bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing the Link between Dollars and Decisions: A Multi-State Study of Campaign Contributions and Judicial Decision Making
Authors: Rebe Ryan J.
Published: July 2017

This article examines the causal connection between attorney contributions and judicial decisions in elective states.  The results show that contributions are a significant predictor of appellant success in state supreme courts when judges receive contributions from the attorneys for the appellant.  However, this relationship is contingent on the competitiveness of the judicial seat.  The analysis shows that judges who received a low percentage of the vote in the previous election are more likely to vote with contributors than judges who received a high percentage.  This evidence bolsters the argument that contributions directly affect decision making when judges feel electoral pressure.  The results also support the proposition that elected judges are more likely to vote with donors in states with nonpartisan ballots.  While the contribution amounts are higher in partisan states, the judges in the nonpartisan sample are more closely aligned with their contributors when it comes to decision making.
Electoral Incongruence and Delayed Republican Gains in Southern State Legislatures
Authors: Myers Adam
Published: July 2017

This paper investigates the impact of electoral incongruence – the tendency of Democratic state legislative candidates to perform better than their co-partisans in higher-level races – on partisan control of southern legislative chambers in the 1990s and 2000s. Using precinct-level data from five southern states, I examine incongruence between presidential and state house election results and show how such incongruence delayed the Republican consolidation of power in southern legislatures during this period. I then develop and test an account of electoral incongruence focusing on the tendency of older white southerners and those living in rural areas to split their tickets across state and federal offices, particularly when given the option of voting for conservative Democratic legislative incumbents. Lastly, I explore possible reasons for electoral incongruence’s recent decline. The results of the paper provide important insights concerning the delayed Republican takeover of southern legislatures, an underexplored aspect of southern partisan change. They also speak to longstanding questions in the state politics literature about the extent of autonomy that state party systems can hope to enjoy in a highly nationalized era.
Public Attention and Head-to-Head Campaign Fundraising: An Examination of U.S. Senate Elections
Authors: Ellis William Curtis , Ripberger Joseph T. , Swearingen Colin
Published: July 2017

Does public attention to political candidates impact fundraising margins in U.S. Senate elections? Applying a novel conceptualization of public attention, we examine U.S. Senate elections from 2004 through 2014 and find that increases in relative public attention relate to increases in head-to-head fundraising margins in open seat races. We conclude by asking whether or not all attention to candidates is "good" attention. Evidence from the 2006 Allen/Webb election suggests that all attention is not "good" attention. This race demonstrates that candidates can supply attention-grabbing action that increases relative public attention while stimulating exceptional losses in relative fundraising margins. Further research must clearly theorize conditions under which supplying public attention-grabbing behavior may damage political campaigns.
Nomination of subcontractors in the UAE
Authors: Lawrence Michael
Published: July 2017

The UAE has benefited from tremendous growth since the discovery of oil there in the 1960s. Such growth continues despite the current low oil price, providing ample opportunities for construction companies in the lead up to Dubai’s Expo 2020. The traditional form of contract based on the International Federation of Consulting Engineers (Fidic) forms continues to dominate the construction procurement scene, with the employer often nominating suppliers and/or subcontractors. This paper examines the contractual and legal pitfalls that the parties, in particular the employer, need to be aware of when nominating under the Fidic forms on contracts, where the governing law is that of the UAE. Parties must be careful when drafting the particular conditions of the contract in order to avoid inadvertently shifting the risks associated with nominated subcontractors and suppliers away from the contractor.
EDUCAÇÃO PERMANENTE E QUALIFICAÇÃO PROFISSIONAL PARA ATENÇÃO BÁSICA
Authors: Moreira Kênia Souto , Lima Cássio de Almeida , Vieira Maria Aparecida , Costa Simone de Melo
Published: July 2017

Objetivou-se analisar a avaliação das equipes de saúde da família quanto aos itens educação permanente e qualificação profissional para Atenção Básica. Pesquisa quantitativa, transversal e analítica, realizada em município polo ao norte de Minas Gerais. Os dados de 75 equipes foram coletados a partir da autoavaliação para melhoria do acesso e da qualidade da atenção básica, em 2014. Consideraram-se dois itens de padrão de qualidade em educação permanente e qualificação. A análise estatística foi realizada no Software IBM SPSS 22.0. Processaram-se análises bivariadas considerando o nível de significância p
DEPRESSÃO EM PACIENTES COM CÂNCER DE MAMA EM TRATAMENTO HOSPITALAR
Authors: Koch Marilena Olga , Zamian Regiane , Victor Graciana Lúcia Grespan , Segura Dora de Castro Agulhon
Published: July 2017

O presente estudo teve como objetivo avaliar a intensidade da depressão em pacientes diagnosticadas com câncer de mama em tratamento hospitalar em uma cidade da região Oeste do Paraná. Foi realizada uma investigação, em que os sujeitos envolvidos responderam a um questionário que faz referência aos sintomas e atitudes frequentes em pacientes depressivos, intitulado Inventário de Depressão de Beck (BDI). Foram avaliadas 20 mulheres, com média de idade 57,35 (±11,24). A análise evidenciou 70% de mulheres com grau mínimo de depressão, 15% com grau leve e 5% com grau moderado. Foi expressivo o percentual de pacientes que referiram não se sentir culpadas, punidas, decepcionadas consigo ou que perderam o interesse pelos outros. Concluiu-se que embora o câncer de mama ocasione repercussões psicológicas importantes para o desenvolvimento da depressão, a amostra da população estudada não pontuou sintomas depressivos graves.
ENFERMAGEM PEDIÁTRICA E O RELACIONAMENTO COM FAMILIARES
Authors: Teixeira Mariana de Ávila Pereira , Coutinho Milena Carine , Souza Ana Lucia Torres Devezas , Silva Renata Martins da
Published: July 2017

Objetivos: descrever a opinião da equipe de enfermagem sobre a participação de mães/familiares na assistência à criança internada; apontar as principais dificuldades referidas pela equipe durante a assistência à criança internada na presença dos responsáveis e analisar a influência do responsável da criança na qualidade da assistência prestada por essa equipe. Método: a coleta de dados foi realizada em dois hospitais, no município de Volta Redonda (RJ). Os sujeitos do estudo foram 36 profissionais da equipe de enfermagem que responderam a um questionário elaborado pelos próprios autores com questões abertas e fechadas. Estudo descritivo com abordagem qualitativa. Resultados: para maioria (81%) dos profissionais a presença dos pais é fundamental, porém podem existir dificuldades quando há intervenção dos pais durante os procedimentos invasivos. Conclusão: demonstra-se assim a importância da relação entre equipe e familiar para o desenvolvimento de uma assistência de qualidade à criança.
IDENTIFICAÇÃO DE NEAR MISS MATERNO EM UNIDADE DE TERAPIA INTENSIVA
Authors: Rudey Edson Luciano , Cortez Lúcia Elaine Ranieri , Yamaguchi Mirian Ueda
Published: July 2017

O objetivo deste estudo foi identificar os casos de near miss materno e listar indicadores de saúde entre pacientes internadas em Unidades de Terapia Intensiva - UTI. Trata-se de estudo transversal retrospectivo realizado na 15ª Regional de Saúde de Maringá-PR. Constatou-se que houve 37 internamentos, dos quais, 16 foram casos de near miss e três de morte materna. As principais complicações foram as doenças hipertensivas (45%), complicações pulmonares (31%) e hemorrágicas (24%). O procedimento invasivo mais realizado foi a transfusão de hemácias em 51% dos casos. Os casos de morte materna tiveram o maior número de critérios identificadores de near miss. A identificação em conjunto dos casos de near miss materno e morte materna pode melhorar o monitoramento dos cuidados obstétricos, tratando-se de um instrumento útil e viável a ser usado pelos comitês de mortalidade materna.
INCIDÊNCIA DA SÍNDROME DO COMER NOTURNO E COMPULSÃO ALIMENTAR EM ESTUDANTES DE NUTRIÇÃO
Authors: Souza Maria Alice Alves de , Gomes Verlene Caroline de Souza , Silva Emerson Iago Garcia e , Messias Cristhiane Maria Bazílio de Omena
Published: July 2017

O presente trabalho objetiva caracterizar a incidência da síndrome do comer noturno e a compulsão alimentar em estudantes do curso de nutrição. Trata-se de um estudo transversal de caráter analítico realizado em uma instituição de nível superior em Petrolina – PE. Foram aplicados três questionários: questionário de hábitos do comer noturno, a escala de ingestão compulsiva e o The Three factor eating questionnaire. Avaliaram-se 81 estudantes de ambos os sexos, com predominância do sexo feminino. Não houve associação significativa entre a síndrome do comer noturno ou a compulsão alimentar com as variáveis sexo e escolaridade. Em relação às variáveis comportamentais, a alimentação emocional foi o fator melhor relacionado ao descontrole alimentar e a restrição cognitiva tem pouca contribuição para o agravamento da alimentação descontrolada. O investimento no estudo dos transtornos alimentares é importante para a criação de uma intervenção adequada, com o intuito de reduzir incidência tanto da SCN como da compulsão alimentar.
PRESSÃO ARTERIAL ALTERADA EM ADOLESCENTES: ASSOCIAÇÃO COM FATORES DE RISCO ÀS DOENÇAS CARDIOVASCULARES DE SEUS PAIS
Authors: Kern Deise Graziela , Silva Priscila Tatiana da , Sehn Ana Paula , Silva Cristiane Fernanda da , Welser Letícia , Burgos Leandro Tibiriçá , Reuter Cézane Priscila
Published: July 2017

Este estudo teve como objetivo verificar se existe associação entre pressão arterial (PA) alterada em adolescentes com fatores de risco às doenças cardiovasculares de seus pais. Estudo transversal com 859 adolescentes, sendo 479 (55,8%) do sexo feminino, entre dez a 17 anos, estudantes de escolas da rede pública e privada, do município de Santa Cruz do Sul-RS. Considerou-se alteração na PA sistólica e diastólica os casos limítrofes e hipertensão. Foram utilizados os valores de razão de prevalência (RP), por meio da regressão de Poisson. Constatou-se elevado percentual de adolescentes com alteração na PA (19,4%), sendo esta superior entre os adolescentes, cujas mães apresentam hipertensão (RP: 1,09) e histórico de infarto (RP: 1,25). Entre os pais, somente colesterol elevado associou-se com a alteração da PA, nos adolescentes (RP: 1,08). Conclui-se que é elevada a prevalência de PA alterada em escolares, estando esta associada com fatores de risco às doenças cardiovasculares dos pais.
QUALIDADE DE VIDA DE PACIENTES TRANSPLANTADOS RENAIS APÓS LONGO PERÍODO DO TRANSPLANTE
Authors: Beber Gabrieli Costa , Fontela Paula Caitano , Herr Gerli Elenise Gehrke , Winkelmann Eliane Roseli
Published: July 2017

O objetivo do estudo foi avaliar a qualidade de vida (QV) de pacientes pós-transplante renal por meio de protocolo genérico e específico. A avaliação da QV foi realizada por meio de protocolo genérico (Medical Outcomes Study 36-Item Short-Form Health Survey - SF-36) e específico (Kidney Disease Quality of Life Short Form - KDQOL-SF). Foram avaliados 24 pacientes. Escores mais baixos foram obtidos nos domínios situação de trabalho (45,6±36,6), papel físico (63,5±42,3), dor (67,0±26,3), composição física (46,8±8,7) e composição mental (48,9±10,8) no protocolo KDQOL; e na saúde mental (53,3±8,2), dor (63,5±26,8), aspecto físico (63,5±42,3) e capacidade funcional (64,4±22,2) no protocolo SF-36. A QV em geral é boa nos pacientes transplantados renais com prejuízo nos domínios referentes às questões físicas, mentais e relacionadas à dor. O protocolo genérico obteve uma pontuação mais baixa que o protocolo específico. Houve correlação entre o questionário de QV específico e o genérico nos domínios correspondentes.
BIOMARCADORES NA RINITE ALÉRGICA: QUAL A IMPORTÂNCIA E POTENCIAL DIAGNÓSTICO?
Authors: Soares Marcos , Mânica Gabriela Gomes , Heck Thiago Gomes
Published: July 2017

O objetivo deste estudo é apontar quais os novos potenciais marcadores biológicos na rinite alérgica (RA). Buscou-se nas bases de dados Scielo e PUBMED artigos com os descritores “Rinite Alérgica” e “Biomarcadores” ou “Citocinas” ou “Interleucinas” ou “Eicosanoides”, bem como na língua inglesa. A perspectiva do uso de novos biomarcadores na rinite alérgica vem sendo pesquisada, visto que marcadores sensíveis e específicos da doença poderiam permitir rápido diagnóstico, avaliação do estágio da doença e estimação da resposta ao tratamento. Vários métodos para coleta de amostras não invasivos ou semi-invasivos nas vias aéreas oferecem a possibilidade de mensuração de uma grande quantidade de novos biomarcadores na RA. Como potenciais biomarcadores, a análise do perfil de citocinas nasais apresenta uma boa caracterização diagnóstica (IL-5 e IL-13), além da relação de severidade da doença (IL-9 e IL-17B). Como avaliação isolada, a dosagem sérica de Proteína da Célula de Clara (CC16) parece ter grande potencial, pois permite o diagnóstico e seus níveis estão inversamente relacionados com a severidade da doença. Além disso, a dosagem de FeNO vem como uma arma importante para predizer asma nos pacientes com RA.
EFEITOS DO LASER DE BAIXA POTÊNCIA NA REMISSÃO DE FERIDAS CAUSADAS PELA PSORÍASE VULGAR
Authors: Silva Maria Julia Schmitt da , Tavares Nathália Jaíne , Röhl Raquel Carolina Trevisan , Portolez José Luiz Marinho , Fréz Andersom Ricardo , Bertolini Gladson Ricardo Flor
Published: July 2017

Psoríase é um tipo de dermatose crônica de evolução variada representada por lesões eritemato-escamosas e alterações proliferativas e inflamatórias da pele, podendo ocorrer em todas as idades e gêneros. Este estudo teve como objetivo avaliar os efeitos do laser de baixa potência, 660 nm, na remissão e melhora do aspecto de feridas causadas pela psoríase em placa. Este é um estudo longitudinal, experimental, de caráter quali e quantitativo. A amostra foi composta por indivíduos com psoríase em placas em período exacerbado e que não estavam passando por nenhum outro tipo de tratamento. A amostra foi dividida em Grupo Controle (GC), que não foi submetido ao tratamento; e Grupo Tratamento (GT) que foi submetido ao tratamento com laser de baixa potência, 660nm. Nos resultados obtidos para GC, a evolução entre as avaliações da área das feridas foi de 83,80±11,96 cm² para 82,90±12,01 cm² (p>0,05), para GT, foi de 74,25±9,61 cm² para 56,25±24,36 cm (p=0,014); a análise qualitativa ratificou que a terapia com laser de baixa potência pode melhorar os aspectos físicos das feridas causadas pela psoríase em placa, bem como diminuir sua área total.
ANEMIA E PERFIL DE LIPÍDEOS EM GESTANTES VIVENDO COM O VÍRUS DA IMUNODEFICIÊNCIA HUMANA
Authors: Pimenta Ana Teresa Mancini , Melli Patricia Pereira dos Santos , Coutinho Conrado Milani , Duarte Geraldo , Quintana Silvana Maria
Published: July 2017

A infecção pelo HIV associa-se à anemia e às alterações no perfil de lipídeos de pessoas que vivem com o vírus. O objetivo deste estudo foi descrever a prevalência de anemia e as alterações nos níveis de lipídeos em gestantes que vivem com HIV/aids. O estudo foi do tipo coorte retrospectiva, realizado com 117 gestantes, em uso de terapia antirretroviral combinada, atendidas em ambulatório de pré-natal no período de 2010 a 2012, utilizando-se de dados secundários. A prevalência de anemia foi de 45,6% e nenhuma gestante apresentou anemia severa. Observou-se aumento progressivo das dosagens de colesterol total (p
PERFIL DAS MULHERES DIAGNOSTICADAS COM CÂNCER DE MAMA NO MUNICÍPIO DE MARINGÁ-PR
Authors: Brochonski Julia Wosch , Rodrigues Sabrina de Almeida , Manzotti Cristiana Aparecida Soares , Bernuci Marcelo Picinin
Published: July 2017

O câncer de mama é uma das neoplasias mais frequentes no mundo e um dos propósitos das instituições de saúde pública é aumentar os índices de diagnóstico precoce. Este estudo teve como objetivo verificar os fatores de risco, estadiamento dos tumores e analisar o tempo de investigação. Estudo descritivo realizado no centro de referência de câncer de mama de Maringá a partir da análise de prontuários de mulheres diagnosticadas com câncer de mama do tipo maligno em 2013 e 2014. Mais de 30% das pacientes diagnosticadas estavam fora da faixa etária de rastreamento e o diagnóstico foi tardio em quase 70%. Fatores de risco como obesidade, histórico familiar e uso de terapia de reposição hormonal estavam ausentes na maioria dos casos. O serviço mostrou-se eficaz na realização da biópsia e indicação do tratamento, porém muitos diagnósticos ainda são realizados em estágios avançados da doença sugerindo a necessidade de conscientização da população-alvo à realização dos exames preventivos.
RISCO PARA DESENVOLVIMENTO DE ORTOREXIA NERVOSA E O COMPORTAMENTO ALIMENTAR DE ESTUDANTES UNIVERSITÁRIOS
Authors: Vital Aline Nataly Soares , Silva Amanda Beatriz Aureliano , Silva Emerson Iago Garcia e , Messias Cristhiane Maria Bazílio de Omena
Published: July 2017

Avaliar o risco para o desenvolvimento de ortorexia nervosa e o comportamento alimentar de estudantes universitários. Pesquisa qualitativa/quantitativa de caráter descritivo e transversal, realizada em instituição de nível superior em Petrolina- PE. Utilizaram-se dois questionários na coleta de dados: o Orto-15 para avaliar o comportamento de risco para desenvolver a ortorexia nervosa, e um questionário de frequência alimentar para investigar o consumo alimentar. Avaliaram-se 40 estudantes, de ambos os sexos, a partir dos 18 anos, cursando o primeiro e sétimo período de bacharelado em educação física. Em relação à ortorexia nervosa, constatou-se que 33 (82,5%) indivíduos apresentaram comportamento de risco para desenvolvê-la, prevalentemente no sexo masculino (88%). Com relação à série do curso, os alunos do primeiro período apresentaram maior risco quando comparados ao sétimo período. Quanto ao comportamento alimentar, escolhas saudáveis predominaram. A partir da análise dos dados, houve prevalência do comportamento de risco para o desenvolvimento de ortorexia nervosa no público avaliado.
AVALIAÇÃO DA FLEXIBILIDADE E FORÇA MUSCULAR DE MEMBROS INFERIORES EM IDOSAS PRATICANTES DE HIDROGINÁSTICA
Authors: Oliveira Daniel Vicentini , Pereira Amanda Piva , Antunes Mateus Dias , Nascimento Júnior José Roberto Andrade do
Published: July 2017

Este estudo teve como objetivo avaliar a flexibilidade e força muscular de membros inferiores de idosas praticantes de hidroginástica no município de Sarandi, Estado do Paraná. Foram avaliadas 31 idosas praticantes de hidroginástica. Para a avaliação da flexibilidade foi utilizado o teste de Sentar e Alcançar e para a avaliação de força muscular de membros inferiores foi utilizado o teste de sentar e levantar de cadeira em 30 segundos. A análise de dados foi realizada por meio da estatística descritiva e inferencial.
Success factors in drug discovery and development
Authors: Wallmark Björn
Published: July 2017

The article aimed to give a personal perspective on drug discovery and development. The author has worked both in Big Pharma as a scientist and manager and more recently also in start-up biotech companies. Drug companies have played a major important role in improving population health and will continue to do so. The hurdles and costs for drug development have continuously risen without a parallel enhancement of productivity. There is no single explanation for this and the article outlines success factors and hurdles for effective drug development. Aspects of the external and internal environments that influence Big Pharma productivity is outlined and discussed.
The role of open innovation in biomarker discovery
Authors: Landeck Lilla , Lessl Monika , Busch Andreas , Gottwald Matthias , Asadullah Khusru
Published: July 2017

Precision medicine aims to treat diseases with special consideration for the individual biological variability.Novel biomarkers (BM) are needed to predict therapeutic responses and to allow for the selection of suitable patients fortreatment with certain drugs. However, the identification and validation of appropriate BMs is challenging. Close collaboration between different partners seems to be a key success factor. While the importance of partnerships and larger,well-established consortia in BM discovery such as the pharmaceutical industry and academic institutions is well understood and has been investigated in the past, the use of open-innovation models, also known as ‘crowd sourcing for biomarkers’, is still in its infancy. Crowd sourcing comprises of a — usually via internet — request for problem solution to an open group of users in a kind of an ‘open call’. The community (crowd) is asked to provide solutions. Since the application of the crowd sourcing method offers the possibility to collect as many as possible novel ideas from a broad community with different expertise, this approach is particularly promising for BM development. In this article we describe the first examples of open-innovation models, such as the ‘grants for targets’ (G4T) and biomarkers initiative ‘InnoCentive’ (innovation/incentive) platform. They may be a fruitful basis for collaborative BM development in the future.
Surgical audit of current management practices of ileal perforations presenting in a tertiary care institute of North India
Authors: Dalal Satish , Singh Mahavir , Kumar Dinesh , Saharan Amandeep , Bhatia Chiesel
Published: July 2017

Background: Small bowel perforation is one of the commonest causes of abdominal emergency in India and other tropical countries mostly due to high incidence of enteric fever and tuberculosis. Surgical approach to these patients is standard but the choice of procedure continues to be debated. It is very important to find the appropriate management of these patients to reduce high mortality and morbidity.Methods: This prospective study on 50 patients of perforation peritonitis with small bowel perforation. After initial resuscitation with intravenous fluids and antibiotics surgery was done by midline incision and three modalities of surgical techniques were compared i.e. primary closure of perforation, resection and anastomosis and ileostomy depending upon the general condition of patient and local condition of gut.Results: Out of 50 patients, ten underwent primary repair of perforation, four patients were managed with ileal resection and end to end anastomosis and rest 36 patient required faecal diversion in form of ileostomy. Two patients expired in post-operative period that were cases of abdominal tuberculosis.Conclusion: Primary closure of perforation is preferable in patients with single small perforation with healthy surrounding bowel. Resection anastomosis is advocated in multiple perforations of any size with localized peritonitis of diseased segment pertaining to good general condition of patient. Ileostomy is lifesaving procedure particularly in patients of fulminant enteritis and peritonitis of long duration with associated co-morbidities but requires second surgery for closure.
Comparison of open pancreatic necrosectomy with step-up minimally invasive approach as surgical treatment of patients with acute necrotizing pancreatitis
Authors: Khomiak Ihor V. , Rotar Oleksandr V. , Tereshkevych Ivan S. , Rotar Vasyl I. , Khomiak Andrii I. , Taneja Krishna Smriti
Published: July 2017

Background: Recent experimental and clinical researches improves our understanding of natural course of acute necrotizing pancreatitis and mechanisms of its complications development. Today there are no disagreements on the issue of timing and main indications for surgery of ANP, but different surgical approaches still exist.Methods: The analysis of treatment of 226 patients with acute necrotizing pancreatitis has been performed. The study group included 116 patients in whom consequently diapeutic methods, endoscopic and lumbotomic video-controlled pancreatic necrsequesterectomy, minilaparo and lumbotomy, in case of their insufficiency- “open” interventions on pancreas were applied. In 110 persons of the control group traditional surgical tactic with application of laparotomic procedures was used.Results: Sequential (step-up) implementation of mini-invasive surgery allowed to reduce the number of open wide operations by 3.4 times (p <0,05) and to postpone their performance: 85% of operations in the study group were performed after 4 weeks of the disease onset, in the control group only 33% (p <0,05). Compared with the control group the level of the first diagnosed OF after the surgery was significantly lower in patients undergoing preliminary mini-invasive surgery (12.5% versus 28.2%, p <0.05), the number of patients requiring prolonged intensive care after the surgery was significantly lower (17.5% versus. 38.2%, p <0.05). 4 patients of the study group died (versus 26 in the control group р<0,05).Conclusions: Application of step-up individualized approach in patients with acute necrotizing pancreatitis ensures a decrease in the number of laparotomic pancreatic necrosectomies and allows to postpone "open" operations for the period after the 4th week of disease onset which is accompanied by reduction of the incidence of postoperative organ failure and mortality.
Surgical management of umbilical and paraumbilical hernias
Authors: G. Purushotham , K. Revanth , M. Aishwarya
Published: July 2017

Background: To evaluate several types of surgical repair and their morbidity and post-operative complications.Methods: This was a prospective observational surgical study conducted in 50 cases of umbilical and paraumbilical hernias were included, the study was carried out by history, clinical examination, and appropriate investigations for operation were conducted. The patients were treated by either of the two surgical procedures Mayo’s repair or tension free repair using prolene mesh (mesh repair).Results: Umbilical and paraumbilical hernias were more common in females. Highest incidence was noted in 30-40 and 50-60 years age groups. Abdominal swelling was the most common complaint followed by pain. Post-operative complications like wound infection and seroma were noted in both the procedures. These hernias were operated by Mayo’s anatomical repair and tension free hernioplasty (mesh repair). Two recurrences were noted in patients operated by Mayo’s repair. There was no recurrence following mesh repair.Conclusions: Surgery was the main modality of treatment. Fewer complications like wound infection and seroma formation which can be managed conservatively by antibiotics, drainage of the seroma and pus with regular dressings were done. Study emphasizes tension free hernioplasty (mesh repair) to be the procedure of choice for the treatment of umbilical and paraumbilical hernias.
Study of clinico-pathological factors, indications and response to chemotherapy in breast cancer patients in a tertiary care hospital in south India
Authors: Shoeb Mohammad Fazelul Rahman
Published: July 2017

Background: Breast cancer is considered a systemic disease, surgical interventions on most of the patients can reduce the loco regional burden and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy. The objective of this study was to assess the clinic-pathological factors of patient presenting with breast cancer and to study the indications and response to chemotherapy for breast cancer.Methods: A prospective study of fifty patients was carried out at Victoria hospital and Bowring and Lady Curzon Hospital between October 2010 to October 2012 who underwent surgery, chemotherapy, radiotherapy and hormonal therapy.Results: Most patients presented with palpable axillary lymph nodes (64%) and belonged to stage II disease (50%). Invasive ductal carcinoma was seen in 90% of cases while medullary in 04%, colloid in 2% and Infiltrating lobular was seen in 04% of patients. Totally 64% cases were ER or PR+, and 36% were ER/PR- among the study participants. 70% of the patients operated had positive nodes. All 50 cases received chemotherapy. Chemotherapy was indicated in node positive patients and in patients whose tumour was measuring more than 1 cm. After follow-up of 50 patients for about a period of two years, 3 patients died, 4 patients had metastasis and in the remaining 47 surviving patients none of them had recurrence at the end of second year.Conclusions: Most cases and belonged to Stage II disease with Invasive ductal carcinoma being most common histological subtype seen in 90% of cases. FNAC is good diagnostic procedure cost effective and reliable as all cases post-operative HPE confirmed malignancy. Patients should be treated by chemotherapy in indicated cases, as carcinoma breast is a systemic disease and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy.
Clinicopathological study on presentation, diagnosis and management of liver abscess in Bhopal region
Authors: Siroliya Anshul , Damor Mahendra , Songra M. C.
Published: July 2017

Background: This prospective observational study is carried out to study cases of liver abscess and to determine demographic profile, spectrum of clinical presentations, aetiology, laboratory investigations. The objective of the study was to evaluate efficacy of Ultrasonographic (radiological) studies in determining the aetiology and in differentiating from other liver pathologies which may change the treatment outcome, bacteriological and serological characteristics, to study the influence of alcohol, diabetics and immunocompromised diseases (esp. HIV) leading to increased incidence of liver abscess and to evaluate efficacy, recurrence rate, complications, morbidity and mortality, duration of hospital stay associated with different management Strategies.Methods: This prospective observational study was carried out in Department of Surgery, Gandhi Medical College Bhopal and Associated Hamidia Hospital, Bhopal between July 2015 to October 2016.Results: Amoebic abscess (74%) is more common than pyogenic abscess (26%). Amoebic abscess is common in the age group of 31-50 years (73%), pyogenic in the age group of 51-70 years (73.1%). Male preponderance is found in case of amoebic liver abscess (90.5%). Right lobe involvement in common. Right upper quadrant pain, tenderness and fever are the most common clinical features. Alcoholism is most common risk factor (71.6%) and diabetes mellitus has strong association with pyogenic liver abscess (15.4%). E coli (19.2%) and klebsiella (11.5%) are the most common organisms cultured. Medical therapy is more useful in case of amoebic liver abscess (58.1%) while catheter drainage is more useful in case of pyogenic liver abscess (61.5%). Pleuropulmonary complications are much more common and complications rate is more common among pyogenic group.Conclusions: In our study, alcohol was found to be the most common predisposing factor for liver abscesses (68%), this underpin the finding of other studies. Amoebic liver abscess is a medically treated common infection prevailing in unhygienic condition, affecting people mostly between 30-40 years of age whereas pyogenic liver abscess patient commonly falls between 50-70 years age group. Both liver abscesses show a male preponderance. The present study also corroborates the catheter drainage procedure as a superior modality in treating pyogenic liver abscess.
Endoscopic management of pancreatic pseudocyst
Authors: Sharon Wormi
Published: July 2017

Background: Pancreatic pseudocyst is a well-known complication of acute or chronic pancreatitis, with a higher incidence in the latter. It represents 80-90% of cystic lesions of the pancreas. Benign and malignant cystic neoplasms constitute 10-13%, congenital and retention cysts comprising the remainder. Diagnosis is accomplished most often by computed tomographic scanning, by endoscopic retrograde cholangiopancreatography, or by ultrasound, and a rapid progress in the improvement of diagnostic tools enables detection with high sensitivity and specificity. Endoscopic drainage provides a good alternative or supplement to a surgical treatment of pancreatic pseudocysts.Methods: This is a prospective study of 26 patients diagnosed to have Pancreatic Pseudocyst and treated by endoscopic drainage from 1st June 2008 to 30th September 2010 in St. John’s Medical College and Hospital, Bangalore. Transabdominal and endoscopic ultrasound, CT scan were used to determine the number, size, volume, wall thickness, location of pancreatic pseudocysts, the extent of pancreatic parenchymal disease, the nature of the main pancreatic duct and its relationship to the cyst, the presence of portal hypertension, venous occlusion, arterial anomalies and pseudoaneurysm. The indications for endoscopic drainage were symptomatic and/or bigger than 6 cm in major diameter pancreatic pseudocysts with a close opposition to the gastric or duodenal wall.Results: There were 26 patients with pancreatic pseudocyst and all of them are located in lesser sac. It mainly affects the middle-aged males with alcohol as the main etiology. Out of 26 patients 24 underwent endoscopic drainage and 2 patients were abandoned in view of vessel between the cyst wall and stomach which was picked up by EUS. Out of 26 patients, 5 developed infection which was proven by culture. Endoscopic cystogastrostomy was performed in 21 patients (80.8%), endoscopic cystogastrostomy with nasocystic drainage performed in 3 patients (11.5%), and abandoned in 2 patients. 2 patients developed bleeding, and managed conservatively. No intervention done. 5 patients underwent re-procedure (3 underwent nasocystic drainage, 1 aspiration, and the other cystogastrostomy), in view of recollection.Conclusions: Endoscopic drainage is safe and effective in experienced hand, less morbidity, cost effective, short hospital stay, can be repeated.
Effect of moist dressing, collagen sheet dressing and epidermal growth factor in healing of chronic wounds
Authors: Jain Sheelchandra , Tote Darshana S. , Kolte Gaurav , Jajoo Suhas , Tote Sachin
Published: July 2017

Background: Surgical literature is full of innumerable solutions to the problems of wound healing and it speaks of itself that the problem is not so simple and straight forward to tackle with. The aim of the present study was to compare three modalities moist saline dressing, collagen sheet dressing and epidermal growth factor in early epithelization and healing of chronic wounds. to study the effect of various dressing modalities on epithelization of chronic wound in terms of time required for healing and the quality of scar it forms, the functional results both early and late, post-healing morbidity and complications and the practicality and the cost involved in using these modalities.Methods: Prospective randomized controlled study. Study including chronic wound cases admit to AVBRH Sawangi over period of 3 years.Results: Reduction in size of wound by 70-100% was found highest in Epigrof group. In Epigrof treated group 88% of wounds healed within 3 weeks while 80% in collagen group and 56% in moist dressing group it. Collagen dressing is the most cost effective of the three whereas Epigrof was most costly due to the initial cost of purchase. The scar quality was satisfactory in 19 of Epigrof group and 17 of the collagen sheet group and 15 of the moist dressing group.Conclusions: Epidermal growth factor is superior in epithelization, collagen is the next best local applicant, but collagen sheet is more cost effective than Epigrof and non-adherent dressings.
Clinical profile and predictors of outcome in congenital duodenal obstruction
Authors: Chandrasekaran Sankkarabarathi , Asokaraju Anirudhan
Published: July 2017

Background: Congenital duodenal obstruction is a broad term that refers to a variety of disorders like duodenal atresia, duodenal stenosis, annular pancreas, duodenal membrane and preduodenal portal vein. The aim of this study was to analyse in detail the entire clinical profile of duodenal obstruction and to study the short-term outcome.Methods: A prospective descriptive study was conducted in the Department of Paediatric Surgery, Institute of child Health and Hospital for Children, Egmore, Chennai, among all babies with suspected duodenal obstruction based on clinical symptoms and subsequently proven by surgery from September 2013 to January 2015. Fifty babies were selected for this study based on the eligibity criteria.Results: Upper gastrointestinal contrast radiography is the gold standard investigation in diagnosing duodenal membrane with a hole. The type of surgery such as the duodenoplasty, duodenoduodenostomy or duodenojejunal anastomosis did not affect the post-op outcome.Conclusions: Long term follow up is warranted to know the actual incidence of requirement for redo procedure for feed intolerance. The presence of coexisting Down’s syndrome and congenital cardiac lesions increases the mortality rate in these children.
A study about urinary tract infection among patients attending tertiary care hospital
Authors: U. Arunachalam , C. Ponmudi , Solanke Prashant V. , Das Deepam , N. Vignesh , Pawade Preeti
Published: July 2017

Background: UTI is a second most common type of infection, accounting for nearly 25% of all infections. Lower UTIs are much more common in women than in men, particularly in the under 50’s. UTI are common among patients with type 2 diabetes mellitus. Recurrent UTI is a common phenomenon that is observed among women who have experienced uncomplicated UTIs. Usually 5-10 days of antibiotic therapy is done for treating UTI. Successful antimicrobial therapy will usually ameliorate symptoms promptly, with substantial clinical improvement in 48 to 72 hours. The objective is to find out the knowledge and practice about UTI among UTI sufferers.Methods: The study design is cross sectional study. The study period is from July 2016 to February 2017. The study place is Sree Mookambika Institute of Medical Sciences. The sample size is (4PQ/d²) = 31. Systematic random sampling techniques are used. Institutional ethical committee clearance was obtained.Results: In the study 90.3% are women. In the study 32.3% had a recurrent UTI. In the study population about 51.7% take adequate or plenty of water. In this study 35.5% have poor knowledge, 42% have moderate knowledge and 19.5% have a good knowledge about UTI.Conclusions: From the study, it is learnt that UTI is common among the women and recurrence is the most common thing among the asymptomatic UTI group. The common symptom experienced by the study group is dysuria and frequency and most in the study group used to take less than recommended amount of water daily. They believe drinking plenty of water and cleanliness can prevent the UTI. The knowledge about UTI among the group is fairly good.
A study of open inguinal hernioplasy with horizontal incision at tertiary care hospital
Authors: Patel Piyush R. , Tandel Chetan J. , Dadiala Gurmitsingh , Parekh Janak N.
Published: July 2017

Background: Transverse incision may be truly horizontal or may curve to varying degrees. Transverse incisions mostly follow LANGER lines and give better cosmetic results. The present study was planned with an objective to study open inguinal hernioplasty with transverse crease (Langer’s line) incisions.Methods: The present cross-sectional study was conducted on patients operated for inguinal hernia in single surgical unit between March 2013 to October 2015. After admission in a surgical ward, thorough history and clinical examination of all patients done. A transverse skin incision was used (follow the Langer’s line) in all cases.Results: The mean age of the cases in the present study was 45.21±14.2 years. It was noted that among Indirect inguinal hernias (IIH), 85% of the cases were below 50 years of age while among direct inguinal hernias (DIH), 66% cases were above 50 years of age. It was seen that 42.6% of the direct hernia was right-sided while 70.0% of the indirect hernias were right sided. All the patient had a very good cosmetic outcome.Conclusions: It was concluded from the present study that right sided indirect inguinal hernia was the most common type of Hernia. The use of transverse incision through Langer lines is aesthetical, no folding of scar is seen, all the layers are not on same level so preventing ridge effect, repair become sounder, bigger lower flap of external oblique aponeurosis and even wound is infected, no scar widening.
Silver colloid dressings score over conventional dressings in diabetic foot ulcer: a randomized clinical trial
Authors: Sharma Rajkumar , Gupta Niraj , Kumar Vipan , Pal Sanjay , Kaundal Vishal , Sharma Vikrant
Published: July 2017

Background: Topical silver treatments and silver dressings are increasingly used for the local treatment of contaminated or infected wounds; however, there is a lack of clarity regarding the evidence for their effectiveness. To compare the outcome of silver colloidal based dressing in comparison to conventional dressing in management of diabetic foot ulcers.Methods: This was a single institution prospective randomized controlled trial. Patients with Wagner grade 1and 2 diabetic foot ulcer were enrolled in this study. Patients were assessed on day one and then at two weeks interval for twelve weeks for ulcer size by planimetry.Results: Out of 25 patients, 13 were randomized to silver colloid group and 12 in conventional dressing group. Age and sex distribution was comparable among two groups. Total 29 ulcers were present in silver colloidal and conventional dressing group. Mean wound area in silver colloidal dressing group and conventional dressing group on admission was 36.8 and 20.46 cm2 respectively. After 12 weeks of dressing mean wound area in silver colloidal dressing group and conventional dressing group decreased by 31.52 (85.65%) and 14.04 (68.62%) and after 12-week complete healing was seen in 11 (84.62%) patients in silver colloidal dressing group and 5 (41.67) patients in conventional dressing group.Conclusions: The results suggest that silver colloidal based dressing had significantly better outcome in form of complete healing and decrease in ulcer size in comparison to conventional dressing in diabetic foot ulcers (p value <0.05).
Two mesh technique in lieu of single mesh in giant prosthetic reinforcement of the visceral sac for bilateral inguinal hernias
Authors: Arora Bhavinder K. , Arora Rachit , Arora Akshit
Published: July 2017

Background: Posterior wall strengthening is the essential aim of Bilateral Inguinal hernia repair. The two methods for it are tissue repair and tension free repair. Tension free repair have become the gold standard. The preperitoneal repair for Bilateral Inguinal hernia is performed by wrapping the lower part of the parietal peritoneum with a large chevron shape polypropylene mesh.Methods: This study presents a modification of stoppas repair using a polypropylene mesh of size 15×9 cm to cover the myopectineal ostium of fruchaud on each side. The direct hernia sac was inverted with a purse string suture. Indirect hernia was opened and margins approximated with a 2-0 polyglycolic acid suture. No drainage was used.Results: Post-operative period was uneventful in all the patients. This new technique uses less post-operative time and the cost of surgery is reduced. There was one post-operative recurrence on one side only on follow up at one week, three weeks and three months.Conclusions: The use of two small size mesh covering both Fruchaud’s myopectineal orifices for bilateral inguinal hernia repair instead of a large size mesh is a promising technique. It saves the operative time and shortens the hospitalization time.
KIMS modification of Alvarado’s score for acute appendicitis
Authors: Premkumar Daivasikamani
Published: July 2017

Background: Abdominal pain is one of the most frequent presentations to the emergency department (ED). Acute appendicitis is by no means an easy diagnosis to make and can baffle the best. Problems related to the diagnosis of appendicitis are evidenced by the significant negative laparotomy rate. A scoring system described by Alvarado was designed to reduce the negative appendicectomy rate without increasing morbidity and mortality. Alvarado’s score does not include ultrasonogram which is most commonly done investigation before any abdominal surgery.Methods: The study included the ultrasonography and modified the scoring system and retrospectively we analyzed 153 patients who were admitted as acute appendicitis. When interpreted considering the clinical examination, sonography and modified scoring system and it significantly reduced the rate of false-negative appendectomies. The use of diagnostic imaging tests such as CT scan or ultrasonography should be selective in those with atypical presentation or findings. Laparoscopy, barium enema, ultrasonography and computer assistance have all been shown to improve accuracy, but no one method is of proven superiority.Results: By using KIMS modification of Alvarado’s score it was found that unnecessary appendectomy can be avoided in 11 out of 132 patients.Conclusions: Such diagnostic aids or intensive in-hospital observation must be used to reduce the 15-30 per cent negative laparotomy rate when acute appendicitis is suspected, without increasing the incidence of appendiceal perforation.
Incisional hernia: preliminary observations at a new institute
Authors: Huda Farhanul , Kumar Abhijit
Published: July 2017

Background: Ventral hernia develops when an area of the abdominal wall weakens and develops a tear or hole. It may develop as a defect at birth, resulting from incomplete closure of a part of the abdominal wall, or develop where an incision was made during an abdominal surgery, occurring when the incision doesn’t heal properly. Incisional hernia is typically observed within the first 5 years after the surgical incision is made, but may develop long afterwards.1 This study was undertaken to review the history and clinical presentations in patients with incisional hernia, and subsequent treatment.Methods: In the present study, the first 20 cases of incisional hernia admitted to this institute for elective herniorrhaphy were studied. History of the previous surgery was obtained and the findings noted. Treatment carried out was included in the study.Results: Out of 20 cases, 12 were female (60%). Mean age of the patient was 41.9±11.9 years. Lower segment Caesarian section was the commonest preceding surgery (7 out of 12 females; 58.33%). Exploratory laparotomy accounted for 5 out of 8 cases amongst males (62.5%). Commonest site of the hernia was infraumbilical (n=9; 45%). Average size of the defect was 6.2 cm x 5.6 cm. 13 patients underwent surgery. Laparoscopic ventral hernia repair was the most common modality used (10 out of 13; 76.9%).Conclusions: Incisional hernia is more common in females, and gynaecological operations are most common cause and most common site is infraumbilical.