bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhabdomyosarcoma of the biliary tract: a case report
Authors: Kouadir Asmaa , Mazghi Abderrahmane El , Hassouni Khalid
Published: April 2017

Rhabdomyosarcoma (RMS) of the biliary tract is a rare tumor that commonly arises from the common bile duct. The most common clinical symptoms are obstructive jaundice and abdominal pain. Although diagnosis is often difficult and is frequently made during surgery, diagnostic imaging techniques including ultrasound, computerized tomography scan, and magnetic resonance cholangiopancreatography remain useful in the diagnosis and evaluation of biliary tree anatomy. In order to improve prognosis, different rhabdomyosarcoma study groups have adopted multidisciplinary treatment approach. Herein we describe a case of three-year-old child with Embryonal rhabdomyosarcoma originating in the common bile duct who was treated with surgery, chemotherapy according to European soft tissue sarcoma group (EpSSG) protocol and adjuvant postoperative intensity modulated radiotherapy to surgical bed with 6 MV photons to a dose of 41, 4Gy in 23 fractions. One year and a half after the end of therapy, the patient is still disease free. Although Rhabdomyosarcoma of the biliary tract is a rare tumor, it should be considered in the differential diagnosis of patients who have obstructive jaundice and a cystic mass within the common bile duct. Once believed to be an incurable disease, the prognosis of patients with biliary rhabdomyosarcoma has improved with a multidisciplinary treatment approach.
Right pulmonary artery agenesis with transient hypothyroidism in a newborn
Authors: Gupta Preeti , Chattopadhyay Amitabha , Gupta Geetanjali , Das Jayita
Published: April 2017

Unilateral absence of pulmonary artery (UAPA) is a rare congenital anomaly that can present as an isolated lesion or may be associated with other Congenital heart diseases. It is usually detected in infancy or incidentally found on X ray chest in adulthood. The diagnosis of UAPA has rarely been made in a newborn. Only one case has been reported in newborn period from Belgium by F. Marchau who reported the rare occurrence of this anomaly in a 2-day old male baby. We report the rare occurrence of UAPA in a newborn female from India who presented with severe respiratory distress at birth with high cord blood TSH levels. Our case also reflects the importance of a high index of suspicion along with the value of X-ray chest and echocardiogram in the neonatal period in detection of this rare anomaly.
Female breast cancer in different age groups: clincopathological features and treatment strategies
Authors: Nuzhat Ayesha , Abouzaid Lamyaa Z.
Published: April 2017

Background: The proportion of breast cancer cases have been alarmingly increasing. In order to investigate the clinical and pathological features of breast cancer arising in all age groups and to provide evidence for therapy based on these features, we intended to conduct this study among three age groups, young (age ≤40), middle aged (>40-50) and elderly patients (>50). Methods: This cross-sectional study obtained data from the cancer center registry at King Fahad Medical City and included all women diagnosed as breast cancer between 1st January 2011 till 31st December 2012 and followed until December 2015 (n=155). Results: 25.2% patients were ≤40 years of age, 38.7% were >40-50 years and 36.1% were >50 years. The upper outer quadrant of the breast was most frequently area involved in all the three age groups. Majority of the cases were Invasive Ductal Carcinoma (IDC). 51.3% cases were of grade III in patients ≤40 years, 43.3% cases in the middle age group (>40-50 years) were of grade II and 44.6% patients were of grade III in the elderly group. More T3 tumours were noticed in the younger group and more T2 in the middle age group and greater lymph node involvement N2 in the age group >50 years. The mean survival time for patients' ≤40 was 37.6 months, 39.3 months for cases >40-50 years and 38.3 for patients >50 years old at the end of three years of follow up. At our cancer centre and among all the groups, majority of patients were treated with a combination of surgery, chemotherapy and radiationConclusions: This study identifies cliniopathological features of breast cancer in all age groups in a tertiary care center, Saudi Arabia. Distant metastasis was more prevalent among younger age group and the middle aged women had the best mean survival time after three years.
A cross-sectional study on prevalence of obesity and its association with dietary habits among college students in Abha, Saudi Arabia
Authors: Alshahrani Mana M. , Chandramohan Sriram
Published: April 2017

Background: During the past few years there was a western influence in the kingdom of Saudi Arabia and as a result of it the eating habits among the male college students had rapidly changed which also increased the prevalence rate of overweight and obesity. Therefore the objectives of the study were 1) To determine the prevalence of overweight and obesity in a sample of male college students in Abha, Saudi Arabia. 2) To determine the relationship between the Student’s body weight and their eating habits. Methods: A cross-Sectional study was done among 445 male college students from king Khalid University, Abha Saudi Arabia. Study participants were selected randomly and self-administered questionnaire was used to collect the data. Data was analyzed by using the statistical package for social sciences (SPSS Inc. version 16.) and expressed in percentages. Results: The study found that 28% and 20 % of students were overweight and obese. Daily intake of snacks and lack of consumption of vegetable and fruits were found to be the common dietary habits among the male college students. Majority of the students were aware about the balanced nutrition and it was positively correlated with the normal body weight. Conclusions: The current study suggest involvement of college Administration and family members will further reduce the burden of overweight and obesity among college students in the nation.
Profile of stroke cases managed at physiotherapy department of a teaching hospital in Maiduguri, Nigeria
Authors: Abiodun Jaiyeola Olabode , Ifeanyi Umeonwuka Chuka , Stanley M. Maduagwu , Esthon Gapsiso Nakum , Yunus Oyeyemi Adetoyeje , Onyinyechukwu Nwachukwu Juliet
Published: April 2017

Background: Apart from the long term disability inflicted on stroke survivors, stroke also imposes heavy emotional and financial burden on the families, care givers and the society. Knowledge of the pattern of presentation, clinical characteristics and the socio-demographic distribution of stroke survivor patients can serve as a guide to physiotherapists in clinical decision making. This study reviewed clinical presentation, types and socio-demographic distribution of stroke survivors attending physiotherapy clinic at a teaching Hospital in Maiduguri, Nigeria.Methods: Purposive sampling was employed to retrieve and review folders of stroke survivors that attended physiotherapy clinic at a teaching Hospital in Maiduguri, Nigeria between January, 2006 and December, 2010. Socio-demographics of the stroke survivors, clinical characteristics and risk factors for stroke were extracted from the retrieved folders. The extracted data were summarized using descriptive statistics of percentages, frequency counts and bar chart. Results: A total of 283 folders of stroke survivors from January, 2006 to December, 2010 were reviewed. Mean age and age range of the stroke survivors in years were 45.2±1.40 and 16 – 85 respectively. Stroke survivors between the ages of 56 and 75 years were in the majority (42.8%). Male stroke survivors accounted for 58% and those that suffered ischemic stroke comprised 85.9% of the stroke survivors. Hypertension was the dominant (62.5%) risk factors among the stroke survivors. Conclusions: Awareness campaign is needed to enlighten the populace on healthy lifestyle and prevention of hypertension and other risk factors for stroke. Also, early presentation for physiotherapy management should be encouraged.
Health emergency preparedness: an assessment of primary schools in Abakaliki, South-Eastern Nigeria
Authors: Ezeonu Chinonyelum Thecla , Okike Clifford Onuorah , Anyansi Maria Nwakaego , Ojukwu James Osaeloka
Published: April 2017

Background: Children spend a significant proportion of their day in school, thus pediatric emergencies such as exacerbation of medical conditions, accidental and intentional injuries are likely to occur. An estimate of 10 -25% of injuries occur while the children are at school. It is the legal responsibility of the schools to ensure the safety and well-being of the pupils/students and staff during school hours working towards prevention of accidents and being prepared for immediate solutions when the accidents occur.Methods: A cross sectional descriptive study of 31 registered primary schools in Abakaliki Metropolis. A prepared check list of facilities necessary for emergency care at schools derived from the school health programme evaluation scale was used for the assessment. Data was analyzed using the SPSS statistical package version 8, comparing findings in public schools with the private schools using Chi square. The level of significance was set at p<0.05.Results: A health room was available in 9.7% of schools exclusively private schools.  Nurses, doctors and trained first aiders were found in 6.5%, 9.7% and 32.3% respectively of schools. First aid boxes were available in 80.6% of the schools but only 67.7% of the schools could offer first aid treatment at emergencies. None of the public schools had a school safety patrol or a fire extinguisher in contrast to the private schools.Conclusions: Schools, especially the public schools in Abakaliki metropolis are ill prepared for emergencies.
Primary health problems in rural school children in Lebanon
Authors: Helou Mariana C. , Adib Salim M.
Published: April 2017

Background: Primary health problems among school children are rarely disaggregated between urban and rural areas. This report describes findings in children examined during school health visits in a rural region in South Lebanon. Methods: Medical visits were carried out in four public schools in the Qana region, district of Sour, between December 2007 and May 2008. Results: A total number of 887 students were examined. Age varied between 4 and 16 years old.  The majority (78%) had a normal weight for their age. Around 7.1 % of males and 3.5 % of females were considered obese for their age. The most frequent abnormality found was dental caries (59%). In addition, 14% of students had cerumen earplugs, and 3.6% had untreated defective visual acuity. Cases of pediculosis (n=62) were found in just one school, indicating a local outbreak of limited scope. Conclusions: There were only minor differences between health problems in this rural area and those measured in an urban area 10 years earlier. Dental problems continued to be predominant. In future campaigns, health education sessions should be conducted about personal hygiene and adequate nutrition with students, teachers and/or parents, in parallel to conducting the medical visits.
A study on postnatal care and its correlates among recently delivered women visiting to BRD medical college Gorakhpur
Authors: Tiwari Harish Chandra , Gupta Sudhir Kumar
Published: April 2017

Background: Postnatal care is crucial in maintaining and promoting the health of the woman and the newborn baby. Despite the known benefits of the postnatal care, there are many access and utilization barriers to care. The present study was conducted on postnatal care and its correlates among recently delivered women visiting to BRD Medical College Gorakhpur. Methods: For present cross-sectional study recently delivered women (RDW) defined as a post natal woman who had a baby between two months to six months of age at the time of data collection were taken as the study subjects. Complete post natal care was considered if RDWs had received post natal check-up (Post natal day -1, day-3, day-7,) along with immunization of child with BCG, OPV and three doses of DPT/Pentavalent vaccine. Sample size was calculated as 275 by using the formula 4PQ/L2 with an allowable error (L) of 20% including 10% extra for non/incomplete responders. The proportion of women receiving postnatal care was considered as 50.0% as by this proportion maximum sample size is arrived. Results: A total of 269 recently delivered women (RDW) were taken as the study subjects. They belonged to age group 19-29 year (Mean age 23.7±6.7 year), either educated up to 12th standard and only few were graduate or post graduate. Majority of them belonged to middle or lower middle class. Conclusions: Postpartum care utilization was associated with socioeconomic status, antenatal care received or not, planned pregnancy or not. Interestingly, access to care was not perceived as a top reason for not obtaining PPC.
A community based cross sectional study to assess the drinking water handling and management practices, sanitary practices at the household level in Sullia taluk, Karnataka
Authors: Kaniambady Sharanya , Vasu Dinesh Peraje , G Sandhya , Kulkarni Annarao Gunderao
Published: April 2017

Background: The Millennium Development Goals (MDGs) - 7 aimed to reduce by half the proportion of population without sustainable access to safe drinking water and basic sanitation by 2015. Without access to clean water and basic toilets, and without good hygiene practices, a child’s survival, growth and development are at risk. This study was conducted to assess the drinking water management and handling practices at household level of Sullia Taluk of Karnataka which would give an insight into drinking water management and handling practices in this area.  Also the present study is planned to determine the sanitary practices in the households of Sullia Taluk. Methods: 260 houses were sampled using a probability proportionate to sampling size . A cross sectional study was done using a semistructured questionnaire to assess water handling, water management and sanitary practices. Free chlorine in the water was assessed by O- Toluidine. Results: Main source of drinking water was protected dug well in 31.5% and 75.3% did not have any alternate source of drinking water. 92% of those who stored water in overhead tanks and sumps did not clean them within seven days. 14% of the households did not use any of the water treatment methods before drinking. There was no free chlorine in the water of any of the households . 4% did not wash their hands with soap post-defecation. 28% of the households threw their waste indiscriminately around their house. 92% had cattle in close proximity to their house. None of the households practiced open field defecation. Conclusions: Health education is very important to prevent the incidences of water and sanitation related diseases. Emphasis needs to be given to behavioural change communication to create awareness among the households regarding the importance of water and sanitation practices.
Knowledge, attitude and practices about tetanus toxoid immunisation amongst general population of an urban semi-slum area: a cross-sectional interview-based study from Western India
Authors: Patel Pruthvi H. , Malgaonkar Aniruddha A. , Kartikeyan S.
Published: April 2017

Background: Members of the public are frequently unaware of tetanus immunisation schedules and its importance in preventing tetanus. This community-based, cross-sectional, complete enumeration, interview-based study was conducted to assess the knowledge, attitude and practices about tetanus toxoid immunisation amongst the general population in an urban semi-slum area located about 30 kms from Mumbai city in Western India.Methods: Respondents comprised adult residents of either sex, who gave written informed consent to participate in the study. After obtaining approvals, the study was explained during routine home visits and the respondents were interviewed at a time convenient to them.  A direct face-to-face interview was conducted using a semi-structured proforma and their responses were recorded and statistically analysed.Results: Of the 161 participants (90 males; 71 females), 16.15% were illiterates. 95.65% thought that a single tetanus toxoid injection was adequate to prevent tetanus while none knew that pregnant women are immunised to protect newborns against tetanus.  67.08% were unaware about the need for maintaining cold chain for storage of tetanus toxoid. 96.89% had received only one injection of tetanus toxoid, irrespective of the type of injury or previous immunisation status. The belief that an adult requires tetanus toxoid after every injury exhibited education-wise significant difference (p=0.02).Conclusion: Sustained and focussed health education efforts are necessary to combat misconceptions regarding tetanus toxoid immunisation.
Contraceptive knowledge, attitude and practice among married women of reproductive age group in a rural area of Karnataka: a cross sectional study
Authors: Ramaiah Radha , Jayarama Srividya
Published: April 2017

Background: India was the first country to implement Family Planning Programme in 1952. The extent of acceptance of contraceptive methods still varies within societies and also among different religious groups. Objectives: To determine knowledge, attitude, practice regarding contraceptive use among married women of reproductive age group in a rural area of Karnataka.Methods: A community based, cross sectional study was conducted among 200 married women of reproductive age group residing in a rural area of Karnataka. Data regarding knowledge, attitude, practice of contraceptive methods was collected using a predesigned questionnaire prepared in local language. Institutional ethical committee approval, informed consent from the study participants was taken and anonymity, confidentiality was ensured.Results: Out of 200 study participants, 81% had knowledge and awareness of family planning methods, positive attitude for contraceptive use was shown by 76% of study participants, 53% were practicing different contraceptive methods.Conclusions: Women education and counseling of couples can play an important role to adopt family planning methods.
Developmental delay among children below two years of age: a cross-sectional study in a community development block of Burdwan district, West Bengal
Authors: Bhattacharya Tridibes , Ray Soumalya , Das Dilip Kumar
Published: April 2017

Background: Developmental delay is a public health problem worldwide. Globally every year approximately 200 million under-five children exhibit significant delay; 86% being in developing countries. Thus screening and early detection has been emphasized for effective measures. The objectives of the study were to estimate the prevalence of developmental delay among children below two years of age and to determine association of demographic and socio-economic factors.Methods: A community based cross-sectional study was conducted between July-November 2016 among 2 – 23 months aged children at Bhatar block, Burdwan district. Calculated sample size was 277; considering 9.5% prevalence (as elicited by Meenai et al in Bhopal), 95% confidence interval, 5% absolute error, design effect 2 and 5% non-response. By simple random sampling, one village was chosen from each of the fourteen gram panchayats of Bhatar block and then equal numbers of children from each selected village. Data were collected by interviewing the respondents with a pre-designed schedule. Developmental status was assessed using Trivandrum developmental screening chart. Chi-square test and logistic regression were applied, p<0.05 was considered statistically significant.Results: Overall prevalence of developmental delay was 7.9%. Chi-square test revealed gender (p=0.04), birth weight (p=0.00), maternal education (p=0.01) and place of delivery (p=0.00) to have significant association; in logistic regression also these factors remained significant. Gestational duration, age at delivery, socio-economic status had no significant association.Conclusions: Developmental delay is substantially high among rural children. Larger study with appropriate diagnostic tool might ascertain the actual burden and determinants to indicate necessary measures.
Junk food, might be one of the major reasons of your depression.
Authors: Hassan Syed Zawahir , Yaqub Muhammad Danial , Awan Mahlail Ahmed , Jawed Osama
Published: April 2017

The study found out that  individuals with higher intakes of trans fats experienced “difficulties with emotional awareness,” and a lower level of emotional “clarity”. While the people who had lower transfats were better able to control their emotions. Consumption of a diet that contains more transfats increases the cholesterol level in blood which in turn can cause heart attack, strokes and even depression
Does awareness on health hazards of tobacco use promote quit attempt? An observational study from urban Pondicherry
Authors: Naik Bijaya N. , Kar Sitanshu S. , Majella Marie G. , S. Parthibane
Published: April 2017

Tobacco use is the most prevalent behavioural risk factors for non-communicable diseases. In rural Pondicherry, the willingness to quit is low despite higher proportion of tobacco users being aware of health hazards of tobacco use. Hence, this observational study was conducted with the aim to assess the awareness on health hazards of tobacco use and quit attempt among the tobacco users attending an urban health centre in Pondicherry. A total of 90 individuals above 15 years of age attending the centre for treatment were included in the study and interviewed after obtaining verbal informed consent. Socio-demographic details, awareness on health hazards of tobacco use, quit attempts and reasons for failed quit attempt were noted down using a semi-structured questionnaire. Majority (64.4%, 58/90) of the current smokers were aware of health hazards related to tobacco use. Only one third of the tobacco users had tobacco quit attempt. Tobacco quit attempt recorded to be significantly (p value < 0.05) higher among people who were aware of health hazards (50%, 29/58) than the people who were not aware of health hazards (12.5%, 4/32). Creating awareness on health hazards and providing personalized counselling services to address reasons for failed quit attempt will improve the successful quitting of tobacco use.
Evaluation of efficacy of a nanoparticle based vitamin D formulation in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D
Authors: Manek Kishore A.
Published: April 2017

Background: In India more than 90% of apparently healthy Indians have subnormal 25(OH) D levels. To maintain sufficient vitamin D level, apart from sunlight and food containing vitamin D, supplementation with vitamin D is also required. The objective of this study was to find out effectiveness of nanoparticle based vitamin D formulations in patient of vitamin D deficiency and insufficiency

Methods: This was a prospective, open label, single arm, non-comparative, dose response post-marketing efficacy study (PMS) – phase-4 study to find the effectiveness of a nanoparticle based vitamin D formulation in adult patients between 18 to 65 years of either gender, attending/visiting the study site with documented deficiency or insufficiency of vitamin D (<30 ng/ml) or sign and symptoms of deficiency or insufficiency of vitamin D. Each subject planned to receive 60,000 IU of nanoparticle based vitamin D, once weekly, for 8 weeks orally. Serum 25(OH) D levels were measured at baseline, 4 and 8 week.

Results: The mean baseline serum 25[OH] D levels were 15.90. After treatment with nanoparticle based vitamin D there was a significant increase in the serum vitamin D levels at 4 weeks (41.03) and 8 weeks (31.38) (p<0.0001). Patients who have received treatment for at least 4 weeks’ period (n=38), the improvement (serum 25[OH] D >30 ng/ml) was seen in 84.2% patients (n=32) at the end of 4 weeks itself. There is significant increased (<0.0001) in the physical component scores of the SF-12 QOL questionnaire after 8 weeks of therapy.

Conclusions: Nanoparticle based formulation of vitamin D3 is effective and safe in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D. Also the safety and tolerability is well accepted and reported good to excellent by patients and physician.

 
Risk factors for septic arthritis of hip in neonates and infants
Authors: Chaudhari Nitin , Gajjar Sharvil , Menon Hari , Patel Yatin
Published: April 2017

Background: Suppurative arthritis of hip is pyogenic inflammation of synovial membrane of the hip, usually due to bacterial infection. The main aim of early diagnosis and treatment of septic arthritis of hip is to prevent damage to articular cartilage and growth plate, give stable and painless hip and to resume normal development and prevent sequelae.

Methods: Prospective interventional study consisted of 34 patients with 36 Hips septic arthritis of hip less than one year of age carried out at Department of Orthopedics of a tertiary care centre during August 2011 to December 2013. Risk factors and related laboratory investigations were carried out. Data entry and analysis was done by MS Excel 3.0.

Results: In our study more than 70% patients presented after one week. Left sided hip involvement (59%) was more common followed by right hip (35%). Sex ratio of the study population was   M: F-4:6.  NICU admission was present in 94% cases.  In many of our patients there were more than one risk factors like septicemia, low birth weight, jaundice and ventilator support.

Conclusions: All NICU neonates should be handled with strict aseptic precaution.
A prospective study of surgical management of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate
Authors: J. Raghu Kumar , H. Manjappa D.
Published: April 2017

Background: Distal tibial fractures are unique and represent a significant challenge in their management. Factors affecting the outcome include location of fractures, proximity to ankle joint, less soft tissue coverage, comminution, unstable and compound fractures, method of treatment and quality of reduction. Distal tibial fractures traditionally were treated with different modalities, LCP with MIPPO (minimally invasive percutaneous plate osteosynthesis) being one of the recent advances.

Methods: Clinical, prospective observational study was conducted at J.J.M. Medical College, Davangere between October 2014 to September 2016. 21 patients with distal 1/3rd tibial fractures with or without intra-articular extensions were included in this study.  All 21 patients treated with LCP by MIPPO were followed for 6 months with clinical and radiological assessment, including ankle scoring system (Olerud and Mollander).

Results: 21 patients with age between 23-65 years (mean 41.6 years) were treated with LCP by MIPPO during the study period. All the patients were followed up at 6 weeks, 12 weeks, 6 months and at 1 year with x-ray and ankle scoring system. All the patients had complete union between 14 weeks to 24 weeks with ankle score between excellent and good in majority of the patients.  There were 2 cases of delayed union, 3 superficial skin infections and 3 cases of ankle stiffness.

Conclusions: Study concludes LCP with MIPPO is a safe, reliable technique to achieve complete union of difficult fractures.

 
The distance of the centre of femoral head relative to the midline of the pelvis: a prospective X-ray study of 500 adults
Authors: Rabari Yash B. , Sanap Amol , Prasad D. V. , Thadeshwar Krunal H.
Published: April 2017

Background: The mechanical axis of the femur is defined as the line joining the centre of the femoral head to the centre of the knee joint. One of the pre-requisites for a successful total knee replacement (TKR) is correct positioning of the implants, so that the mechanical axis of the limb is restored to neutral. During TKR surgery, the distal femoral anatomy can be visualized. However, to identify the mechanical axis of the femur, the location of the femoral head must be known.

Methods: We prospectively measured distance of centre of femoral head relative to the midline of the pelvis in 500 adults, using x ray of pelvic with both hip anteroposterior view done for medical causes during 2-May-2015 to 1-Jan-2017 with satisfied the following inclusion and exclusion criteria. Patient gender and age were known. Both hips were clearly shown on the radiograph and not affected by any developmental or acquired condition that might deform normal anatomy. Radiographs demonstrating unacceptable pelvic tilt or rotation were excluded. Also, we excluded any cases where degenerative changes in the native hip were more severe than grade 1, based on the Tönnis classification.

Results: There were total 500 patients in which 250 were male and 250 were female. The mean age of male was 52.14 year (SD ±80.80 mm, 95% CI 51.05 to 53.24 mm) and female was 52.11 years (SD ±8.82 mm, 95% CI 51.01 to 53.24 mm).The mean distance of femoral head centre from midline in male was 95.02mm (SD ±2.20 mm, 95% CI 94.75 to 95.30 mm) and in female was 91.54 mm (SD ±2.64 mm, 95% CI 91.22 to 91.87 mm).
Conclusions:This study provide a useful information to determine the femoral head center relative to the midline of pelvis which useful intraoperatively. 
 
Fibular collateral ligament reconstruction of knee using titanium button: a new fixation technique and an outcome of 35 cases
Authors: Rai Sanjay Kumar , Varma Rohit , Wani Sunitkumar
Published: April 2017

Background: The fibular collateral ligament (FCL) is an important stabilizer of the lateral side of the knee through the whole range of motion. Likewise, it resists external rotation near full extension. Many techniques has been described in the literature for fixation of graft to the fibula like interference screws, making loop around the fibula head but nothing has been said about Titanium button fixation at Fibula end. In our series graft has been fixed at Fibula end using Titanium button. In this article we described our new graft fixation technique.

Methods: We included 35 patients all were solider of Indian army and navy who got their knee injured during duties, sport, training and accident, were operated with new technique of graft fixation at Fibula end.

Results: As far as my search in the present literature while writing our present study the graft fixation at Fibular end using Titanium button has not yet described by any author. This fixation is robust and results were promising. Out of 35 cases only 02 patients developed knee stiffness and none were has lateral knee opening (Varus stress test was negative). All patients were available for follow up for 18 months.

Conclusions: Based on our new technique of the graft fixation at Fibular end using Titanium button we can conclude that this technique is simple and fixation is robust with promising results.
Functional outcome of displaced proximal humerus fractures managed by proximal humerus interlocking system plate
Authors: Deepak C. D. , D. V. Mahesh , Ravoof Abdul , Baruah Manash Jyoti
Published: April 2017

Background: Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age.

Methods: The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients’ age ranged from 18 to 75 years with a mean of 42.9.

Results: The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients’ ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6.

Conclusions: The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures.
Comparative study on the functional outcome of ligamentotaxis in comminuted fractures of the distal end of radius and with that of conservative means of closed reduction and casting
Authors: Sudheer Urampath , Jayaprakash Chundarathil
Published: April 2017

Background: Comminuted fractures of lower end of radius most often bring out unsatisfactory outcome, if treated by conservative means of closed reduction and casting. This study was aimed to compare the results of ligamentotaxis in comminuted fractures of the distal end of radius and with that of closed manipulative reduction and plaster cast immobilization.

Methods: Patients with comminuted fracture lower end of radius treated by ligamentotaxis or the conservative methods were included in the prospective study. Patients in group l treated by external fixator and in group 2 treated by conservative line of management. Postoperative check X-rays were taken. All the patients were evaluated on 3rd, 6th, 12th and 18th months after surgery. Functional results were assessed by Gartlands point score system and subjected to statistical analysis.

Results: Total fifty patients were included in the study. Twenty five were treated by external fixator and the remaining was treated by conservative line of management. Patients underwent ligamentotaxis had 88% excellent results whereas 52% of patients on conservative care had similar results. When the conservative methods gave poor results for severely comminuted fractures, ligamentotaxis could bring out excellent re-orientation of fragments back to near normal alignment.

Conclusions: Ligamentotaxis using a distracter is a better method to treat comminuted fractures of lower end of radius. Even though the initial reductions were excellent in a plaster cast, re-displacement rates are very high in a plaster cast. Fractures without intra articular extension always yielded far better results than intra articular fractures.
Reflexões sobre a leitura de histórias em quadrinhos da Marvel e da DC Comics e as estratégias de resiliência: relevância e desdobramentos
Authors: Ramos Rubem Borges Teixeira
Published: April 2017

O presente artigo apresenta os conceitos de resiliência e coping, presentes no campo da psicologia positiva, em consonância com conteúdos relatados por leitores de histórias em quadrinhos de super-heróis da cidade de Belo Horizonte – MG. O objetivo do estudo é o de analisar experiências do leitor quanto a leitura de histórias em quadrinhos de super-heróis, tendo por base os preceitos e as estratégias da resiliência e do coping. A correlação se torna possível através dos exemplos citados pelos leitores, os quais apontam pelo menos um conhecimento obtido através dessa leitura e posterior aplicação do mesmo em suas vidas, o qual lhes permite, quando associado a pelo menos uma das subescalas de coping, um meio para superar uma dificuldade ou evento estressante de sua vida, até onde isso for possível.
Dos gibis para as telas: a expansão do universo da “Turma da Mônica” em vinhetas animada
Authors: Rodrigues Monique De Almeida Neves
Published: April 2017

Este artigo tem como objetivo principal analisar uma série de vinhetas produzidas por Maurício de Sousa em parceria com a AMA – Associação de Amigos do Autista – que tematizam o autismo infantil. Para tanto, fez-se uma breve retrospectiva da história do autor e da Turma da Mônica, e buscou-se identificar quais aspectos dos gibis foram mantidos ou adaptados para essas produções audiovisuais.
A late Maastrichtian selachian assemblage from the Peedee Formation of North Carolina, USA.
Authors: Case Gerard R. , Cook Todd D. , Saford Eric M. , Shannon Kevin R.
Published: April 2017

A diverse selachian fauna was collected from the Island Creek Member of the Peedee Formation at Castle Hayne, New Hanover County, North Carolina, USA. This inner neritic assemblage consists of 23 species from eight orders, 17 families, and 20 genera and includes the new species Ptychotrygon clementsi sp. nov.  The dentition of a few large macrophagous species with large palaeobiogeographical ranges is described. However, the majority of the reported specimens belong to relatively small species that are endemic to the southern regions of the Western Interior Seaway and the Atlantic and Gulf Coastal plains of North America.
A construção da confiança em experiências de hospitalidade mediadas pela internet: os casos do Airbnb e do Couchsurfing
Authors: Costa Ramon Bezerra , Fernandes Viviane Marinho , Gonçalves Fernando do Nascimento
Published: April 2017

A partir da premissa da importância da confiança nas relações econômicas e de consumo, este artigo se dedica a refletir sobre os processos de construção da confiança em relações de consumo que se dão no campo da hospitalidade. Tal reflexão é feita a partir das experiências do Airbnb e do Couchsurfing, plataformas que permitem receber estranhos em casa ou se hospedar na casa de desconhecidos pagando ou não por isso. Essas práticas vão nos interessar por indicarem relações de consumo que parecem extrapolar as experiências ordinárias de compra e venda e evidenciar a formação de outros tipos de laços sociais, cuja construção o texto pretende analisar
La subversión de conciencia en Rosario Castellanos: un acercamiento didáctico a “Lección de cocina”
Authors: Saneleuterio Elia
Published: April 2017

“Lección de cocina”, de Rosario Castellanos, se construye en forma de fluir de conciencia de una recién casada mientras asa dos filetes. El discurso se entremezcla con sus propias experiencias culturales, conyugales y con el ardor de las quemaduras solares sufridas en la luna de miel. Los pensamientos se subvierten en consonancia con el propio proceso de cocción de los alimentos, que también van quemándose por su inexperiencia culinaria. Se estructura como respuesta un entretejido simbólico: carne asada como correlato de la propia carne, del coito y de la acción literaria, especialmente en lo que afectan a la identidad de la mujer. Esta triple caracterización sustenta las pautas que proponemos para el acercamiento a este relato, desde una perspectiva didáctica, que trasciende lo literario, pues cada uno de estos estratos se encuentra sazonado por la opresión de la sociedad mexicana hasta mediados del siglo XX.
Calculus II: The Integral and Its Applications
Authors: Clark Patrick
Published: April 2017

Calculus II: The Integral and Its Applications uniquely addresses all of the rules and applications of Integral Calculus necessary for the AP Calculus AB and BC courses. In addition, units are included on power series and convergence, and the calculus of parametric and polar equations.

The material is presented in a modular format that allows great flexibility for the student and teacher. The lessons are designed to be rigorous enough for the serious student, yet user-friendly enough for the independent learner.

All lessons include worked examples as well as exercises with solutions.
Worksheets that Teach: Algebra 2, Volume III
Authors:   Quantum Scientific Publishing
Published: April 2017

Worksheets That Teach are completely different than normal classroom worksheets because they actually teach the content!

Each content-based worksheet begins by actually teaching all of the content in the stated learning objective(s) before moving into the set of exercises that are normally found in a classroom worksheet.

Worksheets That Teach are ideal for:
1. Classroom use to reinforce a topic
2. Student test preparation
3. Homeschooling
4. Individual tutoring sessions
5. Successful students that would like the additional challenge of exploring a new topic on their own
6. Substitute teachers that need to teach a class in an unfamiliar discipline

Worksheets That Teach Series Areas of Study:
Foreign Languages
General Studies
History
Language Arts
Mathematics
Science
Five Phases Music Therapy (FPMT) in Chinese Medicine: Fundamentals and Application
Authors: Zhang Hui
Published: April 2017

Music therapy has served as complementary and alternative medicine for various neurological disorders. Five Phases Music Therapy (FPMT) employs the theory of five phases and five music scales or tones (Gong (do), Shang (ri), Jue (mi), Zhi (so) and Yu (la)) to analyze and treat mind-body illness. In Chinese Medicine (CM) the five music scales are used to connect the human body and the universe, summarize personalities and constitution and analyze the influences of climatic changes on health. FPMT has a self-contained theory and routine of practice application. Large amount of clinical and fundamental reports has been available and clinical benefits have been obtained. However more systemic clinic research esp. Evidence-based and random controlled trials must be performed to validate and optimize it’s routines and biological and neurological mechanism must be further explored. It’s reasonable to believe that the introduction of FPMT to the world outside China may attract more attentions to use this effective music therapy.
Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region
Authors: So Marvin , Ellenikiotis Yianni A. , Husby Hannah M. , Paz Cecilia Leonor , Seymour Brittany , Sokal-Gutierrez Karen
Published: April 2017

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1,407 children from birth through age 6 in the “Alli Kiru” program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for underweight (AOR: 1.27; 95% CI: 1.02 – 1.54) and decreased odds for overweight (AOR: 0.76; 95% CI: 0.58 – 0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.
Multi-objective Optimization of Draft Tube in Francis Turbine Using DOE, RBF and NSGA-II
Authors: Mun Chol Nam , Ba De Chun , Yue Xiang Ji , Kim Myong Il
Published: April 2017

In order to improve the performance of the draft tube in hydraulic turbine, a multi–objective optimization method for the draft tube is developed by combining the design of experiment (DOE), the radial basis function (RBF) and the non–dominated sorting genetic algorithm (NSGA–II) in this paper. The geometrical design variables of the median section in the draft tube and the cross section in its exit diffuser are considered as design parameters in this optimization, which objective function is to maximize the pressure recovery factor (Cp) and minimize the energy loss coefficient (ζ). The limited numbers of design matrix required for the shape optimization of the draft tube is generated by optimal Latin hypercube (OLH) method of the DOE technique, of which performances are evaluated through computational fluid dynamic (CFD) numerical simulation. For reducing of the computational consumption, the approximate model is used based on the RBF. The Pareto optimal solutions are finally performed using the NSGA–II for obtaining the best geometrical parameters of the draft tube. The optimization result of the draft tube shows a marked performance improvement over the original, which verifies the theoretical validity and feasibility of the proposed method in this paper.
Governança Corporativa em Organizações Públicas: Aplicação do Limpe na Mesorregião Centro-Ocidental Rio-Grandense
Authors: Ramos Schirlei Stock , Vieira Kelmara Mendes , Paraboni Ana Luiza
Published: April 2017

A demanda por mais Legalidade, Impessoalidade, Moralidade, Publicidade e Eficiência - LIMPE, nas ações governamentais, sobretudo, nos municípios está diretamente relacionada à questão do desenvolvimento das cidades. Todavia os limites surgem quando os atores envolvidos na governança pública não possuem conhecimentos adequados destes conceitos, resultando em impactos negativos na vida de todos os cidadãos. O estudo analisa a governança corporativa das prefeituras dos 31 municípios que compõem a mesorregião centro ocidental Rio-grandense a partir de um check-list transversal que avalia a governança corporativa tanto na perspectiva do LIMPE quanto na perspectiva do Balanced Score Card. Os dados revelaram que nos municípios pesquisados verifica-se apenas parcialmente a aplicação dos parâmetros pesquisados, sendo os referentes à legalidade os mais praticados. Na perspectiva do Balanced Score Card, os melhores resultados foram obtidos para a dimensão financeira e os piores para a Aprendizagem.
Motivação Acadêmica e sua Relação com o Desempenho Acadêmico: Um Estudo com Alunos do Curso de Graduação em Administração
Authors: Viana Gustavo Salomão , Viana Adriana Backx
Published: April 2017

Considerando a importância do ensino de Estatística para a formação do administrador, bem como a relevância da motivação acadêmica para o bom desempenho dos alunos, surge como objetivo de pesquisa: investigar o modo como se dá a interação da motivação acadêmica, tanto em relação à nota, quanto em relação à autopercepção de desempenho, dos alunos nas disciplinas de Estatística do curso de Administração. Utilizou-se uma amostra de 278 graduandos em Administração respondentes de um questionário que abordou aspectos de autopercepção de desempenho, Escala de Motivação Acadêmica e caracterização (perfil). A pesquisa verificou uma maior desmotivação nos alunos do sexo masculino em relação ao feminino, assim como identificou haver diferença do nível de desmotivação em função da área de interesse do aluno. Como conclusão principal verifica-se que o relacionamento entre os tipos de motivação e o desempenho acadêmico caracteriza-se como área de grandes discussões, necessitando de pesquisas futuras para uma melhor elucidação.
Identificação de Riscos Corporativos no Ambiente de Valor de Instituições de Ensino Superior Privadas (IES)
Authors: Massaini Silvye Ane , Franco de Oliveira Viviane Renata , Oliva Fábio Lotti
Published: April 2017

O presente artigo tem como principal objetivo compreender quais riscos corporativos podem ser identificados no ambiente de valor de instituições de ensino superior privadas (IES). O estudo classifica-se como descritivo e qualitativo, tendo como base a análise de entrevistas com gestores de duas diferentes instituições de ensino superior privadas. Os resultados demonstram que a nomenclatura e tipologia de riscos corporativos ainda é pouco clara aos profissionais responsáveis pela gestão das IES privadas. Além disso, percebeu-se que o risco mais evidenciado foi o risco legal, decorrente da relação com o Ministério da Educação; seguido pelo risco financeiro, ocasionado pela evasão e falta de alunos.