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2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Sabri Selcuk Atamanalp ◽  
Esra Disci ◽  
Rifat Peksoz ◽  
Refik Selim Atamanalp ◽  
Cansu Tatar Atamanalp

Objectives: Ileosigmoid knotting (ISK) is a rare intestinal obstruction form worldwide. The aim of this study was to investigate changing trends in ISK. Methods: The Web of Science and PubMed databases were electronically searched to find all publications to evaluate all epidemiological, etiological, clinical, laboratory, radiological, therapeutic, and prognostic factors in ISK. Results: Most of the cases were reported from Asian and African countries. Mean age was 43.9 years with a 79.9%/20.1% of male/female ratio. Main symptom period was 48.1 hours, while the most common clinical features were abdominal pain/tenderness (99.1%), distention (88.3%), and obstipation/constipation (58.8%). Abdominal X-ray radiography, computerized tomography (CT), and magnetic resonance imaging (MRI) were diagnostic in 8.2%, 96.2%, and 100.0%, respectively, while the total diagnostic accuracy rate was 20.8%. Bowels were gangrenous in 85.6% of the patients. Ileum resection was applied in 14.0% of the cases, while sigmoid colon resection in 7.6%, and both segment resection in 67.1%. The mortality rate was 22.7%, while the morbidity rate was also 22.7%. Conclusion: ISK is a rare disease, but it is still catastrophic despite its two-century recognised past. As an exception, diagnostic convenience arising from CT or MRI looks like the most important change over the last half-century. doi: https://doi.org/10.12669/pjms.38.3.5320 How to cite this:Atamanalp SS, Disci E, Peksoz R, Atamanalp RS, Tatar Atamanalp C. Ileosigmoid knotting: A review of 923 cases. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5320 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2022 ◽  
pp. 344-369
Author(s):  
Albérico Travassos Rosário

Technological advances have caused great business changes. In this new business environment, the internet has become an indispensable technology tool in the creation of new business models, based on the exchange relations between customers/suppliers/distributors/partners, with a significant increase in online purchasing transactions. This virtual environment has provided the development of e-commerce and efficiency gains and influences changes in consumer habits, thus changing consumer behavior. The online purchase presents an important change in consumer behavior; thus, the understanding of online consumer behavior is essential to understand the impact of this behavior on business. This chapter follows a systematic analysis of the literature with a qualitative approach to online consumer behavior in the last 5 years (2015-2020) in order to verify research topics and development patterns. The aim is to identify trends in online consumer behavior and recognize research gaps by providing avenues for further research into online consumer behavior.


2021 ◽  
Vol 22 (4) ◽  
pp. 250-258
Author(s):  
Kyu Yeon Hur

The most important change introduced in the pharmacotherapy session for the 2021 Clinical Practice Guidelines for Diabetes is the recommendation of two different strategies according to the patient’s condition. One approach is to optimize the blood glucose levels, while the other approach is to reduce adverse cardiovascular events or mortality, especially in patients with comorbidities (e.g., heart failure, atherosclerotic cardiovascular disease, or chronic kidney disease). We suggest four algorithms that take into account the patient’s condition (algorithms 1 to 4). The Korean Diabetes Association (KDA) developed a web-based clinical decision support system, known as the KDA support system (KDASS), which helps with the diagnosis of diabetes or gestational diabetes and whether to use glucose-lowering agents according to the patient’s condition.


Author(s):  
Christoffer von Essen ◽  
Riccardo Cristiani ◽  
Lise Lord ◽  
Anders Stålman

Abstract Purpose To analyze minimal important change (MIC), patient-acceptable symptom state (PASS) and treatment failure after reoperation within 2 years of primary ACL reconstruction and compare them with patients without additional surgery. Methods This is a retrospective follow-up study of a cohort from a single-clinic database with all primary ACLRs enrolled between 2005 and 2015. Additional surgery within 2 years of the primary ACLR on the ipsilateral knee was identified using procedural codes and analysis of medical records. Patients who completed the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire preoperatively and at the 2-year follow-up were included in the study. MIC, PASS and treatment failure thresholds were applied using the aggregate KOOS (KOOS4) and the five KOOS subscales. Results The cohort included 6030 primary ACLR and from this 1112 (18.4%) subsequent surgeries were performed on 1018 (16.9%) primary ACLRs. 24 months follow-up for KOOS was obtained on 523 patients (54%) in the reoperation group and 2084 (44%) in the no-reoperation group. MIC; the no-reoperation group had a significantly higher improvement on all KOOS subscales, Pain 70.3 vs 60.2% (p < 0.01), Symptoms 72.1 vs 57.4% (p < 0.01), ADL 56.3 vs 51.2% (p < 0.01), Sport/Rec 67.3 vs 54.4% (p < 0.01), QoL 73.9 vs 56.3% (p < 0.01). PASS; 62% in the non-reoperation group reported their KOOS4 scores to be satisfactory, while only 35% reported satisfactory results in the reoperated cohort (p < 0.05). Treatment failure; 2% in the non-reoperation group and 6% (p < 0.05) in the reoperation group considered their treatment to have failed. Conclusion Patients who underwent subsequent surgeries within 2 years of primary ACLR reported significantly inferior outcomes in MIC, PASS and treatment failure compared to the non-reoperated counterpart at the 2-year follow-up. This study provides clinicians with important information and knowledge about the outcomes after an ACLR with subsequent additional surgery. Level of evidence III.


Author(s):  
Bimal Trivedi

When Alexander had to leave his conquest of India midway, some of his generals stayed back to rule the conquered north-west India the part which was known as Bactria. These Kings and generals held sway and minted their coins with pure Hellenistic motifs, scripts/legends, and styles. By the middle of the 2nd century BCE, by the inclusion of the Indian script Kharoshthi, Indian elements started appearing and became mainstream. Not only the legend but the weight standard was changed and the Indian standard was adopted. This was the most important change. Problems: The vast sum of Indo-Greek coinage has been unearthed so far but had remained under-studied for more than one reason. As it remains, the problem areas have remained unaddressed and unanswered. This has mainly happened due to the study of coinage in isolation far away from the find spots and devoid of stratigraphy and ignoring local knowledge of the subject. This situation has been aggravated by political turmoil and insulating archaeological finds and records by limiting the access combined with poor local scholarly work or absence of scientific approach due to poor economic conditions and access to modern methods and technology to approach, enhance, and understand the historically very important Indo-Greek coinage. Unfortunately, Indo-Greek coinage study is clubbed with Hellenistic outlook and mostly aggravated by vogue historicity. Scope of Study: This paper highlights challenges in studying Indo-Greek coinage and other factors that have not been addressed and difficulties in the way of scholarly pursuit. A modern tech-driven approach is recommended for addressing the challenges. Scientific Evaluation: A more technology-driven approach to study the Indo- Greek coinage will unravel the mysteries and remove the historical blind spots. Exclusively treating the subject of Indo-Greek coinage and thus providing recognition it deserves as unique, de-bracketed from Hellenistic coinage. Conclusions: The modern technology-driven data management scientifically adopted archaeological exploration and excavation paired with the latest Information Technology tools including the use of social media platforms can be networked effectively to build up a fresh modern repository of findings that will help historians, archaeologists, scholars, students, and numismatists/collectors.


Author(s):  
Kendra Jean Jacques ◽  
Preet Sharma

Plasma dynamics have been studied extensively and there is a fair amount of understanding where the scientific community has reached at. However, there is still a very big gap in completely explaining plasma physics at the classical as well as the quantum level. The dynamics of plasma from an entropic approach are not very well understood or explained. There is too much chaos to account for and even a small deviation in terms of perturbations of any kind makes a sizeable difference. This study is based on the entropic approach where we take a model independent classical plasma. Then we apply Langevin equations and Fokker–Planck equations to explain the entropy generated and entropy produced. Then we study various conditions in which we apply an electric field and a magnetic field and understand the various trends in entropy changes. When we apply the electric field and the magnetic fields independently of each other and together in the plasma model, we see that there is a very important change in the increase in entropy. There are also changes in the plasma flow, but the overall flow does not drastically change since we have considered a model independent plasma. Finally, we show that there are indeed changes to the entropy in a model-independent classical plasma in the various cases as mentioned in this study.


E-methodology ◽  
2021 ◽  
Vol 7 (7) ◽  
pp. 151-156
Author(s):  
BARBARA GRABOWSKA ◽  
MARIOLA SEŃ ◽  
IWONA KLISOWSKA

Aim. Aim of the paper: to introduce the subject of e-prescription in Poland. E-prescription is a digital version of the previously used standard paper prescription. In Poland,professional arrangements were made, thanks to which it became possible to promotee-prescriptions in pharmacies and doctors’ surgeries throughout the country.Methods. The authors analyse how e-prescription is introduced in Poland. We appliedcomparative analysis (of eprescining in the European Union countries) , literature review(what are legal and technical constraints) and case study (how it was introduced in Poland).We showed the implementation of the e-Health (P1) system in Poland and describedthe use of the free application of the Ministry of Health. We presented preparations for theimplementation of digital health services by the Center for Health Information Systems(CSIOZ).Results and conclusion. For years in Poland, handwritten prescriptions used to be thepreferred method of communication for doctors when making decisions about therapywith medications and for pharmacists to distribute them. Nonetheless, over the last decade,interest in the subject of e-prescription, alongside other e-health solutions for processinghealth-related data, has increased. E-prescription is fi lled on the basis of a four-digit code,which we receive by text message sent to a given phone number or by email to an indicatedaddress. Alternatively, there is a possibility to obtain an information printout, dependingon the confi guration of our Patient Account. An important change introduced is that wedo not have to physically carry the printed prescription with us anymore. E-prescriptionprovides benefi ts for doctors, patients and pharmacists, such as: convenience, time saving,greater safety of the therapy, less risk of error, less bureaucracy. The main objectives of thee-prescribing system involve facilitation of the process of prescriptions delivery, reductionof errors, time optimisation for doctors and pharmacists and eliminating the problem ofillegible and fake prescriptions, which have so far been a common occurrence.Cognitive value. This article shows the process of introducing E-prescription in Poland.


2021 ◽  
Vol 43 (3) ◽  
pp. 89-101
Author(s):  
Artur Ławniczak

The Polish People’s Republic is a matter of the past, but not entirely. Finally, nolens volens, the current version of our old statehood is its continuation, manifested in numerous formal solutions. This is in an evident manner a republican form of statehood and a democratic system. Similar to the Stalinist Constitution of 1952, it was called a people’s democracy, but from 1976 a socialist democracy as the effect of changes in the written Ius Supremum. In the political practice, after partial totalitarianism came authoritarianism. Before 1980, there were no changes in the institutional state power system. Theoretically, the first in this structure was the Sejm — the official emanation of the Volonté Générale. The collective head of the state was the State Council with a more republican identity than the contemporary president. The Council of Ministers actually has the same shape as before 1989, as well as the parliamentary cabinet system of government. In similar situation are: the Supreme Court, the Administrative Court, the Constitutional Court, the State Tribunal, the Ombudsman, and the Supreme Chamber of Control. Their identity and philosophy of action are similar to the socio-political reality from before the system transformation, mythologized in many aspects. This does not mean that it is fiction. Its result, according to the ancient nomenclature, was the transformation of socialist democracy into bourgeois people’s rule. Actually, we rather talk about the transition from “communism” or totalitarianism to liberal democracy. But Marxist-Leninist classics claimed that communism will be a post-state society without class opposites. Finally, in the Polish People’s Republic real socialism existed, with partial totalitarian character, replaced shortly after Stalin’s death by authoritarianism, which in the socio-economic and cultural spheres tolerates spontaneous manifestations of activity, without inspirations of the authorities, its culmination being in the time of the several-month-long “Carnival of Solidarity”. The Gdańsk Agreement we can understand as a social agreement, later transformed into the Round Table Agreements. After the continuation of these events it is possible to find on the constitutional ground in 1989, and then in 1997, when the new, formalized and complete Highest Law was created, as a formal recapitulation of political transformation. So we observe the mild transition of the Polish People’s Republic into the Third Polish Republic. The first one does not exist in the text of the actual Constitution, but it is impossible to not see a certain continuity. In the situation of the important difference between the two forms of our statehood — old and new — probably in the case of a system transformation there significant revolutionary accidents would have been unavoidable, but they have not happened. Parliamentary democracy was liberalized, which manifested in in the replacement of Gierek’s famous slogan of moral and political unity with the conviction that an official electoral struggle for power between parties is necessary. The second important change in the political sphere is the greater consideration of Montesquieu’s dogma concerning the division of state power. Other changes are less significant. Also, the republican democracy has maintained its fundamental identity, although the system of institutionalized rule had changed.


2021 ◽  
Vol 64 (5) ◽  
pp. VO543
Author(s):  
Stefano Branca ◽  
Daniele Musumeci ◽  
Luigi Ingaliso

The 1971 eruption represents a benchmark in the recent history of Etna volcano. From a volcanological point of view, this eruption was characterised by complex intrusive dynamics associated with significant ground deformation that induced the activation of the Moscarello seismogenic fault and the formation of a new summit crater: the Southeast Crater. At the same time, the 1971 event marks an important change in the eruptive style and composition of the magma towards products richer in K. It is no coincidence that, over the next fifty years, there would be an increase in the frequency of summit and flank eruptions and associated output rate. From an historical viewpoint, the eruptive event of 1971 was the first important flank eruption studied by the International Institute of Volcanology: the analysis of the scientific articles on this activity reveals a greater multidisciplinary content in the descriptions and explanations of volcanic activity. Particularly important were the collaborations of British and French research groups that, together with their Italian colleagues, succeeded in giving a complete picture of the eruption and describing the state of knowledge on the Sicilian volcano. The multidisciplinary methodology used to study this  eruption is still valid today.


2021 ◽  
Author(s):  
Gloabl Rheumatology By PANLAR

The use of cannabis as medicine has undergone an important change in recent years, being currently evaluated as a therapeutic possibility for various pathologies, among them, of course, rheumatic diseases. Today in Un café por la reumatología we will discuss the current state of medical cannabis, the scientific evidence concerning its use, patterns of use and clinical experience in the region. Joining Carlo Vinicio Caballero, editor-in-chief of Global Rheumatology, and Diego Jaimes, will be Dario Scublinsky, a rheumatologist internist with a doctorate in medicine, former editor of the Revista Argentina de Reumatología and currently coordinator of rheumatology at Swiss Medical; as well as Paola Cubillos, Colombian physician from Universidad del Rosario, founding member of Procannacol, focused on the evidence-based use of medical cannabis; and Dr. Jaime Jaramillo Mejía, anesthesiologist, specialist in pain and palliative care.


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