bluuebunny/crossref_metadata_2025 huggingface dataset:
The Study of Stages and Operations Involved in the Preservation and Restoration of two XIX-th Century Icons, on Wooden Support
Authors: Marius Munteanu , Sandu Ion , Huțanu Ioana , Nica Liliana
Published: January 2015

The paper presents the stages and the operations involved in the preservation and restoration of two icons on wooden support, from the XIX-th century, which are part of the heritage of the ”Sfinții Arhangheli Mihail and Gavriil” church, from Galați. The two icon have inventory numbers as part of the collection as followed: 112 for the first icon and 113 for the second one. Both icons have the same theme, ”The Grieving Mother from Rohia” and are made by anonymous painters in egg tempera, on lime wooden support, without ground. Being part of the same collection, they were deposited in the same place and as a direct consequence, they suffer from similar deteriorations and degradations that affect both the support and the painting layer. Both panels are attacked by xylophagous insects and the painting layer has detachments, gaps, cracks, clogged dirt and a cracked and degraded varnish layer. Ten samples taken from the already detached areas were analyzed by optical microscope, SEM-EDX and micro-FTIR. Based on the chemical elements identified in the EDX spectrums, the pigments used to create the painting layer are: ultramarine natural blue Na8-10Al6Si6O24S2-4, carbon black, earth green, K[(Al,FeIII),(FeII,Mg)](AlSi3,Si4)O10(OH)2, ocher (FeO), burned or natural umber Fe2O3· H2O + MnO2·n H2O+ Al2O3, lead white (2PbCO3·Pb(OH)2) and yellow iron oxide (Fe2O3·4H2O). It was also determined that the gold leaf usually used in byzantine icons was replaced in the case of both icons: the icon number 112 has silver leaf covered with varnish, while the halo of the icon number 113 was created with yellow metallic pigments (realgar or orpigment).The pigments were also identified by determining specific peaks in micro-FTIR spectrums. For natural ultramarine blue the peaks between 628 - 724 cm-1 were assigned; the peaks in the interval 795 - 887 cm-1 confirm the presence of carbonates (calcium and lead based). The earth green pigment (aluminum - silicates) had the peaks between 1464 - 1599, while the carbon black pigment was confirmed by the peaks in the interval 921 - 1060 cm-1. After the pigments and the materials used by the author were identified, the restoration process begun with the following stages: consolidation of the painting layer (fish glue 8% and japanese paper), stopping the xylophagous attack (encapsulation with nitrogen), consolidation of the wood supports (colophon and wax, 1:1), cleaning the painting layer (ethylic alcohol and distilled water, 1:1), filling the gaps and reintegrating the fillings in tratteggio, all followed by the process of varnishing the two icons.
Geostatistical Approach to Find ‘Hotspots’ Where Biodiversity is at Risk in a Transition Country
Authors: Petrişor Alexandru-Ionuţ , Petrişor Liliana
Published: January 2015

Global change‟ is a relatively recent concept, related to the energy - land use - climate change nexus, and designated to include all changes produced by the human species and the consequences of its activities over natural ecological complexes and biodiversity. The joint effects of these drivers of change are particularly relevant to understanding the changes of biodiversity. This study overlaps results of previous studies developed in Romania to find, explain and predict potential threats on biodiversity, including the effects of very high temperatures and low precipitations, urban sprawl and deforestation in order to identify „hotspots‟ of high risk for the loss of biodiversity using geostatistical tools. The results found two hotspots, one in the center and the other one in the south, and show that the area affected by three factors simultaneously represents 0.2% of the national territory, while paired effects cover 4% of it. The methodological advantage of this approach is its capacity to pinpoint hotspots with practical relevance. Nevertheless, its generalizing character impairs its use at the local scale..
Characterisation of Agronomic Performance of Baltic Spring Barley Material/ Baltijas Vasaras Mieþu Agronomisko Îpaðîbu Raksturojums
Authors: Kolodinska Brantestam Agnese , Legzdiòa Linda , Cristensen Therese , Weibull Jens , Bothmer Roland von , Martynov Sergey , Yndgaard Flemming , Rashal Isaak
Published: January 2015

Spring barley breeding has been carried out for almost a century in all three Baltic countries. The efforts of breeders have resulted in many new improved varieties released. The goal of our project was to survey the effect of these efforts throughout the century on this crop. The material included in this study consisted of 64 accessions originating from Latvia, Estonia and Lithuania, representing landraces, varieties released from 1927 to 2001, and breeding lines. Six agronomic traits (days to heading, days to maturing, plant height, harvest index, volumetric weight and thousand kernel weight) were recorded during two years (2002 and 2003) at three locations - Priekuïi (Latvia), Landskrona (Sweden) and Bjørke (Norway). The differences between spring barley materials of different origin and from different breeding periods were assessed, and variation of their performance in different environments was discussed
Influence of Nitrogen Fertiliser on Winter Wheat Wholemeal Rheological Properties/ Slâpekïa Mçslojuma Ietekme Uz Ziemas Kvieðu Pilgraudu Miltu Reoloìiskajâm Îpaðîbâm
Authors: Liniņa Anda , Kunkulberga Daiga , Ruža Antons
Published: January 2015

The aim of this investigation was to describe the variation of water absorption and mixing properties of wholemeal dough, depending on effects of, different rates of nitrogen (N) application (N60, N90, N120, N150), weather conditions (in 2010 and 2011) and grain storage time (60, 120, and 360 days) for two cultivars of winter wheat (in Triticum aestivum L.). Trials included winter wheat varieties ‘Bussard’ and ‘Zentos’; both cultivars have high bread-making quality. The farinograph water absorption and wholemeal dough mixing characteristics - dough development time, dough stability time, and degree of softening were tested using a Brabender Farinograph (ICC 115/1). Highly significant effect of cultivars and nitrogen fertiliser were detected on the flour water absorption and dough mixing properties. Grains with higher protein content had better wholemeal dough rheological properties. The wholemeal rheological properties in 2010 and 2011 did not differ significantly. Extended grain storage from 60-360 days resulted in: longer dough development and dough stability time, increased degree of softening, and decreased water absorption. ‘Bussard’ wholemeal had higher water absorption, longer stability time (sometimes excellent quality) and shorter degree of softening compared with ‘Zentos’. According to the farinograph curves, wholemeal dough of ‘Bussard’ can be classified as having medium/long development time and long/excellent stability. Farinograph curve shapes of ‘Zentos’ wholemeal dough indicated medium development time and long stability. A very strong a positive correlation was found for protein content between WA and ST.
The Role of Oxidative Stress Markers in Developing of Acute Respiratory Distress Syndrome / Oksidatîvâ Stresa Marķieru Loma Akûta Respiratora Distresa Sindroma Attîstîbâ
Authors: Ðarkele Marina , Ozoliòa Agnese , Sabeïòikovs Olegs , Ðíesters Andrejs , Silova Alise , Jaunalksne Inta , Strîíe Eva , Krûmiòa Angelika , Vanags Indulis
Published: January 2015

Acute respiratory distress syndrome (ARDS) is common and multi factorial, clinically described as an inflammatory lung disorder that is associated with major morbidity and high mortality in intensive care patients. Recently, investigators have revised the AECC criteria from 1994. To diagnose ARDS and discover its severity we presently use Berlin definition criteria. An important role in developing of ARDS may be through a disbalance between reactive oxygen species (ROS), which have both oxidant and antioxidant compartments. The pathogenesis of ARDS is very complex, and unfortunately, the dynamic development of ARDS in an individual patient is difficult to recognise. ROS can initiate cellular tissue damage by modifying lipids, proteins and DNA, which can seriously compromise cell life ability or induce a large number of cellular responses through generation of secondary reactive species, leading, at last, to cell death by necrosis or apoptosis. Studies have shown that many patients with organ malfunction at admission to the intensive care units (ICU) show decreased antioxidative properties, worsening the harmful effects of lipid peroxidation. That is the reason why predicting development of ARDS has great value for intensive care specialists.
Acute Kidney Injury – An Underestimated Problem In Pediatric Intensive Care / Akûts Nieru Bojâjums — Nenovçrtçta Problçma Bçrnu Intensîvajâ Terapijâ
Authors: Krastiņš Jēkabs
Published: January 2015

Acute kidney injury (AKI) frequently occurs in critically ill children and adults, with 5-20% of patients experiencing an episode during their stay in an intensive care unit. AKI rarely is an isolated event and is associated with a broader spectrum of diseases, including sepsis and respiratory insufficiency, and often progresses into multiorgan dysfunction syndrome. Despite recent advancements in renal replacement therapy (RRT), mortality among patients who sustain AKI complicated by multiorgan dysfunction appears to have remained unchanged and is estimated at approximately 50%. Recent clinical evidence suggests that AKI is not only an indicator for severity of illness, but that it also leads to earlier onset of multiorgan dysfunction with profound effects on mortality rates. The aim of this paper is to inform medical professionals involved in the paediatric intensive care of recent advances in AKI diagnosis and management. Studies were identified from MEDLINE (OVID), PubMed, and the Cochrane Library for topics relevant to AKI. There is limited evidence in paediatrics regarding effective therapy for acute kidney injury, a significant problem in the paediatric intensive care unit that extends length of stay, duration of mechanical ventilation, and overall mortality. Sublethal kidney injury may be contributing to overall morbidity. Prospective clinical trials are needed to evaluate specific diagnostic aids, such as biomarkers, and therapeutic strategies like early initiation of continuous RRT in children with fluid overload
Multimodal Analgesia in Perioperative Settings: Improvement Perspectives / Multimodāla Analgēzija Perioperatīvajā Periodā: Uzlabošanas Iespējas
Authors: Golubovska Iveta , Miščuks Aleksejs , Rudzītis Ēriks
Published: January 2015

The aim of this study was to evaluate the intensity of pain in orthopaedic hospital patients and to identify unsatisfactory pain management and possibilities for improvements in the future. Data collection included Numeric Rating Scale (NRS) scores, which characterised the intensity of pain. Maximum pain on the day of surgery, mean pain on the day of surgery (D0), and mean pain on first (D1) and second (D2) postoperative days were documented. The pain of an intensity from 0 to 3 was defined as mild pain, 4 to 6 as moderate pain, and 6 to 10 as severe pain. Maximum severe pain intensity on the day of surgery was experienced by 20.5% of patients, moderate by 45.8%, and mild by 33.6%. The reported mean pain intensity according to type of surgery was as follows: hip replacement- 2.79 ± 1.6 (D0), 2.09 ± 1.4 (D1), and 1.35 ± 1.2 (D2); knee replacement - 3.39 ± 1.7 (D0), 2.98 ± (D1), 1.82 ± 1.36, and (D2); upper extremity surgery - 3.59 ± 1.9 (D0), 3.4 ± 1.7 (D1), and 2.1 ± 1.5 (D2); lower extremity surgery - 4.1 ± 2.1 (D0), 3.49 ± 1.42 (D1), and 2.58 ± 1.4 (D2); spine surgery - 3.31 ± 1.58 (D0), 2.88 ± 1.96 (D1), and 1.83 ± 1.74 (D2). Patients in the lower extremity group experienced unacceptable mean pain. The maximum pain intensity on day of surgery was experienced by patients after single-shot plexus brachialis block anaesthesia (5.24 ± 2.4). Well-designed multimodal analgesia with special attention to single shot techniques may improve pain management and functional outcomes after orthopaedic surgery.
Anaesthesia Management with Deep Hypothermia and Circulatory Arrest During Surgery for Chronic Thromboembolic Pulmonary Hypertension / Anestēzija Pie Plaušu Artēruas Endarterektomijas Dziļā Hipotermuā Ar Cirkulācijas Apiurēšanu
Authors: Leibuss Roberts , Kalējs Mārtiēņš , Skride Andris , Bekkers Mihails , Ozoliņa Agnese , Stradiņš Pēteris , Strīķe Eva , Lācis Romāns
Published: January 2015

Chronic thromboembolic pulmonary hypertension (CTEPH) occurs in 1 to 4% after acute pulmonary embolism. CTEPH can be cured by pulmonary endarterectomy (PEA), which is approved golden standard in chronic condition. There were performed three cases of PEA in Latvian Cardiology Centre during 2013-2014. General anaesthesia under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrests was provided. The core issue is correct patient selection (in terms of central PA obstruction by thrombus) as well as pulmonary circulation recovery capacity. Neuroprotection was provided by deep hypothermia, topical cooling of the head, Trendelenburg position, mild hypocapnia, Hb 9-10 g/L and pharmacological agents. For screening postoperative cognitive function the mini mental state examination (MMSE) was used before and after the surgery. Postoperative pulmonary vascular resistance index decreased by 56.3% (right ventricular systolic pressure decreased from 93.3 ± 25.7 to 44.5 ± 11.2 mmHg). Before the surgery three patients had NYHA functional class III or IV, at the time of discharge - I or II. In one case moderate (MMSE 18) cognitive disorders was observed at discharge from the ICU. No one died neither in the hospital nor within 30 days of discharge. The surgery improved RV function and pulmonary perfusion with no considerable organ failure, except mild cognitive disorders.
The Activity of Oxidative Stress Markers in Acute Respiratory Distress Syndrome / Oksidativa Stresa Marķieru Aktivitate Akuta Respiratora Distresa Sindroma Gadījuma
Authors: Šarkele Marina , Ozoliņa Agnese , Sabeļnikovs Olegs , Šķesters Andrejs , Silova Alise , Vanags Indulis
Published: January 2015

Acute respiratory distress syndrome is a common complication characterised by severe hypoxemia, which leads to high mortality rates in ICU patients. Imbalance between oxidative stress markers like oxidants and antioxidants may play an important role in pathophysiology of the syndrome. We observed 17 ARDS patients during seven days after inclusion, with the main goal to describe dynamic changes in the level of oxidative stress markers in patients with acute respiratory distress syndrome. We found that there are dynamic differences in the level of malondialdechyde (MDA) and nitric oxide (NO) in patients with acute respiratory distress syndrome. There were also different levels of oxidative stress markers in non-survivor compared with survivor groups. Increased level of an oxidant like a thiobarbituric acid substance with malondialdechyde (TBS_MDA) and antioxidant glutathionperoxidase (GPx) at the first day after inclusion was related with poor outcome in patients with acute respiratory distress syndrome.
Correlation of cardiac 123I-MIBG imaging with conventional markers of the heart failure
Authors: Vajauskas Donatas , Maneikienė Vytė Valerija , Tamošiūnas Algirdas Edvardas , Ručinskas Kęstutis , Lukšaitė Raminta , Balčiūnaitė Evelina
Published: January 2015

Objectives: Quantitative values of cardiac iodine-123 metaiodobenzylguanidine (123I-MIBG) global and regional adrenergic innervation showed promising results in predicting clinical course of heart failure. Nevertheless data is lacking how global and regional cardiac 123I-MIBG imaging parameters correlate with patient’s clinical data and conventional heart failure markers.

Patients and methods: Eighty-six patientswith class II-IVNewYorkHeartAssociation (NYHA) heart failure were investigated. Patients underwent early and late cardiac 123I-MIBG planar and single photon emission computed tomography (SPECT) scanning. Global and regional cardiac 123I-MIBG scores were calculated and compared to conventional heart failure markers (left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP) and maximum rate of oxygen consumption (VO2 max)), followed by NYHA functional class clinical assessment at the time of investigation.

Results: Weak statistically significant correlation was noted between LVEF and global and regional cardiac adrenergic denervation scores, between BNP and VO2 max and global cardiac adrenergic denervation scores. Global and regional cardiac adrenergic denervation scores significantly differed within LVEF ranges. Global cardiac adrenergic denervation scores significantly differed within BNP levels and NYHA functional class.

Conclusions: Conventional cardiac heart failure markers had weak correlation with global and regional cardiac 123I-MIBG imaging parameters. Cardiac 123I-MIBG imaging markers differed significantly depending on LVEF and BNP levels, and NYHA functional class.
Geographical and Human Impact Elements Influence on the Fish Fauna of the Olteţ River (Romania)
Authors: Bănăduc Doru , Mărginean Mircea , Curtean-Bănăduc Angela
Published: January 2015

A white spot regarding the fish fauna of the upper and middle Olteṭ River was covered and the significant changes appeared in this respect and in the lower course were identified. In general the passing of the river from one type of geographical/relief type unit to another, induce the changing of the ichthyological zone and the increasing of the fish species number. There where this natural situation did not appear is because different human impact causes create unnatural variations in fish communities’ compositions and individuals’ number. The presence of a various human impact especially downstream the mountain area makes to exist here a relative unbalanced fish fauna structure, in comparison with the mountainous sector. Overall, the geographical and human impact elements, and a result of them, the self cleaning capacity of river, are main driving forces which induce the fish fauna composition variability.
Experimental and Numerical Analysis of Steel Frame Structure Exposed to High Temperature
Authors: Lausová Lenka , Matečková Pavlina , Skotnicová Iveta
Published: January 2015

Structures exposed to fire loading, where supports prevent thermal expansions, must be calculated according to the basic principles of mechanics while respecting the effect of rising temperature on the structure and its effect on the value of variable material properties at the time of fire. The paper analyzed and compared results of the experiment aimed to verify the behavior of statically indeterminate steel frame exposed to high temperature and numerical modelling using finite element method in the ANSYS software.
Coefficients of Reflection and Transmission of Transverse and Longitudinal Acoustic Wave in the Blatz-Ko Material
Authors: Major Maciej , Major Izabela , Różycka Judyta
Published: January 2015

The purpose of this paper is to analyze the propagation of transverse and longitudinal acoustic wave in a composite made of hyperelastic Blatz-Ko material. Composite consists of a homogeneous layer of predetermined thickness d separating two infinite homogeneous material areas. In the paper it is assumed that the middle layer is filled with a homogeneous rubber (ƒ=1), whereas the external areas with foam rubber (ƒ=0). The final effect of paper are graphs of coefficients reflection of transverse and longitudinal acoustic wave, propagating in this composite.
Thermal behaviour of light lanthanide(III) complexes with 2,3-pyridinedicarboxylic acid
Authors: Rzączyńska Zofia , Danczowska-Burdona Anna , Drewniak Marek
Published: January 2015

The lanthanide(III) complexes with 2,3-pyridinedicarboxylate ligand (PDC) were obtained as crystalline compounds from the water solutions. These compounds form the series of Ln
Perchloric acid catalyzed condensation of amine and aldehydes: Synthesis and antibacterial activities of some aryl (E)-imines
Authors: Mayavel P. , Thirumurthy K. , Dineshkumar S. , Thirunarayanana G.
Published: January 2015

A series of Schiff’s bases (aryl E-imines) have been derived from the perchloric acid catalyzed condensation of aryl amines and substituted benzaldehydes. The yield of the Schiff’s bases are more than 80%. The synthesized Schiff’s bases are characterized by their physical constants, analytical and spectroscopical data. The antibacterial activities of these Schiff’s bases have been studied using Bauer-Kirby method.
Income generation in informal sector: A case study of the street vendors of Kathmandu Metropolitan City
Authors: Adhikari Dipak Bahadur
Published: January 2015

Street vending is important to income earn and poverty alleviation for some people of Nepal. The street trade provides employment and income generation for the rural poor in the urban areas. And not only rural poor are getting earning opportunities in the informal economy; this has been providing goods in cheaper price to urban poor. This paper analyzes the determinants of the street vender’s income. It examines whether the income from vendor business of the people doing street business in Kathmandu metropolitan city increases with the rate of increase in investment, education and labor supply.DOI: http://dx.doi.org/10.3126/ejdi.v13i0.7193Economic Journal of Development Issues Vol.13 & 14 2011, pp.1-14
A methodological review of demand analysis: An example of health care services
Authors: Adhikari Shiva Raj
Published: January 2015

Demand describes the quantity of goods or services per unit of time that an individual purchases and consumes given the set of the prices and income of the consumer. The demand models based on continuous choice or discrete choice are popular in the economic literatures. Discrete choice depicts where and what kinds of health services to consume while the continuous choice portrays how much of health services to consume. Specification of the behavioural model and estimation of the parameters of the model that are interrelated tasks in discrete choice model are challenging for the researchers. Health sector data have special features like discrete nature of the data, problems of censoring, integer counts or time duration and several factors complicate attempts to obtain unbiased estimates of the impact of variables that influence demand for health care. The health care data provide wider applications of econometrics models. These models have some advantages in presenting and analyzing the choice behaviour; however, they have some limitations as well. Subsequently, the researchers are continuously interested to find and to apply appropriate models to describe the choice behaviour of the decision makers.DOI: http://dx.doi.org/10.3126/ejdi.v13i0.7215 Economic Journal of Development Issues Vol.13 & 14 2011, pp.119-130
Growth and inflation: Estimation of threshold point for Nepal
Authors: Bhusal Tara Prasad , Silpakar Sajana
Published: January 2015

This article is primarily meant to estimate threshold level of inflation in Nepal using annual data for the period 1975-2010. The threshold value of inflation is found to be 6% for Nepal. Beyond that level of inflation rate, higher or lower than the threshold value, the economic growth can be jeopardized. Looking specifically at Nepal’s economic and inflation performance, the less than robust link between the two variables is not surprising, given the current structure of the economy and factors which influence inflation.DOI: http://dx.doi.org/10.3126/ejdi.v13i0.7216 Economic Journal of Development Issues Vol.13 & 14 2011, pp.131-138
Socio-Economic Impacts of Dairy Cooperative
Authors: Chaudhary Balak , Upadhyaya Mukul
Published: January 2015

A study was conducted in Adarsha Milk Producer Dairy Cooperative, Mahuli, of Saptari district to find out socio-economic impact of dairy cooperative during May 2008 to Dec.2008. Response from 224 milk producing farmers were randomly collected, stored and analysed using Microsoft excel program. Different sources of income have been recorded and analysed with major category as main crop, cash crop, dairy goat farming and service in organizations. Among them, dairy was found to be the highest income contributor (55%) to the rural farmers. Moreover, dairy was found to be the symbol of pride, prestige and religious priority for the studied community.DOI: http://dx.doi.org/10.3126/ejdi.v15i1-2.11859Economic Journal of Development Issues Vol. 15 & 16 No. 1-2, pp. 15-23
Public debt in Nepal: an assessment
Authors: Bhattarai Kumar
Published: January 2015

Public debt is the instrument of financing budget deficit. One important macroeconomic problem of Nepalese economy is prevailing resource gap. Due to such situation, with the increase in size of government budget, the size of public debt is also increasing. With the increase in public debt, it is worthwhile to study how macroeconomic indicators are changing over the time. This study is based on the descriptive analysis. For this purpose, the period of 1975/76-2010/11 is considered. In this period, public debt has increased, on average, by 18.86%. The share of external loan, on average, seems to be relatively higher, i.e. 58.85% whereas such share of internal loan is 41.15%. However, in the latter period, the share of internal loan has significantly higher than the share of external loan. For example, during the period of 2005/06-2010/11, the average share of internal loan is 68.01% whereas such share of external loan is 31.99%. In spite of increased budget and increased public debt, the growth rate of economy is relatively low. On average, it is 4.28%. But, the rate of inflation is, on average, 8.31%. Thus, Nepalese economy is facing the problem of low rate of economic growth and high rate of inflation.DOI: http://dx.doi.org/10.3126/ejdi.v15i1-2.11864Economic Journal of Development Issues Vol. 15 & 16 No. 1-2, pp. 50-59
International migration and development: perspective from origin countries of migrants
Authors: Kunwar Laxman Singh
Published: January 2015

This paper seeks to critically analyze the role of migration to carry out development in origin countries of migrants. Now, migration and development; development in the origin of migrants’ is being widely discussed among governmental and non-governmental institutions in the world. At the same time the flow of migrants’ from economically less developed nations or regions to more developed nations or regions have been increased significantly. The volume of remittances also has been increased every year. Some countries adopted the policy of labour export since a long period of time but there is no achievement in development in the countries. The aim of this paper is to relate achievement in development of migrants’ origin countries with remittances with the help of available literature. The existing debate on migration and development is also a part of review of this paper. The migration-development relationship is complex and multidimensional, and that there is variation from one context to another with differences in the nature of migration and in the economic, political and social situations in origin and destination. It would be problematic and insufficient to analyze migration process and its consequences with the help of any single theory or approach of migration, because migration process has far reaching effects on national and international level and varies differently for different part of world on the basis of achievement on social, political, and economic development.  DOI: http://dx.doi.org/10.3126/ejdi.v15i1-2.11865Economic Journal of Development Issues Vol. 15 & 16 No. 1-2, pp. 60-75
Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas
Authors: Patel Nitesh V. , Jethwa Pinakin R. , Shetty Anil , Danish Shabbar F.
Published: January 2015

OBJECT

Although control of intracranial ependymomas is highly correlated with degree of resection, it is unknown if the same is true for MRI-guided laser-induced thermal therapy (MRgLITT). The authors report their experience with MRgLITT for ependymoma and examine the utility of the real-time thermal damage estimate (TDE), a recent software advance, with respect to completeness of ablation and impact on tumor control. To the authors' knowledge, this is the largest single-center experience utilizing MRgLITT for recurrent ependymomas.

METHODS

Five tumors in 4 patients were treated with the Visualase Thermal Therapy System. Two tumors were treated similarly on recurrence. Ablation was performed using a 980-nm diode laser with a real-time image acquisition system. Single-plane TDEs were calculated and compared with the original lesion area to compute percentage area ablated (PAA). Volumetric analysis was performed, and percentage volume ablated (PVA) was estimated and correlated with the TDE. Tumor control was correlated with the TDE and volumetric data during treatment.

RESULTS

Nine ablations were performed on 5 tumors, 2 of which had multiple recurrences. The average pretreatment lesion volume was 8.4 ± 6.3 cm3, and the average largest 2D area was 5.3 ± 2.7 cm2. The averaged TDE was 3.9 ± 2.1 cm2, average PAA was 80.1% ± 34.3%, and average PVA was 64.4% ± 23.5%. For subtotal ablations, average recurrence time was 4.4 ± 5.3 months; 1 adult case remains recurrence-free at 40 months. Using TDEs, the correlation between recurrence time and PAA was r = 0.93 (p = 0.01), and for PVA was r = 0.88 (p = 0.02). Furthermore, PVA and PAA were strongly correlated (r = 0.88, p = 0.02).

CONCLUSIONS

Through using the PAA, the real-time TDE correlated with the volume of ablation in this initial investigation. Furthermore, the TDE and volumetric data corresponded to the level of tumor control, with time to recurrence dependent on ablation completeness. MRgLITT may have a role in the management of recurrent ependymomas, especially with recent software advances.
Setting Up an Ethical Oncofertility Practice in Developing Countries
Authors: Linkeviciute Alma , Boniolo Giovanni , Peccatori Fedro A.
Published: January 2015

Fertility preservation for cancer patients is a relatively new field in medicine which requires interdisciplinary approach. Improving therapies and rising survival rates require to consider patients quality of life after cancer is cured which is relevant personal issue regardless of the individual income and the level of development of the country of origin. Fertility preservation offers possible solution but also raises ethical questions. We provide a summary of ethical principles embodied in professional guidelines together with options and restrictions to access fertility preservation in developing countries. We also make a suggestion that oncofertility counselling could be a pillar to address fertility preservation issues in cancer patients. Our proposed decisional support model is patient centred and focuses on patient values, personal philosophy and view of life emphasizing sensitivity to individual patients needs and wishes. Some fertility preservation concerns in oncology might be addressed mirroring already available expertise while some others will call for innovative and region specific solutions. Therefore, in addition to our proposal we also provide a list of organisations working in oncofertility field. DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21532 Bangladesh Journal of Bioethics 2014 Vol.5 (3): 6-17.
Strikes and Doctors- psychosocial and ethical dilemmas
Authors: De Sousa Avinash , Shrivastava Shivanshu , Sonavane Sushma , Shah Nilesh
Published: January 2015

This paper is a commentary on whether doctors have the right to strike work or not while keeping in mind, psychosocial and ethical implications of the same. Certain guidelines and criteria that may be applicable when examining doctors on strike are elucidated and discussed. DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21534 Bangladesh Journal of Bioethics 2014; 5(3):23-25
Oral Propranolol and Prednisolone in the Treatment of Infantile Hemangioma: A Comparative Study
Authors: Haque Md. Mahfuzul , Ferdous KMN , Saha Bablu Kumar , Paul Swapan Kumar , Islam M Kabirul
Published: January 2015

Purpose: Infantile Hemangioma is a common vascular tumor of infancy and children. Although the lesions involute, the results are unpredictable and the time taken is variable. Responses to commonly used drugs like corticosteroid are not satisfactory due to variable effectiveness. There are also hazards of surgical intervention. The aim of this study is to compare the oral propranolol & prednisolone for IH treatment.Methods: In this study 104 patients were included. They were divided into 2 groups by systematic sampling method. In Group-A 52 patients were treated with oral propranolol and in Group-B 52 patients with oral prednisololne as per the protocol at a dose of 2mg/kg/day in two divided doses. Measurements of the size (directly measured by soft flexible rubber tape and calipers) and color assessment (image based by Adobe Photoshop software) were recorded before starting of the treatment. Follow up was done on 15th day, after 1st, 2nd, 3rd and 4th month respectively. Evaluation of percentage of regression of size and color clearance, adverse effects and treatment cost was done at each follow up. Regression in the size and color clearance of IHs was clinically assessed. Data were analyzed with the help of SPSS. P value of < .05 was considered significant.Results: In group-A 42(80.76%) had an excellent response, compared to group-B only 5(9.61%). In group-A, 40(76.92%) had an excellent color clearance, compared to group-B where only 03(05.76%). Regarding adverse effects in group-A, only 08 children (15.38%) complained of mild adverse effects which were self- limiting compared tothat of group-B (47,90.38%). In group-A average treatment cost was 165tk/ patient and in group-B 580tk. During follow up in group-A one case relapse was seen, in group-B 8 patient.Conclusion: Propranolol was safe, more effective and economic than oral prednisolone.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19414
Pattern of Hematological Manifestations in Patients with Systemic Lupus Erythematosus Attending in a Tertiary Care Hospital
Authors: Rouf Md. Abdur , Ryhan Uddin Abdul Ahad Mohammed , Hoque AMM Ehteshamul , Ismail Mohammad , Biswas Rajat Sanker Roy , Alam Farzana , Islam Mohammad Shirajul
Published: January 2015

Hematological abnormalities are frequently encountered in patients with SLE. It was aimed to study the pattern and frequency of hematological abnormalities in patients with SLE. Forty patients were prospectively analyzed who were suffering from SLE in the CMCH over a period of one year. All patients were evaluated according to the case record form with particular reference to hematological manifestations. Most patients were females in the child bearing age. Hematological manifestations were documented in87.5% of patients. Anemia was the most common hematological abnormality detected (57.5%). Iron deficiency anemia(IDA) 60%, Anemia of chronic disease(ACD) 26.9% and Autoimmune hemolytic anemia(AIHA) 8.7 % were the most common cause of anemia detected. The data demonstrated that while hematological manifestations are very common in SLE but they are rarely life threatening.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19420
Familial Association of Gilberts and Beta Thalassemia Trait
Authors: Deb Nath Jishu
Published: January 2015

A 21 yrs old male from Jatrabari, Dhaka became unfit to travel to Gulf, as his serum bilirubin was found 5.7 mg/dl. He was diagnosed to have Thalassemia trait along with Gilberts syndrome. His elder brother has also got similar diseases from age 14. Here both associations of these diseases with positive family history are highlighted.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19425
Primary Umbilical Endometriosis: Report of a Rare Case
Authors: Bhowmik Dilip K. , Mirza Rezwana , Hossain Amzad
Published: January 2015

Endometriosis is the commonest gynaecological problem; it affects 7 to 10% women in reproductive age group. Commonest site being the pelvic organs, extrapelvic presentation in almost all parts of the body have been reported. However umbilical endometriosis has been reported in more than one hundred cases. It was first described by Villar in 1886. Umbilical endometriosis accounts for only 0.5% to 1% of all endometriosis cases. Most of the reported cases occurred in the scar following gynaecological and obstetrical surgery. A few cases of primary umbilical endometriosis have been reported. We report such a rare case of primary umbilical endometriosis and the diagnosis was done by FNAC & the patient underwent wide local excision.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19426
Evidence based guideline for the management of hypertension in adults: appropriate approach
Authors: Karim Md Enamul
Published: January 2015

Abstract not available DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21516 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 108
Microbial aspect of aspiration pneumonia in patients with altered consciousness admitted in Dhaka Medical College Hospital, Bangladesh
Authors: Chowdhury Md Rashed Alam , Azad Khan Abul Kalam , Hossain Mohammad Zaid , Sardar Md Hafiz , Siddiqui Mahmudur Rahman , Saad Sanjeeda , Rahman Md Mostafizur
Published: January 2015

Context: Aspiration Pneumonia is a common complication in patients with altered consciousness, if general supportive care is not taken properly. There is no national study on microbial aspect of aspiration pneumonia in hospitalized patients with altered consciousness. This study was done to see the microbial aspect of aspiration pneumonia in patients with altered consciousness admitted in a tertiary level hospital in Bangladesh. Methods: A prospective observational study was done on 50 adult patients of aspiration pneumonia with altered consciousness admitted in the medicine department of medicine, Dhaka Medical College Hospital, Dhaka, between January and December 2010. Aspiration pneumonia was confirmed by clinical examination and laboratory investigations. Hematologic measurements, chest x-ray, blood gas analysis, estimation of blood urea, serum creatinine and random blood sugar were done in all patients. Sputum for gram staining and culture & sensitivity as well as blood culture & sensitivity were done in patients who were diagnosed as aspiration pneumonia clinically and radiologically. Validated sputum was cultured in blood agar, chocolate agar and McConkeys agar media. Blood culture was done in trypticase soya broth, blood agar, chocolate agar and McConkeys agar media. Results: The mean age was 38.9±17.3 years. 35 (70%) patients were male and 15 (30%) patients were female. Blood culture was found positive in 30.8% patients who developed aspiration pneumonia among the study patients. In sputum for Gram staining, only Gram positive Cocci was present in 46.15%, only Gram negative Bacilli was present in 38.46%, mixed Gram positive cocci and Gram negative bacilli was present in 7.7% and Gram negative Coccobacilli was found in 7.7% patients who developed aspiration pneumonia among the study patients. In growth positive cases (n=11) sputum culture revealed 45.45% streptococcus pneumoniae, 36.36% Klebsiella pneumoniae, 9% Pseudomonas species and 9% Haemophylus influenzae. The mean duration of hospital stay was 8.12±2.42 days with ranging from 4 to 14 days DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21517 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 110-114
Serum Zinc status in patients with haemoglobin-E ? thalassemia
Authors: Morshed AKM Amirul , Islam Shahnoor , Chowdhury Tasrina Rabeya , Islam Afiqul , Islam Ariful , Begum Helena , Haq Sheikh Azimul , Dey Pritam
Published: January 2015

Background: Hb-E â thalassemia is a major congenital hematological disease of Bangladesh. The patients have poor growth and delayed maturation mainly due to iron overload but zinc deficiency also has been suggested as a contributing factor. The aim of this study was to investigate and compare the serum zinc of HbE-â thalassemia patients and normal children. Methods: This cross sectional study was done in the Department of Paediatric Haematology and Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2009 to May 2010. A total of 31children with Hb-E â thalassemia were enrolled for this study and besides, matched 30 healthy children were taken as control. After initial assessment the cases were thoroughly examined by the investigators and history of transfusion, transfusion interval were recorded. Venous blood samples (3mL) were drawn from patients and normal control children then centrifuged and stored at -20°C until analyzed. Serum level of zinc was measured by using Flame Atomic Absorption Spectrophotometry. Results: Mean serum zinc level in thalassemic group and control group were 97.4?g/dl (SD- 18.4) and 99.6?g/dl (SD-18.7) respectively. There is no significant difference between two groups (p=0.47). Conclusion: It may be concluded from this study that serum zinc level did not significantly change in children with Hb-E â thalassemia DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21518 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 115-119
Morbidity pattern and health-seeking behaviour among the senior citizens in selected rural areas of Bangladesh
Authors: Jabeen Suraiya , Bari Mohammad Anwarul , Wazib Amit , Salma Umma , Shaheduzzaman AKM , Das Partho Protim , Hossain Md Sazzad
Published: January 2015

Background: The purpose of this study was to determine the morbidity pattern and health seeking behaviour among the rural elderly population. Methods: This cross sectional study was conducted in six villages of Telihati union of Gazipur District from February to June 2013. Purposive sampling technique was used to collected data from 249 respondents, aged 60 years and above. Results: The mean age of the respondents was 64.2 (SD±5.6) years. About 70.3% of the respondents were male, majority (47%) respondents were illiterate, 33.3% earned less then ten thousand taka per month. About half (58.2%) of the elderly were still working, among the currently not working respondents majority (49%) were totally dependent. and only 52.6% respondents belonged to joint family. Almost all (98.8%) the respondents had some health problems; among these eye problems (81.7%), musculo-skeletal disorders (66.3%), gastrointestinal disorders (52.4%) and sleeping problems (50.4%) were predominant. Females suffered more from eye problems, musculoskeletal disorder, gastrointestinal disorder and sleeping problems. On the other hand, males suffered more from respiratory and genitorurinary problems. About 61% have a Government hospital or Community clinic nearby their residence, 70 % were satisfied with available health care facilities and 72% was satisfied with treating doctors even then a greater part (35%) was irregular for check-up. Majority (73.5%) was regular about taking treatment, among the irregulars majority (77.3%) was for un-affordability of medicine. Only 53% of the elderly knew names of some old age diseases. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21522 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 129-135
Study on role of magnesium Sulphate as a Tocolytic agent in preventing preterm labour
Authors: Lipi Lutfa Begum , Begum Nasima , Alam Ummum Khair , Jahan Rounak , Rahman Mohammed Mizanur , Rumana Ratu
Published: January 2015

A prospective study was done to assess the effectiveness of magnesium sulphate therapy given to women in preterm labour with the aim preventing preterm birth and its sequel. The place of study was the Department of Obstetrics & Gynecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka. The study population were all primi and multigravida with preterm labour admitted in the above mentioned hospital, from January to December, 2009. Gestational age, maternal pulse, blood pressure, temperature, urine output, respiratory rate, uterine contractions, cervical effacement, dilatation and amniotic membrane status were elicited. Data were collected by questionnaire and analyzed with SPSS version 12.0. The results showed that magnesium sulphate injection is an effective method for tocolysis and appears to be safe for the mother and fetus and is a promising option for the treatment of preterm labour in a low resourced setting. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21538 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 179-184
Tuberculosis of Breast - a study of 54 cases in a tertiary level hospital in Bangladesh
Authors: Khan Arif Salam , Hakim Hafiz Ahmed Nazmul , Sultana Iffat , Talukdar Debesh Chandra , Islam Md Rafiqul , Hossain Gazi Jahangir
Published: January 2015

Fifty four cases of histopathologically or cytopathologically confirmed tuberculosis of the breast were found during a period of 3 years in surgery outpatient department of Dhaka Medical College Hospital, Dhaka, which was accountable for 2.42% of all breast diseases. All the patients were female. Most of the cases were in third and fourth decades. Among them, 3 patients were lactating and 1was pregnant. Diagnosis was suspected clinically on the basis of lump or lumpiness and/or solitary or multiple chronic discharging sinuses in the breast or axilla. Breast lumps in 33 cases simulated carcinoma. Histopathological examination was done to establish the nature of the pathology. All patients were treated with four drug combination (4FDC) anti tubercular therapy for 12 months. However, forty patients required some forms of surgery DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21539 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 185-187
Oral Carcinogenesis and role of Bacteria
Authors: Shah Rameez , Talukdar Debesh Chandra , Fakir Md Abu Yousuf , Khan AF Mohiuddin , Datta Raj , Shah Tazin Afrose
Published: January 2015

Cancer, till date stands rigidly unconquered despite most strenuous effort and relentless endeavor by the scientists around the world. In global terms Oral cancer is among the most common malignancy and represents one of the greatest management challenges for the otolaryngologists as well as by the head and neck surgical oncologists. Besides accumulation of genetic mutations, numerous other carcinogens including viral and chemical are well studied and documented. However, in the oral cavity, the role of microbiota in carcinogenesis is not known. Microbial populations on mouth mucosa differ between healthy and malignant sites, and certain oral bacterial species have been linked with malignancies, but the evidence is still weak in this respect. Nevertheless, oral microorganisms inevitably upregulate cytokines and other inflammatory mediators that affect the complex metabolic pathways, and may thus be involved in carcinogenesis. Poor oral health also associates statistically with prevalence of many types of cancer such as pancreatic and gastrointestinal cancer. This review presents commonly implicated bacteria in oral carcinogenesis, and their role in cancer therapeutics as well. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21545 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 211-215
Unusual presentation of a Hydatid cyst: a case report
Authors: Sattar Asifa , Nahar Nazmun , Rahman Md Mizanur , Anwar ASM Tanim , Hossain Anwar
Published: January 2015

Hydatid disease is a parasitic disease, which is most commonly caused by Echinococcus granulosus. It is endemic in many parts of the world. However, Hydatid disease can occur in almost any part of the body. Isolated omenal hydatid cyst is one of the least common sites. A case of very unusual omental hydatid cyst is presented here which was diagnosed in the Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka, and subsequently confirmed by histopathology. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21546 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 216-218