bluuebunny/crossref_metadata_2025 huggingface dataset:
Nuances e desafios do erro médico no Brasil: as vítimas e seus olhares
Authors: Mendonça Vitor Silva , Custódio Eda Marconi
Published: May 2016

Resumo O erro médico refere-se a circunstância que atinge a pessoa em decorrência de atuação médica baseada em atitude imprudente, negligente ou imperita. No Brasil tem crescido o número de casos, mas a discussão a respeito da vítima é quase inexistente. Este trabalho buscou delinear a perspectiva da vítima de erro médico. Utilizando uma entrevista semiestruturada, foi possível conhecer as experiências das vítimas e perceber de que maneira enfrentaram os desafios impostos. Observou-se a perplexidade ao descobrir-se vítima, e a dificuldade em aceitar-se como tal. As mudanças impostas pelo erro acarretaram transformações comportamentais e de atitudes, como a falta de confiança nos profissionais médicos. Sofrimento e sentimentos negativos passam a fazer parte da vivência dessas pessoas. Dessa maneira, é necessário criar estratégias que permitam auxílio e cuidado da saúde mental das pessoas envolvidas com o erro médico.
Alta a pedido contra indicação médica sem iminente risco de morte
Authors: Cano Mariana Vicente , Barbosa Hermes de Freitas
Published: May 2016

Resumo O atendimento à solicitação pelo paciente de alta a pedido contra indicação médica, sem risco iminente de morte, nada mais é do que garantir a autonomia desse paciente. Entretanto, não se trata de tema pacífico. O objetivo deste trabalho foi caracterizar a conduta do médico diante da alta a pedido. Realizou-se estudo de caso qualitativo, a partir de entrevistas individuais semiestruturadas com médicos assistentes de hospital público universitário. Foram realizadas oito entrevistas, gravadas e transcritas, e os dados, trabalhados por análise de conteúdo. Concluiu-se que os entrevistados consideram importante esclarecer o paciente acerca dos riscos de sua decisão, que deverá ser respeitada caso a mantenha; reconhecem também a relevância da documentação de alta e a impossibilidade de emitir receita quando não há alternativa cientificamente reconhecida. Evidencia-se, ainda, a preocupação do médico quanto às implicações legais de atender ao pedido do paciente.
Avaliação do conhecimento de médicos intensivistas de Teresina sobre morte encefálica
Authors: Magalhães Juliana Veloso , Veras Kelson Nobre , Mendes Cíntia Maria de Melo
Published: May 2016

Resumo Trata-se de estudo transversal e descritivo, realizado a partir de questionário respondido por 90 médicos atuantes em unidades de terapia intensiva de Teresina, Piauí, Brasil. Objetivou avaliar o conhecimento dos médicos intensivistas sobre morte encefálica e correlacionar esse dado com tempo de exercício da profissão, tempo de atuação em UTI, tipo de unidade em que o profissional trabalha, curso de residência médica e posse de título de especialista em terapia intensiva. Os participantes demonstraram, em sua maioria, conhecer a definição de morte encefálica, com melhores resultados entre aqueles com menor tempo de exercício da profissão médica. Demonstraram saber da obrigatoriedade de exames complementares para o diagnóstico de morte encefálica e descreveram-se como seguros ou muito seguros para explicar morte encefálica a familiares de pacientes. Os médicos, de modo geral, demonstraram dificuldades em determinar o horário legal do óbito por morte encefálica de paciente considerado doador de órgãos.
Compreensão do termo de consentimento em pesquisa clínica
Authors: Assumpção Clarissa de , Pinto Nínive da Silva , Velarde Luis Guillermo Coca , Nascimento Osvaldo José Moreira do , Olej Beni
Published: May 2016

Resumo O termo de consentimento livre e esclarecido (TCLE) é documento onde se explicita o consentimento do participante, contendo todas as informações necessárias para que seja elucidada a pesquisa da qual se propõe participar. O objetivo deste trabalho foi avaliar o nível de compreensão do TCLE assinado por 146 voluntários, utilizando instrumento de coleta de dados autoaplicável. A média de idade foi 47,3 anos, com prevalência de participantes do gênero feminino (67,2%), ensino fundamental incompleto (53,4%) e sem assistência privada de saúde (93,2%). A média de acertos foi 53,1%. Não houve associação entre o percentual de acerto e as variáveis gênero, idade, escolaridade e tempo de resposta. Houve associação significativa entre levar a via do TCLE para casa e o percentual de acerto. O valor médio de acertos evidenciou a necessidade de novas medidas educativas, buscando aumentar a compreensão e a segurança dos participantes.
As Didascálias Fora do Teatro: um exercício de teatralidade de Eugène Ionesco
Authors: Pereira Viviane Araújo Alves da Costa
Published: May 2016

Resumo: As didascálias constituem um gênero muito particular no domínio teatral: das indicações cênicas à inscrição de uma voz autoral no texto feito para ser representado. Na produção de Eugène Ionesco, as didascálias fogem das peças para encontrar uma função a mais em seus textos críticos e na correspondência com seus diretores. Neste artigo, trata-se de analisar a inserção das rubricas nos textos publicados em Notes et contre-notes e nos manuscritos do Fundo Ionesco, com base em uma discussão teórica sobre o gênero e a relevância da figura autoral, a partir de Bernard Dort, Roland Barthes e Luiz Fernando Ramos, entre outros pesquisadores da teatralidade.
Pedagogy of the Possessed: re-thinking the Dancer-Researcher-Performer (BPI) method in dance curricula in Brazil
Authors: Höfling Ana Paula
Published: May 2016

Abstract: This paper calls into question the central tenets of the Dancer-Researcher-Performer (BPI) method taught at the Universidade Estadual de Campinas (Unicamp) in Brazil. The analysis problematizes the underlying assumption that students lack an awareness of their own Brazilianness, which they must find through BPI, and questions a choreographic methodology where students are coached to be possessed by the dance. The paper draws attention to the power imbalances inherent in BPI's co-habitation experience, where students research marginal others who are understood as the source of authentic Brazilian culture. The paper invites BPI students and teachers to reconsider the ethics of this research methodology, and to consider the possibility of choreographic research that engages both mind and body critically and consciously.
Entre Dissection et Empathie: le cinéma en direct de Katie Mitchell
Authors: Magris Erica
Published: May 2016

Résumé: L'article étudie deux spectacles réalisés par la metteuse en scène britannique Katie Mitchell à la Schaubühne de Berlin - Fraulein Julie (2010), en collaboration avec le vidéaste Leo Warner, et Die Gelbe Tapete (2013) - qui, comme dans un diptyque, explorent la vie intime de deux femmes souffrantes grâce à un dispositif ciné-théâtral complexe au fonctionnement spécifique. La simultanéité de deux régimes de présence sur scène, le jeu et le tournage, ainsi que de l'action scénique et du film, produit une tension permanente entre effets contradictoires - identification/distanciation, continuité/discontinuité, éclatement/concentration - tant sur les acteurs que sur les spectateurs, en créant une interface élastique qui enveloppe la scène et la salle et permet une immersion théâtrale dans la subjectivité.
4D Art: corps réels et virtuels, une réalité augmentée
Authors: Lemieux Michel , Pilon Victor , Isaacsson Marta
Published: May 2016

Résumé: La compagnie canadienne 4D Art surprend le regard du public et interroge les sens de réalité et présence, par l'interaction scénique de corps réels et virtuels en mouvement. Pour comprendre le processus créateur des spectacles de 4D Art, on présente un entretien inédit réalisé avec les directeurs artistiques Michel Lemieux et Victor Pilon. Les motivations artistiques du jeu réel et virtuel, les procédés employés dans la création des figures virtuelles et les défis vécus par les acteurs sont exposés par les créateurs.
Planos de Composição em Ato: possibilidades poéticas do cotidiano
Authors: Rabelo Flávio , Ferracini Renato , Reis Bruna
Published: May 2016

Resumo: Este artigo discute a noção de ação performativa como planos de composição em ato, deslocando a ideia de presença para processos relacionais, nos quais a intensidade da experiência vivida se atualiza no jogo construído a cada instante. Para tanto, apoiamo-nos na experiência de uma pesquisa desenvolvida pelo Núcleo Fuga! como processo criativo que busca fabricar enquadres que tensionam o nexo entre real e ficcional. Desse modo, a partir dos procedimentos escolhidos, artistas e público articulam convites e modos de relação mediados por uma poética híbrida entre dança, teatro e performance, tentando, assim, abrir a escuta às dramaturgias instantâneas que o cotidiano oferece. Tal intento parte do pressuposto de que o Real e a Ficção são planos sobrepostos, existentes numa zona virtual que, ao ser atualizada em ações poéticas pelos artistas em cena, dispara composições cartográficas apoiadas nas relações corpo-ambiente-dramaturgia.
Análisis numérico del ámbito de validez del modelo convencional de tiro oblicuo
Authors: Medina César , Cudmani Leonor Colombo de
Published: May 2016

En una encuesta de diagnóstico planteada a estudiantes del ciclo básico universitario sobre el tema de tiro oblicuo, se obtiene un alto porcentaje de respuestas incorrectas sobre estimaciones referidas al roce del aire y otros fenómenos que influyen en el desplazamiento de un proyectil. Estos desaciertos están asociados al hecho de que, tanto en los textos como en el aula, se emplea un modelo físico simplificado que supone que la velocidad sólo varía por la gravedad. Si bien esta simplificación es razonable en los primeros niveles de enseñanza, no se aclara debidamente que en muchos casos prácticos tal modelo idealizado puede generar errores sistemáticos significativos si no son debidamente analizados sus supuestos y ámbitos de validez. Como una estrategia didáctica para superar estas dificultades, se propone una comparación de las trayectorias del modelo convencional con otras calculadas numéricamente incluyendo distintas fuerzas y efectos (resistencia del medio, empuje, fuerza de Coriolis, perfil de densidad del aire). Las trayectorias se analizan bajo diferentes condiciones y se discute la factibilidad de algunas simplificaciones en términos del error sistemático que introducen.
Influence of the addition sequence of PVA-fibers and water on mixing and rheological behavior of mortars
Authors: França M. S. de , Cardoso F. A. , Pileggi R. G.
Published: May 2016

ABSTRACT The mixing process of fiber-containing cementitious suspensions is a crucial factor to obtaining a good dispersion of fibers and guarantee adequate mechanical performance of the hardened products. The addition of fibers into the suspension causes reduction of the fluidity of the system due to factors inherent to the fibers, the matrix and their interaction. During mixing, these interactions make dispersion and homogenization processes more difficult due to the formation of fibers - particles agglomerates. Conventional techniques to assess workability of mortars are inadequate to evaluate the rheological behavior of fiber-reinforced systems, in which parameters like viscosity and yield stress are not completely taken into account. Therefore, this work employs rotational rheometry to evaluate the influence of fiber and water addition sequences on mixing and rheological behavior of mortars containing Polyvinyl Alcohol (PVA) fibers. Constant test parameters were: mixing time of 317s; impeller velocity 126.5 rpm; water flow 128g/s. A constant mix design was used with a water content of 16%wt, and a 0.2%vol of fibers were added to the reference composition. Four mixing sequences were studied: S1 and S2 are based on the addition of fibers at different stages of the mixing process; while in S3 and S4 not only the fibers are added at different stages, but also the water addition is performed in two steps (25% first and 75% latter).Results showed that it is possible to optimize the mixing step of fiber-containing systems by changing the moment of fiber addition into the mixture. The introduction of fibers after mixing the dry mortar with water, when it already had achieved its fluidity point, demanded a lower mixing effort and produced a more flowable material.
Structural reliability assessment based on optical monitoring system: case study
Authors: Mesquita E. , Antunes P. , Henriques A. A. , Arêde A. , André P. S. , Varum H.
Published: May 2016

ABSTRACT Optical systems are recognized to be an important tool for structural health monitoring, especially for real time safety assessment, due to simplified system configuration and low cost when compared to regular systems, namely electrical systems. This work aims to present a case study on structural health monitoring focused on reliability assessment and applying data collected by a simplified optical sensing system. This way, an elevated reinforced concrete water reservoir was instrumented with a bi-axial optical accelerometer and monitored since January 2014. Taking into account acceleration data, the natural frequencies and relative displacements were estimated. The reliability analysis was performed based on generalized extreme values distribution (GEV) and the results were employed to build a forecast of the reliability of the water elevated reservoir for the next 100 years. The results showed that the optical system combined with GEV analysis, implemented in this experimental work, can provide adequate data for structural reliability assessment.
Deletion of ADP Ribosylation Factor-Like GTPase 13B Leads to Kidney Cysts
Authors: Li Yuanyuan , Tian Xin , Ma Ming , Jerman Stephanie , Kong Shanshan , Somlo Stefan , Sun Zhaoxia
Published: May 2016

The gene for ADP ribosylation factor–like GTPase 13B (Arl13b) encodes a small GTPase essential for cilia biogenesis in multiple model organisms. Inactivation of arl13b in zebrafish leads to a number of phenotypes indicative of defective cilia, including cystic kidneys. In mouse, null mutation in Arl13b results in severe patterning defects in the neural tube and defective Hedgehog signaling. Human mutations of ARL13B lead to Joubert syndrome, a ciliopathy. However, patients with mutated ARL13B do not develop kidney cysts. To investigate whether Arl13b has a role in ciliogenesis in mammalian kidney and whether loss of function of Arl13b leads to cystic kidneys in mammals, we generated a mouse model with kidney–specific conditional knockout of Arl13b. Deletion of Arl13b in the distal nephron at the perinatal stage led to a cilia biogenesis defect and rapid kidney cyst formation. Additionally, we detected misregulation of multiple pathways in the cystic kidneys of this model. Moreover, valproic acid, a histone deacetylase inhibitor that we previously showed slows cyst progression in a mouse cystic kidney model with neonatal inactivation of Pkd1, inhibited the early rise of Wnt7a expression, ameliorated fibrosis, slowed cyst progression, and improved kidney function in the Arl13b mutant mouse. Finally, in rescue experiments in zebrafish, all ARL13B allele combinations identified in patients with Joubert syndrome provided residual Arl13b function, supporting the idea that the lack of cystic kidney phenotype in human patients with ARL13B mutations is explained by the hypomorphic nature of the mutations.
Small-Molecule Inhibitors of Pendrin Potentiate the Diuretic Action of Furosemide
Authors: Cil Onur , Haggie Peter M. , Phuan Puay-wah , Tan Joseph-Anthony , Verkman Alan S.
Published: May 2016

Pendrin is a Cl−/HCO3
− exchanger expressed in type B and non-A, non-B intercalated cells in the distal nephron, where it facilitates Cl− absorption and is involved in Na+ absorption and acid-base balance. Pendrin-knockout mice show no fluid-electrolyte abnormalities under baseline conditions, although mice with double knockout of pendrin and the Na+/Cl− cotransporter (NCC) manifest profound salt wasting. Thus, pendrin may attenuate diuretic-induced salt loss, but this function remains unconfirmed. To clarify the physiologic role of pendrin under conditions not confounded by gene knockout, and to test the potential utility of pendrin inhibitors for diuretic therapy, we tested in mice a small-molecule pendrin inhibitor identified from a high-throughput screen. In vitro, a pyrazole-thiophenesulfonamide, PDSinh-C01, inhibited Cl−/anion exchange mediated by mouse pendrin with a 50% inhibitory concentration of 1–3 µM, without affecting other major kidney tubule transporters. Administration of PDSinh-C01 to mice at predicted therapeutic doses, determined from serum and urine pharmacokinetics, did not affect urine output, osmolality, salt excretion, or acid-base balance. However, in mice treated acutely with furosemide, administration of PDSinh-C01 produced a 30% increase in urine output, with increased Na+ and Cl− excretion. In mice treated long term with furosemide, in which renal pendrin is upregulated, PDSinh-C01 produced a 60% increase in urine output. Our findings clarify the role of pendrin in kidney function and suggest pendrin inhibition as a novel approach to potentiate the action of loop diuretics. Such combination therapy might enhance diuresis and salt excretion for treatment of hypertension and edema, perhaps including diuretic-resistant edema.
Varied Metaheuristics for Uniform Parallel Machine to Minimize Total Weighted Completion Time
Authors: Zaïdi M. , Jarboui B. , Loukil T.
Published: May 2016

In this paper, we consider the problem of scheduling n independent jobs on m uniform parallel machines such that total weighted completion time is minimized. We present some metaheuristics to solve this problem. Based on a set of instances, a comparative study has been realized in order to evaluate these approaches.
The impact of reforming municipal water tariff on water rationing and consumer welfare in Saudi Arabia
Authors: Al Qahtani Safar , Ismaiel Sobhy , Sofian Badr
Published: May 2016

The objectives of this study were to estimate an aggregate price elasticity of demand for municipal water in Saudi Arabia, and to analyze the welfare impact of raising the municipal water tariff. The study utilized available aggregated data (Ministry of Water and Electricity, 1999–2008), and regression techniques to specify water demand functions within the frame of the increasing block tariff applied in Saudi Arabia. The estimated price elasticity of municipal water demand was about –0.39. The impact of an assumed 33% rise in the municipal water tariff was predicted to save about 11.121 cubic meters per household per month, which would lead to a total annual saving of about 128.544 million cubic meters. The percentage increase of the average equilibrium price would reach 12.7%. Therefore, the percentage decrease in consumer surplus per household amounts to 9.43%.
Interest Groups, the Courts, and Educational Equality
Authors: Superfine Benjamin Michael , Thompson Alea R.
Published: May 2016

In Vergara v. California (2014), a trial-level court ruled that California laws governing teacher tenure and dismissal were unconstitutional. This study analyzes Vergara in light of the shifting use of the courts to promote equal educational opportunities and the changing power bases of educational interest groups, including educational advocacy groups and teacher unions. This study particularly uses policy regimes theory to analyze the relationship between political interests, ideas, and institutions and highlights how the case represents an inversion of how educational interest groups have traditionally used the courts as vehicles for effecting education reform. Grounded in this analysis, this study explores legal and policy implications for both courts and reformers acting in this new context.
Teachers’ Rights Versus Students’ Rights
Authors: D’Amico Diana
Published: May 2016

In 1968, New York City’s unionized teachers participated in three separate strikes that spanned two school years. Teachers clashed with Black parents and activists who called for community control as both groups sought authority and recognition in the schools. Racialized assumptions in place before and extending beyond the labor skirmish infused teachers’ professional identity as well as how they understood their students and the communities they served. This article provides a history of how constructions of Blackness and Whiteness permeated teacher preparation programs, administrative policies, and the teachers’ union, in turn delimiting teachers’ collective professional persona. This historical analysis provides a framework to understand the persistent strains between social institutions and the communities they serve.
Narrow band imaging (NBI) in ENT
Authors: Ahmed Khabiruddin
Published: May 2016

Abstract not availableBangladesh J Otorhinolaryngol; October 2015; 21(2): 60-61
Comparative study on complications of emergency and elective tracheostomy
Authors: Rashid Md Harun Or , Taous Ahmmad
Published: May 2016

Background: Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (per operative and post operative) complications.Methods: this was a cross sectional study 120 patients were studied age ranged from 9 years to 79 years in four different tertiary hospitals in Dhaka from July 2011 to June 2013.Results: Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection , Then tube displacement, pericondritis and stomal stenosis/ granulation tissue formation were the complications . In all stages (peroperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically significant (p<0.05).Conclusion: Complications are more in emergency than elective tracheostomy. To reduce complications should be aim of all types of tracheostomyBangladesh J Otorhinolaryngol; October 2015; 21(2): 69-75
Study on Hearing Status of Elderly Patients attending a Specialized ENT Hospital (SAHIC)
Authors: Rahman Mohammad Wakilur , Ahasan Ali Imam , Debnath Timir Kumar , Jamil Abul Naser Md , Barua Raju , Amin M Nurul
Published: May 2016

Background: Age related hearing loss is a natural process in elderly population all over the world.Objectives: To determine the hearing level of elderly patients in relation to age, sex, socioeconomic condition and to determine the pattern and extent of hearing loss in old age.Method: This cross sectional study was carried out at out patient department of Specialized ENT Hospital of SAHIC, Mohakhali, Dhaka, from October 2012 to March 2013. 200 patients were included with age > 50 years and who have no past history of drug therapy. Data were collected by detailed history, clinical examination and audiometric findings and result were expressed in table form.Result: 57% patients were found with normal hearing and 43% had variable degree of hearing impairment. Highest number of hearing impairment was found in 9th decade. Most of hearing loss were found to be bilateral and sensorineural in type.Conclusion: A good number of elderly people in our country is suffering from some degree of hearing loss, which are mostly sensorineural in type. The prevalence and severity of hearing loss increases with increasing age.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 80-84
Clinicopathological Study on Hypopharyngeal Carcinoma in Dhaka Medical College Hospital
Authors: Islam Md Nazmul , Lodh Dipankar , Siddiqui Mohammad Mamun , Khan AF Mohiuddin , Meherunnesa Kazi
Published: May 2016

A Cross-Sectional Study was carried out from July 2006 to June 2007 at Department of Otolaryngology and Head-Neck Surgery of Dhaka Medical College Hospital, Dhaka. Data was collected from 150 patients with histologically diagnosed Hypopharyngeal carcinoma. Results of this study showed that hypopharyngeal carcinoma affects more in fifth (36.7%) and sixth (27.4%) decades of life. It was found that male were highly predominant to develop hypopharyngeal carcinoma and male female ratio was 9:1. People with lower educational level were found to be affected more by hypopharyngeal carcinoma. In this study 86 percent patients had history of smoking. Mean duration of smoking was 38.0±23.6 years. This study found that the key symptoms of hypopharyngeal carcinoma was dysphagia, pain and neck mass. In this study 83.5 percent patients presented with palpable lymph node and most (76.6%) of them were in level II. Pyriform fossa was found to be the commonest site (83.3%). In this study all malignancy in hypopharynx was histopathologically squamous cell carcinomaBangladesh J Otorhinolaryngol; October 2015; 21(2): 85-89
CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum
Authors: Aneesa Mirza , Qazi Sajad Majid , Haq Aijazul
Published: May 2016

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93
Experience of management of nasal foreign bodies in Out patient department of a Tertiary Hospital
Authors: Rahman Md Abdur , Ahmed Mesbah Uddin , Harun Md Abdullah Al , Rashid Mohammad Harun OR , Prodhan MA Kalam
Published: May 2016

Objectives: To evaluate 113 cases of nasal foreign body removal with regard to type of foreign body, location, complications, techniques for removal, age , genderand to present the results of theevaluation.Methods: Between April 2009 to May 2011, a total of 113 nasal foreign bodies were attended inOutpatient Department ofENT, Head and Neck Surgery in Sir Salimullah Medical College, MitfordHospital,Dhaka. A retrospective reviewwas undertaken to evaluate the parameters related to the nasal foreign body and their removal and the data wereanalyzed.Results:113 cases of nasal foreign bodies were attended in Outpatient department of ENT, Head and Neck Surgery in Sir Salimullah Medical College, Mitford Hospital, Dhaka. Of these 113 cases, 101cases were removed in outpatient department and 12 cases were admitted and were removed under general anaesthesia. We found higher incidence in patients between ages 2 and 5 years. The distribution of nasal foreign body was 44.25% in male and 55.75% in female.Conclusion:Nasal foreign bodies are encountered daily in our routine clinical practice in the pediatric age group. General anaesthesia is required in uncooperative agitated patients or impacted foreign body to avoid complications.Button batteries and penetrating foreign body must be treated immediately.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 102-109
Cervical Vagal Swannoma: A Case Report
Authors: Satpathy Shouvanik , Mondal Goutam , Bhowmick Anup Kumar , Dam Aniruddha
Published: May 2016

Cervical vagal schwannomas are rare, slow growing tumours usually occur in patients between thirty and fifty years of age with no sex related predisposition. They are usually asymptomatic benign lesion and complete surgical resection with preservation of neural pathway, whenever possible is the treatment of choice.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 115-118
Seborrheic keratosis of the nasal tip-an unusual case report
Authors: Mamun Abdullah Al , Hasan Dewan Mahmud
Published: May 2016

Seborrheic keratosis is a benign tumour of skin, a common hyperkeratotic lesion of the epidermis,that usually occurs in the trunk and less frequently in the extremities, face and the scalp. A 65-year old farmer presented with a long standing, slowly growing, firm, redbrown, polypoidal mass about 2×2.5 cm in size, located at the skin mucosa interfare of the tip of nose. The lesion was excised under general anesthesia and histopathologic examination showed seborrheic keratosis. Diagnosis is made on the basis of clinical & histopathological examination. Here, we discuss the clinical presentation, differential diagnosis, pathological diagnosis and management of such a case. There was no recurrence during a year follow-up.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 119-121
Primary Laryngeal Tuberculosis Masquerading Laryngeal Malignancy
Authors: Ghani Nik Mohd Syukra Nik Abdul , Mohamad Hazama Binti , Mohd Nik Khairani Nik , Mohamad Amran
Published: May 2016

Nowadays, tuberculosis (TB) infection shows re-emergence again in many other part of the world due to HIV/AIDS- related disease, low socioeconomic as well as insurgence of multidrug resistance tuberculosis. TB is a disease which is primarily affects a lung. However it also can affect other organs as a secondary disease in a body via hematogenous or lymphatic spread. As in ENT field, TB also can manifest as a solely ear, nose or throat (ENT) diseasea such as in primary laryngeal tuberculosis (TB). In the past, laryngeal TB typically presented as a secondary disease with ulcerated laryngeal lesions in advanced pulmonary tuberculosis patient. In our case, we report a case of primary laryngeal tuberculosis masquerading as laryngeal malignancy in adult patient without pulmonary tuberculosis. In conclusion, in a patient who presented with various laryngeal symptoms, physician should be aware of the reemergence of laryngeal tuberculosis and the various manisfestation of the disease.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 122-128
Embryonal Rhabdomyosarcoma: A Case Report
Authors: Mahbub Muntasir , Mannan Nabila , Shaheen Md Mazharul , Chakraborti Manash Ranjan , Shaifuddin AKM , Kabir Shahjahan , Murshed KM Mamun , Hassan Mahmudul , Ahmed Khabiruddin
Published: May 2016

Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood and adolescence. There are four histological types and among them the embryonic types are the most common. It can occur in any anatomic location, although when occurring in the head and neck region, it has an affinity to invade the cranial cavity. Patient was a 5 years old boy who was admitted with the complaints of pain and discharge from the ear, swelling on left side of the upper neck, and mastoid region and a fleshy mass protruding from the ear canal. The mass was confirmed to be Embryonal Rhabdomyosarcoma on histopathology. CT scan of the Head-Neck region, showed extension of the mass into infra-temporal fossa and in the mastoid antrum. After complete excision, the patient was referred to oncology deptt for consultation. The chemotherapy schedule comprised of Vincristine and Dactinomycine for 9-12 cycles. Otolaryngologists need to be aware of this rare condition as it may mimic the symptoms of CSOM or nasal polyp. And also long term followup is needed since recurrence can present several years after initial treatment.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 127-131
Pattern and Trend of Alcohol Abuse: A Study in a Tribal Community of Hill Tract
Authors: Islam Ahmed Tanjimul , Sultana Shamrin , Rabbani Mohammad Golam , Chaudhury Shahed Ahmad
Published: May 2016

Background: Hazardous use of alcohol is a public health problem which accounts for 4.0% of global burden of disease. There are very few studies about alcohol consumption trend among tribal in Bangladesh. We investigated the pattern and trend with reasons for alcohol use in Hill Tract dwellers with the aim to increase the awareness of this problem.Objective: To identify the pattern of alcohol use and its effect among the tribal so that effective measures can be taken to eliminate the social evil.Materials and method: This cross-sectional study was conducted among tribal community of Chittagong Hill Tracts, Rangamati district, Bangladesh between June 2014 to February 2015. Out of 846 people coming in Naniarchor and Langadu upazila health complexes 716 (84.6%) constituted the study group. The CAGE test was used as a screening test in determining alcohol dependence.Results: The prevalence of alcohol consumption among tribal is 48.9%. Rural areas (65%) are the most vulnerable area. Home-made alcohol (61%) was the most patronized alcoholic beverage. Most of the cases (82%) started alcohol before 30 years of age and 46% participants took alcohol daily. To get pleasure is the commonest factor for taking alcohol (57%). Physical and mental degenerations were found in most of the alcoholic cases (88%).Conclusion: The results of the present study are likely to increase the awareness of the problem in hill areas and help the concerned authorities to shape the requisite alcohol control policies in these regions.Delta Med Col J. Jan 2016 4(1): 4-8
Parapharyngeal Tumour  A Study of 30 Cases
Authors: Bhowmik Bithi , Ahmed Miraj , Talukder Debesh Chandra , Siddique Belayet Hossain
Published: May 2016

Background: Parapharyngeal tumours are a group of rare neoplasms arising from structures within the parapharyngeal space. The complex anatomical and pathological consideration of this region often present a substantial challenge to the otolaryngologist and head-neck surgeons in the evaluation and management of these lesions. The majority of tumours arising in the parapharyngeal space are benign and surgical resection is the mainstay of treatmentObjective: To determine frequency, demography, histological pattern and management of parapharyngeal tumour.Materials and method: A cross sectional study was carried out from January 2007 to December 2007. Total 30 cases were selected from Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, Dhaka Medical College Hospital, Dhaka, Bangladesh and Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh.Results: In this study 37% patients were in the fourth decade. Among the study subjects, 21(70%) were male and 9(30%) were female. Most of the patients presented with neck swelling (66%) followed by oropharyngeal swelling (50%). In this study salivary gland tumours were the highest (47%) in number, neurogenic tumours constituted 40% and chemodectomas were 13%. Histopathologically 80% tumours were benign. Both transparotid and inferior approaches were used for surgical resection in each 40% of cases.Conclusion: Most of the cases were benign and detected around fourth decade of life with male predominance. Surgical resection was the lone treatment for the cases with few post operative complications.Delta Med Col J. Jan 2016 4(1): 18-23
Weight of the Human Kidney  A Study on 70 Autopsy Cases
Authors: Zohora Fatema , Nurunnabi Abu Sadat Mohammad , Siddiqua Dilruba , Hena Hasna , Perven Hosna Ara , Ara Shamim
Published: May 2016

Background: Variations in weight of the kidney in different populations and in different age groups are evident.Objective: The aim of the present study was to find out age related changes in weight of the kidney in a Bangladeshi population and compare with previous local and foreign studies.Materials and method: This cross-sectional study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, Bangladesh from July 2008 to June 2009, based on collection of 140 post mortem human kidneys collected from 70 unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine of same institute. All the samples were divided into three different age groups - A (10-19 years), B (20-39 years) and C (40-59 years), and the weight of each kidney was measured by using a digital balance and recorded.Results: The weight of the right and left kidneys were found 86.18±0.32 gm and 86.10±0.10 gm in group A, 102.25±7.64 gm and 101.96±7.27 gm in group B, 95.59±0.75 gm and 95.19±1.24 gm in group C respectively. No difference was found between the right and left kidneys in any group. However, statistically significant differences were evident among age groups.Conclusion: The weight of the kidney was found to increase up to 4th decade of life and then declined with further advancing age.Delta Med Col J. Jan 2016 4(1): 31-34
Hirsutism - Evaluation and Treatment
Authors: Akter Nazma , Qureshi Nazmul Kabir
Published: May 2016

Hirsutism is a distressing clinical condition seen in adult female patients. The cause is mainly hyperandrogenism, which may be ovarian or adrenal. The most common pathological cause is usually polycystic ovary syndrome. It may be part of a rare metabolic syndrome, drug induced, or just idiopathic. It requires in depth clinical evaluation and investigation for treatment. Serum testosterone measurements are not needed in many cases. Hirsutism has a huge psychosocial impact, especially in the young females. This article reviews the current evaluation guidelines and management of hirsutism.Delta Med Col J. Jan 2016 4(1): 35-44
Case Report of a True Accessory Mandibular Condyle - an Exceptionally Rare Abnormality
Authors: Siddika Ayesha , Ferdousi AM
Published: May 2016

Mandibular accessory condyle is rare. Literature search found most of the accessory condyles to arise from the mandibular coronoid process due to hyperactivity of attached temporalis muscle. Although neoplastic growth at mandibular coronoid mimicking an accessory condyle also been cited. Absence of report in recent publications regarding accessory mandibular condyle arising from the main mandibular condyle makes this anomali extremely rare. The present case report is about a true accessory mandibular condyle which caused the patient facial and occlusal disharmony. A 3D computerized tomographic imaging ascertained the exact location of the accessory condyle, its origin and resting position of the accessory and the main condylar head. The facial and occlusal disharmony settled completely within a short postoperative time following surgical intervention and mild elastic traction.Delta Med Col J. Jan 2016 4(1): 45-50
Prevalence of hypertension in people living in coastal areas of Bangladesh
Authors: Sayeed M Abu , Rahman AH Syedur , Ali Md Hazrat , Afrin Subrina , Rhaman Mir Masudur , Chowdhury Mohammad Mainul Hasan , Banu Akhter
Published: May 2016

The prevalence of hypertension was reported higher in the coastal areas in different populations of the world. There was no study on the prevalence of hypertension among the coastal people in Bangladesh. This study addressed the prevalence and risk of hypertension among people living in the coastal areas of Bangladesh. Total 32 different coastal communities were selected purposively in the six coastal districts (Barisal, Borguna, Vola, Pirojpur, Potuakhali and Jhalukathi) of Bangladesh. All people over 18 years were considered eligible. Social, clinical and family histories were taken. Height, weight, waist- and hip-girths were measured including systolic and diastolic blood pressure (SBP and DBP). Fasting blood glucose and lipids were also estimated. The accepted cut offs for systolic hypertension (sHTN) was ?135mmHg and diastolic hypertension (dHTN) was ?85 mmHg. Overall, 7058 (m / f = 2631 / 4427) people volunteered to participate in the study. The crude prevalence of sHTN was 17.8% [95% CI, 17.39  18.21] and dHTN was 19.0% [95% CI 18.08  19.92]. Compared to female, the male participants had higher prevalence of both sHTN (16.4 v. 20.2 %, p<0.001) and dHTN (17.4 v. 21.5%, p<0.001). The prevalence rates of sHTN were 14.6, 18.5 and 24.6% in the poor, the middle and in the rich class, respectively (p<0.001). Similar trend was observed with dHTN. Both types of HTN increased with increasing age (p<0.001), BMI (p<0.001), WHR (p<0.001) and WHtR (p<0.001). Logistic regression analyses proved that the participants of higher social class, of advancing age and with higher obesity had excess risk of hypertension. Positive family history of HTN, DM and stroke had also increased risk for HTN. We found higher prevalence of HTN in Bangladeshi coastal population compared to people living in other areas of Bangladesh. Family history of DM, HTN and stroke were significantly related to sHTN and dHTN. Increasing age, higher obesity and higher social class had excess risk for developing HTN. Further study may be undertaken to address other unexplored risks like physical inactivity, unhealthy diet or psychosocial stress affecting the coastal people. Salt content of water and food consumed by these people should also be investigated.Ibrahim Med. Coll. J. 2015; 9(1): 11-17
Prevalence of CTX-M ? lactamases among Gram negative bacteria in a tertiary care hospital in Bangladesh
Authors: Yasmin Taslima , Hossain Md Akram , Paul Shyamal Kumar , Mowla Golam , Sultana Safia
Published: May 2016

Extended spectrum beta lactamases (ESBLs) produced by Gram negative bacteria are mainly mediated by three important genes, namely TEM, SHV and CTX-M. In this study, we used a multiplex PCR to determine the prevalence of CTX-M and its subgroups CTX-M-3, CTX-M-14, among the members of Enterobacteriaceae family and in Pseudomonas spp that were isolated from different clinical samples in a tertiary care hospital in Bangladesh. A total of 300 culture positive clinical isolates were selected for the study. Out of these, 216 from urine, 45 from wound swab, 39 from pus aspirates. The ESBL status was determined by double disc diffusion test (DDDT) as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and by multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. Out of 300 isolates tested, 71.3% were positive for ESBL production by DDDT. The rate of positivity for TEM, SHV and CTX-M genes in 107 randomely selected isolates was 83.2%. Among these, 56.2% (50/89) was positive for CTX-M. Among the CTX-M positive isolates, CTX-M-3 and CTX-M- 14 were 78.0% (39/50) and 80.0% (40/50) respectively. Our study demonstrated that CTX-M variants were common in Enterobacteriaceae and Pseudomonas spp prevalent in the hospital of Bangladesh.Ibrahim Med. Coll. J. 2015; 9(1): 26-30
Apolipoprotein A-I and B levels in Bangladeshi patients with coronary artery disease
Authors: Chowdhury Ashesh K , Shafique Abu Mohammed , Rahman Zeenat F
Published: May 2016

Coronary arteay disease (CAD) is an important cause of morbidity and mortality in developed as well as developing countries like Bangladesh. In this study, the status of serum apolipoprotein A-I (Apo A-1) and apolipoprotein B (Apo B) levels were assessed in Bangladeshi patients with coronary artery diseases. The study was carried out in the Department of Cardiology, University Cardiac Centre (UCC), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total study population was 100, of which 50 were patients with CAD and 50 were individuals without CAD (control). The patients with CAD and controls were enrolled following the inclusion and exclusion criteria. About 5 ml blood was collected by venepuncture from each individual and apolipoprotein A-1 and B were determined by automated nephelometry. The mean age of total study population was 51.4 ± 10.8 years while the mean age of the patients and control was 51.3 ± 10.9 and 51.4 ± 10.9 years respectively. The Apo A-I level was significantly (p<0.01) different in CAD patients compared to control group (95.10 ± 20.50 mg/dl vs 113.47 ± 20.96 mg/dl). The ratio of Apo B and Apo A1 was also significantly higher (p<0.01) in CAD patients than that of controls (1.25 ± 0.40 vs 0.95 ± 0.26 while Apo B levels was not different among the two groups. The study revealed significant alteration of serum Apo A-I level and Apo B/Apo A-I ratio in patients with CAD compared to those without CAD. Further large-scale study is needed to evaluate the exact influence of apolipoproteins on coronary artery disease in Bengali ethnic population.Ibrahim Med. Coll. J. 2015; 9(1): 31-33
Atypical central serous chorioretinopathy treated with intravitreal injection of bivacizumab  a case report
Authors: Goswami Manash Kumar
Published: May 2016

Central serous chorioretinopathy (CSCR) is common in adult male having sudden dimness of vision in one eye and typical pattern of leakage in fundus fluorescein angiography. Treatment of typical central serous chorioretinopathy is conservative and / or focal laser photocoagulation. But atypical central serous chorioretinopathy is uncommon having different patterns of clinical presentation and features in fundous fluorescein angiography. Treatment option of atypical central serous chorioretinopathy is not yet established. Here, we present a case of atypical central serous chorioretinopathy successfully treated with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF, Bivacizumab).Ibrahim Med. Coll. J. 2015; 9(1): 34-36
HPIP Silencing Prevents Epithelial‐Mesenchymal Transition Induced by TGF-β1 in Human Ovarian Cancer Cells
Authors: Zhang Guo-ying , Liu Ai-hua , Li Guo-min , Wang Jian-rong
Published: May 2016

Hematopoietic pre-B-cell leukemia transcription factor (PBX)-interacting protein (HPIP/PBXIP1) is a nucleo-cytoplasmic shuttling protein, and its expression is associated with cancer aggressiveness. However, the role of HPIP in ovarian cancer is still unclear. Here, we aimed to clarify the role of HPIP in epithelial‐mesenchymal transition (EMT) process of ovarian cancer cells, stimulated by transforming growth factor (TGF)-β1. In this study, we found that HPIP was highly expressed in ovarian cancer cells, and TGF-β1 treatment induced HPIP expression in ovarian cancer cells. In addition, knockdown of HPIP suppressed TGF-β1-induced EMT and migration/invasion in ovarian cancer cells. Moreover, knockdown of HPIP significantly blocked the phosphorylated pattern of both PI3K and Akt induced by TGF-β1 in SKOV3 cells. In conclusion, the present study showed that HPIP silencing might prevent TGF-β1-induced EMT in ovarian cancer cells. Thus, HPIP may be a potential therapeutic target for the treatment of ovarian cancer.