bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressão entre idosos: um estudo de base populacional no Sul do Brasil
Authors: Gullich Inês , Duro Suele Manjourani Silva , Cesar Juraci Almeida
Published: January 2017

RESUMO: Este estudo mediu a prevalência e identificou fatores associados à ocorrência de depressão entre idosos em Arroio Trinta, Santa Catarina. Aplicou-se questionário domiciliar a todos aqueles com 60 anos ou mais de idade residentes nesse município em 2013. O desfecho foi avaliado pela Escala de Depressão Geriátrica Reduzida (EDG-15). Utilizou-se teste do χ2 para comparar proporções e regressão de Poisson com ajuste robusto da variância na análise multivariável. A medida de efeito utilizada foi a razão de prevalências. A prevalência de depressão entre os 552 (de 568) idosos estudados foi de 20,4% (IC95% 17,3 - 23,8). Após análise ajustada conforme modelo hierárquico previamente definido, verificou-se maior razão de prevalências para depressão no sexo feminino, entre solteiros, de menor renda familiar, fumantes e que haviam sido hospitalizados nos 12 meses anteriores à entrevista. Participar de atividades coletivas de lazer, como baile e culto religioso, ou realizar atividade física regular mostraram-se protetores à ocorrência de depressão. Os resultados obtidos neste estudo revelam a necessidade e a possibilidade de tratamento e manejo dessa doença em nível coletivo.
Uso do diagnóstico principal das internações do Sistema Único de Saúde para qualificar a informação sobre causa básica de mortes naturais em idosos
Authors: Cascão Angela Maria , Jorge Maria Helena Prado de Mello , Costa Antonio José Leal , Kale Pauline Lorena
Published: January 2017

RESUMO: Introdução: Causas mal definidas de morte destacam-se entre idosos devido à alta frequência de comorbidades e consequente dificuldade de definir a causa básica. Objetivo: Analisar a validade e a confiabilidade da informação “diagnóstico principal” da internação hospitalar para recuperação da causa de morte natural de idosos que tiveram originalmente “causas mal definidas” como causa básica nas Declarações de Óbito, ocorridas no estado do Rio de Janeiro, em 2006. Métodos: As bases de dados obtidas dos Sistemas de Informações sobre Mortalidade e de Internação Hospitalar foram relacionadas probabilisticamente. Foram calculados percentuais de concordância, coeficiente Kappa, sensibilidade, especificidade e valor preditivo positivo do diagnóstico principal da internação de idosos que evoluíram para óbito por causas naturais. Óbitos por “causas mal definidas” tiveram uma nova causa definida a partir do diagnóstico principal. Resultados: A confiabilidade do diagnóstico principal foi boa, segundo a concordância percentual total (50,2%), e razoável, conforme o coeficiente Kappa (k = 0,4; p < 0,0001). Doenças do aparelho circulatório e neoplasias ocorreram com maior frequência entre os óbitos e as internações e apresentaram maior concordância e valores preditivos positivos por capítulo e agrupamento da Classificação Internacional de Doenças. A recuperação da causa básica ocorreu em 22,6% dos óbitos por causas mal definidas (n = 14). Conclusão: A metodologia desenvolvida e aplicada para recuperação da causa natural de óbito entre idosos neste estudo tem como vantagens a efetividade e a redução dos custos provenientes de uma investigação do óbito. Esta é recomendada nas situações de registros não relacionados e de baixo valor preditivo positivo. O monitoramento do perfil de mortalidade por causas é necessário para atualização periódica dos valores preditivos.
Melhora na qualidade e completitude da base de dados do Registro de Câncer de Base Populacional do município de São Paulo: uso das técnicas de linkage
Authors: Peres Stela Verzinhasse , Latorre Maria do Rosário Dias de Oliveira , Tanaka Luana Fiengo , Michels Fernanda Alessandra Silva , Teixeira Monica La Porte , Coeli Claudia Medina , Almeida Márcia Furquim de
Published: January 2017

RESUMO: A disponibilidade de grandes bases de dados informatizadas em saúde tornou a técnica de linkage uma alternativa para diferentes tipos de estudos, proporcionando a geração de uma base de dados mais completa e de baixo custo operacional. Objetivo: Melhorar a qualidade e a completitude dos casos incidentes de câncer por meio dos linkages probabilístico e determinístico entre o Registro de Câncer de Base Populacional de São Paulo (RCBP-SP), o banco de dados de óbitos e de Autorização e Procedimentos de Alta Complexidade. Método: Foi utilizado o banco de dados do RCBP-SP, composto de 343.306 casos de câncer incidentes no município de São Paulo entre 1997 e 2005, com idades entre 1 e 106 anos, de ambos os sexos. Para o linkage foram utilizadas três bases de dados, a saber: do Programa de Aprimoramento de Mortalidade no Município de São Paulo (PRO-AIM), da Fundação SEADE e da Autorização e Procedimentos de Alta Complexidade/Custo do Sistema de Informação Ambulatorial do Sistema Único de Saúde (APAC-SIA/SUS). Foram analisadas os coeficientes brutos de incidência (CBI) e mortalidade (CBM) e a sobrevida global pela técnica de Kaplan-Meier. Resultados: Após o linkage, verificou-se um ganho de 4,3% para a CBI e 25,8% para a CBM. Na análise de sobrevida global antes do linkage havia uma subestimação da probabilidade de estar vivo para todas as variáveis analisadas (p < 0,001). Conclusão: As técnicas de linkage contribuíram para a melhora da qualidade da informação do RCBP-SP tanto na completitude das variáveis quanto na definição do status vital do paciente, refletindo a capacidade das bases de dados, quando trabalhadas de maneira conjunta, de fornecerem subsídios para diversos tipos de estudos e informações para o planejamento de ações políticas e estratégicas.
Bullying e fatores associados em adolescentes da Região Sudeste segundo a Pesquisa Nacional de Saúde do Escolar
Authors: Mello Flávia Carvalho Malta , Malta Deborah Carvalho , Prado Rogério Ruscitto do , Farias Marilurdes Silva , Alencastro Lidiane Cristina da Silva , Silva Marta Angélica Iossi
Published: January 2017

RESUMO: Objetivo: Estimar a prevalência de bullying, sob a perspectiva da vítima, em escolares da Região Sudeste e analisar sua associação com variáveis individuais e de contexto familiar. Métodos: Analisadas informações de 19.660 adolescentes da Pesquisa Nacional de Saúde do Escolar (PeNSE), calculando-se associação entre bullying e variáveis sociodemográficas, comportamentos de risco, saúde mental e contexto familiar. Foram realizadas análises multivariadas e efetuado cálculo odds ratio (OR), com respectivos valores de intervalo de confiança (IC95%). Resultados: A prevalência de bullying foi de 7,8% (IC95% 6,5 - 9,2). Após o ajuste, foi constatada a sua associação com: os escolares menores de 13 anos (OR = 2,40; 1,4 - 3,93) (p < 0,001); a proteção para estudantes de 14, 15 e 16 anos (p < 0,0001); o sexo masculino (OR = 1,47 IC95% 1,35 - 1,59); a cor preta (OR = 1,24 IC95% 1,11 - 1,40); a cor amarela (OR = 1,38 IC95% 1,14 - 1,6); os alunos de escola privada (OR = 1,11 IC95% 1,01 - 1,23) e os alunos que trabalham (OR = 1,30 IC95% 1,16 - 1,45). Maior escolaridade das mães mostrou-se fator protetor em todas as faixas. Foram considerados de risco: sentir-se sozinho (OR = 2,68 IC95% 2,45 - 2,94), ter insônia (OR = 1,95 IC95% 1,76 - 2,17), não ter amigos (OR = 1,47 IC95% 1,24 - 1,75), sofrer agressão física dos familiares (OR = 1,83 IC95% 1,66 - 2,03), faltar às aulas sem avisar aos pais (OR = 1,23 IC95% 1,12 - 1,34), além de supervisão familiar (OR = 1,14 IC95% 1,05 - 1,23). Como fator de proteção, ter bebido nos últimos 30 dias (OR = 0,88 IC95% 0,8 - 0,97). Conclusão: O bullying amplia as vulnerabilidades entre escolares, o que sugere necessidade de uma abordagem intersetorial na busca de medidas para sua prevenção.
Notas de um diário de crítica
Authors: Lins Álvaro
Published: January 2017

Resumo: Após iniciar a leitura da edição brasileira do livro Nietzsche de Crane Brinton, publicada em 1942, Álvaro Lins insurge-se contra a interpretação leviana do filósofo alemão por parte do historiador norte-americano.
Lou Salomé - A mulher a quem Nietzsche amou
Authors: Monzie A. de
Published: January 2017

Resumo: Partindo de uma referência inicial à tese que nomeia um de seus livros (As viúvas abusivas, 1937), o autor busca explorar o caráter de Lou-Andreas Salomé a partir da obra que ela publicou sobre Nietzsche. A "interpretação testamentária" de Lou sobre a personalidade do filósofo alemão em 1893 revelaria não a Nietzs- che, mas a psicologia de uma "coquete estudiosa", uma "sereia calculista", cujo "cinismo frio" seria, no mínimo, odioso.
Nietzsche contra osjudeus
Authors: Magalhães Neto Couto de
Published: January 2017

Resumo: Criticando o caráter incongruente de algumas teses da Genealogia da moral (a aristocracia e a plebe, o ódio judeu e o amor cristão, a superioridade racial dos árias e os valores da democracia), bem como explorando a insuficiência das concepções de super-homem e de eterno retorno, o autor busca mostrar que o pensamento de Nietzsche tem um caráter destrutivo, sendo ele o principal responsável pela desordem e anarquia existentes no mundo. Na tentativa de ocupar o lugar dos sacerdotes judeus com uma reflexão que se distancia de Deus e prefere os valores decadentes da cultura e da civilização, o filósofo não somente teria nos precipitado no caos, mas, sem conseguir resolver a questão da felicidade humana, seria ele próprio conduzido à irracionalidade. Artigo dividido em três partes, publicadas em três domingos consecutivos, ele é concluído com uma ironia: seria desejável que Nietzsche retornasse à vida para ver os danos que seu pensamento trouxe para nós.
Nietzsche no Brasil (1933-1943): Da ascensão do nacional- socialismo ao Grande Reich Alemão
Authors: Rubira Luís ,   UFPel,  Brazil
Published: January 2017

Resumo A recepção do pensamento de Nietzsche pela inteligência brasileira, entre o início da década de 1930 e a véspera do centenário de seu nascimento, constitui o tema do presente ensaio. Para tanto, busca-se analisar aproximadamente cinco dezenas de artigos que surgiram na imprensa nacional, dos quais dezoito foram trazidos ao público em sua íntegra nos Cadernos Nietzsche. Para bem compreender o debate, investiga- se também o papel desempenhado pelas traduções de livros de intérpretes do filósofo e das primeiras traduções das obras de Nietzsche editadas no Brasil. Em meio à complexidade de abordagens do pensamento nietzschiano entre nomes expressivos do cenário intelectual brasileiro, acaba por transparecer que muitos deles dissociaram o vínculo entre o nome do filósofo e o nazismo, reconhecendo-o como o pensador que antecipara as tensões imanentes do século XX - o "homem que foi um campo de batalha", tal como definiu Mário Ferreira dos Santos no prefácio que escreveu em 1943 para a sua tradução de A vontade de Potência.
Predatory activity of Butlerius nematodes and nematophagous fungi against Haemonchus contortus infective larvae
Authors: Silva Manoel Eduardo da , Uriostegui Miguel Angel Mercado , Millán-Orozco Jair , Gives Pedro Mendoza de , Hernández Enrique Liébano , Braga Fabio Ribeiro , Araújo Jackson Victor de
Published: January 2017

Abstract The purpose of this study was to evaluate the predatory activity of the nematode Butlerius spp. and fungal isolates of Duddingtonia flagrans, Clonostachys rosea, Arthrobotrys musiformis and Trichoderma esau against H. contortus infective larvae (L3) in grass pots. Forty-eight plastic gardening pots containing 140 g of sterile soil were used. Panicum spp. grass seeds (200 mg) were sown into each pot and individually watered with 10 mL of tap water. Twelve days after seeding, the pots were randomly divided into 6 groups (n=8). Two thousand H. contortus infective larvae (L3) were added to each group. Additionally, the following treatments were established: Group 1 – 2000 Butlerius spp. larvae; group 2 – A. musiformis (1x107 conidia); group 3 – T. esau (1x107 conidia); group 4 – C. rosea (1x107 conidia), group 5 – D. flagrans (1x107conidia) and Group 6 – no biological controller (control group). The larval population of H. contortus exposed to Butlerius spp. was reduced by 61.9%. Population reductions of 90.4, 66.7, 61.9 and 85.7% were recorded in the pots containing A. musiformis, T. esau, C. rosea and D. flagrans, respectively. The results of this study indicate that the predatory nematode Butlerius spp. and the assessed fungi display an important predatory activity can be considered suitable potential biological control agents.
Formation of calcium aluminate hydrates in Portland cement modified by organic admixtures
Authors: Zhang Guofang , Wang Peiming , Xu Linglin , Li Haoxin , Yu Long
Published: January 2017

The formation of calcium aluminate hydrates in Portland cement pastes modified with two organic admixtures, hydroxyethyl methyl cellulose (HEMC) and ethylene-vinyl acetate redispersible polymer powder (EVA), was evaluated by using X-ray diffraction analysis. The results show that both the HEMC and the EVA retard the formation of ettringite and postpone the time to reach maximum ettringite content. However, the stability of ettringite is enhanced and the conversion of ettringite to monosulfate (AFm) is delayed by these two organic admixtures to retain a higher ettringite content in cement pastes at later hydration time. With calcite powders contained in EVA as the anti-blocking agents, the formation of two AFm phases, hemicarboaluminate and monocarboaluminate, is promoted by EVA after 3 d of hydration. Accordingly, more types of calcium aluminate hydrates coexist in the cement paste modified with EVA than in the control paste or in cement paste modified with HEMC. Also, having been synchronously mixed in the cement paste, these two organic admixtures have obvious superposition effects on the formation and evolution of calcium aluminate hydrates.
Strength of precast concrete shear joints reinforced with high-strength wire ropes
Authors: Joergensen Henrik B. , Hoang Linh C. , Hagsten Lars G.
Published: January 2017

This paper concerns the in-plane shear strength of connections between precast concrete wall elements reinforced with looped high-strength wire ropes. The looped wire ropes are pre-installed in so-called ‘wire boxes’ which function as shear keys. Although only a small amount of research on the shear strength of such connections can be found in the literature, this type of connection is increasingly being used because wire ropes are much more construction-friendly than traditional U-bars. A rigid plastic upper bound model for the shear strength of wall connections reinforced with looped wire ropes that are pre-installed in wire boxes is presented along with test results on the shear strength of connections with double-wire boxes. It is shown that the plastic solution agrees well with both the obtained test results and results from previously conducted tests.
Early and late outcomes of trans-abdominal pre-peritoneal and Lichtenstein repair for inguinal hernia, a comparative study
Authors: Latif Bahram Mahmoud Abdel
Published: January 2017

Background: Surgical repair of inguinal hernia remains a common operation in general surgery. No consensus has been achieved on the best surgical technique of inguinal herniorrhaphy. Open repair has lower recurrence and complication rates. Laparoscopic approach has less postoperative pain, reduced recovery time, earlier return to activity and fewer wound complications but expose the patient to potential complications, mainly possibility of visceral injury. The aim was to compare early and late outcomes after TAPP and lichtenstein repair.Methods: Three hundreds patients with inguinal hernia were enrolled in this study, divided into two equal groups:  Group I managed by trans-abdominal pre-peritoneal laparoscopic repair (TAPP) and Group II managed by open lichtenstein repair (LR).Results: The operative time was significantly lower in TAPP than LR (50±18.98 min and 75±24.54 min respectively). TAPP has a significant advantage to diagnose and repair contra-lateral inguinal hernia (11.5%) and to repair concomitant umbilical hernia (7.3%). No significant difference between both groups regarding intra-operative visceral injury, ileus, hospital stay or wound complications. TAPP significantly decreased post-operative pain and groin hypothesia, shorten the duration needed to return to activities (7±3 days and 16±5 days respectively). There was no significant difference between both groups regarding the recurrence (4.2% and 2% respectively).Conclusions: TAPP technique is an excellent approach for treatment of inguinal hernia in comparison to LR either unilateral or bilateral, primary or recurrent inguinal hernia with low morbidity and recurrence comparable to that of LR with advantages of less post-operative pain and early return to activities.
Relationship between initial fibrinogen level with coagulopathy and mortality in multiple trauma patients
Authors: Rudiman Reno , Sulistyanti Lyana , Usman Nurhayat
Published: January 2017

Background: In trauma induced coagulopathy (TIC), low fibrinogen value is often found and plasma fibrinogen reached low value earlier than other parameters of coagulation factors. Initial fibrinogen value is strongly correlated to the injury severity score (ISS) and be an independent predictor of mortality. This study was expected to see the relationship between initial fibrinogen level with coagulopathy and mortality, so it can predict early coagulopathy and can prevent bleeding complications that lead to mortality. Methods: The study was conducted prospectively. The entire examination obtained from patients with multiple trauma. Fibrinogen levels and coagulopathy were taken from the blood laboratory tests in conjunction with other routine examination when patients were admitted to the ER of Hasan Sadikin General Hospital. Outcome parameters were the incidence of coagulopathy and mortality. Statistical analyses were performed to look at the significance of relationships.Results: Of the 25 patients with multiple trauma obtained a majority of 80% were male patients and with the highest incidence mechanism was head trauma as many as 16 people (64%). There were 8 patients (32%) experienced coagulopathy and mortality occurred in 7 patients (28%). Chi square analysis found a significant association between fibrinogen and coagulopathy (p = 0.043), while the association between initial fibrinogen with mortality was not significant (p = 0.341).Conclusions: Initial fibrinogen level is significantly associated with coagulopathy but it cannot predict mortality in patients with multiple trauma. Further study is needed in order to assess the benefit of these results on the management of multiple trauma patients.
Evaluation of medial meniscal injury and anterior cruciate ligament tear by MRI with arthroscopic correlation
Authors: Murmu Chiranjib , Tiwari Pushpakant , Agrawal Vijender Kumar
Published: January 2017

Background: Apart from clinical examination multiple modalities (conventional radiography, MRI and arthroscopy) are currently used to evaluate knee injuries. This study is intended to compare the sensitivity and specificity of MRI in correlation of arthroscopy in diagnosing of knee injuries.Methods: This is a prospective study involving 51 patients with history of knee injuries who were admitted in the Department of Orthopaedics, Command Hospital, Kolkata, India from April 2013 to June 2014. MRI of the knee joint was done for all these patients either before or after admission. The patients were then subjected to diagnostic and therapeutic arthroscopy. Statistical analysis was used to calculate the sensitivity, specificity, positive predictive value and the negative predictive value, in order to assess the reliability of the MRI results.Results: The sensitivity and specificity of MRI with respect to arthroscopy in anterior cruciate ligament tear is 87.5% and 66.6%. Positive predictive value is 87.5%. Negative predictive value is 66.6%. Accuracy is 81.82%. The sensitivity and specificity of MRI with respect to arthroscopy in medial meniscal tears is 85.7% and 70.8% respectively. Positive predictive value is 63%, negative predictive value is 89.4%, accuracy is 76.3%.Conclusions: The present study supports that MRI is helpful in diagnosing medial meniscal and anterior cruciate ligament injuries. The negative predictive value of a MRI was found to be high for all structures of the knee joint and hence a MRI can be used to exclude pathology, thus sparing patients from expensive and unnecessary surgery.
Evaluation of results of primary cementless total hip arthroplasty in osteoarthritis
Authors: Bashir Arshad , Manan Qazi , Shah Faisal Younis , Khan Hayat Ahmad , Wani Mohammad Iqbal , Tantray Mehrajud Din , Rashid Shakir
Published: January 2017

Background: Total hip arthroplasty involves removal of diseased bone and soft tissue from both femoral and acetabular side and replacing it with mechanical components. It is one of the most successful surgical procedures. It relieves pain and functional disability experienced by patients with moderate to severe osteoarthritis of the hip, improving their quality of life. The success of THA is its ability to relieve the pain, while maintaining both mobility and stability of the joint. The purpose of this study was to evaluate the results of primary cementless total hip arthroplasty in patients with hip osteoarthritis.Methods: This study was done in a tertiary care teaching hospital. Thirty patients with hip osteoarthritis who were treated with cementless total hip arthroplasty were included in the study. This was a prospective study with a minimum of 12 months follow up (maximum of 25 months). The patients’ pre-operative and post-operative pain and functional status was compared using Harris hip score.Results: Excellent or good pain relief and function was obtained in 83.33% of cases. The mean total pre-operative Harris Hip Score was 32.93 which improved to 88.967 post-operatively. There was a statistically significant improvement in all parameters except absence of deformity. The most common complication was persistent anterior thigh pain that occurred in two patients.Conclusions: Our study suggests that the current generation of cementless implants provide satisfactory clinical and radiographic outcomes. Though the study was not free of complications, the overall clinical and radiological outcome showed encouraging results.
C-reactive protein: an early predictor of sepsis in patients with thermal burns
Authors: John Joby , Chisthi Meer M. , Kuttanchettiyar Krishnakumar G.
Published: January 2017

Background: Due to the high mortality rate of established sepsis in patients with burn injuries, it would be beneficial if the onset can be predicted before it is fully established. The objective of the study was to estimate the predictive value of C-reactive protein in thermal burns patients. The secondary objective was to determine how much earlier CRP level allowed the prediction of sepsis in these patients.Methods: This was a case-control study, conducted prospectively on 60 human patients admitted with thermal burns. Cases were those who developed sepsis following burns and the controls were burns patients without sepsis. All patients underwent serial estimation of C-reactive protein values on alternative days, along with other blood parameters. From the data, the predictive value of C-reactive protein in sepsis was analysed.Results: A significant higher value of C-reactive protein was found in septic patients. Rise in serum C-reactive protein level predicted sepsis with an efficacy of 87%, while the sensitivity was found to be 93% and the specificity was 80%, with a significant odds ratio of 56. Also a pre-defined rise in C-reactive protein predicted the onset of sepsis about 2 days before the clinical onset.Conclusions: C-reactive protein is a useful indicator for sepsis in burns patients. In combination with clinical sepsis markers, C-reactive protein can be used to initiate intensive monitoring and appropriate antibiotic therapy.
Clinical profile and management of breast cancer in women in a rural based tertiary care hospital our experience
Authors: Mohan Ambikavathy , Kumar Chandan
Published: January 2017

Background: Breast cancer is the second most common cancer among women in India and accounts for 7% of global burden of breast cancer and one-fifth of all cancers among women in India. The risk factors are related to lifestyle, early menarche, nulli parity, prolonged use of oral contraceptive pills, hormone replacement therapy, not breast‑feeding, alcohol, obesity, lack of exercise, and induced abortion. A woman who attains menopause after fifty five years of age has an increased risk of ovarian, breast, and uterine cancers. The risk is greater if a woman also began menstruating before twelve years of age. A longer exposure to estrogen increases a woman’s risk of breast cancers.Methods: This is a prospective observational study, conducted in the department of surgery, between December 2013 and June 2015(2 years). Patients diagnosed as breast carcinoma and admitted in surgical wards were included, Data pertaining to demography, clinical and pathological tumor profile, and treatment details were collected prospectively for each patient based on patient interviews and medical records. To analyse the Prevalence of breast cancer, clinical presentation, risk factors, diagnostic methods, treatment protocols, difference between pre and post‑menopausal breast cancer women regarding risk factors, assess the impact of treatment given and women’s knowledge about breast cancer.Results: A total number of 25 cases of breast carcinoma based on detailed history, clinical examination, Trucut biopsy, ultrasonography breast and axilla, ultrasound abdomen, mammogram and chest x-ray were analysed. All of them received three cycles of anterior chemotherapy consisting of 5- Fluorouracil 500 mg/m2,Adriamycin 50 mg/m2 Cyclophosphamide 80 mg/m2 (FAC regimen) administered intravenously followed by modified radical mastectomy. There were no recurrences seen on follow up till date.Conclusions: Late stage at presentation of breast cancer is a challenge to the health care providers. Cancer awareness programmes, multidisciplinary approach and evidence‑based strategies for early detection and effective management of the disease can go a long way in prevention.
A randomized controlled trial evaluating the efficacy of mastectomy flap quilting sutures in reducing post modified radical mastectomy seroma formation
Authors: B. S. Madhu , Reddy M. Naveen Kumar , H. B. Shashi Kumar , Kalabairav Sangeetha , Reddy Abilash V. , Mallikarjunappa Subramanya S.
Published: January 2017

Background: One of the most common complication post modified radical mastectomy is the formation of seroma. Seroma formation in-turn delays wound healing, increases susceptibility to infection, skin flap necrosis, persistent pain and thus prolongs convalescence. For this, several techniques have been tried and trialed to improve primary healing and decrease the formation of seroma.Methods: Between Aug 2014 and July 2016, 60 patients with carcinoma of the breast, posted for modified radical mastectomy at KR Hospital, Mysuru, Karnataka, India were randomly divided into 2 groups, the study group (30) and the control group (30). In the study group; the mastectomy flap quilting sutures were put between the flap and the pectoral fascia and muscle at different parts of the flap and at the flap edge with absorbable sutures (polyglactin 3-0). In the control group; the flaps were approximated by the conventional method at the edges. Closed suction drains were placed in both the groups. Patients, tumour characteristics and operative related factors were documented. The volume and colour of the fluid drained was recorded everyday. The drains were removed when the amount became less than 30 cc in a 24 hour period. The total volume and duration (number of days) of fluid drained and the complications were recorded and compared.Results: In the study group, the drain was removed much earlier when compared to the control group (p < 0.001). The total amount of fluid drained was much lower in the study group (p < 0.001). The study group showed a much lower frequency of seroma formation when compared to the control group.Conclusions: The mastectomy quilting suture technique is an effective procedure that considerably reduces the incidence of seroma formation in patients undergoing modified radical mastectomy.
The role of rebound tenderness in acute appendicitis and appendicular perforation
Authors: Lamture Yashwant R. , Gajbhiye Varsha P.
Published: January 2017

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.
Profile and pattern of obstructive jaundice cases from a tertiary care teaching hospital of Uttar Pradesh
Authors: Gupta Ashok Kumar , Singh Abhishek , Goel Shwetank , Tank Rakesh
Published: January 2017

Background: The common etiologies of obstructive jaundice have been reported to vary from one centre to another and from one individual to another. Only a very few studies have been conducted on this topic and none from the state of Madhya Pradesh, India. The present study was planned to study the profile and pattern of obstructive jaundice cases in the region of Madhya Pradesh, India.Methods: A retrospective cohort of patients with obstructive jaundice admitted to SRMS Institute of Medical Sciences, Bareilly, Uttar Pradesh, India during past one year i.e. January to December 2014 formed the study population. In this study, all the eligible patients positively diagnosed as extrahepatic obstructive jaundice were included in this study. Study tools were records of the patients such as information/records from MRD department and clinical case sheets.Results: Malignant causes (63.89%) were more frequent than benign causes (36.11%). More than 50% cases were in the age group of 55-75 years. Sex wise males outnumbered females. Among the malignant causes of obstructive jaundice, cancer head of pancreas (60.87%) and cholangiocarcinoma (17.39%) were common causes whereas among the benign causes of obstructive jaundice, choledocholithiasis (76.92%) and benign biliary strictures (15.38%) were common causes.Conclusions: Jaundice (91.67%), loss of appetite (77.78%) and pain abdomen (75%) were three most common modes of presentation of obstructive jaundice cases.
Nursing approach to Zenker’s diverticulum surgery patient
Authors: Sen Sevim , Seyman Cigdem Canbolat , Konstantinou Marios , Gaitanakis Stelios
Published: January 2017

Zenker’s diverticulum, which is herniation of pharyngeal mucosa, typically occurs in the elderly population with dysphagia, regurgitation, halitosis, and malnutrition. Here we report one case of Zenker’s diverticulum and nursing care and diagnosis process. The patient complained of weight loss, halitosis and intermittent periods of cough. It was diagnosed that the patient had stage two Zenker’s diverticulum on the upper part of esophagus and back to thyroid gland. The patient successfully underwent surgery and stayed five days in hospital. After the postoperative third day it was allowed the patient’s oral feeding. After an uneventful recovery and adequate oral intake, the patient was discharged on the fifth postoperative day.
Quacks a menace for surgeons: management of a difficult post circumcision deformity
Authors: Vathulya Madhubari
Published: January 2017

Circumcision is one of the commonest surgeries performed worldwide. Yet it is not without complications. It is performed by medical and non-medical persons. A 12 year old boy presented with a severe penile deformity comprising of micropenis and distal urethral fistula following a circumcision performed at the age of 2 years by a? Quack… The patient underwent repair for the same and achieved a near normal penis. Considering the vast amount of complications associated with these surgeries, stricter norms as to who should operate and where should such a procedure be done has to be relooked. Also the absolute indications for circumcision must also be revisited as the fundamental purpose of prophylactic circumcision has not been statistically supported completely from the review of literature.
A rare case of superficial acral fibromyxoma
Authors: Krishnaswamy Jawahar , Balaji Vinod , Rahman Khalilur , Ravi Samson
Published: January 2017

Superficial acral fibromyxoma (SAF) is a rare, distinctive benign soft tissue lesion that often involves the fingers and toes, with great toe being the most frequently affected site. We report a case of SAF diagnosed by core biopsy and confirmed by histopathology. The pre-operative cytological diagnosis will help the surgeon to plan for a wider excision that prevents recurrence.
A prospective randomised double blind study of the comparison of two opioids- fentanyl and buprenorphine – as adjuvant to spinal bupivacaine in caesarean sections
Authors: Sonya Kamal , C. V. Davies
Published: January 2017

Background: Opioids are first introduced as additives to spinal anaesthesia in 1979, with intrathecal morphine as forerunner. Neuraxial opioids when added to local anaesthetics prolong the duration of sensory block, improve quality of block and no unwanted sympathetic blockade leading to hypotension. This prospective randomized double blind study was undertaken to evaluate the duration of analgesia, sensory and motor blocking properties and side effects of two opioids – Fentanyl and Buprenorphine, when used as adjuvant to spinal Bupivacaine in caesarean section.

Methods: Sixty patients between the age group 18-35 years belonging to ASA I and II posted for elective LSCS were randomly divided into two groups. Each group consisting of 30 patients , received either 1.8 ml 0.5% Bupivacaine with 25 mcg Fentanyl (group F) or 1.8 ml 0.5% Bupivacaine with 75 mcg buprenorphine (Group B). The onset, maximum level and duration of sensory and motor blockade and hemodynamic parameters were monitored.

Results: Maximum height of sensory block was achieved faster in fentanyl group (i.e. 4.09±1.12 minutes compared to 4.56±1.21 minutes in buprenorphine group). Duration of analgesia was significantly prolonged in buprenorphine group. It was 317±54 minutes and 214±35 minutes respectively for buprenorphine and fentanyl groups.

Conclusions: The study thus concluded that although fentanyl produce faster sensory block, duration of analgesia is longer with buprenorphine, and both the drugs do not cause significant side effects.
Comparison of intravenous induction with propofol to vital capacity breath induction with sevoflurane for insertion of laryngeal mask airway
Authors: Prakash Sugatha , J. Sreedevi
Published: January 2017

Background: The increasing emphasis on day care anaesthesia has led to the greater use of laryngeal mask airway (LMA) as an alternative to tracheal intubation for short procedure surgeries. Satisfactory insertion of LMA after induction of anaesthesia requires sufficient depth for suppression of airway reflexes. This study was performed to compare intravenous induction with Propofol to vital capacity breath induction with sevoflurane for LMA insertion.

Methods: In this study 100 ASA 1 and ASA 2 patients aged between 20 and 40 years, undergoing short surgical procedures lasting 30 to 60 minutes, were included. The P group received   Inj. Propofol 2.5 mg/kg IV whereas the S group received Sevoflurane 8% vital capacity breaths. After the loss of eyelash reflex, which was considered the end point of induction, the LMA insertion was attempted by an anaesthesiologist blinded to the induction technique. The data that was recorded was induction time with both the drugs, characteristics of LMA insertion, hemodynamic responses and complications if any. The number of attempts at insertion was also noted.

Results: Induction time was 60.1±8.98 secs for propofol induction and 72.8±15.86 for sevoflurane vital capacity breath induction which was found statistically significant. The insertion conditions were found excellent in 88% in the propofol group and 90% in the sevoflurane group which was comparable. There was no statistically significant difference found in the time or characteristics of insertion between both the groups. No incidence of complications was found in both groups.  

Conclusions: Induction with sevoflurane vital capacity breath inhalation compared equally with induction with intravenous propofol for LMA insertion in patients undergoing short surgical procedures.
Recommender system introduction for requests of cancer world
Authors: Aalipour Elham , Ghazisaeedi Marjan
Published: January 2017

Awareness of cancer patients and their families, health care providers, and specialized cancer centers is achieved through access to up-to-date information about various items. Today, intelligent information technology systems have an important role in the awareness of people. Therefore, a type of technology is required that is capable of learning people’s needs, interests and suggesting appropriate information accordingly. The emergence of information technology systems, like recommender systems, is a step towards selecting appropriate information. With modeling the preferences, interests, needs, requests, and behaviors of the users, recommender systems seek to predict the future preferences, needs, and behaviors of the users to recommend appropriate and helpful services accordingly. Recommender systems can be a suitable tool for the information management of cancer-related screenings, diagnoses, treatments, operations, and rehabilitation programs. Access to treatment and health recommendations from valid sources is an important component of the natural processes of human decision making. The aim of this collection is to introduce recommender systems to use in cancer-related issues.
Morbidity among mine workers: a cross sectional study in Chitradurga, Karnataka, India
Authors: Rajashekar Somarouthu , Sharma Prajna
Published: January 2017

Background: Workers represent half the world’s population and are the major contributors to economic and social development. Their health is determined not only by workplace hazards but also by social and individual actors and access to health services. Work-related morbidity and mortality result in suffering and hardship for worker as well as to his or her family. Thus occupational health of working people are crucial prerequisites for overall socioeconomic and sustainable development. The aims and objective were to assess the health status of the people working in mines and study their occupational hazards.Methods: A cross sectional study was conducted in three actively working mines of Chitradurga city for a period of one year. Complete enumeration method was used to include 493 mine workers.  Results: Sesagoa mines were the biggest among the selected mines (69.5% workers). Majority belonged to the age group of 20-30 years with 37.5%, 69% workers were field workers. Around 76.3% workers were working since 1-5 years. 45.20% and 11% workers had undergone pre placement examination and  periodic examination respectively. Personal Protective Equipments (P.P.E) were used by 90.50% workers. History of allergy was seen in 21.7% workers, while 11.2% workers reported history of vector borne diseases. Trouble smelling was found in 1.8% workers while 1.6% workers had trouble hearing.Conclusions: Health education on pre placement, periodic examination and use of PPE was found to be less which on itself can be the reason for morbidities among the mine workers hence efforts must be made to improve their knowledge regarding these.
A cross sectional study of epidemiological determinants correlated with prevalence of hypertension among municipal school teachers located in suburban area
Authors: Vyas Parth H. , Bhate Kamaxi , Bawa Mukesh , Pagar Vikrant , Kinge Amol
Published: January 2017

Background: Hypertension is a major long-term health condition and is the leading cause of premature deaths among persons experiencing sedentary urban life style behaviors such as high calorie diet, lack of physical exercise and job stress. The objectives of the present study was to determine prevalence & various risk factors of hypertension among municipal school teachers in an urban slum.  Methods:The study area was a field practice area of tertiary care hospital in a metropolitan city. Municipal school teachers from suburban slums were the study participants. Teachers above 35 years of age and want to participate in study were included. The total sample size obtained was 220.Results: 40% of the teachers were belonged to 35-40 years of age group. 70.9% of the study participants were women. Among 220 teachers 36.4% were having normal blood pressure. 43.6% teachers were in the pre- hypertension stage, while 14.5% and 5.5% were in stage- 1 and stage- 2 hypertension. The prevalence of hypertension was 20%. In present study it was found that as the age advances chances of contracting hypertension also increases [P=0.006]. Statistically significant relation between obesity and hypertension is seen [P=0.007]. There was a significant relation between physical activity and prevalence of hypertension [P = 0.021].Conclusions:Increasing age, obesity and sedentary lifestyle are proportionally related to the development of hypertension which was statistically significant.
Prevalence and role of risk factors for hypertension in 18-69 years of age in rural and urban areas of district Amritsar, Punjab, India
Authors: Mitra Chasham , Lal Mohan , Singh Tejbir , Deepti S. S.
Published: January 2017

Background: Hypertension is a major public health problem in India and its prevalence is high among rural and urban population. All the risk factors of lifestyle are known to cause the early onset and rapid worsening of hypertension.Methods:A cross sectional study was conducted. 1000 participants (500 rural and 500 urban) between the age group of 18-69 years were selected by systematic random sampling method from 5 villages and 5 urban wards of Amritsar city. Out of total, 500 males and 500 females were selected.Results: This study shows that 332 (33.2%) participants were hypertensive out of total 1000. The chances of Hypertension are directly proportional to age and shows peak between 50-59 years of age, 86 (59.72%). The prevalence among males and females was 32.4% and 34% respectively. Hypertension is highest in respondents with body mass index (BMI >30) i.e. 53.43%. The prevalence of hypertension was slightly higher among smokers than non-smokers and among vegetarians than non- vegetarians.Conclusions:Hence, it becomes necessary to adopt a lifestyle with regular physical activity for at-least 30 min a day, for 5 days of the week, to decrease prevalence of obesity and to maintain BMI within normal range. Thus awareness among communities should be raised regarding prevention of the risk factors for hypertension.
Cleft lip/ palate and its relationship with socio-demographic factors in 0-15 years old children attending tertiary care centre, Nandyal, Andhra Pradesh, India
Authors: G Vijaya Vishnu , Pasha M. A. M. , Fathima Afsar , Gopichand Sumana
Published: January 2017

Background: Cleft lip with or without (CL) cleft palate and cleft palate alone (CP) are a major public health problem.  It is a common developmental and serious birth defects associated with genetic and or environmental factors affecting 1 in every 500 to 1000 births worldwide.Methods: Objectives is to know the prevalence of cleft lip/ palate in children attending Santhiram medical college – Nandyal. Study design is cross sectional study with study population 137 children. Study was conducted for a period of one year from August 2015 –July 2016. Each respondent were interviewed with pretested and semi structured questioner. The limitation of this study was the sample size. We also need to maintain an accurate database for cleft registrations; systematic record keeping is essential in this area.Results: 70% of children were in age group of 0-5 years, 13.3% belongs to 6-10 years age group and 16.7% belongs to 11-15 yrs. 64.2% are Boys and 35.8% are girls were effected. 2.1% of uncles and grandparents have similar complaints. 7.4% of parents and 3.7% of siblings has similar complaints. 33.3% has risk factor consanguineous marriage.Conclusions: Boys were more effected than girl children. 2.1% of uncle’s and grandparents has similar complaints. 7.4% of parents and 3.7% of siblings has similar complaints. Majority has risk factor as consanguineous marriage, followed by history of OCP intake, smoking in family, obesity of mother as risk factor and other siblings with similar complaints. Majority has defect on left side.
Barriers to sustained use of the insecticide treated bed net in the upper east region of Ghana
Authors: Diema Konlan Kennedy , Dodam Konlan Kennedy , Aarah-Bapuah Millicent , Asibi Abdulai Juliana
Published: January 2017

Background: Barriers to sustainable use of the insecticide treated bed nets are responsible for the high incidence of malaria with a concomitant burden on the health delivery system in Ghana. The ITN has proven to be one of the most cost effective means of preventing malaria. This study identified the barriers to the sustainable use of the insecticide treated bed nets in the upper east region.Methods: This was a mixed cross sectional descriptive study that used data from household representatives and interviews with malaria control officers in three randomly selected districts of the region.Results: The study identified that apart from sleeping under the ITN and using it as window curtains and provision of warmth during cold weathers, the ITN is put in to other uses like nursing of seedlings, protecting chickens, fishing and fencing of animal pens. Major barriers to sustained use of the ITN included over complacency and the influence of male dominance. Cost of ITN, room shape and size, design of the ITN were identified as minor barriers to the use of the ITN.  Conclusions: Health care practitioners, social environmental officers and preventive health care services providers should use behavior change communication methods in curtailing most of these barriers to the sustainable use of the ITN.