bluuebunny/crossref_metadata_2025 huggingface dataset:
The tsunami of May 23, 1960, on the Island of Hawaii
Authors: Eaton J. P. , Richter D. H. , Ault W. U.
Published: July 2021

The tsunami of May 23, 1960, originating in an area of profound crustal disturbance along the coast of Chile, resulted in the greatest natural disaster in Hawaii since the Aleutian-born tsunami of 1946. A study of T phases from earthquakes produced by this disturbance suggests that the duration of faulting responsible for the largest earthquake and the tsunami was about 7 minutes. With the exception of the Hilo Bay area, wave heights on the Island of Hawaii were generally low, ranging between 3 and 17 feet, and averaging 9 feet. At Hilo, the third wave, which developed into a bore as it entered the bay, rose 35 feet above sea level. The action of this bore is best explained in terms of an hydraulic shock wave; its relation to the tsunami wave train, however, is poorly understood. Patterns of wave heights on Hawaii's shores produced by recent tsunamis of diverse geographic origin are strikingly different, whereas those from nearly the same origin are remarkably similar. The city of Hilo, which experienced a loss of 61 lives and $20 million in property, sustained the most extensive damage that occurred in the Hawaiian Islands. The need for tsunami research and continual public education, as a means for preventing further disaster, is painfully evident. The wave height data presented, together with the fullest possible evaluation of the seismogram, should aid in indicating danger areas and forecasting wave heights in future tsunamis.
Integrated velocity and displacement of strong earthquake ground motion
Authors: Berg G. V. , Housner G. W.
Published: July 2021

The earthquake ground accelerations recorded at El Centro, 30 December 1934; El Centro, 18 May 1940; Olympia, Washington, 13 April 1949; and Taft, California, 21 July 1952, have been integrated with a digital computer to obtain at each location the three components of ground velocity and ground displacement. Maximum horizontal displacements of 10 and 20 inches are indicated, and maximum vertical displacements of 5 inches are indicated.
The effect of variations in layer thickness on Love waves
Authors: de Noyer John
Published: July 2021

A model is considered in which Love waves propagate perpendicular to the trend of a structure that is varying in thickness as a sine function of distance. The period equation for this model is obtained and average values for phase and group velocities are found for several distance ranges. A method is proposed for finding relative amplitudes as a function of position along the structure for any specified period.
The effect of the earth's surface on the S wave particle motion
Authors: Nuttli Otto
Published: July 2021

This paper is concerned with the determination of the particle motion of the earth's surface due to the incidence of a plane S wave of arbitrary polarization and incidence angles. It is assumed that the earth's surface may be represented by a plane surface.

For angles of incidence less than sin-1(b0/a0, where a0 and b0 are the P and S wave velocities at the earth's surface, all three components of ground motion will be in phase, and the resultant motion is linear. For angles of incidence greater than sin-1(b0/a0), all three components of ground motion will in general be out of phase, with the resultant motion describing some three-dimensional figure. The epicentral distance at which the motion changes from linear to non-linear depends upon the wave length of the S wave and the slope of the travel time curve at that distance.
An observational determination of the variation of the angle of incidence of P waves with epicentral distance
Authors: Nuttli Otto , Whitmore John D.
Published: July 2021

Apparent angles of incidence of the P wave were obtained from the seismograms of the Galitzin-Wilip instruments at Florissant. The “half-periods” of these waves varied from 112 to 312 seconds, and the epicentral distances from 16.5° to 103.2°. The data indicate that the velocity of P waves at the earth's surface is approximately 8 km/sec. This suggests that these P waves do not see or are not affected by the earth's crust, although the crustal thickness is known to be approximately 35 km. P wave data from five other stations for the Alaska earthquake of July, 1958 support the conclusions obtained from the Florissant data.
Response of a simple structure to a random earthquake-type disturbance
Authors: Bogdanoff John L. , Goldberg John E. , Bernard M. C.
Published: July 2021

A physically plausible second order random function has been selected to represent ground acceleration. Several member functions have been presented in graphical form. Some of the statistical properties of the response of a simple structure to this acceleration have been determined and possible uses of these properties by designers of aseismic structures have been commented upon. Lines for additional investigation of the uses of random function theory in the study of seismic disturbances also have been indicated.
Earthquake insurance in the United States—A reappraisal
Authors: Buffinton P. G.
Published: July 2021

The basic objective of this paper is to inform seismologists of some of the major problems which confront the earthquake insurance underwriter and to point out certain areas which are in need of further research and study.

The basic factors which are generally considered in making fire and other property insurance rates are discussed with special emphasis on their application in the earthquake insurance field.

The most important factor from the standpoint of earthquake insurance is the element of time or frequency of loss occurrence. In this connection a comparison is made of the fire and earthquake loss ratios for the period 1916-1957.

The earthquake experience by geographic zone in the United States is discussed and a table is presented showing the frequency of United States earthquakes for the period 1638 through 1956. The author points out that based on this information, it would appear that earthquake rates in the Northeastern United States should be about 110 of the rates charged in California.

A comparison is also made of the average damage in dollars for earthquakes of various intensities and a table is provided showing the results for earthquakes of intensity 7 and over on the Modified Mercali Scale.

The author concludes that the underwriter would be aided by more detailed information on individual earthquakes including specific information on the type of construction damaged, the type of ground upon which the building has been built, the total dollar damage and the estimate of property values in the high damage areas. Also needed is a further evaluation of the relation of intensity and frequency and better analysis of damage caused by earthquakes of various intensities.
An oscillating system for a long-period seismometer for horizontal motion
Authors: Romberg Frederick E.
Published: July 2021

An oscillating system suitable for use in a long-period horizontal-motion seismometer is described. The system consists of a short vertical pendulum whose gravitational restoring torque is opposed by a vertical zero-length spring. By adjusting the spring constant with respect to the mass of the pendulum the net restoring torque can be reduced to almost zero, thus giving the system a long period. The period is less sensitive to tilt than that of the horizontal pendulums commonly used in seismometers for horizontal motion. The lateral dimensions of the system are small so that it is adaptable for use in a bore hole and for easy transportation and setting up. A stable period of 30 seconds has been observed in a prototype model.
Energies, magnitudes, and amplitudes of seismic waves from quarry blasts at Promontory and Lakeside, Utah
Authors: Berg Joseph W. , Cook Kenneth L.
Published: July 2021

The total apparent energy was computed for seismic waves on seismograms obtained at distances of 6.78 and 13.2 km from a blast of 1,221,000 lb of explosives and 22.0 km from a blast of 2,138,000 lb of explosives, at Promontory, Utah. The ratios of the total apparent seismic energy at these distances to the total energy of the explosives were plotted against distance, and the ratios of 0.027 and 0.017 were obtained by extrapolating this plot to zero and 2 km distance from the blasts, respectively. Using the relationship between total apparent seismic energy and magnitude given by Gutenberg and Richter (1956), magnitudes ranging from 4.0 and 3.9 (charge size of 490,500 lb) to 4.6 and 4.4 (charge size of 2,138,000 lb) were computed from the data applicable at zero and 2 km from the large quarry blasts detonated at Promontory and Lakeside, Utah, between 1956 and 1959.

For charge sizes ranging from 490,500 lb to 2,138,000 lb, an approximate linear relationship was found to exist between charge size and average record amplitude of the first cycle of the first arrival as measured on vertical-component seismograms obtained at Eureka, Nevada. The average vertical-component displacement amplitude of the first cycle of the first arrival was calculated to diminish by the 1.7 power of the distance between 6.78 and 22.0 km from the above blasts. The average vertical-component velocity amplitude of the first two cycles of the first arrival was calculated to diminish by the 1.8 power of the distance between 90.0 and 279 km from the above blasts.
Radiation of seismic surface-waves from finite moving sources
Authors: Ben-Menahem Ari
Published: July 2021

A therory is proposed for the propagation of seismic surface-waves from finite moving sources. The method consists of obtaining, in the first place, basic solutions for surface displacements from directional sources. These solutions are integrated to obtain the effect of a moving fault with arbitrary dip angle. Displacements are evaluated for Rayleigh and Love waves at long ranges. It is shown that the dimensions of the source and the speed of rupture play an important role in the wave-pattern and cannot be ignored whenever the dimensions of the source are of the order of the radiation's dominant wave-length. It is demonstrated how this theory may lead to a derivation of the velocity of rupture and the length of faulting from seismic records of a single station.
On the nature of oceanic seismic surface waves with predominant periods of 6 to 8 seconds
Authors: Oliver Jack , Dorman James
Published: July 2021

The train of normally-dispersed, short-period, oceanic surface waves, commonly identified by the near-sinusoidal nature of all three components of ground motion in the period range of about 6 to 8 seconds, is shown to correspond to propagation in the first Love and first shear normal modes. Theoretical dispersion curves which agree with the observed dispersion of these short-period waves, as well as with dispersion of Rayleigh waves and Love waves of longer periods, are obtained for layered models of the oceanic crust which are consistent with results of seismic refraction studies. In order to obtain good quantitative agreement between theory and observation, it is essential that the effect of the small but finite rigidity of the deep-sea sedimentary layer be included in the calculations.
Willard D. Johnson and the strike-slip component of fault movement in the Owens Valley, California, earthquake of 1872
Authors: Bateman Paul C.
Published: July 2021

Maps and photographs made by Willard D. Johnson in 1907 and published by W. H. Hobbs in 1910, together with unpublished illustrations and an incomplete manuscript by Johnson, show convincingly that the faulting that took place near the town of Lone Pine at the time of the Owens Valley earthquake of 1872 involved both dip-slip and right-lateral components of movement. The pattern of movement at Lone Pine in 1872 is opposed to the postulate of regionally systematic left-lateral movement along the east side of the Sierra Nevada during the Cenozoic, but does not prove systematic regional right-lateral movement. Detailed geologic mapping is needed to fully describe the regional pattern of movement during the Cenozoic.
The transfer function of a short-period vertical seismograph
Authors: Bogert B. P.
Published: July 2021

We locate the poles and zeros of the transfer function of a seismograph which consists of the Geotech Model 1051 Benioff vertical seismometer and the Geotech Model 4500 galvanometer-phototube amplifier with a 5 cps galvanometer. A weighted least squares fit to the measured frequency response of the seismometer, assuming a damping ratio of 17 to 1, gives for the pole locations of the seismometer transfer function:

- 10 . 539 ; - 5 . 787 + i 7 . 407 ; - 5 . 787 - i 7 . 407

There is a triple zero at the origin. The overall seismograph transfer function has additional poles at

- 22 . 21 + i 22 . 21 ; - 22 . 21 - i 22 . 21 ; - 0 . 06283 ; - 29 . 62 + i 29 . 62 ; - 29 . 62 - i 29 . 62 ;

an additional zero at the origin, and a quadruple zero at infinity.

an additional zero at the origin, and a quadruple zero at infinity.
Seismic data collection, reduction, and digitization
Authors: Bogert B. P.
Published: July 2021

The facilities set up at the Bell Telephone Laboratories for seismic data collection and reduction are described. The digitization of the data so collected was carried out with existing equipment used for processing speech and visual data. We consider the seismic instrumentation and telemetry set up at the Chester Field Laboratory, Chester, New Jersey, the observation and recording equipment installed at the Murray Hill Laboratory, and finally and digitization and associated computer reduction to punched card form.
GASTOS COM EDUCAÇÃO, SAÚDE E SEGURANÇA PÚBLICA: UMA RELAÇÃO COM AS TAXAS DE HOMICÍDIOS NOS MUNICÍPIOS DO BRASIL
Authors: Rivera Castro Miguel Angel , Pinto da Silva Lindomar , Rios Thiago Henrique
Published: July 2021

Este trabalho teve por objetivo identificar a relação entre as taxas de homicídios nos municípios brasileiros com os gastos com educação e cultura, saúde e segurança pública. Em grandes linhas, está-se investigando em que medida os gastos públicos podem contribuir para a redução dos homicídios nos municípios brasileiros. Para tanto, utilizou-se como método a econometria espacial que permite, dentre outras coisas, verificar se há algum tipo de transbordamento espacial deste tipo de crime entre as cidades vizinhas. Os dados foram obtidos a partir do CENSO do IBGE, DATASUS e do Boletim de Finanças Públicas do Brasil, elaborado pela Secretaria do Tesouro Nacional (STN), referente aos anos de 2000 e 2010. Os resultados para o ano de 2010 indicam que gastos com educação e cultura foram diferentes do esperado, pois foram positivos e significativos. Isto sugere uma espécie de relação positiva entre gastos com educação e cultura e taxa de homicídio. Porém, este resultado ocorreu quando se controla pelo percentual de indivíduos maiores de 15 anos com nível fundamental. Esta variável, por sua vez, mostrou-se negativa e significativa para o ano de 2010. Ou seja, quanto maior o percentual de indivíduos com aquele nível de escolaridade, menores serão as taxas de homicídios. Os gastos com saúde e segurança pública indicam que maiores investimentos nestas áreas tendem a reduzir esses crimes. Outras variáveis usadas no modelo econométrico também se mostraram significativas, especialmente as características dos municípios vizinhos.
GESTÃO FINANCEIRA EM MPEs: UM ESTUDO SOB A ÓTICA DE ESPECIALISTAS ALAGOANOS
Authors: Silva Amyson Jhonata da , Levino Natallya de Almeida , Costa Carlos Everaldo Silva da
Published: July 2021

A micro e pequena empresa (MPE) no Brasil é parte importante da economia, sendo parte de um setor que mais emprega, mas que, ao mesmo tempo, possui alta taxa de mortalidade. Capaz de auxiliar essa tipologia empresarial no âmbito financeiro, há o consultor. No intuito do reforço dessa hipótese em um determinado contexto, este estudo tem como objetivo compreender quais as melhores práticas em gestão financeira segundo a ótica de consultores alagoanos. A metodologia combinada uniu a coleta dos dados – onde foram realizadas entrevistas semiestruturadas com 6 consultores em 2019 – pelo método Delphi e, para a análise, a técnica de Análise de Conteúdo (AC), através dos softwares qualitativos QDA Miner e o WordStat 8. Os resultados apresentaram que, sob a ótica dos consultores, as MPEs alagoanas têm deficiência em práticas básicas, pois muitas não realizam o devido gerenciamento do fluxo de caixa e/ou capital de giro.
PROTEÇÕES AO ACIONISTA E AO CREDOR E POLÍTICA DE DIVIDENDOS: UMA ANÁLISE INTERNACIONAL DOS MODELOS DE RESULTADO E DE SUBSTITUIÇÃO
Authors: Miranda Rodrigues Ana Cristina
Published: July 2021

Este artigo investiga os efeitos dos mecanismos de proteção ao acionista e ao credor sobre as políticas de dividendos, à luz dos modelos de agência de resultado e de substituição. Para dar suporte às hipóteses formuladas, desenvolvem-se estatísticas descritivas, regressões Tobit e o Método dos Momentos Generalizados. Os resultados empíricos, baseados em dados de 18.607 empresas de 40 países, durante o período de 2008 a 2017, sugerem que firmas instaladas em países com alta proteção ao acionista e com melhores oportunidades de investimento são menos propensas a pagar dividendos, como assim o fazem, indicando as efetividades dos modelos de resultado e de substituição, sob a perspectiva do acionista. Sob a perspectiva do credor, os resultados mostram que, em condição de alta proteção, o credor restringe o pagamento do dividendo de firmas com maiores oportunidades de investimento e, quando da baixa proteção à dívida, as empresas pagam mais dividendos. Deste modo, é possível concluir que os direitos dos acionistas, e não dos credores, são consistentes com os modelos de agência de resultado e de substituição dos dividendos.
ESTRATÉGIA NA GESTÃO LOGÍSTICA DA CADEIA DE SUPRIMENTOS: UM ESTUDO MULTICASO COM EMPRESAS DE SOLUÇÕES PARA O SETOR DE MINERAÇÃO
Authors: Cabral Daniel Barbosa , Luz Marcos Augusto Lima , Souza Queren Hapuque Gomes , Vieira Zildinéia Santos
Published: July 2021

Este artigo tem o objetivo de analisar como a estratégia empresarial é adotada na gestão logística da cadeia de suprimentos de empresas do ramo de soluções para a mineração. A pesquisa qualitativa é de natureza exploratória. Foram realizados estudos de múltiplos casos em três empresas de grande porte e multinacionais do segmento de soluções para o setor de mineração. Os gerentes das filiais foram entrevistados nas instalações das empresas e responderam a um questionário semiestruturado. Os resultados foram analisados por meio da técnica de análise de conteúdo. Adicionalmente, foram elaboradas uma matriz SWOT e um fluxograma de processos logísticos para cada empresa visitada.  Os resultados indicaram que as estratégias de gestão logística da cadeia de suprimentos têm contribuído para o gerenciamento dos estoques, transporte, armazenagem e processamento dos pedidos, aumentando, assim, a eficiência dos processos estratégicos da logística empresarial das empresas.
APURAÇÃO DE HAVERES EM PROCESSOS JUDICIAIS: UMA ANÁLISE DE DOIS LAUDOS PERICIAIS COM ÊNFASE NOS PROCEDIMENTOS UTILIZADOS PELOS PERITOS
Authors: Strassburg Udo , Moreno Katyane Aline Cantu
Published: July 2021

A atuação em perícias de apuração de haveres exige um conhecimento amplo sobre toda gama de procedimentos existentes em uma empresa. Em situações adversas, como a saída de um sócio, pode gerar dúvidas entre as partes, principalmente em relação a quanto cabe a cada um, e não havendo acordo amigável, o caso é levado à justiça para que, por intermédio de um magistrado, a decisão possa ser tomada em relação à apuração destes valores. O objetivo da presente pesquisa é analisar dois laudos de perícias para avaliação de haveres, com ênfase nos procedimentos utilizados pelos peritos. Como resultados, a primeira perícia trata sobre uma dissolução parcial de sociedade por desentendimentos e desacordos, e o segundo processo trata de uma dissolução parcial de sociedade pela morte de um dos sócios. Foi evidenciado que os laudos seguiram as formalidades legais, pecando em alguns aspectos como a falta de detalhamento na análise técnica ou científica. Outros achados são das diferenças de visões e abordagens metodológicas e ferramentais. Evidencia-se que os dois laudos chegaram ao objetivo pretendido, mas deixando algumas dúvidas, pois, na visão de quem analisou o laudo, algumas informações não ficaram claras, as quais poderiam ser úteis para o magistrado, na tomada de decisão. Cada laudo tem as suas especificidades e devem ser individuais, seguindo as intuições de cada perito.
DESEMPENHO DE IPOS DE EMPRESAS BRASILEIRAS FINANCIADAS POR FUNDOS DE PRIVATE EQUITY
Authors: Andrade Vitor Fassio , Antônio Rafael Moreira , Gatsios Rafael Confetti , Junior Tabajara Pimenta
Published: July 2021

Este trabalho analisou a relação entre a presença de financiamento de fundos de Private Equity em empresas que realizaram oferta pública inicial de ações (IPO) e o comportamento posterior dos retornos das ações. A partir da estratégia de estudo de eventos foram comparados os Retornos Anormais (AR) e os Retornos Anormais Acumulados (CAR) oferecidos pelas variações dos preços das ações dos dois grupos de empresas (financiadas e não-financiadas por fundos de PE). A amostra do estudo foi composta por 122 IPOs ocorridos no mercado brasileiro no período compreendido entre janeiro de 2007 e dezembro de 2017 e os testes de diferença de média indicaram que o desempenho das ações que não contaram com a participação de PE foi superior em janelas de 21 e 126 dias úteis. No entanto, esse resultado se inverte em na janela de 252 dias. Isso implica dizer que os IPOs de empresas financiadas por fundos de Private Equity obtêm melhor desempenho quando comparados a IPOs de empresas não respaldadas por esses fundos. Ainda, o estudo realizou a estimação de modelos de regressão que indicam que o desempenho das empresas com participação de PE é superior para a janela de 252 dias. Para as outras janelas, 21 dias e 126 dias não existe diferença entre os grupos analisados.
Severe preeclampsia and eclampsia: adverse obstetric outcomes and prognostic factors
Authors: Grover Suparna , Chhabra Ajay
Published: July 2021

Background: Hypertensive disorders of pregnancy are globally a threat to maternal and fetal outcomes. Despite massive efforts worldwide, these disorders continue to be a major adverse influence on the health goals especially in developing countries. The aim of the study was to measure the impact of hypertensive disorders of pregnancy in its most severe form on maternal and fetal outcomes in our region along with the important prognostic factors. The objective of this study was to investigate the maternal and fetal outcome in cases of severe preeclampsia and to evaluate the risk factors and complications associated with adverse outcomes.Methods: Indoor records of pregnant females at more than 20 weeks gestation with preeclampsia with severe features (as defined by the ACOG practice bulletin 222) and eclampsia admitted over a period of one year in a unit of obstetrics at Government Medical College, Amritsar were studied and results were statistically analysed.Results: The incidence of hypertension in pregnancy was 11.85% while that of severe preeclampsia was 6.14%. 57.94% of these women were primigravida’s and 80.16% of the women with severe preeclampsia/eclampsia were in the age group 20-29 years. Severe preeclampsia and eclampsia contributed to 43.75% of maternal deaths (OR 8.8, p value=0.0001) and there was increased incidence of stillbirth (OR 10.03, p value<0.0001) and perinatal mortality (OR 12.97, p value<0.0001). The incidence of preterm birth in cases with severe preeclampsia/eclampsia was 57.14%. Severe anemia as a comorbidity along with respiratory distress and renal impairment were associated with increased probability of maternal death.Conclusions: In addition to ensuring the implementation of routine management principles of, the policy makers should focus on developing critical obstetric care and NICU infrastructure along with dedicated human resources at obstetric centres to manage these high-risk cases. Improvement in the quality of antenatal care can help in diagnosing such patients before the onset of severe features so as to optimize maternal and neonatal outcomes.
A study of bronchial asthma in school going children in Southern part of Rajasthan
Authors: Jain Shubham , Luhadia Atul , Luhadia Shanti K. , Chhabra Gaurav , Sharma Rishi Kumar , Gupta Amit S. , Bansal Monica , Gupta Sujit , Hanfe Mohammed Hamza , Yadav Vishal , Patel Viren , Zota Adit , Nagda Trishi , Oza Divax , Kankrecha Ronak , Saxena Vidit , Shukla Deepak
Published: July 2021

Background: Asthma is a chronic and common inflammatory disease involving mainly large airways of lungs. Childhood asthma is common chronic illness among school going children and is usually underdiagnosed and undertreated. The aim of the present study was to find out of the prevalence of Bronchial asthma in school going children of age group 6-12 years in southern part of Rajasthan (India), and its relation with gender, socio-economic status and heredity.Methods: A questionnaire-based study has been carried out in 1500 children of 6 to 12 years age group in four schools of Udaipur city (Rajasthan, India) with a response rate of 60.23% (904/1500).Results: The overall prevalence of asthma observed is 4.75% (43/904). The prevalence is higher among boys (5.55%) as compared to girls (3.75%). Further the prevalence is higher in upper (7.18%) and upper middle class (7.14%) children as compared to lower middle (4.84%) and upper lower class (2.01%) socioeconomic status. The children with positive family history of asthma also have higher prevalence (26.31%) of asthma.Conclusions: The prevalence of childhood asthma in Udaipur city is relatively lower and supports the already reported relation with gender, socioeconomic status and heredity.
Functional outcome of surgical management of distal humeral fracture with precontoured anatomical locking plate
Authors: Japatti Manjunath S. , Janardhan Pavith T.
Published: July 2021

Background: Intra-articular distal humeral fractures are among the common fractures seen in adults. The cause of injury most commonly being road traffic accidents. These fractures require fixation methods which are technically difficult to achieve a good functional outcome and to minimize complications. This study was useful to analyse the above factors, to come to conclusion.Methods: This was a prospective study of 20 cases of supracondylar fracture humerus with intercondylar extension treated surgically and assessed for functional outcome, which were admitted to our hospital between 2015 to 2017. Precontoured distal humerus anatomical locking plates were used for fracture fixation with various standard approaches to elbow. Various clinical and functional outcome were analysed at the end using mayo elbow performance score.Results: Out of 23 patients, 20 patients were available for final follow up and outcome analysis. There were 15 males and 5 females with an average age of 34.4 year (21-50 years). Average time between admission and surgery was 4 days. Clinical and radiological consolidation of fracture was observed in all cases at an average of 12 weeks (9-14 week). The results obtained using mayo elbow performance score were graded as excellent 10 (50%) patients, fair in 6 (30%), poor in 4 (20%). One case had superficial wound infection and managed with IV and oral antibiotics. One patient had transient ulnar nerve palsy managed conservatively and recovered.Conclusions: Open reduction and internal fixation with anatomical precontoured locking plate is the treatment of choice in comminuted intercondylar distal humerus fractures. specially in young active adults. It provides stable fixation and thereby facilitating early postoperative rehabilitation. However, the outcome mainly depends on restoring the anatomic nature of articular surface along with minimal soft tissue destruction.
Study of the efficacy of trauma and injury severity score to predict survival in patients of polytrauma
Authors: Singh Anant , Chejara Raj K. , Sharma Ashok K. , Tolat Aditya
Published: July 2021

Background: Trauma is one of the major cause of mortality and morbidity in both developed and developing countries. Polytrauma patients present particular challenges as profile of the patient varies with different types and severity of injuries. Prediction of survival in trauma patients is an essential requirement of trauma care. Trauma and injury severity score (TRISS) have been considered as a standard of the quality of trauma care. Study was carried out to evaluate the performance of TRISS in predicting survival in patients of polytrauma.Methods: Prospective observational study was conducted in emergency department of a tertiary care centre. 100 patients were evaluated in the study for a period of 18 months between November 2019 and April 2021. Patient demographics, details of trauma, pattern of injuries and physiological status were recorded. Overall outcome were studied and data analysis was done on the basis of TRISS. Statistical analysis was performed using statistical package for the social sciences (SPSS) program for windows, version 25.0 (SPSS Chicago, Illinois).Results: Young patients with mean age of 34.54 were most commonly affected in polytrauma with male preponderance. Road traffic accidents were the most common mode of trauma followed by fall from height. Blunt trauma was the most common type of injury. TRISS strongly predicted survival in polytrauma patients (AUC 0.926 CI 95% 0.868-0.985). TRISS has high sensitivity 97.62% and specificity 62.50% at a cut off of 64.50%.Conclusions: TRISS is an effective method for predicting survival of polytrauma patients and thus can be utilized to evaluate and compare trauma care.
Surgical site infections in clean and clean contaminated surgeries in a tertiary care teaching hospital
Authors: Tolpadi Anuradha G. , Mane Abhijeet K. , Dhayagude Snehal V. , Modak Meera S. , Dongare Dhananjay M. , Tendulkar Akshata S. , Mahadik Prerana U. , Lamkhade Pallavi
Published: July 2021

Background: Despite major advances in infection control interventions, health care-associated infections (HAI) remain a major public health problem and patient safety threat worldwide. Surgical site infections (SSI) are among the most commonly reported Hospital acquired infections (HAI).Methods: This was a prospective observational study conducted in a tertiary care hospital over a period of one year from May 2019 to April 2020. Total 2382 patients who underwent clean and clean contaminated surgeries were included in the study. The data on demographics, type of surgery, duration of surgery, day of SSI event, use of prosthesis, comorbidities, post-operative stay and resuturing was collected and analyzed. From suspected patients of SSI, pus aspirate/swab was sent for culture and susceptibility.Results: Total 2382 clean and clean contaminated surgeries were included in the study. The incidence of SSI was 2.05%. Association between SSI and gender, age group and whether the surgeries were planned or were emergency surgeries was noted. In 37 (75.51%) patients who developed SSI the post-operative stay was prolonged (>7days). 3 (6.1%) patients had to undergo resuturing due to gaping in the surgical wound. 18(36.73%) cases of SSI were diagnosed after discharge from hospital. The predominant organism causing SSI was Escherichia coli followed by Staphylococcus aureus and Coagulase negative Staphylococcus (CONS).Conclusions: Regular surveillance of SSI with feedback of appropriate data to the stakeholders is desirable to reduce SSI rate. Post patient discharge, surveillance of SSI is challenging but it needs to be addressed by infection control team to identify cases of SSI accurately.
Gall stones and hypothyroidism: a double jeopardy
Authors: Dhoka Gaurav , Kumar Naren A. , Yatheendranathan Gokul D.
Published: July 2021

Background: Gall stones are one of the frequent biliary pathologies in the biliary system. Gall stones are deposition of bile pigments, cholesterol and calcium salts in the form of hard crystalline mass in the gall bladder. Saturation of bile in gall bladder, bile stasis due to sphincter of Oddi dysfunction, biliary sludge and change in chemical disproportion of bile are all risk factors for gall stone development. Thyroid disorders are also a very common endocrine pathology. On the Oddi sphincter, thyroid hormone receptors are present, and thyroxine has a strong relaxing effect on the sphincter. Hypothyroidism reduces the gall bladder contractility and causes lipid metabolism alteration which leads to biliary stasis. These promote the gall stone formation.Methods: A single centre cross-sectional study, was done among 86 patients diagnosed with cholelithiasis clinically and confirmed by ultrasonography. All patients were subjected to thyroid profile test, liver function test, fasting lipid profile test. Patients with a history of hypothyroidism were excluded from the study.Results: Among 86 study subjects, 29 (33.7%) of study subjects had hypothyroidism, out of which 21 (24.4%) had subclinical hypothyroidism, 8 (9.3%) had clinical hypothyroidism. Of the remaining subjects 4 (4.7%) were hyperthyroid and 53 (61.6%) were Euthyroid. A total of 24 subjects had dyslipidaemia of which (15) 62.5% had clinical and sub clinical hypothyroidism (p<0.001).Conclusions: In the evolution of Gall stones in hypothyroid patients, decreased liver cholesterol metabolism, decreased bile emptying and decreased Oddi relaxation sphincter play a role. In our study there was a strong association between hypothyroidism and gall stones. Hypothyroid patients also had abnormal total cholesterol, triglycerides and ALP levels.
Evaluation of platelet count/spleen diameter ratio for detection of oesophageal varices in patients with cirrhosis of liver: a cross-sectional study
Authors: Lakshminarayana Ashok Mysore , Kumbar Shweta Mallikarjun , Chandregowda Manohara Melur , Warrier Kiran
Published: July 2021

Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.
Therapeutic efficacy and safety of Unani formulation in patients of Fasaad-e-tashahhum-e-dam (dyslipidemia): a randomized open standard controlled clinical study
Authors: Sabahat Syed , Ul-Islam Naquib
Published: July 2021

Background: Hyperlipidemia which is interchangeably used with the term dyslipidemia essentially refers to the condition of abnormality of lipid levels measured in the blood typically due to the disorder of lipoprotein metabolism. The objective of this study was to determine the therapeutic effect and safety of newly formulated drug on patients with Fasaad-e-Tashahhum-e-Dam (dyslipidemia) and compare it with the effect of Unani formulation and rosavastatin.Methods: The present study was open randomized controlled clinical study. The study subjects were divided in two groups, one group was given test drug (test group) and another group was given control drug (control group). All the patients who qualified the inclusion criteria were randomly placed in either test or control group.Results: In the present study we observed that both the groups were comparable with respect to age, sex lifestyle, family history and mizaj. We found that both Unani formulated drug and standard drug rosavastatin significantly improves the lipid parameters after the treatment with a p value of (<0.001*).Conclusions: We concluded that the overall effect of the proposed Unani formulated drug was found quite fascinating in the treatment of dyslipidemia. Apart from drug safety, visible improvements were evident in objective parameters like cholesterol, triglyceride and LDL, VLD. However, the present study did not revealed that Unani drug is superior to standard drug instead both the treatments are equally effective on the improvement of lipid profile parameters.
Frequency and type of adverse drug reactions related to multidrug-resistant tuberculosis therapy
Authors: Ahmed Afaq , Gudagunti Ashok Kumar , . Shylendra , Hagalur Nayak Veena , Swamy H. Mallikarjun
Published: July 2021

Background: Adverse drug reactions (ADRs) are inevitable consequences of multidrug-resistant tuberculosis drug therapy. Reporting of ADR in India is poor and inadequate. ADRs monitoring forms an integral part of pharmacovigilance. ADRs with second line anti-tuberculous therapy (ATT) have been mentioned as obstacles in the management of multidrug-resistant tuberculosis (MDR-TB). Objectives of the study was to study the frequency and type of adverse drug reaction related to MDR-TB therapy.Methods: 72 patients diagnosed as MDR-TB and enrolled for DOTS-PLUS (CAT.IV) regimen at NTEP centre, KIMS HUBLI were included. This was a prospective observational study. All patients were followed up for a period of 9 months from the day of commencement of treatment. Adverse drug reactions were determined by monthly clinical and biochemical monitoring of patients to identify ADRs.Results: Among 72 Patients, 42 (58.3%) were males. 44 out of 72 patients experienced at least one type of ADRs (61.1%). Mean age was 35.86±12.62 and mean weight was 42.00±9.05. Four most common ADRs reported were Gastro-intestinal symptoms (29.2%), anorexia (15.3%), giddiness (12.5%), and pain at injection site (11.1%). Highest percentage of ADRs were seen in patients of age group>60 years (66.7%). ADRs were most commonly reported in first 3 months of initiation of therapy. 9 out of 72 patients (12.5%) or 20.5% of 44 patients who showed ADRs required change of treatment. There was a significant impact of ADRs on treatment among those with ADRs (p=0.01).Conclusion: ADRs of varying severity are common in patients of MDR-TB on DOTS-PLUS regimen, occurring in more than half of the cases, with around one fifth requiring change of MDR-TB treatment.
Study of serum albumin as a marker of severity in COVID-19 positive SARI and COVID-19 negative SARI patients
Authors: Vasanth Sudha , R. Madhumathi , Bhakthavatchalam Supriyaa , M. Kushal
Published: July 2021

Background: COVID-19 a pandemic caused by SARS CoV-2 has caused a wide impact globally. Clinical spectrum of COVID-19 ranges widely including asymptomatic infection, mild upper respiratory tract infection, severe pneumonia, ARDS, MODS and even death. Hypoalbuminemia in COVID-19 indicates severe disease. The aim of the study was to determine incidence of hypoalbuminemia and correlation of severity of hypoalbuminemia with COVID-19 positive SARI and COVID negative SARI patients.Methods: A study was conducted on 265 SARI patients who were admitted in hospitals attached to BMCRI. History was taken, general physical examination and a detailed systemic examination was done. Patients were categorized into mild, moderate and severe illness.  RT-PCR for COVID-19 patients done using throat and nasal swab. Total WBC counts and differential counts, platelet counts were estimated. Serum albumin levels were correlated with pneumonia severity and compared between COVID-19 positive and Negative SARI. And also, correlation with comorbities was done.Results: The study included 265 SARI patients, of which 135 were COVID-19 positive patients and 130 were COVID-19 negative. Patients categorized into moderate and severe SARI. Mean age of subjects with COVID-19 positive (severe) was higher- 58.70±15.598 followed by COVID-19 positive (moderate)- 55.13±14.480. About 30% (N=90) were belong to severe SARI group, Chi-square test showed statistical significant association with respect to age. Chi-square test showed no statistical significant association with respect to gender. Independent sample t test showed statistical difference with respect to S. albumin levels between COVID positive and COVID negative subjects. In COVID positive subjects, S. albumin levels showed statistical significant difference between moderate and severe sub groups whereas there was no statistical significant difference seen in COVID negative sub groups.Conclusions: The relationship between hypoalbuminemia and reduced survival in COVID-19 may have several explanations. First, acting as an anti-inflammatory and antioxidant protein, albumin may protect against cytokine storm. Second, albumin encompasses anticoagulant properties and inhibits oxidative stress-related clotting and platelet activation that occurs in severe COVID-19. Third, albumin is an inverse acute phase reactant. In our present study hypoalbuminemia was more significant in severe COVID-19 positive SARI patients compared to COVID-19 negative SARI patients hence, we could say that hypoalbuminemia is inversely related with COVID-19 severity and also more significant hypoalbuminemia in COVID-19 positive SARI.
Role of magnification and microscope in thyroid surgery safety and efficacy
Authors: K. S. Ravi , Naik Kiran M. , M. Swarna Priya , M. P. Abhishek
Published: July 2021

Background: Thyroid surgery becomes challenging, due to closely related structures like recurrent laryngeal nerve and parathyroid gland. Microscope assisted surgery has better visualization for dissection, and decreases the risk of injury to the nerve, parathyroid gland, and its vascular pedicle. Hence it decreases the operative complications.

Methods: This is a retrospective study of microscope-assisted thyroidectomy at Adichunchanagiri hospital and research centre, from May 2016 to April 2020. Ethical approval was obtained from institutional review committee. Types of surgery, post-operative hypocalcemia and recurrent laryngeal nerve function were analysed descriptively.

Results: Out of total 30 microscope assisted thyroidectomy, 26 were female, 42 (87.5%) benign pathology, 6 (12.5%) malignant. Hemithyroidectomy was done in 25 (83.3%), total thyroidectomy 4 (13.3%), and completion thyroidectomy with neck dissection in 1 (3.3%). Among total thyroidectomies, transient hypocalcemia occurred in 2 (6.6%) and no temporary or permanent recurrent laryngeal nerve palsy.

Conclusions: The use of microsurgical technique and loupes magnification in thyroid surgery are safety and effective procedures that require an appropriate training in microsurgery, but may significantly reduce post-operative complications.
Prospective randomised control study of dexmedetomidine for controlled hypotension in functional endoscopic sinus surgery
Authors: K. Mahendran , Priya Rasika
Published: July 2021

Background: Functional endoscopic sinus surgery is one of the commonly performed Surgeries. Induced hypotension is a method employed in functional endoscopic sinus surgery to reduce blood loss and to improve the visibility of the surgical field. This study aimed to evaluate the effect of dexmedetomidine infusion on the requirement of Isoflurane to produce controlled hypotension (mean arterial pressure of 60-70 mmHg), quality of the bloodless surgical field, duration of surgery, and the awakening time in patients undergoing Functional endoscopic sinus surgery (FESS).

Methods: 50 patients were divided into Group D, Group C Group D. After successful tracheal intubation, anesthesia was maintained with 66% nitrous oxide + 33% oxygen + isoflurane titrated to achieve a mean arterial pressure (MAP) of 60-70 mmHg. Isoflurane and dexmedetomidine/saline infusion was stopped 10-15 minutes before the end of surgery. The intraoperative surgical field was assessed by using a 6 points Fromme-Boezaart scale.

Results: A statistically significant (p<0.001) reduction in intraoperative isoflurane requirement in patients receiving dexmedetomidine infusion (0.387±0.102) in comparison to those receiving placebo (1.7±0.211). Both the group provided better visualization of the surgical field. The duration of surgery was statistically (p=0.004) low in Group D (76.84±14.174) compared to group C (94.1±25.083). The awakening time in min was statistically (p=0.001) low in group D (5.12±1.691) compared to group C (9.72±1.100).

Conclusions: Dexmedetomidine infusion helps in achieving a targeted reduction in MAP reduced intraoperative Isoflurane requirement, better bloodless field, and faster awakening in patients undergoing Functional endoscopic sinus surgery.
Traumatic tympanic membrane perforation: an overview in a tertiary care centre-Khammam
Authors: Sailesh Agni Vishnu , Arumugham Vivek , Pakanati Siva Subba Rao , Potnuru Shilpa
Published: July 2021

Background: Aim of the study was to distinguish traumatic tympanic membrane perforation (TTMP) by distribution, etiology and clinical presentation and to assess the prognosis and outcome of treatment and establish masterly inactivity as main treatment modality.

Methods: A prospective observational study was performed on 60 cases of traumatic tympanic membrane perforation in the outpatient department of otorhinolaryngology, Mamatha medical college and general hospital, Khammam from October 2019 to March 2021. All the patients came to ENT OPD with the history of trauma to the ear and hearing loss were examined and after obtaining proper history, all the patients underwent ENT clinical examination, oto-endoscopic and audiological evaluation by pure tone audiometry. All the patients diagnosed with traumatic tympanic membrane perforation after obtaining informed written consent were included in the study. All the patients were followed at regular intervals and observations were recorded.

Results: All patients were evaluated based on oto-endoscopic examination. Age ranges from 20-50 years, mean age of 33.6 years and with a male to female ratio of 1:1.4. Commonest etiology was physical assault (61.66%) followed by self-inflicted injury accounting 20%. Tinnitus (90%) was the common presenting complaint and the perforation spontaneously healing is about 90% patients.

Conclusions: Traumatic perforation of tympanic membrane is under-reported otologic defect which has a good prognosis if treated at right time with a need to educate people on the consequences and about unskilled removal of wax/foreign body, early identification and apt diagnosis and management.