bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oesophageal Atresia without Major Cardiovascular Anomalies
Authors: Sinopidis Xenophon , Athanasopoulou Maria , Panagidis Antonios , Koletsis Efstratios , Karkoulias Kiriakos , Georgiou George 
Published: February 2021

Background:
Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paediatric surgical institution, by evaluating the outcome of surgical correction.

Methods:
Thirty-three neonates underwent surgery for correction of oesophageal atresia during a period of 20 years. They were categorised into two time-period groups, to follow-up the evolution of surgical intervention and complications through time. Evaluation of post-operative outcome and morbidity was performed. The results were related to those of our recent cross-sectional study on families having experienced oesophageal atresia performed years after repair, regarding the long-term quality of life.

Results:
A shift from staged to primary repair occurred throughout time in the patients with a marginal long gap between proximal and distal oesophagus (P = 0.008). Anastomotic stenosis was the major short-term complication encountered, treated with postoperative dilation sessions. Dysphagia and reflux were the most common long-term complications.

Conclusions:
Oesophageal atresia without severe cardiovascular abnormalities could be treated at a peripheral paediatric surgical department with satisfactory outcomes. However, qualified paediatric surgeons, anaesthesiologists and neonatologists and the availability of neonatal intensive care unit should be definitively required.
Haematogenous Osteoarticular Infections in Paediatric Sickle Cell Trait Patients
Authors: Yaokreh Jean Baptiste , Thomas Helen Audrey , Ekobo Paule-Christine , Kouamé Guy-Serge Yapo , Kouamé Bertin Dibi , Ouattara Ossénou 
Published: February 2021

Background:
Sickle cell trait (SCT) affects at least 5.2% of the world population, and it is considered asymptomatic by medical practitioners. There is a paucity of data regarding SCT paediatric patients and haematogenous osteoarticular infections (HOAIs). In our practice, some children with SCT presented HOAIs. This study aims to describe the pattern of HOAIs in children with SCT admitted in our unit.

Materials and Methods:
A single-centre retrospective study of medical records of SCT paediatric patients treated for HOAIs between January 2012 and June 2019 was performed. The data extracted were epidemiologic (gender, age at diagnosis, history of haemoglobinopathy and ethnic group), diagnostic (time to diagnosis, type of infection and fraction of haemoglobin S [HbS] at standard electrophoresis of Hb), germs and complications.

Results:
Among 149 patients with haemoglobinopathy treated for HOAIs, 52 have SCT. The prevalence of SCT patients was 34.9%. Thirty-nine (n = 39) records were retained for the study. The average age at diagnosis was 7.18 ± 4.59 years (7 months–15 years). The Malinké ethnic group was found in 22 (56.4%) cases. The mean HbS fraction was 37.2% ± 4.3% (30%–46%). Septic arthritis and osteoarthritis involved the hip in 11 cases, the shoulder in 4 and the knee in 2. Osteomyelitis was acute in 5 cases (11.1%) and chronic in 16 (35.5%). None of the patients has multifocal involvements. Bacterial identification was positive in 17 cases (37.8%). Staphylococcus aureus was involved in 9 cases (52.9%), and in one case, it was Mycobacterium tuberculosis. This patient has abscess of the psoas. No patient was infected by human immunodeficiency virus. The sequelae were joint destruction (n = 2), epiphysiodesis (n = 5) and retractile scars (n = 2).

Conclusion:
Relatively infrequent in our daily practice, SCT patients present with HOAIs. These infections had characteristics that are not very different from the series of the literature.
Current Issues of GERD Surgical Treatment in Children
Authors: Akhparov Nurlan Nurkinovich , Boranbayeva Riza Zulkarnaevna , Suleimanova Saule Bakhtyarovna , Temirkhanova Madina 
Published: February 2021

Introduction:
Gastroesophageal reflux disease is one of the most common diseases among a wide range of chronic inflammatory diseases of the gastrointestinal tract in children of all ages, significantly impairing the quality of life of the child and posing a serious threat to the health of the patient.

Materials and Methods:
From 2008 to 2019, 134 patients aging from 6 months to 12 years were hospitalized at the Scientific Center for Pediatrics and Pediatric Surgery, including 69 (51%) infants. Of them, 51 (38%) were the patients with persistent manifestations of regurgitation, despite an outpatient course of conservative therapy; 29 (22%) patients with recurrent reflux-associated pneumonia; also, 35 (26%) children with gastroesophageal reflux in the structure of the main pathology of the central nervous system, as well as 19 (14%) patients after surgery of the anastomosis of the esophagus with its atresia. One hundred and seven (79.8%) patients underwent surgery. Nissen esophagofundoplication was traditionally performed in 41 (38%) patients, in combination with Stamm gastrostomy in 14 (34%), with Mikulich pyloroplasty in 9 (22%), and in combination with gastrostomy and pyloroplasty in 12 (29%) children. Laparoscopic Nissen esophagofundoplication was used in 16 (15%). Thall esophagofundoplication was performed in 48 (45%) patients, whereas in two (2%) cases, Borema gastropexy was conducted.

Results:
The immediate results were studied in all 107 patients. Complications in the form of gastric distress syndrome were revealed in four (3.7%) patients who did not undergo pyloroplasty, which in two (1.9%) cases required additional surgery of the stomach draining, whereas in the other two (1.9%) patients, the distress syndrome was stopped conservatively. A dumping syndrome was identified in two (1.9%) patients.

Conclusion:
Timely recognition of the pathological process, its nature, and prevalence determines the indications for the use of various methods of operation, which are based on an individual approach to each patient.
Constipation after Surgery for Anorectal Malformations
Authors: Upadhyaya Vijai D. , Bharti Laxmi K. , Mishra Ashwani , Yousuf Mohd. , Mishra Prabhakar , Kumar Basant 
Published: February 2021

Background:
Constipation is a common problem after surgery for anorectal malformations (ARMs), especially in patients having preserved rectosigmoid after pull-down surgery. Here, we present our experience with patients having constipation after surgery for ARMs and briefly discuss its management.

Materials and Methods:
We retrospectively reviewed electronic operative and follow-up data from January 2015 to December 2019 of all patients having constipation after surgery for ARMs.

Results:
A total of 77 patients were included in the study. The median age was 60 months, and thirty patients were male. Primary diagnoses were rectourethral fistula (26; 33.77%), vestibular fistula (25; 32.47%), perineal fistula/ectopic anus (18; 23.38%), rectovaginal fistula (4; 5.19%) and imperforate anus without fistula (4; 5.19%). Anal stenosis was found in 20 (25.97%) patients, posterior ledge with an adequate anal opening in 5 (6.49%), displaced anus in 4 (5.19%) but no obvious problem found in 48 (62.34%) patients. Non-operative management was successful in 75.44% (43 out of 57) of patients. Surgery was performed in 32 out of 77 patients (41.56%) with no mortality. Forty-three (72.88%) patients are continent, stayed clean, but 16 (27.19%) patients still need some sort of laxative/bowel wash/enema intermittently (Grade I/II constipation). Incidence of constipation was higher in patients operated through anterior sagittal route (27.58%) than posterior sagittal route (23.94%), but it was not statistically significant (P = 0.479). Follow-up ranged from 3 months to 5 years.

Conclusion:
Constipation is a common problem after ARMs surgery, especially in patients having preserved rectosigmoid after pull-down surgery. It is advisable to create relatively larger neoanus after pull through with early practice of neoanus dilatation, especially in redo cases. Repeated counselling, laxatives and dietary manipulations should begin at the first sign of constipation.
The Role of Fluoroscopically Detected Coronary Calcium in Predicting the Presence of Significant Coronary Lesions
Authors: Pinto Jostol , Viswanathan Sunitha K. , Koshy George A. , Gupta Prabha Nini , Radhakrishnan V. V. 
Published: February 2021

Abstract

Context:
Coronary artery disease (CAD) accounts for over 16' of deaths worldwide.[1] As part of its diagnosis and stratification of severity in a patient, a noninvasive modality would certainly be useful to triage CAD.

Aims:
To assess the diagnostic accuracy of fluoroscopically detected coronary artery calcification (CAC) as a tool to grade coronary stenosis.

Settings and Design:
Comparing severity of fluoroscopic CAC with a severity of CAD by coronary angiograms (CAGs) in a high-volume center.

Subjects and Methods:
Fluoroscopic presence of CAC was graded using the Yamanaka method and correlated with CAGs in 200 patients.

Statistical Analysis Used:
Sensitivity, specificity, predictive values, accuracy, Chi-squared tests for significance.

Results:
The overall prevalence of CAC was 43' varying with age, sex, and CAD severity. The most common location of CAC was the left anterior descending artery followed by right coronary artery. Fluoroscopic CAC had 94' specificity and 96.5' positive predictive value for significant stenosis, albeit lower sensitivity of 55.3'. While 63' of those patients with single-vessel CAC had multivessel CAD, 91' of those with multivessel CAC had multivessel CAD. CAC was detected as follows: 6' in minor CAD, 40' in single-vessel disease (VD), 64' in two- or three-VD, and 100' in those with four-VD (P = 0.001). CAC was seen in 69.6' of patients having chronic total occlusions (CTOs) while in only 32.6' without CTOs (P = 0.001).

Conclusions:
A strong relation is present between CAC and severity of CAD. CAC is not a good screening tool for CAD due to low sensitivity. Notably, multivessel CAC strongly predicts multivessel CAD.
Anomalous Right Coronary Artery from the Pulmonary Artery in a Young Infant with Ventricular Septal Defect
Authors: Singhi Anil Kumar , Hawker Richard , Sholler Gary 
Published: February 2021

Abstract
We report a case of anomalous right coronary artery from pulmonary artery (ARCAPA), which is a very rare congenital coronary defect. It can be an isolated lesion or associated with congenital cardiac defects such as tetralogy of Fallot or shunt lesions in up to 40' of cases. The clinical presentation varies from asymptomatic to signs of myocardial ischemia, cardiac failure, and/or ventricular arrhythmia. The electrocardiogram can be normal in a significant fraction of the cases. The diagnosis of ARCAPA may be confirmed by cardiac catheterization, computed tomographic angiogram, and cardiac magnetic resonance angiogram. Reimplantation of anomalous coronary artery is the treatment of choice. In the current era, systematic preoperative screening by echo is recommended.
Case Report: Spinal Subarachnoid Hemorrhage: A Rare Complication of Hemorrhagic Fever with Renal Syndrome
Authors: Lo Shih-Hao , Chen Pei-Ting , Yu Wan-Jin , Hsieh Ke-Syuan , Chen Tun-Chieh 
Published: February 2021

ABSTRACTHemorrhagic fever with renal syndrome (HFRS), caused by hantavirus, is occasionally seen in tropical areas. The virus is carried by specific rodent host species. Hemorrhagic fever with renal syndrome is characterized by renal failure and hemorrhagic manifestations, and its complications may be severe, including massive bleeding, multi-organ dysfunction, and possibly death. In this patient case, a 46-year-old woman diagnosed with HFRS initially presented with fever, impaired renal function, and thrombocytopenia. Four days after symptom onset, the patient complained of abrupt right lower abdominal pain and numbness. Magnetic resonance imaging revealed a spinal subarachnoid hemorrhage (SAH) beyond the T7 to S2 vertebrae. No cases of spinal SAH in HFRS have been reported until now. This case demonstrates that when a patient’s symptoms are atypical, bleeding-related complications must be considered.
The COVID-19 Pandemic in Peru: What Went Wrong?
Authors: Schwalb Alvaro , Seas Carlos 
Published: February 2021

ABSTRACTDespite the early adoption of a national lockdown and other restrictions, Peru has been severely impacted by the COVID-19 pandemic. Having reached a milestone of more than 1,200 deaths per one million inhabitants by February 2021, important messages can be learned from how the pandemic was handled. Possible explanations for poor outcomes are a fragmented and already overwhelmed public health sector, lack of infrastructure and specialized personnel to tackle the pandemic, and deficient leadership from health authorities.
Corrupción y formas de gobierno
Authors: Jiménez-Blanco Carrillo de Albornoz Antonio 
Published: February 2021

Entre las causas de la corrupción las hay o puede haber culturales, estructurales e institucionales. Cabe preguntarse si, dentro de estas últimas, se encuentra la que distingue, dentro de los Estados democráticos, entre formas de gobierno presidencialistas y parlamentarias. En el bien entendido de que la comparación, aplicada a un determinado país, no puede hacerse sobre magnitudes homogéneas, porque estamos comparando una realidad y una mera conjetura.
El autor parte de la base de España (un régimen parlamentario según la Constitución de 1978) y en la que todos los indicadores, sea cual fuere su grado de fiabilidad, arrojan unos elevados índices de corrupción, sobre todo en el período de expansión económica 1996-2008.
El trabajo, que por supuesto comienza poniendo de relieve la dificultad de ofrecer un concepto preciso y universal de corrupción, así como la convergencia entre ambas formas de gobierno, concluye que entre las causas institucionales de la corrupción no tiene por qué encontrarse la forma de gobierno. Y en particular sostiene la idea de que el parlamentarismo no significa necesariamente una mejora con respecto al presidencialismo.
ASSESSMENT OF FINANCIAL MANAGEMENT CHALLENGES FACING THE MICRO AND SMALL ENTERPRISES (MSES) IN KENYA: A CASE OF MERCHANDIZING MSES LOCATED IN NAIROBI RIVERROAD AREA
Authors: Tayari Amos M. , Nkatha Ms. Esther 
Published: February 2021

Purpose: This study was an assessment of the financial management challenges facing MSEs in Kenya in the case of merchandizing MSEs located along River Road.Methodology: A descriptive survey research design was adopted. The target population was all the 210 MSEs located along river Road in Nairobi. The study used systematic random sampling. All the MSEs were numbered and included in the sampling frame. One MSE out of every five MSE was picked at random thus resulting to a sample size of 42 which was 20% of the population. Data was collected using a questionnaire, analyzed by use of descriptive statistics and findings presented using charts and graphs.Results: Findings in this study indicated that the financial management challenges facing MSEs were in the area of trade credit management, inventory management, debtors’ management and cash management. It was concluded that indeed MSEs were facing a serious challenge in financial management.Unique contribution to theory, practice and policy: It was recommended in this study that business incubation projects should be set up to impart financial knowledge to MSE owners. It was suggested that a correlation or a regression analysis should be carried out as an area of further study in order to ascertain the influence of financial management training and MSE success/growth. Such a study would inform the formulation of government policy aimed at promoting the growth of the MSE sector
IMPACT OF STRUCTURAL ADJUSTMENT PROGRAMS ON AGRICULTURAL SECTOR GROWTH IN KENYA
Authors: Mbithe Dr. Pauline , Mwabu Dr. Prof. Germano , Awiti Mr. Maurice 
Published: February 2021

Purpose: The study was an examination of the impact of structural adjustment programs on agricultural growth in Kenya.Methodology: The study examined the short run and long run determinants of agricultural sector performance in Kenya. To achieve this, the study use time series regression modeling for data spanning from 1975 to 2010. Tests of normality, unit roots test and cointergration test was applied to determine the properties of the data. Upon proof of cointergration, an error correction model was estimated to link the short run and the long run relationships.Results: The results indicated that structural adjustment programme (SAPs) had a negative and significant long run effect on per capita agriculture GDP. The study concluded that Post Election Violence had a negative and significant long run effect on the per capital agriculture GDP. The study also concluded that the lagged per capital agricultural performance had a positive and significant effect on the per capita agricultural performance. The results also led to the conclusion that the long run per capita agricultural growth may be linked to the short run growth by an error correction term of -0.242583 which indicates that 0.242% of the disequilibria in short run per capita agricultural sector GDP achieved in one period are corrected in the subsequent period. The results also led to the conclusion that weather indicators (temperature and precipitation), and per capita infrastructure did not have a significant effect on the short run and long run per capita Agricultural GDP.Unique contribution to theory, practice and policy: The study recommends that some harmful policies need to be eliminated such as the removal of subsidies. Other policy recommendations are to enhance the adaptation of privatized agricultural institutions; encouragement of value addition in primary agricultural products; non price mechanisms such as infrastructure should be encouraged especially in the rural areas; and enhancement of the political stability of the country especially during electioneering years.
DETERMINANTS OF SUSTAINABILITY OF DONOR FUNDED COMMUNITY PROJECTS IN GARISSA COUNTY
Authors: Ngatia Arnold , Kihara Dr. Allan 
Published: February 2021

Purpose: This study sought to assess the determinants of sustainability of donor funded community projects in Garissa County. The study specifically focused on community participation, financial administration, training and leadership and management on sustainability of donor funded community projects in Garissa County. The variables were anchored by the freirean theory, results theory, competency theory and the systems theory.Methodology: The study adopted a descriptive research design and the population included donor funded project managers, donor agencies and project beneficiaries. Mugenda and Mugenda’s sample determination formula to acquire a sample size of 246 respondents. Further, the study employed stratified sampling so as to determine the exact number of respondents from the different categories. Primary data was collected through semi structured questionnaire while secondary data was collected through desk search techniques from the internet from past scholarly articles. Quantitative data was analysed using a multivariate regression model while qualitative data was analysed using content analysis method.Results: Inferential results revealed a positive and significant relationship between community participation and sustainability of donor funded community projects and also positive and significant association between financial management and sustainability of donor funded community projects in Garissa County.Contribution: The study concluded that an improvement in various indicators of community participation such as donor funded community projects leaders’ vision, community empowerment and community decision-making, programme planning, monitoring and evaluation, leadership and management skills, establishment of linkages between project components, supervision and mobilization of local resources will result to positive and significant effect on sustainability of donor funded community projects in Garissa County. The study also concluded that improvement in some of the indicators that define financial management results to positive and significant effect on sustainability of donor funded community projects in Garissa County.
DETERMINANTS OF PERFORMANCE OF SANITATION PROJECTS IN INFORMAL SETTLEMENTS IN KENYA: A CASE OF KIAMBIU, KAMUKUNJI SUB COUNTY, NAIROBI, KENYA.
Authors: Mogire Douglas , Ngugi Dr. Patrick 
Published: February 2021

Purpose: The general objective of the study is to establish Determinants of performance of sanitation projects in informal settlements in Kenya. Specific objectives were to assess the effect of project quality, project stakeholder participation, project team development and project resources on performance of sanitation projects in informal settlements in Kenya.Methodology: The study adopted a descriptive research design. Stratified random sampling was used to divide the population into different strata i.e. Project Managers, Project Engineers and Project Architectures so as to draw randomly a predetermined number of units. The collected data was coded and analyzed using the Statistical Program for Social Sciences (SPSS) version 20 because of its ability to analyze data easily and accurately. ANOVA (analysis of variance), multi-regression data analysis methods was applied to analyze the data obtained from the study. The findings was presented by use of bar charts, graphs, tables and pie charts. A multivariate regression model was applied to determine the relative importance of each of the four variables with respect to factors influencing the success of sanitation projects in informal settlements a case of Kiambiu Slums, Kamukunji Sub County.Results: Correlations analysis was then conducted at 95% confidence interval and 5% confidence level 2-tailed., Results showed that there is a positive relationship between all the four factors and success of sanitation projects in informal settlements. The positive relationship indicates that there is a correlation between the factors and the success of sanitation projects in informal settlements. Based on the correlation coefficients, Project quality have the highest influence on success of sanitation projects in informal settlements at r = 0.763 and p = 0.040, followed by Stakeholder participation at r = 0.632 and p = 0.009, then Project team at r =0.614 and p = 0.022 while Project resources had the least influence on success of sanitation projects in informal settlements at r = 0.596 and p = 0.016.Conclusion: The study concludes that Project managers should focus on making sure that stakeholders are understood in terms of their quality needs. It also involves determining what quality outputs will be exchanged over the course of the project for example status updates, minutes of meetings, reports on deliverables. Project managers should make careful plans to outline who receives which quality, who is responsible to deliver and respond to quality content, and how and when quality will be deliveredPolicy Recommendation: The study recommended that Quality plans should be executed and monitored over the course of project implementation and throughout until project is completed