bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addition of Fentanyl to Hyperbaric Bupivacaine in spinal anesthesia for Caesarian section – effect on dose of local anesthetic and duration of postoperative analgesia – a randomized comparative study
Authors: Mir Ghulam Mohammed , Haadi Mohammed Abdul 
Published: March 2019

Background: Spinal anesthesia is commonly used for caesarian section for its reliability and ease of administration. However, it is limited by fixed duration of anesthesia, hypotension and lesser control of block height. The combination of reduced dose of local anesthetic agent with intrathecal opioid makes it possible to achieve adequate spinal anesthesia with minimum hypotension and prolonged postoperative analgesia. The study aims to monitor the effect of intrathecal fentanyl and bupivacaine on reduction of higher blocks and simultaneously improving the quality and avoiding higher doses of local anesthesia agents.
Methods: Forty patients scheduled for elective caesarian section were divided in to two groups of twenty each. Group I patients received Bupivacaine 12.5 mg (0.5%) for spinal anesthesia and group II patients received combination of Bupivacaine 8.5 mg (0.5%) with fentanyl 25 mcg. Patients were observed for hypotension, bradycardia, nausea, pruritus, quality of surgical anesthesia and duration of postoperative analgesia.
Results: All the patients had adequate surgical anesthesia for the procedure and in no patient conversion to general anesthesia was required. Peak sensory level was higher (T2-T3 vs T4-T6) and motor block was more intense in the regular dose bupivacaine group of patients. More patients in bupivacaine only group developed hypotension and the requirement of vasopressors was significantly higher than the low dose bupivacaine with fentanyl group. Also the Visual analogue scale score for pain was less in the bupivacaine-fentanyl group, who received less postoperative analgesics for first twelve hours.
Conclusions: We conclude that combination of low dose bupivacaine (8.5mg) with fentanyl provides adequate surgical anesthesia for caesarian section and with low incidence of hypotension and nausea. Also, addition of fentanyl helps in prolongation of postoperative analgesia. JMS 2017;20(2):62-68
Rare Case of Inguinal Hernia in a Female Patient
Authors: Malik Liaqat Ahmad , Malik Ajaz Ahmad , Dar Parvez Mohi u din 
Published: March 2019

75 years was referred from SMHS hospital as a case of left-sided irreducible inguinal hernia. The patient was a known case of rheumatic heart disease on multiple drugs. The patient was having a history of constipation for 4 days and mild pain lower abdomen. All investigations were within normal limit and patient was afebrile. The abdomen was soft, nondistended. There was mild tenderness over the right inguinal region and a soft boggy swelling was palpable. It was nonreducible. JMS 2018;21(1):47
Surgical Perspective of Wound Site Infection at a Tertiary Care Hospital
Authors: Malik Ajaz Ahmad , Bari Shams Ul , Bhat Sajjid H , Zaroo M Inam 
Published: March 2019

Background:
Surgical wound infection is a common postoperative complication and causes significant postoperative morbidity and mortality, prolongs hospital stay, and adds to hospital costs.
Aims and objectives: This study was designed and carried out in the Department of General surgery SKIMS Srinagar in order to find infection rate after clean and clean-contaminated surgery in our hospital, to study the clinical profile of patients with surgical site infections (SSI), to find out the common organisms involved in different wound infections and to study the risk factors for postoperative wound Infections.
Methods: This study was carried out prospectively in the Department of General and Minimal Access Surgery SKIMS, Srinagar from February 2012 to January 2014 on 117 cases that underwent clean and clean-contaminated surgery.
Results: In our study, the frequency of Surgical Site Infection was 13%. The incidence amongst clean surgical cases was 6.5% and amongst clean-contaminated cases 19.3%.
Conclusion: Despite prophylactic use of broad-spectrum antibiotics and the availability of modern surgical and sterilization techniques, postoperative wound infection still remains a major contributory factor of morbidity in patients who underwent surgical procedures. JMS 2018;21(1):17-23
Endoscopic Surgery in Rectal Cancer- A Review
Authors: Wani Rauf Ahmad , Mehraj Asif 
Published: March 2019

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Total mesorectal excision (TME) remains the gold standard treatment for any stage of rectal cancer, especially in more advanced disease, as it effectively treats the mesorectal lymph nodes and reduces recurrence [1]. Minimally invasive abdominal approach has been established to be oncologically safe, feasible and associated with all the advantages of minimal access surgery, however, it has not had a measurable impact on the incidence of postoperative complications, sexual and urinary dysfunction, or quality of life. TME performed either via open, laparoscopic or robotic approach is accompanied by significant morbidity and mortality [2]. In addition, widespread adoption of laparoscopic techniques in colorectal surgery has been limited by the technical complexity and steep learning curve. In an effort to harness the advantages of a minimally invasive approach to beneﬁt patients with colorectal pathology, trans anal natural oriﬁce transluminal endoscopic surgery (NOTES) has been explored, with promising preliminary results, particularly when used for rectal cancer and other benign lesions. NOTES in Rectal lesions can be carried out using Transanal Endoscopic Microsurgery (TEMS) and Transanal Minimal Invasive Surgery (TAMIS), which can be together termed as Transanal endoscopic surgery. JMS 2018;21(1):3-10
Adenosquamous Carcinoma of Ampulla of Vater: A Case Report and Review of Literature
Authors: Rasool Zubaida , Nazir Mir Wajahat , Khursheed Sumat Ul 
Published: March 2019

Background: Adenosquamous carcinomas are very rare tumors of the ampulla of Vater with only seven cases reported in literature.
Case report: We report a case of adenosquamous carcinoma in a 40-year male that was a known case of chronic pancreatitis and presented on follow up with a contrast enhancing 2.3 x 2.1 cm lesion in the ampullary region. JMS 2018;21(1):44-46
Primary Gall Bladder Carcinoma: A one year prospective study at a tertiary care centre.
Authors: Rasool Zubaida , Samoon Nuzhat , Bhat Nazia , Nazier Huzaifa , Gupta Kanika 
Published: March 2019

Background: Gallbladder carcinoma is not an uncommon clinical entity in the Indian scenario, unlike western countries. It is predominantly a disease of females. Association between gallstones and Gallbladder carcinoma is strong. Its carcinogenesis follows a progression through a metaplasia−dysplasia−carcinoma sequence. An early diagnosis is essential as this malignancy progresses silently with a late diagnosis, often proving fatal. Therefore, every gallbladder should be subjected to routine histopathological examination because with identification of an earlygallbladder carcinoma a curative resection may be possible, and these patients have a good survival rate.Methods: This was a prospective study done on 22 cases of gallbladder carcinomas over a period of 1 year from 1st November 2017 to 1st November 2018.Results: Present study showed that gallbladder cancer is predominantly a disease of elderly females. In the present study, abdominal pain 18 cases (81.81%) followed by anorexia 15 cases (68.18%)and dyspepsia14cases(63.63%) was the most common presenting symptom present. Cholelithiasis was found in only 5 (22.72%) of our patients. Adenocarcinoma was the most common histopathologic variant found in 20 cases (90.90%) followed by squamous cell carcinoma 2cases (9.09%).Conclusions: Every gallbladder should be subjected to routine histopathological examination because with the early-stage disease a curative resection may be possible, and these patients have good long-term survival. JMS 2018: 21 (2):91-94
Are nanomaterials really safe?
Authors: Shiekh Farooq A , Lodhi Mohammad Uzair , Yousuf Syed Douhath , Qureshi Taha A , Mudassar Syed 
Published: March 2019

Nanotechnology is not but many nanoscale technologies with powerful engineering to control nanomaterials or matter-building atom-by-atom is gaining speed and focus. Although, the organization and creation of nanotechnology products or materials is not random, unfortunately a little is done about the mechanisms or rules that govern its assembly and toxicity. As a result, environmental health and safety agencies around the world continue to grapple with how best to regulate these novel materials.
Taken together, the focus must be directed towards approaches and sophisticated tools for risk assessment and management. This review article continues the debate and offers a unique view perspective from the vantage point of a nanotechnologist. JMS 2018: 21 (2):72-76
DIAGNOSTIC LAPAROSCOPY: Utility and solving diagnostic dilemmas
Authors: Malik Ajaz A 
Published: March 2019

Diagnostic laparoscopy is the basic procedure in laparoscopic surgery that has wide utility in practice, thus avoiding morbidity associated with open surgery. Laparoscopy is a minimally invasive technique wherein a fibre optic instrument is inserted through the abdominal wall to view the organs in abdomen/pelvis and permit the diagnosis and necessary surgical procedure. Nowadays, almost all general surgical procedures can be performed using minimal invasive techniques. Laparoscopy can be performed both for diagnostic as well as for therapeutic purposes. JMS 2018: 21 (2):70-71
Hydrocortisone plus Fludrocortisone -- Promising rescue in septic Shock:
Authors: Malik Ajaz A 
Published: March 2019

Septic shock is defined by a dysregulated host response to infection, resulting in life-threatening circulatory, cellular, and metabolic abnormalities. The short-term mortality is approximately 45-50%, and around half of survivors of sepsis may have subsequent long-term cognitive decline. Apart from early hemodynamic, respiratory resuscitation and appropriate antimicrobial treatments, there is no approved adjunct therapy for sepsis. JMS 2018: 21 (2):134-135
Institutional complementarity for social and economic development
Authors: Bilan Yuriy , Vasilyeva Tetyana , Lyeonov Serhiy , Bagmet Kseniya 
Published: March 2019

oday the prevention of global challenges (from global security to the problems of poverty) relates to the institutional quality. Nowadays, the social standards or other “social rules” make the part of the market system, since they are built into the country’s institutional structure. Neither social nor economic reforms can be implemented without the support through institutional mechanisms.
The purpose of this paper is to explore the relationship between social sector institutions and basic institutions, taking into account the economic development of countries and the way in which they are formed.
A number of empiric studies confirmed significant role of institutions to provide conditions for economic development. In order to define and assess the link between the basic institutions and the social sector institutions, we formed panel data that includes 20 countries for the period from 2007-2014. We assessed quality of the basic institutions using The Worldwide Governance Indicators (WGI). WGI methodology provides an evaluation of six dimensions of the institutional quality that enables to define the connection and the impact of every dimension on the institutional quality of the social sector.
The model additionally evaluates the impact of the incomes distribution inequality, general economic welfare on the institutional quality of the social sector. Among all dimensions of governance “Rule of Law” and “Regulatory Quality” the statistically significant direct impact on the institutional quality of the social sector has been revealed. It confirms the complementarity of basic institutions and institutions of the social sector.
The Role of Magnetic Reconnection–associated Processes in Local Particle Acceleration in the Solar Wind
Authors: Adhikari L. , Khabarova O. , Zank G. P. , Zhao L.-L. 
Published: March 2019

Abstract
Recent studies of unusual or atypical energetic particle flux events (AEPEs) observed at 1 au show that another mechanism, different from diffusive shock acceleration, can energize particles locally in the solar wind. The mechanism proposed by Zank et al. is based on the stochastic energization of charged particles in regions filled with numerous small-scale magnetic islands (SMIs) dynamically contracting or merging and experiencing multiple magnetic reconnection in the super-Alfvénic solar wind flow. A first- and second-order Fermi mechanism results from compression-induced changes in the shape of SMIs and their developing dynamics. Charged particles can also be accelerated by the formation of antireconnection electric fields. Observations show that both processes often coexist in the solar wind. The occurrence of SMIs depends on the presence of strong current sheets like the heliospheric current sheet (HCS), and related AEPEs are found to occur within magnetic cavities formed by stream–stream, stream–HCS, or HCS–shock interactions that are filled with SMIs. Previous case studies comparing observations with theoretical predictions were qualitative. Here we present quantitative theoretical predictions of AEPEs based on several events, including a detailed analysis of the corresponding observations. The study illustrates the necessity of accounting for local processes of particle acceleration in the solar wind.
Analyse d’anciennes et nouvelles idéologies du développement en Afrique
Authors: Lafrance Jean-Paul 
Published: March 2019

Gilbert Rist considérait le « développement » comme une utopie occidentale et un élément de la religion moderne du progrès des civilisations. Ce concept peut-il s’appliquer comme tel en Afrique ? L’auteur analyse la naissance politique du paradigme, dit développementiste, en le situant à la fin de la Deuxième Guerre mondiale, au moment où la politique extérieure des États-Unis est en pleine redéfinition.Mais qui dit développement, dit sous-développement, ou pour être plus poli de pays en voie de développement, avec tout ce que cela implique de biais pour ceux-ci. Quoiqu’il en soit, l’Afrique peut-elle se permettre de bouder le développement technologique ? La grande question est de se demander de quel type de développement l’Afrique a besoin ? Revue des aspects positifs et des aspects négatifs du type de développement des pays africains et les chances de réussite.
Discours de haine sur internet : entre la violence du cadrage biopolitique et le langage éthique du visage
Authors: Vieira Frederico , Salgueiro-Marques Angela Cristina 
Published: March 2019

Cet article propose une réflexion à propos de la violence de l’affrontement entre les identités totalisantes et les altérités subalternes exprimées dans les posts (images et textualités) qui circulent sur le réseau numérique. Nous utilisons la perspective biopolitique (Foucault) pour analyser les pratiques discursives révélées dans les sites web sur Tumblr : « Esses nordestinos... » et « Esses Paulistas... ». Ceux-ci ont été créés après la réélection de Dilma Rousseff à la Présidence de la République en octobre 2014 et révèlent comment les populations du Nord-Est et du Sud-Est brésilien sont dirigées vers un conflit dont l’objet de dispute est aussi l’élément qui renforce les formes de contrôle et d’homogénéisation des groupes. Nous considérons dans les analyses les oppositions entre identités et altérités, selon la notion de cadrage interprétatif (Butler), la signification éthique du « Visage » (Lévinas) et la biopuissance (Hardt et Negri, Lazzarato, Pelbart).
Les enjeux de l’utilisation du système de communication VSAT dans les processus électoraux en Afrique
Authors: Napo Sonhaye Kondi 
Published: March 2019

En démocratie, tout citoyen a un réel besoin de transparence. Il revendique à chaque moment où il est sollicité un droit à la vérité et pendant les élections, le droit à la « vérité ». Dans les sociétés occidentales où la question de la transparence est omniprésente, les crises de confiance paraissent être perpétuelles. Plus une société est « des élections ont été mises en place transparente » plus on identifie des dysfonctionnements. La question de la transparence va donc de pair avec le développement des démocraties. (Pascal Dauvin, 2014).En Afrique où la démocratie est encore naissante, la transparence est un enjeu et un défi surtout en période électorale. Compte tenu des difficultés de terrain et de communication dans certaines zones du continent, l’usage des technologies numériques est souvent déterminant dans les mobilisations citoyennes en temps de crise. Le système VSAT est souvent sollicité après un scrutin pour la transmission et le « transport » rapide des données et des informations.Au Togo, lors des élections de 2010 et de 2015, des institutions de transparence pour des élections ont été mises en place, notamment la Commission Électorale Nationale Indépendante (CENI). Les entretiens et enquêtes menés auprès des électeurs et des principaux acteurs de la vie politique et l’analyse des discours de campagne nous a permis de constater que la préoccupation première de chacun pour endiguer la crise électorale récurrente est la mise en place d’un système consensuel pouvant limiter les fraudes et garantir la transparence. C’est dans ce sens que le VSAT a été coopté par la CENI comme matériel de communication dans les deux processus électoraux sans être véritablement utilisé à cause des questions autres que le fonctionnement du système en lui- même.Les deux autres cas analysés où le système VSAT a été utilisé avec des résultats sans contestation sont ceux du Burkina Faso et de la République Démocratique (RD) du Congo.Au Burkina Faso, lors des élections législatives et municipales de 2013, organisées avec l’appui du Programme des Nations Unies pour le Développement (PNUD) et des partenaires au développement ainsi que celles de 2016, le système VSAT avait été utilisé afin de garantir un scrutin transparent et sans contestation dans ce pays. Ce qui a été le cas.En République Démocratique du Congo, vu l’immensité du pays, le système VSAT a été véritablement au cœur des élections sans crise en 2011 avec l’implication active des acteurs indépendants au processus tels que l’Organisation des Nations Unies et le Centre Carter. Cette élection avait pour objectif de ramener la paix après une dizaine d’années de crises et de guerres.Notre contribution a pour objet, les enjeux de transparence autour de l’utilisation de ce système VSAT convoité ou décrié, dans la prévention des crises électorales en Afrique.
De la bataille des chiffres à la bataille des mots. Tensions autour de la fabrication d’une crise
Authors: Stratigos Jean-Marie 
Published: March 2019

Quand un cyclone frappe l’Asie du Sud Est, un conflit se déclenche au Moyen-Orient, ou un tremblement de terre secoue l’Amérique du Sud, ces événements ne sont pas (re)connus en tant que « crises humanitaires » avant d’avoir été qualifiés, quantifiés puis diffusés. Les individus, animaux, végétaux, lieux, objets qui participent de la « catastrophe » doivent être redéfinis dans le vocabulaire de l’humanitaire pour exister. Les individus deviennent des « sinistrés », des « sans-abris », des « déplacés », des « victimes » ; dans un second temps, ils pourront devenir des « bénéficiaires ». Les bâtiments, les arbres, les champs, les voitures deviennent des « dégâts » ; ils pourront ensuite devenir des projets. Toutes ces catégories nouvellement créées justifient la présence des programmes d’aide, de la communauté humanitaire, de ses personnels et de ses activités. Sans processus de quantification et de qualification, sans diffusion de l’information, la crise n’existe pas, et l’aide humanitaire non plus. La fabrication de la crise est donc un moment essentiel qui repose sur la collecte, la mise en forme et la diffusion de l’information. Ce processus qui repose sur la maîtrise des technologies de l’information et des techniques de la communication est aussi le théâtre de tensions et de compétitions entre les différents acteurs de l’humanitaire qui veulent le contrôler. Sur la base d’un travail ethnographique mené en 2007 et 2008 à Madagascar, ce sont ces tensions entre les humanitaires internationaux et leurs contreparties nationales lors du passage des cyclones Fame et Ivan que nous étudierons dans ce travail.
Respiratory Medicine in Iraq – from the Primitive to the Advanced
Authors: Al-khairalla Mudher , Qaraghulli Mwaffaq , Alwan Mohammed 
Published: March 2019

Healthcare in Iraq has seen significant decline over the past few decades. Political instability coupled with austerity due to conflict and war has become a major obstacle in the transition needed to restore acceptable healthcare standards. Respiratory medicine had remained under developed despite the potential benefit it could offer to many people suffering diseases of high prevalence. A dedicated team of experts carried out a feasibility study to create a specialist respiratory centre, ThiQar lung diseases (TQLD). Equipped with advanced diagnostic equipment, a paperless hospital information system and staff trained by specialists from the UK, the centre has reduced a significant healthcare gap. It now serves a large population catchment area and has helped offer people an alternative to seeking healthcare abroad.
Occupational Therapy Can Benefit From an Interprofessional Rehabilitation Treatment Specification System
Authors: Fasoli Susan E. , Ferraro Mary K. , Lin Susan H. 
Published: March 2019

Abstract
To advance evidence-based practice across rehabilitation professions, clinicians, and researchers could benefit from a structured way to clearly describe the treatment interventions used by their discipline. Development of the Rehabilitation Treatment Specification System is an interprofessional effort to use a theory-driven and systematic approach to define, specify, and quantify the complex nature of rehabilitation treatments. In this article, we introduce this novel approach and provide a case example that illustrates application to clinical practice. We invite occupational therapy practitioners to consider how clear specification of the content and process of their interventions could benefit practice, research, and education.