bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinism of the problems of Using the Expert'S Opinion as Evidence by Mistakes Made in the Preparation, Appointment and Production of Forensic Examinations
Authors: Danilova N. A. , Elagina E. V. , Grigorieva M. A.
Published: December 2021

The paper analyzes the errors committed by law enforcement officers in the implementation of various types of special knowledge at all stages of criminal proceedings. Shortcomings under consideration are differentiated into shortcomings committed in the production of investigative actions, during which objects were seized, subsequently presented for an expert examination, when forensic examinations are appointed, in the production of forensic examinations, when examining the expert's opinion by officials of the preliminary investigation bodies and the prosecutor's office. At the same time, such errors are periodically repeated and multiply: forensic examinations, the need for the production of which is caused by the specifics of the crime being investigated, the current investigative situation and, being justified by specially developed recommendations, are not scheduled; the questions posed to the experts do not cover all the circumstances the establishment of which is possible only through the involvement of persons knowledgeable in a particular area of special knowledge; the questions themselves are not always directly related to the expert's specialization and the type of examination; the presence of proper qualifications of a person involved as an expert is not verified, etc.

Without setting themselves the task of analyzing all or most of these errors, the authors thoroughly consider the most serious errors using specific examples from judicial investigative practice and they come to the conclusion that the effectiveness and efficiency of using the expert's conclusion in proving is possible only under the context of impeccable observance by officials of preliminary investigation bodies, forensic experts and heads of forensic institutions of the provisions of the Criminal Procedure Law, the Federal Law "On State Forensic Expert Activity", departmental regulations and forensic recommendations.
The Columbine (School Shooting): Essence, Legal Qualifications, Forensic Diagnostics2
Authors: Nikishin V. D.
Published: December 2021

The the paper is devoted to the results of a comprehensive legal and linguistic study of the "Columbine" ("school shooting") subculture from the standpoint of criminology, criminal law, forensic science and forensic speech studies. Despite some conventionality of the well-established term "school shooting" borrowed from the English language, the author proceeds from the fact that any form of violent actions in educational institutions committed by a student (group of students) or an outsider in relation to teachers and students using weapons and improvised means should be understood as school shooting.

Empirically, the study is based on the publications of Russian and foreign scientists, the results of semi-automated monitoring of social networks for the promotion of school shooting, as well as materials of criminal cases held in the archives of the investigative departments of the Investigative Committee of the Russian Federation for the Volgograd, Moscow, Saratov, Tyumen, Chelyabinsk regions, Krasnoyarsk Territory and Republic of Khakassia. The author concludes that the the Columbine subculture is extremist-terrorist in its essence. The paper summarizes the most characteristic ideological attitudes of this subculture, signs of a person's involvement in the targeted community, examines the problems of the legal characterisation of school shooting acts and proposes criminalistic diagnostic complexes to examine extremist speech actions aimed at promoting Columbine. These complexes give a law enforcement officer clear criteria for recognizing information materials as extremist, as well as for holding liable or discharging an individual under Art. 205.2, 280, 282 of the Criminal Code of the Russian Federation depending on the presence or absence of mass executions propaganda aimed to intimidate the population in order to influence the authorities or other extremist motives.
E. Canton & J. Ingegnieros. Locura del embarazo (Folie gravidiqne). Buenos. Aires. Br. 1903
Authors: Skuridin I.
Published: November 2021

Dr. E. Nicoulau, in No. 2 Annales Medico-Psychologiques, 1906, sets out the contents of the pamphlet by prof. E. Canto`a, and Dr J. Ingegnieros in Buenos Aires. The authors point out the serious importance for a woman of the function of childbearing in the development of psychosis. All stages of this function can give rise to the development of various forms of mental disorder that make up the general group of "PUEU-.moral psychosis", this includes, therefore, the insanity of pregnant women, postpartum women, women in labor and breastfeeding, as well as menstrual insanity, since menstruation can be examined like childbirth in miniature.
S. Korshun. Colony for the mentally ill "Eglfing" near Munich (Oberbayerische Heil und Pfleganstalt Eglfing). Kharkiv Medical. zhurn. 1907 Ns 1
Authors: Rudnev V.
Published: November 2021

An imposing institution recently built by the Bavarian State for 8 million marks on a plot of land worth 1 million marks. A picturesque town with a church, varied architecture of buildings, verandas, gardens. 87 buildings, of which 30 are hospital: workshops, theater, laundry, barnyard.
The definitive VAT system and its impact on tax collection
Authors: Zídková Hana , Balíková Kristýna
Published: December 2021

Value Added Tax (VAT) is a significant source of fiscal revenues in the EU. However, the VAT treatment of cross-border supplies enables large-scale tax frauds, such as the Missing Trader Intra-Community (MTIC), which takes each year billions of euros from Member States' public budgets. In 2016 a definitive VAT system was proposed by the European Commission to respond to the shortcomings of the current temporary system. This new system should reduce the possibilities of MTIC fraud for intra-community transactions through the collection of VAT by the supplier in the same way as for domestic transactions. The tax collection by the supplier would impact the administrative costs of the financial authorities. This paper contributes to the discussion about the advantages and disadvantages of the newly suggested system. The analysis focuses on the study of the change in administrative costs and VAT revenues for individual Member States and across the EU. The results are that after implementing the definitive VAT system, total administrative costs of the Member States would increase at least by EUR 107 million, whereas total VAT revenues would rise by EUR 40 billion. This indicates the overall positive impact of the definitive VAT system for the EU. However, individual Member States would not benefit equally. The net exporters, whose intra-community supplies exceed the intra-community acquisitions, would spend more than others for the collection of VAT in connection with the international trade of goods.
Relación entre ansiedad y rendimiento académico en alumnado de secundaria
Authors: Colunga-Rodríguez Cecilia , Ángel-González Mario , Vázquez-Colunga Julio César , Vázquez-Juárez Claudia Liliana , Colunga-Rodríguez Bertha Alicia
Published: December 2021

El objetivo de este estudio fue indagar la relación entre ansiedad y rendimiento académico en estudiantes de secundaria. El diseño de la investigación fue transversal y correlacional, con una muestra probabilística de 156 estudiantes seleccionados aleatoriamente. Los datos se recogieron con la Escala de Ansiedad Manifiesta en Niños (CMAS-R) y un cuestionario de datos sociodemográficos. El rendimiento académico se calculó en base al promedio de calificaciones. La muestra tenía el mismo número de mujeres y varones, con una media de edad de 13.10 años (DE = 0.94); 69.23% cursaban primer año de secundaria, 19.23% segundo año y 11.54% tercero, y todos procedían de la zona metropolitana de Guadalajara (México). Los resultados mostraron indicios de ansiedad entre el 28.8% de los estudiantes. La media de calificación académica era 8.6 (DE = 0.82); el 42.3% tenía un rendimiento académico alto, el 38.5% medio y el 19.2% bajo. Se observó una puntuación media de ansiedad más alta entre los estudiantes con un rendimiento bajo, en comparación con los que tenían un rendimiento medio o alto. Al comparar los grupos de estudiantes con diferente rendimiento con la presencia o no de ansiedad, se encontró una correlación estadísticamente significativa. La relación entre mayor ansiedad y menor rendimiento académico sugiere la necesidad de evaluar periódicamente tanto la ansiedad como otros trastornos psicoafectivos entre los estudiantes mediante la vigilancia psicoepidemiológica, conjuntamente con el rendimiento escolar, con el fin de poner en marcha estrategias de actuación preventivas y correctoras.
Adli Tıp Uzmanlık Öğrencilerinin Hastane Eğitim Ortamı Algılarının Değerlendirilmesi
Authors: Zeybek Volkan , Cavlak Mehmet , Kara Cüneyt Orhan , Tümer Ali Rıza , Acar Kemalettin
Published: December 2021

Background: The learning environment is key to successful education. By evaluating learning environment, strong parts and parts that need improvement of education process can be revealed. Various scales have been developed in order to evaluate issue. In this study, it was aimed to evaluate educational environments of two different departments of forensic medicine [Pamukkale University Faculty of Medicine (PAUFM) and Hacettepe University Faculty of Medicine (HUFM)] using a standard scale, compare the differences and investigate the reasons.
Materials and Methods: First, resident participating in university were asked demographic information about their university, gender and academic year. Second, Postgraduate Hospital Educational Environment Measure (PHEEM) was applied. The distribution and scores for the items and subtitles were calculated.
Results: Total score of the participants was 131.85 (±22.93) (perfect education environment), perception of professional autonomy subgroup mean score 46.61 (±8.04) (excellent), perception of education subgroup mean score 50.91 (±8.71) (excellent) and social support perception subgroup mean score was 34.32 (±7.11) (environment that supports learning). When scores were compared between two departments, it was observed that mean scores of HUFM were significantly higher.
Conclusion: Our study is the first study in which educational environments of residents who are trained in forensic medicine are evaluated. It was determined that average scores obtained in both departments are higher than other studies conducted in different specialties in our country. It has been demonstrated that PHEEM can be used to identify and correct the problems in forensic specialty training environment and to increase quality of forensic specialty training.
I Got the Poison, I Got the Remedy: Healthcare Serial Killers
Authors: Tırmıkçıoğlu Zeynep
Published: December 2021

Objective: Killing with poison or high-dose drug is an uncommon method used in serial murders. Healthcare serial killers differ from classical serial killers because they frequently use high-dose drugs or poison to kill the victims. In the study, it was aimed to create the most up-to-date list of healthcare serial killers and poisons used.
Materials and Methods: The internet-based databases were used, and a comparative literature review was conducted. Serial killers using poison or high-dose drug as murder weapons were selected and evaluated.
Results: Of the 53 serial killers analyzed, 41 were nurses, 6 physicians, and 6 medical assistants. All physicians and almost all medical assistants were men. In nurses, the male-female gender distribution was almost equal. The median number of victims was 12, and 8 murderers killed 100 or more victims. Morphine (9/53), insulin (7/53), potassium chloride (6/53), succinylcholine (6/53) and lidocaine (6/53) were the most commonly used drugs in murders. Other sedatives, nondepolarizing muscle relaxants such as vecuronium, pancuronium and mivacurium, digoxin, epinephrine, heparin, arsenic and cyanide were also among the poisons and high-dose drugs used. About half (25/53) of serial killers killed their victims using one poison or one drug. Morphine, insulin, potassium chloride, succinylcholine and lidocaine were often used as the single drug in murders.
Conclusion: All serial killers examined in the study used their drug knowledge and authority to commit murder. It is remarkable that most of the murderers did not have a pre-identified psychiatric disorder, and they were not suspicious or even considered reliable.
Giant cell arteritis: a case report with scalp necrosis and sudden blindness
Authors:   Department of Internal Medicine, Landspítali University Hospital, Árnadóttir Berglind , Gröndal Gerður ,   Department of Rheumatology, Laboratory of Rheumatology, Landspítali University Hospital, Tryggvason Þórður ,   Faculty of Medicine, University of Iceland, Reykjavík, Guðbjörnsson Björn ,   3Laboatory of Rheumatology, Landspítali University Hospital, Faculty of Medicine, University of Iceland, Reykjavík
Published: December 2021

In the summer of 2020, an elderly woman in her eighties sought medical attention due to headache and visual disturbances. The diagnosis was unclear, she became blind on both eyes and developed extended scalp necrosis. Later it was clear that these symptoms were due to accelerating symptoms of giant cell arteritis (GCA). GCA is one of the most common disease form of vasculitis and can have various symptoms. In this report, we describe a case of an advanced disease course, discuss the main symptoms, diagnosis and treatment.
Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia : A retrospective case-control study
Authors: Németh Zsófia Klára , Szűcs Anna , Vitrai József , Juhász Dóra , Németh János Pál , Holló András
Published: December 2021

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.
Meteorological Drought Assessment in Sharjah, UAE Using Drought Indices
Authors:   the University of Sharjah, Sharjah, UAE (e-mail: U18200511@sharjah.ac.ae). A. Najah is with Khalifa University, AbuDhabi, UAE, Oyounalsoud Mhamd S. , Najah Arwa , Yilmaz Abdullah G. , Abdallah Mohamed , Siddique Mohsin
Published: December 2021

Drought is a natural disaster that significantly affects environmental and socio-economic conditions. It occurs when there is a period of below average precipitation in a region, and it results in water supply shortages affecting various sectors and life adversely. Droughts impact the ecosystems, crop production, and erode livelihoods. Monitoring drought is essential especially in the United Arab Emirates (UAE) due to the scarcity of rainfall for an extended period of time. In this study, drought is assessed in Sharjah UAE using monthly precipitation and average temperature data recorded for 35 years (1981-2015) at the Sharjah International Airport. The standardized precipitation Index (SPI), and the Reconnaissance Drought Index (RDI) are selected to predict future droughts in the region. SPI and RDI are fitted to the statistical distribution functions (gamma and lognormal) in an annual time scale and then, a trend analysis of index values is carried out using Mann-Kendal test. The correlation between SPI and RDI indices was found to be high where both showed high drought frequencies and a tendency to get drier over time, thus indicating the need of appropriate drought management and monitoring.
CrossQuestion Game: A Design of a Group-Based Assessment Tool to Enhance Student Motivation during Pandemic
Authors: Durrani Usman , Alnajjar Roba , Muaitah Abdulrahman Al , Daqaq Abdulwahab , Salah Abdulrahman , Zeyad Reem
Published: December 2021

This paper explores the effect of applying gamification and flipped classroom approaches through our group-based assessment game, the CrossQuestion, in the course of IT in Business. The course teaches basic IT fundamentals and their application in different functional areas of business and management. In Spring 2020-21, we delivered this course through Moodle platform, integrated with the Zoom video communication tool, to introduce the CrossQuestion game as supplemental resources to engage students. We conducted measurements using the Instructional Materials Motivation Survey scales to verify the game's learning effect. We divided students into an experimental group (85 students who played the CrossQuestion game through gamified flipped classroom session–Spring 2020-21) and a control group (60 students who previously underwent lecture-based instructions and individualized formal assessments–Spring 2019-20). The analysis of students’ grades confirms improvement by applying gamified flipped classroom group-based assessments in the learning process. The students’ questionnaire also confirms that group-based assessments can improve students’ motivation. We developed a game system that was attractive to the students, implying that it can be an effective instructional and recreational material to boost morale, increase collaboration, enhance engagement and socialization opportunities, especially during this challenging pandemic.
Student Performance Prediction Using Case Based Reasoning Knowledge Base System (CBR-KBS) Based Data Mining
Authors:   Sangam University, Bhilwara, Rajasthan, India, Dixit Prashant , Nagar Harish , Dixit Sarvottam
Published: December 2021

Higher education management problems in delivering 100% of graduates who can satisfy business demands. In industry it is often difficult for qualified graduates to identify the appropriate means to evaluate problem - solving abilities as well as shortcomings in the evaluation of problem solving skills. This is partially due to the lack of an adequate methodology. The purpose of this paper is to provide the appropriate CBR-KBS model for predicting and evaluating the characteristics of the student's dataset so as to comply with the parameters of selection required by the university industry. Machine learning algorithms have been used in these study areas under supervision, uncompleted and uncontrolled; K-Nearest neighbor, Naïve Bayes, Decision Tree, Neural Network, Logistic Regression and Vector Support Machines. The proposed model would allow university management to make easier, more professional, experienced and industry-specific plans for the manufacturing of graduates and graduates who passed the type I and II examinations held by the employment opportunities.
Using Screen-Capture Technology to Authenticate IT Online Learning and Assessment
Authors:   Curriculum & Instruction Department, College of Education, Sultan Qaboos University, Oman & Educational Technology Department, College of Education, Cairo University, Cairo, Egypt, Ismail Sameh S. , Abdullah Shubair A.
Published: December 2021

Assessment has always been fundamental to teaching as it aims to gauge the impact of the teaching on students learning. The current assessment in teaching computer literacy is objective assessment that focuses on making it intentional, informative, and formalized. Although this assessment is the best way when assessing large groups of students at one limited time, it has a drawback of being limited to check the knowledge of understanding terminology and recalling steps of a particular process. This study introduces a screen-capture technology based approach to performative and authentic assessment. It involved design and implementation of screen-capture assignments to assess computer maintenance skills. The sample consisted of 28 students enrolled in computer hardware and software maintenance classes. Data from students was collected through a multi-modal student survey and a semi-structured interview. The results analysis has indicated that screen-capture performative assessment promotes students’ engagement and learning level of solving real-world problems.
La ruralización de lo neopolicíaco en Abril rojo de Santiago Roncagliolo
Authors: Carbajal Eric
Published: November 2021

Este artículo analiza el proceso de ruralización del modelo literario latinoamericano de “lo neopolicíaco” en la novela Abril rojo (2006) de Santiago Roncagliolo. Demostrando el distanciamiento del espacio urbano, se analiza cómo el paradigma peruano Andes-ciudad aparece en la obra para mezclarse con “lo neopolicíaco” y contextualizar la representación de las secuelas de la violencia política en el Perú durante el año 2000. Asimismo, esta ruralización le permite a la obra entretener a un público global pero también cuestionar relaciones de poder a un nivel más profundo.
En tierra extraña: relato alternativo de la migración española contemporánea
Authors: Domingo Sancho Irene
Published: November 2021

En este artículo estudiaré cómo En tierra extraña, el documental que Icíar Bollaín rodó en 2014, presenta un relato alternativo al oficial acerca de la migración masiva de españoles, en su caso, a Edimburgo, tras la crisis de 2008. A través de su investigación de la nueva figura migrante y del nuevo fenómeno migratorio contemporáneo, el documental construye una narración que denuncia la imagen del migrante como homo œconomicus fracasado mientras resalta el papel de las políticas neoliberales en la precarización y expulsión de ciertos ciudadanos para lograr la supervivencia del sistema capitalista existente.
El poético envejecer de un novísimo: sobre Regiones devastadas de Guillermo Carnero
Authors: Gómez-Castellano Irene
Published: November 2021

Pocos poetas han logrado expresar la emoción de envejecer como hombre y como artista con la dignidad y complejidad artística del novísimo Guillermo Carnero. En este artículo se explora cómo Carnero comunica en el último ciclo de su poesía la experiencia vital de envejecer. Al igual que Tiziano y que Cernuda, Carnero elige el motivo de la mano del artista como leitmotiv. Esta mano, el punctum de Regiones devastadas (2017), nos ayuda a recoger varios hilos en su obra que conectan el tema de la vejez, el amor, la masculinidad y el papel del artista, enfrentado al trauma de la propia mortalidad frente a la eternidad artificial de lo creado.
STEPHEN BOYD, TRUDI DARBY, AND TERENCE O’REILLY, EDS. The Art of Cervantes in “Don Quixote.” Critical Essays. Cambridge: Legenda, 2019. 289 pp.
Authors: Johnson Paul Michael
Published: November 2021

Reseña de The Art of Cervantes in “Don Quixote.” Critical Essays de Stephen Boyd, Trudi Darby, and Terence O’Reilly, eds.
EMIRO MARTÍNEZ-OSORIO. Authority, Piracy, and Captivity in Colonial Spanish American Writing: Juan de Castellanos’s Elegies of Illustrious Men of the Indies. Lewisburg: Bucknell UP, 2016. xxxix + 155 pp.
Authors: Cacho Casal Rodrigo
Published: November 2021

Reseña de Authority, Piracy, and Captivity in Colonial Spanish American Writing: Juan de Castellanos’s Elegies of Illustrious Men of the Indies de Emiro Martínez-Osorio.
HENRY W. SULLIVAN. Tragic Drama in the Golden Age of Spain. Seven Essays on the Definition of a Genre. Kassel: Edition Reichenberger, 2018. 434 pp.
Authors: Rich Greer Margaret
Published: November 2021

Reseña de Tragic Drama in the Golden Age of Spain. Seven Essays on the Definition of a Genre de Henry W. Sullivan.
Animation and Affirmative Aging in Ignacio Ferreras’s Arrugas
Authors: Nagtegaal Jennifer
Published: November 2021

This paper enters the ongoing debate on the portrayal of old age in Ignacio Ferreras’s animated feature Arrugas (Spain, 2011). My approach to a new understanding of Ferreras’s film is two-fold: first, I engage with the often-overlooked animation to ask how it too contributes to the cinematic vision of later life; second, I aim to liberate Arrugas from the predominant binary discourses of successful aging/aging-as-decline often employed to understand the film. Drawing on theories of animation and aging, I highlight how Arrugas reflects later life as more complex, a notion central to Linn Sandberg’s theory of affirmative old age.
El mandato de parecerse a una cara: desertificación y reconstrucción en El desierto y su semilla de Jorge Baron Biza
Authors: Soifer Alejandro
Published: November 2021

La novela El desierto y su semilla de Jorge Baron Biza presenta de forma ficcional los acontecimientos reales del ataque que el escritor, pornógrafo, político y dandy argentino Raúl Baron Biza produjo a su esposa Clotilde Sabattini cuando le arrojó un vaso de ácido sulfúrico en el rostro deformándola de por vida. La construcción literaria de Jorge Baron Biza, hijo del atacante y la víctima, no solo reconstruye textualmente el ataque y sus consecuencias, sino que plantea una operación formal que emparenta la reconstrucción del rostro de su madre con la construcción básica del relato nacional argentino.
Anaesthetic management in COVID-19 parturients scheduled for caesarean delivery - a comparison with non-COVID-19 parturients
Authors: Singh Ranju , Singh Pooja , Neelakandan Eashwar , Pandey Maitree , Puri Manju , Nangia Sushma
Published: November 2021

Background: Data regarding outcomes after anaesthesia in COVID-19 parturients is scanty. There is hardly any information about the length of hospital stay in COVID-19 parturients who undergo caesarean delivery (CD) as compared to non-COVID-19 parturients.Methods: An observational study of COVID-19 parturients undergoing CD was conducted. Age and CD indication matched non COVID-19 parturients were taken as controls. The length of hospital stay along with maternal and neonatal outcomes were studied.Results: A total of 45 COVID-19 parturients and an equal number of non-COVID-19 parturients were studied. The length of hospital stay was significantly longer in COVID-19 parturients as compared to non-COVID-19 parturients (4.3±1.6 days versus 3.3±0.6 days, p=0.02). One COVID-19 parturient developed severe disease and expired. Apart from this case, the maternal and neonatal outcomes were comparable between the two groups. Mild thrombocytopenia was seen in COVID-19 parturients. One neonate had a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on first day of life.Conclusions: COVID-19 parturients who undergo CD have a longer length of hospital stay than non-COVID-19 parturients. Severe disease is likely to be associated with longer length of hospital stay. Intraoperative hypotension, maternal and neonatal outcome is not significantly different between COVID-19 and non COVID-19 although mild thrombocytopenia is seen in COVID-19 parturients. While vertical transmission of SARS-CoV-2 may be possible, more data is needed regarding vertical transmission is needed.
Hand hygiene compliance of health care workers in a neonatal intensive care unit: a prospective observation study
Authors: Alci Gamze , Bilgen Hulya , Ozek Eren , Yagci Aysegul Karahasan
Published: November 2021

Background: We aimed to determine hand hygiene (HH) compliance of the healthcare workers (HCW’s) and evaluate if there is an epidemiological relation between the microorganisms isolated from the hands of HCWs and patients clinical materials in the neonatal intensive care unit (NICU).Methods: HH compliance was observed in two unannounced phases in March and in August within the scope of 5 indications determined by WHO. Between two phases personnel was trained to improve HH by educational sessions and introduction of Semmelweis system hand in scan (HIS, Sysmex) in the unit.  A total of 22 nurses, 11 physicians and 5 staff was working in the NICU. Hand samples taken from HCW by glove juice method were inoculated quantitatively in culture plates and colonies were identified by MALDI-TOF MS. Epidemiological relation between clinical isolates and hand samples was investigated with arbitrary primed PCR.Results: Although overall compliance remained only 50%, a significant increase in compliance was detected in August prior to aseptic procedures and after contact with patients and body fluids. Alcohol scrub was preferred as 60.4% in March and 75.2% in August. HH efficacy reached to 72% by implementing HIS. During this period, 10.7% of 607 patient’s samples revealed clinically significant growth. Potential pathogens were isolated in 5.2% of 144 hand samples, but any epidemiological correlation with patient isolates was detected.Conclusions: HH compliance observations should be done at regular intervals and current technology could be utilized in trainings to overcome hospital related infections.
Gallbladder perforation with liver abscess; laparoscopic cholecystectomy converted to open: a case report
Authors: Salas Ochoa Edgar Salvador , Gutierrez Maria Eugenia Dominguez , Rocha Alfredo Lopez , Sanchez Edilia Naraleth Arce , Moreno Karla Itzel Altamirano , Garcia Edna Arantxa Segura
Published: November 2021

Gallbladder disease affects more than 20 million people in the United States. Acute cholecystitis is a clinic entity characterized by the inflammation of the vesicular wall that is usually manipulated by abdominal pain, right hypochondrial sensitivity and fever. The technique of choice for the diagnosis of cholecystitis is abdominal ultrasound; gallbladder perforation is a rare complication of acute cholecystitis (2%-11%). The presence of perivesicular abscesses is infrequent, its prevalence varies between 2.1% and 19.5%. Clinical record was reviewed of a 73 years old woman who attended a second level public care unit, with a clinical picture of acute chronic lithiasis cholecystitis, who underwent surgery consisting of open converted laparoscopic cholecystectomy with a finding of vesicular perforation with liver abscess, it was initiated with laparoscopic approach, it was not possible to identify anatomical structures, so it was decided to convert to open surgery. Cholecystectomy and abdominal lavage are usually sufficient in the treatment of gallbladder perforation.
Hemophagocytic lymphohistiocytosis: a rare and life-threatening diagnosis
Authors: Yarky Anu , Kumar Vipan , Chauhan Nidhi , Verma Neha
Published: November 2021

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening syndrome of excessive activation of immune system. It frequently affects infants from birth to 18 months of age, but is also observed in children and adults of all ages. HLH can occur as a familial or sporadic disorder, and it is triggered by a variety of events, Infection being the most common trigger both in familial and in sporadic cases. Prompt treatment is very critical in cases of HLH, but the greatest barrier is often delay in diagnosis due to the rarity of this syndrome, variable clinical presentation, and lack of specificity of the clinical and laboratory findings. The key clinical features of HLH are high persistent fever, hepatosplenomegaly, blood cytopenia, elevated aminotransferase and ferritin levels, and coagulopathy. A diagnosis of HLH is mostly under-recognized, and is associated with high mortality, especially in adults; thus, prompt diagnosis and treatment are essential. We here present a rare case of HLH in an adult which was non-familial and infection being the trigger causing secondary hemophagocytic lymphohistiocytosis.
Giant paratubaric cysts
Authors: Ochoa Edgar S. S , Rocha Alfredo L. , Sanchez Edilia A.
Published: November 2021

Giant paratubaric cysts are mostly benign tumors, with incidence of 10%. The incidence rate of these neoplasms is 2% to 3% including cystitis, papillary carcinoma and serous papillary neoplasms, the course of disease begins with abdominal pain or increase in size of lower hemi abdomen, becoming complicated in approximately 3% of cases. The diagnosis is made with transabdominal or transvaginal ultrasound, abdominal and pelvis tomography or magnetic resonance. The treatment of small cysts is expectant and the large size is surgical way. We present the case of a 35-year-old woman who began her current condition three years after her pregnancy, with urination urgency, abdominal pain and sensation of abdominal mass, who was diagnosed and protocolized in a public second level hospital in Mexico City, treated with opened surgery, and good postoperative evolution.
Factors predictive of complicated appendicitis in children
Authors: Roushan Chandra Prakash , Sah Ganesh Kumar , Mandal Prince , Koirala Dinesh Prasad , Dahal Geha Raj
Published: November 2021

Background: Clinical features of acute appendicitis are often overlapping with other abdominal pathology in children. This increases the risk of complicated appendicitis (CA). It is still difficult to identify CA preoperatively. The study aims to identify pre operative risk factors in children for CA.Methods: A prospective study was conducted in pediatric surgery unit of department of general surgery of a university hospital of Kathmandu, Nepal. All children up to 16 years diagnosed and operated for appendicitis were included in the study. Based on intraoperative findings and histopathological examination (HPE), patients were grouped in simple appendicitis (SA) and CA. Pre-operative clinical and laboratory variables of between simple and CA were compared. P£0.05 was considered as significant.Results: A total of 73 children were included out of which 61 (83.6%) had SA and 12 (16.4%) had CA. Mean age of participants was 12.8±2.9 years. More than half (64.4%) of the participants were male. The median duration of symptoms was 2 days. In bivariate analysis, gender, serum Na, duration of symptoms and rebound tenderness were significantly associated with severity of appendicitis. In multivariate analysis, rebound tenderness (OR-15.36) and duration of symptoms (OR-9.96) were found to be associated with CA.Conclusions: Male patients, rebound tenderness, longer duration of symptoms and hyponatremia can be used to predict CA. Duration of symptoms and rebound tenderness are independent risk factors for CA.
A comparative study of graft uptake in split skin grafting between the first postoperative dressing done on day 3 versus day 5
Authors: Yalagachin Gurushantappa , Hiregoudar Abhijit D. , Mashal Sanjay B. , Bagur Ashika , Shivaramu Naveena G.
Published: November 2021

Background: Skin grafting offers a method of regaining skin continuity. The common causes of skin graft failure are hematoma, seroma, infection. These affect the graft uptake maximally in the initial postoperative period by impairing graft adherence and subsequent revascularization. Aim of study was to compare graft uptake, rejection, seroma and infection among first postoperative dressing on day 3 versus day 5.Methods: A comparative, prospective study conducted at our institute from November 2015 to April 2021, with 100 patients who underwent SSG (split skin grafting) who were distributed into two groups. Group A underwent the first postoperative dressing on day 3 and group B on day 5. The second postoperative dressing was done 2 days following the first. The grafted site was then assessed on for the percentage of graft uptake, rejection, seroma, infection clinically and through culture and sensitivity.Results: The mean graft uptake in group A was 88.48% whereas in group B was 82.62% in the first dressing and in the second dressing, group A was 88.14% whereas group B was 78.02%, with statistically significant data and thus showing less rejection and infection rate in group A. Seroma was present in 82% of cases in group A and 74% in group B on 1st postoperative dressing which reduced to 6% and 12% respectively with the 2nd dressing.Conclusions: Thus, the first postoperative dressing done on Day 3 following skin grafting, significantly increased the final uptake of the graft, reduced seroma, infection and rejection rate.
Meckel’s diverticulum and its plethoric presentation in paediatric surgery: a case series
Authors: Rajaram Gomalaadevee , Singh Pavin Kaur Bal Baldev , Madzlan Muhammad Firdaus Bin , Fernandez John Emmanuel Gilbert , Badarudin Nurdaliza Binti Mohd
Published: November 2021

Meckel’s diverticulum (MD) is a congenital abnormality of the gastrointestinal tract resulting from incomplete obliteration of the vitellointestinal duct by 5th to 7th week of gestation. Incidence is 2% in the general population with a 2:1 male to female ratio. The various presentations of MD include gastrointestinal bleeding, intestinal obstruction, diverticulitis and intestinal perforation. Majority of the MD is asymptomatic however the potential risk of developing complication it's about 4-6%. Preoperative diagnosis of MD is challenging. We present 6 cases of MD managed at our centre over the course of 1 year. Two cases presented as intestinal obstruction secondary to mesodiverticular band from MD, one case with bleeding, two cases with intussusception and one case of meckel’s diverticulitis.
Double appendix with appendicitis: case report
Authors: Baimakhanov Abilay N. , Smagulov Alibek M. , Otegen Sungat M. , Kozhakhmetov Temirkhan K. , Raiymkhanov Aidar D. , Almatayev Ulan K. , Otegenova Aruzhan M.
Published: November 2021

The frequency of doubling of the appendix, according to the literature, is about 0.004% of the number of appendectomies. According to the literature, there were about 100 cases, of which 15 were complicated by the acute form. Doubling can be partial, complete or of several types: a shoot in the form of a double-barreled gun; "avian" in which there are two developed processes located on both sides of the cecum; and one process is located in its usual place, and the other, as a rule, rudimentary, is located along one of the muscle bands. Doubling of the appendix can be in the cecum or in the duplication of the cecum. It was first described and systematized in 1936 by Cave, then in 1962 by Wallbridge, then in 1993 by Biermann.
Mucinous cystic neoplasm of pancreas a case report
Authors: V. Neetha , Joe Anuroop , S. Hanumanthaiah K. , S. Venkatesh
Published: November 2021

Mucinous cystic neoplasm of pancreas are relatively rare >95% occur in the body and tail of pancreas. Majority occur in young and middle aged female containing ovarian type subepithelial stroma. These tumors are either premalignant (MCN with low grade dysplasia) or (MCN with high grade dysplasia) or invasive carcinoma. Differential diagnosis includes pancreatic pseudocyst and pancreatic hydatid cyst. Investigations include ultrasonography (USG), Magnetic resonance imaging (MRI), Contrast enhanced computed tomography (CECT) supplemented by endoscopic USG with cyst fluid aspiration.
Case report of sclerosing encapsulating peritonitis secondary to tuberculosis
Authors: A. Anandi , R. Preethy , R. Rani Suganya , S. Jothiramalingam
Published: November 2021

Sclerosing encapsulating peritonitis (SEP) is a visceral encapsulation syndrome of inflammatory origin, seen as an infrequent cause of intestinal obstruction in young patients. It is a condition characterised by complete encapsulation of small bowel loops by a fibrocollagenous membrane, leading to cocoon formation. Histologically, the membrane is composed mainly of organised fibrin, probably derived from the plasma exudation of peritoneal microvasculature. Clinical presentation is related to the development of altered gut motility, resulting in abdominal pain and features of intestinal obstruction. We here discussed about a young patient who presented with features of intestinal obstruction and diagnosed with SEP, secondary to abdominal tuberculosis and was then treated surgically. SEP as a cause of intestinal obstruction is a rare life threatening entity encountered in day to day practice. Definitive diagnosis of this condition is challenging in the pre-operative period and is usually missed and a high index of suspicion is required.
Richter's type of obturator hernia with Howship Romberg sign: a case report
Authors: Gayathre S. P. , Kudiyarasu M. , Saugunan Bala Brindha , Kannan R.
Published: November 2021

Obturator hernia is a rare type of pelvic hernia in which intraperitoneal contents protrude through the obturator foramen and is most commonly found in females. It accounts for about 1% of all abdominal hernias and possesses a great diagnostic challenge due to the non-specific symptoms and meagre clinical signs. Hereby we report a case of obturator hernia in an nonagenarian emaciated fragile old lady who presented with features of acute Intestinal obstruction and was diagnosed using computed tomography as right sided obturator hernia and eventually was taken up for emergency laparotomy. The herniated segment was resected and anastomosis was done with primary closure of the defect. Postoperative period was uneventful and the patient was discharged on postoperative day 7.
Clinical and bacteriological profile of urinary tract infection in children at a tertiary care hospital
Authors: Nag Bikash Chandra , Rahman M. Mizanur , Pervez Mehdi , Halder Ashis Kumar , Rahman M. Mujibur , Begum Ruksana
Published: December 2021

Background: Urinary tract infection (UTI) is common in children and is an important cause of morbidity. UTI at young age can lead to renal injury and scarring, and ultimately lead to end stage renal disease in adulthood. Aim of the study The objectives of this study were to study the clinical and bacteriological profile of UTI in children.Methods: This prospective study was done in Sher-E-Bangla medical college hospital, Barishal from January 2018 to July 2019. A urine sample was included in our dataset if it demonstrated pure growth of a single organism and accompanying antimicrobial susceptibility and subject demographic data were available.Result: UTI was more common in female (70.0%) than in male (33.0%). Half were in the age group 1-5 years. Fever was the most common presentation (64.0%) followed by abdominal pain (42.0%), dysuria /increased frequency (34%), decreased appetite (28%). Escherichia coli was the most common (64%) bacterial isolate followed by Klebsiella sp. (20.0%) and Proteus sp. (14.0%). E. coli was highly sensitive to ofloxacin, cefotaxime and amikacin (94.0%). Klebsiella was 100% sensitive to ciprofloxacin and amikacin. Greater degree of resistance was seen to ampicillin, cotrimoxazole and nalidixic acid.Conclusions: Though various microorganisms are responsible for UTI in children, E. coli is the most common causative agent. Antimicrobial resistance has already emerged against many antibiotics, making empiric treatment of these infections challenging.
Geometric and game approaches for some discrete optimization problems
Authors:   Russian State Social University, Wilhelm Pieck str. 4, Moscow, Russia, 129226, Melnikov Boris , Melnikova Elena ,   Russian State Social University, Wilhelm Pieck str. 4, Moscow, Russia, 129226, Pivneva Svetlana ,   Russian State Social University, Wilhelm Pieck str. 4, Moscow, Russia, 129226, Dudnikov Vladislav ,   Togliatti State University, Belorusskaya str. 16, Togliatti, Russia, 445020, Davydova Evgenia ,   Moscow Aviation Institute (State Technical University), Volokolamskoe shosse 4, Moscow, Russia, 125993
Published: December 2021

We consider in this paper the adaptation of heuristics used for programming nondeterministic games to the problems of discrete optimization. In particular, we use some “game” heuristic methods of decision-making in various discrete optimization problems. The object of each of these problems is programming anytime algorithms. Among the problems described in this paper, there are the classical traveling salesman problem and some connected problems of minimization for nondeterministic finite automata. The first of the considered methods is the geometrical approach to some discrete optimization problems. For this approach, we define some special characteristics relating to some initial particular case of considered discrete optimization problem. For instance, one of such statistical characteristics for the traveling salesman problem is a significant development of the so-called “distance functions” up to the geometric variant such problem. And using this distance, we choose the corresponding specific algorithms for solving the problem. Besides, other considered methods for solving these problems are constructed on the basis of special combination of some heuristics, which belong to some different areas of the theory of artificial intelligence. More precisely, we shall use some modifications of unfinished branchand-bound method; for the selecting immediate step using some heuristics, we apply dynamic risk functions; simultaneously for the selection of coefficients of the averaging-out, we also use genetic algorithms; and the reductive self-learning by the same genetic methods is also used for the start of unfinished branch-and-bound method again. This combination of heuristics represents a special approach to construction of anytime-algorithms for the discrete optimization problems. This approach can be considered as an alternative to application of methods of linear programming, and to methods of multi-agent optimization, and also to neural networks.
Role of Endoscopic Ultrasonography in Differential Diagnosis of Pancreatic Cystic Lesions
Authors: Kim Young Jung , Han Joung-Ho
Published: December 2021

Pancreatic cystic lesions (PCLs) are being identified increasingly because of recent advancements in abdominal imaging technologies, presenting a number of challenges in clinical practice. Although most PCLs are benign, some carry a significant risk of malignant degeneration. Accurate diagnosis of PCLs is important for proper management and follow-up. Endoscopic ultrasound (EUS) is useful for the characterization of PCLs with high sensitivity and accuracy. Additional information can be obtained using EUS for indeterminate lesions on computed tomography or magnetic resonance imaging. In this review, we introduce the relevant EUS findings for the diagnosis of relatively common PCLs.
Graves’ Disease Following Subacute Thyroiditis
Authors: Choi Young Sik
Published: December 2021

Subacute thyroiditis is an inflammatory thyroid disease caused by viral infection. Graves’ disease is an autoimmune thyroid disease caused by thyrotropin (TSH) receptor antibody (TRAb). Graves’ disease following subacute thyroiditis is rare, and only a few cases have been reported. A 58-year-old woman presented with anterior neck pain and swallowing difficulty. Laboratory tests showed elevated FT4, low TSH, normal TRAb, and elevated erythrocyte sedimentation rate. Thyroid ultrasonography (US) revealed focal, ill-defined hypoechoic areas in both thyroid lobes. The patient was treated with corticosteroid, and symptoms subsided after 1 month. Three months later, she complained of tremor and palpitation. Thyroid function testing showed hyperthyroidism with the positive conversion of TRAb, indicating Graves’ disease. Doppler US showed increased vascular flow in both thyroid lobes. She started treatment for hyperthyroidism with methimazole.