/day for 8 weeks from enrollment. They were then followed up every 4 weeks up to 8 weeks. At each visit, detail anthropometry including e weight, length, and head circumference were recorded at each visit. The infants in the zinc group had significantly higher weight gain (p<0.000), length gain (p<0.000), linear growth velocity and head circumference at 8 weeks. We concluded that zinc supplementation at 2 mg/kg/day for 8 weeks in LBW infants improves their growth during infancy.
A Descriptive Study on Patients of Papulosquamous Lesion at Tertiary Care Institute
Authors: Chavhan S. D. , Mahajan S. V. , Vankudre Ashok J.
Published: August 2016

Background: Papulosquamous lesions of the skin are encountered with considerable frequency. There is overlap of both clinical pattern and distribution of papulosquamous skin disorders, which often makes clinical diagnosis difficult. However, some of the histopathological features are specific and characteristic for each entity. Hence, combination of proper clinical observation and histopathological study will give a conclusive diagnosis. Material & Methods: A cross sectional study was done in department of pathology in which after satisfying inclusion criteria all papulosquamous lesion patients irrespective of age & gender were included in study in defined period. A brief history and dermatological examination was carried out. Skin biopsies taken were fixed in 10% formalin and subjected for tissue processing. The processed tissue was embedded in paraffin to obtain five-micron thin sections. The sections were stained with routine hematoxylin and eosin stain, followed by microscopic examination. Result: Out of 61 patients of papulosquamous lesion most common diagnosis was Lichen planus, (57.37 %) followed by Psoriasis (32.78 %). Commonest age group reporting Lichen planus & Psoriasis was 21-40 yrs. Male preponderance was noted in all papulosquamous lesion patients. Histological features commonly seen were hyperkeratosis, parakeratosis in both Lichen planus & Psoriasis patients.
Uterine Artery Embolization is Advanced, Minimally Invasive Treatment for Fibroids with Intervention Procedure: A Case Report
Authors: Gattani Chandrashekhar M. , Sadavarte Tejas P. , Kamble Shripad S.
Published: August 2016

Uterine Artery Embolization (UAE) has become most effective and minimally invasive alternative treatment over the past many years, especially for women with symptomatic fibroids for whom conservation of uterus is important. Here we are reporting a case of an eighteen year old, unmarried female who presented with pain in lower abdomen and pelvis, menorrhagia and she also noticed gradually increasing lump in pelvis and lower abdomen.

After clinical examination, patient was referred for radiological investigations, initially ultrasonography was performed which revealed, a large sized posterior wall uterine fibroid measuring approx. 19 x 10 x 18 cm and it was further confirmed on MRI with contrast study. UAE was carried out in order to relieve the symptoms, reduce the size of fibroid and at the same time preserve the uterus. The procedure was uneventful after follow-up for 3 months, there was partial regression in the size of fibroid.
Inclusions of Social Determinants for Public Health Care Approach: Does it Really Matter?
Authors: Nanjunda ,
Published: August 2016

The National health policy accepted by the honorable Indian parliament in 1983 states health care as the main device for achieving sustainable development of the community. It is a known factor that development of any society depends on the healthy people only. Without good health even we cannot think appropriately and act properly and expect the society to keep moving smoothly. It is a known fact that without proper health we cannot expect the proper social inclusion of any community in any way. An in-depth study of social determinants on health culture of any society will help in understanding complete knowledge of etiology, various health issues and policy drawbacks etc of nay society. Understanding social determents on health would be more useful in planning geographic and cultural specific health care programmes for the rural people in the county. Holistic knowledge of social determinates will be helpful in understanding health seeking behavior of the people and this will provide valuable insight in framing ground level public health policies in the country. With this background this paper is to reveal various social determinants affecting on health .This paper concluded various social determinates of public health care needs to be focused urgently.
Open Reduction Internal Fixation for Low Subcondylar/Ramus Fracture and High Condylar Fracture - A Case Report
Authors: Marathe-Pagar Manisha , Nampurkar C. R. , Sonawane D. K. , Chindhade Rachana
Published: August 2016

Introduction: Mandibular low subcodylar fractures have a high incidence but not much is given in literature regarding the best method of treatment. This paper describes a surgical management of a low subcondylar /ramus fracture in a 30 year old male patient.

Method: Access to the fracture line was taken via Risdon’s approach that gave the good visualization of fracture line and facilitated better reduction and fixation. Plating was done on the lateral cortex of the ramus of mandible. There was a risk of damaging the marginal mandibular nerve and trauma to facial artery.

Result: Resulted into good anatomical reduction and better functional rehabilitation.

Conclusion: Open reduction and internal fixation (ORIF) can create better function for the temporomandibular joint, compared with closed treatment in low subcondylar/ramus fracture surgery.
Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media
Authors: Patil Devashri Uday , Burse Kiran S. , Kulkarni Shreeya , Sancheti Vandana , Bharadwaj Chaitanya
Published: August 2016

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. Aims and Objectives: 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. Materials and Methods: This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. Result: Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. Conclusion: Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.
Study of Risk Factors and Clinical Profile of Stroke in Young Adults
Authors: Jadhav Yogesh L. , Bondarde Shailesh A.
Published: August 2016

Background: According to the Global Health Observatory, stroke is the second most common cause of death during last decade with a rising trend. Although stroke is considered to be the disease of older population, with the demographic shift the disease incidence is now shifting to younger age group. This shifting trend to younger age group pose a great concern to the world in terms of days lost to work and mortality. There is paucity of information on stroke in young individuals covering important types of stroke. Aims&Objectives: To study the clinical profile and risk factors associated with the stroke in young adults. Materials & Methods: The present descriptive study was carried out at tertiary care Hospital of Nasik from June 2011 to June 2013. A total of 40 consecutive cases between 15-45 years presenting with stroke were recruited for the study after taking prior informed consent. All cases underwent a detailed history taking, general and clinical examination along with all required Investigations. Data was analysed by SPSS software ver. 17 using appropriate statistical tests. Results: Ischemic stroke was the most common presentation and stroke prevalence was similar across both genders. Headache was the most common symptom followed by vomiting in all types of stroke patients. OC Pills and parity was found to significantly associated with CVST. Obesity, smoking and abnormal lipid profile was found to be significantly associated with thromboemblic stroke. Only 3 out of 40 stroke patients died during the course of study. Conclusion: OC Pills and parity were significantly associated with CVST while obesity, smoking and dyslipidemia were significantly associated with thromboemblic stroke. Outcome in young stroke patients was fairly good.
Comparative Study of Efficacy of Glycolic Acid Peel and Intense Pulsed Light in the Treatment of Melasma
Authors: Desale Snehal P. , Gugle Anil S. , Kote Rahul , Jadhav Vikrant M.
Published: August 2016

Background: Melasma, one of the common aesthetically displeasing entities, continues to be a difficult problem to treat. Chemical peeling is one new weapon in the therapeutic armamentarium of melasma. Intense Pulsed Light (IPL) is a noncoherent, broad-spectrum light, ranging from 500 to 1200 nm. Intense Pulsed Light (IPL) treatment is a good option for patients with melasma. Aims and Objective: To compare the efficacy of glycolic acid peel and intense pulsed light in the treatment of melasma. Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and Methods: 60 patients of melasma were recruited in the study. Patients were randomly allocated into two groups: one group (glycolic acid 50%) and another group (IPL) with 30 patients in each group. All the participants were subjected to undergo pre-peel programme of daily application of sunscreens (day time) and 0.025% retinoic acid at bed time for two weeks in GA peel group. 4 peels were carried out at 2 weekly intervals. Four sessions of IPL were done at 3 weeks interval. MASI scoring and coloured photographs (without reavealing identity) of each patient were taken before each peel and at the end of the follow-up period i.e. 2 weeks after 4th sitting in GA peel group and 3 weeks after 4th sitting in IPL group. Side effects, if any, were also recorded. Statistical Analysis Used: SYSTAT version-12. Results: In both the groups there was constant decrease in MASI scores after each sitting as compared to pre-peel scores. However, the comparison of mean MASI scores i.e. both pre-peel and after each peel, between the two groups showed statistically significant difference (p<0.05). Local reactions, such as burning sensation and erythema during the peel were not significant with both the groups. Conclusions: Glycolic Acid (GA) peel (50%) is more efficacious&safe treatment modality in melasma compared to IPL.
Congenital Hernia of Morgagni - A Case Report
Authors: Sonawane Sagar , Tolani M. K. , Sonawane Ravindra , Ahire Nilesh , Patil Suhas , Patil Sandip
Published: August 2016

Congenital Diaphragmatic Hernia of Morgagni occurs through the foramen of Morgagni, is rare in children. It is usually asymptomatic and detected accidentally. If symptomatic, then symptoms are variable and nonspecific making diagnosis difficult . Our patient presented with signs and symptoms suggestive of congenital heart disease, gastroesophageal reflux disease and recurrent pneumonia.
Uterine Reconstruction Following Vehicular Accident in 1 ½ Year Old Patient: A Rare Case
Authors: Patil Abhijeet Madhukar , Mogal Kailash K.
Published: August 2016

Introduction: Uterine injuries following road traffic accidents are very rare and isolated and in the peadiatric age group are even rarer. Case Report: The patient, an 18 month old female child was referred to our hospital in the casualty with history of being run over by the rear wheel of a tractor 11 hours prior to admission. She was admitted with haemoperitoneum due to uterine transection. Reparative surgery was done. Discussion: Complete transection of uterus as a sole cause of haemoperitoneum in a road traffic accident has not been reported. Successful conservative surgery for the same has also not been reported in medical literature. It is our opinion that the good collateral circulation of the uterus and the presence of vital tissue after 16 hours of injury tipped the balance in favor of attempting conservative surgery with the principles of micro-surgery in mind.
A Clinical Study Comparing Different Techniques of Nucleus Delivery in Manual Small Incision Cataract Surgery
Authors: Patil Mrunal Suresh , Balwir Dhiraj Namdeo , Gupta Amal , Kataria Ishan , Chatterjee Sumit
Published: August 2016

Aim: To compare different technique of nucleus delivery in small manual incision cataract surgery,regarding their safety and intra operative complication. Material & Methods: A total of 285 patients with cataract undergoing SICS with posterior chamber IOL implantation were selected. Patients were randomly divided into 7 groups of nucleus delivery. All of the patients were followed up on first postoperative day and discharge. Patients were advised regular follow up at 1st week, 4th week and 6th week. Results: Out of total 285 patients 68 (23.86%) patients had intraoprative complications for all the techniques. There was no intraoperative difficulty to the surgeon for delivery of nucleus by various techniques in 210(73.68%) of cases. Group 1 (wire vectis) had minimum intraoperative complications whereas group 2 had maximum.31 (10.88%)had grade 1 (minimal) difficulty intraoperetively. 25 (8.77%)cases had grade 2 (moderate) difficulty. 19 (6.67) cases had grade 3(abandoned) difficulty. Conclusion: By adjusting parameters like size of cornean incision, hydrodissection or debulking of nucleus before delivery of nucleus in different grades of hardness of cataract, a surgeon may choose any one technique in which he or she is comfortable. Manual small incision Cataract surgery with its low complication rate has now come to be established surgical procedures for cataract surgery.
A Comparative Study of Efficacy, Safety and Relapse Rate of Three Drugs; Systemic Ketoconazole, Systemic Itraconazole and Topical Oxiconazole in the Treatment of Pityriasis Versicolor
Authors: Mohite Amruta , Gugle Anil S. , Kote Rahul , Jadhav Vikrant M.
Published: August 2016

Aim: The aim of our study was to evaluate the efficacy, safety and relapse rate of systemic Ketoconazole, systemic Itraconazole and topical Oxiconazole in the treatment of pityriasis versicolor. Study design: 94 patients who had pityriasis versicolor were included in the study. The patients were given Ketoconazole, Itraconazole and Oxiconazole randomly and were followed up at the interval of 15 days, 1 month and 3 months for assessement of clinical and mycological cure. Results: In assessment of clinical parameters maximum improvement in scaling, pigmentation and pruritus was seen in Oxiconazole group compared to itraconazole and ketoconazole group. During the study it was observed that rate of clinical cure was maximum in Oxiconazole group (76.67%) as compared to Itraconazole (58.82%) and Ketoconazole group (46.66%). Mycological cure during visit 2 in Oxiconazole group was (83.33%), as compared to (88.2%) Itraconazole group and (88.7%) Ketoconazole group. During visit 3, mycological cure was present in 93.3% cases in Oxiconazole group, 94.1% in Itraconazole group and 93.3% in Ketoconazole group. During visit 4 mycological cure was assessed which showed 88.7% cure rate in Oxiconazole group compared to 88.2% in Itraconazole group and 88.7% in Ketoconazole group. These results suggested presence of relapse in 6.6% cases in both Oxiconazole and Ketoconazole group and 5.9% cases in Itraconazole group. There were no side effects with oxiconazole group while cases treated with ketoconazole and itraconazole had side effects like nausea and urticaria. Conclusion: According to the present study we conclude that topical Oxiconazole therapy was more effective as compared to systemic Itraconazole and Ketoconazole therapy in early improvement of scaling, pigmentation and pruritus secondary to Pityriasis versicolor with no significant side effects.
A Prospective Study to Observe the Results and Complications of Lateral Internal Sphincterotomy in Anal Fissure
Authors: Pawar Sandesh , Bhamre Sudhir D. , Malpathak Vijay , Sorate Yamini
Published: August 2016

Aim: To observe the results and complications of lateral internal sphincterotomy in anal fissure. Materials&Methods: The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&surgical management. Results: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. Conclusion: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.
Comparative Study of Efficacy of Topical Minoxidil 5% and Combination of Topical Minoxidil 5%, Topical Azelaic Acid 1.5% and Topical Tretinoin 0.01% on the Basis of Dermoscopic Analysis in Androgenetic Alopecia
Authors: Gugle Anil S. , Jadhav Vikrant M. , Kote Rahul , Deshmukh Milind Devidas , Dalvi Aditi Vijay
Published: August 2016

Background: Androgenetic alopecia (AGA) more commonly known as male pattern baldness affects up to 50% of men worldwide. Tretinoin prolongs anagen phase and increases percutaneous absorption of minoxidil three fold. Azelaic acid is an inhibitor of 5 alpha reductase and could be an effective agent in the treatment of androgen related pathology of human skin. Aims and Objective: 1) To study the efficacy of topical minoxidil 5% in treatment of androgenetic alopecia. 2) To study the efficacy of combination of topical minoxidil 5%, topical azelaic acid 1.5% and topical tretinoin 0.01% in treatment of androgenetic alopecia. 3) To compare the efficacy of foresaid topical preparation in treatment of androgenetic alopecia Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and methods: Topical minoxidil 5 % lotion was used in 23 (50%) patients of the present study. Combination of topical minoxidil 5%, azelaic acid 1.5 % and tretinoin 0.01 % lotion was used in 23 (50 %) patients of the present study. Statistical analysis used: Epi info version 7. Results: There was statistically significant increase in hair number and thickness after treatment in both the groups. The comparison of the increase of hair number and thickness was statistically insignificant. Conclusions: Topical Minoxidil 5% is equally effective to combination of topical Minoxidil 5%, azelaic acid 1.5% and tretinoin 0.01% in treatment of androgenetic alopecia.
Study of Various Organisms Associated with Surgical Site Infection and their Sensitivity Pattern
Authors: Borse Hemant , Shelke Rahul
Published: August 2016

Aim: The objectives of this study was to study the various micro-organisms causing surgical site infection, to study their antibiotic sensitivity and resistance pattern. Setting: Department of Surgery of a tertiary health care centre with an attached medical college. Material and methods: A total of 89 patients with post operative surgical site infection occurring within 30 days of surgery or 1 year of implant were included as subject material after they satisfy inclusion and exclusion criteria. Results: E.coli is the commonest organism isolated in SSI wounds. Overall Imipenem and Amikacin are the most sensitive antibiotics. Over all gentamycin, cefotaxime and clindamycin are the most resistant antibiotics noted. Conclusion: The most common organisms associated with SSI are E. coli and Pseudomonas. Most of the organisms were sensitive to imipenem, amikacin. Sensitivity pattern of the of the organism is changing with time. The common organisms are now no longer sensitive to routinely used cheaper antibiotics. Newer antibiotics, which are more costly, are required to treat the infection which is a burden to the patient.
Asthma and Obesity - the Recent Advancements
Authors: Bharadwaj Puneet , Verma Rahul , Deshkar Atul Manoharrao , Deshkar Akshta Atul
Published: August 2016

The incidence of obesity and asthma is increasing globally. Evidence shows that there is a correlation between the two, both epidemiologically and pathophysiologically. The inflammatory link between the two is now being established as obesity is a risk factor for asthma and also plays an important role in its prevention and management. Evidence shows that patients with metabolic disorders such as insulin resistance may be at an increased risk for asthma, however the exact pathophysiology of the same remains unknown. We hereby present an overview of the recent advancement in this field.