bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical site infection among gynecological group: risk factors and postoperative effect
Authors: Bharatnur Sunanda , Agarwal Vandana 
Published: February 2018

Background: This study was carried out to evaluate the preoperative and intraoperative risk factors associated with surgical site infection amongst gynecology patients and its impact on postoperative recovery.Methods: A prospective, observational study was conducted among 285 patientsWho underwent surgery over a period of two years. Diagnosis of SSI was made as per CDC criteria. Various risk factors and impact of SSI on postoperative recovery were analysed. Statistical analysis was carried out with SPSS version 16.0. Range and mean was calculated for continuous variables and overall incidence rate of SSI is also calculated. Pearson Chi-square test was used to test risk factor association with SSI. Odds ratios and 95% confidence intervals (CI) was calculated. Significance was assumed at a p value of less than 0.05.Results: The incidence of SSI was found to be 52 out of 285 women (46%). Majority of SSI, i.e. 49 out of 52 (94%) were superficial in nature. Deep SSI was seen in 3 patients (6%). No organ/space infection was noted in any patient. Women who were over 50 years had higher risk of developing SSI than women between 36 to 50 years (OR 0.519 Vs 0.214). The risk of SSI was 4 times in case of clean contaminated wounds as compared to clean wounds (OR 3.877). The risk further increased to 7 times in case of dirty wounds (OR 6.753). Other risk factors which are significantly associated with SSI were BMI (p value <0.001), midline incisions (p <0.001) and Mattress suture (p <0.001). Presence of previous scar had intraoperative adhesions, weaker scar and poor healing which predispose to development of SSI. Comorbidities which influence SSI’s in the present study are diabetes mellitus (OR 5.49, 95% CI 2.506-12.066, P <0.001), anaemia (OR 4.63, Cl 2.458-8.756) and hypertension (OR 2.46, Cl 0.994-6.117). Wound swab was sterile in 33(63%) cases and 18(35%) cases showed growth of the organism. Most common organism noted was E. coli 9 (50%) followed by Klebsiella and Staph aureus.Conclusions: SSIs are increasing in the current scenario due to increase in the number of surgeries, however they can be prevented by early identification and optimization of medical comorbidities and BMI. Meticulous preoperative workup and intraoperative surgical steps are important in reducing the risk of developing SSI. A decrease in infection rate can lead to substantial reduction in the burden of disease.
A study on peripheral neuropathy in patients with diabetic foot ulcers
Authors: M. H. Siddesh Kumar , M. S. Moosabba , Koppad Sanjay N. 
Published: February 2018

Background: Diabetic neuropathies are nerve disorders associated with diabetes. The most common complication of diabetes is caused by hyperglycemia which can damage nerve fibers throughout the body. Depending on the types of nerves involved, diabetic neuropathies can be categorized as peripheral, autonomic, proximal, focal neuropathies.Methods: A total of 62 diabetic foot patients admitted in general surgery department of Yenepoya medical college and hospital undergo neurological examination. Patients who were having peripheral neuropathy with diabetic foot ulcer between 18 and 85 years of age were included in the study.Results: On 62 patients with diabetic foot ulcers, 50 were unilateral and 12 were bilateral among which 8 patients had undergone toe amputation prior to examination. Patients were predominantly male 48 (77.4%). There were 14 women and 48 men with an average duration of diabetics being 15.6 and 14.8 years respectively. Women were older than male patient (58.2 v/s 51.7 years). Study of motor and sensory signs men and women patients, abnormal deep tendon reflex and deep sensory loss was high. Abnormal deep tendon reflex was 38 (79.1%) and 11 (78.5%), atrophy was 24 (50%) and 2 (14.2%), loss of pain was 18 (37%) and 4 (28.5%), loss of touch was 32 (66%) and 8 (57%), and deep sensory loss was 42 (87.5%) and 12 (85.7%) in men and women respectively.Conclusions: Diabetes mellitus leads to neuropathies of more than one type and all contribute to diabetic foot pathogenesis. Clinical symptoms and signs, as well as nerve conduction studies may be different between men and women with diabetic foot. Motor neuropathies may constitute an important prognostic parameter in men. Mononeuropathies sometimes reflect more severe involvement and peroneal and ulnar neuropathy is remarkable among these.
Consideraciones de la fragilidad humana frente a la conducta moral del medico
Authors: Ávila Morales Juan Carlos 
Published: February 2018

Este artículo hace parte de una investigación doctoral sobre el mal y la maleficencia en el acto médico, tratando en este escrito las consideraciones relacionadas con la fragilidad humana, su relación con el ejercicio de la medicina y el alcance de la conducta moral del médico. Mediante el método hermenéutico para la interpretación de los documentos encontrados se desarrolla un abordaje analítico de la temática encontrando que desde la ética filosófica se encuentra una gran diversidad de pensamientos bioéticos aplicados a la salud, basados en el respeto de toda persona humana. Es necesario considerar como parte del análisis bioético (en la relación médico paciente, la naturaleza de las decisiones y el conocimiento médico), los conceptos teorizados desde la filosofía, teniendo en cuenta que en el ejercicio de la medicina las valoraciones éticas pueden relacionarse con los dilemas surgidos en el encuentro de los principios y valores de la profesión frente a la autonomía y los deseos de los pacientes.El desarrollo tecnológico y del conocimiento que componen la ciencia (episteme) y el arte (techne) de la medicina, junto a los cambios en la concepción de la relación médico paciente y en las dimensiones del acto médico (antropológica, disciplinar y determinantes sociales) han propiciado la indiferencia del profesional frente al sufrimiento, el dolor, la fragilidad y la vulnerabilidad de las personas (pacientes). Es necesario que el medico reflexione sobre los conceptos de compasión, solidaridad y responsabilidad con el otro, para tratar de restaurar la salud y sanar al enfermo y cuando no lo logre, pueda ayudar y cuidar en cuanto a su dolor y vulnerabilidad. Esto podría fundamentar el ejercicio de la profesión entre otras consideraciones en el imperativo kantiano, en la medida que el profesional de la salud actúe de tal manera que la máxima de su acción pueda ser querida como una máxima universal.
The Impact of Advanced Age on the Outcomes of Primary Total Hip and Knee Arthroplasty for Osteoarthritis
Authors: Murphy Benjamin P.d’S. , Dowsey Michelle M. , Choong Peter F.M. 
Published: February 2018

Background:Elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective options for the management of osteoarthritis that has not responded to conservative therapy, and they are increasing in utilization worldwide. Therefore, we sought to investigate how older age influences the outcomes of THA and TKA through a review of the current literature.Methods:The Embase and MEDLINE databases were examined for relevant studies that assessed the role of older age in determining the outcomes of THA and TKA. All studies except for systematic reviews and case reports were considered for inclusion. Studies were excluded if they included data on procedures other than THA and TKA or if they focused on the effect of surgical techniques and rehabilitation programs rather than age. We excluded studies if they included data on total joint arthroplasty (TJA) performed for indications other than osteoarthritis unless osteoarthritis was the diagnosis for >90% of the patient cohort. Journal references were manually searched to identify any additional articles.Results:Thirty-two articles were identified in this review. The most elderly groups in these studies were shown to experience higher mortality rates, more postoperative complications, and a longer stay in the hospital. Perioperative mortality was reported to be between 2.6% and 2.9% for nonagenarians and 1.09% and 1.54% for octogenarians. The increase in length of stay for the elderly following TJA was reported to be 0.6 to 3.1 days. Despite the increased rate of adverse events, there were gains in terms of pain relief and ability to perform activities of daily living, and overall the most elderly groups were satisfied with the THA or TKA. However, there was considerable inconsistency among studies with respect to the methodology for evaluating health-related quality of life and the level of functional ability postoperatively.Conclusions:Although TJA is considered an effective surgery for the elderly, clinicians should be aware that the elderly are at a higher risk of greater length of stay, complications, and mortality. However, the available literature contained poor data and heterogeneous patient cohorts, and reported on a wide variety of outcomes. Further research assessing the effect of older age on TJA is warranted.
Respon Pertumbuhan dan Produksi Delapan Varietas Kelapa Sawit TM Terhadap Pemupukan N, P, K, Mg, dan B / Response Growth and Yield of Eight Varieties Oilpalm TM to N, P, K, Mg, and B Fertilizer
Authors: Matana Yulianus R. , Mashud Nurhani 
Published: February 2018

<p>This study aims to determine the growth and production response of eight oil palm varities to fertilizer of N, P, K, Mg and B. This research was conducted from January and December 2015 in Sitiung experimental Garden West Sumatra province. The was conducted in the form factrorial experiment using randomized block design . The first factor is the eight oil palm varieties, which consists TS1, TS3, LTC, SMB, PPKS 540 (540), Dumpy, DMP and DMK. The second factor is the comnination of dosage of fertilizer per palm, which consist of 1) 500 g urea + 200 g SP 36 + 750 g KCl + 500 g Kieserit + 50 g of borax, 2) 750 g of urea +1000 g SP 36 +750 g KCl + 500 g Kieserit + 50 g of borax, 3) 1400 g urea + 950 g SP 36 + 1150 g KCl + 350 g Kieserit + 60 g borax, 4) 1 500 g urea + 1000 g SP 36 + 1750 g KCl + 1500 g Kieserit, 5) 1000 g of urea + 800 g SP36 + 1500 g KCl + 700 g Kieserit + 55 g of borax and 6) 500 g urea + 400 g SP36 + 750 g KCl + 350 g Kieserit + 27.5 g borax. The results showed that the growth and produstion respon of oil palm to fertilizer different according variety. Dumpy variety produce most weight fresh fruit namely 4.35 kg on comination of fertilization dosage 1500 g urea + 1000 g SP 36 + 1750 g KCl + 1500 g kieserite. TS3 variety produce most number of leave ( 43.43 leaves/palm) on combination of fertilizer dosage 500 g urea + 400 g SP36 + 750 g KCl + 350 g kieserit + 27,5 g boraks.</p><p><strong>ABSTRAK</strong></p><p>Penelitian ini bertujuan mengetahui respon pertumbuhan dan produksi delapan varietas kelapa sawit terhadap pemupukan N, P,K , Mg dan B. Penelitian ini dilaksanakan bulan Januari hingga Desember 2015 di KP. Sitiung, Provinsi Sumatera Barat. Penelitian dilakukan dalam bentuk percobaan factorial menggunakan Rancangan Acak Kelompok. Faktor pertama adalah delapan varietas unggul kelapa sawit yang terdiri atas TS1, TS3, LTC, SMB, PPKS 540, Dummy, DMP dan DMK. Faktor kedua adalah kombinasi takaran pupuk per pohon yang terdiri atas: 1) 500 g urea + 200 g SP 36 + 750 g KCl + 500 g kieserit + 50 g boraks, 2) 750 g urea +1000 g SP 36 +750 g KCl + 500 g kieserit + 50 g boraks, 3) 1400 g urea + 950 g SP 36 + 1150 g KCl + 350 g kieserit + 60 g boraks, 4) 1500 g urea + 1000 g SP 36 + 1750 g KCl + 1500 g kieserit, 5) 1000 g urea + 800 g SP36 + 1500 g KCl + 700 g kieserit + 55 g boraks dan 6) 500 g urea + 400 g SP36 + 750 g KCl + 350 g kieserit + 27,5 g boraks. Hasil penelitian menunjukkan bahwa respon tanaman kelapa sawit terhadap pemupukan berbeda menurut varietas. Varietas Dumpy menghasilkan TBS paling berat, yaitu 4,35 kg pada kombinasi pupuk 1500 g urea + 1000 g SP 36 + 1750 g KCl + 1500 g kieserite sedangkan varietas TS3 menghasilkan daun yang terbanyak (43.53 pelepah/pohon) pada kombinasi pupuk 500 g urea + 400 g SP36 + 750 g KCl + 350 g kieserit + 27,5 g boraks.</p>
SOCIODEMOGRAPHIC DETERMINANTS OF EARLY, NORMAL, AND DELAYED MENARCHE AMONG FEMALE COLLEGE-AGED STUDENTS IN BANGLADESH
Authors: Khatun Mst. Selina , Islam Md. Rafiqul , Mondal Md. Nazrul , Hoque Md. Nazrul , McNeil Clyde , Siddiqa Fatema 
Published: February 2018

Introduction: The onset of menstruation in adolescence is an important part of the maturational process. However, menstrual disorders are common in all parts of the society. The aim of this study was to identify the factors that influence the menarcheal age of adult female students in Rajshahi University, Bangladesh.
Methods: The data was collected from 1000 female students at Rajshahi University using a purposive sampling technique with direct interview method. The cross-sectional data was used for univariate analysis, to carry out the description of the variables and their attributes on data in list; and bivariate analysis, to find the associations among the variables.
Results: The results revealed that among the respondents more than half (54%) experienced menarche at an early age, more than one-third (37.8%) experienced menarche at normal age, and a few (8.2%) experienced menarche at a later age. The results also revealed that a few (9.2%) respondents experienced irregular menstrual cycles whereas, most of the respondents (69.2%) suffered menstrual pain. The menarcheal age is significantly associated with their living areas. The association between age at menarche and socioeconomic factors was found to be statistically significant. The students having lower mean age at menarche live in urban areas with high family income than that of rural areas and middle or low family income group.
Conclusion and Implications for Translation: Most of the respondents were experienced early menarche and suffered from menstrual pain. The sociodemographic factors were found significantly associated with age at menarche. Information on the factors that influence the menarcheal age of adult female students and related issues on reproductive health need special attention.
Key words: Age at Menarche â€¢ Sociodemographic Factors â€¢ Duration of Menstrual Flow â€¢ Menstrual Cycle

© 2017 Khatun et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Working Conditions and Productivity among Nurses in Selected Hospitals in Southwest Nigeria
Authors: Hanson Victoria Funmilayo , Onasoga Olayinka A. , Babalola Christianah Olayemi 
Published: February 2018

Background: Occupational stress and burnout are both factors that bedevil the healthcare sector in developing countries, particularly in Nigeria. This study explored the perceived impact of working conditions on the productivity of nursing staff in selected hospitals in southwest Nigeria.
Methods: This was a cross-sectional study comprising of 200 respondents randomly selected from two hospitals in the study area. Data were collected using a standardized study questionnaire. The reliability of the study questionnaire was determined using the test-retest method conducted at the interval of two weeks. Data were analyzed using Microsoft Excel and descriptive statistics were reported.
Results: A majority, 106 (53%) of the respondents, reported that work stress caused increased absenteeism among nurses, high staff turnout and deterioration in quality of services provided to patients. The majority (87.0%) of respondents were females, while 13.0% were males. Respondents were aged between 26 and 35 years. About 79% of respondents agreed that their workplace had a warm, friendly and pleasant atmosphere. However, 47.5% of respondents said that the work load was too high and they were unable to cope with its demands.
Conclusion and Implications for Translation: Stress arising from poor working conditions can have an adverse impact on the organization. The most common detrimental effects are increased absenteeism, deterioration in the morale of nurses, lack of job satisfaction and performance. To improve the organization’s effectiveness, employers should consider implementing strategies that are beneficial to both employees and the health organization. This is important because hospital workers face a variety of highly stressful working conditions while meeting the physical and psychological needs of patients.

[This article has been republished with minor changes. These changes do not impact the academic content of the article.]

© 2017 Hanson et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
Overcoming Tight Annulus Cementing Design Challenges: Gulf of Mexico Case Study
Authors: Dooply Mohammed , Sianipar Sakti , Rodriguez Faiber , Poole David , Fuenmayor Cesar , Carrasquilla Juan , Rosero Ivan 
Published: February 2018

Abstract
Achieving successful cement placement in tieback casings and liners on deepwater wells is very critical. One of the design challenges is to displace compressible drilling fluid in the tight annulus within the mechanical limitations of downhole tubulars. Accounting for the compressible nature of drilling fluids with changing pressure and temperature, combined with fluid contamination level, will provide better understanding of cementing dynamic pressure during placement.
Cementing tight annulus normally requires managing high placement pressures within the tubulars mechanical limits. Field measurements from case studies in Gulf of Mexico, were analyzed comparing with simulated cementing dynamic pressure accounting for effect of synthetic based mud compressibility as it is displaced by viscous spacer and cement slurry. The rheology of contaminated mixture also provided an input for better interpretation of cementing surface pressure response. These analyses, including estimating hook load variations while cementing, allow selection of appropriate fluid placement rate without exceeding the mechanical limits while also achieving effective fluid displacement.
Comparison analysis of measured and simulated data shows that use of complete fluid rheology profile at various temperature and pressure provides a more accurate prediction of cementing dynamic pressure in tight annulus cementing with synthetic based mud. This approach also allows a better estimation of the minimum rate required for efficient mud displacement enabling an optimal design of the cement slurry thickening time, when coupled with a representative mud circulation schedule.
Precise annular clearance of tieback strings provides better understanding of fluid positions inside the tieback strings and annulus, which ensures achieving planned top of cement to mitigate annular pressure buildup. This is critical to protect the outer casing against any potential collapse loading in a blowout scenario in deepwater drilling environment.
Synthesis, Characterization and In vitro Evaluation of N-Substituted- Sulfomoyl-Phenyl-Amino Carboxylic Acid Derivatives as Squalene Synthase Inhibitors
Authors: Chokshi Avani B. , Chhabria Mahesh T. , Desai Pritesh R. 
Published: February 2018

Background:Squalene Synthase is one of the cholesterol biosynthetic pathway enzymes, inhibition of which produces potent lipid lowering action. A variety of chemical classes have been evaluated for its inhibition to provide alternate antihyperlipidemic agents to statins.Methods:A series of N-substituted-sulfomoyl-phenyl-amino carboxylic acid derivatives were designed through pharmacophore modelling as Squalene Synthase inhibitors. We report here the synthesis, characterization and in vitro pharmacological screening of the designed molecules as Squalene synthase inhibitors. The target molecules were synthesized by a simple procedure and each molecule was characterized by IR, Mass, 1HNMR and 13CNMR spectroscopic techniques. As a primary site of action for cholesterol biosynthesis is liver, each of the molecules were first screened for in vitro cytotoxicity over human hepatic cell line (HepG2) by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method. The enzyme inhibition assay was performed on cell lysates prepared from HepG2 cells by Human Squalene Synthase ELISA kit, where test compounds were added in the nontoxic concentrations only.Results:Compound 5f was found to be most potent with the IC50 value of 11.91 µM. The CTC50 value for 5f on human hepatic cell line was > 1000 µM so it was considered that the compound was relatively safe and might be free of hepatotoxicity.Conclusion:From the results of our studies, it was observed that compounds with poly nuclear aromatic or hetero aromatic substituent on a side chain were more potent enzyme inhibitors and a distance of 4-5 atoms is optimum between amide nitrogen and hydroxyl group of carboxylic acid.
Política e acção pública. Entre uma regulação centralizada e uma regulação multipolar
Authors: Fontoura Maria Madalena 
Published: February 2018

Este texto situa-se no campo alargado da análise política e tem o propósito de contribuir para a compreensão do processo de construção e regulação das políticas públicas, dando conta da complexidade do processo que vai muito para além do momento da decisão, implicando diferentes instâncias e uma grande multiplicidade de actores. Constitui uma reflexão, construída a partir das análises, interrogações, comentários e críticas produzidas por diferentes autores, a partir de diferentes prismas, que incidiram sobre a política educativa portuguesa das últimas décadas, no que diz respeito à autonomia das escolas e aos efeitos observados na aplicação das medidas que a invocaram, particularmente no que se refere aos projectos, aqui considerados como instrumentos para resolver problemas e criar oportunidades na fronteira entre o social e o político. Representa ainda a oportunidade de mostrar a importância do tempo na construção e análise das políticas públicas. Palavras-chave: Análise política; Acção pública; Politicas públicas; Autonomia das escolas; Projectos
Demandas de poder no Conselho Pedagógico — reflexões a partir de um estudo de caso num agrupamento de escolas
Authors: E Silva Daniela Vilaverde 
Published: February 2018

O presente artigo centra-se num estudo sobre os diferentes jogos de poder e interesses mobilizados pelos actores escolares num dos órgãos de administração das escolas básicas públicas: o Conselho Pedagógico. A implementação do regime de administração das Escolas impulsionado pelo Decreto-Lei nº 115-A/98 trouxe alterações à composição do Conselho Pedagógico. Assim, a pluralidade de actores, decorrente quer da sua composição legal quer da formação dos Agrupamentos de Escolas, veio atribuir uma maior complexidade a este órgão. A partir de um estudo de caso num Agrupamento de Escolas pretendemos, por um lado, analisar diferentes poderes entre os membros do Conselho Pedagógico e, por outro, reflectir sobre a forma como os docentes percepcionam a participação dos diferentes actores que compõem este Conselho. Os dados obtidos na investigação denunciam a existência de diferentes relações de poder e interesses entre os membros deste Conselho. As decisões, os procedimentos e as práticas a adoptar no Agrupamento espelham sobretudo uma maior predominância dos interesses dos docentes do 2º e 3º ciclos face aos educadores de infância e docentes do 1º ciclo, desenvolvendo-se, desta forma, interesses de ciclos que podem fragilizar dinâmicas conotadas com a lógica democrática. Palavras-chave: Conselho Pedagógico; Poderes; Interesses