bluuebunny/crossref_metadata_2025 huggingface dataset:
Comment dépasser le «monolinguisme» au Japon ?
Authors: Koishi Atsuko
Published: November 2021

Un bref état des lieux de l'enseignement des langues vivantes au Japon ne peut que mettre en évidence son caractère «monolingue», tant le seul apprentissage de l'anglais se trouve mis en valeur à tous les niveaux de l'enseignement, du primaire au supérieur. Or, dans un monde à la complexité sans cesse croissante sur tous les plans, un pays peut-il encore se passer de personnes compétentes capables d'agir dans une langue autre que l'anglais? De la même façon, afin de mieux saisir cette complexité de manière adéquate et profonde, n'est-il pas mieux pour un individu de posséder plusieurs langues? À travers plusieurs exemples, nous voudrions montrer que le «monolinguisme» institutionnel est un fait «fabriqué», que ce que l'on appelle le «besoin» langagier est souvent manipulé et qu'au final, il appartient aux enseignants et aux institutions scolaires et universitaires de faire découvrir de vrais besoins aux apprenants. Nous pourrions ainsi faire de l'enseignement des langues vivantes une authentique éducation à l'altérité et non un outil coercitif d'uniformisation.
Les Japonais sont les Français de l’Extrême-Orient
Authors: Graziani Jean-François
Published: November 2021

Le début du XXe siècle a vu, en France, l'apparition des premiers cours de colonisation à l'université, destinés à un public de jeunes métropolitains désireux de s'établir et de faire carrière aux colonies. Paul Vibert, économiste, conférencier et spécialiste des questions coloniales, a été l'un des précurseurs de cet enseignement. Ses deux années de cours libre à la Sorbonne, publiées par la suite en deux volumes, abordent principalement les différents aspects pratiques de la colonisation mais s'ouvrent par endroits à un discours qui relève de la justification de l'action coloniale. Au croisement du discours éthique et de la démonstration pratique, le plaidoyer en faveur de l'enseignement de la langue française aux indigènes met en lumière certains des aspects les plus frappants de l'utopie coloniale-républicaine. L'instrumentalisation du Japon, en particulier, à travers la critique de l'écriture idéographique et l'interprétation de sa modernisation durant l'ère Meiji permet de mieux saisir comment, dans la pensée de Paul Vibert et dans celle d'une large partie des théoriciens de la colonisation, la croyance au progrès, à la mission civilisatrice de la France et à son universalité légitime l'impérialisme français et le transforme en impératif moral.
[RETRACTED] Eagle Hemp CBD Gummies Shark Tank - It Worth the Money? Scam or Legit? v1
Authors: not provided rohitttt
Published: November 2021

[RETRACTED]

Health
Satisfaction and attitudes of the student population about dental aesthetics
Authors: Gavranović-Glamoč Alma , Kazazić Lejla , Strujić-Porović Sanela , Berhamović Emir , Džonlagić Amela , Zukić Selma , Jakupović Selma , Tosum Pošković Selma
Published: November 2021

Introduction: Perceptions of the esthetic appearance of teeth vary in different individuals and can affect satisfaction with the dental appearance, attitudes, and the need for appropriate dental treatment. The research aims to examine the factors influencing the satisfaction with the appearance of the dentition and the attitude toward treatments which improve dental esthetics among students of the faculty of dentistry in comparison to the attitudes of students of non-dental faculties.Methods: The research included a total of 358 students of the Faculty of Dentistry and Faculty of Architecture in Sarajevo who voluntarily filled out a questionnaire created for this research. The questionnaire contained questions related to satisfaction with the appearance of teeth in general, tooth color, tooth position, questions related to the previous, and future desired esthetic restorations and treatments.Results: Female subjects expressed statistically significantly greater dissatisfaction with the appearance of the dentition and did or plan to do treatments that could improve dental esthetics compared to male subjects. Students of the Faculty of Dentistry at final years were significantly more satisfied with the general appearance of teeth and tooth color compared to freshmen students of the Faculty of Dentistry and students of the Faculty of Architecture.Conclusion: Satisfaction with dental appearance is a subjective experience that is influenced by various factors, level, and type of education is among them.
On the Issue of Designing a System for Continuous Control of Road Materials Compaction for Pavers
Authors:   Siberian Federal University, Krasnoyarsk, 660041, Russian Federation, Prokopev A. P. , Nabizhanov Zh. I. ,   Siberian Federal University, Krasnoyarsk, 660041, Russian Federation, Ivanchura V. I. ,   Siberian Federal University, Krasnoyarsk, 660041, Russian Federation, Emelyanov R. T. ,   Siberian Federal University, Krasnoyarsk, 660041, Russian Federation
Published: November 2021

The results of the research on the creation of an automatic compaction control system (ACCS) for pavers in real time are considered. The research is based on the methods of artificial neural networks (ANN). In this paper, an ANN model is obtained, with the help of which it is possible to determine the compaction coefficient (CC) of an asphalt mixture. The input variables of the ACCS are the velocity of movement of the paver, the frequency of impacts of the tamper, the force in the pusher of the tamper, the type of mixture, the thickness of the layer. The results of a computational experiment on the calculation of Cc in real time are presented. The ANN is able to explain more than 98 % of the measured data.
Ege Denizi’nde Yetki Alanları Paylaşımının Öncülü: Karasuları Sorunu
Authors: Şahin Kenan
Published: November 2021

Makalede, karşılıklı önyargılarla biçimlenen Türkiye-Yunanistan ilişkileri çerçevesinde Ege Denizi’nde deniz yetki alanlarının paylaşımıyla ilişkili karasuları sorunu uluslararası hukuk bağlamında incelenmektedir. Bu çerçevede Ege Denizi’nde karasuları anlaşmazlığının ikili ilişkilerde kıta sahanlığı başta olmak üzere diğer sorunları da etkileyen merkezi niteliğine dikkat çekilmektedir. Bu varsayım doğrultusunda Yunanistan’ın karasuları üzerinden Türkiye’nin deniz yetki alanını daraltarak sadece Ege’de değil, Doğu Akdeniz de dâhil olmak üzere uluslararası hukukun Türkiye’ye tanıdığı denizin altındaki enerji kaynaklarına erişim hakkını kısıtlamak gibi bir strateji izlediği ileri sürülmektedir. Makalede öncelikle, karasular hakkındaki uluslararası hukuk kuralları üzerinde durulacaktır. Daha sonra sorunun tarihsel geçmişine yer verilerek tarafların uluslararası platformlarda konu hakkında öne sürdüğü hukuki ve siyasi tezler masaya yatırılacaktır.
Kuşak Yol Girişimi Kapsamında Deniz ve Demir İpekyolu’nun Rekabeti
Authors: Şahin Baha Emir , Erenel Fahri
Published: November 2021

Kuşak Yol Projesi kapsamında Çin’den yola çıkan ve Türkiye’den geçerek Avrupa’ya ulaşan ilk tren ile birlikte, Demir İpekyolu’nun Türkiye’ye ve deniz taşımacılığına etkisi ile ilgili tartışmalar artmıştır. Bu noktadan yola çıkan çalışma, Demir İpekyolu’nun konteyner taşımacılığı üzerinden Deniz İpekyolu ile güncel kapasitelerini ve gelecekte beklenen kapasitelerini karşılaştırmayı amaçlamaktadır. Çalışma, aynı zamanda Kuşak Yol Projesi kapsamında güncel olarak kullanılan veya gelecekte kullanılması beklenen denizyolu ve demiryolu güzergâhları, bu güzergâhlardaki darboğazları ve taşımacılık açısından yaşanan zorlukları da özetlemeyi hedeflemektedir. Bununla beraber Çin’in özellikle deniz darboğazları çevresindeki askerî ve ekonomik tutumu da incelenecektir.
Гуманитарная экспертиза полного цикла
Authors: Шевченко Сергей Юрьевич , Шкомова Екатерина Михайловна , Лаврентьева Софья Всеволодовна
Published: November 2021

В статье предлагается концепция гуманитарной экспертизы полного цикла. В ее основу положен опыт участия авторов в проекте по изучению коммуникативных проблем в сфере геномной медицины. Представленная концепция развивает идеи одного из основоположников гуманитарной экспертизы Б. Г. Юдина об «опереживающем обживании социальных эффектов технологий» и продолжающемся характере экспертной деятельности. Задачи и предметное поле гуманитарной экспертизы полного цикла раскрываются в свете их трактовок в работах А. А. Воронина и Вал. А. Лукова.

Задачи полного цикла экспертизы в отношении отдельной социотехнической практики формулируются как достижение участниками этой практики взаимопонимания по поводу: форм неопределенности, в контексте которых реализуется эта практика; конкретных планов и правил осуществления этой практики; генерализованного смысла реализации этих планов.

Показано, что значимым элементом предметного поля гуманитарной экспертизы является семья. При этом подходом к заданию такого поля может служить теория ассамбляжей, элементы которых не связаны иерархическими отношениями. Иными словами, член семьи не рассматривается как элемент множества (самой семьи), но и семья не задается через отношение к индивиду (например, к пациенту врача-генетика).

В свете указанных предметов и задач рассмотрено три уровня цикличности гуманитарной экспертизы: дисциплинарный (цикличность смены дисциплинарных подходов), эвристический (цикличность использования нарративных и концептуальных инструментов при создании общей эвристики), проблемный (цикличность затруднений в постановке или формулировке проблем).
Родство и родословные в генетике и антропологии
Authors: Шестак Анна Геннадьевна , Румянцева Виктория Алексеевна , Курленкова Александра Сергеевна
Published: November 2021

В статье на основе научной литературы и полевых материалов изложена краткая история исследований родства в социальных науках (антропологии) и генетике как области практики. Авторы-генетики объясняют процесс использования родословной в медико-генетической консультации, необходимый для уточнения диагноза и понимания сути болезни. Они также поясняют, почему вся семья является пациентом медико-генетической консультации, и обосновывают задачи проведения генетической диагностики как можно большего числа членов семьи.

Автор-антрополог отмечает важность симметричного изучения родства в антропологии, говорит о схожести в биоэссенциальном наследии обеих дисциплин, а также обращает внимание на новые формы семьи и отношений, которые меняют значение биологии и культуры.
Проблемы понимания результатов генетической диагностики клиницистами
Authors: Шестак Анна Геннадьевна , Шевченко Сергей Юрьевич , Румянцева Виктория Алексеевна
Published: November 2021

Проблема понимания генетических терминов неспециалистами исследована достаточно широко. Однако до сих пор малоизученными остаются проблемы понимания и интерпретации врачами-клиницистами результатов генетической диагностики. Основная часть данной статьи содержит описание собственного опыта решения вопросов непонимания результатов генетических исследований со стороны врачей-клиницистов, предложенное сотрудницей генетической лаборатории А. Г. Шестак. В начальных разделах статьи философом науки С. Ю. Шевченко представлены варианты теоретического разворачивания изложенных проблем. В статье последовательно представлены: 1) контекст институций и практик, в котором разворачиваются проблемы понимания; 2) авторская типология этих проблем. В последнем разделе намечены пути решения этих вопросов.
Неолиберализм как фактор колоссального роста неравенства в мире
Authors: Ильин Алексей Николаевич
Published: November 2021

Идеология и политическая практика неолиберализма широко утвердилась в мире после разрушения социалистического лагеря. Капитализм победил, а вместе с ним одержала верх ультрареакционная теория неолиберализма. Данная теория выступает за отход государства от его социально полезных функций. Государство призвано осуществлять большое число социально значимых функций — от обеспечения общественной безопасности до ограничения бедности и социально-экономического расслоения. Эти функции нейтрализуются неолиберальным проектом, который стремится отстранить государство от управления обществом и экономикой.

Неолиберальное государство отказывается от регулирования большинства социальных и экономических процессов, чтобы они перешли на уровень самоорганизации. При неолиберальной пассивности государства многие социальные слои обрекаются на нищету, а все общество — на тотальный рост неравенства. Автор приводит большое количество статистических данных, которые указывают на рост социально-экономического расслоения людей в мировых масштабах.

В статье предпринимается попытка собрать максимальный багаж сведений о растущем неравенстве, чтобы создать полную и достоверную картину реализации этого феномена. Широта статистического охвата и новизна материала являются основными достоинствами статьи. Хотя предлагаемые сведения в некоторых аспектах противоречат друг другу, их совокупность говорит о неуклонной актуализации проблемы неравенства. Обосновывается точка зрения, что колоссальное расслоение является итогом функционирования неолиберального проекта по всему миру.
Бунин, Белый, Блок: юбилейный триптих — 2020
Authors: Иванюшкин Иван Александрович
Published: November 2021

В статье освещаются факты биографий и творческого пути русских писателей Ивана Бунина, Андрея Белого и Александра Блока, юбилеи которых отмечались в 2020 г. Перечисляются основные их произведения. Автор говорит о значении литературного наследия этих писателей для осмысления Октябрьского переворота 1917 г. Статья содержит упоминание об адресах, связанных с их творчеством. Биографии Бунина, Белого и Блока раскрывается сквозь призму мемуарной прозы Бориса Зайцева. Автор говорит о значении Серебряного века, наступление которого знаменовало конец эпохи книжной культуры.
Alternative delivery of pregnant women with operated womb
Authors: Krasnopolskiy V. I. , Logutova L. S. , Gasparyan N. D. , Magilevskaya Е. V.
Published: November 2021

In this article, 12-year delivery experience described of pregnant women with hem on womb after cesarean. Labored 723 women: in 465 the repeated cesarean were made, in 258 spontaneous delivery were happened. Depositions for repeated cesarean and intra-operational complications are given. Management tactics of spontaneous delivery in women in childbirth with hem on womb is described. It was decided, that delivery through natural delivery ways in women with hem on womb after cesarean in low uterine segment must be the alternative to repeated cesarean.
On the change in the conduction velocity in the nerve during the development of parabiosis
Authors: Polumordvinov Dmitriy V.
Published: November 2021

General nervous physiology still takes into account a kind of doctrine of the separation of the basic properties of nerves, according to which one of the properties can be changed without changing the other, such as, for example. destroy conduction while maintaining excitability.

In the development of this doctrine, a very significant role belongs to the small and simple experiment of Grungayen, who studied the stepwise effect of carbon dioxide on the excised frog nerve. Exposing a part of the nerve to the influence of carbon dioxide, Grungagen found that excitability in the anesthetized area dropped markedly, while, upon stimulation of the central end, contractions continued to be obtained at the same current strength.
Pierre Marie. Reconsideration of the question of aphasia: aphasia from 1861 to 1866; experience of historical criticism of the origin of Brock's teachings. Revision de la question de l'aphasie; l'apha-sie de 1861-ä 1866; essai de critique liisforique sur la genese de la doctrine de Broca. La semaine medicale No. 48, 1906.
Authors: Sholomovich Alexander S.
Published: November 2021

In a rather long and very detailed article, supplied with 8 figures and illustrations, the author sets out in detail the history and development of Brock's teachings about the specific role of the 3 frontal gyrus as the center of articulate speech. Pointing out that Brock's teachings are based on data from two autopsies Leborgnea and Lelonga, the author aims to convince readers that neither of these 2 Brocks observations allows us to examine the third frontal gyrus as the center of speech.
A. Marie. — Eunuchisme et Erotisme (Nouvelle Icuno graphic de la Salpetridre. No. 5, 1906)
Authors: Zaitsev A.
Published: November 2021

The author cites a case of mental disorder of an erotic character, which he observed in Egypt, with corresponding deceptions of the senses. The case is about a 40-year-old eunuch who was completely castrated in early childhood.
Society for Labor Aid in the Yaroslavl Province Report on the asylum of alcoholics for 1905 Compiled by doctor A.A. Golosov
Authors: Sholomovich A.
Published: November 2021

In the complex system of practical measures that are recommended to society for the fight against alcoholism, one of the important places is occupied by the so-called. shelters or shelters for acute alcoholics. Unfortunately, these shelters are extremely rare, and not only in the provinces, but also in St. Petersburg and Moscow, acute alcoholics find themselves from the street in the most barbaric conditions; quite often they are subjected to uniform torture as, for example. a well-known rubbing of ears for sobering up, they are often robbed, beaten and finally end up in the disgusting, dirty, cold and earthly corners of the "bedbugs".
Chronicle and mix. Volume XIV, № 1 (1907)
Authors: Donskov Nikolay A.
Published: November 2021

On January 9, he died in Leipzig, famous for his works on Basedow's disease, on the treatment of nervous diseases and the organization of hospitals for nervous diseases, on maternal neuritis, on the pathology of the cervical sympathetic nerve, etc. Popular scientific works also brought him great fame.
Kultura strategiczna a kultura bezpieczeństwa w kontekście mentalności
Authors: Magiera Maciej
Published: November 2021

W czasach zaawansowanych procesów globalizacji, których częścią jest społeczeństwo informacyjne, będące jednocześnie społeczeństwem ryzyka, wzrasta zapotrzebowanie na kompleksową ochronę. Zadanie to przekracza możliwości jednostek. Wzrasta więc znaczenie administracji publicznej, zmniejszającej dotychczasowy deficyt działań państwa w tym zakresie. Wsparciem dla tych działań staje się zjawisko kultury strategicznej, zgodnie z którą zapewnianie bezpieczeństwa wymaga uwzględniania nie tylko zasobów i sprawnych struktur organizacyjnych, lecz także mentalności ludzi.
I've Got an Idea! Do IDEA Boards Facilitate Improved Completion of Wellness Focused Activities in a College of Nursing?
Authors: Macali Jennifer , Armstrong Cheryl
Published: November 2021

Background: In any given academic department there are many ideas discussed to promote wellness, yet it is often difficult to move specific wellness activity ideas from the initial conception stage to the implementation and evaluation stages. Wellness Committees are formed in departments where proposed ideas are generated. However, the same issue of lack of follow-through persists. In order to provide better follow-through and completion of wellness activities, an IDEA board was piloted by a Wellness Committee in a College of Nursing.Aim: This pilot project was implemented to determine the feasibility and utility of using an IDEA board to implement and complete wellness initiatives within a College of Nursing.Methods: An online mixed-methods survey was used to evaluate the use of an IDEA board within a Wellness Committee (n = 9) in a College of Nursing over a one-year period.Results: Results of the pilot study were positive and encouraging. Committee members found the visual representation helpful in guiding the group through the process of idea identification generation to idea implementation and evaluation.Conclusions: Using an IDEA board to guide the process of proposed wellness activities may facilitate improved completion of activities.
Hispanidad y modernismo(s): “Clarín” crítico en la encrucijada nacionalista de fines del siglo XIX
Authors: Saba Mariano
Published: November 2021

Dentro del ensayismo crítico de Leopoldo Alas resulta necesario analizar el contraste entre su elogio del influjo francés en el adelantado modernismo catalán, y la denostación del modernismo americano por un esnobismo que adjudica – de forma repetida y paradójica – a ese mismo influjo francés que suele calificar de deseable para Barcelona. En el contraste mismo de sus opuestas apreciaciones sobre ambas grupalidades, pueden rastrearse tal vez los mecanismos más evidentes del nacionalismo de “Clarín”, en su contradicción suspensa entre el impulso de conservación de la tradición hispana y la pugna por reconocer el carácter emancipador de lo nuevo foráneo.
The Last Mission: Religion and Colonial Francoism in Spanish Representations of Africa
Authors: Arbaiza Diana
Published: November 2021

During Francoism, Spanish cultural production on Equatorial Guinea placed missionaries in a central narrative role, exalting their evangelizing labor. This article concentrates on the representation of the colonial mission in works by lay authors who shared an ideological affinity with the regime and received its institutional support: the documentary Una cruz en la selva (1946), the film Misión blanca (1946) and the novel Tierra negra (1957). These works branded a kind of Spanish Catholic colonialism as superior to other European models, but despite their propagandistic intention, they also reveal a series of anxieties and contradictions inherent to the Spanish colonial project.
SANDER BERG. The Marvellous and the Miraculous in María de Zayas. Oxford: Legenda, Studies in Hispanic and Lusophone Cultures, 2019. viii + 177 pp.
Authors: S. Lagresa-González Elizabeth
Published: November 2021

Reseña de The Marvellous and the Miraculous in María de Zayas de Sander Berg.
JUAN R. DUCHESNE WINTER. Plant Theory in Amazonian Literature. New York: Palgrave Macmillan, 2019. 103 pp.
Authors: Swanson Ross
Published: November 2021

Reseña de Plant Theory in Amazonian Literature de Juan R. Duchesne Winter
GORICA MAJSTOROVIC. Global South Modernities: Modernist Literature and the Avant-Garde in Latin America. Lanham: Lexington Books, 2021. 154 pp.
Authors: G. Ramos Juan
Published: November 2021

Reseña de Global South Modernities: Modernist Literature and the Avant-Garde in Latin America de Gorica Majstorovic.
JENNIFER SMITH, ED. Modern Spanish Women as Agents of Change: Essays in Honor of Maryellen Bieder. Lewisburg: Bucknell UP, 2019. 236 pp.
Authors: Escobar Trujillo María Adelaida
Published: November 2021

Reseña de Modern Spanish Women as Agents of Change: Essays in Honor of Maryellen Bieder de Jennifer Smith.
Un católico en Nueva York: Lorca’s Tragic Vision of the United States
Authors: F. Jensen Max
Published: November 2021

This article discusses the role of Spanish Catholic tradition in the poetry of Federico García Lorca, especially in Poeta en Nueva York. Beginning with key concepts from Miguel de Unamuno’s Tragic Sense of Life to elucidate this tradition of irrationality, suffering, and spiritual vitality, we see that Lorca uses similar ideas as resistance to a “Protestant” modernity that, according to Lorca, favored materialist progress while eschewing human suffering. This article also demonstrates how the use of Spanish religious tradition complicates long-standing stereotypes of Spain’s supposed lack of modernization.
“Jugamos a la guerra”: Boys, Toys, and Military Masculinity in Galdós’s La desheredada
Authors: McKinney Collin
Published: November 2021

In the sixth chapter of Benito Pérez Galdós’s La desheredada, we find children at play in an impoverished neighborhood of Madrid. But what at first glance appears to be a simple representation of boys playing war is, upon closer inspection, a problematization of Spanish masculinity. This article suggests that the concepts of militarism and masculinity were synonymous throughout the second half of the nineteenth century. Galdós, however, critiques this conflation by converting the children’s game into a tragedy.
Doppler ultrasound features of ophthalmic artery in diabetic retinopathy in a Nigerian Teaching Hospital
Authors: Iyizoba Ginika N. , Adeyomoye Adekunle A. , Olowoyeye Omodele A. , Oboke Ozoemena S. , Arogundade Rasheed A. , Aribaba Olufisayo T.
Published: November 2021

Background: Diabetes mellitus is a metabolic disease characterized by elevated blood glucose level due to impaired insulin secretion, insulin action or both with diabetic retinopathy being the most common microangiopathic complication. A comparative, cross- sectional study aimed at evaluating Doppler blood flow indices in the ophthalmic artery in diabetic retinopathy and non-retinopathy patients when compared to normal controls in a Nigerian tertiary hospital.Methods: Data were collected over 7 months (April 2017-October 2017) in Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria. Sixty-five diabetic retinopathy patients, 65 diabetic patients without retinopathy and 65 non-diabetic controls had their ophthalmic artery Doppler indices assessed for comparison.Results: The end diastolic velocity (EDV) of the ophthalmic arteries in the diabetic patients were significantly lower than those of control group (EDV=5.84±2.59 cm/s, p<0.001 bilaterally). In diabetic patients with retinopathy, the end diastolic velocity of the ophthalmic arteries was significantly lower than those of diabetic patients without retinopathy (EDV=5.84±2.59 cm/s right eye, EDV=5.75±2.39 left eye, p<0.001 bilaterally). The resistivity index (RI) of the ophthalmic arteries was significantly higher in both diabetic patients with retinopathy and those without retinopathy compared to control group (RI=0.92±0.07 right eye, p=0.044 right eye, p<0.001 left eye) with resistivity index of diabetic retinopathy respondents significantly higher than the diabetic patients with no retinopathy.Conclusions: The study showed that Doppler is a useful screening parameter in identifying eyes at risk of developing sight threatening proliferative disease in diabetic patients. Significant differences exist in ophthalmic artery Doppler flow indices of diabetics with retinopathy compared to the healthy controls.
Aerobic bacterial profile and their antimicrobial sensitivity pattern in patients of otitis media with ear discharge
Authors: G.R. Jagannath Babu , S. Kavya , K. Anuradha
Published: November 2021

Background: The average prevalence of Chronic suppurative otitis media (CSOM) in India is 5.2%. It is more prevalent due to various predisposing factors such as malnutrition, overcrowding, poor hygiene, inadequate health care, and recurrent upper respiratory tract infection. In recent years, there is increased preponderance of multi drug resistant organisms due to the irrational use of antibiotics, making treatment of CSOM more difficult.Methods: Samples from 100 subjects of uncomplicated CSOM who presented to the Oto-Rhino-Laryngology outpatient department of our hospital were collected. Aerobic bacterial profile and its Antimicrobial susceptibility were studied by conventional methods. Results were compiled and evaluated by descriptive statistics and inferential statistics.Results: Pseudomonas aeruginosa (50.7%) and Staphylococcus aureus (19.04%) were the predominant isolates in our study. Aminoglycosides and Fluoroquinolones were found to be effective first line drugs, followed by Carbapenems.Conclusions: These antibiotics can be used to prevent the life-long complications of CSOM. Timely culture and sensitivity helps in the management of these cases.
Computed tomography guided fine needle aspiration cytology of mass lesions of lung: our experience in a tertiary care hospital
Authors: Mahajan Vidhu , Sharma Mansi , Suri Jyotsna , Atri Surinder K. , Kalsotra Nipun
Published: November 2021

Background: The present study was undertaken to evaluate the diagnostic usefulness of image guided fine needle aspiration cytology (FNAC) in various lung lesions-both neoplastic and non- neoplastic.Method: This retrospective study (Jan 2016-Dec 2018) included 34 cases of lung lesions with strong probable radiological diagnosis of lung neoplasm. Computed tomography (CT)-guided FNAC was performed and cytological smears were stained with May-Grunwald-Gimesa (MGG) stain and conventional Papanicolaou (Pap) stain.Result: A total of 34 cases of lung masses in our study, included 21 males (61.7%) and 13 females (38.2%). The age interval varied from 15 to 85 years; majority presenting in 6th and 7th decade of age. Smears were broadly categorized into unsatisfactory (n=2;5.88%), benign (n=3;8.82%), suspicious of malignancy (n=2;5.88%) and malignant lesions (n=27;79.41%). Benign category included 2 cases of tuberculosis and 1 case of abscess. Malignant category included the cases, diagnosed as squamous cell carcinoma(n=8); poorly differentiated carcinoma (n=6); small cell carcinoma (n=3); adenoma carcinoma (n=2); primitive neuroectodermal tumor (n=2); non-Hodgkins lymphoma (n=2) and plasmacytoma (n=1). Malignant category also included one case each of Metastatic Adenocarcinoma, adenoid cystic carcinoma, renal cell carcinoma with known primary site of Tumours.Conclusions: CT-guided FNAC is a less expensive, simple, fast, relatively safe and accurate procedure in the diagnosis of difficult lung lesions; the major limitation being the adequacy of the aspirate.
Study of surgical site infections and its antibiogram in a surgical ICU of a tertiary care hospital in south west Rajasthan
Authors: Bhumbla Upasana , Bishnoi Kamal Kishore
Published: November 2021

Background: Surgical infections can be caused through two major sources: exogenous and endogenous bacteria. Surgical site infections (SSIs) is one of the most common complications encountered in surgery. SSI places a significant burden on both the patient and health system, thus a major cause of morbidity, prolonged hospital stay and increased health costs. Objective of this study was to identify and isolate various bacteria from wound infections in a surgical intensive care unit and to study their antibiogram.Methods: Two wound swabs were collected from the wound and from a drop of aspirate, smear was made on clean glass slide and Gram staining was done for direct microscopic examination under oil immersion 100X objective to know various morphological types of bacteria and presence or absence of inflammatory cells. Second swab/drop of aspirate was used for culture by inoculating it on routine media like blood agar, nutrient agar and MacConkeys agar, incubated at 37° C for 24 hours aerobically.Results: Out of 150 pus samples, 122 (81.3%) were culture positive for bacterial growth and no growth was observed in 28 (18.7%) cases. Out of 122 bacterial culture positive cases, 120 were monobacterial and 2 were poly bacterial. Out of 122 bacterial isolates; E. coli (32/26.2%) was the commonest followed by P. aeruginosa (32/24.5%).Conclusions: The study concludes that variety of aerobic bacteria is responsible for surgical site infections with predominance of Escherichia coli followed by Pseudomonas aeruginosa.
Utility of bile esculin azide agar for screening of stool samples for vancomycin resistant enterococci from patients with gut colonization
Authors: Devhare Deepa Pramod , Pol Sae Satish , Pendse Varsha
Published: November 2021

Background: Due to increased prevalence of vancomycin resistant enterococci (VRE) in hospital settings as an important nosocomial pathogen, microbiology laboratories should be prepared with test protocol for prompt detection and reporting of these resistant organisms. This helps in appropriate treatment of patients without delay and implementation of infection control measures in order to prevent spread of such infections. With this background present study was conducted to demonstrate utility of bile esculin azide agar with vancomycin (BEAV) for screening of enterococci for vancomycin drug resistance.Methods: Over a period of one year 200 stool samples were collected from hospitalized patients in a tertiary care hospital. Samples were inoculated on bile esculin azide agar with vancomycin (6ug/ml) to screen for vancomycin drug resistance in enterococci isolated from stool samples. Vancomycin drug resistance was confirmed by agar dilution method.Results: Out of 200 stool samples collected from hospitalized patients, 13 (6.5%) samples showed growth on bile esculin azide agar with vancomycin (6 µg/ml). Of these 13 isolates, 12 (92.3%) isolates were confirmed as VRE by agar dilution method and demonstrated minimum inhibitory concentration (MIC) of ≥32 µg/ml and all 12 isolates were identified as E. faecium. One (7.7%) isolate grown on BEAV was identified as E. gallinarum and showed MIC value of 8 µg/ml.Conclusions: Present study recommends use of bile esculin azide agar with vancomycin (6 µg/ml) as a screening medium for isolation of VRE from stool samples which usually carries mixed commensal flora of gastrointestinal tract.
Difference in clinical profile between juvenile onset and adult-onset systemic lupus erythematosus: a meta-analysis
Authors: Shah Mandar Kalpesh , Shah Mihika Ashish , Goghawala Gayatri Anand , Kathayat Priyangi Manohar , Shah Parshwa Keyur , Shah Sharan Dharmesh , Patel Harshil Devang , Patel Kaushal , Abbas Kiran , Srivastava Puja , Pandya Sapan C.
Published: November 2021

The aim was to systematically review the studies that compared clinical and serological variation between adult-onset systematic lupus erythematosus (aSLE) andjuvenile-onset systematic lupus erythematosus (jSLE). A comprehensive literature search was done, in various available electronic databases for relevant publication that compared juvenile onset SLE and adult onset SLE. The data of adverse clinical features, serological profile and mortality were extracted. Juvenile onset was defined as <18 years and adult onset was defined as >18 years. The methodological quality of study was assessed by Newcastle Ottawa scale (NOS) criteria and R version 3.3.1 was used for analysis and ORs and 95% CIs, were used as statistical parameter. A total of 14,920 patients; (12,230: aSLE, and 2,690: jSLE) were included. Renal involvement especially nephritis was significantly more in j-SLE OR: 2.18, 95% CI: [1.81;2.62]; I2=10.8% whereas musculoskeletal was significant in aSLE O.R: 0.64; C.I: [0.44; 0.93]; I2=83.4%. Seizure and malar rash were significantly higher in J-SLE OR:1.69, CI: [1.31; 2.18]; I2=31.1%,1.43; C.I [1.04; 1.97]; I2=82%, respectively. Raynaud’s phenomenon and pleuritis were significantly higher in adult onset SLE. Anemia and thrombocytopenia were significantly higher in juvenile onset SLE. Anti-ds DNA, anti-histone, and anti-ribosomal-P were more frequent in juvenile-onset SLE while, anti-Ro was more common in adult-onset disease. The cause of mortality was not significantly different in both groups. Renal biopsy of class III and IV combined and class V were significantly more in adult-onset SLE. SLEDAI was higher in j-SLE. Meta-analysis indicated that, regardless of many similar clinical and serological manifestations, there is still some variation between adult-onset SLE and juvenile-onset SLE. Although, SLE disease is continuum from juvenile to adult but disease aggressive in juvenile onset SLE.
A case of subretinal hemorrhage due to choroidal tear in right eye following blunt trauma in a 35 years old female
Authors: Doshi Shrushti , Sangada Yamini B. , Juneja Stuti V.
Published: November 2021

A 35-year-old Asian Indian female presented to our institute with a history of fall on road and accidental hit by stone over her right eyebrow, grossly no anterior segment abnormality was noted. On dilated fundus examination, a superotemporal choroidal tear was noted which led to choroidal hemorrhage. Patient was managed conservatively by giving oral steroids and tablet vitamin C. After 2 months of treatment there was complete resolution of the lesion with a final best corrected visual acuity of 6/6.
Trichosporon species isolated from scald burn wound in an immunocompetent adult: a case report from Southern Assam
Authors: Bhattacharjee Barnamoy , Chanda Debadatta D. , Chakravarty Atanu
Published: November 2021

There are quite a good number of case reports on fungal infection in burn wounds in addition to the conventionally notorious bacterial infections in immune-compromised burn trauma patients leading to protracted course of morbidity and higher chances of mortality due to delay in diagnosis. The incidence of fungal infection in burn patients has been increasing with paradigm shift of causal fungus over last 2 decades from Candida albicans and molds to non-albicans Candida, Trichosporon species and other yeast like fungus. But there are rarely few cases of invasive Trichosporon infection in scald burn wounds in immunocompetent individuals. We therefore report a case of Trichosporon species isolation from a scald burn ulcer of an immunocompetent young male industrial worker in 2nd week of its clinical course which responded to oral fluconazole followed by skin grafting since this case scenario in itself is an uncommonly presented and reported event coupled with finding of first ever case with such presentation in this tertiary care institute of Southern Assam. This case is also reported with intention of raising awareness in surgeons for keeping vigil on non-healing burn wounds with empirical antibiotics and about the need of timely pus culture and sensitivity testing to rule out fungal colonization and prevent mortality due to disseminated fungal infection.
A rare case of bilateral ocular manifestations of Sturge-Weber syndrome
Authors: Basyach Pranami
Published: November 2021

Sturge–Weber syndrome (SWS) is a group of phakomatoses characterized by hamartomas involving brain, skin and eyes. A 36 years old female presented with pain and diminution of vision in both eyes since last 1 year. On examination she has bluish sclera in B/L eyes with characteristic facial port-wine stain. Best corrected visual acuity (BCVA) in R/E- 6/18, N6 and in L/E- 6/6, N6. Intra-occular pressure (IOP) in R/E – 27 mm Hg and in L/E –18 mmHg. On gonioscopy – open angle B/E. On direct ophthalmoscopy and slit-lamp examination with 90 D lens, cup-disc ratio in R/E – 0.9 and in L/E – 0.7 with thinning of neuro-retinal rim in B/E. In optical coherence tomography (OCT), retinal nerve fibre layer (RNFL) and optic nerve head (ONH) it was confirmed. Other systemic examination – within normal limit. Initially, she had been on conservative treatment. As intraocular pressure remained high after several weeks of treatment, trabeculectomy in R/E done under local anaesthesia. No post-operative complications were seen. After 7 days of follow-up IOP – within normal limit, vision in R/E unchanged and had been frequently followed-up.
Microvascular skin coverage in wounds that expose the Achilles tendon
Authors: Barrera-Mera Baltazar , Salgado-Adame Israel , Grajeda-Chávez Obed Horacio , Chávez-Hernández Jazmín Danaé , Aguilar-Barragán Cuauhtémoc , Abundez-Pliego Ana Lilia , Jiménez-Caprielova Yuri , Hernández-Arteaga Leonel Dalain , De la Rosa Llergo Román Alberto , Pérez-López José Enrique , Valderrama-Treviño Alan Isaac
Published: November 2021

Achilles tendon rupture is one of the most frequent tendon ruptures. Surgical intervention is the best option, but it has a high rate of complications leading to skin infections and necrosis. Extensive and aggressive debridement is necessary, producing tendon exposure and large skin defects. There are many alternatives for the skin coverage of the Achilles tendon, like sequential closures, vacuum assisted closure, local flaps, regional flaps, and more recently and efficiently microsurgery flaps. Skin defects in the Achilles tendon region have many peculiarities in comparison with other parts of the body: it is a zone that is always under mechanical stress due to footwear, this is why it must be highly resistant but thin. Its coverage must have sensitive properties, endure tendon gliding and allow early rehabilitation. Sometimes tendon reinforcement or creation or a neo tendon will be needed. For fulfilling these requirements free flaps by microsurgery are the only option in 90% of the cases. In this review article, we analyze three of the most frequently used free flaps in reconstructive medicine for complex Achilles tendon defects; free radial forearm flap, free radial forearm flap with vascularized flexor carpi radialis tendon and free anterolateral thigh (ALT) flap with vascularized fascia lata. This choice will be determined by the number of tissues involved, size of the defect, etiology of the defect, overall condition of the affected extremity and quality of neighboring tissues.
Glycated albumin as medium-term glycemic control in diabetes mellitus
Authors: Rosyid Fahrun Nur , Hario Seno Khristophorus Heri Nugroho , Rahman Ahmad Fadhlur
Published: November 2021

Monitoring of glucose levels is essential in preventing the complications of diabetes mellitus, including short, medium and long-term monitoring. Short-term monitoring includes random plasma glucose, fasting plasma glucose, 2-hour post prandial plasma glucose and Oral glucose tolerance tests (OGTT). The medium-term monitoring includes fructosamine and Glycated albumin (GA) while the long-term monitoring is glycated hemoglobin (HbA1c). Currently, the most recommended examination for glucose level monitoring in patients with diabetes mellitus is the glycated hemoglobin (HbA1c). However, there seem to be some conditions where the HbA1c value is doubtful or unreliable. Some of these conditions include anemia, thalassemia, dialysis and pregnancy. The best choice at this time is GA.
Indian consensus on durability of glycemic control in type 2 diabetes management and role of oral antidiabetic drugs
Authors: Chawla Manoj , Kalra Pramila , Khanna A. K. , Mahapatro Sisir Kumar
Published: November 2021

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in an alarming way in India as well as across the globe. In order to minimize complications, there is a need to maintain good glycemic control in patients with T2DM and long-term durable glycemic control remains a challenge. Clinically, this challenge was addressed by step-wise intensification of therapy with additional antidiabetic drugs to maintain glycemic control. Various disease and patient-related factors as well as different antidiabetic agents influenced the durability of glycemic control differently. While understanding of the factors that influenced therapeutic outcomes had evolved, there was paucity of information about the durability of glycemic control and the role of oral antidiabetic drugs (OADs) in achieving it. With an objective to understand the role of durability of glycemic response in the management of Indian patients with T2DM, 4 advisory board meetings attended by 48 physicians from across the country were conducted in Mumbai, Delhi, Kolkata and Bengaluru. There was consensus to consider durability of glycemic control as an important goal in the management of T2DM. Personalized approach in T2DM management along with early initiation of dual combination therapy were recommended to achieve durability. Age group of patients, body mass index, glycated hemoglobin levels at diagnosis, presence or absence of comorbidities and complications are important factors that need to be considered before initiating dual combination therapy for patients with T2DM.
Study of acute intestinal obstruction management and its outcome
Authors: M. Valarmathi
Published: November 2021

Background: Acute intestinal blockage (AIO) is a common abdominal emergency with a high morbidity and mortality rate. Early blockage diagnosis, skilled operative management, correct technique during surgery and intense postoperative therapy yield superior results. The aim was to study the aetiology, clinical presentation, therapy and outcomes of patients with IO who presented in the emergency department.Methods: This prospective study was conducted at the general surgery department from June 2019 to May 2021. The study comprised 60 patients with IO who presented to the OPD or emergency room and the data was analysed.Results: Among 60 patients with IO, peak incidence was observed in patients above 50 years of age, predominantly among males. Abdominal pain turned out to be the most common symptom of IO in our patients. Patients obstructed in the small intestine were found to be predominant. Post-operative adhesions were the most common cause of IO.Conclusions: Early diagnosis, proper preoperative hydration, fast investigations, and early operational intervention were found to increase survival in patients with intestinal obstruction in the current study.
A novel treatment protocol in severe acute pancreatitis: the first double blinded comparative trial to assess efficiency of omega 3 fatty acid infusion
Authors: M. Rudraiah H. G. , Davis Benita
Published: November 2021

Background: For decades, the treatment of acute pancreatitis (AP) has been largely supportive. However, a therapeutic window for intervention using immune modulators exists between the onset of clinical symptoms and peak pro-inflammatory cytokine expression. Soybean oil derived ω-3 PUFA is shown to inhibit the formation of ω-6 PUFA derived pro-inflammatory eicosanoids and suppresses pro-inflammatory activity of nuclear transcription factors (NF-κβ); thus, bringing about a much-needed immune regulation, both locally and systemically. Our aim was to study the efficacy of ω-3 PUFA infusion in severe AP (SAP) and set a new treatment protocol.Methods: This, first of its kind, doubled blinded randomised control trial was undertaken to assess the efficacy of early ω-3 PUFA supplementation in patients with predicted SAP by using serum amylase, serum lipase and C-reactive protein (CRP) with BISAP and Marshal scoring systems as markers for clinical outcome. 60 such patients were randomised into two groups: 30 were given ω-3 PUFA infusion and 30 were given a placebo. Chi square test and unpaired t test were used for comparison.Results: ω-3 PUFA infusion was found to be highly significant (p<0.05) in bringing about clinical improvement, reduced progression of SAP, reduced hospital stay and prompt reversal of organ dysfunction and SIRS.Conclusions: ω-3 PUFA infusion is the future for the treatment of patients with SAP. This drug is cheap and easily available, has no known side effects, reduces the morbidity and mortality, reduces the duration of hospital stay; thus, resulting in overall reduced medical expenditure.
A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital
Authors: Saraswat Bharti , Gill Kapil Kumar , Yadav Ashok , Kumar Krishan
Published: November 2021

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.