bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of clinico-demographic risk factors for postoperative pulmonary complications following gastrointestinal surgery
Authors: Sinouvassan Vijay , Dayalane Hemalatha , Balagurunathan Subalakshmi , Sahoo Ashok Kumar , Kanth Vishnu , Thirthar Palanivelu Elamurugan
Published: December 2019

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increased mortality, increased length of intensive care unit (ICU) stay, and higher cost of treatment. Identifying the risk factors of PPC helps in predicting its occurrence and to develop preventive measures. The objectives of the present study were to study the clinical and demographic risk factors for PPC following gastrointestinal surgery.Methods: The study was designed as an observational descriptive analytic study. All the patients ≥18 years of age undergoing gastrointestinal surgery were included. The patients with preoperative lung pathology requiring ICU care or ventilatory support and patients with lung metastasis were excluded. The demographic and clinical parameters at admission were recorded. The details of pulmonary complications like the time of occurrence after surgery and the mode of treatment for pulmonary complications were noted. The risk association was assessed for statistical significance.Results: A total of 100 patients were underwent various gastrointestinal surgeries during the study period. The incidence of PPC was 34% in our study. Age, education status, smoking, and presence of comorbidities were found to be positively associated with an increased incidence of PPCs. The serum albumin of less than 3.5gm and the haemoglobin of less than 8 gm were also associated with an increased incidence of PPC. Pleural effusion was the commonest PPC seen in 15 (44.1%) patients followed by pneumonia in 9 (26.5%).Conclusions: Age, smoking, education status, serum albumin, haemoglobin, emergency surgery, elective postoperative ventilation, nasogastric intubation and blood loss in the intraoperative period were found to associated with increased risk of PPCs.
Demographics in trauma: a prospective observational study in a tertiary care zonal hospital
Authors: Manwatkar Shrikant , Sharma Aniket , Gupta Anurakshat , Chhikara Amit , Trehan Vikram , Ranjan Rajiv , Yadav Dheeraj , Sharma Harimohan , Antony Tinku , Karuparthy Nagakishore , Dhanvijay Pallavi , Chaudhary Vishy
Published: December 2019

Background: Trauma represents a major challenge worldwide and is the leading cause of morbidity and mortality in young population. There is significant change in trauma related injuries due to urbanization, motorization, industrialization and the socioeconomic changes in India. Road traffic accidents (RTA) pose the largest threat to human lives and have become the number one public hazard all across the world causing morbidity and mortality. The aim of this study is to find out the demographics and to determine the injury pattern of surgical trauma cases presenting to this tertiary care zonal hospital.Methods: A prospective observational study was conducted in a tertiary care zonal hospital from June 2018 to December 2018. Data was collected for 105 patients presented with trauma in surgical emergency centre of this hospital were included in the study which excluded only orthopaedic trauma cases. The data collected was analysed.Results: Out of 105, 76 (72.38%) were male and 29 (27.61%) were female with 21 (20%) in the 31-40 age group. The average age of cases was 40.2 years.  RTA was the major cause of trauma i.e. (77.14%) followed by accidental fall and slips (18.09%) and assaults (4.76%). Contusion was the common injury sustained (45.71%) followed by laceration (38.09%), abrasion (35.23%) and fracture (17.14%).Conclusions: There is a need for trauma registries which can help to formulate strategies towards decreasing the burden of trauma and improved outcomes at hospital as well as in public health.
A comparative study of various types of intravenous fluids on the changes during induction of general anaesthesia
Authors: Kumar Surendra , Singh Desh Pal , Sharma Shailja , Kumar Praveen
Published: December 2019

Background: The induction and endotracheal intubation is the most risky and initial process of general anaesthesia. Without induction and endotracheal tube placement one cannot imagine the general anaesthesia. Propofol and fentanyl are the commonly used drugs for induction of general anaesthesia. These drugs produce hypotension and other cardiorespiratory disturbances. These hazardous and sometimes fatal effects can be reduced and eliminated by preloading the patients with colloid or crystalloid solutions.Methods: We selected 90 patients who visited our hospital in the last 2 years from June 2017 to May 2019. All the investigations and pre-anaesthetic check-up was done routinely. These patients had to undergo different surgical procedures under general anaesthesia. The induction of anaesthesia was done with propofol and fentanyl. These patients were divided in three groups A, B and C. Group A patients did not receive any preloading. Group B was given colloids (3.5% gelatins) and group C received crystalloids (Ringer’s lactate solution). The haemodynamic changes were noted and analysed statistically.Results: The study showed that IV fluids given before induction of general anaesthesia blunts the adverse cardiovascular response.Conclusions: We concluded that preload with fluids whether colloids or crystalloids are beneficial to counter the detrimental effects of propofol and fentanyl for induction of general anaesthesia. The preload fluids stabilise the patient haemodynamically. When compared the two, colloids were better to blunt the cardiovascular changes.
Retrospective observational study about patient friendly and cost effective wound care by newer concept of open dressing
Authors: Mane Arun Y. , Naik Narendra G.
Published: December 2019

Background: The choice of dressing material and to give wound cover varies according to the type of ulcer and the surgeon’s experience. It is practically not possible to do comparative evaluation among different types of dressing material and method to dress. The ideal dressing material and method to dress must be cost effective, comfortable to patient and early wound healing with minimal sequel of scar tissue. The article discusses about a newer method cost effective and patient friendly dressing to achieve effective end result in wound healing.Methods: Retrospective analysis of 50 patients treated from 01 April 2019 to 31 August 2019 by open dressing with written informed consent of patient and fulfilling ethical requirements at Rajiv Gandhi Medical College, Thane, Mumbai. The selection criteria of patients were cases with pressure dressing are excluded. The diabetic (40%), venous (20%) and traumatic (20%) ulcers are selected.Results: Out of 50 cases, in 76% sample cases ulcer healed by secondary intention without skin grafting. It was noticed better early improved status of the ulcer by excellent granulation tissue and without deterioration in status of large ulcers (24%), operated for skin grafting. The concept of covering wound by washed cotton cloth after regular wound wash, antiseptic ointment, and adjuvant conservative therapy, helped to improve patient’s comfort during outpatient department visit and inpatient department stay.Conclusions: It concludes that the newer concept of wound cover by washed cotton cloth is patient friendly and cost effective without compromising the status of wound healing.
Male breast cancer a rare entity: the experience from North-East India
Authors: Das Gaurav , Yadav Jitin , Purkayastha Joydeep , Talukdar Abhijit , Khanna Sachin
Published: December 2019

Background: Breast cancer is one of the most common malignancy among women but it is not common in men. Male breast cancer (MBC) is a rare disease and accounts for ∼1% of all cancers in men. There is lack of data related to MBC. The objective was to study the clinic-pathological characteristics and outcome of MBC patients at this institute.Methods: It is a retrospective study. Author analyzed clinico-pathological factors, management and follow up details of all patients with MBC from 2012 to 2018 at the cancer centre.Results: Total 20 patients were included in the study. No risk factor identified in any patient. The median age at diagnosis was 57.5 years. Most common location was central quadrant. Most common stage at presentation was stage 3. Fifteen patients underwent upfront surgery while neoadjuvant chemotherapy was given to two patients. One patient had complete pathological response (cPR). The median follow up was 24 months (4-60 months). Three patients developed local recurrence (3 chest wall and 1 axilla). Two patients developed distant metastasis (lung, liver and bone). Actual overall survival rate at 5 years was 67.5% with median disease-free survival was 55%.Conclusions: Multicentric trials are necessary to understand the predictive and prognostic markers and to improve the outcome in male breast cancer.
A comparative study of laparoscopic appendectomy versus open appendectomy
Authors: Khadilkar Reina , Panditrao Ashwini Anil , Inturi Ramteja
Published: December 2019

Background: Obstruction of appendiceal lumen resulting in acute appendicitis is diagnosed by clinical examination, supported by raised neutrophil count, computed tomography and/or ultrasonography.Appendectomy one of the most commonly done surgeries is the standard line of management for acute appendicitis. Trend is towards greater utilization of laparoscopic appendectomy despite lack of consensus on superiority of laparoscopic procedure, hence imperative to prove scientifically the effectiveness of the two methods. The aim of the present study was a comparative study of laparoscopic appendectomy versus open appendectomy.Methods: A prospective cohort study of 100 cases of acute appendicitis above 16 years of age with no co morbidities was carried out in Dr. D. Y. Patil Medical College, Hospital and Research Centre from July 2017 to September 2019.Results: Mean age was 28.82 years, 64 (64%) males and 36 (36%) females, pain in abdomen (100%) being most common complaint followed by fever (77%) with positive correlation with severity of appendicitis (Alvarado score) and with total leukocyte count. Mean duration of surgery and hospital stay in laparoscopic appendectomy was lesser than open and difference was statistically highly significant (p=0.000). No difference in pain score observed. Retrocaecal (58%) was the most common position, slightly higher rate of complications in open appendectomy, no conversion of laparoscopic to open. Subjective level of satisfaction score (0-10) in laparoscopic appendectomy was higher than in open and difference was statistically highly significant (p=0.000).Conclusions: Laparoscopic appendectomy had advantages like better cosmesis, shorter duration of procedure and hospital stay, fewer post-operative complications and early return to work with disadvantage of steep learning curve, while open appendectomy, does not require special instruments, and is performed under direct three-dimensional vision.
A clinical study on the surgical management of intestinal obstruction
Authors: Gogineni Jyotsna Choudary , Tonape Trupti , Athavale V. S. , Kumar Sree , Kutty Shweta Achuthan , Sri Likhita K.
Published: December 2019

Background: Intestinal obstruction remains one of the common emergencies encountered by general surgeons all over the world. Acute intestinal obstruction occurs when there is a disruption in the frontward flow of intestinal contents.Methods: This study is a prospective study conducted in Dr. D Y Patil Medical College and Hospital, Pimpri, Pune. Patients coming to the hospital with signs and symptoms suggestive of intestinal obstruction and willing for surgical management in our hospital were included after taking written and informed consent.Results: In our study, pain abdomen and abdominal distension was the most common presenting complaints in 90% and 92% of the patients respectively. On palpation, 96% of the patients had abdominal tenderness, 72% of the patients had guarding and 12% of the patients had rigidity. On auscultation, all patients had some abnormality with regard to bowel sounds. It has been noted that intestinal strictures and abdominal adhesions were amongst the most common causes of intestinal obstruction in our study.Conclusions: Prompt clinical assessment aided by radiological imaging is of crucial importance in reaching the diagnosis of intestinal obstruction. Decision regarding surgical intervention is taken based on the initial presentation of the patient, and his/her response to first line conservative management and fluid resuscitation
Gender specific variation in risk factors of gallstone disease among adult patients
Authors: Dhamnetiya Deepak , Goel Manish K. , Dhiman Balraj , Pathania Om P.
Published: December 2019

Background: Gallstone disease (GSD) is a common gastrointestinal disease diagnosed in patients presented with abdominal pain. The present study was aimed to find the association between demographic, personal, behavioural and dietary factors and GSD by gender among adult population for suggesting specific gender wise intervention to control GSD.Methods: Case-control study was conducted in 120 cases and same number of controls. Data was collected on a self-designed pretested “interview schedule”. To measure the strength of association OR was calculated by matched pair analysis using McNemar’s test.Results: Among 120 study subjects, 83 cases were females and 37 were males. Strength of association was found to be significantly higher for family h/o GSD in females (OR=8), physical inactivity (OR=8), waist-hip ratio (OR=4.2), calorie intake more than recommended dietary allowance (RDA) (OR=2.09), and diabetes (OR=4) as compare to males OR=3, OR=2.8, OR=2.5, OR=1.43, OR=2.33 respectively.Conclusions: Family h/o GSD, physical inactivity, high waist-hip ratio, calorie and fat intake more than RDA, protein intake less than RDA, hypertension and diabetes were found to be potential risk factors for the development of GSD in females. Consumption of smokeless tobacco, physical inactivity, non-vegetarian diet and intake of fats more than RDA were risk factors for GSD in males.
Role of colour Doppler in evaluation of venous abnormalities of lower limb
Authors: Sharma Dinika , D’Souza John , Joshi Priscilla
Published: December 2019

Background: Venous abnormalities of lower limb are a fairly common cause of morbidity. Although clinical diagnosis is the cornerstone of the diagnosis of lower limb venous disease, Colour Doppler ultrasound has become the investigation of choice to confirm the diagnosis. This study evaluated the role of Colour Doppler ultrasound in various venous pathologies of the lower limb and the sonographic findings were correlated with surgical and clinical findings.Methods: 100 patients of all age groups of either sex presenting with clinically suspected entities affecting venous system of the lower limb were selected for this study.Results: Our study showed a definite male preponderance (65%) with an incidence of 41% in the age group of 21-40 years. Isolated varicose veins had an incidence of 58% followed by isolated deep vein thrombosis (DVT) (29%), varicose veins with thrombophlebitis (5%), DVT with thrombophlebitis (5%), DVT with varicose veins (2%) and hematoma (1%). The findings correlated with surgery and gave a sensitivity of 100%.Conclusions: Colour Doppler ultrasound is unique due to its feasibility, accessibility and cost effectiveness. Its dynamism is also exploited by various maneuvers done by the patients, radiologist and the machine parameters to bring about changes in blood flow to reach the exact diagnosis.
Liver function trends after biliary decompression in obstructive jaundice: a clinico-pathological-biochemical study
Authors: Lal Mohan , Dayal Prabhu
Published: December 2019

Background: Liver functions tests suggest the underlying cause, estimate the severity, assess prognosis and monitor efficacy of therapy. Severity of liver dysfunction when performed serially may predict prognosis and may be helpful in assessing response to medical therapy or a surgical intervention.Methods: The data was collected in thirty cases of surgical obstructive jaundice in terms of age, sex, etiology, clinical presentation, surgical intervention for biliary drainage and the laboratory liver biochemical and coagulation profiles on a day prior to surgical intervention and post-operatively on 1st week and 4th week were recorded.Results: Of total 30 patients 56.66% were females. Patients with 73.68% of benign disease and 100% of malignant disease were of age more than 40 years. 63.33% of patients had benign cause for biliary obstruction. Choledochoithiasis and periampullary carcinoma were two most common causes of obstructive jaundice. The commonest complaints were; yellowish discolouration of sclera and skin, high colored urine (100%) and acholic stool (70%). Hepatomegaly, palpable gallbladder and ascites were observed in only malignant conditions. Serum bilirubin and transaminases were significantly higher in patients with malignant lesions on pre-operative and postoperative assessment. After decompression the rate of fall of serum bilirubin, serum glutamic-oxaloacetic transaminase and SGPT were almost identical in both benign and malignant biliary obstructions. However, a better biochemical recovery profile was observed in patients with benign lesions, as they returned to normal by 4 weeks but remained at 2 to 3 times of the normal in malignant lesions.Conclusions: Sequential biochemical assessment of liver functions has diagnostic as well as prognostic value in surgical obstructive jaundice.
A comparative study of single layer extra mucosal versus conventional double layer anastomosis of intestines in elective and emergency laparotomy
Authors: Sai K. Lohit , Sugumar C.
Published: December 2019

Background: Gastrointestinal anastomosis has been a part of research since decades and is one of the key skills in surgeon’s armamentarium. This study compared the outcome of single layer anastomosis with double layer anastomosis.Methods: The study was designed as a prospective comparative study and 29 cases were included in the study during December 2016 to September 2017, who consented for being part of the study. Patients were alternatively allotted into the either group. Group A underwent single layer anastomosis and Group B underwent double layer anastomosis. Outcome parameters were analysed in the form of ‘duration required to perform anastomoses, ‘duration of hospital stay’ and ‘dnastomotic leak.Results: Mean duration required to perform anastomosis in Group A is 21.64±1.60 minutes and in Group B is 29.6±2.02 minutes. The difference between the mean duration required for anastomosis between the two groups were statistically significant (p<0.005). Mean duration of hospital stay in Group A was 12.35±1.72 days and Group B was 12±2.44 days (difference was statistically insignificant), 3 (10%) cases in Group A and 2 (6.8 %) cases in Group B developed anastomotic leak and the difference was statistically insignificant.Conclusions: Our study concluded that there is statistically significant difference between the single layer anastomosis and double layer anastomosis in terms of time taken to perform anastomosis, however there is no difference in postoperative anastomotic leak and duration of hospital stay.
Postoperative posterior fossa pseudomeningocele: risk factors and management strategies
Authors: Sharithra D. , Anand Sathish , Rajan Thanga Thirupathi , Kumar Aravind
Published: December 2019

Background: Pseudomeningocele is a considerable morbidity after posterior fossa surgery. Its incidence and optimal management strategies are quite unclear. Hence the objective of this study is to define the risk factors and evaluate the management strategies and to study the incidence and morbidity of postoperative posterior fossa pseudomeningocele.Methods: A retrospective study of 33 patients undergone posterior fossa surgery for variety of diseases in the department of neurosurgery, Saveetha Medical College and Hospital from January 2015 to December 2018 with emphasis on incidence of pseudomeningocele,its morbidity and treatment strategies.Results: Out of 33 posterior fossa surgeries performed, 9 developed pseudomeningocele. Hence the incidence of pseudomeningocele in hospital is 27.27%. Out of 9 patients who developed pseudomeningocele, 6 patients were symptomatic, and aspiration was done to 5 patients and one patient underwent resurgery. That one patient underwent subgaleal-peritoneal shunt, excision of recurrent tumor was performed after which the symptoms subsided.Conclusions: Psudomeningocele is a well-known complication of posterior fossa surgery. The risk factors for pseudomeningocele formation after posterior fossa surgery has been evaluated. Age, sex and type of surgery are found to be a risk factors in our study. Conservative management is effective in most cases to reduce the symptoms. Surgical intervention is advocated, only when conservative treatment fails. Preventive measures like careful perioperative planning, strict adherence to aseptic techniques, usage of autologous pericranium with dural sealant augmentation, polyethylene glycol hydrogel dural sealant can be adopted.
Minimally invasive procedures for urological disorders in pregnant patients: our experience
Authors: Dar Manzoor Ahmad , Iqbal Muzzain , Khawaja Abdul Rouf , Wani Mohammad Saleem , Bhat Arif Hamid , Malik Sajad Ahmad , Dar Yaser Ahmad
Published: December 2019

Background: Urological disorders like stone disease, pyonephrosis secondary to obstruction and trauma are common during pregnancy with global incidence of 1 in 250 to 1 in 3000. These diseases can complicate any pregnancy and timely diagnosis and management is of utmost importance for safety of the mother and fetus. Managing these cases entails morbidity and minimally invasive procedures avoiding anesthesia have definite advantage.Methods: It was an observational study. Pregnant patients with nephrolithiasis, pyonephrosis, complicated post-traumatic ureteropelvic junction (PUJ) obstruction (PUJO) and trauma were included in the study.Results: Out of total 84 cases, 45 required intervention. Percutaneous nephrostomy (PCN) for pyonephrosis secondary to PUJO and obstructed PUJ calculus was done in 11 and 14 cases respectively. Bilateral PCN for bilateral nephrolithiasis was done in 7 cases. Silicon double-J stenting for ureteric calculus was done in 13 cases. One case of spontaneous fornicial rupture of kidney without stone disease was managed conservatively as were 4 cases of trauma with concomitant renal injury, 18 cases of non-obstructive renal stones and 16 cases of pyelonephritis. Seven patients lost follow-up. One case each of pyonephrosis and polytrauma had fetal death at term unrelated to urological cause. In rest 75 patients, primary pathology was tackled after 6-8 weeks of delivery.Conclusions: Urological diseases during pregnancy are not an uncommon entity and can pose risk to both mother and fetus. With good clinical vigil, use of minimally invasive procedures, close monitoring and follow up, these patients can be safely managed without any adverse events to the fetus and mother.
The ideal timing of cholecystectomy for mild gallstone pancreatitis
Authors: R. Satishkumar , J. Anukethan
Published: December 2019

Background: Gallstone disease is one of the most common problems affecting the digestive tract with a prevalence of 11% to 36% and is the most common cause of gall stone pancreatitis. The cholecystectomy is necessary to prevent recurrent pancreatitis in gallstone pancreatitis, but the ideal timing for cholecystectomy is controversial.Methods: This was a prospective randomized study with 59 patients conducted in the department of general surgery, KIMS, Bangalore from 2014 to 2019. All patient with mild gallstone pancreatitis, the following variables, duration and cost of hospital stay, readmission rates, intraoperative time, intra and postoperative complications and conversion to open cholecystectomy were studied.Results: A total of 59 patients in the age group of 21 to 71 years with mild gallstone pancreatitis were included in the study. Mean age of presentation was 57years. Out of 59 patients 28 underwent same admission cholecystectomy and 31 underwent interval cholecystectomy. There was a significant difference noted in terms of  mean duration of hospital stay (9.28 versus 17.20 days), mean cost of hospital stay (19340 versus 28240rs) and readmission rate (0% versus 19.35%), but in terms of mean intraoperative time (85 min versus 92 min) and conversion rate (0% versus 6.4%) there was no statistically significant difference between two group.Conclusions: Same admission cholecystectomy for mild gallstone pancreatitis can significantly reduce cost and duration of hospital stay and readmission rates. With regard to intraoperative time, conversion to open, intraoperative and postoperative complication there is no statistically significant difference seen. Hence same admission cholecystectomy is safe, feasible and recommended.
A study of pattern of pathogen and their sensitivity isolated from surgical site infections in abdominal surgeries
Authors: M. S. Anilkumar , K. R. Deepakraj
Published: December 2019

Background: Surgical site infection (SSI) is defined as those infections presenting up to 30 days after a surgical procedure if no prosthetic is placed and up to 1 year if prosthesis is implanted in the patient. SSI contributes to increasing morbidity, mortality and cost related to surgeries and continues to be a major problem even in tertiary care modern hospitals following standard protocols of peri operative preparation and antibiotics prophylaxis. Objective of this study was to study and analyse the pattern of pathogen causing SSI in abdominal surgeries in a tertiary care hospital.Methods: Descriptive study on patients undergoing abdominal surgery in the department of surgery. Patients satisfying inclusion criteria will be assessed on 2nd postoperative day and then daily for surgical site pain, redness, warmth, discharge and swelling of surgical site till the patient gets discharged and followed up after discharge every 7 days up to 1 month. If SSI is detected, swab will be taken and sent for culture and sensitivity.Results: At the end of the study, after analysing the pattern of pathogens and antibiotic susceptibility, we intend to conclude the safe usage of empirical antibiotic prophylaxis to prevent the incidence of SSI’s in our hospital.Conclusions: Appropriate prophylactic therapy for any open abdomen surgeries reduces incidence of surgical site infection thereby reducing morbidity, mortality and cost burden in patients undergoing abdominal surgeries.
Assessment of the success rate of specialised female surgical clinic in tertiary care hospital
Authors: Gupta Anand , Sharma Anshuman
Published: December 2019

Background: Specialized female surgical clinics are the basic requirement in surgical department which should be addressed routinely. The management of surgical problems in female patients requires multidisciplinary approach mainly general surgery, obstetrics and gynaecology, general medicine, paediatrics, dermatology and psychiatry. If proper care is provided then this will uplift the follow up of same patients in such clinics. The objective of the study was to assess the success rate of female surgical clinics and to determine the follow up visits done by female patients once visited the female surgical clinics.Methods: Prospective educational interventional study was conducted. A total of 952 patients visiting the clinic were studied. Statistical analysis was done.Results: Out of 952 cases 944 (99.2%) cases were willing to continue visit to the clinic, while 809 (84.9%) cases revisited for follow up treatment in female surgical clinics within one year duration.Conclusions: It can be concluded that there is a requirement and need of a fully functional specialized female surgical clinic in our hospital. As the success rate for follow up visit by patients in this clinic was high.
Interpositional arthroplasty with temporalis myofascial flap reconstruction in a case of temporomandibular joint bony ankylosis: a case report and review of literature
Authors: Vishwani Ankit , Arora Vipin , Goyal Kavita , Arya Suvercha , Khan Mohsin
Published: December 2019

The report describes the treatment of a 30 year old female patient having unilateral right temporomandibular joint (TMJ) bony ankylosis whose mouth opening was restricted to 5 mm and had additional mandibular retrognathism causing severe mastication problems besides speech difficulties and low morale. The ankylosis had resulted in facial asymmetry due to bony hard swelling in front of right tragus. The patient was taken up for right interpositional arthroplasty with temporalis myofascial flap reconstruction by pre auricular approach and left coronoidectomy by intraoral approach as a preferred technique. A satisfactory mouth opening of 33 mm was achieved in immediate post-operative. Patient was followed up with aggressive mouth opening exercises in postoperative period.
Perforated isolated jejunal diverticulum: a rare cause of acute abdomen
Authors: Jha Abhijeet , Ghuliani Deepak , Jain Sudhir K. , Ansari Faiz M.
Published: December 2019

A 45-year-old female presented with pain in peri-umbilical region for past one day along with history of non-bilious vomiting and non passage of stool and flatus for past one day. On physical examination, patient was afebrile, mild dehydration was present, tachycardia of 102 beats per minute with normal blood pressure. On clinical examination, the abdomen was diffusely tender with rebound tenderness. Bowel sounds were absent. Laboratory investigations revealed leucocytosis. An erect plain chest X-ray was done, didn’t reveal any gas under the diaphragm. Contrast enhanced computed tomography abdomen was done which showed a hollow viscus perforation with intra-abdominal free air and pelvic free fluid. Patient was resuscitated with IV fluid, broad-spectrum antibiotics were started and immediately taken up for exploratory laparotomy. Three jejunal diverticula identified at mesenteric border, with pin-head perforation in one of the diverticula. Small bowel resection including the three diverticula and primary end-to-end anastomosis was performed. Post-operative period was uneventful. Patient discharged on satisfactory conditions. This case stresses the importance to consider this entity in cases of unexplained gastrointestinal symptoms because any treatment delay may lead to unsuccessful clinical outcome.
Conservative management of an iliopsoas hematoma causing walking difficulty in an elderly patient on anticoagulation therapy: a case report
Authors: Kisku Deepak Kumar , Panigrahi Sudhir Kumar , Mishra Amaresh , Kanungo Abinash , Moharana Niranjan
Published: December 2019

Spontaneous iliopsoas hematoma is a rare complication in patients suffering from bleeding disorders like hemophilia, Von Willebrand’s disease or those taking blood thinners like aspirin and clopidogrel or anticoagulant medications like warfarin for atrial fibrillation or post-thrombotic status. It can present as severe pain, muscle dysfunction, difficult walking or neurological dysfunction due to compression on femoral nerve or lumbar plexus. A high index of suspicion with early blood and radiological investigations like contrast enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) of the part is immensely helpful in diagnosis and prompt management of such patients. A low hemoglobin or hematocrit level and a high INR is supportive while CECT or MRI of the abdomen and pelvis is confirmatory. Management in a hemodynamically and neurologically stable patient include immediate withdrawl of the anticoagulant, bed rest, infusion of I.V. fluids, vitamin K, fresh frozen plasma and packed red cell transfusion, which ensures complete recovery in most of the cases. However angio-embolization to control ongoing arterial bleeding is lifesaving when feasible or emergent open decompression and bleeding control surgery can save the life or prevent permanent neurological damage to the limb. Decompression of the hematoma by ultrasound or computed tomography guided catheter drainage is helpful alternative in few selected cases. We report an elderly patient on warfarin, who suddenly developed difficulty in walking within hours of a strained defecation, diagnosed to suffer from left iliopsoas hematoma and responded to conservative management with complete resolution of symptoms by 3 weeks.
Aquinas’s Real Distinction and Its Role in a Causal Proof of God’s Existence
Authors: Klima Gyula
Published: December 2019

This paper is not going to offer any criticism of the way Gaven Kerr treats Aquinas’ argument. Instead, it offers an alternative way of reconstructing Aquinas’ argument, intending to strengthen especially those controversial aspects of it that Kerr’s reconstruction left untreated or in relative obscurity. Accordingly, although the paper’s treatment will have to have some overlaps with Kerr’s (such as the critique of Kenny’s critique of Aquinas), it will deal with issues essential to adequate replies to certain competent criticisms of his argument untreated by Kerr (such as Buridan’s critique). For the sake of the “formally inclined” reader, the paper’s treatment will also include an Appendix offering a formal reconstruction of both the main argument and its sub-arguments to demonstrate the formal rigor of Aquinas’ original.
The Analytical Thomist and the Paradoxical Aquinas: Some Reflections on Kerr’s Aquinas’s Way to God
Authors: Knasas John F.X.
Published: December 2019

My article critically evaluates five key claims in Kerr’s interpretation of Aquinas’s De Ente et Essentia, ch. 4, proof for God.  The claims are: (1) the absolutely considered essence is a second intention, or cognitional being; (2) à la John Wippel, the real distinction between essence and existence is known before the proof; (3) contra David Twetten, Aristotelian form is not self-actuating and so requires actus essendi; (4) the De Ente proof for God uses the Principle of Sufficient Reason; (5) an infinite regress must be eliminated before concluding to God.  This author wonders if these questionable claims are traceable to the mindset of analytic philosophy which values precision and discreteness and so can fail to appreciate crucial paradoxes in Aquinas’s metaphysics.
Existence and God: On Aquinas–Kerr’s Metaphysical Argument
Authors: Wojtysiak Jacek
Published: December 2019

In this paper, I discuss, as carried out by Gaven Kerr, a reconstruction of Aquinas’s argument for the existence of God from his work De Ente et Essentia. My analysis leads to complementing Kerr’s proposal with the following elements: (i) a summarization of the presented argument in a more formal manner; (ii) a specification of the main presuppositions of the Thomistic conception of existence; (iii) a drawing of attention to the fact that the essence–esse composition is a borderline case of the array of potency–act compositions; (iv) a distinguishing of the empirical (connected with the problem of the regress) and speculative (deprived of such a problem) interpretations or versions of Aquinas’s argument; (v) a clarification of what is the Divine exception from the essence–esse composition; (vi) a distinguishing of the three models of participation and a defence of the moderate model. I regard the following two issues to be of key importance for the argument under discussion: the relation between the Aristotelian compositional model and the Platonic model of participation as well as the defence of the Thomistic conception of the essence–esse composition.
Existence and Wisdom
Authors: O’Grady Paul
Published: December 2019

In this paper, I examine the debate about existence between deflationist analytic accounts and the ‘thicker’ conception used by Aquinas when speaking of esse. I argue that the way one evaluates the debate will depend on background philosophical assumptions and that reflection on those assumptions could constitute an account of theoretical wisdom
Capturing emotions in voice: A comparative analysis of methodologies in psychology and digital signal processing
Authors: Hekiert Daniela , Igras-Cybulska Magdalena
Published: December 2019

People use their voices to communicate not only verbally but also emotionally. This article presents theories and methodologies that concern emotional vocalizations at the intersection of psychology and digital signal processing. Specifically, it demonstrates the encoding (production) and decoding (recognition) of emotional sounds, including the review and comparison of strategies in database design, parameterization, and classification. Whereas psychology predominantly focuses on the subjective recognition of emotional vocalizations, digital signal processing relies on automated and thus more objective vocal affect measures. The article aims to compare these two approaches and suggest methods of combining them to achieve a more complex insight into the vocal communication of emotions.
Negative arousability and relationship satisfaction: The mediating role of empathy
Authors: Łada Ariadna B. , Kaźmierczak Maria
Published: December 2019

Temperamental traits and empathy are both associated with emotional regulation; they thus shape both the quality of an individual’s life and the functioning of his or her social relationships. However, the mediating effects of emotional empathy in the relationship between temperamental characteristics and relationship satisfaction have not been closely analyzed and therefore require further study. This study examined the effects of temperamental arousability – global negative arousability and its components (fear, sadness, discomfort, frustration) – on emotional empathy and, consequently, on relationship satisfaction. One hundred and fifty young adults (104 women, 46 men) aged 20 to 35 participated in the study. The participants had been in romantic relationships for at least six months. The study used a sociodemographic survey and a set of questionnaires which included the Adult Temperament Questionnaire – Short Form, the Empathic Sensitiveness Scale and the RELAT Questionnaire. The results showed that empathic concern fully mediated the relationship between global negative arousability and relationship satisfaction. Furthermore, the effects of fear and sadness on relationship satisfaction were fully mediated by empathic concern and personal distress. Additionally, personal distress fully mediated the relationship between discomfort and relationship satisfaction. Neither empathic concern nor personal distress were mediators in the relationship between frustration and relationship satisfaction. It can therefore be concluded that although partners who exhibit higher global negative arousability report lower relationship satisfaction, they might become more satisfied when being more compassionate and caring towards others.
Paradigma fikih baru Jamal al-Banna dan relevansinya terhadap pembaruan peran perempuan dalam hukum keluarga Islam (Fiqh al-Munakahat)
Authors: Bahri Syaiful
Published: December 2019

The role of women, according to classical fiqh (Islamic law) literature, especially fiqh al-Munakah}at (Islamic family law), tends to be regarded as a complementary part of domestic life. Their role is limited to the domestic territory, and restrain to play a public role. This paper tries to reconstruct the role of women in Islamic family law, utilizing the new fiqh paradigm initiated by Jamal al-Banna. To answer this problem, the author conducted a literature study by examining two works of Jamal: Nah}wa Fiqhin Jadid and Al-Mar'ah al-Muslimah bayna Tah}rir Al-Qur'an wa Taqyid al-Fuqaha'. This paper concludes that some issues regarding the role of women in Islamic family law need renewal. There are four crucial issues that are reviewed using the new fiqh paradigm of Jamal al-Banna, namely the minimum age of marriage, wali’s ijbar rights, polygamy, and divorce.
Breach of contract: an Indonesian experience in akad credit of sharia banking
Authors: Ningsih Ayup Suran , Disemadi Hari Sutra
Published: December 2019

This research aims to determine and analyze the implementation of the concept of profit-sharing in Islamic banking credit agreements based on regulations in force in Indonesia and also to find out and analyze defaults undertaken by customers in Islamic banking credit agreements. The method used in this research is normative juridical, which is a method that puts forward secondary data in the form of primary, secondary and tertiary legal materials. The secondary data in question such as Law Number 21 of 2008 concerning Sharia Banking, related books, and legal research journals. This research is based on the high community needs for capital to achieve the objectives of a business into a separate phenomenon. The concept of muamalah on the teachings of Islam that Muslims want to adhere to is one of the reasons for the birth of the concept of Islamic banking in Indonesia. The concept of profit sharing is one of the concepts known in Islamic banking. The risk of breach of contract by the customer is a necessity.
Hydrogen sulfide formation in experimental model of acute pancreatitis
Authors: Bronowicka-Adamska Patrycja , Hutsch Tomasz , Gawryś-Kopczyńska Marta , Maksymiuk Klaudia , Wróbel Maria
Published: December 2019

Acute pancreatitis (AP) is a disease defined as acute or chronic inflammatory process of the pancreas characterized by premature activation of digestive enzymes within the pancreatic acinar cells and causing pancreatic auto-digestion. In mammalian tissues, H2S is synthesized endogenously from L-cysteine in regulated enzymatic pathways catalyzed by pyridoxal phosphate-dependent enzymes: cystathionine beta - synthase (CBS), gamma - cystathionase (CTH) and cysteine aminotransferase (CAT) coupled with 3-mercaptopyruvate sulfurtransferase (MPST). In the mitochondria, hydrogen sulfide is oxidized to sulfite, which is then converted to thiosulfate (sulfane sulfur-containing compound) by thiosulfate sulfurtransferase (rhodanese; TST). The activity and the expression of CBS, CTH, MPST, and TST have been determined in vivo in pancreas of control rats, rats with acute pancreatitis and sham group. Levels of low-molecular sulfur compounds such as reduced and oxidized glutathione, cysteine, cystine and cystathionine were also determined. The study showed the significant role of MPST in H2S metabolism in pancreas. Stress caused by the surgery (sham group) and AP cause a decrease in H2S production associated with a decrease of MPST activity and expression. Markedly higher level of cysteine in the AP pancreas may be caused by a reduced rate of cysteine consumption in reaction catalyzed by MPST but it can also be a sign of the processes of proteolysis occurring in the changed tissue.
Laser Ignition of Liquid-Oxygen–Gaseous-Hydrogen Fuel in a Large-Scale Combustion Chamber
Authors: Rebrov S.G. , Golubev V.A. , Kosmachev Y.P. , Kosmacheva V.P.
Published: December 2019

The article presents a review of the results of studies of laser ignition of a cryogenic mixture (gaseous hydrogen and liquid oxygen) in an experimental combustion chamber, carried out at the bench testing facility of KBKhA (Voronezh). A laser ignition module specially designed at the Keldysh Research Centre and with parameters optimized for use in the rocket engine launch system was used during the experiments. Fuel ignition by the laser system occurred directly in the experimental chamber without the use of an ignition device or pre-chamber. To implement this ignition method, inflammation of the fuel in the chamber was carried out by focusing the laser radiation into the mixture, with the initiation of a spark of optical breakdown in the selected area with conditions favorable for the start of combustion. The results of the experiments confirmed the efficiency of the laser module during both standalone and firing tests, including multiple launches of the propulsion unit operated on a cryogenic mixture (gaseous hydrogen and liquid oxygen).
A Method for Determining the Conversion Factors to Convert Gas Turbine Engine Parameters to Normal Values Based on Test Results in a Thermal Pressure Chamber
Authors: Grigoriev V.A. , Kalabukhov D.S.
Published: December 2019

The article presents a method for determining the normalizing coefficients of recalculation of the main technical parameters of a gas turbine engine when undergoing production testing. The method is based on the application of methods for planning a design experiment. The mathematical models of the output data of the engine, necessary for carrying out such an experiment, were obtained by means of static processing of the protocols of the previous tests that contained the results of direct measurements of the parameters in a thermal pressure chamber. The ambient conditions (atmospheric pressure and temperature) and the operating parameters (rotational frequency and effective power of the engine) were selected as variable factors of the experimental design. Depending on these factors, the normal values of the parameters and the normalizing conversion factors for fuel consumption, air consumption, gas temperatures in the flow part of the engine and other output data were determined analytically. The method was demonstrated by processing test results of the 9I56 engine.
The Influence of Configuration on the Range of a Hypersonic Flight Vehicle under Space Limitations
Authors: Presnyakov S.V. , Usachev V.A. , Koryanov V.V. , Kudryavtseva N.V.
Published: December 2019

The article examines the influence of the configuration of a hypersonic flight vehicle with a hori-zontal cruise flight section on the maximum flight range under the conditions of limiting dimen-sions. The ram jet and the solid propellant rocket engine were chosen as the cruise engine, and re-spective calculations were performed. The hypersonic flight vehicle was configured based on the design patented in the Russian Federation, under the condition of launch using the 3S14 universal launcher. Dependencies of the maximum range on the ratio between the launch mass to the payload were analysed. The mass efficiency indicator for a two-stage ballistic missile was chosen as a crite-rion for a comparison with other available alternatives.
An Analysis of Increasing Thrust of an Air Propeller Through Additional Lift Surface
Authors: Tumur-Ochir Erdenebat , Batzorigt Erdenebat , Danaa Ganbat
Published: December 2019

Air propellers used in small scale unmanned aircraft operate at low Reynolds numbers. The aerody-namic force occurring on the blade when the air propeller is in operation is of variable nature. It is observed that for Reynold numbers below 5⋅105 flow separation can occur on some sections of the propeller surface. To deal with the problem, increase the lift on the blade and therefore, reduce the turbulence boundary level, a new design called bi-blade propeller is developed and patented. This design features an additional blade above the main one. Using ANSYS Fluent, samples of the bi-blade propellers were investigated to determine the positions where the inductive resistence and the turbulence boundary level decreased, and the lift increased when the air propeller was in operation. A comparison study was conducted in laboratory conditions to investigate static thrust of the bi-blade propeller on a test bench at 2000–4500 мин–1. The bi-blade propeller was compared with a conventional propeller.