bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective study on outcome of post-partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India
Authors: Ninama Shilpa N. , Shah Tejas A. , Gandhi Mayur R.
Published: May 2019

Background: This study was conducted to evaluate the acceptance, safety, efficacy, complications and expulsion rate of post-partum intrauterine contraceptive device (PPIUCD) insertion among post-partum pregnant women in a rural tertiary care center. Objective of this study was assessment of the efficacy and safety of post-partum IUCD insertion. Comparing the complications and client satisfaction in both groups (intra caesarean insertion versus vaginal route of insertion).Methods: This is a prospective study conducted at one of the rural tertiary care teaching institution. A total of 150 patients with caesarean or vaginal deliveries had PPIUCD insertions and they were followed up for a period of one year. The outcome measures analyzed were menstrual irregularities, vaginal discharge, pelvic infection and perforation and efficacy measures - failure, expulsion and removal. Data are expressed in frequency and percentage. Chi square test was used for comparison and P value <0.05 was considered significant.Results: The study shows that PPIUCD is an effective intervention in both caesarean and vaginal delivery with non-significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation and no significant risk of infection in either caesareans or delivery. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the caesarean group compared to vaginal insertion.Conclusions: PPIUCD is a safe, effective and long term reversible method of contraception and should be encouraged by public awareness and community acceptance.
Prevalence of female genital tract tuberculosis in suspected cases attending Gynecology OPD at tertiary centre by various diagnostic methods and comparative analysis
Authors: Sharma Diksha , Depan Anju , Yadav Kanti , Narayan Suchitra , Sharma Anubhav
Published: May 2019

Background: The genital tract tuberculosis is one of the most common causes of tubal factor infertility. This study was conducted to compare the results of different diagnostic methods used in screening for female genital tuberculosis in suspected cases attending Gynecology OPD at RMC, Ajmer.Methods: This prospective study was conducted in department of obstetrics and gynecology, J. L. N. Medical College, Ajmer, Rajasthan, for studying incidence of genital tuberculosis by various diagnostic methods (viz. AFB smear examination, AFB Lowenstein Jensen culture method, TB-PCR and CBNAAT).Results: Prevalence of genital TB was 5.5% in study population of 200 selected women meting the inclusion criteria. 72% women were in between 20-30 years age group. Oligomenorrhoea (24%) was found to be significant symptom with P value of <0.05. TBPCR and CBNAAT were found to be statistically significant with P value of <0.001 for diagnosing FGTTB.Conclusions: We concluded that genital tuberculosis is paucibacillary disease, TBPCR and CBNAAT appears to be rapid and sensitive diagnostic modality.
Effect of duration of pre-operative admission on surgical site infection in major abdominal surgeries: an observational study
Authors: Gupta Alka Shantiprakash , Shetty Arthika
Published: May 2019

Background: Surgical site infection (SSI) are second most common cause of mortality in surgical patient, situation has been further complicated by emergence of drug resistant strains. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stays, need for readmission, high end antibiotic treatment and re-surgery. The study was done to see if   incidence of SSI is decreased with decreased pre-operative admission time. Others factors associated with SSI were analysed including the microbiological spectrum.Methods: The study was an analytical, observational, case control study. Sixty (60) cases each of gynaecology and obstetrical post-operative patients who developed SSI within 30 days were taken as cases and who did not develop SSI were taken as controls and preoperative admission time was analysed in both cases and controls to observe if risk of surgical site infections decreases due to decreased exposure to nosocomial pathogens when the pre-operative admission time was less than 48 hours.Results: Author found that there was statistically significant difference in the time between surgery and admission in the gynaecological surgeries with p value 0.023, as compared to the obstetrics surgeries where there was no statistically significant difference. Common organism isolated was E. coli sensitive to gentamicin.Conclusions: From this study, it seems to be a good policy to evaluate the patient on OPD basis and admit them about 24 to 48 hours prior to the surgery rather them keeping them admitted for prolonged duration in wards for diagnostic evaluation. This prevents nosocomial contamination in the patient’s skin flora thereby preventing SSI. This practice not only conserves the hospital resources but also makes the patient turn over faster. Further this might in the long run reduce the antibiotic resistant hospital flora.
Meconium stained liquor and fetal outcome: a hospital based follow up study
Authors: Kalpana P. , Kavitha A.
Published: May 2019

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.
Feto maternal outcome in obstructed labor: a tertiary centre study
Authors: Bansal Anshul , Kalra Ruchi
Published: May 2019

Background: The number of maternal deaths as a result of obstructed labor is 8% globally but this number varies in developing country, it ranges 4-70% of all maternal deaths and it is also associated to high perinatal mortality rate. Objective of the study was to find out the proportion of obstructed labour cases and their feto-maternal outcome during last 3 years at tertiary level institute.Methods: A cross sectional observation study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre Bhopal. All pregnant women presenting with obstructed labor who delivered at our hospital during last 3 years duration (January 2015 to December 2017) were studied for their feto -maternal outcome.Results: 53% cases had duration of trail more than 16 hours. 84% were referred from primary health centers of nearby rural areas. All  cases  of obstructed labor  delivered by cesarean section (100%). 44% were primigravida. 72% of cases had Cephalopelvic disproportion as the cause. 28% of cases had longer stay more than 7 days at hospital. 32% had  fever  during post operative period 12.5% cases had wound sepsis and 6% of cases required re-suturing of wound during post operative period. 72% baby's birth weight was between 3 to 3.4 kg. 94% of the babies survived where as 6% of babies were still birth. 16% of babies born to obstructed labor mother had APGAR less than 7 at 5 minutes of birth. 6% fetus were IUFD.Conclusions: Cephalopelvic disproportion was the most common cause for obstructed labor. Timely identification of prolonged labor and timely referral and management at place where operation theatre, NICU and blood bank facilities are available can save the life of both baby and mother.
Maternal and perinatal outcome of Evan’s syndrome: a 5 years study in a tertiary care centre
Authors: K. Manjula S. , T. Jasmine Deva Arul Selvi , N. Vishnu Priya K. M.
Published: May 2019

Background: Evans syndrome is a rare autoimmune disorder characterized by simultaneous or sequential presence of a positive antiglobulin test, autoimmune haemolytic anemia (AIHA), and immune thrombocytopenia (ITP). It is characterised by frequent exacerbations and remissions within a chronic course. It was first described by Robert Evans in 1951.  Incidence of AIHA is 1 per 75 - 80,000 and ITP is 5.5 /100000 per general adult population.  Incidence of Evans syndrome is 1.8% to 10% of patients with ITP. Objective was to study the maternal and perinatal outcome of women with Evans syndrome (E).Methods: About 4 antenatal mothers were identified with Evans syndrome at St. Johns medical college and hospital, Bengaluru during the study period of 5 years from July 2013-July 2017. They were followed up during their antenatal, intra natal and postnatal period and outcomes were studied. All patients included in the study fulfilled the criteria for Evans syndrome.Results: There were 4 cases of Evans syndrome, with a total number of deliveries of 11859, during this 5 year study. Incidence was 0.09 per 1000 births. All patients presented with bleeding manifestations ranging from mucosal haemorrhage to subarachnoid haemorrhage (SAH) at the time of diagnosis. All patients were on treatment with either 1st or 2nd line of management with corticosteroids/ azathioprine. None had bleeding during pregnancy after the initiation of treatment. Patients had antenatal complications like preeclampsia 25%, IUGR 25%, oligohydraminos 50%, IUD 25%. 2 patients received platelet transfusions intrapartum. None had intrapartum or postpartum haemorrhage. There were no maternal and neonatal mortality.Conclusions: Evans syndrome in pregnancy is a rare condition and requires multi disciplinary approach involving specialists from obstetrics, neonatology, and hematology. Close maternal and fetal surveillance and management during pregnancy is essential to increase the possibility of a favourable pregnancy outcome in these women.
Attachment, perceived social support and mental health problems in women with primary infertility
Authors: Saleem Sadia , Qureshi Namra S. , Mahmood Zahid
Published: May 2019

Background: Infertility is one of the fastest growing concerns when it comes to reproductive health and most often, women get the blame. Consequently, females suffer from major psycho-social and emotional problems that may lead to serious mental health concerns.Methods: To fill the gap in literature, a cross-sectional research design was used to measure the attachment styles with spouse, perceived social support, and predict mental health problems in women attending infertility clinics with ages ranging from 19-45 (M 27.21, SD 4.79). Adult Attachment Questionnaire, Multidimensional Perceived Social Support, and Depression Anxiety Stress Scale were used among experimental subjects selected through purposive sampling technique.Results: About 32% women reported themselves as secure, 49% as ambivalent, and 19% as avoidant in their attachment style with spouse. The results revealed that a significant negative correlation exists between perceived social support and mental health problems among women with infertility. Moreover, women who identify their attachment pattern as Ambivalent perceive less social support and experience more mental health problems.Conclusions: Education is one of the strongest predictors of how likely infertility is to cause mental health issues while Attachment style is another strong indicator since infertile women with secure attachment pattern have fewer mental health problems. However, the sample size was modest to make any wide-scale assumptions, so further trials with larger participant pools must be performed. Additionally, future studies should include both rural and urban samples with different psychological variables to find the similarities and differences between various groups of people with diverse backgrounds.
Malrotation of gut presenting in adolescents and adults at a tertiary care hospital: a prospective study
Authors: Mir Shabir Ahmad , Lattoo Mohd Riyaz , Dar Waseem Ahmad , Wani Mumtazdin
Published: May 2019

Background: Although malrotation of gut presenting in adolescents and adults is rare, but exists. Also its presentation is nonspecific.  Hence its diagnosis needs high index of suspicion.Methods: This prospective study was done in the department of surgery at SMHS hospital (GMC Srinagar) over a period of 5.5 years from July 2012 to December 2017. The patients included all  the adolescent and adult patients who proved  to be the cases of malrotation of gut on intraoperative  visualisation.Results: During the study period, 14 patients with malrotation of gut (belonging to adolescent and adult age group) were recorded. Age of the patients ranged from 16 to 54 years with an average of 26.21±11.15years. Majority of the patients belonged to adolescent age group. Preoperatively CT (computed tomography) scan was done only in 4 patients, thereby making the diagnosis of malrotation preoperatively in these 4 patients. In all other patients, the diagnosis was made only after laparotomy (for acute abdomen) and intraoperative visualisation. Ladd´s procedure was done successfully in majority of patients with two patients requiring resection of gangrenous small bowl and stoma formation.Conclusions: Malrotation of gut presenting in adolescents and adults is a rare phenomenon and also the symptoms are similar to several other abdominal pathologies, hence it represents a diagnostic challenge. Hence a high index of suspicion is needed to diagnose this rare entity early without undue delay. Threshold for CT scan should be kept a little low in suspicious cases so as to diagnose and intervene in time.
Non diabetic chronic leg ulcers: etiology and management
Authors: Narwade Pankaj , Saxena Divish , Wasnik Nitin , Akhtar Murtaza
Published: May 2019

Background: Chronic leg ulceration has varied etiologies and a systemic approach towards its pathogenesis, definitive diagnosis and optimal treatment is the need of the hour. Paucity of research data on non-diabetic chronic leg ulcer becomes the rational of present study.Methods: Total number of 60 patients with non-healing ulcer below knee and above ankle for more than 6 weeks duration were included in this observational study. A detailed clinical presentation, relevant biochemical, microbiological and imaging investigations were recorded. The management of these ulcers was based on its etiology with an approach to conservative management (antibiotics, daily dressings, improvement in nutritional status) to surgical debridement, wide local excision followed by split thickness/full thickness skin grafting. Outcome of present study was in terms complete or partial healing of ulcer, persistence or recurrence of ulcer.Results: Majority of patients (28.33%) with chronic leg ulcer presented during sixth decade with a male to female ratio of 5:1. The mean duration of chronicity of ulcer was 17.75 months with standard deviation of 7.83 months. Trauma was the commonest etiological factor (45%) followed by venous insufficiency (31.66%). About 31.66% of ulcers were managed conservatively and 68.32% by surgical procedure. Complete healing rate was found in 66.67% patients, persistence of ulcer in 18.32%, partial healing in 11.67% patients and 1.67% patient showed recurrence.Conclusions: Trauma and venous etiology were commonest cause of chronic leg ulcer. A comprehensive etiological assessment and judicious use of conservative or surgical therapy are pivotal in management of these ulcers.
A comparison of Tzanakis and Alvarado scoring system in the diagnosis of acute appendicitis
Authors: Anupriya R. , Babu C. P. Ganesh , Rajan K. V.
Published: May 2019

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV–  100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.
Outcome of Desarda repair in incarcerated inguinal hernia repair: experience in university hospital
Authors: Pachauri Avtar , Kumar Awanish
Published: May 2019

Background: Synthetic mesh based hernia repair is usually avoided in contaminated and dirty inguinal hernia repair to minimize the risk of infection. Desarda’s technique is a tissue based inguinal hernia repair method which avoids the use of prosthetic mesh. So this study was conducted with the aim to observe the outcome of Desarda’s technique in incarcerated inguinal hernia repair as an alternative procedure to mesh repair.Methods: This study was conducted in Emergency surgery department KGMU Lucknow. Total 30 patients with incarcerated inguinal hernia were included. Patients with recurrent hernia were excluded. Desarda repair was done in all patients. Patients were followed for 1 year to assess the outcome.Results: The mean age was 52±3 years. Mean operative time was 55±5 mins. Total duration of hospital stay was 4-16 days. Mild to moderate pain observed more frequently on 3rd and 7th post-operative day. Complication rates were found to be SSI (6%), seroma (3%), and recurrence (3%). Time taken to return to daily basic and work activities was 3 (3-5) and 15 days respectively. Patients’ subjective assessment of foreign body sensation done at 6th and 12th month follow up was found in 16% and 13% cases and that of abdominal wall stiffness in 23% followed by a reduction of upto 16% cases by 12th month.Conclusions: Desarda’s method is a safe, effective technique and may potentiate the use of tissue based repair for treating incarcerated, contaminated inguinal hernia repair. It has very low rate of recurrence and low cost of treatment.
Comparison of outcomes of open hernioplasty- Lichtenstein versus laparoscopic trans abdominal preperitoneal mesh repair in patients with uncomplicated unilateral inguinal hernias
Authors: S. Elakkiya , T. Deepu
Published: May 2019

Background: Inguinal mesh hernioplasty is one of the common procedures performed throughout the world. There are open and laparoscopic techniques of hernia repair. The laparoscopic approach to inguinal hernioplasty is now well established. The purpose of this study was to compare the outcomes of Lichtenstein tension free hernioplasty and laparoscopic TAPP (transabdominal preperitoneal mesh repair) considering these criterias, such as, duration of the surgery, hospital stay, and duration to resume normal activity, cosmesis, degree of postoperative pain, wound infection, recurrence and complications.Methods: A prospective randomized study was conducted by comparing patients (two groups) who underwent laparoscopic (TAPP) and Lichtenstein Tension free open hernioplasty in SVMCH and RC from November 2016 to June 2017.Results: Among the two groups of patients, depending on my criteria’s, namely, cosmesis (p-0.074) and postoperative cord edema (p-0.042), patients who underwent TAPP had statistically better outcomes than open hernioplasty.Conclusions: My study concludes that laparoscopic TAPP repair is safe and efficacious and the analysis here states the absolute superiority of laparoscopic TAPP over Lichtenstein tension free hernioplasty.
Clinico-pathological presentation of gastric carcinoma and its relation to the anatomical site of occurrence among patients in the hilly state of Himachal Pradesh, India
Authors: Chand Amar , Malhotra Parikshit , Barall Deepesh , Singh Sudhir , Thapa Garima
Published: May 2019

Background: The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. Himachal Pradesh, located in the north of India, has different customs, food habits, life-style and diverse ethnic groups. We undertook this study to analyze the clinical presentations and pathological characteristics of stomach cancer patients in the biggest referral center in the state.Methods: All endoscopic biopsy proven cases of carcinoma stomach attending the OPD or admitted in the general surgery ward between July 2014 to June 2015, went through a thorough clinical examination, routine and diagnostic investigations and endoscopic biopsies for histopathological confirmation.Results: The study included 62 patients of adenocarcinoma stomach with maximum cases between 45 to 65 yrs age, more in males (2:1). Borrmann type II was most common macrocsopic appearance followed by type IV. As per Lauren classification, 36 were of intestinal, 24 diffuse and 2 had mixed type. 10 patients had well differentiated, 28 moderately differentiated and 24 patients had poorly differentiated tumors. Anorexia, abdominal pain, weight loss, nausea and vomiting was the most common symptoms seen in antral lesions (distal) and anemia was the most common sign followed by dehydration, mass abdomen and ascitis.Conclusions: The study has added to the literature of clinical and pathological presentation and relation of signs and symptoms to the site of occurrence of gastric carcinoma from the hilly and rural state of northern India.
Subungual glomus tumor
Authors: Salem Yousif , Al Khalifa Jawaher , El Shayeb Ashraf
Published: May 2019

We are presenting a twenty-year-old female, who presented with distal left little finger pain for more than a year. Pain is very localized to the nail root, and increases in severity in cold weather or exposed to cold water. The patient was diagnosed based on history and physical examination to have a glomus tumor and surgical excision was done after that and histopathological examination confirmed the clinical diagnosis. The aim of this case is to present a rare disease and to show the pronounced treatment of such a case.
Rare case of retroperitoneal cystic lymphangioma in an adult
Authors: Tandup Cherring , Chowdhury Anish , Sakaray Yashwant Raj , Karthik Nasika Venkata Kanaka Naga
Published: May 2019

Cystic lymphangioma is benign tumor originating from the lymphatic vessels. Most commonly occurs in childhood and in the head or neck regions, retroperitoneal localization and presentations in adulthood are rare. Making a pre-operative diagnosis is challenging, and only possible subsequent to the histological examination. En bloc resection is the recommended treatment for cystic lymphangioma, and recurrence occurs due to an incomplete excision. We here present a case of 40 year female presenting with progressive palpable lump associated with pain in right quadrant of abdomen, which on computed tomography revealed a large retroperitoneal cystic lesion probably lymphanigoma or cystic mesothelioma.
Dutch scientists and the UNESCO Statement on Race
Authors: Harkema Bram , Sysling Fenneke
Published: May 2019

Central to this paper is a survey held among Dutch scientists in 1951 after the publication of the first UNESCO Statement on Race. The Statement, issued by a committee of experts at UNESCO, was a condemnation of scientific racism and declared that race was a social myth. The statement led to strong international criticism from physical anthropologists and geneticists, who disagreed with the dismissal of the concept of race and because they were poorly represented on the committee of experts. This paper traces the reception of the first Declaration on Race among scientists in the Netherlands to demonstrate how the Statement’s impact differed in different contexts. The survey about the Statement organized by Dutch anthropologists shows how Dutch racial scientists used the Statement to distance themselves from Nazi racial science by employing a rhetoric of humility, insistence on the difference between scientific findings and moral choices, suggestions for alternative conceptualizations of race, and a strategic internationalism to connect with the international community of experts. The success of this strategy can be concluded from the fact that one of the organizers of the Dutch survey, physical anthropologist Rudolf Bergman, was invited, very last minute, to participate in the expert meeting of biological scientists that formulated a second UNESCO Statement on Race, issued a year after the first.
Pierre Lyonet’s (1706–1789) Study of Insects: Displaying Virtue and Gaining Social Status through Natural History
Authors: Scholten Koen
Published: May 2019

This paper looks at the gentlemanly natural history practiced by Pierre Lyonet (1706–1789). Eighteenth-century natural history was inextricably linked to social status and Enlightenment ideals such as civility. By looking at the social network Lyonet built, we can reconstruct how past-time naturalists could enter the Republic of Letters, learned societies, and what this meant in the wider culture. For Lyonet, his study of insects had profound moral, religious and patriotic dimensions. This political and societal embeddedness enabled Lyonet to be both a benefactor to the state’s “public good”, meet the standards of a gentleman, while at the same time adhering to politesse in the Republic of Letters. All in all, this paper presents Lyonet as a gentlemanly naturalist working for state and status.
Physical Activity in the Elderly with Fall Experience Over the Past Year: Results from Amirkola Health and Ageing Project
Authors: Safarpour Mehdi , Hosseini Seyed Reza , Fotouhi Akbar , Zeraati Hojjat , Mohamadzade Masume , Bijani Ali
Published: May 2019

Background and purpose: Nowadays, immobility is known to be the fourth risk factor for mortality. The aim of the present study was to investigate the relationship between fall experience over the previous year and levels of physical activity in the elderly.Materials and Methods: The study was performed with 1616 participants of 60≤ years. The relationship between physical activities in the elderly with age, sex, educational level, body mass index, comorbidities, and fall experience over the previous year was evaluated. Physical activity in the elderly was evaluated using the physical activity scale for the elderly.Results: In the multiple regression model, the age (β: -1.6, 95% CI:  -2.0- -1.1), sex, female (β: 11.0, 95% CI: 4.3-17.6), and comorbidities (β: -6.8, 95% CI: -13.5 - -0.1) had a significant relationship with the physical activity score. On the contrary, there was no significant difference between the score of physical activity and both groups with and without the experience of fall over the previous year (β: 0.09, 95% CI: -8.0 - 8.2).Conclusion: Increasing age with comorbidity resulted in a decrease in the average physical activity score in the studied elderly population. However, the experience of fall had no relationship with it. Providing the conditions alongside the training required to carry out physical activities, especially in the elderly people with the disease, was suggested.
Reference Values for Serum Total Cholesterol Concentrations Using Percentile Regression Model: A Population Study in Mashhad
Authors: Esmaeily Habibollah , Dolat Elham , Heidarian Miri Hamid , Taji-Herav Ala , Kiani Omid
Published: May 2019

Background and Purpose: Serum total cholesterol (TC) concentrations are affected by several factors including ethnicity, diet, geographic, and environmental determinants, and are related to another disease, including hypothyroidism, and renal and liver disease. It is associated with an increased risk of cardiovascular disease, particularly if associated with high levels of serum low-density lipoprotein (LDL). The distribution of TC levels within populations may be useful, and the current study aimed to determine the reference values and specific cut points in a population sample from Mashhad, Iran.Methods: A cross-sectional study was conducted, and data was collected from 6518 individuals (2483 men and 4035 women) aged 25–64 year-old living in Mashhad city using a stratified cluster random sampling design.Reference values for borderline and high TC levels in three age groups were obtained using a percentile regression model. Data were analyzed using Quantreg Software Package and R Ver. 3.1.2 Software.Results: Within the population sample, 38% of the subjects were male and 62% of them were female. The mean and standard deviation for age were found to be 47.07±9 years and 45.28±9 years for men and women, respectively. Percentile regression showed that borderline TC levels for men and women aged 25-64 years were 198-216 mg/dl and 176-243mg/dl, respectively. The values for defining high TC levels were also 226-239 mg/dl in men and 202 - 271 mg/dl in women.Conclusion: Our study estimated reference values and cut points for borderline and high TC separately in both men and women, and age-related sub-groups for a population derived from Mashhad. These findings could be used in local policy plans to allocate health resources.
Circulating miR-95 Is a Potential Biomarker of Chronic Lymphocytic Leukemia
Authors: Nateghi Behnaz , Behshood Parisa , Fathullahzadeh Sima , Mardanshah Omid
Published: May 2019

Background: MicroRNAs (miRNAs) have crucial roles in cellular and molecular processes related to different malignancies including chronic lymphocytic leukemia (CLL). Studies revealed altered miR-95 expression in several diseases. Long non-coding RNAs (lncRNAs) are a heterogeneous group of non-coding and regulatory RNAs. Aim: The present study was conducted to investigate the association of miR-95 expression with CLL by quantitative real-time PCR. Materials and Methods: Sixty samples, including 30 CLL and 30 healthy controls, were sampled during a period of 4 months. The expression of miR-95 was evaluated by quantitative real-time PCR in peripheral blood mononuclear cells from patients with CLL and in healthy subjects. Additionally, in silico pathway enrichment analysis was performed on validated and predicted targets of miR-95 in several databases, including miRecords and miRTarBase, while the interactions between predicted putative lncRNAs and genes and miRNA expression were examined with miRWalk. Results: The expression of miR-95 was found to be significantly reduced in patients with CLL compared to that in healthy controls (P < 0.005). Conclusion: miR-95 showed potential as a biomarker for the early diagnosis of patients with CLL. LncRNAs play a significant role in regulating cellular evolution, differentiation, and other processes and may be important regulators in tumorigenesis.
A Simple Self-Clamped High Step-Up DC-Dc Converter Employing Coupled Inductor
Authors: Hass Eduardo S. , Nascimento Claudinor B.
Published: May 2019

This paper proposes a high-voltage-gain boost-based converter employing a coupled inductor. The proposed circuit presents high efficiency, absence of clamping circuits for limiting the voltage spikes over all semiconductor devices and reduced number of components. Besides employing a coupled inductor, the converter also has two stacked capacitors in its output. Thus, the total voltage gain is defined by the duty cycle, the turns ratio of the coupled inductor and the sum of these two capacitor voltages, resulting in the high gain of the system. It is demonstrated that the efficiency is high, because extreme duty cycle values are avoided. Its steady-state operating principle are presented. So, it can be observed that maximum voltage spikes on the all semiconductors (main switch and diodes) is equal to the output voltage Vo, turning the proposed converter suitable for applications where voltage levels on the load need to be not too high (400 V - 600 V). Finally, experimental results in by open loop control are presented for 30 V and 48 V input voltages, 400 V output voltage, 100 kHz switching frequency and 300 W output power.
A ATRATIVIDADE DA DOCÊNCIA NA EDUCAÇÃO INFANTIL EM INGRESSANTES DO CURSO DE PEDAGOGIA
Authors: Corrêa Carla Patrícia Quintanilha , Vital Mabta Almeida Galdino , Lima Patrícia de Souza Gomes , Guimarães Sabrina Almeida de Azevedo Miranda , Moreira Thayná Barros
Published: May 2019

Esta pesquisa objetiva investigar a atratividade para a docência na educação infantil entre ingressantes de um Curso de Licenciatura em Pedagogia, buscando conhecer suas impressões iniciais acerca do trabalho do professor com crianças dessa etapa da educação básica. Para isso, utilizamos como instrumento de pesquisa um questionário preenchido por 63 licenciandos que aceitaram colaborar com o estudo. Tendo como fundamentação teórica os trabalhos de Gatti (2014), Tartuce et al. (2010), Kramer (2014), Brandão e Leal (2011), dentre outros, obtivemos como resultado que a docência na educação infantil é a primeira intenção de atuação entre a maioria dos ingressantes, que demonstraram estar cientes da complexidade do trabalho com crianças dessa faixa etária, indicando a necessidade de um trabalho pedagógico voltado aos interesses próprios do público infantil. Esses resultados nos fazem refletir que mesmo em meio a um cenário de baixa atratividade docente, os ingressantes do curso pesquisado parecem valorizar a docência na educação infantil. Esperamos, com este trabalho, enriquecer o debate sobre a temática proposta, reunindo mais dados de pesquisa que auxiliem na discussão sobre a docência na contemporaneidade.

Palavras-chave: Atratividade docente. Educação Infantil. Valorização da docência.
Los japonesismos culinarios
Authors: Fernández Mata Rafael
Published: May 2019

Dentro del grupo de japonesismos utilizados en el español actual, los japonesismos culinarios constituyen la segunda mayor área referencial (16 voces de un total de 92 ítems). En el presente artículo se pretende, por primera vez en la lengua española, realizar un estudio exhaustivo de los japonesismos culinarios, atendiendo a diferentes perspectivas (formal, semántica e histórica), además de indicar su grado de adaptación al inventario léxico del español.
David Serrano-Dolader, Formación de palabras y enseñanza del español LE/L2
Authors: Zacarías Ponce de León Ramón F.
Published: May 2019

David Serrano-Dolader, Formación de palabras y enseñanza del español LE/L2, Londres, Routledge, 2018, 368 pp. ISBN: 978-1-138-68412-6.
¿Divisoria e invisible a la vez? La frontera hispano-francesa de la zona vascoparlante desde el prisma de la movilidad nupcial (1780-1920) = Divisive yet also invisible? The Franco-Spanish border of the Basque-speaking area through the prism of nuptial mobility (1780-1920)
Authors: Duinat Benjamin
Published: May 2019

Resumen: A través del estudio sistemático de la frecuencia de los matrimonios transfronterizos entre 1780 y 1920 en el valle de Xareta situado a caballo en el límite hispano-francés, se pretende revisar la interpretación dominante según la cual los fronterizos de la zona vascoparlante fueron dándose la espalda a lo largo del siglo XIX. La permanencia y regularidad de las uniones transfronterizas demuestran que las observaciones acerca de la formación inexorable de una ruptura territorial entre vascos de España y Francia no reflejan un hecho real, sino impresiones erróneas que han sido hasta hoy repetidas acríticamente. En definitiva, la frontera posee una naturaleza muy polisémica, en tanto en cuanto es aprehendida y apropiada de modo muy distinto en función de los individuos y grupos. La línea divisoria de los agentes estatales permanece casi invisible al analizar las dinámicas espaciales vinculadas a la movilidad nupcial.Palabras claves: Frontera, Movilidad nupcial, Zona vascoparlante, Siglos XVIII-XX.Abstract: Through the systematic study of the frequency of cross-border marriages, between 1780 and 1920 in the valley of Xareta straddling the Franco-Spanish border, we aim to revise the dominant interpretation according to which the frontier population of the Basque country turned their back on their neighbours during the 19th century. The permanence and regularity of cross-border nuptial unions show that remarks about the establishment of a permanent territorial divide between Basques in France and Spain do not relate to a real fact and are thus erroneous impressions that have been repeated uncritically. Ultimately, the border is polysemic, as the range of actors and groups apprehended and appropriated it very differently. When analysing the spatial dynamics linked to nuptial mobility, the dividing line of the State is almost invisible.Key words: Boundary, Nuptial Mobility, Basque-speaking área, 18th-20th centuries.
Hacia una geografía histórica del Gerês/Xurés: la conformación de una región transfronteriza = Towards a historical geography of Gerês / Xurés: the making of a cross-border region
Authors: Paül Valerià , Trillo Santamaría Juan M.
Published: May 2019

Resumen: En el espacio central de la raya entre Galicia y el Norte de Portugal se extiende el Gerês/Xurés. Este ámbito territorial está conformado por dos Parques, uno Nacional en Portugal y otro Natural en Galicia. El presente artículo aporta los mimbres para una geografía histórica de este ámbito, en clave de región transfronteriza. La metodología aúna trabajo de campo (entrevistas semiestructuradas) y análisis de diversas fuentes de información: libros, documentos oficiales, artículos, páginas web y documentación de archivo.Palabras clave: Geografía histórica, territorio, frontera, región transfronteriza, espacio natural protegido transfronterizo,Galicia/Portugal.Abstract: The Gerês/Xurés region is located in the central area of the Galician-North Portuguese borderlands. The territory encompasses two parks: a national park in Portugal, and a natural park in Galicia. In this article, a historical geography of the area, under the theoretical framework of cross-border region. The methods combine fieldwork (semi-structured interviews) and analysis of different sources: books, official documents, articles, web pages and archives.Key words: Historical geography, territory, boundary, crossborder región, Transboundary Protected Area (TBPA), Galicia/Portugal.
Arqueología de la Arqueología: ensayos sobre los orígenes de la disciplina en México
Authors: Maier Allende Jorge
Published: May 2019

--
A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery
Authors: Temel Mehmet Emrah , TOTOZ Tolga , ERKALP KEREM , TEMEL Gulen Safiye , SELCAN Aysin
Published: May 2019

Background: Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS, by ultrasound assessment.
Methods: Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after the orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before the anaesthesia induction) and postoperatively (before the extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in the subgroup analyses according to the surgery type. Pearson correlation analysis was performed to assess correlations between the variables.
Results: AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05). Patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively (p < 0.05).
Conclusions: The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in an elective NS. It is therefore a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.
WITHDRAWN: Novel repetitive sequences decipher the evolution and phylogeny in Carthamus L
Authors: Mehrotra Shweta , Goyal Vinod
Published: May 2019

Repetitive sequences are ubiquitous features of eukaryotic genomes, which contribute up to 70-80% of the nuclear genomic DNA. They are known to impact genome evolution and organization and play important role in genome remodelling. The widespread distribution and sufficient conservation of repeats reinforce the value of repetitive DNA sequences as markers of evolutionary processes. The repetitive DNA-based phylogeny reconstruction method is consistent in resolving expected phylogenetic and evolutionary relationships. In the present study, we address the isolation and characterization of four novel repetitive sequences (pCtHaeIII-I, pCtHaeIII-II, pCtHaeIII-III and pCtTaqI-I) from Carthamus tinctorius. Detailed phylogenetic analysis of 18 taxa belonging to 7 species of Carthamus has also been done with pCtHaeIII-I, and pCtHaeIII-II which clearly indicated concerted evolution while delineating phylogenetic relationships among the 18 taxa studied. The above understanding can assist in the marker assisted genetic improvement/ enhancement programmes in this crop species.
Cone-beam Computed Tomography Investigation of Middle Mesial Canals and Isthmuses in Mandibular First Molars in a Chinese Population
Authors: Xu Shuaimei , Dao Junfeng , Liu Zhongjun , Zhang Zhiyong , Lu Yu , Zeng Xiongqun
Published: May 2019

Background

While there is ample research into the anatomy of mandibular molars, little is known regarding isthmuses and middle mesial (MM) canals in Chinese populations. The goal of this study was to determine the prevalence of MM canals and isthmuses in the mesial root of mandibular first molars using Cone-beam Computed Tomography.

Methods

Cone-beam Computed Tomography images of 357 mature mandibular first molars were retrospectively analyzed. Data regarding demographics, side of mandible, presence of separated distal-lingual roots, presence of isthmuses and MM canals, and the length of isthmuses in the mesial root were recorded.

Results

Of these 357 teeth, 209 showed evidence of either complete or partial communication in the mesial root. Of these, 11(3.08%) exhibited true MM canals while 198(55.46%) exhibited isthmuses. Sex or side of mandible was not correlated with the incidence of communication (isthmuses or MM canals) (P> 0.05). However, there was a significant association between the presence of a distal-lingual root and the incidence of such communication (P< 0.05). The average length of isthmuses was 4.26 ± 3.14mm.

Conclusions

We detected high rates of mandibular molars with isthmuses, which is important as such areas should be identified and cleaned during root canal treatment.
Constructing an Experiential Education Model in Undergraduate Radiology Education by the Utilization of the Picture Archiving and Communication System (PACS)
Authors: Chen Yingqian , Zheng Keguo , Ye Shanshan , Wang Jifei , Xu Ling , Li Ziping , Meng Quanfei , Yang Jianyong , Feng Shiting
Published: May 2019

Background

Medical education in China is in a transitional period, from passive learning models to experiential education. We developed an experiential education method for radiology education. The aim of this study is to evaluate the effect of this method on undergraduate radiology education.

Method

With the help of the picture archiving and communication system (PACS) and RadiAnt DICOM Viewer, we developed an experiential education method that simulates similar working conditions for undergraduate medical students to formulate radiology diagnosis similar to clinical radiologists. A total of 101 students were allocated into either the experimental group or the control group. The final examination scores and a 5-point Likert scale self-assessment questionnaire of radiologic skills were collected from all the students as an objective assessment and a subjective assessment respectively. A questionnaire was also used to assess the satisfaction with the experiential model in the experimental group. Mann-Whitney U test was used to compare the ranked data, and t-tests were used to compare the numeric data.

Results

The experimental group demonstrated significantly higher scores (7.4±1.3) compared to the control group (6.7±1.5, p <0.05) in the question type “description and diagnosis”. The self-assessment questionnaire indicated that the experiential education was related to increased familiarity with the diagnosis thinking principle and the sequences and reconstruction methods of computer tomography (CT) imaging, which also strengthen participants’ self-confidence to perform future clinical work (p <0.05). The self-assessment questionnaire in the experimental group showed that the majority of students were satisfied with the organization (82.5%), interactivity (85%) and quality (85%) of the learning activity. Most students found this model of learning to be helpful for studying radiology (85%) and for understanding anatomy (90%).

Conclusion

Compared with the traditional radiology education approach, the experiential education method showed greater efficacy in improving students’ analysis and diagnostic skills and their self-confidence.