bluuebunny/crossref_metadata_2025 huggingface dataset:
O Processo de Gestão do Conhecimento: uma pesquisa teórico-conceitual
Authors: Gonzalez Rodrigo Valio Dominguez , Martins Manoel Fernando
Published: January 2017

Resumo: A gestão do Conhecimento (GC) é um tema que vem despertando o interesse de muitos pesquisadores nas últimas décadas, sendo grande parte das contribuições orientadas por etapas, denominadas processo de GC. Por se tratar de um tema abrangente, as publicações sobre o processo de GC apresentam contribuições multidisciplinares e, desta forma, esta pesquisa tem por objetivo conceituar este processo, analisando as principais abordagens que orientam o estudo de cada etapa, e, também, levantar as principais publicações que tratam do tema, classificando-as quanto à sua área de contribuição. Para alcançar estes objetivos, este artigo é orientado por uma pesquisa teórico-conceitual, na qual foram estudados 71 artigos. Os resultados desta pesquisa apontam que o processo de GC é constituído de quatro etapas: aquisição, armazenamento, distribuição e utilização do conhecimento. Na fase de aquisição, as temáticas estudadas são aprendizagem organizacional, absorção de conhecimento, processo criativo e transformação do conhecimento. Na fase de armazenamento, as contribuições tratam do indivíduo, organização e tecnologia da informação, enquanto na fase de distribuição os estudos concentram-se nas temáticas contato social, comunidade de prática e compartilhamento via tecnologia de informação. E, por fim, na fase de utilização, são abordados os temas forma de utilização, capacidade dinâmica e recuperação e transformação do conhecimento.
Sistematização da implementação de outsourcing logístico por meio de práticas de gestão de projetos
Authors: Camargo Junior João Batista de , Pires Silvio Roberto Ignácio
Published: January 2017

Resumo: O outsourcing logístico, aplicado como uma das práticas da Gestão da Cadeia de Suprimentos (Supply Chain Management – SCM), vem demonstrando ser efetivo para a construção de vantagens competitivas nas organizações. A literatura acadêmica tem contribuído com essa prática especialmente ao relacionar seus conceitos com as teorias da economia dos custos de transação (Transaction Cost Economics - TCE) e da visão baseada em recursos (Resource-Based View – RBV). Porém, poucos trabalhos têm abordado a efetiva implementação da relação, ou seja, o momento em que a parceria começa a funcionar de fato. Por meio de uma pesquisa exploratória, este artigo propõe uma sistematização para projetos de implementação de outsourcing de processos logísticos. A proposição é baseada nos conhecimentos da Gestão de Projetos (Project Management) e aprimorada por um processo de verificação realizado a partir de entrevistas com profissionais que passaram ou estão passando pelo processo de terceirização logística em suas respectivas empresas. Os resultados apontam que a sistematização descrita é aplicável no ambiente corporativo, especialmente ao auxiliar a compreensão dos profissionais envolvidos quanto ao trabalho necessário.
Revisitando o desastre de Bhopal: os tempos da violência e as latitudes da memória
Authors: Martins Bruno Sena ,   Universidade de Coimbra,  Portugal
Published: January 2017

Resumo Na madrugada de 3 de dezembro de 1984, um acidente numa fábrica da filial indiana da empresa estadunidense Union Carbide Corporation (UCC) viria a desencadear o maior desastre industrial da história: o desastre de Bhopal. Neste texto, a partir de um trabalho etnográfico recente, propõe-se um encontro, mais de 30 anos depois, com as vozes daqueles cujas vidas foram afetadas pelo desastre de Bhopal. Esta abordagem pretende convocar leituras sobre o tempo, a violência e as demarcações de humanidade que definem a memória social. Em particular, pretende-se questionar os processos pelos quais algumas vidas são desproporcionadamente expostas à violência e fracassam em receber justa compensação, bem como os itinerários pelos quais alguns sofrimentos são tendencialmente elididos da memória social do Ocidente. Finalmente, analisa-se a forma como a vulnerabilidade biográfica e corpórea, imposta pelo desastre, criou espaços de enunciação e narrativas de resistência.1
À procura de um outro constitucionalismo económico: construindo a cidadania a partir de iniciativas de economia solidária e popular lideradas por mulheres do Sul
Authors: Cunha Teresa ,   Universidade de Coimbra,  Portugal, Lauris Élida
Published: January 2017

Resumo Onde existe cidadania, existe uma constituição. No âmbito da soberania política liberal, por meio da constituição, definem-se os deveres do Estado, estabelecem-se critérios de partilha do poder e limites ao seu exercício. Um desses limites prescreve as fronteiras e as continuidades da relação entre estado e economia. Nesse sentido, enquanto a vertente liberal das constituições tende a reforçar as barreiras da intervenção do Estado na economia, as constituições sociais têm inovado o repertório de previsão de direitos económicos e sociais, bem como mecanismos para impelir a sua aplicabilidade. Neste artigo, argumentamos a necessidade de ampliar o cânone do constitucionalismo económico a partir das experiências de injustiça epistémica (Santos, 2014). A partir de baixo, isto é, das iniciativas engendradas e lideradas por mulheres no Brasil, em Moçambique e África do Sul, pretendemos trazer novos elementos de racionalidade moral e prática política que questionam os princípios subjacentes à funcionalidade económica e do progresso nacional, como está previsto nas constituições. A nossa pesquisa discute, ainda, o impacto efetivo destas socioeconomias nas mudanças sociais e no avanço da cidadania económica.
Apontamentos para uma sociologia da valentia
Authors: Oliveira Eliézer Cardoso de ,   Universidade Estadual de Goiás, Brazil
Published: January 2017

Resumo O artigo objetiva a construção de uma tipologia da valentia a partir da sociologia compreensiva de Weber, Simmel e Elias. A valentia é considerada como uma escolha valorativa de indivíduos inclinados a levarem uma vida de aventura e convictos da legitimidade de um estilo de vida baseado na proximidade com a violência, com a morte e com o risco. Mesmo com o advento da modernidade, quando emergiu o “processo civilizador”, responsável por refrear os instintos violentos, a valentia, restringida na vida cotidiana, mantém-se atuante como um valor social legítimo.
Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise
Authors: Pelizzer Thaisa , Dias Caroline Pieta , Poeta Julia , Torriani Tânia , Roncada Cristian
Published: January 2017

RESUMO: Introdução: O câncer colorretal é um dos tipos de tumor mais prevalentes na população mundial. A mortalidade causada por esses tumores malignos continua elevada e mantém-se praticamente no mesmo nível nas últimas décadas. Entre os fatores de risco já estabelecidos para o desenvolvimento do câncer estão as infecções por patógenos ou vírus. Entre os vírus, o papilomavírus humano (HPV) é o mais prevalente, tendo mais de 180 cepas, das quais 40 estão diretamente relacionadas com infecções anogenitais. Objetivo: Avaliar de forma sistemática, com metanálise, os principais estudos que associam o HPV ao câncer colorretal. Métodos: Como estratégia de busca foi adotada a lógica baseada em descritores específicos (idioma inglês), vinculados aos operadores booleanos (AND/OR). As buscas foram aplicadas nas bases de dados PubMed, ScienceDirect e Scientific Electronic Library Online (SciELO), no período de abril e maio de 2015. Resultados: Foram avaliadas 1.549 amostras, sendo 956 (61,7%) do sexo masculino. Foram diagnosticados 630/1.358 casos de câncer colorretal por HPV (51,9%). Destes, 408/767 (51,9%) eram do sexo masculino e 404/598 (67,5%) foram associados aos HPVs 16 e 18, com prevalência tumoral na região do colo (253/411; 61,3%). Do total de 598 amostras para estimativa das prevalências de HPV-16 e HPV-18, a quantidade de casos com valores muito semelhantes foi de 204 (31,7%) e 200 (35,8%), respectivamente. Foram verificados valores relativamente expressivos na região do colo, 253 (61,3%), e na região retal, 158 (38,7%). Conclusão: Após a realização do presente estudo, a associação entre HPV e câncer colorretal ficou evidente, não havendo distinção entre gêneros, com valores muito semelhantes entre o HPV-16 e o HPV-18.
Transmissão urbana da esquistossomose: novo cenário epidemiológico na Zona da Mata de Pernambuco
Authors: Gomes Elainne Christine de Souza , Mesquita Millena Carla da Silva , Rehn Vitorina Nerivânia Covello , Nascimento Wheverton Ricardo Correia do , Loyo Rodrigo , Barbosa Constança Simões
Published: January 2017

RESUMO: Introdução: A esquistossomose é considerada uma endemia em Vitória de Santo Antão, Pernambuco, o qual apresenta há décadas altas incidências e prevalências para essa doença. Nesse município ocorre a transmissão clássica da doença por meio do contato da população de áreas rurais com águas contaminadas durante o desenvolvimento de suas atividades de vida diárias. Recentemente surgiram indícios da presença do caramujo vetor na área urbana da cidade, o que pode configurar um novo modelo de transmissão para esquistossomose nesse município. Objetivo: Identificar novo cenário epidemiológico para ocorrência da transmissão urbana da esquistossomose em Vitória de Santo Antão, Pernambuco. Métodos: Foi conduzido um inquérito malacológico, investigando-se todas as coleções hídricas do perímetro urbano quanto à presença do caramujo vetor da esquistossomose (Biomphalaria spp.). Os caramujos coletados foram examinados para identificação taxonômica e de infecção pelo Schistosoma mansoni. Todos os criadouros (CRs) foram georreferenciados para construção de mapas de risco por meio dos software TrackMaker-Pro e ArcGIS. Resultados: Foram identificados 22 CRs da espécie Biomphalaria straminea, nos quais foram coletados 1.704 caramujos. Desses CRs, um foi identificado como foco de transmissão da doença e sete como focos potenciais para transmissão. Os mapas construídos identificaram duas áreas de risco para transmissão urbana da esquistossomose, bem como áreas de expansão dos CRs, configurando um aumento no risco de transmissão para a população. Conclusão: Os resultados constatam a existência de um novo cenário epidemiológico, no qual a possibilidade de transmissão urbana dessa doença foi confirmada.
Nietzsche e as consequências
Authors: Carpeaux Otto Maria
Published: January 2017

Resumo: Na tentativa de compreender o dilema entre "os valores da civilização alemã e as forças destruidoras no seio do mesmo povo que os criou", Carpeaux refuta três teorias então vigentes e considera Nietzsche, o "Dionísio Crucificado", como aquele que experimentou e antecipou as forças contraditórias do espírito alemão. Após fazer um balanço dos mal-entendidos em torno da recepção de Nietzsche tanto na Alemanha quanto na Europa até o ano de 1942, o autor então parte da tese de que o pensador alemão seria simultaneamente poeta, filósofo e profeta, algo que somente seria possível no interior de um "homo religiosus", daquele que vivenciaria o conflito oriundo da antiga barbárie nórdica e da barbárie dos novos burgueses alemães. Dotado de um intelecto que possuía uma "estrutura heraclítica", tal como o de Hegel, Nietzsche, no entanto, na qualidade de "profeta do niilismo europeu", teria não somente descoberto "a estrutura heraclítica do espirito alemão", mas, sobretudo "o caminho da autodestruição deste espírito". Ou seja, antecipado "o caminho do nacionalismo e do socialismo à fusão no nacional-socialismo".
As tendências políticas de Nietzsche
Authors: Lafayette Pedro
Published: January 2017

Resumo: Consciente das tentativas europeias de apropriação política do pensamento de Nietzsche, Lafayette conclui em 1942 que o filósofo alemão não pode ser tomado nem como baluarte revolucionário de esquerda nem como expoente reacionário de direita. Gênio singular, seria mais apropriado considerá-lo como a "expressão superlativa das imensas contradições de sua espécie". Pensador antidemocrático, ele estaria, como Platão, preocupado em formar uma "elite dirigente", cuja hierarquia política deveria estar fundamentada na hierarquia intelectual.
A sublime loucura de Nietzsche
Authors: Mantain Paul de
Published: January 2017

Resumo: Analisando Ecce homo como uma obra que Nietzsche teria escrito "à beira da loucura definitiva", algo que transpareceria também em suas cartas finais, o autor julga que o filósofo alemão sobrestimava demais a si próprio, possuindo traços megalomaníacos que o conduziram a julgar-se como o "reformador do mundo" e o "guia espiritual da humanidade". Pretensões estas que, embora sob a influência do delírio, em nada desvaneceriam o gênio de Nietzsche.
GEN - Grupo de Estudos Nietzsche 25 anos
Authors: Marton Scarlett ,   USP,  Brazil
Published: January 2017

Resumo trata-se de fazer um balanço, ainda que parcial, da atuação do GEN - Grupo de Estudos Nietzsche tanto no Brasil quanto no exterior nos seus vinte e cinco anos de existência.
Seasonal and spatial variation of the epilithic diatoms: case study of an organic pollution gradient in a subtropical region of southern Brazil
Authors: Salomoni Saionara Eliane ,   Universidade Estadual do Rio Grande do Sul,  Brazil, Rocha Odete , Torgan Lezilda Carvalho ,   Universidade Federal de São Carlos,  Brazil,   Museu de Ciências Naturais, Fundação Zoobotânica do Rio Grande do Sul,  Brazil
Published: January 2017

Abstract: Aim This study aimed to understand the seasonal variation of epilithic diatoms in the Gravataí River regarding their composition and density along the river, as well as the respective relationships with local limnological variables. Methods The diatoms were sampled quarterly using a EDS sampler exposed for four weeks from September 2000 to August 2002. An area of 75 cm2 was scraped off the upper surface of three submerged stones totalizing a composed sample. An aliquot of 1 ml of oxidized material was mounted on a slide for the quantitative and qualitative analysis. Results A spacial organic contamination gradient was observed in the Gravataí river due the decrease of dissolved oxygen, and increase of BOD5, total nitrogen and ortho-phosphate from the upper to the lower course and the predominance of eutrophic conditions during periods of higher temperature (spring and summer). The epilithic diatoms presented, in the upper stretch, a seasonal pattern in abundance with the highest densities during the fall and winter, the density enhance was associated to mild and low temperatures, lowest turbidity and nutrients availability. Bacillariaceae was dominant in the spring, Eunotiaceae and Bacillariaceae in the summer and fall and Gomphonemathaceae was strongly dominant followed by Eunotiaceae in winter. In the lower course Bacillariaceae was dominant in all seasons except on fall 2001. These changes were determined by the substitutions in the occurrence and relative abundance of some species as Achnanthidium minutissimum, Cocconeis placentula, Eunotia bilunaris, Frustulia saxonica, Gomphonema parvulum, Nitzchia palea and Sellaphora seminulum. Conclusions The seasonality of the diatoms was well evidenced in upper stretch of the river, therefore in the lower course with greater anthropogenic impact, fewer changes occurs in the number of species present and/or of substitution of some species by others, showing that the seasonality of the diatoms can be affected by organic contamination and eutrophication.
Paclitaxel-carboplatin chemotherapy induced hematologic toxicities among epithelial ovarian cancer patients
Authors: Charles Afandi , Dewayani Birgitta M. , Sahiratmadja Edhyana , Winarno Gatot N.A. , Susanto Herman
Published: January 2017

Background
Epithelial ovarian cancer (EOC) is one of the most common cancers diagnosed in Indonesian women. A combination of paclitaxel and carboplatin is used to treat EOC as standard chemotherapy which is known to have hematologic toxicities. This study aimed to investigate the effect of combined paclitaxel-carboplatin chemotherapy on hematologic status in EOC patients managed at Dr. Hasan Sadikin General Hospital, Bandung, West Java.

Methods
All patients with confirmed pathological diagnosis of EOC at Dr. Hasan Sadikin General Hospital in the period of 2013 to 2014 were registered. Only patients with complete hematologic data before and after chemotherapy were collected and compared using the paired non-parametric Wilcoxon and McNemar tests.

Results
In total there were 147 patients with EOC (median age 46 ± 12 years), with the most dominant pathological diagnosis of mucinous (32.7%) and serous (29.3%) types. Only 33 patients had hematologic data before the initiation of chemotherapy. There was a significant decrease after chemotherapy including hemoglobin level (12.0 vs 10.9 g/dL, p=0.013), erythrocyte count (4.53 vs 3.74 million/mL, p<0.001), leukocyte count (7,700 vs 4,000/mm3 p<0.001) and platelet count (343,000 vs 215,000/mm3, p<0.001). Interestingly, anemia cases after chemotherapy were predominant (87.9%) compared with erythopenia, leukopenia, thrombocytopenia i.e. 39.4%, 57.6%, and 27.3% respectively.

Conclusions
This study confirmed the hematologic toxicities after paclitaxel-carboplatin chemotherapy in EOC patients treated in Hasan Sadikin General Hospital, West Java. The hemoglobin concentration may serve as prognostic factor. Further studies directed to other factors such as genetic factor for polymorphisms may be encouraged to explore the decrease of the hematologic indices.
Gall bladder specimen following cholecystectomy: a resource
Authors: Giridharan Bhanumati , Madhivadhanam P.
Published: January 2017

Background: Gallbladder stones are very common and cholecystectomy is the most commonly performed surgery globally. Gallbladder stones have been reported to be the leading cause of cholecystectomies worldwide. Other mechanisms have also been known to constitute for cholecystectomy, but the evidence is still weak with the exact mechanism unknown. The present study thus aims to assess the importance of routine histopathology of the gall blabber following cholecystectomy.Methods: The study is a retrospective one that employs the use of patient records to achieve the objective.Results: The findings of the study depict a significant association between the findings of the histopathology, ultrasound and clinical features.Conclusions: The researcher presents the relevance of histopathology with respect to ultrasound and clinical presentation of the patient, thereby stating the need for a routine gall bladder specimen following cholecystectomy.
Clinico-pathological study of intestinal obstruction and its management
Authors: Shukla Samir , Kumar Krishna , Khusram Bhupesh , Damor Mahendra
Published: January 2017

Background: Intestinal obstruction is one of the most common surgical emergencies, for which the therapeutic strategy has progressed through several evolution. The aim was to study the various etiologies, spectrum of clinical features, factors affecting type of management- conservative or operative, various surgical procedures and its outcome in relation to etiological factors in patients of intestinal obstruction.Methods: It is prospective study including 200 patients fulfilling the inclusion criteria were part of this study conducted from March 2015 to September 2016 with a provisional diagnosis of intestinal Obstruction carried out in Gandhi Medical College associated Hamidia Hospital, Bhopal, Madhya Pradesh, India.Results: The patients were mostly males and from age group 30 -50 years and least were from 70-80 years. The most common clinical symptom was abdominal pain and the sign was tenderness, least common were irreducible hernia and mass per abdomen. Commonest etiology was adhesion and least was worm infestation. Most patients were treated by operative procedure in comparison to conservative management, commonest procedure done was laparotomy with resection and anastomosis and hernioplasty was least common. The histopathology study of resected specimens reveals inflammation as the commonest and the malignancy as the least one. The mortality was highest in patients of adhesions and the least in patients of obstructed hernia. Discharge rates were maximum in patients of adhesion and minimum in patients of volvulus.Conclusions: In our study it had been observed that early diagnosis, adequate preoperative hydration, prompt investigations and early operative intervention improves survival in patients of intestinal obstruction. If preoperative preparation is improved and anesthetic management is more skillful, the mortality from abdominal exploration should approach to minimum.
Breast cancer, Clinical presentations, Risk factors, Staging
Authors: Shoeb Mohammad Fazelul Rahman , Pinate Anil Reddy , Shingade Poonam Prakash
Published: January 2017

Background: Breast cancer is most common cause of cancer related mortality and second most common cause of cancer in females in India. Hence study aims to evaluate the clinical profile and risk factors of the breast cancer.Methods: This is cross sectional study done at Victoria hospital and Bowring and Lady Curzon Hospital between January 2012 to October 2012 among 50 females patients more than 18 years of age, presented with breast cancer irrespective of tumour stage, size and location and for whom preliminary diagnosis of carcinoma breast was confirmed on fine needle aspiration cytology. Preformed, pretested semi-structured questionnaire was used to collect the data regarding the risk factors and clinical presentations of the patients.Results: Maximum participants 18 (36%) were in the age group of 41-50 years, 32 (64%) patients belonged to lower class with mean age at menarche of 13.3 years. About 26 (52%) patients were in premenopausal state. In present study, 48 (96%) of the total patients were multiparous and 47 (94%) women practiced breast feeding for more than 4 months. None of the patients in this study had a family history of breast cancer. Most breast cancer patients presented with history of lump followed by pain 14 (28%) and nipple retraction 9(18%). Most of the patients 29(58%) had upper outer quadrant involvement followed by upper inner quadrant in 7 (14%).In about 26 (52%)patients, tumour size was more than 5 cm and 32 (64 %) patients had axillary lymph nodes.Conclusions: Breast cancer was predominantly a disease of middle aged, lump in breast is commonest mode of presentation with upper outer quadrant involvement and 26 (52%) patients were in stage II of TNM classification.
Is using peritoneal drains in bowel surgeries beneficial?
Authors: Bhoir Lata N. , Jagne Nilesh Y. , Murali Divya
Published: January 2017

Background: Surgical drains of various types have been used, with the best intentions, in different surgeries for many years. It is often open question whether they achieve their intended purpose despite many years of surgery. There is paucity of evidence for the benefit of many types of surgical drainage and many surgeons still ‘follow their usual practice’. The dictum ‘when in doubt, drain’ from Lawson Tait, is well known to surgeons’. But many studies we find routine placement of drain has been shown to be ineffective or potentially harmful in various abdominal surgical procedure. We thus performed a systematic review of the studies of outcomes of with or without peritoneal drain in abdominal surgeries.Methods: A comparable study was conducted in between two groups with and without drain in patient belonging to all age undergoing small and large bowel surgeries. A random patient selection was done. Pooled estimates of mortality, morbidity, wound infection, blockage, pain, anastomotic leak, re-intervention and length of hospital stay were calculated.Results: With drain; duration of stay is more than without drain with p value found to be 0.0087. Drain is ineffective due to blockage in 38% patient. Wound infection is more with drain with p (0.003). Pain is more with drain with p (0.0001). There is no difference in anastomotic leak, distension, re-intervention and mortality with or without drain.Conclusions: After a century of scientific investigation and research, all surgeons should recall the words of Halstead ‘no drainage at all is better than ignorant employment of it’ rather than the advice of Lawson Tait ‘when in doubt, drain.
Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study
Authors: Nair Sharath S. , Surendran Anilkumar , Prabhakar Rajmohan B. , Chisthi Meer M.
Published: January 2017

Background: Head injuries are a major cause of mortality and morbidity across the world. Effective initial assessment and early intervention is of importance in patients with traumatic brain injury, so as to ensure the maximum favorable outcome. Glasgow Coma Scale is the widely accepted scale to assess severity in head injury patients, albeit with many inadequacies. The objective of this study was to test the validity of full outline of unresponsiveness score, an alternate tool, in assessing severity in patients with traumatic brain injury.Methods: This was a descriptive study, conducted on 69 patients admitted to the general surgical and neuro-surgical wards of Government Medical College, Trivandrum, India with traumatic head injury. For all these patients, full outline of unresponsiveness score and Glasgow Coma Scale were calculated at the time of presentation and serially thereafter. The predictive value of full outline of unresponsiveness score as well as its correlation with Glasgow Coma Scale was studied.Results: A statistically significant correlation was found between full outline of unresponsiveness score and Glasgow Coma Scale in estimating the severity of head injury. Also Full Outline of unresponsiveness score was able to furnish better details about the neurological status of trauma patients.Conclusions: As per the results, it can be concluded that the full outline of unresponsiveness score can be applied as an ideal tool to evaluate consciousness levels and patients’ status in patients with traumatic head injury. It can be used as the ideal replacement for Glasgow Coma Scale.
A comparative study between totally extraperitoneal and transabdominal preperitoneal laparoscopic inguinal hernia repair techniques
Authors: Rambhia Samir Ushakant , Modi Rajan
Published: January 2017

Background: Laparoscopic groin hernia repair can be done by trans-abdominal pre-peritoneal (TAPP) approach and also by total extra peritoneal (TEP) approach. The objective of this study was to compare the clinical effectiveness and relative efficiency of trans-abdominal pre-peritoneal (TAPP) versus totally extra peritoneal (TEP) techniques of laparoscopic inguinal hernia repair.Methods: All the patients aged 18 years and above admitted in HBT Hospital undergoing laparoscopic inguinal hernia repair were included in this study from June 2014 to January 2016. Diagnosis was made based on history and clinical examination and ultrasound scan of the abdomen. Patients undergoing open hernia surgery and those having contra-indications to laparoscopic hernia repair were excluded from the study. The patients underwent laparoscopic TAPP or laparoscopic TEP repair of hernia based on surgeon’s preference.Results: Total 56 patients were included in the study. It was a non-randomized study, where patients were allocated in TAPP and TEP group based on surgeon’s preference. Hence, 29 patients were included in TAPP group while 27 patients were allocated to TEP group. Post-operatively all patients were evaluated for pain at 6 hours, 12 hours, 24 hours, 1week, 6 months and 1 year. They were also evaluated for length of hospital stay and any operative site complication like hematoma/seroma, wound/mesh infection, recurrence, port site hernia, persisting numbness. 2 patients in TAPP group and 3 in TEP group were lost to follow up at the end of 1 month. Further 4 patients in TAPP group and 1 patient in TEP group were also lost to follow up at 6 months. Apart from statistically significant difference in pain at 24 hours, which was more in TAPP group than TEP group, we found no other significant difference between the two methods.Conclusions: In this prospective non-randomized study comparing laparoscopic TEP and TAPP repair, for the standard parameters of duration of surgery, conversion, serious adverse event, post-operative pain, local complications, recurrence both locally and port site and length of hospital stay, we had a follow up of 1 year which is adequate for most parameters except recurrence. Our follow up does not allow us to make any conclusion about recurrence. Though the patient numbers are small, our study resonates with the larger studies regarding most parameters. This study leaves us none the wiser as to the superiority of one technique and hence, it is the individual surgeon’s preference and proficiency which dictates the choice of procedure.
Frequency of infra-orbital nerve injury after a Zygomaticomaxillary complex fracture and its functional recovery after open reduction and internal fixation
Authors: Noor Maria , Ishaq Yaser , Anwar Malik Adeel
Published: January 2017

Background: Maxillofacial injuries are on the rise and the etiology of maxillofacial injuries varies from one country to another because of social, cultural and environmental factors. Road traffic accidents (RTAs) are still the most common cause of maxillofacial injuries. Nerve injury following fracture may involve traction, pressure, ischemia, inflammation and physical damage; therefore fractures of Zygomaticomaxillary complex (ZMC) are characterized by sensory neuropathy in the area of innervation of infra-orbital nerve both as presenting symptom and as a postop complication. The objectives of the study were to investigate the frequency of infra-orbital nerve paresthesia following ZMC fractures and determine the frequency of functional nerve recovery in patients with paresthesia treated with open reduction and internal fixation.Methods: Patients (n = 75) qualifying our inclusion criteria were selected, examined, reduced by surgery and followed up.Results: A total of 75 patients were included in the study with male: female ratio of 5:3. Mean age was 37.43±3.78 years, with majority of patients (72 %) presenting with RTAs. Infra-orbital nerve paraesthesia was found to be positive in 70.67% (n = 53) patients with 62.26% (n = 33) patients with functional nerve recovery after 3 months.Conclusions: Prognosis of infra-orbital nerve recovery after a Zygomaticomaxillary complex fracture can be enhanced by open reduction and internal fixation.
Hydrostatic reducibility of intussusception among different age groups in paediatric population-a descriptive study
Authors: Haridas Sreejith , S. Vineed , Sivakumar K.
Published: January 2017

Background: Intussusception is one of the most frequent causes of bowel obstruction in infants and toddlers. In children, it is often an idiopathic condition and treated non-surgically by radiologic reduction. Primary aim of study was to analyse the outcome of hydrostatic reduction of intussusception across different paediatric age group patients admitted in a medical college hospital.Methods: This is a hospital based descriptive study conducted in tertiary care centre for one year duration in 2014-2015. 90 patients admitted with diagnosis of intussusceptions for hydrostatic reduction were interviewed with the proforma and details were collected. The procedural detail of hydrostatic reduction was also collected. Patients were followed up for a period of 48 hours post successful hydrostatic reduction.Results: Hydrostatic reducibility of intussusception was 63.3% in less than 3 months age group compared to 93.3% each in other two groups. Overall hydrostatic reducibility was of 83.3%, while 16.7% went for laparotomy. First group had 36.7% cases gone for laparotomy. Analysis of each of the study variables was done to find out their association with hydrostatic reducibility. Only duration, bleeding per rectum, lethargy, dehydration, side of lesion and total count were found to have a statistically significant p value. Logistic regression analysis of the above five variables revealed that only the ‘duration of symptoms’ had a statistically significant independent association with hydrostatic reducibility of intussusception ,with a p value of 0.033 and odds ratio 12.477. 5.3% of cases of first group had recurrence within 48 hours of hydrostatic reduction, while 10.7% and 21.4% of cases from second and third group respectively had recurrence within 48 hours of reduction. Overall recurrence of intussusception within 48hours is 13.3%.Conclusions: Hydrostatic reduction of intussusception is more successful in paediatric age group > 3 months compared to < 3 months. Shorter duration of symptoms, especially < 48 hours may have a favourable effect on hydrostatic reducibility of pediatric intussusception. Rate of recurrence of intussusception within 48 hours of successful hydrostatic reduction is 13.3 per 100 paediatric cases.
Efficacy and safety of ultrasound guided foam sclerotherapy with sodium tetradecyl sulphate for residual and minor varicosities
Authors: B. S. Madhu , H. B. Shashi Kumar , Reddy M. Naveen Kumar , Kalabhairav Sangeetha , Reddy V. Abilash
Published: January 2017

Background: Ultrasound-guided foam sclerotherapy (UGFS) is becoming an accepted standard of treatment varicose veins. It is a relatively safe, effective inexpensive method in limited, small varicose veins.This study aims to assess the safety and efficacy of UGFS using sodium tetradecyl sulphate (setrol) in patients presenting with minor varicosities and residual varicosities of lower limb.Methods: 78 patients with minor varicosities or residual varicosities post-surgery who presented between January2015 and June2016 at KR hospital attached to Mysore Medical College and Research Institute, Mysuru, underwent ultrasound-guided foam sclerotherapy with 0.5ml (at a single session) setrol prepared as a foam by Tessari technique. The efficacy criterion was the disappearance of the varicosities and improvement in symptoms and signs: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up.Results: Decrease or withdrawal of complaints was reported in 96% of cases (74 patients). Disappearance or decrease of varicose veins was observed in all patients (100%). Phlebitis and pigmentation as a complication was noted in 5 (7%) and 9 (11.5%) cases respectively. Major complications, such as deep vein thrombosis, pulmonary embolism, dyspnoea, anaphylaxis, or neurological abnormalities, were not reported.Conclusions: Ultrasound-guided foam sclerotherapy for minor varicosities and residual varicosities with sodium tetra decyl sulphate is a safe and satisfactory method of treatment of minor and residual varicosities.
The use of ultrasonographic and Alvarado scores in evaluating abdominal pain suggestive of acute appendicitis
Authors: Álvarez Jorge Fernández , López José Manuel Gómez , Chávez Alberto M González , Acosta Benjamín Valente , Hénandez Diego Abelardo Álvarez , Pascual Silviano Ríos , Vázquez Alain Arturo García
Published: January 2017

Background: Ultrasonographic scores for appendicitis to determine if, combined with Alvarado scores, they can increase the sensitivity and specificity of the diagnosis of appendicitis.Methods: All cases of abdominal pain suggestive of appendicitis presented between 2013 and 2015 were analysed. An Alvarado score was obtained. All patients underwent ultrasound, and an ultrasonographic score was determined, including the appendicitis classical findings.Results: Two hundred and fifty-one patients with abdominal pain in the right lower quadrant were analysed. Appendicitis was confirmed in 211 (84%) patients. For these patients, the average Alvarado score was 7.95/10 (±1.25) vs. 5.7/10 (± 1.11) for patients who did not have appendicitis (p < 0.001). In patients with confirmed appendicitis, the average ultrasonographic score was 2.48/6 (± 1.06) vs. 0.6/6 (± 0.92) for patients who did not have acute appendicitis (p < 0.001). The ultrasonographic score has a sensitivity of 90% and a specificity of 87% with only two parameters. The combination of the Alvarado and ultrasonographic scores decreased the percentage of negative appendectomies to 2.36% and increased the area under the curve by 0.970.Conclusions: The sum of the Alvarado and ultrasonographic scores provides an efficient alternative for diagnosing abdominal pain suggestive of appendicitis and predicts which patients should undergo surgery with good certainty.
Synchronous liposarcoma of pancreas and stomach: a case report and literature review
Authors: Jiang Hua-Feng , Ying Xiao-Jiang
Published: January 2017

Liposarcoma is a common soft tissue sarcoma. However, its occurrence in pancreas or stomach is extremely rare. In the present study, a rare case of a 55-year-old female with sclerosing liposarcoma in pancreas and stomach is presented.  Ultrasound, magnetic resonance imaging and computed tomography examinations were performed, which revealed a pancreatic mass. Subsequently, the patient underwent surgical resection of the tail of the pancreas and spleen and partial resection of stomach following the identification of a second mass. After surgery, the patient received no adjuvant treatment. Subsequent to 3 years of clinical follow up, the patient remains alive without recurrence or distant metastasis so far. As far as we know, this is the first reported case of sclerosing liposarcoma involving pancreas and stomach.
An outline of data management in clinical research
Authors: Matkar Sunmeet , Gangawane Ajit
Published: January 2017

Clinical data management (CDM) is an indispensable part of clinical research. CDM activities lead to the collection of reliable, high-quality and statistically sound data generating from the clinical trials. Several studies suggest that such data helps in extreme reduction in time from drug development processes to the marketing stage. Several practices in CDM including CRF annotation, case report form (CRF) designing, data extraction, data entry, data validation, database designing, database locking, discrepancy management and medical coding are evaluated for quality checks at regular intervals during clinical trial. In recent times, the huge gap about improvements of the CDM standards for meeting the regulatory requirements remains to be filled. Fulfilling these requirements will help the clinical trial sector to stay ahead of the game. The current article accentuates the practices followed and activities involved in CDM. Therefore, it enables the reader an outline of management of data in the clinical research.
Effects of self-conditioning techniques in promoting weight loss in patients with severe obesity: a randomized controlled trial protocol
Authors: Bo Simona , Rahimi Farnaz , Properzi Bice , Regaldo Giuseppe , Goitre Ilaria , Ponzo Valentina , Boschetti Stefano , Fadda Maurizio , Ciccone Giovannino , De Francesco Antonella , Abbate Daga Giovanni , Mengozzi Giulio , Belcastro Sara , Broglio Fabio
Published: January 2017

Background: Obesity is a worldwide epidemic; most obese individuals who lose weight after lifestyle educative treatments, soon regain it. Our aim is to evaluate the effectiveness of a training to teach self-conditioning technique (self-hypnosis) added to standard care in determining weight loss compared with standard care in patients with obesity

Methods: This randomized controlled open trial will recruit 120 obese patients (BMI 35-50 Kg/m2), aged 20-70 years. The control group will receive a traditional approach: diet + exercise + behavioral recommendations. The experimental group will receive self-conditioning techniques + traditional approach.

Three individual sessions of hypnosis with rapid-induction techniques will be administered by trained personnel. All the participants of both groups will be assessed at three, six, nine and twelve months after randomization. The primary outcome is weight loss difference between groups at 12 months after randomization; secondary outcomes are changes in adherence to dietetic and exercise recommendations, appetite and satisfaction/well-being, waist circumference and body fat, blood pressure and blood metabolic and inflammatory variables.

Conclusions: The results of this trial will assess whether a self-conditioning approach, based on self-hypnosis, is able to help participants to modulate unhealthy patterns of eating and sustain weight loss in the long term.
Protocol for a randomized trial on nausea, vomitus and arterial hypotension comparing carbetocin and oxytocin as prevention for hemorrhage after cesarean section
Authors: V. Ann , M. Dominique , L. V. D. Veeken , D. M. Katrien , C. Hilde , J. Yves
Published: January 2017

Background: To prevent hemorrhage after cesarean section uterotonics are often administered after fetal extraction. At this moment two frequently used and available products are short working oxytocin and its long working analogue, carbetocin. Both have proven and similar efficacy. Side effects are nausea, vomitus and arterial hypotension resulting in dizziness. Differences in nausea, vomitus and blood pressure changes between oxytocin and carbetocin have been studied as secondary outcome measures only and results have been conflicting.  The aim of the present study is to compare nausea, vomiting and changes in blood pressure between carbetocin and oxytocin used as prevention for postpartum hemorrhage after cesarean section.

Methods: Patients are women undergoing a planned term cesarean section for singleton pregnancy without other medical complications. One hundred patients will be randomized to receive either a single intravenous dose of 100 microgram carbetocin, either an intravenous bolus of 5 units of oxytocin followed by 10 units of oxytocin over 24 hours. As primary outcome nausea and vomitus are evaluated before, during and immediately after surgery, using a standard scale, blood pressure is automatically measured every three minutes. Secondary outcome measures are the difference between pre- and postoperative hemoglobin and the need for additional uterotonics. Analysis will be based on intention to treat.

Conclusions: This study will offer data on the difference in clinically relevant side effects between carbetocin and oxytocin helping clinicians to choose between both products in low risk cesarean sections.
Comparison of esmolol versus combination of esmolol and fentanyl in preventing cardiovascular stress response to intubation
Authors: Bhalke Rahul , Karale Maroti S. , Deshmukh Umesh
Published: January 2017

 

Background: A number of cardiovascular responses occur during laryngoscopy and intubation which can have serious consequences during anaesthesia.We planned to conduct a study to evaluate effectiveness of intravenous Esmolol and intravenous Fentanyl in attenuating hemodynamic stress response to laryngoscopy and endotracheal intubation.

Methods: A prospective, observational, randomized, double blind comparative clinical study, conducted on 60 cases of ASA grade I/II patients undergoing elective abdominal surgery under general anesthesia. The data obtained was divided in the two groups based on drug used 5 min prior to induction, Group 1 (I.V. Esmolol 2 mg/kg) and Group 2 (I.V. Esmolol 2 mg/kg & I.V. Fentanyl 2 µg/kg). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured at various time intervals.

Results: There was no significant difference in HR, SBP, DBP, MAP after premedication and induction in both the groups. However at intubation, both groups showed an increase in HR, SBP, DBP and MAP but the rise was attenuated in both groups. Increase in HR was more in group 1 as compared to group 2 and it was statistically significant at 01 and 02 minutes post intubation. The increase in SBP was statistically significant at 00, 01 and 02 minutes post intubation. The increase in MAP was statistically significant immediately after induction, at 00, 01, 02, 05 and 10 minutes post intubation.  

Conclusions: Combination of intravenous Esmolol and intravenous Fentanyl is more effective in attenuating heart rate, systolic, diastolic and mean arterial pressure response to intubation than intravenous Esmolol alone.
Clinical appraisal of Lodhradi Kashaya on type 2 diabetes mellitus patients
Authors: Singh Varun K. , Reddy K. R. C.
Published: January 2017

Background: Lodhradi Kashaya (LKSD) is basically ayurvedic kwath dosage form, described as Madhumehajeet (winner of diabetes mellitus) in ayurvedic classics Basavarajeeyam and the same formulation in Vaidya Chintamani and Charaka Samhita too. The aim of this study was to assess prospectively the drug’s ability in management of type 2 diabetes.

Methods: Total 31 patients were taken following the guideline mention in CCRAS protocol for diabetes mellitus research. They are divided into two groups, group A and B, given LKSD 4 g & 2 g TDS respectively for three-month follow up. They are investigated against their blood glucose, HbA1C and liver profile tests. Patients were also investigated for subjective parameters viz polyurea, polyphagia, exhaustion and constipation and their response has also been noted regarding palatability acceptance and ease of administration.

Results: Patients has responded positively for formulation. Decrease in FBS and PPBS were found highly significant (P ˂ 0.001) in both groups but more in higher dose (group A). Decrease in HbA1C is also found highly significant in both groups. In LFT, SGOT level were also decreased more in group B in comparison to group A, and it is significant (P = 0.017 and 0.002). SGPT level were also decreased more in group B in comparison to group A, and it is significant in group B (P= 0.085 and 0.002).  

Conclusions: LKSD is having astringent taste due to tannins and phenols in it. It was found significant not only in controlling blood sugar but also in management of other factors related to diabetes mellitus.
Beliefs and practices of newborn feeding in tribal areas of India: a decennary review
Authors: Srikanth Latha , Subbiah Kamala , Srinivasan Srikanth
Published: January 2017

Background: Newborn feeding among tribes in India is influenced by traditional beliefs and practices.  Each tribal community has its own unique feeding practices which have considerable impact on the health and survival of infants. Information about these practices is vital in planning effective child health services.Methods: A review of published articles in Google Scholar and Pubmed databases during the period 2006 to 2016 was carried out to retrieve information on newborn feeding practices in tribal areas in various parts of India. Prelacteal feeding, feeding of colostrums and time of initiation of breastfeeding were considered for analysis.Results: Thirteen full text studies were reviewed. It was observed that the newborns had been fed with prelacteal feeds such as plain water, sugar or salt solution, honey, diluted cow’s milk and milk mixed with jaggery. The beliefs were that these feeds help to resist hunger, clean the tongue and stimulate suckling. The common beliefs for delayed initiation of breastfeeding were that it was harmful or not ready to be fed for 3 days. The reasons for discarding colostrums were that it was impure, causes indigestion or diarrhea. These harmful practices were observed to be prevalent among most of the tribes in different geographic locations of India.Conclusions: There is a need to explore the area specific tribal cultural feeding beliefs and practices. This could enhance the knowledge of healthcare providers to promote proper newborn rearing.