bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Two-Port Verses Three-Port Laparoscopic Appendicectomy in CCM Medical and Hospital
Authors: Khare Dr. Manish , Khanolkar Dr. Ajay
Published: March 2019

One of the most common cause of acute abdomen is acute appendicitis. A concept of ‘‘scarless’’ abdomen first described in 1998 by Esposito by Single Incision Laparoscopic Surgery was and has gained popularity. Still appendectomy is performed by laparotomy in most of the countries, causes may be the cost of the instruments or availability and affordability by the patients. Laparoscopic appendectomies are gaining popularity because of decreased pain, fewer postoperative complications, earlier mobilization, shorter hospitalization, earlier return to work, and better cosmesis. The aim of the study is to compare operative time, intra and post -operative complications, hospital stay after surgery in patients with two-port laparoscopic appendicectomy with the conventional three-port laparoscopic appendicectomy and to describe this technique for performing laparoscopic appendectomy with three portals at very low cost and with good aesthetic appearance and to compare the results with the conventional three-port laparoscopic appendicectomy.

Material and Methods - Patients over the age of 18 with a diagnosis of acute abdomen, later on confirmed to acute appendicitis were included in the study. Out of 50 patients with laparoscopic appendicectomy, 23 for two port appendicectomy and 27 three port were included in the study. Hasson's technique was adopted for laproscopic access in to the abdomen. 10-mm umbilical port and 5-mm port was inserted with a grasper. Through the umbilical working trocar mesoappendix transected base of the appendix was ligated and the appendix was resected.

Results - 23 cases performed using the two-port technique and 27 cases were performed using conventional 3 port technique. Operative time in two port appendicectomy (n=23) was 58±3.6 while in Conventional 3 port appendicectomy (n = 27) it was 52±2.4. Hospital stay for patients with two port appendicectomy was shorter and statistically significant.

Conclusion - Two port appendicectomy is a safe and cost effective procedure and no major complications were found in this procedure.
Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section
Authors: AboBaker Dr.Randa Mohammed
Published: March 2019

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.
Study of Ultrasound in Acute Abdomen at Ccmmc and Hospital, Durg
Authors: Shah Dr. Urvil A. , Shah Dr. Anil K.
Published: March 2019

Acute abdomen is a term frequently used to describe the patients who are having abdominal tenderness and rigidity. Before the use of imaging technique, these patients were candidates for surgery. Ultrasound plays an important role in the initial evaluation of the acute abdomen. Ultrasound may be used as a first line of investigation in order to make a definitive diagnosis or can be used as a triage tool to direct subsequent patient management appropriately. Ultrasonography remains the primary imaging technique in the majority of cases, especially in young and female patients, when there is a limitation of the radiation exposure. Material and methods: 50 cases of acute abdomen were selected for the study. Patients with trauma and with compromised vital signs were excluded from the study. History taking and thorough clinical examination was carried out. All necessary biochemical and haematological investigations were carried out. Provisional diagnosis was made on the basis of sonographic findings. Results: 27 patients were male and 23 were females. Mean age of the patients was 36.34± 21.03 years. Final diagnosis was made on the basis of operative procedure, histopathology and therapeutics. Finally, 15 (30%) cases were diagnosed as acute appendicitis. 9 (18%) were diagnosed as acute cholecystitis, 4 (8%) each as pancreatitis, ulcer perforation and instentinal obstruction, 2(4%) each were diagnosed as ectopic pregnancy, Amoebic liver abscess, psoas abscess and Renal cause, 4 (8%) were diagnosed as pelvic inflammatory disease and 2 (4%) were chronic liver disease. Among the surgically treated patients, 38 patients (72%) were correctly diagnosed by preoperative ultrasonography. These included acute appendicitis (n = 14), acute cholecystitis (n = 10), ulcer perforation (n = 4), and liver abscess (n = 2), ectopic pregnancy (n=2), intestinal obstruction (n=4) and psoas abscess (n= 2). Conclusion: Ultrasonography plays an important role in the evaluation of the acute abdomen and initial evaluation by supporting the differential diagnosis.
Vitamin and HbA1C Status in Tuberculosis Patients with Diabetes and its Association
Authors: Singh Dr. Charanpreet
Published: March 2019

Diabetes mellitus (DM)-tuberculosis is associated with poor glycemic control in DM patients. 2. DM is the most common risk factor associated with tuberculosis (TB); TB is also the third cause of death due to non-communicable disease (NCD).

Materials and Methods: Present study was conducted in Dept. of TB and Chest Vedanta Institute of Medical sciences, Vedanta Hospital. A total of 100 patients of Type 2 DM were enrolled in the study of which 60 were male and 40 were female. Written consent was obtained from each patient to participate in the study. The study will be conducted in the patients admitted in the Department of TB and Chest in collaboration with Dept. of Biochemistry, Intensive Coronary Care Unit at Vedanta Hospital. All patients of DM with TB infection are diagnosed by clinician and admitted in our hospital for treatment. Informed consent was taken from all patients, who participated in our study and the study was approved by the college ethics committee.

Blood pressure, height, body weight, and waist and hip circumferences of each patient were measured as an anthropometric and dietary measurement. Body mass index (BMI) and ratios of waist to hip circumference was calculated. Blood pressure of each patient was measured after giving rest for at least 5 min.

Results: HbA1C levels were higher in the selected group of DM + TB patients mean value being 8.1 ± 0.56 %. There was a significant difference in Vit. B12 levels between cases (218.15 ± 35.65) and controls (355.02 ± 23.39), where serum level was low in cases compared to control group. About 13(18.88%) patients had Vit. B12 level less than 150pg/ml and 28(40.58%) were lying in the intermediate level between 150pg/ml to 350pg/ml. Serum vit.B12 levels ranged from 118pg/ml to 315pg/ml. 25(OH) D3 levels were 17.09 ± 2.15 ng/ml in study group where as in control group the levels were found to be 22.88±4.01.The BMI was higher in those suffering from DM+TB (28.13± 3.24) in comparison to normal subjects (24.89 ± 3.95).

Conclusion: Our study has showed high prevalence of TB-DM co-burden of disease in our hospital settings and TB+DM TB-DM were significantly associated with age. Also it is concluded that vitamin D is a link between PTB and DM. Vitamin D levels are lower in patients with TB with DM. This study recommends the importance of performing diabetes screening among pulmonary TB patients and further similar studies needs to be done to determine the feasibility of TB-DM co-management.
TAP Block in Children: Does Inflammation Affect on Pain Score?
Authors: B. Odgerel , O. Sergelen , L. Ganbold
Published: March 2019

Objective: The aim of this study was to evaluate of analgesic effect of ultrasound guided transversus abdomines plane (TAP) block in children undergoing open laparotomy surgery and compare to children were used general anesthesia (GA) alone. Methods: 60 children aged 3-18 years with ASA I-III classification were randomly enrolled in this study. We divided these children in to two groups: control group (GA alone, n=31) and study group (GA+TAP block, n=29) and also divided each group in two subgroups which were with inflammation and without inflammation. All children were received GA with same techniques. Study group (TAP block group) were assigned to receive ultrasound guided block in both side of abdomen using 0.3 ml/kg of Bupivacaine 0.25%, but not more than 12 ml in each side. Hemodynamic variables such as heart rate, blood pressure were measured at baseline (T0), after induction (T1), after skin incision (T2), and end of surgery (T3), and in the recovery room or ICU, at the 2nd, 4th, 6th hours  postoperatively and examined pain intensity and analgesic requirement and frequency, also correllation between inflamatory process and pain intensity were studied. Statistic analysis was made in Excel using ANOVA, descriptive analysis, correlation and regression analysis. A p-value<0.05 was considered significant. Results: There was no differencies between the two studied groups regarding demographic and clinical characteristics. Intraoperative heart rate elevation was higher in GA group with an inflammation (13.3%) and the systolic blood pressure changes was higher (4.2%) after skin incision than study group and GA group without inflammation.  Level of WBC had very weak positive and statistically significant correlation with intraoperative opioid usage (GA+Inf: r=0.029, p=0.023; ТAP+Inf: r=0.18, p=0.016; GA-Inf: r=0.018, p=0.014) but there was not observed correlation in TAP-Inf group. Postopeative pain score was higher in control group and an analgesic requirement and frequency was much more. Conclusion: Transversus abdomines plane block under ultrasound guidance was easy, safe, reliable and effective analgesic in children undergoing open laparotomy surgery and TAP block is a good component of postoperative multimodal analgesia. The inflammatory process increases pain intensity and intra and postoperative analgesic requirements.
Familial Hypocalciuric Hypercalcaemia (FHH): A Case Report
Authors: Kulasegaran Tivya , Kumar Pranav
Published: March 2019

Familial hypocalciuric hypercalcaemia (FHH) is a rare genetic autosomal dominant disorder, with 3 variants described. An inactivating mutation in the calcium sensor receptor (CASR) gene causes the subtype 1, which represents 65% of the cases. Inactivation of Ca-sensing receptors (CaSR) can also lead to hypercalcemia associated with increased parathyroid hormone (PTH) secretion.[1]

It is characterised by causes mild asymptomatic hypercalcemia[2] and hypocalciuria with normal or elevated PTH. FHH is generally asymptomatic and treatment is not needed. Differential diagnosis with primary hyperparathyroidism (PHPT) is crucial and based on calcium-creatinine clearance ratio (CCCR), which, when under 0.02 points to the diagnosis of FHH.[3] Genetic test is necessary for confirmation.[4]
Study of Drug Utilization on Acute Poisoning Cases Treated at Tertiary Care Hospital
Authors: Todi Dr. Sreya
Published: March 2019

Acute poisoning is common everywhere in medical emergency.  Acute poisoning may be due to deliberate exposure to drugs, chemicals and natural toxins or accidental which is emergency for common medical health.  The main aim of this study was to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with treated acute poisoning. Material and Methods:  This prospective cross sectional study was carried out in the emergency department of a tertiary care centre over a one year period. Result: During the period of 1 year total 310 Acute poisoning cases were recorded by us. Out of 310 acute poisoning cases 170(54.8%) were male where as females were 140(45.2%). The majority of cases were from age group of 20 -50 years in males whereas mean age of female patients was 37.3 years and majority of the cases were from 25-50 age group. The most common route of exposure to poisons (69.6%) was ingestion and followed by dermal exposure (in cases of venomous animal exposures) (25.8%) and inhalation (4.6%).The most common symptomatic treatments given to the patients were antimicrobials (88.7% of cases),  antiemetics (82.6%% of cases), H2 blockers (72.9% of cases) and Atropine (51% of cases), pralidoxime (41.6% of cases)  Proton pump inhibitors and  Vasopressor agents  etc respectively. The most commonly prescribed specific antidotes were Anti-snake venom (ASV) (12.9% of cases).Conclusion: In the present study, the main causes of poisoning were identified as household products in urban areas of India. Awareness about the dangers of such poisons should be the added responsibility of  health and hospital authorities. Poison control center establishment in the region will also help in preventing and controlling such poisoning events.
Detection of Multiresistance Tuberculosis in the Surrounding of Tuberculosis Patients with Multiresistant Bacillus in Kinshasa (DRC)
Authors: B.M.J. Kabedi , K. Taba , N.J.M. Kayembe , K.P. Kayembe , M.O. Lunguya , F.S. Bisuta , K.P. Mbaya , T.J.J. Muyembe
Published: March 2019

Context - Diagnosis and early treatment of MDR-TB in contact cases is a major challenge in hope to reduce the burden of morbidity and mortality due to this condition. Objectives - The objective was to assess the prevalence of drug-resistant TB and to compare the phenotypic and genotypic profile of the contact case with that of the index. Material and Methods - Prospective cohort study of 240 household contacts of 59 MDR-TB cases diagnosed and having a positive Ziehl at Elonga, St Alphonse and CUK CSDT was carried out from July 1, 2011 to August 28, 2013. Two sputum specimens were examined in each suspected tuberculosis contact for Ziehl-Neelsen's Koch bacillus and cultured for susceptibility testing on Lowensten-Jensen medium. The tuberculin test was performed on each contact and the spoligotyping of the index of contact cases was performed to determine whether the strains were epidemiologically linked. Results - Twenty-nine contacts out of 240 (12.1%) had symptoms suggestive of tuberculosis and 29 strains of Mycobacterium were isolated from 18 HIV-positive and 11 HIV-negative patients. The identification of these strains shows 26 Mycobacterium. tuberculosis and 6 Mycobacterium africanum. Of these contacts, 23 had a positive Ziehl and 6 had a negative IDR and Ziehl with positive HIV status. The antibiogram performed shows 16 resistant strains at least to one antituberculosis drug. MDR-TB (6.3%) and among them 4.2% preXDR (10) and 0.4% XDR-TB were detected. The phenotypic profile of 15 strains of the contacts corresponded to that of the index case and among the 8 typed strains, six were identical to the source case and 2 had a different profile. Conclusion - The survey determined the prevalence of TB and MDR-TB among the index case contacts. The high proportion reported in this survey is reminiscent of the WHO's alarm bell for early detection to halt the spread of the disease in the population.
Nasolabial Flap Tunneled Under Mandible (NLFTUM) - An Alternative to Free Flap, in T3 Tongue Reconstruction
Authors: Riju Dr. Jeyashanth , Thomas Dr. Shaji , Mathew Dr. Elizabeth , George Dr. Nebu Abraham
Published: March 2019

Introduction : Nasolabial flap tunneled under mandible(NLFTUM) is a good option for reconstruction of any T3 lesion in the oral cavity. It is oncologically safe and gives a better functional outcome compared to other locoregional flaps. When compared to free flap it is a cost effective and time saving procedure. Methods: We present a series of our results wherein NLFTUM was used in 9 patients who presented with biopsy proven carcinoma tongue,  clinically T3 lesion which was away from the mandible. Wide excision of lesion was performed with neck dissection and  NLFTUM reconstruction was used in all patients, preserving mandible.  All these surgeries were performed in 2017 in a 5 months window period. A total of 9 flaps were harvested. Adjuvant radiotherapy was given when indicated. Results: Reconstruction was done in 9 patients in whom 7 were men and 2 women. Mean size of the surgical specimen for which reconstruction done was 5.3 +/- 0.6cm.  89% cases had defect which reached posterior 1/3rd tongue. Reconstruction was successful in 89%  of the cases. Total flap necrosis occurred in 1 patient, 2 patient had minimal necrosis in the distal end of the flap, all were managed conservatively. Oral function and swallowing were satisfactory in all these patients. Cosmetic result was comparable to the normal nasolabial flap. There was no major complication associated with the procedure, none needed any major intervention. Conclusion: NLFTUM is reliable for reconstruction of lesion with defect which is as big as 6 cm in oral cavity, especially for tongue defects, even if it extends to posterior 1/3rd. We have used this in tongue defect because of its excellent functional outcome and there is no risk of added complications.
Acupuncture Treatment in Patient with Uterine Polyp
Authors: Zhu Prof Dr Jihe , Arsovska BSc Blagica , Kozovska BSc Kristina
Published: March 2019

Uterine polyps are benign growths on the inner wall of the uterus, which extend into the uterine cavity. Excessive growth of the mucous membrane of the uterus (endometrium) leads to the formation of polyps on the uterus. Uterine polyps are usually non-cancerous (benign), although some may be carcinogenic or possibly develop over time into cancer. Polyps can be divided into two groups: endo-cervical polyps and endometrial polyps. Uterine polyps most commonly occur in women who undergo menopause or are in postmenopausal period, although polyps may occur in younger women too. In Traditional Chinese Medicine (TCM), the cause for uterine polyps is usually a combination of Blood deficiency, Blood stagnation and Liver/Kidney Deficiency. The aim of the treatment is to move the blood, to make the blood flow free and smooth, resolve the dampness, resolve the blood stagnation, treat the underlying deficiencies and etc. The treated patients is 41 year old woman, diagnosed with 10 mm uterine polyp. The patient was also diagnosed with infertility and was having irregular periods. The patient was treated with acupuncture in a clinic for TCM and acupuncture in Skopje. In a period of 4 months, 14 treatments were made, indoor, on a room temperature, with duration of the treatments of 30-45 minutes. After the 4th treatment her period was regularized and after 14 treatments the polyp was gone. Acupuncture as a treatment for uterine polyps is safe and effective treatment and gave very satisfying and positive results in our treated patient.
Ear Abuse among School Children in Ekiti, Nigeria
Authors: Olajide Toye Gabriel , Olajuyin Oyebanji Anthony , Eletta Adebisi Paul , Dosunmu Adepeju Oluwatona
Published: March 2019

Background/Aim: Otological trauma due to physical abuse is a common occurrence among the young persons. However, the condition is overlooked and underreported. This study aimed at determines prevalence and profile of ear abuse in school children in Ekiti, Nigeria. Methodology: This study was a cross sectional survey among secondary school students in Ekiti, South Western Nigeria. Data were collected using a semi-structured interviewer administered questionnaire. Results: A total of 130 students aged 13 and 16 years participated in the survey. Of the 130 students that were interviewed, 76 (58.5%) had been otologically abused (Slapped) at one time or the other. Majority (26.9%) of the students were slapped by their parents. Left ear was mostly affected in 39 (51.3%) of them. The most common reason for the slap was disobedience in 56 (73.7%) of the students. Only 5.4% reported the case of slap to appropriate authority. About 73.7% did not receive treatment or any form of intervention. Pure tone audiogram (PTA) done showed that 32.9% (19.7 % male and 13.2 % female) of the respondents had mild conductive hearing loss. Conclusion: Ear abuse, although poorly recognized and underreported is still common in our society. A prevalence of 58.4 % with 32.9% hearing loss was recorded in this study. There is need for a public enlightenment programs in order to create awareness among teachers, school managers and parents so as to address these ugly trends and to prevent late sequel of hearing loss and learning disability.
Conventional Dacryocystorhinostomy Versus Pawar’s Implant Dacryocystorhinostomy- A Prospective Study
Authors: Chandravanshi Shivcharan Lal , Shrivastava Sunil Kumar , Shakya Devendra Kkumar , Tiwari Uma Saran
Published: March 2019

Purpose: To compare conventional dacryocystorhinostomy (DCR) with Pawar’s intracystic implant dacryocystorhinostomy in terms of surgical technique, complications and success rate for primary acquired nasolacrimal duct obstruction (NLDO).

Materials and Methods: This is a prospective comparative, nonrandomized, clinical study. It is carried out on 50 cases of primary acquired NLDO. The 50 cases were divide into two groups; Group A consisting of 30 cases that underwent Pawar’s intracystic implant DCR whereas Group B consisting of 20 cases those operated by conventional DCR technique.

Data regarding demographic profile of patients, mode of presentation, diagnosis, intraoperative variables such as surgical duration, intra- and post-operative complications, hospital stay and causes of failure and final surgical outcome, were analyzed. Clinical success was defined as patent lacrimal system on irrigation (objective) and absence of symptoms (subjective).

Results: Out of 50 cases 40 (80%) were female and 10 cases (20%) were males. In this study, 39 (78%) cases had chronic dacryocystitis, followed by pyocele/mucocele 5 (10%), chronic dacryocystitis with lacrimal fistula 3 (6%), and previous failed DCR surgery 3 (6%).

Hemorrhage from nasal mucosa was observed in 9 cases (45%) during conventional DCR surgery and one case (3.33%) in implant DCR. Hemorrhage from angular vein occurred in 1 case (5%) during conventional DCR. Nasal mucosa was disrupted/damage in 8 cases (40%) during conventional DCR. The average operating time in convention DCR is 110.50 minutes while for Pwar’s implant DCR is 27.33 minutes. The commonest post-operative complication of Pawar’s intracystic implant DCR was obstruction of passage found in 4 cases (13.33%). Hypertrophic scar was the most common postoperative complication in 8 cases (40%) in conventional DCR. Success rate of implant DCR at 2 months follow up was 83.33% and at the end of 3 months after management of failed cases of implant DCR was 96.66%. Success rate of conventional DCR at 2 months follow up was 80% and at the end of 3 months after management of failed cases of conventional DCR was 85%.

Conclusion: The success rate of Pawar’s intracystic implant DCR is comparable with conventional DCR with additional advantages such as easy, quick, minimal intra- and post operative complication and possibility of conventional DCR in future in failed Pawar’s implant DCR.
Burden of Malaria in three Endemic Districts of Bhutan: Road to Malaria Elimination
Authors: Chhetri Vishal , Dukpa Tobgyel , Namgay Rinzin , Wangchuk Kesang , Pokrel Hari Prasad
Published: March 2019

Introduction: Bhutan is considered as a low endemic country for malaria. In the last decade, Bhutan has successfully reduced the number of malaria cases with the support from Global Fund and WHO. Sarpang, Samtse and Samdrup Jongkhar districts located in the Southern foothills of Bhutan records the most cases. Method: This retrospective study was undertaken with the available census record maintained in health centers of the three endemic districts and VDCP. Results: There were 892 confirmed malaria cases in 2009 and 41 cases in 2017 in three endemic districts. The slide positivity rate (SPR) declined from 2.2% in 2009 to 0.1% in 2017. The distribution of disease was significantly higher (p<0.05) amongst the male population with the increasing trend of Plasmodium vivax infection. The study found predominance of P. vivax in Samtse (93%), and Sarpang (62%) and Plasmodium falciparum in Samdrup Jongkhar (61%). The last four years (2014-2017) data showed that maximum cases detected were imported, followed by indigenous and introduced malaria; with 50%, 44% and 6%, respectively. The mortality and morbidity due to malaria has magnificently declined in the last decade. Conclusion: The large-scale implementation of vector control interventions, such as insecticide-treated bed nets, indoor residual spraying, free health care service and active vector surveillance has achieved a marked reduction in malaria incidence. Cross border malaria is still a huge challenge for elimination of malaria in Bhutan. Thus, imported malaria is an increasing problem due to high receptivity, and vulnerability.
Investigation of the Arrhythmia Parameters of Hemodialysis Patients with Hypotensive Episodes
Authors: Yalım Zafer , Demir Mehmet Emin , Alp Çağlar , Özkan Melike , Yalım Sümeyra Alan
Published: March 2019

Background: Sudden cardiac death is the leading cause of cardiac caused death in hemodialysis patients. Hypotensive episodes in pre- intra and post-dialytic periods are the serious clinical challenges that effect patients life quality and prognosis. We investigated whether hypotensive episodes have an association with ventricular arrhythmias and discuss literature. Methods: Totally 56 cases; twenty-two patients with frequent hypotension episodes, and 15 normotensives patients who were on maintenance hemodialysis treatment and 19 healthy individuals were included in the study. Pre-intra and post-dialytic periods recorded by using a 24-h Holter rhytm device. p< 0,05 is postulated as significantly distinct. Results: Records of 50 participants were evalated properly. Both in hypotensive and normotensive hemodialysis patients ventricular extrasystoles [VES] counts were in a strong relation with lower blood pressure p<0,05. Comorbid diseases [diabetes mellitus, coronar artery disease] which may lead arrhtymias were similar in all three groups. 16 of 18 hyptensive patients also were non-dipper [p<0,05]. Conclusion: Our study revealed that frequent hypotensive episodes are associated with arrhythmia. Clinicians should be aware of arhhythmia which is most important cause of sudden cardiac death and must consider performing a deep cardiological evaluation.
Vitamin B12 Deficiency an Unusual Cause of Fever: A Case Report
Authors: . Shyama , Kumar P. , . Surabhi
Published: March 2019

Introduction: An unusual case of a 19 year old female, presenting with fever, pallor and hepatosplenomegaly for one month. She had microcytic anemia on peripheral smear examination but her bone marrow aspiration & biopsy revealed a hypercelluar marrow with megaloblastic erythroid hyperplasia. Resolution of fever within 48 hours of Vitamin B12 supplementation, initiated in view of the megaloblastic bone marrow picture & low serumVitamin B12 level, suggests a causal association. Conclusion: Vitamin B12 deficiency seems to be an unusual cause of PUO (Pyrexia of unkown origin) which should be ruled out in every case of PUO.
An Integrated Intervention for the Treatment of Serious Psychosomatic Illnesses Such As Cancer
Authors: Fortuna Fabiola
Published: March 2019

Background: The term “psychosomatic”often is improperly used: currently psychosomatic means both the set of morbid states that can create mental illness, and the psychic implications in the aetiopathogenesis of organic diseases.

Personally, I think it is more useful to focus on the question from this last point of view. I think also that the real psychosomatic disorders should also include cancer, cardiovascular diseases and multiple sclerosis.

This does not imply that the etiopathogenesis of these diseases might solely be of a psychic nature, but we should also hypothesize this possibility, along with hypothesizing the contributing factor of psychological causes.

Actually the hypothesis most credible is that the serious organic diseases such as cancer, originate from three main factors: genetic, environmental and psychic.

Methods: The N.M.P.M.P. (New Psychotherapeutic Method Psychosomatic Diseases) is a integrate method that consists in individual collogues, psychophysical relaxation techniques and group psicotherapy with analytical psychodrama created by Eugenie and Paul Lemoine.

Results: Even though it is not possible to get statisical data, the NMPMP’s results are very promising: the method are generated a significant improvement in health conditions for patients; from alleviation of chemotherapy symptoms to complete remission of the symptoms related to neoplasie.

Conclusions: The clinical experience described shows to be strategically indispensable an integrate psychological intervention for patients suffering from serious organic diseases.
CLUSTER APPROACH TO DEVELOPMENT OF THE REGIONAL HEALTH SYSTEM
Authors: Gabbasov Farid Fargatovich , Samedova Elmira Nazimovna , Zverev Vladimir Vladimirovich
Published: March 2019

The article touches upon the problem of the importance of health system in reproduction of human capital, maintenance and restoring the social and physical well-being of the people. In modern conditions regional health systems are not able to fully implement their functions due to insufficient funding, poor management, and irrational use of resources. There has been investigated the scheme of producing and rendering medical services, as well as the main functions, areas and activities of the health care system. Three business lines of health system entities have been determined: producing, utilization and regulation. Priorities of health care development that must be regularly revised due to changing factors, conditions, technologies are presented schematically. It has been substantiated that the cluster approach is one of the most effective mechanisms for improving the management system in health care. Benefits of clustering of constituent entities of the healthcare system have been refined. There is proposed a methodical approach to forming clusters in the Russian regional health care. The implementation of the cluster approach is noted to be determined by the rationality of organizational and economic support of the health care system, which means a set of organizational, legal, infrastructure, financial methods and instruments of influence. The algorithm of formation of the medical cluster structure on the basis of which the model of the Astrakhan regional medical cluster is developed is proposed. The most important stage of developing cluster is found forming its core by means of assigning the key medical organizations and their business satellites. It has been inferred that the cluster functioning helps to reduce costs of its participants, provide investment attractiveness of the cluster itself and its separate participants, raise efficient use of resources at the expense of mutual application of medical equipment and technologies, guarantee the quality and availability of medical care, develop competitive behavior etc.
De subdelegado a jefe político: la conformación de la autoridad gubernativa 1812-1841. Planteamiento a partir del caso de Yucatán
Authors: Brondino Laura
Published: March 2019

Este artículo explora la conformación de la autoridad gubernativa en el contexto de la separación de poderes estrenada en 1812. Para ello, se analiza el tránsito del subdelegado de origen borbónico, figura judicial de nombramiento real, al jefe político, agente del ejecutivo estatal republicano, ambos abocados al gobierno en el ámbito de los partidos. Este proceso se estudia en el caso yucateco, pues en Yucatán la supervivencia prolongada de los subdelegados y la instalación relativamente tardía de los jefes políticos permiten observar, mejor que en otras regiones, los detalles de la problemática transformación de la autoridad de judicial a ejecutiva.La hipótesis central es que, por lo menos en el caso yucateco, la supervivencia prolongada del subdelegado, prolongó a su vez la concepción jurisdiccional antigua del gobierno, sin generar una nueva autoridad ejecutiva, al mismo tiempo que su adaptación al marco republicano de separación de poderes modificó las prácticas de gobierno, favoreciendo el desarrollo de una autoridad gubernativa. El jefe político, definitivamente institucionalizado en 1841, marcó un hito en este desarrollo: más que ser ejecutor de leyes y órdenes con capacidad negociadora, su función esencial y su autoridad radican en la negociación de intereses y derechos, imitando discrecionalmente las antiguas formas jurisdiccionales. El objetivo es esclarecer la forma en que se obró por construir y concentrar la coacción legítima en el México decimonónico, que constituye una de las peculiaridades de su conformación gubernamental.
El legado de las Siete Leyes: una reevaluación de las aportaciones del constitucionalismo centralista a la historia constitucional mexicana
Authors: Andrews Catherine
Published: March 2019

El objetivo de este artículo es analizar las principales características de la constitución de las Siete Leyes (1836) y evaluar su impacto en el constitucionalismo mexicano posterior. El consenso de la historiografía es que las Siete Leyes fue el primer texto constitucional del grupo político conservador y, por ende, se considera que esta constitución no tuvo impacto en el desarrollo del proyecto liberal que desembocó en la Constitución de 1857. La investigación aquí presentada muestra que esta apreciación es falsa y que las ideas constitucionales de las Siete Leyes influenciaron tanto las Bases Orgánicas y el constitucionalismo conservador posterior, como el constitucionalismo liberal.
Gobierno, legitimidad y movilización: aspectos de la vida electoral en tiempos insurgentes
Authors: Ducey Michael Thomas
Published: March 2019

Partiendo de las valiosas observaciones de Virginia Guedea sobre las elecciones insurgentes convocadas por José María Morelos en 1813, esta investigación, basada en información proveniente del Archivo General de la Nación y de colecciones impresas de fuentes primarias, indaga sobre la función de los comicios en las regiones rurales del país controladas por las fuerzas rebeldes. En vez de discutir los temas de política nacional asociados con la formación del Congreso de Chilpancingo, el artículo centra su atención en la experiencia electoral en los pueblos del territorio insurgente. Las elecciones permitieron a los mandos medios y bajos de la rebelión fortalecer su posición ante la sociedad local haciendo evidente a las poblaciones su autoridad y valiéndose de los eventos para establecer su legitimidad como gobernantes. También sirvieron como actos públicos de adhesión al movimiento y una oportunidad para movilizar a los habitantes a su favor. Además de la cuestión de movilización social, el estudio explora el lenguaje de los actores y los aspectos ritualistas de los comicios para examinar la mentalidad de los insurgentes.  Por este medio, podemos mejor entender como éstos concebían el papel de los elementos corporativos en el proyecto de construir un gobierno nacional de forma republicana y representativa desde las bases comunitarias del país. El artículo concluye que de una manera orgánica los revolucionarios aprovecharon las tradiciones coloniales enraizadas en las Repúblicas de indios para crear una visión novedosa de la relación entre la sociedad y el gobierno.
La globalización temprana. Réplica a Mariano Bonialian
Authors: Hausberger Bernd
Published: March 2019

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Geologists of Russian origin in Latin America
Authors: Tchoumatchenco Platon , Riccardi Alberto C. , Durand Delga Michel , Alonso Ricardo , Wiasemsky Michel , Boltovskoy Demetrio , Charrier Reynaldo , Minina Elena
Published: March 2019

We describe here the life and career of geologists   who beyond their nationality (Russian, Ukrainian, Tatar, German, etc.), were born on the territory of the Russian Empire, the Soviet Union or the Russian Federation  and  their descendants that  became geologists, all of whom  lived and worked in Latin-American  countries (where Spanish and Portuguese languages prevail).We include  also geologists from USSR who worked temporary in some countries of Latin America and left contributions to geology in form of publications.
The implications of the impact of the recreational use of forest mining ponds on benthic invertebrates with special emphasis on gastropods
Authors: Spyra Aneta , Strzelec Małgorzata
Published: March 2019

The relationships between the distribution and diversity patterns of benthic invertebrates in forest ponds used for different recreational activities were examined in this study. The study was based on sampling of benthic invertebrates, plant coverage, physical and chemical analysis of water samples and multivariate species analysis. Mining ponds varied in their solution chemistry and plant cover, with those used for recreation having significantly lower invertebrate occurrences (755 ind. m−2) compared to ponds with no recreational use (2629 ind. m−2). Statistically significant differences were also observed in the density of Oligochaeta, Hirudinea, Coleoptera, Trichoptera and Diptera between the two types of ponds. Overall, gastropods were more diverse and abundant in ponds not used for recreation. This appeared to relate strongly to plant cover, since cover was greatly reduced in recreational ponds, although plant diversity was enhanced. Density and diversity of benthic invertebrates was also observed to differ in relation to the kind of recreational use involved (recreational angling, swimming, power boating) although this was not quantified. The occurrence of freshwater snails primarily depended on the Ca concentration, the conductivity of the water and plant cover, but recreational disturbance appeared to reduce abundance where it occurred and was related to a reduction in overall plant cover.
Institutions, trust and the high level of innovativeness in the Scandinavian countries
Authors: Misiura Gabriela , Rozkwitalska Małgorzata
Published: March 2019

The aim of this study was to show the relationship between the level of the confidence indicator and the innovation of the economies of individual Scandinavian countries in the context of the new institutional economy (NEI). Literature studies and analysis of available results of social research indicate the importance of formal and informal institutions in Denmark, Sweden, Norway and Finland in making these countries world leaders in innovation.
Curvas características de humedad como herramienta de optimización y determinación del tiempo de riego
Authors: Izquierdo B. Jaime , Javela Liseth Nayibe , Oviedo Yilberth Alexander
Published: March 2019

Se propone un método para determinar el tiempo de riego mediante la relación entre la retención de humedad, las propiedades físicas de los suelos y la función de pedotransferencia de lámina neta. Las curvas características de humedad a presiones de 0.1, 0.3, 0.5, 5.0, 10 y 15 bares por el método de membranas de Richards y las propiedades físicas de los suelos definidos por zonas (6): Eucaliptos, P, E, C, Huerta y G en la Finca La Esperanza del municipio de Algeciras (Huila), destinados a la producción de pasto Brachiaria Decumbens. Se determina la correlación para cada zona con valores de 0.97, 0.87, 0.95, 0.92, 0.93 y 0.99 respectivamente, obteniendo el porcentaje de humedad a incrementos de presión de 10, 100 y 500 cm - bares en el rango de agua aprovechable para las plantas y se calcula la lámina de agua en el suelo (LAS), y el tiempo de riego para cada suelo, proponiéndose además la metodología para la corrección del tiempo de riego.
Effects of π-Extension on Pyrrole Hemithioindigo Photoswitches
Authors: Newhouse Timothy , Zweig Joshua E. , Ko Tongil , Huang Junrou
Published: March 2019

The most red-shifted hemithioindigo photoswitches have been identified through systematic introduction of aryl units to a parent pyrrole hemithioindigo photoswitch. Increasing the size of the 5’-aryl substituent is ineffective at producing further redshifted chromophores. A second generation of 3’,5’-diarylated photoswitches which possess increased tunability is reported. Experimental and computational evidence indicates the 4’ position is electronically isolated from the bulk of the conjugated system.
Tuning of Hyperpolarizability, One- and Two-Photon Absorption of D-A and D-A-A Type Intramolecular Charge Transfer Based Sensors
Authors: Samanta Pralok K. , Alam Md Mehboob , Misra Ramprasad , Pati Swapan K.
Published: March 2019

Solvents play an important role in shaping the intramolecular charge transfer (ICT) properties of π-conjugated molecules, which in turn can affect their one-photon absorption (OPA) and two-photon absorption (TPA) as well as the static (hyper)polarizabilities. Here, we study the effect of solvent and donor-acceptor arrangement on linear and nonlinear optical (NLO) response properties of two novel ICT-based fluorescent sensors, one consisting of hemicyanine and dimethylaniline as electron withdrawing and donating groups (molecule 1), respectively and its boron-dipyrromethene (BODIPY, molecule 2)-fused counterpart (molecule 3). Density functional theoretical (DFT) calculations using long-range corrected CAM-B3LYP and M06-2X functionals, suitable for studying properties of ICT molecules, are employed to calculate the desired properties. The dipole moment (µ) as well as the total first hyperpolarizability (βtotal) of the studied molecules in the gas phase is dominantly dictated by the component in the direction of charge transfer. The ratios of vector component of first hyperpolarizability (βvec) to βtotal also reveal unidirectional charge transfer process. The properties of the medium significantly affect the OPA, hyperpolarizability and TPA properties of the studied molecules. Time dependent DFT (TDDFT) calculations suggest interchanging between two lowest excited states of molecule 3 from the gas phase to salvation. The direction of charge polarization and dominant transitions among molecular orbitals involved in the OPA and TPA processes are studied. The results presented are expected to be useful in tuning the NLO response of many ICT-based chromophores, especially those with BODIPY acceptors.
Electronic Transitions of Molecules: Vibrating Lewis Structures
Authors: Liu Yu , Kilby Phil , Frankcombe Terry J. , Schmidt Timothy
Published: March 2019

In this work we demonstrate a simple and intuitive description of electronic resonances in terms of localized electron vibrations. By partitioning the 3N-dimensional space of a many-electron wavefunction into hyper-regions related by permutation symmetry, chemical structures naturally result which correspond closely to Lewis structures, with identifiable single and double bonds, and lone pairs. Here we demonstrate how this picture of electronic structure develops upon the admixture of electronic wavefunctions, in the spirit of coherent electronic transitions. We show that pi-pi* transitions correspond to double-bonding electrons oscillating along the bond axis, and n-pi* transitions reveal lone-pairs vibrating out of plane. In butadiene and hexatriene, the double-bond oscillations combine with in- and out-of-phase combinations, revealing the correspondence between electronic transitions, molecular normal mode vibrations, and molecular plasmonics. This analysis allows electronic excitations to be described by building upon ground state electronic structures, without the need for molecular orbitals.
Effect of Symmetric and Asymmetric Substitution on the Optoelectronic Properties of 9,10-Dicyanoanthracene
Authors: Rosspeintner Arnulf , Glöcklhofer Florian , Pasitsuparoad Pakorn , Eder Simon , Fröhlich Johannes , Angulo Gonzalo , Vauthey Eric , Plasser Felix
Published: March 2019

A set of substituted 9,10-dicyanoanthracenes (DCA) has been synthesized, their photophysical and electrochemical properties in liquid solution have been characterized and supplemented by high level ab initio quantum chemical calculations. Three different methoxy-group-containing substituents have been linked to the DCA core in a symmetric and asymmetric fashion to produce six different species with strong quadrupole and dipole moments, respectively. The major difference between the symmetrically and asymmetrically substituted species are the enhanced two-photon absorption intensities of the former. In most of the cases studied, the molecules show reasonably large optical transition probabilities. The fluorescence brightness of these substances makes them interesting objects for two-photon absorption applications. Additionally, all molecules can be both easily reduced and oxidized electrochemically and are therefore suitable for optoelectronic applications.
UN CRISTO COLONIAL EN HUANCAVELICA
Authors: Plasencia Sot Rommel
Published: March 2019

En esta presentación se muestra la aparición y culto de un cristo milagroso en una comunidad de Huancavelica. Dicha aparición se dio en el contexto de la evangelización religiosa en los Andes durante el periodo colonial. Además se presentan las bases sociales y simbólicas de dicha aparición y se la compara con otros “cristos” de la región.
EJERCICIOS PEDAGÓGICOS CON CAJÓN PERUANO E INTELIGENCIA MUSICAL EN ESTUDIANTES DEL NIVEL SECUNDARIO
Authors: Yurivilca Asencio Teodoro
Published: March 2019

El objetivo de la investigación fue establecer el efecto de los ejercicios pedagógicos con cajón peruano en el desarrollo de la inteligencia musical en estudiantes del nivel secundario – Huancayo. Se enmarcó en el tipo de investigación aplicada y por su nivel fue tecnológico, el diseño utilizado fue el cuasi experimental con grupo experimental y grupo control. Los resultados evidencian si se usa el cajón peruano como herramienta didáctica pedagógica se desarrolla la inteligencia musical en los estudiantes y con ello desarrollar el cerebro, además el estudiante estuvo en contacto con algo que le pertenece y es patrimonio cultural del Perú.
La teoría de la tonalización y la de valoración: dos visiones complementarias
Authors: Pardo María Laura
Published: March 2019

El propósito de este trabajo es analizar dos teorías: 1. la de la tonalización (Lavandera, 1986, Pardo, 1996) y 2. la de la valoración (Iedema et al, 1994, Martín 2000 y White 2003). Ambas exploran los fenómenos de lo que se denomina “evaluación”, “apreciación” o “tonalización”. Con el fin de compararlas se analiza un ejemplo y se marcan diferencias y similitudes de estas aproximaciones que implican también miradas distintas en el plano cultural, ya que una proviene de occidente y la otra de oriente.
CORPO, POLÍTICA E TECNOLOGIZAÇÃO: UM ESTUDO DA REPRESENTAÇÃO DE DILMA ROUSSEFF NO CONTEXTO DA MÍDIA
Authors: Gomes Maria Carmen Aires
Published: March 2019

Neste trabalho, com fundamentação teórica da análise crítica do discurso, analisa-se a forma como a mídia impressa de informação geral semanal representa a então Ministra Dilma Rousseff. Para tanto, tomaremos como ponto de partida o conceito de tecnologização do discurso, conforme discutido por Fairclough (1997, 2001). Para este autor, a tecnologizaçào discursiva se refere à reformulação das práticas discursivas de organizações e instituições sociais de acordo com estratégias e objetivos específicos.