bluuebunny/crossref_metadata_2025_split huggingface dataset:
La rebelión del libido sexual en la vejez
Authors: Valdizan Hermilio , Delgado Honorio 
Published: January 2017

Conocidos los orígenes de la sexualidad y sus variaciones a lo largo de la jornada de la vida hemos pensado, el doctor Delgado y yo, en el vivo interés del conocimiento de la etapa evolutiva terminal de esa sexualidad. Y por ello, desde hace algunos años, venimos observando, con máxima atención, el libido senil de nuestros enfermos, tanto en la práctica civil como en la nosocomial.
Tratamiento Médico de la Hipertensión Arterial
Authors: Monge Casinelli Carlos 
Published: January 2017

El 95% de los pacientes hipertensos tienen hipertensión esencial. Dentro del 5% que resta puede encontrarse casos en quienes el diagnóstico de feocromocitoma, o lesión unilateral renal puede resultar en la cura definitiva de la hipertensión. Existe una variedad de hipertensión esencial llamada maligna cuya rápida evolución hace imperioso el tratamiento. Debe ser separada del grupo de la nefritis crónica en bajar la presión arterial, que no sólo alivia al enfermo, sino que rompe un círculo vicioso que daña los vasos sanguíneos. Deben ser tratados todos los pacientes con hipertensión arterial maligna y todos los que teniendo hipertensión arterial esencial presentan una diastólica muy elevada más de 120 mmHg, o rápida evolución de la enfermedad. En el resto de hipertensos basta la psicoterapia y la terapéutica sedante. Es preciso tener especiales precauciones con pacientes arterioesclerósicos o urémicos, en quienes una excesiva reducción de la presión arterial o su caída brusca puede producir trombosis cerebral, o aumento de la uremia respectivamente. El procedimiento, o droga a escoger, será bueno si es que se logra una baja razonable de la presión arterial sin daño mayor para el paciente, o sin causarle excesivas molestias. Se hace una somera descripción de los principales procedimientos o drogas actualmente en uso.
Enfermedad de Chagas - Estado Actual en el Perú
Authors: Cornejo Donayre Alberto 
Published: January 2017

1.- La enfermdad de Chagas está ampliamente diseminada en el territorio peruano, habiéndose demostrado su presencia en los departamentos de Tacna, Moquegua, Arequipa, Madre de Dios, Amazonas y San Martín. 2.- En el Perú se ha diagnosticado un total de 204 casos de Trypanosomiasis cruzi hasta el año 1957, de los cuales 202 corresponden a los últimos siete años, debido al mayor número de encuestas epidemiológicas realizadas en este lapso. 3.- Se presenta un resumen de los síntomas y signos observados en los pacientes de Trypanosomiasis cruzi, diagnosticados en el Perú, señalándose que el mayor número de casos agudos se observó en niños menores de cinco años y los casos crónicos, tanto en adultos como en menores. 4.- Se ha capturado traitóminos capaces de trasmitir la enfermedad de Chagas, en los departamentos de Tacna, Moquegua, Arequipa, Ica, Lima, Junín, Cusco, Madre de Dios, La Libertad, Piura, Tumbes, Cajamarca, Amazonas y San Martín. 5.- En el Perú se ha encontrado las siguientes especies de triatóminos: Triatoma infestans, Trianoma dimidiata, Triatoma carrioni, Panstrongylus herreri, P. geniculatus, P. Chinai, Panstrongylus rufotuberculatus, Belminus peruvianus, Rhodnius pallescens y Microtriatoma trinidadensis. El T. insfestans es el único trasmisor en la región sudoccidental y el P. herreri es el trasmisor más importante en el norte del país. El T. infestans ingresó en el Perú procedente de Chile y las especies T. dimidiata, T. carrioni y P. rufotoberculatus, lo hicieron posiblemente desde la vecina república del Ecuador. 6.- El reservorio de la Trypanosomiasis cruzi más importante en el Perú, es el cuy o cobayo; pero también se ha encontrado infección natural en perros y gatos de la zona endémica. 7.- Las condiciones y características de la vivienda humana en las zonas rurales y semi-rurales de la zona endémica del Perú, constituyen factor importante en la epidemiología de la enfermedad de Chagas, pues se ha demostrado que los triatóminos ingresan y se multiplican fácilmente en el interior de las habitaciones. El hombre vive en marcada promiscuidad con animales domésticos que sirven de reservorio al T. cruzi y la vivienda está sobrepoblada. 8.- El hombre, actúa como diseminador de la enfermedad de Chagas al transportar triatóminos, cobayos, perros y gatos con infección natural por T. cruzi.
Prevalencia del síndrome metabólico en pobladores peruanos por debajo de 1 000 y por encima de los 3 000 msnm
Authors: Pajuelo Ramírez Jaime , Sánchez-Abanto José , Torres Harold L. , Miranda Marianella 
Published: January 2017

<strong>Objetivos:</strong> Determinar y comparar la prevalencia del síndrome metabólico y de sus diferentes componentes en población adultaperuana que habita por debajo de 1 000 y por encima de 3 000 msnm. <strong>Diseño:</strong> Análisis de los datos de la Encuesta Nacional deIndicadores Nutricionales, Bioquímicos, Socioeconómicos y Culturales Relacionados a las Enfermedades Crónicas Degenerativas2006. <strong>Institución: </strong>Instituto Nacional de Salud Centro Nacional de Alimentación y Nutrición, Ministerio de Salud, Lima, Perú. Participantes:Personas mayores de 20 años.<strong> Métodos:</strong> Se incluyó 3 384 personas mayores de 20 años, 4225 que habitaban por debajo de 1 000(nivel-I) y 959 por encima de los 3 000 msnm (nivel-II). El síndrome metabólico fue definido de acuerdo a los criterios del NationalCholesterol Education Program Adult Treatment Panel III (NCEP ATP III). <strong>Principales medidas de resultados:</strong> Prevalencia del síndromemetabólico y sus componentes. <strong>Resultados:</strong> La prevalencia de síndrome metabólico fue significativamente mayor en el nivel-I (19,7%)que en el nivel-II (10,2%), p&lt;0,001. En varones, la prevalencia fue 9,2% en el nivel-I y 5,1% en el nivel-II. En mujeres fue 29,9% en elnivel-I comparado con 15,2% en el nivel-II. La obesidad central (35,5% vs. 21,1%), elevación de presión arterial (20,9% vs. 15,0%),hiperglicemia (3,9% vs. 1,7%), hipertrigliceridemia (31,3% vs. 25,7%) y concentraciones bajas de HDLc (57,4% vs. 52,5%) fueronsignificativamente más prevalentes en el nivel-I comparado con el nivel-II (p&lt;0,05). Los componentes del síndrome metabólico másfrecuentes en los varones fueron la hipertrigliceridemia y el HDLc bajo, mientras que en las mujeres fueron la obesidad central y elHDLc disminuido. <strong>Conclusiones: </strong>El síndrome metabólico fue significativamente más prevalente en la población por debajo de los 1 000msnm; esto podría ser resultado de la transición nutricional, demográfica y socioeconómica en esta área. Las mujeres fueron mássusceptibles a los factores de riesgo cardiovascular.
Gall bladder specimen following cholecystectomy: a resource
Authors: Giridharan Bhanumati , Madhivadhanam P. 
Published: January 2017

Background: Gallbladder stones are very common and cholecystectomy is the most commonly performed surgery globally. Gallbladder stones have been reported to be the leading cause of cholecystectomies worldwide. Other mechanisms have also been known to constitute for cholecystectomy, but the evidence is still weak with the exact mechanism unknown. The present study thus aims to assess the importance of routine histopathology of the gall blabber following cholecystectomy.Methods: The study is a retrospective one that employs the use of patient records to achieve the objective.Results: The findings of the study depict a significant association between the findings of the histopathology, ultrasound and clinical features.Conclusions: The researcher presents the relevance of histopathology with respect to ultrasound and clinical presentation of the patient, thereby stating the need for a routine gall bladder specimen following cholecystectomy.
Clinico-pathological study of intestinal obstruction and its management
Authors: Shukla Samir , Kumar Krishna , Khusram Bhupesh , Damor Mahendra 
Published: January 2017

Background: Intestinal obstruction is one of the most common surgical emergencies, for which the therapeutic strategy has progressed through several evolution. The aim was to study the various etiologies, spectrum of clinical features, factors affecting type of management- conservative or operative, various surgical procedures and its outcome in relation to etiological factors in patients of intestinal obstruction.Methods: It is prospective study including 200 patients fulfilling the inclusion criteria were part of this study conducted from March 2015 to September 2016 with a provisional diagnosis of intestinal Obstruction carried out in Gandhi Medical College associated Hamidia Hospital, Bhopal, Madhya Pradesh, India.Results: The patients were mostly males and from age group 30 -50 years and least were from 70-80 years. The most common clinical symptom was abdominal pain and the sign was tenderness, least common were irreducible hernia and mass per abdomen. Commonest etiology was adhesion and least was worm infestation. Most patients were treated by operative procedure in comparison to conservative management, commonest procedure done was laparotomy with resection and anastomosis and hernioplasty was least common. The histopathology study of resected specimens reveals inflammation as the commonest and the malignancy as the least one. The mortality was highest in patients of adhesions and the least in patients of obstructed hernia. Discharge rates were maximum in patients of adhesion and minimum in patients of volvulus.Conclusions: In our study it had been observed that early diagnosis, adequate preoperative hydration, prompt investigations and early operative intervention improves survival in patients of intestinal obstruction. If preoperative preparation is improved and anesthetic management is more skillful, the mortality from abdominal exploration should approach to minimum.
Breast cancer, Clinical presentations, Risk factors, Staging
Authors: Shoeb Mohammad Fazelul Rahman , Pinate Anil Reddy , Shingade Poonam Prakash 
Published: January 2017

Background: Breast cancer is most common cause of cancer related mortality and second most common cause of cancer in females in India. Hence study aims to evaluate the clinical profile and risk factors of the breast cancer.Methods: This is cross sectional study done at Victoria hospital and Bowring and Lady Curzon Hospital between January 2012 to October 2012 among 50 females patients more than 18 years of age, presented with breast cancer irrespective of tumour stage, size and location and for whom preliminary diagnosis of carcinoma breast was confirmed on fine needle aspiration cytology. Preformed, pretested semi-structured questionnaire was used to collect the data regarding the risk factors and clinical presentations of the patients.Results: Maximum participants 18 (36%) were in the age group of 41-50 years, 32 (64%) patients belonged to lower class with mean age at menarche of 13.3 years. About 26 (52%) patients were in premenopausal state. In present study, 48 (96%) of the total patients were multiparous and 47 (94%) women practiced breast feeding for more than 4 months. None of the patients in this study had a family history of breast cancer. Most breast cancer patients presented with history of lump followed by pain 14 (28%) and nipple retraction 9(18%). Most of the patients 29(58%) had upper outer quadrant involvement followed by upper inner quadrant in 7 (14%).In about 26 (52%)patients, tumour size was more than 5 cm and 32 (64 %) patients had axillary lymph nodes.Conclusions: Breast cancer was predominantly a disease of middle aged, lump in breast is commonest mode of presentation with upper outer quadrant involvement and 26 (52%) patients were in stage II of TNM classification.
Is using peritoneal drains in bowel surgeries beneficial?
Authors: Bhoir Lata N. , Jagne Nilesh Y. , Murali Divya 
Published: January 2017

Background: Surgical drains of various types have been used, with the best intentions, in different surgeries for many years. It is often open question whether they achieve their intended purpose despite many years of surgery. There is paucity of evidence for the benefit of many types of surgical drainage and many surgeons still ‘follow their usual practice’. The dictum ‘when in doubt, drain’ from Lawson Tait, is well known to surgeons’. But many studies we find routine placement of drain has been shown to be ineffective or potentially harmful in various abdominal surgical procedure. We thus performed a systematic review of the studies of outcomes of with or without peritoneal drain in abdominal surgeries.Methods: A comparable study was conducted in between two groups with and without drain in patient belonging to all age undergoing small and large bowel surgeries. A random patient selection was done. Pooled estimates of mortality, morbidity, wound infection, blockage, pain, anastomotic leak, re-intervention and length of hospital stay were calculated.Results: With drain; duration of stay is more than without drain with p value found to be 0.0087. Drain is ineffective due to blockage in 38% patient. Wound infection is more with drain with p (0.003). Pain is more with drain with p (0.0001). There is no difference in anastomotic leak, distension, re-intervention and mortality with or without drain.Conclusions: After a century of scientific investigation and research, all surgeons should recall the words of Halstead ‘no drainage at all is better than ignorant employment of it’ rather than the advice of Lawson Tait ‘when in doubt, drain.
Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study
Authors: Nair Sharath S. , Surendran Anilkumar , Prabhakar Rajmohan B. , Chisthi Meer M. 
Published: January 2017

Background: Head injuries are a major cause of mortality and morbidity across the world. Effective initial assessment and early intervention is of importance in patients with traumatic brain injury, so as to ensure the maximum favorable outcome. Glasgow Coma Scale is the widely accepted scale to assess severity in head injury patients, albeit with many inadequacies. The objective of this study was to test the validity of full outline of unresponsiveness score, an alternate tool, in assessing severity in patients with traumatic brain injury.Methods: This was a descriptive study, conducted on 69 patients admitted to the general surgical and neuro-surgical wards of Government Medical College, Trivandrum, India with traumatic head injury. For all these patients, full outline of unresponsiveness score and Glasgow Coma Scale were calculated at the time of presentation and serially thereafter. The predictive value of full outline of unresponsiveness score as well as its correlation with Glasgow Coma Scale was studied.Results: A statistically significant correlation was found between full outline of unresponsiveness score and Glasgow Coma Scale in estimating the severity of head injury. Also Full Outline of unresponsiveness score was able to furnish better details about the neurological status of trauma patients.Conclusions: As per the results, it can be concluded that the full outline of unresponsiveness score can be applied as an ideal tool to evaluate consciousness levels and patients’ status in patients with traumatic head injury. It can be used as the ideal replacement for Glasgow Coma Scale.
A comparative study between totally extraperitoneal and transabdominal preperitoneal laparoscopic inguinal hernia repair techniques
Authors: Rambhia Samir Ushakant , Modi Rajan 
Published: January 2017

Background: Laparoscopic groin hernia repair can be done by trans-abdominal pre-peritoneal (TAPP) approach and also by total extra peritoneal (TEP) approach. The objective of this study was to compare the clinical effectiveness and relative efficiency of trans-abdominal pre-peritoneal (TAPP) versus totally extra peritoneal (TEP) techniques of laparoscopic inguinal hernia repair.Methods: All the patients aged 18 years and above admitted in HBT Hospital undergoing laparoscopic inguinal hernia repair were included in this study from June 2014 to January 2016. Diagnosis was made based on history and clinical examination and ultrasound scan of the abdomen. Patients undergoing open hernia surgery and those having contra-indications to laparoscopic hernia repair were excluded from the study. The patients underwent laparoscopic TAPP or laparoscopic TEP repair of hernia based on surgeon’s preference.Results: Total 56 patients were included in the study. It was a non-randomized study, where patients were allocated in TAPP and TEP group based on surgeon’s preference. Hence, 29 patients were included in TAPP group while 27 patients were allocated to TEP group. Post-operatively all patients were evaluated for pain at 6 hours, 12 hours, 24 hours, 1week, 6 months and 1 year. They were also evaluated for length of hospital stay and any operative site complication like hematoma/seroma, wound/mesh infection, recurrence, port site hernia, persisting numbness. 2 patients in TAPP group and 3 in TEP group were lost to follow up at the end of 1 month. Further 4 patients in TAPP group and 1 patient in TEP group were also lost to follow up at 6 months. Apart from statistically significant difference in pain at 24 hours, which was more in TAPP group than TEP group, we found no other significant difference between the two methods.Conclusions: In this prospective non-randomized study comparing laparoscopic TEP and TAPP repair, for the standard parameters of duration of surgery, conversion, serious adverse event, post-operative pain, local complications, recurrence both locally and port site and length of hospital stay, we had a follow up of 1 year which is adequate for most parameters except recurrence. Our follow up does not allow us to make any conclusion about recurrence. Though the patient numbers are small, our study resonates with the larger studies regarding most parameters. This study leaves us none the wiser as to the superiority of one technique and hence, it is the individual surgeon’s preference and proficiency which dictates the choice of procedure.
Frequency of infra-orbital nerve injury after a Zygomaticomaxillary complex fracture and its functional recovery after open reduction and internal fixation
Authors: Noor Maria , Ishaq Yaser , Anwar Malik Adeel 
Published: January 2017

Background: Maxillofacial injuries are on the rise and the etiology of maxillofacial injuries varies from one country to another because of social, cultural and environmental factors. Road traffic accidents (RTAs) are still the most common cause of maxillofacial injuries. Nerve injury following fracture may involve traction, pressure, ischemia, inflammation and physical damage; therefore fractures of Zygomaticomaxillary complex (ZMC) are characterized by sensory neuropathy in the area of innervation of infra-orbital nerve both as presenting symptom and as a postop complication. The objectives of the study were to investigate the frequency of infra-orbital nerve paresthesia following ZMC fractures and determine the frequency of functional nerve recovery in patients with paresthesia treated with open reduction and internal fixation.Methods: Patients (n = 75) qualifying our inclusion criteria were selected, examined, reduced by surgery and followed up.Results: A total of 75 patients were included in the study with male: female ratio of 5:3. Mean age was 37.43±3.78 years, with majority of patients (72 %) presenting with RTAs. Infra-orbital nerve paraesthesia was found to be positive in 70.67% (n = 53) patients with 62.26% (n = 33) patients with functional nerve recovery after 3 months.Conclusions: Prognosis of infra-orbital nerve recovery after a Zygomaticomaxillary complex fracture can be enhanced by open reduction and internal fixation.
Hydrostatic reducibility of intussusception among different age groups in paediatric population-a descriptive study
Authors: Haridas Sreejith , S. Vineed , Sivakumar K. 
Published: January 2017

Background: Intussusception is one of the most frequent causes of bowel obstruction in infants and toddlers. In children, it is often an idiopathic condition and treated non-surgically by radiologic reduction. Primary aim of study was to analyse the outcome of hydrostatic reduction of intussusception across different paediatric age group patients admitted in a medical college hospital.Methods: This is a hospital based descriptive study conducted in tertiary care centre for one year duration in 2014-2015. 90 patients admitted with diagnosis of intussusceptions for hydrostatic reduction were interviewed with the proforma and details were collected. The procedural detail of hydrostatic reduction was also collected. Patients were followed up for a period of 48 hours post successful hydrostatic reduction.Results: Hydrostatic reducibility of intussusception was 63.3% in less than 3 months age group compared to 93.3% each in other two groups. Overall hydrostatic reducibility was of 83.3%, while 16.7% went for laparotomy. First group had 36.7% cases gone for laparotomy. Analysis of each of the study variables was done to find out their association with hydrostatic reducibility. Only duration, bleeding per rectum, lethargy, dehydration, side of lesion and total count were found to have a statistically significant p value. Logistic regression analysis of the above five variables revealed that only the ‘duration of symptoms’ had a statistically significant independent association with hydrostatic reducibility of intussusception ,with a p value of 0.033 and odds ratio 12.477. 5.3% of cases of first group had recurrence within 48 hours of hydrostatic reduction, while 10.7% and 21.4% of cases from second and third group respectively had recurrence within 48 hours of reduction. Overall recurrence of intussusception within 48hours is 13.3%.Conclusions: Hydrostatic reduction of intussusception is more successful in paediatric age group > 3 months compared to < 3 months. Shorter duration of symptoms, especially < 48 hours may have a favourable effect on hydrostatic reducibility of pediatric intussusception. Rate of recurrence of intussusception within 48 hours of successful hydrostatic reduction is 13.3 per 100 paediatric cases.
The use of ultrasonographic and Alvarado scores in evaluating abdominal pain suggestive of acute appendicitis
Authors: Álvarez Jorge Fernández , López José Manuel Gómez , Chávez Alberto M González , Acosta Benjamín Valente , Hénandez Diego Abelardo Álvarez , Pascual Silviano Ríos , Vázquez Alain Arturo García 
Published: January 2017

Background: Ultrasonographic scores for appendicitis to determine if, combined with Alvarado scores, they can increase the sensitivity and specificity of the diagnosis of appendicitis.Methods: All cases of abdominal pain suggestive of appendicitis presented between 2013 and 2015 were analysed. An Alvarado score was obtained. All patients underwent ultrasound, and an ultrasonographic score was determined, including the appendicitis classical findings.Results: Two hundred and fifty-one patients with abdominal pain in the right lower quadrant were analysed. Appendicitis was confirmed in 211 (84%) patients. For these patients, the average Alvarado score was 7.95/10 (±1.25) vs. 5.7/10 (± 1.11) for patients who did not have appendicitis (p < 0.001). In patients with confirmed appendicitis, the average ultrasonographic score was 2.48/6 (± 1.06) vs. 0.6/6 (± 0.92) for patients who did not have acute appendicitis (p < 0.001). The ultrasonographic score has a sensitivity of 90% and a specificity of 87% with only two parameters. The combination of the Alvarado and ultrasonographic scores decreased the percentage of negative appendectomies to 2.36% and increased the area under the curve by 0.970.Conclusions: The sum of the Alvarado and ultrasonographic scores provides an efficient alternative for diagnosing abdominal pain suggestive of appendicitis and predicts which patients should undergo surgery with good certainty.