bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinação do turno de rega para a produção de mudas de pitaia em ambiente protegido
Authors: Moreira Antonio Robson , Souza Fernanda Ludmyla Barbosa de , Silva Raimundo Thiago Lima da , Oliveira Raimundo Leonardo Lima de , Alonço Airton Dos Santos , Souza Leane Castro de , Carpes Dauto Pivetta
Published: January 2018

Este trabalho teve como objetivo avaliar a influência do turno de rega sobre o desenvolvimento de mudas de pitaia, produzidas em ambiente protegido, assim como estabelecer um intervalo de tempo em dias, confiável entre as irrigações. O experimento foi realizado na área experimental da Universidade Federal Rural da Amazônia, Campus Capitão Poço, Pará. O delineamento experimental utilizado foi o inteiramente casualizado (DIC), com sete tratamentos constituídos pelos seguintes turnos de rega: T1 - sem irrigação durante todo o período de avaliação; T2 - turno de rega de um dia; T3 - turno de rega de dois dias; T4 - turno de rega de três dias; T5 - turno de rega de quatro dias; T6 - turno de rega de cinco dias; T7 - turno de rega de seis dias; com doze repetições, totalizando oitenta e quatro unidades experimentais. Aos vinte e sete dias, após a implantação do experimento, com a emissão dos primeiros cladódios pelas mudas, foi iniciada a mensuração dos parâmetros biométricos: altura, número de cladódios emitidos, comprimento e diâmetro do cladódio de primeira ordem, e comprimento do cladódio de segunda ordem. A irrigação das mudas proporcionou incremento significativo nos valores de altura, número de cladódios emitidos e no comprimento e diâmetro dos cladódios de primeira ordem, maioria dos parâmetros biométricos avaliados, em comparação com a testemunha. O turno de rega de três dias (T4) foi o tratamento que garantiu melhor uso consultivo da água, apresentando os pontos de máxima para altura, comprimento e diâmetro do cladódio de primeira ordem.
Electrophoretic Mobility Shift Assay (EMSA) Using IRDye® Oligonucleotides v2
Authors: Biosciences LI-COR , Feekin Lauren
Published: January 2018

This is a sample Mobility Shift Protocol (NFκB).Each oligo labeled with IRDye 700 provided by LI-COR® Biosciences for EMSA reactions will have an optimized protocol to measure the protein-DNA interaction. See the specific EMSA oligo pack insert for more information. As an example, the NFκB protein-DNA interaction will be described in this protocol. Please refer to your manual to confirm that this protocol is appropriate for the applications compatible with your Odyssey Imager model.
Autódiagnosztikai adatok feldolgozása NI DIAdem programmal
Authors: Torma Dávid , Sarvajcz Kornél , Husi Géza
Published: January 2018

Egy olyan autódiagnosztikai feldolgozó szoftvert terveztünk, amely képes automatikusan importálni a szükséges állományokat, létrehozni a megjelenítő felületet, elemezni az információ halmazokat és jelentéseket készíteni előre beállított paraméterek alapján. A szoftver egy komplex autódiagnosztikai rendszer része, amely lehetőséget biztosít a gépjármű diagnosztikai csatlakozóján keresztül adatok kinyerésére, az aktuális pozíció tárolására és az adatok feldolgozására. A program képes videófelvételeket és GPS adatokat is szinkronizáltan hozzárendelni a menetdinamikai adatokhoz, majd animáltan megjeleníteni azokat. A beépített elemző funkciók segítségével az állományok előre definiált feltételeknek megfelelően kerülnek feldolgozásra. A szkriptek segítségével automatikus jelentések készíthetők, amelyek mindig az aktuális igények alapján készülnek el. A választott fejlesztőkörnyezet a National Instruments által fejlesztett NI DIAdem.
GPS adatok mérése és feldolgozása NI, LabVIEW szoftverrel
Authors: Balogh Ildikó Julianna , Sarvajcz Kornél , Husi Géza
Published: January 2018

Ezen fejlesztés keretein belül egy GPS adatok mérésére, feldolgozására képes program készült el LabVIEWban, amely képes a feldolgozás után az adatokat olyan formátumú fájlba kimenteni, amely alkalmas térkép megjelenítő szolgáltatások általi betöltésre, mint például a Google Map vagy Google Earth.
The “I” Boundaries and the Psychological Well-Being of Children Aged 2–10 Years Old
Authors: Silina O.
Published: January 2018

The article discusses the phenomena of a psychological health through such integrative concepts as "the psychological well-being" and "the “I” boundaries". Theoretical analysis shows the oppositional nature of the studied concepts. The “I” boundaries provide contacts with the outside world, while the psychological well-being is a resource state, which allows to preserve stability of the environment and a self-stability. The aim of the study is to identify statistically significant relationships between a well-being and psychological boundaries. Control and regulation of the “I” boundaries have backward correlation with psychological well-being, which can be explained as follows: the boundaries of I in its phenomenological sense suggests the presence of another man with his desires and needs, which may be diametrically opposite; psychological well-being, on the other hand, suggests a lack of strict rules and needs to follow the requirements. The “I” boundaries protection methods ( with adult’s help and the use of speech) and psychological well-being have positive correlation. The practical meaning of the study is to confirm the thesis that a child needs private time and space, which would be accepted and protected by adults. Thus, in order to maintain mental health in childhood it is presupposed to have a balance between the relationships with environment and at the same time, the possibility of privacy.
In the Memory of L.F. Obukhova
Authors: Lubovsky D.
Published: January 2018

Lyudmila Fillipovna Obukhova has gone. Lyudmila Fillipovna was the scientist of worldwide reputation, brilliant teacher, surprisingly open and emotionally generous.
The Study of Teachers' and Parents' Needs for Psychological Consultation from School Psychologist
Authors: Savina E.A. , Savenkova I.A. , Esterle A.E. , Ovsyanikova E.A. , Khudaeva M.Y.
Published: January 2018

The present study was aimed at the investigation of teachers’ and parents’ needs in consultation with a school psychologist. Participants were 159 teachers and 292 parents from three cities in Russia. Two surveys were designed to measure teachers’ and parents’ desire to receive psychological consultation regarding behavioral, emotional, learning and interpersonal problems of students; teaching methods and relationships with colleagues (for teachers); and child-parent relationships. In addition, the participants were asked to indicate whether they received a consultation from a school psychologist in the past and their satisfaction from the consultation. The results indicated that, in general, both teachers and parents are satisfied with the consultation; however, fewer parents received such a consultation compared to teachers. Both teachers and parents are more willing to receive consultation regarding children’s behavioral and emotional problems and relationships with peers. Teachers are less motivated to receive consultation about teaching methods, students’ learning problems, and teachers’ relationships with colleagues. Parents were less interested to receive consultation about child-parent relationships. The results of this study are interpreted in terms of their alignment with standards, which regulate the school psychology profession and training.
The Choice of a Profession by Blind Senior Students and their Relevance to the Labor Market
Authors: Komova N.S. , Sokolov V.V.
Published: January 2018

This article presents results of the research on the professional orientation and employment of blind graduates of schools in six regions of the Russian Federation specialising in teaching children with visual impairments. Also analysis related to the situation with the employment of people with visual disabilities are given. This analysis are based on information from Russian Association Of The Blind. Reasons of low rates of the employment of young people with disabilities are shown. The dependence of the awareness of the choice of the profession by the blind during the period of school education on specifics of the organisation of vocational guidance work for children with visual impairments, as well as on the level of maturity of the personality and personal qualities of students is presented. The ways of overcoming the reasons negatively affecting the results of career guidance work and the employment of graduates of special schools are indicated. Examples of effective career guidance work and successful employment of young people with visual deprivation are given. The article is Amed at researchers involved in education of children with visual disabilities, organisers of career guidance work, tiflopedagogs and parents who have blind children.
Model of Development of Self-determination as the Basis of Prevention of Addictive Behavior of Adolescents in Contemporary Educational Organizations
Authors: Stepanova N.A.
Published: January 2018

The article presents the analysis of the current domestic research of the problem of self-determination. It is shown that adolescence is a sensitive period for the development of self-determination, but there are not enough studies of its dynamics at this age and ways of the formation. Self-determination is considered in the article as the opposite of addictive behavior, which makes it a resource in terms of prevention of pathological dependencies. Therefore, the proposed approach to optimization of the system of prevention in educational institutions through the development of self-determination in adolescence, based on the development of the spiritual fulfillment of the individual as the main stage of formation of the self. A model of interaction between education experts in the course of prevention of addictive behavior in educational organizations, reflecting the main stages of development of self-determination in the course of maintenance work.
Metacognitive Monitoring of the Solution of Tasks for Examination: Psychological Predictors and Relations with the Academic Success
Authors: Fomin A.E.
Published: January 2018

The role of researches of metacognitive monitoring of knowledge in achievement of metasubject educational results is opened. The concept "metacognitive monitoring", its role of the academic success and theoretical approaches to an explanation of distortions of a self-assessment are analysed by pupils of own knowledge. In an empirical part on material of a research of students of average and professional educational institutions (N = 72; average age of 15,5 years; 45 young men, 27 girls) are shown: a) according to the ANOVA the accuracy of judgments of monitoring acts as a progress factor on discipline «English» (p=0,002); b) a significant psychological predictor of monitoring is the subjective availability of the answer to questions of test tasks acting as the basis for formulation of metacognitive judgments (р =0,000). In the conclusion the value of results of a research for practice of formation of reflexive competences of structure of metasubject results of training is discussed.
Relationships among Verbal Memory, Spatial Working Memory and Intelligence in Children of 10-11 years
Authors: Burdukova Y.A. , Alekseeva O.S. , Chizhova B.A. , Shcheglova A.V.
Published: January 2018

The issue investigates the relationship Selective Reminding Test (SRT), a test of spatial working memory (SWM) with Kaufman Assessment Battery for Children (KABC II). It has been found that the efficiency of memorizing verbal material is associated with the estimates on the K-ABC Sequential processing scale and K-ABC Simultaneous processing scale, but not to the Learning scale of education, is measured indirectly verbal memorization. Spatial working memory is not related to IQ.The issue is part of a research project on cognitive function in children with neuro-oncological disorders
Prevention of Risky Sexual Behaviour through the Formation of Psychological Readiness to Parenthood
Authors: Krysko A.A.
Published: January 2018

In the world there are tendencies of early entering into sexual relations and simultaneous withdrawal of the age of marriage, an increase in the number of early pregnancies and abortions among minors. Existing programs for the prevention of risky sexual behavior are ineffective, since they are one-time, narrowly focused. The author presents the results of an experiment on the prevention of risky sexual behavior in adolescents based on the formation of their ideas of parenting and child-parent relations, and through the prism of this topic, allowing to build an image of reproductive behavior in the present and future. The program is designed taking into account the psychology of modern adolescents, in accordance with the principles of awareness and responsibility, is based on a restorative approach and resource approach to the formation of psychological readiness for parenthood M.E. Lantsburg. The program for the development of psychological preparedness for parenting in adolescents has two targets: the nearest: preventing adolescent pregnancy and reducing its negative consequences in the event of an early pregnancy, and strategic - preparing for the planning and birth of the coveted child in the future. The results prove that the adolescents' views about the family depend both on the experiences they experienced in their own childhood and on the trends in the social and political space discussed in this topic. The study showed that adolescents' views on sexual relations, family and parenthood can be purposefully influenced through a program based on the knowledge of age-related psychology, resource and recovery approaches and using interactive methods of teaching relevant to this age group.
Special Features of Creativity at the Teenage Period
Authors: Shumakova N.B.
Published: January 2018

The article is devoted to a study of the aged differences in creativity of junior adolescents. The paper presents the results of an empirical study of the dynamics of verbal and nonverbal (figural) creativity of the school children of the 4th, 5th and 7th classes. The hypothesis tested was that the creativity of the adolescents characterized by special features which are manifested in its qualitative uniqueness, but not in the quantity indicators of fluency, flexibility and originality. Within the framework study is proposed the original test of the study of verbal and figural creativity. In the study took part 147 school boys and girls at the age from 10 to 14 years old. It was shown that the dynamics of the indices of verbal and figural creativity at the teenage period has opposite direction: an increase in verbal creativity is accompanied by reduction in the figural (at the level of tendency). The special features of adolescent’s creativity are revealed in the qualitative uniqueness both of the verbal and nonverbal manifestations of the creativity.
STUDI EKSPERIMENTAL DAMPAK IKLAN DENGAN KLAIM RAMAH LINGKUNGAN VS KINERJA HEBAT TERHADAP NIAT BELI LAMPU MEREK PHILIPS DI SURABAYA
Authors: Gunawan Linda , Margaretha Silvia , Anandya Dudi
Published: January 2018

ABSTRACT This study aims to identify and analyze the impact of an environmentally friendly advertising claim vs great performance claim on purchase intentions of lamps with Philips brand in Surabaya. Data processing is performed by using Manova, one way Anova, and independent sample t-test with SPSS 18.0 software for Windows. This research hypothesis testing aims to see significancy value from one way ANOVA test. Data obtained directly from participants who meet the characteristics of the population that is determined by conducting experiments and distributing questionnaires. This study used 134 participants as sample. The results showed that the influence of a great performance claim was positively related to attitudes toward the advertisement. Further, a great performance claim was positively related to attitudes toward the brand and able to increase brand beliefs. A great performance claim influence on purchase intention is also proven.
PROSES ADOPSI INOVASI DALAM PROSES BELAJAR ENTREPRENEURSHIP
Authors: Liliani Liliani , Sidharta Helena
Published: January 2018

ABSTRACT Entrepreneurship has a relationship with innovation, because an entrepreneur should have the future vision, a innovative thinking and could know the opportunities and create the values. One of the efforts to develop entrepreneurship more intensively is through a formal education. The study will discuss the process of innovation’s adoption in learning process of entrepreneurship in the formal education. The process of innovation’s adoption is a process to create an individual or organization change to improve the performance effectiveness. The study used case study on the students of the program of international studies management in Ciputra University. The technique of data collection used an observation, interview, and documentation. Testing of data credibility used sources and technique triangulation. Data analysis is interactively performed continually until completed so the data saturated. The research result shown that in the process of an innovation adoption a student started to launch many ideas openly, filtering the ideas based on a challenge and bottleneck probably faced, receiving an input of the other parties to complete their innovation and want to continually innovation. The research shown that the internal factor as an awareness to take a risk and external factor as a market network will influence their decisions. The factors of facilitator and target also influence or contribute in direction of the innovation adoption of students.
STARR surgery in treatment of SRUS: an observational study on clinical outcomes
Authors: Porwal Ashwin , Gandhi Paresh , Kulkarni Deepak
Published: January 2018

Background: SRUS is a condition with inadequately learned pathogenesis and usually associated with disorders of pelvic floor. Commonly seen in young adults and impairs quality of life. Because of these facts the management of SRUS is difficult and there is no clear consensus over it.Methods: An observational, prospective study was planned at a single center with purposive sampling. All clinically diagnosed, histologically and endoscopically confirmed SRUS patients treated with STARR surgery and followed for two years. Data collected and analyzed to evaluate the effectiveness and patients satisfaction.Results: Total of 46 patients with median age 47.8 years; of which 27 (58.70%) were females underwent STARR surgery. The average procedure time was 40 minutes, average length of stay was 24 hours and minimum duration of follow up was about 2 years (range 2-4 years). All patients had a pre-surgery history of digitations, which resolved in 91.3% patients post-surgery. There was a significant improvement in the ODS scores at the end of 2 years (82%; P <0.001). Excessive bleeding from staple line (48.57%), staple line dehiscence in 34.28% and staple line stricture (15.71% all males) are complications observed. No recurrence reported at the end of 4 years.Conclusions: Short postoperative length of stay and the short time to return to work after the STARR procedure for management SRUS, minimal manageable complications, no recurrence and patient’s satisfaction makes STARR a cost-effective procedure.
A retrospective study on patients with appendicular mass after successful conservative treatment and to assess the need for interval appendicectomy
Authors: N. Sasikumar M. , Mammen Sam Christy , Das Shankar
Published: January 2018

Background: Appendicular mass is one sequelae in unoperated cases of acute appendicitis which are managed conservatively followed by interval appendicectomy (IA). Currently the need for IA has been questioned due to low risk of recurrence.Methods: Data of all AM patients from 2005 to 2010 were collected and revised the following parameters: age, sex, length of hospital stay, symptoms and signs, total leucocyte count and USG. Those who developed similar pain and those who underwent emergency appendicectomy were considered as recurrence. Patients were grouped as: 1-patients who developed RIF pain,2-asymptomatic patients,3-patients who developed recurrent a/c appendicitis,4-patients who did not developed recurrent a/c appendicitis.Results: Of the 93 patients, 12 patients underwent IA. Average duration between mass resolution and recurrence is 4.16 months. 14.8% patients had recurrent similar abdominal pain, and only 7.4% patients had recurrent acute appendicitis. Length of hospital stay had a statistically significant correlation with recurrence. The mean TC in the group with recurrent acute appendicitis was 12,500 and asymptomatic group who had a mean TC of 10678.28 which was statistically significant.Conclusions: Conservative treatment is successful for majority of appendicular masses. A routine IA seems unnecessary. Asymptomatic patients can be followed up without IA. Most of the recurrences occur within the first 3 to 6 months. Length of hospital stay and total leucocyte count influenced the recurrence. IA may be considered in those who are prone for recurrence.
Sonoelastography in the diagnosis of breast mass: an extended armamentarium
Authors: Kannappan K. Manickkam , Dev Bhawna , Ramakrishnan Ramya
Published: January 2018

Background: To presenting with breast lumps are very common in surgical practice and the routine use of ultrasound in the diagnosis is well validated. But there are gray zones in equivocal cases which increase the number of negative biopsies. To increase the sensitivity and specificity of ultrasound by adding another non-invasive modality, namely strain elastography, can reduce this rate. To evaluate the sensitivity and specificity of strain elastography in the diagnosis of breast masses.Methods: As part of the triple assessment patients presenting with breast lumps underwent ultrasonography and strain elastography, where strain ratios were calculated. Based on which they either underwent percutaneous biopsy or surgical excision. A total of 30 patients with breast lesions underwent sonomammogram in which the breast lesions were both graded with BIRADS and also the elastography and strain ratio was calculated.Results: Strain ratio has higher sensitivity and specificity which makes it a valid diagnostic tool in the evaluation of breast masses.Conclusions: It can also help in reducing the number of benign lesion biopsies and also reduce the number of negative biopsies. Being a non-invasive modality, it is much more patient compatible and economically cheaper when compared with MRI and modalities.
Eras: is it possible to follow it in a tertiary government hospital set up?
Authors: Pattanayak Sibaprashad , Maharana Binoy Kumar , Behera Manoj Kumar , Malla Tapan Kumar , Kumar Manish
Published: January 2018

Background: Fast-track surgery (enhanced recovery after surgery) is a set of protocols to reduce surgical trauma and postoperative stress by decreasing pain and complications, improving outcomes and decreasing length of hospital, while expediting recovery following elective procedures without an increase in complications or readmission.Methods: This was a prospective study over 2 years from March 2015 to February 2017 with 6 months follow up. 647 patients undergoing elective general surgery were followed up. Details regarding the age, sex, health status parameters and diagnosis collected. Preoperative evaluation, operative parameters and postoperative complications recorded. Post-operative course in hospital and any deviation of normal post-operative course and its management recorded and analyzed.Results: In government hospital (MKCG Medical College, Berhampur, Odisha), following ERAS protocol completely is impossible. But most protocols in preoperative, intraoperative, postoperative phases were followed, leading to early discharge of patients without any complications in most cases. In my study, drains were given in 157 cases, nasogastric tube in 89 abdominal surgeries. 129 cases were performed under general anaesthesia and 518 cases under spinal/epidural/mid thoracic epidural anaesthesia. 60 underwent overnight fasting. All received carbohydrate loading, antibiotic prophylaxis, thrombo-prophylaxis before surgery. Bowel preparation done in 50 abdominal surgeries.Conclusions: The study provided a strong evidence that ERAS is safe to practice in elective general surgeries. It is associated with decreased incidence of complications, significant reduction in duration of hospitalisation and reduction in overall morbidity and decreased rate of re-admission. Thus, improves patient’s compliance.
Clinical presentation and outcome in diabetic foot cases: a prospective study in a tertiary care teaching hospital of Uttarakhand, India
Authors: Bijalwan Anurag , Mishra Ratnanjali , Beg Mirza A.
Published: January 2018

Background: Aim of study was to investigate the clinical presentation, management of soft tissue infection and their outcome in diabetic foot patients in a tertiary care teaching hospital.Methods: A total of 106 patients with diabetic foot presented to General Surgery department of SGRRIMHS, Dehradun, were included in the present study. Grading of ulcers was done by using Wagener grading. Peripheral neuropathy was confirmed or ruled out using tuning fork (128 hz). The diagnosis of vascular insufficiency was made by palpating pedal pulses of the involved foot and/or by colour Doppler.Results: Out of 106 patients, 87(82.7%) were male and 19 (17.92%) were female. Mean age of the patients was 56.04±10.31 years, 40 (37.73%) were smoker, 62 (58.49%) were anaemic, 80 (75.47%) patients had poorly controlled diabetes and mean duration of diabetes was 8.2 years. The majority of ulcers belonged to grade 3 and grade 4, i.e. 50 (47.17%) and 30 (28.30%) respectively. 80 (75.47%) patients had peripheral neuropathy and 67 (63.20%) had arteriopathy. 17 (16.03%) patients required only dressings, while 89(83.97%) needed surgical interventions.Conclusions: In the present study, most of the patients presented with diabetic foot were treated by surgical intervention.
A comparative study of traditional and digital method in teaching surgical pathology to undergraduate medical students
Authors: Nautiyal Hemant K. , Pathak Priyank , Nautiyal Ruchira , Sachdev Guruvansh , Pandey Shubham
Published: January 2018

Background: During undergraduate medical course surgical pathology is taught on formalin preserved specimens (FPS), a traditional teaching method. These specimens are morphologically altered in color and size due to chemical effect of formalin. Author believe that surgical pathology and disease process can be better understood by digital pictures and videos of surgical procedures. Hence, author did this intervention study to compare the teaching of surgical pathology by traditional method (i.e. Formalin preserved specimen) with digital method.Methods: This prospective study was conducted at Department of Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University. Final year MBBS (Bachelor of Medicine, Bachelor of Surgery). Students (Four Batches, 20-25 students, n=91) were taught surgical pathology by digital method (per operative and resected specimen pictures/videos) and traditional method (Formalin preserved specimen). Four specimens were taught with cross over i.e. two specimens with help of digital method and two by traditional method. Before start of teaching pretest (Multiple choice Questions, MCQ) was taken and it was followed by post-test (MCQ) for each topic. All teaching was done by single associate professor of surgery. Response of students was assessed by Likert’s scale. Evaluation of the results was done by paired t-test.Results: 94.3% students liked new method of teaching and 90.8% believed that new method leads to better understanding of the subject. In two specimens (Appendix and Gall Bladder) taught by digital method there was statistically significant increase in post test score as compared to FPS method. In specimens (carcinoma colon and breast carcinoma) there was also increase in the post test score though not statistically significant.Conclusions: Digital method was found to be better method for understanding surgical pathology and clinical correlation and should be used to complement traditional method.
Hemithyroidectomy with or without use of drain a randomized prospective clinical study
Authors: G. V. Ravi Kumar , S. Madhu B. , Jhajharia Ajay Kumar
Published: January 2018

Background: The practice of using the drain in thyroid surgery including hemithyroidectomy is common to avoid complications like a hematoma. The aim of this study is to evaluate the necessity of routine drainage in hemithyroidectomy.Methods: In this randomized prospective clinical study conducted in tertiary care government training hospital,60 patients who underwent hemithyroidectomy for various thyroid disorders were randomly allocated to either non-drainage (group A) or drainage (group B). The various complications including hematoma, seroma, wound infection, post-operative pain, the length of hospital stay was then compared.Results: Both groups were comparable according to age, gender, thyroid size and histopathological diagnosis. A total number of 60 patients evaluated among them 45 females (75%) and 15 males (25%) were there. No significant difference in complications was observed between two groups regarding hematoma, wound infection, but the length of hospital stay was significantly reduced in the non-drainage group compared to drainage group (p-0.004), along with the significant reduction in post-operative pain (p-0.001).Conclusions: In present study, author observed that there is a significant reduction in length of hospital stay and post-operative pain in non-drainage group compared to drainage group. So suction drainage should be done in selected patients rather than a routine procedure and it is safe without suction drain especially in hands of experienced surgeons.
Adequate timing of thromboembolic prophylaxis in colorectal cancer surgery
Authors: Morshed Ghada , Zaki Nader
Published: January 2018

Background: It has been found that patients with colorectal cancer are at increased risk for postoperative venous thromboembolism. The aim of this prospective study is to evaluate the incidence of venous thromboembolism and major bleeding complications in patients undergoing colorectal cancer who are treated with preoperative or postoperative venous thromboprophylaxis.Methods: This prospective study included 30 patients from September 2013 to November 2017. There were 22 males and 8 females; mean age was 66.7±5.5 years (range 44-78). Author divided the patients randomly into two groups (group A=15 cases with preoperative and group B = 15 cases with postoperative venous thromboprophylaxis).Results: There was no significant difference in preoperative versus postoperative thromboembolic prophylaxis regarding postoperative DVT 0/15(0%) vs 1/15 (6.6%), P=0.69, no bleeding complications and no pulmonary embolism.Conclusions: Preoperative and postoperative thromboembolic prophylaxis are equally safe in venous thromboembolism protection.
Small bowel obstruction: need for surgery based on history and radiology
Authors: Meena L. N. , Bhatt Neha , Jain Sanchit
Published: January 2018

Background: Small bowel obstruction is a common clinical challenge because the proper management of small bowel obstruction requires a methodology which on one hand can promptly recognise the presence of strangulation-obstruction and hence the need for urgent operative intervention; and on the other hand, can avoid a non-therapeutic laparotomy along with its associated morbidities and further adhesion formation with its potential sequelae. The study was done to identify relevant features in the patient’s clinical and CT abdomen findings which when present would be highly predictive of the requirement of an operative intervention in a patient with small bowel obstruction.Methods: The study was a hospital based analytical observational study on patients admitted from March 2013 to May 2014 with a diagnosis of small bowel obstruction and who underwent a concurrent CT abdomen. Correlation of line of management was done with respect to the three chosen parameters, obstipation (history), mesenteric edema (CT imaging) and lack of small bowel feces Sign (CT imaging).Results: A total of 74 patients were included with Male:Female ratio being 3.1:1. Forty patients were managed conservatively and remaining underwent surgery with adhesions being the most frequent etiology. The most common operative procedure performed was adhesiolysis with or without band release. Twenty-three cases were performed by open method and remaining laparoscopically. Evaluation of the three parameters revealed that these variables, when present independently or in combination, are predictive for need for operative intervention (p-value <0.001). The sensitivity and specificity to predict the need for exploration when all 3 features were present concurrently was 38.24% and 100%, respectively.Conclusions: Small-bowel obstruction is a common surgical dilemma, the management of which is dealt on a daily basis by surgeons and non-surgeons. The management using variables based on history and radiology may help classify patients into those requiring conservative management and those in need of early exploration.
Preoperative predictors of a difficult laparoscopic cholecystectomy
Authors: Kulkarni Shrirang V. , Kumar Sukumar S.
Published: January 2018

Background: Laparoscopic cholecystectomy (LC), the gold standard of treatment of gallstone disease, is a widely performed surgery, but it can become a challenge to complete at times. Aim of present study was to find out the possible preoperative features in a gallstone disease patient that predispose him to having a difficult LC. Methods: All cases of gallstone disease undergoing LC at a tertiary care hospital were studied over one year. Patients with jaundice, abnormal liver function tests, concomitant common bile duct stones, ongoing acute cholecystitis or concurrent gallstone pancreatitis were excluded. Various preoperative clinical, laboratory and ultrasound parameters were studied to see their correlation with different aspects of difficult LC.Results: 166 patients were studied with age ranging from 10-80 years, maximum incidence (36.14%) being in the age group 35-50 years. The time taken for LC increased significantly with increasing age. 70.48% were females but gender status did not affect the difficulty. Pain in the preceding 15 days of surgery increased the operating time as did the association of diabetes mellitus. Increasing body mass index (BMI) also increased the surgery time as well as the conversion rate (7.69% in patients with BMI >30Kg/m2). Clinically palpable gallbladder increased the surgery duration, difficulty and conversion rate. TLC >11000/mm3, contracted gallbladder, wall thickness ≥4mm made LC longer, while multiple stones increased surgeon’s difficulty and impacted stone in gallbladder neck increased the conversion rate.Conclusions: Certain factors that increase the difficulty of LC can be identified preoperatively and this knowledge should be used when planning LC.
A study the profile of pathological disorders resulting in acute abdominal non-traumatic surgical emergencies in a tertiary care hospital, North India
Authors: Zahid Mohamamd , Raza Mohd Arshad , Mohan Manjul , Agrawal Ranjan , Kumar Pramod
Published: January 2018

Background: Acute abdomen has a sudden onset, can persist for several hours to days and is associated with wide variety of clinical features requiring evaluation and treatment. The present study has been done to establish the etiopathological details and diagnostic verification of the patients presenting with non-traumatic pain in abdomen. Also, the management and admitted care of non-traumatic abdominal surgical emergencies and their outcome has been discussed.Methods: A prospective observational study was done in Rohilkhand Medical College and Hospital (RMCH) during November 2015 to October 2016. The study includes acute abdominal non-traumatic surgical emergencies presenting in general surgery department. All the data were analyzed through SPSS 22.Results: A total of 182 patients were included in the study. The most common complaint among patients was pain in abdomen followed by constipation and vomiting. The most common cases were intestinal perforation (57%) followed by acute appendicitis (14.89%), acute pancreatitis (9.34%), acute intestinal obstruction (9.34%) and others. Most common treatment modalities applied were Exploratory Laparotomy with true Graham’s patch repair (30.22%), non-operative/conservative treatment (26.92%) and Exploratory Laparotomy with ileostomy (13.19%). Total 13 cases (7.14%) expired (all post-operatively) and 8 cases (4.39%) developed major complications.Conclusions: The clinical course and outcome of acute abdominal emergencies in present study showed that a judicious and careful use of clinical evaluation with high index of suspicion along with radiological and biochemical findings help to reach a diagnosis based on which the appropriate management strategy ensures good outcome.
Voice changes after thyroidectomy: an experience with 364 cases of thyroid surgery
Authors: Prabhat Arvind K. , Dash Niranjan , Gadekar J. M.
Published: January 2018

Background: To study voice changes and to evaluate the impact of thyroidectomy and effects of factors such as patient age, sex, operation-type, surgeons-experience, laryngeal nerve injury and orotracheal intubation on voice of patients undergoing thyroidectomy.Methods: Author prospectively analyzed 364 cases of multinodular goiter (MNG) and neoplastic thyroid disorders, undergoing sub-total/total-thyroidectomy and completion-thyroidectomy in the department of surgery, during the study period of June 2016 to December 2016.Results: The study comprised of 364 patients, with 298 females and 66 males. Voice changes were seen in 216(59.34%) patients. Transient voice changes were seen in 212(98.15%) patients and permanent in 4(1.85%) patents. Out of 216 patents, age group ≥65 years were 128(59.25%) and age group <65 years were 88(40.75%) patients(p:0.012324). Out of 216 patients in which voice changes were seen,165(76.39%) patients were females and 51(23.61%) patients were males(p:0.001046). Voice changes were seen in 190(88%) patients in which sub-total/total-thyroidectomies were performed and in 26(12%) patients completion-thyroidectomies were performed. Voice changes were statistically significant in which completion-thyroidectomies were performed(p:0.002102). Voice changes were seen in 205(68.56%) cases and 11(16.92%) cases which were performed by post-graduate-trainee and experienced-surgeon respectively. Voice changes were seen in 122(67.77%) cases in which orotracheal intubation was performed and in 94(51.65%) cases cervical-epidural anaesthesia was given (p:0.00281). RLN palsy was seen in 2(0.60%) cases in which sub-total/total-thyroidectomy were performed and 2(6.25%) cases in which completion-thyroidectomy was performed (p:0.003426).Conclusions: Voice changes is common after thyroid surgery but usually transient and sometimes, permanent. So, patients must be informed about the risk of voice-impairment after thyroid surgery. Present study is novel as it investigates not only laryngeal neve injury but also highlights patient age, sex, types of operation, surgeons experience and laryngeal complications during orotracheal intubation.
Outcome of traumatic head injury in unknown patients
Authors: Ahuja Ankit , Verma Siddhartha , Chaudhary Aditya Narayan
Published: January 2018

Background: Traumatic brain injury is the most common cause of death in trauma victims accounting for about half of deaths at the accident site. Most commonly, traumatic brain injury occurs in the presence of additional injuries to other major organ systems, but it can also occur in isolation. Complications from closed head injuries are the single largest cause of morbidity and mortality in patients who reach the hospital alive. The objective of this study was to determine the outcome of traumatic head injury in patients admitted in the Department of Neurosurgery as unknown.Methods: All patients admitted as “unknown” to Neurosurgery department with traumatic head injury were studied retrospectively. Data was collected regarding demography, mode of injury, clinical presentation at the time of admission, management and outcome of these patients.Results: Data pertaining to 107 unknown patients were collected. Most patients were found to be males in 3rd decade of their lives with vehicular accidents as the common mode of injury. Patients presenting with Glasgow coma scale (GCS) score <8 at the time of admission had poor outcome and associated with higher mortality. Intra-cranial hemorrhage were predominantly found on CT scan. Only one-third of the patients were discharged after treatment while half of them suffered untimely death.Conclusions: Outcome of these neglected patients is poorer in comparison to patients who are accompanied by their relatives. Their management from pre-hospital to treatment and discharge from hospital is fraught with challenges. They need special care from trained nursing staff as well as help from social workers for recovery and rehabilitation.
Low dose computed tomography KUB region for management of urolithiasis in Indian scenario
Authors: Sharma Satyadeo , Chaudhari Rajeev , Rawal Krutik , Khant Shahil
Published: January 2018

Background: The incidence, prevalence and recurrence of urolithiasis are very high; especially in the north-western part of India. Ultrasonography has decreased sensitivity and specificity as compared with NCCT for detection of both renal and ureteral calculi. Drawbacks of NCCT in terms of radiation exposure, cost and repeatability can be overcome by Low dose NCCT protocols. Low dose NCCT can be an investigation with high diagnostic accuracy, less radiation hazards and financial acceptability. Aim of this study was to evaluate use of Low dose CT-KUB over ultrasound (US) for diagnosis of urolithiasis, in Indian scenario.Methods: This is a prospective study, at Tertiary Care Hospital. Patients with acute flank pain, who underwent both US and Low dose NCCT within an interval of 24 hours, at Tertiary Care Hospital. Helical CT scanner (Phillips 128 slice medical systems) with exposure factors setting of KVp 120 and mAs 70 was used.Results: A total of 136 Patients with mean age of 33.01 years (range 19-62 years, SD 10.93), were examined with 82(60.29%) males and 54(39.7%) females, average BMI was 25.07(range 17.2 to 35.02). Low Dose NCCT has a sensitivity of 95% (CI of 89.43-98.14%) and specificity of 87.50% (95% CI of 61.65-98.45%) in the diagnosis of urolithiasis. Mean effective dose of radiation administered in low dose CT-KUB was 1.8-2.2 mSv.Conclusions: In view of information, reliability, repeatability, radiation exposure and cost acceptability; unenhanced Low dose CT-KUB region should be the preferred investigation for the management of urolithiasis, in the scenario of a developing country.
Laparoscopic cholecystectomy in anemia patients: a retrospective cohort study
Authors: Al-Mulhim Abdulrahman Saleh
Published: January 2018

Background: Preoperative anemia is associated with adverse outcomes after surgery, but no evidence study demonstrates this risk after laparoscopic cholecystectomy. This study aimed to measure the prevalence of preoperative anemia, and to assess its effect on early clinical outcome in laparoscopic cholecystectomy patients.Methods: Data of 6342 consecutive laparoscopic cholecystectomy patients between Januarys 1995 to January 2015 were evaluated. Preoperative anemia was defined as a hemoglobin level of less than 120gm/l in female, and less than 130gm/l in male. Logistic regression used for analysis.Results: Preoperative anemia identified in 37.4% of laparoscopic cholecystectomy patients and it more prevalence in women. Analysis showed that patients with severe [odds ratio1.83 (95% Confidence interval 1.62-3.66)], moderate [odds ratio 1.21 (95% Confidence interval 1.11-1.38)], and mild [odds ratio 1.04 (95% Confidence interval 0.91-1.13)] anemia had higher morbidity than those with normal preoperative hemoglobin.Conclusions: Anemia is common among laparoscopic cholecystectomy patients, and it is associated with more complications.
Transperitoneal laparoscopic pyeloplasty: a single center experience of 28 cases
Authors: Chaudhary Ranjit , Dausage Chirag Shanti
Published: January 2018

Background: To evaluate prospectively the results obtained in 28 patients undergoing laparoscopic pyeloplasty through transperitoneal access.Methods: From January 2014 to June 2016, twenty-eight patients between 12 and 55 years old underwent laparoscopic pyeloplasty for primary ureteropelvic junction (UPJ) obstruction via a transperitoneal approach. Eighteen cases had the obstruction on the left side and the other ten on the right side. All patients had radiographic evidence of obstruction with signs, symptoms or deterioration of renal function. Anderson-Hynes dismembered pyeloplasty was performed in 25 patients and Fenger technique in the other 3 cases. Three patients had non-obstructing renal stones and underwent concomitant pyelolithotomy.  Patients were evaluated clinically and by imaging in the postoperative period at 3 and 6 months and then followed-up annually.Results: The operative time ranged from 190 to 330 min. The average blood loss was 70 mL. Analgesic requirements were also minimal with patients requiring PCA for an average of 1.1 days. Average days to free fluids were 1.5 days. The mean hospital stay was 3.76 days. The time to return to normal activities ranged from 7 to 12 days. Crossing vessels were identified in 16 patients, intrinsic stenosis in 14 patients and 5 patients had high implantation of the ureter. There were no conversions to open. One patient had longer urinary fistula (9 days), 2 patients had prolonged ileus and 3 patients had port site infection. The follow up ranged from 6 to 72 months. From the later postoperative complications, 2 patients had re-stenosis. The success rate was 92.85%.Conclusions: Laparoscopic pyeloplasty has functional results comparable to conventional open technique. It offers less morbidity, with aesthetic and post-operative convalescence benefits and lower complication rates.
Pattern of use of analgesics in post-operative pain management in adults undergoing laparotomy surgery: a prospective observational study
Authors: Toro Mohna M. , John Sheetal , Faruqui Atiya R.
Published: January 2018

Background: Previous studies on post-operative pain document that most patients continue to experience pain after surgery. This study was done to record the drug use for post- operative pain in laparotomy and to determine the patient characteristics that affect their pain score.Methods: A prospective observational study in 250 adult patients undergoing laparotomy surgery from General Surgery and Obstetrics and Gynaecology (OBG) at a tertiary care hospital.Results: Among patients recruited, 161 (64.4%) were females, 134 (53.6 %) from surgery department, mean age 37.29±14.9 years. Caesarean section 85 (73.27%) followed by meshplasty 46 (34.3%) were most common.Parenteral tramadol 100mg (40%) was the most common analgesic post-operative, subsequently shifted to oral. Epidural analgesia used in 31 (12.4%) patients, only from surgery department. First analgesic received within 6 hrs in 55.5 % in surgery and 44.5 % in OBG (Pearson χ2 =2.535, p = 0.111) with mean time to first analgesic 2.85±2.33 hrs. Pain score, using Numerical Rating Scale (NRS) recorded for 200 (80%) patients showed 76 (30.4%) had severe pain on day 1 which decreased to 12 (4.8%) on day 3. Speciality (p=0.01) and nature of surgery (p=0.05) were significantly associated with severity of pain. Gender [OR = 0.55 (95% CI = 0.26, 1.19), p=0.13], nature of surgery  [2.32 (1.02, 5.32), p=0.05], speciality [0.35 (0.15, 0.80), p=0.01] and surgical category [0.76 (1.01, 5.32), p=0.05] affected pain score on univariate logistic regression, but were not significant on multivariate analysis.Conclusions: Despite the use of opioids and combination analgesics, one third of patients reported severe pain on the first day after surgery.