bluuebunny/crossref_metadata_2025 huggingface dataset:
Daganatos megbetegedések és a depresszió: rövid irodalmi áttekintés
Authors: Szelei Antónia , Döme Péter
Published: May 2020

Absztrakt:

Mind a depresszió, mind a daganatos kórképek népbetegségek, melyek ráadásul
sokszor komorbid módon fordulnak elő. Nem szisztematikus (narratív) összefoglaló
tanulmányunkban röviden áttekintjük a depresszió és a malignus betegségek közti
epidemiológiai összefüggéseket, melyek kapcsán elmondható, hogy 1) a depresszió
előfordulási gyakorisága daganatos betegekben jóval meghaladja az
átlagpopulációban mérhető értékeket; 2) depressziós páciensekben gyakrabban
alakul ki malignus megbetegedés, és 3) a depresszió növeli a daganatspecifikus
mortalitást. Az epidemiológiai összefüggések kapcsán röviden tárgyaljuk a
daganatos betegek suicid halálozását is. Ezenkívül összefoglaljuk a két
kórállapot gyakori együttállásának lehetséges etiológiai magyarázatait, ennek
részeként azokat a biológiai és pszichológiai mechanizmusokat, amelyek
magyarázhatják, hogy a depresszió (és/vagy annak kezelése) hogyan vezethet
daganatok kialakulásához és vice versa. Végül röviden kitérünk
még a depresszió szűrésének és kezelésének aspektusaira a daganatos betegek
körében, megállapítva, hogy tekintettel a daganatos betegek között a depresszió
aluldiagnosztizáltságára, az onkológiai ellátásban javasolt a depresszió
szűrése, felhíva a figyelmet arra, hogy a szűrésnek csak akkor van
létjogosultsága, ha a kiszűrt pozitív esetek pszichiáterhez való eljutása (ahol
megtörténhet a klinikai diagnózis felállítása és valamiféle antidepresszív
kezelés elindítása) biztosított. Orv Hetil. 2020; 161(22): 908–916.
Manganese-Induced Nephrotoxicity Is Mediated through Oxidative Stress and Mitochondrial Impairment
Authors: Niknahad Amir Mohammad , Ommati Mohammad Mehdi , Farshad Omid , Moezi Leila , Heidari Reza
Published: May 2020

Manganese (Mn) is an essential element that is incorporated in various metabolic pathways and enzyme structures. On the other hand, a range of adverse effects has been described in association with Mn overexposure. Mn is a well-known neurotoxic agent in mammals. Renal injury is another adverse effect associated with Mn intoxication. No precise mechanism for Mn nephrotoxicity has been identified so far. The current study was designed to evaluate the potential mechanisms of Mn-induced renal injury. Rats were treated with Mn (20 and 40 mg/mL, respectively, in drinking water) for 30 consecutive days. Markers of oxidative stress, as well as several mitochondrial indices, were assessed in the kidney tissue. Renal injury was evident in Mn-treated animals, as judged by a significant increase in serum BUN and creatinine. Moreover, urinalysis revealed a significant increase in urine glucose, phosphate, and protein in Mn-treated rats. Kidney histopathological alterations, including tubular atrophy, interstitial inflammation, and necrosis, were also detected in Mn-treated animals. Biomarkers of oxidative stress, including an increment in reactive oxygen species (ROS), lipid peroxidation, and oxidized glutathione (GSSG), were detected in Mn-treated groups. On the other hand, kidney glutathione (GSH) stores and total antioxidant capacity were depleted in Mn groups. Mn exposure was associated with significant mitochondrial depolarization, decreased mitochondrial dehydrogenases activity, mitochondrial permeabilization, and depletion of adenosine tri-phosphate (ATP) content. These data highlight oxidative stress and mitochondrial impairment as potential mechanisms involved in Mn-induced renal injury.
Asociatividad empresarial: una estrategia para las organizaciones del sector cacaotero del municipio de Fortul Arauca.
Authors: Burgos-Cañas Dairo , Fonseca-Pinto Dora Esther
Published: May 2020

Fortul – Arauca es un municipio que ha presentado problemas de conflicto armado causando atrasos sociales, económicos y tecnológicos especialmente en el sector agropecuario; en la región uno de los productos más representativos es el cacao, el cual se encuentra como alternativa para la sustitución de cultivos ilícitos; es así que el propósito del presente estudio es “diagnosticar el sector cacaotero del municipio Fortul bajo la metodología de acción participación”, destacando como resultado el logro en la creación de la Asociación de productores de cacao ASPROCAF del municipio de Fortul.
Análise inicial da correlação espacial entre a incidência de COVID-19 e o desenvolvimento humano nos municípios do estado do Ceará no Brasil
Authors: Maciel Jacques Antonio Cavalcante , Castro-Silva Igor Iuco , Farias Mariana Ramalho de
Published: May 2020

RESUMO: Objetivo: Analisar a distribuição espacial da incidência de Covid-19 e sua correlação com o índice de desenvolvimento humano municipal (IDHM) dos municípios do Ceará. Métodos: Trata-se de um estudo ecológico com dados recuperados da 15ª e da 19ª semana epidemiológica do ano de 2020 utilizando como variáveis o IDHM e o coeficiente de incidência de Covid-19 para cada município. Foi analisada a correlação espacial uni e bivariada por meio dos softwares TerraView e GeoDa. Resultados: A incidência da Covid-19 possui dependência espacial com correlação positiva moderada e formação de clusters do tipo alto-alto localizados na região metropolitana de Fortaleza e municípios da região norte. As menores incidências foram cluster tipo baixo-baixo na região sul e na região oeste. Houve correlação bivariada positiva entre IDHM e incidência de Covid-19 com formação de cluster na região metropolitana de Fortaleza. Conclusão: O mapeamento desigual de Covid-19 e sua relação com IDHM no Ceará podem contribuir com ações de enfrentamento regional à pandemia.
PERSPECTIVA FINANCEIRA SOBRE REGULAÇÃO DE FILAS DE ESPERA PARA FISIOTERAPIA NA ATENÇÃO PRIMÁRIA À SAÚDE
Authors: Meneses Abel Silva de , Silva Joice Sales Mesquita , Silva Laurentino Elias da
Published: May 2020

Objetivos: Apresentar o impacto assistencial e financeiro de um modelo de gestão do acesso que envolveu a atuação do fisioterapeuta do Núcleo Ampliado de Saúde da Família sobre a fila de espera de Fisioterapia de 30 Unidades Básicas de Saúde. Métodos: Estudo de caso conduzido à luz dos princípios da equidade e integralidade do cuidado, no contexto de 30 unidades básicas de saúde, contendo 170 equipes de saúde da família com 604.772 pessoas adscritas. Resultados: Aumento na capilaridade das vagas, o que pode ser evidenciado pela redução de até 74,2% da fila de espera de fisioterapia e redução de até 67,9% no tempo médio de espera para o atendimento. No tocante aos resultados financeiros, o número de pacientes que evitaram ocupar vagas de serviços de reabilitação em fisioterapia no recorte temporal do estudo, resultou em economia estima da ordem de US$ 284.097,75. Conclusões: Observou-se economia financeira, além de aumento na capilaridade de atendimento, favorecendo os pacientes mais graves (alta complexidade), que antes competiam por vaga de fisioterapia com os demais pacientes de média e baixa complexidade.
Unlearning as Moving Towards Dehumanism and Decolonial Entanglements – Singh, Julietta (2018): Unthinking Mastery: Dehumanism and Decolonial Entanglements. Durham, NC: Duke University Press
Authors: Jaeckel Monika
Published: May 2020

Unthinking Mastery examines the routes of knowledge production for their ongoing and sometimes even unconscious reliance on masterful ways of thinking. In assessing discourse from an inevitable ‘inside position’, Singh's non-masterful attempt follows a strategy of sensibility. As a practice of ‘vulnerable readings’ of a selected literature this diverts from masterful routines through attentiveness to the emerging slippages in interpretations. This admittance of an ambivalence uncovers how masterful structures of knowing contribute to the obscuring of particular bodies, spaces, and things. Her engagement not only touches on feminist and queer theories but also provides a powerful interconnection between environmental and postcolonial studies.
Second Language Acquisition of English Unaccusative Verbs: A Theoretical Critique and Prospects for Future Studies
Authors: Mo Junhua
Published: May 2020

Unaccusative verbs are a focus of second language acquisition research. Taking the second language acquisition of English unaccusative verbs as an example, this study first reviews the Unaccusative Hierarchy Hypothesis, the Unaccusative Trap Hypothesis and the Semantic Verb Class Hypothesis, which are exclusively concerned with the acquisition of unaccusative verbs. Then it examines the Entrenchment Hypothesis and the Interface Hypothesis, which address language acquisition in general, but shed light on the second language acquisition of English unaccusative verbs. This study maintains that these five hypothesis help to provide a panoramic view of second language acquisition of English unaccusative verbs. But it also points out that these hypotheses need to be further tested. It advises future studies to take a usage-based theoretical approach. It also calls for more attention to the possible between-verb variations, the possible influence of L1 transfer and the online processing of English unaccusative verbs
Projected international geopark «Polesie» (Ukraine-Poland-Belarus) as a form of preservation of geovariety and popularisation of geoheritage of Threelateral Biosphere Reserve «West Polesie»
Authors: Dubis Lidiia , Shevchuk O. , Lohyn S.
Published: May 2020

In this article we offered a creation of international geopark «Polesie» (Ukraine-Poland-Belarus) within a Threelateral Biosphere Reserve «West Polesie» and adjoining territories. Future geopark will embrace the biggest lake-marsh Europe massif (polish Lęczna-Włodawa lake group, ukrainian Shatsk lake group and belarusian Brest lake group) with complicated geological structure and interesting combination of different genetic types of relief. Geoheritage of Shatsk lake group consists of the biggest number of natural water-divided lakes of Polesie lake belt (28 lakes; the biggest lakes are Svitiaz, Luky, Liutsymer, Pulymetskie, Somynets and others; lakes that are significant in area, upper part of Pripyat and small fragment of valley of West Bug, aeolian forms (dunes) with different morphology, fluvial and glacial deposits and forms (eskers, kames), glacial deposits (moraine) of Riss glaciation).Geoheritage of Lęczna-Włodawa lake group consists of 17 lakes (the most famous are Ustswiez, Piaseczno, Bzesichno, Lukietek, Charne Goscinieckie; the most used in recreation – Piaseczno, Roguzno, Krasne, Lukcze, Zaglebocze), flat and hilly relief with reminders of terminal moraines (in the areaof lakes Miske and Kleszczow) and a small number of sand dunes, and different types of lowland swamp (Korovyache Boloto, Dubechynske Boloto, Bolota over Chorne swamp and others) and the upper reaches of rivers (Pivoniya, Tysmenytsia and Bobrivka). Geoheritage of Brest lake group consists of: 130 lakes (the biggest 7 of them create Brest lake group: Seliahy (the biggest), Rogoznianske, Bile, Tajne, Chorne, Mednianske, Stradechske), system of artificial basins «Stradoch» (Tovarnyj, Dovgyj, Kutjevo, Rakovo and others), famous water reservoir Orhovo; areas with flat and hilly relief of moraine plain and flat and wavy fluvial and glacial, floodplain and overfloodplain terraces; many sand dunes on the river and lake banks; parts of river plains of West Bug, Stepanivka, Seredova Richka, Kopayivka, many small streams and systems of amelioration channels. We consider that there are all preconditions for creating this geopark: outstanding geodiversity of territory (wide spectrum of geological (rocks, minerals, fossils), geomorphological (relief forms, processes) and soil features); substantive concentration of geoheritage objects; different protection forms of natural, historical and cultural heritage; availability of clear management and strategies of constant development. Newly created geopark will give an allowance for effective management of geoheritage of West Polesie region, implementation of new forms and methods of geoconservation, active development of geoeducation and geotourism.
Effect of Different Kefir Grain Starter Concentration on Yield, pH, CO2 Content, and Organoleptic Properties of Buffalo Milk Kefir
Authors: Margareth Lorentia Lydia , Nurwantoro Nurwantoro , Rizqiati Heni
Published: May 2020

This research was investigated the effect of different kefir grain starter concentration on yield, pH, carbon dioxide (CO2) content, and organoleptic properties of buffalo milk kefir, and to investigated the ideal kefir grain concentration for good quality of kefir. Complete randomized design used in this research with 4 treatments and 5 replications in concentration 2.5, 5, 7.5, and 10% g/v kefir grain. Buffalo milk, kefir grain, Na2CO3 solution, 1% PP solution, pH meter, burette, and analytical balance were used in this research. The yield and pH of kefir was measured. Carbon dioxide (CO2)  content was measured by Na2CO3 titration, while the organoleptic properties that included level of sourness, sour aroma, texture, and overall acceptance were done by 25 panelists. The results indicated that different kefir grain starter concentration significantly affected to the yield, pH, CO2 content, and organoleptic properties (p<0.05). The most optimal kefir grain concentration was 5% proved by yield 81.81%, pH value 4.20, CO2 content 0.43%, and proper organoleptic properties which were low level of sourness, acceptable aroma of kefir and texture. As conclusion, the concentration of grain relied on the kefir properties that may achieve in the optimum quality of kefir.
Effect of Lesser Yam Flour Addition on Water Content, Texture, Crude Fiber Content, and Reducing Sugar Content of Donut Made from Wheat Flour
Authors: Putri Indri Iriana , Dwiloka Bambang , Bintoro Valentinus Priyo
Published: May 2020

This research aimed to determine the addition of lesser yam flour on water content, texture, crude fiber content, and reducing sugar content of donut made from wheat flour. This research was arranged using completely randomized design with 5 treatments and 4 replications consisted of 5 different lesser yam flour concentrations (0–30%) from total flour that had been used. Water content, texture, and crude fiber content were analyzed using Analysis of Variance (ANOVA) at 5% significance level and reducing sugar content was analyzed using regression equation. The result showed the addition of lesser yam flour can reduce water content. However, it can increase texture, crude fiber content, and reducing sugar content. As conclusion, the concentration of lesser yam flour affected the water content, texture, crude fiber, and reducing sugar in donut.
Capturing, Preserving, and Digitizing Legacy Seismic Data from the Montserrat Volcano Observatory Analog Seismic Network, July 1995–December 2004
Authors: Thompson Glenn , Power John A. , Braunmiller Jochen , Lockhart Andrew B. , Lynch Lloyd , McCausland Wendy , Rowe Charlotte A. , Shea Thomas , White Randall A. , Breithaupt Charles I.
Published: May 2020

An eruption of the Soufrière Hills Volcano (SHV) on the eastern Caribbean island of Montserrat began on 18 July 1995 and continued until February 2010. Within nine days of the eruption onset, an existing four-station analog seismic network (ASN) was expanded to 10 sites. Telemetered data from this network were recorded, processed, and archived locally using a system developed by scientists from the U.S. Geological Survey (USGS) Volcano Disaster Assistance Program (VDAP). In October 1996, a digital seismic network (DSN) was deployed with the ability to capture larger amplitude signals across a broader frequency range. These two networks operated in parallel until December 2004, with separate telemetry and acquisition systems (analysis systems were merged in March 2001). Although the DSN provided better quality data for research, the ASN featured superior real-time monitoring tools and captured valuable data including the only seismic data from the first 15 months of the eruption. These successes of the ASN have been rather overlooked. This article documents the evolution of the ASN, the VDAP system, the original data captured, and the recovery and conversion of more than 230,000 seismic events from legacy SUDS, Hypo71, and Seislog formats into Seisan database with waveform data in miniSEED format. No digital catalog existed for these events, but students at the University of South Florida have classified two-thirds of the 40,000 events that were captured between July 1995 and October 1996. Locations and magnitudes were recovered for ∼10,000 of these events. Real-time seismic amplitude measurement, seismic spectral amplitude measurement, and tiltmeter data were also captured. The result is that the ASN seismic dataset is now more discoverable, accessible, and reusable, in accordance with FAIR data principles. These efforts could catalyze new research on the 1995–2010 SHV eruption. Furthermore, many observatories have data in these same legacy data formats and might benefit from procedures and codes documented here.
A questão do erro em língua portuguesa: uma abordagem teórica / The matter of error in Portuguese language: a theoretical approach
Authors: Poll Margarete von Muhlen , Pereira Alexandre Macedo
Published: May 2020

Resumo: Neste artigo, abordamos os conceitos de erro linguístico surgidos com a relativização do conceito de norma linguística, que, após os estudos da Linguística Moderna, não mais diz respeito unicamente às regras prescritas pela gramática normativa. Defendemos a tese de que o erro linguístico existe e está diretamente relacionado às normas linguísticas exigidas para o contexto de emprego da língua. Este artigo tem os seguintes objetivos: a) demonstrar que linguistas de perspectivas teóricas distintas reconhecem a existência do erro linguístico; b) demonstrar que o erro linguístico não exclui o reconhecimento da variação linguística, mas o endossa; c) apresentar os diferentes entendimentos sobre a questão do erro linguístico; e d) fomentar uma rediscussão sobre o conceito de erro linguístico. Metodologicamente, este é um trabalho bibliográfico de caráter qualitativo. A pesquisa bibliográfica implica a análise ou a resolução de um problema, recorrendo a referenciais teóricos enquanto fontes importantes para a pesquisa. A pesquisa qualitativa preocupa-se com a dimensão descritiva do fenômeno, ocupando-se primordialmente com o(s) processo(s), sem ignorar os resultados e os produtos. Concluímos que as discussões que se dão no campo da Linguística Aplicada sobre o erro no emprego da língua ocorrem basicamente no âmbito da terminologia, e não no âmbito do que constitui o erro em língua.Palavras-chave: norma linguística; erro linguístico; correção linguística.Abstract: This article aims to discuss the concepts of linguistic error which have arisen from the relativization of linguistic norm definition, since under the light of Modern Linguistic studies, linguistic norm does not only refer to prescriptive grammar’s rules anymore. We defend that linguistic error does exist and it is directly related to linguistic norms required for the language usage context. This article has the following objectives: a) demonstrate that linguists from different perspectives recognize the existence of linguistic error; b) expose that linguistic error does not exclude linguistic variation recognition; c) present different understandings about linguistic error and d) foment a rediscussion concerning the concept of linguistic error. This is a qualitative research based on bibliographic data. Bibliographic research implies the analysis or the resolution of a problem, taking theoretical references into consideration, whereas the qualitative research considers the descriptive dimension of the phenomenon and is concerned primarily with the process itself, without taking into account the results and products. We conclude that discussions about error in language usage, which take place in the Applied Linguistics field of studies, basically occur in the terminology aspect, not in what error in language use is constituted of.Keywords: linguistic norm; linguistic error; linguistic correction.
Акторные модели глобальной образовательной политики
Authors: Антюхова Екатерина
Published: May 2020

Актуальность глобальной образовательной политики определяется совокупностью новых реалий цифро-глобального мира с быстрым изменением традиционных технологий во многих сферах деятельности. Автор анализирует сущностную компоненту этой политики как области научных исследований (в образовании, политологии, социологии, педагогике и т.п.), так и сферы практической деятельности и направления деятельности государства. Установлено, что акцент на образовательной повестке является важным феноменом современного развития, которое сопровождается ускоренным внедрением цифровых технологий и необходимостью адаптации человека к этим изменениям. При этом глобальное образование учитывает как национальные политики стран, так и транснациональную экономическую политику. Глобальное образование рассматривается как подход к образованию в части его предметно-содержательного наполнения и распространения в мире с учетом современных технологических возможностей, который воспитывает сознание глобального гражданина, приверженного национальным интересам и способного к самореализации в мировом пространстве. Показано, что трансформация образования (как в части просвещения, так и в части становления новой личности, владеющей глобальной компетенцией) лежит в рамках интересов всего мирового сообщества, а не только отдельных государств. Уточнено понятие глобальной образовательной политики и подтверждена перспективность использования акторного подхода, сформировавшегося в рамках неолиберализма. Выделено пять акторных моделей в образовательной сфере (модели с одним актором – государством; модели, дополненные деятельностью неправительственных акторов; модели, учитывающие развитие роли и статуса неправительственных акторов; модели, отражающие прогресс технологических инноваций; модели, возводящие в статус акторов образовательные экосистемы, носящие надгосударственный характер). Рассмотрена гипотеза, согласно которой наиболее перспективна модель, состоящая из образовательных экосистем как акторов глобального уровня.
Perceived Tourism Impacts of Tourists on the Environment of the Philippine Military Academy in Baguio City, Philippines
Authors: Altarez Richard Dein D. , Lopez Gabriel Mariko L. , Sawate Shalimar Elvin M. , Bautista Jujefell P. , Gayagay Mark C. , Lamberte Mark Delph Q. , Julaquit Alberto Lester G. , de Jesus Ryan Joeferson B.
Published: May 2020

There has been an incredible increase in tourism activities in the Summer Capital of the Philippines, Baguio City, specifically at the Philippine Military Academy over the years. Unfortunately, these tourism activities led to the growth of a variety of environmental pressures. An environment-friendly or a sustainable form of tourism is seen as a solution to this growing problem. A perception analysis of tourists on the impacts of tourism on the environment of the Philippine Military Academy (PMA) was undertaken. This is a practical approach to gain information about the extent of environmental effects of tourism activity which will also identify areas that can be improved. The study adopted a survey research design with 109 PMA visitors, mainly women (63.3%), that are randomly selected. Respondents were surveyed through an online questionnaire from February to April 2019. Results of this study revealed that tourism has a moderate impact on the environment of PMA as perceived by the tourists on the different aspects of tourism including: general management, commercial areas, tourist routes and facilities. It also shows that respondents, regardless of gender, have a considerable level of awareness and concern about the effects of tourism on the PMA environment. Although considered as an environmental disturbance it is also offered that when managed properly, tourism is a positive activity benefiting the host community, environment and all stakeholders alike.
Big Data meets Big Fridge (a frolic)
Authors: Estaunié Edouard
Published: May 2020

This article offers a possibly optimistic view of the influence of the new anti-terror laws on the profitability of the telecommunications industry.
Locally advanced breast cancer: an observational study for the delay in presentation of patients
Authors: Shah Priti , Save Maitreyee , Khadilkar Reina , Shah Pranjal , Kader Hanaa , Eswarawaka Mridula
Published: May 2020

Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time by taking alternative treatment, 52% presented late due to painless lump; 30% had fear of losing breast, 18% didn’t get support from family, 4% presented late due to other reasons.Conclusions: Awareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, making it important reason for delayed presentation. Other significant factors being socioeconomic status and education. The need for increased awareness and use of screening practices was identified to be essential for early diagnosis of the disease and for improved outcomes.
Prospective interventional study of staple line reinforcement and buttressing in laparoscopic sleeve gastrectomy
Authors: Gedam Manik C. , Tayade Priyanka C.
Published: May 2020

Background: Laparoscopic sleeve gastrectomy has gained increasing acceptance among bariatric surgeons and patients. The three main options for staple line reinforcement are over-sewing and buttressing with synthetic polymers or biologic tissue. The purpose of this study was to prospectively analyse the relative efficacy of gastric staple line reinforcement (SLR) by using over sewing as the method of reinforcement and comparing it with non-reinforcement laparoscopic sleeve gastrectomy (LSG) in 60 patients who were admitted in IGGMC Nagpur from May 2017 to November 2019.Methods: Obese patients with age 18-65 years, BMI 40 and above with-out co-morbidities and 35 and above with co-morbidities, and BMI below 60, with no malignancy, no hiatus hernia, no previous bariatric procedure were included. All patients underwent LSG after thorough evaluation. 30 patients had reinforced staple line, while 30 had simple staple line.Results: Total 60 patients were studied, 30 in each group. Intraoperative leak was seen in 1 patient each in both study groups. No bleeding was seen in reinforced LSG, while 3 patients had intraop bleeding in simple staple line group. 1 patient each of non-reinforced group had postop leak, postop bleeding and post op morbidity and mortality in 1 patient, while no postop leak or bleeding, morbidity or morality was seen in reinforced group.Conclusions:Reinforcement of staple line by over sewing in LSG resulted in significantly fewer surgical complications, lesser morbidity and no mortality compared to simple stapling of the gastric tube.
Clinical and laboratory risk indicator for necrotizing fasciitis score in predicting the outcomes in necrotizing soft tissue infection patients
Authors: Gupta Madhusoodan , Aggarwal Aditya , Singh Hardeep , Khazanchi Rakesh K. , Mahendru Sanjay , Brajesh Vimalendu , Singh Sukhdeep , Jeedi Arun , Varshney Deepti , Biswkarma Vishal K.
Published: May 2020

Background: Necrotizing soft tissue infection (NSTI) is a serious condition that can be diagnosed on a high index of suspicion and require urgent surgical treatment. NSTI involved epidermis and dermis but more frequently it affects the deeper layer of adipose tissue, fascia, and muscle. NSTI diagnosis and its treatment include emergent surgical intervention and the use of appropriate antibiotics. In this study, we have been evaluated the laboratory risk indicator for necrotizing fasciitis (LRINEC) score in predicting the outcomes in patients of NSTI.Methods: We have conducted a prospective study of 36 patients with NSTI. The LRINEC score, predisposing factors, etiology, risk factors, causative microbiological organisms have been studied.Results: LRINEC score >8 is associated with NSTI in all cases. The mortality and morbidity, length of stay including ICU stay increases with an increase in LRINEC score. The most common microorganism was found to be E. coli followed by Klebsiella.Conclusions: Although, we used the emergent and liberal debridement and appropriate antibiotic and resuscitation. In this study, morbidity, mortality, and length of hospital stay all are increased with respect to the increase in LRINEC score.
A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis
Authors: Singh Mayank , Agarwal Ratika , Singh Rahul
Published: May 2020

Background: surgical site infections (SSIs) are recognized as a common surgical complication occurring in about 3% of all surgical procedures and in upto 20% of patients undergoing emergency intraabdominal procedures. Aims: To determine the incidence of SSIs in emergency laparotomies done for perforation peritonitis and the organisms involved and their sensitivity pattern in superficial SSI. The objective of the study was to determine the effect of planned intra operative intervention [antibiotic lavage with III generation cephalosporin e.g. ceftriaxone 1 gm and metronidazole 100 ml (5 mg per ml)] on superficial surgical site infection in emergency laparotomies done for perforation peritonitis.Methods: This prospective randomized case controlled study was carried out in P. G. Department of Surgery, S. R. N. Hospital associated with M. L. N. Medical College, Allahabad, from September 2018 to August 2019 after approval from the ethical committee and after obtaining written and informed consent either from patient or their guardian. Patients were divided into two groups viz. control group receiving the normal saline lavage and case group receiving the antibiotic lavage (III generation cephalosporins i.e., ceftriaxone (1 gm in 1000 ml NS) and metronidazole- 5 mg/ml (100 ml in 500 ml NS).Results: There is almost 50% incidence of SSI in emergency laparotomy done for perforation peritonitis. The most common organism involved in superficial SSI in present study was gut flora (E. coli) followed by normal skin colonizer (Staph. aureus).Conclusions: Intraperitoneal antibiotic lavage has a significant role in reducing the rate of SSI especially in gastroduodenal perforations.
Laparoscopic versus open appendicectomy: a non-randomized comparative study
Authors: Hanspal Swatej , Shah M. Yunus , Akhtar Murtaza
Published: May 2020

Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p<0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p<0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.
Effect of early enteral feeding on recovery profile in mild acute pancreatitis
Authors: Chandran Kailash , Mammen Sam Christy
Published: May 2020

Background: Acute pancreatitis is a pestilent disease with severity ranging from mild and self-limiting to a rapidly progressive illness leading to multi organ failure. Mild acute pancreatitis is inflammation of the pancreas with minimal remote organ involvement. Since the disturbance in the homeostasis is minimal, the treatment aims at supporting the native reparative processes of the body. One of the main supportive mechanisms is adequate nutritional supplementation. Gut barrier damage in the early phase of acute pancreatitis accounts for the bacterial translocation, initiation of sepsis, infected pancreatic necrosis and SIRS. Aim of the study was to determine the feasibility, advantages and disadvantages of early enteral nutrition in mild acute pancreatitis.Methods: 40 patients taken consecutively from units which start enteral feeds before 48 hours (study group) were compared against 40 patients taken consecutively from units where patients will be kept fasting for 48 hours (control group) to determine whether early enteral feeding is better in determining the recovery in terms of duration of hospital stay, reduction in abdominal symptoms and use of analgesics.Results: There was significant reduction in the duration of hospital stay (p=0.011), intensity and duration of abdominal pain, need for analgesics, and risk of oral food intolerance in the study group.Conclusions: Patients with mild acute pancreatitis can safely be started on early enteral feeds. It reduces gastro intestinal adverse effects, abdominal pain and need for analgesics and improves oral food tolerance causing shorter hospital stay.
A rare location of primary extrahepatic hydatid cyst in the soft tissue
Authors: Shanker S. Uma , Sreenivas U. V. Sai , Swathanthra N.
Published: May 2020

Hydatid cyst or cystic echinococcosis in human is rare disease caused by tapeworm Echinococcus granulosa. Hydatid cyst of soft tissue is a rare condition and we had a case of large hydatid cyst in lumbar region. This is a case of 48 years old female presented to us during October 2018 with a large diffuse swelling over the left lumbar region which was gradually grown over the last 2 years without pain. The diagnosis of hydatid cyst was not sure even in CT scan but it was in our differential diagnosis. It is confirmed during surgery after seen the multiple cyst removed from the large cystic lesion. No recurrence even after 15 months of follow up. Presence of hydatid cyst in soft tissue is usually rare and its diagnosis is not expected clinically when it presents as a soft tissue swelling. We need to confirm it during surgery or by presence of typical germinal membrane under microscope.
A dangerous surgical masquerade - medial arcuate ligament syndrome as acute coronary syndrome: a case report
Authors: Subramanian Preethi , Vaithianathan Rajan
Published: May 2020

Median arcuate ligament syndrome is an uncommon cause for abdominal pain and weight loss, caused by median arcuate ligament compressing the celiac plexus or artery. Median arcuate ligament is the continuation of the posterior diaphragm which passes superior to celiac artery and surrounds the aorta. In this case report, A 67 year old male presented with complaints of sudden onset chest pain and loss of weight for the past 6 months. CECT thorax and abdomen it showed features of focal stenosis of coeliac axis and post stenotic dilation of the coeliac trunk suggesting median arcuate ligament syndrome. Laparoscopic median arcuate ligament release was done to relieve the patient from symptoms. Diagnosis of median arcuate ligament syndrome should be considered in a patient presenting with chest pain and weight loss with normal cardiac status and unexplained etiology.
Dual malignancy: a rare presentation of synchronous periampullary carcinoma with renal cell carcinoma
Authors: Kumar Lovekesh , Sundar Shyam , Vindal Anubhav , Lal Pawanindra
Published: May 2020

The occurrence of synchronous pancreatic cancer and other primary cancer is not frequent and reaches about 5.6% as reported in autoptic studies. Double resections of the pancreas with another organ due to synchronous malignancies have been published only in quite sporadic sets of cases or individual case reports. We present a case report of a 40 years lady who presented with intermittent pain, fever and jaundice for 15 days. Examination revealed a palpable gall bladder, firm in consistency and tender to touch. She was admitted with a provisional diagnosis of cholangitis and started on intravenous antibiotics. Patient’s clinical condition improved and she was planned for a CECT and MRCP which revealed an heterogenously enhancing mass lesion in upper pole of left kidney, s/o of renal cell carcinoma (RCC) and an enhancing lesion in periampullary region s/o periampullary carcinoma with no evidence of free fluid or metastasis. ERCP guided biopsy revealed moderately differentiated adenocarcinoma and USG guided renal biopsy revealed clear cell carcinoma. Whipple’s procedure with left nephrectomy was performed. Intra operative findings revealed post-operative course and hospital stay was uneventful. Biopsy revealed poorly differentiated pancreaticobiliary adenocarcinoma with no lympho vascular or lymph nodal invasion (pT3aN0) and left sided clear cell renal carcinoma with no lympho vascular invasion (pT1N0). Synchronous malignancy of pancreas and kidney is a very rare presentation. Literature describes presence of RCC with periampullary metastasis and patients presenting with RCC post whipple’s procedure but only a handful of case reports describe presence of dual malignancy as reported above.
A case of laparoscopic excision of patent urachus
Authors: Bansod Atish Naresh , Nadar Premalatha Andrews , Umalkar Rohan , Mishra Sarvagya , Mirajkar Girish , . Ankur
Published: May 2020

Patent urachus is an uncommon congenital anomaly caused by persistence of embryologic communication between bladder and umbilicus. The traditional surgical approach has been open for years but laparoscopic approach has become an effective and minimal invasive technique to treat urachal remnants. A 11 years old child presenting as umbilical discharge was diagnosed with patent urachus and treated by laparoscopic excision. There was no intra or postoperative complications. Patient was discharged on post-operative day 1. The urachus connects the fetal allantois at umbilicus to the dome of bladder. Normally it obliterates and gives rise to median umbilical ligament. Urachus is extraperitoneal and easily viewed during laparoscopic visualization of pelvis. Urachal remnants represent a rare congenital anomaly due to failure in obliteration process. Complete excision is indicated both in case of persistent symptomatic remnants and also when asymptomatic for the associated risk of malignant degeneration. The traditional approach has been open surgery. However, it is associated with increased morbidity and longer convalescence. Reporting our experience, we describe the technique step by step of laparoscopic patent urachus excision as minimally invasive diagnostic and surgical approach in comparison to open surgical approach, with better post-operative analgesia, rapid healing and cosmetic results.
Amyand’s hernia: a case report
Authors: Namdev Gawade Harshad , Sanjay Padale , Varun Shetty , Padnanabh Deshpande
Published: May 2020

Amyand’s hernia is a rare pathology of an appendix with or without inflammation within the hernia sac is named after the French born English surgeon Dr. Claudius Amyand. We hereby present a case report of this rare entity known as a type 2 Amyand’s hernia. A 64 years old male, who had had a left-sided inguinal hernia for the previous 5 years, presented with a 2-day-history of fever, pain, vomiting, and irreducibility of the hernia. Upon exploration an irreducible inguinal hernia with appendix as its content was identified. Appendectomy was performed followed by a tension free mesh repair of the underlying hernia. Consequently, our recommendation is that the decision to perform an appendectomy and/or to use mesh to repair hernias should always be individualized.
Infective endocarditis: An Orthodontist’s perspective
Authors: Kumar Yadav Sumit , Bharat Kedia Neal , Kedia Gunjan , Kumar Kunal
Published: May 2020

Infective endocarditis associated with orthodontic treatment is a rare occurrence. Unfortunately, many orthodontic practitioners do not treat patients potentially at risk of developing endocarditis due to the lack of practical guidelines and fear of precipitating the infection. Additionally, many patients that undergo orthodontic treatment are inappropriately prescribed antibiotic cover for procedures that have a minimal bacteraemia risk. In this paper the literature linking orthodontic treatment and infective endocarditis was examined. The appropriate management were recommended for patients with risk of infective endocarditis during orthodontic procedures.
Comparative evaluation of facial soft tissue characteristics inherited between parents and off springs in families native of Himachal Pradesh-A photographic study
Authors: Singh Sohinderjit , Mehra Amit , Kour Guneet
Published: May 2020

The form and function of the craniofacial complex is determined by a complex interaction between genetic and environmental factors thus influencing facial morphology. Facial photographs taken in a standardized pattern assumes great significance in studying heritability of soft-tissue facial features between parents and their offspring.

To evaluate the facial soft-tissue pattern of parents and their offspring with the help of standardized facial photographs and to find the degree of correlation between them.

A total sample of 120 children within the age-group of 16-25 years and their parents were selected from ethnic Himachal Pradesh population. Standardized photographs (frontal and right lateral) of entire sample were taken and then traced. Twenty-four parameters involving linear and proportional measurements were measured.

Statistically significant correlations between parents and their offspring were found for upper facial height, total facial height, lip length at philtrum, chin projection, upper lip to S line, Nasal prominence, true vertical to tip of nose, true vertical to subnasale, true vertical to pogonion, vertical lip-chin ratio. Stronger heritability was found between daughters to their mothers than to their fathers. Sons showed heritability from both parents for Upper lip prominence to E-line and True vertical to Subnasale.

There was strong evidence indicating genetic contribution for both linear and proportional parameters. Highest correlations in inheritance of facial features was found between mother and daughter. Thus, parental data can be used to predict soft tissue facial form of offspring and information from siblings can also be used.
Cephalometric norms for north indian population using burstone analysis
Authors: Kumar Yadav Sumit , Bharti Yadav Achla
Published: May 2020

Cephalometric norms are extremely useful to the orthodontist for providing guidance during diagnosis and treatment planning. But they are subjected to variability in morphologic characteristics in different ethnic and racial groups.

The study was conducted on 76 subjects of 18-28 years of age with class I occlusion with acceptable facial profile. Standardized lateral cephalograms were taken in a natural head position and analyzed.

North Indians exhibit increased facial convexity, greater mandibular prognathism, more obtuse lower face- throat angle and greater amount of upper lip - lower lip protrusion. Males showing larger cranial base length, vertical positioning and length of maxilla, ramal length, and the chin prominence. On dental analysis, females tend to have lesser proclined anterior teeth

The present study was an attempt to provide better knowledge of facial morphology in the North Indians hence a comprehensive treatment planning can be done based on the norms derived for the correction of skeletal discrepancies.
COVID-19 Pandemic Hemoperfusion Therapy Versus Plasma Exchange Therapy in Intensive Care
Authors: Esmaeili Vardanjani Ali , Moayedi Siamak , Golitaleb Mohamad
Published: May 2020

This article is a Letter to the Editor and does not include an Abstract.
Forty Years of Research and Treatment in Immunology and Allergy: In Honor of Professor Reza Farid Hosseini
Authors: Jafari Reza , Moin Mostafa , Kashanchi Fatah , Ranjbar Alireza
Published: May 2020

In light of various supports of prodigious figures in the field of immunology and allergy, the subject area has been faced a great leap during the last century. The current state of the discipline owes an abundant appreciation for the scholars motivated in escalating the true nature of the science, who left no stone unturned in improving the general common sense and understanding of the human knowledge in general, and immunology and allergy in particular. Professor Reza Farid Hosseini is among the dignitaries who invested his life and energy on weaving the tapestry of the immunology and allergy. He delivered a great deal of influence on the field by his ethical devotion to science and was a significant contributor in the realms of the human immune system. His presence drastically rehabilitated the place of the Immunology in Iran, and the current paper seeks to review the personal and academic life of Professor Reza Farid Hosseini in honor and appreciation for his in-depth involvement in the field. The paper summarizes Professor Farid’s childhood, school, and higher education, compilations, and translation of books, his contribution to the research both inside and outside of Iran, and scientific activities of Dr. Farid Hosseini.