bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspects du mal et de la méchanceté chez Sade / Aspects of Evil and Villainy in Sade
Authors: Tavakkoli Amirpasha 
Published: July 2017

Résumé: Influencé par la philosophie des Lumières et hostile à l’égard de la morale chrétienne, Sade envisage de déconstruire le discours philosophico-moral de son temps. Il s’intéresse à l’idée de l’état de nature sous un angle différent de celui des philosophes et des moralistes. En plaçant le Mal au centre de ses réflexions, l’objectif pour lui est de renverser le discours dominant de son temps en prenant l’inceste, le meurtre et les perversions comme étant les maximes conductrices de sa pensée. Malgré l’apparence immorale de ses écrits, Sade tombe dans un schéma moralisant reposant sur l’idéal du Mal qu’il adore. Agir et penser selon les commandements du Mal, deviennent les fondements de l’éthique sadienne. Une réflexion que nous allons approfondir à la lumière des réflexions de Klossowski, Bataille et Jacques Lacan.Mots-clés : mal; état de nature; loi; éthique; transgression.Abstract: Influenced by the philosophy of the Enlightment and hostile toward Christian morality, Sade endeavored to criticize the moral-philosophical discourse of his time, focusing on the idea of the state of nature in a radically different way from contemporary philosophers and moralists. By placing Evil at the center of his considerations, he aims to overturn the dominant discourse of his time by enlisting incest, murder, and perversions as the tenets guiding his thought. Despite the immoral appearance of his writings, Sade falls prey to a moralizing schema based on the ideal of Evil. Acting and thinking according to the commandments of Evil then becomes the fundaments of Sade’s ethics. The idea moving this paper is to deepen our understanding of this theory in light of reflections by Klossowski, Bataille, and Lacan.Keywords: Evil, state of nature, law, ethic, transgression.
A clinicopathology study to establish the accuracy of diagnosis of acute appendicitis in case of acute right lower quadrant pain of abdomen
Authors: Thakur Bhushankumar A. , Shinde Parnika Ravindra , Sharma Anuj R. 
Published: July 2017

Background: Acute appendicitis, one of the most common surgical emergency is also one of the most challenging surgical dilemma for every surgeon, both in diagnosis and treatment. A negative exploration on one hand has to be weighed against the risk of subsequent perforation during expectant management especially in doubtful cases. We conducted a study to find out if diagnosis by scoring systems and graded ultrasonography improves clinical outcomes for patients with suspected appendicitis.Methods: It was a prospective and observational study including 52 patients of clinically suspected acute appendicitis presenting in the surgical emergency. All patients underwent clinical scoring using Alvarado scores and Ohmann’s score and Ultrasonography. Later, based on the intra operative findings and histopathological diagnosis of acute appendicitis, the sensitivity, specificity, positive predictive value and negative predictive value were calculated individually and by combining the scoring systems and imaging together.Results: The sensitivity, specificity, PPV and NPV of ultrasonography when combined with scoring systems (both Alvarado and Ohmann’s) is increased significantly as compared to when used individually for diagnosis of acute appendicitis. As calculated by our study, the sensitivity of USG was 90.32%, specificity 80.95%, PPV 87.5%, NPV 85% and diagnostic accuracy of 86.54% which has been comparable with the other studies in the previous literature.Conclusions: Combination of scoring systems with Ultrasonography leads to the prompt diagnosis and early treatment of many cases of appendicitis. Hence, improving clinical outcomes in doubtful cases.
Single center experience of urinary bladder malignancy: a 10-year retrospective analysis of hospital data
Authors: T. P. Rajeev , Singh Yashasvi , Barua Sasanka Kumar , Sarma Debanga 
Published: July 2017

Background: Albeit the EAU, NCCN and AUA guidelines provide an excellent evidence-based protocol for the management of MIBC and NMIBC, these guidelines differ with respect to critical issues such as risk level definitions and management strategies. The NE part of the country has always bore the brunt of heavy oncological catastrophe like urinary bladder carcinoma related to extensive tobacco and pesticide usage. MIBC treatment usually encompasses RC with AC/NAC (Level I evidence for NAC use in MIBC exist) but the majority of patients seen at our center have already progressed to advanced stage at presentation and could not undertake full treatment.Methods: Cancer registry of the last 10 yrs at Dept. of Urology and Renal Transplant Gauhati Medical College Hospital was searched for demographic, clinical, pathological and prognostic data and results summarized using statistical parameters of univariate analysis.Results: There were a total of 168 patients in the NMIBC group with a majority in the 60-70-year age group. The most common grade was G2 and all DM type 2 and CKD were significantly associated in all the patients analyzed. Chemical exposure in the form of pesticide and smoking was a constant phenomenon in all patients of NMIBC and MIBC (n=66) population. CKD was significantly associated in the MIBC population along with positive urine cytology.Conclusions: Despite a paucity of high level evidence regarding the majority of management topics in Urinary Bladder cancer in NE part of the country, there was general agreement among the various guideline panels and management guidelines at our institution. Identification of the upfront clinical parameters suggesting severity of disease and time to progression are the two most important domains which will decide the future of UB carcinoma treatment in this part of the world. Categories of evidence synthesized and grades of recommendations will have to be constantly gazed upon to modify and enhance treatment strategies.
Abdominal tuberculosis: a clinicopathologic study in Kashmir valley
Authors: Kumar Ravinder , Digra Madhu , Kumar Dinesh 
Published: July 2017

Background: Tuberculosis is a major health hazard in India. Because of its diverse manifestations, difficult diagnosis, widespread complications, prolonged morbidity and increased mortality the study of this disease becomes even more important. The objectives of the study were to study age and sex distribution of abdominal tuberculosis, to study association of abdominal tuberculosis with pulmonary tuberculosis, to study various clinical presentations of abdominal tuberculosis, to study various modalities for diagnosis of abdominal tuberculosis and to study the surgical management in relevant patients of abdominal tuberculosis.Methods: This study was carried out in 50 patients of abdominal tuberculosis of different age group and sex admitted in Department of Surgery, SMHS Hospital, Govt. Medical College, Srinagar during the period from 2002 to 2004. The patients of abdominal tuberculosis fell into two broad categories - those presenting with acute/sub-acute intestinal obstruction and those without obstruction. All patients were worked up with the elicitation of proper history, clinical examination, laboratory investigation, etc. The diagnosis was confirmed by IgM ELISA for tuberculosis, peritoneocentesis, FNAC, laparotomy and biopsy of the specimen obtained at the time of surgery.Results: Maximum incidence of abdominal tuberculosis was noted in third and fourth decades followed by second decade of life. Males constituted 60% and females constituted 40% of total patients. 23 patients presented with acute and 27 patients with chronic onset of signs and symptoms respectively. Abdominal pain, anorexia, weight loss, weakness, vomiting and constipation were the main presenting symptoms. No haemoglobin and raised ESR were the commonest finding on routine laboratory investigations in majority of the patients. IgM ELISA for tuberculosis was positive in 41 patients (95.34%). Surgical intervention was required in 50% of the patients.Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and timely management of this curable disease.
A study on faciomaxillary injuries in a tertiary care hospital
Authors: G. Ravikumar , Manoharan . , G. R. Sugapradha 
Published: July 2017

Background: Faciomaxillary injuries are increasing in frequency and severity due to road traffic accidents and violence among the people of the delta districts of Tamilnadu. Alcohol plays a major role both in road traffic accidents and assaults resulting in faciomaxillary injuries. Human bites play a significant role in the soft tissue injuries of the face resulting in loss of lobule of ear, nasal tip loss and partial loss of lower lip. The purpose of this study was to evaluate the aetiology, incidence, patterns and treatment modalities of faciomaxillary injuries which include both soft tissue and bony injuries.Methods: The study was conducted in the Department of Plastic and Reconstructive Surgery of Thanjavur Medical College, Tamil Nadu, India between 2012-2015. About 850 patients in and around the delta districts of Tamilnadu admitted with various soft tissue and bony injuries of the faciomaxillary region were studied. Age, sex, time, mechanism and aetiology of injury, history of bleeding, unconsciousness and prior first aid, type of vehicle and use of preventive measures, type of fracture, associated injuries and treatment modalities were evaluated.Results: Faciomaxillary injuries were mostly due to road traffic accidents. Highest number of fractures was predominantly occurring in the age group of 21-30 years. Males incurred more fractures with a male to female ratio of 7.4:1.1. Fracture mandible was the most common followed by zygoma, nasal and naso ethmoid fractures. Pan facial fractures were more common among alcoholics. 28 patients had associated head injury and 14 patients had cervical spine injuries. Open reduction and internal fixation was the preferred modality for mandible whereas the mid face fractures were treated more often by closed methods. Soft tissue injuries involving ear, nose, lip and eyelids were more common.Conclusions: Drunken driving should be curbed in the society. Educating the people about road safety rules will bring down the faciomaxillary injuries. Motivating the public against violence will reduce human bites and soft tissue injuries of the face.
A study of febrile seizures in children in relation to iron deficiency anemia
Authors: Shah Gautam , Parmar Ritesh 
Published: July 2017

Background: Febrile seizures are the most common cause of convulsions in children between 6 months to 5 years, occurring in 2-5% of children. Iron deficiency is postulated as a risk factor for febrile seizures in children and it is an easily correctable condition. The objective of the study was to study the clinical profile and risk factors of febrile convulsions and to establish an association between febrile seizure and iron deficiency anemia.Methods: The study was carried out in Department of Pediatrics, Dhiraj General Hospital, Piparia, a tertiary care teaching hospital. 34 cases and 34 controls were included in the study. Controls were children of same age group presenting with short febrile illness but without any seizures. Febrile seizures were defined according to the AAP (American Academy of Pediatrics) criteria. Iron deficiency was diagnosed by hematologic investigations of haemoglobin value < 11 g/dl, MCV <70 fL and RDW > 15.6%.Results: Iron deficiency anemia was present in 23.52% (8/34) of cases as compared to 17.64% (6/34) in the control group. Odds ratio was 1.436 (95% CI 0.439-4.669, p value 0.549), which suggest there is no significant association of iron deficiency anemia with febrile convulsions. Subgroup analysis for association of iron deficiency anemia with simple febrile convulsion cases showed Odds ratio of 1.11 (95% CI 0.298-4.138), which suggests there is poor association of iron deficiency anemia with simple febrile convulsions. Subgroup analysis for association of iron deficiency anemia with complex febrile convulsion cases showed Odds ratio of 2.809 (95% CI 0.521-15.041), which suggests there is poor association of iron deficiency anemia with complex febrile convulsions. Wide confidence interval indicates less sample size. Study with large sample size is required for reliable interpretation.Conclusions:The study reveals iron deficiency anemia is not a significant risk factor in children presenting with febrile seizures. Further study with large sample size is required.
A study on prevalence of myopia and its associated factors in school children of Salem, Tamil Nadu
Authors: K. Chellavel Ganapathi , R Arun Vijay Paul , K. Kokila , S. Bharath Kumar 
Published: July 2017

Background: Myopia is the major refractive error having a worldwide prevalence of 1.5 billion. Children with Myopia feel difficulties in viewing blackboard in school; they avoid outdoor activities and get isolated from the peer groups. Untreated myopia may lead to Macular degeneration, Glaucoma, Cataract, Retinal detachment. Thus this study was carried out. The aim of the study to find out the prevalence of myopia among school children and its associated factors.Methods: The study was a cross sectional study carried out among students of government higher secondary school, Sarkar Kollapatti, Salem. Total sample size of 854 Students from class 6-12 was selected by simple random sampling. Students were examined by Snellen’s chart, non-cycloplegic auto refractometry and by pin hole test. Finally all data were entered in EPIDATA and analysed in IBM SPSS software version 20.Results: After complete analysis, prevalence of myopia was 11.7% of which 46% were boys and 54% were girls. Among students of age 8 to 19 years, the most common age group involved was 14-17 years of age followed by students of 10-13 years of age. Time spent on visual gadgets was the major factor associated with myopia. Familial predisposition, average amount of time a person spends on near work showed significant association with myopia.Conclusions: This study throws light on prevalence of myopia in semi-urban school children & various factors associated with myopia. Students with myopia were referred to Department of Ophthalmology, GMKMCH and thus they were prevented from further complications due to myopia and improve the academic performance.
12-month assessment of increase in total kidney volume in children and young adults with autosomal dominant polycystic kidney disease – a pilot study
Authors: Pawlak-Bratkowska Monika , Afshari Susan , Grzelak Piotr , Podgórski Michał , Wosiak Agnieszka , Młudzik Katarzyna , Michalak Krzysztof , Kostrzewa Marta , Faltin Kamil , Tkaczyk Marcin 
Published: July 2017

WstępAutosomalna dominująca wielotorbielowatość nerek (ADPKD – autosomal dominant polycystic kidney disease) to najczęstsza z dziedziczonych monogenowo chorób nerek. Stanowi przyczynę schyłkowej niewydolności nerek u 5–10% dorosłych leczonych nerkozastępczo. Dawniej uważana była za chorobę ludzi dorosłych, lecz od czasu upowszechnienia badań ultrasonograficznych zaczęto obserwować jej występowanie także u dzieci.Materiał i metodyGrupę badaną stanowiło 19 pacjentów z prawidłową czynnością nerek (w wieku 1,8–18,8 roku w trakcie kontroli, 12 dziewczynek, 7 chłopców) chorujących na ADPKD. Spośród pacjentów 15 spełniało ultrasono-graficzne kryteria rozpoznania choroby, a 4 nie spełniało kryteriów, przy czym były to dzieci z dodatnim wywiadem rodzinnym w kierunku ADPKD, a w USG stwierdzono minimum 2 torbiele. Całkowita objętość nerek (TKV), określona jako suma objętości obu nerek, została odniesiona do powierzchni ciała pacjenta (TKV/BSA). Dzieci badane były średnio co 12 miesięcy.WynikiW badanej grupie stwierdzono istotny statystycznie roczny przyrost całkowitej objętości nerek (w 2015 r. 296,71 ± 178,67 cm3 vs. 350,38 ± 195,86 cm3 w 2016 r.; p = 0,019) oraz także TKV w odniesieniu do powierzchni ciała (w 2015 r. 191,23 ± 86,29 cm3/m2 vs. 221,15 ± 96,99 cm3/m2 w 2016 r.; p = 0,037). Nie uwidoczniono różnic w tempie przyrost całkowitej objętości nerek w zależności od płci (dziewczynki 32,45 ± 51,88 cm3/m2/rok vs. chłopcy 25,56 ± 71,00 cm3/m2/rok; p = 0,81) oraz ze względu na zaawansowanie choroby, ocenianej jako liczba stwierdzonych w badaniu ultrasonograficznym torbieli w obrębie nerek (< 5 torbieli 30,77 ± 61,6 cm3/m2/rok vs. ≥ 5 torbieli 29,41 ± 58,22 cm3/m2/rok; p = 0,96).WnioskiU dzieci i młodych dorosłych z ADPKD można zaobserwować zwiększenie względnej całkowitej objętości nerek (w odniesieniu do BSA) już w trakcie 12-miesięcznej obserwacji.
Assessment of growth retardation in children on renal replacement therapy from 2000 to 2016 – one center experience
Authors: Zachwieja Katarzyna , Drożdż Dorota , Hubert Joanna , Dudek Natalia , Moczulska Anna , MIklaszewska Monika , Pietrzyk Jacek 
Published: July 2017

WstępCelem pracy była ocena wzrastania dzieci dializowanych w latach 2000–2016.Materiał i metodyU 102 dzieci w wieku 10,2 roku ± 5,66 przeanalizowano rozpoznania, schorzenia dodatkowe, czas i rodzaj dializoterapii, losy pacjenta, zastosowanie hormonu wzrostu. Niedobór wzrastania (Z score) stwierdzono u 87 dzieci przy rozpoczęciu badania i u 94 przy zakończeniu leczenia.WynikiU 60% dzieci pierwszą metodą dializoterapii była dializa otrzewnowa, u 38% hemodializoterapia, u 2% wy-przedzające przeszczepienie nerki. W chwili zakończenia obserwacji 70% pacjentów żyło z czynnym przeszczepem nerki, 15% było nadal dializowanych, 13% zmarło, u 2% doszło do poprawy funkcji nerek. Średni czas dializoterapii (94 dzieci) wynosił 34,6 mies. (1–136 mies.) i był dłuższy w latach 2000–2008 niż w okresie 2009–2016 (śr. 43,3 ± 32,7 mies. vs 18,3 ± 13,1; p = 0,00005). W grupie ze schorzeniami dodatkowymi (46% dzieci) stwierdzono większy niedobór wzrostu na początku (Z score 0: -2,3 ± 2,3 vs -1,08 ± 1,6; p = 0,003) i na końcu leczenia (Z score 1:-2,7 ± 2,6 vs -1,2 ± 1,5; p = 0,001) oraz dłuższy czas dializoterapii (42,7 ± 34,4 mies. vs 27,8 ± 23,8; p = 0,02). Z score 0 wyniósł dla wszystkich pacjentów -1,7 ± 2,0 (-9,3 do +2,0) przy rozpoczęciu leczenia i nie różnił się od Z score 1:
-1,9 ± 2,2 (-8,3 do +2,4); p = 0,37 w chwili zakończenia. U 42,5% dzieci na początku i u 45% na końcu terapii Z score był < -2,0. W grupie 17% dzieci leczonych hormonem wzrostu stwierdzono wyrównanie się niedoboru wzrostu po zakończeniu dializoterapii w porównaniu z grupą nieleczoną (Z score 1: -2,4 ± 1,7 vs -1,9 ± 2,3; p = 0,37).WnioskiNiskorosłość stanowi istotny problem dzieci dializowanych. Współchorobowość jest czynnikiem pogarszającym niedobór wzrostu. Zastosowanie hormonu wzrostu daje szansę na poprawę wzrastania.
Pericarditis constrictiva: Causa de falla cardiaca en una paciente joven
Authors: Quispe Jorge 
Published: July 2017

La pericarditis constrictiva es una causa de falla cardiaca derecha, que produce típicamente una alteración diastólica progresiva. Su corrección quirúrgica es posible con la pericardiectomía. La presentación en jóvenes y el compromiso importante de la función sistólica son escenarios infrecuentes. Se presenta el caso de una joven de 17 años con un cuadro de falla cardiaca congestiva. Los hallazgos de la ecocardiografía y resonancia cardiaca confirmaron el diagnóstico de pericarditis constrictiva. Se evidenció una disfunción sistólica con hipocinesia apical severa y con presencia de una masa a este nivel, compatible con trombo por la respuesta a anticoagulantes. La pericardiectomía se difirió por un alto riesgo operatorio y criterios de mal pronóstico por resonancia cardiaca.
Patient Outcomes After Observation Versus Debridement of Unstable Chondral Lesions During Partial Meniscectomy
Authors: Bisson Leslie J. , Kluczynski Melissa A. , Wind William M. , Fineberg Marc S. , Bernas Geoffrey A. , Rauh Michael A. , Marzo John M. , Zhou Zehua , Zhao Jiwei 
Published: July 2017

Background:
It is unknown whether unstable chondral lesions observed during arthroscopic partial meniscectomy (APM) require treatment. We examined differences at 1 year with respect to knee pain and other outcomes between patients who had debridement (CL-Deb) and those who had observation (CL-noDeb) of unstable chondral lesions encountered during APM.

Methods:
Patients who were ≥30 years old and undergoing APM were randomized to receive debridement (CL-Deb group; n = 98) or observation (CL-noDeb; n = 92) of unstable Outerbridge grade-II, III, or IV chondral lesions. Outcomes were evaluated preoperatively and at 8 to 12 days, 6 weeks, 3 months, 6 months, and 1 year postoperatively. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) pain score, Short Form-36 (SF-36) health survey, range of motion, quadriceps circumference, and effusion. The primary outcome was the WOMAC pain score at 1 year. T tests were used to examine group differences in outcomes, and the means and standard deviations are reported.

Results:
There were no significant differences between the groups with respect to any of the 1-year outcome scores. Compared with the CL-Deb group, the CL-noDeb group had improvement in the KOOS quality-of-life (p = 0.04) and SF-36 physical functioning scores (p = 0.01) as well as increased quadriceps circumference at 8 to 12 days (p = 0.02); had improvement in the pain score on the WOMAC (p = 0.02) and KOOS (p = 0.04) at 6 weeks; had improvement in SF-36 physical functioning scores at 3 months (p = 0.01); and had increased quadriceps circumference at 6 months (p = 0.02).

Conclusions:
Outcomes for the CL-Deb and CL-noDeb groups did not differ at 1 year postoperatively. This suggests that there is no benefit to arthroscopic debridement of unstable chondral lesions encountered during APM, and it is recommended that these lesions be left in situ.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.