bluuebunny/crossref_metadata_2025 huggingface dataset:
Plan de desarrollo del posconflicto en las zonas desocupadas por las farc en relación a la planificación y administración integral turística y hotelera en Colombia. Primera parte 2015-2016
Authors: Segura Mateus Jairo Alonso
Published: February 2018

La Planificación y la Administración Turística y Hotelera como un efecto multiplicador para la transformación de los espacios en conflicto armado en territorios de paz, pueden ser hoy una realidad como emporio turístico y hotelero del siglo XXI gracias a las iniciativas que evocan la consolidación de una “paz recreativa, turística y hotelera”, está en el país. Pensar en impactos beneficiosos que se pueden sembrar en zonas de gran valor turístico, natural y de recuperación del medio ambiente, de culturas y específicamente en los destinos que han sido víctimas del conflicto armado como lo han sido una mayoría de zonas de Colombia, son oportunidades para el desarrollo y practica del turismo, ecoturismo, producción artesanal, etnoturismo, de la recuperación de atractivos turísticos naturales y artificiales de alto valor nacional e internacional como ejes fundamentales para promover la innovación, la competitividad y potencializar este mercado. Con esta premisa, además, se hace necesario diseñar El Diagnóstico de las percepciones en estas áreas sobre los temas planteados como la Primera encuesta nacional de percepción pública-2016.Segunda parte.2016-2017.
Do we need more than ultrasound endometrial thickness to predict malignancy?
Authors: Al Fattah Adly N. , Anggraeni Tricia D. , Aprilia Bella , Ikhsan Muhammad
Published: February 2018

Endometrial thickness (ET) ultrasound measurement has high diagnostic performance for detection of endometrial cancer in symptomatic postmenopausal women. Identified clinical risk factors, Doppler or 3D ultrasound parameters to predict endometrial malignancy had been proposed in several studies. We compared the accuracy of ultrasound endometrial thickness with scoring system/index involving both of clinical and ultrasound parameters to predict endometrial malignancy. Eight eligible diagnostic studies were appraised to assess the accuracy of ultrasound ET and/or ultrasound-based index to predict malignancy. The incidence of endometrial malignancy confirmed by histopathology examination was ranging from 10.5 to 58% from 8 studies. Ultrasound-based index to predict endometrial malignancy had good accuracy (AUC 75% - 98%). The addition of endometrial volume/uterine corpus volume ratio (EV/UCV) and Doppler to clinical parameters had increased the prediction accuracy of the index. While ultrasound ET alone has also high sensitivity, respectively 90.6% and 96.9% using the cut-off 4 mm and 3 mm with low accuracy. Ultrasound-based index to predict endometrial malignancy had better accuracy compared to ultrasound ET alone. Combination of ultrasound including Doppler parameters and clinical parameters had increased the prediction accuracy of the endometrial malignancy prediction index.
Indonesian primary care physician perception towards contraception usage: a review
Authors: Santoso Budi I. , Surya Raymond , Hakim Surahman
Published: February 2018

Background: Indonesian Health Profile (IHF) showed that Indonesian population reached 255.46 million people in 2015. A way to control population growth is through family planning (FP). This study aims to evaluate knowledge, attitude, and practice (KAP) of general practitioner in Indonesia regarding to contraception and postpartum contraception.Methods: A cross sectional descriptive study to all internship doctors in Indonesia was held between July and August 2016. There were 8, 10, 9, 6 questions focusing on characteristics demographic, knowledge, attitude, and practice towards contraception including postpartum contraception, respectively. The inclusion criteria were all general practitioners who were doing the internship in Indonesia during this study. The exclusion criteria were general practitioners who postponed the internship due to any reasons. Descriptive statistics were used for data analysis using SPSS 23.0 for Windows.Results: Most of them (56.4%) had good knowledge, 97.4% respondents pointed out positive attitude, and 72.3% of them showed positive practice towards contraception. Meanwhile, the experience of inserting IUD, implant, and performing contraceptive injection was only 58.5%, 43.6%, and 79.0%; contributively.Conclusions: Supervision training starting from contraceptive counselling to procedure of insertion on long acting and permanent methods (LAPM) should be conducted to allow quality contraceptive service in Indonesia.
Study the cases of rupture uterus in a tertiary care teaching hospital, Jharkhand, India and its maternal and perinatal outcome
Authors: Beck Rameshwari , Minj Shashi Dinkar , Tirkey Sarita , Kumar Ajit , Sen Sukanta
Published: February 2018

Background: Rupture of a pregnant uterus is a serious obstetric emergency and a common cause of maternal death. Study was done to evaluate the incidence, risk factors, management, maternal and fetal outcome of rupture uterus at RIMS.Methods: The present study was carried out in 80 cases of rupture uterus admitted in labour room in the department of Obstetrics and Gynaecology, RIMS, Ranchi, India from March 2014 to September 2015.Results: It was observed that the incidence rate of 0.763%. About 53.75% of ruptures of uterus were noted after 38 weeks of pregnancy. The cause of rupture uterus during labour in most of the cases was spontaneous (49.34%). scar rupture was the next frequent cause (45.33%) and traumatic rupture were 5.33%. Malpresentation and malposition contributed the most important aetiological factors causing spontaneous rupture during labour (43.24%). Hysterectomy was performed in 53.75% (subtotal, 32 cases i.e. 40% and total, 11 cases i.e. 13.75%).Conclusions: Rupture uterus is a serious and life threatening complication for both mother and the fetus. The leading cause of uterine rupture was found to be neglected and obstructed labor due to mismanagement by local untrained birth attendants. Timely recognition and referral to higher centers can reduce the maternal and fetal morbidity and mortality due to uterine rupture. Education and proper care especially of high risk patients like previous caesarean by competent personnel, proper use of oxytocin and early referral may help to reduce the incidence of rupture uterus.
Assessment of menopausal symptoms using modified menopause rating scale (MRS) in women of Northern India
Authors: Khatoon Fareha , Sinha Parul , Shahid Sana , Gupta Uma
Published: February 2018

Background: Menopause is defined as complete cessation of menses for twelve months or more. It is a normal physiological change experienced by middle aged women and some of the menopausal symptoms experienced by these women can be severe enough to affect their normal daily activities.Methods: An observational cross sectional study was carried out in the Department of Obstetrics and Gynecology, Era’s Lucknow Medical College and hospital, Lucknow for a period of one year.300 patients who had attained menopause were analyzed. Menopausal symptoms were assessed using Modified Menopause Rating Scale (MRS).Results: Majority of patients attained menopause at the age of 50-54 years and the calculated mean age came to be 50.33±5.26. The most common symptom reported was joint and muscular discomfort (87%), depressive mood (70%), heart discomfort (60.3%), physical and mental exhaustion (60%), sleep problems (56%). The most classical symptom of menopause i. e. hot flushes was reported in 53.3%. Prevalence of other symptoms in decreasing order were irritability (46.6%), anxiety (40.3%), bladder problem (26%), dryness of vagina (23%), sexual problems (20%). The menopausal symptoms were found to be more prevalent in women of lower socio economic strata and those who had no formal education and this difference was found to be statistically significant.Conclusions: There is a high burden of postmenopausal symptoms which have shown an increasing trend with advancement of age. This calls for establishment of specific health intervention for postmenopausal women through the existing health centres by having geriatric clinics.
Comparative study of mifepristone and misoprostol versus misoprostol alone in induction of labour in late intrauterine fetal death
Authors: K. R. Hemalatha , Mulla Qutejatul Kubra
Published: February 2018

Background: Intrauterine fetal death is most undesirable consequence of pregnancy and stressful condition for women and family and for health professional. Naturally, majority of women (over 90%) go in for spontaneous labour and deliver within 3 weeks of intrauterine death. Prolonged retention of dead fetus in utero has complications like DIC, psychological stress and infection. Various methods are available to induce labor in intrauterine fetal death. One such regimen is medical management using a combination of Mifepristone and Misoprostol. The objective of this study was to compare efficacy and safety of combination of mifepristone and misoprostol versus misoprostol only in induction of labour in late intrauterine fetal death.Methods: A prospective study was carried out in KIMS, Hubli between Jan 2014 to Dec 2015.Data from 100 women with intrauterine fetal death between gestational age of 24-42 weeks were analysed. They were divided into 2 groups of 50 each. Group I received single oral dose of 200mg mifepristone followed 24 hours later with oral misoprostol (100µg-50µg) every 4 hourly. Group II received only misoprostol. Outcomes were measured in terms of induction to delivery interval and number of misoprostol doses required.Results: Mean induction to delivery interval in Group I was 8.3 hours versus13.4 hours in Group II. Induction delivery interval was shorter in combined regimen. Total dose of misoprostol was also less in Group I.Conclusions: Both regimens are safe for induction of labour in late intrauterine fetal death. However, the induction delivery interval and dose of misoprostol required was decreased in combination regimen.
Newborn birth weight: a trend towards positive paradigm shift in rural central India
Authors: Tayade Surekha A. , Gangane Neha , Kore Jaya , Singh Noopur , Harne Shalaka
Published: February 2018

Background: Birth weight is one of the important determinants of neonatal wellbeing. It has many determinants including maternal nutritional status and gestational age. Low birth weight is associated with high neonatal and childhood mortality and morbidity. Over the years the birth weight is showing the increasing trend in developing countries like India. The study aimed at finding out the changing pattern of birth weight over a decade in rural India.Methods: Retrospective data of 43,114 births was collected through hospital information system. Neonatal birth weight was analyzed over a period of 10 years from 2007-2016. Demographic data was studied to study the determinants.Results: Over the period of 10 years, proportion of newborn with low birth weight (below 2500 grams) declined from 56.35 % to 43.65 %. The rise in mean birth weight was 147 gram in male infant and 114 grams in female. There was overall reduction in proportion of very low birth weight and extremely low birth weight babies. A linear relationship was observed between improved birth weight, socio economic status, age at marriage and maternal weight gain during pregnancy.Conclusions: A positive trend towards improved newborn birth weight was observed in study site of rural central India. Better antenatal care, improved maternal nutrition and improved social status of women in the community are the determinants found to have a positive correlation.
Severe anemia in late pregnancy: a retrospective study at a tertiary care rural medical college in Gujarat, India
Authors: Sapre Shilpa A. , Raithatha Nitin S. , Bhattacharjee Rumi S.
Published: February 2018

Background: Anaemia in pregnancy is the commonest medical disorder in developing countries like India. It has multifactorial etiology and is associated with increased maternal and perinatal morbidity and mortality. The study aimed at analyzing the socio-demographic variables and also the maternal and perinatal outcome of pregnant women admitted to labour room with severe anaemia (Hb <7 gm%) late in pregnancy.Methods: This is a retrospective observational study done at a tertiary care rural medical college in Gujarat over a 3 year period from January 2014 to December 2016.Results: Results of the study were analyzed. Out of 3963 deliveries during the study period 225 (5.6%) patients were severely anaemic. There were 177 (78.6%) unbooked patients and 169 (75.1%) were multigravidas. Majority of patients belonged to under 24 yr age group. Maternal complications were in form of preterm labour (44%), pre-eclampsia-ecclampsia (24.8%), cardiac failure (2.2%), PPH (2.2%) maternal death (0.4%). Neonatal outcome was analyzed in terms of prematurity (44%), LBW (24.8%), NICU admission (15.1%), still birth (4.4%), neonatal death (11.5%).Conclusions: Severe anaemia during pregnancy is associated with adverse maternal and perinatal outcome. It is also one of the preventable indirect cause of maternal mortality. Imparting health education to adolescent girls, regular antenatal check-ups, early diagnosis and treatment along with active participation of ASHA workers at grass-root level might help in bringing down the prevalence. A more focused approach is warranted towards pregnant women in rural and underdeveloped areas of India.
The study of arterial and venous Doppler in high risk pregnancies and its role in perinatal outcome
Authors: Tabitha S. , Rajini Madishetti
Published: February 2018

Background: Antepartum foetal surveillance is the corner stone in the management of high risk pregnancies, aimed at reducing maternal and perinatal mortality and morbidity. This study was conducted to analyse the blood flow in umbilical artery, middle cerebral artery, umbilical vein and ductus venous using doppler ultrasound in high risk pregnancies.Methods: This was a prospective study conducted in pregnant patients with high risk factors after 28 weeks of gestation who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Hyderabad during the period from October 2013 to December 2014.Results: Patients were divided into two groups, first with normal Doppler and second with abnormal Doppler, containing 76 and 20 patients respectively. Group 2 is again 4 sub-groups according to the vessel affected. Group A included the cases with affected umbilical artery, Group B included the cases with affected middle cerebral artery, Group C included the cases with both affected umbilical artery and middle cerebral artery (UA+MCA), Group D included the Cases with the affected umbilical artery, middle cerebral artery and Ductus Venosus (UA+MCA+DV) containing 12, 2, 4 and 2 patients respectively. There were more number of emergency caesarean sections than vaginal deliveries which is statistically significant (p <0.034), there were more number of sick babies than healthy babies and there are more number of still births which is statistically significant (p <0.0001), there are more number of low birth weight babies in comparison to normal weight, which is statistically significant (p <0.0037). Distribution of cases with abnormal Doppler depending on vessel abnormality according to gestational age at the time of delivery, mode of delivery, perinatal outcome, birth weight, which was statistically significant. The sensitivity and specificity of abnormal Doppler in predicting perinatal outcome is 45% with (95% CI 26.9-64.0) and 89.5% with (95% CI 79.0-95.3) respectively. The positive predictive value is 65% with (95% CI 40.9-83.6) and negative predictive value is 78.9% with (95% CI 67.7-87.1).Conclusions: This study recommends that all high risk pregnant women should undergo serial foetal monitoring. When doppler abnormalities are detected, delivery should be conducted at a tertiary care centre where facilities for caesarean section and NICU are present.
Effect of cardiac surgery on maternal and perinatal outcome in rheumatic heart disease with pregnancy: a comparative study
Authors: Yadav Vikas , Sharma J. B. , Kachhawa Garima , Kriplani Alka , Mahey Reeta , Dalal Venus , Kriplani Isha
Published: February 2018

Background: Rheumatic heart disease remains the commonest heart disease in India with mitral stenosis being the most common lesion and is associated with significant maternal and perinatal mortality and morbidity. The objective of this study was to compare maternal and perinatal outcome in women with rheumatic heart valvular disease who had no surgery or had percutaneous balloon mitral valvuloplasty (PBMV) or had valvular replacement surgery.Methods: It was a retrospective study in 113 women with rheumatic heart disease with various valvular lesion admitted in the hospital in previous 10 years. There were 58 (51.35%) patients without cardiac surgery (Group 1), 24 (21.23%) with PTMC (Group 2) and 31 (27.43%) with valve replacement surgery (Group 3). Maternal and perinatal outcome were compared in three groups.Results: The baseline characteristics were similar in the three group. In cardiac complications New York Heart Association (NYHA) deterioration was significantly higher (24.1%) in non-operated group (Group 1) as compared to Group 2 (12.3%) and Group 3 (16.1%). There was no difference in Group 2 and Group 3. Need of cardiac medication (digoxin) was also highest (67.2%) in Group 1 as compared to Group 2 (24.6%) (p = 0.002) and Group 3 (38.7%) (p = 0.001) but no difference in Group 2 and Group 3. Anticoagulant were given to significantly higher number (54.8% of cases in Group 3 (valve replacement) as compared to Group 1 (3.4%) and Group 2 (12.5%). There was no significant difference in obstetric events and mode of delivery in the three groups. Similarly, there was no difference in fetal outcome in the three groups as regard to mean birth weight, APGAR score, fetal growth restriction, fetal or neonatal death or congenital anomalies in the three groups.Conclusions: Cardiac surgery before or during pregnancy did not significantly improve maternal or perinatal outcome. Only cardiac events and need of medication was reduced with surgery. Hence surgery should be performed judiciously in selected cases.
The incidence and management of hypotension in the pregnant parturients undergoing caesarean section following spinal anaesthesia with 0.5% bupivacaine
Authors: Minj Shashi Dinkar , Beck Rameshwari , Kumar Ajit , Tiwari Praveen , Chandan Raj Kumar , Sen Sukanta
Published: February 2018

Background: Spinal anesthesia for cesarean section is not a 100% successful technique. At times, despite straightforward insertion and drug administration, intrathecal anaesthesia for cesarean section fails to obtain any sensory or motor block.Methods: This study is aimed at comparing the incidence of hypotension and the need for vasopressors in patients submitted to caesarean section under spinal anaesthesia following preload with either crystalloid or colloid. This study was carried out on 100 healthy pregnant women with single term foetus and not in labor admitted at the labor room of Gynecological department of RIMS. Blood pressure, Pulse rate, O2 Saturation and episodes of hypotension were recorded every 5 minutes from the spinal block.Results: The study showed that maximum number of caesarean sections here performed for the indication of foetal distress which is seen in 44%, 48%, 52%, and 48% in Group A, Group B, Group C and Group D respectively. This is followed by scar tenderness and obstructed labour. In Group A maximum number of patients developed hypotension during 11-20 minutes duration which is 13 (61.9%) followed by 5 (23.8%) patients during first 10 minutes.Conclusions: The study concludes that the combined use of volume preloading to compensate for vasodilatation and vasopressor to counteract arterial dilatation is a very effective method in reducing the incidence, severity and duration of spiral hypotension. The combination group with decreased volume of preload and reduced dose of vasoconstrictor provides better haemodynamic stability when compared to preloading of vasoconstrictors alone.
Successful laparoscopic assisted myomectomy of a gigantic 9.4 kg uterine parasitic myoma: a case report and review of literature
Authors: Dash B. B. , Kapur Anuradha , Bahadur Anupama
Published: February 2018

Uterine leiomyomas are the most common benign tumours of the female pelvis affecting around 25-30% women of reproductive age. A case of successful laparoscopic assisted myomectomy in a giant uterine parasitic myoma is presented. A 42-year nulliparous morbidly obese lady presented with an Ultrasound diagnosis of a large uterine mass, detected during routine health check-up. MRI revealed a giant uterine pedunculated myoma of size 35 × 28 × 18 cm arising from the fundus and a 6 × 7 cm posterior wall myoma. After counselling the patient regarding surgical and anaesthesia risk, need of hysterectomy and laparotomy, laparoscopic myomectomy was planned. Laparoscopic findings revealed an exceptionally large parasitic fundal myoma filling the whole abdominal cavity and another 7 × 6 cm subserous myoma. main technical challenge was to tackle the big feeding vessels from the omentum providing massive blood supply to the gigantic tumor. Laparoscopic myomectomy was completed successfully using harmonic ace for coagulating the giant feeding vessels from the omentum. As the size of myoma was too big to put in the morcellation bag, so specimen retrieval was done through small incision and manual morcellation. The weight of the specimen was 9.4 Kg. This case emphasizes that size does not pose a limit to removing these gigantic myomas laparoscopically when surgical expertise and good anaesthesia facility is available. This is the case of largest myoma managed laparoscopically.
A clinical study of peripheral vascular disease due to atherosclerosis in diabetic foot infections
Authors: Tyagi A. , Lavanya S. , Lavanya S. , Prasad G. Hari , Prasad G. Hari
Published: February 2018

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics, with faster progression. The prevalence differs among populations. This study aimed to clinical prevalence of peripheral vascular disease due to atherosclerosis in patients with diabetic foot infections presenting to this tertiary care centre.Methods: This clinical study was conducted in ASRAM hospital, Eluru, Andhra Pradesh, India. All patients admitted with a diagnosis of diabetic foot infection to the department of general surgery during a period between October 2015 to October 2017, who fulfilled the inclusion and exclusion criteria, were enrolled for the study. After recording the pertinent information (as per performa), patients were subjected to a lower limb arterial Doppler and ABPI findings were tabulated.Results: Peripheral vascular disease was found in 35% of patients studied. Majority had distal below the knee vessels stenosis or occlusion. There was significant correlation with age, history of tobacco use and various risk factors. The clinical presentations and outcomes were worse in individuals found to have peripheral vascular compromise on arterial Doppler study.Conclusions: The care of diabetic patients should start with preventive measures which include proper foot care, glycaemic control and education about diabetic foot are key factors for better out come and quality of life.
Blunt abdominal trauma: a tertiary care experience
Authors: Trehan Vikram , Kumar Sukumar S.
Published: February 2018

Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Aim of present study was to find out demographic details, causes of injury, management options and treatment outcomes of BAT.Methods: Retrospective study of cases of BAT was carried out at a tertiary care hospital of India spanning five years, between June 2012 to June 2017. Authors analyzed the demographic profile of the trauma victims, etiological factors of BAT, the abdominal organs involved, the treatment modalities adopted and the final outcome.Results: There were 231 cases of BAT. Most common age group was 11 to 30 years which accounted for 42.42% of the total. The study had 181 (78.35%) males and 50 (21.64%) females. Road traffic accident was the most common cause of BAT and it accounted for 67.97%. Liver (34.20%) was the most commonly involved organ followed by spleen (22.51%), bowel (15.58%), mesentery (8.23%), kidney (7.36%), pancreaticoduodenal injuries (3.46%) and diaphragm (3.46%). 56.71% underwent non-operative management (NOM), 3.90% underwent angio-embolization and 39.39% eventually required operative treatment. Mortality occurred in 31 patients (13.41%) because of septicemia, renal failure, shock, acute coronary event or respiratory complications.Conclusions: NOM for BAT was found to be successful in haemodynamically stable patient with solid organ injury. Along with sophisticated infrastructure like ultrasound or CT Scan, close supervision with repeated examination by a treating surgeon were the sheet anchors of NOM. Angio-embolization is a feasible modality of treatment in solid organ injury and can avoid surgery in an appropriate patient. Definitive indications for laparotomy were hemodynamic instability and perforation-peritonitis. Initial hemodynamic instability, haemorrhagic shock, and associated injuries influenced morbidity and mortality in BAT.
Etiology and pathogenesis in the causation of vesical calculus: a prospective study
Authors: M. L. Ramachandra , H. D. Pradeep Kumar
Published: February 2018

Background: Vesical calculus are the most common manifestation of lower urinary tract stones accounting for approximately 5% of all urinary stone diseases. In pediatric population bladder stones are most commonly due to malnutrition and poor socioeconomic factors. In adults they are most commonly associated with bladder outlet obstruction. In this context we study the different etiological factors and pathogenesis in the causation of vesical calculus.Methods: This is a prospective study that included 40 patients admitted with clinical diagnosis of vesical calculus at KR Hospital, Mysore from June 2016 to May 2017.Results: Maximum patients belong to age group of 51-60 years (30%) and minimum numbers belongs to age group of 1-10, 11-20 and 81-90 years age group. Male to female ration in present study is 5:1. In present study patients with bore well as source of water were highest in number i.e., 22 patients. Maximum number of patients i.e., 22 patients (55%) presented with history of pain abdomen and 15 patients (37.5%) with dysuria. Twenty-four patients (60%) had alkaline urine. Urine albumin was positive in 10 patients (25%), urine sugar was present in 8 patients (20%), pus cells were found in urine of 28 patients (70%) and RBCs were present in 24 patients (60). Klebsiella was the commonest organism isolated from the urine of 22 patients (55%) and E. coli was isolated in 8 patients (20%). Ultrasonography of abdomen and pelvis detected associated other conditions such as hydroureteronephrosis in 8 patients (20%), cystitis in 10 patients (25%) and benign prostatic hyperplasia in 20 patients (50%).Conclusions: Bladder calculi are most common in people of old age group indicating obstruction could be the cause for stone formation. They are rarely formed spontaneously. There must be an inciting event namely bladder outlet obstruction or infection to promote the stone formation.
A prospective, randomize study of comparison of lateral internal sphincterotomy versus Lord’s anal dilatation in chronic anal fissure
Authors: Kumar Dhiraj , Negi Anil , Kumar Neeraj , Pandey Avinash
Published: February 2018

Background: Surgical techniques for management of chronic anal fissure are Lords anal dilatation (LAD) and Lateral internal sphincterotomy (LIS). The aim of this study is to compare the symptoms, post-operative complications and recurrence risk of the above two techniques.Methods: It was a prospective, randomized controlled trial done in department of General Surgery of a tertiary care hospital from June 2016-May 2017. A total of 100 patients lined up for surgical management of CAF were divided into two groups (50 each). In group A, 50 patients underwent LAD and in group B, 50 underwent LIS. Patients were followed up for 6 months following surgery for pain, bleeding, incontinence, post-operative hospital stay and recurrence. Wong Baker scale, Modified Longo score and Wexner scales were used for assessment of pain, constipation and incontinence respectively. Various post-operative symptoms, complications and recurrence risk were evaluated post operatively at 24 hours, before discharge from the hospital, 1st, 3rd and 6th months of operation respectively.Results: Male female ratio was 1.7:1. Most common presenting complaint was pain seen in 96% patients. Sentinel tag at 6 o’clock position was seen in the majority (93%) patients on presentation. Except for pain score, which was statistically more significant at 24 hours postoperatively in the LAD group (p=0.012), there was no statistical difference between the two groups when compared at different points of evaluation for symptoms, complications and recurrence (p=0.565).Conclusions: With minor difference in pain, Lord’s dilatation has similar post-operative symptoms; complications and recurrence risk when compared with lateral internal sphincterotomy procedure, for management of CAF and can be safely performed.
Epidemiology, types and clinical features of cases of ocular injuries attending a tertiary care teaching hospital of Eastern India
Authors: Naskar Asok Kumar , Adhikari Suman , Bandopadhyay Sabyasachi , Mondal Kanchan Kumar , Chakravorty Asim , Sen Sukanta
Published: February 2018

Background: Ocular trauma is one of the main causes of severe ocular morbidity. The goals of this study were to describe epidemiology, causations, clinical features of ocular trauma, to analyse visual outcomes of ocular trauma.Methods: The patient was enquired about the time of occurrence of the injury, place, types of injury inflicted, any prior trauma or surgery, any treatment received before attending to the hospital. Visual acuity of each eye was recorded by using Snellen’s chart. In patients with poor vision gross assessment was done by counting fingers at specific distance, hand movements, perception of light present or not, projection of rays- accurate or not. Ocular motility testing was done in all patients.Results: Patients suffering from ocular injuries in one or both eyes, were examined clinically at the eye department of R G Kar Medical College and Hospitals, Kolkata, from December 2011 through August 2012. Approximate 757 persons had injury in one eye and 100 had injuries in both eyes (totalling 957 eyes with injuries in 857 patients). Males, 640 (74.7%) had more number of injuries than females 217 (25.3%) and injury was more common between 21 and 50 years of age groups in both sexes.Conclusions: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority.
Extensive pneumatosis intestinalis: a benign bystander
Authors: Johari Yazmin , Ooi Geraldine , Narasimhan Vignesh
Published: February 2018

Pneumatosis intestinalis is a rare clinical finding detected radiologically and intraoperatively that points to an underlying benign or worrisome cause. Management of pneumatosis intestinalis poses an interesting dilemma for surgeons given the heterogeneity of its potential causes. In clinically significant pneumatosis, urgent surgical management is paramount. However, in benign causes of pneumatosis, surgical exploration is not necessary and maybe harmful. Clinical findings of peritonism, increased lactate and radiological finding porto-mesenteric venous gas are suggestive of clinically significant pneumatosis that warrants surgical management. In this case report, we described an incidental computed tomography (CT) finding of extensive pneumatosis in an elderly man with appendicitis.
Acute gastric volvulus: a case report
Authors: Sedik Alaa , Elhoushy Salwa
Published: February 2018

Acute gastric volvulus is a rare, life-threatening condition, but its intermittent nature and vague symptoms may make diagnosis difficult. Imaging is usually only diagnostic if carried out when patients are symptomatic. In the acute scenario, severe epigastric pain, retching with or without vomiting and difficulty or inability to pass nasogastric tube, constitute the Borchardt ’s triad that may be diagnostic. Herein, author reported a case that presented lately to the emergency department in shock with severe abdominal pain, abdominal distension and vomiting. Unfortunately, she died before surgery. Acute gastric volvulus is a surgical emergency requiring early diagnosis and aggressive management, as a delay results into complications like gangrene and perforation which substantially increase the morbidity and mortality in these patients.
Identity of Religious Education in School Space
Authors: Junqueira Sérgio , Rocha Terezinha Sueli
Published: February 2018

This article results from the studies carried out on the Identity of Religious Education in the school space based on the current reality and having its referential in the guidelines of the Catholic Church. Religious Education seeks through specific knowledge to articulate religion and culture and is challenged to promote an education aimed at overcoming prejudices and proselytism. Therefore, this study aims to collaborate to identify in the official texts of the Catholic Church, the possibility of organizing a specific discipline, with identity for the school space. The research sought to reflect on this theme that has been occupying space in the agendas of professionals involved with education and religion.

Identidade do Ensino Religioso no Espaço Escolar

Este artigo resulta dos estudos realizados sobre a Identidade do Ensino Religioso no espaço escolar, tomando por base a realidade atual e tendo seu referencial nas orientações da Igreja Católica. O Ensino Religioso procura por meio de um conhecimento específico articular religião e cultura e é desafiado a promover uma educação voltada para a superação de preconceitos e proselitismo. Portanto, este estudo visa colaborar para identificar, nos textos oficiais da Igreja Católica, a possibilidade de se organizar uma disciplina específica, com identidade para o espaço escolar. Na pesquisa buscou-se refletir sobre este tema que vem ocupando espaço nas agendas dos profissionais envolvidos com a educação e a religião.
The Shopping Centers of Belo Horizonte: Ties of Sociability and Memory
Authors: Cassiano de Araújo Cristiano
Published: February 2018

The objective of the article in question is to analyze the sociability and memory elements of the city of Belo Horizonte through the gradual replacement of the trade in its central area by the Shopping Centers. It wants to list the consequent changes in the relations that both spaces provided and provide, and, in this way, to understand how the changes in the symbolic construction of the collective spaces of sociability in the metropolis may have in the Shopping Centers a new milestone in the memory of city, and can be considered a new locus of this symbolic production or even representing another strategy of stratification and socio-spatial segregation.

Os Shoppings Centers de Belo Horizonte: Laços de Sociabilidades e Memória

O objetivo do artigo em questão é analisar os elementos referentes à sociabilidade e à memória da cidade de Belo Horizonte por meio da substituição gradativa do comércio na sua área central pelos Shoppings Centers. Quer-se com isto, elencar as consequentes mudanças nas relações que ambos os espaços proporcionavam e proporcionam, e, dessa forma, compreender como as alterações na construção simbólica dos espaços coletivos de sociabilidade nas metrópoles podem ter nos Shoppings Centers um novo marco na memória da cidade, podendo ser considerados um novo lócus dessa produção simbólica ou mesmo representando mais uma estratégia de estratificação e segregação socioespacial.
Hibridisms and Dialogy in the Folia dos Santos Reis: an Introdution
Authors: Ecco Clóvis , Martins Filho José Reinaldo
Published: February 2018

In this work we chose to approach the concept of dialogism developed by Bakhtin and his circle in treating discourse as a dynamic and responsive construction, and the notion of hybridization, also present in Bakhtin, but, in our view, best presented by Canclini in his analysis of contemporary culture. Starting from these two theoretical approaches, we will try to establish a dialogue between the concepts of dialogism and hybridization, elucidating them through examples extracted from the specific context of Folia de Reis. Among other contributions, this will help us to understand the creative reciprocity existing between the dictates of the sacred and the profane, without one necessarily having to cancel out for the other to take effect.

Hibridismos e Dialogia na Folia dos Santos Reis:

uma Introdução

Neste trabalho optamos por abordar o conceito de dialogismo desenvolvido por Bakhtin e seu círculo ao tratarem o discurso como uma construção dinâmica e responsiva, e a noção de hibridação, também presente em Bakhtin, mas, a nosso ver, melhor apresentada por Canclini em suas análises sobre a cultura contemporânea. Partindo destas duas abordagens teóricas, tentaremos estabelecer diálogo entre os conceitos de dialogismo e hibridação, elucidando-os por meio de exemplos extraídos do contexto específico da Folia de Reis. Entre outras contribuições, isso nos ajudará a entender a reciprocidade criativa existente entre os ditames do sagrado e do profano, sem que um tenha que, necessariamente, se anular para que o outro se efetive.
Estrategias compositivas de Joaquín Nin en la “Tonada de Valdovinos” y la “Tonada de la niña perdida” (Castilla, siglo XVI)
Authors: Díaz Pérez de Alejo Liz Mary
Published: February 2018

Este artículo aborda dos tonadas recogidas en la colección Vingt chants populaires espagnols (1923-1924) de Joaquín Nin (1879-1949): “Tonada de Valdovinos” y “Tonada de la niña perdida”. Dicha colección –en dos volúmenes– comprende cantos de diversas regiones de España, algunos con carácter de danza (Castilla, Galicia, Cataluña, Levante, Murcia, Asturias y Andalucía). Ambas piezas proceden de dos manuscritos de fines del siglo XV: el romance Sospiraste Valdovinos, localizado en el Libro de música de vihuela de mano intitulado El maestro, de Luys Milán (1536) y el romance castellano anónimo So ell encina, anotado por Francisco A. Barbieri en el Cancionero Musical de los siglos XV y XVI (1890) con el nº 402. La perspectiva analítica adoptada se fundamenta en el método de tópicos y estrategias compositivas, derivado de las teorías de Kofi Agawu (2009).
STIMULASI KECERDASAN SPIRITUAL ANAK PADA PERIODE PENDIDIKAN PRANATAL DALAM PERSPEKTIF ISLAM
Authors: Laila Qumi
Published: February 2018

People in the world are provided with intelligence by the Lord, the intelligence is exactly what can make the difference between humans and other creatures. There are many kinds of intelligence that was found by experts, including three intelligence (Q), namely IQ, EQ, SQ. In general, people are more likely to pay attention to intelligence (IQ), when there is more intelligence main EQ. Along with developmental era, EQ also felt less able to provide meaning in human life, and finally found the type of supreme intelligence that is SQ or Spiritual Intelligence. Spiritual Intelligence spiritual been bestowed by God when humans are not born, but the need for stimuli that serves to maintain and develop that intelligence. The stimulation done by parents, especially the mother as the person most close and interact most with the fetus. This research discussed spiritual intelligence in Islam and how to stimulate spiritual intelligence in the perspective of Islam. It is a library research; the authors use content analysis to analyze the content of the various literature which may include books, journals, articles from the internet, and thesis. And finally this research lead to the conclusion that parents can stimulate spiritual intelligence in children who are still in the prenatal period, to perform or to practice diligently, diligently worship, reading the Qur'an, dhikr, play religious songs or sholawat to the child in the womb, noble, telling tales of the Prophet to the child in the womb.
Neurotoxicidad alcohólica
Authors: Schlesinger Piedrahita Antonio , Pescador Vargas Beatriz , Roa Culma Laura Alejandra
Published: February 2018

El alcohol es un tóxico que, actúa como depresor del sistema nervioso central (SNC).  Sus efectos son consecuencia directa de su acción sobre las membranas celulares y sobre los neurotransmisores.  Las neuronas son particularmente sensibles al efecto neurotóxico del Etanol (EtOH) y su exposición afecta la morfología neuronal, ya que en estudios recientes se ha observado una disminución en la longitud del árbol dendrítico.  El EtOH también produce cambios en la expresión de las proteínas sinápticas, aumento del lumen del retículo endoplasmático, así como también, desorganización del aparato de Golgi y de las mitocondrias. Objetivos: Describir los efectos del Etanol a nivel celular y molecular en el Sistema Nervioso Central y su repercusión en la salud humana. Métodos: Se realizó una búsqueda de literatura en las siguientes bases de datos disponibles en web: PubMed, ScienceDirect, Jama Journal, Scielo y portales de salud, utilizando las palabras claves: “etanol y farmacología”, “alcohol y toxicología”, “neurotoxicidad y etanol”. Resultados: De las bases consultadas se obtuvo un total de 120 referencias de las cuales se aceptaron solo 55 que resaltan los aspectos más relevantes de la fisiopatología de la intoxicación con etanol y ciertos aspectos a nivel molecular relacionados con los efectos sobre el SNC. Conclusiones: Los efectos del EtOH sobre el sistema nervioso pueden ser consecuencia de un consumo agudo y excesivo o secundario a un consumo crónico, en relación a un estado de adicción y dependencia al mismo.  La toxicidad sobre el sistema nervioso es consecuencia directa de la agresión del etanol o por diferentes trastornos metabólicos ligados a la toxicidad del mismo sobre otros órganos. La neurotoxicidad del alcohol se debe a la activación del sistema inmunitario innato en el cerebro, que promueve compuestos inflamatorios que serían los responsables del daño de la morfología neuronal, además de la alteración neuroanatómica de la corteza.
Knowledge and Awareness of root canal therapy for population in Saudi Arabia: A questionnaire-based study
Authors: Ahamed Zeeshan H , Alwakeel Abdulaziz , Alrshedan Abdulelah , Altimsah Fahad
Published: February 2018

Objective: The present study was planned with an aim to evaluate the knowledge and awareness regarding root canal treatment in a sample of Saudi population.

Material and methods: A cross-sectional questionnaire-based survey was conducted among a sample of participants in the Saudi population. Participants were asked questions to assess their knowledge about endodontic treatment.

Results: A total of 568 patients (343 males and 225 females) participated in the study. When the patient’s responses were analyzed regarding endodontic treatment, it was found that 68.55 % of participants had a good experience of root canal treatment in the past. 27.9% of the respondents describe their knowledge of root canal treatment as average. Spontaneous toothache was considered the most important factor to seek endodontic treatment in majority (40.1%) of the participants and 86.6% of the participants preferred a specialist to undergo a root canal treatment.

Conclusion: Pain associated with root canal treatment was the most important factor that dithered the surveyed participants from root canal treatment. The results of the survey reveal an improvement of knowledge and awareness of patients about root canal treatment
Correlation between Visual Warning on Cigarette Pack Sand Smoking Behavior of Man Students in Banda Aceh Year 2016
Authors: . Ismail
Published: February 2018

The dangers of smoking cigarettes are commonly known especially by the smokers because every pack of cigarettes contained the words “smoking can cause cancer, heart attack, impotence, as well as pregnancy and fetal disorders.” The objective of this study was to determine the correlation between visual warning on cigarette packs and smoking behavior among teenagers. The population of this study were the 11th and 12th grade male students in a MAN (Madrasah Aliyah Negeri—Public Islamic Senior High School) in Banda Aceh with a sample of 71 students. This research was designed in the form of analytical survey with cross-sectional study approach. Data collection was conducted from 17 to 18 June 2016. The result of the study shows that teenage smoking behavior in a MAN in Banda Aceh correlates to visual illustration with p-value of 0.003, typography with p-value of 0.016, coloring with p-value of 0.037, and layout with p-value 0.001. Therefore, it is suggested that smoking hazards awareness programs need to be improved with various approaches. The government is expected to enact a regulation on using plain packaging and visual warning images that cover at least 50% of the cigarette package. The school is expected to administer regular health education programs and to provide guidance to students who smoke.
Territórios de Trabalho, Circulação de Saberes e Processos Educativos em uma Comunidade Ribeirinha Amazônica
Authors: Silva Maria Das Graças da , Aleixo Sônia Maria Do Rosário
Published: February 2018

Este artigo trata da relação entre ser humano e natureza em suas interfaces com saberes culturais e processos educativos que circulam em experiências singulares de trabalho na Comunidade ribeirinha de Sobrado, região do Salgado do Estado do Pará. Discute a configuração dos territórios que conformam essas experiências no cotidiano social desta comunidade. O trabalho, como uma forma de apropriação histórica, social e cultural de grupos sociais locais, efetiva-se por meio de materialidades socioambientais. As matas, os rios e os mangues para além da dimensão geográfica, constituem-se como territorialidades onde a vida de homens e mulheres residentes na Comunidade é engendrada na trama cultural. Personagens míticas como os encantados e outros seres povoam o universo simbólico e imaginário local, fazem morada nestes territórios, e matizam a cotidianidade do lugar. Por fim, analisa-se o trabalho como mediador cultural entre o ser humano e natureza, cuja materialidade das práticas produtivas saberes coletivos é acionada. Trata-se de uma etnografia do modo de ser e viver da comunidade, que tem como substrato o trabalho em seu sentido ontológico, por meio do qual são revelados processos educativos que potencializam uma concepção ampliada de educação e de condições de reprodução social da comunidade.