bluuebunny/crossref_metadata_2025 huggingface dataset:
Ruptured cornual ectopic pregnancy: a case report
Authors: Sharma Arti , Singh Dipika , Verma Sarika
Published: July 2020

A cornual gestation is one of the most hazardous and life-threatening type of ectopic pregnancy with a mortality rate of 2-5 times higher than other ectopic pregnancies. Because of the myometrium stretch ability, they usually present late around 7-12 weeks of gestation. Thus, the diagnosis and treatment of such cases become challenging. In the case of ruptured cornual ectopic pregnancy, the patient usually presents with hemodynamic instability. Presenting a case report of a 28-year-old female who presented to the labour room of ESI hospital, Okhla, New Delhi at 12 weeks of pregnancy in a state of shock. A provisional diagnosis of ruptured cornual ectopic was made based on clinical examination and ultrasound report. Resuscitation followed by emergency laparotomy done as a life-saving procedure for the patient. Ruptured cornual ectopic needs urgent intervention and multidisciplinary approach. However, with the advancement and expertise in the field of radiology and early diagnosis can be made which can contribute towards more conservative management of such cases.
Primary malignant melanoma of vagina: a case report
Authors: Shambharkar Smruti , Sharma Tarachand
Published: July 2020

Primary malignant melanoma of the vagina is a rare and aggressive disease with worse prognosis as compared with non-genital melanomas or other vaginal malignant neoplasms. Presented here is a case of 42 years female with 3 months history of amenorrhea and vaginal discharge. On vaginal examination, a firm growth of size approximately 7-8 cm was found attached to the left postero-lateral wall of vagina and extending up to the introitus. On biopsy and histopathological examination, it was diagnosed as a case of high-grade malignant melanoma of amelanotic type. Radiotherapy was started as a part of treatment after consultation with an oncologist, considering non-resectable nature of the mass. The patient received first 5 cycles of radiotherapy but succumbed to the disease during treatment.
Laparoscopy and the impalpable testes: diagnosis, treatment options and the literature
Authors: Najar Fayaz Ahmad , Makhdoomi Peer Hilal Ahmad , Rashid Tajamul , Bhat Suhail Nazir
Published: July 2020

Background: Laparoscopy is the best available tool and method to manage impalpable undescended testes; management of the impalpable testis often pose a significant diagnostic and therapeutic challenge to a surgeon. The aim of this work was to elucidate and present the sensitivity and the value of laparoscopy, as a surgeon’s tool, for the diagnosis and treatment of the impalpable testis.Methods: From November 2015 to December 2018, 56 patients with 60 impalpable testes were operated upon by laparoscopic approach by a single surgeon. One-stage Fowler-Stephens laparoscopic orchidopexy was performed in 14 cases, while two-stage Fowler-Stephens laparoscopic orchidopexy was performed in 16 cases and Vessel-Intact Laparoscopic Orchidopexy (VILO) was done in 22 cases. In 2 cases vessel and vas was entering through deep ring and inguinal orchidopexy was done. Blind ending vessel/vas was noticed in 4 cases (vanishing/absent testes). Laparoscopic orchidectomy was required in 2 patients for nubin. No case of disorder of sexual dysfunction was (DSD) was found.Results: Laparoscopy was successfully completed in all the cases. 34 testicles were impalpable on right side, 18 on left side and other 4 cases (8 testicles) were bilaterally impalpable. Laparoscopic orchidopexy was carried out for 36 testes at the same. 16 needed a staged procedure. Orchidectomy was done in 2 cases/testes. In 4 cases testes was absent/vanishing. In 2 cases testes was canalicular, standard inguinal orchidopexy was done. The mean operative time was 48 minutes. Patients were allowed oral fluids 6 hours of the operation and were discharged at one day after the procedure.  None of the patients had wound infection. Patients were followed up for a mean period of 12 months. At follow-up, all but one of the testes were well down in the bottom of the scrotum. In one patient, the testis was in a high scrotal position. All testes were of normal size, no atrophy was seen so far and no malignant change is suspected in any case so far. No severe morbidity or death was observed in our study.Conclusions: Laparoscopy offers surgeons a safe and reliable diagnostic and therapeutic option to patients with impalpable testes. No other imaging investigation is required, if well versed with basic laparoscopy. Intra-abdominal dissection allows more testes to be brought down to the scrotum. Even when open orchidopexy is being done for intra-canalicular testes in a child, it is advisable to be ready with laparoscopy if necessary, at the same time, in case open surgery fails to mobilize the testicular vessels adequately. The procedure is best viewed as laparoscopy-assisted; as Orchidopexy has to be done in a conventional manner.
The value of serum C reactive protein in the assessment of severity of HIV infection among children in a resource limited setting
Authors: Udoh Otobong C. , Dixon umo Ofonime T. , Bassey Enobong U.
Published: July 2020

Background: Human immuno-deficiency virus (HIV) infection has devastating impact especially on well-being of children. Management of HIV infected children in resource-limited countries poses significant difficulties. The role of C-reactive protein as a potentially useful/cost-effective tool for assessing severity of HIV infection is yet to be established. The relationship between serum C-reactive protein and severity of HIV infection among children aged 6 months to 12 years was evaluated.Methods: Authors recruited 85 children each on combined antiretrovirals for ≥3 months, and apparently healthy HIV-negative controls. Severity of HIV infection was assessed by classification into immunologic categories 1, 2, 3 and clinical categories N, A, B, C according to the Centre for Disease Control revised classification system. Enzyme linked immunosorbent assay (ELISA) was used for serum CRP estimation. CD4 count was estimated by flow cytometry. Data analysis was with Statistical Package for Social Sciences version 20.Results: Response rate was 160 (94.1%) with mean age of participants being 8.50±3.36 years. Male to female ratio was 1.35:1. Lymphadenopathy was the commonest clinical feature in 26 (32.50%) participants, 59 (73.75%) participants were asymptomatic, and 52 (65.00%) were immunologic stage 1. Median serum CRP of HIV infected group and controls were 4.2 (1-13.9) mg/l and 0.5 (0.2-1.9) mg/l respectively. There was an association between Clinical and immunolological stages of infection and levels of serum CRP, p values = 0.001 and 0.002 respectively.Conclusions: The serum level of CRP may predict the severity of HIV infection among children.
Varied presentations of cutaneous vasculitis: a case series
Authors: Gupta Pinky , Ganorkar Shweta , Bhalekar Surekha , Rao Rajiv
Published: July 2020

Vasculitis involves a wide spectrum of clinicopathological process with reactive damage to the involved blood vessels. There is loss of vessel integrity instigating haemorrhage & luminal compromise leading to ischemia and necrosis of the tissue supplied by the involved vessels. It may affect varied size and type of blood vessels at different locations. It may be primary or secondary to systemic disease. It may involve a single organ like skin or may involve different organ systems at the same time. This case series include six cases of cutaneous vasculitis affecting different organs with varied presentations. Skin biopsies of six patients with unusual presentations were studied. Their complete history, physical examinations, laboratory investigations including serology were analysed and correlated with histopathological findings. The patients presented with different duration of symptoms varying from as short as 15 days to 1 year. Skin lesions were present in all cases while cardiac manifestation was seen in one. Serology and autoimmune disease markers were negative in all cases except one. However, histopathological features were in concordance with the clinical diagnosis of vasculitis. They were further classified as vasculitis secondary to Churg Strauss syndrome, venous stasis, Henoch Schonlein purpura or leucocytoclastic vasculitis.Vasculitis though a rare disease may manifest as an acute or chronic condition. It needs timely diagnosis by histopathological examination to aid in further management. It is important to assess the clinical severity in primary and secondary vasculitis, as it determines morbidity and mortality.
Management of a case of symblepharon by freshly prepared amniotic membrane transplantation: a clinical case report
Authors: Baruah Mamoni , Das Rajiv Kr. , Dam Bikram , Nandi Sunanda
Published: July 2020

Amniotic membrane transplantation has been in common therapeutic use for a variety of ocular disorders. Authors present a case of a 50-year-old man who was diagnosed to be a case of total symblepharon following an episode of membranous conjunctivitis who was treated with freshly prepared Amniotic membrane transplantation with satisfactory cosmetic result.
A rare case of cranial metastasis from an initial presentation of hepatocellular carcinoma
Authors: Kalal Chetan , Wagh Adinath , Patel Atif , Joshi Harshad , Surude Ravindra , Jain Samit , Bhatia Shobna , Bhatt Chetan
Published: July 2020

Cranial metastases from hepatocellular carcinoma (HCC) has been seldom reported. Reported herein is the case of a painless parietal bone mass as an initial presentation of HCC in a 63-year-old female patient who was subsequently diagnosed to have HCV related cirrhosis. The biopsy from cranial lesion was confirmatory of HCC on immunohistochemistry. The patient had no known history of chronic liver disease. The presented diagnosis was made through detailed history, laboratory parameters and cross sectional imaging.
A rare case report of eyelid basal cell carcinoma with special emphasis on its unusual presentation and role of radiotherapy as its treatment options
Authors: Gogoi Rajendra Nath , Nandi Sunanda , Agarwalla Vijaya
Published: July 2020

Basal cell carcinoma (BCC) is the most common type of skin cancer in white-skinned individuals but is rare in blacks and Indians. Skin cancers mainly affect sun-exposed areas like the neck and face (88-90%). BCC rarely metastasizes or kills, but is still considered as malignant because it can cause significant destruction and disfigurement by invading surrounding tissues. Here we present a case of BCC appearing in upper eyelid at the eyebrow region which is very rare to cite in literature. The patient was a resident of high altitude with no evidence of local invasion or distant metastasis for which she was treated with radiation therapy. Radiation therapy is a good therapeutic option in patients who are unwilling for surgery and in those requiring extensive surgery. BCC is usually not fatal, but early diagnosis and appropriate treatment promises better functionality and esthetic outcome.
Model of trigger mechanisms of SARS CoV-2 infections
Authors: Galarza Nestor Cahui , Monge Condori Maria De Los Angeles
Published: July 2020

Coronavirus disease-2019, is a pandemic that is causing great loss of life and economy. Knowledge of the pathogenesis of the disease is required for the control and treatment of clinical manifestations. The aim of this review is to analyses the information on the molecular mechanisms that trigger the alterations caused by SARS-CoV-2 from published articles related to COVID-19. The onset of the COVID-19 virus infection in humans occurs when the SARS-CoV-2 S protein reaches cells containing ACE2 receptors, being mainly the upper respiratory tract, followed by the oral cavity, and in lesser frequency through the conjunctiva. Inflammation and thrombus formation in symptomatic patients have been the major cause of SARS-CoV-2 aggravation, this occurs largely due to the imbalance of regulation by diminishing ACE2 receptors, which serves to activate the regulatory axis Ang-II→ACE2→Ang-(1-7)→MAS receptor, which counteracts the negative actions caused by Ang-II. The ACE2 is also the main receiver for the SARS-CoV-2 so that it can trigger the virulence processes in the host.
Necrotizing fasciitis: presentation, microbiology and outcomes in a community hospital
Authors: Jimenez Mercy N. , Seltzer Emily S. , Devanabanda Bhavana , Louis Martine , Mandava Nageswara
Published: July 2020

Background: Necrotizing fasciitis (NF) is an aggressive and often fatal, soft tissue infection. Delayed surgical therapy leads to worsened outcomes. This study evaluates the mortality, outcomes, and characteristics of patients with NF in a diverse New York City Community Hospital Network.Methods: Retrospective chart review from 2012 to 2019 using ICD-9 and ICD-10 codes of gas gangrene, Fournier’s gangrene, and necrotizing fasciitis was done. Of the 297 patients reviewed 28 met inclusion criteria of imaging findings, operative reports, and clinical diagnosis of NF by an attending surgeon.Results: On average patients in ER were seen by the surgical team within less than 12 hours. Most patients were debrided within 10 hours of surgical consultation and on average received 2.2 procedures. Of the wound cultures obtained 65.38% were polymicrobial in nature. The average length of stay was 17.4 days and 32% of patients required ICU admission. The surgical mortality rate was 7.61%.Conclusions: Necrotizing fasciitis is a rare entity and increasing provider knowledge on patient characteristics as well as the complexity of these patients and the types and number of procedures they require may help guide clinical decision making. We identified that while most of our patients had negative blood cultures on admission, those that had positive blood cultures had multiple organisms growing. Knowing that these patients are complex and likely require multiple procedures, prompt operative intervention is key.
Frequency, causes, and findings of brain CT scans of neonatal seizure at Ardabil City Hospital, Ardabil, Iran
Authors: Ahmadabadi Farzad , Mirzarahimi Mehrdad , Ahadi Adel , Alizadeh Zahra
Published: July 2020

Background: Neonatal seizures are the primary and most important signs of neurologic function disorders that often lead to serious complications. However, this disorder is predictable and manageable with suitable diagnostic and therapeutic methods. The aim of this study was to investigate the frequency, causes, and findings of brain CT scans of neonatal seizure.Methods: This descriptive cross-sectional study has been done on 70 neonates with seizures who hospitalized in Ardabil city hospital during 2016-2017. CT scans were done for all patients. Necessary information for each patient was recorded in a checklist including demographic data, history of diabetes mellitus, hypertension, and maternal endocrine disorders, and history of resuscitation and clinical data including type of seizure and its duration, Cause of seizure and CT scan findings (cerebral hemorrhage, local ischemic lesions, hypoxemic-ischemic encephalopathy, and anatomical cerebral malformations).Results: The mean age of neonates was 12.41±9.33 days. Of them, 61.4% were boys, 3.24% LBW and 40% were preterm at birth time. Of all neonates, 21.4% had history of seizure in their relative degree family members. Fever was the most common symptom accompanying seizures (40%). The most common form was tonic seizure (n=30, 42.9%) and its duration time was 4.99 minute.  A total of 41.4% of neonates (29 cases) had abnormal CT scan reports. Hypoxic-ischemic encephalopathy (47%) was the most common findings in the CT scans of neonates with seizures.Conclusions: Results showed that, a considerable number of neonates had abnormal CT findings and the most common abnormal form was hypoxemic-ischemic encephalopathy.
Modified Karydakis procedure for uncomplicated pilonidal sinus
Authors: George Thomas , Mathew Joe
Published: July 2020

Background: Pilonidal sinus disease is a chronic infection of the natal cleft commonly affecting young adults. Out of the standard operative techniques, the Karydakis procedure is a relatively simple procedure associated with low rates of wound complications and recurrence. In this study we present a modified version of the Karydakis procedure to treat less extensive disease, which enables better skin closure without cavitation and tension.Methods: Patients with uncomplicated pilonidal sinus who presented to our centre during the period from April 2015 to March 2019 were prospectively enrolled. Patients with recurrent or complex sinus disease were excluded. In those enrolled, our modified Karydakis procedure was performed. In this method, after excision a flap of skin and subcutaneous tissue was raised to one side and sutured across the midline by advancement in layers.Results: 34 patients underwent our modified Karydakis procedure. 91% (31/34) of patients had uncomplicated recovery and could return to work after two weeks. There were minimal post-operative complications, in the form of erythema around the wound (8.8%), wound discharge (5.9%), seroma (5.9%) and infection (2.9%). No patient developed wound dehiscence or flap necrosis. There were excellent cosmetic results and no recurrence at one year post-surgery.Conclusions: Our modification of the Karydakis procedure is a simple and effective surgery for the management of uncomplicated pilonidal sinus disease which achieves good results.
Incidence of thyroid pathologies requiring thyroid surgeries in a tertiary care hospital
Authors: Panchal Anuradha , Ray Aniket , Gautam Raj , Shah Aashay , Singh Chandan , Chandrashekhar Shantanu , Shah Yashraj , Krishna Kumar G. Ashwanth , Shahid Mehreen
Published: July 2020

Background: Diseases of the thyroid gland are one of the most common endocrine disorders in India and the world, many of these diseases require surgery for their treatment. The incidence of thyroid diseases differs from one geographical area to another. This study was aimed at finding out the thyroid pathologies for which thyroid surgeries were performed in D. Y. Patil Hospital, Nerul, Navi Mumbai.Methods: It is a retrospective analysis of all the patients who have undergone thyroid surgeries (lobectomy, hemithyroidectomy, subtotal or near total thyroidectomy or total thyroidectomy) in D. Y. Patil hospital, Nerul, Navi Mumbai from 1st January 2018 to 31st December 2019 (2 years duration).Results: Most common pathology for which thyroidectomy was performed was colloid goitre (41.33%). Benign diseases of the thyroid was much more common (76%) than malignant diseases (24%). Most common malignancy was papillary carcinoma thyroid. Thyroid surgeries were most commonly performed on women in their 5th decade of life.Conclusions: Colloid goitre was the most common pathology for which thyroid surgeries were performed and females in their 5th decade of life were the most common patients undergoing thyroidectomy.
Prospective study of accuracy of C-reactive protein and leucocyte count in diagnosis of acute appendicitis in comparison with histopathology
Authors: Jaiswal Anand Kumar , Rai Rajesh Kumar , Chandra Abhishek
Published: July 2020

Background: Acute appendicitis is one of the most common surgical emergencies. Approximately 7.0% of the population will have appendicitis in their lifetime with the peak incidence occurring between the age of 10 and 30 years. The classical history of peri umbilical pain at beginning and later shifting to right iliac fossa is present in only 50% cases. C-reactive protein is an acute phase reactant synthesized by liver in response to tissue injury. Serial measurement of CRP can improve the accuracy of diagnosing acute appendicitis.Methods: A prospective study of 70 cases with clinical diagnosis of acute appendicitis admitted in the department of surgery, B. R. D. Medical College Gorakhpur during a period of one year.Results: There was young age predominance (54.2%) and commonest presenting symptom was RIF pain (100%) followed by nausea/vomiting (66%) and fever (60%). Among 48 cases of histopathology proven appendicitis, CRP was raised in 44 cases (91.6%).Conclusions: Serial measurement of CRP is more sensitive and specific than TLC count and the raised value of CRP is directly related to the severity of inflammation. Combining the TLC and CRP increases the diagnostic accuracy and therefore may reduce rate of negative appendectomy.
Large posterior mediastinal goiter post total cervical thyroidectomy: a case report
Authors: Fesatidou Maria , Fesatidou Vasiliki , Tsoulfas Georgios , Fessatidis Ioannis T.
Published: July 2020

Thoracotomy approach is indicated for a complete and safe posterior mediastinal goitre removal. A 68 years old male was hospitalized due to a right mediastinal mass found in a chest X-ray and confirmed by computed tomography. The patient had undergone total cervical thyroidectomy thirty years ago. A computed tomography (CT) guided percutaneous needle biopsy of the mass revealed thyroid tissue. Subsequently, the mass was completely resected through a right posterolateral thoracotomy. The histopathology confirmed a large mediastinal goitre with no signs of malignancy. The patient had an uncomplicated recovery. We present a relatively rare case of a successful resection of a posterior mediastinal goitre, occurring thirty years post-total cervical thyroidectomy. We advocate lateral thoracotomy to achieve a broad operative field and enhance surgical safety.
Complete transection of third part of duodenum following blunt injury abdomen: a rare case report
Authors: Basheer Noufal Thekkekara , Venkatesan Jothiprasad , Pravallika Amaradeepthi , Subramaniam Sureeskumar , Sarveswaran Venugopal
Published: July 2020

Blunt injury abdomen (BIA) is an ever-increasing problem. Isolated injury to duodenum following BIA is rare (1-4%). It can be a challenge to the surgeon and failure to manage it properly can lead on to devastating results. Blunt duodenal injury can occur in isolation or with pancreatic injury. We report a case of an isolated transection of third part of the duodenum following BIA. Initial clinical changes in isolated duodenal injury may be subtle before life-threatening peritonitis develops. High index of suspicion, knowledge of mechanism of injury, physical examination and proper imaging techniques are the key in early detection of duodenal injury.
A novel way to deal with challenge and fear of smoke and gas evacuation during minimal invasive surgery in the current era of COVID-19 pandemic: an ingenuity with review of literature
Authors: Singh Kaptan , Joshi Atul S. , Khemchand Agrawal K. , Sheoran Hariom , Rabadiya Priti
Published: July 2020

Presently COVID-19 viral transmission is a major concern among surgeons worldwide with the use of minimally invasive surgery due to creation of pneumoperitoneum. Due to this proposed concern, we sought to review the scientific data, evaluate the use of MIS and introduction of a novel concept to deal with surgical smoke and gas to prevent the risk of COVID-19 viral transmission. A review of literature of viral transmission in surgery, especially emphasizing the transmission of the COVID-19 was done. We also reviewed other surgical society guidelines and recommendations regarding surgery during this pandemic. Few studies have been performed on viral transmission during surgery, but to date there is not enough evidence to support use of MIS over open surgery or vice versa. There are societal guidelines and expert consensus on the modification of standard practices to minimize the risk of viral transmission. With every day rise in COVID-19 patients therefore consequent increase in surgeries in suspected or confirmed cases and exposure of operative staff to aerosolized particles during MIS, use of surgical smoke and gas evacuation system becomes essential. Although different available filters, insufflation systems are part of the surgical procedures but their cost and availability may concern a COVID-19 fighting or a developing nation. We introduced a novel, simple, easily available and cost effective technique to prevent and reduce the risk of viral transmission in the current era of COVID-19 pandemic.
Compliance to advocated therapeutics in and head and neck oncosurgery clinic in a tertiary health care facility in North India: a pilot study
Authors: Munjal Manish , Kaur Japneet , Tuli Nitika , Rishi Porshia , Sidhu Harjinder , Munjal Shubham
Published: July 2020

Background: Head and neck neoplasms are the tumours of head and neck region including various subsites in oropharynx, nasopharynx, larynx, upper oesophagus, paranaal sinuses, and ear. Various treatment modalities are available depending on the stage, type, site of tumour. This study was conducted to study the compliance of patients diagnosed with various head and neck neoplasms towards recommended treatment modalities.Methods: 243 patients presenting in the outpatient department of a tertiary care hospital in Northern India with positive biopsy for neoplastic pathology, benign and malignant were included in the study for a period of 2 years (January 2018-December 2019). All the patients were counselled and those who complied with the suggested therapeutic modality were further evaluated.Results: Surgical intervention was carried out in 79 subjects with benign and 133 with malignant pathologies. 49 patients among 133 were advised further surgical intervention. 31 patients underwent second surgery. Radio-therapeutic and chemotherapeutic modalities were undertaken in 66 subjects. 39 patients did not comply with treatment and were lost to follow up.Conclusions: Decision making for head and neck neoplasms is extremely important and should be considered after thorough discussion with the patient.
Inequalities in women’s empowerment and prevalence of HIV in India
Authors: Singh Shri Kant , Vishwakarma Deepanjali , Sharma Bhawana , Sharma Santosh Kumar
Published: July 2020

Background: Over the years, there has been growing evidence of continuous narrowing gender gap in new HIV infections, despite stagnation in overall HIV prevalence in India. Among others, one of the reasons behind the exiting pattern in HIV/AIDS in the country is the poor status of women, lack of control over their sexuality and poor reproductive and sexual rights.Methods: This paper analyses the troika of women’s empowerment, spousal-violence, and HIV prevalence in India using data from two rounds (2005-2006 and 2015-2016) of Indian DHS having a community-based HIV testing.Results: Results corroborate the recent spurts in women’s empowerment in India, which cuts across socio-economic groups. It has positively influenced a decline in spousal-violence even in the lowest socio-economic strata despite significant inequality across states. HIV prevalence among women has not been changed over the last decade (0.22% to 0.23%) despite decreased adult HIV prevalence. Women having control over their sexuality is significantly less likely to have HIV infection. Relationship between marital control behavior of husband and HIV prevalence, which was significant in 2005-06 (OR=1.2, p<0.10), has emerged to be insignificant in 2015-16. This means that increasing women's empowerment has altered their HIV prevalence through increasing sexual-rights and reducing the intensity of marital control behavior.Conclusions: A combative relationship has been established between women’s empowerment and their risk of HIV/AIDS. The results have been consistently showing the variations of inequality in women’s empowerment across different states, consequently affecting the risk of HIV/AIDS. Ensuring sexual-rights of women should be the best strategy.
Estimation of hemoglobin for screening of anemia in undergraduate students in Hyderabad city, India
Authors: Nasreen Syeda , Syeda Uzma N. , Unnisa Naseem
Published: July 2020

Background: Anemia is a condition that is marked by low levels of hemoglobin in the blood. Iron is a key component of hemoglobin, and iron deficiency is estimated to be responsible for half of all anemia globally. The present study was conducted to find out the prevalence of anemia among undergraduate students of (17-21 years) in Hyderabad city, India.Methods: A cross-sectional study was conducted in different UG colleges in urban areas of Hyderabad for 3 months and a total 57 women participants were selected to volunteer study. All participants underwent screening using anthropometry with haemoglobin estimation using Sahli’s method. The 24-hour dietary recall was also recorded and analysed to assess the nutritional adequacy of the diet.Results: Prevalence rate of iron deficiency anemia was found to be 57.89 per cent, of the total 54.38 per cent were mild anemic and 3.51 percent were moderately anemic.  Conclusions: Nutritional anaemia is one of the most preventable forms of anaemia if resources available individualize therapy focusing on the confluence of various causative factors should be implemented.
Knowledge regarding rabies among school children in an urban area of Kancheepuram district: a cross sectional study
Authors: Grace G. Angeline , S. Gopalakrishnan , Edward Shanthi
Published: July 2020

Background: Out of ten people who die due to rabies, four of them are children. Awareness regarding the disease is important to bring down the rabies mortality among children. This study was planned to assess the knowledge regarding rabies among high school students in an urban area of Kancheepuram district.Methods: This study was a school based cross sectional study done in chrompet, an urban area in Kancheepuram district. All students studying in IX and X standards in a school chosen by simple random sampling method were included in the study. Sample size of 335 was calculated using the formula 4pq/l2 and adjusting for 10% non-response. Data was collected using a pre-tested, structured questionnaire and analysed using SPSS version 22.0. Knowledge score of >50% was taken as “adequate knowledge”.Results: Out of the total 340 respondents, 189 (55.6%) were girls and 151 (44.4%) were boys. Around 23.5% reported having pets at home. Though 97.6% of children were aware that dog is an important reservoir of rabies, only 46% knew that the disease is caused by a virus. About 25.6% had knowledge about other reservoirs of rabies. About 72% knew about prevention through anti-rabies vaccine but only 31.5% were aware of the vaccine availability in government hospitals. Overall adequate knowledge on rabies was noted in 46.2% of respondents.Conclusions: Children’s understanding on the cause of rabies, prevention and control of rabies was inadequate. Health education activities need to be promoted for the school students to improve their level of awareness on rabies.
Optimizing telemedicine for providing obstetric and reproductive health care services during COVID-19 pandemic
Authors: Sharmila Vijayan , Babu Thirunavukkarasu Arun , Balakrishnan Padmapriya
Published: July 2020

The coronavirus disease (COVID-19) outbreak was first declared in China in December 2019, and WHO declared the outbreak as a pandemic on 11 March 2020. A fast-rising number of confirmed cases has been observed in countries across all continents over the past few months. This pandemic is forcing government of nations to take strict measures such as complete lockdown and curfews to ensure that citizens stay at home, as a measure to contain the spread of infection. Health sector is facing  challenges such as high demand for doctors, limited resources of personal protective equipment and challenges in providing  in-person consultation due to fear of spread of infection. Telemedicine is making positive contribution to healthcare during this pandemic, as it caters to   health care of people in wide geographical area without risk of acquiring COVID-19. Telemedicine is defined as the provision of health care services by health care professionals, using technology to exchange information. A broad range of obstetric and reproductive health services can be offered via telemedicine. Telemedicine can help pregnant women to maintain high quality of care during this pandemic without compromising on the perinatal outcome.  It allows for constant interaction between patient and doctor throughout pregnancy, thereby ensuring that the goals of antenatal care are fulfilled, while limiting unnecessary travel and time away from work and family. This article mainly concentrates on the essential obstetric and reproductive health care services that can be provided by telemedicine during COVID-19 pandemic.
Educação e ensino da saúde: ensino formal, não formal e informal
Authors: Ceccim Ricardo Burg , Ferla Alcindo Antônio
Published: July 2020

Editorial ao Volume 6, Número 1, 2020.
CLASSIFICAÇÃO DE ARRANJOS PRODUTIVOS LOCAIS A PARTIR DO MODELO TEÓRICO PROPOSTO PELO SEBRAE (2014): UM ESTUDO NO SETOR DE CONFECÇÕES DO MUNICÍPIO DE CARUARU – PE
Authors: Araújo de Souza Sandra Maria , Silva Bezerra Paloma Rayanne , Rocha Sandra Ferreira , Da Costa Gonçalves Gêuda Anazile
Published: July 2020

Os Arranjos Produtivos Locais configuram-se como novas formas estratégicas para melhorar o desempenho organizacional, em razão das vantagens competitivas que podem ser potencializadas devido à proximidade geográfica. Entretanto, nem todos se configuram como casos de sucessos, devido as dificuldades encontradas nas relações estabelecidas entre os atores que os compõem, o que torna necessário averiguar o estágio de desenvolvimento destas estruturas organizacionais, para que seja possível identificar limitações, e assim, traçar políticas de apoio. Este trabalho objetivou identificar o estágio de desenvolvimento do Arranjo Produtivo Local de confecções do município de Caruaru – PE. A pesquisa é exploratória e descritiva, com abordagem qualitativa conduzida sob a forma de estudo de caso. Para isso, foi utilizada a classificação de APLs do Serviço Brasileiro de Apoio às Micro e Pequenas Empresas – Sebrae (2014), que divide os Arranjos em: Incipientes, em Desenvolvimento e Desenvolvidos. Os resultados demonstram que o Arranjo Produtivo estudado, encontra-se no estágio de desenvolvimento, dado que há um ambiente propício às relações de cooperação, em razão da diversidade de agentes e de instituições que podem proporcionar apoio ao empresariado, contudo, faz necessário buscar alternativas que possibilitem melhorias na articulação destes atores sociais, dado que a competitividade entre os empresários e entre as instituições pode ser um empecilho para que o setor encaminhe para o estágio desenvolvido.
AN EXAMINATION OF FOCUS PROGRESS OF STUDIES ON MARPOL ANNEX IV AND ANNEX VI: A REVIEW
Authors: ŞAHİN Volkan , BİLGİLİ Levent , VARDAR Nurten
Published: July 2020

International Convention for the Prevention of Pollution from Ships (MARPOL) is an international agreement, signed in 1973 and amended in 1978, to prevent pollution of seas from ship-based waste. In this review study, the Annex IV (Prevention of Pollution by Sewage from Ships) and Annex VI (Prevention of Air Pollution from Ships) contents of this agreement, which contains six annexes, are examined and changes in the focus of past studies and current studies are examined. Within the scope of Annex IV, the treatment procedures before the discharge of ship-based sewage wastes, special zones for wastewater discharge, and studies on the dilution of wastewater at sea after discharging to the sea were discussed. Within the scope of Annex VI, studies on emission inventory development, new technologies and alternative fuels have been examined. As a result of the review, the progress of the related studies has been evaluated and the future projections, which focused on the possible tendency of the studies, have been propounded.
Motivational Elements of Employees as a Competitive Advantage of Companies in the Conditions of Globalization
Authors: Zilincikova Maria , Repkova Stofkova Katarina
Published: July 2020

The article analyzes with the analysis of the influence of incentive elements on the motivation of workers to better performance and satisfaction, across the whole active population in the context of the new economy. For specific generations, motivational incentives are diverse. The main reasons of using the award, recognition of the performance and motivation are long-term sustainable good relationships in the workplace, as well as demonstrable work successes and, last but not least, an increase in the success of the whole company. Different incentive elements also used in the Slovak Republic and other European Union countries. A majority motivation characterizes Slovakia through financial evaluation. However, recent years indicate a change of mindset of employers and employees. The population of the Slovak Republic is ageing, the retirement age is increasing, which demographically affects the development of the labour market. The age structure of the society suggests that everyone has a better performance stimulant. Motivating incentives that can offset the employee’s financial remuneration become a competitive advantage for businesses. Recently, the state has been helping businesses to stimulate employees properly through holiday vouchers. In the future, it expected that it would be just incentive elements that will attract potential employees to companies and secondly it will be the financial evaluation of the employee. Slovak society can be inspired in many ways by other European Union countries. In contrast, the Slovak Republic still has many professionals in the areas of health, education, engineering, and many others. The paper points to changes related to the demographic development of the company, the change of motivation for permanent and new employees. The aim is to anticipate the possible development of incentives and the incorporation of new elements of motivation into human resource management in companies. Autoregres prepared in MATLAB. The article deals with the prediction of the selection of individual incentives for specific age groups of employees.
The Impact of Job Satisfaction on Turnover Rate in the Contact Center Environment in the Jordanian Labor Market
Authors: Ismael Samira , Shehada Mohammad
Published: July 2020

The Jordanian economy is declining due to the political and economic conditions in the region, which caused more scarcity of resources and lowering the investment rate. Therefore, the services sector has become more important in the Jordanian labor market and the Contact Center Environment has become even more important. Yet, one of the most brilliant goals for the Contact Center is to lower the turnover rate and deliver the best service to the clients. This paper measured the impact of job satisfaction on turnover rate in the Contact Center Environment. Service providers at inbound call centers answered the questionnaires designed to measure the impact of their job satisfaction with its elements (social satisfaction, salaries, benefits, career growth and safety, psychological and physical environment) on their intent to turnover. 100 questionnaires were distributed randomly in different Contact Centers in the Jordanian labor market. Sixty-eight respondents were received, and the valid ones for analysis were 58. The research identifies a significant impact of Job safety and career growth as major variables that affect the intention and the turnover rate among employees in the Contact Center.
Ład przestrzenny w Piotrkowie Trybunalskim
Authors: Rudalska Katarzyna , Bartosiewicz Bartosz
Published: July 2020

Na wszystkich poziomach planowania przestrzennego, zagospodarowanie zmierza do osiągnięcia ładu przestrzennego. Oznacza on przede wszystkim uporządkowanie i harmonię pomiędzy różnymi składnikami i funkcjami przestrzeni. Łatwe do obserwacji zjawisko to jest bardzo trudne do zbadania. Celem artykułu jest wypracowanie metody pomiaru ładu przestrzennego w skali morfologicznej i fizjonomicznej oraz jej przetestowanie na przykładzie Piotrkowska Trybunalskiego. Wypracowana metoda nie tylko pozwala na badanie ładu w różnych skalach, ale pozwala porównywać wyniki dla różnych badanych przestrzeni. Jest to gotowe do stosowania narzędzie, które nie wymaga skomplikowanych procedur czy trudnych do pozyskania danych.
Profilowanie geograficzne, czyli wykorzystanie analiz przestrzennych do wykrywania sprawców przestępstw
Authors: Mordwa Stanisław
Published: July 2020

Głównym celem artykułu jest przedstawienie podstaw profilowania geograficznego, jako metody mającej zastosowanie w analizach przestrzennych sporządzanych na potrzeby wykrywania sprawców przestępstw. Wychodząc z założenia, że rozmieszczenie przestępstw i zachowania sprawców wykazują pewne prawidłowości przestrzenne, wykorzystuje się podejście geograficzne w procesie wykrywania tych sprawców. W kolejnych częściach artykułu przedstawione zostały podstawy teoretyczno-metodologiczne profilowania geograficznego, uwarunkowania skuteczności prowadzenia analiz przestrzennych, zasady generowania geoprofili. Na podstawie analizowanej literatury przedstawiona została krytyka i ograniczenia stosowania profilowania geograficznego, ale także dowiedziona została efektywność tej metody jako techniki śledczej.
Manejo integrado del suelo para mejorar la producción del cultivo de Elaeis guineensis (palma africana) en tres fincas de Quinindé, Ecuador
Authors: Lazo Pérez Yamila , Morales Moreno Arliet , García Quintana Yudel , Arteaga Crespo Yasiel , Castelo Naveda María del Carmen , Ramos Flores María Eugenia
Published: July 2020

En Ecuador, los sectores de Quininde y Puerto Quitoson reconocidos por su alta producción de Elaeisguineensis (palma africana o aceitera) como contribuciónal desarrollo socioeconómico de la región, sin embargo,los suelos son ácidos, el clima es húmedo con fuerteslluvias, lo que provoca la remoción de nutrientes delsuelo y de metales pesados, limitando el buen desarrollode los cultivos en sus primeras fases de crecimiento. Elobjetivo de este trabajo fue evaluar el efecto del manejointegrado de suelo en la producción del cultivo de Elaeisguineensis en tres fincas Nueva Esperanza, El Recreo yLa Comuna. Para ello se aplicó enmiendas, magnesitaal 20%, 2 kg alrededor de la corona en cada planta aun diámetro de 1.80, en el área de las raíces, ademásde microorganismos benéficos Bacthon, Tricho-D yMicosplag y se evaluó la producción total y rendimientodurante los años 2014, 2015 y 2016, en comparación conel año 2013 donde no se realizó ningún tipo de manejo alsuelo. Los resultados indicaron que el manejo integradodel suelo resultó una alternativa factible para mejorarlos rendimientos de este importante cultivo. Mediante laaplicación de enmiendas y microorganismos eficientes,se mejoró las propiedades edáficas, la produccióny rendimiento de Elaeis guineensis. Se comprobódiferencias en los niveles de producción y rendimientosa nivel de fincas, resultando El Recreo y La Comunacon valores superiores y semejantes y Nueva Esperanzacon resultados inferiores, atribuido a las característicasecológicas de la zona.
Editorial to the special issue: Social work research and social justice
Authors: Barnard Claudia
Published: July 2020

This is the editorial to the special issue: Social work research and social justice
The standard of proof at adjudication of abuse or neglect
Authors: Provencher Ashley J. , Gupta-Kagan Josh , Hansen Mary Eschelbach
Published: July 2020

We measure the extent to which the standard of proof the CPS must meet at trial in a child abuse or neglect case influences the outcomes in the case. In the United States, the government of each of the 50 states and the District of Columbia sets its own standard of proof. We measure the influence of the standards of proof using survey data. We find that a higher standard of proof – one requiring the government to present clear and convincing evidence of abuse or neglect rather than only requiring a preponderance of the evidence of abuse or neglect—decreases the probability that the judge rules in favor of CPS. A clear and convincing standard also affects decisions before trial: it increases the number of visits made by CPS during an investigation; it lowers the odds that CPS substantiates the case; and it lowers the odds that a case reaches trial. After trial, it increases the probability of an out-of-home placement.
A Mentor’s PATH: Evaluating how service users can be involved as mentors for social work students on observational practice placements
Authors: MacSporran Jill
Published: July 2020

This paper will explore the experience of service user involvement in social work education, examining the challenges of involving ‘seldom heard’ service user voices. Over a six month period, a group of four people with learning disabilities were supported and enabled to take on an assessment role as Mentors for four first year BA(Hons) Social Work students at the University of the West of Scotland. The article will focus on an evaluation of this pilot project and will outline the partnership work between the university and placement agency in planning, preparing, and supporting the mentors to carry out their role in supporting students on placement and assessing their communication skills, value base and readiness to practise. Central to the planning process was the use of PATH – a person centred planning tool. The evaluation will detail the crucial role played by the support staff in the placement agency, without whom this project would not have been possible.The evaluation was carried out using a mixed methods approach and embraced the principles and values of participatory action research. The evaluation provides insight into the experiences of the mentors, the students and support staff, and demonstrates that with the right support in place, and with commitment to thorough planning and preparation, seldom heard service users can be meaningfully involved in social work education.
Challenges for social work Education in Vietnam: Voice of social work students
Authors: Kham Van Tran
Published: July 2020

In the early 1990s, some academic institutions in Vietnam introduced the subject of social work into their curricula and began training students in related programs. The training was, however, not internally coherent, and social work education in Vietnam only really emerged in Vietnam in 2004, when the Ministry of Education and Training approved the national curriculum in the field. In 2010, the government of Vietnam recognized the urgent need for social work professionals to solve various social problems and build public welfare, democracy, and the socialist state. Since then, Vietnam’s social work education has developed rapidly. Currently there are around 55 universities and colleges at the national and provincial levels with active social work programs. But social work education in Vietnam faces many challenges. This paper gives  voice to social work students on some of those challenges, including different layers of educators, licensing, materials, and practicum. The paper is based on a survey of, and interviews with, students from 17 universities in Vietnam, and includes concrete recommendations for improving the professional training of social work students.
‘The voice of the street’: Using peer led outreach with people who use drugs to inform the development of Ireland’s National Drug Strategy
Authors: Melaugh Brian , Rodrigues Hannah
Published: July 2020

The purpose of this article is to share how an Irish drugs advocacy organisation, UISCE conducted a consultation with ‘People Who Use Drugs’ (PWUD) to inform the development of Ireland’s National Drugs Strategy: Reducing Harm Supporting Recovery. People who use drugs are considered a ‘hard to reach’ or ‘hidden’ population’ who, because of their marginal status, are often absent from research and drug policy. Indeed, there is a lack of published data on how to engage with PWUD to inform policy development. The paper aims to extend the literature by highlighting how UISCE, employing a ‘peer-led street outreach’ approach, included 51 PWUD in the consultation to inform the Irish national drug strategy. Central to the paper is a description of the steps taken to conduct the consultation with a review of the challenges and benefits of using a ‘street based recruitment’ strategy to engage with hard to reach people who use drugs.Keywords: hard to reach; people who use drugs; peer led; drug use; drug policy