bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for hemoglobinopathies in a socially disadvantaged population from a rural district of West Bengal, India
Authors: Mandal Prakas Kumar , Dolai Tuphan Kanti , Mandal Soma , Mondal Tamanash , Maji Suman Kumar
Published: November 2020

Background: Detection of traits/carriers plays an important role in preventing the birth of a thalassemic child. West Bengal, one of the eastern states in India is the home to a bulk of socially challenged population including scheduled castes and scheduled tribes among others. The present study aimed to detect the prevalence of different hemoglobinopathies in a socially challenged district of West Bengal.Methods: In this retrospective cross sectional study thalassemia detection camps were organized at the community level over a period of four years. Venous blood samples were subjected to complete hemogram and high performance liquid chromatography (HPLC). In few difficult cases samples were sent to the reference laboratory for molecular characterization. The prevalence of heterozygous, homozygous or compound heterozygous states of different thalassemias and hemoglobinopathies across various respondent groups (e.g. children, premarital, postmarital and antenatal) and existing caste categories (scheduled tribes, scheduled caste and general) were analyzed.Results: We analyzed a total of 114,606 HPLC reports; 18681 (16.30%), 15438 (13.47%) and 80487 (70.23%) cases belonged to scheduled tribes, scheduled castes and general category respectively. Out of 114,606 cases, 11,001 (9.6%) had revealed abnormal hemoglobins; beta thalassaemia trait was the most common (6.63%; n=7602) across all subgroup analysis. Among others, HbE trait, sickle cell trait and HbD trait were detected in 1788 (1.56%), 1362 (1.18%) and 126 (0.11%) cases respectively.Conclusions: Beta thalassaemia trait and HbE trait are the common haemoglobin variants in this rural district of West Bengal. The prevalence of sickle gene revealed in the present study is much less than previous studies in the locality.
Correlation of cyclin D1 between hormones receptors and other clinical parameters in invasive breast carcinoma
Authors: Singh Seema , Mabood Abdul , Dwivedi Neetu , Alam M. Qamar , Gangwar Abhinav
Published: November 2020

Background: Breast carcinoma is the most common malignancy in women. The prognosis of breast carcinoma is determined by different prognostic factors including age of patients, type of tumour, stage of tumours, grade of tumors, presence or absence of metastasis and hormones receptor status. The present study was conducted to assess the expression of cyclin D1 in invasive breast carcinoma and its correlation with age, tumour grade, lymph node metastasis and hormones receptors (estrogen receptors and progesterone receptors).Methods: Present study was conducted in department of pathology UPUMS, Saifai, Etawah, Uttar Pradesh. This was a prospective cross sectional observation study conducted on 21 mastectomy specimen from January 2019 to June 2021, diagnosed as invasive breast carcinoma on routine haematoxylin and eosin stain. Immunohistochemistery marker was scored by using allred scoring methods. Grading was calculated according to Nottingham grading system.Results: It was observed out of 21 cases 9 (42.8%) cases were showing cyclin D1 positivity. In our study 14 cases were estrogen receptor and progesterone receptor positive, out of 14 ER and PR positive cases 9 (64.2%) cases showing cyclin D1 positivity. There was significant correlation between cyclin D1 and hormones receptors (ER and PR). No significant correlation between cyclin D1and age, tumour grade and lymph node metastasis.Conclusions: Present study depicts significant correlation between cyclin D1 and hormones receptors (ER and PR). No significant correlation between cyclin D1and age, tumour grade and lymph node metastasis.
Prevalence of duodenal ulcer and associated Helicobacter pylori infection in chronic liver disease
Authors: Nanda Rajesh A. , George Melvin
Published: November 2020

Background: Aim was to determine the prevalence of duodenal ulcer (DU) and associated H. pylori infection in patients with liver cirrhosis.Methods: A prospective observational study was conducted at a tertiary care medical college hospital and research center in Suburban Chennai, Southern India, where consecutive patients with cirrhosis of liver undergoing UGI endoscopy were screened for duodenal ulcer and in those with duodenal ulcer H. Pylori testing was performed with RUT and histology of antral biopsy specimen. Prevalence was compared with age and socioeconomic status matched control population who presented with dyspepsia and underwent UGI endoscopy during the study period.Results: Total 106 patients with chronic liver disease and 481 matched non cirrhotics with dyspepsia underwent UGI endoscopy during the study.Duodenal ulcer was diagnosed in 19.08% patients with cirrhosis and in 6.02% non-cirrhotic patients with dyspepsia.16.66% patients with DU in chronic liver disease (CLD) group were diagnosed to have H. Pylori infection by histology and RUT in comparison to 93.1% H. Pylori infection in control population with DU.Conclusions: The incidence of DU in CLD was significantly higher when compared to general population with dyspepsia. However, majority of patients with PUD in cirrhosis of liver did not have associated H. Pylori infection. Increased incidence of DU in CLD is probably due to several other mechanisms related to portal hypertension. Routine treatment with anti H. Pylori regime may not be warranted with CLD patients with DU, therefore a test and treat strategy for H. Pylori will be more optimal in CLD.
Bacteriological profile and antibiogram of cancer patients admitted in intensive care unit of a tertiary care cancer hospital in central Kerala
Authors: Ramakrishnan Sanjana , Radhakrishnan Sourabh , Cyriac Sonu Lazar
Published: November 2020

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.
Hemolytic anemia in a case of SARS CoV2 infection without respiratory involvement: a new dimension of COVID-19
Authors: Pandey Saurabh , Gupta Manoj Kumar , Butta Shristi , Rai Priyanka
Published: November 2020

Severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection is a predominantly respiratory illness with variable organ involvement. Hematological changes are an important manifestation and anemia is usually autoimmune in origin. It is easily identifiable and treatable complication. In absence of tell tail sign of COVID-19 infection high index of suspicion is required with prompt testing. Our patient presented as case of autoimmune hemolytic anemia with no evidence of COVID-19 infection and tested after ruling out common causes in Indian setting. He responded to steroid therapy and viral clearance.
Talaromycosis in Assam: a case report
Authors: Borah Nilakshi , Sharma Ajanta , Saikia Lahari
Published: November 2020

Talaromycosis is an opportunistic infection caused by a dimorphic fungus, Talaromyces marneffei. We describe here a case of 38 years old HIV seropositive male patient from Assam presented with fever, cough, weight loss and discrete, multiple, umbilicated papules and nodules in face and upper trunk. Differential diagnosis of histoplasmosis, giant molluscum contagiosum and talaromycosis were considered. Histopathological and mycological study of skin biopsy tissue confirmed the diagnosis of talaromycosis. Primary treatment with amphotericin B and itraconazole showed promising results. Early diagnosis and adequate antifungal therapy are imperative to avoid the complications. Talaromyces requires further in-depth study with respect to its global distribution, natural history, pathogenesis and the impact of antiretroviral therapy.
Parachordoma: a rare recurring case at a rare site
Authors: Vernekar Sunita S. , Patil Ankitha , Giriyan Sujata S.
Published: November 2020

Parachordoma is an uncommon tumor of soft tissue and the orign is not clear. This soft tissue tumor resembles chordomas as well as extraskeletal myxoid chondrosarcomas and has only recently been fully characterized. Although it is considered a benign lesion, its behavior tends to be locally aggressive, with reports of a recurrence rate of up to 20% and of several cases of metastasis. In this article, we report a case of parachordoma in the neck with recurrence that we met in clinical works.
Assessment of colorectal cancer lifestyle risk factors distribution and colonoscopy utilization among a sample from the south of Saudi Arabia
Authors: Hakami Riyadh A. , Shahar Atheer I. , Alharbi Sana A. , Aburasain Khadijah S. , Bakri Atyaf A. , Kaabi Fatimah M. , Hakami Nouf A. , Gosadi Ibrahim M.
Published: November 2020

Background: To assess the distribution of colorectal cancer lifestyle risk factors, utilization of colonoscopy for colorectal cancer screening among a sample from Jazan region, Saudi Arabia.Methods: Presented study was a case control study conducted in King Fahad central hospital and Prince Mohammad Bin Nasser hospital in Jazan region. This study involved three groups where patients diagnosed with colorectal cancer, their first degree relatives and patients visiting other clinics were recruited. Data was collected via a structured questionnaire including data about lifestyle factors associated with colorectal cancer, such as eating behaviour, physical activity level, tobacco product consumption, and khat chewing behaviour and data about utilization of colonoscopy for screening purposes.Results: A total of 148 individuals participated in this investigation including 56 patients diagnosed with colorectal cancer. Fourteen colorectal cancer patients (25%) were diagnosed with the disease below the age of 50. Utilisation of colonoscopy was the lowest among the first degree relatives of the colorectal cancer patients. First degree relatives of the colorectal cancer patients had higher levels of body mass index, lower consumption of fruits, vegetables and whole grain products and had higher levels of red meat consumption in comparison to participants in the other study groups.Conclusions: The distribution of colorectal cancer risk factors among first degree relatives in our sample might indicate a need to target this group to increase awareness about the prevention of the disease and utilisation of screening services for colorectal cancer.
Relation of sympathetic activation and stress-induced hypertension in atherosclerosis of the thoracic aorta: a cadaveric study
Authors: Gogakos Apostolos S. , Koletsa Triantafyllia D. , Pavlidis Leonidas C. , Paliouras Dimitrios A. , Rallis Thomas S. , Lazopoulos Achilleas A. , Barbetakis Nikolaos G. , Chatzinikolaou Fotios G.
Published: November 2020

Background: The autonomic nervous system (ANS) has been associated with numerous atherosclerosis-induced cardiovascular events, such as myocardial infarction and aortic disease. Although evidence suggests a relationship between autonomic dysfunction and atherosclerotic disease, the underlying mechanisms are still under investigation. The purpose of this study is to investigate the effect of ANS to the development of atherosclerosis and vice versa, in human thoracic aorta.Methods: An autopsy analysis from three segments of the thoracic aorta was performed; ascending aorta, aortic arch, descending aorta, using 52 unselected adult cadavers (38 male, 14 female – mean age 64.4 years; age range 19-90 years). Subjects were divided in two age groups (<65 years – N=26, >65 years – N=26). Tissue specimens were macroscopically examined and histopathologically divided into 7 grades of scoring for atherosclerosis (ATHERO, from 0=intact, to 6=thrombi formation). The relationship between ANS and atherosclerosis was depicted by further immunohistochemical analysis for detection of neuron terminals onto the aortic wall. All data were evaluated according to the subjects’ demographic and clinical characteristics.Results: Total 96.2% of all subjects had atherosclerosis of variable degree in one or more segments. No aneurismal change was found. The presence of atheromas were common in all subjects regardless of age and segment, with atherosclerosis increasing by age; ascending aorta (r=0.571, p<0.001), aortic arch (r=0.655, p<0.001), descending aorta (r=0.659, p<0.001). Hypertension was a significant factor in the development of atherosclerosis in adults >65 years (r=0.450, p=0.023). In addition, a positive history of hypertension was statistically significant regarding both the presence of atherosclerosis and neuron terminals in all three aortic wall segments; ascending aorta (p=0.037), Aaortic arch (p=0.046), descending aorta (p=0.045). Furthermore, there was a strong negative correlation between the ATHERO score and the presence of neuron terminals in all three aortic segments; ascending aorta (r=-0.264, p=0.041), aortic arch (r=-0.400, p=0.003), descending aorta (r=-0.234, p=0.047).Conclusions: Human cadaveric studies are extremely useful in understanding the pathophysiology of ANS, along with clinical and animal studies that are most commonly performed. These data suggest that there is a link between autonomic disfunction and the presence of atherosclerosis in human thoracic aorta, especially when hypertension is present. It is therefore possible that stress-induced hypertension can be considered as a potential risk factor for the development of atherosclerosis.
Right renal vein lengthening with cava patch in cadaveric donor kidney transplantation: cohort study
Authors: Ulloa-Torres Jorge Martinez , Parra-Avila Idalia , Gutierrez-Torres Paulo , Chan-Canche Belem Arieth , Carlos Daniel Moo-Rivas , Baas-Cruz Juan Pablo , Aguilar-Castillejos Luis Fernanado , Tun-Abraham Mauro Enrique , Bernal-Mier Jesus Manual
Published: November 2020

Background: Right kidney transplant can become a surgical challenge, due to anatomical length disparity between the right and left veins. From 2011, lengthening of the right renal vein has been used in our program. The objective was to evaluate the outcome among kidney transplant recipients with or without the use of a cava patch, comparing safety, complications and patient / graft survival in both groups.Methods: Retrospective single center cohort study between 2011-2020 in a Kidney transplant program at Mexico.Results: 27 right cadaveric kidney transplant recipients were identified, 13 (48%) with and 14 (52%) without right renal vein lengthening (RRVL). Median overall operative time was 135 (120-157) minutes, with no significant difference between groups (p=0.181), even in overweight or obese recipients. Perioperative bleeding and postoperative drainage output was similar in both groups. There were two graft failures among recipients without RRVL one due to arterial bleeding and the other secondary to venous thrombosis. After one year of follow up, renal graft function and graft survival was similar in both groups.Conclusions: RRVL technique is safe and facilitates anastomoses in complex cases. Although no statistically significant difference in operative time was found between the groups, the RRVL technique in overweight / obese patients was thirty minutes faster. Routine use of this technique is suggested in cadaveric donor right kidney transplants.
The alcoholic individual and facial trauma: a 3 years survey
Authors: Munjal Manish , Kanotra Sonika , Munjal Shubham , Chopra Parth , Saggar Tullika , Chopra Hemant , Uppal Sanjeev
Published: November 2020

Background: Road traffic accidents, under the influence of alcohol constitute a majority of patients in the emergency trauma services in tertiary health care facilities. The incidence of the same and the region predominantly involved was analysed.Methods: 61 subjects in the Otorhinolaryngology and Maxillofacial trauma services were studied, during a period of 2 years, at Dayanand medical college, Ludhiana, Punjab. In this prospective study the admission records were analysed in context to alcohol intake prior to the trauma.Results: The incidence of facial fractures, attributed to road-side accidents was the highest i.e. 72%. Other antecedent events were, assaults in 15%, fall from heights in 8% and due to sport injuries in 3.2%. 34% of our patients were under the influence of alcohol at the time of injury. Incidence of facial fracture in our series were fracture mandible, 39.3%, zygomatic 23.5%, Le Fort II 17.9% and nasoethmoid 12.3%. One case of Le Fort I, orbital and alveolar fracture was seen.Conclusions: Drunken driving in Punjab was behind one third i.e. 34% of the trauma patients in our casualty services.
Neurovesical dysfunction in anorectal malformation
Authors: Inugala Anusiri
Published: November 2020

Background: Anorectal malformations are congenital anomalies characterized by the absence of a normally formed anus. Obstructive uropathy, vesicoureteral reflux neurovesical dysfunction are the leading causes of mortality and morbidity in ARM. Early diagnosis and treatment of NVD prevents renal parenchymal damage.Surgical interventions for the correction of anorectal malformation may also lead to the development of NVD. The incidence of urologic and spinal anomalies associated with ARM and the relationship between the anorectal malformations, spinal abnormalities and voiding dysfunction was studied by means of MRI spine and urodynamic studies. Methods: A prospective, observational study was done over a period of 2 years. All patients with ARM underwent MRI of the spine, ultrasound of abdomen, micturating cystourethrogram and urodynamic study.Results: Forty two patients were included in this study. Out of the 42 patients 17 (40.5%) were female and 25 (59.5%) were male. The ages of the patients ranged from 4 months to 14 years with an average of 32.9 months. 5 patients (12%) had complaints pertaining to neurovesical dysfunction. MRI of the spine revealed abnormalities in 10 patients (23.8%). Urodynamic study was abnormal in 8 patients (19%). Therefore a total of 8 patients (19%) had neurovesical dysfunction in the present study. This included 3 female patients with cloaca and 5 male patients with high anorectal malformations.Conclusions: Neurovesical dysfunction is frequently seen in patients with anorectal malformations. NVD may be due to the spinal abnormalities or due to iatrogenic injuries to the bladder innervations during surgical reconstruction.
Comparison of local versus spinal anaesthesia in inguinal hernia repair
Authors: Bhardwaj Suraj , Sharma Shuchi , Bhardwaj Vatika , Lal Roshan
Published: November 2020

Background: Inguinal hernioplasty remain one of the most commonly performed operations worldwide.  Local anaesthesia can be a preferred method in day-case hernia surgeries. Present study was thus conducted to determine whether local anaesthetic technique is an acceptable alternative to spinal anaesthesia for hernia repair, especially with regards to operative conditions, postoperative pain relief and complications.Methods: This was a prospective randomized single blinded clinical study consisting of sixty patients conducted after the ethical committee clearance. The patients posted for tension free lichtenstein elective hernioplasty were allocated to either of two groups, group A (n=30) were given local anaesthesia and patients in group B (n=30) were given spinal anaesthesia. The operative and postoperative pain sore using visual analogue scale, duration of surgery and any other complications were recorded.Results: There was no demographic difference between the two groups. Time taken in local anesthesia was higher than spinal anesthesia. Intraoperative pain was higher in local anesthesia than spinal anesthesia. There was no difference in post-operative pain scores (p>0.05). Post-operative complications were more in spinal anesthesia group e.g. urinary retention, headache, etc.Conclusions: Local anesthesia can be another good choice for inguinal hernia repair owing to its advantages and less complications, but it can’t be confirmed that local anaesthesia is better than spinal anaesthesia. It can be reliably concluded that local anaesthesia can be a preferred method in day-case hernia surgeries owing to its advantages of ease of administration and less complications.
A clinicopathological evaluation of solitary nodule in thyroid; a retrospective observational hospital based study
Authors: Lakshmi Y. Ananta , Narasimha Reddy K. V.
Published: November 2020

Background: The solitary node in thyroid is a palpably discrete swelling within an apparently normal thyroid gland. It is usually a benign lesion but from clinical standpoint the possibility of neoplastic disease is of major concern for surgeon and patient. AS there is variability in the conclusion of various authors and there is no work about clinicopathology of solitary nodules of thyroid in our region. Present study has been designed to evaluate the epidemiology, fine needle aspiration cytology and incidence of malignancy in solitary nodule.Methods: As per exclusion and inclusion criteria 80 patients with solitary nodule of thyroid were included in this study. Various data like age, sex, family history, duration of nodule, site and size of nodule were recorded. Thyroid function test, fine needle aspiration cytology and ultrasonographic finding were recorded from case record.Results: Out of all histopathological finding of nodules follicular adenoma was most common followed by multinodular goitre (25%) and Adenomatous goitre (7.5%). Carcinoma was present in (17.5 %) and thyroiditis is 7.5% patients.Conclusions: Most of the patients were Euthyroid and benign condition was more common than malignancy. Follicular adenoma was most common among benign lesion and papillary carcinoma was more common neoplasm. Most of the patients required hemithyroidectomy.
Pattern of surgical emergencies during COVID-19 lockdown in a tertiary care centre
Authors: Verma Surender , Verma Anjali , Garg Pradeep , Godara Rajesh , Sirohi Vivek , Garg Neha , Pal Vijay
Published: November 2020

Background: COVID-19 is a novel pandemic affecting almost all countries of the world. The containment measures in form of lockdown taken to prevent its spread has impacted pattern and volume of surgical emergencies. As emergency admissions form a major bulk of total surgical admissions hence this study was planned to look for the impact of lockdown on the spectrum of surgical emergencies in a tertiary care hospital.Methods: A descriptive register based study was done by collecting data of surgical emergencies in three phases – pre lockdown, lockdown and lockdown with relaxations. Data regarding surgical admissions which includes trauma as well as non-trauma emergencies during various phases was collected and analysed.Results: Total number of surgical emergencies decreased by 55.6% during lockdown when compared with pre-lockdown phase. In lockdown phase with relaxations, total admissions increased by 35.2% over lockdown phase however they was overall decrease by 19.4% than pre-lockdown phase. Physical assault was most common cause of trauma admissions in both lockdown (48.2%) as well as relaxation phases (57.1%) whereas RSA was the most common cause in pre-lockdown phase (50.5%).Conclusions: As there was significant decrease in surgical emergencies particularly road side accidents during both lockdown and relaxation phases, hence we conclude that maximum emergencies can be avoided which ultimately decrease the burden on existing health care system. However lockdown has adversely affected economy of country and public comfort i.e. travel restrictions, jobs, recreation etc. Moreover, rise in cases of physical assaults also warrants urgent attention in the community.
Biliary collection masquerading as Grey Turner sign
Authors: Kapur Kanika , Jadhav Sarojini Pramod , Kasekar Ajinkya Janardhan
Published: November 2020

Grey turners sign has been conventionally associated with acute pancreatitis; however, this series is a deviation from the traditional paradigm of the former mentioned sign and describes cases of flank discoloration post cholecystectomy performed for varying indications. The aim of study was to highlight correlation between biliary collection and simultaneous flank discoloration. The study describes a series of 3 cases complicated post operatively by flank discoloration, each with different indication, operative procedure, course of events however united by a common factor (biliary collection). Each case was managed on conservative lines i.e. by MgSO4 glycerine dressing. The above-mentioned cases were admitted in male surgical ward in a Tertiary care hospital over a period spanning from April to Oct 2018 whereby they responded to the conservative management albeit varying in duration of recovery and showed a gradual change in discoloration probably reflecting the sequential degradation of haemoglobin in subcutaneous tissue. In contrast to the classically mentioned Grey Turners sign, there was no evidence of pancreatitis but the mere presence of biliary sanguineous collection which tracked to the skin through a breach in transversalis fascia. To conclude, there are many eponyms describing body wall ecchymosis in relation to intra-abdominal or retroperitoneal pathology, however, there is a dearth of data pertaining to association of Grey Turner sign with biliary collection. From the above 3 cases it’s a sign that highlights itself as an index of morbidity than mortality unlike pancreatitis.
Aspergilloma or intrapulmonary teratoma - time to rethink
Authors: Thapaliya Pratikshya , Ahmad Fatima T. , Abid Ambreen , Mazcuri Misauq , Sikander Nazish , Ahmad Tanveer , Ali Nadir
Published: November 2020

Intrapulmonary teratoma (IPT) is a rare type of extra gonadal germ cell tumor which can often be misdiagnosed due to its non-specific presentation. Complete surgical resection should be done because of its malignant potential. We report a case of 33 years old female previously treated as tuberculous osteomyelitis of sternum. She presented with chest pain and sudden hemoptysis. Based on the radiological picture she was diagnosed as complex aspergilloma of lung with a thick walled cavity. Hemoptysis was controlled with supportive management. On surgery right upper lobe was densely adherent to the anterior chest wall. Exploration of the cavity revealed a 6×4 cm whitish mass with non-pigmented hair. Right upper lobectomy and wide excision of the mass was performed. Histopathology was consistent with the diagnosis of IPT with no malignant cells.
Common bile duct worm induced pancreatitis: a rare case report from an urban area
Authors: Panda Viraj , Padebettu Devendra A.
Published: November 2020

Ascaris is the most common intestinal helminth to infest humans in the world. In India, it is endemic to Kashmir and rarely occurs in an urban setting. It has a varied presentation including pancreatitis. Here, we present a case report of a female patient suffering from pancreatitis induced by common bile duct ascariasis in a non-endemic urban area. A 56 year old lady presented with pain upper abdomen and nausea with tenderness in her epigastrium. Contrast enhanced computed tomography was suggestive of pancreatitis. Patient then vomited a worm and further similar history of worm emesis and passage in faeces was elicited. Magnetic resonance cholangiopancreatography showed linear filling defect in distal CBD. 5 live worms were removed via endoscopic retrograde cholangiopancreatography. Vermifuge was started and her follow-up was uneventful. Therefore, there should be a strong suspicion in patients presenting with pancreatitis having a past history or family history of passage of worms in vomits or faeces, even in non-endemic areas.
Obstructed right Morgagni hernia with multiple congenital anomalies: a rare presentation
Authors: Chaudhary Anuradha , Ansari Fahad U. , Ramole Yashpal , Gupta Aryesh , Chaudhary Devendra , Rai Arvind , Grithlahrev Rajendra
Published: November 2020

Congenital diaphragmatic hernias occur in 1 in 3500 live births. Among the congenital diaphragmatic hernias, morgagni hernias are the rarest accounting for 2-3% of all diaphragmatic hernias. They occur through a congenital defect in the anterior part of the diaphragm just behind the sternum. In most cases the defect in the diaphragm is small and the patient may remain asymptomatic. The occurrence of obstruction or strangulation in these hernias is a rare occurrence. We report a rare case of right sided Morgagni hernia in a 14 years old boy who presented with features of subacute intestinal obstruction. Chest X-ray showed a large right sided diaphragmatic hernia with stomach and bowel loops compressing the right lung. A contrast enhanced computed tomography (CT) scan indicated large right sided diaphragmatic hernia containing gastric volvulus with twisted small bowel loops causing right lung collapse, and congenital anomalies of the right kidney and liver. The patient underwent exploratory laparotomy with an upper midline incision with reduction of hernia and primary repair of the diaphragmatic defect found in the anterior aspect of right diaphragm without placement of a mesh. An ICD was placed in right thoracic cavity to allow the lung to expand. Due to inadequate lung expansion a second ICD was placed in the right third intercostal space on the 9th post-operative day and removed on the 18th post-operative day. Patient was discharged with a single ICD on 20th post-operative day which was removed on first follow up. Patient was asymptomatic and recovered well subsequently.
Acute appendicitis in mobile ceacum: a diagnostic dilemma: a case report
Authors: K. C. Naren Karthik , N. Dhinesh Kumar , Subbarayan Boopathi , T. Tirou Aroul
Published: November 2020

Acute appendicitis is usually diagnosed on the basis of clinical history, physical examination and results of laboratory tests. The position of the appendix can vary considerably, both in relation to the caecum and because of the inconsistent position of the caecum itself. Acute appendicitis in a mobile caecum can pose a diagnostic dilemma which can lead to delay in appropriate treatment. In this case report, we present a 21 year old male with acute appendicitis and surgically proven to be acute appendicitis in a mobile caecum.
A case of incarcerated spigelian hernia causing small bowel obstruction
Authors: Murugesan Ravi Kumar Sabu , Ross Kannan , Prabakar Joyce
Published: November 2020

Spigelian hernias are rare anterior abdominal wall hernias in which the defect occur at the semilunar line lateral to rectus abdominis muscle. It mostly occurs in the lower half as posterior sheath is deficient in that region. Spigelian hernias are rare and moreover it is difficult to diagnose clinically. It constitutes about 0.12% of abdominal wall hernias. Even though it is rare, it is more prone for complications. It affects both sexes and sides equally. It is a diagnostic difficulty especially in obese patients as in our case where physical examination will often be inconclusive. Majority of the spigelian hernias are diagnosed intra operatively. Here in this case report, we present a case of obese 48 years old female who presented with abdominal pain and signs of intestinal obstruction which was found out to be an incarcerated spigelian hernia. Recently laparoscopic repair has been found to be safe and effective.
Solitary plasmacytoma: a rare entity
Authors: Shrotriya Siddhant , Rokade Vishal , Bandaru Vaishnavi SRI
Published: November 2020

Plasmacytoma is a plasma cell disorder characterized by localized accumulation of neoplastic monoclonal plasma cells in bone, or in soft tissues with no skeletal component, without any evidence of systemic involvement as demonstrated by the lack of clonal plasma cells in the bone marrow and absence of features of end organ damage. Spine plasmacytoma is a rather common entity, but solitary occurrence is not. It is usually described as a single lytic lesion without signs of myeloma cells, which is later diagnosed on radiological investigations and confirmed on bone marrow examination and histopathology examination. Imaging diagnosis is extremely helpful in early diagnosis and planning appropriate treatment. We present a case of a 55 year old female with pain bilaterally in lower limbs. A routine MRI shows focal lesion in the right pedicle of L4 vertebrae with bulging discs.
“Sin tener absolutamente un rincón de tierra”. La política indígena ante la privatización de las Pampas y Norpatagonia (1860-1890)
Authors: Literas Luciano
Published: December 2020

El objetivo del siguiente artículo es analizar los rasgos que tuvo la política indígena en el contexto de formación de un mercado de tierras en las Pampas y Norpatagonia durante la segunda mitad del siglo xix. Para ello, se reconstruyen y analizan diferentes experiencias protagonizadas por caciques de tribus de “indios amigos”, en virtud de obtener la propiedad de la tierra, poniendo el foco en los recursos empleados, qué tipo de acción colectiva habilitaron y cuáles fueron sus resultados. Los principales resultados muestran la relevancia que adquirieron en estas experiencias las redes y relaciones sociopolíticas construidas por los caciques en los espacios de frontera e identifican los tipos de capitales que intervinieron de manera decisiva.
Aprendizagem Humanizada por meio do Ensino Híbrido
Authors: Soares Junior Robert da Silva , Martins José Lauro
Published: November 2020

As novas demandas para a continuidade da promoção de um ensinovirtual de qualidade conduz os profissionais de educação a pesquisa e horas deplanejamento. Como uma das soluções possíveis para este fato, o Ensino Híbridoou Blended-Learning busca unir os conhecimentos tradicionais em favor depotencializar as capacidades de aprendizagem dos estudantes com o uso dastecnologias presentes na web, com o uso de atividades ou lições que podemcomeçar em um ambiente presencial, sendo posteriormente aprofundada com oestudo virtual dos aprendentes. Para conquistar o êxito neste modelo de ensino, énecessário conhecer as possibilidades deste ambiente, promover conteúdos quesejam interessantes e engajadores para os participantes, e acima de tudo, colocaros estudantes como peça central no caminho para seu desenvolvimento em meioaos conteúdos propostos. Este artigo trata-se de uma pesquisa derivada de umarevisão sistemática com objetivo de descrever formas de promove um ensinohumanizado por meio do blended-learning Para isso, foi feita uma análise baseadaem 20 artigos internacionais, com publicações de 5 países diferentes, com oobjetivo de descrever as principais dificuldades e propostas encontradas emestudos externos com o foco na implementação de pesquisas para promoção do blearning no ensino de Ciências da Natureza e Matemática no Ensino Médio.
Palavras-chave: Ensino híbrido. Educação secundária. Educação a distância.
Pedagogia Social em Tempos de Pandemia: Ações Extensionistas do Fora da Sala de Aula
Authors: Sirino Marcio Bernardino , Ferreira Arthur Vianna
Published: November 2020

O presente relato de pesquisa tem como objetivo mostrar as práticas extensionistas realizadas pelo Projeto de Extensão Fora da Sala de Aula, da Universidade do Estado do Rio de Janeiro, dedicado à reflexão das práticas educativas não escolares e sua relação com as camadas empobrecidas da região metropolitana do Rio de Janeiro. Nesse tempo de Pandemia da COVID-19, as ações extensionistas continuaram regularmente sendo realizadas por meio de plataformas digitais comuns e gratuitas disponíveis. Dessa forma, o presente texto vem demonstrar a nova organização do grupo de bolsistas que fazem parte desse projeto de forma a dar continuidade aos seus trabalhos de formação continuada. Ao mesmo tempo, mostrar que, ao utilizar os recursos digitais gratuitos disponíveis, de forma democrática na internet, ampliou-se o seu alcance a outros sujeitos da educação de forma a favorecer a formação contínua de muitos educadores sociais. Assim sendo, o referido projeto, e suas ações extensionistas, ganham uma nova forma de (re)existência e de transposição dos muros da academia para entrar na rede crescente de sujeitos que buscam a formação continuada, através da educação remota, em tempos de isolamento/distanciamento social.
Palavras-chave: Atividades educativas não-escolares. Pedagogia social. Formação continuada.
Analysis Study of Islamic Nomocracy and Pancasila Democracy in Indonesia
Authors: Riyadi HS Dedi Eko , Syaiful Ach. , Syamsuri Syamsuri , Lutfi Moh. , Homaidi Homaidi , Mas'odi Mas'odi , Qodariyah Lailatul , Huda Zainol , Fadli Moh
Published: December 2020

Basic Demand is a concept of a rule of law of a nation. An indisputable fact is that in all countries in this world, there is nothing that is not included based on their country, be they communist, liberal, religious, national, or otherwise. In a complete understanding, we can understand that Islam is a comprehensive religion; This right is proven by how Islam can parse and become a solution to various moral and material problems and includes various human activities in life not only in the world but also concerning life in the hereafter. According to the author's analysis, the term nomocracy is the most appropriate choice to be used in the term "rule of law", a version of Islamic law, not "theocracy". The analysis of this author comes to this conclusion because it is based on the principles of Islamic nomocracy including the principle of power as 1) trust, 2) the principle of equality, 3) the principle of recognition and protection of every human rights, 3) the principle of deliberation, 4) the principle of justice, 5) principles of the free trial, 6) principles of peace, 7) principles of welfare and so on. As for the constitutional state of Pancasila, it is based on the values a) divinity, b) humanity, c) integrity, deliberation, and justice. The occurrence of a combinative conception relationship; Islam, the West, and Indonesia led to the formation of the concept of the rule of law, Pancasila. Based on this understanding, it can be concluded that the principles contained in the constitutional state of Pancasila are part of the values contained in the Islamic nomocracy.
THE ROLE OF MANAGERIAL ABILITY IN INDONESIA: INVESTMENT OPPORTUNITY SETS, ENVIRONMENTAL UNCERTAINTY, TAX AVOIDANCE
Authors: Dwi Laksono David Gilang , Firmansyah Amrie
Published: November 2020

Purpose of the study: This study aims to obtain empirical evidence of the effect of investment factors that consist of investment opportunity sets and environmental uncertainty on tax avoidance and the role of managerial ability in moderating these effects.

Methodology: The analysis was conducted on 49 manufacturing companies listed on the Indonesia Stock Exchange from 2012 to 2018. It was chosen through a purposive sampling method, so 343 observations were obtained. This study engages two-panel data regression models, a model with and without moderation managerial ability. Also, this study employs factor analysis to produce investment opportunity sets that can represent this variable.

Main Findings: This study reveals that investment opportunity sets and environmental uncertainty positively affect tax avoidance. Meanwhile, managerial ability failed to moderate the effect of investment opportunity sets and environmental uncertainty on tax avoidance.

Implications: The results of the profiling can be used as an early warning, especially for account representatives and tax auditors at the Indonesia Tax Authority, so that potential tax exploration and examination can be more in-depth for firms that fulfill these characteristics. Also, this study provides advice to the Government of Indonesia to provide tax holidays for firms with high IOS who invest in the real sector and tax incentives for firms that are facing an environment with high uncertainty.

Novelty: This study deploys managerial ability as a moderating variable between the relationship of investment opportunity sets and environmental uncertainty to tax avoidance. The managerial ability has an important role in firms' IOS and environmental uncertainty faced by the firms because the level of managers will produce differences in the economic outcomes and the effectiveness of the discretion.
STUDENT RESILIENCE IN FACING COVID-19 PANDEMIC VIEWED FROM SOCIAL SUPPORT
Authors: Nur Asiyah Siti , Kumalasari Mei Lina Fitri , Kusumawati Estri
Published: November 2020

Purpose: This study aims to determine the correlation between resilience and social support for students of the Faculty of Psychology and Health at the State Islamic University of Sunan Ampel in Surabaya in participating in academic activities during the COVID-19 pandemic. Methodology: This research uses quantitative methods. The data collection has been done using a questionnaire. Main Finding: The results show that social support can increase student resilience in the face of the COVID-19 pandemic. Applications of this study: The participant of the research is a student of UIN Sunan Ampel Surabaya. Novelty/Originality of this study: COVID-19 pandemic is a very new situation. As well as the government regulations in implementing. Learning causes many mental problems. The results of this study indicate that students need social support to survive through this pandemic.
EFFECT OF PERCEIVED ORGANIZATIONAL SUPPORT AND SELF-EFFICACY TO CHANGE READINESS FOR CHANGE IN HOSPITAL OF MUHAMMADIYAH MALANG UNIVERSITY, INDONESIA
Authors: Riyanto Dicky Wisnu Usdek , Purnama Putri Viajeng , Abdul Rahman Rafiduraida
Published: November 2020

readiness to change in the Hospital of Muhammadiyah Malang University. Methodology: This research sample of 129 respondents, taken based on Purposive Sampling of Muhamadiyah University Hospital’s employee population. This path analysis technique will be used in testing the amount of contribution shown by the path coefficient on each path diagram of the causal relationship between variables X1, X2, and X3 on Y. Main Findings: Self-efficacy and perceived organizational support have a positive and significant effect on willingness to change, and self-efficacy is able to mediate the effect between perceived organizational support on readiness to change. Self-efficacy and perceived organizational support had positively and significantly influenced the employees’ responses to change readiness at Muhammadiyah Malang hospital. Applications of this study: This study’s findings contribute to the theory of organizational change that self-efficacy and perceived organizational are essential factors in realizing organizational change. Novelty/Originality of this study: This study’s novelty is that this study uses the concept of self-efficacy and perceived organizational support as essential factors that influence organizational change. Both of these essential factors are a unity system that needs to be considered in making organizational changes.
MOTIVATION FOR PURCHASING HALAL PRODUCTS: THE INFLUENCE OF RELIGIOSITY, TRUST, AND SATISFACTION
Authors: Nurrachmi Intan , Setiawan  , Saripudin Udin
Published: November 2020

Purpose of the study: This study examines the influence of religiosity on the intention to purchase halal products through satisfaction and trust.

Methodology: The study was conducted through a survey method by distributing questionnaires to respondents using random sampling techniques. Respondents obtained totaled 295 from various backgrounds, gender, age, education, employment, and income. Data analysis was carried out through the SEM-PLS approach, and the tool used was WarpPLS.

Main Findings: The study results show that religiosity, trust, and satisfaction significantly influence the decision to purchase halal products.

Applications of this study: This paper will be useful for the manager of the halal product who prefers the factor that influences the usage dimension of human behaviour. The manager of halal product providers in the area of the halal industry will be able to improve the effectiveness of their implementation strategies on the halal industry. This finding can be made by increasing religious attributes that emphasize the importance of halal products as part of religious obligations. Besides, managers of the halal product must ensure that the products they sell meet the halal standards of official organizations. Products that meet halal standards must be guaranteed that they are labeled halal so that consumers are confident in the halal status of the products purchased even in the majority of Muslim countries.

Novelty/Originality of this study: This research links religiosity, trust, satisfaction, and interest in buying halal products. The study was limited to conducting in Indonesia, the country with the largest number of Muslims worldwide.
Quilombos, ecologia, política e saúde: perspectivas antropológicas
Authors: Arruti José Maurício , Silva Hilton Pereira da
Published: December 2020

Apresentação do dossiê.
Miasta studentów – miasta konsumentów. Zachowania konsumenckie studentów w rozwoju Łodzi i Turynu
Authors: Zasina Jakub
Published: November 2020

Umasowienie szkolnictwa wyższego zapewniło miastom dostęp do nowej, licznej grupy konsumentów – studentów. W konsekwencji wiele ośrodków akademickich przeistoczyło się w ostatnich dekadach w swoiste „miasta studentów”. Struktury gospodarcze i przestrzenne takich miast funkcjonują i rozwijają się dzięki zaspokajaniu potrzeb konsumenckich młodzieży akademickiej. Biorcami rosnącej populacji studentów okazały się jednak nie tylko ośrodki o ugruntowanej tradycji akademickiej, ponieważ studenci stali się także użytkownikami miast zdominowanych niegdyś przez produkcję przemysłową. W książce przedstawiono szeroko zakrojone studium porównawcze dwóch poprzemysłowych miast akademickich – Łodzi i Turynu – w którym kluczowe znaczenie przypisano badaniu ankietowemu nad zachowaniami konsumenckimi studentów. Miało ono na celu określenie roli tych zachowań w rozwoju gospodarczym i przestrzennym obu ośrodków. Analizie poddano trzy wymiary zachowań konsumenckich studentów – gospodarczy, przestrzenny i czasowy – na rynkach edukacyjnym, mieszkaniowym, handlowym, transportowym, gastronomicznym oraz usług czasu wolnego.