bluuebunny/crossref_metadata_2025 huggingface dataset:
Double Lip: A Review of Literature and a Case Report
Authors: Zardawi Faraedon , Gul Sarhang , Hama Balen , Khursheed Dler
Published: May 2019

Ascher’s syndrome is a rare congenital anomaly causes recurrent edema of the upper eyelid resulting in blepharochalasis in one hand and similar edema of the lip resulting in a double lip on the other hand. Double lip is characterized by two soft, flabby masses of tissue on either side of the midline of the lip. This anomaly primarily causes an aesthetic problem, and it becomes more apparent during speak and smile. Thus, unaesthetic appearance remains the main patients’ complain for surgical correction. A 33-years-old male patient complained gradual enlargement of his upper lip resulting in unpleasant appearance causing him embarrassment during smile and speech. The patient was systemically healthy no history of systemic diseases, no family history for the reported condition. Clinical examination revealed bilateral blepharochalasis clinically presented as atrophy of redundant upper eyelid skin with an obvious double upper lip at rest with the inflated appearance on smiling. Based on patient’s demand for enhancing appearance and smile, surgical treatment of the double lip by transverse elliptical incisions from both commissures to the midline was performed in order to reduce the excessive bulk of redundant tissues. Ten days later, sutures removed, healing was more than satisfactory, and treatment resulted in improved esthetic with high patient satisfaction.
PROBLEMS OF CREATION AND FUNCTIONING OF THE MANAGEMENT SYSTEM OF A COMMERCIAL ORGANIZATION
Authors: Soustina S. A.
Published: May 2019

The article deals with topical issues of creating and operating a commercial organization management system. from the standpoint of modern practice. Analyzed opportunities to ensure more effective management of the organization. In today’s dynamic innovation economy, in order to achieve the strategic goals of business structures, it is necessary to carry out systematic work to improve the organization’s management process and deliver targeted strategic targets to employees to increase their motivation and integration into business processes.
Özofagusun fungal enfeksiyonları; tek merkez deneyimi
Authors: AKBAŞ Enver
Published: May 2019

Giriş ve Amaç: Araştırmamızda hastanemizde çeşitli endikasyonlar
ile üst
gastrointestinal sistem endoskopisi yapılan hastalarda özofagus fungal enfeksiyonlarının
sıklığını, başvuru semptomlarının dağılımını, buna zemin hazırlayan durumları
değerlendirmeye çalıştık. Gereç ve Yöntem: 2015-2019 yılları arasında hastanemize başvuran ve üst gastrointestinal
sistem endoskopisi yapılan 2862 hastadan endoskopik olarak özofagusta fungal
enfeksiyon tespit edilen ve mikrobiyolojik olarak bu tanısı doğrulanan 33 hasta
değerlendirmeye alındı. Bulgular:
Toplam 2862 hastanın 33 (%1,2) tanesinde özofagusta fungal enfeksiyon
tespit edildi. Eşlik eden hastalık olarak en sık %71 ile reflü özofajit
zemininde fungal enfeksiyon gelişmişti. Hiçbir hastada insan bağışıklık
yetmezliği virüsü pozitifliği tespit edilemedi. Hastaların %27,3’ünde immünsupresyona
neden olan bir patoloji ya da ilaç kullanımı mevcut iken %72,7’sinde böyle bir
neden tespit edilemedi. Hastaların başvuru şikayeti olguların %21.2’sinde disfaji, %6.1’inde hıçkırık, %21.2’sinde reflü semptomları, %6.1’inde ses kısıklığı, %6.1’inde kilo kaybı, %15.2’sinde
bulantı-kusma iken %42.4 ile hastaların çoğunluğunda mide ağrısı gibi klasik
bir dispeptik yakınma şeklindeydi. Sonuç: Dünyada Kandida özofajitinin en sık nedeni insan bağışıklık
yetmezliği virüsü enfeksiyonu, maligniteler ve immünsüpresyon yaratan durumlardır.
Bizim hastalarımızda Kandida enfeksiyonuna daha çok reflü özofajit eşlik
etmekte iken sadece %15 hastada enfeksiyon immünsüpresyon yaratan bir durumda
gelişmişti. Bulgularımız insan bağışıklık yetmezliği virüsü negatif
hasta profilindeki dünya literatür verileri ile uyumu bulundu.
Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital
Authors: Momo Romaric Joel Tetsiguia , Fouedjio Jeanne Hortence , Fouelifack Florent Ymélé , Mbu Robinson Enow
Published: May 2019

Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.
Thyroid function in abnormal uterine bleeding
Authors: Kundoor Ruthvika , Rani Burri Sandhya
Published: May 2019

Background: AUB is any abnormal uterine bleeding in the absence of any palpable pelvic pathology and demonstrable extra genital causes. AUB is responsible for 10% of gynaecological complaints. Thyroid hormone is very important to affect the menstrual pattern. The objective of this study was to evaluate thyroid function test in women with AUB and to assess the menstrual pattern in women with thyroid dysfunction.Methods: The present study was conducted in the Department of Obstetrics and Gynecology, Laxmi Narasimha Hospital, Hanamkonda, Hyderabad, Telangana, India 80 women of reproductive age group between 15-45 years women with menstrual disorders like menorrhagia, oligomenorrhea, hypomenorrhea, polymenorrhea, metrorrhagia, and amenorrhea. Quantitative determination of T3, T4, and TSH by CLIA estimated in autoanlyser.Results: About 80 women participated in the study in which Most of the subjects belong to 26-30 years of age group. Maximum patients i.e. 41 (51.2%) patients were para one to 2. Commonest cause bleeding pattern was menorrhagia 41.25%. 15 apparently normal patients with AUB belonged to the category of subclinical hypothyroidism (15%). Hormonal levels revealing profound hypothyroidism in patients without any symptoms was present in only 10% of cases. 2.5% of cases had hyperthyroidism though they were clinically normal. Patients who were sub-clinically hypothyroid were maximally presenting as polymenorrhoea (50%) and menorrhagia (12.1%) and only 6.27% of patients had oligomenorrhoea. Patients who were profound hypothyroid were predominantly having polymenorrhagia (83.3%) and (62.5%) of patients had oligomenorrhoea.Conclusions: So, biochemical evaluation of thyroid functioning should be made mandatory in all provisionally diagnosed cases of AUB to detect thyroid dysfunction.
A study for efficacy and safety of ferric carboxymaltose versus iron sucrose in iron deficiency anemia among pregnant women in tertiary care hospital
Authors: Agrawal Divyani , Masand Deepa Lokwani
Published: May 2019

Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.
The effect of information, education and communication on knowledge and practice regarding prevention/treatment of iron deficiency anaemia among the antenatal women attending primary health centre in Puducherry, India: a randomised control study
Authors: Chandran Athul , M. Subashini , Kate Nina
Published: May 2019

Background: IEC (Information, Education, and Communication) strategies may help pregnant women to prevent disease and to improve and maintain health. The present study was carried out with an aim to evaluate the effectiveness of IEC in improving the knowledge and practice regarding prevention/treatment of iron deficiency anaemia among the antenatal women attending Primary Health Centre in Puducherry.Methods: The present study was carried out in Puducherry, as a randomised control trial among antenatal mothers attending antenatal clinics in Primary Health Centre from February 2016 to August 2017. Block randomization technique was used to designate study participants into intervention and non-intervention groups. The minimum required sample size was calculated to be 84 in each group. Then intervention (Information, Education and Communication) was given to these antenatal women by using interpersonal communication methods, PowerPoint presentation and audio visual aids.Results: Correct responses to the questions were compared among the intervention and non intervention group in pre test and post test. It was noted that the proportion of correct responses were significantly higher among intervention group than that of non-intervention groups.Conclusions: Well planned and tailor made IEC material, acceptable by the regional population, by using various modes of interpersonal communication, improves the knowledge and practice of the antenatal mothers. It was also found that the haemoglobin levels of mothers in the intervention group were higher than the antenatal mothers who did not receive any IEC intervention.
Evaluation of partogram in 100 cases of both primi and multi gravida each, their outcome in labour and perinatal outcome
Authors: Krishna K. Sowmya , Paladi Rajshree
Published: May 2019

Background: the objective of this study was to study the utility of partogram in both primi and multi gravida and evaluate its role in preventing prolonged labour; assess the rate of cervical dilatation on admission, and to evaluate the maternal and perinatal outcome by comparing their partogram in labour.Methods: This observational prospective clinical study involved randomly selected 200 patients in labor divided into 2 groups of 100 each admitted in Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga. Modified WHO partogram was used. Statistical analysis done by Chi square test.Results: Mean age group in primi was 22.05 years with standard deviation of 2.38 years and in multi mean age group was 25.19 years with standard deviation of 3.09 years. Mean duration of active phase of labor in primi was 2 hrs 12 mins and in multi was 1 hours and 35 mins from time of admission into hospital. Mean duration of second stage of labor in primi was 57 mins and in multi was 35 mins. Out of 100 primi gravida 68% had NVD, 1% had outlet forceps. 13% had vacuum application and 18% underwent LSCS. Out of 100 multigravida 86% had NVD, 1% had outlet forceps, 7% had vacuum application and 6% underwent LSCS. In group A in primi 75% had NVD, 0% had forceps, 5% had vacuum application and 0% LSCS whereas in multi 93% had NVD and 7% had vaccum, NO forceps /LSCS. In group B, in primi 20% had NVD, 4% had forceps, 33% had vacuum application and 43% had LSCS whereas in multi 34% had NVD, 8% had forceps, 8% had vacuum application and 50% LSCS. In group C, in primi 100% had LSCS whereas in multi there were no NVD/Vaccum/ forceps/ LSCS cases. In primi 100% and in multi 96% had no maternal complications. In primi 96% and in multi 97% had no neonatal complications.Conclusions: The partogram is used to assess the labor progress and identify when intervention is necessary. This study showed that it can be highly effective in reducing complications from prolonged labor for both mother & neonate, in reducing operative intervention and improving their outcome.
Knowledge of Cancer cervix and its causative agents among HIV-infected and HIV-uninfected adolescent women in rural Medical College in Maharashtra, India
Authors: Raval Ravi M. , Patil Vaibhav B. , Thaware Pradnya P.
Published: May 2019

Background: The aim of this study is to examine the knowledge of human papilloma virus (HPV) and cervical cancer among HIV-infected and HIV-uninfected female adolescents attending Antenatal OPD in Department of Obstetrics and Gynecology, Government Medical College, Miraj, Maharashtra, India.Methods: Subjects were recruited randomly from OPD attending patients.  A total of 30 subjects, 15 HIV-infected and 15 HIV-uninfected were selected via randomization and completed a measure of HPV knowledge, based on a previously validated instrument. The study took place in December 2017.Results: The overall mean score on the measure for all subjects was 43.3% (S.D. 10.9). There was no significant difference in HPV knowledge between the HIV-infected and HIV-uninfected groups. Based on results from a previous large-scale study using the same validated measure, this sample scored significantly worse on general HPV knowledge than samples from the other studies.Conclusions: Given the limited knowledge of HPV in this sample, there is greater need for education about the prevention of cervical cancer, specifically among high-risk adolescent women.
Prevalence of menstrual disorder among college girls and correlation with body mass index
Authors: J. Jeevitha K. , S. Rajarajeswari
Published: May 2019

Background: Menstrual irregularity is the most common gynaecological disorder in all age group. Adolescence is a transitional period between childhood and adulthood and involves physical, biological and psychosexual changes and is characterized by hormonal changes. Aim of this study was to find out the prevalence of menstrual abnormality in college girls in Madurai and their association with their Body mass Index (BMI).Methods: A cross sectional study was conducted among 200 girls of age group 18-22 years in a college in Madurai after getting their consent from college authorities and students. All details regarding their age of menarche, type of menstrual disorder and their BMI, stress factors were collected. The results were compared using chi square test and the pattern of menstrual abnormality and its relation with BMI and with stress was obtained.Results: The average age of menarche was 13.38 years in our study, irregular cycle was present in 47.5%, dysmenorrhoea was the commonest disorder and accounts for 26% students requiring medical treatment. Underweight students have irregular cycles compared to other groups. Stress had a significant correlation with menstrual irregularity.Conclusions: Many students in our study was under obese category, lifestyle modification like regular exercise, avoiding junk food and promoting healthy eating habits should be emphasised among students to have a healthy life. Students should also be informed about menstruation, physiological changes and its importance.
Efficacy of Mefipristone for induction of labour in late term pregnancy
Authors: K. Roopa N. , N. Rekha
Published: May 2019

Background: Late-term pregnancy defined as one that has reached between 41 0/7 weeks and 41 6/7 weeks of gestation is associated with an increased maternal morbidity as well as an increased risk of fetal and neonatal mortality and morbidity. Mifepristone, an anti-glucocorticoid and antiprogesterone, though not an oxytocic increases uterine activity and causes cervical effacement and dilatation and improves the Bishop score without over/hyper stimulation of uterus. Increased maternal and fetal mortality from late term pregnancy could be prevented by induction of labour. The objective of this study was to know the efficacy of single dose of oral mifepristone in induction of labour in late term pregnancy and to assess the induction delivery interval in the study population.Methods: This was a prospective interventional study conducted in Department of Obstetrics and Gynaecology at BGS Global Institute of Medical Sciences, Bengaluru. 100 Women with late term pregnancy who fulfilled the inclusion and exclusion criteria were considered for the study after an informed written consent.Results: 73.5% (n=36) of multigravida and 80.4% (n=41) of prim gravida showed improvement in the Bishop score post induction with mifepristone and majority (89.79 % primigravida and 84.31% multigravida) of the study population had vaginal delivery. Multigravida (73.5%) had less induction delivery interval (less than 48hours) compared to primigravida (19.6%).Conclusions: Mifepristone, a progesterone antagonist causes a significant improvement in the Bishop’s score and is associated with an increased rate of vaginal deliveries.
Effectiveness of Cabergoline therapy in hyperprolactinemic infertility
Authors: Pitale Devdatt Laxman
Published: May 2019

Background: Hyperprolactinemia may be associated with ovulatory dysfunction and resultant subfertility. Hyperprolactinemia affects the pulsatile release of GnRH, which in turn impairs the secretion of FSH and LH. It may also affect the endocrine activity of ovarian follicles, resulting into luteal phase defect and ovulatory dysfunction. Hyperprolactinemia may be associated with infertility in up to one-third of women undergoing infertility workup. Women with hyperprolactinemia are generally treated with dopamine receptor agonists to reduce serum prolactin levels and regularisation of menses. The aim of this study was to study the effectiveness of cabergoline therapy in hyperprolactinaemic infertility.Methods: This prospective study was performed from June 2017 to July 2018 in women with Hyperprolactinemic infertility attending the infertility clinic at INHS Patanjali. In this study, 20 women with hyperprolactinemic infertility who satisfied the inclusion and exclusion criteria were started on four week cabergoline therapy. The effectiveness of therapy was evaluated on the basis of normalization of prolactin levels, regularization of menses, reduction in galactorrhea, successful conception and adverse effects if any.Results: The women on Cabergoline therapy showed marked improvement in menstrual irregularity, near normal prolactin levels and reduced galactorrhea. After the four week Cabergoline therapy the frequency of galactorrhea and irregular menses was reduced in 8 (80%) and 14 (93.3) per cent, of women respectively. Successful conception was achieved in 17 (85%) women after regularization of menses with no any major adverse effects.Conclusions: This study shows the effectiveness of cabergoline therapy both on lowering the serum prolactin levels and successful Conception with no any major adverse effects. Cabergoline therapy is a cost effective and safe option in hyperprolactinaemic infertility.
Abnormal uterine bleeding in women of peri-menopausal age: a retrospective study
Authors: Chennuru Rambabu , Potnuru Ramkumar
Published: May 2019

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of abnormal uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders.Methods: A retrospective study of randomly selected 200 cases of abnormal uterine bleeding between 40–55 years of age during January 2018 to January 2019, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months.Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 60% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (21%) uterus was most common. Maximum number of patients (75%) was treated surgically and 20% got medical treatment.Conclusions: Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.
Breast feeding knowledge, attitude and perspective in immediate postnatal mothers
Authors: Shetty Vishma H.
Published: May 2019

Background: The aim of the study is to understand the knowledge, attitude and practice of breastfeeding among postnatal mothers and optimize the breast feeding practices and overcome various factors that hinder and influence the full realization of benefits of breast feeding.Methods: The study was conducted in the postnatal ward of Rajarajeswari medical college and hospital, Bangalore. 500 postnatal mothers were included. A structured interview schedule was prepared to collect sociodemographic data, perceptions, knowledge, attitude and practices of mothers regarding breastfeeding. Data was collected by interviewing mothers (in their own language) using proforma.Results: About 100% of mothers and newborn infant have skin to skin contact within one hour of an uncomplicated vaginal delivery. Majority of the mothers knew about the importance of breast feeding for babies and herself. Only 17% of the mothers were working in our study and majority of them had resigned from their work as there was no option of maternity leave and baby friendly work environment at their working places. 69% intended to breastfeed up to 6 months. 23% mothers discarded colostrum and 11% gave prelacteal feeds to their babies.Conclusions: The mothers should be encouraged and reinforced about the benefits of breastfeeding for both baby and herself. The workplace condition has to be improved and make it more breast feeding friendly. The study also will assist the health care providers and community workers to understand the attitude and practice in the area and help them to prioritize and focus on these aspects and decrease the incidence of suboptimal feeding practices.
A molar pregnancy detected by following irregular vaginal bleeding after a first trimester evacuation: rare case report
Authors: Salvi Meena Bhati
Published: May 2019

In this case report summarizes the sequence of events that led to detection of a molar pregnancy missed by ultrasound and initial pathology examination. A 29 years old Asian nulliparous patient came to our clinic with missed period. On beta HCG she was 6 weeks pregnant. After 20 days she was diagnosed with 7 weeks missed abortion on ultrasound. surgical evacuation done for same. After 3 weeks she came with irregular vaginal bleeding. After physical and vaginal examination Beta HCG done, which was very high. On transvaginal ultrasound partial molar pregnancy was detected, so she was immediately admitted and repeat surgical evacuation was done. Histopathology report confirmed partial molar pregnancy which was not detected in previous report. She was regularly followed up with Beta HCG value up to 1 year which declined dramatically. Though molar pregnancy is rare, but it has the potential to develop into invasive mole, so any abnormal bleeding post evacuation should be followed up properly. Beta HCG values and histopathological evaluation is important for correct diagnosis and follow up.
Unilateral hydronephrosis in adults: etiology, clinical presentations and management
Authors: Dare Gowardhan , Akhtar Murtaza , Chaudhary Swanand
Published: May 2019

Background: Hydronephrosis is dilatation of renal pelvis and calyces resulting from intermittent and incomplete obstruction to the urine outflow with incidence of 1:100. This study aims to evaluate etiological factors, clinical presentations, diagnostic modalities and management options of unilateral hydronephrosis.Methods: In a tertiary care based observational study, patients more than 18 years age of either gender with unilateral loin pain with or without lump in loin were clinically diagnosed as unilateral hydronephrosis and confirmed on imaging studies were enrolled as subjects. Pregnant patients and patients not consenting were excluded. Patients with mild unilateral hydronephrosis were managed conservatively. Those of moderate to severe grade were investigated with CT urography and those with no excretion of dye in affected kidney were further investigated with DTPA scan. In patients with function of less than 10% on DTPA scan were subjected for nephrectomy.Results: Of the total 72 patients of unilateral hydronephrosis enrolled, 50 (69.44%) were due to ureteric calculi, 18 (25%) were PUJ obstruction and 4 (5.56%) were renal calculi. Highest incidence was seen in third and fourth decade with Males to female ratio of 1.25:1. Commonest symptom was pain in abdomen followed by hematuria. Ureteric calculi of size less than 7 mm were given conservative trial and rests were managed surgically. Out of total 72 patients 43 patients were managed conservatively and rest 29 were treated surgically.Conclusions: Ureteric calculus, pelviureteric junction obstruction and renal calculus were the etiological factors causing unilateral hydronephrosis and management was as per etiology.
Effectiveness of preoperative scoring in predicting the difficult and extremely difficult laparoscopic cholecystectomy
Authors: Kanagala Rajesh , Nallapaneni Viswanath
Published: May 2019

Background: To reduce the complications and conversion rate among the patients undergoing laparoscopic cholecystectomy, preoperative scores have been developed based upon the experience of surgeons and experience of the surgeries. Certain preoperative factors are thought to predict the difficult or extremely difficult laparoscopic cholecystectomy. Studies have shown the utility of the preoperative scoring to predict the difficult or extremely difficult laparoscopic cholecystectomy. To study the effectiveness of pre operative scoring in predicting the difficult and extremely difficult laparoscopic cholecystectomy.Methods: Present study was hospital based cross sectional diagnostic evaluation study carried out among 50 patients who were posted for laparoscopic cholecystectomy. The parameters which defined pre operative scoring as well as parameters which defined intra operative scoring were recorded and based on the total score, the difficulty level was assessed preoperatively and confirmed intraoperatively. The efficacy of preoperative scoring was determined by comparing it with intra operative scoring.Results: History of previous hospitalization, Palpable gall bladder, impacted stone and USG wall thickness/pericholecystic collection were significant preoperative factors. The overall diagnostic accuracy of preoperative scoring in predicting difficult laparoscopic cholecystectomy was 80%. Sensitivity was 94.44%, the specificity was 84.38%, positive predictive value was 77.27%, negative predictive value was 96.43%, likelihood ratio of a positive test was 6.044, and likelihood ratio of a negative test was 0.06584. Thus it can be said that the efficacy of preoperative scoring in predicting difficult laparoscopic cholecystectomy was very good.Conclusions: The efficacy of preoperative scoring in predicting difficult laparoscopic cholecystectomy was very good.
A clinicopathological study of stomach carcinoma in a tertiary care hospital of central India
Authors: Akulwar Anil , Akulwar Akshay , Rao Siddarth , Narang Ravinder
Published: May 2019

Background: The incidence of gastric cancer varies in different part of world. It is a series problem as it involves development of malignancy in stomach and affected by with daily life style of the habituates.Methods: The present study was carried out at tertiary care center of districts of Vidarbha region of Maharashtra and neighborhood districts of Andhra Pradesh and Madhya Pradesh for the tenure of six years. Study and collection of data were assessed by examination of one hundred and seven patients suffering with the gastric carcinoma.Results: Males were found to be more susceptible in a ratio of 1.22/1. Mean age of incidence was assessed as nearly 55 years. Smoking, alcohol, mixed diet, weight gain, positive family history and history acid peptic disease were reported in 23.4%, 24.3%, 63.8%, 2.8% 36.4% and 36.4% cases. Mild to severe anemia was also reported. Most accountable symptom was abdominal pain, followed by vomiting. Lump in abdomen and nausea were some other symptoms. Jaundice in little percentage was also observed. Antrum was most common site of malignancy observed in more than 50% cases. Cardia, pylorus and fundus were involved in 17, 14 and 03 patients. Thickening of stomach wall were observed. Adrenocarcinoma was in 100 patient’s symptoms.Conclusions: Incidence of cases in these areas refers to poor dietary habits. Increasing the literacy and awareness regarding the causative factors in the respective areas contributes to decrease the incidence and risk too.
Management of hand burns using tangential excision and grafting versus delayed excision and grafting
Authors: Sharma Dev J. , Langer Vijay
Published: May 2019

Background: A burn injury to the hand, whether in isolation or associated with a major systemic burn injury, continues to be a challenge to the treating surgeon, as correct clinical judgment and decision regarding management thereof can affect the final outcome both aesthetically and functionally.Methods: A total of 84 patients (140 hands) were covered under the study, bilateral hand involvement in 56 patients (80% of hands) and unilateral involvement in 28 patients (20% of hands). Each group had 42 patients each. All patients were admitted to the hospital within 48-96 hours of the injury and operated within 3-7 post injury day.Results: The skin graft take was much superior in the early excision group as compared to delayed excision group and hence resulted in decreased overall hospital stay. The functional and aesthetic outcomes were better achieved with less need of secondary surgical procedures. There were no major complications. Patients were followed up for a period ranging from six to twenty four months.Conclusions: The skin graft take was much superior in early excision group as compared to delayed group and hence resulted in decreased overall hospital stay. The functional and aesthetic outcomes were better achieved and the needs for secondary surgical revision were far lesser with early excision and grafting. Both early excision and grafting, and delayed excision and grafting modalities lead to post-burn deformities of hand, albeit different from each other, but more common with delayed grafting.
A clinical study of the incidence of salivary gland tumors in a tertiary care teaching hospital
Authors: Babu N. Sathish , Mahadev Naveen H. , V. Kumar G.
Published: May 2019

Background: The salivary gland system of the upper aero digestive tract plays a critical role in the functions of digestion, respiration, communication, and overall homeostasis. The Salivary gland swellings can be broadly classified into inflammatory, non-inflammatory and neoplastic swellings like calculi, benign tumours such has pleomorphic adenoma, oncocytoma, Warthin's tumour, malignant tumors which include-adenocarcinoma, adenoid cystic carcinoma, undifferentiated carcinoma.Methods: The present cross-sectional study was conducted at the Department of general surgery, Sri Siddhartha Medical College over a period of 2 years from August 2016 to July 2018.  All major salivary gland neoplastic swellings confirmed by FNAC were included in this study.Results: In our study 23 patients had major salivary gland tumours out of that 19 patients had parotid and 4 had submandibular major salivary gland tumour. In our study out 23 cases of salivary tumours 19 cases were benign and 4 cases were malignant, out of 19 cases of parotid tumours, 15 (78.94%) cases were seen in superficial lobe and 4 (21.06%) were in deep lobe, out of 23 salivary gland tumours, 19 (82.6%) cases were pleomorphic adenoma 3(13.05%) cases were mucoepidermoid carcinoma and one case (4.35%) was acinic cell carcinoma.Conclusions: Parotid gland was the most common site of origin of both benign and malignant tumours, Pleomorphic adenoma was the most common benign salivary gland tumour and mucoepidermoid carcinoma was the most frequent malignant neoplasm.
Missing inferior vena cava: report of a rare case
Authors: Perumal Senthil Kumar , Subramaniam Sugi R. V.
Published: May 2019

Missing inferior vena cava (IVC) is an uncommon but well recognised anomaly. Our case was a 32 year old male, presented to us with features suggestive of gastric outlet obstruction. When evaluated he was found to have gastric outlet obstruction secondary to cicatrized duodenum and a large subcutaneous vein running from supra pubic region towards the left axilla. Further imaging revealed the complete absence of inferior vena cava and the large collateral drainng the venous blood from lower half of the body into left interal jugular vein. Surgical correction of this rare anomaly is not required in the absence of deep vein thrombosis and venous ulcers of lower extremity. Here we report a case of young male with incidentally detected missing IVC as a contribution to the limited literature available on this rare anomaly.
Brachial artery pseudo-aneurysm in intravenous drug abuser: a rare case report
Authors: Nabi Naveed , Beigh Firdous , Mir Showkat
Published: May 2019

Brachial artery pseudo-aneurysm (BAP) is a rare entity because pseudo-aneurysms are common in lower limbs.1 Usual causes of BAP are humeral fractures, iatrogenic causes (repeated punctures for sample collection, following construction of Brachio-cephalic fistula) or some genetic causes like Ehler Danlos syndrome (EDS). This case has been reported to highlight the importance of considering all the differential diagnosis while evaluation of an upper limb swelling especially in the cubital fossa and due consideration of history of any IV drug abuse.
Parathyroid microadenoma as a cause of chronic intractable cough
Authors: Diwakar Deepak K. , Wadhwani Nikita , Rana Nisha , Paruthy Shivani
Published: May 2019

Chronic non-productive cough is one of the most common non-specific symptom with multiple etiologies and is treated non-surgically. Rarely, it can be caused by anatomical causes. We present a case of parathyroid microadenoma presenting with chronic intractable cough and dysphagia, diagnosed after a battery of tests and failed treatments and cured by a simple parathyroidectomy.
Maxillary distraction osteogenesis for correction of maxillary retrognathia in cleft lip and palate patients: a case series
Authors: Kaya Burçak , Cubuk Secil , Akdeniz Sıdıka , Bayram Burak
Published: May 2019

The treatment protocol of patients having maxillary retrognatia is presented in this case series. Maxillary expansion, secondary alveolar bone grafting and/or oronasal fistula closure were performed in 6 cleft lip and palate patients. Preoperative simulation of Le Fort I osteotomy and adaptation of maxillary distractors were realized with stereolytographic cranium models. Intraoral maxillary distraction was applied under general anesthesia. A single unit acrylic occlusal splint was ligated to maxillary dental arch and worked as a guide during entire activation and consolidation period of distraction osteogenesis. Rigid internal fixation plates were placed in the osteotomy sites at the end of consolidation period. The amount of maxillary advancement was between 5-14 mm.  Satisfying occlusal and skeletal relationships were obtained in all patients. Advancement of maxilla by distraction osteogenesis resulted in gradual formation of bone at the osteotomy line and enhanced treatment outcome in patients with cleft lip and palate.
Self care management in diabetes mellitus: a pitfall in treatment?
Authors: T. K. Raja , M. Buvneshkumar , D. Raja , T. Muthukumar
Published: May 2019

Diabetes mellitus is a lifelong disease, which affects both urban and rural population. Approximately 425 million adults were living with diabetes; by 2045 this will rise to 629 million. To achieve glycemic control and prevent complications, apart from pharmacological treatment, the patients required to follow self-care practices. Unfortunately, the knowledge of proper diabetes self-care among diabetic patients is insufficient which hampers the effective management
ARTIFICIAL INTELLIGENCE VERSUS PUBLIC ADMINISTRATION: LIMITATIONS OF APPLICATION
Authors: M. Morkhat Petr , V. Ponkin Igor , V. Markhgeym Marina , K. Botnev Vladimir , O. Turganbayev Aidyn
Published: May 2019

Purpose of Study: The present study was designed to study possibilities, conditions, grounds and limitations regarding the use of technologies and units of artificial intelligence in public administration. Determinants of the need to use such technologies in public administration were also considered. In this study, directions of realizable engagement which is already implemented, as well as directions of the possible use of artificial intelligence units in the future for public administration were investigated to ensure the functioning of system of state executive bodies.

Methodology: The present research carried out based on the application of research methods such as system analysis, synthesis, and classification. Using these research methods, the concepts of describing conditions, possibilities, modes and functional-target load of using technologies and units of artificial intelligence in public administration, as well as limitations of its application in public administration were developed.

Results: It was found that the use of artificial intelligence by the state for performing its various own tasks is highly relevant as it might lead to finding many positive approbations. However, despite the fact that technologies and artificial intelligence units have been developed for a relatively long time, and some of them are already widely used, it is still impossible to talk about the integrated, fully tested and properly regulated implementation of this kind of technology and units for management, therefore, it is suggested to further investigate on this issue from a theoretical (prognostic) point of view, taking into account potential directions and possibilities regarding    the use of such technology and units.

Implications/Applications: The use of technologies and units of artificial intelligence does not necessarily take into account as a panacea for solving the problems and may not lead to solving some systemic problems in public administration, but, on the contrary, may even aggravate some existing problems in public administration and contribute to the emergence of new problems and risks.
Perceptions of broadcast and film media practitioners in UK higher education
Authors: Mateer John
Published: May 2019

With a growing emphasis on employability and commercial relevance, universities are increasingly involving practitioners in delivery to add perceived value and credibility to their film and television courses. Likewise, film education researchers, including Bergala (2016), see significant
value in practitioner involvement in teaching. Yet, from both the academic and industry sides, this integration has been questioned and challenged, resulting in a long-standing discussion of the 'theory/practice divide'. Through analysis of two formal surveys conducted in 2012 and 2014, involving
131 respondents from 64 UK higher education institutions, this paper reports on the perceptions of broadcast television and film practitioners working in academia. It also briefly considers whether the issues raised have changed since the surveys were completed. Responses suggest that an appreciable
number of respondents encountered a mixed or negative reaction from new academic colleagues immediately upon joining their institution, and that this has had a potentially lasting negative impact on their productivity. The data indicate that many media practitioners working in higher education
do not feel that they are seen as equal to non-practitioner colleagues, although they do still feel part of the academy as a whole. Respondent institutions were broken down by type, and there is statistically significant evidence of perceptions of systematic disadvantaging of media practitioners
across all types of UK academic institutions, although Arts-focused universities were seen most favourably. This suggests that, despite the UK government's increased emphasis on teaching and employability, and new commercially focused research funding initiatives, higher education institutions
need to do more to redress the perception of a theory/practice divide.
Exploring co-creation in practical film education from primary school to postgraduate study: Theoretical and auto-ethnographic perspectives upon teaching film practice
Authors: Chambers Jamie
Published: May 2019

Considering the emergent discourses around film education, there has been little discussion to date of co-creation: that is, how student practical film work might be mediated by, collaborated upon, or even contributed to, by those teachers, instructors, lecturers and practitioners
assisting them in the process. This study explores the thorny question of co-creation through a series of case studies, employing an auto-ethnographic approach to reflect upon first-hand experiences of film education at primary, secondary, undergraduate and postgraduate levels.
Perspectives: A dialogue upon the question of value in film education
Authors: Bernstein Alan , Burn Andrew
Published: May 2019

The question of aesthetic value remains a source of tension within diverse film education environments. While film-makers and audiences have visceral experiences of the value of cinema, these experiences are troubled by a contemporary film studies that tends to adopt a more relativist
approach, suggesting that the experience of value is reflective of sociocultural subjectivity. Speaking from two different perspectives, Alan Bernstein and Andrew Burn explore the role of value in film education, and film culture more widely, in 2019. While Bernstein argues for a reinstatement
of value as a fundamental aspect of how film is experienced and understood in educational contexts and beyond, Burn contextualizes questions of value within a wider framework of semiotic and aesthetic theory, arguing for a multimodal approach that takes into account the multifaceted nature
of film.
Los causativos emocionales del español. Un estudio aspectual
Authors: Melis Chantal
Published: May 2019

El presente trabajo ahonda en la estructura aspectual o Aktionsart de los llamados causativos emocionales del español, tales como asustar, inquietar o molestar. Defiendo la hipótesis de que, tanto en su variante transitiva cuanto en la construcción pronominal (se), estos verbos exhiben el comportamiento del ‘logro compuesto’ (Fernández Lagunilla y De Miguel 1999, 2000). Así lo sugiere el conjunto de diagnósticos aspectuales, que aplico a datos de corpus. La hipótesis depende crucialmente de que el concepto de causa se deslinde de las propiedades eventivas de los verbos, como se ha argumentado en trabajos recientes y como también se verificará examinando los empleos estativos de los causativos emocionales.
Los elementos de contorno dentro de los (sub)lemas pluriverbales (locuciones): fraseología contrastiva español-croata
Authors: Mušura Josipa , Valero Fernández María Pilar
Published: May 2019

El presente artículo pretende mostrar el tratamiento recibido por parte de las obras lexicográficas (tanto las generales monolingües o bilingües como las de material locucional específico) en lo que respecta al contorno de la entrada o subentrada lexicográfica de las locuciones (español-croata) dada su complejidad intrínseca, especialmente, vinculada a la idiomaticidad y pluriverbalidad de las mismas. Para ello, las siguientes líneas se centrarán en el estudio minucioso y detallado del trato que adoptan los elementos de contorno en dichas unidades. En concreto, se hará examen del contorno lexicográfico referido a la información de sujeto, de los complementos de OD y de OI y, por último, de lo concerniente a la preposición y al término. En última instancia, se expondrán ejemplos ilustrativos extraídos de los corpus de referencia con el fin de constatar la relevancia de la información reunida en el contorno lexicográfico en la actividad traductora.