bluuebunny/crossref_metadata_2025 huggingface dataset:
Métodos de ADN Barcode revelan diversidad de especies de Astroblepus en la cuenca del río Porce, Colombia
Authors: Hernández-Zapata Marcela , Ochoa-Orrego Luz E. , Jiménez-Segura Luz F.
Published: October 2018

El género Astroblepus es endémico de la región Andina y está representado poraproximadamente 81 especies válidas que habitan ríos de alta montaña desde Panamá hasta Bolivia. Para Colombia, se han registrado 32 especies, de las cuales 23 fueron registradas en monitoreos recientes en la cuenca del río Porce, indicando que cerca del 71% de la diversidad de especies se encuentra en esta área. Morfológicamente, las especies de Astroblepus son muy similares y los caracteres empleados tradicionalmente para su determinación son poco resolutivos, lo que dificulta su identificación taxonómica. Con el objetivo de determinar la diversidad de Astroblepus en la cuenca del río Porce, se analizaron 129 individuos empleando herramientas de identificación genética mediante la secuenciación del gen Citrocromo Oxidasa sub-unidad I (COI) de 580pb y un análisis morfométrico basado en proporciones corporales, usando 12 hitos morfológicos. Los análisis genéticos y el método de delimitación de especies “General mixed Yulecoalescent”, indicaron la presencia de 12 entidades taxonómicas, las cuales fueron soportadas por sus distancias genéticas y por 13 medidas corporales basadas en proporciones. Los resultados indican que la diversidad de especies en el área ha sido sobreestimada, por lo que es necesario integrar diferentes metodologías para una correcta delimitación de especies.
Correction of hypoxic state by metabolic precursors of endogenous activator of mitochondrial ATP-dependent K+channels
Authors: Krylova Irina B. , Safonova Albina F. , Evdokimova Natalia R.
Published: October 2018

Aim. The antihypoxic properties of uridine and uridine-5'-monophosphate (UMP), which are the metabolic precursors of the natural activator of mitochondrial ATP-dependent K+ channels (mitoKATP channels) uridine diphosphat were investigated on the models of hypoxic hypoxia with hypercapnia (HHH), hemic hypoxia and local circulatory hypoxia.

Methods. HHH was created in males and females white mice weighing 28-30 g. The animals were placed one by one in hermetically closed container and the duration of their life was determined. The antihypoxic activity of the substances was compared with the reference anthypoxant amtizole (50 mg/kg). Hemic hypoxia was caused in Wistar rats weighing 350-370 g by the injection of sodium nitrite (intramuscularly, 100 mg/kg). Uridine or UMP 30 mg/kg was injected intraperitoneally 30 minutes before the onset of HHH and hemic hypoxia. Local circulatory hypoxia was modeled in male Wistar rats weighing 250-300 g. Acute coronary occlusion lasting 60 min was reproduced by legation of descending branch of the left coronary artery (LCA). Uridine or UMP (30 mg/kg) was administered intravenously 5 minutes prior to LCA occlusion. Selective blocker of mitoKATP channels 5-hydroxydecanoate (5 mg/kg, intravenously, 5 minutes prior uridine or UMP) was used to determine the role of these channels in the mechanism of antihypoxic action of the studied drugs. The volume of the damaged myocardium was used as the marker of antihypoxic activity of uridine and UMP.

Results. Different resistance to hypoxia in female and male mice was observed in HHH. The female mice were more resistant, their life duration was 43% more than the males. Uridine and UMP displayed antihypoxic activity only in male mice, increasing their life duration by 25% and 20% respectively. This effect was 2 times less than that of amtisol. In similar conditions in females mice the preparations did not show a protective effect. In hemic hypoxia the life duration of rats treated with uridine and UMP did not differ from the control values. Circulatory hypoxia, caused by occlusion of the LCA, led to the formation of a local zone of myocardial damage. Uridine or UMP decreased the damage zone in 2 and 3,5 times respectively. The inhibitor of mitoKATP channels blocked the protective effect of these compounds.

Conclusion. Uridine and UMP have a distinct antihypoxic effect in HHH and a marked protective effect in local circulatory hypoxia. The antihypoxic activity of druges in HHH is manifested differently in female and male mice. It may be due to sexual differences in the resistance to hypoxia. The maximum effect is observed in male who have initially low resistance to oxygen deficiency. The mechanism of the protective action of uridine and UMP in the circulatory hypoxia is associated with the activation of mitoKATP channels.
Effect of the anticancer drug methotrexate on the ascites form of a teratocarcinoma and survival of mice
Authors: Dyban Pavel A.
Published: October 2018

The dose-dependent effect of a methotrexate is established as on an ascite form of a teratocarcinoma CBA9H6, and mice-recipients, however various doses of the entered methotrexate (6; 4 and 2 mkg/g body weights of an animal), at repeated introduction at an interval of 48 and 24 hours, don't destroy all population of embrioid bodies. So, at 3-fold and even 10-fold daily injections in a dose of 2 mkg/g of body weight in an abdominal cavity of mice 1,6 ± 0,2% and 0,038 ± 0,01% embrioid bodies (ascite form of a teratocarcinoma ) remain, respectively, at survival of mice 93,0 ± 8,5% and 14,0 ± 3,0%. The morphological analysis of a mode of a differentiation of embrioid bodies retransplantated from experimental animals to intact has shown earlier that the methotrexate hasn't had effect on histoblastic potentialities of stem cells of a teratocarcinoma CBA9H6.
Problems of promoting drugs in the Kyrgyz Republic
Authors: Zurdinova Aida A.
Published: October 2018

The article describes the results of the assessment methods of medicines promotion in health care organizations The purpose of our study was to study the factors affecting the prescribing, consumption and dispensing of medicines to develop measures to contain unethical drug marketing. For study this issue was used the method of interviewing and questioning of doctors, pharmacists and patients. Our results have shown that there are numerous factors in the health system, which contribute to a violation of the practice for rational prescribing and dispensing of medicines, as well as the absence of regulatory mechanisms in the medicines promotion on the market in the Kyrgyz Republic. The results of the study among this category of respondents confirm the limited access of doctors and pharmacists to quality sources of medicines information, which explains the shortcomings in informing patients on their part, which also serves unethical drug marketing. A direct correlation was established between information sources of about medicines and work experience, i.e. than more work experience, the more information is used from medical representatives and activities conducted by pharmaceutical companies (p < 0.05). The identified factors are associated with unethical medicines promotion, inadequate implementation of the generic strategy, non-prescription dispensing of all medicines, inadequate provision of quality reliable information, low awareness, lack of skills in critical assessment of the information provided. In connection with this, there is a high sensitivity of specialists to various incentives from pharmaceutical companies. All of the above in aggregate contribute to the irrational use of medicines, with all the ensuing consequences.
¿Cómo diseñar la práctica para optimizar el desempeño y aprendizaje motor? Una revisión de literatura
Authors: Jiménez-Díaz Judith , Morera-Castro María
Published: October 2018

Este manuscrito presenta una síntesis de literatura de cinco tipos de práctica más utilizados: variabilidad de la práctica, ejecución de la práctica, composición de la práctica, frecuencia de la práctica e interferencia contextual; y como estas pueden incidir en el desempeño o el proceso de aprendizaje de una destreza motriz. Este resumen permite a profesionales en ciencias del movimiento humano y carreras afines, la toma de decisiones en el momento de diseñar la sesión de trabajo.
Estilos educativos parentales percibidos y orden de nacimiento en deportistas
Authors: González García Higinio , Pelegrín Antonia
Published: October 2018

El objetivo de este trabajo fue conocer las diferencias en los estilos educativos parentales percibidos en deportistas y practicantes de actividad física en función del orden de nacimiento. La muestra se compuso de 492 deportistas y practicantes de actividad física españoles. Se utilizó un cuestionario sociodemográfico ad hoc, el Test Autoevaluativo Multifactorial de Adaptación Infantil y la Escala de Oviedo de Infrecuencia de Respuesta. Los resultados mostraron mayores niveles de permisivismo materno (p<.01) y restricción paterna (p<.05) en los deportistas y practicantes de actividad física primogénitos e hijos únicos. Por otro lado, cuando se examinó solamente a los deportistas, los resultados mostraron mayores niveles de permisivismo materno (p<.05), en los deportistas primogénitos e hijos únicos. Cuando se analizó a los practicantes de actividad física, no se encontraron diferencias significativas (p>.05) entre las variables de estilos educativos y la posición de nacimiento de los hijos. Se concluyó que los deportistas y practicantes de actividad física primogénitos e hijos únicos recibieron una educación con mayor permisivismo materno y restricción paterna.
La actividad física como medio de prevención de problemas cardiovasculares una revisión sistemática
Authors: Puertas Molero Pilar , Castro Sánchez Manuel , Zurita Ortega Félix , Chacón Cuberos Ramón , Sánchez Zafra María
Published: October 2018

Actualmente nos encontramos ante una situación preocupante debido a que los problemas cardiovasculares cada vez están más presentes afectando a un elevado porcentaje de la población, los cuales están llegando a desencadenar enfermedades que ponen en riesgo la salud de la población, provocados mayoritariamente a causa de la adquisición de hábitos no sanos o sedentarios, los cuales se están desarrollando cada vez más en edades tempranas. Por ello, en este estudio se ha llevado a cabo una revisión sistemática que aborda estudios científicos pre-experimentales o cuasi-experimentales, los cuales han aplicado intervenciones utilizando la práctica de actividad físico deportiva como medio para mejorar la frecuencia cardiaca, el volumen sistólico, el VO2 máximo y la condición física de los sujetos. Los resultados de las diversas investigaciones han puesto de relieve que la realización regular y continuada de ejercicio adaptada a las características individuales de cada uno de los participantes reporta beneficios mejorando la salud y las cualidades físicas.
La relación entre el tipo de liderazgo de los entrenadores de remo de banco fijo, el número de regatas remadas y la satisfacción de sus deportistas
Authors: León Guereño Patxi , González Rodríguez Óscar , Aguayo Benito Yolanda , Arruza Gabilondo José Antonio
Published: October 2018

Las regatas de traineras son una modalidad deportiva que se desarrolla en mar abierto. El objetivo de este estudio fue examinar la relación existente entre el liderazgo de los entrenadores en remo de banco fijo y la satisfacción de los deportistas, a lo que se añade la participación de los remeros como covariable. Cuatro equipos con un total de 66 remeros de élite (edad: 28.0 ± 5.5 años) y sus cuatro entrenadores (edad: 36.1 ± 1.1 años) tomaron parte en este estudio. Para valorar el liderazgo ejercido por los entrenadores y su relación con la satisfacción de los deportistas, la adaptación al castellano de la Escala de Liderazgo en el Deporte (Leadership Scale for Sports-LSS) fue utilizada en dos de sus versiones (preferencias y percepciones) y la traducción al castellano de la Escala de Satisfacción de los Deportistas (Athletic Satisfaction Questionnaire-ASQ). Además del liderazgo, que obtuvo relaciones estadísticamente significativas con los factores de satisfacción tomadas en su conjunto (p=>.001), y con numerosas dimensiones de la escala, el número de regatas también mostró asociaciones estadísticas con la satisfacción general de los remeros (p=.018). Los datos obtenidos confirman la hipótesis de la congruencia planteada en el Multidimensional Model of Leadership (MML) y dada las diferencias de liderazgo halladas surge la necesidad de futuras intervenciones de mejora de los entrenadores en esta especialidad deportiva.
Addressing the unmet need in respiratory viruses: an interdisciplinary analysis of product development pipeline in Asia
Authors: Feddema Jelle J. , Claassen Eric
Published: October 2018

Background: Respiratory tract infections (RTIs) pose a significant burden on health systems worldwide. Progress has been booked in reducing RTI disease burden through development of diagnostics, therapeutics and vaccines, though most efforts often fail to address the contribution of non-influenza viruses. Increasing awareness and the prevailing unmet need has resulted in the establishment of initiatives that aim to explore ways in which to extend innovation efforts for influenza to the broad range of respiratory viruses. This study will provide a detailed description of the state of the RTI market in Asia.

Methods: By developing a dataset containing data from patent documents and clinical trials (CTs) we aimed to provide a detailed description of the RTI market in Asia.

Results: We found a downward patent filing trend in respiratory diagnostics but a high number of phase 3 studies. A strong preference for the development of therapeutics and vaccines targeting bacterial pneumonia and influenza became apparent, whereas less attention is given towards product development targeting non-influenza viruses.

Conclusions: The findings indicate a mature respiratory diagnostics market with minor industrial interest but at the same time an evolving RTI CT market with a strong late-stage pipeline. Asia represents only a handful of studies related to non-influenza viruses, mostly conducted by non-profit organisations. The business segment appears to focus upon product development for more profitable respiratory infections thereby suggesting that involvement and engagement of the industry within global initiatives and efforts to increase innovation for non-influenza viruses is not optimal.
Relationship between epidemiologic surveillance with geo-climatic variables during Zika outbreak in Guerrero State, Mexico 2016
Authors: Jimenez-Alejo Abel , Zárate-Nahón Ewry A. , Sampedro-Rosas María L. , García-Ibáñez Sergio , Rosas-Acevedo José L.
Published: October 2018

Background: Zika like dengue and chikungunya represent public health problems. Cases of ZIKV infection are emerging in the Americas, from Argentina spread until Brazil and Colombia, later entry to Mexico and managed to establish itself in most of the states.Methods: The cases (2016-2017) of epidemiological surveillance of the first outbreak of Zika in Guerrero were used. The incidence rates (IR) for each municipality were estimated (cases/100 000 inhabitants) to develop the first maps at the municipal and state level; which aimed to explore the relationship between Zika cases and geo-climatic variables.Results: At January 3, 2017 in Guerrero State [epidemiological week (SE) 52 of the year 2016] were reported 861 confirmed ZIKV cases (10.06% of total registered cases at federal level). Guerrero State it was placed within the six states with the largest number of cases: Veracruz (1967), Yucatan (1284), Nuevo Leon (844), Chiapas (804) and Oaxaca (507); concentrated 73.26% (6 267/8 554) of the country's cases. In this study we identified the geo-environmental factors associated with ZIKV occurrence in each municipality of the Guerrero State: very high rain (1201-1460 mm), low elevation (2-398 masl) and high population density (≥62071 inhabitants/km2).Conclusions: This study represents the first approach to Zika outbreak in Guerrero State. Although tests of spatial nature are not presented; the maps presented show how the characteristics by region have high influence and that the most affected areas were the coastal areas: Acapulco, Small Coast and Big Coast.
Dengue prevention practices among community in dengue hotspot area
Authors: Said Muhammad Faridzuan Faiz , Abdullah Hasmah , Abdul Ghafar Noraini
Published: October 2018

Background: Dengue is one of the most important mosquito-borne diseases which can cause a major problem to human health. Poor practices in dengue prevention especially in the area where dengue is prevalent is among the factors contributing towards dengue spike. This study was commenced to assess the level of attitude and practice toward dengue prevention among the community residing in a dengue prone area, beside identifying the environmental characteristics surrounding the housing compound.Methods: A cross-sectional study was conducted among 132 respondents living in a dengue hot spot area. A set of questionnaire form consisted of four parts; socio-demographic information, environmental characteristics around the house, and attitudes and practices toward dengue prevention were distributed to respondents.Results: More than half of the respondents possessed good level of attitude, and more than half scored moderately for practice (57.6% and 56.1% respectively). Data on the environmental characteristics showed that majority of the respondents’ houses have no potential breeding sites for Aedes mosquito. Findings also indicate that there was no significant association between dengue prevention practices and socio-demographic factors such as age, gender, educational level and occupational status.Conclusions: Level of practice of dengue prevention is still considerably low and could be improved through educational campaign. Proper knowledge and information regarding dengue practices should be emphasized among the community especially in high risk area to raise up the awareness and cultivate better practices for dengue prevention.
Clinical and histopathological pattern of colorectal malignancies, the experience in a tertiary hospital in south-western region, Saudi Arabia
Authors: Aldayhum Majed Saleh M. , R. Alshehri Anas Abdullah , AlQahtani Dlaim H. , Alfussaily Eman Yahia , Althibait Suha Abdulrahman S. , Alshehri Ziyad Abdullah R.
Published: October 2018

Background: Colorectal cancer is the third most common cancer all over the world and the second leading cause of the cancer death in both sexes. CRC is the second most common cancer in Kingdom Saudi Arabia. However, this aspect was not recently studied.Methods: This is a retrospectively cohort based study. We collected and analyzed the records of the patients with CRC diagnosed at Aseer Central Hospital, Abha, Saudi Arabia from January 2008 to June 2016. A pre-specified data sheet was used to collect information regarding socio-demographics, age, Altitude, site of tumor, clinical presentation, outcome and prognosis as well as histopathological pattern of cancer and the stages of disease. Descriptive statistics was performed using SPSS.Results: A total of 291 cases of CRC were registered in the Aseer Central Hospital. 171 cases 58.87% were males while 120 cases 41.2% were females. The mean age of patients (SD) at the time of diagnosis was 59.38 years. At the time of diagnosis, 219 patients 84.6% presented with early stage disease and 40 15.4% had distant metastasis advanced stage. The most frequent CRC located in sigmoid 26.5%, rectal 23.7%and 14% in ascending. The moderately differentiate adenocarcinoma grade of tumor is being the most common grade among all variants 75.6%.Conclusions: In this study, we have nearly similar results found in previously published study by Alshehri et al. Males considered most affected, most of the patients were more than 50 years, 84.6% of the patients came with early stage disease. Left side colon were the most common site of CRC.
Contribution of media on knowledge generation about tuberculosis in Palpa district, Nepal
Authors: Karki Deelip Kumar , Singh Birendra Kumar , Khanal Pravin Kumar
Published: October 2018

Background: Media is the means of communication, as radio, television and newspaper that reach or influence people widely. It is a tool for the transfer of information and ideas to audiences. The media plays the crucial role in instructing, motivating and guiding the public for control of tuberculosis. The objectives of the study were to study the knowledge and the source of information regarding tuberculosis.Methods: A cross sectional study was conducted whereas multistage sampling was adopted.Results: Around half of respondents (46.5%) were 15-24 years of age and 63.9 per cent were female. Overwhelming number of the respondents (95.1%) had radio and more than one fourth (76.4%) had television at home. More than three quarter (88.9%) respondents said droplet infection is the mode of transmission of tuberculosis but 11.1 per cent said sharing common utensil. 97.2 per cent respondents had good behaviour towards TB patient. In respect to knowledge score, 18.1 per cent had high level of knowledge followed by 56.2 per cent had medium and 25.7 per cent had low level. Fifty per cent respondents said television, 46.5 percent said radio were the source of information for tuberculosis.Conclusions: The study found that majority of the respondents had satisfactory knowledge level about tuberculosis. The results exemplify the contribution of media on improving TB related knowledge. Most of the respondents ranked media, i.e., radio and television is the number one source of information.
Knowledge and attitude regarding breast feeding among lactating mothers in a rural area, Bellur
Authors: Manchegowda Ramya , Hulugappa Lakshmi
Published: October 2018

Background: Breastfeeding has a wide range of health benefits for mothers and children. The main obstacle in raising the exclusive breastfeeding rate is lack of awareness, false belief and customs. The current study was designed to assess knowledge and attitude to breastfeeding among rural lactating mother.Methods: A descriptive study was conducted in community health centre, Bellur during July 2017 to December 2017. Lactating mother were included in the study after meeting inclusion and exclusion criteria. Data was collected using semi structured proforma by interview method.Results: Around 80% of the mothers were aware about the time of initiation of breast feeding, 56% knew about advantage of breast feeding and 70% of the mothers were aware of exclusive breast feeding. Attitude of the mothers towards breast feeding is favourable. Only 34% of the mother knew that breast feeding should be continued till 2 years. Majority i.e. 95% of the mothers were not aware regarding the breast feeding advantage to the mother.Conclusions: The study revealed that there is a lack of knowledge in continuation of breast feeding upto two years and breast feeding benefits to the mother among lactating mothers.
Neonatal jaundice causes and management
Authors: Althomali Ruya , Aloqayli Renad , Alyafi Basma , Nono Ahela , Alkhalaf Suhaib , Aljomailan Abdulaziz , ALHarbi Hesham , Alqahtani Abdulrahman , Alherz Hawra , Aldebani Moluk
Published: October 2018

80% of healthy neonates present with some degree of hyperbilirubinemia after birth, however, only 5-10% would require therapy to prevent damage or treat the cause of jaundice. Neonatal jaundice can be classified as physiological and pathological and can have several causes such as breast milk feeding, blood group incompatibility, hemolysis, or genetic defects of enzymes in the bilirubin metabolism pathway. We tried to understand the various types of neonatal jaundice, and also focus on its management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 2001 to March 2017. The following search terms were used: neonatal jaundice, hyperbilirubinemia, ABO incompatibility, neonatal hemolysis, kernicterus, phototherapy, exchange transfusion. Hyperbilirubinemia and jaundice are common issues encountered neonates and infants. Most cases of neonatal hyperbilirubinemia and jaundice are physiological and benign. However, some severe cases may progress to develop severe and permanent long-term complications. Therefore, early diagnosis and management is essential. Neonatal jaundice can be treated using phototherapy, pharmacological agents, intravenous immunoglobulins and exchange transfusion in severe cases.
Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients
Authors: Falewee Marie Noëlle , Hebert Christophe , Benezery Karen , Bozec Alexandre , Guigay Joël , Chamorey Emmanuel , Michel Cécile
Published: October 2018

Background: Dysphagia is a serious sequel of head and neck cancer (HNC) and its treatment. This dysfunction is frequent and likely underreported by clinical exam. It seems necessary to assess its global burden during the pre, per and post treatment periods (up to 18 months), regardless of the treatment received.

Methods: This was a prospective cohort study assessing the rate of dysphagia in first-time treated HNC patients, using the deglutition handicap index questionnaire (DHI) and the clinician reporting. Time to occurrence, severity and length of the dysfunction were recorded. The benefit of an evaluation by the patient himself was investigated.  

Results: Of 134 evaluable patients: 22 were treated by surgery alone (16.4%), 16 by radiotherapy (RT) alone (11.9%), 3 by chemotherapy (CT) alone (2.2%), 28 by RTCT (20.9%), 31 by induction chemotherapy followed by RTCT (23.1%), 11 by surgery+RT (8.2%) and 23 by surgery+RTCT (17.2%). Patients completed 87.9% of the expected DHI. The dysphagia frequency reported was 92.2% by patient-reporting and 80.9% by clinicians-reporting, whatever the intensity. Self-perceived moderate to severe dysphagia was reported in 69.8% of patients.

Conclusions: Given the strong impact of dysphagia on the quality of life and prognosis of HNC patients, it appears essential to perform screening and systematic monitoring. Using a simple and well accepted questionnaire, such as DHI, which is also well correlated with clinical evaluation, we demonstrated a significant frequency of dysphagia. The use of real-time patient-reported outcomes for its early detection would be an asset, particularly during long-term follow-up.

Registered under ClinicalTrials.gov Identifier no. NCT03068559.
The correlation between allergic rhinitis with hyperactive lower airway disorders and effect of management of allergic rhinitis on lower airway
Authors: Ekhar Vipin Ram , Shelkar Ritesh N. , Pardhi Krupal , Vedi Jeevan N.
Published: October 2018

Background: Allergic rhinitis and brochial asthma are interrelated diseases because of the shared respiratory epithelium and the common allergens affecting both the areas. The treatment of both these conditions is often overlapping. Although no treatment modality is perfect in treating the disease, corticosteroids are the mainstay of the treatment for both the conditions. This study was conducted to quantify strength of association between allergic rhinitis and hyperactive lower airway disorders and to study the effect of topical intranasal steroid Fluticasone on Bronchial hyperactivity in patients with allergic rhinitis.

Methods: Patient with moderate to severe allergic rhinitis presenting to ENT OPD with symptoms of lower airway hyperactivity were subjected to pulmonary function tests. After all routine investigations, the patients were started on fixed dose of intranasal fluticasone furoate nasal spray for a period of 2 months and the pretreatment and post treatment FEV1 and PEFR were compared and statistically analysed for the effect.  

Results: Approximately 50% of patients with allergic rhinitis showed associated lower airway hyperreactivity. There was statistically significant improvement in pulmonary function test readings after 2 months therapy with intranasal fluticasone spray.

Conclusions: The study showed that the treatment of inflammation in the upper airways indirectly improves the symptoms of hyperactive lower airway disorders and decreased bronchial hyperactivity.
Management of invasive fungal rhino sinusitis in a tertiary health care center
Authors: Thaduri Abhinav , Kamanur Samson Deva Kumar , Vishnuvardan Dipin Kumar , Hanumantha Rao A. V. S , Sravani Reddy K. , Chandrashekar Annam
Published: October 2018

Background: Invasive fungal sinusitis, though considered to be rare entity, is nowadays frequently encountered, mostly in immunocompromised patients like uncontrolled diabetes, haematological malignancy and organ transplants on immunosuppressive drugs. There are only a few landmark studies from the Indian subcontinent on invasive fungal rhino sinusitis. The lack of awareness among clinicians regarding the varying clinical presentations of fungal rhino sinusitis prompted us to undertake this study, as our hospital is referral centre we get to see varying presentations and most terminal stages of disease.

Methods: This is a prospective study in which we report 30 cases reported to Gandhi Hospital, Secunderabad, invasive fungal rhino sinusitis. Evaluated in detail the clinical presentation, radiological features, specimens collected were subjected to both microbiology and pathologic examination; data collected and were analysed. Treated medically and surgically.  

Results: The most common co-morbid condition is uncontrolled diabetes mellitus. Mucoraceae (53%) and Aspergillus (10%) were the main fungi found. Mucosal biopsy confirmed fungal invasion to the nasal mucosa in all cases. Computed tomography and endoscopic findings showed a predominance of unilateral disease, with various stages of nasal involvement. All patients underwent surgical debridement and systemic antifungal therapy immediately after diagnosis.

Conclusions: Early medical and surgical treatment is essential to improve the prognosis along with better control of comorbidities.
Full mouth rehabilitation of Kennedy class 1 edentulous situation complicated with excessive deep bite: an interdisciplinary approach
Authors: Kumar Bhushan , Kumar A. Navin , Sandhu Prabhdeep Kaur
Published: October 2018

Oral rehabilitation of bilateral mandibular edentulous posterior segments becomes even more difficult if patient had severe deep bite in natural dentition. This case report demonstrates the intelligent way of managing severe deep-bite by adapting multi-disciplinary approach. Involved steps are: Mandibular subapical osteotomy of mandibular anterior segment to lower down the fragment; secondly, the maxillary anteriors were done with crown lengthening followed by decreased incisal display and thirdly by restoring vertical dimension of occlusion by replacement of missing posterior teeth. The addition of surgical intervention (anterior mandibular osteotomy) in the present case has found to be effective and quick adjunctive in achieving functional improvement in occlusion by reducing anterior teeth overlap (deep bite), by decreasing incisal guidance steepness and esthetic display of anterior teeth. Bilateral edentulous situation was managed by precision attachment retained cast partial denture. A satisfactory functional and esthetic result was obtained.
Results of distal femur fractures managed by blade plate 95° at Brazzaville teaching hospital
Authors: Marius Monka , Kevin Bouhelo-Pam , Terence Olivier Ohoya Etsaka , Albert Ngatsé Oko , Armand Moyikoua
Published: October 2018

Background: The objective of the study was to report the anatomical and functional results of distal femur fractures treated by blade plate 95° AO at CHU-Brazzaville.

Methods: This is a retrospective study of patients operated by blade plate for distal femur fractures between January 2012 and December 2016. Fourteen out of seventeen patients operated by blade plate met the inclusion criteria. Fractures of the distal femur were divided according to Chiron's classification. The anatomical and functional results were evaluated according to the analysis criteria of the SOFCOT 1988 round table.

Results: Of the 14 patients in our study, 8 were men and 6 were women. The average age was 35 (range 18 to 54). The fractures were consecutive to a road accident (n=13) and a fall in a gutter in 1 case. Bone healing was achieved in all our patients. The reduction was anatomic in 13 patients and in 1 patient there was a 10° angulation of the recurvatum type. According to the criteria of the SOFCOT 1988 round table, the results at the average follow-up of 12 months were judged very good in 7 patients, good in 3 patients, average in 1 patient and bad in 3 patients..

Conclusions: The results of our study confirm the performance of blade plate fixation in fractures of the distal femur. However, the other implants constitute a therapeutic arsenal of complex epiphyseal fractures of the distal femur, which should benefit trauma-orthopedics surgery wards for the management of all varieties of fractures of the distal femur. 
Patient reported satisfaction following 1578 primary total knee arthroplasties in different ethnic groups in Leicester: are Caucasian patients more satisfied?
Authors: Suzangar Mehdi , Esler Colin , Kennedy James , Chatterji Urjit
Published: October 2018

Background: Several non-UK and non-European studies, have suggested differences in post-operative outcome measures, including patient satisfaction, following total knee arthroplasty (TKA) when assessed against ethnicity. The aim of our study was to assess patient reported satisfaction following primary TKA in an ethnically diverse part of the UK, Leicestershire, to find out whether the Caucasian patients were more satisfied compared to non-Caucasians.

Methods: Using our regional joint Registry, the Trent and Wales Arthroplasty Audit Group (TWAAG) registry, a retrospective analysis of the prospectively collected patients’ reported satisfaction following primary TKA was performed. 1578 patients from Leicester province who had undergone their first TKA in Leicester between 1990 and 2007, and who had responded to their 12 month validated post-operative questionnaires were included.

Results: Overall patient reported satisfaction was 87.6%. Patient satisfaction was 87.7% in ‘British White’, 92.4% in ‘Other White’, 83.5% in ‘Indian/Pakistani’ population. When categorising patient ethnicity to ethnic groups, reported satisfaction was 88.1% in the ‘Caucasian’ group and 83.4% in the ‘non-Caucasian’ groups. Fisher’s exact test did not indicate a statistically significant difference in the reported satisfaction between these ethnic groups.
Conclusions:In our study, ethnicity was not a significant attributing factor in patient reported satisfaction following primary TKA. 
 
Prevalence of psychiatric illnesses after major limb amputation and early recognition and treatment in economically lower income group patients
Authors: Ali Zameer , Khurshid Lubna , Bhat Towseef , Bhat Aejaz A. , Vakil Suhail M.
Published: October 2018

Background: There is high prevalence of psychiatric illness after major limb amputation and need for early recognition and treatment should be the goal but often is overlooked. Psychological support by the treating physician and the surgeon can help in adaptation to the disability but unfortunately is often overlooked.

Methods: A total of 120 patients were screened for psychiatric disorder using HADS criteria Anxiety was found to be in 38 (32%) patients and depression was found to be in 27 (23%) (Table 1) (Figure 1) 55 patients had no psychiatric illness. Psychiatric illness either depression or anxiety was found to be in 65 patients.

Results: In our state which is a zone of conflict between two countries prevalence of anxiety was 32% and depressive symptoms were 23%, respectively. Causative factors associated with high prevalence of psychological symptoms included unmarried young females, lower socioeconomic status, single earning member, lack of social support, unemployment, traumatic amputation. These ﬁndings were conﬁrmed by a signiﬁcant reduction of anxiety and depression scores in patients who received social support, patients with amputation due to disease, and patients with above the knee amputation.

Conclusions: Our study showed higher prevalence of psychological symptoms in association with lower socioeconomic status, single earning member, lack of social support, unemployment, traumatic amputation vs amputation secondary to chronic disease. Extensive rehabilitation with the use of an interdisciplinary team approach is one of the most successful ways to return the amputee to the work place. Surgeons should give proper attention to the psychological state of amputees. Because of high prevalence of psychiatric illness after major limb amputation. It is suggested that psychiatric evaluation and adequate rehabilitation should form a part of treatment.
Idiopathic clubfoot treated by Ponseti method: a series of 300 cases
Authors: Bhatiwal Sunil Kumar , Chopra B. L. , Khajotia B. L. , Chauhan Shakti
Published: October 2018

Background: Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.

Methods: This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.

Results: Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.

Conclusions: Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age.
Evaluation of association of vitamin D level with types of proximal femoral fractures in elderly patients
Authors: Khan Afroz Ahmed , Kumar Vipin , Yadav Ashok Kumar , Singh Robin , Chauhan Karn Singh , Hasan Areeba
Published: October 2018

Background: Proximal femoral fractures are very common in elderly patients. These fractures are thought to be associated with osteoporosis. Vitamin D is a possible risk factor for osteoporosis. So, this study was done to evaluate the association of serum vitamin D level with types of femoral fractures in elderly patients.

Methods: The study was done between September 2013 to August 2016, 75 patients with age >60 years (male and female both) with proximal femoral fractures were studied. Serum 25-hydroxy vitamin D, calcium, phosphate, alkaline phosphatase levels, liver function test, renal function test, hemoglobin and complete blood counts of all the patients were assessed.

Results: On assessment of serum vitamin D in proximal femoral fracture in elderly patients, it shows an increase incidence of proximal femoral fractures in patients with low serum vitamin D level. Fracture of neck of femur was most common among all. Type of fracture has no significant statistical relationship with serum vitamin D levels.

Conclusions: Osteoporosis and serum vitamin D level depends on age and sex of the patient. But type of proximal femoral osteoporotic fracture has no association with either grade of osteoporosis or serum vitamin D level.
Isolated muscle tuberculosis: exceptional location
Authors: Bouya Ayoub , Rhounimi Mounir , Boufettal Moncef , Berrada Mohamed Salah
Published: October 2018

The authors report the exceptional case of isolated muscular tuberculosis affecting the anterior compartment of the right thigh in a 38-year-old man. The diagnosis was based on histology and GeneXpert. The subject received a surgical treatment followed by medical treatment for 6 months. The GeneXpert test has proved to be useful in the diagnosis of muscular tuberculosis. We have not found in the literature the use of GeneXpert in this type of localization of tuberculosis whose diagnostic is not always easy. Through the study of this case and a review of the literature, the authors review the pathogenesis of this particular affection as well as the diagnostic and therapeutic modalities.

 
Study of skin changes and associated diseases in pregnancy
Authors: Haritha Komeravelli , Nataraj Perumalla
Published: October 2018

Background: Pregnancy accounts for profound changes like endocrinal, vascular, metabolic etc. The body adjust to these changes by compensating. Most changes are temporary but some may be permanent. Skin also undergoes changes and can be a cause of anxiety. Hence identification and management and counselling of these changes are important. Objective was to study the skin changes and associated diseases in pregnancy.

Methods: A hospital based cross sectional study was carried out among 100 pregnant women who were selected as per eligibility criteria of the study over a period of one and half year. Those women having skin conditions were included in the present study.

Results: Among both primigravida as well as multigravida women the most common condition was linea nigra i.e. 80.4% and 93.9% respectively. Breast changes were seen in 12.2% of the multigravida women and none in primi. Only 18 women were found to develop the specific dermatoses of pregnancy. Among them the most common dermatoses was Prurigo of pregnancy in 66.7% of the cases 5% had bacterial skin infections. 9% had viral skin infections. 16% had scabies. 14% had fungal skin infections and among them, Tinea versicolar was more common. 3% had angular stomatitis.

Conclusions: Dermatoses of pregnancy were common in the study sample. They need proper attention in order to treat, and manage properly and at the same time it needs psychological counselling to relieve anxiety among pregnant women.
ÇÖLYAK HASTASI ÇOCUKLARDA GLUTENSİZ DİYETİN HEMATOLOJİK PARAMETRELER ÜZERİNDEKİ ETKİLERİ
Authors: Terlemez Semiha , Tokgöz Yavuz
Published: October 2018

AMAÇ: Çölyak hastalıklı çocuklarda glutensiz diyetin hematolojikparametreler üzerindeki etkilerini değerlendirmekamaçlanmıştır.GEREÇ VE YÖNTEM: Öncelikle kliniğimizde çölyak hastalığıtanısı almış olan çocuk hastalar belirlenmiştir. Dahasonra retrospektif olarak bu hastalar arasında glutensizdiyeti doğru şekilde uygulayabilmiş hastalar belirlenmiştir.Bu hastaların tanı sırasında ve glutensiz diyetten 6 aysonra hematolojik parametreleri karşılaştırılmıştır.BULGULAR: Çölyak hastalığı konulmuş 97 çocukhastadan 66’sı çalışmaya dahil edilmiştir. Hastaların44’ü kız (%66.7), 22’si erkek (%33.3) olup tanı yaşlarıortalama 7.1 ± 4.2 yıl olarak saptanmıştır. Hastalardaen sık saptanan hematolojik bozukluklar, sırasıyla 38hastada (%57.5) trombositoz ve 28 hastada (%42.2)anemi olmuştur. Anemilerin 24’ü (%36.6) demir eksikliğianemisi, 2’si (%3) folat eksikliği anemisi, 1’i (%1.5) vitaminB12 eksikliği anemisi olarak değerlendirilmiştir. Altı aydevam eden glutensiz diyetten sonra anemi sıklığı 8hastaya (%13) düşmüştür. Glutensiz diyet sonrasındatrombosit sayısı 351.2 ± 11.0 (103/μL)’den 310.5 ± 82.0(103/μL) değerine, lökosit sayısı 8.82 ± 3.04 (103/μL)’den8.04 ± 2.56 (103/μL)’ye, ortalama platelet hacmi 10.1 ±1.1fl’den 9.5 ± 1.2 fl değerlerine düşmüştür. Buna karşılık;hemoglobin, ortalama korpuskuler volüm ve eritrositdağılım genişliği değerlerinde ise anlamlı derecede artışolduğu görülmüştür.SONUÇ: Çölyak hastası çocuklarda en sık saptananhematolojik bulgular, trombositoz ve anemi olmuştur.Glutensiz diyet sonrasında anemide düzelme olduğugörülmektedir. Bundan başka, hemostazda etkili birçokparametrenin de glutensiz diyetle birlikte düzeldiğigözlenmiştir.
SEVERE ASTHMA
Authors: Sağmen Seda Beyhan , Ceyhan Berrin
Published: October 2018

Asthma is a common inflammatory disease that has wideclinical characteristics of the airway of the lungs. Asthmasymptoms can be prevented by avoiding triggers likeallergens and by the effective inhaled treatment. Themajority of asthma patients can be treated effectivelyby current medications. Difficult asthma is a distinctentity of asthma, comprising approximately %5-10 ofasthmatic patients. Despite the high effective treatment,the patients with asthma have disease that is poorlycontrolled. Severe asthmatics account for up to half ofthe cost for asthma. It will include asthma uncontrolledby new standard therapy, steroid dependent, steroidresistant asthma patients. Asthma related deathsare seen especially in severe asthma group. Asthmais a heterogeneous disease, consisting of differentphenotypes. It requires multidisciplinary approach fortreatment management. Severe asthma may suddenlydevelop in early time in disease or overtime. There was anevidence that severe asthma related to genetic factors,environmental factors, age, inflammation, duration ofdisease The genetic and environmental factors mayplay a role in severe asthma management. Phenotypetargetedtherapy has an important role in severe asthma,but it is associated with high treatment costs. At firstdiagnosis of asthma must be confirmed COPD and vocalcord dysfunction is needed to be particular interest indifferential diagnosis. Triggering factors such as smoking,atopy, work place condition and aspirin hypersensitivityshould be evaluated. Comorbidities that may affectasthma should be considered. This review examinesthe definition of asthma, its differential diagnosis,phenotypes and available treatment options.
Physician and Patient Attitudes Toward Screening for Kidney Complications in Type 2 Diabetes: Is There A Role for Patient Self-Advocacy?
Authors: Frischknecht Bart , Giudice Lindsay , Perkins Robert M , Urbany Joel E
Published: October 2018

Urine protein screening rates among patients with type 2 diabetes are suboptimal despite evidence supporting its efficacy in preventing or slowing the progression of diabetic kidney disease (DKD) [1]. Testing of untimed urine specimens to quantify albumin (urine albumin-creatinine, or uACR)-the recommended screening test based on combination of simplicity, cost, and cardiovascular and renal prognostic value-is particularly underutilized, despite longitudinal efforts to improve awareness and screening among physicians [2].
Uses of Spatial Analysis in Oral Health Research
Authors: Fonseca Emílio Prado da
Published: October 2018

Spatial analysis provides an innovative decision- support tool in health informatics with a substantial potential to harness in oral epidemiology, planning, monitoring and evaluation of public health care services such as dental care. In this context the application of innovative technologies promote the use of available tools that enhance the design of the health sector based on a spatial approach. This scenario involves the appropriation of available technologies and strategies that strengthen differentiated and modern management with the focus on making health decision. Mapping and spatial analysis in oral health conditions couple with population characteristics becomes important in this context. The aim of this study, besides presenting the uses of spatial analysis in oral health, is to discuss some representative applications of methods that deal with the analysis of spatial patterns of oral health events, analyzing advantages, disadvantages, and applicability of the spatial analysis in oral health status and planning.