bluuebunny/crossref_metadata_2025 huggingface dataset:
Adenocarcinoma in situ of the Cervix – is Loop Electrosurgical Excision Procedure an Acceptable Alternative to Cold Knife Cone Biopsy?
Authors: Salcedo Mila Pontremoli , Costales Anthony , Munsell Mark F , Ramalingam Preetha , Reis Ricardo Dos , Milbourne Andrea , Beitune Patrícia El , Schmeler Kathleen M ,   The Department of Obstetrics & Gynecology, Federal University of Health Sciences/Irmandade Santa Casa de Misericordia, Porto Alegre, Rio Grande do Sul, Brazil,   The Department of Gynecologic Oncology & Reproductive Medicine,   The Department of Biostatistics,   The Deparment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, US,   The Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil,   The Department of Gynecologic Oncology & Reproductive Medicine,   The Department of Obstetrics & Gynecology, Federal University of Health Sciences/Irmandade Santa Casa de Misericordia, Porto Alegre, Rio Grande do Sul, Brazil,   The Department of Gynecologic Oncology & Reproductive Medicine
Published: June 2017

Objective: To compare cone specimen size between loop electrosurgical excision procedure (LEEP) and cold knife cone (CKC), and evaluate the association between specimen size and margin status. Methods/materials: A retrospective review was performed of women with adenocarcinoma in situ (AIS) who underwent CKC or LEEP between 1998 and 2013. Specimen size, including length (distance from the external cervical os to the endocervical margin) and volume were compared between LEEP and CKC, and correlated with margin status. Results: Eighty-five patients underwent a total of 136 procedures, including 91 CKCs (67%) and 45 LEEPs (33%), with 27 removed as a single specimen (one-piece LEEP) and 18 as two specimens with an ectocervical specimen and a deeper endocervical top-hat specimen (two-piece LEEP). The two-piece LEEP specimen median length was significantly longer (2.1 cm) versus CKC (1.4 cm, p<0.01) and one-piece LEEP (0.6 cm, p<0.01). Median specimen volume was greater for two-piece LEEP (7.4 cm3) versus CKC (3.4 cm3, p<0.01) and one-piece LEEP (1.6 cm3, p<0.01). A higher rate of positive margins was noted when comparing all LEEP (67.6%) with CKC specimens (34.2%), p<0.01. However, when the LEEP specimens were analysed separately, one-piece LEEPs had a higher rate of positive margins (81.0%) versus CKC (34.2%) (p<0.01), but there were no significant differences between two-piece LEEP (50.0%) and CKC (34.2%), p=0.26. Conclusion: Our results suggest that a two-piece LEEP produces a larger specimen size with similar rates of positive margins compared with CKC. Given the decreased cost and morbidity compared with CKC, a two-piece LEEP should be considered in the management of women with AIS.
Clinical Development and Manufacture of Chimeric Antigen Receptor T cells and the Role of Leukapheresis
Authors: Fesnak Andrew , O’Doherty Una ,   University of Pennsylvania, Philadelphia, Pennsylvania, US,   University of Pennsylvania, Philadelphia, Pennsylvania, US
Published: June 2017

Adoptive transfer of chimeric antigen receptor (CAR) T cells is a powerful targeted immunotherapeutic technique. CAR T cells are manufactured by harvesting mononuclear cells, typically via leukapheresis from a patient’s blood, then activating, modifying the T cells to express a transgene encoding a tumour-specific CAR, and infusing the CAR T cells into the patient. Gene transfer is achieved through the use of retroviral or lentiviral vectors, although non-viral delivery systems are being investigated. This article discusses the challenges associated with each stage of this process. Despite the need for a consistent end product, there is inherent variability in cellular material obtained from critically ill patients who have been exposed to cytotoxic therapy. It is important to carefully select target antigens to maximise effect and minimise toxicity. Various types of CAR T cell toxicity have been documented: this includes “on target, on tumour”, “on target, off tumour” and “off target” toxicity. A growing body of clinical evidence supports the efficacy and safety of CAR T cell therapy; CAR T cells targeting CD19 in B cell leukemias are the best-studied therapy to date. However, providing personalised therapy on a large scale remains challenging; a future aim is to produce a universal “off the shelf” CAR T cell.
Immunotherapy and Targeted Therapies in the Treatment of Non-small Cell Lung Cancer
Authors: Nguyen-Ngoc Tu , Reck Martin , Tan Daniel SW , Peters Solange ,   Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland,   Department of Thoracic Oncology, Lungen Clinic, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany,   Division of Medical Oncology, National Cancer Centre Singapore, Singapore,   Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
Published: June 2017

In the last decade, the emergence of targeted therapies has changed the treatment paradigm for non-small cell lung cancer (NSCLC). The growing availability of therapies targeting specific genetic alterations, such as epidermal growth factor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements, have led to changes in the guidelines to reflect the need for molecular profiling. More recently, immunotherapeutic approaches have been investigated in the treatment setting of NSCLC, and these may provide superior outcomes and have substantially better tolerability compared to chemotherapy. Immunotherapies currently available for NSCLC include the checkpoint inhibitors anti-PD-1 antibodies nivolumab and pembrolizumab. Several other anti-PD-L1 compounds such as atezolizumab, durvalumab and avelumab are also very advanced in clinical investigation, in monotherapy as well as in combination with immune priming phase activators anti-CTLA4 ipilimumab and tremelimumab, across all treatment lines. The challenge facing oncologists is identifying which therapy is best suited to the individual patient.
Molecular Diagnostics in Breast Cancer Routine Practice
Authors: Hoeve Natalie D ter , Moelans Cathy B , Schrijver Willemijne AME , Leng Wendy de , Diest Paul J van ,   Department of Pathology, University Medical Center Utrecht, The Netherlands,   Department of Pathology, University Medical Center Utrecht, The Netherlands,   Department of Pathology, University Medical Center Utrecht, The Netherlands,   Department of Pathology, University Medical Center Utrecht, The Netherlands,   Department of Pathology, University Medical Center Utrecht, The Netherlands
Published: June 2017

The portfolio of adjuvant systemic treatment of breast cancer nowadays contains novel anti-hormonal and chemotherapeutic drugs, immunotherapeutic approaches and small molecules that are only effective in a limited number of patients and are often associated with high costs and significant side effects. Therefore, a personalised approach based on individual tumour biomarkers is required to arrive at the optimal balance between effectiveness on the one hand, and costs and side effects on the other. The aim of this paper is to provide an overview of the molecular biomarkers and associated molecular tests that are currently relevant in pathology of invasive breast cancer.
Plasmacytic Post-transplant Lymphoproliferative Disorder – Case Report
Authors: Hanousek Jiri , Radocha Jakub , Soucek Ondrej , Pliskova Lenka , Kamaradova Katerina , Zavrelova Alzbeta , Zak Pavel ,   4th Department of Internal Medicine – Haematology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   4th Department of Internal Medicine – Haematology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   Institute of Clinical Immunology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   Institute of Clinical Biochemistry, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   The Fingerland´s Department of Pathology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   4th Department of Internal Medicine – Haematology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic,   4th Department of Internal Medicine – Haematology, University Hospital Hradec Kralove and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
Published: June 2017

We present a case of a 43-year-old Caucasian female with acute myeloid leukaemia (AML), who developed Epstein-Barr virus (EBV) positive post-transplant lymphoproliferative disorder (PTLD) of duodenum, with plasma cell differentiation after second haematopoietic stem cell transplantation. The patient was given rituximab and CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone); however, these were only temporarily effective, and the patient passed away 36 days after PTLD was diagnosed. PTLD with plasma cell differentiation is a rare type of PTLD, and there are no strict treatment guidelines.
The impact of maternal body mass index on maternal and perinatal outcome
Authors: Bhushan Nishu , Kumar Surinder , Kumar Dinesh , Khajuria Reema
Published: June 2017

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Obesity is a chronic illness which is associated with metabolic disease, nutritional deficiency, musculoskeletal complications and carcinomas. The aim of the study was to evaluate and compare the maternal and perinatal outcome in patients with BMI 20-24.9 kg/m2 (normal), with BMI 25-29.9 kg/m2 (overweight) and with BMI >30 kg/m2 (obese).Methods: This cross-sectional study was conducted on 300 singleton pregnant women with gestational age>37 weeks with cephalic presentation. The selected women were categorized into three groups of 100 each according to their BMI: Category I included normal women (BMI 20-24.9 kg/m2), Category II included overweight women (BMI 25-29.9 kg/m2) and Category III included obese women (BMI >30 kg/m2).Results: There was increased incidence of antepartum complications in obese women. The difference in the occurrence of pre-eclampsia among the three categories was statistically significant (p=0.001). Similarly, more obese women had eclampsia (5%) and gestational diabetes mellitus (6%) as compared to overweight and normal women and the difference was statistically significant in both these complications (p=0.02 for each). The risk of induction of labour was highest in obese women and so was the incidence of caesarean and instrumental deliveries and the difference was statistically significant. The difference in the onset of labour as well as mode of delivery among the three categories was statistically significant (p<0.05). In perinatal outcomes, the difference in mean birth weight of the babies among three categories was statistically significant (p<0.0001). The difference in incidence of low birth weight (<2.5 kg) as well as macrosomia (>4 kg) among babies of three BMI categories was statistically significant (p<0.05). The difference in the incidence of NICU admissions was statistically significant (p=0.02).Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence preventable steps should be taken for reducing the maternal and perinatal morbidity and mortality.
Occult parametrial metastasis in operable cancer cervix: is a routine radical hysterectomy justified?
Authors: Jose Tony , Chawla Sushil , Seth Atul
Published: June 2017

Background: Operable Ca cervix is treated by a Type III Radical hysterectomy(RH) with pelvic lymphadenectomy and comprises of a complex parametrial resection (PR) due to the possibility of occult parametrial metastasis(OPM) leading to high post-operative and delayed morbidity especially after adjuvant radiotherapy(RT). If risk factors for OPM were known, a less radical procedure could be performed in low risk patients thus minimizing the morbidity.Methods: A retrospective study was carried out to evaluate the incidence of OPM in operated patients and to study the risk factors associated with OPM and explore the theoretical feasibility of doing a type I hysterectomy in low risk patients.Results: The incidence of OPM was 16.1% in all stages (0% in IA, 10.71% in IB1, 33.3% in Stage IB2 and 18.8 % in IIA1). Primary tumor diameter (PTD) and LNM were the most statistically significant risk factors for OPM. 90% of patients with OPM also had lymph node metastasis (LNM). In this study, all patients with OPM had other risk factors for adjuvant treatment.Conclusions: Small size early stage tumors may be considered for less radical surgery in the absence of obvious intermediate risk factors. A node dissection with negative frozen section during surgery can finally select patients for a simple hysterectomy(SH). More evidence from randomized trials are needed to evaluate the oncological safety of a less radical procedure and define the type of surgery to be done.
Efficacy of growth hormone in improving the pregnancy rate in poor responders in ART
Authors: E. Nisha , H. B. Sunitha , Bhat Vidya V. , Guddy K. M.
Published: June 2017

Background: Poor responders impose a great challenge to ART clinicians. Research to improve their pregnancy rate is going on. This study was conducted to analyze the effect of growth hormone in poor responders in ART.Methods: This study was done from January 2015 to December 2015. It was a retrospective, single centre, cohort study in which 36 poor responders were selected and allotted into group A (18) with growth hormone and group B (18) without growth hormone. High dose of gonadotrophins was used for ovarian stimulation and antagonist protocol was followed in all patients. Group A received 4 IU of growth hormone along with usual treatment from day 2 till ovulation trigger with HCG injection, group B usual protocol.Results: Statistical analysis was done with independent T test, and p value <0.05 was considered significant. Higher number of mature oocytes and pregnancy rates were observed in growth hormone group. Number of MII oocytes was 5.8, on an average in group A and 3.7 in group B, the difference was statistically significant (p 0.0000001).  Clinical pregnancy rates were 27.7% in group A and 16.6% in group B, statistical significance (p 0.02).Conclusions: Addition of growth hormone shows increase in number of oocytes retrieved and pregnancy rates in poor responders in ART patients.
Pregnancy outcome in working women with work place stress
Authors: M. V. Kusuma Naik , Nayak Vedavathy , Ramaiah Renuka , Praneetha .
Published: June 2017

Background: The employment rate of mothers has increased worldwide in recent years. So, there is concern about possible effects of work related risk factors and pregnancy outcome in working women. As a growing percentage of women work outside home before, during, and after pregnancy in most countries and its related occupational factors deserve to be studied in relation to pregnancy outcomes. To identify the effect of work place stress, on pregnancy and perinatal outcome.Methods: 100 pregnant working women, who were visiting the antenatal care unit and labour room taken into study. They were interviewed using predesigned questionnaire, Physical activity questionnaire, Workplace Stress Survey. Statistical analysis performed using SPSS version 21.Results: Mean age was 27yrs, with hrs of working/wk of 47hrs, 41 women studied were working in garment factories,46% of them had complications during their antenatal period, 56% of them were primigravidas.  Among studied working conditions, working more than 40 hours/ week was significantly associated with high rates of preterm delivery (12%) and Small for gestational age (SGA) (22%) was significantly increased with high work stress.Conclusions: Among the studied, work conditions for working women working more than 40 hours/week, social stress index were found to be a significant risk factor for adverse pregnancy outcomes. General practice physical activity (GPPA) 80% of both active and moderately active women had some problems. In work place stress survey (WSS), 100% of women encountering problems at work place had problems during their pregnancy, 72% of women who handled stress moderately had problems. Therefore, as long as the health of the pregnant woman permits her to continue work during pregnancy that is not stressful or overloading for her, no adverse effect on pregnancy outcomes is expected.
Maternal and fetal outcome in post term pregnancy
Authors: Verma Vandana , Kanti Vaibhav , Shree Pragya
Published: June 2017

Background: The term delivery is defined as that occurring between 259 and 294 days of pregnancy from the last menstrual period. If the pregnancy exceeds this period, it is called as post term pregnancy. Our center is in rural area where most of the patients are unbooked or even booked patients are also loss of follow up. So, this study was done to know the incidence of prolonged pregnancy and maternal and fetal outcome in case of prolonged pregnancy in our rural population.Methods: This study was a retrospective observational study for 1 year, to analyze the maternal and fetal outcome of post term pregnancies. Data was collected from hospital record and analysed.Results: Out of 5210 total deliveries 1.49 % were beyond 42 wks. 57.69 % patients delivered vaginally whereas 42.3 % patients needed cesarean section.  6.41 % neonates developed meconium aspiration syndrome and 15.38 % of neonates needed NICU admission for different indications.Conclusions: This study concluded that prolonged pregnancy is associated with adverse outcomes like fetal distress, meconium aspiration syndrome and more neonatal ICU admissions. The outcome of prolonged pregnancy can be improved by proper counselling for follow up during pregnancy and proper monitoring and appropriate management during labour.
Comparison of tramadol and pethidine for control of shivering in regional anesthesia
Authors: Paul Cherish , Paul John
Published: June 2017

Background: Shivering is a common problem faced by anaesthesiologists in the intraoperative as well as post-operative period. It occurs during both general anesthesia and regional anesthesia, but is more frequent and troublesome during regional anesthesia. There are many pharmacological and other methods to tackle this issue. Not many studies have compared between pharmacological agents that control shivering.Methods: This randomized, prospective study conducted in 80 adult patients, was designed to explore the efficacy and potency of Tramadol in comparison to Pethidine for control of shivering under regional anesthesia. Patients received Tramadol or Pethidine in a dose of 0.5 mg/kg intravenously after the appearance of shivering. Disappearance and recurrence of shivering, sedation as well as haemodynamics were observed at scheduled intervalsResults: The complete disappearance of shivering took a mean 4.5 minutes in Tramadol group while 8 minutes in pethidine group (p value<=0.05). Tramadol was more potent than Pethidine with respect to control of shivering and its recurrence.Conclusions: Intravenous Tramadol is qualitatively superior to Pethidine for control of shivering after regional anesthesia.
FNAC and histopathological correlation of salivary gland lesions: an observational study
Authors: Kakoty Sneha , Baruah Tridip Dutta , Babu C. P. Ganesh
Published: June 2017

Background: Fine needle aspiration cytology (FNAC) is a sensitive and specific and yet an economically effective technique for diagnosis of salivary gland lesions. FNAC of salivary glands has achieved a pivotal role in the diagnosis and management of salivary gland lesions since its induction by Stewart et al in 1933. However, it has always been under scrutiny when compared to histopathology. Histopathology of salivary gland lesions is still the final method to establish diagnosis and predicting prognosis in these lesions.1Methods: A prospective observational study of 50 patients with salivary gland lesions was done at Gauhati Medical College and hospital from June 2011 to May 2012. 39 patients underwent histopathological confirmation. Cases with histopathological correlation were included in calculating diagnostic accuracy. The cytological findings were correlated with that of the histopathological diagnosis to obtain the accuracy of the cytological diagnosis. The parameters of diagnostic validity of the cytological technique in terms of sensitivity, specificity and predictive value were evaluated.Results: Study population included patients of age group ranging from 13-70 years with median age group being 31-40 years (30%). 54% of the affected patients were male with the parotid being the most commonly involved gland (62%). Neoplastic lesions constituted the major bulk of the lesions (39 cases, 78%) with benign tumours constituting 54%. The most commonly involved benign neoplastic lesion was pleomorphic adenoma (22cases, 44%). Among the non-neoplastic lesions (22%), the acute sialadenitis was frequently noted. Histopathological correlations were available in 39 cases with 11 cases being the malignant lesions. The acute sialadenitis lesions did not undergo histological examination. 28 cases of non-malignant lesions underwent the histological confirmation. In the present study, the specificity and the sensitivity were found to be 96.42% and 90.91% respectively. The predictive value of salivary gland cytology was 90.91% and diagnostic accuracy was 94.87%.Conclusions: Fine Needle Aspiration Cytology is thus a safe, reliable, quick, convenient and accurate method of diagnosis and should be considered as one of the first line of investigations in the evaluation of salivary gland lesions.
Thrombocytopenia and raised hematocrit-predictor in dengue hemorrhagic fever
Authors: Upadhyay Nisha , Joshi Himanshu , Upadhyay Chintan
Published: June 2017

Background: This study evaluated the symptoms and routine laboratory investigation to arrive at a bedside diagnosis of dengue hemorrhagic fever and to predict the prognosis on the basis of clinical features and investigation.Methods: This was a prospective study and included children age up to 15 years admitted in the pediatric ward over 2 years period. Dengue fever and dengue hemorrhagic fever were defined according to WHO guidelines.Results: Out of 90 Dengue positive children 44 (48.8%) were of Dengue Hemorrhagic Fever. The common clinical features were fever (100%), bleeding (100%), and rash (84%). 100% children had thrombocytopenia and 36% had raised hematocrit.Conclusions: Triad of fever, bleeding tendencies and rash along with thrombocytopenia and raised hematocrit can be considered as predictive marker for the early diagnosis of dengue hemorrhagic Fever before the specific test like NS1 antigen and antibodies are available.
Management of peritoneal metastasis of gastric cancer
Authors: Qaid Ammar Mohammed , He GuiJuan , Qiang Chen
Published: June 2017

Peritoneal metastases (PM) from disseminations of gastric cancer, presented as a recurrence, its considered fatal with no definitive cure. newer agents like S1 and docetaxel have shown some advantage but nevertheless the median overall survival with the current first line chemotherapy is only 8 to 14 months which shows no great improvement when adding targeted therapy. A multidisciplinary approach combining cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been developed. European and Far East studies reported long-term survival benefits in case of complete cytoreduction with 5-year survival rates up to 25%. In order to prevent peritoneal recurrence and to improve overall survival, adjuvant HIPEC is the most evidence-based indication for advanced-stage gastric cancer patients without PM. The rationale for immunotherapy is solid, with ongoing studies combining CRS and intraperitoneal immunotherapeutic agent. The detection of peritoneal cancer cells is the most reasonable way for identifying the metastasis risk after operation. Peritoneal washing appears to be a sensitive method. Thus, the prevention of peritoneal recurrence mandates the use of multiple modalities and locoregional treatments strategy.
Evaluation of nutritional status in chronic kidney disease patients undergoing hemodialysis
Authors: S. Nagabhushana , M. Ranganatha , G. K. Ranjith Kumar , Virupakshappa .
Published: June 2017

Background: Kidneys perform the important function of excreting nitrogenous waste products and regulating the volume and composition of body fluids. Malnutrition is common phenomenon in maintenance dialysis patients and risk factor for poor quality of life and increased morbidity and mortality. An association of low albumin levels with increased mortality and morbidity in hemodialysis patients has been hypothesized. Present study aims to go through nutritional status of CKD patients in our institute and their relation to disease or dialysis outcome.Methods: Study is conducted on 100 CKD patients on haemodialysis admitted in various medical wards of the Mc Gann hospital attached to Shimoga institute of medical sciences, Shimoga, Karnataka, India. From August 1st, 2016 to April 30th, 2017 detailed history was taken in all the patients and a thorough physical examination was done. Dietary history was taken and blood is collected for analysis of Hb, blood urea, SR electrolyte, serum calcium, phosphorus, serum albumin, cholesterol, creatinine and CRP. BMI is calculated in all patients.Results: There were 60 males and 40 females. Average age is 46±3.6 years. Most of these patients belong to the age group of 41-50 years (37%). According to WHO BMI classification 55% had BMI between 18.5 to 24.9. 17% less than 18.5.  13% more than 30BMI. Blood urea, serum creatinine was elevated as expected. Mean Hb is 8.21±2.57 gm/dl. Serum albumin is lower mean being 2.66±1.86 gm/dl. CRP elevated 16.5±2.36. low calcium is also seen.Conclusions: The malnutrition in CKD is associated with increased morbidity and mortality rates. Despite the better understanding of the pathophysiologic mechanisms of uremic malnutrition and the improvements made in nutritional support, the nutritional condition of CKD and ESRD patients remains a significant cause for concern. Multimodal therapeutic strategies should be considered. Present study showed elevated prevalence of malnutrition in HD subjects. The nutritional status in patients on HD needs more attention. The role of nutrition in the management of CKD is important and needs to be further researched and newer guidelines are need of the hour.
DA PARCEIRA DEDICADA À “PERIGUETE”: SEXUALIDADE E IDENTIDADES DA MULHER EM CLAUDIA E TPM
Authors: Bittelbrun Gabrielle Vívian
Published: June 2017

Supõe-se que, comparando-se com décadas anteriores, as revistas femininas brasileiras do século 21 concentram discursos de uma liberação inédita no que tange à temática da sexualidade, até pela maior participação da mulher na sociedade e pelas inúmeras possibilidades de controle de fertilidade. No entanto, um olhar sobre matérias jornalísticas de Claudia e TPM – dois títulos que são referenciais no mercado no país – dá as pistas de normas remanescentes sobre o gênero feminino, referindo-se também a um regime de patriarcado. Assim, as edições trazem recomendações sobre a vida sexual e, conectada à ela, a vida amorosa, propondo como seduzir e atrair o parceiro, sempre sob a perspectiva da heterossexualidade. Apoiando-se em pesquisas como de McClintock (2010) e Funck (2014), acredita-se que exemplares entre 2012 e 2014 dos dois veículos em questão possam servir como um caminho para se avaliar a construção de diferenciações de gênero e a manutenção, ou não, de antigas atribuições. Acredita-se que ao discorrer sobre a sexualidade da mulher, seja falando da parceira dedicada ou da “periguete”, as revistas acabam por interpelar identidades, com sugestões de como ser, agir, parecer, o que requer uma discussão, também com o apoio de teóricos como Culler (1999) e Hall (2014).
Knowledge, Practice and Willingness to Participate in Community Health Insurance Scheme among Households in Nigerian Capital City
Authors: Adedeji Aderibigbe S. , Doyin Aganaba , Kayode Osagbemi G. , Ayodele Aderibigbe A.
Published: June 2017

Background: Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals. The objective of the survey was to determine knowledge, practice and willingness of households in Nigerian Capital City to pay and participate in Community Health Insurance Scheme.Materials and Methods: This descriptive and analytical cross-sectional study was carried out using the multistage cluster sampling technique to obtain data from 300 selected household heads or main financial decision makers. The data was analyzed using EPI-INFO software package. Statistical significance of p < 0.05 and confidence limit of 95% was used.Results: The major findings showed that the level of awareness (13%) concerning Community Health Insurance (CHI) was found to be very low among the respondents. The general principles of CHI were also poorly understood by the respondents. Attitude to the programme was positive as many showed interest in participating and enrolling themselves (97.0%), some family members (96.3%) and entire family members (90.3%).  Borrowing money to settle medical bills in this study has occurred in 30% of instances. Majority of respondents were willing to pay premiums ranging from N450 (96.6%) to N1200 (72.5%) for simple packages that do not include surgery and hospitalization.Conclusions: The community members were willing to participate and enrol if the programme is brought to them. There is a need to adequately subsidize the premiums that respondents were willing to pay in order to meet up with the cost of treatment.Key Words: Willingness, Participate, Community Health Insurance.
Aetiology of Vertigo as Seen at the Federal Medical Center Lokoja, North Central Nigeria
Authors: Agbomhekhe Ogah Stephen
Published: June 2017

Background: Human beings are able to maintain their balance from a combination of proprioceptive, graviceptive, visual and the vestibular inputs integrated by the central nervous system. Hence, symptoms of imbalance can arise whenever there is a defect either in these peripheral sensors or the modulating central nervous system. The prevalence of vertigo is 20-30% and it is a major health issue all over the world.Objectives: To determine the prevalence and causes of vertigo in Federal Medical Center Lokoja, North Central Nigeria.Materials and Methods: This is a 3-year retrospective hospital based study undertaken in the ENT Unit of the Department of Surgery Federal Medical Centre, Lokoja. From the hospital Medical Records, patients' files were retrieved. Data about their age, sex, occupation, presentation, treatment modality and outcome were extracted, studied and analyzed.Results: Three thousand two hundred and fourteen patients were seen and 65 of them had vertigo with a prevalence of 2.0%. Fifteen files had incomplete information and were not include in the study. The remaining 50 patients' files that were reviewed, consisted of 32 males (64%) and 18 females (36%). Male to female ratio was 1.8:1 and a mean age of 24.8 years. Bengin Paroxysmal Positional Vertigo (BPPV) 22(44%) was the commonest aetiology found followed by Meniere's disease 8(16%), trauma 7(14%) and Vestibular Neuronitis 5(10%) respectively.Keywords: Aetiology, vertigo, BPPV, Meniere's disease.
Teaching Procedures and Skills in Medical Schools: Gaps, Weakness, and Challenges
Authors: Gismalla Mohamed D. Awadalla
Published: June 2017

There is deficiency and gaps among medical graduates in performing certain procedures and skills. Till recent years, some school used an apprenticeship model for teaching procedures. The way of teaching skills should be revised and reinforced. Medical schools showed adopt formal curricula based training for teaching procedure. In this letter, we would like to highlight the challenges and weakness in teaching procedure for undergraduates medical students.
In-vitro anti-bacterial activity and phytochemical screening of crude extracts of Catharanthus roseus L. (G.) Don.
Authors: Kapoor Manish , Rani Jyoti , Kaur Rupinder
Published: June 2017

Present study aims to investigate phytochemical analysis as well as in vitro antimicrobial activity of crude aqueous, methanol, ethanol, chloroform and petroleum ether extracts from leaves of C. roseus. Antimicrobial activity of extract was studied against various bacterial strains (Escherichia coli, Bacillus subtilis, Pseudomonas aeruginosa, Staphylococcus aureus and Mycobacterium smegmatis). Qualitative preliminary phytochemical analysis revealed that alkaloids, phenols, flavonoids, amino acid and cardiac glycosides are present in the extracts. The result for total phenol and flavonoids content was the highest in methanol and the lowest in petroleum ether crude extract. The study revealed that inhibition significantly depend upon the solvent used for extraction and bacterial strain tested for susceptibility. Aqueous extracts were found less efficient as compared to organic solvent. Methanolic extract were found more effective against tested microbes.
Mitigating effect of foliar applied ascorbic acid on morpho-physiological, biochemical changes and yield attributes induced by salt stress in Vigna radiate
Authors: Nagda Jagdish Kumar , Bhanu Nishant A. , Bhanu Nishant A. , Katiyar Deepmala , Hemantaranjan Akhouri , Yadav Dinesh K.
Published: June 2017

The present investigation was carried out to examine the role of exogenously applied ascorbic acid which mitigates the deleterious effects of salt stress in mungbean (Vigna radiata L.) genotype HUM-1. Plants grown under induced salinity stress at 150 mM NaCl were treated with different concentration of ascorbic acid, i.e., 0.5 mM, 1.0 mM and 2.0 mM. To study the effects of treatments of salt stress on chlorophyll content, proline content, nitrate reductase activity, superoxide dismutase activity and yield attributes data were recorded at 20, 40, 60 day after sowing. Nitrate reductase activity and chlorophyll content with 1.0 mM ascorbic acid under salinity (150 mM NaCl) while the activities of superoxide dismutase get reduced up to 43.71% at 40 days after sowing. In plant treated with combined treatment of 150 mM NaCl and 1.0 mM foliar applied ascorbic acid caused a decline in the level of proline, which was 3.38 mg, 3.35 mg and 6.30 mg at 20, 40 and 60 days after sowing. The threshold level of ascorbic acid was 150 mM NaCl along with 1.0 mM ascorbic acid, that improved the yield attributes under salinity. Ascorbic acid inhibits the adverse effect of NaCl for growth and development of plants. So ascorbic acid may be a promising treatment to ameliorate the deleterious effects of salt stress in crops.
Effects of heavy metals on protonemal growth and bud formation in the moss Hydrogonium arcuatum
Authors: Rachna Preet , Vashistha B. D.
Published: June 2017

The present study was conducted to investigate the toxic effects of cadmium and lead salts on protonemal growth and bud formation. For this purpose bryophyte tissue were acclimated to the laboratory conditions by culturing on Nitsch’s basal medium supplemented with various salts of heavy metals (Cadmium and Lead) in the specific concentration range 10-8 – 10-4 M to assess physiological stress- response. Rounding of protonemal cells and formation of brood cells like structures were observed and Bud formation was adversely affected. The present study thus confirmed the morphological changes by mosses can be used to detect heavy metal pollution.
Chemical constituents from the fruits of Citrus unshiu and their inhibitory effects on acetylcholinesterase
Authors: Baek Jiwon , Lee Hye Lim , Kang Ki Sung , Kim Ki Hyun
Published: June 2017

Acetylcholinesterase (AChE) inhibition has been considered a promising temporary treatment for Alzheimer’s disease. The present study was conducted to isolate chemical constituents from the fruit of Citrus unshiu Markovich (Rutaceae) and evaluate their inhibitory effects on AChE. Phytochemical investigation of C. unshiu fruit led to the isolation of methyl nomilinate (1), limocitrunshin (2), nobiletin (3), kaempferol 3-O-rutinoside (4), limocitrin 3-glucoside (5), kaempferol 3-(2G-rhamnosylrutinoside) (6), didymin (7), (2S)-narirutin 4'-O-glucoside (8) and naringenin 7-O-rutinoside (9). The structures were identified with 1H and 13C NMR spectroscopic data and ESI-MS, then comparison of their spectroscopic and physical data with those previously reported, as well as by measurement of their specific rotations. A limonoid, methyl nomilinate (1), inhibited AChE activity by more than 50% at a concentration of 30 μg/ml. The findings in this study provide the first experimental evidence that a limonoid compound 1 from C. unshiu fruit acts as a natural AChE inhibitor.
Menyelesaikan Problem Materi Belajar bagi Anak-anak Berkebutuhan Khusus dengan Research and Development in Education
Authors: Irfan Lukman
Published: June 2017

This paper discusses the problem of education for children with special needs (difable) related to problems of educational material for them, such as curriculum design, the design of textbooks, learning model, and the design of instructional media. Research conducted by the authors prove that these problems can be solved by using Method Research and Development (R D) in Education. Excellence of R D is a design study that combines theory, experts, and real conditions on the ground so that the results are very good and appropriate. R D also has a very small risk in product development and learning materials for children with special needs, because product trials conducted in stages from small, medium, and then a large scale. Key Word: Education, Difable, R D.AbstrakPaper ini membahas bertujuan menyelesaikan problem pendidikan bagi anak berkebutuhan khusus (difable) terkait dengan problem materi pendidikan bagi mereka, seperti desain kurikulum, desain buku ajar, model pembelajaran, dan desain media pembelajaran. Hasil penelitian yang dilakukan oleh penulis membuktikan bahwa problem tersebut dapat diselesaikan dengan menggunakan Metode Research and Development (R D) in Education. Keunggulan R D di antaranya adalah desain penelitian yang menggabungkan antara teori, ahli, dan kondisi riil di lapangan sehingga hasilnya sangat bagus dan tepat. R D juga mempunyai risiko yang sangat kecil dalam pengembangan produk materi belajar bagi anak-anak berkebutuhan khusus, karena uji coba produk dilakukan secara bertahap dari skala kecil, menengah, dan kemudian skala besar.
Peningkatan Aktivitas dan Hasil Belajar Membaca Al Qur’an tentang Perintah Menjaga Kelestarian Alam Melalui Teknik Mind Mapping pada Siswa Kelas XI IPS2 SMA 1 Cepiring Semester 2 Tahun Pelajaran 2015-2016
Authors: Aliyah Siti
Published: June 2017

This study aim to know what the using of mind mapping learning model canimprove the activity and outcomes of learning of reading the Qur'an class XI SMAN IPS2 1 Cepiring Kendal in the academic year 2015/2016. This study design using classroom action research (Class Research and Development). Depending on the action, it can be concluded that: Using learning model mind map / mind mapping can improve learning outcomes recitation class XI student of SMAN 1 Cepiring IPS2 Kendal in academic year 2015/2016 from pre-conditions that they have not been able reading makhroj aspect, tajwid fluently to be able makhroj, tajweed and tartil fluently. Average value learning and reading outcomes also increased 70.52 into 86.88.AbstrakPenelitian ini bertujuan untuk mengetahui apakah melalui pemanfaatanmodel pembelajaran mind mapping dapat meningkatkan aktivitas dan hasilbelajar membaca Al Qur’an siswa kelas XI IPS2 SMA 1 Cepiring KabupatenKendal tahun pelajaran 2015/2016. Penelitian ini menggunakan desainPenelitian Tindakan Kelas (Class Research and Developement). Berdasarkantindakan yang dilakukan, dapat disimpulkan bahwa: Pemanfaatan modelpembelajaran peta pikiran/mind mapping dapat meningkatkan hasil belajarmembaca Al Qur’an siswa kelas XI IPS2 SMAN 1 Cepiring KabupatenKendal tahun pelajaran 2015/2016 dari kondisi awal belum mampumembaca dengan aspek makhroj, tajwid dan fasih-tartil secara baik dan benarmenjadi mampu membaca dengan aspek makhroj, tajwid dan fasih-tartil.nilai Nilai rata–rata hasil belajar membaca juga mengalami peningkatan darikondisi awal rata-rata hasil belajar membaca 70,52 menjadi 86,88.
Implementasi Pembelajaran Baca Tulis al-Qur’an dengan Metode Iqra pada Anak Usia Dini di RA Perwanida Slawi Kabupaten Tegal
Authors: Srijatun Srijatun
Published: June 2017

The research aims to know how to read and write the application of Al quran with Iqro methods in early childhood and the factors that support and impede learning to read and write the Qur’an. This research is a qualitative descriptive which examines data quality (concepts, thoughts and actions) and describe what it is. The results of learning to read and write first penelititan Al quran with methods Iqro prepared in a planned and systematic based on the curriculum RA. Secondly, there is a supporting factor in the application of methods Iqro is the availability of books, media, and other learning tools that support this learning process. Their infrastructure and tenacity educators in the implementation of learning. While the inhibiting factors such as lack of training on a regular basis for the application of methods for Teachers Iqro RA. Still their parents are less attentive to the children in learning Al-Quran.AbstrakPenelitian ini bertujuan untuk mengetahui bagaimana penerapan baca tulis Al-Qur’an dengan metode Iqro pada anak usia dini dan faktor-faktor yang menunjang dan menghambat pembelajaran baca tulis Al-Qur’an. Jenis penelitian ini adalah kualitatif deskriptif yakni mengkaji data-data kualitas (konsep, pemikiran dan tindakan) dan mendeskripsikannya apa adanya. Hasil penelititan, pertama pembelajaran baca tulis Al-Qur’an dengan metode Iqro dipersiapkan secara terencana dan sistematis dengan berpedoman pada kurikulum RA. Kedua, terdapat faktor pendukung di dalam penerapan metode Iqro yaitu tersedianya buku-buku, media, dan alat-alat pembelajaran lainnya yang menunjang proses pembelajaran ini. Adanya sarana prasarana dan keuletan para pendidik di dalam pelaksanaan pembelajaran. Sedangkan faktor penghambat antara lain karena kurangnya pelatihan secara rutin untuk penerapan metode Iqro bagi Guru RA. Masih adanya orang tua yang kurang perhatian kepada anaknya dalam pembelajaran Al-Qur’an.
Signifikansi Brain Based Learning Pendidikan Anak Usia Dini
Authors: Jazariyah Jazariyah
Published: June 2017

This study based on the reality of learning in the early childhood level and the system has not noticed the potential of the brain learners. The potential and the working system of the brain is very important in early childhood. This paper aims to reveal the importance of brain-based learning in Early Childhood Education (ECD). The problem in this study are what the nature of early childhood education and how to use the potential and work system of the brain in early childhood learning. This study used library research. From the discussion showed that the brain-based learning was important for use in teaching and learning of young children. One of aplication, brain-based learning use quantum learning by optimizing learning with active learning strategies so that potential students can be optimized. This research had contribution to brain based learningAbstrakKajian ini dilatarbelakangi oleh realitas masih adanya pembelajaran di jenjang PAUD yang belum memperhatikan potensi dan system kerja otak peserta didik. Padahal potensi dan system kerja otak sangat penting dalam pembalajaran di PAUD. Tulisan ini bertujuan untuk mengungkapkan pentingnya brain based learning pada Pendidikan Anak Usia Dini (PAUD). Rumusan masalah pada kajian ini adalah seperti apa hakikat Pendidikan Anak Usia Dini dan bagaimana penggunaan potensi dan system kerja otak dalam pembelajaran anak usia dini. Penelitian ini menggunakan metode library research Dari hasil pembahasan menunjukkan bahwa brain based learning penting untuk digunakan dalam proses belajar mengajar anak usia dini. Salah satu pelaksanaan pembelajaran berbasis otak ini dapat menggunakan pembelajaran quantum dengan mengoptimalkan pembelajaran dengan strategi pembelajaran aktif sehingga potensi anak didik dapat dioptimalkan. Penelitian ini memiliki kontribusi pada pembelajaran berbasis otak.
Limited services? The role of shared sanitation in the 2030 Agenda for Sustainable Development
Authors: Evans Barbara , Hueso Andrés , Johnston Richard , Norman Guy , Pérez Eddy , Slaymaker Tom , Trémolet Sophie
Published: June 2017

Target 6.2 of the Sustainable Development Goals calls for universal access to sanitation by 2030. The associated indicator is the population using ‘safely managed’ sanitation services. Shared sanitation is classified as a ‘limited’ sanitation service and some donors and governments are reluctant to invest in it, as it will not count towards achieving Target 6.2. This could result in poor citizens in dense slums being left out of any sanitation improvements, while efforts are diverted towards better-off areas where achieving ‘safely managed’ sanitation is easier. There are sound reasons for labelling shared sanitation as ‘limited’ service, the most important being that it is extremely difficult – for global monitoring purposes – to differentiate between shared toilets that are hygienic, accessible and safe, and the more common ones which are poorly designed and managed. There is no reason to stop investing in shared sanitation. ‘Safely managed’ represents a standard countries should aspire to. However, the 2030 Agenda and the human rights recognise the need for intermediate steps and for reducing inequalities. This calls for prioritising investments in high-quality shared toilets in dense informal settlements where it is the only viable option (short of rehousing) for improving sanitation services.
Estimating evapotranspiration using the complementary relationship and the Budyko framework
Authors: Kim Homin , Kaluarachchi Jagath J.
Published: June 2017

Several models have been developed to estimate evapotranspiration. Among those, the complementary relationship has been the subject of many recent studies because it relies on meteorological data only. Recently, the modified Granger and Gray (GG) model showed its applicability across 34 diverse global sites. While the modified GG model showed better performances compared to the recently published studies, it can be improved for dry conditions and the relative evaporation parameter in the original GG model needs to be further investigated. This parameter was empirically derived from limited data from wet environments in Canada – a possible reason for decreasing performance with dry conditions. This study proposed a refined GG model to overcome the limitation using the Budyko framework and vegetation cover to describe relative evaporation. This study used 75 eddy covariance sites in the USA from AmeriFlux, representing 36 dry and 39 wet sites. The proposed model produced better results with decreasing monthly mean root mean square error of about 30% for dry sites and 15% for wet sites compared to the modified GG model. The proposed model in this study maintains the characteristics of the Budyko framework and the complementary relationship and produced improved evapotranspiration estimates under dry conditions.