bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypothyroidism in pregnancy: the scourge of the hills
Authors: Chakravarty Rony , Bajaj Varun , Nair Rajesh , Gupta Ramkumar , Rao Pankaj P.
Published: May 2018

Background: Hypothyroidism is a causal agent sub serving a multitude of complications in pregnancy. There is a lot of controversy regarding universal screening for thyroid abnormalities during pregnancy. An attempt was made to ascertain the incidence of hypothyroidism during pregnancy in a peripheral hospital.Methods: All patients reporting to ANC OPD were subjected to thyroid profile and results tabulated as per ATA guidelines 2017. Patients with clinical hypothyroidism were followed up with treatment to look for condition related complications if any. Complications despite treatment were noted and included only after ruling out masquerading mimickers or co existent conditions.Results: An incidence of 14.46% per two years was detected with hypothyroidism.Conclusions: The need for universal screening for hypothyroidism is inescapable particularly in hilly terrain.
A study of thyroid profile in cases of primary infertility attending a tertiary care hospital of south India
Authors: B. Anitha Nirakari
Published: May 2018

Background: Infertility is a rising major problem affecting more than 50 million couples globally every year. Endocrine as well as immune system abnormalities can impair the fertility. Most of the studies globally indicated association of infertility with multiple factors like stress, luteal phase defects, structural and functional reproductive disturbances. Many infertile women with thyroid dysfunction had associated hyperprolactinemia with increases TSH in ovulatory dysfunction. The aim of the present study was to determine the association of hypo and hyperthyroidism with infertility among cases of primary infertility in women.Methods: A cross sectional study was conducted among the patients attending the infertility clinic for the first time. The study was approved by the institutional ethical committee and the study was carried as per the guidelines of the ethical committee. The serum levels of T3, T4 and TSH were estimated and Prolactin in cases where necessary by Chemiluminiscence immunoassay. The data was analyzed by using the unpaired “t” test. A ‘p’ value <0.05 was considered significant.Results: 285 cases were enrolled and majority (38.6%) was in 31-34 age groups with mean age of 24.2± 1.6 years. 30.53% were found with thyroid dysfunction. Majority (16.49%) were found with subclinical hypothyroid, followed in order by primary hypothyroid (9.82%), subclinical hyperthyroid (2.11%), primary hyperthyroid (1.05%), secondary hypothyroid (0.70%) and secondary hyperthyroid (0.35%).Conclusions: To conclude, thyroid dysfunction is a common cause of infertility and can be easily managed by correcting the levels of thyroid hormones. Present study suggests that thyroid replacement therapy in subclinical hypothyroidism at an early stage is justified in infertile women. Borderline variations in TSH levels should not be ignored in infertile women who are otherwise asymptomatic for subclinical hypothyroidism. Hence for better management of cases of primary infertility studies with large sample size and long term follow up are required to validate and justify the variation in TSH and prolactin levels.
A study of syndromic and etiological approach for the diagnosis of reproductive tract infections
Authors: Saharan Surbhi
Published: May 2018

Background: Reproductive tract infections (RTIs) are one of the most common and major health problem around the world and they are much more widespread in developing countries than in developed countries due to Inadequate health services.Methods: Detailed history including, menstrual, obstetric and sexual history of the patients were taken and general, physical and local examination was done and clinical symptoms and sign were noted using a structured screening proforma.Results: In our study syndromic approach has a moderate diagnostic accuracy in detecting vaginal discharge syndrome and pain abdomen syndrome. Syndromic diagnosis is low cost effective, more acceptable and easily available at primary and secondary health centre. It should be continued as first line management.Conclusions: In present study the vaginal discharge syndrome has sensitivity of 64.71% and specificity of 57.14%, PPV 61.11%, NPV 60.87% and accuracy is 61%. If treatment is given only on the basis of syndromic approach for vaginal discharge syndrome it results in over-treatment in 42.86% (false positive) and under diagnosis in 35.29% (false negative). This approach was found less effective. For lower pain abdomen syndrome the sensitivity is 21.74% and specificity is 84.62%, PPV 38.46%, NPV 70.97% and accuracy is 65.33%. If treatment is given only on the basis of syndromic approach for lower pain abdomen syndrome results in over -treatment in 15.38% (false positive) and under diagnosed 78.26%.(false negative). This approach was found less effective.
A study on rapid diagnosis (by PCR) and cost-effective treatment of pulmonary mycosis
Authors: Kumar Saurabh , Shaifali Iram , Chandra Shalini
Published: May 2018

Background: Incidence of Pulmonary Mycosis is rampantly growing in critically ill patients. This study was designed to comparatively evaluate conventional and molecular method-Polymerase Chain Reaction (PCR) for detecting Candida and Aspergillus species in Brocho-Alveolar Lavage (BAL) samples and secondarily to find out the Cost-Effective treatment for Pulmonary Mycosis.Methods: In this study 100 BAL-specimens were collected from patients suspected of Pulmonary Mycosis. These samples were examined for Aspergillus and Candida species by preparation of wet smear using potassium hydroxide, Gram staining, Culture media and Polymerase Chain Reaction (PCR). For Cost-Effectiveness analysis(CEA), a decision tree model was constructed for Anidulafungin and Fluconazole The probability of treatment success and mortality rate were extracted from published Randomized Control Trials. Incremental Cost Effectiveness Ratio (ICER) was calculated.Results: Out of 100 samples, 22 were found to be positive for mycotic infections, 9 were detected as Candida and 13 as Aspergillus. On comparing with KOH and Culture, it was observed that all KOH positive and all Culture positive fungal infections were PCR positive. In no cases PCR negative was identified either culture or KOH positive. This establishes the superiority of PCR over conventional diagnostic methods. Anidulafungin was associated with an Incremental Cost Effectiveness Ratio (ICER) of INR 1,13,217 per LY saved, which was below the implicit ICER threshold for India.Conclusions: PCR is a novel molecular method for early and definitive diagnosis of fungal infection and Aidulafungin appears to be the cost-effective drug for treatment of Pulmonary Mycosis.
Evaluation of serum hepcidin as a biochemical marker in diagnosis of anemia of chronic disease
Authors: Vyas Sonal , Suman Sanjeev , Kapoor Anil , Nema S. K.
Published: May 2018

Background: Anemia is a serious public health problem. It affects two billion people worldwide, particularly infants and young children mainly in developing countries where its etiology is multifactorial. Anemia in infancy is generally associated with impaired cognitive and behavioral development, impaired oxygen transport and a poorer prognosis in the context of many chronic diseases or chronic infections. The Present study aims to detect the serum hepcidin and ferritin levels in chronic disease anemia and correlate the values of serum hepcidin levels with their serum ferritin levels and IL-6 levels.Methods: A total of 86 individuals were enrolled in the study. Sample for hematological evaluations were collected and estimation was carried out for biomarker estimation by ELISA method(s) using specified kit(s) procured commercially. The statistical evaluation was done using SPSS version 24.0. Analysis of variance (ANOVA) and Pearson's correlation tests were used to compare the variables and to see the correlation between the different variables.Results: In present study, we observed statistically significant lower values of RBC count, Hbgm/dl, MCV, MCH, MCHC in ACD group than the normal group. For serum hepcidin when ROC curves and Pearson’s scattered plot were made in case of ACD group; the ROC was recorded to be maximum >0.869; with a sensitivity of 84.62% and specificity 94.12% while the confidence level was 95% with an interval of 0.779 to 0.932. Further, the cutoff point determined was >72.93. Thus, the hepcidin level > 72ng/mL and above is related to the ACD. These cut off points had strong confidence interval and valuable predictive potential.Conclusions: Serum Hepcidin can be used as a simple and cost effective diagnostic marker for identification of anemia.
Clinico epidemiological and mycological study of pityriasis versicolor PITYRIASIS VERSICOLOR
Authors: Snekavalli R. , Madhu R. , Ramesh A. , Janaki C. , Dhanalakshmi U. R.
Published: May 2018

Background: Pityriasis versicolor, a chronic superficial fungal infection caused by lipophilic yeasts of the genus, Malassezia is a common infection in the tropical and subtropical regions. Objective was to study the epidemiology, clinical presentation, associations, etiological agents and clinico-mycological correlation of pityriasis versicolor.  Methods: Hundred patients with clinical diagnosis of pityriasis versicolor who attended the mycology out-patient (OP) clinic between September 2014 and August 2015 were enrolled. Skin scrapings from these patients were subjected to 10% potassium hydroxide (KOH) and culture.Results: Out of the 100 patients with pityriasis versicolor (PV), 70% were males and 30% were females and the most affected age group was between 21-30 years (43%). The youngest age affected was a 13 years old male while the oldest was a 65 years old male. Duration of the infection ranged between 1 month to 6 months in 65% while it was more than 1 year in 9% of patients. Recurrence was observed in 35% of them. Back was the most common site (48%) to be involved. Seventy percent of patients had more than 30% body surface area involvement. Achromic type of PV was the most common clinical presentation in 68% of patients. Out of the 76 isolates, Malassezia globosa was the predominant isolate (48.7%), followed by M. sympodialis (25%), M. furfur (10.5%), M. restricta (7.9%) and M. obtusa (6.6%).Conclusions: Achromic type of PV is the most common clinical presentation. Malassezia globosa is the most common etiological agent of pityriasis versicolor.
Serum hepcidin and interleukin-6 as biochemical markers in differentiation of iron deficiency anemia and anemia of chronic disease
Authors: Vyas Sonal , Suman Sanjeev , Kapoor Anil , Nema S. K.
Published: May 2018

Background: Iron deficiency (ID) is the most prevalent nutritional deficiency and the most common cause of anemia in the world. It is defined as a reduction in total body iron to an extent that iron stores are fully exhausted and even some degree of tissue iron deficiency results. The Present study aims to compare the serum hepcidin and IL-6 levels in anemia of chronic disease (ACD) and iron deficiency anemia (IDA) groups and correlate the values of serum hepcidin levels with their serum ferritin levels and IL-6 levels.Methods: A total of 112 individuals were enrolled in the study. Samples for hematological evaluations were collected and estimation was carried out for biomarker using ELISA method(s) using specified kit(s) procured commercially. The statistical evaluation was done using SPSS version 24.0. Analysis of variance (ANOVA) and Pearson's correlation tests were used to compare the variables and to see the correlation between the different variables.Results: In present study, we compared the values of RBC count, Hb gm/dl, MCV, MCH, MCHC in ACD and IDA group. Serum Hepcidin, a marker of iron deficiency anemia was significantly low in case of IDA 33.23±12.46ng/mL, on the contrary in case of ACD group the serum hepcidin level was elevated 98.36±24.29ng/mL. It is found that IL- 6 plays an important role in the regulation of hepcidin as reflected especially in ACD and IDA groups. In case of IDA the level of IL6 was significantly reduced to an average concentration 7.62±3.51ng/mL on the contrary in case of ACD group the serum IL-6 level was elevated to 115.82±33.7ng/mL. Thus, it provides for conclusive differentiation or diagnosis of iron deficiency anemia and anemia of chronic disease.Conclusions: Serum Hepcidin can be used as a simple and cost effective diagnostic marker for differentiation of iron deficiency anemia and anemia of chronic disease.
Clinical profile and outcome of organ dysfunction in sepsis
Authors: Dash Laxmikanta , Singh Lagendra Kumar , Murmu Malati , P. Susruth Krishnadas , Kerketta Amita , Hiregoudar Mrutyunjay B.
Published: May 2018

Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%.
Can vein patch interposition after sapheno-femoral ligation prevent postoperative neovascularization at the saphenofemoral junction?
Authors: Goda Asser Abd El-Hamid
Published: May 2018

Background: Majority of recurrence of varicose veins following both primary and repeated surgery was attributable to neovascularization. The aim of this study was to evaluate the efficacy and safety of the new natural origin anatomical barrier (vein patch) in decreasing neovascularization after initial surgery.Methods: The study included 50 patients with primary varicose vein and incompetence of SFJ. The patients are divided randomly into 2 groups, group (A) (conventional surgical group) and group (B) (barrier technique group), each one included 25 patients. In group (A) SFJ ligation with ligation of all the tributaries and stripping of great saphenous vein (GSV) in the thigh portion was done. In group (B), after conventional surgical procedure was done vein patch was taken from striped LSV. The vein patch was applied on the cribriform fascia opening. This barrier of vein patch is reinforced by good tight subcutaneous tissue suture.Results: Neovascularization was seen on duplex in 4 (16%) limbs of group (A) conventional surgical group at one year follow up, but in group (B) barrier technique group neovascularization was seen only in one (4%) limb. Groin infection was registered in 3 (12%) limbs, 2 (8%) of them in group (A) conventional surgical group and the third one (4%) in the group (B) barrier technique group.Conclusions: Vein patch interposition after correctly SFJ ligation seems to lower the incidence of neovascularisation after one year. This technique may constitute additional option to prevent recurrence.
A community based screening of gestational diabetes mellitus within 16 weeks of pregnancy: a study from Mysuru district, Karnataka
Authors: Sinha Abhishek Kumar , B. Madhu , M. R. Narayana Murthy
Published: May 2018

Background: Gestational diabetes mellitus is defined as carbohydrate intolerance with onset/recognition during pregnancy where maternal and perinatal complications are increased. Aged care facilities in rural areas reports disparity in the management of gestational diabetes as compared with urban counter parts. As a need to address this, study conducted with objective to estimate prevalence of gestational diabetes mellitus within 16 weeks of gestation for GDM by oral glucose challenges test.Methods: Antenatal mothers attending primary health centers within 16 weeks of gestation were screened for GDM. Two hours, venous samples were calculated for estimation of blood glucose level. Plasma glucose level of >140mg/dl was considered as OGTT positive.Results: Among 301 patients examined 11 mothers had OGTT positive results. GDM was seen in 3.7% of Mothers. GDM is found significantly associated with increasing age (p=0.01, t=2.52, mean difference 2.54 CI 0.5-4.5), weight (p=0.04, t=2.24, mean difference 10.8 CI 0.11-21.5), and BMI (p<0.01, t=2.97, mean difference 3.6 CI 1.2-6). GDM was seen more in multigravida (P=0.01). Statistically significant association of GDM was found with mean systolic (p<0.01, t=2.62, mean difference 8.08 CI 2.01-14.14) and diastolic blood pressure (P<0.01, t=3.44, mean difference 7.87 CI 3.38-12.36). A multiple regression shows these variables statistically significantly predicted GDM, F (5, 295)= 7, p<0.001, R2=0.106.Conclusions: GDM is statistically associated with increasing age, increasing weight, BMI and multiple gravida in pregnancy. It is recommended to screen for GDM within the 1st trimester & follow up needed to prevent further complications.
Prevalence of rifampicin resistant mycobacterium tuberculosis and associated factors among presumptive tuberculosis patients in eastern Uttar Pradesh: a cross sectional study
Authors: Gautam Praveen B. , Mishra Ashwini , Kumar Santosh
Published: May 2018

Background: Drug resistant tuberculosis threatens global TB control and is a major public health problem in several countries and India has the highest tuberculosis in the world. The rifampicin resistance is a good predictor of multidrug resistant tuberculosis. The aim of this study was to determine the prevalence of rifampicin resistance M. tuberculosis and associated factor among presumptive tuberculosis patients in eastern Uttar Pradesh.Methods: A cross-sectional study was conducted from October 2016 to September 2017. Detection of M. tuberculosis and resistance to rifampicin was performed using Gene Xpert MTB/RIF assay. Data was collected using pre-structured questionnaire by face to face interview. The chi-square test was used to assess the statistical significance of each ratio, p<0.05 was considered significant.Results: Out of 510 patients, Mycobacterium tuberculosis was detected in 168 (32.9%). Out of these 168 patients, the prevalence of rifampicin resistance tuberculosis was 44 (26.1%). It was higher among male 38 (30.6%) than female 6 (13.6%). Regarding age distribution, maximum numbers of rifampicin resistance patients were in the age group of 20-40 years 36.7%. The prevalence of rifampicin resistance was 36 (27.6%) and 8 (21.0%) in pulmonary and extra-pulmonary respectively. Out of 44 rifampicin resistant cases, 39 (37.8%) were previously treated and 5 (7.6%) cases were treatment naïve patients. In this study, among presumptive DRTB cases, new 2 (11.7%), relapse 13 (39.3%), failure 23 (46.0%), loss to follow-up 1 (10.0%) and MDR contact 1 (20.0%) respectively were rifampicin resistant and one HIV seropositive patient was found to be rifampicin resistant.Conclusions: Previously treated cases were significantly associated with rifampicin resistance tuberculosis. The Gene Xpert is a good equipment for rapid detection and management of drug resistant tuberculosis for both pulmonary as well as extra-pulmonary tuberculosis.
Study of the knowledge regarding reproductive health among the second PUC students from the colleges of Bangalore city
Authors: Menzil Margaret , L. N. Deepa
Published: May 2018

Background: According to an analysis by the World Bank and WHO, reproductive ill-health accounts for over 30% of the overall burden of disease and disability among women, compared with 12% for men. Reproductive health of adolescent girls is crucial since it determines the health of future generations to come. With this in background we conducted a study to find out the difference in the knowledge among the science and the non-science students and to find the relationship between the knowledge scores regarding the reproductive health with respect to select variables.Methods: A cross sectional study was done during July 2004 and January 2005, on 600 girl students (300 each from science and non-science stream) using a pre validated self administered questionnaire amongst II PUC students.Results: 68% science students knew that RTIs can be caused by unhygienic conditions, bacterial infections, STDs and unsafe abortions when compared to only 28% non-science students who knew the cause of RTIs. 64% Science students knew that the predominant routes of HIV transmission is unsafe sex, unsterilized instruments, contaminated blood transfusion, infected mother to child as compared to only 42% non-science students.74% science students knew that STDs can be prevented by use of condoms as compared to only 44.3% non-science students.Conclusions: The science students were found to be more knowledgeable than the non-science students.
The incidence of elongated styloid process in chronic tonsillitis
Authors: Pandurangarao Santosh Uttarkar , Panicker Raga , Jonnalagadda Dheeraj Kumar , Ramachandra Aravind Darga , Janarthanan Sridurga
Published: May 2018

Background: The styloid process is a conical projection of the temporal bone lateral to the jugular foramen, and is of variable length. The objective of this study is to know the incidence of elongated styloid process in patients presenting with chronic tonsillitis, and whether x-ray Towne’s view should be part of preoperative evaluation.

Methods: A prospective study was conducted on 160 patients who attended ENT OPD with symptoms of chronic tonsillitis. Towne’s view x-rays were taken and elongated styloid process looked for.  

Results: 73.4% of patients with chronic tonsillitis have associated elongated styloid process.

Conclusions: X-ray Towne’s view should be considered as part of routine preoperative evaluation in patients with chronic tonsillitis. 
Surgical management of mallet finger with extension block pinning
Authors: Sadiq Mohammed , Kulkarni Vikrant
Published: May 2018

Background: Various surgical and nonsurgical treatments have been described in the management of mallet finger. The purpose of this study is to evaluate the effectiveness of extension block pinning in the management of displaced mallet finger fractures.

Methods: We conducted a retrospective study in which extension block pinning was done for displaced Mallet finger fractures. We included 10 patients in our study who were treated between 2016 and 2018. Fractures were classified according to Wehbe and Schnieder’s classification. All the procedures were done using ring block anaesthesia. Postoperative radiographic assessment was done at each follow up at 15 days interval. Wires were removed after radiologic confirmation of fracture healing. Assessment of the outcome was done using Crawford’s criteria.

Results: According to Wehbe and Schnieder’s classification IIB type was the most common. All fractures involved more than 30% of articular surface. Average operative time was 30 mins. Congruent anatomical reduction was achieved in all the patients (intrarticular step off less than 1 mm). Average healing time of the fractures was 40 days. Seven out of the ten patients had excellent results. No wire related complications were seen in our patients.

Conclusions: Extensor block pinning when performed accurately is an easy, economical and effective technique in treatment of mallet fingers.
Clinical outcome of primary cemented hemiarthroplasty in unstable trochanteric fractues in elderly patients
Authors: Mukherjee Jayanta , Ganguli Ritwik
Published: May 2018

Background: Management of unstable trochanteric fracture in elderly patients is challenging due to poor bone quality. Fracture stabilization and early mobilization is very important in preventing the complications. Fixation of the fracture with proximal femoral nail and dynamic hip screw has its complication and it takes time to mobilization of the patient after consolidation of fracture. Cemented bipolar hemiarthroplasty in osteoporotic unstable comminuted trochanteric fracture helps in early mobility and reduces complications.

Methods: We prospectively analyzed 20 cases of cemented hemiarthroplasty in unstable intertrochanteric fractures. The functional outcomes were assessed based by Harris hip score.

Results: The functional outcome measured with Harris hip score is excellent to good in most of the patients.

Conclusions: Primary cemented hemiarthroplasty in unstable trochanteric fracture in elderly results in early ambulation with good functional outcome.
Functional outcome of humeral shaft fractures in adults treated with titanium elastic nailing
Authors: Patel Ishani , Modi Dhaval R. , Patel Mansi
Published: May 2018

Background: This study was done to analyse the functional outcome of humeral shaft fractures (upper and middle third) managed with closed ante-grade intramedullary titanium elastic nailing.

Methods: This was a prospective study of 20 patients, aged between 18 and 60 years, with humeral shaft fractures treated with titanium elastic nailing from May 2016 to April 2018 at our institute. Upper and middle humeral shaft fractures of both sexes were included in the study.

Results: Eighteen (90%) fractures united in 12-20 weeks. Two (10%) patients had delayed union which ultimately united without any intervention. Two (10%) patients developed shoulder stiffness due to nail impingement. By evaluating ASES score, good to excellent results were noted in 18 (90%) and moderate in 2 (10%). There were 15 males and 5 females with an average age 32.75 years (range: 18-60 years).

Conclusions: Titanium elastic nailing is a good method for treatment of humeral shaft fractures in adults. It provides early fracture union, high union rates, minimal soft tissue damage, early rehabilitation and short hospital stay.
A comparison of blood loss and the need for transfusion following primary total knee replacement with or without the use of a tourniquet
Authors: Kirmani Sayyied J. , Middleton Mark , Fontalis Andreas , Srivastava Raka , Dinah Feroz
Published: May 2018

Background: Primary total knee replacement (TKR) has traditionally been carried out with the use of a tourniquet. More recent trends towards performing the surgery without a tourniquet have had some support in the literature and may improve patient recovery.

Methods: A retrospective cohort of 198 consecutive primary TKRs from our institution were identified and analysed, 52 used a tourniquet and 146 did not. All TKRs also utilised a standardised interventions protocol including withholding of anticoagulants and antiplatelet medications, topical adrenaline injection, and both IV and topical tranexamic acid. Outcomes measured were estimated intra-operative blood loss, overall blood loss through comparison of pre and post-operative haemoglobin laboratory values, and the need for post-operative blood transfusion.

Results: Analysis demonstrated a statistically significant reduction in estimated intra-operative blood loss when a tourniquet was used (p<0.001). However, overall blood loss indicated by the haemoglobin drop after surgery was not significantly affected by tourniquet use (p=0.342). Transfusion requirements were also similar among the groups (4.8% vs. 5.8%) and no tendency was suggested towards an increased rate of transfusion in the non-tourniquet group.

Conclusions: Our study shows that although estimated intra-operative blood loss is increased without a tourniquet, total blood loss as measured by haemoglobin levels is no different for primary TKRs that use a tourniquet and those that do not. Furthermore there is no difference in post-operative blood transfusion rates. It is our hope that this study will add to the body of evidence for surgeons to consider no longer using a tourniquet for primary TKR.
Prospective study of managing long bone fracture nonunion: is bone graft needed in every case?
Authors: Balagani Srinivas
Published: May 2018

Background: Increased road traffic accidents lead to increased incidence of fracture of long bones. It has a tendency of non-union. Infection is very common in these cases which are an important cause of nonunion of long bone fractures. The objective of the study was to study the incidence and patterns of non-union of long bone fracture.

Methods: Hospital based prospective study was carried out at Department of Orthopedics, from June 2017 to March 2018. Patients admitted to wards of Department of Orthopedics with nonunion of long bones were included. During the study period a total of 20 cases were eligible for the present study as per the inclusion and exclusion criteria.

Results: Males were more affected than females. Most commonly affected age group was 41-50 years and 61-70 years (25% each). Most commonly affected long bone was femur in 35% of the cases. Most common type of non-union was hypertrophic (50%). Most common cause of non-union was broken implant in 35% of the cases. Maximum number of patients had union in 4-6 months in 60% of the cases after surgery of previous non-union of long bones. Only four patients developed complications like shortening of the limb or persistent non-union.

Conclusions: Hypertrophic non unions doesn’t require bone graft, they require only stable fixation. For removal of broken implant in hypertrophic non-union if we open the fracture site, then even the gap after debridement of fracture site shows partial segmental defect it doesn’t require bone grafting.
The Influence of Human Resources, Use of Information Technology and Public Participation to the Transparancy and Accountability of Village Financial Management
Authors: Jannah Riadul , Handajani Lilik , Firmansyah M.
Published: May 2018

This study aims to examine and obtain empirical evidence on partial evidence of the influence of Human Resources, Use of Information Technology and Public Participation on Transparency and Accountability of Village Financial Management in East Praya District, Central Lombok Regency. Type of research is explanatory method with purposive sampling method. It retrieved by 55 respondents, who are the core of the village, members of BPD and communities willing to provide information on village financial management. Data analysis is SmartPLS 3.0. The results of this study indicate Human Resources, Use of Information Technology and Public Participation have a significant positive effect on Transparency and Accountability of Village Financial Management in East Praya Subdistrict. This research is expected to be able to give contribution to Local Government, Village Government and society in order to have the better level of transparency and accountability of village financial management as one effort to improve prosperity of society in East Praya Sub-district
The Influence Of Financial Literacy, Social Environment Factors And Cultural Factors To Consumption Behaviour (Survey on Faculty of Economics Students, Manado State University-Indonesia)
Authors: Watung Sjeddie Rianne
Published: May 2018

This research aims at scrutinizing and analyzing how financial literacy, social environmental factors and cultural factors affect consumption behavior of the students of Economics Education Department, Faculty of Economics Universitas Negeri Manado. The research design applies quantitative approach with survey method. The samples consist of 67 students who are chosen as the respondent by using proportionate stratified random sampling. Research instrument is quetionnaire using likert scale as the measurement, and instruments are tested by using validity and reliability tests (SPSS 16 application). Data analysis includes; 1) descriptive analysis, 2) classical assumption test, and 3) multiple linear regression analysis. The results of research are as follows 1). Financial literacy has a significant influence to consumption behaviour of the students, and the magnitude of financial literacy to consumption behaviour of the students is 33.1%; 2). social environmental factors has a significant influence to consumption behaviour of the students, and the magnitude of social environmental factors to consumption behaviour of the students is 34.91% 3). Social environment factors has a significant influence to consumption behaviour of the students, and the magnitude of social environment factors to consumption behaviour of the students is 32.4%, and 4) Financial literacy, social environmental factors and cultural fctors  have a significant influence to consumption behaviour of the students, and the magnitude of social environmental factors to consumption behaviour of the students is 83.5%. It can be concluded that financial literacy, social environmental factors and cultural factors partially and simultaneously affect consumption behaviour of the students of, Faculty of Economics Universitas Negeri Manado.
A Compensation Management (Case Study At District Government of Kutai Kartanegara)
Authors: Iswan Muhammad , Luddin Muchlis R. , Hanim Zaenab
Published: May 2018

The objectives of this research are to describe the compensation management in District Government of Kutai Kartanegara that consists of planning compensation management, organizing compensation management, actuating compensation management, and controlling compensation management.The findings indicate that (1) Compensation management plan formulates the objectives and requirements that is to arrange employees, motivate improve performance, improve prosperity and spur and improve productivity and quality in providing services to the community and improve the orderly administration of local finance. (2) In Organizing, Procedure for the payment of additional income shall be made monthly, the procedure and the payment mechanism according to the prevailing laws and regulations. (3) Implementation of compensation management are the ongoing compensation process and compensation practice is provided. Requirements to be fulfilled by the employee in compensation (4) Control and evaluation shall be performed by each Local government agency (SKPD) for employees through performance and attendance performance to identify the beneficiary in accordance with the data provided by each local government agency  (SKPD)
An Empirical Analysis Of The Determinants Of Exchange Rate In Nigeria
Authors: Ojo. Oke, Michale , Temitayo Adetan, Taiwo
Published: May 2018

This study examined empirically the determinants of exchange rate in Nigeria using the ARDL Bounds test approach to co-integration for the period spanning 1986-2016. The result of the analysis shows that the gross domestic product (GDP), Interest rate (INT) and inflation rate (INF) have positive effect on exchange rate in Nigeria while degree of openness (DOP) recorded a negative effect on exchange rate (EXR) in Nigeria. The Error Correction Mechanism result appeared to be correctly signed and significant. The study therefore concluded that gross domestic product, interest rate and inflation rate are the major determinant of exchange rate in Nigeria under the study period. It is therefore recommended that government should focus more on production of goods and services that can be exported and also introduce policies that can discourage importation of goods into the country. The government must pursue a realistic and pragmatic exchange rate policy in  the  less  free  trade areas that would stem capital  flight and  ensure more investment in the Nigerian economy.
A Probabilistic Inventory Model with Two-Parameter Exponential Deteriorating Rate and Pareto Demand Distribution
Authors: Fergany Hala Aly , Hollah Osama Mahmoud
Published: May 2018

Although the deterioration is one of the main problems that have been investigated in the inventory systems science the last twenty years ago but Most deteriorating inventory studies focused on deterministic models. This paper presents a Constraint Deteriorating Probabilistic Periodic Review Inventory Model (CDPPRIM); a model is applicable when: (1) the demand is a random variable that follows Pareto distribution without lead-time, (2) some costs are varying, (3) shortages are permitted, and (4) the deterioration rate follows exponential distribution.The objective function under a constraint is imposed here in crisp and fuzzy environment. A numerical analysis method (Newton's method) is used to solve the model. The main objective is to find the optimal values of four decision variables (maximum inventory level, stock-out time, the deteriorating time and review time), which minimize the expected annual total cost under the assumptions. At the end, the paper explains the model through an application.
The Unmet Need of Rohingya Refugee Children in Bangladesh
Authors: Zinia Josinta -
Published: May 2018

Rohingyas are a small Muslim ethnic group of Myanmar those who are not recognized as citizens or one of the 135 recognized ethnic groups in the country. They are the people without any identity, without any home. The aim of the present study is to evaluate the vulnerability of Rohingya refugee children and the military violence of Myanmar against Rohingya people that leads to the complete violation of global human right adopted by United Nations. The study was carried out by descriptive qualitative research techniques. To conduct the study, several Rohingya refugee camps were visited and different literature regarding Rohingya issues were reviewed. The result revealed that the ongoing genocide in Rakhaine state by  Myanmar military force on helpless Rohingya people is a complete violation of human rights. Therefore, it can be concluded  that the crisis make the Rohingya children homeless and lead them to an uncertain future.
Benefits gained by the rural women of Udaipur from Rashtriya Krishi Beema Yojana
Authors: Kharkwal Akansha , KMaheshwari Snehlata
Published: May 2018

The study was conducted in the Udaipur district of Rajasthan to find the knowledge and benefits gained by rural women from Rashtriya Krishi Beema Yojana (RKBY) and problems faced by them in gaining benefits of the scheme. A sample of 100 rural women was selected randomly for the present study from four villages namely Dhar, Kathar,Madar and Mathatha from the Badgaon panchayat samiti of Udaipur, Rajasthan. Personal interview method was used for data collection. Frequencies, percentage, means percent scores and mean weighted scores were used for analysis of the data. Findings reveal that the respondents possessed average knowledge about RKBY with the MPS of 38.54. Regarding the benefit of RKBY gained by the rural women, it was found that the benefit of scheme was gained only by 2 per cent of the respondents. Study of problems experienced by rural women in gaining benefits of the RKBY revealed that the respondents faced the problems of unavailability of benefit on time to large extent with MPS 3.
Analysis of the economic impact of Rural Enterprise Development Hub Project on maize farmers in Mqanduli, South Africa
Authors: Iortyom Enoch Terlumun , Mazinyo Sonwabo P. , Nel Werner
Published: May 2018

The research analysed the economic impact of Rural Enterprise Development Hub Project (RED Hub Project) on maize farmers. A sample of 200 maize farmers was drawn from a total of 398 beneficiaries of the project using Cochran sample size formula. Convenience sampling was done at the second stage using structured questionnaires which were administered on the beneficiaries of the project from 9 villages in Mqanduli Community. With the use of a ‘before’ and ‘after’ approach the study determined the provision of market for supply of maize produce by benefitting farmers and change in annual income of maize farmers. The data were analysed using descriptive and inferential statistics. P-value less than 0.05 were considered to be statistically significant. The results revealed that there has been a significant positive impact of RED Hub Project on the income of benefitting maize farmers per hectare and per farm. This is represented by 100% provision of market by the project for maize produce, a significant (t-statistics 179.4 and p-value less than 0.05) mean change of 212.47% in income per hectare in the area, a significant (t-statistics 38.4 and p-value less than 0.05) improvement of the mean income of benefitting maize farmers per farm by 264.32% in the area. Therefore, the study recommends sustained purchase of maize produce by the project from its beneficiaries and an extension of purchase from all maize farmers in Mqanduli.
MENIMBANG NASIB PEREMPUAN DALAM AGAMA & FEMINISME
Authors: Rofiq Aunur
Published: May 2018

The inhuman treatment of others, however, can not be tolerated. The acts of violence, sexual harassment, and injustice against women prevailing throughout the period are no longer compatible with human rights, and the demands of the development of the level of consciousness, the education that no longer recognize the gender limit, even the religion of Allah swt that is revealed for the freedom of human beings from the shackles of the fitrah. This paper deals with the treatment of violence against women by discussing it through various perspectives. Why violence against women can happen, what is the factor behind it? Many factors or motives behind the violence. Cultural, social, political, ideological, racial, ethnic, religious, and even gender biased factors can trigger violence. The efforts of women's liberation by Indonesian feminists, can be said to be very noble. Even so religious social and cultural factors need to be considered. However, the feminism of the West is a role model, not free from the content of sociological value, culture, ideology, philosophy born there. Thus it is not wise, if Indonesian feminism uses the paradigm, or ideology of Western femme in offering the best solution for women of the Eastern nations-especially Indonesia.

 

Perlakuan tidak manusiawi terhadap sesama, bagaimanapun tidak bisa dibiarkan. Tindak kekerasan, pelecehan seksual, dan ketidakadilan terhadap perempuan yang berlaku sepanjang kurun tidak lagi sesuai dengan HAM, dan tuntutan perkembangan tingkat kesadaran, pendidikan yang tidak lagi mengenal batas gender, bahkan agama Allah Swt yang diturunkan demi kebebasan manusia dari berbagai belenggu yang memasung fitrah. Tulisan ini mengangkat tentang perlakuan kekerasan pada perempuan dengan membahasnya melalui beragam perspektif. Mengapa kekerasan terhadap perempuan bisa terjadi, apa faktor di balik itu? Banyak faktor atau motif yang melatarbelakangi terjadinya kekerasan. Faktor budaya, sosial, politik, ideologi, ras, etnis, agama, bahkan pandangan bias gender bisa menjadi pemicu timbulnya kekerasan. Upaya pembebasan perempuan yang dilakukan para feminis Indonesia, bisa dikatakan sangat mulia. Sungguhpun begitu faktor sosial budaya timur yang religius perlu dipertimbangkan. Bagaimanapun lahimya feminisme Barat yang menjadi panutan, tidak bebas dari muatan nilai sosiologis, budaya, ideologi, filsafat yang lahir di sana. Dengan demikian tidaklah bijak, jika feminisme Indonesia menggunakan paradigma, atau ideologi femnisme Barat dalam menawarkan solusi terbaik untuk perempuan bangsa-bangsa Timur-khususnya Indonesia.  
Air Permeability of Thick Foams: Flow Numerical Simulations
Authors: Adámek Karel
Published: May 2018

From measured data are determined permeability parameters of thick perforated foam samples, used as car seats cushions. Parameters are used for numerical flow simulations in foam samples. Model of detailed geometry gives good view about detailed flow field (pressure and velocity) in foam volume, influenced by perforations and grooves. However, simulated flow is several times different from measured one. The main flow is through perforations (99%) and flow through foam is of two orders lower. Using homogenous geometry with “averaged” permeability parameters, evaluated from measured values, the coincidence of measured and simulated flow is very good, difference of 1-5%. However, it is not possible to get any details of flow in foam volume. Using inlet layer, the flow is decreasing, first in perforations and the ratio between perforation and foam flows is more balanced.
Spatial decisions under uncertainty: fuzzy inference in urban water management
Authors: Makropoulos C. K. , Butler D.
Published: May 2018

The endogenous complexity and spatial nature of the problems encountered in the urban water management environment present decision-makers with three major problems: (a) in the urban environment, every decision is site-specific, almost on a case-by-case basis, (b) the decision-maker must access, simultaneously, a large amount of information, increasing with rising spatial resolution and (c) the information to be evaluated is heterogeneous, including engineering, economical and social characteristics and constraints. The first two problems indicate that urban water management is an ideal field to develop and use spatial decision support systems (SDSS), while the latter promotes the use of fuzzy inference systems as a key mathematical framework. This research discusses the nature of uncertainty in environmental management in general and urban water management in particular, argues that fuzzy, rule-based, inference systems can be an invaluable tool for uncertainty quantification and presents the relevant elements of a prototype SDSS for urban water management. The examples presented in this paper are based on an application of the SDSS in water demand management.
Maps of Finland's Water Balance Elements
Authors: Lemmelä Risto , Solantie Reijo
Published: May 2018

Maps of water balance elements, i.e. precipitation, water equivalent of snow cover on March 16, runoff and evapotranspiration are presented for the period 1931–1960.

Methods for preparing the precipitation, runoff and evapotranspiration maps are given, as well as information on the accuracy of the maps.
Stormflow Production in a Headwater Basin Swamp
Authors: Roulet Nigel T.
Published: May 2018

Summer stormflow from a 1.57 km2 headwater basin in southern Ontario, Canada, which contained a 0.31 km2 valley-bottom, treed spring-fed swamp, was examined in 1987 and 1988. A large and annually constant groundwater flux emerged in the swamp, producing permanent saturated areas and a series of surface streamlets. The streamlets play a significant role in the production of an overland flow component of storm runoff. Stormflow volume produced by the basin was very small (runoff coefficients less than 0.01), but because of the well developed surface ‘streamlet’ system stormflow response and recession were rapid. Stormflow yield was equivalent to the depth of precipitation incident on the surface streamlets and stormflow volume was directly proportional to the volume of rain, indicating the size of the saturated zone was constant and not influenced by the storm rainfall. There was no evidence of groundwater being a major contributor to storm runoff. However, because groundwater controls the development of the surface streamlets and swamp saturation, seasonal groundwater hydrology and storm surface hydrology are inseparable.