bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Keloid's Treatment in a Tertiary Care Hospital
Authors: Karn Binod , Mishra S. M. 
Published: July 2019

Introduction: Keloids are characterized by their continued growth following trauma, extension into normal tissue and their high recurrence rate following excision. Keloids are common following ear piercing or flame burns. These lesions are highly conspicuous and cosmetically unappealing. Multiple methods including surgery, radiotherapy, antimitotic agents, silicone sheet, pressure clipsand cryotherapy have been advocated. The risk of recurrence and the need to prevent distortion of following resection is a challenge to the surgeon.
Material and Methods: A total of 46 patients with keloid were treated at the plastic surgery department of the Nepalgunj Medical College between January 2013 to March 2017. The patients were divided in two groups. Group A consisted of 24patients with keloid in their ear where complete excision of keloid was done with tension free repair and was supplemented withintralesion triamcinolone injection at the time of operation and thereafter as and when needed. Group B consisted of 22 patients. Out of these 15 patients had keloid over the anterior chest wall and rest 07 had keloid over the deltoid region. These cases receivedintralesional triamcinolone only, a total of 5 such injections at month interval as a tension free repair after excision was notconsidered feasible.
Results & Conclusion: Patients in Group A underwent surgical excision and intra and post operative intralesionalsteroids and patients in Group B received 4 weekly intraregional injection of triamcinolone injection 40 mg. Out of 24 keloid in Group A two developed post-excision recurrence during a mean follow-up period of 24 months. However they regressed with subsequent local injection of steroid. The group B consisting of scar over the deltoid region and anterior chest wall were not found suitable for excision as a tension free repair (a must to prevent recurrence) was not considered possible. Complete Excision of keloids with tension free suture and local steroid injection is a simple & favored technique for the management of keloid, it preserves contour &skin quality and has a low recurrence rate. Unfortunately all cases are not suitable for total surgical excision. In such cases, steroid locally has to given locally at monthly intervals. The keloids regresses, but atrophy and depigmentation at the site of injection are the complications.
Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy is it Necessary?
Authors: Sharma Anup , Shah Arun 
Published: July 2019

Background: Elective laparoscopic cholecystectomy (LC) has a low risk for Surgical Site Infection (SSI). In spite many surgeons still use prophylactic antibiotics. The aim of this study was to find out the need of prophylactic antibiotics in elective LC.
Method: This study was carried out from 2017 June to 2018 August in the Department of Surgery Nepalgunj Medical College and Teaching Hospital Kohalpur (NGMC). Patients were placed into two groups. Group A received a single dose of prophylactic antibiotic and group B patients did not receive any prophylactic antibiotic. In both groups the SSI were recorded and compared.
Results: Overall SSI was 5(3.33%) among 150. In group A 2 (2.66%) patients had SSI and in group B 3 (4%) had SSI. Using or not using prophylactic antibiotics did not correlate with SSI (p= .154).
Conclusions: Prophylactic antibiotic is not recommended in elective LC. Prophylactic antibiotic does not reduce the rate of SSI.
Open Globe Injury in a Tertiary Care Hospital
Authors: Thapa Bikram Bahadur , Thapa Dabal Bahadur , Nath Har Karan 
Published: July 2019

Introduction: Open Globe Injury (OGI) is a type of mechanical eye injury in which there is a full thickness defect of the outer fibrous coat of eye ball. The Prognosis in the eyes with OGI has improved in these days. 2.4% of blindness in Nepal was due to ocular trauma in 1981. The aim of this study was to describe epidemiological profile, clinical profile and treatment outcome in eyes with open globe injury.
Methodology: It is the prospective interventional non randomized hospital based study on the patients of open globe injury presented to the Nepalgunj Medical College, Nepalgunj from April 2017 to May 2018. Visual acuity, anterior and posterior segment evaluation, site and size of wound were recorded. All the eyes were underwent primary repair surgery. Postoperative visual acuity, anterior and posterior segment evaluation was carried out on all follow up. Second surgery was done if required.
Results: 0.4% of ophthalmic and 0.016% of all hospital patients had open globe injury. Most of the victims were young males. The mean age of study population was 10.98±17.1 year. Playing (62.5%) was the most common time of injury and wooden stick (50%) was most common agent of injury. Zone I involvement (87.5%) and penetrating type (91.7%) was found in most of cases. 87.5% of eyes were blind, 4.2%were visually impaired and 8.3% had normal vision at the time of presentation. 79.2 % of eye were improved after treatment on visual function, 12.5% remained unchanged while 8.3% deteriorates and leads to pthysis bulbi.
Conclusion: The incidence of open globe injury was 0.4% among ophthalmic patients and 0.016% among all patients of Nepalgunj Medical College Teaching Hospital, Nepalgunj. Early Primary repair, use of systemic antibiotics and postoperative care provides encouraging anatomical and functional outcome in these eyes with OGI.
The subjective acceptance in presbyopic patient receiving correction based on conventional method of age v/s amplitude of accommodation
Authors: Chaudhary Neha Priyadarshani , Gautam Pramod Sharma 
Published: July 2019

Objective: To observe the subjective acceptance in presbyopic patients following prescription of spectacles.
Material and method: This is a hospital based cross sectional study which was conducted in 100 presbyopic patients in age group of 35 to 60 years at outpatient department of ophthalmology in Nobel Medical College Teaching Hospital, kanchanbari from 1 August 2018 to 30November 2018. The patients were divided into two groups, First group received the presbyopic correction according to conventional method of age and the second group received the prescription according to their amplitude of accommodation. Patient's satisfaction in terms of symptoms like eyestrain, headache or difficulty with the usage of glasses was noted. The data collected were subjected to statistical analysis.
Conclusion: When presbyopic correction is given according to amplitude of accommodation in patients belonging to 36-45 years age group, it is tolerated better and patients are more satisfied in terms of symptoms like eyestrain and headache than getting the simple correction as per their age. However after the age of 45 years, presbyopic correction given according to age is equally tolerated well among all refractive error groups.
Results: 100 patients in this study who visited our OPD with presbyopic symptoms were divided into two groups, each of 50 patients. Patient's satisfaction and tolerance was better when presbyopic correction was given on the basis of their amplitude of accommodation in age group 36-45, in comparison to the prescription given according to conventional method of their age. However, there was no statistically significant difference in the patient's satisfaction level in the two groups after the age of 45.
Authors: Setyarini Didien Ika 
Published: July 2019

Afterpain adalah rasa sakit yang berlangsung selama 2-3 hari setelah lahir, kondisi ini disebabkan oleh kontraksi rahim. Penggunaan metode farmakologis secara tidak langsung dapat mempengaruhi kualitas ASI dan terhadap bayi yang mengkonsumsinya. Maka diperlukan metode alternatif untuk mengurangi afterpain. Tujuan penelitian ini adalah mengetahui pengaruh Candle Therapy terhadap afterpain. Penelitian ini adalah pra eksperimen dengan sampel 10 responden secara purposive sampling. Desain yang digunakan adalah one group pre-post-test design. Instrumen penelitian berupa lilin berwarna dan NRS (Numerical Rating Scale). Hasil penelitian sebelum dilakukan Candle Therapy adalah 10% mengalami nyeri berat terkontrol, 33% nyeri ringan, dan 57% nyeri sedang, sedangkan setelah dilakukan Candle Therapy adalah 3% mengalami nyeri sedang, 30% tidak nyeri, dan 67% nyeri ringan. Hasil penelitian dianalisa dengan menggunakan Paired T-Test, dengan dk=18 dan α=0,05 menunjukkan nilai thitung=8,054, ttabel=2,101, sehingga thitung > ttabel. Hasil uji dengan menggunakan SPSS 16 menunjukkan hasil p=0,000, sehingga p < α. Maka Ho ditolak. Dari hasil penelitian ini dapat disimpulkan bahwa terdapat pengaruh Candle Therapy terhadap tingkat afterpain.
Kata kunci: Candle Therapy, afterpain, ibu postpartum
La objeción de conciencia en el Derecho Chileno
Authors: Nuñez Leyva José Ignacio 
Published: July 2019

En 1914 el portentoso –y díscolo compulsivo- Vicente Huidobro, artista principalmente dedicado a la poesía, escribió en uno de sus textos llamado NonServiam:
“Y he aquí que una buena mañana, después de una noche de preciosos sueños y delicadas pesadillas, el poeta se levanta y grita a la madre Natura: Non serviam. Con toda la fuerza de sus pulmones, un eco traductor y optimista repite en las lejanías: «No te serviré». La madre Natura iba ya a fulminar al joven poeta rebelde, cuando éste, quitándose el sombrero y haciendo un gracioso gesto, exclamó: «Eres una viejecita encantadora». Ese non serviam quedó grabado en una mañana de la historia del mundo. No era un grito caprichoso, no era un acto de rebeldía superficial. Era el resultado de toda una evolución, la suma de múltiples experiencias. El poeta, en plena conciencia de su pasado y de su futuro, lanzaba al mundo la declaración de su independencia frente a la Naturaleza”.
Public Access Defibrillation: Utilisation and Missed Opportunities
Authors: Cunningham Chris , Lowe Jared R , Johnson Arthur , Carter William , Whited William M , Shofer Frances F , Brice Jane H , Williams Jefferson G 
Published: July 2019

Introduction Automated external defibrillators (AEDs) for public use are becoming increasingly prevalent, but little is known about utilisation. The purpose of this study was to compare the locations of out-of-hospital cardiac arrests (OHCAs) to the locations of AEDs to determine whether missed opportunities exist. Methods A retrospective study was performed of all OHCAs in which resuscitation was attempted between 1 January 2005 and 31 December 2010 in Orange County, North Carolina, United States of America, a mixed suburban/rural emergency medical services (EMS) system. Emergency medical services records were used to determine public AED utilisation and OHCA location. The locations were plotted on a map using ArcGIS. Businesses, public buildings and facilities located within a 100 metre radius of each OHCA were surveyed to determine AED availability. Data were analysed using standard descriptive statistics. Results During the study period, 307 OHCAs occurred at 282 locations. Of these, 219 (71%) occurred in private homes, 26 (9%) in nursing or assisted living facilities, and 62 (20%) in public locations. An AED location was within 100 metres of an OHCA location in 22 cases. Five cases were excluded due to the arrest being witnessed by EMS, and late or unknown AED installation time. Of the remaining 17 OHCAs, seven (41%) had a nearby AED that was not used, constituting a missed opportunity for deployment. Conclusion In nearly half of OHCAs that have a nearby public AED, the AED was not utilised. This suggests that public awareness and accessibility of AED locations should be improved.
Parlamentos nacionales y Unión Europea. El papel de las Cortes Generales en la cooperación interparlamentaria europea.
Authors: Sánchez-Abarca Gornals Carmen 
Published: July 2019

El presente artículo expone una visión del papel de los Parlamentos nacionales en la Unión Europea y su evolución desde 2010, año de entrada en vigor del Tratado de Lisboa y momento en el que se crea el puesto del Letrado de las Cortes Generales ante la Unión Europea, basado en Bruselas. La autora expone desde una perspectiva práctica y comparada el enfoque de los asuntos europeos en los Parlamentos nacionales de nuestro entorno, así como en especial la actividad europea en las Cortes Generales y su presencia, tanto en el procedimiento legislativo, a través del control de subsidiariedad, como en la cooperación interparlamentaria. En todos estos aspectos se aprecia el reforzamiento de la actividad europea de las Cortes Generales en la línea marcada por el Tratado de Lisboa, conocido como “el Tratado de los Parlamentos”.
La imprecisión en las leyes, vulneradora de la seguridad jurídica. El Tribunal Constitucional no puede asumir la función de legislador positivo
Authors: García-Escudero Márquez Piedad 
Published: July 2019

En cuestión de inconstitucionalidad planteada por la Sala de lo Contencioso-administrativo del Tribunal Supremo, el Tribunal Constitucional declara inconstitucional un precepto de la LOPJ cuya imprecisión no puede sersalvada sin su reconstrucción, vetada al TC porque supondría asumir la función de legislador positivo que institucionalmente no le corresponde. La orfandad reguladora resulta vulneradora del principio de seguridad jurídica reconocido en el artículo 9.3 de la Constitución, cuyas exigencias se ven reforzadas en este caso como consecuencia de la reserva de ley orgánica.
Metode Simple Additive Weighting Dalam Sistem Pendukung Keputusan Pemilihan Tempat Kuliner Di Kabupaten Purwakarta
Authors: Resmi Mochzen Gito , Irmayanti Dede 
Published: July 2019

Abstract

Tourism in Purwakarta Regency has an impact on culinary development. Many culinary places in Purwakarta can make people sometimes confused to determine which appropriate place for eating. Lack of information on available locations is a problem for tourists who want to enjoy the satisfaction of culinary tourists. Some criteria can be chosen, namely: price, type of food, location or cleanliness, and facilities. Therefore,a support system was proposed using a simple Additive Weighting method (SAW) and the Waterfall development method. This system provides an appropriate a decision system in choosing the culinary place.

Keywords: Simple Additive Weighting, Decision Support System, Waterfall

Abstrak

Meningkatnya jumlah wisatawan di Kabupaten Purwakarta memberikan dampak terhadap perkembangan usaha kuliner. Banyaknya lokasi penjualan kuliner yang ada di Purwakarta membuat wisatawan bingung untuk menentukan tempat makan mana yang sesuai dengan keinginan mereka. Kurangnya informasi terhadap lokasi yang tersedia menjadi masalah bagi wisatawan yang ingin menikmati berwisata kuliner. Beberapa kriteria dapat menjadi pilihan dalam wisata kuliner antara lain, harga, jenis makanan, lokasi atau kebersihan, dan fasilitas Sehubungan dengan wisatawan yang mengalami kesulitan dalam menentukan tempat kuliner di Purwakarta, maka penulis akan membuat sistem pendukung keputusan dengan metode Simple Additive Weighting (SAW) dengan metode pengembangan Waterfall. Sistem ini dapat membantu memberikan alternatif keputusan dalam menentukan tempat kuliner di Purwakarta mengacu kepada kriteria-kriteria pengambilan keputusan tersebut.

Kata kunci: Simple Additive Weighting, Sistem Pendukung Keputusan, Waterfall,
Evolución del microcredito del sector popular y solidario frente a la banca pública-privada del Ecuador
Authors: Vallejo Ramírez Jorge Baltazar , Ochoa Herrera Johanna Maribel 
Published: July 2019

El presente artículo presenta la evolución del microcrédito en Ecuador, las microfinanzas son una herramienta efectiva en la lucha contra la pobreza; estos están dirigidos especialmente a mujeres que tratan de promover su participación en la economía global; por ello se estudia las tasas de interés, la participación que tiene la banca pública-privada y el sector popular y solidario en el mercado sobre los microcréditos, se utilizó varios métodos, técnicas y procedimientos, se realizó una revisión de aspectos teóricos, el uso de análisis históricos de hechos y fenómenos con la presente área de estudio. Fue necesaria la información estadística que proviene del Estado y sus instituciones como el Banco Central, ministerios entre otras. Se concluye que los microcréditos han evolucionado en estos grupos, fortaleciendo la economía de las pequeñas empresas y emprendedores con un enfoque principal a las mujeres, quienes también aportan económicamente a su hogar.

Palabras clave: evolución, microcrédito, microfinanzas, público.

ABSTRACT

This article presents the evolution of microcredit in Ecuador, microfinance is an effective tool in the fight against poverty, these are aimed especially at women who seek to promote their participation in the global economy, therefore we study interest rates, the participation of public-private banking and the popular and solidarity sector in the market on microcredit, used various methods, techniques and procedures, conducted a review of theoretical aspects, the use of historical analysis of facts and phenomena with this area of study. Statistical information was needed from the State and its institutions such as the Central Bank, ministries, among others. It is concluded that microcredits have evolved in these groups, strengthening the economy of small businesses and entrepreneurs with a main focus on women, who also contribute economically to their homes.

Key words: evolution, microcredit, microfinance, public.
Diarreia causada por Clostridium difficile: recentes avanços
Authors: Moreira Bárbara de Oliveira , Pais Luana Silva , Costa Lívia de Almeida 
Published: July 2019

A infecção causada por Clostridium difficile (C. difficile), um dos agentes causadores de diarréia aguda e recorrente, tem como principal fator de risco o uso de antimicrobianos. Recentemente, houve um aumento da incidência e da mortalidade desta afecção. Clinicamente, a mesma pode manifestar-se desde um quadro de diarreia aquosa leve até a forma grave de colite pseudomembranosa. O objetivo deste artigo é apontar as mudanças epidemiológicas da infecção pelo C. difficile, além de rever fatores de risco, manifestações clínicas, métodos diagnósticos, tratamento e prevenção desta infecção. O aumento na gravidade da infecção causada pelo C. difficile é relacionado a uma nova cepa hipervirulenta, BI/NAPI/Ribotipo 027, que apresenta maior capacidade de produção de toxinas. Essa nova cepa, mais virulenta, ainda não foi detectada no Brasil, porém como já foi identificada em outros países da América, alerta para a preocupante capacidade de disseminação universal. Essa revisão é baseada em artigos publicados nos últimos 10 anos, utilizando como base de dados o PubMed e o Scielo (Scientific Eletronic Library Online), com as palavras-chave: Epidemiologia, diarreia, Clostridium difficile e cepa hipervirulenta.
Relação entre vitamina D e cálcio no desenvolvimento do Diabetes Mellitus tipo 1 e 2 - Uma revisão de literatura
Authors: Dazini Paula Oliveira , Lanna Carla Márcia Moreira , Moreira Ana Paula Boroni 
Published: July 2019

A prevalência de obesidade, associada a hábitos alimentares inadequados e sedentarismo tem aumentado a ocorrência Diabetes Mellitus, tornando-se um problema de saúde pública. Perspectivas imediatas na mudança do ambiente para reverter o aumento dos níveis de obesidade não são promissores, e existe uma necessidade de considerar outras opções para prevenir o diabetes. Tem sido apontada uma associação inversa entre os baixos níveis da vitamina D e cálcio com a incidencia do Diabetes Mellitus. Desse modo, a vitamina D e o cálcio têm sido propostos como um possível agente terapêutico para a prevenção e tratamento da doença. O objetivo do estudo foi realizar uma revisão de literatura sobre a influência da vitamina D e do cálcio na fisiopatologia do diabetes mellitus, assim como no controle glicêmico. Estudos têm mostrado que a vitamina D em conjunto com o cálcio são capazes de reduzirem o risco do desenvolvimento do diabetes mellitus tipo 2, enquanto que a insuficiência de vitamina D e de cálcio pode influenciar negativamente a glicemia. Além disso, nível plasmático de 25(OH)D, tem sido correlacionado com o diagnóstico de Diabetes Mellitus tipo 1. Evidências recentes demonstram que a concentração sérica de vitamina D e do cálcio podem estar relacionados ao diabetes. Entretanto, estudos prospectivos e de intervenção em humanos que comprovem a efetividade de ambos, tanto na prevenção como no tratamento dessa doença, ainda são necessários.
Avaliação dos níveis de albuminúria em adultos obesos e sua associação com marcadores de risco cardiovascular.
Authors: Braga Danielle , Lemos Laura Brandao , Silva Caio Rivelli , Andrade Carlos Eduardo Barquette , Reis Juliana Teixeira Rodrigues , Oliveira Laura Leite , Moreira Rodrigo Oliveira 
Published: July 2019

Introdução: A obesidade é um dos fatores mais importantes para explicar o aumento incidência das Doenças Cardiovasculares (DCV). Dentre os múltiplos fatores de risco para estas doenças, a albuminúria é dos mais importantes. Objetivos: Avaliar os níveis de albuminúria e correlacionar com outros marcadores de risco cardiovascular em pacientes obesos que procuraram tratamento para obesidade. Materiais e métodos: Estudo transversal, retrospectivo, através dos prontuários de 183 pacientes de ambos os sexos, entre 18 e 65 anos, com índice de massa corpórea (IMC) ≥ 30 Kg/m². Todos os pacientes foram submetidos a exame físico e receberam um pedido de rotina laboratorial, incluindo de albuminúria em amostra isolada de urina. Resultados: Dados de albuminúria estavam disponíveis em 81 prontuários. Destes, 15 pacientes (18,5%) tinham valores acima de 17 mg/L de albuminúria. Nenhuma correlação foi encontrada entre os níveis de albuminúria e os parâmetros antropométricos (IMC, r=0,08; p=0,47; Cintura, r=0,17; p=0.11; Quadril, r=0,11; p=0,35; RCQ, r=0,03; p=0,75), Pressão Arterial (PA) sistólica (r=0,013; p=0,21) ou diastólica (r=0,11; p=0,32). Nenhuma diferença foi encontrada entre os pacientes que já usavam anti-hipertensivos ou não (p=0,25). Foi encontrada correlação entre os níveis de albuminúria e o high-density lipoprotein cholesterol (HDLc), (r=-0,27; p=0,012), além de uma tendência a significância com os níveis de Proteína C Reativa Ultrassensível (PCR-us; r=0,21; p= 0,081). Conclusão: Apesar da alta frequência (18,5%) de albuminúria em pacientes obesos, não foi encontrada correlação entre este marcador e os parâmetros antropométricos. Foi encontrado uma relação inversa da albuminúria com HDLc e uma tendência a significância com a PCR-us, sugerindo uma associação limitada entre a albuminúria e alguns marcadores específicos de risco cardiovascular.