bluuebunny/crossref_metadata_2025 huggingface dataset:
Nasal carriage of Staphylococcus aureus among indigenous people of Toba Qom ethnic, Benjamín Aceval, Paraguay
Authors: Norberg Paulo Roberto Blanco Moreira , Villalba Maria Laura Meister , Ortellado Larissa Duarte , Coronel Marcelo , Ribeiro Paulo César , Norberg Antonio Neres
Published: June 2018

Background: Staphylococcus aureus are Gram positive cocci components of the normal microbiota of the skin and mucosa, but can attack other sites of the organism depending on favourable conditions. The condition of host of this bacterium colonizing the nasal mucosa is recognized as a potential risk factor for subsequent invasive infections. This research had the objective to investigate the prevalence of nasal carriers of S. aureus among Toba Qom indigenous ethnic group of the San Francisco de Asis community, Paraguay, and to determine the sensitivity profile to antimicrobial agents.Methods: 141 samples of the nasal cavities were analyzed. Isolation and identification were performed by conventional microbiological methods, by the staining characteristics of the Gram method, catalase and coagulase tests, mannitol fermentation test and deoxyribonuclease test. Antimicrobial susceptibility test was performed by the agar diffusion technique according to a procedure standardized by the National Committee for Clinical Laboratory Standards.Results: 22 of the 141 individual examined samples were colonized by Staphylococcus aureus, which corresponds to a prevalence of 15.6%.Conclusions: Multidrug-resistant strains were not isolated. All samples presented good sensitivity to most antibiotics except for nalidixic acid, which all samples presented resistance.
Study of some epidemiological aspects of seizure disorders among children in rural area of a district
Authors: Potdar Pralhad Sureshrao
Published: June 2018

Background: Seizures are the most common paediatric neurologic disorder, with 4% to 10% of children suffering at least one seizure in the first 16 years of life. Most seizures occur before age 3 years.Methods: The present study was undertaken with an objective to study prevalence of seizure disorders among the children aged 14 years and below in rural area of a district and to study some socio-demographic factors and some risk factors associated with it among the study subjects. This was a community based cross-sectional descriptive study.Results: The prevalence of seizure disorder in the area studied was 10.84%. Of the total 1200 subjects examined, 52.67% were males and 47.33% were females. Mean age of the study population was 6.48±3.33 years, median was 6 years. Age, sex, family history, and socio-economic status were highly statistically significant with risk of seizure disorders (p<0.01). H/o Head injury, H/o CNS infection were statistically age, sex, family history of seizure disorders and socio-economic status were independently associated with risk of seizure disorders (p<0.01).Conclusions: prevalence of seizure disorder in the area studied was 10.84%.Significant association was observed between seizure disorder and age, sex, socio economic status, family history of seizure disorder, h/o infections and h/o head injury. Further research is needed to better understand the intricate relationship among socio-demographic risk factors and seizure disorders in order to ensure the best possible outcomes for individuals with seizure disorders.
Challenges of working mothers: balancing motherhood and profession
Authors: Kadale Prajakta G. , Pandey Aastha N. , Raje Swati S.
Published: June 2018

Background: Females contribute to 48.5% of population of India. Shouldering dual responsibilities of house and work can eventually take toll on women’s physical and mental health. The work and family commitments are likely to be influenced by parity, duration of breastfeeding, work environment and social support. This study is conducted to assess the stress levels among working professional mothers and their associated risk factors.Methods: It was a cross sectional study conducted in working professional mothers of India. Data was collected using structured questionnaire and perceived stress scale (PSS-4) for assessing stress. The form was made available on internet so as to approach wide spectrum of professionally working mothers.Results: Moderate to severe stress was perceived by 63.04% women. Severity of stress increases with shift duties (p=0.05), lack of family support (p=0.08) and inability to exclusively breastfeed child for 6 months (p=0.09). Only 1/3rd (31.88%) working mothers could exclusively breastfeed their child for 6 months. Exclusive breastfeeding was more observed in mothers with higher socio-economic status (OR=2.39) and also among those who had shift duties (OR=5.23).Conclusions: In spite of family support for childrearing, most of the professional working mothers are experiencing perceived stress. Work environment flexibility and efficient social support to reduce stress is recommended.
Prevalence and pattern of alcohol consumption using alcohol use disorder identification test among students at a medicalcollege in Goa, India
Authors: Verenkar Yash Jairam , Vaz Frederick Satiro
Published: June 2018

Background: Alcohol use is a complex health and social issue, especially in developing countries like India and in particular the western Indian state of Goa moreover, adolescents are usually more vulnerable to alcohol-related harm from a same volume of alcohol compared to other age group individuals.Methods: A cross-sectional design was conducted over a period of two months in Goa medical college, Goa. Students pursuing the MBBS Course in all semesters for the academic year 2015-16 were the study partici pants. Data was collected by interviewing the students. The pre-tested structured questionnaire used to collect the data. Alcohol consumption pattern was assessed using alcohol use disorder identification test (AUDIT). Approval was obtained from the Institutional Ethics Committee of the Medical College. Informed written consent was obtained from the participant prior to the interview. SPSS Software Package was used for statistical analysis.Results: Prevalence of alcohol consumption was found to be 39.4%. Prevalence among females was higher (40.6%) compared to Males (38%). Among the alcohol consumers 82.3% were light drinkers (AUDIT <8) while 17.7% were identified as heavy drinkers. Hazardous alcohol consumption was identified in 46.7% of alcohol consumers. 20.9% of alcohol consumers showed signs of alcohol dependence.Conclusions: Awareness of ill effects of alcohol consumption, counselling to deal with stress related to studies, negotiating peer pressure etc. need to be the possible solutions to address this health and social issue of alcohol use among young adults.
A study to assess internet addiction among undergraduate medical students of MMC&RI, Mysore
Authors: J. Sushma , Ahmed Mansoor , A. M. Amrutha
Published: June 2018

Background: Developmental stressors, along with free access to Internet services, may contribute to college student's vulnerability to internet dependence. Research indicates that Internet addiction is often associated with depression, impulse control disorder, and low self-esteem. Medical students are a particularly vulnerable group on account of the time they spend on the internet. The objective of the study was to assess Internet addiction among undergraduate medical students of MMC&RI using Young’s internet addiction test.Methods: A cross sectional observational study was conducted among medical students of MMC&RI during the period from August to November 2015. A total of 236 students were included. Kimberly young’s internet addiction test was used to assess the level of internet addiction.Results: The mean age of the students was 20.6 years (SD 1.97). The mean duration of internet use was 4.4 years (SD 1.64) and the mean duration of internet use per day was 1.96 hours (SD 0.99). The prevalence of severe internet addiction, moderate internet addiction, and mild internet addiction were found to be 0.8%, 19.5% and 58.2% respectively.Conclusions:There is a need to focus on mental health with regard to internet Addiction, as problematic internet use is increasingly being reported and younger Internet users are more at risk of becoming Internet addicts.
A study on victims of road traffic accidents attending casualty in a tertiary care hospital, Khammam
Authors: Neeluri Rajesh , Anga Venkata Suresh
Published: June 2018

Background: As per global status report on road safety 2015, 1.25 million road traffic deaths occurred every year. Most common cause of death among those aged 15-29 years was road traffic accidents. The objectives of the study were to study the socio-demographic profile of the victims of road traffic accidents, to identify the risk factors responsible for road traffic accidents and to identify the various presenting injuries of road traffic accident victims.Methods: It was a Hospital based cross sectional study. Victims of road traffic accidents attending casualty during July 2011 – June 2012 were studied. A pretested semi structured questionnaire was administered. A total of 280 road traffic accident victims were interviewed during the study period. Data was entered in Microsoft excel sheet and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results were expressed as proportions for different study variables.Results: Out of the 280 victims, majority 206 (73.57%) of study participants were males. The highest numbers of victims (34.20%) were between 21-30 years of age group. 40.71% were using two wheelers. Most of the accidents took place in the evening (6 pm to 12 am) i.e. 39.10%. Most common site of presenting injury was lower limb (40.71%). In this study 22.5% were under influence of alcohol while driving.Conclusions: Road traffic accidents were more in young age groups and in males. Road safety education should be promoted.
Health status of elderly: a comparative study among urban and rural dwellers
Authors: Zare V. R. , Kokiwar Prashant , Ramesh B.
Published: June 2018

Background: Due to advancement in the medical science, the life expectancy is showing an increase in every census. Hence there is also growing demand to have good quality of life among the elderly. The objective of the study was to assess and compare the health status of elderly in urban areas of Shapur and rural areas of Gummadidala.Methods: A Community based cross sectional study was carried out in rural areas located at Gummadidala, Nallavelli, Anantharam and in urban areas located at Shapur, Kalavathinagar, Subashnagar among geriatric aged people above 60 years. Study was conducted over a period of eight months from August 2017 to March 2018.Results: Overall almost all diseases were more common in rural elders compared to the urban elders except gynecological diseases. Among these hypertension, ear diseases, skin diseases, musculoskeletal disorders, psychological disorders, cancer and neurological diseases were significantly more common in rural elders than urban elders (p<0.05). Only gynecological diseases were significantly more common in urban women and this may be due to more percentage of hysterectomies among rural females.Conclusions: Elderly people in the rural areas are more prone to suffer from diseases as compared to their urban counterparts.
Perceptions and practices about menstrual hygiene among women of reproductive age group (15-49 years) attending out-patient department of CIMS, Bilaspur Chhattisgarh
Authors: Pandey Bhavana , Shukla Devesh
Published: June 2018

Background: Women suffer due to their ignorance on hygienic requirement during menstruation. Hygiene related practices of women during menstruation are of considerable importance, as it has a health impact in terms of increased vulnerability to RTI. Inthis paper our objectives is to detect the menstrual health problems and to assess menstrual hygiene practices among women of reproductive age group (15-49 years) attending OPD of CIMS Bilaspur Chhattisgarh (Obstretic and Gynaecology, OPD).Methods: Females of reproductive age group (15-45 years) attending routine obstretics and gynaecology OPD during 1st May to 15th September 2015 were included in the study after taking their verbal consent at CIMS hospital. Pretested semi-structured questionnaire were used to take history regarding knowledge and practices related to menstrual hygiene. Statistical test like chi-square test were applied using Epi info 7 software.Results: 36% of study population belonged to the 21-30 year age group. About 75% were married. Majority of women had primary education (43.3%) and 54.3% belonged to lower middle class. Majority of women 51.8% used cloth during menstruation; about 45.7% used the same cloth by washing and reusing every month.Conclusions: Most women were found to follow unhygienic practices. Hence, efforts such as improving female literacy and health education regarding the various risk factors should be made by the policy makers to increase menstrual hygiene among rural population. Literacy status was found to be significant for awareness about menstruation and the use of sanitary pads.
A feedback survey on the clinical performance and acceptability of levonorgestrel releasing intrauterine system (EMILY®) during two years of usage
Authors: G. Manoj , C. Amrutha , G. Rajmohan , Bhaskar Sunil , A. Rajeev , Aprem Abi Santhosh
Published: June 2018

Background: Objective of the study was to evaluate the long term clinical performance and acceptability of levenorgestrel releasing intrauterine system (LNG-IUS), ‘Emily’, for the treatment of abnormal uterine bleeding (AUB).

Methods: A two year feed back survey was carried out by telephonic conversation and the data obtained was fed in to the house web application system in the respective Emily users. Subjective perceptions were verbally assured based on a questionnaire framed on the quality of the life led by the Emily users.  

Results: The treatment resulted in a significant reduction in the menstrual bleeding of 102 patients who completed the two year study. The mean bleeding score and SD 18.79 (13.36) in first year falls to 10.76 (12.40) in second year. 78 (76.47%) users were very satisfied with the product usage.

Conclusions: Use of ‘Emily’ LNG-IUS resulted in significant reduction of menstrual bleeding in women with AUB in two years and most of the users were very satisfied with the product.
Postoperative stroke in head and neck cancer patients submitted to surgery
Authors: Silva Diana P. , Silva Joaquim C. , Monteiro Eurico
Published: June 2018

Background: Stroke is a highly morbid complication after head and neck surgery (HNS). Our purpose was to report the casuistic of postoperative stroke (POS) in ENT Department of Oporto Cancer Institute, discuss predictable causes and prognosis.

Methods: Retrospective study that included cases of POS in our Department, between 2012 and 2017. Medical files were reviewed and perioperative aspects were analysed.  

Results: We identified 8 cases of POS in 293 HNS performed. All underwent to HNS including bilateral ND as primary treatment. Several cardiovascular risk factors (CVRF) were present, especially carotid artery stenosis (CAS). Complete internal carotid artery (ICA) encasement was present in 2 patients, in whom artery ligation was performed. Acute drop of bispectral index (BIS) occurred in 1 patient. Stroke occurred at 2.8 post-operatory day (in mean) and was ischemic in 7 patients and haemorrhagic in 1. The most affected vessel was cerebral media artery (87.5%). Hemiparesis was the main clinical manifestation (63%). Incidence of POS was 2.7%. Functional and neurologic recovery occurred in 50%. Mortality rate was 37.5%.

Conclusions: Our findings suggest that worst outcomes were observed in patients with advanced tumour stages, vessel tumour involvement or carotid artery stenosis presence with requirement ligation of ICA, higher number of CVRF, and low or sudden decrease in BIS values during surgery. According to our results we recommend to screen, select and optimize patients to minimise the incidence and severity of this complication.
Audiometric assessment of adolescents and adults with tympanic membrane perforation in Benin City
Authors: Ediale Johnson , Adobamen Paul R. O. C. , Ibekwe Titus S.
Published: June 2018

Background: The degree of hearing loss is directly proportional to the size of tympanic membrane (TM) perforation. However, there is dearth of information on correlation between severity of hearing loss and location of perforation on the tympanic membrane. The objective of the study was to determine the hearing level of adolescent and adult patients with tympanic membrane perforation.

Methods: A cross sectional study at the ENT Clinic, University of Benin Teaching Hospital (U.B.T.H), Benin City. Consecutive patients with TM perforations were examined with ‘‘Firefly video-otoscope’’, and subsequently had pure tone audiometry. The contralateral intact TMs in individuals with unilateral TM perforation and the ears of students and staff of Institute of Health Technology UBTH were used as control. Data was analyzed using statistical package for social sciences (SPSS) version 20 and Image J software. P≤0.05 was considered statistically significant.  

Results: Two hundred ears from 148 patients with TM perforation in either or both ears were studied. Conductive hearing loss (CHL) had the highest prevalence; 64.3% and 55.9% in the right and left ears respectively. Slight CHL; 67.5% was more common. However, the severity of hearing loss increased with the size and also varied with the location of TM perforation.

Conclusions: The hearing level among adolescent and adult patients with TM perforation showed a significant association with the size and the location of the perforation on the TM.
Outcome of retroviral screening among patients undergoing ear, nose, throat, head and neck surgery, at the University of Benin Teaching Hospital, Nigeria
Authors: Adobamen Paul R. O. C. , Ediale Johnson
Published: June 2018

Background: In Nigeria it has been estimated that 3.6% of the population are living with HIV/AIDS. Patients with different social, family, occupational and epidemiological background present for ear, nose, throat, head and neck (ENTH&N) surgeries in our hospital. The aims of the study were to determine the prevalence of HIV infection among patients for ENTH&N surgeries and to document the ENTH&N conditions that were associated with HIV infection.

Methods: This was a prospective study that was carried out in the ENTH&N Surgery department of UBTH, Benin City, Nigeria, between January, 2009 and December, 2010. All patients that were worked up for surgeries were enrolled into the study. Appropriate data were retrieved from the patients who gave informed consent for surgery and had retroviral screening and confirmatory tests by ELISA and Western blot methods respectively. The retroviral status of all the patients and the indications for the surgical procedures done were documented.  

Results: There were 173 patients; 100 males and 73 females, with a male to female ratio of 1.37:1. Ages ranged from 0.83 years to 72 years, with an average age of 26.82 years. Out of a total of 168 patients screened for HIV infection in this study, 6 patients were retroviral positive. This gives a prevalence of 0.036%. Out of the 6 patients that were retroviral positive, 3 patients had chronic tonsillitis, 1 patient had chronic tonsillitis and otitis media with effusion, while the other 2 patients had submandibular gland and nasopharyngeal tumours respectively.

Conclusions: A prevalence of 0.036% of HIV infection was found in patients for ENTH&N surgeries. Chronic tonsillitis was the commonest presentation of HIV infection, equally followed by OME, nasopharyngeal and submandibular gland tumours. 
Anatomical variations of maxillary and ethmoid sinus in chronic rhinosinusitis
Authors: Rajeev Karthika , S. Ravishankara , S. Chethana C. , Shenoy Supreetha B. , . Jyoti
Published: June 2018

Background: The objectives of the study were to compare the anatomical variants of maxillary and ethmoid sinus in CT PNS and diagnostic nasal endoscopy, to determine the incidence of variations of maxillary and ethmoid sinus and to determine the association of anatomical variations with extent of the disease.

Methods: Patients with chronic rhinosinusitis attending the outpatient department of otorhinolaryngology, head and neck surgery (ENT-HNS) of KVG Medical College for a period of 12 months from December 2016 to November 2017. 100 consecutive patients with history of CRS subjected for nasal endoscopy and CT-PNS.  

Results: The majority of patients were females. Male to female ratio was 1:1.46. Headache and postnasal drip were the main symptoms (76%). Concha bullosa (42.4%) was most common anatomical variation, which was detected in 59(42.4%) patients on CT PNS and DNE. There was statistically significant correlation between right septal deviation and right maxillary sinusitis (p<0.01), left septal deviation and left maxillary sinusitis (p=0.001) and left deviation and left ethmoid sinusitis (p=0.017). We also found correlation between left Haller cells and left ethmoid sinusitis (p=0.003).

Conclusions: By using diagnostic nasal endoscopy and CT PNS, anatomic variations can be easily identified and aid as a guide map during functional endoscopic sinus surgeries. 
A clinico-radiological study of anatomical variations of nose and para-nasal sinuses in chronic rhinosinusitis patients
Authors: Shankar Daya , Kumar Sunil , Singh H.P. , Verma Veerendra , Mishra Anupam
Published: June 2018

Background: There are a lot of anatomical variations in para-nasal sinuses that are responsible for various sinus pathologies. CT scan of paranasal sinuses prior to functional endoscopic sinus surgery has become extremely important to know the anatomy and its variations to avoid complications during surgery.

Methods: This study was performed in 100 patients at King George’s Medical University, Lucknow UP, India to compare the anatomical variations between nasal endoscopy and CT scan findings. The outcome measures were deviated nasal septum, paradoxical middle turbinate, concha bullosa, medialized/lateralised uncinate process, pneumatized uncinate process, large ethmoid bulla, accessory ostium, Agger nasii cells, Haller’s cells and Onodi cells.  

Results: In this study the age of the patients were 30.00±9.56 yrs. with male to female ratio 1.9:1. Deviated nasal septum was the most common anatomical abnormality (70%) followed by large bulla ethmoidalis 17%. Occurrence of different types of special cells were studied which are better visualized on coronal CT scan images. Among these cells Agger nasi was the most common variety (15%) followed by Haller’s cells (11%) and Onodi cell (3%). Concha bullosa was present in 8%.

Conclusions: The importance of CT and nasal endoscopy can be seen in patients with persistent symptoms to identify the anatomical variations that may responsible for the development of chronic sinus disease. In cases of sinusitis patients all the para-nasal sinus should be properly investigated to avoid complications. 
Correlation of severity of tinnitus with severity of anxiety and depression in adults in a tertiary care hospital at Bhuj, Gujarat, India
Authors: Khilnani Ajeet Kumar , Thaddanee Rekha , Chodvadiya Manali , Khilnani Gurudas
Published: June 2018

Background: Tinnitus may be objective or subjective. Subjective tinnitus is the type most commonly associated with psychosocial co-morbidities. This study was conducted with an aim to assess the severity of tinnitus and to know its correlation with anxiety and depression in adult population of Western Gujarat region.

Methods: This prospective observational study was conducted in a tertiary care teaching hospital of Western Gujarat from December 2016 to July 2017. Patients with tinnitus were screened for anxiety and depression using tinnitus handicap inventory (THI, validated in Gujarati language), generalized anxiety disorder (GAD-7) and patient health questionnaire (PHQ-9). Severity of anxiety and depression was further evaluated using The Hamilton anxiety rating scale (HAM-A) and the Hamilton rating scale for depression (HRSD, also called HAM-D) respectively.  

Results: 68 patients fulfilled the inclusion criterion. Maximum patients (30.9 %) had moderate tinnitus, followed by severe (26.4 %), catastrophic (19.1 %), mild (16.2 %) and slight (7.4 %). There was a strong and significant correlation between the average THI scores and average GAD-7 scores (r=0.9708, p<0.00001) and average THI scores and average PHQ-9 scores (r=0.9906, p<0.0001) suggesting that patients with tinnitus were very likely to have anxiety as well as depression. However, irrespective of the severity of tinnitus, most patients had only mild anxiety (r=0.9403, p<0.00001) and mild depression (r=0.6758, p=0.001).

Conclusions: The patients with tinnitus are very likely to suffer from mild anxiety as well as mild depression. 
A comparative study of endoscopic assisted curettage adenoidectomy with conventional adenoidectomy
Authors: Kumar Abhay , Narayan Prabhu , Narain Prem , Singh Jaypal , Porwal Prateek Kumar , Sharma Sanjay
Published: June 2018

Background: In ENT adenoidectomy is a commonly performed surgery. It is conventionally done using the curettage method. This present study aims to evaluate endoscopic assisted curettage adenoidectomy as an alternative.

Methods: The present study consisted of forty cases requiring adenoidectomy were divided into two groups of twenty each. In Group A adenoidectomy was done by conventional curettage method and in Group B by endoscopic assisted micro-debrider adenoidectomy. The parameters studied between two groups were intra-operative time, intra-operative bleeding and completeness of resection .The study period was from June 2015 to December 2016.  

Results: The average time taken in Group A (conventional surgery) was 5.30 minutes and in Group B (powered endoscopic surgery) was 12.30 minute. The average blood loss in Group A was 35 ml (range 10–50) as compared to 30 ml in Group B. Nearly 25 % of the patients who underwent endoscopic assisted adenoidectomy had grade II adenoids. About 30% of the patients who underwent conventional adenoidectomy had Grade III adenoids. A total of 10% of the patients developed primary haemorrhage which was more in conventional adenoidectomy (15%) as compared to endoscopic adenoidectomy (5%).
Conclusions:Endoscopic assisted microdebrider adenoidectomy was found to be a safe and effective tool for adenoidectomy. Endoscopic adenoidectomy better for completeness of resection, accurate resection under vision. On the other hand, in conventional adenoidectomy operative time and intra-operative bleeding was less.
 
Outcomes of circumferential tympanomeatal flap tympanoplasty in large central perforation
Authors: B. K. Venkatesha , B. S. Yogeesha , Khan Shibu
Published: June 2018

Background: Tympanoplasty is the commonest procedure performed in patients with chronic otitis media. Circumferential elevation of tympanomeatal flap and underlay graft placement is thought to be a good surgical technique as it ensures elevation of canal skin over the Eustachian tube area to form a good assemble between the temporalis graft and the flap to increase the success rate. In our study we intend to study the surgical and hearing outcome in patients undergoing tympanoplasty with circumferential tympanomeatal flap in large central perforations.

Methods: A prospective study with 25 patients in a tertiary care hospital for a period of 2 years, who underwent circumferential tympanomeatal flap tympanoplasty. Patients were followed up on one month and two months. Graft outcomes and hearing outcomes were studied.  

Results: Graft uptake was 92%. Blunting was noticed in 4% and medialisation in 4% of patients in circumferential group. Average air-bone gap closure achieved was 17.468 dB.

Conclusions: Circumferential flap elevation in tympanoplasty is an effective surgical technique in patients with anterior and large central perforations with satisfactory outcomes. 
Hearing loss and ossicular status in cholesteatoma
Authors: Doddamani S. S. , C. Yasha
Published: June 2018

Background: Chronic otitis media with cholesteatoma is associated with hearing loss. Cholesteatoma causes bone erosion leading to ossicular chain defects. These ossicular lesions are only detected intraoperatively. If the ossicular status could be detected preoperatively by audiometric parameters, it would aid in better information to the patient, surgeon and preparation for the surgery. The aim of this study is to describe the intraoperative ossicular status, preoperative hearing status and to correlate them in patients with cholesteatoma.

Methods: This is a retrospective case series study conducted in a tertiary care centre. Data was collected from inpatient files of 47 patients who underwent surgery for cholesteatoma from January 2016 to December 2017. Air and bone conduction thresholds, air- bone gaps from pure tone audiometry (PTA) reports were collected. The status of the ossicles was collected from the operative notes.  

Results: PTA revealed hearing loss in all the patients, predominantly conductive loss (83%). Ossicular defects were noted in 87% with incus most frequently involved (78.7%). Ossicular lesions were significantly associated with worse air conduction, bone conduction thresholds and air bone gap.

Conclusions: Cholesteatoma is frequently associated with ossicular defects. PTA shows worse parameters in ossicular defects. But, it doesn’t reflect the status of ossicle involved or the number of ossicles involved.
Metastatic renal cell carcinoma in the head and neck region
Authors: Gandla Sowjanya , Ramaswamy Veena , Rao Vishal
Published: June 2018

We describe 3 rare cases of metastatic renal cell carcinoma in the head and neck region. Our first case was a 72 years old male presented with profuse bleeding from the left ear. On examination, proliferative, pink, friable mass was present in the left external auditory canal. On eliciting the detailed history, it was found that patient had renal cell carcinoma in the left kidney four years back and underwent left radical nephrectomy. Patient underwent left lateral temporal bone resection with cul-de-sac closure. Histopathological examination of the specimen showed metastatic renal cell carcinoma. Our second case was a 64 years old male presented with complaints of growth in the oral cavity of 1 month duration. On examination, 5×3 cms proliferative growth was present in the hard palate. Biopsy from the growth in the hard palate showed metastatic renal cell carcinoma. Patient gave history of renal cell carcinoma in the past for which he did not receive treatment. Our third case was a 45 years old male who presented to us with a diffuse swelling in the left temporal region of 2 months duration. On examination, 3×2 cms swelling was present in the left temporal region. Patient had history of renal cell carcinoma of left kidney and underwent left nephrectomy one year prior to the presentation of the left temporal swelling. Ultrasonography guided biopsy of the left temporal region showed metastatic renal cell carcinoma.
Evaluation of functional outcome of lumbar spondylolisthesis treated with posterior lumbar interbody fusion with instrumentation
Authors: Raja K. S. , Ravi M.
Published: June 2018

Background: Spondylolisthesis with or without spondylolysis occurs in 5% to 8% of the adult population. It is commonly believed that spondylolysis does not exist at birth. The incidence is 4.4% to 5% at the age of 6 years, increasing to 6% at the age of 18 years, which is quite similar to that observed in adulthood.To analyze the functional outcome of posterior stabilization by pedicle screws with decompression and interbody fusion by PLIF (Posterior Lumbar Interbody Fusion) technique in adult single level spondylolisthesis. In this study our aim is to analyze the correlation between the degrees of fusion with functional outcomes.

Methods: This is a prospective study of 20 patients carried out in the Department of Orthopaedics, Govt. Dharmapuri Medical College Hospital, Dharmapuri from January 2016 to December 2017. All patients were evaluated with anteroposterior, lateral and oblique radiographs of the lumbosacral spine. Dynamic plain radiographs of all our patients showed instability. CT/MRI evaluation of all patients was done.

Results: In our study four patients (20%) had a complete reduction of the preoperative slip, fourteen patients (70%) showed a reduction of slip by one grade, while in two patients (10%) there was no change from the preoperative slip percentage.

Conclusions: Further, three dimensional multislice thin section CT scans with multiplanar reconstruction are ideal to study the incorporation of the bone graft within the disc space.
Functional outcome after surgical treatment of ankle fracture using Baird Jackson score
Authors: Mohapatra Amlan , Raj Karthik
Published: June 2018

Background: Ankle fractures have been identified as a significant source of morbidity for both the young and the elderly. In this study we aim to evaluate the functional outcome of patients who were operated for ankle fracture at our centre and to assess the factors associated with the functional outcome.

Methods: An observational study in the Department of Orthopedics, AJ Institute of Medical Sciences, Mangalore, Karnataka from January 1, 2017 till December 31, 2017 of all patients who presented with any type of ankle malleolar fracture and underwent surgery were included in the study. Clinical history, socio-demographic profile, anatomic classification and Weber’s classification was noted for all patients. Functional outcome was evaluated 6 months post-operatively using the Baird Jackson scale and factors associated were assessed.

Results: During the study period 84 patients were enrolled in the study, mean age was 43.8±5.46 years and 48 were male patients. Supination external rotation was the most commonly seen injury in our patient population. Postoperatively, superficial skin infections were seen in 15% and restricted ankle movement in 11% patients. According to the Baird and Jackson score, clinical functional outcome was excellent in 17 cases, good in 47, fair in 15 and poor in 5 patients. Patients aged less than 45 years and supination external rotation injuries were significantly associated with excellent and good functional outcomes as compared to patients of older age.

Conclusions: Surgical treatment resulted in excellent to good functional outcome in majority of the patients of this study. Further research is required to assess the clinical and functional outcomes in patients with long term follow up. 
Evaluation of talus fractures treated with fixation- correlation of functional outcome with the fracture type and wound condition
Authors: Mahajan Neetin Pralhad , Palange Nikhil Dilip , Pawar Eknath , Supe Amit , G. S. Prasannakumar
Published: June 2018

Background: Fractures of talus are one of the most difficult ones to treat owing to the problems of complicated fracture patterns, wound problems, risk of osteonecrosis etc. This study aims to evaluate the relation of the fracture type and wound with the functional outcome after open reduction and fixation.

Methods: The study was conducted in Sir J. J. Group of Hospitals from June 2014 to March 2018. A consecutive series of 28 patients with displaced fractures of talus were selected after approval from ethical committee. All patients were operated and evaluated at average of 6 months after surgery.

Results: The Hawkins score was used to evaluate the functional outcome. 60% of patients of type II gained good to very good score as compared to 40% of patients of type III and 30% of type IV. With increase in severity of the fracture, percentage of score decreased.

Conclusions: Most precise method of restoring and maintaining the anatomy of talus fracture is open reduction and internal fixation to allow early motion. Surgery for displaced fractures consists of anatomically correct reconstruction to avoid articular surface incongruence and angular deformity as well as preservation and rapid restoration of talar blood supply. This will ensure early mobilization and satisfactory outcome. Open fractures have worse functional outcome than closed fractures owing to lower union rates, higher osteonecrosis rates and higher re-operation and infection rates. 
Senhorio, poder senhorial e exercício da justiça nos Costumes de Beauvaisis
Authors: Zema de Resende Ana Catarina
Published: June 2018

O estudo dos direitos de justiça e de polícia na obra de Philippe de Beaumanoir, Costumes de Beauvaisis, foi conduzido a partir do exame dos conceitos de senhorio e de poder senhorial, conceitos fundamentais para compreensão das relações de poder no período medieval. Sob o ângulo da antropologia jurídica, pretendeu-se analisar os direitos de justiça e de polícia dos senhores feudais como estabelecidos nos Costumes de Beauvaisis, para mostrar que, no século XIII, quando os conflitos entre senhores cessam, o que passa a ter importância para a afirmação do poder do senhor é o exercício de justiça. Após breve apresentação do autor e da fonte, retoma-se, em um primeiro momento, o debate historiográfico mais recente sobre a temática do senhorio e do poder senhorial para, em seguida, analisar nos Costumes de Beauvaisis os direitos de justiça e de polícia que são aqueles que dão ao senhor o poder de julgar, de punir, de cobrar taxas e multas e de afirmar seu poder de ban.  Finalmente, conclui-se que o exercício da justiça está na base de todos os outros direitos e que é graças ao seu direito de justiça que o senhor vai adquirir o poder necessário para exigir de todos seus súditos os outros direitos.
A Vigilância nos Ambientes e Processos de Trabalho em Palmas – Tocantins: Diagnóstico Situacional e Contribuições ao setor.
Authors: Silva Renata De Freitas , Fonseca Betânia Moreira Cangussu
Published: June 2018

Este estudo teve como objetivo contribuir com a reestruturação do processo de trabalho do Núcleo de Vigilância nos Ambientes e Processos de Trabalho da Vigilância em Saúde do Trabalhador do município de Palmas – Tocantins, descrevendo o mesmo, identificando suas fragilidades e buscando soluções, sendo este Núcleo portanto, o universo da pesquisa. Trata-se de um estudo descritivo tipo intervenção, constituído por quatro fases. A fase I contextualizou historicamente a Saúde do Trabalhador no município de Palmas – TO; A fase II descreveu o atual processo de trabalho da equipe de Vigilância em Ambientes e Processos de Trabalho; Na fase III foram identificadas as necessidades da equipe quanto às melhorias necessárias; A fase IV foi destinada à construção dos fluxos e instrumentos necessários para a estruturação do setor no planejamento e execução de suas ações. A história da Saúde do Trabalhador no município iniciou-se em 2004, a partir da habilitação do CEREST Regional de Palmas, perpassando por várias fases até a habilitação do Núcleo de Vigilância em Saúde do Trabalhador. Foram identificadas dificuldades no desenvolvimento do trabalho integrado com outros setores, ausência de legislações municipais para a saúde do trabalhador, da Comissão Intersetorial de Saúde do Trabalhador junto ao Conselho Municipal de Saúde e de recurso federal. Também se percebeu a informalidade nas solicitações de demandas e respostas entre os setores da Vigilância em Saúde do Trabalhador e um fluxo não estruturado na rotina do serviço. Desta forma, o trabalho trouxe contribuições de intervenção nesta realidade, de maneira participativa e democrática.
Estudo Sistemático sobre Poluição por Cargas Difusas em Bacias Urbanas
Authors: Moura Bruna Moreira Dias de , Lima Eliana Beatriz Nunes Rondon
Published: June 2018

A poluição causada pela inserção nos corpos d’água de poluentes oriundos do processo de urbanização é cada vez maior. Estes poluentes afetam a qualidade da água e dos ecossistemas em geral. A busca por soluções que sejam adequadas à realidade de cada local se torna imprescindível. Este estudo tem por objetivo geral identificar metodologias para a avaliação da poluição por cagas difusas em bacias urbanas. O método empregado foi a revisão sistemática nos portais Capes e Scopus. A partir da compilação de 20 estudos selecionados pode-se destacar que os poluentes mais utilizados para estudos de cargas difusas são nitrogênio, fósforo, sólidos e DQO, e ainda, a utilização de seis softwares que simulam a qualidade da água, levando em consideração a poluição difusa. O Best Management Practices (BMP) demonstrou resultados satisfatórios nos Estados Unidos como forma de mitigação dos impactos causados. No Brasil ainda são poucos os estudos que visam traçar diagnósticos de poluição levando em consideração as cargas difusas, desta forma este estudo buscou identificar os modelos de simulação utilizados, bem como os dados para calibração, possíveis impactos causados e as ações adotadas no mundo para sua mitigação.
Deep vein thrombosis and pulmonary embolism in a patient with acute type B aortic dissection: a case report
Authors: Akgül Engin , Alptekin Erkul Gülen Sezer , Erkul Sinan , Vural Ahmet Hakan
Published: June 2018

Acute
dissection involving ascending aorta contains high risk of mortality and requires
surgical treatment immediately. Venous thrombosis can manifested as deep vein
thrombosis or pulmonary embolism. It may be isolated or complication of another
disease. Because of pulmonary thromboembolism risk, treatment of deep vein
thrombosis is strongly recommended. A 61-year-old male patient with severe back
pain and shortness of breath presented to the emergency service. The findings
of the physical examinations, chest x-ray and electrocardiogram were normal. Contrast-enhanced
computerized tomography showed an aortic intimal tear that started just below
the subclavian artery and extended into the iliac arteries. The patient was hospitalized
and the medical treatment started. On the 4th day of clinical
follow-up, pain and swelling started at his right leg with severe shortness of
breath. Venous Doppler ultrasound was performed and there were thrombosis at
popliteal, femoral and even at iliac veins. Computed tomography showed pulmonary
embolism at pulmonary trunk. Aortic dissection treated with endovascular stent
graft firstly to prevent aortic rupture because of anticoagulation and then
pulmonary embolism treated with anticoagulant drugs. Hypercoagulation is a self
defence of the body for limiting the aortic intimal tear to prevent aortic
rupture. So many complications could be seen because of this situation and the
physicians should be awaken for this.
探究建筑管理与建筑成本的实质联系
Authors: 薛 伟
Published: June 2018

随着我国建筑行业的不断发展,其逐渐成为了国民经济发展中的重要推动力量。新时期背景下,做好建筑成本控制工作,并提升工程管理质量是建筑行业发展的必然趋势,符合现代社会发展需求。鉴于建筑成本和建筑管理之间具有着较为密切的联系,文章在分析了建筑成本管理要点的前提下,对成本控制中存在的问题进行了研究,最后提出通过建筑管理控制建筑成本的有效途径。
关于建筑机电设备安装施工管理的分析
Authors: 韩 大明
Published: June 2018

建筑工程的机电设备安装施工是一项系统性的工作,安装施工人员必须具备较强的专业知识和技能,同时必须加强施工的管理,才能确保工程的质量。文章对建筑机电安装施工与管理的特点进行了总结,提出了安装施工中存在的管理问题,重点对技术管理、安全管理、合同管理、进度管理等内容作了介绍,只有加强机电设备安装施工的现场管理,才能解决施工中存在的质量隐患与安全问题,保障建筑工程的施工质量。
浅析工程造价的管理与控制
Authors: 蔡 敏霞
Published: June 2018

近些年以来,我国的各个方面都在迅猛的发展,建筑业作为我国经济中的最重要的一部分,建筑行业也在不断的发展,并且取得了令人瞩目的成绩,但是建筑行业在快速发展的同时也不可避免的出现了一些问题,建筑行业并不像它看起来那么简单,它也存在着很多形式,具有多样性和复杂性,基于建筑行业这些特性的存在,在建筑工程项目管理过程中,对于建筑工程造价的管理与控制就更显得严格,这也就给一项工程的完成增加了难度,我们应该怎样做才能保证在工程本身的质量不受影响的前提下,去利用科学有效的方法去尽可能的降低工程造价,已经成为了建筑行业急需要解决的问题,本文就是针对现阶段建筑行业领域中工程造价这个重要的要素,探究它在各个阶段的管理与控制的方法,来为我们的建筑行业提一些有效的建议。
EPC模式下工程造价管理的理论研究
Authors: 王 秀英
Published: June 2018

目前我国工程呈现出迅速发展的良好趋势,工程在承包模式上向多样化的方向不断发展。从当下的工程建设状况来看,EPC 总承包模式是经常采用的,此类模式能够促使各单位间建立起良好的合作关系,并且在工程设计环节、工程施工作业中发挥其固有的独特优势,从而实现企业承包模式的有效转变。总承包模式下,做好工程造价管理工作具有十分重要的意义。为此,则需要在获取最高利润的基本前提下,有效地规避风险。接下来,文章围绕EPC 模式下工程造价管理的理论进行研究,望能够对同行业有一定的可参考价值。
关于建筑基础工程CFG桩施工及其质量控制的探析
Authors: 李 长锋
Published: June 2018

随着城市化建设的不断得意洋洋电,促进了建筑业的快速发展,使得建筑工程项目建设不断增多,并且建筑工程地质也变得日益复杂,为保证承载及变形要求,须采用桩基础或采取地基处理措施。而建筑基础工程建设中CFG 桩施工工艺简单、效果明显、造价低,使其在工程建设中得到广泛应用,为了充分发挥其作用,本文阐述了建筑基础工存在的主要问题以及CFG 桩作用,对建筑基础工程中的CFG 桩施工要点及其质量控制进行了探讨分析,旨在保障建筑工程质量。
市政给排水中的顶管施工
Authors: 路 程
Published: June 2018

市政给排水是市政基础设施工程中的重要内容，其应用顶管施工技术，可以提高施工企业的经济效益和社会效益，并且从根本上改变了城市管网工程乱开挖现象。为了提高市政给排水工程施工质量，在顶管施工过程中，应当严格遵守施工的技术规范和设计规范，从而确保市政给排水质量。基于此，本文概述了顶管施工技术，阐述了顶管施工的类型，对市政给排水中的顶管施工要点进行了探讨分析。
铸造设备综合效率提升的途径
Authors: 邓 家宏
Published: June 2018

设备综合效率是衡量其使用、维修效果的好坏,已成为诸多世界级设备维修的重要衡量指标。在具体的施工运行中,设备的使用、维修、养护和管理关系到了建筑工程企业生产效益。本文从铸造施工机械设备的维护和管理角度出发,以系统的预防维修体系为载体,以点检为核心,以维修规范为落脚点,不断提升设备维护保养质量,确保设备能够以最佳运行状态,持续稳定的运作,同时达到节能降耗,维持设备较长寿命的目标,实现铸造设备的可持续健康运作。
城市建筑垃圾处理现状及优化措施初探
Authors: 张 菲菲
Published: June 2018

以往的城市建设中,垃圾是人们所摈弃的废物,对城市的建设有着严重的影响,不过随着技术的提升以及人们认知能力的增长,垃圾被当作是最有潜力的可再生资源,利用合理的处理方式可以将垃圾进行不断的优化和处理,从而提升其使用的效率,为城市建设提供有力的支持。
探析园林绿化工程建设中的花卉造景应用
Authors: 黎 江萍
Published: June 2018

花卉不仅具有绿化、美化环境的作用,还具有防尘、杀菌以及吸收有害气体的卫生防护的作用。因此加强园林绿化工程建设中的花卉造景应用,不仅可以提高城市园林的观赏性,还可以有效促进我国花卉事业的发展,基于此,本文简述了园林绿化工程建设中的花卉造景应用要求及其原则,对园林绿化工程建设中的花卉造景应用要点进行了探讨分析,旨在提高园林绿化水平。
电力企业管理规章制度探究
Authors: 闻 清 , 钟 华
Published: June 2018

随着电力企业体制的改革以及电力市场的不断开放,电力行业发展的必然选择已经逐渐变成建立开放、统一、有序以及透明的企业,这就要求电力企业在今后的发展过程中不能因循守旧、故步自封,要调动一切市场积极因素,坚持创新驱动,进而推动我国电力行业管理工作的进步,保障电力行业在市场上占据的有利地位,进一步促进我国电力企业的发展。
简析市政规划中的地域性设计问题及其设计要点
Authors: 张 健 , 孔 祥雯
Published: June 2018

市政规划中的地域性设计具有文脉传承的作用,其在满足现代城市基础发展的需求上,注重体现城市的历史文化和区域性特征,从地域文化出发设计城市与人的空间关系,充分满足人的适居要求。基于此,本文阐述了市政规划思路及其现状问题以及市政规划地域性设计的重要性,对市政规划中的地域性设计问题及其设计要点进行了简要分析。
OPPORTUNITIES AND THE ROLE OF RADIOLOGIC METHODS (CT, SPIRAL CT, MSCT) IN THE EVALUATION PROCESS OF THE EXPERT INSIGHTS
Authors: Dadabayev V. K.
Published: June 2018

The article is devoted to the opportunities and correct interpretation of «reading» x-ray images (RCT, MSCT) in different types of bone tissue. These methods are invaluable in clinical and forensic practice for the purpose of diagnosis, treatment, evaluation of severity, age of education, as well as in addressing the causes of diagnostic and medical errors at all stages of medical care in the production of examinations.
THE CASE OF SPOTTING VISCHNEVSKIY’S SPOTS ON THE CORPSE EXHUMED TWO YEARS AFTER THE BURIAL
Authors: Avkhodiyev G. I. , Starnovskiy A. P. , Butin A. P. , Turanov O. A.
Published: June 2018

The article describes an occasion from expert practice – detection of Vischnevskiy’s spots on the corpse exhumed two years after burial.
FORENSIC MEDICINE OF GREAT BRITAIN, PAST AND PRESENT
Authors: Klevno V. A. , Nazarov Y. V.
Published: June 2018

In the publication, based on the book «The history of forensic medicine» under the editorship of doctor of medical sciences, professor Burkhard Madea, provides detailed information on forensic science in the United Kingdom of Great Britain and Northern Ireland, shows the story of its origin, highlights the contemporary organizational structure of forensic medicine, the way and the complexity of its development. The organizational problems of the service, both in the past and in the present, are noted. The basic information about obtaining the specialty of forensic medical examination in the UK is given.
MEDICAL EXAMINERS OF THE MOSCOW REGION IN DAYS OF THE GREAT PATRIOTIC WAR
Authors: Romanko N. A. , Chumakova Y. V. , Potankina T. V.
Published: June 2018

The article is devoted to the medical examiners of the Moscow region – veterans of the Great Patriotic War and participants of the labor front. The questions of the state of the forensic medical service of the Moscow region in the war years are covered. Staff of Bureau of Forensic Medical Examination of the Moscow Region in 1941–1945 is presented.