bluuebunny/crossref_metadata_2025 huggingface dataset:
Um Estudo Sobre o Matemático Português Pedro Nunes
Authors: Ferreira Denise Helena Lombardo , De Carvalho Tadeu Fernandes , De Oliveira Sandro Joel Mariano
Published: June 2020

Trata-se de um artigo que tem por objetivo estudar as obras do matemático português Pedro Nunes, ou Petrus Nonius, destacando a obra intitulada Libro de Algebra em Arithmetica y Geometria. Para a elaboração deste trabalho foram usados informações e dados que se encontram disponíveis na internet e na literatura científica. Foram estudados os métodos de resolução de equações, para os quais Nunes usava tanto a álgebra quanto a geometria para suas demonstrações, além dos conhecimentos aprofundados dos livros de Euclides, os Elementos. Além disso, Nunes criou diversos instrumentos de medida, dentre os quais, anel náutico, instrumento de sombras e o nônio, mencionados neste trabalho.

 

Palavras-chave: Pedro Nunes. Álgebra. Geometria. Instrumentos de Navegação.

 

Abstract

It is an article that aims to study the works of the Portuguese mathematician Pedro Nunes, or Petrus Nonius, highlighting the work entitled Book of Algebra in Arithmetic and Geometry. For the elaboration of this work, information and data were used that are available in the internet and in the scientific literature. Methods for solving equations were studied, for which Nunes used both algebra and geometry for his demonstrations, as well as the in-depth knowledge of Euclid's books, the Elements. In addition, Nunes created several measuring instruments, among them, nautical ring, shadow instrument and the vernier, mentioned in this work.

 

Keywords: Pedro Nunes. Algebra. Geometry. Navigation instruments.
La participación política como herramienta de inclusión para una ciudadanía plena de las mujeres=Political participation as an inclusion tool for full citizenship of women
Authors: Fernández de Castro Patricia
Published: June 2020

ResumenEn el artículo se hace un recorrido por los modelos teóricos de ciudadanía, interesando fundamentalmente su vinculación con la participación política e incorporando la perspectiva de género al análisis de las teorías contemporáneas sobre la noción de ciudadanía. Se sostiene que, para la reivindicación de una ciudadanía inclusiva para las mujeres, es necesario distanciarse del posicionamiento que obliga a elegir entre el reclamo de la igualdad o la diferencia, así como de las argumentaciones que separan, de manera tajante, los espacios público y privado. El concepto de ciudadanía cobra, así, su máximo sentido a partir de la participación política activa, siendo ésta una estrategia clave para eliminar las condiciones desiguales y discriminatorias hacia las mujeres en las sociedades democráticas actuales.AbstractIn the article, a path of the theoretical models of citizenship is performed, fundamentally interesting their relationship with political participation and incorporating the gender perspective into the analysis of contemporary theories on the notion of citizenship. It is argued that, in order to demand inclusive citizenship for women, it is necessary to distance oneself from the position that forces one to choose between the claim of equality or difference, as well as the arguments that sharply separate public and private spaces. Thus, the concept of citizenship takes its maximum meaning from active political participation, this being a key strategy to eliminate the unequal and discriminatory conditions of women in today's democratic societies.
Ciencias y género: los supuestos de la exclusión=Science and gender: the assumptions of exclusion
Authors: Gálvez Méndez Victoria Elizabeth
Published: June 2020

ResumenEste artículo pretende reflexionar sobre la aparente neutralidad de las ciencias y la exclusión de las mujeres a través de la historia. La visión crítica sobre los supuestos que subyacen a las teorías epistemológicas tradicionales, releva la necesidad de transitar a ciencias inclusivas, desde la perspectiva de la complejidad. Se considera indispensable tal enfoque en la construcción de nuevas ciencias, a partir de un estudio realizado en Chile sobre epistemologías, mujeres y ciencias, del cual se recogen algunos aspectos claves para la reflexión.AbstractThis article tries to reflect on the apparent neutrality of the sciences and the exclusion of women throughout history. The critical view of the assumptions underlying traditional epistemological theories, reveals the need to move to inclusive sciences, from the perspective of complexity. Such an approach is considered essential in the construction of new sciences, based on a study carried out in Chile on epistemologies, women and sciences, which includes some key aspects for reflection.
Una científica ilustrada que luchó por su visibilización: Madame de Châtelet=An enlightened woman scientist who fought for her visibility: Madame de Châtelet
Authors: Pérez González Lourdes
Published: June 2020

ResumenA lo largo de la historia, los nombres y los hechos de mujeres fueron invisibilizados en todos los ámbitos por el patriarcado, que fue deformando la construcción científica y cultural, al dar por válidos y neutrales una historia y unos resultados sesgados y parciales. Los mecanismos para invisibilizar a las mujeres son múltiples: borrarlas, opacarlas minimizar su obra, tergiversar su vida, desvalorizar o robar su trabajo… La lucha por la visibilización suele ser un trabajo de recuperación a posteriori y es habitual que la propia mujer —siendo consciente de las dificultades que tenía en razón de su sexo— haya tratado de que su nombre no se extinguiera. Este es el caso de una mujer ilustrada, Madame de Châtelet, que en varias ocasiones reclamó, defendió y protegió su nombre como científica, frente a los que querían usurparle la autoría, marcando así un hito en la historia de las mujeres científicas.AbstractThroughout history, the names and facts of women were made invisible in all areas by the patriarchy, which deformed the scientific and cultural construction, by giving biased and partial results as valid and neutral. The mechanisms to make women invisible are multiple: erase them, overshadow them, minimize their work, misrepresent their lives, devalue or steal their work... The struggle for visibility is usually a post-recovery work and it is not usual that the woman herself — being aware of the difficulties she had because of her sex — to have tried that its name was not extinguished. This is the case of an enlightened woman, Madame de Châtelet, who repeatedly claimed, defended and protected her name as a scientist, against those who wanted to usurp her authorship, thus marking a milestone in the history of women scientists.
Desigualdad de género en las carreras STEM en el Uruguay. Construyendo cultura y registros: la experiencia en Institut Pasteur de Montevideo con InMujeres (Uruguay)=Gender inequality in STEM careers in Uruguay. Building culture and records: the experience at the Institut Pasteur de Montevideo with InMujeres (Uruguay)
Authors: Prieto-Echagüe Victoria
Published: June 2020

ResumenEn el Uruguay la participación global en la investigación es paritaria, aunque las mujeres tienen una participación minoritaria en los ámbitos de decisión. Se reportan aquí indicadores para visibilizar el problema de desigualdad de género en la ciencia como un problema público. Se analizan las consecuencias y causas de este problema y se proponen lineamientos para una política pública de igualdad enfocada en atender las necesidades estratégicas de género. Finalmente, se describe la experiencia de un instituto de investigación con la aplicación de una herramienta de política pública de igualdad de género diseñada para promover cambios culturales en las organizaciones. Esta u otra herramienta auditable podría convertirse en un pilar fundamental de una política pública de igualdad en la ciencia. AbstractIn Uruguay, global participation of women in research is equal, although they do not have equal participation in decision-making spaces. Here I report inidcators that show a gap in women participation and visibilize a gender equality problem in science and academia. The consequences and causes of this problem are analyzed and guidelines are proposed for a public equality policy focused on addressing the strategic gender needs. Finally, I describe the experience of a research institute with the application of a gender equality public policy tool designed to promote and bring about cultural changes in organizations. This or a similar auditable tool could become a fundamental pillar for a public policy of equality in science.
Mujeres en TIC: una historia de pioneras ocultas/menoscabadas y omisiones en la bibliografía=Women in ICT: A history of hidden/undermined pioneers and omissions in bibliography
Authors: Henning Gabriela Patricia
Published: June 2020

ResumenEste trabajo analiza algunas dimensiones de la brecha de género en el campo de las TIC. Ésta no puede comprenderse en forma cabal, si no se reconoce cuál ha sido la historia de la mujer en la disciplina. Esta es una historia de mujeres invisibles, opacadas, a quienes se les negaron las posiciones de liderazgo o se les dificultó sobremanera alcanzarlas. También expone una situación donde la negación de la mujer se llevó al extremo. Tal es el caso de la Inteligencia Artificial y el taller que le dio origen como disciplina, configurando un universo masculino que se manifiesta desde las casi nulas posiciones de liderazgo, hasta la bibliografía sesgada que es discutida en el artículo.AbstractThis contribution analyzes some dimensions of the gender gap in the ICT field. This problem cannot be fully understood without recognizing the history of women in the discipline. This is a story of invisible, opaque women, who were denied leadership positions or had great difficulty in reaching them. It also exposes a situation where the denial of women was carried to the extreme. Such is the case of Artificial Intelligence and the workshop that gave rise to it as a discipline. This birth configured a masculine universe that manifests itself from the almost null positions of leadership, to the biased bibliography that is discussed in the article.
La destrucción de la obra codificadora = The Destruction of the Coding Work
Authors: Bercovitz Rodríguez-Cano Rodrigo
Published: June 2020

La competencia legislativa que la Constitución permite a las Comunidades Autónomas con propio derecho civil para desarrollarlo requiere que el desarrollo esté justificado por los principios peculiares de aquél y por tener una conexión con su contenido normativo previo. Lo que determina que ese desarrollo legislativo no puede ser ilimitado. Tal es la doctrina del Tribunal Constitucional al interpretar el artículo 149.1.8 de la Constitución. El propio Tribunal ha venido aplicando dicha doctrina con poco rigor. Pero su Sentencia 132/2019 prescinde de esa doctrina, a pesar de que aparenta respetarla, al admitir la competencia legislativa de la Comunidad Autónoma de Cataluña para regular todo tipo de contratos, sin que la competencia exclusiva del Estado para regular las bases de las obligaciones contractuales pueda impedirlo. Con lo que se permite que las Comunidades Autónomas con propio derecho civil lo desarrollen ilimitadamente, prescindiendo del valor y del significado de nuestro Código Civil. The legislative competence that de Constitution allows the Autonomous Communities with their own civil law to develop it requires that development be justified by its peculiar principles and by having a connection with its previous normative content. What determines that this legislative development cannot be unlimited. Such is the doctrine of the Constitutional Court when interpreting article 149.1.8 of the Constitution. The Court itself has been applying this doctrine with little rigor. But his Sentence 132/2019 disregards this doctrine, despite appearing to respect it, by admitting the legislative competence of the Autonomous Community of Catalonia to regulate all kinds of contracts, without the exclusive legislative competence of the state to regulate the bases of contractual obligations may prevent it. Thus the Autonomous Communities with their own civil law are allowed to develop it unlimitedly, regardless of the value and meaning of our Civil Code.
Effect of benzo(a)pyrene on the expression of AhR-regulated microRNA in female and male rat lungs
Authors: Filippov S.V. , Yarushkin A.A. , Yakovleva A.K. , Kozlov V.V. , Gulyaeva L.F.
Published: June 2020

Smoking is the main risk factor for lung cancer, mainly due to presence of nitrosamines and polycyclic aromatic hydrocarbons, including benzo[a]pyrene (BP) in tobacco smoke composition. The genotoxic effect of BP is based on the high DNA-binding ability of its metabolites, while the epigenetic effects are mediated by a change in the expression of cancer related genes or regulatory RNAs. It has been shown that women have a higher risk to develop lung cancer upon smoking rather than men. We hypothesized that crosstalk between signaling pathways activated by BP and estrogens could underlie the sex-dependent differences in miRNAs expression. To test this hypothesis, male and female rats were subjected to short-term or long-term BP exposure. Using in silico analysis, miRNAs containing the ER- and AhR-binding sites in the promoters of the genes (or host genes) were selected. During chronic exposure of BP the expression of miR-22-3p, -29a-3p, -126a-3p, -193b-5p in the lungs of male rats were significantly increased, while the level of miRNA-483-3p were decreased. Expression of miRNA-483-3p was up-regulated during chronic BP exposure in the lungs of female rats and the levels of other studied miRNAs were unchanged. In turn, changes in the expression of miRNAs were followed by changes in the expression of their target genes, including PTEN, EMP2, IGF1, ITGA6, SLC34A2, and the observed changes in female and male rat lungs were varied. Thus, our results suggest that sex-dependent epigenetic effects of BP may be based on different expression of AhR- and ER- regulated miRNAs.
Modeling of drug-drug interactions between omeprazole and erythromycin with cytochrome P450 3A4 in vitro assay
Authors: Koroleva P.I. , Kuzikov A.V. , Masamrekh R.A. , Filimonov D.A. , Dmitriev A.V. , Zaviyalova M.G. , Rikova S.M. , Shich E.V. , Makhova A.A. , Bulko T.V. , Gilep A.A. , Shumyantseva V.V.
Published: June 2020

In the present study the electrochemical system based on recombinant cytochrome P450 3A4 (CYP3A4) was used for the investigation of potential drug-drug interaction between medicinal preparations employed for Helicobacter pylori eradication therapy. Drug interactions were demonstrated in association of omeprazole as a proton pump inhibitor (PPI) and macrolide antibiotic erythromycin during cytochrome P450 3A4-mediated metabolism. It was shown that in the presence of omeprazole the rate of N-demethylase activity of CYP3A4 to erythromycin measured by means of product (formaldehyde) formation decreased. Mass-spectrometry analysis of omeprazole sulfone as a CYP3A4-mediated metabolite demonstrated the absence of erythromycin influence on CYP3A4-dependent omeprazole metabolism. This phenomenon may be explained by lower spectral dissociation constant of CYP3A4-omeprazole complex (Kd = 18±2 μM) than that of CYP3A4-erythromycin complex (Kd = 52 μM). Using the electrochemical model of electrochemically-driven drug metabolism it is possible to register CYP3A4-mediated catalytic conversion of certain drugs. In vitro experiments of potential CYP3A4-mediated drug-drug interactions are in accordance with in silico modeling with program PASS and PoSMNA descriptors in the case of omeprazole/erythromycin combinations.
Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies
Authors: Malhotra Khushboo , Kumari Archana , Anand H. P.
Published: June 2020

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.
A study of prevalence of thyroid dysfunction in abnormal uterine bleeding
Authors: Rai Aditi , Raina Sapna
Published: June 2020

Background: Abnormal uterine bleeding (AUB) is one of the most frequent presentation to gynecology OPD. AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Thyroid disorders are more common in women than in men and cause abnormal sexual development, menstrual irregularity, infertility and premature menopause. Objective of this study was to estimate the prevalence of thyroid disorders in women in reproductive age group with AUB.Methods: A hospital based prospective cross sectional observational study was carried out in department of obstetrics and gynecology, Mazumdar-Shaw Cancer and Medical Center and Narayana Hrudayalaya Hospital at Narayana Health City, Bangalore with abnormal uterine bleeding during the period of 2 years (December 2015 to November 2017), total 153 patients were included in the study. All women with AUB in reproductive age group were included. Diagnosed cases of ovarian cyst, uterine fibroid, polyp, adenomyosis, endometriosis and malignant (endometrial and cervical) tumors were excluded. Women who are on drugs or hormone therapy (for past 3 months. IUCD users/oral contraceptives pill user. Patients with known case of thyroid disorder, carcinoma thyroid patients with history of coagulation disorder, liver disorder, renal disorder, tuberculosis.Results: A total N=115 (75.2%) of patients who took part in this study had euthyroid status. The estimated prevalence of thyroid dysfunction was 24.9%. Out of which n=22 (14.4%) had subclinical hypothyroidism, n=14 (9.2%) had overt hypothyroidism, n=2 (1.3%) had hyperthyroidism. The most common thyroid dysfunction amongst the study group was noted to be subclinical hypothyroidism (14.4%).Conclusions: There is a high prevalence of thyroid disorders in cases which are clinically diagnosed as AUB. TSH is most sensitive test in detecting thyroid dysfunction. Subclinical cases need to be treated. Hence thyroid function evaluation should be made mandatory in cases of AUB to detect thyroid dysfunction.
Contraceptive use and quality of life among women of reproductive age, attending a general outpatient clinic in a Nigerian tertiary hospital
Authors: Salam Tawakalit O. , Mosuro Olushola A. , Muyibi Sufiyan A. , Adetunji Adedotun A.
Published: June 2020

Background: In Sub-Saharan Africa, unplanned pregnancies, sexually transmitted infections (STIs) and low use of modern contraceptives are major reproductive health problems affecting women of reproductive age. However, there is evidence of an increase in contraceptive use over the past decade. This study was carried out to assess the pattern of contraceptive use, and its association with quality of life among women of reproductive age, attending a general outpatient clinic, at the University College Hospital (UCH), Ibadan, Nigeria.Methods: A descriptive, cross-sectional study conducted with 323 women aged 15-49 years for three months. Data were retrieved using a semi-structured questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS) version 23.Results: The mean age of the participants was 34.9±8 years. The prevalence of contraceptive use was 43.7%, and out which, 34.4% accounted for modern methods. At least 72.4% ever heard about a method of contraceptive. Male condom was the most heard (96.6%) and most used (39.0%) contraceptive method. Majority of the quality of life parameters had higher mean scores, with significant mean values in vitality and social functioning categories among contraceptive users (72.41±14.82 and 72.07±18.39 respectively, p=0.029) compared with non-contraceptive users.Conclusions: Despite a higher mean quality of life scores among contraceptive users, less than half of the respondents made use of contraceptives. Therefore, the need for more orientation on the use of contraceptives to promote safe sexual practice and birth control is required.
Comparative study of clomiphene citrate versus letrozole as first-line ovulation induction drug in infertile polycystic ovary syndrome women
Authors: Sahu Mahija , Rout Nihar Ranjan
Published: June 2020

Background: Polycystic ovary syndrome is the commonest endocrinopathy resulting in anovulatory infertile young women. Clomifene citrate (clomiphene) is a long-standing standard drug for ovulation induction, and is still considered as first line option in PCOS women. However, clomiphene has certain disadvantage letrozole an aromatase inhibitor acts by reducing estrogen production and has no adverse effects on endometrium and cervical mucous. Indian PCOS women have high prevalence of insulin resistance and thus are likely to have high clomiphene resistance. So letrozole could prove to be a good alternative for ovulation induction in such women.Methods: This was a prospective randomized, parallel, comparative clinical trial of two ovulation induction drugs letrozole 5 mg versus clomiphene citrate 100 mg as first-line ovulation induction drug in infertile polycystic ovarian syndrome women. The target population of the study was one hundred infertile women with PCO (taking at least 2 Rotterdam’s parameters). 50 women were allocated to clomifene citrate and 50 were allocated to Letrozole for ovulation induction. Parameters like age, duration of infertility, B MI, ovulation rate, number of follicles, pregnancy rate, endometrial thickness were noted and analyzed.Results: In letrozole group, the ovulation rate, mono-follicular development, mean endometrial thickness and pregnancy rate was better in comparison to clomifene citrate group.Conclusions: The result of this study suggests that letrozole may replace clomiphene as the first line drug for ovulation induction in infertile PCOS women.
Clinical study of gestational trophoblastic disease in a tertiary care hospital
Authors: Mulik Jayashree , Choudhary Archana
Published: June 2020

Background: Gestational trophoblastic diseases (GTDs) had been associated with significant morbidity and mortality till recently. Wide variation in incidences have been reported worldwide. The present study was planned with the objective of determination of incidence, assessment of risk factors, clinical presentation, management protocols and outcomes in GTD cases in Indian population at a tertiary care centre.Methods: All the diagnosed cases of GTD reporting to study centre during study period of 1.5 years were included. Detailed history taking, examination and relevant investigations (Hb%, blood grouping, thyroid functions, serum ß-hCG, USG and chest X-ray) were undertaken. Suction and evacuation were done for all patients as primary mode of management and samples were sent for histopathological examination. Comprehensive follow ups were done, including weekly ß-hCG until normal for 3 consecutive weeks followed by monthly determination until the levels were normal for 6 consecutive months.Results: Total 22 cases out of 19500 deliveries were diagnosed as GTD (incidence rate-1.13/1000 deliveries). Mean age was 23.64±3.89 years with 50% participants being primigravida. The commonest symptom after amenorrhea 22 (100%) was bleeding per-vaginum 15 (68.2%). Maximum cases were of complete hydatidiform mole histopathology 16 (72.73%), USG 19 (86.4%). Clinical characteristics were statistically comparable between patients of complete mole and partial mole. Out of 22 cases, 1 (4.5%) was diagnosed as GTN.Conclusions: Early diagnosis and treatment along with regular follow up is the key in GTD. There is need to establish a centralized disease specific registry in future.
Preterm deliveries and progesterone levels in pregnant women attending antenatal care in a health care facility in Sokoto state, Nigeria: a preliminary study
Authors: Sadiq Mas’ud E. , Abubakar Aminu L. , Lawal Almustapha , Ahmad Alkassim H. , Sada Nafisa
Published: June 2020

Background: Progesterone related complication during pregnancy is currently being viewed as one of the underlying causes of miscarriages and preterm deliveries. Progesterone assay is often neglected during routine screening in antenatal clinics (ANC) in primary health care centres in Nigeria. This study was designed to monitor 40 volunteer expecting mothers between the ages 18-35 years with a history of child birth and to evaluate serum progesterone levels accordingly for pregnancy in second and third trimesters.Methods: Volunteers were categorized according to their age and stage of pregnancy. Progesterone was estimated in serum collected from each volunteer using ELISA kits (Cayman chemicals, USA).Results: The results showed that age disparity among subjects did not play a role in the observed progesterone levels in both trimesters. Second trimester progesterone levels (37.73±0.32 ng/ml) were closest to lower limits of reference ranges for second trimester pregnancy (25.60-89.40 ng/ml). However, third trimester average serum progesterone levels of 36.31±0.26 ng/ml fell below minimum values of 42.50 ng/ml expected in normal pregnancy. Three preterm deliveries were recorded among the monitored subjects while an incidence rate of 1:32 births was observed for all deliveries received at the facility within the five months period all monitored subjects gave birth.Conclusions: The preponderance of low gestational progesterone constitutes a risk factor to delivery at term. It is recommended that local ANC programme include progesterone monitoring and therapy as an intervention strategy against preterm births.
Meckel-Gruber syndrome: a rare and lethal foetal anomaly
Authors: Jondhale Parikshit , Marda Mohit , Bangal Vidyadhar B. , Bagdi Nikita
Published: June 2020

Meckel-Gruber syndrome (MGS) is a rare and lethal autosomal recessive disorder characterized by occipital encephalocele, postaxial polydactyly and bilateral dysplastic cystic kidneys. It can be associated with many other congenital malformations. The incidence of Meckel-Gruber syndrome ranges between 1 in 13,000 to 4,00,000 live births. Antenatal ultrasound examination establishes the diagnosis by identifying at least two of the major features. A case is presented that describes a baby with ambiguous genitalia, who presented with the triad of Meckel-Gruber syndrome. The baby died shortly after birth.
Case report on toxicity of methotrexate in tubal ectopic pregnancy
Authors: Lodha Surbhi , Mali Kimaya
Published: June 2020

Ectopic pregnancy is defined as pregnancy outside uterine cavity. Of all ectopic pregnancy, tubal ectopic is most common. Most cases today are diagnosed early and hence timely treatment is possible. In stable patients, medical line of management with methotrexate can be used. With early diagnosis and medical line of treatment, use of injectable methotrexate is on rise. Being aware of characteristics of methotrexate like mechanism, dosage, side effects and contraindications, appropriate patient selection and watchful monitoring will help reduce methotrexate induced toxicity.
The role of Helicobacter pylori in preeclampsia and in gastric diseases in pregnant women
Authors: Sabah Hasan Jehan , Alshami Mohammed Ahmed
Published: June 2020

Background: Helicobacter pylori is a gastric organism was first observed more than 100 years ago. It may cause chronic gastritis, peptic ulcers and gastric adenocarcinoma and lymphoma. It can produce some extragastric disorders including preeclampsia. This study aimed to focus on the importance of H. pylori and its relationship with preeclampsia and gastric illnesses in pregnant patients.Methods: This study includeed 100 pregnant women, half of them were healthy and the other half with preeclampsia. Patients with chronic medical illnesses were excluded. Data was collected and laboratory investigations were done including that for H. pylori. Oesophagogastroduodenoscopy then was done 6 weeks post-delivery or termination of pregnancy for symptomatic H. pylori positive women.Results: 50% of the total number were healthy, 17% had mild preeclampsia, 33% suffering from severe preeclampsia. Seropositivity for H. pylori is significantly higher in preeclampsia and significantly related to severity of preeclampsia and complications of pregnancy. Positive H. pylori test in stool was seen in (45%) of total number of patients. Epigastric pain persist in 41 (91%) of patients with positive H. pylori test in stool. Gastritis, duodenal ulcer, and gastric ulcer were found in 85.3%, 12.1% and 2.4% of symptomatic patients respectively.Conclusions: Significant correlation between Helicobacter pylori seropositivity and preeclampsia may indicate the benefit of using this parameter in the prediction and management of preeclampsia and its severity. H. pylori infection plays an important role in gastric pathologies in pregnant women that can be dealt with or may be prevented more efficiently in future.
Study of percutaneous endoscopic gastrostomy compared to nasogastric tube feeding in patients requiring prolong enteral nutritional support
Authors: Gedam Manik C. , Mankar Yogesh D. , Samala Devdas S. , Ingale Leena Y. , L. Lavanya , Sagrule Dhiraj D.
Published: June 2020

Background: The aims and objectives of this article were to compare the advantages, disadvantages associated with percutaneous endoscopic gastrostomy (PEG) and nasogastric (NG) tube and also to compare complications, to measure the outcomes in terms of hospital stay, mortality and improvement in nutritional status.Methods: In this prospective and interventional study 25 patients were selected in each group on an alternate basis. Study was conducted on cases of traumatic brain injury and cerebrovascular accident patients admitted in Department of General Surgery, IGGMC for a period of November 2013- November 2015 with a need to provide prolonged enteral nutritional support. Each patient was assessed by a dietician and received a standard enteral feeding according to their body weight. The main outcome was measures at 4 weeks were complications (tube dislodgement, aspiration pneumonia, tube blockade and peristomal infections) and nutritional status.Results: The anthropometric parameters (mid arm circumference, biceps skin fold thickness and triceps skin fold thickness) and serum albumin showed a rise in PEG group at 4 weeks when compared to baseline (0 week) whereas they showed a decline in NG group at follow up (4 weeks). The NG group has got higher mortality 4 (17%) when compared to PEG group 2 (7%) due to aspiration pneumonia. Hence, PEG is better tolerated with lesser complications better nutritional support as assessed by the anthropometric parameters at 4 weeks.Conclusions: We conclude that whenever feasible percutaneous endoscopic gastrostomy (PEG) feeding is a choice over nasogastric (NG) feeding in patients requiring long term enteral support.
Role of prophylactic antibiotics in elective surgeries and postoperative surgical infections
Authors: Asif Ali S. , Ehtesham Afzal M.
Published: June 2020

Background: Health care associated infections (HAIs) present a significant source of preventable morbidity and mortality. More than 30% of all HAIS are represented by surgical site infections (SSIs) making them most common sub types between 1.9% and 2.7% of all surgical patients. Joseph Lister “the man who made surgery safe” introduced antiseptic method for safe surgeries. As many are now considering antibiotics “wonder drug” which covers the surgical techniques and having asepsis. Extensive indiscriminate use of antibiotics has resulted in developing resistance.Methods: Study conducted in about 100 cases in various surgical units having various surgical procedures. Only clean cases are taken. A single stat dose of first generation cephalosporin 1gm given IV at the time of giving anesthesia. Postoperative any signs and symptoms like infections, fever with chills, wound discharge are observed. If any evidence of wound infection is present, accordingly sent for culture and sensitivity and suitable antibiotics are given.Results: In our study 5 patients had fever with serous discharge 2 patients showed no growth, 3 patients had got growth positive (2- staphylococcus aurous, 1- pseudomonas). Hence our infection rate is 3%.Conclusions: Single dose prophylaxis has got definite advantage to overcome the postoperative wound sepsis. Prolonged antibiotic therapy should be avoided as it has got no added advantaged over single dose antibiotic.
Resectable locally advanced gastric adenocarcinoma: interim analysis
Authors: Shanmugam Subbiah , Kishore Prem
Published: June 2020

Background: The MAGIC and ACCORD 07 trials have established the role of perioperative chemotherapy in locally advanced gastric adenocarcinoma. A more recent study has demonstrated the superiority of the FLOT perioperative regimen. The best strategy to improve outcomes has yet to be determined. Aims of the study were to evaluate perioperative chemotherapy in terms of morbidity and tolerance of FLOT regimen with modification and histopathological responseMethods: This prospective study was started after ethical committee approval in February 2019 at a tertiary cancer center in South India for a period of 1 year up till February 2020. Patients fulfilling inclusion criteria were enrolled. Perioperative chemotherapy was given as scheduled regimen and adverse effects and response to preoperative chemotherapy were recorded. Radical D2 gastrectomy and histopathology assessed analysed by using IBM SPSS statistics ver. 21 and descriptive statistics used.Results: From February 2019 till February 2020, a total of 24 patients of newly diagnosed adenocarcinoma of the stomach of which 18 patients were nonmetastatic on workup. Moderately different (38.8%), well-differentiated in 11.2%, poorly differentiated in 50%. Total 66.7% were diagnosed as metastatic on staging laparoscopy, peritoneal wash cytology in 50% was negative. The cardiopulmonary resuscitation was seen in two patients.Conclusions: Even though it is an interim analysis with less number of patients enrolled, so far it can be concluded that all patients where surgery is planned should undergo peritoneal lavage cytology and FLOT regimen can be practised with acceptable morbidity. Long term results after completion of study will definitely throw more light.
Incidence of complications following non-watertight dural reconstruction with a non-suturable, absorbable collagen matrix onlay graft in elective cranial surgery
Authors: Ali Asman , Saha Debadatta
Published: June 2020

Background: Collagen matrices are effective duraplasty grafts with increasing acceptability. However, little evidences exits for dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Purpose of our retrospective analysis was to advance our understanding of the use of semisynthetic collagen as dural substitute in elective cranial surgery.Methods: A consecutive series of sixty patients who underwent elective cranial surgery, where non-watertight dural reconstructions were done with a non-suturable, absorbable collagen matrix onlay graft, has been analysed retrospectively.Results: Overall, the most common indication for duraplasty was tumor resection (93.3%). CSF leak rate was 10.0%. Incidence of aseptic meningitis was 8.3% and all cases has been resolved with steroids alone. Similarly, postoperative surgical site infection rate was 8.3%. Incidence of pseudomeningocele in follow-up was 6.7%. Only in one case (1.7%), permanent CSF (cerebrospinal fluid) diversion was needed due to troublesome CSF leak with associated hydrocephalus.Conclusions: Semisynthetic, monolayer collagen matrix used as an onlay dural graft is a simple, yet an attractive alternative in duraplasty due to their easy handling, lower surgical time, and high biocompatibility, where primary dural closure is undesirable or not feasible. Our study provides greater insight into non-water tight duraplasty procedure.  However, further study is needed to determine the optimal strategy for dural reconstruction. Data from this study may be used to compare alternative methods of dural reconstruction in elective cranial surgery.
Renal profile of COVID-19 infected patients admitted in a tertiary care hospital in Western Rajasthan
Authors: Sharma Pradeep K. , Aggarwal Vikas , Sapariya Naresh , Baweja Shekhar , Nagori Rupesh , Chabbra M. K.
Published: June 2020

Background: A recent cluster of pneumonia cases all over the world including India, is caused by a novel beta coronavirus, the 2019 novel coronavirus (2019-nCoV). The objective of this study was to observe the effect on renal profiles at admission of these COVID-19 infected patients.Methods: All the patients were admitted to Dr. S. N. Medical College and Hospital, Jodhpur, a tertiary care hospital of Western Rajasthan and were tested for COVID-19 by real time reverse transcription polymerase chain reaction assay of 2019-nCoVRNA. All data in relation to patients including blood renal profile were collected from data collection form from electronic medical records and history given by COVID-19 infected patients admitted.Results: Out of total 300 COVID-19 patients, majority of patient were male i.e. 210 (70%) and majority of the patients 70% were below 60 years of age. The underlying diseases were present in 98 (32.67%) patients. Cough was the most common symptom (80%) followed by fever (72%) in out of 180 (60%) symptomatic patients. 64 (21.3%) patients had deranged renal function tests with abnormal blood urea nitrogen and serum creatinine. Overall, 56 patients (18.6%) without chronic kidney disease showed mild increase of BUN or serum creatinine. 35 patients (11.6%) had high blood urea nitrogen and 18 patients (6%) had raised creatinine.Conclusions: In setting of COVID-19 infected patient’s presentation, renal profile remained essentially normal with deranged RFT seen in patients with comorbidities. Nevertheless, the renal function of patients with COVID-19 needs to be monitored regularly, especially in patients with elevated plasma creatinine.
Ramifications of coronary angiography with effect to time comparing two groups: undergoing off pump coronary artery bypass grafting within or more than seven days of coronary angiography
Authors: Loona Manpal , Mahant T. S.
Published: June 2020

Background: Acute kidney injury (AKI) following off pump coronary artery bypass grafting (OPCABG) within short interval from coronary angiography (CAG) has been well documented. This prospective study is aimed to delineate perioperative effects and effects of elective 7 days interval between CAG and off pump CABG, to observe its outcome on renal functions.Methods: The present study was conducted in a total of 1102 consecutive patients who underwent coronary angiography following coronary artery bypass surgery in Fortis hospital, Mohali. Patients were divided into 2 groups - group A (patients undergoing CABG within 7 days of CAG) and group B (patients undergoing CABG beyond 7 days of CAG). Comparison was made between the two groups, in relation to the timing between CAG and CABG, with its impact on perioperative renal functions.Results: Statistically it was found highly significant higher values of 1st and 3rd day serum creatinine and high incidence of postoperative AKI in patients of group A in comparison to patients of group B.Conclusions: Thus, our study confirms that patients with a shorter interval between CAG and subsequent OPCAB are more likely to present higher peak creatinine level as well as lower minimum eGFR. A gap of 7 days for elective cases is more likely to present less postoperative AKI.
General surgeon’s experience in managing extra pelvic endometriosis
Authors: Sapiee Muhammad Eimaduddin , Ramli Roziana , Waheeda Alias Nor Syahaniza , M. Zailani
Published: June 2020

Two unusual cases of extrapelvic endometriosis are discussed here. Both presented themselves to the general surgeons. Case 1 presented with cyclical painful abdominal wall mass at the left iliac fossa region. Ultrasound and computed tomography scan showed a solitary mass at the subcutaneous region and fine needle aspiration cytology revealed endometriosis. The patient underwent wide surgical excision and recovered. Case 2 presented with painless swelling at the left inguinal area whilst being pregnant. Surgical exploration was performed for ‘left inguinal hernia’ but an encysted mass was found in the inguinal canal which was excised. Histopathological examination reported endometriosis. Both cases were subsequently under gynaecological follow-up. It is important for the surgeons to include endometriosis as one of the differential diagnosis in the management of their female patients with mass or swelling.
Managing lip large papilloma extirpation defect by arterialized advancement vermilion flap
Authors: Sahai Rahul , Singh Sudhir
Published: June 2020

The close resemblance of squamous papilloma with verrucous carcinoma and the chief etiological factor associated with its development, the human papillomavirus (HPV) raises a doubt about its close association with malignancy. The best way to treat HPV growths is surgical removal and assessment of lesion by histopathology. The defect needs reconstruction with full function and aesthetic outlook. Thirty-seven years old young man with history of tobacco chewing developed slow growing papilloma in upper lip in one year. It was excised fully and the defect was repaired by arterialized lip vermilion mucosal flap based on slightly tortuous labial vessel and so the flap could be elastically stretched even up to fifty percent of lip length and applied successfully. Same patient developed papilloma in lower lip as a separate primary after two years of nonrecurrence of previous operated upper lip papilloma. Lower lip lesion was excised similarly and repaired with same type of vermilion mucosal advancement flap from adjacent part of lower lip defect created. The post-operative period was uneventful and after three years of last operation there is no recurrence in either lip. Vermilion flap which is based on labial artery containing composite tissue comprising of mucosa and portion of orbicularis muscle mainly has been utilized to reconstruct the post excision papilloma lip defect with excellent functional and aesthetic results. There was no microstomia. It is single stage not involving donor site like tongue or cheek mucosa and is good upto half of lower lip defects.
Stump appendicitis
Authors: Vagholkar Ketan
Published: June 2020

Appendectomy is one of the commonest abdominal operation performed all over the world. Stump appendicitis is one of the uncommon complications of appendectomy. The diagnosis of stump appendicitis is delayed due to low index of suspicion by virtue of the fact that an appendectomy has already been done. The clinical presentation exactly simulates acute appendicitis. Contrast enhanced computed tomography is diagnostic. Completion appendectomy either open or laparoscopic is the mainstay of treatment. Awareness regarding the possible aetiology, diagnosis and management is essential for avoiding delay in the diagnosis.
Persistent adenoids and their secondary effects
Authors: Rangaiah Sowmya Tumkur , Bhat Vikram Kemmannu , Yadav Mona
Published: June 2020

Background: Regression of adenoids is assumed to be a physiological phenomenon at puberty. However, it has been found that it can persist well beyond adolescence into early adulthood, cascading a series of after effects in the upper respiratory tract that can cause considerable morbidity leading to public health problems. This study aimed to explore the clinicopathological features of persistent adenoids and their secondary effects on the upper respiratory tract.

Methods: This was a prospective controlled study of 100 eligible patients in the age group of 15-60 years presenting with enlarged adenoids confirmed by nasal endoscopy. Equal number of controls without enlarged adenoids was also taken. Both the groups were evaluated for secondary effects like chronic rhinosinusitis, otitis media with effusion, chronic otitis media and Eustachian tube dysfunction. The relationship between adenoid enlargement in adults and secondary effects was analysed statistically.  

Results: Seventy-seven patients with persistent adenoids had some or the other secondary effect. Eustachian tube dysfunction was present in 21, otitis media with effusion in 10, chronic otitis media in 29 and chronic rhinosinusitis in 33. In the control group only 46 had secondary effects. The association between the presence of adenoids and secondary effects was statistically significant.

Conclusions: Adenoids can persist into early adulthood and majority of them can have secondary effects. Chronic rhinosinusitis was the commonest in this study. Careful evaluation by means of nasal endoscopy is required to identify them. This is crucial for the timely treatment of this condition in order to prevent the associated secondary effects.
Growing incidence of fungal flora in mucosal chronic otitis media
Authors: Singh Priyanka , Gupta Ankur , Sen Kanwar
Published: June 2020

Background: Chronic otitis media (COM) is commonly encountered chronic inflammation of the middle ear cleft caused by dysfunction of Eustachian tube followed by microbial infection. Fungal infections superimposed over COM are suspected when the discharging ear does not respond to the local antibiotic ear drops. Many authors have focused their attention on the bacterial flora of COM but very little is known about the mycological aspects.

Methods: Ear discharge or scrapings of debris were collected from one hundred patients of active mucosal COM in whom discharge persists after two weeks of medical management and sent to the microbiology laboratory for microscopic examination and fungal culture.  

Results: Fifty seven percent cases had positive fungal KOH mount whereas fungal culture demonstrated Aspergillus flavus in 15 cases, Aspergillus niger in 38 cases and Candida albicans in 4 cases.   

Conclusions: We conclude that the fungal isolation rate is very high among the patients who did not respond to antibiotic therapy and therefore, culture and sensitivity of discharge and removal of the focus of infection should be sought before using topical drops in cases of persistent otorrhoea.