bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of negative pressure wound therapy with moist wound therapy in the treatment of diabetic foot ulcers with non-revascularisable peripheral vascular disease
Authors: Pallela Someshwara Rao Narayana , Narahari Padmavathi 
Published: June 2017

Background: Diabetic foot problems are the commonest reason for hospitalization of diabetic patients (about 30% of admissions) and absorb some 20% of the total health-care costs of the disease more than all other diabetic complication. The numbers of patients with chronic wounds and wound complications continues to increase. Wound management is a challenge in diabetic wound. Chronic wounds require significant medical, nursing and financial input with poor long-term results. One-third of all diabetic patients have significant peripheral neuropathy and/or peripheral vascular disease (PVD). In India prevalence of foot ulcers in diabetic patients in clinic population is 3%. Over the past several years negative pressure wound therapy (NPWT) using vacuum- assisted closure has emerged as the treatment of complex wounds of the diabetic foot. Many reports on the use of Vacuum Assisted Closure (VAC) therapy after failed revascularization have found increased chances of success. Clinicians should consider negative pressure wound therapy as an adjunct to other modalities in an effort to avoid complications.Methods: Total of 51 patients were included in this prospective study. They were randomly divided into two groups, negative pressure wound therapy (NPWT) group (25 patients) and control group (26 patients) who were treated with regular dressings. All the patients included had peripheral vascular disease which was declared non-revascularisable after vascular workup. Initial mean surface area was measured in each patient. Transcutaneous oxygen pressure was recorded in all the patients and each patient followed up based on their granulation tissue development and need for amputation in each group.Results: After wound management, mean surface area of the diabetic wounds was 39.08cm2 in the NPWT group (P=0.019), and 38.63cm2 in the control group (P=0.327). The use of NPWT may be an effective initial wound therapy to achieve faster wound bed granulation showing signs of healing in 19 among 25 patients (76%) compared to control group 7 showed granulation among 26 patients (26%) (P=0.001). The incidence of secondary higher amputation in NPWT group is 6/25 (24%), the control group 17/26 (65%) (P=0.003), suggesting reduced incidence of secondary higher amputations in NPWT group. After treatment, the experimental group significantly improved in measures of foot ulcer surface area compared with the control group. Further studies are needed to clarify the effects and indications and to modify the technique of this alternative treatment for use on non healing wounds.Conclusions: NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. NPWT appears to be a safer and efficacious method, than moist wound therapy for the treatment of diabetic foot ulcers.
Protection of femoral vessels and vascular grafts after inguinal lymphadenectomy or femoral bypass by using prophylactic routine sartorius muscle flap shield coverage
Authors: Fawzy Ahmed , Gaber Ahmed , Abugruidah Hesham , El Kased Ahmed 
Published: June 2017

Background: Groin vascular infections are potentially catastrophic situations as limb loss or even death may occur in a high percentage of patients. A growing evidence support the benefit of muscle flap covering for these non-healing or infected wounds with stressing on their increased efficacy when used prophylactically. Sartorius muscle flap is granted here by its anatomical characteristics.Methods: Fifty Sartorius muscle flaps were done for 39 patients. Flaps were done routinely on prophylactic basis for protection of native femoral vessels or vascular grafts either for oncological or vascular causes in conjunction with inguinal lymphadenectomy or femoral bypass graft. Great care was taken to preserve the first segmental branch to the muscle and avoided its injury.Results: Prophylactic Sartorius muscle flap was done for oncological causes in 46% while for vascular causes in 54% of total flap number. The operative time ranged from 14-20 minutes for every flap with mean 16 minutes with negligible blood loss and no any donor site morbidity. The complication rate was 26%, including mild skin infection 12%, seroma 6%, partial superficial skin necrosis 6%, and hematoma 2%.Conclusions: Sartorius muscle flap has versatile benefits. Its role has been proved as a shield protecting and covering the femoral vessels or vascular grafts and resulted in decreased rate of overall complications. We recommend prophylactic Sartorius muscle flap coverage on routine basis considering it the workhorse of efforts done to vascular protection.
Bladder injuries during obstetrical and gynecological surgeries
Authors: Vaidya Beena , Chaudhari Manish , Parmar Deep , Chaudhari Vipul , Daginawala Taha , Shah Ritesh 
Published: June 2017

Background: The reproductive and urinary tracts in women are closely related anatomically and embryologically. Knowledge of this anatomy plays an important role in the prevention of urinary tract injury during gynaecologic surgery. The primary approach to prevention is careful surgical dissection and knowledge of the position of urinary tract structures within the surgical field.Methods: Prospective interventional study consisted of 28 patients with obstetrics and gynecological surgeries was carried out at department of surgery, new civil hospital, Surat during December 15th to January 16th. Out of 28 patients 13 patients had bladder injuries which repaired and studied in detail.Results: Out of these 28 patients undergone various obstetrics and gynecological surgeries, 13 patients were having iatrogenic urinary bladder injuries. Bladder injury occurred commonly during in LSCS and in hysterectomies. Out of 13 urinary bladder injuries, 8 injuries repaired in 2 layers by Vicryl 2-0 without insertion of SPC and 5 injuries were managed by primary repair with vicryl 2-0 with insertion of SPC (SPC= suprapubic cystostomy).Conclusions: Surgery adjacent to or within urinary bladder continue to result in occasional iatrogenic injury. These injuries can be minor with no long-term sequelae, or they can result in significant morbidity and inconvenience to patients.
Role of fibrin glue in seroma reduction after modified radical mastectomy
Authors: Fawzy Ahmed , Gaber Ahmed , Farid Abd Al Monem 
Published: June 2017

Background: Seroma is one of the most common morbidity occurring post modified radical mastectomy (MRM). It can delay post-operative initiation of adjuvant therapy. This study was designed to determine the role of fibrin glue spray in reduction of seroma volume and duration after breast surgeries.Methods: A prospective, randomized, controlled study over forty female patients who underwent (MRM) was done. The study cohort was randomized into control group where only conventional drain placement was used and experimental group where double dose of fibrin glue has been sprayed to the axillary and mammary beds plus conventional drain placement. Data regarding the amount of drained fluid in the first post-operative day, hospital stay, length of drain placement, amount and duration of post-operative seroma, number of excised lymph nodes (L. Ns) and pathological results were recorded.Results: No difference in mean age, number of excised L. Ns and rate of post-operative infection between both groups was detected. There was significant reduction in hospital stay time favouring fibrin glue group (p=0.006). Fibrin glue group had a significant reduction in the length of drain placement (p=0.001). The amount of post-operative serous fluid was reduced and the incidence of occurrence of post-operative seroma was (7/20) 35% in control group compared to (1/20) 5% in fibrin glue group giving significant reduction in incidence and amount.Conclusions: Use of fibrin glue sealant during MRM resulted in noticeable and significant decrease of post-operative rate of seroma formation, its amount and the length of drain placement.
Evaluation of modified Alvarado scoring system in acute appendicitis at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
Authors: Rithin Punjala Sai , Agarwal Aman , Budigi Bhavana 
Published: June 2017

Background: Despite of much advancement in modern diagnostic technology, decision making in patients with acute appendicitis is still a challenge worldwide. Many diagnostic scoring systems have been developed. Of them modified Alvarado scoring system (MASS) has been reported to be a cheap and quick diagnostic tool which minimizes negative appendectomy rate. The present study was aimed to evaluate the efficacy of MASS in diagnosing acute appendicitis and correlating the same with histopathological results.Methods: This prospective cohort study conducted from November 2012 to April 2014, over a period of 18 months at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. 100 patients with symptoms of acute appendicitis were enrolled in the study. They were diagnosed using MASS. Patients with a score of 7 to 10 were taken up for surgery. Patients with a score below 7, but with high suspicion of acute appendicitis by the surgeon were taken up for surgery. Following surgery all appendix specimens were sent for histopathologic examination.Results: A total number of 100 patients were participated in the study. Of them patients under the age group of 21-30 years were more affected with acute appendicitis (51%). Male predominance was observed in the study (74%). The common symptom observed in all patients (100%) was tenderness in right Iliac fossa (RIF). Out of 100 patients, 79% of the patients were presented with a modified Alvarado score of ≥7 and 21% presented with a score of <7. The sensitivity and specificity of the MASS in this study was 89.66% and 92.31% in both males and females respectively. The positive predictive value was 98.73%, negative predictive value was 57.41% and the NAR was 6.75% and 30.76% in male and female patients respectively.Conclusions: The observations of the study confirm that use of MASS in patients suspected to have acute appendicitis provides a high degree of diagnostic accuracy and subsequently reduces the negative appendicectomy and complication rates.
A study of occurrence of postoperative sensorineural hearing loss after middle ear surgeries
Authors: Mazhar Md. Shafiuddin , B. H. Shrikrishna 
Published: June 2017

<p class="abstract"><strong>Background:</strong> Chronic otitis media is the most common middle ear disease that is encountered in our hospital. There are various surgical procedures that are performed in cases of COM and other similar conditions of the middle ear. Any type of otosurgical procedure involves the risk of inner ear damage. As middle ear surgery is also performed for functional reasons this risk should be taken into consideration. There have been some studies mentioning many insults to the cochlea during middle ear surgeries. Some studies claim that sensorineural hearing loss post-surgery is not significant at all. In view of these contradictory studies, further study is essential on this subject<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> All patients undergoing middle ear surgeries are subjected to pure tone audiometry pre-operatively and tenth day, one month and three months postoperatively. Hearing assessment done with pure tone audiometer. The hearing threshold for pure tone audiometer was determined in a sound treated room at frequencies ranging from 125-8000 Hz for air conduction and 250-4000 Hz for bone conduction<span lang="EN-IN">. </span></p><p class="abstract"><strong>Results:</strong> Sensorineural hearing loss was not found in any of the patients postoperatively on 10th day 1st month and 3rd month<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> There was no significant variation between preoperative and postoperative bone conduction levels. Therefore middle ear surgeries have not resulted in any SNHL. Duration of ear discharge, duration of surgery, type of surgery had no bearing on postoperative sensory neural hearing levels<span lang="EN-IN">.</span></p>
A clinicoepidemiological study of sexually transmitted infections among men who have sex with men from a tertiary care centre in South India
Authors: Binesh V. G. , Sarin A. , Ambooken Betsy , Suprakasan S. , Rakesh T. P. 
Published: June 2017

<p class="abstract"><strong>Background:</strong> The prevalence of men who have sex with men (MSM) is showing an increasing trend in general population. MSM being a high risk population are more prone to develop sexually transmitted infections (STIs)<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> With the help of Sevana, a nongovernmental organization (NGO), we were able to mobilize 81 MSM for detailed evaluation. All MSM, after an informed consent were given a behavioural questionnaire, followed by detailed history taking, clinical examination, pre-test counselling and specimen collection.<strong></strong></p><p class="abstract"><strong>Results:</strong> All of them were clinically asymptomatic. Of the total 81 MSM in our study, 27(33.3%) had STIs as evidenced by laboratory investigations. Out of these, 3 (3.7%) had multiple STIs. The most common STI in our study group was asymptomatic herpes gentalis (12.4%), followed by latent syphilis (9.9%) and non gonococcal urethritis (8.6%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The high incidence of asymptomatic STIs among MSMs in our study points to the need for strengthening targeted intervention including condom usage and a compulsory medical check-up and serological screening at least once in six months for early detection and treatment of STIs. This in turn would help us in preventing the transmission of STIs including HIV<span lang="EN-IN">.</span></p>
O QUE É ISSO? COMO OS CONSTRUTOS DE APRENDIZAGEM ORGANIZACIONAL SOCIOPRÁTICA, COMUNIDADES DE PRÁTICA E MENTORIA SÃO COMPREENDIDOS NA VISÃO DE EXECUTIVOS DA ORGANIZAÇÃO ALPHA.
Authors: PAMPONET DE ALMEIDA NEYLLA CAROLINA , DE SOUZA SILVA JADER CRISTINO 
Published: June 2017

O propósito desse artigo consistiu em investigar o que os executivos da empresa Alpha entendem sobre os construtos: aprendizagem socioprática, comunidades de prática e mentoria. A abordagem da pesquisa empírica foi fundamentalmente qualitativa e adotou-se o estudo de caso simples e a análise do discurso do sujeito coletivo (DSC), visando à interpretação dos achados empíricos. Como resultado, verificou-se que os gestores da organização Alpha - embora desconhecessem a nomenclatura dos termos, bem como a amplitude desses estudos no âmbito acadêmico-científico - apresentaram considerável compreensão acerca dos seus significados práticos, demonstrando semelhanças com o que é abordado sobre tais conceitos na literatura.
Water Blocks in Tight Formations: The Role of Matrix/Fracture Interaction in Hydrocarbon-Permeability Reduction and Its Implications in the Use of Enhanced Oil Recovery Techniques
Authors: Longoria Rafael A. , Liang Tianbo , Huynh Uyen T. , Nguyen Quoc P. , DiCarlo David A. 
Published: June 2017

Summary
Hydraulic fracturing is used to obtain economical rates from tight and unconventional formations by increasing the surface area of the reservoir within the flowing distance to a high-conductivity pathway. However, a significant fraction of the fracturing fluid is never recovered, and thus may reduce the hydrocarbon permeability near the fracture. Here, we experimentally mimic the water-invasion process during fracturing, and measure the effective permeability changes in a low-permeability core. Measurements of water flowback and effective permeability as a function of interfacial tension (IFT), flow rate, and shut-in time suggest that water is being held at the fracture face because of the capillary discontinuity (i.e., when the water leaves the matrix and enters a space with minimal capillary pressure). This effect arises from the capillary interaction between the matrix and the fracture, and is akin to the capillary end effect in coreflood experiments. The results show that this effect, although only a laboratory experimental artifact for conventional reservoirs, can be a significant source of effective hydrocarbon-permeability reduction by fracturing-fluid invasion into the formation in unconventional and tight reservoirs.
Experimental Study on the Wellbore-Cleaning Efficiency of Microhole-Horizontal-Well Drilling
Authors: Song Xianzhi , Xu Zhengming , Wang Mengshu , Li Gensheng , Shah S. N. , Pang Zhaoyu 
Published: June 2017

SummaryMicrohole-drilling technology is a high-efficiency and low-cost technology that has developed rapidly in recent years. However, during microhole-horizontal-well drilling, cuttings are easy to deposit at the bottom of the wellbore because of gravity and nonrotation of drillpipe. Inadequate drill-cuttings removal can cause costly problems such as excessive drag, and even mechanical pipe sticking. Therefore, many laboratory studies as well as field observations have been directed toward addressing the cuttings-transport problem. In the present study, a full-scale horizontal-cuttings-transport flow loop was set up and a total of 136 experiments were conducted. By analyzing the cuttings volumetric concentration and the dimensionless height of the cuttings bed, the effects of flow rate (0.00058–0.00078 m3/s), cuttings diameter (0.0003–0.005 m), rate of penetration (ROP) (0.00211–0.00636 m/s), eccentricity (0–0.8), and wellbore diameter (0.04–0.08 m) on wellbore-cleaning efficiency were obtained. It was found that cuttings-transport efficiency increased first and then decreased as cuttings diameter increased. Flow rate was the main parameter. Higher flow rate, lower ROP, lower eccentricity, and smaller drillpipe/wellbore-diameter ratio all led to higher wellbore-cleaning efficiency in microhole horizontal wells. In addition, a model for estimating the cuttings volumetric concentration and the cuttings-bed height was proposed by dimensional analysis dependent on the thorough understanding of the effects of various variables. The predictions were good when they were compared with the experimental data obtained. Major factors influencing cuttings transport in the field during microhole drilling and conventional rotary drilling were compared, and the reasons for their differences were discussed. The limitations of the proposed model in this study were also discussed. These results could provide a factual basis for improving microhole-drilling hydraulics.
Thirty-Six-Month Clinical Comparison of Bulk Fill and Nanofill Composite Restorations
Authors: Yazici AR , Antonson SA , Kutuk ZB , Ergin E 
Published: June 2017

SUMMARY

Objectives:
The aim of this study was to evaluate the clinical performance of a nanofill and a bulk fill resin composite in class II restorations.

Methods and Materials:
In accordance with a split-mouth design, 50 patients received at least one pair of restorations, restored with a nanofill resin composite (Filtek Ultimate [FU]) and with a bulk fill resin composite (Tetric EvoCeram Bulk Fill [TB]). Each restorative resin was used with its respective adhesive system according to the manufacturers' instructions. A total of 104 class II restorations were placed by two operators. The restorations were blindly evaluated by two examiners at baseline and at six, 12, 18, 24, and 36 months using modified US Public Health Service Ryge criteria. The comparison of the two restorative materials for each category was performed with the chi-square test (α=0.05). The baseline scores were compared with those at the recall visits using the Cochran Q-test.

Results:
At six, 12, 18, and 24 months, the recall rate was 100%, 98%, 94%, and 82%, respectively, with a retention rate of 100%. At 36 months, 81 restorations were evaluated in 39 patients with a recall rate of 78%. For marginal adaptation, four restorations from the TB group and 10 from the FU group rated as Bravo. Two restorations from the TB and eight restorations from the FU group showed marginal discoloration. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p&lt;0.05). No differences were observed between the restorative resins in terms of retention (p&gt;0.05). One restored tooth from the FU group was crowned. The retention rates for the TB and the FU groups were 100%. In the FU group, two restorations showed slightly rough surfaces, and two showed a slight mismatch in color. None of the restorations showed postoperative sensitivity, secondary caries, or loss of anatomic form.

Conclusions:
The tested bulk fill restorative resin demonstrated better clinical performance in terms of marginal discoloration and marginal adaptation.
Influence of Emission Spectrum and Irradiance on Light Curing of Resin-Based Composites
Authors: Shimokawa CAK , Sullivan B , Turbino ML , Soares CJ , Price RB 
Published: June 2017

SUMMARY

Purpose:
This study examined the influence of different emission spectra (single-peak and broad-spectrum) light-curing units (LCUs) delivering the same radiant exposures at irradiance values of 1200 or 3600 mW/cm2 on the polymerization and light transmission of four resin-based composites (RBCs).

Methods and Materials:
Two prototype LCUs that used the same light tip, but were either a single-peak blue or a broad-spectrum LED, were used to deliver the same radiant exposures to the top surfaces of the RBCs using either standard (1200 mW/cm2) or high irradiance (3600 mW/cm2) settings. The emission spectrum and radiant power from the LCUs were measured with a laboratory-grade integrating sphere coupled to a spectrometer, and the light beam was assessed with a beam profiler camera. Four RBCs (Filtek Supreme Ultra A2, Tetric EvoCeram A2, Tetric EvoCeram T, and TPH Spectra High Viscosity A2) were photoactivated using four different light conditions: single-peak blue/standard irradiance, single-peak blue/high irradiance, broad-spectrum/standard irradiance, and broad-spectrum/high irradiance. The degree of conversion (N=5) and microhardness at the top and bottom of 2.3-mm-diameter by 2.5-mm-thick specimens (N=5) were analyzed with analysis of variance and Tukey tests. The real-time light transmission through the RBCs was also measured.

Results:
For all light conditions, the 2.3-mm-diameter specimens received a homogeneous irradiance and spectral distribution. Although similar radiant exposures were delivered to the top surfaces of the RBCs, the amount of light energy emitted from the bottom surfaces was different among the four RBCs, and was also greater for the single-peak lights. Very little violet light (wavelengths below 420 nm) reached the bottom of the 2.5-mm-thick specimens.
The degree of conversion and microhardness results varied according to the RBC (p&lt;0.05). The RBCs that included alternative photoinitiators had greater microhardness values at the top when cured with broad-spectrum lights, while at the bottom, where little violet light was observed, the results were equal or higher when they were photoactivated with single-peak blue lights. With the exception of the microhardness at the top of TPH, equivalent or higher microhardness and degree-of-conversion values were achieved at the bottom surface when the standard (1200 mW/cm2) irradiance levels were used compared to when high irradiance levels were used.

Conclusions:
Considering the different behaviors of the tested RBCs, the emission spectrum and irradiance level influenced the polymerization of some RBCs. The RBCs that included alternative photoinitiators produced greater values at the top when cured with broad-spectrum lights, while at the bottom, results were equal or higher for the RBCs photoactivated with single-peak blue lights.