bluuebunny/crossref_metadata_2025 huggingface dataset:
Personalized medicine: consequences for drug research and therapy
Authors: Ruppert Thorsten , Sydow Sabine , Stock Günter
Published: July 2017

In drug research, a serious transformation has taken place. With increasing knowledge gained from molecularmedicine, it became possible to refine and develop new therapies based on the molecular mechanisms of diseases.Medicine and drug development have seen a paradigm shift which can be characterized with the catchword “personalized medicine”, also called “stratified medicine” or “precision medicine”. Personalized medicine is based on definedtandems of therapeutic agents and diagnostic tests. With this addition to the regular medical examination of the patient, specific patient characteristics are determined. The results of such diagnostic tests are then decisive for the choice of therapy or control of the effectiveness of the chosen treatment. The benefit of personalized medicine for the patient is the higher probability of treatment success as well as improved effectiveness and reduced / avoided side effects. Health insurance systems and the public may have the advantage that the health funds can be used more efficiently on this basis. This new paradigm requires also a new debate on the remuneration in health care. In order to bring personalized therapies to patients as quickly as possible, all players in health care should work together to address the challenges associated with personalized medicine.
Precision medicine: do not neglect the hurdles
Authors: Landeck Lilla , Carrigan Patricia , Asadullah Khusru
Published: July 2017

Tremendous expectations have been connected with precision medicine in the past years. Be-side the advantages that this type of therapy offers we should be aware of its challenges too. In this issue we will highlight on specific challenges that the pharmacological industry is opposed with when de-veloping new targeted therapies. In addition, we will discuss issues with the reproducibility of published scientific data.
The research data reproducibility problem solicits a 21st century solution
Authors: Bhullar Bhupinder
Published: July 2017

Reproducibility is a hallmark of scientific efforts. Estimates indicate that lack of reproducibility of data ranges from 50% to 90% among published research reports. The inability to reproduce major findings of published data confounds new discoveries, and importantly, result in wastage of limited resources in the futile effort to build on these published reports. This poses a challenge to the research community to change the way we approach reproducibility by developing new tools to help progress the reliability of methods and materials we use in our trade.
Neutrophil gelatinase-associated lipocalin as a potential therapeutic integrator of glycolipid metabolic and inflammatory signaling
Authors: Gong Junhua , Zhu Rongtao , Gong Jianping , He Kun , Chen Jiahai
Published: July 2017

Metabolic syndrome constitutes a group of metabolic conditions that increase the risk of developing diseases, including cardiovascular disease (CVD), non-alcoholic fatty liver disease (NAFLD), obesity and type 2 diabetes mellitus (T2DM) etc. Subclinical inflammation is a candidate etiological factor in the pathogenesis of metabolic syndrome and in the progression of related diseases. Although studies have revealed that subclinical inflammation was activated by intermediary products of basic metabolic processes, the cellular and molecular mechanisms in this association remain largely uncharacterized. Recently, increasing evidence suggests that neutrophil gelatinase-associated lipocalin (NGAL) not only plays a significant role in the glycolipid metabolism, but also modulates immune and inflammatory responses in macrophages. Taking together the ability of NGAL in metabolic and inflammatory signaling, these data suggest that NGAL may be a potential therapeutic target for metabolic and inflammatory signaling for intervention in human glycolipid metabolic disease. This review focuses on current knowledge of the integrators role of NGAL in both glucose and lipid metabolism and inflammatory signaling and discusses the potential therapeutic target in the treatment of glycolipid metabolic-related disease.
Laparoscopic versus open appendectomy during pregnancy
Authors: Alkatary Mohammed M. , Bahgat Nagwan A.
Published: July 2017

Background: Various causes can be claimed for abdominal pain during pregnancy. Acute appendicitis is the most common cause of abdominal pain during pregnancy. Diagnosis of acute appendicitis during pregnancy is a quiet challenging due to anatomical and physiological changes that occur during pregnancy.Methods: On the period from January 2010 to January 2012we reviewed the number of pregnant patients presented to our facility by abdominal pain and diagnosed as acute appendicitis. Total number was 23 patients. 2 patients were excluded as their magnetic resonance imaging showed normal appendix and were discharged. 6 patients presented on the 1st trimester, 7 patients presented on the 2nd trimester and 8 patients on the 3rd trimester. Laparoscopic appendectomy performed in 9 patients while 12 patients had open appendectomy.Results: The operative time on the laparoscopic group ranged from 50-80 minutes while on the open appendectomy ranged from 40-60 minutes. The length of stay after laparoscopic procedure was 1.5-3 days in comparison to 3-5 days following open appendectomy. Postoperative wound infection detected in 2 patients after open appendectomy (16%) compared with 1 patient (11%) following laparoscopic appendectomy. The postoperative pathology was classified as normal appendix, suppurated appendix and complicated appendix. Table 2 showed the postoperative pathological examination. Preterm labor detected in one patient only had open appendectomy. Fetal outcome was evaluated by Apgar scoring together with fetal length and weight after delivery with no significant abnormality.Conclusions: Laparoscopic appendectomy is safe for both the mother and the fetus during pregnancy irrespective of gestational age, and the procedure is associated with a low risk of post-operative complications.
A review of appendectomy cases at a single teaching hospital, Baghdad, Iraq
Authors: Abdullah Mohanad Hamed , Saood Mahmood J. , Tawfiq Naser R.
Published: July 2017

Background: Appendectomy is one of the most commonly performed operations. Accurate preoperative diagnosis has long been a great challenge, even to experienced surgeons. To determine the pattern of presentation and rate of atypical pathological presentation of appendicitis.Methods: This is a cross-sectional study in which patients who underwent appendectomy for presumed acute appendicitis from June 2012 to June 2016 were recruited. Incidental appendectomy was excluded. Patient demographics, pathological findings, and surgical outcomes were collected.Results: It was found that the median age of the patients with acute appendicitis was 29 (male 27.3, female 30.7; range (4-67) years. The median length of hospital stay was 2 (range, 1-22) days. There were 184 (75%) patients with clinically and pathologically confirmed acute appendicitis. Out of the 243 patients, 47 appendices were normal, making the overall negative appendectomy rate (NAR) 19.3%; 14.0% in males and 24.6% in females (P<0.001).Conclusions: Appendectomy continues to be a very common surgical procedure. We suggest a more liberal utilisation of preoperative imaging in females of reproductive age, and patients at the extreme age.
A profile study of 50 cases of liver abcess treated by percutaneous catheter drainage
Authors: Patel Prakash Babubhai , Shah Jignesh , Baria Suyadeep
Published: July 2017

Background: Liver abscess is a life-threatening disease. Continuous catheter drainage is widely accepted and in combination with antibiotics is considered a safe and effective method of management of liver abscess. The objective of this study was to evaluate predisposing factors and incidence of liver abscess in various age group, sex, social economic study and its comparison with various studies and to evaluate morbidity, mortality and complication rates in patients of liver abscess treated either by percutaneous USG guided catheter drainage.Methods: This is an observational study of 50 patients with pigtail catheter drainage and needle aspiration in liver abscess treated during the period of May 2011 to December 2013 at New Civil Hospital, Surat.Results: In the present study majority of case [11 cases (22.5%)] were observed in the age group of 31-40 years. Male female ratio in our study was 8.2:1. Majority of Liver abscess cases [34 cases (68 %)] belongs to low socio-economic class. The commonest symptoms are pain and fever seen in 64% each. In the present study 100% success rate with no recurrence. None of the patients expired in the present study. Median hospital stay is 5 days with range from 2-25 days.Conclusions: Percutaneous pigtail catheter drainage is more effective in large liver abscess.
Cancer penis evaluation of role of prophylactic inguinal lymph nodes dissection
Authors: Nichkaode Prabhat B. , Agrawal Rajendra , Kulkarni Sayali
Published: July 2017

Background: Incidence of penile cancer is considerably variable across the globe; this disease is uncommon in the western world. But it is not uncommon to see the disease in Indian subcontinent. Also, it is not uncommon to see Penile growths with palpable unilateral or bilateral lymph nodes. In this retrospective observational study, we would like to present our data of 31 cases of Penile cancer with variable presentations, in terms of palpable groin lymph nodes. FNAC from palpable lymph nodes may not be diagnostic of metastasis. It is said that battle of cancer penis is either won or lost depends on how you deal with groin. It is a clear understanding that in presence of positive groin nodes Lymphadenectomy is the choice of treatment but it is unclear, how to deal with negative groin? In this study we present experience, in terms of deal with the groin lymph nodes aggressively, even when they not palpable for a better outcome after balancing the morbidity of the procedure. Aim was to evaluate the role of early prophylactic inguinal node dissection in patients with squamous cell cancer of Penis.Methods: This retrospective observational study was carried out at tertiary care teaching institute from 2003 till 2012. The clinical, investigational, operative, pathology details and follow-up data were collected from patient records.Results: Study showed data of 47 patients treated during the period from 2003 to 2012 and included 31 patients in this study, 21 patients (67.74%) presented with palpable inguinal nodes at the time of primary presentation. FNAC from these lymph nodes could prove metastasis, only in 16 patients (76.19 %). 5 patients (23.80) on FNAC had no metastasis. Remaining 10 patients were without lymph node enlargement at the time of primary presentation. Patients presented without palpable lymph nodes were offered modified inguinal block dissection. Histology showing 8 nodes positive for metastatic disease. And were FNAC was negative 4 (80 %) out of 5 patients with negative nodes shown positive for metastasis.Conclusions: This retrospective observational study concludes with fact that palpable lymph nodes in the groin, is no doubt an indication for Inguinal node dissection but even when nodes are negative on FNAC or not palpable then prophylactic lymph nodes dissection should be undertaken. Delay in inguinal lymphadenectomy in non-palpable nodes you may lose the battle on cancer penis, as many reports say that, delayed lymphadenectomy has a strong impact on the survival. The only drawback with prophylactic lymph node dissection is the associated morbidity. But with modified procedures this can be very well minimized.
Searching for the safest abdominal closure technique after emergency laparotomy for Hinchey III and IV peritonitis
Authors: Tamini Nicolo , Cereda Marco , Capelli Giulia , Giani Alessandro , Gianotti Luca
Published: July 2017

Background: The optimal strategy for abdominal wall closure has been an ongoing issue of debate and convincing evidence is still lacking. The INLINE systematic review and meta-analysis published on annals of surgery 2010 suggested that a running suture with a slowly absorbable suture material was the gold standard technique for abdominal wall closure after elective surgery, while there’s no general agreement in the emergency setting.Methods: Retrospective study regarding patients who underwent emergency surgery for a generalized peritonitis due to colonic perforation from 2002 to 2014 at San Gerardo hospital (Monza, Italy). Particularly study analyzed differences between continuous suture (Maxon loop, Covidien ©) and interrupted suture (Safil, B. Braun ©) for fascial closure and between metallic clips and second intention healing for incision management. After completion of data retrieval, 110 patients were included in the statistical analysis.Results: Incisional hernia rate was 15/101 (14.9%) and surgical site infection rate was 29/110 (26.4%). No significant statistical differences were found between incidence of incisional hernia and surgical site infection in the two groups, although there was a higher prevalence of incisional hernia in the running suture group (25% vs 11,7%). There was no difference between skin-stapler’s and second-intention’s wound closure groups in terms of surgical site infection and incisional hernia development.Conclusions: We consider reasonable to use an interrupted long time absorbable suture for fascial closure after emergency midline laparotomy for Hinchey III and IV peritonitis, at least in high-risk patients. Considering skin closure, suggestion is to perform a primary skin closure.
Comparison between laparoscopic and open abdominal rectopexy for full-thickness rectal prolapse: controlled clinical trial
Authors: Abdelraheem Omar , Singh Magdy Khalil
Published: July 2017

Background: Abdominal rectopexy is an appropriate treatment option for full-thickness rectal prolapse (FTRP). Our aim is to evaluate the effectiveness and surgical outcome of laparoscopic posterior mesh rectopexy in treatment of FTRP by comparing this procedure with the traditional open approach.Methods: Thirty consecutive cases with FTRP were included and subjected to abdominal posterior mesh rectopexy from September 2013 to February 2016 at Sohag University Hospital. Thirteen patients were managed laparoscopically and 17 patients underwent open posterior mesh repair. Demographic data and surgical outcome were compared in both groups.Results: Laparoscopic group showed an earlier tolerance to oral feeding (1.26±0.42 versus 2.16±1.36 days, p=0.03), and earlier hospital discharge and return to work (5.63±2.91 versus 8.24±4.64 days, p=0.016, 18.28±2.61 versus 28.64±3.82 days, p=0.032, respectively). The mean consumed postoperative analgesics per day was less among laparoscopic group (1.63±16.2 versus 2.68±34.21 ampoule/day, p=0.012). Incidence of wound infection, wound dehiscence, prolonged ileus and postoperative chest infection were more in open group. There were significant postoperative improvement of continence status, rectal bleeding and abdominal pain in each group. Incidence of postoperative constipation was slightly increased in both groups, but without significant difference. Recurrence occurred in one case only in open group. There were no mortalities in both groups.Conclusions: Laparoscopic posterior mesh rectopexy for FTRP can be done safely even in elderly patients. It offers less postoperative pain, low incidence of postoperative morbidities, early hospital discharge and return to work, in addition to cosmetically better outcome. Laparoscopic rectopexy has the same functional outcome as open technique.
A study of the role of diagnostic laparoscopy in 25 cases of acute abdomen
Authors: Ram Kamlesh , Chandana Sanjog
Published: July 2017

Background: Acute abdomen is associated with patient discomfort and diagnostic challenges. Diagnostic laparoscopy is a tool which can help in providing diagnosis and treatment. This study is aimed to use laparoscopy as diagnostic and therapeutic procedure. It can avoid unnecessary open procedure, provide early discharge, and decrease patient discomfort.Methods: A case study of 25 cases of acute abdomen was done. All cases were initially evaluated with ultrasonography abdomen and abdominal X-ray and diagnostic laparoscopy was done. Therapeutic procedures were done according to pathology encountered. All patients were followed up 1 year from dischargeResults: A total 25 cases were used; appendicectomy was done in 12 patients, adhesiolysis in 3 patients, peptic perforation repair done in 3 patients. Drainage of fluid done in 1 patient. Omental biopsy was taken in 1 patient. Marsupialisation of left ovary done in 1 patient. 8% cases required open surgery. Open right hemicolectomy and resection anastomosis, open enteric perforation repair was done in 1 patient each. 52% cases were discharged within 2 days. 10% patient required stay for 6 days.Conclusions: Diagnostic laparoscopy can be used in acute abdomen. It avoids unnecessary laparotomy and helps in diagnosis in which radiological findings are equivocal. Post-operative recovery is fast in compare to open procedure.
Dor fundoplication for achalasia of the esophagus: is it time to simplify the established technique? evaluation of clinical outcome
Authors: Triantafyllou Tania , Natoudi Maria , Stathopoulos Ioannis Ntanasis , V. Xiromeritou , A. Mantides , G. Zografos , D. Theodorou
Published: July 2017

Background: Surgery is the most efficient treatment to achalasia of the esophagus with a success rate estimated 90%. Laparoscopic myotomy is combined with a fundoplication. One of the most common types of wrap is the anterior partial fundoplication, also known as Dor fundoplication. The 10% of surgical failure has been attributed to incomplete myotomy and/or tight fundoplication. The present study describes a modified anterior partial fundoplication that may have the potential to improve the clinical outcome of surgical treatment for achalasia.Methods: In this prospective study, we describe a modification of the standardized technique of Dor fundoplication applied to twenty-nine achalasia patients with intention to decrease the rates of failure. Short-term clinical result was evaluated with preoperative and six- months postoperative Eckardt scores (ES).Results: The mean number of months from initial symptoms to the time of diagnosis was 35.5 months (range 3-156 months). According to the Chicago Classification (CC v3.0), 11 patients (37.9%) were classified as achalasia type I, 17 (58.6%) as type II and 1 (3.4%) as type III. The mean ES was diminished from 7.8 to 0.6 postoperatively.Conclusions: The modification proposed in the present study omits the fixation of the right side of the myotomy to the right crus. This alteration may have the potential to anatomically and functionally affect postoperative rates of dysphagia and antireflux result among patients surgically treated for achalasia.
The role of microvascular tissue transfer in severe limb trauma
Authors: Kakkar Vikas , Kansal Sandeep , Sachdeva Kamal , Bajwa Balcharan Singh
Published: July 2017

Background: Lower extremity reconstruction is an essential part of plastic surgery and focuses on the treatment of wounds. The restoration of an intact covering is the primary surgical requisite following trauma of the lower extremity because deep healing can be no better than the surface covering. Present study will review the field of lower extremity reconstruction focusing on the micro-vascular tissue transfer for severe limb traumatic injuries.Methods: Patients were fully evaluated and defect was assessed depending on the defect requirement free micro- vascular flap was planned. 20 micro vascular flaps in 18 males and 2 females were used for the wound / defect of lower limbs following trauma.Results: There were 18 men and 2 women with a mean age of 43.6 years (range, 18-62 years) in the present study. The overall survival of the flaps was 95% (19/20).Conclusions: The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.
Observational study of small bowel perforation in a tertiary care hospital
Authors: Nahar Shashank , Ranjan Alok
Published: July 2017

Background: Perforation of the small intestine causing peritonitis is the most common abdominal surgical emergency encountered in study region. Late presentations with sepsis and septic shock makes evaluation and management of these patients a formidable surgical challenge. The aim of this study was to identify the etiologies, clinical presentation, diagnostic dilemmas and modalities of treatment of the small bowel perforation of diverse etiology in this study region. Objective was to study the demography, etiology, pathology, clinical presentation and various surgical procedures in treatment of small bowel perforation in hospital.Methods: This study was a prospective observational study conducted in the department of general surgery Rohilkhand medical college Bareilly, Uttar Pradesh, India from November 2015 to December 2016. 90 patients admitted in the emergency of this hospital who eventually turned out to be those of small bowel perforation were included in this study and an analysis of the demographic data, clinical presentations, radiological findings, site of perforation, surgical procedure performed, surgical complications and duration of hospital stay was done.Results: Duodenal perforation was the commonest cause of small bowel perforation, contributing to 51 (56.66%) patients. Peptic ulcer disease accounted for 49 (96.07%) patients and blunt trauma abdomen for 2 (3.9%) of these patients.  Jejunal perforations accounted for 9 (10%) patients and ileal perforations for 30 (33.34%) patients. Typhoid fever was the commonest cause of ileal perforation in 24 (80%) patients Blunt trauma abdomen was the commonest cause in 5 (55.55%) patients of jejunal perforations.Conclusions: Indiscriminate use of NSAIDS/Steroids accounted for most of the peptic ulcer perforation in our region. The other additive factors include alcohol consumption and smoking.
Limb cellulitis in rural setting in India: a case control study
Authors: Grover Ankur , Shahapurkar Vinay V. , Shinde Raju K.
Published: July 2017

Background: Cellulitis is the bacterial infection of dermis and the subcutaneous layer. Limb cellulitis is the most common and yet least studied form. This study aims at studying clinical profile, management and complications of limb cellulitis in inpatients at an Indian rural hospital.Methods: After taking institutional ethics committee approval, patients admitted to Jawaharlal Nehru medical college and Acharya Vinoba Bhave rural hospital, Wardha, Maharashtra, India with limb cellulitis during April 2007 to September 2009 were included. Their history, clinical examination and photographs were noted. They were treated conservatively or surgically depending on severity and followed up till complete recovery or 30 days after discharge whichever was earlier.Results: 130 patients i.e. 40 (30.77%) females and 90 (69.23%) males were included in this study with farming being commonest occupation. Commonest risk factor was bare foot working while least common was venous insufficiency. Right lower limb was frequently affected. Local swab cultures were sterile in 74 (56.92%) patients while E. coli grew predominantly in positive cultures and all blood cultures were negative. 84 (64.62%) patients were treated conservatively and only 46 (35.38%) required surgical intervention. 125 (96.15%) patients showed complete recovery while 5 (3.85%) patients succumbed to illness due to sepsis and multiorgan dysfunction syndrome.Conclusions: Limb cellulitis is a common disease to outpatient department and needs admission in patients with elevated risk factors. Most cases can be managed conservatively and seldom surgical intervention. Though majority can be cured completely, few with elevated risk succumb to the disease.
Comparative efficacy of different modules on pulmonary functions after lung resection
Authors: S. Ghandi , Ramana Kumar G. V.
Published: July 2017

Background: Lung resection in patients with lung cancer and inflammatory lung pathology, not only improves the symptoms but also long-term survival. The aim of this study was to compare the effect of conventional chest physiotherapy, continuous positive airway pressure (CPAP) and incentive spirometry (IS) after lung resection on pulmonary function tests and postoperative pulmonary complications.Methods: A prospective, randomized, case control study was conducted in a tertiary care teaching hospital. Thirty patients were included, who underwent lung resection. Detailed clinical history, examination and appropriate investigations were done. Patients were randomized into three groups, and accordingly postoperative incentive spirometry with physiotherapy, CPAP with physiotherapy and physiotherapy alone was given. All the groups were compared pre-and postoperatively for pulmonary functions and complications.Results: Majority males (90%) patients of 40-60 years. Significant difference was present in FEV1/FVC on post-OP day one and day twenty-eight only (p<0.05). FVC in all three groups declined most significantly on first postoperative day and then consistently increased till 28th day. Group II and III patients showed a significant difference in increase in FVC between 8th and 28th postoperative day. In group, I maximum increase in FEV1 occurred till day 8th, whereas in group II and III significant difference was still present on day 28th. There was no significant difference between the three groups with regard to FVC, FEV1 and FEV1/FVC. No significant difference in pH value while pO2 showed a marked decrease on first post-op day in all groups. Incidence of atelectasis was found to be highest in group I (5 out of 11).Conclusions: As incentive spirometry offered no advantage over chest physiotherapy but does involve the added expense of spirometer, a vigorous chest physiotherapy requires no special equipment and can be delivered by less trained personnel, chest physiotherapy is more economic.
Prospective study of 50 cases of perforative peritonitis a single centre experience
Authors: Patel Prakash B. , Baria Suryadeep
Published: July 2017

Background: Perforative peritonitis are most common surgical emergencies seen worldwide. Despite improvement in diagnosis, antibiotics, surgical treatments and intensive care support, it is still an important cause of mortality in surgical patients. This study was done to know the spectrum of etiology, clinical presentation, management and treatment outcomes of patients admitted with perforation peritonitis in our hospital.Methods: A prospective study was done over a period of 3 years from January 2007 to December 2010 in NHL Medical College and V.S. hospital, Ahmedabad which included 50 patients diagnosed with perforation peritonitis. All patients admitted with perforation of gastrointestinal tract were included in this study. All cases of primary peritonitis and anastomotic leaks were excluded from this study.Results: Total 50 cases were included with 80% being males. Highest incidence of perforation peritonitis was noted in 21-30 years of age group in the present study. Most common etiology of perforative peritonitis was noted in the present study was peptic perforation 40% (20) cases, abdominal pain, tenderness were present in all of the perforative peritonitis patients.Conclusions: Perforative peritonitis is more common in male and most common pathology was peptic perforation due to acid peptic disease, in most of the cases after adequate resuscitation and stabilization of the patient Exploratory laparotomy is mainstay treatment modality
Intraperitoneal access by closed method (veress needle) versus open (Hasson’s) method in laparoscopic surgery to create pneumoperitoneum
Authors: Chotai Neet R. , Choksi B. B. , Damor Sushil , Bhedi Amul
Published: July 2017

Background: Access into the abdomen is the one challenge of laparoscopy that is particular to the insertion of surgical instruments through small incisions. In the last three decades, rapid advances in laparoscopic surgery have made it an invaluable part of general surgery, but there remains no clear consensus as an on optimal method of entry into the peritoneal cavity. The objective of this study was to study the comparison and efficacy between closed (veress needle)and open method (Hasson’s) of intraperitoneal access to create pneumoperitoneum in laparoscopic surgeries.Methods: All patients >18 year undergoing laparoscopic procedure at Sir Sayajirao Gaekwad Hospital attached to Medical College Baroda from November 2015 to November 2016, and include 160 patients. This was Prospective study and total 160 cases of Laparoscopic surgery was taken in 1-year period. Methods used to create pneumoperitoneum were of surgeon’s choice in each case. Cases were performed by one method more than other method (63 patients by veress needle and 97 by open method). Student t test (two tailed, independent) had been used to find the significance of study parameters on continuous scale between two groups. All data were entered in Microsoft Excel sheet. Data calculation was done in software - Microsoft Excel and Medcalc statistical software 16.8.4.0.Results: The Mean operative time for access in veress needle group was 5.12 mins as compare to open method where it was 3.94 mins. Port site Gas leakage was slightly more in open method. There were no any major complications occurred in any group. There were minor complications occur in both methods at access like; omental injury, port site gas leakage, extra-peritoneal insufflations, loss of space and entry in wrong plane.Conclusions: For intraperitoneal access in laparoscopy, both the closed and the open methods are safe and the open technique had a time advantage over the closed method.
Utility of pre-operative serum thyroid stimulating hormone in predicting thyroid malignancy
Authors: K. Arun , K. Santhosh Nayak , Gowda Suhas
Published: July 2017

Background: Thyroid cancer is the most common endocrine malignancy and its incidence continues to rise. Thyroid carcinoma in most cases presents clinically as a solitary nodule or as a dominant nodule within a multinodular thyroid gland. There are a number of well-established of predictors of malignancy in thyroid nodules. More recently studies have suggested that higher concentration of TSH, even within the normal range are associated with subsequent diagnosis of thyroid cancer in patients with thyroid nodules and even higher serum TSH levels have been found associated with advanced stages of thyroid cancer. The objective of this study was to determine the serum thyroid stimulating hormone (TSH) concentration before surgery in different thyroid malignancies and to compare serum TSH concentration after surgery in thyroid malignancyMethods: A hospital based observational study was conducted in a tertiary care hospital for a period of 2 year. 120 patients presenting with thyroid nodule without an overt thyroid dysfunction during the study period were included in the study. Chi-square was used as test of significance. Independent t test was the test of significance for quantitative data between two groups.Results: Mean serum TSH was higher in thyroid malignancies and significant difference was observed between solitary and multinodular goitre. Mean serum TSH concentrations was significantly high in papillary carcinoma and advanced stages of carcinoma. Mean serum TSH was high in stage III and stage IV (5.17±1.36 mIU/l) compared to stage I and II (4.03±1.87 mIU/l).Conclusions: The study concludes that TSH levels were high in thyroid malignancies arising from multinodular goitre, majority of thyroid malignancies had high levels of serum TSH concentrations and TSH was high with advanced stage of thyroid cancer
Idiopathic scrotal calcinosis: a rare case report and review of pathogenesis and surgical management
Authors: Yudawan Herman , Safriadi Ferry
Published: July 2017

Scrotal calcinosis is an uncommon benign disorder of the scrotal skin characterized by multiple calcified intradermal nodules that occurs in the presence of normal calcium and phosphate metabolism. The pathogenesis of scrotal calcinosis is still controversial. Our Aim is to report this disease in 33-years-old man and review the pathogenesis and surgical management. We presented 33-years-old male patient with a 10 year history of painless scrotal nodules which gradually increased in size and number. Physical examination revealed multiple scrotal nodules with diameter of 5-10 mm, respectively. The nodules were firm and skin-colored. The nodules grow from small bud with chalky white exudative discharge but no history of vesicle, papule or any sign of inflammation. The patient’s symptoms were mild itching with no pain. He had no history of trauma, malignancy, or any metabolic disorder. His old brother had a history with the same complained. Laboratory findings including serum electrolyte and level of creatinine, urea, calcium and phosphorus, were within normal limit. The patient was performed biopsy before procedure showed dystrophic calcinosis appearance. We performed wide local excision of lesion with primarily closure with good postoperative outcome, with histopathology result calcinosis subcutaneous at region scrotum. Dystrophic scrotal calcinosis is a benign condition which can affect a patient’s quality of life. Irrespective of the etiology, surgical excision seems to be gold standart is required both for confirming the diagnosis as well as for treatment but occasionally may require complex scrotal reconstruction to provide a good clinical outcome with good patient satisfaction.
Acute cholecystitis with Cholecystocolic fistula: a case report and pertinent literature review
Authors: Alqunai Mansur S. , Daif-Allah Mahmoud Abdul-Kareem , Alhammad3 Loai
Published: July 2017

Cholecystocolic fistula (CCF) is a rare late complication of gallstones. The clinical features of CCF are nonspecific and variable. No single test is sufficient to diagnose CCF because of the low sensitivity of the tests or the invasive nature of the procedures, and these tests are not routinely requested for asymptomatic patients. Because CCF is rarely diagnosed preoperatively, patient history, laboratory, and radiological data play an important role in alerting surgeons to the possible existence of a CCF. Treatment involves closing the fistula and performing an open or laparoscopic cholecystectomy.
Primary rectal tuberculosis mimicking malignancy
Authors: Jagtap Sunil V. , Ingale Shivani H. , Jagtap Swati S.
Published: July 2017

Primary rectal involvement by tuberculosis infection is rare. We present a relatively uncommon case of primary rectal tuberculosis. A 35-year-old male patient presented with history of long duration of anorexia, altered bowel habits, painful defecation, fever, and rectal bleeding. On clinical and radiological finding case was suspected of rectal malignancy. The proctoscopic biopsy was performed. On histopathology, it was diagnosed as rectal tuberculosis. We are presenting this case for its rarity, mimicking malignancy and difficulty in diagnosis.
A case of dual ectopic thyroid
Authors: Hussain S. Zahir , Ayub Muhamed Faizal
Published: July 2017

The presence of two ectopic foci of thyroid tissue in a single patient is an uncommon presentation. Ectopic thyroid reportedly has a low incidence. We are reporting here a case of dual ectopic thyroid present in the lingual and sub hyoid region in a 33 years old lady with short stature and hypothyroidism. Ultrasonography of the neck had revealed no thyroid gland in its normal anatomical position. The presence of ectopic thyroid tissue in the lingual and sub hyoid region were confirmed with a technetium-99m sodium per technetate thyroid scan.
Ruptured mediastinal pseudocyst- a case report
Authors: Darlington C. Danny , Anitha G. Fatima Shirly
Published: July 2017

Pseudocysts are one of the common complications of chronic pancreatitis. Usually they present with chronic abdominal pain and obstructive symptoms. The symptomatology mainly correlates with the location of the pseudocysts. Thoracopantreatic pseudocysts are rarely encountered in surgical practice. They can present in the acute setting with hemoptysis or rupture. They can also have an indolent course with dysphagia and other mass effects. We report a rare case of mediastinal pseudocyst with rupture into the bronchus causing massive haemoptysis.
Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures: the suture “bridge” pull out technique and evaluation of results
Authors: Patel Mihir R. , Butala Ushma K. , Thakor Nirlepsinh S. , Bansod Raunik R. , Dhotre Rohan A.
Published: July 2017

Background: Tibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. Operative treatment is indicated for type 2, 3 and 4 fractures. Arthroscopic fixation is the preferred method and numerous fixation options are described. The purpose of this study is to evaluate the results of a new technique of arthroscopic fixation.

Methods: A retrospective study was done involving twelve patients having displaced ACL tibial avulsion fractures. The arthroscopic suture “bridge” pull out technique was used to fix these fractures. Patient symptoms like knee pain, locking, clicking, sensation of giving way and clinical signs like tenderness, range of motion, Mc Murray’s test, stability test and Lysholm knee scores were evaluated pre operatively and post operatively at 3 months and 6 months. Patient satisfaction was noted at latest follow up.

Results: One patient had type 2, 7 patients had type 3 and 4 patients had type 4 tibial ACL avulsion fractures. All the fractures united and all patients achieved full knee range of motion by 2 months post-operative. The clinical symptoms and signs improved post operatively. The mean Lysholm knee score at 3 months follow up was 88.8 and at 6 months follow up were 98.8. At latest follow up, all the patients were satisfied with their knee function.

Conclusions: The arthroscopic suture “bridge” pull out technique is an effective method for fixation of ACL tibial avulsion fractures with respect to knee stability, range of motion and resumption of pre injury activity level.
Análise comparativa de procedimentos para a estimativa de incertezas em ACV: um estudo baseado na produção de blocos cerâmicos de alvenaria
Authors: Silva Fernanda Belizario , Yoshida Olga Satomi , Arduin Rachel Horta , Vinhal Laís David , Teixeira Cláudia Echevenguá , De Oliveira Luciana Alves
Published: July 2017

O presente trabalho tem como objetivo discutir a estimativa de incertezas em ACV, utilizando-se três procedimentos de cálculo, a partir de dados de inventários da produção de blocos cerâmicos de uma fábrica localizada no Estado de São Paulo (berço ao portão). O primeiro procedimento para a estimativa de incertezas consistiu na atribuição de modelos probabilísticos e seus parâmetros aos valores obtidos na fábrica. As distribuições de probabilidade foram selecionadas dentre as disponíveis no Simapro (versão 8.1.1.16). O segundo procedimento consistiu na aplicação das diretrizes do Ecoinvent versão 3.1 relativas a incertezas, adotando-se valores padronizados de incerteza básica e incertezas adicionais da matriz Pedigree, com distribuição lognormal. O terceiro procedimento consistiu em uma mescla dos procedimentos prévios: adotou-se o primeiro procedimento para o cálculo da incerteza básica e a matriz Pedigree para a atribuição da incerteza adicional. Os ICVs foram inseridos com as suas respectivas incertezas no Simapro e foram feitas simulações de Monte Carlo com parâmetros equivalentes para as três situações. Realizaram-se também análises de variância (ANOVA) para verificar a distribuição das incertezas entre o processo principal e os processos à montante. Observou-se que os procedimentos 1 e 2 são passíveis de adoção em estudos de ACV, a depender da disponibilidade de recursos e do nível de detalhamento do estudo em questão, sendo que o primeiro procedimento, que envolve o cálculo direto das incertezas associadas, tem potencial de agregar maior confiabilidade ao estudo de ACV, enquanto o segundo requer menor esforço para a estimativa de incertezas. Ambas as abordagens melhoram a qualidade do resultado final a ser comunicado em relação à divulgação de um valor determinístico único.
JSD Volume 2, Issue 3: Full Issue
Authors: Office Editorial
Published: July 2017

View the full issue here.
METODOLOGI KITAB AL-ISRÂ’ÎLIYYAT WA AL-MAUDHÛ’ÂT FÎ KUTUB AL-TAFSÎR KARYA SHEIKH ABU SYAHBAH: SATU ANALISIS
Authors: Abidin Zahidah Zainal
Published: July 2017

Kitab al-Isrâ’îliyyat wa al-Maudhûcât fi Kutub al-Tafsîr is the great work of Sheikh Abu Shahbah which tells the stories of Israiliyyat that exist in the Qur'an and Hadith. This book is considered as an important effort to know the elements of dakhil in the commentaries. This book has been raised as the main and best reference in the discussion of Israiliyyat in the Fakulti Pengajian Islam, Universiti al-Azhar. This study analyzes the methodology used by Sheikh Abu Shahbah in this book. It also briefly discusses the background of Abu Shahbah as a respected muhaddith. This study is a qualitative one and focuses to analyze Abu Shahbah’s work, al-Isrâ’îliyyat wa al-Maudhûcât fi Kutub al-Tafsîr. The results of this study do have the features and strengths that are mutually studied and utilized. The form of argumentation in this work encompasses the Qur'an, the hadith of muktabar, the ijtihad of the scholars' salaf, his views, and some of the latest scientific theories of natural phenomena related to Israiliyat.
PLURALITAS AGAMA MENURUT PANDANGAN TOKOH-TOKOH AGAMA DAYAK DI DESA KAPUL KECAMATAN HALONG KABUPATEN BALANGAN
Authors: Hamid Abdul
Published: July 2017

Religious plurality is condition which no one can reject it but it must be thought how to respond the issue. So far, many recorded attitude show various respond about it. This work will elaborate the issue from religious people’s perspective, especially the figures in Kapul village, Halong districts of Balangan regency. Actually, it is Dayak’s region. But, there are many religious followers such Islam, Catholics, Hinduism, Buddhism, and local religion. They live together in harmony. This research is a qualitative one with sociological approach as the main theory of Max Weber’s charismatic. While the methods are direct observation, interview, and documentation.It concluded that Dayak figures believe that everyone can choose their religion without force and pressure so then they can respect another highly. Even in the village, every community will attend an event that hold by other religious communities. They believe that all of them are originated from the same ancestor so religion cannot change this principle.
IMPELEMENTING PADLET APPLICATION TO IMPROVE WRITING ABILITY IN ENGLISH WRITING SKILL FOR NON ENGLISH DEPARTMENT STUDENTS
Authors: Lestari Sri
Published: July 2017

This study is aimed to know teaching learning process in writing by using padlet application for Primary Education Department’s students whether there is improvement of students writing English skill by using that application. Subject of this research was third semester students of Primary Education Department. This is a Classroom Action Research. In collecting the data, the writer  used some techniques: observation, interview, and writing test. The data were analyzed quantitatively and qualitatively. Result of this research were: those application can be implemented as online writing practices every time that made students ability improve, the situation of wall in padlet can stimulate students to explore idea because they could upload video, recording, or picture suitable with topic that can support their writing. Students improvement in writing can be seen from postest score in every cycles. Based on the results above, it can be concluded that implementing padlet application can improve students Non English Department’ writing skill.
Use of a Reverse Thermodynamic Gel to Manage Chronic Shedding in Equine Strangles
Authors: Bowen Mark
Published: July 2017

Strangles is a common condition in equine practice with high morbidity. Management of outbreaks is complicated by the development of asymptomatic carriers with the causative organism (Streptococcus equi var equi) being retained within the guttural pouch1,2. This Bright Veterinary Idea looks at the use of a reverse thermodynamic gel to manage chronic shedding in equine strangles.
Sabedoria popular andina: provérbios Quéchuas
Authors: Mesquiati de Oliveira David , Terra Kenner Roger Cazotto
Published: July 2017

A sabedoria popular andina expressa nos provérbios Quéchua é rica em elementos morais e comportamentais. No provérbio analisado aqui, o Ama llulla, ama qhilla, ama suwa (“Não sejas mentiroso, não sejas preguiçoso, não sejas ladrão”) fica evidente essa moral comunitária e social. Esse Tricálogo ético e moral dirigia a vida dos Quéchuas desde os pequenos povoados até o Tawantinsuyu Inca, perpassando centenas de anos e ainda servindo de referência para os cerca de 10 milhões de latino-americanos que atualmente falam o idioma quéchua e vivem sua cultura nos Andes (Bolívia, Peru e Equador). Como gênero literário sapiencial, os provérbios podem ser analisados e comentados. Nesse texto, buscou-se fazer a conexão entre a cultura Quéchua do provérbio e a fé cristã.
Fluidos de perfuração usados na construção de poços marítimos e requisitos ambientais para descarte
Authors: Vieira da Silveira Wilker Marcolongo , Junior Jader Lugon , Paiva Pedro Mello , Campos Letícia Ferraço
Published: July 2017

Este trabalho apresenta uma descrição das etapas de perfuração de poços de óleo e gás, tratando especificamente da geração de resíduos e dos fluidos de perfuração utilizados. São discutidas as limitações e a possibilidade do descarte de fluido de perfuração na proximidade da plataforma levando em consideração a minuta de 2014 do IBAMA, órgão ambiental que regulamenta o descarte de resíduos. Foram também pesquisados os resultados de trabalhos utilizando modelagem computacional para estudar o descarte dos resíduos das atividades de perfuração e cimentação durante a construção de poços de óleo e gás. Assim pôde-se analisar a área de dispersão levando em consideração as correntes marítimas, temperaturas e profundidade, bem como seus efeitos ambientais.
Contaminação por metais pesados e hidrocarbonetos de petróleo: uma ameaça para os manguezais
Authors: Alencar Thaís Dos Santos , Santos de Oliveira Vicente De Paulo , De Oliveira Manildo Marcião , Saraiva Victor Barbosa
Published: July 2017

O ecossistema manguezal é um dos mais produtivos do planeta e possui relevante importância ecológica. Ele oferece diversos serviços como a proteção da região costeira, imobilização de contaminantes, e é fonte de alimento e refúgio para diversos organismos. No entanto, os manguezais encontram-se frequentemente ameaçados por atividades antrópicas. Os derrames de petróleo em áreas próximas a manguezais, por exemplo, são fontes potenciais para entrada de contaminantes como metais pesados e hidrocarbonetos. Dentre outras fontes, podem-se citar os resíduos industriais e de esgotos, a mineração e o uso de fertilizantes. Esses contaminantes alcançam os manguezais, podendo causar diversos efeitos negativos e afetar seu equilíbrio.