bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalência de Síndrome da Estafa Profissional e fatores associados em fisioterapeutas intensivistas
Authors: Santos Cleide Lucilla Carneiro , Barbosa Gabriella Bené , Nascimento Deise Santos Silva , Martins Júnior Davi Félix , Nascimento Sobrinho Carlito Lopes
Published: August 2018

INTRODUÇÃO: Os estudos sobre síndrome de burnout em fisioterapeutas intensivistas são raros e muitos desses profissionais ainda desconhecem esta síndrome. OBJETIVO: Estimar a prevalência e os fatores associados da Síndrome da Estafa Profissional (burnout), em Fisioterapeutas trabalhadores de Unidade de Terapia Intensiva adulto, pediátrica e neonatal de uma cidade da Bahia. MÉTODOS: Estudo epidemiológico de corte transversal, em uma população de 60 fisioterapeutas trabalhadores de Terapia Intensiva na cidade de Feira de Santana, Bahia. Um questionário autoaplicável avaliou dados sociodemográficos, características do trabalho e a síndrome de burnout por meio do Maslach Burnout Inventory (MBI). RESULTADOS: 51,7% trabalhavam em UTI adulto, 20,0% em UTI pediátrica e 28,3% em UTI neonatal, muitos profissionais trabalhavam em duas ou mais unidades, 80,0% do sexo feminino e 20,0% do sexo masculino, com média de idade de 32,2 ± 4,9, 55,0% era solteiro e 45,0% tinha companheiro, 58,3% não tinham filhos e 41,7% tinham filhos. A prevalência da síndrome de burnout foi de 33,3%, considerando - se o nível alto em pelo menos uma das três dimensões do MBI. CONCLUSÃO: Observou-se elevada prevalência da síndrome de burnout entre os fisioterapeutas intensivistas estudados. Os resultados estimulam a se continuar investigando as condições de trabalho e outros fatores que podem estar associados a essa elevada prevalência.
Política indutora brasileira de formação em saúde: avaliação do desenvolvimento da formação integral para o SUS
Authors: De Araujo Bruna Nadaletti , Crivellaro Gonçalves Carla Beatrice , Godoy Bertolin Julio Cesar
Published: August 2018

Trata-se de um estudo resultante de uma dissertação de mestrado, de abordagem qualitativa, que buscou avaliar a preparação dos sujeitos envolvidos no Programa de Educação pelo Trabalho (PET-Saúde) de uma universidade da região norte do RS para atuarem no SUS segundo os preceitos da integralidade e interprofissionalidade. É imprescindível o monitoramento e avaliação das orientações propostas pelas Diretrizes Curriculares Nacionais para os cursos da saúde, bem como pelos programas de reorientação da formação profissional, para tanto se faz necessária a construção e aplicação de instrumentos de avaliação e acompanhamento que funcionem como indicadores de rumos e de correções de percurso. Como resultados obtidos podemos enfatizar uma familiaridade dos sujeitos entrevistados com os conceitos utilizados pelos autores que trabalham o assunto; demonstraram em suas falas o quanto é claro em suas concepções o papel que o programa possui no processo de formação em saúde; também foi possível reconhecer que o programa está conseguindo incutir em seus participantes a necessidade e benefício do desenvolvimento de algumas habilidades essências para a qualificação do SUS; o reconhecimento dos participantes sobre a relevância da integração ensino-serviço-comunidade.
Перспективные расчеты населения в Германии
Authors: Пётч Ольга
Published: August 2018

Целенаправленная социально-экономическая политика немыслима без представлений о будущем развитии населения и его структуры. Перспективные расчеты населения позволяют получить такого рода компас. Их результаты показывают, как будут изменяться численность и структура населения при определенных гипотезах о развитии рождаемости, смертности и миграции. Поскольку эти демографические процессы протекают очень постепенно и их воздействие проявляется в полной мере лишь через несколько десятилетий, особый интерес представляют расчеты на долгосрочную перспективу.

Данная статья знакомит с официальными перспективными расчетами населения Федерального статистического управления Германии. Опираясь на широко распространенные в международной практике когортно-компонентный метод и сценарную технику, они имеют ряд особенностей. Как трактовка целей и интерпретация результатов, так и некоторые детали методологии, и дизайн сценариев как системы равноценных вариантов будущего развития отличны от принятых в настоящее время в России. На примере предположений 13-го координированного перспективного расчета о будущей динамике рождаемости статья знакомит с одним из возможных подходов к моделированию гипотез. В основе этого подхода находится анализ тенденций динамики репродуктивного поведения женщин реальных поколений. В заключение сделанные на базе данных 2013 г. выводы о будущем уровне итоговой рождаемости критически анализируются с учетом новых данных до 2016 г. о подъеме деторождения в Германии. Анализ факторов, сопутствующих этому процессу, позволяет оценить их потенциал для будущего развития рождаемости.
Микропереписи населения России: прошлое, настоящее и будущее
Authors: Пьянкова Анастасия Ивановна , Щербакова Екатерина Михайловна , Васин Сергей Алексеевич
Published: August 2018

Прослежена история трех микропереписей населения, проведенных в России в 1985, 1994 и 2015 годах. Выделены их организационно-методологические характеристики, программные особенности. Поскольку микропереписи дают большее поле для исследований по сравнению сo всеобщими переписями населения, особое внимание уделено тому, какое отражение итоги микропереписей нашли в научных исследованиях и какие были получены выводы на их основе.
Более пристальное внимание уделено микропереписи населения 2015 г. (МПН-2015). Выявлены отклонения выборки МПН-2015 по регионально-территориальной структуре от постоянного населения России. Из-за значительной вариативности объема выборки по регионам пострадала репрезентативность данных по стране в целом, наблюдается смещенность социально-демографических и географических характеристик населения. Сопоставление численности и структуры населения по МПН-2015 с данными текущего учета и всеобщих переписей населения, оценка возрастной аккумуляции показали наличие серьезных проблем с качеством полученных данных, а также наличие типичных для всеобщих переписей ошибок. Акцентируется внимание на смещении в старшие возраста структуры населения по МПН-2015, что может повлиять на оценку общих показателей образования, экономической активности, заболеваемости, инвалидности, демографического состава домохозяйств и других переменных, для которых существует тесная связь с возрастом, что в целом может отразиться на востребованности данных МПН-2015. В заключении, обращаясь к опыту микропереписей и социально-демографических обследований в зарубежных странах, а также выборочным обследованиям Росстата по социально-демографическим проблемам, поставлен вопрос о перспективах развития данного метода статистико-демографического наблюдения в России.
Александр Кулишер о демографическом будущем России
Authors: Тольц Марк
Published: August 2018

На рубеже 1920-х и 1930-х годов А.М. Кулишер написал три статьи, посвященные проблемам демографической динамики некоторых стран мира, которые были напечатаны в наиболее солидной и широко читаемой газете русской послереволюционной эмиграции – «Последние новости» (Париж). В них впервые в предсказании демографического будущего России использовалась общая схема демографических изменений, ныне известная как концепция «демографического перехода» или «демографической революции». В настоящей публикации приведены тексты этих статей, недоступные современному читателю, которые предваряются предисловием и дополнены комментариями к ним. В предисловии отмечены важные особенности статей А.М. Кулишера в контексте развития демографии того периода и нацеленность их автора на предвидение будущей динамики населения России.
Дорогие дети, бедные матери
Authors: Борусяк Любовь Фридриховна
Published: August 2018

Новая книга Анны Шадриной «Дорогие дети. Сокращение рождаемости и рост «цены» материнства в XXI веке», опубликованная издательством «Новое литературное обозрение» в мае 2018 г. была награждена премией «ЛибМиссия» в номинации «Аналитика». Эта книга не является строго научной, академической, хотя базируется на большом теоретическом материале, автор хорошо знакома с научной литературой. Она не является и публицистической, хотя может быть интересна широкому кругу читателей. Как и в своей предыдущей книге, Анна Шадрина пытается осмыслить свой личный опыт: на этот раз сложных отношений с матерью и рефлексию по поводу того, хочет ли она сама стать матерью. В рецензии анализируются основные идеи автора книги по поводу того, насколько в современном мире высоки требования к матерям, как они переживают это давление, как понимается сегодня понятие «ответственного материнства». При этом большое внимание уделяется описанию соотношения биологического и социального в материнстве. Кроме научной литературы автор книги использует метод самонаблюдения, она подробно иллюстрирует свои соображения, базируясь на художественных фильмах, сериалах, художественной литературе. Не все главы книги представляются одинаково убедительными, тем не менее, «Дорогие дети» представляют существенный интерес для социологов, психологов, демографов, специалистов в области гендерных исследований.
От просторов к пространствам: о поиске географии в книге о географии
Authors: Попов Фёдор Аркадьевич
Published: August 2018

Размышления о невозможности комплексного изучения миграций без обращения к географии как способу познания действительности. На примере коллективной монографии, созданной без непосредственного участия географов, показывается, что пространственная природа феномена проявляется даже при формальном отсутствии внимания к ней. Коллективный труд по исследованию миграций сравнивается с воображённым атласом: за каждым из разделов монографии стоит своя воображённая карта или серия карт, которые связаны между собой как общей структурой книги, так и множеством внутренних отсылок и перекличек.
YEP Medium v1
Authors: Vaulot Daniel
Published: August 2018

Use in the RCC for Schizochytrium
Experimental test of the intrinsic dimensionality of Hounsfield unit measurements v1
Authors: Levine Zachary , Peskin Adele , Holmgren Andrew , Garboczi Edward
Published: August 2018

Purpose: The immediate purpose is to determine the maximum number of tube voltages which are useful for acquiring information in medical computed tomography (CT) along with specific linear combinations of quantities of chemical elements which are observable with the current generation of medical CT machines. The larger purpose is to encourage the development of CT reconstruction algorithms based on the material basis described herein and, ultimately, to tie the measurand of CT to the International System of Units (SI).Methods and Materials: Experimentally, we scanned samples at four tube voltages, namely 80 kV, 100 kV, 120 kV, and 140 kV on a medical CT. The samples included 30 small plastic bottles of powders containing various compounds spanning the atomic numbers from 1 to 20, along with a similar bottle of water and one of air. Using the known chemical formulas and measured masses, we formed a matrix giving the number of Hounsfield units per (mole per cubic meter) at each tube voltage for each of 13 chemical elements. Theoretically, we took the XCOM cross sections, combined them with the tungsten anode spectral model using interpolating cubic splines (TASMICS), with a one-parameter filter, and a simple detector model, and created a similar matrix for the first 20 chemical elements. In the training phase, we found a best-fit parameter. We define the molar Hounsfield unit (HU) potency as the difference in HU values that anadded mole per cubic meter in a given voxel would add to the measured HU value. We built a matrix of molar potencies for each chemical element and tube voltage and performed a singular value decomposition (SVD) on these. In a validation phase, we compared the model predictions to Hounsfield unit measurements on three CT calibration phantoms taken from the literature.Results: We found that we could predict the measured HU potency for the chemical elements within our model. The singular values and singular vectors of the model and powder measurements are in substantial agreement. Application of the Bayesian Information Criterion (BIC) shows that exactly two singular values and singular vectors describes the results over four tube voltages. We were able to give a good account of the HU values measured for the calibration phantoms at several tube voltages for several vendors within our model withoutintroducing additional parameters.Conclusions: Measurements at two tube voltages are necessary and sufficient to extract the available material dependent information in medical CT. The linear combination of elements that can be observed using a medical CT have been characterized, providing a material basis for use in dual-energy reconstruction. This approach provides groundwork for improved reconstruction and for the link of Hounsfield units to the SI.
POIRIER_ET_AL_FOODMICROBIOME_16S_GYRB_DATASET v2
Authors: Chaillou Stephane
Published: August 2018

Food Microbiome dataset for comparison of 16S V3-V4 rDNA amplicon sequencing and gyrB amplicon sequencing.
The Impact of Education on the Youth Labour Market in Serbia
Authors: Pavlović Dejana , Domazet Ivana S. , Lazić Milena
Published: August 2018

The high rate of youth unemployment is an issue that is largely present in developing countries, such as Serbia. The results of the research will provide a major contribution whether education has an impact on the labour market among young people in Serbia. Decision tree was performed to identify impact constructs. In order to define public policies, an insight is provided into the characteristics of young people that largely contribute to the probability of being employed. The results showed that education has an impact on youth unemployment. Results of the research will be useful for decision makers in the implementation of a strategic model of the labour market. Theoretical and practical implications are discussed in the paper.
Revisiting Binarism: Hollywood’s Representation of Arabs
Authors: Chahdi Chadi
Published: August 2018

This article throws into relief the tropes by which Hollywood has come to churn out identical Arabs bent on destruction, yet ones that need to be salvaged. However, the salvation process is never complete(d) because the Arabs are not worthy of redemption, which sinks them further into the abyss of darkness. The representation of Arabs in Hollywood movies mostly aims at disseminating a stereotypical image that demeaninglyhomogenizestheir cultures and identities. Hollywood here participates in a process of imperial hegemony. The repetition in producing suchimagined cultureof Arabs and Muslims is seen as a hegemonic act of naturalizing orientalist ideologies that tend to over-idealize the Western culture and relegate the Eastern counterpart. In this light, this article attempts to deconstruct the visual representations (ideologies) produced to malign and vilify Arabs in Hollywood movies. Such movies are always premised upon a structure of binary oppositions that establish a motion picture of a civilized center dominating the margins, the so-called uncivilized subjects.
Sexual behaviour of pregnant women attending antenatal care clinic at Assiut Women's Health Hospital, Egypt
Authors: Bahloul Mostafa , Othman Ahmed M. , Abbas Ahmed M. , Salman Safwat A. , Sayed Gamal H.
Published: August 2018

Background: The aim of the current study was to describe the knowledge, attitudes, beliefs and behavior of pregnant women regarding sexuality during pregnancy. Study was carried out at Women’s Health Hospital, Assiut University, Egypt.Methods: A cross-sectional study included pregnant women at different gestational ages between December 2016 and Jun 2017 recruited consecutively at the antenatal outpatient clinic of women’s Health Hospital at Assiut University. We used the Arabic version of the Female Sexual Function Index (Ar-FSFI) in the interview to evaluate the sexual functions or problems during the last month. The cut-off score used to indicate sexual dysfunction was 28.1. The obtained data were analyzed by means of SPSS software (version 22.0) and p<0.05 was taken as the significant level.Results: The study included 140 pregnant women at different ages and trimesters and also at different socio-economic states. Concerning the level of knowledge, the classification in recorded a mean score =11.91±4.05 which revealed a level of knowledge below average. Regarding the extent of beliefs in relation to sexuality during pregnancy, the mean score=2.72 of the respondents’ beliefs means that the impact of the beliefs regarding sexuality during pregnancy was weak among respondents. On assessing their perceptions about sexual intercourse during pregnancy, majority of them [130 (93.1%)] felt that sex have no negative impacts on pregnancy while 10 (6.9%) opined that sex during pregnancy had negative effects. Perceived negative effects of sex during pregnancy included vaginal bleeding and miscarriage.Conclusions: The low rate of sexual activity in our study, regardless question about the taboo of sexual intercourse during pregnancy, could be related to a cultural background in which women avoid speaking about their desires and sexual needs.
Study of perinatal outcome of labour complicated with meconium stained liquor
Authors: Patil Asmita N. , Inamdar Misbah M. , Senapati Jaynarayan B.
Published: August 2018

Background: Meconium stained amniotic fluid occurs in 9 to 20% of deliveries. It has long been implicated as a factor influencing foetal wellbeing during the intrapartum and postpartum period. Many authors have suggested that the type and the time of passage of meconium are most significant factors affecting foetal outcome. This study was carried out to find out the effect of meconium stained liquor during labour and its perinatal outcome.Methods: This prospective cross sectional and comparative study was carried out in a tertiary care hospital over a period of 1 year. The study group comprised of 118 women having MSAF during labour and the comparative group of 118 women with clear amniotic fluid which were randomly selected. The demographic data, obstetrical history, intrapartum findings and Apgar score were documented on predesigned proforma. Data collected was analysed using student t-test, chi square test, Z test for comparison of proportions and coefficient of variation for comparison of consistency of distributions.Results: Out of 1192 cases studied 118 cases showed presence of meconium stained liquor (9.89%). Caesarean section was performed in 41.52% cases with meconium stained liquor versus 31.35% in clear liquor group. Apgar score at 1 minute was significantly lower in meconium stained liquor (p<0.01). In meconium stained liquor group 42.37% foetuses had normal, 36.44% had suspicious and 21.18% had abnormal heart rate patterns respectively. There was no significant difference in the number of cases requiring NICU admission in meconium stained liquor (14.4%) and clear liquor groups (9.3%) (Z=1.214, P>0.05).Conclusions: Meconium staining is a commonly observed phenomenon. labour complicated with thick meconium stained liquor should ideally be categorised in to high risk obstetrics and managed in tertiary care with consultant obstetrician, consultant neonatologist and NICU in order to improve the perinatal outcome.
Preoperative prediction of surgical outcome in advanced ovarian cancer by computed tomographic scan and Eastern Cooperative Oncology Group-performance status
Authors: S. Nithya , D. Jayalakshmi , Barathi Deepak , Dubashi Biswajit
Published: August 2018

Background: Ovarian cancer represents the sixth most common cancer in women with almost 2 lakh new cases diagnosed every year. Present study was done to investigate the role of preoperative Computed Tomographic scan (CT) and Eastern Cooperative Group Performance Status (ECOG-PS) in the prediction of surgical outcome in advanced ovarian cancer.Methods: It is a Prospective cohort study of 41 cases of advanced ovarian cancer. Patients fulfilling the inclusion criteria were included after obtaining informed consent. A detailed history with general examination of the patient and relevant preoperative investigations were carried out. A preoperative Contrast Enhanced Computerised Tomography scan (CECT) was obtained and relevant CT parameters were analysed by a senior radiologist. Surgical outcome and its correlation with the CT scan findings and ECOG-PS were calculated by statistical analysis.Results: Among the 41 patients 23(56%) had optimal cytoreduction. Among the CT parameters, omental extension to spleen, stomach, lesser sac (specificity-100%, PPV-100%, NPV-60.5%), suprarenal lymph nodes >1 cm (specificity-100%, PPV-100%, NPV-59%), infrarenal lymph nodes >2 cm (specificity-95.7%%, PPV-66.7%, NPV-59.7%) were found as better predictors for suboptimal cytoreduction. ECOG-PS didn’t have a statistically significant association with surgical outcome.Conclusions: Presence of omental extension to adjacent structures and suprarenal lymphnodes on CT scan predicted suboptimal cytoreduction with 100% specificity. Though CT served as a valid tool in the preoperative prediction of surgical outcome in advanced ovarian malignancy, these results cannot be extrapolated to the general population nor can this be universally applied in determining the mode of treatment. Future studies are required to validate the findings of the present study on a larger scale.
Correlation of Doppler assessment of fetal aortic isthmus with perinatal outcome in intrauterine growth restriction
Authors: Tantuway Bhoomika , Mala Y. M. , Garg Anju , Tripathi Reva
Published: August 2018

Background: The objective of the present study was to find out association between aortic isthmus Doppler changes and perinatal outcome in growth restricted fetuses with placental insufficiency.Methods: It is a prospective case control study, cases were 43 pregnant women with fetal growth restriction (FGR) with abnormal umbilical artery (UA) Doppler while 43 pregnant women with FGR but normal UA doppler, matched with period of gestation were taken as control. The direction of blood flow in aortic isthmus studied which may be antegrade, absent or retrograde and correlation between qualitative parameters of umbilical artery, aortic isthmus and ductus venosus were studied. Quantitative parameters, PI and RI were also calculated. Patients were managed as per hospital protocols. Perinatal outcome and any adverse event e.g. stillbirth, neonatal death, respiratory distress syndrome, intensive care unit stay >14 days etc. was noted.Results: The number of intrauterine death (IUD) and still birth was increased in women with absent and retrograde flow in aortic isthmus, 66.7% and 71.4% respectively (p value <0.001). Retrograde blood flow in the aortic isthmus is consistently associated with absent or reverse end diastolic velocity in umbilical artery and ductus venosus.Conclusions: Doppler of aortic isthmus is an additional parameter to assess severity of FGR. It plays an important role in termination of preterm FGR fetuses.
A prospective study of insulin resistance among infertile women with polycystic ovarian syndrome
Authors: Smitha M. , Jyothi S. , Acharya Anand
Published: August 2018

Background: Insulin plays a key role in producing hyperandronism and suppression of insulin secretion in women with PCOS is associated with decreased cytochrome P450c17α. cytochrome P450c17α is a bifunctional enzyme present in ovary is a key enzyme for androgen synthesis. Various studies have been conducted regarding association of insulin resistance with PCOS in infertile patients but there is no study is available about this in our area. So we have designed this study to evaluate insulin resistance in infertile patients with PCOS in rural Andhra Pradesh.Methods: The study population include 180 untreated patients who attended the infertility clinic in outpatient department of obstetrics with infertility due to different cause that include polycystic ovarian disorder also. They have been selected for this study randomly based on inclusion and exclusion criteria.Results: The mean value of glucose insulin ratio was 5.146+2.611 in group A and 8.62 + 5.55 in group B the P value was 0.004909. The mean of LH/FSH ratio was 1.78+0.423 in group A and 1.02 +0.042 in group B. The P value was <0.00001. The mean of HOMA IR was 8.375+ 2.68 in group A and 3.03+ 1.09 in group B, with P value <0.00001. The mean value of QUICKI was 0.2815+ 0.0002875 in group A and 0.347+0.10 in group B with P value <0.00001. Mean serum DHEAS level was 275.59 + 53.48 in infertile patient with PCOS and 208.48 + 36.11 in infertile patients without PCOS. The p value was 0.00012.Conclusions: Based on present study we would like to conclude that the body mass index was high among infertile women with PCOS and a greater number of women presented with acanthosis. There was decrease insulin sensitivity and increase insulin resistance among infertile women with poly cystic ovarian disease, in rural area of Andhra Pradesh and that is not different from the study of other part of world.
Unusual presentation of uterine rupture following laparoscopic myomectomy: a case report and literature review
Authors: Cheong Cassandra P. S. , Tan Andy W.K. , Tan Lay Kok , Yu Su Ling
Published: August 2018

Laparoscopic myomectomy is preferred to the laparotomy approach as the former promises a better postoperative course, with fewer complications and faster recovery. It is increasingly performed in younger women in recent years. However, although rare, uterine rupture is an important and dangerous complication. Authors report a case of 36-year-old lady who presented at 23 weeks and 4 days gestation of an in vitro fertilization (IVF) dichorionic diamniotic twin pregnancy with spontaneous uterine rupture. She underwent a laparoscopic myomectomy three year prior for a 4.5cm fundal fibroid. Her presenting symptoms include acute onset of epigastric pain. Uterine rupture was confirmed using Computed Tomography scan. She underwent an exploratory laparotomy and the placenta was found extruding from a 4cm defect on the posterior fundus along the previous myomectomy scar with active bleeding. Current literature suggests it is difficult to predict when uterine rupture may happen. Proper selection criteria for suitable cases may allow trial of labour after myomectomy to be a viable option. Potential considerations include interval between myomectomy and conception, scar integrity, method of repair, and the use of electrocoagulation. This case reports the worrying features of an early antepartum rupture presenting with atypical symptomatology. In pregnant patients presenting with abdominal pain or haemodynamic instability, it is imperative to consider uterine rupture so as to perform timely intervention. Those with a history of laparoscopic myomectomy should be considered high risk and counseled about the risk of rupture with extensive discussion about mode of delivery.
Diagnosing celiac disease: a review of diagnostic modalities of celiac disease
Authors: Javaeed Arslaan
Published: August 2018

Celiac disease is known as gluten-sensitive enteropathy. By enteropathy it simply means it is pathology of the gastrointestinal tract and that is why diarrhea (a common GI symptom) is usually one of the commonest presentations of celiac disease. So, it is safe to define celiac disease as an autoimmune disorder that mainly afflicts the small intestine. By autoimmune authors are referring to a disorder in which the body’s immune system works against the body itself. It is a chronic disorder where the sufferer is not able to tolerate gliadin, which is the alcohol soluble component of gluten. Gluten of course is a protein that is usually found in common foods like barley and wheat. Celiac disease which can also be regarded as celiac sprue has a genetic and immunological aspect to its etiology both of which would need to be considered when screening anyone for celiac disease.
Current prevalence of falciparum malarial infection among HIV patients on highly active antiretroviral therapy in university of Uyo teaching hospital, Uyo Nigeria
Authors: Amadi Chijioke Patrick , Ikon Grace Michael , Inyang Udoinyang Clement
Published: August 2018

Background: Malaria and HIV remain two leading causes of morbidity and mortality to patients in developing African countries. Both infectious diseases have been documented to account for an enormous morbidity and mortality in Sub-Saharan Africa. The geographical overlap in sub-Saharan Africa and South America has led to similarities in co-infection with Plasmodium and HIV, this has resulted in the quick progression and severity of both diseases particularly among the poor, and contributes to the poverty of sub-Saharan African nations by taking a toll on young people who contribute greatly to the workforce of the economy. The present study was conducted to determine the prevalence of malarial infection in HIV patients receiving high active antiretroviral therapy in university Uyo teaching hospital, Uyo Nigeria.Methods: A predesigned structured questionnaire was administered to collect bio data and socio-demographic characteristics from the participants consisting 35 HIV infected adult patients and 32 non HIV infected adults as controls. All HIV patients were receiving HAART during this study. The HAART regimens used by HIV infected patients consist of zidovudine, lamivudine, efavirenze, and nevirapine.Results: About 5 (14.2%) HIV patients on HAART had falciparum malaria. No falciparum malaria was detected in HIV negative participants. Of the five positive malaria cases detected in HIV patients, 8.5% were females and 5.7% were males.Conclusions: There was no significant difference of malaria parasite infection by gender (P = 0.88), age group (P = 0.17), and CD4+ count (O.R:1.0, P = 0.81).
Abdominal incisional hernia: retrospective study
Authors: Shukla Archana , Ahmed Sameer
Published: August 2018

Background: Incisional hernia presents as herniation or protrusion occurring along a prior abdominal scar. It is a known complication of abdominal surgery. They are the second most common type of hernia after inguinal hernias. This study was undertaken to study the incidence and various risk factors leading to incisional hernia.Methods: It is a retrospective study done in Gandhi Medical College, Bhopal; Department of Surgery during January 2017 to January 2018. All the cases were analyzed in various aspects like age, sex, relative incidence, clinical presentation, nature of previous operation, site of previous scar, precipitating factors like obesity, wound infection, abdominal distension.Results: The incidence is around 18.5%. Patients in the age group of 30-50 years found to have highest incidence of incisional hernia. Females outnumbered the males with the ratio of 6:1. Incisional hernia was more common in patients with previous history of gynecological operation. Most of the patients presented with incisional hernia in the infra umbilical region.Conclusions: Incisional hernias can be prevented by avoidance of midline incisions, especially in the infra umbilical region. Mesh repair results in less post-operative complications provided drains are used.
Introduction of near peer assisted learning approach in teaching proper hand scrub technique among undergraduate students
Authors: Sangwan Vijayata , Sangwan Mukesh , Siwach Sunita , Khandelwal Shivani , Lakra Pinky , Mahendru Rajiv
Published: August 2018

Introduction: In near peer assisted learning (NPAL)tutor is of the same level of education as with one to two years senior but within the same broad grade. Literature suggests that it fosters qualities like leadership, self-confidence and mentoring in tutors with simultaneous provision of a cordial learning environment to tutees. With this study we introduced NPAL in our newly established institute and assessed its feasibility, student’s perception, future applicability.Method: After having ethical clearance from institution, the students and faculty of Department of Obstetrics and Gynaecology were sensitized. The interns posted in labor room were designated as tutors and maternity students were included as tutees. The surgical hand scrub was the topic of teaching. The faculty taught interns and assessed, then interns taught maternity students and they were assessed by faculty members. The interns were again assessed by faculty. Afterwards both these interns and maternity students supposed to work together in labor room, the feedback was taken from all with a structured questionnaire using Likert scale.Result: The results were encouraging from all the corners, the tutors, tutees and faculty agreed that NPAL is a better method of teaching strongly enhancing the learning of tutors and their communication skills and develops positive attitude towards teaching as a part of their profession. The tutees found a cordial learning environment with a cognitive congruence with their tutors and felt very comfortable while working with them. Faculty also showed a positive attitude towards NPAL.Conclusion: NPAL is a good adjunct to standard teaching but could not substitute standard teaching.
Incidence of biliary complications in living donor liver transplantation
Authors: Varghese Joseph
Published: August 2018

Background: Liver transplantation is a widely accepted treatment for end stage liver diseases and selected cases of hepatocellular carcinoma, if it is limited to the liver. Biliary complications such as biliary strictures and bile leaks after the liver transplantation remain the major cause for morbidity and mortality. This study was aimed to estimate the incidence of biliary complications in live donor liver transplantation (LDLT) patients and the rate of radiological intervention in its management.Methods: Case records of LDLT patients during the past two years were retrospectively studied to estimate the incidence of biliary complications. Biliary complications were diagnosed based on clinical features like pain, fever, jaundice or increased bile from biliary drains. The patients were imaged using ultrasonogram, computed tomogram, magnetic resonance imaging or Endoscopic retrograde cholangiopancreatography (ERCP) for any biliary strictures and leaks, choledocholithiasis or sphincter of oddi dysfunction. The rate of ERCP and Percutaneous Trans Biliary Drainage (PTBD) interventions in these patients was recorded.Results: Fifty cases of post LDLT patients (both prospective and retrospective) were analysed in the study. The incidence of biliary stricture was 12% (6/50) and among the 6 patients with biliary stricture, 4 had bile leak. Among the total cases, the incidence of biliary leak was 8%. Eighty three percent of the biliary complications were managed by ERCP, whilst 17% by PTBD.Conclusions: The incidence of biliary stricture was 12% and biliary leak was 8%. The biliary complications were managed by ERCP in 83% and percutaneous approach in 17% of cases.
Anatomical variations of sphenoid sinus on multi-detector computed tomography and its usefulness in trans-sphenoidal endoscopic skull base surgery
Authors: Lokwani Manisha S. , Patidar Jayant , Parihar Vijay
Published: August 2018

Background: Knowledge of sphenoid bone and sinus anatomy and its variations is of central importance in transsphenoidal endoscopic skull base surgery. It allows endoscopic surgeon to safely approach the sella turcica, anterior skull base and orbit. The aim of the study was to evaluate the different anatomical variations of the sphenoid sinus that are relevant to trans-sphenoid endoscopic skull base surgery on multi-detector computed tomography.Methods: A prospective observational study of the CT analysis of the anatomical variations and various dimensions of sphenoid sinus relevant to trans-sphenoidal endoscopic neurosurgery was performed in 260 patients (173 male; 87 female).Results: The average presellar width of sphenoid sinus on axial CT scan images was 11.75mm (7.2 to 18.6mm). Average value of maximum width of sphenoid sinus was 30.52 mm (13.1 to 42.2 mm). The most common pattern of inter-sphenoid septum was single septum which was present in 207 patients (79.61%); double inter sphenoid septum in 47 patients (18.1%) and diverging septa in 13 patients (5%). 138 out of 260 subjects (53%) showed at least one septum attached to either carotid protuberance. Most common pattern of pneumatization in sphenoid sinus was sellar type (63.46%). Average suprasellar depth was 10.78 (5.4 to 18.7mm). Average presellar depth of sphenoid sinus was 13.47mm (8.1 to 22.5mm). Average infrasellar depth of sphenoid sinus was 25.46mm (11.9 to 37.9mm). Average presellar height of sphenoid sinus was 21.27mm (13 to 27.6mm).Conclusions: A preoperative review of the sphenoid sinus anatomy by CT allows safer endoscopic management of skull base pathology preventing injury to vital structures surrounding the sphenoid sinus.
Isobaric levobupivacaine a better and safer substitute for spinal anaesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries
Authors: Hoda Wasimul , Kumar Abhishek , Roychoudhury Priodarshi
Published: August 2018

Background: Bupivacaine being the drug of choice for spinal anaesthesia is associated with serious cardiac toxicity. Levobupivacaine and ropivacaine, both being the two S enantiomers of bupivacaine can be a safer alternatives with better cardiovascular safety. Hence, the clinical efficacy of both were assessed and compared in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double blind study was done in 68 adult posted for elective lower abdominal and lower limb surgeries under spinal anesthesia. They were randomized into 2 groups. About 3ml isobaric levobupivacaine 0.5% (15mg) was given in group A and 3ml isobaric ropivacaine 0.5% (15mg) was given in group B. Onset, duration of sensory and motor blocks, time for maximum sensory and motor block, time for 2 segment sensory regression and haemodynamic parameters were recorded and analyzed.Results: All patients achieved a sensory block of T10 dermatome. Onset of sensory blockade at T10 was similar in both groups, group A (5.71±1.31min) and group B (5.94±1.72min). Time from injection to two dermatomal regression was 129.68±15.54min in group A and 111.38±22.35min in group B. Onset of Bromage score of 1 in group A was 4.68±1.27min and in group B was 6.44±1.64min. The mean duration of motor and complete motor block was prolonged in group A patients (197.74±18.51min, 168.82±17.90 min) as compared to group B (131.88±20.41min, 106.71±10.85min).Conclusions: Isobaric levobupivacaine was found to be a better and safer substitute for spinal anesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries.
Association between serum zinc level and simple febrile seizures in children: a hospital-based study
Authors: Saqib Najmus , Qazi Mahvish
Published: August 2018

Background: Febrile seizures are the most common cause of convulsions in children and a frequent cause of emergency hospital admissions. There are different hypothesis about neurotransmitters and trace element (such as zinc) changes in cerebrospinal fluid and serum, which can have a role in pathogenesis of febrile convulsions. Hence we want to study this association in our set up. Objectives was to study the association between serum zinc levels and febrile seizures in childern in our set up.Methods: This hospital based, prospective case control study was done in SKIMS Soura Srinagar, Kashmir (J and K), India for one-year period from August 2015 to July 2016. A total of 100 children aged 6 months to 6 years admitted in the hospital presenting with febrile seizures after fulfilling our inclusion and exclusion criteria were enrolled for the study. Informed consent was taken from their attendants and classified into 2 groups of 50 each. Patients with history of simple febrile seizures were taken as cases and those with fever without seizures as controls. A detailed history was taken, and complete physical examination was done on the patients and recorded on a precoded and pretested proforma. Blood was collected within 12 hours of admission and serum zinc levels were estimated. For statistical analysis, SPSS 17 program using t-test was employed. Chi-square test was performed to compare proportion between 2 or more discrete variables. P<0.05 was considered statistically significant.Results: Out of 100 children enrolled, male to female ratio was 1.63:1. Majority of the children were between 6 to 12 months (36%). The clinical presentation comprised of mainly non localized fevers majority of which had clinical evidence to suggest viral etiology (60%), followed by ARI (20%), ASOM (10%), UTI (6%) and bronchiolitis (4%). Mean serum zinc level in cases was 30.96±7.93ugm/dl and in controls it was 35.95±9.25ugm/dl. Serum zinc level was found significantly low in cases of simple febrile seizures as compared to controls (P<0.05).Conclusions: This study reveals that there is positive correlation between low serum zinc levels and febrile convulsions.
Spontaneous intravesical knotting of infant feeding tube: a rare case report
Authors: Gadhvi Ashvin S. , Gadhvi Udit I. , Thakkar Nimesh B. , Shah Nidhi D. , Zapadiya Ranjit
Published: August 2018

Infant Feeding tube is universally used in Paediatric Patients for many diagnostic as well as therapeutic purposes. Intravesical knotting of IFT is rare but having significant morbidity. We here present such a rare case report in 6 month old patient treated endoscopically. Sometimes it is very difficult to remove knotting with various techniques discussed later, but it may cause more trauma to urethra. There are only few reported cases worldwide about it in few journals. But Endoscopic removal being safe among all. In such Urological Emergency, always early Identification is most important to prevent further complications. As neonate and infant’s urethra is small compared to the available smallest Foley catheter (8Fr), a 5 Fr and 8 Fr feeding tubes are practical alternatives to drain urine from the bladder. Intravesical catheter knotting of small feeding tubes placed as urinary diversion from the bladder is rare. The first case of catheter knotting in a pediatric patient was reported in 1976.
Stenosis in single coronary artery originating from right sinus of valsalva: asymptomatic upto sixth decade of life
Authors: Subramanyam Kasam , Dangeti Guru Kiran , Ramalingam Rangaraj R. , Moorthy Nagraj S.
Published: August 2018

Among all coronary anomalies, the prevalence of single coronary artery (SCA) originating from right sinus of Valsalva is 1.3%. Here, we report a rare case of a 60-years-old male serendipitously diagnosed with SCA originating from right aortic sinus with pre-pulmonic course of anomalous left coronary artery (LCA). His angiogram revealed 90% stenosis in distal right coronary artery with normal anomalous LCA. Thus, the patient was treated with percutaneous coronary intervention using a stent and was found stable post-procedure.
The effect of polypropylene mesh on different layers to the formation of collagen type I/ III ratio and total collagen density in incisional hernia repair
Authors: Yur Mesut , Çetinkaya Ziya , Kuloğlu Tuncay , Dabak Dürrin Özlem , Aygen Erhan , Doğru Osman
Published: August 2018

Background: In incisional hernia patients, collagen type I/III ratio and total collagen density (TCD) emerges a main etiological factor. If they are low, recurrence risk can be high. The aim of this study was to determine the ratio of collagen type I/III and TCD after incisional hernia repair in different layers with polypropylene mesh.Methods: In the study, 40 Wistar Albino rats were used. They were divided into four equal groups: control, preperitoneal, intraperitoneal and onlay. In control group, defect was repaired with prolene suture. In other groups, prolene mesh was placed to the different layers. Incisions were reopened 30 days later, and tissue samples were taken. Samples were stained by double-immunohistochemical methods and examined under light microscope.Results: Collagen type I/III ratio and TCD was highest in preperitoneal group. Intraperitoneal group was the second highest group. There was no difference between onlay and control group for collagen type I/III ratio except TCD. There was a significant correlation between TCD and collagen type I/III ratio in all samples.Conclusions: Mesh repair in different layers has an effect on TCD and collagen type I/III ratio in incisional hernia repair. Preperitoneal layer is better than other layers.
Nephroureterectomy versus pyeloplasty for giant hydronephrosis in children with upper urinary tract obstruction; perspectives from a tertiary health facility in Southern Nigeria
Authors: Okoro Philemon E. , Ekeke Ngozi O.
Published: August 2018

Background: Unrecognized or neglected cases of obstructed upper urinary tract in children can cause marked dilatation and structural damage to the ureters and kidney/s. In our region, many of such unrecognized obstructions result in giant hydronephrosis with resultant poor outcomes of pyeloplasty. We present our perspective of such giant hydronephrosis and make a case for straight nephroureterectomy rather than pyeloplasty which has been our standard treatment.Methods: This is a review of cases of congenital upper urinary tract obstruction with giant hydroureteronephrosis seen in children in our practice between March 2008 and February 2017. Case notes of patients who were managed within the period were retrieved to extract relevant data. Data obtained included the biodata, presenting features, dimension of renal pelvis and ureter at imaging and intraoperatively, treatment offered, outcome as at one-year follow-up. Results were subjected to simple statistical analysis.Results: There were 39 patients and they comprised 22 (56.4%) males and 17 (43.6%) females. Their age range was 3 to 14 years with a mean of 7 years. The most consistent clinical feature was abdominal distension. Five (12.8%) patients had abnormality of renal function preoperatively. The obstruction was unilateral in 30 (76.9%) cases and bilateral in 9 (23.1%) cases giving a total of 48 obstructions. All the patients were operated on. Complications encountered were mostly related to patients in whom we performed pyeloplasty. There were three mortalities related to sepsis and end stage renal disease.Conclusions: Upper urinary tract obstruction is often recognized late in our practice. Abdominal swelling is a common presenting feature of upper urinary tract obstruction in our practice. It appears that in unilateral cases, nephroureterectomy is a safer and more effective treatment option than pyeloplasty in such late cases with giant hydronephrosis. There is need for a well-designed prospective study to evaluate the option of nephroureterctomy in these cases.