bluuebunny/crossref_metadata_2025 huggingface dataset:
Enmarcando cuestiones controvertidas: el uso de drogas como problema de política pública en Argentina.
Authors: Cunial Santiago Luján
Published: June 2016

Toda política pública se funda en determinadas visiones del problema al que busca responder. En lo que refiere a la problemática del uso de drogas, desde comienzos del siglo XXI diversos Estados han propuesto leyes y políticas públicas que cuestionan el paradigma prohibicionista desde una perspectiva de derechos humanos y salud pública. La presente investigación se interroga: ¿cómo enmarcan los decisores políticos la cuestión del uso de drogas ilegales en Argentina? El objetivo general es describir y comparar los modos en los que los policymakers se representan la problemática del uso de drogas ilegales en Argentina. Realicé un estudio de caso sincrónico, descriptivo y exploratorio, sustentado en el análisis del corpus normativo de políticas públicas nacionales vigentes a mayo del 2014 en Argentina y de fuentes documentales de los decisores políticos implicados en la problemática.

La cuestión del uso de drogas ilegales en Argentina ilustra cómo un mismo problema conlleva diferentes formas de interpretarlo. En los documentos analizados surge que el uso de drogas ilegales responde a una crisis de valores y otra socioestructural, que llevan a los ciudadanos al consumo de estupefacientes y que impiden que puedan desarrollarse plenamente. La delimitación de estas dos causas da lugar a cuatro modos de enmarcar la cuestión: como un problema de seguridad; de salud pública; de desarrollo y salud social; y como una cuestión que forma parte de la autonomía de los individuos. Las respuestas del Estado para hacer frente al problema del uso de drogas varían en función de cada tipo de marco: en los documentos coexisten medidas de seguridad, de inclusión social y curativas. Finalmente, la multiplicidad de marcos con los que los decisores políticos piensan la cuestión del uso de drogas ilegales se traduce en cuatro modos de enmarcar a los usuarios: como enfermo-paciente; como excluido social; como potencial delincuente; y como sujeto de derechos.
Otro socialismo y la cuestión del indio: la política en el pensamiento de Mariátegui
Authors: Fajardo Carrillo Christian
Published: June 2016

La reflexión de Mariátegui acerca de una política no-colonial gira alrededor de una concepción particular del socialismo. Desde esta apuesta se deriva el llamado que hace el pensador peruano, en el tercer aniversario de la revista Amauta, a una generación para “situar” el pensamiento sobre la emancipación de los pueblos del Perú. Ahora bien, para comprender esta invitación es preciso mostrar cómo Mariátegui, en los Siete ensayos sobre la interpretación de la realidad peruana, busca redefinir un socialismo propio de la realidad peruana sin crear una oposición dicotómica entre Indoamérica y Europa. De ahí que se pueda decir que el elemento fundamental que definiría un socialismo Indoamericano no consiste en suscribir dicha oposición, sino más bien someter a crítica las condiciones que hacen posible que exista una frontera de sentido que separa, de una manera dicotómica, Indoamérica y Occidente o incluso lo mismo y lo otro. Para sostener esta hipótesis el siguiente texto hará un recorrido por la comprensión quechua de lo común y de la religión y, para finalizar, se analizará la perspectiva de Mariátegui sobre el papel que jugó la literatura alrededor a la cuestión del indio.
Nanopartículas lipídicas a base de propóleos como transportadores de activos de interés cosmético: Desarrollo, caracterización y evaluación de seguridad
Authors: Correa González Yuly X. , Paillié Jiménez Daniela , Valenzuela Correa Alba L. , Rojas Cardozo Maritza A. , Mora Huertas Claudia E.
Published: June 2016

En el ámbito cosmético, la tecnología a escala nanométrica resulta atractiva para el diseño de productos novedosos y funcionales. Así, para el caso de las nanopartículas lipídicas, se ha demostrado su capacidad para incrementar la estabilidad de moléculas activas y modificar su liberación. Como un aporte en la búsqueda de alternativas innovadoras para la preparación de este tipo de transportadores (carriers), el presente trabajo propone el aprovechamiento de las ceras provenientes de propóleos para la preparación de partículas lipídicas conteniendo extracto del árbol de té. Las partículas obtenidas presentan tamaños cercanos a 200 nm con polidispersidades inferiores
a 0,1. Los valores de potencial zeta cercanos a cero sugieren un mecanismo de estabilización del sistema particulado vía efecto estérico. De otro lado, la incorporación del activo dentro de la estructura de las partículas es confirmada por DSC. En conjunto, los resultados evidencian la posibilidad de generar valor agregado a un producto de la colmena reconocido y valorado por sus propiedades biológicas. Además, ofrecen un material de partida que constituye una alternativa interesante para el desarrollo de productos cosméticos novedosos en los que podrían incorporarse moléculas activas.
Costo efectividad del suplemento de calcio para reducir la mortalidad materna asociada a preeclampsia en Colombia
Authors: García Molina Mario
Published: June 2016

Objetivo. Estimar el costo-efectividad de la administración de calcio (1 200 mg diarios) a partir de la semana 14 de gestación a todas las gestantes, comparada con no administrarlo, para reducir la incidencia de preeclampsia. Métodos. Se construyó un árbol de decisión en TreeAge® con desenlace en años de vida ganados (AVG). Los costos se incluyeron desde la perspectiva del sistema de salud colombiano, en pesos (COP) de 2014. La tasa de descuento fue de 0%. Se realizaron análisis de sensibilidad univariados y probabilísticos para costos y efectividad. Resultados. El suplemento de calcio es una alternativa dominante frente a la no intervención. Si la incidencia de preeclampsia es menor a 51,7 por 1 000 gestantes o el costo por tableta de calcio de 600 mg es mayor a COP$ 507,85, el suplemento de calcio deja de ser una alternativa costo-efectiva en Colombia para un umbral de 3 veces el PIB per cápita de 2013 (COP$ 45 026 379) por AVG. Conclusiones. La administración de calcio a todas las gestantes a partir de la semana 14 de gestación es una alternativa dominante frente a la no intervención, que permite ganar 200 años de vida, al tiempo que disminuye costos del orden de COP$ 5 933 millones por 100 000 gestantes.
La afirmación de un Panamá extrovertido en las narrativas de Ángel Ricardo Martínez y Ramón Francisco Jurado
Authors: López Cruz Humberto
Published: June 2016

Aspectos que descuellan en la narrativa contemporánea panameña proponen, como nuevas tendencias, dejar atrás ciertas convicciones temáticas ya que se desea no tan lo superar algunos de los conceptos trabajados, sino avanzar hacia otros desmontajes textuales. Con el propósito de añadir a las ideas precedentes, no de enmendarlas, se sugeriría que una vez que se expandieran los horizontes narrativos y se lograra una madurez literaria, el siguiente paso debería ser el indagar, con igual rasero, qué se podría lograr después. Es en este punto donde una lectura extrovertida de los espacios geográficos en cuestión, expuestos por Ángel Ricardo Martínez, en De Marruecos a Kenia. Crónicas de un panameño en África (2013) y Ramón Francisco Jurado, en Impulsos taliónicos (2013), pudiera arrojar nuevas posibilidades interpretativas. Esta propuesta genera, además, un acercamiento discursivo a los estudios transatlánticos y logra así una satisfactoria intersección en los textos analizados.
La sexología frente al cuerpo de las biomujeres: un análisis crítico a partir de dos programas televisivos
Authors: Fernández Fernández Daniel
Published: June 2016

El presente artículo analiza el tratamiento de la sexualidad de las biomujeres por parte del discurso sexológico, tomando como referente dos programas televisivos en los que interviene el criterio de un profesional de dicho campo. Contrario a otras producciones televisivas con enfoque sexológico en las que prima una perspectiva “orgasmológica”, la visión que presentan dichos programas conlleva un acento marcadamente mórbido y profiláctico, dando como resultado una corporalidad femenina deserotizada. Concomitantemente, la sexualidad femenina deviene en estos programas un objeto de codificación binaria, aspecto que ratifica los patrones coercitivos del contrato heterosexual.
Tejiendo espacios queer en Latinoamérica: el travestismo en Herrera Velado y Donoso
Authors: Melgar Jonathan Eli
Published: June 2016

En esta investigación comparada, me propongo explorar los personajes travestis en “La corrección de menores (Manuscrito de un escolar)”, un poema que pertenece a Mentiras y verdades (1923) por el salvadoreño Francisco Herrera Velado (1876–1966), y El lugar sin límites (1966), una novella del chileno José Donoso (1924–1996). Al comparar ambos textos, mi intención no es de contrastar los niveles de sofisticación o estética, sino identificar una línea de textos queer en Centroamérica que podrían abrir un nuevo espacio dentro de los estudios queer en Latinoamérica. Específicamente, en este proyecto me enfocaré en una breve contextualización de los estudios queer en Latinoamérica; la inversión de roles sexuales que fue acuñada en el ya clásico ensayo “Escritura/Travestismo” (1969) de Severo Sarduy; la representación de las mujeres en la inversión y la revisión de una interpretación acerca del poema de Herrera Velado.
The law of the canals and postural clinic*
Authors: Gagey Pierre-Marie
Published: June 2016

An hypothesis on the construction of the coherence of the perception of space, visual and proprioceptive, through the three afferents, retinal, oculomotor and canalicular, allows us to offer a way to deconstruct this consistency by an optical prism. And this deconstruction exhibits the organization between space perception and regulation of the postural tonic activity.
The war against cancer: Suicide gene therapy
Authors: Izmirli Muzeyyen , Sonmez Dilara , Gogebakan Bulent
Published: June 2016

The National Cancer Institute and the American Cancer Society announced that 1.6 million new cancer cases are projected to occur in the USA in 2016. One of the most innovative approaches against cancer is suicide gene therapy, in which suicide-inducing transgenes are introduced into cancer cells. When cancer treatments target the total elimination of tumor cells, there will be no side effects for normal cells. Cancer tissues are targeted through various targeted transport methods, followed by tissue-specific enzymes converting a systemically suitable prodrug into an active drug in the tumor. Suicidal genes are delivered by transporters, such as viral and non-viral vectors, into cancer cells. Suicide gene therapeutic strategies currently pursued are herpes simplex virus thymidine kinase gene with prodrug ganciclovir, cytosine deaminase gene, carboxyl esterase/irinotecan, varicella zoster virus thymidine kinase/6-methoxypurine arabinonucleoside, nitroreductase Nfsb/5-(aziridin-1-yl)-2,4-dinitrobenzamide, carboxypeptidase G2/4-[(2-chloroethyl)(2- mesyloxyethyl)amino]benzoyl-L-glutamic acid, cytochrome p450-isofosfamide, and cytochrome p450-cyclophosphamide. The goal of this review is to summarize the different suicide gene systems and gene delivery vectors addressed to cancer cells, with a particular emphasis on recently developed systems. Finally, we briefly describe the advantageous clinical applications and potential side effects of suicide gene therapy. 
Digestive resections in advanced-stage ovarian cancer
Authors: Bacalbasa Nicolae , Ionescu Olivia , Ionescu Paris , Balescu Irina
Published: June 2016

The standard frontline treatment for advanced-stage ovarian cancer (ASOC) consists of maximal cytoreduction surgery associated with platinum/paclitaxel-based chemotherapy. Several studies have proven that patients with no gross residual disease (RD) have better survival rates than those with optimal but visible RD (RD ≤1 cm). In order to achieve this, more radical cytoreductive procedures such as radical pelvic resection and extensive upper abdominal procedures are performed. However, some investigators have suggested that, although effective, radical surgery cannot fully compensate tumor biology, which is a major determinant in survival and in turn influences the likelihood of surgical cytoreduction. The aim of this review was to present the procedures defining ultra-radical (extensive) surgery and to evaluate its feasibility and morbidity in the management of ASOC.
The Effectiveness of Inside-Outside Circle Method by Using Cue Card for Students’ Speaking Ability at Seventh Graders
Authors: Wijaya Armeria , Sudrajad Mochammad
Published: June 2016

As far as the researcher’s knowledge, the analysis of “The Effectiveness of Inside-Outside Circle Method  by Using Cue Card for Students’ Speaking Ability” is still difficult to find, the researcher formulates the  statement of the research, Inside-Outside Circle method is effective for student’s speaking ability. The objective of research is to find out whether Inside-Outside Circle method can be effectively for students’ speaking ability. This research uses experimental design. The subject are 7B grade as experimental group and 7C as controlled group at SMP Muhammadiyah 11 Surabaya, this sample is taken by snowball sampling. The data collection uses test (pre-test and post-test) as intrument to measure the result of students. The results of the research will be counted using T-test statistic with
La prostitución, una mirada desde sus actores
Authors: Montoya Restrepo Luisa Fernanda , Morales Mesa Santiago Alberto
Published: June 2016

Este artículo surge de la investigación Aspectos sociales y familiares que conllevan al ejercicio de la prostitución a 14 jóvenes de la ciudad de Medellín, a partir de sus relatos de vida, que en su proceso de generación de información implementó entre otras estrategias, una serie de talleres con población –hombres y mujeres– en ejercicio de la prostitución y con el equipo profesional que les brinda atención psicosocial, como parte del desarrollo del diseño metodológico planteado para la generación de información. Con esta publicación se pretende reflexionar sobre las diferentes concepciones y significados que se le ha dado a la palabra prostitución, estigmatizada no solo desde el imaginario social, sino también desde la religión. Se retoman para ello algunas posturas disciplinares y especialmente las voces de los actores que participaron como fuentes originales en el proceso de investigación; por ende, se realizará un breve recorrido que recoja las connotaciones más comunes de las personas que ejercen cotidianamente la prostitución. © Revista Colombiana de Ciencias Sociales.
Clément Rosset y la experiencia musical
Authors: López Betancur Olga Del Pilar
Published: June 2016

Este artículo se centra en una inquietud fundamental: pensar la filosofía musical en Clément Rosset. Para comprender las premisas fundamentales que guían al autor, debemos tener en cuenta su lectura de Schopenhauer, Nietzsche y Jankélévitch, ya que es con estos filósofos-músicos que Rosset elabora su comprensión de la música. Por ello, si es posible reconocer una línea de pensamiento que ligue la filosofía y la música desde el siglo XIX, es necesario a la vez preguntarnos si con Rosset existe una verdadera modificación, o si su escritura se dedica a repetir únicamente los enunciados ya planteados por Nietzsche y Jankélévitch. Este debate es pertinente, ya que Rosset es considerado en Francia como el heredero de una nueva filosofía musical, sin embargo su aporte no aparece muy claro, lo cual nos hace pensar que es la única alternativa que queda frente a la escasez filosófica que sufre el ambiente intelectual parisino. Queremos ver, por tanto, si las reflexiones de Rosset llevan la filosofía musical hacia nuevos territorios o si estamos frente a un silencio que se impone por la incapacidad de filosofar.© Revista Colombiana de Ciencias Sociales.
Eficacia de dos programas de prevención del consumo de alcohol en función del tipo de aplicador
Authors: Gázquez Mónica , García del Castillo José A. , García del Castillo-López Álvaro
Published: June 2016

Currently, it is still unclear how to translate effectively programs validated in research for use in real-world contexts. Among the efforts being made to identify strategies which optimize the application of these programs in everyday practice are tests of the differential effectiveness of the programs depending on the application agent. Method: this study analyses the effects of two programs on alcohol use and its variables as a function of provider type. Two hundred students from the first year of secondary education were distributed among five experimental conditions: four treatment conditions, in which the two programs were applied by teachers at the school or external psychologists, and a control condition. Results: the results suggest that, for both programs, teachers obtain better outcomes in alcohol use and concern about addiction. Conclusions: teachers are the ideal application agents in terms of efficiency, and we discuss the implications for research and preventive practice.
Compromiso ético-político de los profesionales de las Ciencias Sociales
Authors: Durán Palacio Nicolasa María
Published: June 2016

Una reflexión sobre la importancia que tienen las ciencias sociales y el quehacer ético de sus profesionales. © Revista Colombiana de Ciencias Sociales.
Movimientos sociales con racionalidad ambiental: el caso de Kimsakocha
Authors: Alvarado Vélez Julio A.
Published: June 2016

El presente artículo estudia el surgimiento de movimientos sociales en la provincia de Azuay. En particular, se enfoca en aquellos movimientos en defensa del agua en el páramo Kimsakocha y que al mismo tiempo rechazan la minería en gran escala. Para ello, el artículo utiliza como método de investigación un estudio de caso. Se examina el período desde los primeros indicios de movilizaciones en el 2003, hasta la aprobación del mandato minero en el 2008. La hipótesis de la investigación sugiere que los movimientos sociales que surgieron en torno a la minería en gran escala en Ecuador durante el período 2003-2008 son portadores de racionalidad ambiental, construyen su identidad con base en la defensa del agua. Los resultados demuestran el surgimiento de movimientos sociales con racionalidad ambiental que, además, construyen su identidad con base en la defensa del agua. © Revista Colombiana de Ciencias Sociales.
La profecía de Freud: del psicoanálisis a la biología de la mente en el estudio del origen y tratamiento de la enfermedad mental
Authors: Jiménez-López José Luis
Published: June 2016

Sigmund Freud fue considerado un científico revolucionario de la talla de Nicolás Copérnico y Charles Darwin por sus teorías psicológicas sobre el funcionamiento mental en un momento en el que la biología no podía explicarlo. En sus inicios, el psicoanálisis no fue aceptado por los profesionales de la medicina debido a la falta de verificación empírica de sus conclusiones y a la imposibilidad para identificar los sustratos orgánicos que Freud suponía que participaban en la psicopatología; sin embargo, a mediados del siglo pasado se convirtió en el principal fundamento para la psiquiatría en el tratamiento de la enfermedad mental, lo que la distanció del resto de las especialidades médicas. El psicoanálisis, como herramienta terapéutica, empezó a ser sustituido por tratamientos con evidencia empírica en el ámbito psiquiátrico como consecuencia de los descubrimientos sobre el mecanismo de acción de los psicofármacos y la aparición de psicoterapias breves. En este artículo se presenta un breve recorrido sobre el estudio de la enfermedad mental desde el nacimiento de la psiquiatría hasta la época actual, y los recientes hallazgos de las neurociencias que sugieren que se han empezado a descubrir los mecanismos orgánicos que Freud suponía involucrados en la génesis y tratamiento de los trastornos mentales. © Revista Colombiana de Ciencias Sociales.
Contradicciones del sistema y mundo de la vida desde un tiempo acelerado
Authors: Román Maldonado Carlos Eduardo
Published: June 2016

El artículo presenta la colonización del mundo de la vida por el sistema desde la perspectiva del tiempo social, donde el tiempo sistémico impone sus lógicas productivas y expansivas frente a las del mundo de la vida afectando a los individuos porque acelera el tiempo social haciéndose más rápido. En este sentido, el sistema y el mundo de la vida como categorías de análisis presentan una dialéctica que abordamos en términos del tiempo social. La metodología es la hermenéutica textual. La densidad social del sistema crece exponencialmente y la del mundo de la vida disminuye re-significando lo social en términos funcionales, siendo necesario más tiempo del que antes se tenía. © Revista Colombiana de Ciencias Sociales.
Conflictos socioambientales y acción colectiva de jóvenes de la región de Los Lagos (Chile)
Authors: Cabello Cádiz Patricio , Torres Rodrigo
Published: June 2016

Esta investigación caracteriza la articulación entre los conflictos socioambientales y la participación política y ciudadana de jóvenes de la Región de Los Lagos, Chile. Se realizaron 44 entrevistas en profundidad a jóvenes entre 18 y 30 años de edad, que participan en algún tipo de colectivo, organización ciudadana o política. Entre los principales resultados, podemos indicar que la identidad y los afectos operan tanto como medio para la integración, como para el impulso de la acción colectiva en conflictos ambientales. Se discute el papel de los conflictos ambientales en la construcción de los jóvenes de la Región como individuos y sujetos colectivos, emergiendo identidades que podemos denominar “ecoterritoriales”. La discusión de estos resultados permite además resaltar la profunda crisis de legitimidad de las formas de representación, sobre todo cuando lo que está en disputa es el territorio y el medioambiente. © Revista Colombiana de Ciencias Sociales.
Effect of Family Ownership towards Tax Aggressiveness on Food and Beverages Industrial Company Listed in Indonesia Stock Exchange
Authors: Sunaryo Sunaryo
Published: June 2016

The primary objectives of this research were to learn the effects of family ownership, return on assets, leverage, property plant, and equipment with tax aggressiveness, either simultaneously or partially. This research used quantitative method with secondary data collected by purposive sampling from foods and beverages industrial companies group listed in IDX and preceding journals of scientific articles research. This research used simple regression to test the hypothesis simultaneously with F test and t test for testing the partial hypothesis. Results of this research show that family ownership, return on assets, leverage, and property, plat, and equipment have affected tax aggressiveness simultaneously and significantly. The family ownership and property, plant and equipment have significant effects to tax aggressiveness, but the return on assets and leverage do not have significant effects to tax aggressiveness.
Chest wall defects and their reconstruction
Authors: Khan Farid Ahmad , Farooq Muhammad Umar , Zafar Humera
Published: June 2016

Background : Chest wall reconstruction remains one of the most challenging areas of Plastic and Reconstructive Surgery. The purpose of this study is to report our 4 year experience with chest wall reconstruction. Methods: A review of 62 patients who had chest wall reconstruction from 2001 to 2004, is included in the paper. Indications include, defects secondary to congenital deformity correction, post neoplastic reconstructions, post burn defects and sternotomy wounds. Procedures performed included direct closure after debridement, vacuum assisted closure with and without skin grafting, pectoralis major flap, rectus abdominis flap, omental flap and free flaps including latissmus dorsi flap. The average hospital stay was 13 days. The uneventful recovery was seen in 50 patients. Minor complications were seen in 12 patients whereas major complications were not seen in any patient. Conclusion: Chest wall reconstruction can be performed with satisfactory outcome provided that reconstruction ladder is followed
In vitro activity of glycopeptides against clinical isolates of Entercocci from a tertiary care hospital
Authors: Majeed Muhammad Tahir Majeed Tahir , Izhar Mateen
Published: June 2016

Objective: The objective of this study was to establish the prevalence of glycopeptide (vancomycin and teicoplanin) resistance among clinical isolates of enterococci in Shaikh Zayed Hospital, Lahore, and comparison of antimicrobial sensitivities of vancomycin and teicoplanin among these isolates. Design: A comparative analytical study. Place of study: This study was conducted in the Department of Microbiology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore. Materials and methods: 60 (Sixty) enterococci isolates were collected from clinical specimens received in the laboratory. Identification of these bacteria was done utilizing standard laboratory operating procedures. Their sensitivity to glycopeptide antibiotics was tested by disk diffusion method in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) guidelines. Results: Results show that all enterococci were sensitive to teicoplanin. However, among these isolates 1.7% resistance to vancomycin was detected. Conclusion: The results indicate that resistance to glycopeptide antibiotics in the test organisms is low in our hospital. The presence of vancomycin resistance in 1.7% clinical enterococcal isolates necessitates strict surveillance of these organisms, institution of effective infection control policies and judicious use of antibiotics.
Simple repair is sufficient for most injuries to the duodenum - a case series of 23 patients
Authors: Rathore Munir Ahmad , Najfi Syed Muzahir , Afzal Muhammad Farooq , Chaudhry Abdul Majeed
Published: June 2016

Background: Duodenal injury is the most important hollow viscus injury in the abdomen. The study analysed the outcome of duodenal injuries at the unit. Patients & Methods: Prospectively collected data on a case series involving 23 patients over 3 years. It involved demographic details, part of duodenum injured, injury severity according to the AAST, injury-operation time lag, mode of repair, and the extent of significant associated injuries. Results: M:F ratio was 4.75:1. Mean age 33yrs. Patients with non-perforating injury were excluded. All were operated by a senior registrar or senior. 7/23 were blunt, 13/23 firearm & 3/23 stab injuries. D2 was involved in 87%. Injury severity was graded according to AAST (American Association for Surgery of Trauma). 17/23 were Grade II/III, 3 Grade IV & 3 Grade V injuries. Four had injury-operation lag of >18hrs. Two injuries were missed. All injuries up to Grade IV had simple repair. Two of them had T-tube duodenostomy. None had pyloric exclusion. Complex repairs wer e required for 3/23 patients. Five patients died, as a result of associated insults. One delayed repair developed duodenal fistula. Intra-abdominal abscess, septicaemia and wound dehiscence were seen in two patients each. Duodenum-related mortality was zero. Adverse prognostic factors towards morbidity were injury severity >GIII and injury-operation lag >18hrs. The mortality was related to associated injuries. Conclusion: Primary repair is sufficient for most non-resectional duodenal injuries.
ENT Manifestations of Wegener`s Granulomatosis
Authors: Aslam Muhammad Javed , Aslam Muhammad Azeem , Ahmed Malik Iftikhar , Batool Amna
Published: June 2016

Objectives: The purpose of this study was to find out the presenting features, diagnostic problems, treatment, and prognosis of Wegener`s granulomatosis (WG), with special reference to ENT manifestations. Study Design: It was a prospective descriptive study. Study Setting: The study was conducted at the Department of Otorhinolaryngology and Head & Neck surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from 1st March1999 to 30th Sep 2001. Results: The ten patients included in this study comprised of six males and four females, with a male to female ratio of 1.5:1. The age of patients ranged from 16 years to 55 years with an average age of 38.5 years. The most common presentation in our patients was due to nasal involvement of disease. Nasal obstruction, epistaxis, and rhinorrhoea was seen in 80% of patients with WG. Next common symptom was headache (60%) followed by other symptoms Two patients had ear pain and conductive deafness along with nasal symptoms. One patient in addition to nasal symptoms mentioned presented with saddle nose deformity. One patient presented with hoarseness and progressive stridor, having subglottic stenosis as an isolated finding. Conclusion: Most common symptoms in WG localized to ENT region are nasal obstruction, rhinorrhoea and epistaxis. Biopsy and c-ANCA have key role in diagnosis of WG. ESR has a good prognostic relevance
Comparison of treatment of chronic obstructive pulmonary disease (COPD) by family physician and consultants
Authors: Haque Israrul , Zafar Shamail , Salam Tanviruss , Kashif Ali , Rashid Shid Butt A , Arfeen Nooul , G N Tayyab
Published: June 2016

The goal of the study is to determine whether care for COPD patients is more consistent with guidelines when a Consultant rather than a Family Physician treat the patients. We use the Global Initiative for Obstructive Lung Disease Guidelines as a standard 1. We studied seven parameters, offering Pulmonary Function Test, Smoking cassation guidance, vaccination, use of oral steroid, inhaled steroids, inhaled Impratropium bromide, and symptom documentation. We concluded that both Family Physicians and Consultants are not fully following the guidelines. In compression Consultants are better than Family Physicians.
Efficacy of ultrasound diagnostic criteria using scoring system for Infantile Hypertrophic Pyloric Stenosis (IHPS)
Authors: Talat Nabila , Dar Sajid Hameed , Afzal Muhammad , Sheikh Muhammad Afzal
Published: June 2016

An analytic cross sectional study in the Department of Paediatric Surgery, Mayo Hospital, Lahore conducted. Twenty patients of non-bilious projectile vomiting with a control group of 20 patients were evaluated from June 2001 to May 2002. An attempt was made to prepare a diagnostic criteria with a scoring system using ultrasonography as a primary tool. Pyloric diameter was 9.1?0.51 in control and 15.25 +/-1.75 patients. Muscular thickness in control group was 1.72 +/- 0.51 in comparison with 4.64 +/- 1.09 in patients. Similarly pyloric length was 11.37 +/-1.47 in control group and 19.84 +/- 1.50 patients. Using probit analysis of ultrasonographic findings a composit scoring was developed and results evaluated. Evaluating 40 cases which included the normal infants (n=20) and infants with IHPS (n=20) both groups could be identified 100% with overall score of 2 or less as normal and those with overall score of 3 or more as having IHPS. All cases of IHPS can be correctly discriminated and diagnosed using these criteria.
Pheochromocytoma - an institutional experience
Authors: Shenoy Rajgopal , Rodrigues Gabriel , Jain Vikas , Khan Sohil Ahmed
Published: June 2016

Objective: The present study envisages evaluating the clinical presentation, diagnosis, management, with particular reference to pharmacological and anesthetic considerations, and outcome in patients with pheochromocytoma. Design: A retrospective study. Place and Duration of Study: The study was conducted at the Department of Surgery, Kasturba Medical College Hospital, Manipal, India from January 1, 1996 to December 31, 2003. Patients and Methods: Seventeen patients diagnosed to have pheochromocytoma were included for this study. Our assessment of age at presentation, sex, presenting complaints with details of hypertension (HT), diagnostic tests, surgical procedure and follow-up was based on patient records. Results: Peak incidence was observed in 40-50 years age group, with male preponderance. All the patients had diastolic HT of more than 100 mm of Hg at presentation. Systolic blood pressures (SBP) were between 150 mm Hg to 230 mm Hg, with mean of 170 mm Hg; nine patients presented with persistent HT and seven had paroxysmal HT. One patient infact presented with hypotension due to septic shock and was incidentally detected to have an adrenal tumor. Computed tomography (CT) scan and urinary levels of vanillylmandelic acid (VMA) were mainstay of diagnosis. These patients had adequate preoperative control of HT. All patients underwent exploration of the tumor by an extraperitoneal approach. 70% tumors were on the right and 30% were on the left side. Histopathologically, all the tumors were benign except for one, which was malignant. An average of three to five units of blood transfusion was required and mean operating time was 4.5 hours. Six patients had extensive intra-operative blood pressure (BP) fluctuation, but were adequately managed by the anesthetic team. One patient with post-operative pulmonary edema died in our series; rest all the patients are on regular follow-up, till date and doing well. Conclusion: Pheochromocytoma is an important cause of endocrine HT. Elevated urinary VMA is diagnostic of this tumor with imaging studies used to localize the tumor. Adrenalectomy results in complete cure of HT with an excellent long-term outcome.
Role of Deliberate Creation of Control Enterocutaneous Fistula in Patients of Abdominal Tuberculosis with Perforation of Small Bowel and Matted Small Intestine
Authors: Abbas Muhammad Hassan , Ali Kamran , Bari Mahbood , W Ahmad , M Anwer , A Niazi N , H M Tabassum
Published: June 2016

Objective: To study the results after forming the controlled enterocutaneous fistula in the patient of abdominal tuberculosis with matted and perforated small bowel. Design, place and duration of study This study based on therapeutic trial and conducted in one and half years from january1999 to june2001 at Mayo Hospital, Lahore. Patients and methods: All these 20 patients either operated in emergency or on elective list were malnourished, toxic and their operative findings were almost the same , these patients had extensively matted, friable and perforated gut. In these patients it was technically not possible to perform some definite procedure like right haemecolectomy or ileostomy with out increasing the morbidity or mortality. Under these circumstances, minimal surgical procedure which can be life saving is to oppose the anterior abdominal wall to the perforation and thus create a controlled enterocutaneous fistula. In 11 patients fistula closed on its own and in eight patients fistula remained patient and needed re-exploration and repair. Conclusion: This new method of treatment has yielded excellent results. We were able to cure the disease with no mortality. It is recommended that in cases of TB peritonitis with perforation and matted gut making of a controlled enterocutaneous fistula saves the life of the patient.
The Outcome of Darning method of inguinal hernia repair using polypropylene in Sir Ganga Ram Hospital, Lahore
Authors: Naazar Ali Abid , Arshad Saleem , Waheed Abdul , S Qureshi M
Published: June 2016

Objectives: To valuate the darning method of inguinal hernia repair with polypropylene. Material and Methods: 300 patients of unilateral inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using No.1 polypropylene. Patients were operated under, spinal or general anesthesia. Patients were followed up at one week, six weeks and six months after operation for wound healing and complications. Results: Out of 300 patients, ranging in age from 20 to 70 years, 250 patients were given spinal anaesthesia, 45 patients (20%) were operated under local anesthesia. 196 patients were discharged from the hospital on the following day. 3 patients went into urinary retention and one patient had large haemotoma requiring exploration. Recurrence rate was 1% (n=3). Conclusion: Darning method of inguinal repair with polypropylene is a safe and cheaper method of hernia repair.
Outcome of babies admitted with hypoxic-ischemic encephalopathy in Neonatal Unit of Services Hospital, Lahore
Authors: Rana Muhammad Nasir , Kazi Muhammad Yakoob , Nasir Ambreen , Abbas Muhammad
Published: June 2016

Objectives: To determine the outcome of newborns, admitted with different stages of HIE in Neonatal Unit, Services Hospital, Lahore. Study design: Descriptive Study. Place and duration of study: Neonatology Section, Pediatrics Department, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore. Over a period of Six months, from 1st August 2005 to 31st January 2006. Material & methods: A total of 170 newborns having Apgar score less than 7 were included in the study. Babies with any congenital anomaly were excluded. Results: 80% were males. 17.64% had weight less than 1.5 Kg, 37.06% weight between 1.5 Kg to 2.5 Kg and 45.29% had weight more than 2.5 Kg. 90.5% of our babies were delivered in Services Hospital, Lahore. 77.64% babies were full term. Babies were divided into three groups; Group-I had Apgar score 0-3, Group-II between 4 & 5 and Group-III had Apgar score 6-7. In Group-I, 65% babies died, whereas 100% had any one of the complications, in Group-II, there were 22% deaths and no baby died from Group-III. Conclusions: Despite advanced technology, a high number of babies have HIE and its complications. It is better to prevent babies from HIE, because once HIE occur, you cannot save babies completely from its complications.
Prevalence of hepatitis B in pregnant females
Authors: Rana Gule , Akmal Noreen , Akhtar Naseem
Published: June 2016

Hepatitis B during pregnancy is an important cause of morbidity and mortality. A study was conducted on 1000 pregnant females at Sir Ganga Ram Hospital to find out the prevalence of Hepatitis B in pregnant females. 18 (1.8%) were found to be hepatitis B surface antigen positive thus showing a high prevalence rate for this disease in the study population.
Assessment of Nutritional Status of Adolescent College Girls at Rawalpindi
Authors: Shahid Afshan , Siddiqui Farah Rashid , Bhatti Mohammad Ayaz , Ahmed Mahmood , Khan Mohammad Wasif
Published: June 2016

Objectives: To assess the nutritional status of adolescent college girls by assessing the dietary intake in terms of carbohydrates,proteins, Estimating the hemoglobin levels in the study group and studying the clinical signs of malnutrition withspecial emphasis to vitamin A, iron and iodine deficiency.Design of Study: A cross-sectional study.Settings: Two Post-Graduate women colleges of Rawalpindi.Study Duration: 9 Months (From Jan 2006 to September 2006).Materials and Methods: Nutritional status of 508 adolescent girls was assessed with a questionnaire, clinical examinationand biochemical estimation (hemoglobin). The data thus collected was analyzed in July 2006 on computer with the help ofStatistical Package for Social Sciences (SPSS) and Excel.Results: Results revealed that 20%of girls were having BMI <18.5, 77% above 18.5% and 3% were obese. 57.09% of thegirls had goiter out of which 52.96% had palpable goiter and 4.13% had visible goiter. Pallor conjunctiva was seen in 1%girls. No clinical signs of Vitamin A deficiency were seen. Biochemical results indicated that 32.87% of the girls was sufferingfrom Iron deficiency anemia.Conclusions: Large longitudinal and cross-sectional studies, regarding nutrient consumption, dietary habits and nutritionalintervention are required in the adolescent girls. These studies can be thought provoking for the policy maker at thegovernment level. Nutritional education and health promotion can be used as tool to improve the health status of the nation.Key Words: Adolescent Health, Nutrition, Nutritional Assessment.
OUTCOME OF EARLY CLOSURE OF TEMPORARY STOMA
Authors: Alam Muhammad Shahid , Gondal Khalid Masood , Siddique Humayun , Muhammad Yar
Published: June 2016

AbstractIntroduction:A stoma is a surgical procedure in which a part of gut is taken out and connected on the anterior abdominal wall. An anastomosis is the joining together of the two intestinal ends that remain after a diseased section has been removed. The closure of the stoma though thought to be minor surgical procedure, yet it may be associated with appreciable morbidity. When the reversal of stoma is done in less than 8 weeks following primary surgery then it is considered to be early closure. Early closure of the temporary stoma might reduce both stoma related complications and patient ailment. Wound complications are common but there are many associated morbidities due to delay in closure. So the aim of this study is to find the complications associated with early closure of temporary stomaObjective:To evaluate the outcome of early closure of temporary stoma.Material and Methods:This descriptive case series study of 350 patients of both gender aged between13 70 years was conducted in surgical ward of mayo hospital, Lahore in one year duration from 01-01-2014 to 31-12-2014. The non-probability purposive sampling technique was used in this study. Written consent was obtained from the patients. Only the most senior consultants with 5 years experience after post-graduation were the part of the team. Following admission they were advised distal loopogram to rule out any distal obstruction, leakage or any other pathology. Closure was performed and the evaluation of the patient and relevant investigations pertaining to diagnose complications like anastomotic leakage and wound complications was done. This was recorded daily for 5 days post-operatively in ward and then a follow up weekly for 1 month was performed. Analysis of data was done statistically using version 13.0. Mean SD were calculated for age. Frequency and percentages were calculated for gender, anastomotic leakage and wound complications. Post-stratification chi-square test was applied keeping a P-value ? 0.05 as significant.Results:In our study mean age of the patients was 42.73 13.68 years, 60% patients were males whereas 40% patients were females. The study results showed that anastomotic leakage was found in 29 (8.3%) patients and wound complication was found in 20.57% patients. Statistically insignificant difference was found between the wound complication and gender of the patients i.e. p-value = 0.82.Conclusion:According to our study results the outcome of early closure of temporary stoma is a feasible and effective procedure with fewer complications.Keywords:Early Closure, Temporary Stoma, Wound Complication, Anastomotic Leakage.
GYNECOLOGICAL LAPAROSCOPIC SURGERY: LEARNING CURVE
Authors: Khanum Zohra , Khanum Amna , Rehman Aman -ur-
Published: June 2016

AbstractA study was conducted to review the learning curve of gynecological laparoscopic surgery from January 2012 to December 2014. Total 310 cases were included in the study. These patients had pelvic surgery including hysterectomy either total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy and Ade-nexal surgery (cystectomy, oophorectomy or adhesionolysis). After preoperative evaluation counseling and consent procedures were performed. Data was collected regarding patients profile variables, indications for surgery, intraoperative findings, intraoperative time, post operative recovery findings, analgesia requirements and discharge time from the hospital. Regarding the intraoperative time, comparison was made for duration of surgery in the 2012 and at the end of study period 2014.Results:Results of the study showed that there was no significant increase in complication either minor or major related to urinary tract or bowel injury. Operative time was decreased with time. Most common indication for hysterectomy was fibroid uterus or dys-functional uterine bleeding. Most common indication for adenexal pelvic surgery was ovarian cyst and in most cases cystectomy was done. Patient recovery was smooth and post operative analgesia was much less as compared to the routine. Patient hospital stay was less as compared to the routine procedures for hysterectomy. It is concluded from the study that laparoscopic surgery is safe procedure with the clear advantages for the patient. With appropriate surgical training & skills, the surgical time is reduced. In the study complication rate, operating time was comparable to the already published studies. With proper training it is acceptable alternate to open abdominal procedures with clear advantages for the patient.Key words:Laparoscopic surgery, Learning curve.
CIRCADIAN VARIATION IN ACUTE CORONARY SYNDROMES AMONG PATIENTS PRESENTING IN A TERTIARY CARE HOSPITAL IN LAHORE
Authors: Ghous Zeeshan , Naseer Nauman , Hassan Ahmed
Published: June 2016

AbstractBackground:One of the most important cause of death is Acute Coronary Syndrome (ACS) throughout the world. Its incidence is also increasing in Pakistan. The phenomenon of circadian rhythm is well known among the patients presenting with ACS. This study has been designed to find out the occurrence of this phenomenon in local population. Most of the ACS patients present in early morning hours making management a challenging task at that period of time if no proper logistics are available. The rationale of this study is to emphasize the importance of logistical preparation for management of ACS patients in light of presentation at off hours due to circadian variations.Objective:To determine the frequency of patients with ACS who fall in various categories of timings of day.Methodology:300 subjects those fulfilling the inclus-ion and exclusion criteria were studied at the department of Cardiology, Jinnah Hospital Lahore, after obtaining the informed consent, data was collected through the proposed performa by researcher himself. We divided the patients into three groups who presented in 24 hours based on the timing of most recent worst symptoms onset that made the patient come to emergency department i.e., 12 am 08 am, 08 am 04pm and 04 pm 12 am. Data was entered and analyzed in SPSS ver: 17.0. Frequency tablulation and percentages were calculated for circadian rhythm.Results:When mean age of the patients was calcula-ted it was 54.66 12.45 years that included 30.33% females and 69.67% male patients. Most of the pati-ents 44% (n = 132) were in the time interval group of 12 am 08 am. There were 25% (n = 75) of patients in the time interval group of 08 am 04 pm, and 31%(n = 93) patients were presented in the time interval group of 04 pm 12 am.Conclusions:This study has shown that circadian variation in Acute Coronary Syndrome also exists in our local population, as most of the patients presented in the time interval of 12 am 08 am.