bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinical profile of poisonous snake bite in children of North Kerala, India
Authors: K. P. Shyna , K. Sudhakaran , M. T. P. Mohammed
Published: January 2018

Background: Snake bite is a common medical emergency and underestimated public health problem causing significant morbidity and mortality worldwide. Poisonous snake bite is a common problem in north Kerala and a significant number of children are bitten by snakes every year. Majority of studies in this respect have been done on adult snake bite victims and only limited studies are available based on poisonous envenomation in children in our region. The clinical profile of snake bite in children can differ significantly from adult snake bite victims so study was conducted to find the clinical profile of poisonous snake bite in children less than fifteen years.Methods: This was a descriptive cross sectional study conducted in a tertiary care academic institution located in the northern part of Kerala from December 2009 to November 2010. All children less than 15 years with poisonous snake bite were included in this study. Patients with non-poisonous bite, without signs of envenomation and with pre-existing bleeding and renal disorders were excluded.Results: There were fifty cases of poisonous snake bite and among them 76% were males and 24% were females. The highest numbers of bites (50%) occurred in the age group between 11-15 years. Maximum number of snake bite occurred during the months of June and July. The majority of the bites occurred during night between 6 pm to 9 pm (42 %). Among the identified venomous bite Viper accounted for the highest number (48%), followed by Krait (12 %) and Cobra (4%). Lower extremities were the most observed bitten part of the body (82%) and the commonest site was foot. Eighty four percentage of victims reached hospital within 6 hours of snake bite. The most common clinical manifestation was local pain (94%) followed by swelling (90%) and regional lymphadenopathy (82%). Majority had hemotoxicity (94%) and neurotoxicity (6%) was comparatively lesser in our study. Most common complication was overt bleeding manifestations (14%) followed by gangrene of bite site (8%), acute kidney injury (6%) and respiratory paralysis (2%). Thirty eight percent of cases required more than 10 vials of ASV and reaction to ASV occurred in 40% of cases. No mortality occurred during this study period.Conclusions: Poisonous snake bite is a common life threatening medical emergency in our region. Morbidity and mortality due to this can be reduced by early administration of anti-snake venom and prompt recognition and management of complications. So, prompt referral of children with poisonous snake bite to centres where facilities in managing snake bite is crucial in preventing mortality.
A study of blister beetle dermatitis
Authors: Kambil Srinath M.
Published: January 2018

Background: Blister beetle dermatitis is an irritant dermatitis caused mainly by beetles of the genus Paederus. It is clinically characterised by acute onset of linear erythematous plaques mainly over exposed areas like face, neck and upper limb.

Methods: Fifty four patients with blister beetle dermatitis who presented to the dermatology outpatient department over a period of three months from May 2017 to July 2017 were included in this study. The various clinical patterns of blister beetle dermatitis observed in these patients are described.

Results: Face was the commonest site involved (48%) followed by upper limb (33%). Linear erythematous plaques with or without vesiculation were seen in 78% and kissing lesions were seen in 6 patients. Majority of patients (83%) had burning sensation at the site of the lesions and residual pigmentation was seen in 92% of patients.

Conclusions: Blister beetle dermatitis is a common problem in tropical countries like India. Knowledge about the various clinical presentations will help in early diagnosis and treatment. 
Javanese Asceticism in Serat Kalatidha
Authors: Rahayu Yuminati , Rahayu Zuminati
Published: January 2018

This article focuses on discussing Javanese asceticism in Serat Kalatidha. The purpose of this study is to identify the concept of Javanese culture in Serat Kalatidha. The data were extracted through the text analysis techniques of Serat Kalatidha. Text analysis is conducted with a structural analysis approach that focuses on the concept of Javanese asceticism. The results of the study show that Serat Kalatidha by Ranggawarsita contains the values of Javanese philosophy which is the basic foundation in Ranggawarsita's thinking. Serat Kalatidha teaches philosophy on how to deal with developing conditions. There are some wise attitudes shown in Serat Kalatidha described by the poets which are considered as a very useful advices when dealing with a particular situation or challenge of life.
Motion Thamrin: Language Politics and Inlander (Indigenous) Appellation for Indonesian People
Authors: Rohmadi Nazirwan , Akhyar Muhammad , Warto Warto
Published: January 2018

Volksraad is a legislative institution that is formed by Dutch East Indies Government on May 8th, 1918. Volksraad is formed in order to achieve decentralization idea from Dutch government and to develop Dutch East Indies democratic Country. Volksraad member forms politics wings to win the voting in every making decision process. Politic wing that is represented Indonesian Nation is National Fraction. National fraction has found on January 27th, 1930 and led by Mohammad  Husni Thamrin. National fraction has main purpose, that purpose is achieving Indonesian independence through the legitimate way. National fraction has member  such as M. H. Thamrin (Kaum Betawi), Iskandardinata (Pasoendan), Soeroso (PVPN), Koesoemo Oetojo, Dwidjosewojo, Soekardjo Wirjopranoto, Wiwoho Poerbohadidjojo (BO), Mochtar bin Praboe Mangkoe Negara (Sumatera), Abdul Firman Gelar Maharadja Soangkoepon (Batak), and Jahja Datoek Kajo (Sumatera). Thamrin and national fraction often do not agree with Dutch East Indies Government policy that only stand to European. That policy is criticized by Thamrin and national fraction is language political policy in society and inlander (Indigenous) appiliation that humiliate Indonesian nation.
Character-Based History Worksheet for Grade X Students
Authors: Samodra Yan Driya
Published: January 2018

Abstract: This research aimed at finding out: (1) the development of character-based History worksheet, (2) the appropriateness of character-based History worksheet for grade X students, and (3) the implementation of character in History worksheet. This research fitted Research and Development adapting development model from Borg & Gall (1983). Seven steps were adapted: (a) collecting information, (b) planning, (c) developing preliminary form of product, (d) conducting preliminary field testing, (e) revising main product, (f) conducting main field testing, and (g) revising operational product. The data were collected through survey, observation, and interview. The result of this research was a set of character-based worksheet. It embodied six units. To find out the feasibility, the worksheets were validated by experts and field tested. The result showed that the product had been appropriate to be used as it met the students’ needs and the employed curriculum.
Epochal Challenges: the Robotic Revelation in Anthropology
Authors: Wu Xinyi
Published: January 2018

In this technological epoch, the development of cyborgs and robots has affected perceptions inside and outside anthropology as a new thinking model of knowledge construction. Moore (2003: 7) asserts that ‘science and technology are transforming anthropological knowledge through a transformation of its objects of enquiry’. The robotic technology has posed potential threats as well as brought new hopes to the field of anthropology. This essay illustrates both sides in terms of three anthropological topics—(i) identity; (ii) family structures and values; and (iii) religion. Through analysis, it shows the importance of reducing risks through regulations, seizing opportunities through rethinking old concepts and applying new techniques to the existing knowledge. Moreover, a pioneering spirit is called to face challenges and to make contributions for humanity’s sake.
Iran's Foreign Policy Toward Iraq Crisis After 2014
Authors: Ghadbeigy Zohreh , Ahangaran Masoumeh
Published: January 2018

To achieve national objectives and interests, different countries adopt specific orientations and strategies according to their domestic needs and geopolitical conditions, and based on the structure of the international system. In this regard, Iran's national power components, including strong national government, geopolitical position, and ideological elements, provides this country with a leading role in regional issues. Iran's strategic and geopolitical position, attained through its connection to some issues in the Middle East, provides it a context for serving the role of a regional player. This focus of Iran's foreign policy on regionalism safeguards the country's national interests in the long run. Thus, the Islamic Republic of Iran not only acts as a major player in the Middle East, but also upholds decisions to strengthen its position and to promote its national interests. At present, Iraq crisis is one of the central issues of Iran's foreign policy decisions in the region. In this study, we intended to discover the performance of Iran's foreign policy in Iraq crisis based on the components of its national interests. The investigated hypothesis is developed based on a realistic logic from the perspective of Iran's national interests including political-strategic and economic-commercial interests, as well as development model of Iran-Iraq cooperation.
Iranian Students’ Specific Life Style and Leisure Time; a Case Study of University of Tehran
Authors: Ramazaniandarzi Ali Akbar , Nik Yohan , Hajivand Mahdi , Sattari Mohammad Reza
Published: January 2018

Leisure time as a modern social is being focused these days, albeit any sort of interest isn't specifically arranged under it. Inside this exploration the framing encounters of necessities and styles of college students were examined. In this examination it has been attempted by using Bourdieu hypothesis the exploration questions are proposed. The members of the examination are for the most part female and male understudies University of Tehran. The specimen was picked by the use of Cochran with the standard deviation of 0.4.5% 470 students. The outcomes demonstrated that members can isolate in two sections dynamic and idle style which the vast majority of interviewees are willing toward a dormant style of relaxation time. While the significant piece of understudies' chance is spent on the utilization of innovative devices conveniently. For sure, watching satellite motion pictures and arrangement, investing energy in broad daylight talk rooms, PC amusements, are only a misuse of understudies' opportunity.
Innovative approaches on modular apparel design
Authors: Cileroglu Birsen , Nadasbas Serdar Egemen
Published: January 2018

Within the globalized environment, the competitiveness,which expresses the talents needed for the sustainability of long term financial growth, has a crucial role affected by innovation and makes significant contributions to the development. One of the innovative methods used by enterprises to remain ahead of the game of competitiveness is mass customization(MC). MC is to change,assembleor modification of components of a product or a service according to the desires and needs of the customer. This study aims to determine how to meet the changing desires and demands of clothes with the modularity method of MC.With this respect,common modules which can be applied on different skirts and enables the changes on size&model had been designed,the specialities which models should have were determined and studies on the assembly phase had been performed.This study which was completed with the experimental design method,is important on offering new experiences to the consumers with spare modules applicable to existing clothes and meeting the demand on new products by avoiding the usage of sources on production phase.

                      

Keywords: Mass customization, fashion, innovation, modularity, apparel design
Pridevi sa značenjem optativne modalnosti
Authors: Киш Наташа Б.
Published: January 2018

U ovom radu analizirani su pridevi sa značenjem optativne modalnosti u savremenom srpskom jeziku. Zadatak je bio da se predstavi modalna situacija u kojoj se kao nosioci modalnog značenja pojavljuju pridevi, te da se ukaže na specifičnosti leksičkog značenja ovih prideva. Analiza je pokazala visok stepen gramatikalizovanosti i leksikalizovanosti ovog tipa modalnosti iskazane pridevima. Teorija prototipa kao metod analize leksičkog značenja upućuje na postojanje potkategorija unutar ovog semantičkog polja sa prototipičnim pridevima željan, voljan, rešen i odlučan.
TEMPORAL CHANGES IN THE EVALUATION OF POLITICAL PARTIES: DOES EVALUATION OF POLITICAL PARTIES REFLECT ATTITUDINAL IDEOLOGIES?
Authors: Petrović Boban , Međedović Janko
Published: January 2018

Previous research has shown that since the beginning of the 1990s, differentiation in the ideological orientations of political parties in Serbia has been increased. Comparing three samples, we explored the temporal stability of relations between evaluations of Serbian political parties (DSS, DS, SRS, SPS, SNS, and LDP) and lexically derived ideological dimensions: Traditional and Religious Sources of Authority, Unmitigated Self-Interest, Communal Rationalism, and Subjective Spirituality. We hypothesize that: 1) political parties should be divided into conservative and socio-liberal parties, and this structure should become stable over time; 2) the evaluation of political parties should consistently reflect their political ideology orientation : conservative parties should be related to an indicator of conservative ideology, Traditional Religiosity, while socio-liberal parties should be related to a humanistic ideological orientation, Communal Rationalism. Data was collected in three time-points: 2010 (N = 102), 2014/15 (N = 358) and 2016 (N = 117) from university students in Serbia. In all three studies principal component analyses of evaluations of political parties showed that two components were extracted and interpreted as evaluations of the National-Conservative Parties and Socio-Liberal Parties (in 2010 and 2014), i.e. Democratic parties (in 2016). However, while the structure of evaluations of the National-Conservative Parties remained stable, the congruence of evaluations of the Socio-Liberal Parties decreased over time. Additionally, the results of regression analyses showed that evaluations of the National-Conservative Parties were rooted in Traditional and Religious Sources of Authority and Unmitigated Self-interest, but the percentage of explained variance decreased over time. The evaluations of the Socio-Liberal Parties had much weaker relations with ideological orientations throughout all three time-points. The findings suggested that there was some kind of ‘’ideological crisis’’ in Serbia, primarily regarding the Socio-Liberal Parties and their supporters.
Pemahaman Kompetensi Lintas Budaya bagi UNTSO (United Nations Truce Supervision Organization) untuk Memecah Kebuntuan dalam Penyelesaian Konflik Palestina-Israel [UNTSO Competence in Cross-Cultural Understanding to Break the Deadlock in the Settlement of the Israeli-Palestinian Conflict]
Authors: Indrawan Raden Mas Jerry
Published: January 2018

UNTSO was the first peacekeeping mission created by the United Nations. They have been in the Middle East since June 1948 with the task of overseeing the implementation of the ceasefire between Israel and Arab countries, including seeking resolution of the conflict between Israel and Palestine. One of the reasons many UN peace missions fail, including UNTSO, was because the peacekeepers do not have the ability to understand the local culture in which they are placed. One of the main difficulties faced by peacekeepers in a conflict involving two groups with two different cultures is uncertainty about cultural values. UNTSO personnel very rarely received training as such and like the usual army, their tendency is to use violence to solve conflicts. There should be a special cultural training focused on developing an understanding of the cultural context, such as background orientation, origin, conflict parties, history, religion, customs, and local community language. This paper tries to provide an analysis through an understanding of cross-cultural competency, which is expected to provide recommendations for resolving the Palestinian-Israeli conflict.
The Neo-Mercantilist Model of Development for Indonesia
Authors: Jasmanto -
Published: January 2018

Seventy-two years after gaining independence from the Netherlands, the Indonesian economy remains that of a developing country. Under the New Order, the country attained significant economic growth but failed to sustain it. Its neighboring countries like Singapore, Hong Kong, Taiwan and South Korea have reached sensational economic growth and in a much shorter time were upgraded into developed country status. This article explains the economic model used in their economies that accelerated their economic standing. It finds that Neo-Merchantilist practice has successfully propelled economic growth in certain countries. Asian Tigers also demonstrate economic success with the same model. Learning from success and experience, this article recommends Indonesia to adopt a Neo-Merchantilist economic model for development in order to become a developed country.

BAHASA INDONESIA ABSTRAK: Sudah 72 tahun Indonesia merdeka dari Belanda namun perekonomian Indonesia masih digolongkan sebagai negara berkembang. Indonesia mencapai pertumbuhan ekonomi luar biasa di bawah Orde Baru, sayangnya pertumbuhan itu tidak berlangsung lama. Sebaliknya, tetangga Indonesia seperti Singapura, Hong Kong, Korea Selatan dan Taiwan telah mencapai pertumbuhan ekonomi yang sensasional dan telah berpindah dari negara berkembang ke negara maju dalam waktu singkat. Bagaimana mereka melakukan ini? Model ekonomi manakah yang mereka terapkan pada ekonomi mereka? Apakah ada faktor pemicu lain diluar fokus ekonomi Investasi Asing Langsung (Foreign Direct Investmen/FDI) dan berorientasi kepada ekspor dalam pertumbuhan ekonomi? Artikel ini menemukan bahwa praktek ekonomi Neo-Mercantilist berhasil mendorong pembangunan pesat perekonomian Tiongkok. Macan-macan Asia juga menunjukkan perkembangan mengejar ekonomi maju seperti Dunia Barat dan Jepang dengan model yang sama. Haruskah Indonesia sebagai negara berkembang menggunakan model pembangunan ekonomi yang sama? Dengan melihat pengalaman dan keberhasilan ekonomi negara-negara tersebut, artikel ini merekomendasikan agar Indonesia juga menggunakan model pembangunan ekonomi Neo-Mercantilist untuk menjadi negara maju.
Linguagem e sociedade contemporânea - sujeito, mídia, mercado
Authors: Payer Maria Onice
Published: January 2018

A teoria do discurso considera que os discursos, materializados em textos que circulam nas práticas sociais, desempenham um papel fundamental na constituição do sujeito e da sociedade. Nesta perspectiva, este artigo propõe compreender a Mídia como o Texto fundamental do Mercado: um grande e disperso texto pelo qual o sujeito é constituição do sujeito em face da Instituição Religiosa na Idade Média e o Texto Jurídico (Constituição, Leis) foi  base para a constituição do sujeito junto ao funcionamento do Estado na Modernidade. São analisados assim, com algum detalhamento, os processos de constituição do sujeito na sociedade contemporânea.
Foreword to the Special Issue
Authors: Burns Jane
Published: January 2018

[first paragraph of article]This year marks the 50th anniversary of the description of the publication in Japanese of Dr. Kawasaki’s landmark series of 50 children suffering from the condition that would later bear his name (Kawasaki, 1967). The fact that Kawasaki felt the need to gather 50 subjects before publication attests to the uphill battle that he waged in getting the medical establishment in Japan to recognize that he was describing a new clinical entity (Burns et al., 2000). Kawasaki had no knowledge of the potentially dire consequences of the condition that he described, as it was not until 1970, when the Japanese Ministry of Health conducted a questionnaire survey of Japan, that the 10 deaths from acute myocardial infarction were discovered. By the time of his seminal publication in English in 1974, the complications of coronary artery vasculitis and aneurysm formation were clearly linked to the clinical illness (Kawasaki et al., 1974).
Opposing forces and a river into a lake: Relevance to coronary hemodynamics in Kawasaki disease
Authors: Yacoub Magdi , Aguib Heba
Published: January 2018

[first paragraph of article]Kawasaki disease (KD) continues to interest, intrigue, and challenge clinicians, basic scientists, and engineers. One of the defining features of the disease is the development of coronary aneurysms of varying sizes and shapes, reproducing the phenomenon of ‘‘River into a lake’’, and introducing profound changes in the coronary circulation. These changes reflect many physical, engineering and even cultural beliefs which might be of interest to the readers of this special issue of the Journal dealing with KD. Some of these ideas are presented in this article.
The global epidemiology of Kawasaki disease: Review and future perspectives
Authors: Lin Ming-Tai , Wu Mei-Hwan
Published: January 2018

Kawasaki disease (KD) is one of the most common childhood vasculitides and may lead to coronary arterial complications. KD has been reported in more than 60 countries over five continents. Previous publications have provided a comprehensive description of the epidemiologic features of KD including incidence, age of onset, seasonal trends, and rates of cardiac lesions. However, the interactions among the KD patients, time (seasons) and place have been less well studied. We review the current global epidemiology of KD and focus on the longitudinal changes in incidence, seasonality and response to intravenous immunoglobulin (IVIG) therapy.
The emergence of Kawasaki disease in India and China
Authors: Jindal Ankur Kumar , Pandiarajan Vingesh , Khubchandani Raju , Kamath Nutan , Sabui Tapas , Mondal Rakesh , Pal Priyankar , Singh Surjit
Published: January 2018

Kawasaki disease (KD) is recognized as a leading cause of acquired heart disease in children in developed countries. Although global in distribution, Japan records the highest incidence of KD in the world. Epidemiological reports from the two most populous countries in the world, namely China and India, indicate that KD is now being increasingly recognized. Whether this increased reporting is due to increased ascertainment, or is due to a true increase in incidence, remains a matter of conjecture. The diagnosis and management of KD in developing countries is a challenging proposition. In this review we highlight some of the difficulties faced by physicians in managing children with KD in resource-constrained settings.
Remote sensing observation of annual dust cycles and possible causality of Kawasaki disease outbreaks in Japan
Authors: El-Askary Hesham , LaHaye Nick , Linstead Erik , Sprigg William A , Yacoub Magdi
Published: January 2018

Kawasaki disease (KD) is a rare vascular disease that, if left untreated, can result in irreparable cardiac damage in children. While the symptoms of KD are well-known, as are best practices for treatment, the etiology of the disease and the factors contributing to KD outbreaks remain puzzling to both medical practitioners and scientists alike. Recently, a fungus known as Candida, originating in the farmlands of China, has been blamed for outbreaks in China and Japan, with the hypothesis that it can be transported over long ranges via different wind mechanisms. This paper provides evidence to understand the transport mechanisms of dust at different geographic locations and the cause of the annual spike of KD in Japan. Candida is carried along with many other dusts, particles or aerosols, of various sizes in major seasonal wind currents. The evidence is based upon particle categorization using the Moderate Resolution Imaging Spectrometer (MODIS) Aerosol Optical Depth (AOD), Fine Mode Fraction (FMF) and Ångström Exponent (AE), the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) attenuated backscatter and aerosol subtype, and the Aerosol Robotic Network’s (AERONET) derived volume concentration. We found that seasonality associated with aerosol size distribution at different geographic locations plays a role in identifying dominant abundance at each location. Knowing the typical size of the Candida fungus, and analyzing aerosol characteristics using AERONET data reveals possible particle transport association with KD events at different locations. Thus, understanding transport mechanisms and accurate identification of aerosol sources is important in order to understand possible triggers to outbreaks of KD. This work provides future opportunities to leverage machine learning, including state-of-the-art deep architectures, to build predictive models of KD outbreaks, with the ultimate goal of early forecasting and intervention within a nascent global health early-warning system.
Cardiovascular outcomes following Kawasaki disease in Moscow, Russia: A single center experience
Authors: Lyskina Galina , Bockeria Olga , Shirinsky Olga , Torbyak Alena , Leontieva Anna , Gagarina Nina , Satyukova Anna , Kostina Julia , Vinogradova Olga
Published: January 2018

Background: Awareness of Kawasaki disease (KD) is emerging in Russia but the diagnosis is still often missed. Methods: This is a retrospective study of 303 children with KD who received care at a single center in Moscow over the period from 2004 to 2016. Results: Overall, coronary artery aneurysms were documented in 91 (30,0%) of 303 patients and transient ectasia in 40 (13,2%). Intracoronary thrombi were found in 12 of 15 patients with giant aneurysms and in 3 patients with medium-sized aneurysms. Conclusion: The patients with KD in the Moscow region had typical features of the disease described in the literature but the proportion of patients with coronary artery aneurysms was higher than reported from other countries. We assume that this is due to delayed treatment, which has gradually improved over time. Increased awareness of KD in Russia is critical to ensure timely diagnosis and treatment.
Incomplete Kawasaki disease in Egypt
Authors: Agha Hala M , Hamza Hala S
Published: January 2018

[first paragraph of article]Kawasaki disease (KD) is a hybrid condition at the junction of infectious diseases, immunology, rheumatology, and cardiology.1 KD is a systemic vasculitis of unknown etiology predominately affecting medium-sized vessels such as the coronary arteries, which mainly affects infants and children2. The disease itself may be the characteristic manifestation of a common pathway of immune-mediated vascular inflammation in genetically susceptible hosts3. Untreated KD may lead to the formation of coronary artery aneurysms and sudden cardiac death in children. The diagnosis of KD is based on the clinical features of fever of at least 5 days together with at least 4 or 5 other features including rash, bilateral conjunctival injection, changes in peripheral extremities, lymphadenopathy and oropharyngeal changes4. The diseases that must be differentiated from KD because of similar clinical findings include viral infections (measles, adenovirus, enterovirus, and Epstein-Barr virus), scarlet fever, staphylococcal scaled skin syndrome, toxic shock syndrome, polyarteritis nodosa, bacterial cervical lymphadenitis, and juvenile rheumatoid arthritis5,6. Because each of the symptoms commonly occurs in other childhood illnesses, the disease can be difficult to diagnose, especially in children who present with an incomplete form of the disease. KD has not been previously reported from Egypt and there are special challenges in recognizing complete KD in a country where physicians have limited experience with the disease. The diagnosis of incomplete KD is thus even more challenging in this setting.
Kawasaki disease among Egyptian children: A case series
Authors: Attia Tarek Hamed , Morsy Saed M , Hassan Bashier A , Ali Al Shymaa A
Published: January 2018

Kawasaki disease is an acute vasculitis of early childhood. Its incidence varies among different ethnic groups with higher rates among Asians. In this case series, we presented four cases of Kawasaki disease with incomplete or atypical presentations in Egyptian children. Two cases presented with meningitis, which is not a criteria for the diagnosis of Kawasaki disease. The other two cases presented with pharyngitis and fever, which did not respond to antibiotics. The clinical criteria for diagnosis of Kawasaki disease were either incomplete or appeared sequentially. Coronary artery aneurysms were detected in one case, while the others had normal coronary by echocardiography. All cases were followed in our clinic, according to international guidelines. Early diagnosis and management of Kawasaki disease are important to ensure a good outcome and a high index of suspicion in febrile children is required irrespective of the clinical presentation.
Aneurysmal coronary artery disease: An overview
Authors: ElGuindy Mohamed S , ElGuindy Ahmed M
Published: January 2018

Aneurysmal coronary artery disease (ACAD) comprises both coronary artery aneurysms (CAA) and coronary artery ectasia (CAE). The reported prevalence of ACAD varies widely from 0.2 to 10%, with male predominance and a predilection for the right coronary artery (RCA). Atherosclerosis is the commonest cause of ACAD in adults, while Kawasaki disease is the commonest cause in children and adolescents, as well as in the Far East. Most patients are asymptomatic, but when symptoms do exist, they are usually related to myocardial ischemia. Coronary angiography is the mainstay of diagnosis, but follow up is best achieved using noninvasive imaging that does not involve exposure to radiation. The optimal management strategy in patients with ACAD remains controversial. Medical therapy is indicated for the vast majority of patients and includes antiplatelets and/or anticoagulants. Covered stents effectively limit further expansion of the affected coronary segments. Surgical ligation, resection, and coronary artery bypass grafting are appropriate for large lesions and for associated obstructive coronary artery disease.
Acute Kawasaki disease with emphasis on the echocardiographic profile: A single center experience
Authors: Hamza Hala S , Rouff Wessam A , Zaher Asmaa Z , Agha Hala M
Published: January 2018

Background: Echocardiographic features of acute Kawasaki disease (KD) have not been well characterized in Egyptian children. This study aimed to provide insight into the pattern of cardiac involvement in Egyptian children with Kawasaki disease, focusing on echocardiographic coronary abnormalities and their associated risk predictors. Methods and Results: Medical records of 64 KD patients from 2012 to 2016 were retrospectively analyzed with recalculation of coronary artery z-scores during the first eight weeks after fever onset. All patients received intravenous immunoglobulin (IVIG) and 57.8% were treated within 10 days of illness onset. Coronary abnormalities were found in 53.1% of all patients, and in 43.2% of those who received IVIG within 10 days. Giant aneurysms (z-score>10) comprised 23.5% of all coronary abnormalities. Coronary thrombosis occurred in two patients (5%), both of whom developed myocardial infarction, and one succumbed to heart failure with eventual in-hospital death. Overall, 7% of patients had mitral regurgitation (n = 5), 1.5% had aortic regurgitation (n = 1), and 7.8% had pericardial effusion (n = 5). Among a number of laboratory and clinical predictors, platelet count had the strongest association with coronary abnormalities (Area under Receiver-operating characteristic (ROC) curve: 0.794; 95% confidence interval 0.678–0.910; P < 0.001). Conclusion: Coronary abnormalities occur in a substantial percentage of KD in Egypt, with associated evidence of severe inflammation. Further efforts are required to increase awareness of the disease and to emphasize the importance of early IVIG administration. Future studies should also be undertaken to characterize the long term progression profile of the disease as well as the possible genetic background of the disease in Egypt.
Computed tomography coronary angiography is the way forward for evaluation of children with Kawasaki disease
Authors: Singhal Manphool , Gupta Pankaj , Singh Surjit , Khandelwal Niranjan
Published: January 2018

Kawasaki disease (KD) is an acute idiopathic vasculitis affecting infants and children. Coronary artery abnormalities and myocarditis are the major cardiovascular complications of KD. Coronary artery abnormalities develop in 15–25% of untreated KD. Two-dimensional transthoracic echocardiography has hitherto been considered the modality of choice for evaluation of children with KD. There are, however, several limitations inherent to echocardiography - including limited evaluation of distal vessels, left circumflex artery and poor acoustic window in growing children. Catheter angiography is the gold standard for evaluation of coronary artery abnormalities in older children and adults; however it also has inherent limitations - including complications related to its invasive nature, higher radiation exposure, and inability to evaluate intramural abnormalities. Thus serial invasive coronary angiography studies are not feasible in children. There have been major advances in computed tomography (CT) coronary imaging so that it is now possible to delineate the coronary artery anatomy with higher temporal resolution and motion-free images at all heart rates with acceptable radiation exposure. There is, however, a paucity of literature with regard to the use of this technique in children with KD. In this review, we discuss the application of computed tomography coronary angiography (CTCA) in children with KD with special reference to strategies aimed at reducing the effective radiation dose.
Computational blood flow simulations in Kawasaki disease patients: Insight into coronary artery aneurysm hemodynamics
Authors: Gutierrez Noelia Grande , Kahn Andrew , Burns Jane C , Marsden Alison L
Published: January 2018

[first paragraph of article]Coronary artery aneurysms (CAA) as a result of Kawasaki disease (KD) create abnormal flow conditions that can ultimately lead to thrombosis, with associated risks of myocardial infarction and sudden death. The primary long-term clinical decision required for KD patients with aneurysms is whether to treat with anticoagulation therapy. Current clinical guidelines recommend CAA diameter 8 mm or Z-score >10 as the criterion for initiating systemic anticoagulation therapy. In general, these aneurysms cause regions of flow stagnation, but the complexity of their geometry including changes in diameter, tortuosity and even proximal and distal stenoses make it difficult to evaluate thrombotic risk and predict patient outcomes based solely on a single anatomical measurement taken from image data, usually the maximum aneurysm diameter.
Frequently asked questions regarding treatment of Kawasaki disease
Authors: Burns Jane C
Published: January 2018

[first paragraph of article]The mainstay of therapy for acute Kawasaki disease (KD) is intravenous immunoglobulin (IVIG), which was first described in a case series from Japan and later proven through a nationwide clinical trial in the U.S. published in 1986. Since completion of the initial clinical trials, many questions have arisen regarding the nuances of KD treatment. In the absence of an evidence base, what follows is an attempt to devise rational responses to these questions that draw upon common sense and the personal experience of this author.
Pseudo-normalization of a coronary artery aneurysm detected by IVUS
Authors: Rizk Sherif , Amin Waseem , Hamza Hala , Said Karim , El Said Galal
Published: January 2018

[first paragraph of article]Coronary artery aneurysm (CAA) is found in 0.3–5% of patients undergoing coronary angiography. Atherosclerosis is the main cause, followed by Kawasaki disease and infectious emboli. The pathogenetic mechanisms underlying aneurysm formation have not been clearly delineated, but inflammation is suspected to play a role. Symptoms, if present, are usually related to myocardial ischemia. In adults, angiography is the mainstay for diagnosis. Management varies from antithrombotic therapy to PCI or surgical treatment.
ACCIDENTAL ARCHAEOLOGICAL FINDS IN THE SOUTH AREAS OF THE LOWER TOM’ RIVER VALLEY
Authors: Marochkin A. G. , Bobrova L. Yu.
Published: January 2018

The article introduces for scientific use and achaeological interpretation the items from the collection of the Kemerovo Regional Local History Museum, Museum-Preserve "Tomskaya Pisanitsa", the Archaeology, Ethnography and Ecology of Siberia museum (Kemerovo State University Museum) and the Museum of Archaeology and Ethnography (Tomsk State University). The methodology of the research is based on the definition of the term «incidental find» for particular cases of incidental finding of an archaeological site which allows one to use this type of sources for historical and cultural reconstructions in that region for the first time. The research applies the methods of mapping and landscape-geomorphological analysis, comparative and typological method, periodization method. The article determines the main meaning of accidental finds for updating the archaeological map of the least researched Tom region areas connected to the territory of Kemerovo and watershed areas of the right bank of the River Tom. The work outlines the chronological group of the items and presents some conclusions about the possible connection of the stone tools with those from Izylinka, Irbinsko-Novo Kuskovo or Krokhalevo Neolithic-Early period of the Developed Bronze Age settlements; about the accidentally found knives and diggers confirming Irmen cultural domination in Late Bronze period and exchanges with cross-border cultural groups; about typological proximity of a number of Scythian period accidental finds with the same period complex in the Middle Yenissey area, Achinsk-Mariinsk forest-steppe and Tomsk Ob River area; about the association of the Kulay and Post-Kulay period findings with ritual practices at cult places.
RUSSIAN ARCHEOLOGY OF THE KUZNETSK TOM’ RIVER VALLEY: HISTORY OF RESEARCH, CURRENT CONDITION AND PROSPECTS
Authors: Sizyov A. S.
Published: January 2018

The current paper features the research history of the Russian period archeological sites (fortified and unfortified settlements, cemeteries) on the territory of the Kuznetsk Tom’ River valley from the second quarter of XX century to the present day. Three stages of this process, which demonstrate the trend of increasing scale of Russian archeology in Western Siberia, were distinguished. The article analyzes the qualitative aspect of the research on the Russian period archeological sites. The analysis was performed on the basis of object dependency, studied by split-level methods of field archeology (reconnaissance and excavation) and type of publication (descriptive and analytical). A mapping of the Russian time archeological sites was conducted. It highlights some irregularities in their studies in the Kuznetsk Tom’ River Valley. The article points out some directions for further field research, among which: a search for new Russian settlements of XVII–XIX centuries at the estuaries of the tributaries of the Tom’ river near old stockade towns; excavation work at previously discovered old Russian villages and cemeteries and the assessment of their current state.
Czym jest podejście, a czym metoda?
Authors: Bartnicki Roman
Published: January 2018

polemika
Superficial Angiomyxoma causing Torsion of an Extra-Digit
Authors: Abbas Tariq Osman
Published: January 2018

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Assessment of Predictors of Mortality in Neonatal Intestinal Obstruction
Authors: Ali Imran , Mufti Gowhar N , Bhat Nisar A , Baba Aejaz A , Sheikh Khurshid A , Hamid Raashid , Khurshid Zubair , Andrabi Faheem , Wani Sajad , Buchh Mudasir , Banday Shahid
Published: January 2018

Background: Neonatal intestinal obstruction (NIO) continues to be a life-threatening condition with high mortality rates especially in developing countries. Highly skilled specialized care and facilities are required for survival. This study was conducted to assess various factors responsible for outcome in such neonates, so that extra attention is paid to the ones at high risk, with the idea to bring down the mortality rates in neonates admitted with intestinal obstruction.Materials and Methods: This study was a prospective observational study conducted on all neonates admitted with features of intestinal obstruction in our hospital from February 2014 to August 2016. The patients were followed up for a minimum of 1 month. Data was collected on prescribed proforma and analyzed for age, sex, prematurity, birth weight, clinical features, duration of symptoms, diagnosis, lab investigations, surgical procedure performed, complications etc. using the Statistical Package for Social Sciences (SPSS).Results: There were 120 neonates with intestinal obstruction, of which 92 neonates survived and 28 died. The mortality rate was 23.33%. There were 74 males and 46 females. The mean gestational age was 38.2±1.77 wks with a range between 32 to 41 wks. The mean age at presentation was 5.58 days with a range between 5 hrs to 26 days. The mean weight at presentation was 2510g. Mean duration of symptoms was 3.40 days. Gross congenital anomaly was seen in 22 neonates. Sepsis on admission was noted in 51 patients out of whom 23 died. Twenty-two patients presented with perforation peritonitis, of which 14 expired. Fifty-four neonates experienced significant in-hospital delay in surgery. The mean duration of stay in the hospital was 8.40 days. Overall, 92 neonates were discharged from the hospital.Conclusion: Neonatal intestinal obstruction is still associated with high mortality. After analyzing various factors we conclude, that increased age at presentation, delay in seeking treatment after the onset of symptoms, CRP/ blood culture positive sepsis on arrival, thrombocytopenia, acute kidney injury (raised urea and creatinine), acidosis and coagulopathy on admission, bowel perforation with peritonitis and the need for continued mechanical ventilation after surgery were the statistically significant risk factors for mortality in neonates with NIO in our series. However, sex, mode of delivery, gestational age, weight at presentation, hypothermia on arrival, associated gross congenital anomalies, delay in surgery after admission (in-hospital delay) and duration of stay in hospital were found to be statistically insignificant risk factors for mortality in our series.
Anorectal Atresia with Rectoscrotal Fistula: A Rare Anorectal Malformation
Authors: Jadhav Bhushanrao Bhagawan , Rijwani Ashok
Published: January 2018

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Safety of Probiotic Supplementation in Preterm Infants with Gastrointestinal Surgical Conditions: A Retrospective Audit
Authors: Abdul Hakeem Mohammed , Patole Sanjay , Keil Anthony , Rao Shripada
Published: January 2018

Background: Limited data exists on the safety of probiotic supplementation in preterm infants with gastrointestinal (GI) surgical conditions.Aims: To assess the safety of Bifidobacterium breve (B. breve) M-16V supplementation in preterm in-fants with GI surgical conditions in our unit with regards to probiotic sepsis.Methods: This retrospective audit of prospectively collected data involved screening of neonatal data-bases to identify preterm infants.Results: Data on 33 preterm infants who underwent 43 GI surgeries and received probiotics was ana-lysed. The median (IQR) gestation at birth and postnatal age at surgery was 30 (26.8-30.7) weeks, and 5 (1-34) days respectively. Twelve (36.3%) infants received probiotics in the preoperative period, 24 (72.7%) received it in the post-operative period, and 10 (30.3%) received it both in the pre-operative and post-operative period. The median (IQR) post-operative age at commencement, duration and number of doses of probiotics was day 10 (6-13), 43 (34-56) days, and 70 (61-100) respectively. Only one infant died; the reason for death was midgut volvulus. None developed Bifidobacterial sepsis.Conclusions: Probiotic sepsis did not occur following B. breve M-16V supplementation in our small cohort of preterm infants with GI surgical conditions. Adequately powered randomised controlled trials are needed to confirm safety and efficacy of B. breve M-16V in this cohort.
Obstructed Inguinal Hernia in a New-Born
Authors: Batool Tayyaba
Published: January 2018

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Neonatal Intussusception: A Review
Authors: Bothara Vipul Prakash , Pandey Anand , Rawat Jiledar
Published: January 2018

Intussusception is defined as a process in which a segment of bowel invaginates into the adjoining intestinal lumen, causing bowel obstruction. It is the most common cause of intestinal obstruction in infants and children between 6 months to 18 months of age. In neonates and premature infants, it accounts for only 3% of intestinal obstruction and 0.3% (0–2.7%) of all cases of intussusception Since neonatal intussusception is an uncommon entity, we conducted this review to examine its occurrence, clinical features, diagnostic modalities, and treatment options.
Bilateral Testicular Torsion in a Neonate
Authors: Zouari Mohamed , Ben Abdallah Ahmad Khalil , Louati Hamdi , Abid Imene , Jallouli Mohamed , Mhiri Riadh
Published: January 2018

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Fate of Manuscripts Rejected by Journal of Neonatal Surgery
Authors: Sarin Yogesh Kumar
Published: January 2018

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Goldenhar Syndrome associated with Vestibular Fistula and Esophageal Atresia – A Rare Association
Authors: Barolia Dinesh Kumar , Mehra Sunil Kumar , Chaturvedi Vinita , Raipuria Guruddat , Singh Aditya Pratap , Rai Abhishek Kumar
Published: January 2018

Goldenhar syndrome is associated with various other congenital anomalies of gastro-intestinal tract, heart, kidney and genitourinary system. We report a rare association of Goldenhar syndrome with vestibular fistula and esophageal atresia.
Malignant Yolk Sac Tumor in Neonate: A Management Dilemma
Authors: Pathak Manish , Saxena Rahul , Sinha Arvind
Published: January 2018

Neonatal sacrococcygeal teratoma with yolk sac tumour is rare. We report a case of sacrococcygeal teratoma which was proven to be yolk sac tumor after excision. The patient developed complications related to chemotherapy. The baby was ultimately managed without chemotherapy on close monitoring.
Prenatal Diagnosis Of Congenital High Airway Obstruction Syndrome
Authors: Miura da Costa Karina , De Oliveira Sandro José , Morgato de Mello Miyasaki Andréa
Published: January 2018

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Neonatal Solitary Intestinal Myofibromatosis
Authors: Laamiri Rachida , Kechiche Nahla , Braiki Meriem , Hadhri Rim , Sahnoun Lassaad , Mekki Mongi , Belghith Mohsen , Nouri Abdellatif
Published: January 2018

Solitary intestinal myofibromatosis (SIF) is a very rare condition affecting the pediatric population and carries good prognosis following adequate management based on segmental resection. We describe a rare case who presented with features of neonatal intestinal obstruction due to a solitary stenosing fibrotic lesion originating from the ileum and compatible with SIF.