bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical profile of patients with below knee soft tissue injuries
Authors: Sachdev Gurvansh S. , Rajan Manu , Dvivedi Sanjay , Agrawal Saurabh , Rawat Kinnari A. V. 
Published: January 2018

Background: In the recent era of trauma majority of people suffer from lower limb injuries, which cause functional disabilities and psychosocial consequences. Lower limb injury specially below knee generally involves young and productive people so it is the prime responsibility of the society to prevent such incidents. Our aim is to study clinical profile of various below knee soft tissue injuries to develop better prediction models for defining the most important target for prevention and to reduce morbidities and disabilities.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Subjects were recruited from patients presenting in Emergency/Surgery OPD, HIMS, Dehradun with a primary diagnosis of below knee soft tissue injuries. A total of 64 patients were included in the study.Results: Maximum number of patients were in the age group of 20-40 years (46.88%), and were predominantly males (84.38%). The commonest mode of injury was RTA (75%) primarily involving 2 wheelers (72.91%). Most patients (42.18%) had late presentation to the hospital i.e. after 72 hours of injury which was found to be associated with contamination of wound in 66.6% of patients.Conclusions: The study emphasizes the need for preventive strategies and protection mechanisms for lower limb injuries. Late presenting contaminated wounds leads to higher complication rates hence there is need for efficient ambulance services for ensuring timely intervention.
Comparative evaluation of subcutaneous infiltration (port site) vs intraperitoneal infiltration of bupivacaine on post laparoscopic cholecystectomy pain
Authors: Gupta R. S. , Rai A. , Vasuniya Vikram , Choudhary Devendra 
Published: January 2018

Background: Laparoscopic cholecystectomy (LC) is now the gold standard technique for the treatment of gallstones disease. Although pain after LC is less intense than after open cholecystectomy, some patients still experience considerable discomfort during early postoperative hours. The aim of this study is to evaluate the effect of intraperitoneal and port site instillation of local anaesthetics on pain relief in early postoperative period following LC.Methods: This is a randomized, prospective analytical study among patients subjected to elective laparoscopic cholecystectomy. Patients were divided into 3 groups as; Group 1 was control, Group 2 was assigned to receive portside infiltration of bupivacaine, while group 3 received combined port site and intraperitoneal instillation of bupivacaine. The evaluation of postoperative pain was done according to the visual analog scale and the dosage of narcotic analgesics consumed and duration of hospital stay was also recorded.Results: At 1st post-operative hour, minimum VAS score was in group 3 (p=0.003). At 4th post-operative hour, Minimum VAS score was in group 3(p=0.015). At 8th post-operative hour, Minimum VAS score was in group 3, (p=0.044). Patients in group 3 received a lower total amount of rescue analgesia and they also had the shortest hospital stay after LC, compared to the patients in the other groups. As regarding the incidence of right shoulder pain, group 3 has minimal no of patients experienced rt shoulder tip pain.Conclusions: Infiltration of bupivacaine into port site and intraperitoneal space is simple, inexpensive and effective technique to minimize early postoperative pain and can be practiced for elective LC.
Clinical, radiological and pathological evaluation of residual disease in women receiving neoadjuvant chemotherapy for locally advance carcinoma breast
Authors: Mishra Mayank , Singh Puspendra , Tripathi Alok 
Published: January 2018

Background: Egyptians were first to note this disease, 3,500 years ago and described fairly accurately in George Ebers papyri. This disease occurs almost entirely in women, but men can get it, too. Breast cancer is most common among women worldwide. In India, its second after cancer cervix. Its incidence outranks all other cancers in women >35 years of age. Age adjusted incidence rates vary from 9.7- 28.2/100,000. The treatment of locally advanced breast cancer has considerably changed and now includes a multidisciplinary approach, which is directed both to locoregional control and destruction of distant micro-metastasis. Neoadjuvant therapy causes a reduction in size of primary tumor allowing more conservative surgical approach without any increase in locoregional recurrence rate. Limitations of clinical methods for assessment of response to neoadjuvant chemotherapy have now incorporated by imaging and pathological method.Methods: In present study author assess LABC clinically, radiologically and pathologically by mammography USG, FNAC and histopathologic examination, pre- and post-neoadjuvant chemotherapy and evaluate response to chemotherapy, reduction of tumor volume and prior assessment of the patient’s prognosis.Results: Present study shown USG is more accurate in assessing residual disease in post neoadjuvant chemotherapy in defining the real extent of residual disease and also superior in term of detecting complete pathological response.Conclusions: A multimodal assessment of response of neoadjuvant chemotherapy is needed to direct optimal surgical treatment with acceptable cosmesis.
The frequency of infection in early versus late surgery of compound depressed skull fractures in adults
Authors: Irshad Muhammad , Manzoor Ch Ali , Aamir Muhammad 
Published: January 2018

Background: The treatment of penetrating head injuries and depressed skull fracture has shown a gradual change over the past decades. A proper debridement and closure of scalp wounds and dural tears have been shown to decrease infection and mortality rate of compound skull fractures. This study has been designed to determine the frequency of infection in early versus late surgery of compound depressed skull fractures in adults.Methods: A total of 226 (113 in each group) patients with compound depressed skull fracture were taken. Group A was managed by early surgery while group B underwent late surgery. Data were entered and analyzed using computer program SPSS version 18.Results: Out of these 226 study cases, 143(63.3%) were male, while 83 (36.7%) were females. The mean age of study cases was 37.50±10.58. The mean duration of presentation at the hospital was 6.76±2.41 hours. Roadside accident was noted to be a major etiological factor, i.e. 132 (58.4%) presented with the history of roadside accident. Base of the skull was a major site of wound, i.e. 79 (35.0%). The mean size of the wound was 13.79±3.49cm. Wound infection was seen in 51 (22.56%) of present study cases. Wound infection in group A was seen in 11 (9.7%) out of 113 patients while in group B it was 40 (35.4%) out of 113 patients (p=0.000).Conclusions: The findings of the current study have indicated that early surgery among the targeted population is associated with significantly less frequent wound infection.
A randomized control trial to determine the need for postoperative antibiotics after laparoscopic appendicectomy in nonperforated appendicitis
Authors: Kajagar B. M. , Jakiyuddin Rampurwala 
Published: January 2018

Background: Acute Appendicitis is the most common cause of acute pain in the abdomen. Appropriate use of prophylactic antibiotics prevents the risk of postoperative surgical site infections (SSIs). However, there is no conclusive guideline concerning the duration of antibiotic usage. A single preoperative prophylactic dose has been recommended by many randomized control trials. Hence, the study aimed to determine the need for postoperative antibiotics after laparoscopic appendicectomy for nonperforated appendicitis.Methods: A total of 100 patients with nonperforated appendicitis undergoing laparoscopic appendicectomy divided into two groups. Group A (n=50) patients received single dose of preoperative antibiotic and group B (n=50) patients received preoperative dose, as well as three postoperative doses of antibiotics. Routine investigations including complete blood count, blood urea, serum creatinine; other investigations such as ultrasound of abdomen were also performed. Following laparoscopic appendicectomy, surgical wound was inspected after 48 h, 72 h, and on day 7 to look for any signs of postoperative SSI.Results: The mean age in group A was 30.74±10.69 years compared to 30.72±9.56 years (p=0.757) in group B. All the patients in study presented with right iliac fossa pain. Three patients in group A (6%) and two patients in group B (4%) had grade III SSIs, which were managed conservatively. The difference between both the groups for incidence of SSIs was statistically insignificant (p=1.000).Conclusions: Prophylactic postoperative doses of antibiotics confer no additional benefit over a single preoperative dose in preventing the postoperative SSIs after laparoscopic appendicectomy.
Penile fracture; three years’ experience from a tertiary care centre
Authors: Dar Hanief Mohamed , Mala Tariq Ahmed , Hassan Yaqoob , Malla Shahid Amin , Ahmad Mir Mujtaba , Dogra Varun 
Published: January 2018

Background: To study cause, presentation, diagnosis and early management of penile fracture and to prevent the complications.Methods: In this study 48 patients of penile fracture were included in the study who were admitted in general surgery department at Government Medical College Srinagar from May 2007 to May 2010. All patients were evaluated with detailed history, clinical examination and baseline investigations followed by immediate surgical repair.Results: Age range of patients was 21-75 years. Youngest being 21 years and eldest being 75 years (median-30 years). 38(79.1%) patients were married while as 10(20.9%) patients were unmarried. Sexual intercourse was main cause, seen in 41(85.4%) of patients, aggressive masturbation in 5(10.4%) patients and rolling over in bed during erection was seen in 3(6.2%) patients. All patients presented in general surgery department with complaints of pain and swelling in penile region. Time interval between injury and presentation to the department ranged from 4-24 hours (mean 11 hours). Isolated cavernosa injury was seen in 43 (89.6%) patients, while as 5 (10.4%) patients were having associated urethral injury (3 were having partial injury and 2 complete urethral disruption). There was a ventral rent in 31(64.6%) patients and lateral rent in17 (35.4%). Size of tear in tunica albuginea was less than 1cms in 19(39.6%) patients, 1-2cm in 17(35.4) patients and more than 2cms in 12 (25%) patients. Patients were discharged on 2-5 days (mean 3.1 days). There were no immediate postoperative complications. 2 (4.1%) patients had pricking sensation at repair site, 1(2.05%) patient had pain during erection and 2 (4.01%) patients had mild deviation during erection on follow up.Conclusions: Penile fracture is a relatively rare urological emergency which mostly occurs during sexual intercourse or aggressive masturbation and is usually a clinical diagnosis. Early surgical repair avoids complications and preserves both sexual and voiding functions.
The study of prognostic significance of CA 15-3 in breast cancer
Authors: Gupta Shankar Kumar , Kumar Vinod , Anees Afzal , Goel Arjun 
Published: January 2018

Background: Cancer Antigen 15-3 (CA 15-3) is a tumour-associated antigen used as serum marker for breast cancer surveillance in patients and for monitoring the response to treatment. Aim of this study was to prospectively evaluate CA 15-3 as a prognostic factor in early detection of breast cancer relapse, recurrence and early detection of distant metastasis as well as to analyse the statistical correlation between CA 15-3 levels and clinical-pathological parameters including tumour size, lymph node, histological type, grading, hormonal receptors.Methods: Sera of 85 women with breast carcinoma obtained pre-treatment, post-treatment and follow-up at 6 months were assayed for CA 15-3 by solid phase enzyme-linked immunosorbent assay (ELISA).Results: Author founds that the mean serum CA 15-3 levels in patients before treatment were significantly higher (50.59U/ml) compared with those of CA 15-3 after treatment (24.07U/ml) and follow-up at 6 months (21.07U/ml). Author also found that elevated pre-treatment serum levels of CA 15-3 were significantly correlated with poor prognosis of patients. In particular, among 16/85 patients (18.8%) that displayed over cut-off (>24.95U/ml) pre-treatment levels of CA 15-3, 2 patients (2.35%) developed recurrence,2 patients (2.35%) developed residual tumour, 2 patients (2.35%) developed advanced disease (metastases to distant sites) and 10 (11.76%) patients expired during and after study. Chi-square correlation analysis revealed that the presences of increased serum levels of CA 15-3 after treatment are significant risk factors for poor prognosis in patients.Conclusions: Elevated pre-treatment concentrations of CA 15-3 may be a useful prognostic factor for cancer progression in patients.
Gastric outlet obstruction: clinical presentations and its surgical management
Authors: P. Tejas A. , Jade Rajashekar , S. Srinivas 
Published: January 2018

Background: Gastric outlet obstruction (GOO) mechanically impedes gastric emptying, normal emptying of the stomach. It is a diagnostic and therapeutic challenge for general surgeons in their daily practice. This paper highlights the etiology, clinical presentation and treatment outcome of GOO.Methods: A Prospective study was conducted on patients with GOO treated at Rajarajeswari medical college and hospital, Bangalore during September 2015 to august 2017. Data was tabulated and analyzed using descriptive statistical methodology.Results: Carcinoma stomach with antral growth and cicatrized duodenal ulcer (both 41.5%) were the most common cause of gastric outlet obstruction. Male were more affected than females (2.5:1). Most common symptom was vomiting and abdominal pain (noted among all), followed by loss of appetite (83%) and loss of weight (82.35%). 94.1% patients of Cicatrized duodenal ulcer underwent truncal vagotomy with posterior gastrojejunostomy and 5.9% underwent truncal vagotomy with antrectomy. 58.8% patients of carcinoma stomach, underwent distal gastrectomy with ante-colic Roux-en-Y gastro- jejunostomy, 12.1% patients underwent subtotal gastrectomy with ante-colic and Roux-en-Y gastro jejunostomy and 4.8% patients underwent palliative gastrojejunostomy. In corrosive antral stricture Billroth I gastrectomy was done. Patients of pancreatic malignancy underwent palliative anterior gastrojejunostomy and pseudo- pancreatic cyst was treated by cystojejunostomy. The average hospital stay was 10-14 days and an overall mortality of 5.8% for malignant patients was noted.Conclusions: Study concludes that gastric outlet obstruction is an important and a common surgical condition in tertiary hospital. Malignancy and benign cicatrized duodenal ulcer being the most common cause.
Impact of using triclosan-impregnated sutures on incidence of surgical site infection: a real world Indian study
Authors: Samra Shivpreet Singh , Jagad Vijay , Mahajan Munish , Randhawa M. S. , Trehan Chetna 
Published: January 2018

Background: Surgical Site Infection is an index of health care system of any hospital. Surgical material is a risk factor for SSI that can be easily changed. One of such measures is the use of antimicrobial suture technology which involves the impregnation of synthetic, absorbable, polymeric sutures with the antiseptic, Triclosan. Triclosan-coated sutures inhibit bacterial colonization of wide-spectrum of pathogens. This study was designed to assess the efficacy of triclosan coated sutures in reducing incidence of surgical site infection in Indian population.Methods: This is a retrospective ‘real-world’ study of 150 patients who underwent surgery and wound closure with triclosan-coated suture from May 2015 to December 2015 at Hospital, Mohali. Incidence of SSI was recorded, and nature of wound was categorized. Data was subject to descriptive analysis.Results: 99.3% of wounds sutured with triclosan coated sutures did not have surgical site infection. The single case of SSI encountered was categorized as superficial-incisional. All the evaluated cases were categorized as ‘clean’ at the time of discharge.Conclusions: Triclosan-coated sutures were responsible for the reported reduction in SSI, particularly in adult patients with clean wounds. This study justifies that in addition to the mandated core measures of surgical care, adjunctive evidence-based interventions such as Triclosan-coated sutures should be considered in the comprehensive effort to decrease risk of surgical site infection and improve outcome at both patient and institutional levels.
Epidemiological characteristics of deaths related to surgical emergencies in Sub-Saharan Africa: case of Parakou, Benin
Authors: Allode Alexandre S. , Hodonou Adrien M. , Tamou-Sambo Bio , Seto Morel D. 
Published: January 2018

Background: Emergency and resuscitation departments, often on the front lines of the hospital care system, are sadly the site of many deaths. Author aim to study the epidemiological characteristics of deaths related to surgical emergencies at Parakou Teaching Hospital in Benin.Methods: This was a prospective, descriptive study covering 6 months from January 1st to June 31st 2016. It focused on patients admitted to the emergency department and hospitalized in general surgery or resuscitation department during the study period. Three criteria were defined: admission for a surgical emergency, clinical classification of emergency patients (known as CCMU: Classification Clinique des Malades aux Urgences) between 1 and 5 and evolution marked by death.Results: A total of 54 deaths were recorded out of 379 surgical emergencies (14.2%). The sex-ratio was 2.2. The average age was 31±18.8 years old. The average admission time was 75.7±95.2 hours. The CCMU 4 and 5 were the most numerous (77. 7%). Traumatic emergencies were the most likely cause of death (56.6%), with cranio-encephalic trauma being the leading cause (38.9%). for non-traumatic emergencies (44.4%), acute generalized peritonitis is the leading cause of death (18.5%). The average time to surgical management was 87.4 hours, mainly related to the indigence of patients.Conclusions: The reduction of deaths related to surgical emergencies requires the adapted equipment of the different services involved in the care, the continuous training of staff and the creation of a health insurance.
Legislasi hukum Islam dalam perspektif produk perundang-undangan di Indonesia: integrasi antara maqasid al-shari'ah dengan tujuan legislasi
Authors: Mudzakir Mudzakir 
Published: January 2018

The challenge in the implementation of Islamic laws faced by Indonesian Muslims has not to do with the struggle for recognition by national laws. Instead, it deals with effort to clarify their position among various social groups. It also examines how much Islamic laws contribute values that stimulate development, order, peace and welfare for the nation and country. Historically, qur’anic verses in concerning with legal were revealed mostly after the Messenger migrated to Medina, while Meccan verses are identified as to consolidate the ummah so that they were ready to bear the burden imposed by the Islamic laws (taklif). The regulations reflecting shar laws issued by the local governments and their implementation tend to be euphoric taking the chance given by the reform. They have not reflected different social groups on which the regulations will be imposed. Islamic laws as the basic consideration in formulating the local government regulations seem not to have accommodated religious elements comprehensively, i.e. integrating aqidah, akhlaq and shariah guiding people’s behavior conceptually as well as in practice. Therefore, partial implementation of Islamic shariah will result in pseudo-religiousity, and tend to become a problem for the ummah themselves.
Association Between HLA genotypes and Oxcarbazepine-induced Cutaneous Adverse Drug Reactions: A Systematic Review and Meta-Analysis
Authors: Tangamornsuksan Wimonchat , Scholfield Norman , Lohinavy Manupat 
Published: January 2018

PURPOSE: To systematically review and quantitatively synthesize associations between HLA genotypes and oxcarbazepine-induced cutaneous adverse drug reactions (OXC-cADRs), including Stevens–Johnson syndrome (SJS) and maculopapular rash. METHODS: Studies investigating associations between HLA genotypes and OXC-cADRs were systematically searched irrespective of language, in PubMed, HuGENet (Human Genome Epidemiology Network), and the Cochrane Library from their inception until January, 2017. Inclusion criteria were studies investigating associations between HLA genotypes and OXC-cADRs that reported sufficient data for calculating the frequency of HLA genotype carriers among cases and controls. Overall odds ratios (ORs) with corresponding 95%CIs were calculated using a random-effects model to determine the association between HLA genotypes and OXC-cADRs. RESULTS: The initial searches identified 91 articles, of which 6 studies met the selection criteria. The studies included 229 patients with OXC-cADRs, 251 OXC-tolerant patients, and 2,358 participants from general populations of Han Chinese, Korean, and Thai ethnicities. Associations between HLA-B*1502 and OXC-induced SJS were found in both the general population [OR=30.2 (95%CI=3.45-264)] and in OXC-tolerant individuals [OR=26.4 (95%CI=7.98-87.6)]. An association between the HLA-B*1502 and OXC-induced maculopapular rash was found in the general population [OR=5.67 (95%CI=2.03-15.9)] while HLA-A*3101 also associated with OXC-induced maculopapular rash [overall OR=29.2 (95%CI=6.70-128)]. CONCLUSIONS: Strong associations between the HLA-B*1502 and OXC-cADRs (SJS and maculopapular rash) were found in both controls from general population and OXC-tolerant groups. There was also an association between HLA-B*3101 and OXC-induced maculopapular rash. For patient safety, genetic screening especially for HLA-B*1502 prior to OXC therapy at least in these closely related ethnicities is warranted. Further studies need to better define other ethnicities at risk and a wider range of MHC gene subtypes. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
How can we Engineer Stock Markets like NSEIL with BSE SENSEX index data using String Theory
Authors: Mallick Soumitra 
Published: January 2018

<span class="fontstyle0">This paper considers the problem of sustainably developing<br />stock exchanges like NSEIL and measurable index systems like BSE SENSEX by developing strategies to achieve sales volume which achieve optimal<br />growth rates. Experimental data on BSE SENSEX and Companies over time<br />are used which closely mimics now active NSEIL. This requires consideration<br />of consumer choice in intertemporal markets with endogenous stock market<br />products. A sequence of five steps is derived to characterize the venturing<br />technology which will achieve such desired stock market sales volume with<br />fixed prices and hence the optimal growth rate. It is derived how String Theory is sufficient to build such stock markets in value and volumes by using<br />depositories. </span>