bluuebunny/crossref_metadata_2025 huggingface dataset:
Ética e Ensino de Administração: Um Referencial Protestante no Ensino de Administração
Authors: Oliveira Éder Júnio de , Silva João Paulo Henriques Lopes , Santos Murillo César Barbosa dos , Miranda Rodrigo
Published: September 2017

Resumo Este caso para ensino descreve, baseado em fatos reais, a história de Pedro, ex-aluno de Gestão de Recurso Humanos da Faculdade Cristã. A Faculdade é pertencente ao grupo Comunidade Cristã, que há anos atua no setor educacional no município de Uberlândia, Minas Gerais. Pedro optou pela área de Recursos Humanos para construir carreira numa grande confecção de roupas da cidade. Essa confecção não possui marca própria e não comercializa no varejo as peças feitas por ela, entretanto apresenta históricos de decisões baseadas em ética empresarial. Seu objetivo é trabalhar como terceirizada de grandes lojas de departamentos nacionais e internacionais que atuem no Brasil. Seus empregados são homens e mulheres de baixa renda e com pouca instrução. Pressionada pela incapacidade de fechar grandes contratos, a solução encontrada foi a submissão de seus funcionários a condições de trabalho análogas às da escravidão. Pedro, diretor de Recursos Humanos, não concorda com as decisões tomadas até então, pois fogem da conduta ética do administrador. Ao longo da vida, envolvido por suas crenças e preceitos éticos aprendidos na faculdade, Pedro não se conforma, pois decisões dessa dimensão colocam a empresa em um risco maior, podendo acarretar em uma destruição da imagem corporativa e uma desonra à ética empresarial. Sua decisão provoca dúvidas entre os gestores, prorrogando a decisão.
Social rights of children with chronic conditions: a critical analysis of brazilian public policies
Authors: Tavares Tatiana Silva , Duarte Elysângela Dittz , Sena Roseni Rosângela de
Published: September 2017

Abstract Objective: To analyze the current Brazilian public policies that guarantees the social rights of children with chronic conditions, in the areas of health, social assistance and education. Method: Documentary research of laws that shape policies related to the attention to children with chronic illness and people with disabilities in the areas of human rights, health, social assistance and education. A critical analysis of the discourse of three selected legislations was carried out. Results: Children with chronic conditions are covered by legislation for the representation of children with chronic diseases or disabilities. There are discourses of the social model of disability, of children and people with disabilities as subjects of rights, of the state's responsibility in relation to the guarantee of social rights and the co-responsibility of the family. Discourses associated with the ideology of human rights in conflict with the ideology of normalization were evidenced. Conclusion: The actions defined for this group are incipient and with signs of restricting financing, revealing ideological struggles.
Maturação dos potenciais evocados auditivos de longa latência em crianças ouvintes: análise do complexo P1-N1-P2-N2
Authors: Silva Liliane Aparecida Fagundes , Magliaro Fernanda Cristina Leite , Carvalho Ana Claudia Martinho de , Matas Carla Gentile
Published: September 2017

RESUMO Objetivo O objetivo deste estudo foi monitorar o surgimento e as mudanças nos componentes dos Potenciais Evocados Auditivos de Longa Latência (PEALL) em crianças com audição normal. Método Estudo longitudinal com crianças de ambos os gêneros, sendo: sete crianças com idade entre 10 e 35 meses, e oito crianças com idade entre 37 e 63 meses. A avaliação eletrofisiológica da audição consistiu na análise dos PEALL obtidos em campo sonoro com as caixas posicionadas a 90° azimute, por meio da sílaba /ba/ na intensidade de 70 dBnNA. Cada criança passou por uma avaliação inicial seguida por duas reavaliações após três e nove meses. Resultados Foi observado surgimento dos componentes dos PEALL ao longo dos nove meses de acompanhamento, sendo os componentes P1 e N2 os mais frequentes em crianças desta faixa etária. Não houve diferença estatística no que diz respeito à ocorrência dos componentes P1, N1, P2 e N2 entre as crianças mais novas ou mais velhas. No que tange aos valores de latência, as maiores diferenças ao longo dos nove meses foram observadas no componente P1 para as crianças mais novas e para o componente N2 para as crianças mais velhas. Somente o componente P1 apresentou diferença estatisticamente significante entre os grupos, sendo que foram observados maiores valores de latência entre as crianças mais novas. Conclusão A maturação dos PEALL ocorre gradualmente e o surgimento dos componentes do complexo parece estar mais relacionado à maturação do sistema nervoso auditivo central do que à idade cronológica.
WEED COMMUNITY INTERFERENCE AND PHYTOSOCIOLOGICAL STUDIES IN A SWEET SORGHUM CROP
Authors: GIANCOTTI P.R.F. , MORO M.S. , NEPOMUCENO M.P. , MARTINS P.F.R.B. , BARROSO A.A.M. , ALVES P.L.C.A.
Published: September 2017

ABSTRACT This research was carried out to evaluate the interference periods and phytosociological indexes of the weed community on sweet sorghum, hybrid CVSW 80007, cultivated for two seasons in a year. The treatments were based on an increased duration of weed presence and weed absence after sowing (0, 4, 7, 14, 21, 28, 35, 42, 56 and 68 days after crop emergence for the summer season and 0, 4, 7, 14, 21, 28, 35, 42, 49, 56, 63 and 100 days for the fall season). The weed community was evaluated based on the number of weeds and the dry mass of each weed population in each period of weed control in the summer season and each period of no weed control and weed control in the autumn season. These data were used to determine the relative indexes of density, dominance and importance, and the weed community indexes of diversity and equitability. The main weeds comprising the community were Cyperus rotundus, Alternanthera tenella, Indigofera hirsuta, Amaranthus sp., Digitaria nuda, and Portulaca oleracea. The weed density was found to be the primary factor for the importance of weeds in the community, once their development and biomass accumulation were suppressed by the sweet sorghum competition. The sweet sorghum hybrid proved highly competitive and, in the agro-ecological conditions of the trials, weed interference did not reduce crop yield.
APPLICATION OF PRE AND POST EMERGENCE HERBICIDE UNDER IMPROVED FIELD IRRIGATION SYSTEM PROVED A SUSTAINABLE WEED MANAGEMENT STRATEGY IN COTTON CROP
Authors: HAKOOMAT A. , AROOJ M. , SARWAR N. , AREEB A. , SHAHZAD A.N. , HUSSAIN S.
Published: September 2017

ABSTRACT Successful weed control in cotton crop is an imperative as weeds not only reduce the cotton production but also deteriorate the lint quality and harbor insect pest. Thus a field study was carried out to evaluate the various weed control strategies under different irrigation systems. Pendimethlin (pre-emergence), S-metolachlor (pre-emergence), glyphosate (post emergence) were used alone or in combination as chemical weedicides along with mechanical weeding under drip and furrow irrigation systems. Results showed that all the weed control treatments with drip irrigation significantly decrease weed density compared with weed control treatments where watering was practiced through furrow irrigation method. However, combined application of pendimethalin with glyphosate and S-metolachlor has significantly reduced the weed density. This combination also resulted in improved bolls per plant, boll weight, sympodial branches, seed cotton yield, ginning out turn, seed index, lint index and water use efficiency. These parameters were also improved under drip irrigation as compared to furrow irrigation system. In a nutshell it can be concluded that combination of post and pre-emergence herbicides improved the cotton lint yield and water productivity which can be further improved by adopting drip irrigation as appropriate irrigation system.
SPECTRUM OF WEED CONTROL WITH 2,4-D AND DICAMBA HERBICIDES ASSOCIATED TO GLYPHOSATE OR NOT
Authors: OSIPE J.B. , OLIVEIRA JR. R.S. , CONSTANTIN J. , TAKANO H.K. , BIFFE D.F.
Published: September 2017

ABSTRACT The possibility of using auxin mimics herbicides in culture postemergence applications contributes to weed management. This study aimed at evaluating and comparing the effectiveness of 2,4-D and dicamba herbicides on glyphosate resistant or tolerant weeds. The treatments were dicamba and 2,4-D doses with or without glyphosate. The evaluated weeds in the experiment were Richardia brasiliensis, Commelina benghalensis, Conyza sp. and Ipomoea nil. Herbicides were applied when weeds were in 4 to 6 and 10 to 12 leaves stages. Data referring to evaluations on day 30 after application were submitted to analysis of variance. Response-dose curves were obtained for herbicides, and C85 and C95 values were identified. Weed species showed different tolerance to dicamba and 2,4-D, and differences were more evident for C. benghalensis. The addition of glyphosate to the auxin mimic reduced the differences between them. For plants in less developed stages, regardless of the species, mixtures of glyphosate + 2,4-D or glyphosate + dicamba provided excellent levels of control. In general, considering equivalent doses, for R. brasiliensis, C. benghalensis and I. nil, 2,4-D herbicide was superior to dicamba. As for Conyza bonariensis, dicamba showed better control percentages.
EFFECT OF PLANTING DENSITIES OF “BRS PRINCESS” BANANA TREE IN THE SUPPRESSION OF WEEDS
Authors: LANZA T.R. , MACHADO A.F.L. , MARTELLETO L.A.P.
Published: September 2017

ABSTRACT The objective is to evaluate the effects of plant density in banana crops against weed suppression. Six treatments were used: 1,200 (3.33 x 2.5 m), 1,600 (2.5 x 2.5 m), 2,000 (2.0 x 2.5 m), 2,400 (1.67 x 2.5 m), 2,800 (1.43 x 2.5 m) and 3,200 (1.25 x 2.5 m) banana plants per hectare, arranged in an experimental design of randomized blocks with four replications. The phytosociological study of weed communities was carried out one month after transplanting and then every 90 days, totaling six samples in 16 months of cultivation, always those being held 15 days after mowing. With the data of dry mass and number of individuals per species Relative density (De.R) Relative frequency (Fr.R) Relative dominance (Do.R), importance value value (IVI) of weed communities were calculated. Forty-three 43 species of weeds associated with the crop were identified, especially in the early stages of culture, of species such as Panicum maximum and nut grass. After 90 DAT it was found that the increase in the diversity of weed species, besides the reduction in IVI of P. maximum and C. rotundus, and increased IVI for species such as C. benghalensis and Vernonia cinerea, were more adapted to shade conditions. There was a reduction in the density dominance of weeds in higher plant density treatments, especially between 210 and 300 DAT. There was a change in the population of weeds, depending on the plant spacings in the banana crop.
FORAGE PLANTS AND WEEDS THAT ARE SENSITIVE TO ATMOSPHERIC CLOMAZONE RESIDUALS
Authors: SILVA M.M. , SANTOS J.B. , FERREIRA E.A. , BRITO O.G. , DONATO L.M.S. , SANTOS M.V.
Published: September 2017

ABSTRACT The use of indicator plants can be an effective alternative in monitoring the presence of toxic molecules in the air, such as herbicides. Thus, in the goal of this study is to assess the sensitivity of forage plants and weeds to atmospheric residual concentrations of clomazone. The treatments were arranged in a 6x5 factorial scheme, with the first factor corresponding to the plant species triticale (Triticosecale rimpaui), maize (Zea mays), sorghum (Sorghum bicolor), palisade grass (Urochloa brizantha), purslane (Portulaca oleracea) and signal grass (Urochloa decumbens), and the second factor to doses of 0, 90, 180, 270 and 360 g ha-1 clomazone doses (equivalent to atmospheric concentrations of 0.0, 0.05, 0.10, 0.15 and 0, 20 mg L-1). Twelve days after emergence, the plants were allocated inside experimental rectangular chambers with a volume of 500 dm3, covered by 150 uM of transparent polyethylene film. The plants remained exclusively in the chamber atmosphere with the herbicide for a period of 96 hours. After the chambers were opened, there were the first evaluation of intoxication and chlorophyll content, as well. The evaluations were repeated on day 7 and 14 after the chamber opening. The presence of clomazone in minimal concentrations in the atmosphere affected the quality of the evaluated plants. Signal grass, palisade grass, sorghum, triticale and purslane were sensitive to atmospheric residual concentrations of clomazone and they can be used to monitor the air quality when there are wastes from this molecule.
«Conduire à cela qui est refusé au mot» Walter benjamin ou la critique de l'idéologie de la communication
Authors: Berdet Marc
Published: September 2017

Resumé: Walter Benjamin est de plus en plus présent dans les départements de communication aujourd'hui, et parfois même utilisé dans le discours des communicants eux-mêmes. Pourtant, quelque chose en lui résiste à cette instrumentalisation: c'est que, dans son œuvre, le langage (politique comme esthétique) ne sert pas à communiquer un sens prédéfini, mais à exprimer cela même qui est refusé au mot. Le philosophe allemand va jusqu'à liquider la posture révolutionnaire de l'artiste encore pris dans l'idéologie de la communication: il ne s'agit ni de remplacer le contenu, ni de rénover la forme, mais, objectif apparemment modeste mais radicalement plus ambitieux, de changer la technique.
Rawls e a justificação da punição
Authors: Coitinho Denis
Published: September 2017

Resumo: O objetivo central deste artigo é procurar compreender a concepção normativa híbrida usada por John Rawls para justificar moralmente a punição legal, fazendo uso de um recurso consequencialista, a fim de justificar a instituição da punição, isto é, a eficácia social e um recurso retributivista para justificar os atos punitivos particulares, ou seja, a culpa do agente. Analisaremos, especialmente, o artigo "Two Concepts of Rules" e o livro A Theory of Justice. Defenderemos que Rawls faz uso de uma visão liberal de punição, bem como utiliza o método de equilíbrio reflexivo, estipulando uma regra para aprovação da punição legal, a partir da coerência com nossos juízos morais ponderados, o que parece reconciliar a justiça retributiva com a justiça distributiva.2
Proteo y la desaProPiación del tiemPo en simone weil
Authors: Jiménez Juan Manuel Ruiz
Published: September 2017

Resumen: En este trabajo estudiamos la génesis de la concepción de la percepción de Simone Weil. Apoyándonos en algunos textos clave de juventud de la autora, hacemos el seguimiento al manejo que le da la filósofa a la figura mitológica de Proteo y a las nociones de tiempo y espacio. Así, nuestra intención es evidenciar la aparición de los principales fundamentos teóricos que estructurarán la fenomenología weiliana de los años de madurez.2 En este sentido, intentamos demostrar en particular que si bien el proceso perceptivo weiliano de los años de juventud está determinantemente influenciado por la fenomenología kantiana, aparece ya un aporte original en lo que atañe a la relación de la conciencia del sujeto y los datos espaciotemporales que se le revelan al aprehender el objeto.
A crítica à superstição no pensamento de pierre bayle
Authors: Primo Marcelo de Sant'Anna Alves
Published: September 2017

Resumo: A superstição é definida por Bayle, em diversos momentos e diversas obras do filósofo francês, como: a) algo característico da corrupção natural humana; b) a prova da facilidade do homem em se ater às mais diversas crendices, logo, estando sujeito não só a uma, mas a todo tipo de superstições; c) o fenômeno que se instaurou e se disseminou na sociedade, perseguindo a todos e gerando ilusões por toda parte, através de presságios, profecias, prodígios, e sinais. Nesse quadro de diversas e intangíveis absurdidades, a superstição ganha forma, indo para além dos domínios da razão e, assim, Bayle, em seus escritos, torna manifesta a oposição entre a filosofia e a ignorância supersticiosa, entre o entendimento e a imaginação e entre as explicações científicas e os relatos fantásticos.
Estética y mística en la recuperación experiencial del símbolo
Authors: Rastrojo José Barrientos
Published: September 2017

Resumen: Este trabajo parte de la debilitación o pérdida del símbolo en nuestra sociedad contemporánea. Resume cómo la modernidad renunció a él asentada en discursos ilustrados. Establecidos estos fundamentos, analiza las bases para su recuperación, localizando, previamente, al símbolo respecto al signo y a la analogía. Finalmente, concluye con una propuesta restauradora del concepto por medio de la experiencia. Este último concepto se abrirá desde los mundos de la estética y mística.
A double face view on mind-brain relationship: the problem of mental causation
Authors: Coelho Jonas Gonçalves
Published: September 2017

Abstract: Interpreting results of contemporary neuroscientif studies, I present a non-reductive physicalist account of mind-brain relationship from which the criticism of unintelligibility ascribed to the notion of mental causation is considered. Assuming that a paradigmatic criticism addressed to the notion of mental causation is that presented by Jaegwon Kim’s analysis on the theory of mind-body supervenience, I present his argument arguing that it encompasses a formulation of the problem of mental causation, which leads to difficulties by him pointed. To ask "how mental events, being a non-physical property of the brain, could act causally on brain structure and functioning?", is not to treat the mind as a property of the brain, but as a Cartesian substance. I argue that, rather than asking "how does mind could act causally on the brain?", as if the mind were something apart and independent of the brain, it would be more in line with a non-reductive physicalist view to ask "how the brain, guided by its mind, could act causally on itself?". To justify this last formulation of the problem of mental causation, I propose a "double face view", which consists in considering the consciousness as the essential property of the mind, and mind and brain as inseparable, dependent and irreducible faces. It means, in general terms, that the conscious mind is the result of brain structure and activity - "conscious mind as brain" - and that the brain, using its conscious mind as a guide to its actions, interacts with its body, and with the physical and sociocultural environment, constructing and being constructed by both - "brain as conscious mind".
Quadrimestre ideal: dispositivo de controle de tempo no currículo da UFABC
Authors: Xavier Allan Moreira , Steil Leonardo José
Published: September 2017

Resumo O currículo do bacharelado em ciência e tecnologia (BC&T) da Universidade Federal do ABC (UFABC) apresenta uma proposta flexível de formação superior. No entanto, a flexibilidade aventada pelo projeto pedagógico passa, quando de sua execução, por um conjunto de fatores limitadores cujo estabelecimento reaproxima a proposta ao currículo tradicional. Compreender como funcionam os agenciamentos nos quais está circunscrito o curso a partir da identificação de enunciados de controle do tempo é o principal objetivo deste artigo. Para tanto, realizou-se um levantamento arqueológico dos discursos, a partir de entrevistas semiestruturadas acerca da execução do projeto original e documentos oficiais, incluindo as revisões do projeto original, que balizam seu cumprimento. Os dispositivos de tempo se utilizam do estabelecimento de novos ritmos de controle, dentre os quais: a carga horária das unidades curriculares descritas por horas de trabalho pedagógico em sala de aula ou experimental e pelas horas necessárias para bom rendimento; o aumento do número de períodos anuais – três quadrimestres letivos –, ajustando o currículo às demandas de internacionalização; o desenho de matriz sugerida, distribuição temporal das unidades curriculares que compõem o curso, única e cartesiana em detrimento de propostas mais abertas e fluídas de composição e organização das trajetórias acadêmicas; e o estabelecimento do conceito de quadrimestre ideal, beneficiando academicamente alunos que causam menos distorções à proposta de execução enrijecida do currículo.
“Quem ensina também aprende” : a formação pela prática de professores primários na província do Paraná
Authors: França Franciele Ferreira , Souza Gizele de
Published: September 2017

Resumo Segundo a historiografia da educação brasileira, muitas foram as ações relacionadas aos modos de formar professores primários durante o período imperial. Desses estudos, a maioria se centra na formação de professores atrelada à instituição das escolas normais, entretanto, há uma parcela menor de trabalhos que se propõem a discutir outro aspecto da formação de professores ao longo do século XIX, mais especificamente, a forma como sujeitos que não frequentaram esse espaço institucional (a escola normal), constituíram-se docentes primários. O artigo que aqui se apresenta partilha dessa perspectiva, e volta o olhar para os modos de formação pela prática de professores primários no Paraná na segunda metade do século XIX, por compreender que esse tipo de formação marcou um período em que a instrução pública estava se consolidando em meio a ações, deliberações, dificuldades e tensões, na tentativa de melhorias de sua condição. A pesquisa valeu-se da consulta da legislação educacional do período e de documentos advindos dos sujeitos envolvidos com a instrução pública, naquele momento, disponíveis no acervo do Arquivo Público do Paraná. No cotejamento e análise das fontes, é possível afirmar, que a formação pela prática dos professores primários na província do Paraná se deu no decorrer do desenvolvimento do processo de constituição do magistério primário.
The Evolving Complexity of the Podocyte Cytoskeleton
Authors: Schell Christoph , Huber Tobias B.
Published: September 2017

Podocytes exhibit a unique cytoskeletal architecture that is fundamentally linked to their function in maintaining the kidney filtration barrier. The cytoskeleton regulates podocyte shape, structure, stability, slit diaphragm insertion, adhesion, plasticity, and dynamic response to environmental stimuli. Genetic mutations demonstrate that even slight impairment of the podocyte cytoskeletal apparatus results in proteinuria and glomerular disease. Moreover, mechanisms underpinning all acquired glomerular pathologies converge on disruption of the cytoskeleton, suggesting that this subcellular structure could be targeted for therapeutic purposes. This review summarizes our current understanding of the function of the cytoskeleton in podocytes and the associated implications for pathophysiology.
A study on medication adherence, medication related challenges faced and coping strategies adopted by visually impaired subjects in a tertiary care hospital
Authors: R. Apoorva , Vasundara K. , R. S. Umadevi
Published: September 2017

Background: Visual impairment poses a significant threat to proper medication practice leading to medication related challenges and some adopted self coping strategies with substantial impact on medication adherence. Visually impaired are potentially more likely to have unsafe medicine related practice which by itself is more rampant in general population. Studies related to them are largely unexplored and can provide data to improve disease management and health related quality of life. Objectives was to study the level of medication adherence, medication related challenges and self adopted coping strategies in visually impaired people.Methods: A cross sectional descriptive study enrolling 204 subjects with VI was done. Medication adherence was assessed using MMAS. Medication related challenges and self-adopted coping strategies was assessed by using pre-validated semi-structured questionnaire.Results: Majority of the subjects showed medium medication adherence with forgetfulness to take medicine as the main reason for non adherence. Difficulty in remembering the instructions, spilling of liquid medicine, taking wrong dose, difficulty in using topical medications were the most common challenges faced by them in daily drug administration. To overcome challenges locating the drugs at different places, finger felt volume for liquid medication, textural feeling of the drug or container, time tracking were the major self adopted coping strategies by the visually impaired subjects.Conclusions: Creating awareness of the medication related problem faced by visually impaired helps to provide adequate assistance to medication use and improve proper health care services in them.
To study the clinical profile, management and outcome of diabetic pregnancies in a rural tertiary care institute of Punjab
Authors: Sood Reena , Arora Parvinder , Nagpal Madhu
Published: September 2017

Background: Diabetes mellitus is a disorder of carbohydrate metabolism. In India, about 50.9 million people suffer from diabetes, and this figure is likely to go up to 80 million by 2025, making it the 'diabetes capital' of the world. GDM develops due to an inability to compensate for physiological increase in insulin resistance that develops progressively throughout pregnancy as a consequence of multiple factors including placental hormones, increased caloric intake and reduced physical activity. Many studies report increased incidence of adverse foetal and maternal outcome in diabetic pregnancy.Methods: The present study is a retrospective cum prospective analysis carried out in SGRDIMSAR from 1st May 2015 to 30th April 2017. Patients with diabetic pregnancies who had delivery in our institution were included.Results: Total number of diabetic pregnancies during the study period were 76. Out of 76 patients 15 were PGDM and 61 were GDM. Maximum no of patients in PG group were in age group of 31-35 years, while in GDM group were upto 30 years of age. Gestational age at diagnosis in PGDM group is 13.42±1.2 weeks versus 29.62±4.53 weeks. Maximum patients (70.5%) in GDM group were managed by diet and exercise, while in PGDM group maximum patients (93.3%) needed insulin for glycemic control. Maternal complications were maximum in PGDM group. Most common complication was hypertensive disorders of pregnancy. Mean gestational age at delivery was 35.15±1.42 weeks and 37.06±1.29 weeks in PGDM and GDM respectively (p value= 0.00). 11.8% neonates had a birth weight of >4 kg (macrosomia). 77% of neonates in GDM group had an uneventful outcome.Conclusions: Considering rising incidence and magnitude of the problem and its complications, identification and treatment of diabetic pregnancy is the need of hour.
Retrospective study of post term pregnancy and its outcome
Authors: Prajapati Shetal , Chavda Dolly
Published: September 2017

Background: Post Term Pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks (259 to 294 days) from the last menstrual period. If the pregnancy exceeds this period (above 42 completed weeks) it is classified as post term pregnancy. The overall incidence of post term pregnancy is 10.0% of all pregnancies. We estimate the recent incidence of post-date in Obstetrics and Gynecology Department, P. D. U. medical college, Rajkot (Gujarat).Methods: We are taking 500 cases of Post-date pregnancy (Retrospective cases) at P. D. U. Medical College, Rajkot (Gujarat) to know the method of induction, pregnancy outcome, maternal and Fetal complications.Results: In present study, out of 500 patients, induction was done in 366 patients and number of normal delivery was 377 (75.4%), LSCS was 113 (22.6%) and 10 (2%) was instrumental delivery.Conclusions: Post term pregnancies require early identification, effective and proper planned management. Rate of vaginal deliveries has increased due to effective Prostaglandins (PGs) and their easy availability.
Knowledge, attitude and behaviour of women towards abnormal menstrual bleeding and its impact on quality of life
Authors: R. Bhatiyani Binti , V. Dhumale Shrikant , B. Pandeeswari
Published: September 2017

Background: Abnormal menstrual bleeding has a major impact on a woman's quality of life. Any intervention therefore should aim to improve this rather than focusing on the amount of menstrual blood loss. The aim of this study was to gain an in depth understanding of women’s current knowledge, attitudes and beliefs around abnormal menstrual bleeding. Also, to understand how it affects their lives, while identifying current misconceptions and gaps in knowledge and their expectations and attitudes towards the treatment so that treatment can address their most bothersome complaint.Methods: A total of 200 women, between 18-55 years of age, not on any hormonal treatment attending the gynaecology OPD at a tertiary care centre between Jan 2017 to May 2017 were interviewed by a questionnaire. Women who had undergone hysterectomy were excluded from the study.Results: Of the 200 women interviewed, 49 women felt that their bleeding was heavy and formed the heavy menstrual bleeding group (HMB) while 151 women who perceived their bleeding to be normal formed the normal bleeding group. In the (HMB) group, a significantly greater proportion of women identified their menstrual bleeding as being an inconvenience and a disruption to their lives. HMB also significantly affected their relationships, social life and productivity at work place.Conclusions: Despite its common occurrence, awareness and understanding of HMB and its treatment within the survey population was poor.
A correlation of lactate dehydrogenase enzyme levels in pregnancy induced hypertensive disorders with severity of disease, maternal and perinatal outcome
Authors: Bhave Neha V. , Shah Parmanand K.
Published: September 2017

Background: A spectrum of hypertensive disorders in pregnancy contribute to maternal and perinatal morbidity and mortality. For prediction and early diagnosis of preeclampsia various biochemical markers, vascular function test and renal markers have been developed. The objective of the study is to measure the lactate dehydrogenase enzyme (LDH) levels in pregnant women with pregnancy induced hypertensive disorders and correlate the levels with the severity of condition, maternal and the perinatal outcome.Methods: In this prospective observational study, a total of 150 pregnant women were studied. Out of these 150 women, 30 women had normal blood pressure, 30 women had gestational hypertension, 30 women had mild preeclampsia, 30 women had severe preeclampsia and 30 women had eclampsia. The serum LDH levels were measured in third trimester and patients followed up until early postpartum period and babies were followed up till early neonatal period to assess the maternal and neonatal outcomes.Results: Higher lactate dehydrogenase enzyme (LDH) levels were observed in pregnant women with severe form of hypertensive disorder and those who had a poor maternal and perinatal outcome. This is statistically significant (p<0.001).Conclusions: Lactate dehydrogenase enzyme (LDH) level is a useful biochemical marker to assess and predict the severity of disease, maternal and perinatal outcome as higher levels of the enzyme are associated with worsening severity of disease, a poor maternal and perinatal outcome.
Complications of female sterilization procedure: review over a decade at district tertiary care hospital
Authors: Mule Vidya Dinkar , Date Shilpa Vishwas , Gadekar Madhura S.
Published: September 2017

Background: Female sterilization is the most requested permanent contraceptive method worldwide and one of the most frequently performed elective, intra-abdominal surgical procedure in reproductive-age women. Even though considered as simple and safe procedure, complications do occur including death.Methods: The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization complications and secondary is to evaluate possible etiological factors leading to complications and lay standard guidelines to reduce complication rate.Results: Over a decade, 103 cases of female sterilization related complications were documented, out of 14 cases (13.6%) were of laparoscopic tubal ligation and rest 89 were minilaparotomy (86.4%). In 3 cases tubal ligation was not performed as surgeon was not able to either open peritoneal cavity or find fallopian tubes due to adhesions (2.91%). In 70 cases (67.96%) sterilization were performed in primary health centre (PHC). Four patients (3.88%) required hospital stay of more than a month with longest stay being 43 days. Exploratory laparotomy with surgical intervention was done in 34 cases (33%). Two patients (1.94%) died due to tubectomy complications due to septicemia and encephalitis.Conclusions: Female sterilization is very popular and commonly performed permanent method of sterilization but complications can happen and many of them are preventable with proper screening and selection of cases with proper evaluation before surgery. There is a need to have proper training in sterilization and to stick to standards of sterilization procedure to minimize chances of complications.
Role of uterine and umbilical artery doppler assessment of the uteroplacental circulation in predicting pre-eclampsia: comparison between different doppler parameters
Authors: Dhakar Vimla , Naz Sabiha
Published: September 2017

Background: Hypertensive disorders are the common cause of maternal death which affecting nearly 5-10% of pregnancies all over the world. Pre-eclampsia develop from inadequate trophoblast invasion of the maternal spiral arteries and Doppler values permits non-invasive evaluation of uteroplacental circulation and is of great importance in the management of high risk pregnancies. The aim of the study was to assess the findings of Doppler data in predicting pre-eclampsia and comparison of the efficacy of uterine artery Doppler and umbilical artery Doppler.Methods: The study comprises of 100 women with high risk pregnancy attending antenatal clinic at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This was a prospective study over a period of 1 year from 2015-2016.Results: The results of the study revealed that 5 out of 100 participants developed pre-eclampsia. Out of different parameters, notch is the best predictor of pre-eclampsia with high sensitivity and highest PPV for uterine artery Doppler and S/D ratio is considered to be best indicator for umbilical artery Doppler. Regarding efficacy, umbilical artery Doppler is more predictive than uterine Doppler.Conclusions: Doppler study can be used for the prediction of pre-eclampsia to reduce maternal morbidity and mortality.
The value of colour doppler assessment of the uteroplacental circulation in predicting intrauterine growth restriction
Authors: Dhakar Vimla , Naz Sabiha
Published: September 2017

Background: Intrauterine growth restriction is a complication that arises due to decrease in uteroplacental blood flow during pregnancy. This decrease is associated with a pathological condition of spiral arteries thought to arise during placentation in first trimester of pregnancy. Thus, it might be possible to predict the development of these conditions by assessing uteroplacental blood flow in pregnancy with colour Doppler. The aim of the study was to assess the findings of Doppler data in predicting IUGR and finding the best predictors of IUGR in uterine and umbilical artery Doppler.Methods: In this prospective study, total of 100 women with high risk pregnancy attending Department of Obstetrics and Gynecology at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This study was carried over a period of 1 year from 2015-2016.Results: Out of total 100 patients, 8 were found to have IUGR. Out of different parameters, Notch is the best indicator with high sensitivity and highest positive predictive value (PPV) of 50% followed by combination of parameter as it had the highest sensitivity of 62.5% for uterine artery Doppler. S/D Ratio is the best indicator with high sensitivity and highest positive predictive value (PPV) of 25% and 40% respectively followed by RI with highest sensitivity of 42.86% for umbilical artery Doppler.Conclusions: Value of Doppler assessment of uteroplacental circulation in predicting IUGR and is very useful in improving pregnancy outcome.
Retrospective analysis of endoscopic retrograde cholangio pancreatography (ERCP) procedures in a tertiary care centre in coastal Odisha
Authors: Panda Chitta Ranjan , Das Haribhakti Seba , Behera Sambit Kumar , Nath Preetam
Published: September 2017

Background: ERCP is commonly performed for radiologic visualisation and therapeutic procedure for treating various pancreatico-biliary disorders. There is no comprehensive data available till date about ERCP procedures from Odisha. The aim of this study was to review the indications and complications of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a tertiary care centre in Odisha.Methods: From July 2013 to December 2016, consecutive patients undergoing ERCP procedure were included in the study. Patients with any previous papillary intervention like papillotomy, sphincterotomy or stent placement were excluded from the study. Patients’ demographic characters, ERCP indications and post-ERCP complications were reviewed.Results: Three hundred and fourteen patients were included in the study. Among them male patients were 161 and females were 153. Mean age was 50.75 years and the age range was 18 to 82 years. Most common indications for ERCP was malignant obstructive jaundice (N = 171, 54%) and choledocholithiasis (N = 137, 43.6%). Post ERCP complications developed in 25 patients (8%). Pancreatitis was the most common post-ERCP complication.Conclusions: ERCP is a safe procedure. ERCP complications in our centre are similar to those reported from other centres.
Optimal timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography
Authors: Sahoo Rasmiranjan , Samal Debasish , Pradhan A. , Sultana Rima , Nayak Nabakishore , Padhy Rabindra Nath
Published: September 2017

Background: Nowadays in patients with cholelithiasis with choledocholithiasis, the ideal treatment is endoscopic retrograde cholangiopancreatographic (ERCP) removal of duct stone and laparoscopic cholecystectomy. But when to do and whether we can do it simultaneously or one after another and what interval should be there, that is always controversial. The purpose was an optimal gap for cholecystectomy after ERCP.Methods: We have done a comparison study in 60 patients within a duration of 2 year who had already done ERCP. Group 1, those patients who had laparoscopic cholecystectomy within 72 hours compared with group 2 who had laparoscopic cholecystectomy after an interval of 6 week. Primary outcome was the conversion rate from lap to open cholecystectomy. Secondary outcome was duration of operation, intra-operative difficulties, postoperative morbidity and hospital stay.Results: Of 60 consecutive patients 30 were in group I and 30 were in group II. There is no difference in demographics, laboratory or ultrasonographic findings. The hospital stays in group I is significantly shorter than group II and conversion rate; operative time is higher in group II. No statistically significant difference in post-operative morbidity between both groups.Conclusions: Early laparoscopic cholecystectomy within 72 hr is better than interval (6 week) cholecystectomy after ERCP with shorter hospital stay and less intraoperative difficulties.
A prospective study to evaluate the utility of Mannheim peritonitis index in predicting prognosis of perforation peritonitis at our tertiary care centre
Authors: K. V. Saravanan , Alagarsamy Gowri Sankar , Sankar Udhaya
Published: September 2017

Background: This study was aimed to evaluate the validity of Mannheim Peritonitis Index (MPI) in predicting the outcome in patients with perforation peritonitis.Methods: A prospective study was designed for a study period of 2 years, 75 patients who underwent operation for perforation peritonitis were included in the study. Post evaluation done with predesigned proforma, MPI score was calculated and analyzed for each patient who underwent surgery, death being the main outcome measure. The MPI scores were divided into three categories. MPI scores <15 (category 1), 16-25 (category 2), and >25 (category 3).Results: Present study consisted of 60 males and 15 females (male:female ratio of 4:1) with the mean patients age 37.96±17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3. The dominating source of perforation was small intestinal. The individual parameters of MPI score were assessed against the mortality, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) were the factors significantly associated with mortality. The sensitivity of MPI was 92% and specificity was 78% in receiver operating characteristic curves.Conclusions: MPI is an effective tool for prediction of mortality in cases of perforation peritonitis.
Endoscopic management of foreign bodies in the upper gastrointestinal tract
Authors: Mirji Pramod , Daddenavar Vikas , Kalburgi Eshwar
Published: September 2017

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 2 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body (FB) ingestion admitted to department of general surgery from January 2015 to December 2016 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 23 cases were studied. Age range was 2-75 years. Males were predominant (60.87%). Coins were found most commonly (52.17%). Esophagus was the commonest site of FB lodgment (65.22%). Upper esophagus being the most common (39.13%). Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 23 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.
A prospective randomized controlled study: early enteral nutrition following gastrointestinal surgery
Authors: Bajwa Rajbir Singh , Brar Navjot
Published: September 2017

Background: The word anastomosis originates from the Greek word (ἀναστόμωσις) meaning communicating opening. Gut anastomosis is one of the frequently performed surgeries in both emergency and elective setup. Anastomosis following gut resections in emergency set up is mostly done due to traumatic rupture, benign or malignant perforation or obstruction and in certain other inflammatory conditions. Anastomosis is also done in some elective conditions like mostly due to malignancy of GI system. As conventional practice following gut anastomosis, patients are kept “NIL BY MOUTH” till bowel sounds return.Methods: It’s a prospective study, carried out over period of 18 months in Department of General Surgery, Sri Guru Ramdas Institute of Medical Sciences and Research, Vallah, Amritar. The objective of this study was to whether early enteral feeding within 48 hours of small gut anastomosis is tolerable to the patient. Whether early enteral feeding within 48 hours of small gut anastomosis is beneficial to the patient.Results: This prospectively conducted comparative study was carried out on 60 patients, meeting inclusion criteria, undergoing gastrointestinal anastomosis either elective or emergency, in the Department of General Surgery, SGRD Medical College, between Jan 2012 to June 2013. Random selection of patients into group A (30) and group B (30) was done after having fulfilled inclusion and exclusion criteria. The group A was fed via enteral route within 48 hrs of enteric anastomosis. The group B was fed via enteral route after 48-72 hours or appearance of full peristaltic sounds following enteric anastomosis. These patients were followed in post-operative period for their drain output, any nausea, vomiting, or significant abdominal distension, prolonged ileus, clinical leakage, infective complications, hospital stay.Conclusions: The following inferences can therefore be drawn from this study: Appearance of intestinal peristaltic sounds is earlier in early enterally fed group, Mean duration of post-operative hospital stay is lower in early enterally fed group, mean post-operative day 4 albumin level is higher in early enterally fed group. The rate of infective complications (UTI, RTI, wound complications) is equal in both the groups. The rate of clinical leakage, nausea/vomiting are equal in both the groups. The rate of re-exploration for anastomotic leakage is equal in both the groups.
Anomalies of branchial cleft: our experience and review of literature
Authors: Shenoy Neha Sisodiya , Tiwari Charu , Gandhi Suraj , Dwivedi Pankaj , Shah Hemanshi
Published: September 2017

Background: Anomalies of branchial arches are uncommon anomalies of embryonic development and may present as cysts, sinus tracts, fistulae or cartilaginous remnants. We describe our experience with 30 children with branchial cleft anomalies.Methods: Case records of all patients were retrospectively reviewed and analysed with respect to age, sex, clinical presentation, duration of symptoms, investigations, management and follow up. All patients underwent complete excision of the tract/cyst.Results: There were 15 males and 15 females (ratio of 1:1). The average age of presentation was 5 years. Majority of the patients presented with discharging sinuses (n=26). Twenty-six patients had branchial sinuses, three patients had branchial cysts and one had pyriform fistula. The anomalies were lateralized to left side in 17 patients (56.66%), right side in 11 patients (36.66%) and bilateral in 2 patients (0.066%). Complete excision was done in all patients. Four patients presented with abscesses and required incision and drainage. Definitive surgery was done after 6 weeks. There were no complications.Conclusions: Abnormal development of branchial apparatus lead to formation of different anomalies which remain asymptomatic and present later in life as cysts, sinuses or fistulae in neck. Diagnosis is mostly clinical and complete excision provides definitive cure.