bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception des étudiants infirmiers au Liban de l’apprentissage par problème
Authors: Sassine Kazan Rima , Merheb Pauline , Chemali-Hajal Gisèle , Karam-Bader Joêlle 
Published: July 2019

Introduction : l’apprentissage par problème (APP) a été introduit dans les programmes universitaires de formation infirmière suite à l’implantation de l’approche par compétences (APC) qui a exigé une réforme pédagogique d’où l’intérêt de cette méthode. L’APP permet de stimuler chez les étudiants des habiletés de pensée critique, identifiées comme le défi prioritaire de la formation infirmière au XXI ème siècle. Contexte : plusieurs études ont été réalisées pour comprendre la perception des étudiants infirmiers de premier cycle quant à l’utilisation de l’APP dans la formation. Les résultats ont mis en relief la présence des aspects positifs et négatifs émanant de cette méthode. Objectif : le but de cet article est de décrire la perception des étudiants infirmiers quant à l’évaluation de l’APP dans leur processus d’apprentissage. Méthode : il s’agit d’une étude qualitative descriptive réalisée auprès de 20 étudiants en sciences infirmières à l’aide d’entrevues individuelles semi-dirigées. Résultats : les résultats issus de l’étude ont regroupé deux grands thèmes qui sont les aspects positifs et négatifs perçus par les étudiants envers l’APP. Les aspects positifs comprennent le développement des relations amicales dans les sous-groupes, le changement comportemental lors de l’apprentissage ainsi que le développement de l’autonomie de l’étudiant. Quant aux aspects négatifs, ils englobent le sentiment d’avoir des connaissances insuffisantes, la difficulté de gestion du temps lors de l’apprentissage et le manque de cohésion dans le groupe. Conclusion : les résultats émanant de cette étude permettraient de développer des stratégies de promotion de l’apprentissage afin d’aider les étudiants à être plus actifs dans leur apprentissage.
A Rare Case Report of High-Grade Endometrial Stromal Sarcoma in a Seemingly Healthy Uterus of a Young Patient – Optimally Managed by Minimally Access Surgery
Authors: Jain Kanika , Dutta Debasis , Chopra Kanika , Gupta Pallav 
Published: July 2019

AbstractEndometrial stromal sarcomas (ESSs) are a rare entity, constituting 10% of all uterine sarcomas and 0.2% of all uterine malignancies. We report a very rare case of high-grade endometrial stromal sarcoma in a 34-year-old female with fibroids uterus diagnosed postlaparoscopic hysterectomy. Thereafter, laparoscopic paraaortic and pelvic lymphadenectomy and bilateral oophorectomy were done. The diagnosis of high-grade endometrial stromal sarcoma Stage 1A was made, with lymph nodes and ovaries free from the disease. The patient is undergoing chemoradiotherapy at present and is in a close follow-up with us. ESS should be included as differential diagnosis of abnormal uterine bleeding so that best possible management of the patient can be done.
Acute Pancreatitis Caused by Pemetrexed, Carboplatin, and Gemcitabine in a Patient with Lung Cancer: A Rare Case Report
Authors: Kulkarni Vishal , Srinivasa BJ , Kiran PK , Sarathy Vinu , Swamy S Shivakumar , Naik Radheshyam 
Published: July 2019

AbstractDrug-induced pancreatitis is reported as one of the less common causes of acute pancreatitis. Many drugs such as sulfonamides, estrogens, tetracyclines, valproic acid, antiretroviral drugs, some chemotherapy drugs such as azathioprine, and 6 MP are known to cause acute pancreatitis. We report a case of acute pancreatitis following administration of chemotherapy for non-small cell lung cancer (NSCLC). The patient was diagnosed to have NSCLC (histologically proven adenocarcinoma). After thorough evaluation including radiological investigations consisting of a positron-emission tomography computed tomography scan, he was staged as a Stage III B NSCLC. As per protocol, he was started on combination chemotherapy with pemetrexed and carboplatin. After 2 weeks of chemotherapy, he developed acute pancreatitis which was managed conservatively. He was administered different drug combination during the next cycle involving gemcitabine and carboplatin. However, he developed recurrent acute pancreatitis which was managed conservatively. He was then referred to the radiotherapy department as it was deemed that he is at risk of recurrent episodes of pancreatitis if further cycles of chemotherapy are continued.
Angiomatous Granuloma Mimicking Verruciform lesion
Authors: Bhayya Harsha , Tejasvi Avinash , Donempudi Pavani , Paramkusam Geetha , Kardalkar Swetha 
Published: July 2019

AbstractAngiomatous granuloma also called as pyogenic granuloma (PG) is a benign soft-tissue tumor of the skin and mucous membrane arising in response to various stimuli such as local irritation, traumatic injury, or hormonal factors. PGs show a striking predilection for the gingiva. Extragingivally, it can be seen in areas of frequent trauma. It predominantly occurs in the second decade of life and is more common in females than males due to vascular effects of female hormones; here, we present a unique case in a 4-year-old female patient with a gingival growth mimicking a verrucous hyperplasia which is very rare in that age.
Outcomes of Breast Cancer Management from an Urban Specialist Breast Center in South India
Authors: Mullapudi Naga Amulya , Kirti Kabeer Katherine , Padmanaban Naveen , Nimmagadda Ramesh , Radhakrishna Selvi 
Published: July 2019

AbstractContext and Aims: The disease pattern and presentation of breast cancer in India are thought to differ from the West. The purpose of this study is to describe and to discuss the presentation, clinicopathological data, and survival from an urban specialist breast center in Southern India. Materials and Methods: Prospectively collected data were analyzed for clinicopathological details, treatment variables, and survival outcomes were analyzed. Cumulative survival curves were estimated using the Kaplan–Meier method for patients treated from 2007 to 2011. Results: A total of 1671 patients were operated at our center from January 2007 to December 2016. Average age at diagnosis was 54.2 years. Over 70% had Stage I and Stage II disease, infiltrating duct carcinoma was predominant in 88.2%. Average clinical tumor size was three centimeters. Breast conservation was performed in 22.4%. Sentinel lymph node biopsy was performed in 44.6%. Estrogen-receptor positivity was seen in 64.6%, 22.2% were Her2Neu positive. Triple negative disease was seen in 19.1%. Survival analysis was done using the Kaplan–Meier curves for 540 patients treated from 2007 to 2011. The median follow-up of surviving patients was 70 months with 10% lost to follow-up. In our study population, the 5 years overall survival rate is 88.3% and disease-free survival is 85.7%. Conclusion: Our study reflects a higher percentage of early breast cancer with outcomes comparable to the West. More research is required to understand the genetic predisposition in our population.
Treatment Refusal and Abandonment Remain Major Concerns Despite Good Outcomes with Multi-Modality Management in Pediatric Medulloblastoma: Experience from a Cancer Center in Eastern India
Authors: Das Anirban , Achari Rimpa Basu , Zameer Lateef , Sen Saugata , Krishnan Shekhar , Bhattacharyya Arpita 
Published: July 2019

Abstract
Context: Survival in medulloblastoma, the most common pediatric brain tumor, has lagged behind in developing countries in comparison to the West. Aim: The aim of this study was to analyze the clinical profile and outcome in a cancer center in Eastern India. Methods: Twenty-nine children were retrospectively analyzed over 6 years. Results: Vomiting (79%), headache (69%), and unsteadiness (55%) were the presenting complaints. The majority (67%) had classical histology. High-risk (HR) disease (61.6%) exceeded average-risk (AR) (38.4%) disease in numbers. Treatment-refusal (27.6%) and abandonment (6.9%) were major concerns. Four-year EFS was 81% and 52%, excluding and including refusal/abandonment, respectively. There was no relapse/progression among AR patients. Four-year EFS in HR was 63%. Posterior fossa syndrome (37.5%), febrile neutropenia (29%), and ototoxicity (16.7%) were the main treatment-related morbidities. Implications: Following this audit, patient tracking to reduce abandonment, coordination to limit delay in postsurgical referral, developing strategies for molecular subgrouping, and reducing cumulative cisplatin exposure were measures adopted to improve outcome in the unit.
Bone Marrow Infiltration by Nonhematopoetic Small Round Cell Tumors: A Clinicopathological Study from a Tertiary Care Centre in South India
Authors: Bhopal Triveni , Hussain Abid , Mallikarjun Sai , Lakshmi Sree , Sinha Sudha 
Published: July 2019

Abstract
Objectives: The objective of this study to comprehensively analyze bone marrow (BM) infiltration by nonhematological round cell tumors. Materials and Methods: A total of 206 diagnosed cases of small round blue cell tumors (excluding lymphomas) during a period of 2½ years, referred for BM examination were included in the study. Clinical details were obtained from medical records. BM aspiration (BMA) and BM biopsies (BMBx) were performed under local anesthesia for staging workup. BMBx were studied for cellularity, presence of infiltration by round cells (nonhematopoietic), histologic patterns (island/nests and diffuse sheets), fibrosis, necrosis and other secondary changes. Immunohistochemistry panel was used depending on the morphology. Results: The cases included age range from 45 days to 25 years with a median age of 12 years. There was a male predominance with male:female 1.5:1. Among these, 37/206 cases (17.9%) were positive for BM involvement (BMI) on BMBx. Of these, 24 cases were neuroblastoma (64.8%), 9 cases Ewing’s sarcoma/primitive neuroectodermal tumor (24.3%), and 4 Rhabdomyosarcoma (10.8). BMBx was done in all the 206 cases. Among these, 37/206 cases were positive for BMI on BMBx while 35/206 cases were positive on BM imprints and 33/206 cases were positive on BMA. Conclusion: Detection of metastasis in the BM has both therapeutic and prognostic significance. BMBx are complementary in the diagnosis of small round cell tumor.
A Rare Disease of the Breast: Bowen’s Disease
Authors: Mishra Nabal Kumar , Jain Atul , Patel Gaurav , Nurbhai Sajid Makbul 
Published: July 2019

AbstractBowen’s disease is also known as squamous cell carcinoma in situ and it occurs predominantly in older patients. Etiological factors for Bowen’s disease include ultraviolet light mainly, and in some cases, carcinogenic agents such as arsenic coal tar and petroleum products. It is frequently seen in sun-exposed area; however, other unexposed area can also be affected in few patients. Among the unexposed area, this disease affecting breast is a rare entity. These lesions are erythematous with raised, well-defined borders and a scaly appearance that may be confused with psoriasis. They present with an indolent history, having been present for years with slow growth. Histopathologically, there is atypia of the full thickness of the epidermis without dermal invasion. Progression to squamous carcinoma is slow, but 5% ultimately develop dermal invasion. Treatment generally requires complete excision for both definitive diagnosis and to rule out invasion and cure.
Expected Hepatocarcinoma Cancer Rate Due to Escape Mutant among Local Population in Thailand: The Situation after the Implementation of Universal Hepatitis B Vaccination at Birth
Authors: Joob Beuy , Wiwanitkit Viroj 
Published: July 2019

Abstract
Background: Chronic hepatitis B infection is an etiology of hepatocellular carcinoma. The high prevalence of hepatitis B can be seen in several regions including Indochina. In Thailand, a country in Indochina, according to the local public health policies, the universal hepatitis B vaccination is freely given to any infant at birth without charge. Despite the universal vaccination, the hepatitis B seropositive rate is still observed, and it can still be a cause of hepatocellular carcinoma among the hepatitis B carriers in the future. Methods: Here, the authors try to estimate the expected hepatocarcinoma cancer rate due to escape mutant among local population in Thailand, the situation after the implementation of universal hepatitis B vaccination at birth. Results: Based on the present study, the mutant escape contributes to only a few parts of overall estimated cancer cases in the situation that there is an implementation of universal hepatitis B vaccination at birth. Conclusion: Efficacy of theuniversal hepatitis B vaccination is not improved by specific management on escape mutants.
Profile of Pediatric Chronic Myeloid Leukemia in the Era of Imatinib: A Study from South India
Authors: Bernard Catherene , Suman Febe R , Rashmika Rajendran , Latha Magatha Sneha , Scott Julius Xavier , Rajesh V 
Published: July 2019

Abstract
Introduction: Chronic myeloid leukemia (CML), a chronic hematologic malignancy, is rare in pediatric patients. Studies of the tyrosine kinase inhibitor imatinib are required so that uniform guidelines may focus on disease therapy and follow-up for children. We analyzed the clinicohematologic features of the disease, treatment response to imatinib, follow-up measures, and the impact of the disease on the patients and their family. Materials and Methods: All pediatric patients diagnosed with CML and treated and followed-up were studied regarding demographics, clinical features at presentation, and diagnostic profile, including laboratory parameters, peripheral blood smear test, fluorescent in situ hybridization and karyotyping, and reverse-transcriptase polymerase chain reaction for the BCR-ABL fusion gene. Treatment modalities, adverse reactions, remedial measures, assessment at every follow-up visit, patient’s education, parents’ socioeconomic status, and economic and psychological stresses were also evaluated. Results: Six patients were administered upfront therapy with a standard dose of imatinib. Hematological and biochemical parameters were monitored after the drug administration. We assessed the treatment response using molecular detection of the BCR-ABL transcripts. All patients who complied with drug therapy showed a complete molecular response and minimal toxic symptoms. However, parents found it difficult to cope socially and economically. Conclusion: Imatinib mesylate is effective and has a good molecular response, minimal toxicity, and good patient compliance. However, due to its cost, families reacquire financial debt, and the disease creates uncertainty about the child’s future, thereby necessitating psychosocioeconomic support for parents. Changes in the policies of cancer support groups are urgently needed to provide lifelong, lifesaving drugs free of cost.
Metastatic Synovial Sarcoma: Experience from a Tertiary Care Center from India
Authors: Babu K Govind , Patidar Rajesh , Kuntegowdanahalli C Lakshmaiah , Dasappa Lokanatha , Jacob Linu Abraham , Babu Suresh , Rudresha AH , Kadabur Lokesh N , Rajeev LK , Koppaka Deepak , Asati Vikas 
Published: July 2019

Abstract
Background: Synovial sarcoma represents 8% of all soft-tissue sarcoma (STS). It is a high-grade STS, and 50% of patients develop metastasis. The most common site of metastasis is the lungs, lymph nodes followed by bones. Ifosfamide-based chemotherapy is associated with improved outcome. In this study, we report our experience of metastatic synovial sarcoma according to primary sites, metastatic pattern, and their outcome. Materials and Methods: This was a retrospective observational study carried out at our institute from January 2013 to December 2016. The aim of our study was to evaluate the pattern of metastasis, response to chemotherapy, and survival in patients with metastatic synovial sarcoma. Results: Over a period of 4 years, 43 patients with metastatic synovial sarcoma were diagnosed with median age of 30 years. Nearly 70% of patients had lung metastasis, other site of metastasis were lymph node, bone, and liver. Thirty patients received chemotherapy with a combination of ifosfamide and doxorubicin. The overall response rate was 87% with median progression-free survival of 8 months. Patients with lung only metastasis had better survival compared with nonpulmonary metastatic site (18 months vs. 12 months). The median survival was 18 months. Conclusion: Metastatic synovial sarcoma is chemoresponsive tumor with lung being the most common metastatic site. Patients with lung only metastasis had a better outcome than nonpulmonary metastasis.
Isolated Splenic Recurrence of Treated Jejunal Cancer: A Case Report with Brief Review of Literature
Authors: Agrawal Chaturbhuj Ramanand , Sharma Manish , Talwar Vineet , Goel Varun , Singh Ajit Pratap 
Published: July 2019

AbstractSpleen is a very infrequent site of metastasis despite the fact that it is the most vascular organ in the body. Even if systemic metastasis occurs, splenic metastasis largely remained asymptomatic due to its large functional reserve, and most often, the metastasis is detected incidentally on follow-up scan. Many cases of asymptomatic splenic metastasis detected on follow-up scans are reported in literature from different primary sites. Herein, we report a similar case of a 33-year-old male who presented with isolated splenic recurrence after a long treatment-free interval following curative treatment of adenocarcinoma jejunum. As stated, there are few previous reports of isolated splenic metastasis from carcinoma colon, but considering small intestinal adenocarcinoma, this is the first unique case reported to the best of our knowledge. Due to rarity of clinical scenario and lack of established guidelines, the treatment of such cases varies from patient to patient, and the knowledge, whatever we owe, is on the basis of case reports only.
Pleurodesis in Pulmonary Langerhans Cell Histiocytosis in Children: A Life-Saving Measure
Authors: Prakash Anand , Durugappa Tarangini , Ramachandran Priya , Lalitha AV 
Published: July 2019

AbstractIsolated pulmonary Langerhans cell histiocytosis (LCH) is uncommon in children. Often recurrent pneumothorax complicates therapy and contributes to morbidity. Chemotherapy does not always prevent the complications of pneumothorax. We report here a young girl with isolated pulmonary LCH who presented with respiratory failure, successfully treated with chemotherapy, and pleurodesis. We report this case to highlight the use of pleurodesis in this setting.
Gestión de la marca Ciudad de México (CDMX) y su impacto económico
Authors: Carrillo Sanchez Laura Grisel 
Published: July 2019

Ante la globalización, los gobiernos y las empresas turísticas buscan generar ventajas competitivas que las distingan del resto del mercado. En este documento se explora la manera en que la gestión de la marca de la Ciudad de México (CDMX) apoya esta búsqueda de competitividad, considerando el entorno, su composición y relaciones.Se emplea una metodología de análisis documental, exploratorio y transversal que permite comparar la gestión de la marca CDMX, con su posicionamiento y la derrama económica en cuanto a la hotelería, dada la necesidad de análisis de los resultados económicos para considerar la viabilidad del producto.
Adoption of Recommended Fertilizer dose in Farmer’s Field of Bangladesh
Authors: Mou Tamanna Haque , Islam Md. Matiul , Ahmed Mohammad Bashir 
Published: July 2019

The study was conducted to explore the farmer’s level of adoption of recommended fertilizer dose in the field. A survey was conducted at Batiaghata upazila of Khulna, Bangladesh during January to February in 2019 on purposive randomly selected 120 respondents in respect of selected twelve variables. The selected variables (characteristics of the respondents) were age, educational qualification, family size, farming experience, annual family income, farm size, organizational participation, agricultural training, cosmopolitanism, extension contact, attitude and practice. Two aspects of adoption i.e., innovativeness (time dimension) and extent of adoption (spatial dimension) of recommended fertilizer dose were considered as the focus variables. Data analysis was performed using SPSS (Statistical Package for Social Science) software version 20.0. To explore the relationship between the concerned variables Pearson’s Product Moment Coefficient of Correlation (r) for ratio data and Spearman’s Rank Order Correlation Coefficient (ρ) for ordinal data were employed. The result showed that majority of the respondents were old aged (41.7%), had secondary level of education (56.70%), belonged to small family size (50%), had high annual family income (66.7%) and high farming experience (40%) with small farm size (76.67%). Majority of the respondents had low organizational participation (44.16%), low contact with extension agent (57.5%) and medium cosmopolitanism (57.5%) and had no agricultural training (59.2%). Findings also revealed that majority of the respondents (62.5%) showed high positive attitude towards adoption of recommended fertilizer dose. About half of the respondents (43.3%) belonged to medium practice category of recommended fertilizer dose in the field. Considering the innovativeness still 45.83% of the respondents belonged to late majority to laggard category of innovation diffusion, and still 36.66% land is not under recommended fertilizer dose application which significantly differ from the amount of land under recommended fertilizer dose application. Among 120 respondents there was no innovator. Among twelve variables age and farming experience had significant positive relation with their innovativeness, and educational qualification, annual family income, farm size and extension contact had significant positive relation with their extent of adoption of recommended fertilizer dose. Thus, it might be concluded that, the remaining farmers should be motivated to adopt and the remaining land should be practically taken under proper application of recommended fertilizer dose to sustain agricultural production in the field.
Capabilities for Use of Improved Catfish Production Technologies among Fish Farmers in Delta State, Nigeria
Authors: Okeke M. N. , Mbah E. N. , Enibe D. O. 
Published: July 2019

The survey was conducted to assess use of improved catfish production technologies among fish farmers in Delta State, Nigeria. Data were collected from a sample of 50 different fish farmers in Delta State using questionnaire. Frequency, percentage and mean score were used in analyzing data for the study. Results indicated that majority (70.0%) of the respondents were male, 40.0% were between the ages of 25 and 34 years, 72.0% were married, 60.0% had a household size of 6-10 persons, 50.0% got an annual income of above ₦300,000 with 92.0% having formal education. Sources of funds for the respondents were personal savings (60.0%), friends/relations (20.0%), cooperative society (12.0%) and loans from banks (8.0%). Findings showed that improved catfish production technologies used by the respondents included fortification of cat fish feeds using root and tuber crops (M= 2.2), improved techniques in pond construction and maintenance (M= 1.7), non-conventional feed stuff for catfish (M= 1.6), fertilization and liming of catfish pond (M= 1.6), improving water quality in catfish culture (M= 1.3), prevention and control of catfish diseases (M=1.0), among others. Also, constraints to use of improved catfish production technologies were inadequate processing and storage facilities (M= 2.5), disease infestation (M= 2.3), high cost of feeds (M= 2.2), high cost of inputs (M= 2.1), inadequate funds (M= 2.1), poor market network (M= 2.0), etc. The study recommended that financial institutions should ensure timely availability of credit facilities to enable catfish farmers make provision for improved processing and storage facilities in order to boost their productivity.