bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety level differentiation in 6-12 years old children before and after loss dental care using topical anasthesy at Dental Hospital Hasanuddin University
Authors: Hamudeng Adam M. , Ryanda Fynna R.
Published: December 2016

Anxiety is a psychological and physiological condition which signed by emotion, cognitive, and someone’s behavioral component. Anxiety behavior has long been recognized as the most difficult aspect in the management of patients and may frustrate a dental treatment that will be carried out, especially in children ages 6-12 years. Fear of treatment tooth extraction and local anesthesia is the main reason for kids disliking dental care. This type of research is observational analytic with nonprobability sampling technique, because this study used a population of pediatric patients who visited the location of the research that has been determined. Total sample of this research are 30 people who fulfill the criteria. The sample consist of 16 boys and 14 girls with age range of 6 to 12 years old. The level of anxiety before and after tooth extraction assessed using Facial Image Scale (FIS). Facial Image Scale (FIS) has five criteria which describe the level of anxiety in children, very happy by point 1, happy by point 2, normal by point 3, unhappy by point 4, and very unhappy by point 5. The results of the analysis of differences in anxiety with FIS measurement tools show there are differences in the level of anxiety in children before and after tooth loss based on the location of the jaw, the type of anesthesia applied topically, gender, and overall. Overall, there is a difference in children before and after tooth loss and the difference is significant
Effectiveness comparison of inferior alveolar nerve block anesthesia using direct and indirect technique
Authors: Yongki Rehatta , Kawulusan Netty N. , Purwanti Iis
Published: December 2016

Local anesthesia is important to do prior to tooth extraction procedure to control the patient's pain. Local anesthetic technique in dentistry consists of topical, infiltration, and anesthetic blocks. For molar tooth extraction, mandibular block technique is used either direct or indirect. This study aimed to see if there are differences in effectiveness of inferior alveolar nerve block anesthesia techniques between direct and indirect. This clinical experimental design study used 20 patients as samples during February-April. 10 patients were taken as a group that carried out direct technique while 10 others group conducted indirect techniques. The sample selection using purposive sampling method. Pain level were measured using objective assessments (pain experienced by the patient after a given stimulus) and subjective evaluation (thick taste perceived by the patient). The average time of onset in direct and indirect techniques in each sample was 16.88 ± 5.30 and 102.00 ± 19.56 seconds (subjectively) and 22.50 ± 8.02 and 159.00 ± 25.10 (objectively). These results indicated direct techniques onset faster than indirect techniques. The average duration of direct and indirect techniques respectively was 121.63 ± 8.80 and 87.80 ± 9.96 minutes (subjectively) and 91.88 ± 8.37 and 60.20 ± 10.40 minutes (objectively). These results indicated the duration of direct technique is longer than indirect technique. There was no significant difference when viewed from anesthesia depth and aspiration level. This study indicated that direct technique had better effect than indirect technique in terms of onset and duration, while in terms of anesthesia depth and aspiration level was relatively equal. Insignificant differences were obtained when assessing anesthetic technique successful rate based on gender, age and extracted tooth.
Patient satisfaction against the quality of dental health services at dental polyclinic of Tenriawaru General Hospital in Bone Regency
Authors: Akbar Fuad H. , Pratiwi Rini
Published: December 2016

Patient satisfaction against the quality of dental health serviceswas a comparison between the perception of care received by expectation before getting treatment. The Research was conducted at Tenriawaru General Hospital in Bone Regency based on the five dimensions of service quality, they were the assurance, empathy, responsiveness, physical appearance, and medical services by using Likert scale. The study was descriptive with a sample of 65 people. The research subjects were all visitors (patient) Dental Polyclinic of Tenriawaru General Hospital in Bone Regency. Results showed patient satisfaction on dimensions of assurance 84.6% falling into the category satisfied. On the dimensions of empathy showed 81.5% of patients satisfied. On the dimensions of responsiveness showed 36.9% of patients satisfied. On the dimensions of physical appearance showed 84.6% of patients satisfied. On the dimensions of medical services showed 72.3% of patients satisfied. Based on the result of patient satisfaction against the quality of dental health services at the Dental Polyclinic of Tenriawaru General Hospital in Bone Regency which reviewed from five dimensions showed patients satisfied against the quality of dental health services at Tenriawaru General Hospital in Bone Regency.
Parotid gland tuberculous abscess
Authors: Bustomi Ahmad F. , Sylvyana Melita , Syamsudin Endang , Rizki Kiki A.
Published: December 2016

Clinically speaking, parotid gland tuberculosis is a rare case. Its diagnostic values are hard to determine as it has clinical similarities with neoplasms. Mistakes during diagnosis happen quite often thus additional layer of examinations are required to be conducted. An 18-year-old woman was referred from a privately-owned hospital with initial diagnosis of infected parotic sinistra tumor. Physical examination discovered a swelling on her sinistra parotid gland and a lump at the colli sinistra region. Ultrasound scan showed benign hypoechoic areas and cystic regions at the left of submandibular muscle which then expanded towards the neck. Results from the PPD5TU (-), BTA 3X (1X positive) and FNAB pointed out an existing a/r parotid and colli sinistra or Tuberculous abscess. The diagnosis of parotid gland tuberculosis is often established after conducting superficial parotidectomy. During this discussion we will present and elaborate a case of parotid gland tuberculous abscess which was diagnosed with PPD5TU, BTA and FNAB. The patient managed to be cured with OAT distribution and no recurrences were recorded afterward. Parotid gland tuberculous abscess is rarely found in clinics. Tuberculosis examination (including PPD5TU and BTA) and FNAB need to be conducted to prevent unnecessary treatment and medical operations.
Fiber composites as a method of treatment splinting tooth mobility in chronic periodontitis
Authors: Ichwana Dewi L.
Published: December 2016

Patients with periodontal disease can lead to severe tooth mobility so often complains of pain when eating, decreased chewing ability and functional occlusion. Tooth mobility is a movement in a horizontal or vertical direction and one of the most unpleased effects from periodontal disease. Basically, tooth mobility is not a disease that requires treatment, but it is a symptom of periodontal tissue morphology changes, so it became a challenge for dentists in making decisions to maintain proper care of the teeth. Recent studies improved the use of periodontal splint with fiber reinforced composite (FRC) or fiber composite may lead to a long-term prognosis of teeth mobility due to periodontal disase. The case report describes treatment of chronic periodontitis patients with splinting fiber composites as a method for stabilization of the lower anterior teeth providing aesthetics, comfort, improved functionality occlusion, mastication and a good prognosis.
Preventive and conservative prosthodontic treatment using overdenture and Richmond crown
Authors: Cialy Jevin S. , Thalib Bahruddin , Dharmautama Mohammad , Wiro Wahipa , Ervina Ervina
Published: December 2016

Prosthodontic treatment aims to restore the chewing function (rehabilitation) and to prevent tooth decay and bone resorption (preventive and conservative). As an example, treatment by overdenture and Richmond crown. Overdenture is a partial or complete removable denture covered and supported by one or more teeth, the tooth roots and/or dental implants. Richmond crown is fixed denture by post and crown system, in which the post part goes into the root canal and its crown covers the entire of original tooth crown surface. By retaining the original teeth and/or roots, it could improve the stability and retention of the denture, and defend proprioseptic of teeth and vertical dimensions. To provide information about preventive prosthodontic treatment and prevention by using overdenture and Richmond crown. Case Report: A 50 year old woman only has 44 teeth on the mandible which is indicated for the overdenture construction and loss teeth 13, 14, 17 and 27 on the maxilla with deep caries in teeth 22 which is indicated for a removable partial denture (RPDs) construction by Richmond crown gear 22. On an early stage study, printing models is done. Then treatment of the root canal on teeth 22 and 44, followed by root canal preparation, core construction (cast post) and Richmond crown on tooth 22 and bareroot preparation on tooth 44 for overdenture construction. The procedure followed by printing, recording bite to insertion. Choosing treatment either overdenture or Richmond crown is very important because it could mantain remain original teeth, thus it can help to improve the retention and stabilization.
Enlargement gingival treatment on teeth 11 and 21
Authors: Tjiptoningsih Umi G.
Published: December 2016

Gingival enlargement in the interdental papillae, thickened, rounded gingival contour and discomfort became major issues that must be treated in order to be optimal appearance and function. Gingival enlargement that experienced fibrosis would not disappear with only plaque control, but required surgery that is gingivectomy and gingivoplasty. The 24-year-old woman came to the periodonsia clinic with complaints maxillary anterior gingiva swelled at teeth 11-21 with plaque index 52%. The depth of the tooth pocket 11: labial (mesial: 4, medial: 1, distal: 3). Palatal (mesial: 3, medial: 2, distal 1). The depth of the tooth pocket 21 is labial (mesial: 4, medial: 1, distal: 1), palatal (mesial: 3, medial: 1, distal 1). Gingivectomy treatment and gingivoplasty were performed with the aim of eliminating pockets and restore physiologic gingival contour which can help prevent the recurrence of the disease periodontal. In performing surgical gingivectomy and gingivoplasty, which must be considered is to minimize the disposal of gingival tissue to maintain the aesthetic, adequate access to the bone defect in order to make good corrections, and the minimization of bleeding and discomfort after surgery.
Hemimandibulectomy of mandibular large odontogenic myxofibroma in adolescence girl and immediate reconstruction with AO plate
Authors: Pamolango Victor T. , Nurwiadh Agus , Sylvyana Melita , Kasim Alwin
Published: December 2016

Odontogenic myxofibroma is a rare, benign, but locally aggressive neoplasm found exclusively in the jaws. It has a predilection to occurs in the 2nd–3rd decade. The lesion often grows without symptoms and presents as a painless swelling. Most common clinical variant is associated with the impacted tooth and shows local invasion. The surgical treatment of these tumors consists of complete enucleation or radical excision. 15th year old girl with a slow growing, painless swelling in the left mandibular region since 2 years. Results of a radiological examination revealed a multilocular radiolucency extending from first molar up to coronoid process with impacted 3rd molar. Biopsy was done, and the histopathological examination showed a myxofibroma. Hemimandibulectomy was done and the tumor mass was resected along with it. Then the mandibular was reconstructed with AO plate. In this case hemimandibulectomy was done due to high rate of recurrence, surgical treatment through bone resection is the most indicated treatment modality and the patient must be followed‑up closely for years. AO Plate for mandibular reconstruction was considered because it was safe, rapid, easy and tissue tolerance is good. The neoplasm diagnosed on the basis of radiographic imaging modalities and histopathological examination.
Prosthetic rehabilitation using adhesive bridge and fixed-fixed bridge on the maxilla and telescopic crown overdenture on mandible
Authors: Sulistiawaty Indah , Dharmautama Mohammad , Machmud Edy , Cialy Jevin S. , Elvi Elvi
Published: December 2016

Prosthetic rehabilitation is the rehabilitation process of masticatory and esthetics function for patients missing teeth and alveolar bone by means of manufacture and installation of dentures. The prosthetic rehabilitation commonly used include denture adhesive bridge, fixed-fixed bridge, as well as telescopic overdenture. Adhesive bridge is bridge denture consisting of single pontic and two retainer wings attached to the abutment using cement or resin. Fixed-fixed bridge is a bridge denture with rigid connectors on both ends of the pontics, whereas the telescopic crown Overdenture is a removable denture that uses linked precision on the original tooth in the form of primary coping on abutment and secondary coping on the denture. To expose the procedures of prosthetic rehabilitation using adhesive bridge and fixed-fixed bridge on the maxilla and telescopic crown Overdenture on mandible. Male patients aged 32 years came with complaints of difficulty to chew food because he had lost some teeth behind. In the maxilla, teeth are lost in the region of 15 and 16 performed by making the fixed-fixed bridge with abutment teeth 14 and 17. Loss of teeth in the region of 26, performed the manufacture of adhesive bridge with a box preparation on the occlusal 25 and 27. In the mandible, tooth loss in the region of 36,37,46, and 47 performed manufacture of telescopic crown Overdenture with primer coping on the teeth 35.38, 45, and 48 and the secondary coping on a metal frame. Prosthetic rehabilitation especially in the case of loss of back teeth is very important because with the denture patients can chew properly and maintain the stomatognathic system.
Moeda e crescimento: Uma análise para os municípios brasileiros (2000 a 2010)
Authors: Gama Fábio Júnior Clemente ,   Universidade Federal de Juiz de Fora, Brazil, Bastos Suzana Quinet Andrade , Hermeto Ana Maria ,   UFJF, Brazil,   UFMG, Brazil
Published: December 2016

Resumo: O objetivo do presente trabalho é analisar as relações entre o desempenho regional e variáveis financeiras para os municípios brasileiros, tendo como pano de fundo os conceitos da teoria pós-keynesiana. Com base na técnica de estatística multivariada de clusters, foi possível agrupar os municípios de acordo com as suas similaridades de desenvolvimento socioeconômico. Como resultado, obtiveram-se três clusters de municípios: Centrais, Intermediários e Periféricos. Empregando a técnica de dados em painel, avaliaram-se as implicações das variáveis financeiras e seus efeitos sobre o nível de atividade dos diferentes clusters de municípios. Os resultados para o período de 2000 a 2010 mostraram evidências a favor da hipótese de existência de efeitos diferenciados da moeda no sentido pós-keynesiano sobre o nível de atividade dos municípios brasileiros. Não obstante, essas evidências corroboram os resultados encontrados por uma gama de estudos aplicados para a questão regional do Brasil.
Proteinograma sérico de éguas com placentite ascendente e seus respectivos neonatos: dados preliminares
Authors: Haetinger C. , Curcio B.R. , Lins L.A. , Müler V. , Feijó L.S. , Pazinato F.M. , Amaral L.A. , Nogueira C.E.W.
Published: December 2016

RESUMO Este estudo teve por objetivo estabelecer o proteinograma sérico em éguas com placentite induzida e em seus respectivos neonatos. Foram coletadas amostras de sangue das éguas em oito momentos diferentes e dos potros em quatro momentos. Para obtenção da concentração das frações proteicas, utilizou-se eletroforese em gel de acrilaminada contendo dodecil sulfato de sódio (SDS-PAGE). No método utilizado, foram observadas 23 bandas proteicas, cujos pesos moleculares variaram de 16KDa a 245KDa, sendo possível a identificação das seguintes frações: 175KDa, 102KDa, 83KDa, 63KDa, 50KDa, 41KDa, 39KDa e 28KDa. De todas as bandas proteicas encontradas, somente as de 39KDa e 41KDa apresentaram alteração na cinética nos momentos avaliados. De acordo com a solução marcadora, pode-se sugerir que essas proteínas seriam α1-glicoproteína ácida (39KDa) e haptoglobina (41KDa). A concentração de imunoglobulinas nos potros apresentou aumento significativo a partir das 12 horas de nascimento. Não está elucidado se estes níveis refletem a persistência do processo inflamatório placentário ou se são alterações fisiológicas do periparto. Não foram observadas alterações na cinética das proteínas nos potros nas primeiras 48 horas.
Avaliação da interação biológica entre compósito de quitosana, colágeno e hidroxiapatita e tecido ósseo ovino
Authors: Marcondes G.M. , Nóbrega F.S. , Corrêa L. , Chavez V.E. Arana- , Plepis A.M.G. , Martins V.C.A. , Zoppa A.L.V.
Published: December 2016

RESUMO As lesões em membros de grandes animais são um desafio para médicos veterinários, uma vez que somente a osteossíntese não garante resultados satisfatórios. Muitos pesquisadores vêm se dedicando ao desenvolvimento e estudo de substitutos ósseos produzidos de materiais naturais, como quitosana, colágeno e hidroxiapatita, que auxiliam na regeneração óssea. Seis ovinos fêmeas da raça Santa Inês foram submetidos a ostectomias unicorticais de sete milímetros de diâmetro na região proximal da superfície dorsomedial dos III/IV metacarpianos. Foi implantado compósito de quitosana, colágeno e hidroxiapatita em um membro torácico para avaliação da biocompatibilidade do material ao tecido ósseo ovino, e no membro contralateral foi reproduzida a mesma técnica, porém foi mantido sem preenchimento, como controle. Após 60 dias do procedimento cirúrgico, realizou-se biópsia óssea na área de interface entre biomaterial/osso (membro com compósito) e tecido neoformado/osso (membro controle), para realização de avaliação histológica do material não descalcificado, por meio de microscopia de luz e microscopia eletrônica de varredura. Na análise histomorfométrica, mediante microscopia de luz, foi possível identificar maior porcentagem de tecido neoformado em membro controle, quando comparado ao membro com compósito (80% e 63,5%, respectivamente; P<0,05). Por meio da microscopia eletrônica de varredura, observou-se invasão da estrutura interna do compósito por tecido ósseo neoformado. Não houve formação de tecido cicatricial, reação de corpo estranho ou resposta inflamatória crônica nas amostras analisadas. Conclui-se que o compósito de quitosana, colágeno e hidroxiapatita, quando implantado em tecido ósseo ovino, apresenta biocompatibilidade e perfil osteocondutor.
Visceral Marek's disease in white-peafowl (Pavo cristatus)
Authors: Blume G.R. , Cardoso S.P. , Oliveira M.L.B. , Matiolli M.P. , Gómez S.Y.M. , Reis Júnior J.L. , Sant'Ana F.J.F. , Martins N.R.S.
Published: December 2016

ABSTRACT Marek's disease (MD) is a lymphoproliferative disorder caused by Gallid herpesvirus 2 (MDV) that infects mainly domestic gallinaceous birds although wild birds may occasionally be affected. The current report describes the anatomopathological and molecular findings of a case of MD in a white-peafowl (Pavo cristatus). The signs included apathy, hyporexia, and diarrhea. Grossly, 0.5 to 1.5cm in diameter, yellow, soft nodules were observed in the skeletal muscle, lung, kidney, air sacs, small intestine, heart, ovary, ventriculus, and proventriculus. Microscopically, numerous atypical round neoplastic cells were noted. The molecular detection of MDV DNA was implemented to amplify part of the meq gene and products were sequenced for the phylogenetic analysis. Template DNA was obtained from tissues of the affected bird and from blood of all the gallinaceous birds of the Zoo. The expected amplicon for the partial amplification of MDV meq gene was obtained and the amplicons were sequenced. Sequences obtained enabled grouping the strain (accession no. KT768121) with MDV serotype 1 strains from the GenBank. Based on the anatomopathological and molecular findings, the diagnosis of MD in a white-peafowl was reached, and to the authors' knowledge, no previous report regarding MD was published in Pavo cristatus.
Evaluation of the cardiopulmonary and antinociceptive effects of bupivacaine administered epidurally at the first lumbar vertebra in awake dogs
Authors: Silva P.E.S. , Nunes N. , Gering A.P. , Prada T.C. , Simões A.P.R. , Bompadre T.F.V. , Castro R.V.G. , Paula D.P.
Published: December 2016

ABSTRACT The aim of this study was to evaluate the effect of epidural bupivacaine administration at the first lumbar vertebra on cardiopulmonary variables, arterial blood gases and anti-nociception. Sixteen healthy female dogs were randomly assigned into two groups based on bupivacaine dose: G1 group, 1mg kg-1 or G2 group, 2mg kg-1, diluted in the same final volume (1mL4kg-1). Cardiopulmonary variables were measured and arterial blood gas was collected (T0), it was repeated 10 minutes after intravenous administration of butorphanol 0.4mg kg -1 (T1). Anesthesia was induced with intravenous etomidate at 2mg kg-1 and the epidural catheter was introduced and placed at the first lumbar vertebra. Thirty minutes later, bupivacaine was administered epidurally. Cardiopulmonary measurements and arterial blood gas analysis were recorded at 10 minute intervals (T2 to T6). Evaluation of pre surgical anti-nociception was performed at 5 minute intervals for 30 minutes by clamping the hind limbs, anus, vulva, and tail with the dogs awake. Subsequently, ovariohysterectomy was performed and adequacy of surgical anti-nociception was evaluated at 5 time points. Parametric data were analyzed using the F test with a <0.05 significance. After bupivacaine administration, there were differences between groups just for bicarbonate means (HCO3 -) on T6 (P=0.0198), with 18.7±1.3 and 20.4±0.8 for G1 and G2, respectively. After T1, before bupivacaine administration, both groups presented a slightly lower pH, base excess (BE), the end-tidal carbon dioxide tension (PECO2), and partial pressure of carbon dioxide (PaCO2), suggesting mild metabolic acidosis. G2 showed better antinociceptive effect both before and during surgery. It was possible to perform ovariohysterectomy in 87.5% of the G2 bitches and 25% of the G1 bitches. The two doses of bupivacaine evaluated do not cause important alterations in the studied parameters and the dose of 2mg kg-1 results in a better antinociceptive effect.
Are Abrolhos no-take area sites of naïve fish? An evaluation using flight initiation distance of labrids
Authors: Nunes José de Anchieta C. C. ,   Universidade Federal da Bahia,  Brazil, Loiola Miguel , Miranda Ricardo J. , Sampaio Cláudio L. S. , Barros Francisco ,   Universidade Federal da Bahia,  Brazil,   Universidade Federal da Bahia,  Brazil,   Universidade Federal de Alagoas,  Brazil
Published: December 2016

ABSTRACT Fishing pressure affects the behavior of reef fish, especially of fishery-targeted species. In this context, it is critical to understand if fish behavior is preserved in no-take areas (NTAs), which are considered the best instrument for the recovery of fish stocks. Comparing the flight initiation distances (FIDs) of fish inhabiting multiple-use areas (MUAs), where fishing is allowed (including spearfishing), and NTAs is a useful approach to test whether NTAs can be effective as fish refuges. Here, we compared whether the FIDs of two target (Sparisoma axillare and Scarus trispinosus ) and one non-target (Halichoeres poeyi ) labrids are greater in the MUAs than in the NTAs. We also investigated whether group size (GS) and body size (BS) exert any effect on the FID. We sampled four MUAs and four NTAs in the Abrolhos Bank (Brazil). We found that only for the targeted species FID was shorter inside the NTAs and that the BS had a positive effect on the FID of all species. The GS and BS of the fish are greater in the NTAs than in the multiple-use areas only for S. trispinosus . Our study shows that fish, especially those species that are fishery targets, display an avoidance behavior against spearfishermen likely as a consequence of fishing pressure. We suggest that the NTAs in Abrolhos are not only important sites for the recovery of fish stocks but also possibly act as a repository area of naïve fish (fish that allow human approach), for reefs open for fishing.
Linguagem, comportamento e neurodesenvolvimento na Síndrome de Joubert: relato de caso
Authors: Lamônica Dionísia Aparecida Cusin , Ribeiro Camila da Costa , Richieri-Costa Antonio , Giacheti Célia Maria
Published: December 2016

RESUMO A síndrome de Joubert (SJ) é uma condição genética heterogênea, rara, do grupo das ciliopatias. Mais de 20 genes foram identificados relacionados com este fenótipo. As principais manifestações incluem hipotonia, ataxia, atraso psicomotor, apraxia oculomotora e anormalidades respiratórias neonatais. O objetivo deste artigo foi apresentar achados de linguagem e neurodesenvolvimento de um indivíduo com diagnóstico da SJ. Foi realizada a anamnese, avaliação genética clínica, observação do comportamento comunicativo, avaliação da linguagem, o Teste de Screening de Desenvolvimento Denver-II (TSDD-II) e a Early Language Milestone Scale (ELMS). Os principais achados da Ressonância Magnética do encéfalo mostraram grave hipoplasia do vérmis cerebelar, “sinal do dente molar”, tronco cerebral hipoplásico, atrofia dos hemisférios cerebelares. A avaliação da linguagem mostrou ausência de oralidade, prejuízo na recepção da linguagem, confirmando o diagnóstico de transtorno de linguagem, com grau de comprometimento grave. O TSDD-II e a ELMS comprovaram a observação e avaliação clínica e indicaram atraso grave nos domínios motor, autocuidados e de linguagem receptiva e expressiva. Diante da presença de hipotonia, ataxia, atraso psicomotor e anormalidades respiratórias neonatais é imprescindível a realização de exame por imagem e avaliação genética para o diagnóstico desta condição, tão complexa, com necessidades terapêuticas peculiares. Este conjunto de achados, associado à história familial e características fenotípicas peculiares reforçam o diagnóstico genético clínico da SJ. Esta síndrome genética é pouco reconhecida e merece ser apresentada para o reconhecimento da comunidade científica, visando o diagnóstico correto e planejamento terapêutico que minimize os efeitos deletérios desta condição.
The importance of recognizing faciobrachial dystonic seizures in rapidly progressive dementias
Authors: Simabukuro Mateus Mistieri , Nóbrega Paulo Ribeiro , Pitombeira Milena , Cavalcante Wagner Cid Palmeira , Grativvol Ronnyson Susano , Pinto Lécio Figueira , Castro Luiz Henrique Martins , Nitrini Ricardo
Published: December 2016

ABSTRACT Background: Creutzfeldt-Jakob Disease (CJD) is the prototypical cause of rapidly progressive dementia (RPD). Nonetheless, efforts to exclude reversible causes of RPD that mimic prion disease are imperative. The recent expanding characterization of neurological syndromes associated with antibodies directed against neuronal cell surface or sympathic antigens, namely autoimmune encephalitis is shifting paradigms in neurology. Such antigens are well known proteins and receptors involved in synaptic transmission. Their dysfunction results in neuropsychiatric symptoms, psychosis, seizures, movement disorders and RPD. Faciobrachial dystonic seizure (FBDS) is a novel characterized type of seizure, specific for anti-LGI1 encephalitis. Objective: In order to improve clinical recognition we report the cases of two Brazilian patients who presented with characteristic FDBS (illustrated by videos) and anti-LGI1 encephalitis. Methods: We have included all patients with FBDS and confirmed anti-LGI1 encephalitis and video records of FDBS in two tertiary Brazilian centers: Department of Neurology of Hospital das Clínicas, Sao Paulo University, Sao Paulo, Brazil and Hospital Geral de Fortaleza, Fortaleza, Brazil between January 1, 2011 and December 31, 2015. Results: Both patients presented with clinical features of limbic encephalitis associated with FBDS, hyponatremia and normal CSF. None of them presented with tumor and both showed a good response after immunotherapy. Conclusion: FBDSs may be confounded with myoclonus and occurs simultaneously with rapid cognitive decline. Unawareness of FDBS may induce to misdiagnosing a treatable cause of RPD as CJD.
Efficacy of endovascular management approach of ruptured abdominal aortic aneurysm
Authors: De Oliveira Junior Senival Alves , Freire Artur Dantas , De Carvalho Aline Vasconcelos , Rafael Silva Xavier Clara , Barros Medeiros Lucas de Faria , Menezes Rego Amalia Cinthia , Araujo-Filho Irami
Published: December 2016

The abdominal aortic aneurysm (AAA) can present a serious complication, which is rupture, which is associated with a high mortality rate. As a result, the early surgery of ruptured abdominal aortic aneurysm can provide greater survival for these patients. However, there are two methods to do this fix. This article makes a bibliographical revision, in order to compare the procedures used in this emergency surgery (open and endovascular surgery technique), with the purpose of defining which approach offers greater benefit.
Evaluation of prognostic predictors of mangled extremity severity scoring system on the outcome of traumatic extremities injuries at emergency department in Suez Canal University Hospitals
Authors: Essa Ahmed A. , El-Shaboury Islam M. , El-Beltagy Yasmin E.
Published: December 2016

Background:Severe traumatic lower limbs injuries have been associated with high incidence of multiple systems involved (integument, nerve, bone, and vascular structures). That’s make difficulty and stress on surgeon’s decision making either to amputate or preserve the injured limbs. The Mangled Extremity Severity Score (MESS) was developed in Seattle (Johansen et al), based on both retrospective and prospective analysis of admission data of patients with severe limb injuries. The objective of this study was to evaluation of the prognostic predicting factors of outcome of traumatic extremities patients using Mangled Severity Scoring System at Emergency Department in Suez Canal University Hospital in order to help surgeon to make decision either to preserve or to amputate.Methods: This is a descriptive study (cross sectional), conducted on 60 patients with severe extremities injuries that met the criteria of the Mangled Extremity Severity Scoring attending to the Emergency Department (ED) at Suez Canal University Hospital.Results:This study showed that 83.33% of the patients had associated fractures, 8.33% of them had pneumothorax, 5% of them had abdominal collection and 3.33% of them had brain injuries. This study showed that 75% of the studied patients had MESS less than 7 while 25% of them had MESS > or = 7. The Mangled scoring system was a good predictor of amputation among the studied patients with sensitivity of 71.4%, specificity of 100% and 90% accuracy.Conclusions:Most of the patients had Mangled Extremity Severity Score less than 7. The MESS showed statistically significant difference between the amputated and the not amputated patients with 90% accuracy in prediction of amputation.
A prospective study of surgical site infections and related risk factors in a teaching hospital
Authors: Amrutham Rajanikanth , Reddy Madhu Mohan B. , Pyadala Nagababu
Published: December 2016

Background:Surgical site infections are the most common nosocomial infection causes morbidity and mortality among inpatients of hospital. Surgical site infection (SSI) varies hospital to hospital. The present study was designed to find out the incidence and various risk factors associated with surgical site infection in the surgical wards of MNR hospital, Sangareddy, Telanagana, India.Methods: The study was carried out on 248 patients who underwent various surgeries in the General Surgery department of MNR hospital, Sangareddy, Telangana, India. A predesigned protocol was used to collect the data. Surgical site infections were examined and graded. All the samples were collected aseptically and were processed by the standard microbiological techniques. Data was analysed by SPSS.20 software.Results:Among 248 patients, 45 developed surgical site infection. Among 45 patients, 25 were grade 3 and 20 were grade 4 type of infection. Surgical site infections (SSIs) were most commonly found among males, aged, diabetics, anaemic, underweight and overweight, hypertensive, blood transfusion and patients with longer hospital stay. Surgical Site Infections were higher in emergency cases than elective surgeries. Staphylococcus aureus was the most common organism isolated from surgical site infections. Multidrug resistance organisms were predominant in surgical site infections.Conclusions:The incidence of surgical site infection is high. Age, sex, diabetic, blood transfusion, prolonged hospital stay are the important risk factors for SSIs. So implementing proper antibiotic policies and infection control measures can reduce SSIs to great extent.
A prospective study of epidemiology and clinical presentation of non-traumatic acute abdomen cases in a tertiary care hospital of central India
Authors: Jain Rajiv , Gupta Vikas
Published: December 2016

Background:Acute Abdomen is a term used to encompass a spectrum of surgical, medical and gynecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment. The purpose of this study was to identify the epidemiological pattern and to determine the spectrum of disease causing “non-traumatic acute abdomen in central India”.Methods: This is a prospective study of 98 patients of non-traumatic acute abdominal cases conducted in the Department of Surgery, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India. In this study, preoperative detailed history and thorough physical examination was done for all acute abdominal emergencies, to arrive at pre-operative diagnosis.Results:Amongst the study of 98 patients, males have higher incidence of acute abdomen with the young age group (21-30 years) most commonly affected. Perforation peritonitis constituted the most common cause of acute abdomen (39.7%), followed by acute appendicitis (37.7%), followed by intestinal obstruction (14.2%).Conclusions: This study was conducted to evaluate the epidemiology, etiology and differential diagnosis of non-traumatic acute abdomen. At the end of the study, we had a better insight of the spectrum of the condition and we concluded that there is more scope for further work in the same field for better understanding of this topic.
Evaluation and management of cholelithiasis in children: a hospital based study
Authors: Bhasin Sanjay Kumar , Gupta Ankit , Kumari Sunita
Published: December 2016

Background:Earlier cholelithiasis was extremely unusual in childhood. Presently there is sharp increase in detection of cholelithiasis in children, which forms basis to investigate the overall changing pattern of cholelithiasis. This prospective study in referral centre has been under taken to evaluate childhood cholelithiasis and its management.Methods: The present prospective study was conducted in the Postgraduate Department of Surgery, GMC Jammu, Jammu & Kashmir, India over a period of two years. 80 patients in age group of 3-14 years were included in the study group with ultrasound proved cholelithiasis. Data reviewed with respect to patient demographics profile, clinical history including risk factors, imaging studies, operative techniques, postoperative complications, postoperative recovery and primary outcome parameters assessed accordingly.Results:During the study period 80 children (52 males and 28 females) with cholelithiasis were evaluated and treated by laparoscopic cholecystectomy. The mean age was 10.1 years (range 5 to 14 years). 75% patients (n = 60) belonged to rural background and rest to urban set up, 56 patients belonged to hindu religion and rest were muslims. In 47.5% patients no risk factor could be traced. Fifty two children (65%) had mixed gallstones. 78 patients underwent LC, two needed conversion and rest 02 children were subjected to mini cholecystectomy. The mean operative duration was 29.92 minutes (range 15-50 minutes). The average duration of hospital stay was 3.82 days (range 3-8 days). No major intra operative or post-operative complications could be detected except 01 case biliary peritonitis.Conclusions:Cholelithiasis in children was reported about three centuries back, remained relatively uncommon in the past but now it is evolving and ever increasing in frequency. In this part of country in almost 50% of patients risk factors could not be traced, obesity could not be held responsible for cholelithiasis. Male children with low socioeconomic status, rural area and belonging to Hindu religion were more affected by the disease. In view of high incidence of serious complications of gall stones in children and because of longer life expectancy we also recommend that expectant management of gallstones may not be safe and hence laparoscopic cholecystectomy must be done even in asymptomatic cholelithiasis.
A clinical study of gastric outlet obstruction
Authors: Clement H. Suresh , Cherukumalli Ram Prasad , Rao Ch. Ravinder
Published: December 2016

Background:From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but, is more often placed immediately proximal to the spinchter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. The aim was to study infantile hypertrophic pyloric stenosis, benign peptic ulcer and gastric carcinoma and evaluation of electrolyte abnormalities in gastric outlet obstruction, to study various modalities of treatment and to assess pertaining to recovery from paralytic ileus.  Methods: This was a clinical observational study comprising of 40 cases of gastric outlet obstruction. The patients for this study have been selected from Prathima Institute of Medical Sciences, Karimnagar, Telangana, India from December 2013- November 2015. The cases were selected who were willing to undergo surgery.Results:Congenital hypertrophic pyloric stenosis (CHPS) is more common among first born male infants. Parental consanguinity is associated with increased incidence of congenital hypertrophic pyloric stenosis. CHPS is common in the age group of first 3-6 weeks of life (average 4 weeks). Males are more commonly affected with gastric outlet obstructions in adults. Cicatrized duodenal ulcer is more common in the age group of 30-40 years, while carcinoma stomach is more common in age group of 50-60 years. Vomiting and visible gastric peristalsis are the most common and constant symptom and sign of gastric outlet obstruction, more so in cases of cicatrized duodenal ulcers.Conclusions:Ramstedt’s pyloromyotomy is the gold standard treatment for CHPS. Patients with gastric outlet obstruction due to cicatrized duodenal ulcer require truncal vagotomy with posterior gastrojejunostomy. Vagotomy is optional in view of better response with drugs for APD. Antral carcinoma cases require curative or palliative surgery depending on the stage of the disease.
Retrospective analysis of 30 cases of pilonidal sinus by various techniques of conservative and surgical management and review of literature
Authors: Karandikar Sangram , Naik Narendra G.
Published: December 2016

Background:The pilonidal sinus disease may present as chronic cutaneous infection, pilonidal abscess, pilonidal sinus or recurrent pilonidal sinuses. There are several conservative non-surgical and surgical methods of treatment of pilonidal sinus. The wound healing of pilonidal sinus depends upon multiple factors such as the stage at which patient presented to the surgeon, co-existing medical conditions, method of medical/surgical treatment chosen and the expertise of the surgeon. Here we are presenting the retrospective analysis of 30 cases of pilonidal disease, in view of different modalities of treatment, challenges faced, post-operative results and hospital stay.Methods: Over a period of 7 years, 30 patients suffering from various stages of pilonidal sinus disease were treated by conservative and surgical methods. The choice of treatment modality offered to each patient was individualized based on the stage and severity at the time of presentation. The patients were followed up to assess recurrence for 1 year after complete healing of the pilonidal sinus.Results:All patients with pilonidal sinus/ ulcer < 5 mm showed complete healing without recurrence with conservative line of management. There was recurrence of sinus in 80 % patients treated with only Incision and Drainage for pilonidal sinus abscess. The patients with large sinus (> 5 mm ulcer or skin involvement), were treated by excision with healing by secondary intension. This group of patients was associated with recurrence in 80% cases. The remaining patients with large pilonidal sinus disease were treated by the newer technique of semi-closed method with drain. In this group, only 20% patients developed recurrent sinus. All patients with recurrences healed after either conservative method or surgical method involving local skin flap.Conclusions:The conservative method of treatment is suitable for early and superficial pilonidal sinuses. For chronic and extensive pilonidal sinus disease, surgical treatment with the newer technique of semi-closed method with drain was found to reduce the rate of recurrence. The cases with superficial recurrent pilonidal sinuses may heal with conservative approach and extensive recurrent lesions require reconstruction with local skin flap. The results of the newer technique of semi-closed method with drain were found to be comparable with that of surgery by excision with primary closer. These results may be further evaluated at high volume centre for practical statistical significance regarding choice of treatment.
Benzodiazepine hypnotics as oral preanaesthetic medication: a comparative clinical study
Authors: Dasgupta Arup , Dasgupta Sayandev , Sen Supratik , Sen Sukanta , Sinha Girish Kishore
Published: December 2016

Background:An ideal pre-medicant should allay fear and anxiety without producing its effect on vital functions of the body and body chemistry, with minimal depression of the respiratory and circulatory systems. The ideal pre-medicant with all good qualities and no side effects at all is yet to be found. The search for a drug which will be an appropriate pre-anesthetic medication is still going.Methods: Four drugs of BZD group namely diazepam, nitrazepam, lorazepam, and oxazepam were chosen as oral pre-anesthetic medication. Total number of cases were 100, of which 25 patients belonging to each group of drug respectively. Standard doses of oxazepam (30 mg), nitrazepam (5 mg), diazepam (10 mg) and lorazepam (2 mg) by oral route were administered. All study participants were examined night before operation to observe the following clinical parameters like level of apprehension, excitement, blood pressure, heart rate, respiration (rate, rhythm and minute volume).Results:Diazepam and nitrazepam produced fair degree of sedation whereas oxazepam appears to be lagging behind. So far as anxiolysis is concerned, all the drugs appear to be good anxiolytics. Nausea, vomiting and dizziness are some of the problems which may occasionally be faced by this group of drug. On reassessment of patients 60 minutes after premedication, it was revealed that the efficacy so as anxiolysis and sedative effect is concerned was in the following order, lorazepam headed the list; diazepam and nitrazepam followed closely and oxazepam was at the bottom. Toxicity in all the four drugs were minimal. The degree of sleepiness varied from drug to drug. Ninety minute after premedication patients were found to be in a better state of sedation than at 60 minute’s level in all the four groups. The degree of sedation and anxiolysis was in the same order as that of 60 minutes level.Conclusions:The overall impression was that four members of the benzodiazepines, serve as as a good premedication in the absence of pain. The sedation and anxioysis produced by them are of fair degree even when given orally. Side effects produced were minimal except in the lorazepam group when they are used as night time sedative. Given orally only lorazepam is capable of producing anterograde amnesia.
A case series of laproscopic management of hydatid cyst of liver
Authors: Pothare Amit N. , Ilamkar Karuna N.
Published: December 2016

Background:Hydatid cyst is zoonosis caused due to Echinococcus species mainly, Echinococcus granulosus and Echinococcus multilocularis. It was first described by Hippocrates as “liver full of water”. In developing countries like India, Iran, China and Mediterranean countries it is still remains a major problem. It can involve any organ and can mimic almost any pathological condition.Methods: The present study was carried out from January 2014 to December 2015. Total 20 cases of liver hydatid operated laproscopically studied prospectively. Omentoplasty with external drainage was done as sole operative modality. Postoperative follow up was done on 2nd week, 1, 3 and 6 months.  Results:Among the observed patients most common age group was 31-40 years (40%), with male predominance (60%). Abdominal pain was most presenting symptom (65%). Right lobe involved involved in 75% patients. Cysts are usually single (90%). Bleeding and contamination of peritoneal cavity with scolices was main intra-operative complication (5% each). Mean operative time was 99.95 minutes. In post-operative period biliary leak was major complication (10%). Cosmetic results were good with barely visible scar (90%).Conclusions:Surgery is the gold standard treatment for hydatid liver and laproscopic technique is gaining more and more importance with advantage of being minimal invasive and less complications with better patient satisfaction.
Oesophagogastroduodenoscopy in patients with incidental cholelithiasis, its significance and therapeutic value: an observational study
Authors: Kalpande Sanket , Mondal Abhishek , Pandya Jayashri
Published: December 2016

Background:Cholelithiasis along with other causes of upper abdominal pain, have a similar mode of presentation. Often the cholelithiasis is an incidental finding not causative. Aims and objectives of this study was to determine the role of oesophagogastroduodenoscopy (OGDscopy) in patients presenting with upper abdominal pain and sonographically documented cholelithiasis being considered for cholecystectomy and to eliminate the confounding causes of pain and avoiding cholecystectomy in incidental cholelithiasis.Methods: 200 patients with upper abdominal pain (typical/atypical) and sonographically documented gallstones underwent OGDscopy. Patients with normal OGDscopy underwent cholecystectomy while it was deferred in those with positive OGDs copy findings. These patients were appropriately managed and followed up with a repeat OGDscopy at 6 weeks. All patients were re-assessed for resolution of symptoms at 6 weeks and those with persistence of symptoms in spite of a normal OGDscopy on reassessment were then subjected to cholecystectomy. Pearson’s chi-square test was applied to study association between type of pain (typical/atypical) and OGDscopy findings and type of pain (typical/atypical) and requirement for cholecystectomy.Results:Of the 200 patients, 120 presented with typical and 80 with atypical pain. Among those with atypical pain (n = 80), a significant 95% (76/80) had positive findings on OGDscopy while none of those with typical pain had positive finding on OGDscopy (p<0.005). Cholecystectomy to relieve pain was needed in all 120 patients with typical pain while only 17.5% (14/80) of those with atypical pain required cholecystectomy (p<0.005).Conclusions:The study shows that OGDscopy in patients with cholelithiasis can suggest alternative management plan particularly in those with atypical pain.