bluuebunny/crossref_metadata_2025 huggingface dataset:
Significance of level of bifurcation of common carotid artery and variant branches of external carotid artery in cervicofacial surgeries with ontological explanation: a cadaveric study
Authors: Sonje Preeti , Kanasker Neelesh , Vatsalaswamy P.
Published: September 2019

Background: External carotid artery is the main artery supplying the structures of neck and face. Variability in the branching pattern of external carotid artery is important surgically and radiologically from the point of view of procedures carried out in that region. Purpose of the present study was to study the branching pattern of external carotid artery.Methods: Carotid triangle of the neck and the infratemporal fossa was dissected for studying the external carotid artery.Results: Generally the common carotid artery bifurcates at the level of upper border of lamina of thyroid cartilage. Level of bifurcation of common carotid artery may vary; it may arise at a lower level or at a higher level than its normal level of origin, which was observed in this study. Amongst the branches of external carotid artery like the superior thyroid artery, the facial artery, the lingual artery usually shows variations in their origin. These include origin of superior thyroid artery from common carotid artery, common trunk for facial and lingual arteries and many other different types of variations were seen in this study.Conclusions: Variant origins of the branches of external carotid artery are of significance in surgeries of thyroid, parotid gland, tongue as well as important in diagnostic procedures of head, neck, face region.
Expression of proliferating cell nuclear antigen and Ki-67 in renal cell carcinoma in eastern Indian patients
Authors: Pramanik Sandip , Sur Subhayan , Bankura Biswabandhu , Panda Chinmay Kumar , Pal Dilip Kumar
Published: September 2019

Background: Several molecular markers play important role in development and prognosis of renal cell carcinoma (RCC). Proliferating cell nuclear antigen (PCNA) and Ki-67 are such kind of molecular markers which may have prognostic significance in RCC and need to be studied about. Estimation of proliferation index by immunohistochemical expression analysis of PCNA and Ki-67 at different clinical stages of RCC samples and correlations of expression of the genes with different clinicopathological parameters between tumour tissue cells and adjacent normal tissue cells were the objectives.Methods: Thirty two patients of RCC who had been operated at one tertiary care institute of eastern India were taken for the study. Histopathological and immunohistochemistry analysis of PCNA and Ki-67 from tumour tissue and normal tissue were done. Patients who received radiotherapy, chemotherapy etc. before operation and who had benign tumours of the kidney in histopathological examination were excluded from the study.Results: Mean PCNA expression in normal renal tissue is 4.54%; whereas the clear cell RCC, papillary RCC and chromophobe RCC showed 49.81%, 50.75% and 66.50% of mean PCNA expression respectively. Mean expression of Ki-67 in normal tissues was 1.75%. Whereas the clear cell RCC, papillary RCC and chromophobe RCC showed 23.96%, 24.75% and 31% of mean Ki-67 expression respectively. Both molecular markers were positively correlated overall.Conclusions: PCNA and Ki-67 expression is increased in RCC when compared with normal tissues and it increases with Stage of RCC. PCNA expression is positively correlated with Ki-67 in different stages and histopathological groups of RCC.
Primary versus delayed wound closure technique in laparotomy wound of perforation peritonitis
Authors: Sasikumar M. N. , Mammen Sam Christy
Published: September 2019

Background: There is no consensus on the ideal techniques for wound closure of contaminated wounds. Multiple techniques have been proposed. The aim of the study is to compare the wound infection rates of laparotomy wounds in perforation peritonitis in primary and delayed primary wound closure. The purpose is comparison of primary wound closure and delayed primary wound closure with respect to rate of wound infection and other associated complications like wound dehiscence, stitch sinuses, incisional hernias and duration of hospital stay.Methods: This study included 106 patients, divided into two groups, primary closure (A) in which wound was primarily closed and secondary closure (B) in which wound was left open without suturing and saline irrigation was given and were sutured once the wound is clean and culture sterile. The wound infection was assessed using Southampton scoring system.Results: A total of 106 patients, 60 (56.6%) males and 46 (43.4%) females were included. Group A, 53 patients with 54.7% males and 45.3% females and in B, 53 patients with 58.5% males and 41.5% females. The mean age in A was 38.4 11.8while that in B 37.02 12.59. Group A had an infection rate of 77.4%whereas group B had only 34%. The duration of hospital stay for B was 9.72 2.57 and for group A, 11.74 2.87days.Conclusions: The delayed primary closure is the optimal technique for wound closure in contaminated wounds like perforation peritonitis as it reduces wound infection rates and hospital stay.
Desarda’s versus Lichtenstein technique of inguinal hernia repair: a comparative study
Authors: Akhtar Mohammad Sadik , Mani Suraj Kant , Alvi Yasir , Alam Parveg , Rizvi Syed Amzad Ali , Raza Mohammad Habib
Published: September 2019

Background: Inguinal hernias rank among the commonest of all hernias and surgery is the only definitive treatment. We analyzed the outcomes of desarda tissue based repair in comparison with the standard Lichtenstein tension free mesh repair of primary inguinal hernia.Methods: A total of 164 patients were randomly allocated into two groups, Desarda (group D) or Lichtenstein (group L) (80 VS 84, respectively). The primary outcome measures were chronic groin pain and recurrence during the follow up period. Secondary outcome measures included operating time, post-operative pain scores, duration of post-operative hospital stay, time to return to basic physical activity and to work, foreign body sensation, and post-operative complications.Results: During two year follow up, no recurrence was detected in each group. Operative time was significantly less in the Desarda group (28.91±5.82 min as compared to 34.07±8.63 min in the Lichtenstein group). Postoperative day 1, day 3 and day 7 groin pain was more in the Desarda as compared to the Lichtenstein group. Basic physical activity, chronic groin pain, cost, seroma formation, foreign body sensation, were also significantly less in the Desarda group.Conclusions: The successful primary inguinal hernia repair without mesh implantation can be achieved using Desarda tissue based repair, as it is effective as the standard Lichtenstein tension free mesh repair. Shorter operative time, early return to basic physical activity, lower cost, less chronic groin pain, less foreign body sensation are potential benefits of Desarda repair and can be preferred for inguinal hernia repair.
Study of serum fucose level in breast malignancy
Authors: Kamble Ashok S. , Kanthawar Raj , Vijayan N.
Published: September 2019

Background: Although for advanced tumour of breast have certain obvious physical characteristics, seldom is such physical finding seen in early malignant breast tumour. Keeping all these in mind, the present study aims at estimation of serum fucose which may help in early detection of breast malignancy.Methods: The present study was carried out over a period of one and a half year. A total of 68 patients were studied. Out of these 68 cases, 32 cases were having breast malignancy. After noting details history, through examination was done according to the proforma. Investigations were carried out as shown in proforma. Estimation of serum fucose was done in all these cases. Estimation of serum fucose was also done pre-operatively and in post-operative period.Results: It is evident from this that 70% of malignant lumps were seen in upper and outer quadrant of breast, 25% lumps in lower quadrant. It is obvious that as age advances average serum fucose level in breast cancer, starts decreasing. Thus younger patients have high Serum level as compared to old patients. Rise in serum level with the progression of stage of breast cancer. There was significant reduction observed in serum fucose level after surgery (p<0.0001).Conclusions:The estimation of serum fucose level can be used to screen cases of breast malignancy though neither as a strong arbiter, nor as a distinct diagnostic test. Its use is only as an ancillary investigation which may provide collaborative evidence only.
A comparative study of Lichtenstein hernioplasty performed under spinal anaesthesia versus local anaesthesia in treatment of unilateral inguinal hernia
Authors: Besra Siddhabrata , Mohanta Pradip Kumar , Mallik Chinmoy , Hussian Noor Hassan , Biswas Subikash , Pal Sabuj , Roy Debasish
Published: September 2019

Background: Lichtenstein mesh repair technique is widely used throughout the world in inguinal hernia repair. Hernioplasty done under local anaesthesia certainly has some benefits but it is yet to be proven as standard procedure. The aims of this study are to provide the data of a comparative study between Lichtenstein hernioplasties done under local versus spinal anaesthesia as well as add more data in this scenario.Methods: In this non randomized clinical study, 84 patients were selected by calculation of sample size. 42 patients were operated under spinal anaesthesia and another 42 were operated under local anaesthesia.Results: Mean duration of operation was slightly was slightly more in local anaesthesia i.e. 62.5 minutes (SD=17.8) versus 51.1 minutes (SD=21.5) in spinal anaesthesia. At 6 hours, 12 hours and 24 hours postoperative pain was significantly less in local anaesthesia group in comparison to spinal anaesthesia group with p=0.04, p=0.042, p=0.041 respectively. Postoperative complications like urinary retention, hypotension, and headache were more in spinal anaesthesia than in local anaesthesia. Duration of hospital stay was significantly less in local anaesthesia group i.e. 24.5 hours (SD=12.8) in comparison to spinal group 57.1 hours (SD=16.7).Conclusions:The study concludes that in local anaesthesia group, postoperative pain was significantly less and postoperative complications like urinary retention, headache, and hypotension were less evident compared to spinal anaesthesia. Hence the study concludes that local anaesthesia can be used as an alternative of spinal anaesthesia as a standard mode of anaesthesia for Lichtenstein hernioplasty operation.
Effect of persistence of left ventricular hypertrophy and left atrial dilatation after aortic valve replacement on early outcomes and survival: a prospective study
Authors: Murthy P. Hari Krishna , Chandra Abha
Published: September 2019

Background: The objective of the study was to evaluate the early outcomes and survival in patients with severe aortic stenosis associated with concentric left ventricular hypertrophy following aortic valve replacement.Methods: This is a prospective study done at SVIMS, Tirupati, from June 2014 to September 2015 evaluating out comes and survival in patients undergoing primary isolated aortic valve replacement (AVR) for severe aortic stenosis, severe aortic stenosis with mild aortic regurgitation and severe aortic stenosis with moderate aortic regurgitation.Results: A total of 40 cases 26 males and 14 females aged 18 to 60 years (mean age, 48.5±13.4 years) underwent elective AVR. Left ventricular end diastolic diameter (p=0.008) at 6 months, a statistically highly significant difference in left ventricular mass  preoperatively, at discharge, at 3rd and 6th month follow up. The difference in mean left ventricular mass index (LVMI) had declined from 244.425 to 141.100 at 6 months, showing a statistically highly significant difference in LVMI preop, at discharge, at 3rd month and at 6th month follow up.Conclusions: Patients with preoperative increase in LVMI, with large left atrial diameter carries a strong predictor of postoperative mortality for patients undergoing aortic valve surgery. We also conclude that there will be significant regression of LVMI following successful AVR. But, the decrease in LVMI is maximum during early three months and it is minimal though significant in the later course of follow up.
A clinicopathological study of cervical lymphadenopathy
Authors: Mukherjee Avijeet , Ramamurthy Vikram
Published: September 2019

Background: Lymphadenopathy is a very common clinical manifestation of many diseases. It is defined as an abnormality in the size of character of lymph nodes, caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. The study intends to find out systematically the various pathological conditions presenting with enlarged lymph nodes in the neck, also the various nodes of clinical presentations and behaviors of these conditional.Methods: The clinical material consists of all inpatients and outpatients presenting to department of General Surgery. The study was conducted during the period from January 2017 to June 2018. This study consisted of 50 consecutive cases and diagnosis was made on the basis of clinical and histopathological findings. Patients, in whom FNAC and/or biopsy of enlarged node could not be carried out, were excluded.Results: Out of 50 cases in the study, 76% were non-neoplastic. 44% of the cases were due to tuberculosis. Majority of the cases were in 3rd and 4th decade of age. After swelling in the neck, pain and fever were the most common presentation.Conclusions: In the present study, non-neoplastic accounted for 76% of cases, 44% turned out to be tuberculosis and 30% reactive lymphadenitis. Among the neoplastic lesions, malignant secondaries accounted for 16% while non-Hodgkin’s lymphoma and Hodgkin’s lymphoma accounted for 6% and 2% respectively. In this present study, fine needle aspiration cytology was found to be reliable and cheapest method of diagnosis without any significant morbidity and with good patient compliance.
Perforated appendicitis as a source of Fournier’s gangrene in an immunocompetent male
Authors: Alzerwi Nasser Alzerwi , Alshanwani Mohammed , Alsultan Afnan Sultan , Almutairi Sulaiman , Aldebasi Yasser Ibrahim , Ali Bandar Idrees
Published: September 2019

Fournier’s gangrene is a synergetic polymicrobial necrotizing fasciitis of the perianal, perineal and genital areas, it is a rare condition and it has a high mortality rate of up to 67%. Acute appendicitis has been identified as another cause of Fournier’s gangrene. This case demonstrates the critical importance of considering a diagnosis of Fournier’s gangrene because of a missing diagnosis of appendicitis even if the patient is young, healthy, immunocompetent and without a background of abdominal pain. We discuss a case of 35-year-old male, immunocompetent and medically free, who was presented to Emergency Department with a clinical picture of Fournier’s gangrene due to acute perforated appendicitis without a history of abdominal pain, and within 48 hours of the onset of bilateral scrotal swelling. Our case demonstrates the importance of considering Fournier’s gangrene as a complication of an intra-abdominal septic process, even in a young, healthy, immunocompetent patient.
Spontaneous umbilical hernia rupture with omental evisceration and Flood syndrome
Authors: Colbran Rachel , Smith Alison , Melloy Aemelia , Iyer Ramesh
Published: September 2019

Cirrhotic patients are at increased risk of developing umbilical hernias. Many cirrhotic patients’ umbilical hernias are not repaired electively due to concerns for high perioperative morbidity and mortality. This case report aims to inform clinicians about the unique challenges that arise during emergency management of umbilical hernias in the cirrhotic patient. A 59-year-old male with Child-Turcotte-Pugh grade B cirrhosis presented to our hospital with an incarcerated umbilical hernia that spontaneously ruptured with large volume ascitic leak (known as Flood syndrome) and omental evisceration. The patient underwent emergency sutured umbilical hernia repair, and required a prolonged post-operative stay in the hospital intensive care unit after suffering from complications including spontaneous bacterial peritonitis, anaphylaxis to antibiotic treatment, aspiration pneumonia, encephalopathy and worsening ascites. He eventually made a good recovery and underwent rehabilitation prior to discharge home. This case highlights the rare complication of spontaneous omental evisceration of an umbilical hernia in the cirrhotic patient and details its subsequent management. It is important to note that elective hernia repair after medical optimisation is high risk in the cirrhotic patient, but is recommended to avoid the high perioperative mortality and morbidity associated with emergency repair.
Leiomyosarcoma of vascular origin: a rare presentation
Authors: P. N. Sreeramulu , A. C. Nipun , . Anup , Suresh Vikranth N.
Published: September 2019

Malignant soft tissue neoplasm exhibiting smooth muscle differentiation is called leiomyosarcoma (LMS). LMS arising from the smooth muscles of tunica media of the major blood vessels like inferior vena cava (IVC) is a rare type of neoplasm, accounting for less than 0.5% of adult soft tissue sarcoma, affecting <1/1,00,000 of all adult malignancies. The prognosis of this tumor is poor, as patients often present with intra or extra-luminal growth often with invasion of adjacent structures. Only 400 cases of IVC LMS have been reported. Here we report a case of 40 year old female with large asymptomatic mass per abdomen of 3 months duration occupying the central and right part of abdomen. Investigations revealed a large retroperitoneal mass of 20.4*22.8*22.5 cms arising from the right kidney, likely Renal cell carcinoma. On exploration a huge tumor of size 25*25*20 cms was seen arising from retroperitoneum on right side, right kidney its vessels and ureter could not be seen separately. IVC could not be delineated. Histopathology report revealed it to be LMS of vascular origin. We report one such case because although incidence of such cases is low but should be considered in the differential diagnosis of mass per abdomen which grows unusually fast.
Adult intussusception as rare anomaly: case reports and management
Authors: Goyal Kirti Savyasacchi , Sodhi Tejinder Pal Singh , Utaal Maneshwar Singh , Dhawan Nitish , Garg Mani
Published: September 2019

Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency surgery. Use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial. Laparoscopic management has been reported to be a safe and feasible option regardless of the etiology. This paper presents the diagnosis and management of two cases of adult intussusception, their presentation and management.
A rare case of a true (degenerative) axillary artery aneurysm, secondary to chronic usage of crutches and its surgical management
Authors: Patel Soham , Modi Kunal , Haridas Arun Kumar
Published: September 2019

Aneurysms of the axillary artery are rare but potentially dangerous lesions that threaten the upper extremity with vascular and neurologic compromise. These aneurysms may arise as an aneurysm or pseudoaneurysm secondary to trauma or iatrogenic complications, or as degenerative lesions but secondary to the chronic use of crutches is rare. Inappropriate placement of the patient’s body weight on the axillary pad by the crutch causes repetitive trauma to an axillary artery leading to stenosis or aneurysm formation. The signs and symptoms vary with the cause of the aneurysm. It may include mass effects with brachial plexus compression and thromboembolic events involving the hands and fingers. Treatment should be considered in most of these lesions to prevent spontaneous rupture or microembolisation to the extremity leading to ischemia, gangrene, and amputation of the affected extremity. Surgical resection of aneurysm remains mainstay treatment followed by either interposition graft or direct end to end anastomosis.
Addition of rituximab to hyper-CVAD improves overall survival in newly diagnosed Burkitt leukemia/lymphoma from the Middle East and North Africa region
Authors: Bin Sabbar Najla S. , Alowirdi Fatimah S. , Basakran Fatimah A. , Al-Badr Lujain A. , Assiri Rawan A. , Alshahrani Wafa A. , Althubaiti Alaa , Damlaj Moussab
Published: September 2019

Background: Burkitt leukemia/lymphoma (BL) is a highly aggressive malignancy treated with intensive combinational chemotherapy. However, there is paucity in the literature with regards to outcome in patients with BL from the Middle East and North Africa Region (MENA).Methods: We examined the impact of incorporation of the monoclonal antibody rituximab within a chemotherapy backbone of hyper-fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, cytarabine and methotrexate (hyper-CVAD). Between 2007 to 2016, a total of 21 patients were identified and data retrospectively collected with median follow up was 32 months (1.1-120). The cohort was stratified based on exposure to rituximab and there was no significant difference regarding gender, age, stage, presence of constitutional symptoms, baseline presenting blood counts and proportion of patients completing prescribed therapy regimen between the strata.Results: Estimated overall survival (OS) of the entire cohort at 2 years was 71.1%; however, patients who received rituximab in conjunction with hyper-CVAD had a statistically significant improvement in 2-year OS at 81.2% vs 40% (p=0.048).Conclusions: In conclusion, we observed that incorporation of rituximab within a hyper-CVAD backbone improved OS in BL patients from the MENA region. These results warrant further evaluation.
Pattern of utilization of health insurance in two districts of South Karnataka
Authors: Shet Nagaraj , Qadiri Ghulam Jeelani , Saldanha Sunita , Kanalli S. Gayathri , Sharma Prajna
Published: September 2019

Background: Health insurance is a widely recognized and preferable mechanism to finance the health care expenditure of the individuals. It is an important mechanism in the modern world to save the individuals from the huge health shock but only a small percentage of people even from educated higher income groups are covered under any health insurance policy. This study was undertaken to know the pattern of health insurance utilization in Uttar Kannada and Udupi districts of Karnataka.Methods: A descriptive study was conducted among 550 household of Uttar Kannada and Udupi districts. Household were selected using multistage sampling technique.Results: Of the 550 study participants, 348 (63.27%) were aware and also subscribed for any type of the health insurance and of these only 89 (25.57%) utilized them. 190 (34.55%) had availed Rashtriya Swastya Bima Yojana, 42 (7.64%) for Yashasvini, 6 (1.09%) forESI, 12 (2.18%) for Sampoorna Suraksha and 15 (27.27%) had private insurances. Reasons for not availing health insurances other than being unaware were complicated process 85 (42.08%) and provides only partial coverage 49 (24.26%). The main reasons for not using the health insurance were non availability of empaneled hospital 84 (74.34%), disease not being under the scope of scheme 60 (23.17%) and 32 (12.36%) were unaware about the process of availing.Conclusions: Health insurances being are the best way to help people reduce their financial burden has to be made aware and the drawbacks have to be addressed.
Sleep deprivation, stress and anxiety among pre-university college students of Mangaluru city, India
Authors: Nartiang Durka , P. Jagannath
Published: September 2019

Background: Adequate sleep is extremely important for appropriate physical growth, emotional stability, behavior, and maintenance of cognitive function. Good quality of night sleep will reflect in better school performance and increased motivation to study. The aim of this study is to determine the level of sleep deprivation, daytime sleepiness, stress and anxiety and to associate stress, anxiety with sleep pattern.Methods: A college based, cross-sectional study was conducted in Mangaluru City, Karnataka. The study has been conducted among 5 pre–university colleges (2 from Aided, 2 from private and 1 from government). A total of 634 participants were enrolled from grade 11th and 12th irrespective of their stream and responded to a questionnaire that included socio-demographic characteristics, sleep pattern, daytime sleepiness by using Epworth sleepiness scale, level of stress using Perceived stress scale-10, level of examination anxiety and general anxiety by using Westside Anxiety scale and Anxiety Self-Rating scale. Descriptive statistics, chi square or likelihood ratio test were used. The data was entered and analysed using SPSS 16v.Results: Among 634 students the mean age was found to be 16 years. Prevalence of sleep deprivation was found to be 39%, daytime sleepiness was 66.6%, 77.8% had moderate stress and 9.1% had high stress. Moderately high-test anxiety was observed among 22.6% of the respondents and 1.4% with extreme anxiety.Conclusions: The study showed that 1/3rd of the respondents had sleep deprivation and 2/3rd had daytime sleepiness and the prevalence of general anxiety was higher than examination anxiety and most of the respondents had moderate stress.
Study of health care seeking behaviour for illnesses among malnourished children of age 06-59 months in rural and urban areas of Jabalpur district, Madhya Pradesh
Authors: Shukla Nandini , Toppo Neelam Anupama , Thakur Aditya , Kasar Pradeep Kumar , Sharma Brajesh
Published: September 2019

Background: Even though appropriate medical care seeking could prevent a significant number of child deaths, significant numbers of children die without ever reaching a health facility or due to delays in seeking care.1 This study aimed to compare health seeking behaviour among malnourished children in rural and urban areas.Methods: Cross sectional study carried out in rural and urban areas of Jabalpur district among 1237 children of age group 06-59 months in randomly selected in eight wards and two blocks of Jabalpur District. Where 720 children were from urban wards and 517 from rural villages. Multistage random sampling technique was used for the selection of study subjects. Predesigned questionnaire used to collect data.Results: Out of 720 children of urban area, percentage of acute malnutrition (low weight-for-height) was 136 (18.8%) while in rural area, out of 517 children percentage of acute malnutrition (low weight-for-height) was 102 (19.7%). Out of 136 malnourished children in urban, 32 (23.5%) were having illness while in rural out of 102, 43 (42.1%) were having illness. In rural areas, the mother or primary care giver of the study subjects preferred nearby government hospital (21.9%) the most during illness. While in urban, registered private practitioner (47%) were mostly preferred for consulting during sickness. Still 16.3% of the caregiver in rural area preferred quacks.Conclusions: This shows that the approach of health seeking behaviour is better in urban areas as compared to rural as people still prefer quacks in rural areas.
Study of contraceptive use in married women of reproductive age group in urban slum area of western Maharashtra
Authors: Mitkari Kuldeep Kalyanrao , Haralkar Santosh , Sancheti Poonam , Gokhale Ramakant
Published: September 2019

Background: India is world’s second most populous country next to China. Family planning is a key intervention for population control. In urban field, most of population (60%) resides in urban slum area with deprived and vulnerable population. This study was conducted to determine the prevalence of contraceptive use in married women of reproductive age group also to study socio-demographic factors and sources associated with the contraceptive use and the reasons behind not using.Methods: A community based descriptive cross sectional study of 5 months duration was conducted among married women in reproductive age group (15-45 year) resident of urban slum area. 234 samples were selected by simple random sampling method. Data was collected through interviews of study subjects using a semi structured questionnaire.Results: Out of 234 women, 98 (41.9%) women said that they are using some method of contraception, which are condom (6.8%), OC pills (4.3%), copper-T (4.7%) and female sterilization (26.1%). Religion, socio-economic status is not significantly associated with acceptance of contraception, but the education and employment are the key influencers for the contraceptive use. The major sources of information are doctors from the government hospitals and auxiliary nurse midwives.Conclusions: The prevalence of contraceptive use in married women of reproductive age group (15-45 year) in urban slum area is found to be 41.9%. Spacing methods including the modern methods of contraception are not getting accepted. More efforts should be taken to remove fear and misconceptions about contraceptive use.
Utilization of sinogram affirmed iterative reconstruction on 128 multi slice computed tomography scan to reduce radiation dose and improve image quality on thorax multi slice computed tomography scan: chest phantom study
Authors: Fatmayanti Halinda , Adi Kusworo , Kartikasari Yeti
Published: September 2019

Background: Thorax MSCT examination is a diagnostic imaging that is capable of displaying both normal and pathological lung and respiratory organs. MSCT examination also has a better level of sensitivity and specificity compared to other modalities, but the radiation exposure given is very high, so the radiation dose given to patients is high. The reduction in radiation dose is very important because of the direct exposure to sensitive tissue. One method of reducing radiation dose is by reducing the tube voltage. However, the decrease in tube voltage causes a decrease in image quality as indicated by increased noise and decreased CNR. To maintain the quality of the image at low tube voltage setting, an IR reconstruction of SAFIRE was used. The purpose of this research is to know the impact of using SAFIRE on dose radiation and image quality of thorax MSCT.Methods: This study was an experimental study with a quasi-experimental study design. The object used was the N-1 Lungman chest phantom in which an artificial tumor was attached. Radiation dose assessment used CTDI value, while image quality assessment used noise and CNR. Data processing was conducted using linear regression test.Results: There was an effect of tube voltage setting and SAFIRE setting on radiation dose and image quality.Conclusions: Tube voltage ssetting and SAFIRE setting had an effect on radiation dose and image quality. Tube voltage setting and SAFIRE strength level setting that were able to provide optimal radiation dose and image quality were tube voltage of 80 kVp and SAFIRE strength levels 3 and 4 (S3 and S4).
The quality of life and coping skills of patients with human immunodeficiency virus among different occupation
Authors: Kamthan Shivam , Pant Bhawna , Kumar Deepak , Gupta Monika , Nasser Kaynat
Published: September 2019

Background: Nowadays, HIV and AIDS has become an important public health issue across the world. Quality of life (QOL) is an important tool to assess general wellbeing of HIV patients. Coping skills are the psychological skills to face the difficult situations like HIV or AIDS. The workplace plays an important role in determining general wellbeing and the psychological problems in HIV patients. Therefore, it is very important to assess the quality of life and coping skills of HIV patients among different occupations.Methods: A cross-sectional study consisting of conveniently selected 200 HIV patients was conducted at ART center LLRM Medical College, Meerut. The study subjects were interviewed by using questionnaire consisting of WHOQOL HIV BREF (WHO quality of life questionnaire) and Brief-COPE scale questionnaires. Descriptive statistics and ANOVA test were used for analysis of the data.Results: 36% of HIV patients were housewives and 26.5 % of HIV patients were drivers. The quality of life score was higher in HIV patients who were in unemployed (14.98) and farmers (14.49) whereas was lowest in all others category (10.73). The housewives, farmers, government jobs or service, drivers and other had maximum adaptive coping in religion and minimum adaptive coping in humour. There was no uniform pattern of maladaptive coping skills of HIV patients among different occupations.Conclusions: Quality of life score was better in HIV patients who were unemployed and farmers as compared to HIV patients who were drivers, housewives, government jobs or service. Religion was most effective adaptive coping strategy and humour was least effective adaptive coping strategy in HIV patients.
Факторы конкурентоспособности российских компаний на рынке консалтинговых услуг
Authors: Лапенков Вячеслав Юрьевич
Published: September 2019

В данной статье были рассмотрены особенности конкурентных стратегий российских компаний на рынке консалтинговых услуг. По результатам анализа были сформированы факторы и основные конкурентные преимущества, которыми должны обладать отечественные консалтинговые фирмы.
THE WORK CULTURE OF SOUTH KOREAN COMPANIES IN INDONESIA
Authors: Mochklas Mochamad , Panggayudi Dwi Songgo , Soenarto
Published: September 2019

Research purpose: Analyzing the factors that influence the work culture of South Korean companies in Indonesia.

Methodology: The population in this study was employees who worked at a South Korean company in Surabaya. The sampling technique in this study is stratified random sampling. The appropriate data and can be processed as many as 229 people and the data were analyzed in a quantitative manner using SEM-AMOS version 20.0.

Main Findings: Work culture in South Korean companies in Indonesia, such as the harmonious relationship in the work culture of South Korean companies in Indonesia is more reflected in indicators of cooperation, work integrity is more reflected in indicators of honesty and further work discipline. reflected by indicators working on time. The work culture of South Korean companies in Indonesia is more dominant in work integrity, which can encourage the quality and quantity of work produced.

Implications: Changing cultures requires enormous effort and requires the involvement of all elements in the organization. The role of the leader is very important in shaping the culture of the organization and is crucial in efforts to achieve predetermined goals. By knowing the factors that influence the work culture of South Korean companies in Indonesia, it is hoped that it can provide information to South Korean expatriates to improve the work culture of the company in maintaining its long-term business by building cooperation and relationships with local employees.

The novelty/originality of this study: The work culture of South Korean companies in Indonesia is more dominantly demonstrated by work integrity in shaping work culture. The work integrity of a South Korean company is demonstrated by indicators of honesty, confidence, and responsibility in completing work.
MÍNIMO EXISTENCIAL CONSTITUCIONAL E VULNERABILIDADE SOCIOAMBIENTAL NO ÂMBITO DOS DESLOCAMENTOS COMPULSÓRIOS
Authors: Silva Delmo Mattos da , Cruz Saile Azevedo da
Published: September 2019

O advento da instalação da Termelétrica do Porto do Itaqui, em São Luís-MA, proporcionou o deslocamento compulsório de famílias oriundas da comunidade da Vila Madureira, Itaqui-Bacanga, São Luís-MA, para a Vila Nova Canaã, Paço do Lumiar-MA. Nessa conjuntura, alguns direitos socioambientais que compõem o direito ao mínimo existencial foram mitigados. Com base nesse pressuposto, este artigo almeja analisar e discutir a efetivação do alcance do mínimo existencial na comunidade reassentada em questão, demonstrando que tal possibilidade somente será concretizada com a aplicação de políticas públicas não discriminatórias que possam diminuir a vulnerabilidade socioambiental. Para tanto, foi analisada a efetividade dos direitos à saúde e ao trabalho, por meio da observação participante com a aplicação de entrevistas. Por intermédio da coleta desses dados, pôde-se, portanto, evidenciar o não reconhecimento de certos direitos subjetivos a prestações relativas ao mínimo necessário para a existência digna. Assim, demonstra-se que os direitos fundamentais e da proteção ensejam incondicionalmente a inserção da proteção ambiental nos direitos fundamentais, proporcionando a garantia do mínimo existencial para o desenvolvimento pleno da personalidade humana.
Ultrasonic Welding by Pressing into Constant and Variable Gaps in Rigid Plastic Products
Authors: Volkov S.S. , Nerovnyy V.M. , Bigus G.A.
Published: September 2019

A technique and a tool for ultrasonic welding by pressing a connecting element into a constant gap is proposed. The welded joints of plates arranged parallel to each other prove to be consistent in terms of strength and transparency. It is established that the coefficient of concentration of energy released per unit of volume of the parts being welded greatly depends on the contact area between them. When designing a welded seam, it is necessary to ensure edge preparation to reduce the contact area between the welded parts. In the case of a V-shaped protrusion in the design, the angle at its top should be approaching 90. The optimal technological parameters for ultrasonic welding by pressing into a constant gap are determined.
Modeling Results of Gas-Dynamic Characteristics of Low and Medium Flow Rate Model Stages for an Industrial Centrifugal Compressor
Authors: Borovkov А.I. , Voinov I.B. , Galerkin Y.B. , Drozdov A.A.
Published: September 2019

The paper presents the results of CFD calculations of two model stages with 2D impellers. The results were compared with the experimental characteristics obtained at the LPI Problem Laboratory. The centrifugal stage of the 2D impeller 0028-056-0373 was calculated for three different Mach numbers, with and without the gaps in the labyrinth seals. Calculations for the sector with one blade were performed using the NUMECA software, those for the full 360-degree model — in the ANSYS CFX software package. CFD calculations in all the cases gave an unacceptably high overestimation of the loading factor compared to the experimental data. It was established that the calculated characteristics of the stage efficiency leant towards high flow rates compared to the measured values. A stage of the 2D impeller 0048-048-029 was calculated for one Mach number without taking into account the gap in the labyrinth seals and for the full 360-degree model. A study of semi-empirical parameters and coefficients included in the SST turbulence model implemented in the ANSYS CFX software was carried out. The calculations showed that their choice for solving this class of problems had little effect on the calculation results, thus it was not possible to influence the loading factor.
РЕЗУЛЬТАТЫ МОДЕЛИРОВАНИЯ ПРОЦЕССА ТЕЧЕНИЯ ЖИДКОСТИ В СКВАЖИННОМ САМООЧИЩАЮЩЕМСЯ ФИЛЬТРЕ
Authors: Третьяк Александр Александрович , Кузнецова Алла Витальевна , Швец Виталий Викторович
Published: September 2019

Актуальность исследования обусловлена необходимостью создания оптимальных фильтров, конструкция и физические принципы которых обеспечивают замедление процессов кольматации, снижение гидравлического сопротивления и длительный период эксплуатации. Цель: разработать самоочищающийся фильтр оптимальной, с точки зрения гидродинамики, конструкции. Объект: скважинный самоочищающийся фильтр, требующий улучшения гидродинамических характеристик течения жидкости за счет изменения конструкции перфорационных отверстий. Методы: компьютерное моделирование гидродинамической задачи течения жидкости в скважинном самоочищающемся фильтре с использованием прикладного программного продукта SolidWorks. Результаты. Описана предложенная авторами конструкция частицеудерживающего скважинного самоочищающегося фильтра, оснащенная системой вращающихся постоянных магнитов. Магнитное поле, создаваемое при вращении постоянных магнитов, обеспечивает существенное снижение процессов кольматации. Дальнейшее совершенствование конструкции связано с понижением гидравлического сопротивления, препятствующего проникновению откачиваемой жидкости в полость фильтра. Приведена методика создания имитационной модели для решения внутренней гидродинамической задачи течения жидкости в скважинном самоочищающемся фильтре с использованием прикладного программного пакета SolidWorks. Моделирование предназначено для имитации прохождения текучей среды (воды) через цилиндрические отверстия в стенке фильтра в направлении снаружи внутрь. Исследованы гидродинамические эффекты и основные физические параметры, имеющие место в результате прохождения жидкости через цилиндрические перфорационные отверстия. Выполненное моделирование течения откачиваемой жидкости в скважинном самоочищающемся фильтре позволило установить оптимальную конструкцию сверления перфорационных отверстий в каркасе фильтра и оптимальную длину фильтра, равную 0,4 мощности пласта.
ПОВЫШЕНИЕ ЭНЕРГЕТИЧЕСКОЙ И ЭКОЛОГИЧЕСКОЙ ЭФФЕКТИВНОСТИ СИСТЕМ ГАЗООЧИСТКИ НА ТЭС
Authors: Замалиева Альбина Таврисовна , Зиганшин Малик Гарифович
Published: September 2019

Актуальность исследования обусловлена необходимостью повышения энергетической и экологической эффективности систем очистки выбросов систем пылеприготовления и дымовых газов ТЭС при угольной генерации и систем подготовки газа при газовой генерации, во исполнение Федерального закона № 261-ФЗ от 23.11.2009 г. (ред. от 29.07.2017) «Об энергосбережении и о повышении энергетической эффективности и о внесении изменений в отдельные законодательные акты Российской Федерации», а также требований по контролю за выбросом парниковых газов (напр., приказа № 330 от 29.06.2017 года «Об утверждении методических указаний по количественному определению объёма косвенных энергетических выбросов парниковых газов» и др.) выбросов систем пылеприготовления и дымовых газов ТЭС с угольной генерацией и в системе подготовки газа с газовой генерацией. Цель: разработка устройства циклонной фильтрации для повышения эффективности систем газоочистки на ТЭС, снижения выбросов взвешенных частиц в атмосферу от систем пылеприготовления и дымовых газов при угольной генерации и увеличения надежности работы агрегатов газотурбинных и парогазовых установок ТЭС вследствие снижения износа рабочих поверхностей поршневых и винтовых дожимающих компрессоров дожимных компрессорных станций, предотвращения попадания продуктов внутренней коррозии газопроводов в газотурбинных установках, в соответствии с п.п. 93, 94 ФНиП в области промышленной безопасности «Правила безопасности сетей газораспределения и газопотребления» (Серия 12, вып. 13). Объект: модель циклона на базе ЦН-11-200, обеспечивающая повышение энергетической и экологической эффективности систем газоочистки на ТЭС. Методы: стендовые испытания циклонного фильтра, изготовленного путем модернизации циклона ЦН-11-200, аэродинамические расчёты; численное моделирование аэродинамических параметров работы циклона-фильтра на основе методов вычислительной гидродинамики. Для математического моделирования процесса сепарации использована система уравнений, состоящая из осредненных по Рейнольдсу уравнений движения однофазного потока Навье–Стокса и уравнения движения частиц, основанного на законе Ньютона. Для определения эффективности отделения взвешенной части потока в циклоне-фильтре использован безразмерный комплекс Rer, с помощью которого численные значения параметров осаждения взвеси из многофазного потока в сепараторе найдены расчетным путем. Результаты. Анализ литературных источников показал отсутствие конструкций циклонов-фильтров, которые обеспечивали бы надлежащую (более 98 %) степень очистки выбросов без резкого увеличения энергозатрат на обработку выбросов. Проведенные опыты показали целесообразность конструктивного дополнения возвратно-поточных циклонов фильтрующей вставкой в зоне, где происходит инерционное осаждение пыли. Для определения эффективности отделения взвешенной части потока в данном циклоне-фильтре был использован безразмерный комплекс Rer. Расчеты показали соответствие результатов теоретических и натурных исследований.
ИЗУЧЕНИЕ ВИДОВОГО СОСТАВА МИКРООРГАНИЗМОВ, ОСУЩЕСТВЛЯЮЩИХ ОЧИСТКУ СТОЧНЫХ ВОД
Authors: Джумагулова Назира Тентимишовна , Гаврилов Иван Евгеньевич , Нгуен Динь Дап
Published: September 2019

Актуальность. Одним из наиболее эффективных способов очистки сточных вод является биохимический метод, дающий возможность практически полностью удалить из сточных вод различные растворенные органические вещества. Для улучшения окислительной мощности аэротенков и управления биохимическим процессом очистки сточных вод необходимо было выяснить экспериментально изменчивость биоценоза под влиянием среды и других факторов. Целью настоящей работы является интенсификация биологической очистки сточных вод за счет непосредственного воздействия на метаболизм микроорганизмов активного ила. Объекты: видовой и количественный состав микроорганизмов в результате очистки бытовых сточных вод на аэротенках; структуры и состава ферментов, сформировавшихся в процессе очистки. Методы: исследование биоценоза, методы гидробиологического контроля активного ила и микроскопии активного ила. По исследованиям индикаторных организмов определяется эффективность процесса очистки сточных вод. При микроскопировании активного ила определяют функциональное состояние организмов, особенно индикаторных, подсчитывают организмы тем или иным методом количественного учета, классифицируют их по индикаторным группам, затем определяют тип биоценоза, его характерные особенности. Для исследования микроорганизмов активного ила с помощью микроскопирования используется метод «живой» капли под покровным стеклом. Результаты. На основе проведенных исследований было выявлено, что снятие загрязнений по аммонийному азоту и фосфору до нормативно-допустимых значений в аэротенках без создания анаэробных зон недостижимо. Присутствие в водной среде органических веществ угнетает развитие нитрифицирующих бактерий, поэтому процесс нитрификации начинается лишь после окисления углеродсодержащих органических соединений, когда создаются условия для первой стадии нитрификации. Нитрифицирующие бактерии также способны накапливать полифосфаты в своих клетках. В обычных условиях биологической очистки, если нитрификация неглубокая, за счет потребления фосфатов бактериями удаляется от 10 до 30 % растворенных соединений фосфора. Для развития нитрифицирующих бактерий в аэротенках старой конструкции возможно применение прикрепленной микрофлоры с помощью различных загрузок, а также создание в одном из коридоров анаэробных зон, с устройством перемешивающего оборудования и рециркуляции иловой смеси в голову сооружения. Исследование биоценозов активного ила по стадиям его развития позволяет определить доминирующие формы организмов в илах аэротенков, работающих с разными нагрузками на активный ил. При налаженной работе аэротенков в активном иле устанавливается постоянный биоценоз, соответствующий определенной стадии развития ила. Изменение этого биоценоза свидетельствует об изменении режима работы аэротенка.