bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and perinatal mortality of cord prolapse and presentation
Authors: Fazil Aqila , Zafar Fareed , Asifa Al , Akmal Noreen , Karim Attiya
Published: June 2016

Aims and objectives; To analyse the prevalence and perinatal mortality in cord prolapse. Study design: All cases of cord prolapse managed in gynae unit 3 at Sir Ganga Ram Hospital were identified. Period: From 20 March 2004 to 20 March 2005. Results: 23 patients of cord prolapse and presentation were identified During this time 5408 births took place giving a prevalence of I in 235 total births which comes upto 0.42%. There were 6 cases of cord presentation (0.11%) and 17 cases of cord prolapse (0.31%).19 cases were born alive(82.6%). There were 4 still births giving a still birth rate of 17.4% or 174/1000 births with cord prolapse and presentation. One neonatal death occurred among 19 live born babies giving a rate of 5.21% or 52.1/1000 live births . The uncorrected perinatal mortality was 217/1000 births or 21.7% with cord prolapse and presentation. Conclusion: : Cord prolapse and presentation occur with prevalence of 0.43% The perinatal mortality rate in this series was 21.7% of births with cord prolapse and presentation.
Sensitivity and resistance of microorganisms in infected surgical wounds on surgical floor of Mayo Hospital
Authors: Ghazi Muhammad Ahmad , Akram Yasir , Akram Yasir , M A Cheema , M A Cheema
Published: June 2016

Background: There is an overwhelming concern around the world regarding the increasing number of resistant strains of microorganisms in all sorts of wounds. There is hardly any information about the prevalence and incidence of such resistance pattern in our local hospitals Methods: This study was done to probe into the common microorganisms and their culture sensitivities to antibiotics in surgical wound infections in general surgery wards of Mayo hospital. The study material included the pus specimens sent to pathology lab from general surgical wards. There culture sensitivity results were interpreted to find out the prevalence of individual microorganisms in surgical wounds and sensitivities and resistance to different antibiotics. Results: Staphylococcus aureus was the most common organism cultured (54.87%), followed by E.Coli (10%), pseudomonas(10%), proteus (7.9%) and kleibsiella (5.3%). 20 percent of wounds had mixed growth of organisms. Mixed growth of microorganisms was seen in 20% of cases. Conclusion: Most of the bacteria cultured were resistant to routinely used antibiotics.
Alterations in lipid profile in old age hypothyroid patients
Authors: Jawed Samia , F Khawaja Tariq , Sultan Asghar , Mahmood Tariq
Published: June 2016

The current investigation was designed to study the changes of lipid profile in hypothyroid patients in local population and t o investigate the importance of thyroid profile in oId age dyslipidemia patients. Ninety five newly diagnosed untreated h ypothyroid patients (aged 4 9.2112.47 years, BMI 3 0.365.8, 74 females and 21 males) were identified from thyroid OPD of INMOL, PGMI, Lahore. Patients were compared with 78 control subjects (aged 48.8011.00 years, BMI 30.5104.70, 54 females and 24 males) matched by age and body mass index (BMI). Serum TSH, FT4, FT3, Triacylglcerol (TAG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. Significantly increased levels of TC and LDL-C in overt hypothyroid patients were observed. No significant differences were found in HDL-C and TAG in overt hypothyroid patients as compared to the control group. Elevated levels of TC and LDL-C in hypothyroid patients represent an increased risk of ischaemic heart disease that requires therapeutic intervention. The deranged lipid profiles in hypothyroidism can not be corrected without the treatment for hypothyroidism in these patients. Therefore, all older patients referred for diagnosis and treatment of dyslipidemia should also be screened for hypothyroidism.
Automated detection of malaria: a comparison with microscopy
Authors: Ali Soad Fadlalla , Jamil Sajid , Akhtar Muhammad Naveed , Farooq Muhammad
Published: June 2016

Objective: To compare the automated detection of malaria with microscopy. Methods: In this study 250 blood samples submitted for malaria investigation were studied microscopically for malaria parasites. All samples were additionally analyzed for same parameters with automated hematology analyzer, Cell Dyn 3700 (CD3700). The results from the instrument generated as scatter plots (derived by laser light depolarization), were compared with microscopy results. Results: The atypical depolarizing events or positive patterns were observed in 43 out of 250 samples on cell Dyn 3700, while microscopically 3 7 samples were found to b e positive. Three samples positive on microscopy, were found t o b e negative on CD-3700. Compared with microscopy the sensitivity of CD3700 was 92.5% and specificity was 97.3%. Maximum parasitaemia was 6.5%. Conclusions: Automated detection of malaria by CD3700 automated hematology analyzer is feasible for screening purpose in malaria endemic and non-endemic areas.
Treatment of unilateral Temporomandibular joint ankylosis with silastic interpositional Arthroplasty
Authors: Akhtar Muhammad Usman , Shah Adnan Ali , Abbas Iram
Published: June 2016

Background: Ankylosis is a very common condition developed mainly after damage to mandibular condyles or temporomandibular joint (TMJ) at a growing age. Different autogenous and alloplastic interpositional materials have been attempted after the resection of the ankylotic bone to achieve desirable results. This condition is relatively common in Pakistan. We treated TMJ ankylosis with alloplastic medical grade silicone "silastic" interpositional arthroplasty. Eight joints accompanied ipsilateral or contralateral coronoidectomy to achieve desirable results. Method: All patients were presented at Punjab Dental Hospital Lahore. Sixty-one joints with unilateral TMJ ankylosis were underwent surgery after careful examination and final radiographic confirmation. The preoperative CT scan was also performed in few patients. Results: The postoperative measurements of the interincisal opening with lateral and protrusive jaw movements were criteria for success of surgery. The lateral and protrusive jaw movements were assessed as excellent, good and poor. Less than 25 mm interincisal opening was considered as poor jaw opening. Conclusion: The overall success rate was 98.4 "Ai with 84 % desirable interincisal jaw opening. Less than 5 % patients were observed with poor jaw opening. The immediate late complications were transient and were included oedema, weakness of a branch of the facial nerve on the operated side. Two implants were infected along with one wire in the first month of surgery and were removed under local anesthesia` without further complication.
Lichtenstien repair of inguinal hernia under local anesthesia - day case surgery
Authors: Choudry Zafar Ali , Khan Sadaqat Ali , Islam Haroon Rafiul , Siddique Tariq , Malik Javed I
Published: June 2016

This prospective study was carried on 250 patients to study the complication and recurrence rate associated with Lichtenstien repair of inguinal hernia in our clinical and socioeconomic settings. The cost effectiveness and return to work after surgery were the other outcome measures. Two hundred and fifty patients underwent mesh repair of inguinal hernia at two different centers over a period of two years. All the patients were operated under local anesthesia. A bolus dose of preoperative antibiotic was given intravenously. The patients were followed up for two years and their post operative course was assessed according to a prescribed proforma. The rate of minor complications was in the range of 11.8%. The recurrence rate was 1.2%.There was minimal pain and the procedure was cost effective in terms of operative cost and less economic loss due to early return to work. It is concluded that Lichtenstien repair as a day case is safe and effective procedure to be performed by a trained general surgeon under local anesthesia. The infection rate and the recurrence rate are low. The compliance and acceptability of the patient and ease of carrying out the procedure under local anesthesia by surgeon is acceptable. In our view this type of hernial repair is an appropriate method in district hospital and tehsial headquarter hospitals where provision of anaesthesia facilities are yet to be fully developed and hospitals cater a major hernial load due to elderly patients with background of farming professions being admitted. The patient can be sent home on same day after surgery.
Epidemiology of attempted suicides in emergency of Mayo Hospital in 2004
Authors: Asif Aftab , Yusuf Fatima , Haider Kamran , H Gul , S Usman , S Akbar , M Hussain , H Rashid , N A Balouch
Published: June 2016

Background: Suicide is one of the ten leading causes of death in the world, it ranks 8th leading cause in America and 4th as years of lost life. It accounts for more than 400,000 deaths annually. Different countries have different incidence rate and suicidal patterns, which are in accordance to their cultural, religious and social values. Suicide, a major global public health problem, is an under-studied and under researched subject in Pakistan, a conservative Islamic and developing country, with severe, legal, social and religious sanctions against it. Basic epidemiological data including national suicide rates are neither known nor reported to the World Health Organization. Despite this there is strong suggestive evidence that suicide not only occurs regularly but there has been an increase in the incidence over the last few years. Objective: The purpose of this study was to evaluate all the cases that presented in Mayo hospital Lahore from the duration 1st January 2004-31st December 2004, of attempted suicide. We wanted to find out what area they belonged to, which age group had an increased incidence, what was the male to female ratio, What method of suicide was adopted and during which season was the incidence the greatest. Materials and methods: All people who attempted suicide (medico-legal cases) from 1st January 2004 to 31st December 2004 were included in the study. Detailed information was provided by forensic department in Mayo Hospital, about age, sex, date of attempt and area they belonged to. Results: showed a male dominance, also the age group of 21-30 years showed the greatest frequency. Greater number of cases belonged to the urban area, the most common mode of suicide was by poisoning and contrary to international studies the greatest number of attempts was during the summer season. Conclusion: The results in our study show that attempted suicidal rate has rapidly increased since 1995. In 2004 almost 4/day of attempted suicide (medico-legal) cases presented in the emergency department of Ma yo hospital compared to less than 0.4/day in 1995. Our study also shows male dominance in number of attempted suicide. It also showed that in our population 21-30years had the highest number of attempts. . Our study also shows a greater number of attempts during summer months where as in the western countries a greater number is shown during spring and winter.
Non surgical treatment of chronic anal fissure: one year`s experience with GTN paste
Authors: Aziz Rizwan , Din Faridud , Shoaib Muhammad , Kamran Muhammad
Published: June 2016

Objective: Assessment of the efficacy of topical 0.2% glyceryl trinitrate (GTN) paste in the treatment of chronic anal fissure. Patients and Methods: Sixty two patients were treated with 0.2% GTN paste and reviewed at 3, 6 and 12 weeks interval to assess efficacy and side effects. Results: At 6 weeks, 72% of patients were treated successfully. In 28% of cases treatment was unsuccessful. At 12weeks follow up there was no early recurrence. The prevalence of headaches was 70%. Conclusions: The use of GTN induces rapid healing of chronic anal fissures with a 72% healing rate in this study. But balance is required between fissure healing and headache intolerance.
Peripheral Lymphadenopathy in Children, Comparison of Fine Needle Aspiration Cytology with Open Biopsy
Authors: Hussain Mukhtar , Chishti Akram Shad , Mukhtar Rubina , Khan Hanif , Siddiqui Hussain , Pasha Haroon Kd
Published: June 2016

Objective: To compare the results of Fine Needle Aspiration Cytology (FNAC) with open biopsy in cases of Peripheral Lymphadenopathy. Design: A comparative study. Place and duration of study: Department of Paediatric Surgery & Department of Pathology, Nishtar Medical College & Hospital, Multan from January 2004 to September 2004. Subjects and methods: Patients presenting with Peripheral Lymphadenopathy in Paediatric Surgery out patient department were included in study. Relevant history and clinical findings were entered in performa and patients were submitted to investigations like FNAC and open lymphnode biopsy, after getting consent, on OPD basis. Results: Results of both FNAC and histopathology in 54 patients were available for comparison at the end of study. FNAC showed tuberculosis in 36 (66.67%), lymphoproliferative process in 16 (29.63%) and poor yield in 2 (3.71%) cases. Whereas open lymphnode biopsy on histopathology confirmed tuberculosis in 42 (77.78%), Hodgkin`s lymphoma in 4.(7.42%), Non Hodgkin`s in 6 (11.13%) and reactive hyperplasia in 2 (3.71%) cases. Sensitivity of FNAC in tuberculosis was 85.7% with a specificity of 100% in cases of tuberculosis while it was 71.5% in cases of lymphomatous process with an overall sensitivity of 78.5% in peripheral lymphadenopathy. Conclusion: In our setup lymphnode biopsy should be performed in all suspected cases to avoid long term morbidity and mortality especially in clinically malignant illnesses.
Management of empyema thoracis: Peshawar experience of 450 patients
Authors: M Salim , Bilal Amer , Nishtar Tahira , Nabi, Shoaib , Ali Gohar , Mansoor Ayesha , Shah Haider
Published: June 2016

Objective: To observe the various clinical presentations of empyema thoracis and evaluate its management and outcome. Study design: An observational descriptive study. Place and duration: Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from June 2001 to June 2004. Materials and methods: Clinical record of 450 patients who underwent various surgical procedures during 3 years were retrospectively analyzed. Detailed scrutiny of record was carried out to analyze the clinical presentation; various surgical procedures and outcome. Results: There were 270 (60%) male and 180 (40%) female patients. Majority of the patients 310 (68.8%) were in the age range of 20 - 40 years. Common presentation was fever (62%); cough (26%) and chest pain (11%). The duration of symptoms was less than 8 weeks in 57 % and more than 8 weeks in 42% cases. Common etiologies were pneumonia (31%), post tuberculous (37.7%), traumatic (24%) and iatrogenic (6.6%). Tube thoracostomy was the initial l ine of management in 200 patients. Decortication was required in 200 patients while 50 patients needed thoracoplasty to obliterate persistent residual pleural space. The mortality was 4% (18/450). Thirty one (7%) had wound infection, air leak in 18 (4%), wound dehiscence in 9 (2%) and septicemia in 14 (3%) cases. Conclusion: Depending upon the stage, various surgical options exist for the treatment of thoracic empyema. Selection of the most appropriate procedure must be individualized but the basic principle is evacuation of pus from the pleural space, appropriate antibiotic therapy and obliteration of empyema cavity.
Acute appendicetomy is better choice for appendicular mass
Authors: Imran Muhammad , Ayyaz Mahmood , Majeed Hamid , Ghafoor Tariq
Published: June 2016

Objective: To compare the cost effectiveness, hospital stay and morbidity in each type of management of appendicular mass i.e. early surgical intervention and conservative management. Design: A randomized comparative study. Place and duration: South Surgical Ward, Mayo Hospital Lahore from July, 1999 to January, 2001. Patients and Methods: 40 patients were included dividing in two equal groups. Group A patients were explored early and group B patients were managed conservatively. Cost effectiveness, hospital stay and morbidity were determined in each group. Results: Mean hospital stay was 2.85 days (2-4 days) in group A and 6.25 days (5-8 days) in group B (p value< 0.001). Mean expenditure in group A was Rs.1255 and Rs. 2183.75 in group B (p value < 0.001). 100% patients in group A got complete pain relief within three days while it took 7 days for 90% of patients in group B (p value<0.001). Oral fluids were started earlier in group A as compared to group B (p value<0.05).
Abdominal TB, iliostomy is a safer option
Authors: Moin Amna , Gondal Sikandar Hayat
Published: June 2016

A prospective study of 50(100%) cases, 34(68%) males and 16(32%) females is presented. All were having abdominal TB and were presented in surgical emergency of a teaching hospital. Age ranging from 21 to 65 years. With mean of 34.5 years. 17(34%) known cases of TB and 33(66%) were histological proved. In 45(90%) abdominal pain was the symptoms and 5(10%) presented with pain RIF. In 40(80%) iliocecal regions was involved. In 30 cases (60%) intestinal obstruction and in 14(28%) perforation was seen. In 35(70%) patients iliostomy was performed that were revered three month later without any mortality. It is concluded that iliostomy in the management of abdominal TB is safer option.
Carotid Endarterectomy at Punjab Institute of Cardiology, Lahore: mid term postoperative results
Authors: Waheed Abdul , Shahbaz Ahmad , Ghaffar Abdul , Abid Abdul Rehman , Ahmed Naseem , Khan Jawad Solid
Published: June 2016

Objective. This study was designed to review postoperative results of the carotid endarterectomy (CABG/CEA) performed at the Punjab Institute of Cardiology, Lahore. Material and methods. Cconsecutive 10 patients with coexisting severe ischemic cardiac and carotid artery disease were operated on during 1-year period ending December 2003 at Punjab Institute of Cardiology, Lahore. Results: The mean age of the study population was 60.20±7.56 years, among theses 9 were male and 1 female patient. Four (40%) patients with carotid artery stenosis were asymptomatic. Previous stroke occurred in 2 (20%) patients: two (20%) patients presented with a history of blackouts and two (20%) with a transient ischemic attack. The mid term results with regard to 30-day postoperative mortality, stroke and major postoperative complications were significantly low in terms of post operative infection as only one (10%) patient had chest infection and there was no in-hospital mortality. Conclusions. Combined interventions of CE and CABG can be performed with an acceptable morbidity and mortality when severe carotid stenosis is associated with advanced, symptomatic ischemic heart disease. The introduction of routine preoperative carotid duplex scanning resulted in higher diagnostic rate for asymptomatic carotid artery disease among the patients scheduled for combined CABG/CE procedure.
Incidence of negative appendicectomy, our experience of 100 patients at Sir Ganga Ram Hospital Lahore
Authors: Aslam Muhammad , Shaukat Ayesha , Zafar Farid , Bhutta Amir Riaz , Choudhri Aftab A , Asif Muhammad
Published: June 2016

Background: Despite recent advances in diagnostic medicine, the diagnosis of Acute Appendicitis is still doubtful in a number of cases. Majority of the Clinicians rely on their clinical examination, strengthened by the laboratory tests. This study was done to see the incidence of negative appendicectomy in Patients, who presented in surgical emergency with pain in Rt. Iliac fossa. These patients were assessed and evaluated by clinical examination as well as with the help of Modified Alvarado Scoring system and surgery was decided accordingly. Aims and Objective: To see the incidence of Negative appendicectomies at Sir Ganga Ram Hospital, Lahore and comparing the rate with the rate of other international Studies. Study Design: It was a prospective clinical and Pathological study, consisting of 100 patients, presenting in the Sir Ganga Ram Hospital Lahore, with history of right iliac fossa pain. Material and Method: One hundred patients were included in the study, and diagnosis of acute appendicitis was bas ed on Clinical Examination and Modified Alvarado Score. The patients selected for this study were of all age groups and both sexes. Out of hundred, 56 patients were operated after being assessed by clinical Examination and Modified Alvarado Scoring System. Results: The incidence of negative appendicitis was about 7% in male, 20% in female and about-10% in children. Conclusion: Over all the rate of negative appendicectomies was 15%, which is with in lower limit of the other international studies.
Comparison of intravenous hydralazine-bolus dose versus continuous infusion drip in Eclampsia
Authors: Waheed Fatima , Chohan Arshad
Published: June 2016

The leading cause of maternal death from eclampsia is cerebral hemorrhage, which is presumably the consequence of severe hypertension, so the acute elevations in blood pressure above 160/100 mm Hg should be brought under control. A study of forty diagnosed cases of eclampsia was carried out in Lady Willingdon Hospital, Lahore to determine the time and quantity of drug required to control high blood pressure levels by intravenous hydralazine bolus dose versus continuous infusion drip. Patients were divided into control and case group. In control group continuous infusion was given and in cases bolus dose was given. Mean time taken to control blood pressure by continuous infusion was 124.75 minutes and drug quantity was 23.50 mg while it was 52 minutes and 12.25 mg in case of bolus method. The study showed that 60-70% less time was required and 37.5-50% less drug quantity was used in bolus method versus continuous infusion of intravenous hydralazine. Regarding efficacy of intravenous hydralazine, it was fou nd to be statistically superior in this study (P<0.05) so that management strategy should be changed in favour of bolus dose as compared to continuous infusion of intravenous hydralazine.
Association of malaria with thrombocytopenia
Authors: Akhtar Muhammad Naveed , Jamil Sajid , Amjad Syed Ikhlaq , Butt Anjum Rashid , Farooq Muhammad
Published: June 2016

In this study, 250 blood samples submitted for malaria investigation were studied microscopically for malarial parasites and platelet count. All samples were additionally analyzed for platelet count with automated haematology analyzer. Thirty seven (37) samples were found to be malaria positive microscopically. Out of 37 cases with malaria positive microscopically, thrombocytopenia was observed in 24 (64%) cases of malaria. So there is association of thrombocytopenia with malaria.
Role of ileostomy in advanced cases of typhoid perforation
Authors: Maqsood Lubna , Mumtaz Fawad , Wahla Muhammad Zakaria
Published: June 2016

A study of 72 cases with typhoid perforation is presented. All the cases included in the study had more than 48hrs peritonitis with highly inflamed gut and presented late with septic shock. They were treated with exteriorization of the perforation as ileostomy. Postoperative recovery was satisfactory with minimal complications and very few mortalities. The ileostomy was closed 2 months later in all the cases.
Relationship of secretor status in patients with oral cancers
Authors: Jamil Sajid , Tayyab Muhammad , Farooq Muhammad
Published: June 2016

Present study was designed to find the association of secretor status with oral cancers. In this study 50 diagnosed cases of oral cancers and 50 healthy controls were selected. Secretor status on saliva sample was performed in all these subjects. 39 (78%) subjects were secretors and 11 (22%) were non secretors in control group. 28 (56%) patients with oral cancers were secretors and 22 (44%) were non secretors. Conclusions: Oral cancer was found to be associated with non-secretor status.
Occupational hazards for surgeons
Authors: Qadir Abeer , Salahuddin Omer , Aslam Muhammad Nadeem
Published: June 2016

Background In spite of the radical advances made in the field of surgery to save lives, we find it is the surgeons who are becoming the patients by being exposed to a host of occupational hazards, which places them at a significant risk of acquiring many infectious diseases in addition to other safety threats. In context to guidelines set down by International Labor Organization the hazards a surgeon can face at work can be broadly categorized into Accidental, Chemical, Biological, and Ergonomic, Psychosocial and Organizational Hazards. Objectives To identify the occupational hazards surgeons face in our set-up and their inevitable consequences as compared to international standards. Setting The survey was carried out in a major tertiary care hospital of Lahore with inspection of operation theatres, surgical emergency room, and surgical wards. Results The surgeons in our setup are exposed to infectious diseases such as Hepatitis B and C, HIV and typhoid via accidental pinpricks from infected needles and s harps due to multiple hazards. Other risks include latex sensitization, back problems, post-traumatic stress syndrome and many others. Conclusion Spread of awareness of these occupational hazards should be undertaken with a change in attitudes.
Recurrent retinal artery ischemia as a presenting symptom of ophthalmic artery aneurysm
Authors: Qamar Rao Muhammad Rashad , Mansoor Qasim , T Majeed
Published: June 2016

An 81 years old woman presented with sudden painless greying of her vision in the right eye. This resolved within l-2 hours without any residual visual loss. She experienced similar symptoms twice in 4 months. The attacks lasted forty to sixty minutes. She had no history of hypertension, diabetes mellitus, migraine, ischemic heart disease and atrial fibrillation. Further neurological and systemic enquiry was negative On ocular examination, best visual acuity was 6/9 right eye and 6/60 in left eye. Slit lamp biomicroscopy, tonometry and discs appearances were normal. Right macula showed multiple drusens and dry type of ARMD.There was left disciform macular degeneration. The vascular pattern of both fundi was normal and did not reveal any embolus. Extraocular movements were normal. Cardiovascular examination, Carotid artery palpation and auscultation were all normal. Serum cholesterol level was normal. Thrombophilic screen was negative. Magnetic Resonance Angiogram showed aneurysm of right ophthalmic artery near the junction of carotid-ophthalmic artery. After neurosurgical consultation, she was advised to take Tab. Aspirin 75mg daily.
Xeroderma Pigmentosum
Authors: Ghazi Muhammad Ahmad , Maqsood Amna , Akram Yasir , Cheema Muhammad Arshad
Published: June 2016

Xeroderma pigmentosum comprises of a heterogeneous group of autosomal recessive hereditary diseases, which are characterized by a number of clinical characteristics and abnormal DNA repair mechanism. These patients are prone to multiple cutaneous malignancies at an early stage in life. We present 2 cases of xeoderma pigmentosum with malignant melanoma and conclude that such cases must be identified at an early stage and properly educated to protect themselves from malignancies.
Behcet`s syndrome with coronary arteritis
Authors: Ahmad Khurram , Chishti Waqas , Yusuf Jawwad , Jawwad Madiha
Published: June 2016

Forty nine years old African American Female with Past medical h/o HTN, Behcet`s Syndrome since 1988 with recent flare up of disease with oral and genital ulcers, headache, arthralgia and gastrointestinal symptoms was referred to cardiology clinic with do chest pain for 4 days, reterosternal, non radiating,4/10 in intensity, no aggravation on exertion, relieved by SL nitroglycerine associated with mild SOB, nausea and diaphorersis. Patient denied tobacco, alcohol and illicit drugs. Never had similar chest pain before. Review of system was unremarkable except for Behcet`s Syndrome flare up. Her medications were tenolol, Valsartan, Indocin, ASA, Lortab, Zoloft, Premarin, Triamatrene and Tagamet. Her family history was negative for coronary Artery disease. On physical exam pt was afbrile, heart rate 52/min,blood pressure 140/90, respiratory rate 16/min average built female 3-4 oral mucosal ulcers. Eye exam was unremarkable. Cardiac exam showed normal Sl and S2,no added sounds. Abdomen was soft, non tender and no hepatosplenomegaly. Her Right knee and both ankle joints were mildly tender without signs of effusion. Her genital exam revealed 2-3 small painful ulcers on labia minora. Rest of systemic exam was unremarkable.
Prevalence of congenital duplication of collecting system in Pakistan
Authors: Nasim Mamoona , Batool Alvia
Published: June 2016

The urogenital system is more likely to have birth defects than any other system. Of all the urinary tract anomalies, Double ureter is the most common one. It may be incomplete (bind ureter) or complete duplication. In order to collect data for this various medical colleges were approached & 120 cadaveric kidney pairs were examined for the presence or absence of double ureters. It was found that 02 out of all examined kidney pairs were showing this anomaly. One pair was having bilateral double ureters while other was showing right sided ureteric duplication.
Procuring 230 Football Fields of Membrane - Strategy, Results and Lessons Learned
Authors: Grundestam J.
Published: June 2016

Stockholm is currently one of Europe’s fastest growing cities, with its population increasing by approximately 1.5% per year, corresponding to 15,000 to 20,000 people. Sweden’s commitment to the Baltic Sea Action Plan and the EU Water Directive will lead to more stringent effluent requirements (6 mg-Tot-N/l, 0.2 mg-Tot-P/l and 6 mg-BOD7/l), and wastewater treatment in Stockholm will require major investment to handle these challenges. As Stockholm Vatten’s two wastewater treatment plants (WWTPs) – Bromma, 320,000 people, and Henriksdal, 780,000 people – are both located in or near residential areas in the city, plant development must be coordinated with its needs on economic, political, sustainable and long-term bases. Both WWTPs being facilities located underground also pose a challenge for any extension works.
SHAFDAN (Greater Tel Aviv Wastewater Treatment Plant): recent upgrade and expansion
Authors: Messing Arie , Sela Yuval
Published: June 2016

The SHAFDAN is the largest wastewater treatment plant in Israel and currently treats 360,000 m3/day of municipal wastewater, about 92% of its treatment capacity. Waste sludge from the plant is discharged to the Mediterranean Sea through a marine outfall. The SHAFDAN is committed to ending the disposal of its sludge to the sea by the end of 2016 by providing a land-based biosolids management program that produces a Class A biosolids for agricultural use. In order to implement this strategy, a number of large-scale construction projects were undertaken. These projects include a new sludge thickening and dewatering facility, updated headworks, a new primary treatment facility, and a new 3-stage thermophilic anaerobic digestion facility. The total capital cost of these projects is estimated to be US $300 million. This paper describes the principal components of these projects and their design parameters.
The development of aCurve: a rich internet application for process analysis at Käppala WWTP
Authors: Thunberg A. , Medoc M. , Bäckman J.
Published: June 2016

In modern wastewater treatment plants (WWTPs) the demand for advanced process control is a prerequisite for a smooth and energy efficient operation of the plant. Most large WWTPs have distributed control systems (DCS) and advanced supervisory control and data acquisition systems installed for operation and supervision of the plant. Normally the DCS is sufficient for the operators to run the plant efficiently. However, data is also often wanted by others than the operators (e.g. research engineers, students, scientists or consultants) for analysis and reporting or to perform different calculations. At Käppala a new web based program, aCurve, has been developed to meet such needs. The program is a so-called Rich Internet Application and is accessible via internet and requires no desktop installation. The main features of the program are rapid presentation of graphs, easy zoom, changing resolution, performing calculations and plotting the results and simple statistics (e.g. mean values, integration, maximum and minimum values). If advanced calculations are acquired, the data is easily exported as an xlsx-file for use in Microsoft Excel or other software capable of reading the Office Open XML SpreadsheetML File format. aCurve can also produce automatically updated reports that are built in Microsoft Excel. This makes the reporting function flexible and any user with Excel knowledge can create and edit a report with a professional result. The reports can easily be shared throughout the organization. The program has replaced other expensive and complex desktop application that were previously used at the Käppala WWTP. Process and laboratory data that can be used for follow up of plant performance has now become available for a greater part of the staff which improve the quality assurance of reported data to authorities and researchers.
Adaptation of microbial communities in activated sludge to 1-decyl-3-methylimidazolium bromide
Authors: Gendaszewska Dorota , Liwarska-Bizukojc Ewa
Published: June 2016

The effects of 1-decyl-3-methylimidazolium bromide on activated sludge process and microbial composition were investigated. Ionic liquid (IL) was dosed continuously to the laboratory activated sludge system at an influent concentration from 1 to 20 mg l−1 for about 1 month. As compared to the control test, mean values of degree of chemical oxygen demand removal and degree of biochemical oxygen demand removal were almost remaining constant at a high level, equaling 92.6% and 98.1%, respectively. In addition, no influence of IL on size and shape of flocs was observed. The values of the sludge biotic index indicate that sludge exposed on IL was stable and very well colonized with good biological activity. Increases in Proteobacteria (mainly Variovorax sp., Vogesella sp., Hydrogenophaga sp.), Bacteroidetes (mainly Lewinella sp., Haliscomenobacter sp., Runella sp.) and Nitrospirae were detected in sludge adapted to IL compared to the control system. The results showed that activated sludge can adapt to IL present in wastewater.
Tecendo as redes entre natureza e sociedade: os desafios das mulheres pescadoras em Sergipe
Authors: Almeida Santos Eline , Cássia Oliveira Aragão Miria , Melo e Souza Rosemeri
Published: June 2016

As interações entre a sociedade, os sistemas ambientais e os recursos naturais são caracterizadas pelas formas e necessidades impostas pelo modo de produção em vigor, ou seja, pelo padrão de consumo expresso em cada sociedade. O espaço da pesca é caracterizado, principalmente, pela profunda ligação entre homem e natureza, pelos saberes tradicionais adquiridos nessa relação e pelos laços construídos no desenvolvimento da atividade. A inserção da mulher nos mais altos estratos da sociedade e no mercado de trabalho mundial demonstra as conquistas das mesmas em diversasatividades. Porém, no âmbito da pesca muitos são os obstáculos enfrentados, principalmente quando o assunto é valorização e reconhecimento profissional, visto que há diferenças em termos salariais e direitos sociais. Diante desse quadro, o presente texto tem como objetivo instigar o debateacerca da participação da mulher no setor pesqueiro, suas relações com o meio e os principais desafios enfrentados em sua luta cotidiana. Entende-se que analisar a participação da mulher na pesca é contribuir para a formulação de políticas que conduzam a uma maior equidade entre os gêneros e para a manutenção da atividade com a elaboração de plano coerentes com as intempéries observadas no setor.
A utilização de mini-estações de tratamento de esgoto em residências
Authors: Fernandes Martins Nícolas
Published: June 2016

O presente trabalho tratará do desenvolvimento de um protótipo de estação detratamento de esgoto (ETE), sendo um protótipo onde foram analisados dadosquímicos e levantamento da microfauna do lodo ativado.  Foram analisados antes eapós o tratamento do protótipo dados referentes à Demanda Bioquímica de Oxigênio(DBO), Nitrogênio Amoniacal, fosfato, óleos e graxas, ph e espectrofotometria. É oprimeiro trabalho que utiliza medidas de espectrofotometria em analises de águastratadas. Todos os resultados comprovam que a estação de tratamento pode ser eficazem residências que não possuem tratamento de esgoto. Foram realizadas plantas parainstalação de uma estação de tratamento em residências.
Saneamento básico urbano e a epidemiologia sócioambiental de idosos moradores de um conjunto habitacional do município de Anápolis.
Authors: Dias Barbosa Vilar Welton
Published: June 2016

Saneamento básico está intrinsecamente interligadas a condições de saúde da população, de forma que a falta de um sistema de esgotamento e abastecimento de água tratada pode resultar em profundos impactos em termos de saúde pública e nesse cenário merece destaque a população idosa. Nesse sentido, o presente estudo teve por objetivo analisar os riscos sócioambientais causados pelos problemas de saneamento básico e suas relações com o perfil epidemiológico de uma população de idosos. Optou-se por realizar um estudo de caso de natureza descritivo-exploratória, por melhor permitir a proximidade dos objetivos deste trabalho. O estudo foi realizado em um Conjunto Habitacional, localizado ao leste da cidade de Anápolis. Através da epidemiologia descritiva e de análises de correlação constatou-se boa cobertura de serviços de abastecimento de água e uma ausência dos serviços de esgotamento sanitário e mesmo havendo uma importante ocorrências crônico-degenerativas, as doenças infecto-parasitárias ligadas ao saneamento básico, mostrou-se importante nessa relação.
PLANTAS MEDICINAIS, FITOTERÁPICOS E SAÚDE PÚBLICA: UM DIAGNÓSTICO SITUACIONAL ENTRE PROFISSIONAIS DA ÁREA DA SAÚDE EM ANÁPOLIS, GOIÁS
Authors: Glória Mirley
Published: June 2016

Objetivou-se avaliar o conhecimento sobre o uso de plantas medicinais e  fitoterápicos pelos profissionais da saúde em Anápolis, GO, tendo como embasamento a Política Nacional de Práticas Integrativas e Complementares (PNPIC) no Sistema Único de Saúde. Utilizou-se de questionário estruturado, sendo amostrados 220 profissionais da área da saúde. Somente 17% fazem uso das plantas e fitoterápicos, sendo estes: enfermeiros, técnicos em enfermagem e fisioterapeutas. Quanto ao posicionamento em relação ao usodas plantas medicinais e fitoterápicos, foram favoráveis: 100% dos fisioterapeutas, farmacêuticos e odontólogos; 86% dos técnicos em enfermagem, 65% dos enfermeiros, e 17% dos médicos. A PNPIC é totalmente desconhecida por esses profissionais, o que sugere que para a efetiva implantação dessa política pública de saúde no município, ações no sentido de esclarecimentos e capacitação devem ser tomadas. Cabe ressaltar a importância da informação para que o profissional possa se posicionar em relação as Práticas Integrativas e Complementares, sobretudo sobre suainserção no SUS.
Acanthaceaes do Bioma Cerrado: Identificação dos fitoquímicos das folhas da espécie justicia thunbergioides (lindau) leonard (acanthaceae) ocorrente no parque estadual Serra dos Pireneus, Pirenópolis, GO.
Authors: Suelem Gomes da Silva Raíssa , De Castro Peixoto Josana
Published: June 2016

A família Acanthaceae compreende cerca de 250 gêneros e 2.500 espécies com distribuição predominantemente tropical. O gênero Justicia compreende o maior gênero desta família possuindo cerca de 900 espécies, onde várias espécies desse gênero são amplamente utilizadas na medicina popular por possuírem uma grande diversidade de classes químicas são encontrados nas espécies de Justicia, principalmente alcalóides, lignanas, flavanóides e terpenóides que possui potencial farmacológico, sendo utilizadas a planta inteira e partes áreas. A espécie Justicia thunbergioides (Lindau) Leonard possui distribuição no Bioma Cerrado possuindo como principais características folhas opostas, simples, lanceoladas e margens onduladas. O objetivo deste estudo foi identificar as principais classes de metabólitos secundários das folhas da espécie ocorrente no Parque estadual Serra dos Pireneus para contribuir com o conhecimento botânico das Acanthaceae brasileiras do Cerrado. Foram coletadas amostras de folhas adultas, completamente expandidas abaixo do terceiro nó, contadas a partir do ápice, de 5-10 indivíduos das populações naturais. A fim de realizar a prospecção fitoquímica as folhas foram secas ao ar durante sete dias, até peso constante. A análise qualitativa dasprincipais classes de metabólicos secundários utilizou-se de metodologias adaptadas já descritas na literatura. Como resultado, nas folhas adultas, verificou-se a presença deheterosídeos antraquinônicos, cardioativos, flavonóides, cumarinas e taninos.
Os Recursos Vegetais Medicinais Utilizados pela População da Região Centro Oeste do Brasil: Uma compilação de espécies ou checklist de fanerógamas
Authors: Rodrigo Beltrão Carneiro Marcos , Luciene dos Santos Mirley
Published: June 2016

Este texto é fruto da dissertação sob o título “A Flora Medicinal no Centro Oeste do Brasil: um estudo de caso com abordagem etnobotânica em Campo Limpo de Goiás”, defendida no Mestrado de Sociedade, Tecnologia e Meio Ambiente, no ano de 2009.
Fronteiras do Oeste Brasileiro
Authors: Cesco Susana
Published: June 2016

Fronteira Cerrado: Sociedade e Natureza no Oeste do Brasil é uma coletânea de textos que propõe um debate interdisciplinar sobre o Cerrado. Mais do que isso, insere a temática do Cerrado e da fronteira em um debate interdisciplinar original e necessário aos trabalhos acadêmicos quer da Geografia, da Historia Ambiental, da Biodiversidade, da Biologia da Conservação, do Desenvolvimento Sustentável, da Sociologia Rural ou das Geociências.Essa proposta de analise, muito bem organizada na forma de coletânea, permitiu que todos os textos aqui reunidos, estruturados em três eixos temáticos, discutam o Cerrado e a fronteira oeste do Brasil numa perspectiva multifacetada, abordando importantes questões que envolvem as sociedades e o meio ambiente.Ao afirmar que o livro tem por objetivo “discutir temáticas relacionadas com a ocupação de diversos territórios do Brasil, mais especificamente de trechos do bioma Cerrado, no passado e no presente. Trata-se de entender como se constituem as relações entre sociedade e natureza, aspectos de devastação, manifestações de preocupação com o ambiente natural, os laços de cooperação e de exploração entre os diversos atores sociais, e as representações que orientam e dão sentido a multiplicidade de experiências individuais e coletivas” Os organizadores anunciam uma empreitada árdua que, posso afirmar, foi amplamente realizada. Agora cabe ao leitor geógrafo, historiador, biólogo, cientista social… conhecer essa importante reunião de textos e refletir sobre as “novas” questões relacionadas com a ocupação da fronteira Oeste brasileira.
“Notícias” sobre o beribéri em Goiás
Authors: De Magalhães Sônia Maria
Published: June 2016

Esta analise confere notícias sobre a incidência do beribéri em Goiás no século XIX. Embora a literatura médica do período não mencione ocorrências dessa mazela na região, a pesquisa documental constituída sobretudo por registros de óbito, de administradores da províncias e de diários de viagem tem comprovado que ela se manifestava de forma endêmica e, por vezes epidêmica no território.
Storehouse and sanctuary: the role of Brazil in world food security
Authors: Pires Tiburcio James Augusto , Bursztyn Marcel
Published: June 2016

Natural endowments such as land availability, abundant water, fertile soils, and favorable climate combined with decreasing population growth place Brazil as the leading force in world food production. Brazil is also the guardian of the most diverse eco-systems in the planet and is continuously wrestling between the expansion of the agricultural land area and the preservation of the most diverse fauna and flora, embodied in the Amazon forest. Addressing the international political economy of trade and food security from a Brazilian perspective, this paper argues that the main obstacles facing Brazil in food security are not domestic, but international. International political issues are at the core of the most relevant hurdles and understanding the reciprocal relationship between world food security and the emerging economies position especially that of Brazil in food production and trade is crucial. I argue that comprehending the elements that constrain the present and future role of Brazil in fulfilling its potential as food supplier in an ecologically and economically sustainable path, as well as its new found role as agricultural cooperation partner in the promotion of a food safe world is paramount if the world is to feed 7 billion mouths.
Brazil x China Trade Frictions: Overview and a brief case analysis
Authors: Silva Omar Rodrigo Ribeiro , Yueming Zheng
Published: June 2016

O presente artigo tem por objetivo descrever a presente realidade econômica e de mercado no que tange ao comércio internacional e suas imperfeições (conflitos) que confrontam a China, especialmente aqueles originados em um de seus maiores parceiros comerciais, o Brasil. Através de uma pesquisa empírica, este trabalho demonstra, de forma breve e descritiva, as construções históricas que formaram a realidade econômica de ambos os países e, de uma forma quantitativa, os conflitos existentes entre os últimos.Palavras-Chaves: Conflitos comerciais; Brasil x China; barreiras comerciais; indústria da celulose.
Variação da Diversidade α e β das Assembleias de Peixes num Gradiente Montante-Jusante em um Rio Tropical, Brasil Central
Authors: Santana Andréia Oliveira , Tejerina-Garro Francisco Leonardo , Carvalho Rodrigo Assis
Published: June 2016

O presente estudo foi desenvolvido ao longo da calha do ribeirão João Leite, afluente do rio Meia Ponte, alto da bacia do rio Paraná, Goiás. Foram determinados previamente três trechos amostrais de 500m de comprimento, onde foram realizadas as amostras das assembleias de peixes. Os peixes foram coletados durante o período de estiagem utilizando-se um jogo de redes de diferentes malhas (12, 15, 20, 25, 30, 35, 40 e 50mm entre nós) e cinco armadilhas. A diversidade α foi verificada através dos descritores ecológicos abundância, riqueza, índice de Shannon-Wiener e uniformidade, e a β pelo Índice de Morisita-Horn. Corroborando com o conceito de rio contínuo, os atributos riqueza e diversidade de espécies aumentam no sentido montante-jusante...Palavras-Chaves: Ribeirão João Leite; Ictiofauna; Diversidade de Espécies; Distribuição Longitudinal.
Aves Endêmicas do Cerrado no Estado de Goiás
Authors: Braz Vivian da Silva , Hass Adriani
Published: June 2016

Espécies endêmicas merecem atenção especial em estratégias de conservação, sendo que no Cerrado grande parte das espécies de aves endêmicas é considerada também ameaçada de extinção. O presente estudo analisou a ocorrência das espécies de aves endêmicas do Cerrado em Goiás, discutindo o papel do Estado na preservação da avifauna do bioma. A grande riqueza de espécies de aves em Goiás, bem como a alta representatividade de endêmicas e ameaçadas, o coloca no centro de estratégias de conservação para a avifauna do Cerrado. Suas principais Unidades de Conservação, PN Emas e PN Chapada dos Veadeiros, se mostraram extremamente relevantes na representação da riqueza do bioma, bem como das espécies endêmicas e ameaçadas de extinção, e são um componente central na conservação da fauna do Cerrado. Além disso, deve ser dada atenção especial aos centros de endemismo do Vale do rio Paranã e Vale do rio Araguaia para garantir a conservação das espécies de aves endêmicas de distribuição restrita no Estado.Palavras-Chave: Espécies Ameaçadas; Conservação; Áreas Protegidas.