bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding BNS Sections 238 and 61(2): Evidence Tampering, Supplying False Information to Protect a Criminal, and Police Accountability
Authors: - Md. Imran Wahab, IPS
Published: November 2024

This paper provides a detailed analysis of Sections 238 and 61(2) of the Bharatiya Nyaya Sanhita, 2023 (BNS), focusing on the implications of tampering with evidence or providing false information to protect a criminal, especially concerning the responsibilities of police officers. Those who deliberately obliterate, remove, destroy or conceal evidence related to a crime or offer false information to shield an offender face penalty under Section 238 BNS, where the severity varies based on the nature of the offence, potentially resulting in a prison sentence of up to seven years and a fine. In addition, Section 61(2) BNS in this regard addresses issues related to criminal conspiracy between two or more persons in order to destroy or temper with evidence or furnish false information to shield a criminal from arrest or criminal liability and stipulates punishment commensurate with the seriousness of the offence. It also underscores the importance of investigating police officers' safety and the need to adhere to ethical and investigative standards. The study highlights the crucial role of honesty and transparency within law enforcement to promote accountability and uphold the principles of justice.
The Sloth of Luddite Sorrow in Thomas Pynchon’s Writings
Authors: - Raja Sekhar Patteti , - Ch. Manjusha
Published: November 2024

The technological inventions have been dominating the present times. The world is in awe of the way AI is replacing human intelligence but not without a remorse fear of the threat of apocalypses this AI and Scientific expansion could cause. The scientific and technological advancement has made the imperialism, subjugation and exploitation seamless and transcendent. The public fail to recognize this transcendent exploitation as their vision is outshined by miraculous sophistication these inventions ducks human life with. Some good minds might envision the ramifications but fear to be branded as luddites. Almost thirty nine years ego Pynchon foresees the paradoxical paranoia and reassures to be fine be a luddite. He professes that a person with the sloth of luddite sorrow is a real human defeating the merciless omniscient exploitation. Though this vision of Pynchon pervades all his novels, my article refers to his magna Opus Gravity’s Rainbow and his mature novel Vineland to illustrate his vision.
Digital Dynamics in BRICS: Exploring Digital Access and Policy Challenges
Authors: - Nikita Nimbalkar
Published: November 2024

As the global economy continues to digitize, BRICS nations are at a pivotal juncture in leveraging digital technologies for economic growth. This paper investigates the dynamics of digitalization in these countries focusing on the three major parameters of digitalization- internet penetration, cost of internet and digital payment. It also analyses government strategies in these countries. As BRICS accounting for a significant share of global GDP yet experiencing disparities in digital service export and adoption, understanding these dynamics is essential for adopting comprehensive policies that harness their digital potential. The research highlights the historical context of BRICS as an influential economic bloc, its rapid digital transformation influenced by emerging technologies. Additionally, the study emphasizes the importance of internet penetration as a fundamental enabler of socio-economic activities, correlating better internet infrastructure with increased economic participation. Employing a comparative analysis methodology, this research examines the performance of individual BRICS nations, revealing challenges and opportunities in enhancing connectivity and fostering financial inclusion through digital payment systems. The study also analyses the relationship between cost of internet and internet users in the BRICS countries. This study ultimately aims to put forward analysis about the diverse digital ecosystems within BRICS, advocating for collaborative strategies to navigate inherent challenges while maximizing economic growth and inclusivity.
Effort, Lever, and Fulcrum Failures in the Development of Trendelenburg Sign and Gait: A Physiotherapist’s Insight
Authors: - Lili Silumesii , - Angel Magapatona
Published: November 2024

This short review explores how failures related to the fulcrum, lever, and effort of the hip joint contribute to the development of a positive Trendelenburg sign and gait. It highlights the anatomy and biomechanics of the hip joint, emphasising its function as a first-class lever essential for lower limb activities such as walking. The review discusses how various pathologies affecting the hip joint’s lever arm, fulcrum, and effort can lead to instability and compensatory gait patterns. By understanding the biomechanical principles and anatomical structures involved, healthcare professionals can devise effective interventions aimed at restoring normal hip function and improving patient outcomes.
LIVE MRP (Material Requirements Planning) Impact on Supply Chain
Authors: - Manikandan Natarajan
Published: November 2024

Live Material Requirements Planning (Live MRP) refers to an advanced, real-time approach to managing and optimizing inventory, production, and procurement processes. Unlike traditional MRP systems that update periodically (e.g., daily, weekly), Live MRP integrates dynamic data from across the supply chain and production processes, providing instantaneous updates to material needs, production schedules, and procurement activities. This capability allows companies to respond more swiftly to market fluctuations, production disruptions, and changing customer demands, enhancing operational efficiency, reducing lead times, and improving decision-making
Predictive Modeling for Bike Rental Demand: Enhancing Operational Efficiency and User Satisfaction in Urban Mobility
Authors: - Swapnil Chaurey , - Shreyash Jodhe , - Priyanshu Yawalkar , - Sufiyan Sheikh , - Rohan Mahajan , - Mrs.Kamal.S.Chandwani
Published: November 2024

This project focuses on developing a predictive model to forecast bike
rental demand by analyzing historical rental data, weather information,
and temporal variables. The model will employ machine learning
techniques, such as regression analysis, time series forecasting, and
ensemble methods, to capture the complex relationships between these
factors and rental demand.
Examining The Variables That Impact Academic Performance In Higher Education
Authors: - Ashutosh Kumar , - Prof. G. Anburaj
Published: November 2024

This research paper examines the multifaceted variables that impact academic performance in higher education, with a particular focus on time management skills. Academic performance is influenced by a complex interplay of economic, social, psychological, environmental, and personal factors, each of which plays a role differently in a student's success. The objective of this study is to explore how these factors, especially time management, influence academic outcomes, and to provide a comprehensive review of the literature surrounding this topic.
Academic performance in higher education is a multifaceted phenomenon influenced by an intricate mix of economic, social, psychological, environmental, and personal factors. This review critically examines key variables affecting student performance, focusing on underexplored areas such as time management skills, psychological well-being, and the changing landscape of digital learning environments. Drawing from extensive literature, this paper identifies gaps in current research and evaluates how higher education institutions can address these issues through targeted interventions. The results highlight the need for greater emphasis on mental health support, personalized learning approaches, and strategies to enhance students' time management and adaptability in evolving academic contexts.
This paper highlights the significance of addressing both external and internal factors that affect academic performance. By fostering a supportive environment, providing necessary resources, and offering time management interventions, institutions can better support students in achieving academic success.
Employee Engagement - A Literature Review
Authors: - MOAMMAR JAMAL AYYUBI , - SHIV KUMAR SINGH
Published: November 2024

Employees are one of the main resources and part of the organization. They play a crucial role in running to the organization. Good relation between owner and employees is important for achieving the desired goal and better working condition, payment system, relations between employees etc. in also so important for an employee for smoothly helping to operate the business. Employee Engagement is that construct which can do all the above works effectively. For remaining the employees engaged for a long time, it is
important for the employer that he recognize their work, appreciate their work when needed, allow them to participate for making any important decision making etc. In this paper, various definitions and thoughts and aspects of Employee Engagement has been explained. This is a review paper and many articles, research papers are included for studying this research paper.
CALCULATION OF TYPE A UNCERTAINTY USING IN-LABORATORY REPEATABILITY FOR DETERMINATION OF WATER CONTEN IN DIESEL
Authors: Farid Kazimov, Arzu Ibrahimova Farid Kazimov, Arzu Ibrahimova
Published: November 2024

Understanding and managing measurement uncertainty in petroleum testing laboratories is critical to ensuring the accuracy and reliability of test results. Measurement uncertainty is an indicator of the reliability or validity of a measurement result. Here we explore factors contributing to measurement uncertainty, methods for calculating it, and strategies for minimizing it in the context of petroleum product testing.
Measurement uncertainty refers to the doubt that exists about the result of any measurement. For every measurement - even with the most advanced equipment - there is always an error, and no measurement can be considered absolutely accurate. In laboratory settings, especially in the analysis of petroleum products, quantification of this uncertainty is essential to meet international standards and ensure the quality and comparability of results.
Keywords: uncertainty, quality control, repeatability, standard deviation, in-laboratory repeatability.
ИННОВАЦИИ В КОНСТРУКЦИИ КЛИНОВЫХ ПОДВЕСОК КОЛОННЫХ ГОЛОВОК ДЛЯ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ И БЕЗОПАСНОСТИ ПРИ БУРЕНИИ СКВАЖИН
Authors: Эмин Аскеров Эмин Аскеров
Published: November 2024

В данной статье рассматриваются современные инновации в конструкции клиновых подвесок колонных головок, используемых при бурении нефтяных и газовых скважин. Особое внимание уделено изменениям в материалах, конструктивным особенностям и внедрению автоматизированных систем, которые направлены на повышение безопасности и эффективности бурения. В статье анализируются преимущества использования новых технологий и их влияние на эксплуатационные характеристики и безопасность скважин.
Ключевые слова: клиновые подвески, колонные головки, нефтегазовые скважины, инновации, материалы, автоматизация, безопасность, эффективность.
ON THE DEVELOPMENT OF ECONOMIC RELATIONS AND ORIGIN OF GRAPHIC SIGNS (ACCORDING TO ARCHAEOLOGICAL MATERIALS DATED BACK TO 3.3 MILLION – 10,000 YEARS AGO)
Authors: Gia Kvashilava Gia Kvashilava
Published: November 2024

In this paper, the issues of economic relations, origin and development of graphic signs are discussed. In this regard, socio-economic eras and “Upper Paleolithic Revolution” are covered, which show how a person is formed in the process of obtaining livelihood.
The Paleolithic Age – the period when people followed “natural farming” is researched. The development of productive forces expanded the knowledge of nature, especially about the useful properties of natural resources. These qualities were manifested through the means of labor in affecting the objects of labor in the process of production, which contributed to the association of men and the division of labor in order to obtain, by common action, the objects of labor. This process arised and developed languages, abstraction, conventional graphic signs, etc.
Keywords: economic relations, socio-economic eras, Paleolithic Age, Upper Paleolithic Revolution, graphic signs
Taaitta Arap Toweett: A Life Of Social and Political Influence (1925-2007)
Authors: Sitonik Fancy Chepkoech , Wagura Peter Waweru , Chacha Babere Kerata
Published: November 2024

Taaitta Toweett emerges as a prominent and influential political figure in Kenya's historical landscape, attracting scholarly attention due to his noteworthy contributions and intriguing life trajectory. With a commanding presence, Toweett is characterized by his insightful and earnest demeanor, infusing his life story with a nearly mythical quality that showcases its uniqueness and intricacy. Researchers in contemporary discourse focus on Toweett's formative years, educational pursuits, political engagements, and personal attributes, examining these aspects in depth. Born in 1925 and passing away in 2007, Toweett's Life spans significant historical periods, enriching his experiences with temporal and socio-political relevance. His rise from relative anonymity to political prominence illustrates leadership's intricate paths in Kenya's socio-political context. Toweett's life story presents a fascinating subject for scholarly analysis, inviting exploration of themes such as social advancement, leadership dynamics, and the interplay between individual will and structural limitations. Through academic investigation, Toweett's legacy emerges as a part of broader socio-political dynamics, enhancing our understanding of Kenya's historical trajectory and the multifaceted nature of its leadership landscape
Analysis of Factors Influencing Agricultural Commercialisation Among Youth Group in Agricultural Output Market: Empirical Evidence from Mwanza City and Ukerewe Districts, Tanzania
Authors: Kilamlya Jacob , Mhina Juma Almasi , Regnard Irene Joseph
Published: November 2024

Although agriculture has great potential for Sub-Saharan Africa particularly in the creation of decent jobs for youth, the youth are less attracted and reluctant to pursue agriculture as both a career and activity for livelihood due to several aspects. For this reason, the study examined the Agricultural Commercialisation among youth groups in the agricultural Output Market in the Mwanza region, Tanzania. The cross-sectional study used a quantitative and qualitative approach and included ninety-three (93) youth groups from two selected Districts (Mwanza City and Ukerewe District) Data were analyzed with the Commercialisation Index and Tobit Regression Model with the aid of statistical tools for analysis which were R-Software (Ri3863.6.1) and SPSS version 20. The results showed that the commercialisation index for this study is about 79.4 %, then empowered youth groups were highly participating in the agricultural output market for both Mwanza City and Ukerewe District. This justifies the assumption of the Commercialisation Index (CI) when CI is greater than 50% of farmers are considered they be commercial oriented which in other words they participate in agricultural output markets. Moreover, the degree of participation in agricultural output among empowered youth groups was also influenced by market experience, market arrangement and market infrastructure. The participation of empowered youth groups from both agricultural output markets seemed also to be determined by the education level of group leaders.  Youth groups in which their leaders had attained diploma education level had less participation in the agricultural output market as compared to groups with leaders who attained primary school education level
Reactive oxygen species and oxidative stress in acute pancreatitis: Pathogenesis and new therapeutic interventions
Authors: Xia Chuan-Chao , Chen Hong-Tan , Deng Hao , Huang Yi-Ting , Xu Guo-Qiang
Published: November 2024

Acute pancreatitis (AP) is a common acute gastrointestinal disorder affecting approximately 20% of patients with systemic inflammatory responses that may cause pancreatic and peripancreatic fat necrosis. This condition often progresses to multiple organ failure, significantly increasing morbidity and mortality. Oxidative stress, characterized by an imbalance between the body’s reactive oxygen species (ROS) and antioxidants, activates the inflammatory signaling pathways. Although the pathogenesis of AP is not fully understood, ROS are increasingly recognized as critical in the disease's progression and development. Modulating the oxidative stress pathway has shown efficacy in mitigating the progression of AP. Despite numerous basic studies examining this pathway, comprehensive reviews of recent research remain sparse. This systematic review offers an in-depth examination of the critical role of oxidative stress in the pathogenesis and progression of AP and evaluates the therapeutic potential of antioxidant interventions in its management.
Establishment of a surveillance program for anal cancer in Crohn's disease
Authors: Kayano Hajime , Okada Ken-Ichi , Yamamoto Seiichiro , Koyanagi Kazuo
Published: November 2024

This letter discusses the incidence of anal cancer among Crohn's disease (CD)-related malignancies. Patients with CD have been demonstrated to be at a higher risk of developing small bowel and colorectal cancers than healthy individuals. Although CD-associated anal cancer is relatively rare, patients with CD accompanied by anal or perianal lesions are at increased risk of anal cancer. Additionally, compared to ulcerative colitis, which is also an inflammatory disease, CD-related anal cancer is often detected at an advanced stage owing to the complexity of CD and is associated with a poor prognosis with frequent local recurrences. Therefore, the detection of early-stage cancer is crucial for improving the prognosis. However, the surveillance methods recommended for CD-related malignancies in the United States and Europe are similar to those for ulcerative colitis. They are not appropriate for detecting CD-related malignancies in the recto-anal region. Therefore, there is an urgent need for surveillance programs aimed at the early detection of malignant anorectal lesions in patients with CD.
User-friendly prognostic model for rectal neuroendocrine tumours: In the era of precision management
Authors: Chen Si-Hai , Xie Chuan
Published: November 2024

In this letter, we explore into the potential role of the recent study by Zeng et al . Rectal neuroendocrine tumours (rNETs) are rare, originate from peptidergic neurons and neuroendocrine cells, and express corresponding markers. Although most rNETs patients have a favourable prognosis, the median survival period significantly decreases when high-risk factors, such as larger tumours, poorer differentiation, and lymph node metastasis exist, are present. Clinical prediction models play a vital role in guiding diagnosis and prognosis in health care, but their complex calculation formulae limit clinical use. Moreover, the prognostic models that have been developed for rNETs to date still have several limitations, such as insufficient sample sizes and the lack of external validation. A high-quality prognostic model for rNETs would guide treatment and follow-up, enabling the precise formulation of individual patient treatment and follow-up plans. The future development of models for rNETs should involve closer collaboration with statistical experts, which would allow the construction of clinical prediction models to be standardized and robust, accurate, and highly generalizable prediction models to be created, ultimately achieving the goal of precision medicine.
A new helcionelloid mollusc from the Cambrian of Green land and Idaho (Laurentia)
Authors:   University of Science and Technology, Republic of Korea, Oh Yeongju , Peel John S. ,   Department of Earth Sciences (Palaeobiology), Uppsala University, Sweden.
Published: November 2024

Ressericonella gen. nov., a new genus of helcionelloid mollusc, characterized by a narrow shell with a shallowly convex dorsal surface and flat to shallowly concave lateral areas, is described from the Cambrian of Greenland and Idaho. The type species is Helcionella aequa Resser, 1939 from the Langston Formation (Naomi Peak Limestone Member) of early middle Cambrian age (Miaolingian Series, Wuliuan Stage, Albertella Biozone). Ressericonella pipalukae gen. et sp. nov. occurs in the latest early Cambrian (Cambrian Series 2, Stage 4, Bonnia–Pagetides elegans Biozone) of southern Freuchen Land, North Greenland. Silicified specimens of Ressericonella pipalukae from North Greenland preserve two-layered shell structure in which an inner layer with a transverse fibrous pattern similar to lamello-fibrillar structure is overlain by an outer layer with fine threads radiating from the apex.
Holocene history of Fiskesø, Prinsesse Ingeborg Halvø, eastern North Greenland
Authors:   University of Cologne, Institute of Geology and Mineralogy, Köln, Germany, Wagner Bernd , Bennike Ole ,   Geological Survey of Denmark and Greenland (GEUS), Copenhagen, Denmark.
Published: November 2024

Sediment cores up to 92 cm in length were recovered with gravity and Russian peat corers from Fiskesø, Prinsesse Ingeborg Halvø, eastern North Greenland, during the summer 2014. The correlated sediment succession consists of clastic sediments that are interspersed in the upper part with layers of organic material and likely record the environmental history of the lake since deglaciation. The paucity of macrofossil remains hampered radiocarbon dating of the sediments from Fiskesø. According to published data, the deglaciation of the region took place c. 10 cal. ka BP. Relative sea-level reconstructions from the region suggest that the Fiskesø basin, which is today located at 33 m above sea level, was characterised by marine conditions until c. 8.1 cal. ka BP. Marine fossils in the lower part of the sediment succession support the prevalence of marine conditions. A reliable radiocarbon age from 5 cm above the isolation horizon in Fiskesø sediments indicates an age of 6.1 cal. ka BP and supports the isolation of the basin prior to this time. Cooling is indicated in the upper part of the sediment succession and is reported to have taken place in the region stepwise shortly after 6.1 cal. ka BP and at c. 4.5–4.0 cal. ka BP. Despite the poor chronology the data from Fiskesø support existing terrestrial and marine reconstructions from the region.
ROBÓTICA EDUCACIONAL E PENSAMENTO MATEMÁTICO: UMA ANÁLISE SOBRE O INTERESSE DE ESTUDANTES DO ENSINO MÉDIO PARA AS ÁREAS STEM
Authors: Pereira Campos Lílian Barros , José de Oliveira Dair , Cristina Ferreira Marli , Roquim Romanelli Joao Paulo , Ferreira da Silva Rosa
Published: November 2024

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The Issues of English Literature in South Sudan: An Analytical of Five Articles Published on Line in Four Selected Schools and University of Juba
Authors: Deng Clement Aturjong Kuot
Published: November 2024

English Literature deterioration in Sudan and South Sudan is due to inconstant education policy by precious governments. It has been observing that they are lacking interest and commitment to learn and teaching Literature at the secondary level. There are claims that students and lectures are not contributing extensively in African Literature and World Literature. The causes for lecturers, are attribute to low salaries, demotivation, lack of internet connectivity, unregular payment of the salaries, lack of accommodation and transport. The reasons of graduate students of Language and literature are related to incompetence and uninterest in producing literary works such as poetry, drama, fiction and non-fiction. The third causes for lectures were attributed to teaching in numerous universities, in order to generate more payments to cater for their family’s needs. The critics and analysts argued that the students are not sponsored by the government in order to learn and teach at the secondary schools. The study explores the two groups; the first group think that English Literature is dying in South Sudan since there are no more literary works produced in South Sudan. The second group disagrees that English is not dying since English Language is an official language in South Sudan.
Discourse Production and Distribution in the Translation of City Promotion Materials
Authors: Jin Lu , Wang Yanzhi
Published: November 2024

With China's rising global presence, translating city promotion materials is crucial for effective international discourse. This study aims to explore how discourse is constructed in these translations, investigate the relationships among participants, and analyze the dissemination of the materials. Utilizing Fairclough's critical discourse analysis framework, 337 English texts from official Chinese sources are examined. The findings highlight how national consciousness influences translation practices and reveal biases in international media reports. This research enhances translation studies by addressing the social factors behind translation, providing valuable insights for improving city promotion materials in China's global narrative.
Impact of Play Therapy on Learning Outcome in Attention Deficit Hyperactivity Disorder Pupils: An Experimental Approach
Authors: Amaechi-Udogu Vivian Chukwunonyenim , Ekeh Princess Udochi
Published: November 2024

The study examined the impact of play therapy on learning outcome on attention deficit hyperactivity disorder pupils in Port Harcourt Metropolis, Rivers State. Quasi experimental design within which the Solomon four group design was employed. Using purposive sampling technique, a sample of 60 primary three pupils who met the criteria for ADHD were randomly assigned into the four groups which was made up of two experimental groups and two control groups. Two valid instruments titled: Conners' Rating Scales-Revised (CRS-R) for assessment of Attention Deficit Hyperactive Disorder and Mathematics Achievement Test (MAT) were used for collection of data in the study. The research questions were answered with mean and standard deviation. Hypotheses were tested for significance at 0.05 using dependent sample t-test, Analysis of Covariance (ANCOVA) and One-way analysis of Variance (one-way ANOVA). The result revealed that play therapy is effective in the improvement of learning outcome of attention deficit hyperactivity pupils. There was a significant difference of play therapy on learning outcome among the groups (experimental group 1, control group 1, experimental group 2 and control group 2). Based on these findings’ recommendations were made.
Analysis of The Incidence of Uterine Leiomyoma Based on Body Mass Index and Neutrophil-Lymphocyte Ratio
Authors: Fauzan Farma Aufa Faza , Kurniati Yuni Prastyo
Published: November 2024

Leiomyoma is the most common benign uterine tumor in the female with an incidence rate of 70-80%. The cause of these tumors is still unknown, but one of the known causes is that they grow in response to hormonal stimulation. Lymphocytic infiltration in this disease has been identified as an unusual finding. This suggests a potential role for lymphocytes in the development of such tumors. A bibliometric analysis of various sources found minimal research on the Neutrophil-Lymphocyte Ratio (NLR) in uterine leiomyoma, especially in Indonesia. This study analyzed the incidence of uterine leiomyoma based on Body Mass Index (BMI) and Neutrophil-Lymphocyte Ratio (NLR). This study used an observational analytic method with a case-control design. The sampling technique used was consecutive sampling and 129 samples were obtained in the form of 65 uterine leiomyoma case groups and 64 adenomyosis control groups. BMI variable parameters were obesity (>25kg/m2) and not obese (≤25kg/m2), while NLR was at risk (>3.53) and not at risk (≤3.53). Data analysis consisted of univariate, bivariate with a Chi-Square test, and continued with multivariate using logistic regression analysis. There was a significant relationship between BMI and uterine leiomyoma incidence (p = 0.028). There was also a significant relationship between NLR and uterine leiomyoma (p = 0.017). NLR had a 3,688-fold more association with the incidence of uterine leiomyoma than BMI. In conclusion, a relationship exists between BMI and NLR in the incidence of uterine leiomyoma. NLR can be a predictor of uterine leiomyoma, especially in women of reproductive age.
ALTERAÇÕES ECOCARDIOGRÁFICAS EM FILHOS DE MÃES DIABÉTICAS INTERNADOS EM UMA UTI NEONATAL
Authors: Lima Midiã Fonseca , Santos Simone Carrijo , Castro Lourenzo Lorena Cabral de , Evangelista Patrícia Gonçalves , Magalhães Danilo Freitas
Published: November 2024

Introdução: A gravidez é um período onde ocorrem várias modificações endócrino metabólicas. Com o aumento progressivo da sobrevida dos recém-nascidos (RN) de alto risco, a ecocardiografia vem se tornando ferramenta essencial para um bom diagnóstico e adequado tratamento para esses pacientes. Objetivos: O objetivo do presente estudo é descrever as alterações ecocardiográficas dos filhos de mães diabéticas e características desses recém-nascidos que ficaram internados na Unidade de terapia intensiva neonatal. Métodos: Trata-se de um estudo descritivo retrospectivo. As variáveis foram extraídas a partir de prontuários dos pacientes internados nesse período. A amostra foi composta por 782 prontuários, porém apenas 37 foram de filhos de mães com diabetes, no período entre primeiro de janeiro de 2017 e 31 de julho de 2019. Resultados: Observou-se no estudo que a maior parte das mulheres tinham em média 2-3 gestações equivalendo a (46%), 13 pacientes apresentaram 1 gestação equivalendo (35%), e pacientes com mais de 4 gestação foram 7, totalizando uma média de (19%). Em relação aos abortos 7 pacientes evidenciaram ter tido aborto e 30 pacientes (81%) não tiveram nenhum aborto. Dos 37 partos realizados, 26 deles foram cesáreas equivalendo a (70%). 25 bebês (68%), nasceram pre-termos. Quanto ao tamanho, 14 recém-nascido (38%) foram GIG (grande para idade gestacional).A duração da internação foi que dos 37 recém-nascidos 15 deles (41%) ficaram de 1 a 5 dias internados, já 16 recém-nascidos (43%) precisaram ficar de 6-10 dias internados, enquanto 6 (16%), apresentaram internação acima de 11 dias. Com relação as alterações ecocardiográficas encontradas no presente estudo, vale ressaltar que algum dos recém-nascidos apresentaram mais de uma alteração nos exames o que difere nas médias encontradas. Conclusão: As alterações nos ecocardiogramas que prevaleceram foram FOP e PCA. Apenas 5 recém-nascidos não apresentaram nenhuma alteração ecocardiográfica.
NEOPLASIA MALIGNA DA MAMA COM POSSÍVEL METÁSTASE PLEURAL
Authors: Rabelo Wanessa , Silva Alline , Braga Vitória , Graciano Izabella , Coutinho Miguel
Published: November 2024

Introdução: Em pacientes com diagnóstico de câncer de mama, as metástases distantes ocorrem principalmente no cérebro, nos pulmões, no fígado e nos ossos. Com relação aos casos de metástase pulmonar, derrames pleurais neoplásicos são comuns e estão associados a um pior prognóstico2,3, sendo que para o diagnóstico utiliza-se a análise do líquido pleural, além dos resultados de biópsia da pleura parietal. O diagnóstico e tratamento precoce do derrame pleural maligno são essenciais para promover uma melhor qualidade de vida aos pacientes com câncer avançado. Relato de caso: paciente, do sexo feminino, 52 anos, com diagnóstico de neoplasia maligna da mama diagnóstico em 2004. Submetida a tratamento cirúrgico e quimioterápico do tumor. Evoluiu com derrame pleural recidivante secundário a provável metástase pleural, que interferia na qualidade de vida da paciente. Realizado toracocentese de alívio e diagnóstica num primeiro momento com evidência de boa expansibilidade pulmonar ao raios-x de tórax de controle após o procedimento. Diante disso, optado por realizar pleuroscopia videotoracoscópica, pleurodese com talco estéril, biópsia pleural e toracoscopia com drenagem pleural fechada em selo d’água. Paciente evoluiu bem no pós-operatório e apresentou excelente resultado após o procedimento. Discussão: O derrame pleural por malignidade metastática, causa comprometimento importante da função respiratória, comprometendo a qualidade de vida dos pacientes, em decorrência de sintomas extenuantes como dispneia, dor torácica, anorexia e perda de peso. Embora a cura não seja possível, o tratamento paliativo realizado com sucesso, como no caso apresentado acima, permite meses a anos de vida produtiva, evitando a necessidade de hospitalização e toracocenteses de repetição.
RELATO DE CASO
Authors: Falone Valdivina , Martins Lucca , Leite Patrícia , Silva Winston , Saidah Tárik Kassem , Amaral Waldemar Naves do
Published: November 2024

A gestação heterotópica é uma condição extremamente rara em que há uma gravidez ectópica e uma eutópica simultaneamente, sendo que o tratamento de reprodução assistida pode aumentar a incidência dessa condição. O caso apresentado trata-se de uma paciente primeiramente diagnosticada com gravidez ovariana que é um tipo raro de gestação ectópica, sendo considerada uma urgência ginecológica e um risco à vida materna. Após tratamento cirúrgico, a ultrassonografia obstétrica demonstrou a existência concomitante de uma gravidez eutópica, caracterizando um caso de implantação heterotópica. No caso apresentado, evidencia-se uma dificuldade no diagnóstico, sendo a gravidez eutópica suspeitada apenas após a resolução da gestação ovariana. Esse caso ressalta a importância de se realizar um acompanhamento clínico pós-resolução de gravidez ectópica e de se observar os sintomas da paciente. Destaca-se também a relevância de se excluir uma gravidez ectópica, principalmente quando a paciente possuir muitos fatores de risco, como reprodução assistida, além de salientar que não se deve desconsiderar a presença de uma gravidez ectópica na existência de uma eutópica, sendo o inverso verdadeiro.
SÍNDROME DA ARTÉRIA MESENTÉRICA SUPERIOR SÍNDROME DE WILKIE
Authors: Silva Rômulo Mendes , Linhares Lohana Mendonça , Eduardo Natállia Rosa , Mendonça Isabela Couto , Canedo Raphael Sales Nogueira Amorim
Published: November 2024

Introduction: Superior Mesenteric Artery Syndrome / Wilkie Syndrome is characterized by the compression of the third portion of the duodenum, due to the reduction of the aorta angulation with the superior mesenteric artery. A rare disease, with few cases described in the medical literature. Case 01: A 13-year-old male patient, diagnosed with Diamond-Blackfan Anemia and with acute intestinal occlusion for 2 days with previous recurrent episodes of intestinal occlusion. CT showing gastrectasis and dilation of slender loops up to the third portion of the duodenum. Case 02: 18-year-old female patient, without previous comorbidities, with high intestinal obstruction for 7 days, with CT showing duodenal obstruction and reduction of aorto-mesenteric angulation. Discussion: The most prevalent age group occurs between 18 and 35 years. Associated with mainly weight loss and Cast Syndrome. The diagnosis is given by clinical suspicion followed by imaging tests such as upper gastrointestinal tract radiography and contrast abdominal CT. Treatment may be conservative with weight gain or surgical measures, the duodenojejunoanastomosis is the technique of choice. Diamond-Blackfan anemia despite being related to staturo-ponderal alterations no association was identified in the medical literature with Wilkie Syndrome. Conclusion: Differential diagnosis should be made in young patients with repetitive vomiting. Upper Gastrointestinal Endoscopy may delay the diagnosis.
RELATO DE CASO DE LARVA MIGRANS RETINIANA EM COMUNIDADE QUILOMBOLA DE GOIÁS
Authors: Brito Ana Carolina Poloniato , Silva Vieira Rafael da , Sobrinho Vinícius Stival Veneziano , Melo Alves Fernando Augusto de
Published: November 2024

A neurorretinite unilateral subaguda difusa (DUSN) é uma uveíte posterior unilateral caracterizada pela presença de um nematódeo no espaço subrretiniano. Acomete indivíduos jovens e saudáveis e é dividida em precoce e tardia de acordo com as manifestações clínicas. O tratamento principal é a fotocoagulação a laser se a larva for identificada ou tratamento medicamentoso com anti-helmínticos específicos naqueles casos não detectados ou até identificados, porém com o nematódeo próximo à mácula do indivíduo. O objetivo desse artigo é relatar o caso de um paciente jovem do sexo masculino proveniente de uma região vulnerável, com quadro de perda visual unilateral progressiva, no qual foi detectado a presença de um nematódeo no espaço subrretiniano perifoveal associado a alterações retinianas inflamatórias e degenerativas compatíveis com a hipótese de neurorretinite unilateral subaguda difusa. Foi optado pelo tratamento medicamentoso com Albendazol por um período de 30 dias devido à localização da larva em região macular. Com o tratamento, o paciente apresentou melhora da acuidade visual de forma significativa, além da migração e morte da larva em periferia temporal retiniana.
PREDITORES DO RISCO PARA O DESENVOLVIMENTO DA DOR AGUDA PÓS-OPERATÓRIA NOS PACIENTES COM TRAUMA ORTOPÉDICO
Authors: Barros Caio , Carneiro Antonio , Casali Tolomeu , Moreira Milena
Published: November 2024

Objetivo: Identificar a incidência de DAPO e fatores de risco associados ao seu desenvolvimento. Materiais e métodos: Estudo observacional longitudinal prospectivo, realizado em um centro estadual de referência para trauma ortopédico com pacientes que internaram na referida unidade para tratamento cirúrgico ortopédico. Para a análise estatística, dividiu-se a amostra em grupos sem dor, com dor leve, moderada e grave, de acordo com a Escala Visual Analógica (EVA) após 24 horas da cirurgia. Resultados: Foram incluídos 82 pacientes, sendo que 26 (31,7%) apresentaram dores moderada a forte em 24 horas de pós-operatório. Três fatores de risco apresentaram diferenças importantes entre os grupos: idade, ansiedade e dor pré-operatória. Neste último obteve-se relevância estatística. Conclusão: Pacientes com dor na internação hospitalar previamente à cirurgia apresentaram um maior risco para o desenvolvimento da DAPO. A intensidade da dor está diretamente relacionada nos períodos pré e pós-operatório. A identificação dos preditores de risco para DAPO auxilia a equipe na tomada de decisões. Nesse contexto, o anestesiologista tem papel fundamental na prevenção e controle da DAPO.
FIBRILAÇÃO ATRIAL E EXERCÍCIO
Authors: Gardenghi Giulliano , Lima Pollyana Barbosa de , Balestra Luciana Fernandes
Published: November 2024

A fibrilação atrial (FA) é comum em adultos e muitas vezes o cardiologista e os demais profissionais de Saúde, como fisioterapeutas e professores de educação física se deparam com situações em que a prescrição de exercício para essa população se torna desafiadora. O presente artigo se propõe, por meio de extensa revisão da literatura, a abordar a FA em seus aspectos epidemiológicos, sua fisiopatologia, aspectos do tratamento farmacológico, repercussões do exercício como gatilho para o surgimento da FA e ainda sobre seu efeito como parte do tratamento dessa arritmia. O artigo irá ainda oferecer sugestões de abordagem por meio do exercício em indivíduos com FA que procuram programas de reabilitação cardiovascular.
LUXAÇÃO INFERIOR DO ÚMERO PROXIMAL (LUXATIO ERECTA) BILATERAL EM SESSÃO DE PILATES
Authors: Arbildi Eduardo César Almeida , Carmo Jorge Vítor do , Matushita Danilo Tetsuo Taia , Pinto Kenny Rogers Marcondes , Lopes Daniel Rossi
Published: November 2024

Definida pela perda da congruência articular, parcial ou total, as luxações mais frequentes são as glenoumerais. Destas, as mais incomuns têm sua apresentação inferior, sendo ainda mais raras em caso de bilateralidade. Normalmente associadas a pouca ou nenhuma alteração neurovascular, tem apresentação típica de “braços levantados”, sendo impossível a redução sem auxílio de sedação em centro cirúrgico, devido à dor e dificuldade da manobra e colaboração do paciente. Apresentamos aqui o caso de um paciente com luxatio erecta após uma sessão de pilates, que foi bem manejado em atendimento de pronto socorro de um hospital particular, tendo perdas de amplitude de movimento e alterações neurovasculares compatíveis com a literatura disponível.
GESTAÇÃO ECTÓPICA EM CICATRIZ DE CESAREA PRÉVIA
Authors: Paula Vasconcelos Ana Carolina de , Amaral Waldemar Naves do
Published: November 2024

Introdução: Gestação ectópica em cicatriz de cesárea (GECC) consiste na implantação do blastocisto na intimidade do miométrio de uma cicatriz de cesariana prévia. A incidência de GECC vem aumentando em paralelo ao aumento de cesarianas e atualmente varia de 1:1800 a 1:2216 gestações. Objetivo: Relatar uma série de casos e seus desfechos, conhecer as características ultrassonográficas que corroboram para o diagnóstico e identificar as complicações maiores associadas, discorrer sobre as formas de tratamento e relatar a evolução após a resolução do quadro. Método: Série de casos. Discussão: A melhor proposta terapêutica nos casos de GECC é a interrupção da gravidez no primeiro trimestre para prevenir as temíveis complicações inerentes à implantação miometrial do concepto (hemorragia e rotu-ra uterina). A conduta expectante é desaconselhável e associada a elevada morbimortalidade feita de forma excepcional. Os perfis das pacientes dos casos se enquadram nos fatores de risco citados nos estudos. Todos os casos possuíam cesárea anterior e diagnóstica de gestação ectópica em cicatriz de cesárea; média de idade: 31,25 anos (29-33 anos); média de paridade (gesta): 3 (G5-G2). Desta forma, vamos ao encontro com o que a literatura cita como os principais fatores de risco. Nos casos 1 e 3 as pacientes foram tratadas através do esvaziamento uterino guiado por ultrassonografia associado ao tratamento medicamentoso. O caso 2 recebeu tratamento medicamentoso com metotrexato através de uma dose intramuscular e posteriormente, acrescido da injeção intrasaco gestacional do medicamento. E no caso 3 a paciente recebeu tratamento medicamentoso e após quadro de hemorragia foi submetida a tratamento cirúrgico com diagnóstico de acretismo placentário através da histeroscopia. Em todos os casos as pacientes foram diagnosticadas de forma precoce, passíveis de tratamento conservador e tiveram sua fertilidade preservada. Considerações finais: Uma boa conduta diante da gestação ectópica em cicatriz de cesárea após diagnóstico precoce com USG e Doppler realizado por equipe experiente tem o poder de mudar o prognóstico e o futuro reprodutivo da paciente.
DESFECHOS PERINEAIS EM PARTOS VAGINAIS ACOMPANHADOS EM UMA MATERNIDADE PÚBLICA
Authors: Poloniato Thays Barbieri , Santos Ludmira Fortuna , Uliana Filho Irumuara Interaminense , Lopes Renata Silva , Cardoso Ana Vera Alves , Carvalho Laura Araújo de , Amaral Waldemar Naves do
Published: November 2024

Cerca de 85% das mulheres que realizam parto vaginal sofre algum tipo de trauma perineal. As lesões provocadas espontaneamente podem levar à necessidade de sutura, perda aumentada de sangue, dor perineal no pós-parto, além de represetar fator de risco para o surgimento de disfunções do assoalho pélvica. As lesões perineais estão relacionadas à assistência prestada durante o trabalho de parto. O objetivo desta pesquisa foi descrever as características socioemográficas e obstétricas e a prevalência de trauma perineal em partos. Estudo com delineamento transversal, descritivo analítico e de abordagem quantitativa, com coleta secundária de dados em prontuário físico/eletrônico entre os meses de janeiro a março de 2022, a ser realizado no Hospital e Maternidade Dona Iris, de caráter público, referência em saúde materno-infantil na Região Centro-Oeste. Os dados serão inseridos em software estatístico, software Statistical Package for the Social Sciences (SPSS) versão 22.0. Foram realizadas estatísticas simples com frequência absoluta e relativa. Os dados foram coletados após apreciação e aprovação do Comitê de Ética em Pesquisa do Hospital e Maternidade Dona Iris, sob o número 5.610.634. Os resultados encontrados neste estudo, permitem concluir que os traumas perineais devem ser tratados com importância pela assistência à parturiente, pois podem resultar em desfechos negativos para a mulher nos aspectos físicos, psíquicos, emocionais e sociais; com consequências a longo prazo.
SÍNDROME DE OSLER WEBER RENDU
Authors: Moraes Helaine Bueno , Pires Romulo Braga , Gomes Juliane Honda , Costa Carolina Rodrigues , Rabahi Stéphane Lima
Published: November 2024

A doença de Osler Weber Rendu ou telangiectasia hemorrágica hereditária é uma doença genética autossômica dominante rara. A manifestação clínica mais comum é epistaxe, mas pode apresentar- se também com melena e dispneia. O diagnostico pode ser feito com os critérios de Curaçao que são quatro, sendo eles: epistaxe recorrente, telangiectasias, malformações arteriovenosas e história familiar, três critérios positivos confirmam o diagnóstico. Objetivo: Apresentar um caso de uma paciente do sexo feminino, diagnosticada aos 53 anos com a síndrome de Osler Weber Rendu. Metodologia: Coleta de dados no prontuário da paciente selecionada com diagnóstico da síndrome de Osler Weber Rendu. Foram coletadas informações, clínicas, de exames realizados, a terapêutica de escolha e desfecho. Buscou-se artigos para revisão bibliográfica na Biblioteca Virtual em Saúde (BVS), LILACS, PubMed. Conclusão: O relato de caso contribuiu para discussão e alerta sobre as manifestações clínicas de uma síndrome rara, mas que pode estar presente em pacientes de diversas especialidades médicas, visto que seus principais sinais e sintomas acometem vários sistemas do corpo humano.
ANÁLISE EPIDEMIOLÓGICA DAS NOTIFICAÇÕES DE LESÕES AUTOPROVOCADAS NA CIDADE DE ANÁPOLIS (GO), NOS ANOS DE 2018 A 2022
Authors: Rodrigues Pedro , Naves Thaynara
Published: November 2024

Introdução: As lesões autoprovocadas apresentam números crescentes ao longo dos últimos anos, constituindo um desafio para a elaboração de políticas públicas na saúde Objetivos: Identificar o cenário epidemiológico das notificações de lesões autoprovocadas e suas variáveis, no município de Anápolis-GO, entre os anos de 2018 a 2022 Métodos: Trata-se de um estudo transversal, retrospectivo, referente aos dados das notificações de lesões autoprovocadas obtidos por meio de acessos a plataforma do Sistema de Informação de Agravos de Notificação (SINAN), no DATASUS Resultados: Observou-se que o cenário de notificações de lesões autoprovocadas na cidade de Anápolis (GO) apresentou aumento estatístico entre 2018 a 2022. Existiu um predomínio das notificações no sexo feminino, na população parda, entre as faixas etárias de 10-14 anos e nos níveis de instrução das 5 a 8 séries incompletas. Em se tratando dos meios empregados, observou-se o predomínio de meios menos letais (envenenamento e uso de objetos perfuro-cortantes). Verificou-se a associação entre o consumo de álcool e as lesões autoprovocadas Conclusões: Com base no estudo epidemiológico observou-se que a cidade de Anápolis apresentou estatísticas crescentes de notificações. Esperase que a gestação municipal da cidade de Anápolis (GO), observando a epidemiologia das variáveis envolvidas, possa manter as condições básicas para os atendimentos em saúde mental, pela Atenção Básica e com suporte dos Centros de Atenção Psicossocial (CAPS), ambulatórios de saúde mental e pelos hospitais referências para o atendimento dos pacientes que necessitem de internações psiquiátricas.