bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infection complicating locked intramedullary nailing of open lower-extremity fractures: incidence, associated risk factors, and lessons for improving outcome in a low-resource setting
Authors: Adesina Stephen A. , Amole Isaac O. , Akinwumi Akinsola I. , Adegoke Adepeju O. , Owolabi James I. , Adefokun Imri G. , Durodola Adewumi O. , Awotunde Olufemi T. , Eyesan Samuel U. 
Published: February 2023

Abstract. Introduction: Infection is the chief complication that makes open fractures difficult to treat. Most low- and middle-income countries (LMICs) are missing out on modern management techniques developed to achieve better outcomes in high-income countries (HICs). One of these is the use of locked
intramedullary (IM) nails. This study aimed to determine the factors associated with infection of open fractures treated with the surgical implant generation network (SIGN) nail at a Nigerian tertiary hospital.
Methods: Data were collected prospectively on 101 open fractures of the femur and tibia over an 8-year period. Active surveillance for infection was done on each patient. Infection was diagnosed as the presence of wound breakdown or purulent discharge from (or near) the wound or surgical incision. Potential risk factors were tested for association with infection.
Results: There were 101 fractures in 94 patients with a mean age of 37.76 years. The following treatment-related factors demonstrated significant associations with infection – timings of antibiotic administration (p<0.001) and definitive fracture fixation (p=0.002); definitive wound closure (p<0.001), fracture-reduction methods (p=0.005), and surgery duration (p=0.007).
Conclusions: Although this study has limitations precluding the drawing up of final conclusions, the findings suggest that the risk factors for infection of nailed open fractures in LMICs are similar to those in HICs. Consequently, outcomes can potentially improve if LMICs adopt the management principles used in HICs in scientifically sound ways that are affordable and socially acceptable to their people. Further studies are suggested to establish our findings.
ENTREVISTA COM FÁBIO DE SOUZA ANDRADE SOBRE A OBRA DE JORGE DE LIMA
Authors: Andrade Alexandre de Melo , Yokozawa Solange Fiuza Cardoso 
Published: February 2023

Fábio de Souza Andrade é ensaísta, tradutor e crítico literário, pesquisando e orientando trabalhos nas áreas do modernismo brasileiro e europeu. Assinou a coluna Rodapé, na Folha de S. Paulo, entre 2005 e 2009. Professor Associado de Teoria Literária e Literatura Comparada na USP, é autor dos livros Samuel Beckett: o silêncio possível (Ateliê, 2001) e O engenheiro noturno: a lírica final de Jorge de Lima (Edusp, 1997), entre outros. Foi professor na Unesp e na Unicamp e professor convidado na Universidade de Paris 8 e na Freie Universität Berlin. Organizou antologias críticas da obra de Jorge de Lima (Antologia Poética Jorge de Lima, Cosac Naify, 2014 e Poemas Negros - edição ampliada, Alfaguara, 2016), bem como edições, posfácios e aparatos críticos a seu poema maior, a Invenção de Orfeu (Cosac Naify, 2013, e Alfaguara, 2017). Lidera o GP Estudos sobre Samuel Beckett (USP). Do autor irlandês, traduziu Esperando Godot (Companhia das Letras), Fim de Partida, Dias Felizes e Murphy (Cosac Naify) e Disjecta: escritos diversos e um fragmento dramático (Globo), além dos romances Murphy e Watt (Companhia das Letras).
UMA TORRE DE GUERRA: ANÁLISE DA IMAGEM DA TORRE DE MARFIM EM DOIS SONETOS DE JORGE DE LIMA
Authors: Rigoni Rafael Iatzaki 
Published: February 2023

A partir da análise da imagem da torre de marfim em dois sonetos do Livro de Sonetos (1949) de Jorge de Lima, apresenta-se uma reflexão sobre a posição do sujeito-lírico diante do mundo ao redor. Partindo de uma leitura atenta aos textos poéticos, consciente da diversidade e da multiplicidade de sentidos dos poemas e procurando dialogar com a fortuna crítica da obra de Jorge de Lima que credita ao autor uma poética de viés negativo, autocentrada e desinteressada de versar sobre sua própria realidade histórica e social, analisa-se a maneira como a imagem-conceito da torre de marfim é construída nos sonetos e conclui-se que a negatividade presente na poética do autor não está relacionada com uma recusa ao real ou à comunicação. Antes, tal negatividade deve ser entendida como resultado das tensões que estruturam o poema. Dentre as várias tensões presentes nos textos focamos em duas em particular: o conflito entre o elemento “automático” e o elemento “arquitetado”, como indica Fábio de Souza Andrade (2010), e a tensão resultado da tentativa de fundir diferentes concepções temporais, como a humana e a divina, indicada pela recepção do autor.
THE INFLUENCE OF INSTITUTIONAL FACTORS IN ACCESS TO HEALTHCARE IN KENYA: A CASE OF NAIROBI COUNTY, KENYA.
Authors: N. Chelogoi Davies , Jonyo Professor Fred , Amadi Dr. Henry 
Published: February 2023

This study examines the influence of institutional factors on access to public healthcare in Kenya, a case for Nairobi County. It addresses the influences of health policies, leadership and governance, health infrastructure, health facilities, health workers, health finances and health insurance. The objective of the study is to evaluate the influence of institutional variables in access of public healthcare.
The study used data from a sample of 1066 households purposively selected from Nairobi County. All households were aged 15 years and above. The households were subjected to interviews that covered a wide range of topics. Descriptive design was chosen for the study. The study adopted multiple sampling methods for the study. These included purposive sampling, systematic sampling, snowball sampling and multi stage cluster sampling frame.
The data was collected using various techniques or instruments which included observation, key informant interviews, questionnaires, in-depth interviews, and focus-group discussions. The data was processed using descriptive statistics. Correlation and regression analyses were used to correlate and interpret the data of the study.
The findings show access to healthcare is inadequate and unevenly distributed among the households in Nairobi County. The factors attributed to these inequalities were inadequate and poorly implemented health policies, inadequate health facilities, and inadequate health workers, shortage of essential drugs, low level funding and poorly managed health insurance. This study argues that these institutional factors should be made adequate, accessible and quality improved. The focus should be on the lower social classes, who are deprived, and denied capabilities to access healthcare. This is despite the interventions made to access healthcare to the entire population in the County.
HUSSERL, HEIDEGGER AND PHENOMENOLOGICAL METHOD
Authors: Onwuegbusi Ph.D Martin Okwu 
Published: February 2023

This paper is on Husserl’s phenomenological method; it is an attempt to show how Husserl in pursuit for a philosophy without presuppositions, established phenomenology to serve as a rigorous science of the world. Husserl in developing phenomenology insists that its procedure has to deal only with description of its objects rather than explanations. Phenomenology only begins after the phenomenologist has carried out transcendental phenomenological reductions, starting first with eidetic reduction through which all existential and natural attitudes are brack-eted and put out of action to yield only essences before consciousness. This is followed by phen- omenological reduction proper, which involves a complex of reductive phases Husserl, refers to as ‘epoche’ – which involves bracketing of all historical and existential judgments regarding what is ‘given’ and even the experiencer himself. What is left after the reduction is the transcendental ego with its transcendental life. It is then possible for consciousness to begin an entirely new task of interpreting the world at this level, as a coherent system constituted by itself alone. Husserl’s Phenomenological method is contrasted with Heidegger’s phenomenological method. Heidegger strongly rejected Husserl’s bracketing of the actual world and his transcendental ego.
CHILDREN WITH BETTER BREAKFAST HABIT AND FAMILY SOCIOECONOMIC STATUS TENDED TO HAVE BETTER ACADEMIC ACHIEVEMENT
Authors: Kustiyah Lilik , Trini Kusprasetia Maudi 
Published: February 2023

Skipping breakfast affects learning performance at school. This study aimed to analyze correlation between breakfast habits, family socioeconomic status and academic achievement among elementary school children. This cross-sectional study was conducted from March to May 2016 on 150 fifth graders. Subjects’ characteristics, family socioeconomic status and breakfast habits were collected by filling out questionnaire, academic achievement was estimated by average score of midterm test. Subjects with good academic achievement had better socioeconomic status than those with poor academic achievement. Most of the subjects had breakfast 5-7 times/week and it was usually done before 7 AM. Breakfast was usually served and consumed at home. Staple food and animal-based side dish were usually consumed for breakfast. Breakfast’s energy and protein contributions were significantly higher (p<0.05) among subjects with higher academic achievement than those with lower academic achievement. Subjects with better breakfast habits and socioeconomic status tended to have better school achievement.
LES MANIFESTATIONS NEUROLOGIQUES DES MALADIES INFLAMMATOIRES CHRONIQUES
Authors: Al Kadaoui Nihal , Chkirate Bouchra , Bentahila Abdelilah 
Published: February 2023

Introduction: les manifestations neurologiques dans les maladies inflammatoires chroniques sont de fréquence ET de gravité variable en fonction de la pathologie. Elles peuvent être centrales ou périphériques
Matériels ET Méthodes: étude rétrospective descriptive des enfants suivis à l’unité de rhumatologie pédiatrique au service de pédiatrie IV à l’Hôpital d’Enfants de Rabat pour une maladie inflammatoire chronique ayant présenté des manifestations neurologiques centrales ou périphériques.
Résultats: Nous rapportons 12 cas suivis pour maladie de Behçet dont 8 ont présenté des céphalées isolées et 4 cas une hypertension intracrânienne, 3 cas suivis pour lupus érythémateux disséminé ayant présenté respectivement: un syndrome d’HTIC au cours de l’évolution, une polyneuropathie sensitivomotrice, un syndrome cérébelleux avec hypertonie axiale des membres inférieurs; et 1 cas suivi pour syndrome de Sharp ayant présenté une parésie du membre supérieur gauche
Conclusion: Les manifestations neurologiques peuvent inaugurer une maladie inflammatoire chronique. Elles sont très polymorphes, d’une gravité variable ET nécessitent une adaptation thérapeutique sous peine d’évolution redoutable
Adatok a magyarországi fosszilis vörös talajok genetikájához
Authors: Fekete József 
Published: February 2023

A régebbi geológiai időszakokban képződött vörösagyagok Magyarország talajtakarójának jellegzetes színfoltjai. Elterjedésük többnyire azokhoz a területekhez kötött, amelyek a harmad időszakban szárazföldek voltak, s így nem borították el tengeri üledékek. A negyedkor éghajlata csak pusztulásukat idézte elő. Ezért jelenleg ott találhatók meg, ahol a jégkorszaki pusztulás ellen védve voltak, vagy ahol nagy ellenálló képességük és vastagságuk miatt anyaguk az eróziónak ellen tudott állni. Ez egyik oka annak, hogy fokozott figyelmet kell fordítanunk megismerésükre és védelmükre. Gazdasági jelentőségük sem elhanyagolható, terüle- tükön szőlőtelepítéseket, erdőket és szárazföldi műveléseket találunk. A vörösagyagok, vörös talajok közel másfél évtizedes vizsgálata után fontosabb eredményeinket „A magyarországi vörösagyagok, vörös talajok” c. munkánkban (Fekete 2010) foglaltuk össze: Vörös talajképződményeink harmad időszaki meleg éghajlat alatt keletkezett reliktum, illetve fosszilis talajok, melyek kémiai, ásványtani sajátosságaikban és genetikájukban sok hasonlóságot mutatnak a jelenlegi trópusi talajokkal. E hasonlóságot, és reliktum talajaink harmadkori, trópusi szubtrópusi eredetét támasztják alá újabb vizsgálati eredményeink.
Awareness and Practices Regarding Crimean-Congo Haemorrhagic Fever among Animal Handlers in Peri-urban Karachi and Rural Areas of Sindh
Authors: Murad Qadir  , Tanzil Jamali  , Khurshid Nadir  
Published: February 2023

Objective: To assess the awareness and practices among animal handlers regarding Crimean- Congo haemorrhagic fever and compare the awareness and practices among different groups of animal handlers in Sindh, Pakistan.
Methods: Cross-sectional study conducted among 150 animal handlers with the response rate of 93%, including sellers, butchers, transporters, caretakers and veterinary doctors in peri-urban Karachi and rural areas of Sindh. Quota sampling technique was adopted to select the study population. The duration of the study was three months from August 2016 to October 2016; this period includes selling of animals of sacrifice for Eid-ul-Azha in temporary established markets. Data was entered into Epidata 3.1 and analysed using SPSS version 23.
Results: A total of 150 participants enrolled in the study. The mean age of the study participants was
35 ± 7.5 years. Among the subjects, 48% were uneducated. Overall, 52% of the participants were aware about the Crimean-Congo fever. The hygiene practice among animal handlers was found to be washing; 40.7%, bathing; 27.3% and tick removal; 11.3%. The awareness of Crimean-Congo fever among animal caretakers was 50%, animal sellers; 43.3%, transporters; 36.7% and butchers; 30% (p<0.001).
Conclusion: The awareness among animal handlers was on the lower side among animal sellers, transporters, butchers and animal care taker and there is a need to improve the awareness level among these groups regarding practices, hygiene of the animal as well as handling procedures.
Post-Electric Burn Blisters in a Child: A Case Report
Authors: Mawra Shahid  , Ayesha Khan  , Hira Khalid Zuberi  , Aisha Ikram  
Published: February 2023

Electrical burn injuries are few of the most devastating injuries seen in the emergency room. We report the case of a 4-year-old child, weighing 15 kg who presented in the Paediatric Emergency Room of Abbasi Shaheed Hospital with loss of consciousness. He had a history of touching a broken electric wire of unknown voltage and fell to the ground few hours before being taken to the hospital. Central nervous system examination showed a Glasgow Coma Scale score of 10/15, bilateral mute planters and decreased tone in all four limbs. Upon local examination, 4 small black-yellow lesions almost 2 cm in size and in the form of blisters were seen on his left palm. The child was successfully managed in the Paediatric Intensive Care Unit of Abbasi Shaheed Hospital. This case is noticeable as its complications are disastrous. Our case study highlights the importance of early diagnosis and proper management which is vital to prevent long term damage in electrical burn victims.
Froin's Syndrome due to Spinal Paraganglioma - A Case Report
Authors: Nazish Iqbal  , Muhammad Waqaruddin Sheroze  , Abdul Ali Khan  
Published: February 2023

Yellow coloured, i.e. xanthochromic cerebrospinal fluid, with hypercoagulability and high protein con- tent is pathognomic of Froin's syndrome. We present a case of Froin's syndrome in a patient with spinal paraganglioma.
A 55-year-old male patient presented with urinary hesitancy, numbness in lower limbs and difficulty in walking. During spinal anaesthesia, the anaesthetist noticed xanthochromic spinal fluid. Upon mag- netic resonance imaging lumbosacral, an intradural focal lesion of abnormal signal intensity extend- ing from T12-L1 vertebral level was seen. Laminectomy with excision of the mass was performed and a fleshy encapsulated mass was excised. Histopathology report showed the specimen to be a neoplastic lesion, and immuno-histochemical studies confirmed the mass to be a paraganglioma.
This case emphasizes that in case of Froin's syndrome, one should think of spinal cord tumours while evaluating the patient. A magnetic resonance imaging of the spine should also be done to look for spinal pathology along with other investigations.
Frequency of Degree of Depression in Relation to the Duration of Diabetes Mellitus in a Tertiary Care Hospital in Patients Aged 20-55 Years
Authors: Hira Muzaffar  , Jamal Ara  , Syeda Wajiha Anwar  , Quratulain Saleem  
Published: February 2023

Objective: To determine the frequency of depression and the relation of duration of diabetes with degree of depression.
Methods: A cross-sectional study was carried out at Abbasi Shaheed Hospital, North Nazimabad, Karachi, Pakistan. The duration of the study was six months from December 2017 to May 2018. It comprised of male and female patients between the age brackets of 20-55 years of age who had been pre-diagnosed with diabetes for at least 5 years and were currently not on any anti-depressants and did not have history of any other psychiatric illness. Demographic data including the age, sex, education level, marital status, occupation and religious belief of the participants along with the duration of diabetes for each individual was recorded. The ICD-10 major depression inventory was translated into Urdu and validated in the same institution before this study was conducted and was administered during face-to-face interviews. ICD here refers to the International Classification of Dis- eases (ICD) which is the international standard diagnostic tool for epidemiology, health management and clinical purposes. A minimum score of 4 or 5 in two of the first three items plus a score of at least 3 on two or three of the last seven items means that the person is mildly depressed and as the score increases so does the severity of depression .
Results: Of the 378 people who were assessed 216 (57.1%) were depressed. Data analysis showed that out of the 216 depressed patients, 25.7% had mild, 26.2% had moderate, 4.2% had severe and 1.3% had major depression. On performing chi-square test there was a relation between the increase in duration of diabetes and the degree of depression.
Conclusion: Results of our sample show that a higher degree of depression is related to a longer duration of diabetes.
Outcomes of Laparoscopic Appendectomy; A Prospective Study Focusing On Gender Wise Comparison of Complications of the Surgery
Authors: Paras Mahesh  , Raheel Ahmed  , Nargis Anjum  , Adnan Anwar  
Published: February 2023

Objective: To assess the postoperative outcomes of laparoscopic appendectomy in terms of compli- cations and to compare them on gender basis.
Methods: This was the prospective observational study conducted at department of General Surgery Chandka Medical College Hospital Larkana with non-probability convenient sampling technique. The duration of study was one year from January 2013 till December 2013. 150 patients were selected that were diagnosed with acute appendicitis. Patients were followed up for 2 weeks and their compli- cations were observed. All data was entered and analysed on SPSS version 20. Inferential analysis was performed using chi-square test whereas the significance level was set at 0.05.
Results: The study results showed that 14 male (18.7%) and 16 female (21.4%) patients developed complications (p=0.094). 5 male (6.6%) and 8 female (10.6%) patients developed paralytic ileus (p=0.384). 5 male (6.6%) and 3 female (4%) patients developed urinary retention (p=0.471) whereas 2 male (2.6%) and 6 female (8%) patients complained to have wound infection (p=0.146). The overall frequency of patients that did not develop any complications among 150 patients was 121 (80.6%) while 13 (8.6%), 8 (5.3%) and 8 (5.3%) were reported to develop paralytic ileus, urinary retention and wound infection respectively.
Conclusion: Laproscopic appendectomy is safer and clinically advantageous technique. The differ- ence in the complications of the laproscopic appendectomy with respect to the gender was insignifi- cant. However, significant difference existed on visual analogue pain scale.
Cadaver Prosection Significance in Medical Field: Analytical Survey of Anatomy Pedagogy
Authors: Nadeem Baig  , Syed Meesam Iftikhar  
Published: February 2023

Objective: To determine the effectiveness of dissection as a useful pedagogy in the field of anatomy through assessment of views of respondents.
Methods: A cross-sectional study was carried out in the anatomy department of a private and a public sector college for a period of twelve weeks during the year 2018.A total of 135 participants were re- cruited in this survey. The nature of participation (regular or irregular) in comparison was used as the predictor variable. The average scores for each item were calculated and compared between the par- ticipants at dissections using Mann-Whitney's U test. Likert-style survey was designed for evaluation. The IBM SPSS statistics version 21 was used for the analysis of data.
Results: A large number of participants overall strongly supported the version that a dissection pro- gram should be essentially inducted into the curriculum; viewed non-participation at dissection ses- sions as to be disadvantageous in terms of their learning repertoire. Seventy eight percent stated it deepens understanding of anatomy as a subject. Around 80% of the participants preferred dissection over other tools of learning, whereas 67% agreed that it develops 3-dimensional structural approach; also agreed with the time allocated for dissection is sufficient for learning (57%). Besides this, a mi- nority of respondents put up a negative perception in terms of dissection being time consuming (36%), stress inducing (18%), boring (20%), and difficulty in finding out structures was also reported (43.3%).
Conclusion: The use of dissection in undergraduate medical education as part of anatomy pedagogy may develop a useful golden opportunity for students to work on additional learning objectives such as professionalism, manual dexterity, ethics, teamwork, self- and peer evaluation.
Intra-Abdominal Gossypiboma found during Cholecystectomy, 12 years after Lower Segment Caesarean Section
Authors: Omama Sumbul Islam  , Hajra Hilal Ahmed  , Muhammad Jamaluddin  
Published: February 2023

Retained Surgical Foreign Bodies (RSFBs) is an uncommon event in the surgical practice. Most of them occur after intra-abdominal and pelvic surgeries. They usually present within days after surgery but their incidental discovery after decades has also been reported.We present a case of a 44-year- old obese and diabetic female patient who presented with clinical and radiological findings of chronic calculus cholecystitis. She had past surgical history of Lower Segment Caesarean Section (LSCS) 12 years back, followed by a negative laparotomy. During her open cholecystectomy procedure, a hard mass was found between the small bowel loops. When removed and examined, it was found to be a retained surgical sponge which was most likely left in her body during prior LSCS procedure. Asymp- tomatic, uncomplicated and (ultrasonographically) undetected nature of RSFB in our case suggests its consideration and careful search if there is past history of intra-abdominal or pelvic surgery.