Natural canal deviation and dentin thickness of mesial root canals of mandibular first molars assessed by microcomputed tomography

Abstract The aim of this study was to assess the centralization and dentin thickness of mesial root canals of the first mandibular molars by microcomputed tomography (micro-CT). Material and methods: Ninety-nine mandibular molars of Vertucci's type IV canals were scanned by micro-CT. The mesiodistal deviation and centroid were assessed, in both mesiobuccal (MB) and mesiolingual (ML) canals, for the apical 4mm and the full canal length. Results: The dentin thickness was similar for both MB and ML canals. The narrowest thickness was in the distal wall of an MB canal (0.07mm), while the widest was found in the mesial wall of an MB canal (2.46mm). In centroid analysis, both the MB and ML canals exhibited deviations when compared to the root centroid, along the full canal length and the apical 4mm. For the MB canal, the mean deviation was 0.83mm (0.02 mm-2.30 mm) for the full canal and 0.18mm (0.01 mm-1.01 mm) for apical 4mm. Similarly, for the ML canal, the mean deviation measured 0.83 mm (0.05mm-3.99mm) for the full canal and 0.21 mm (0.01mm-1.01mm) for the apical 4 mm. Overall, deviations were observed towards the mesial of the roots, with 69% for MB and 57% for ML canals for the full canal, and 51% for MB canals within the 4 mm. The exception was the ML canal, which exhibited a higher deviation towards distal in the apical 4mm, accounting for 52% of cases. The dentin thickness was consistent between the mesial canals of mandibular molars. However, there is no centrality of mesial canals in their roots, with frequent deviation to mesial.

Resumo O objetivo deste trabalho foi avaliar a centralização e a espessura da dentina dos canais radiculares mesiais de primeiros molares inferiores por meio de microtomografia computadorizada (micro-CT). Material e métodos: Noventa e nove molares inferiores com canais tipo IV de Vertucci foram escaneados por micro-TC. O desvio mesiodistal e o centroide foram avaliados para os canais mesiovestibular (MB) e mesiolingual (ML), nos 4mm apicais e em todo o comprimento do canal. Resultados: A espessura da dentina foi semelhante para os canais MB e ML. A espessura mais estreita foi encontrada na parede distal de um canal MB (0,07mm), enquanto a mais larga foi encontrada na parede mesial de um canal MB (2,46mm). Na análise centroide, tanto o canal MB quanto o ML exibiram desvios quando comparados ao centroide da raiz, ao longo de todo o comprimento do canal e nos 4 mm apicais. Para o canal MB, o desvio médio foi de 0,83mm (0,02mm-2,30mm) para canal inteiro e 0,18mm (0,01mm-1,01mm) para o apical de 4mm. Da mesma forma, para o canal ML, o desvio médio mediu 0,83 mm (0,05 mm-3,99 mm) para o canal inteiro e 0,21 mm (0,01 mm-1,01 mm) para os 4 mm apicais. No geral, foram observados desvios em direção mesial das raízes, sendo 69% para canais MB e 57% para canais ML para canal inteiro, e 51% para canais MB dentro dos 4 mm. A exceção foi o canal ML, que apresentou maior desvio para distal nos 4mm apicais, representando 52% dos casos. A espessura da dentina foi consistente entre os canais mesiais dos molares inferiores. Entretanto, não há centralidade dos canais mesiais em suas raízes, com frequente desvio para mesial.

Classification of furcation involvement of endodontically treated mandibular first permanent molars based on cone beam CT / 口腔疾病防治

Objective @#To classify the furcation involvement (FI) of endodontically treated mandibular first permanent molars based on cone beam computed tomography (CBCT), provide reference for individualized treatment of FI. @*Methods@#CBCT images of the FI of 164 endodontically treated mandibular first permanent molars from 163 patients in Nanjing Stomatological Hospital, Medical School of Nanjing University were collected retrospectively. On the CBCT images, the shape and extent of periapical and periodontitis bone resorption, the thickness of residual dentin in the pulp floor and root canal wall, and the periodontal bone resorption of the complete dentition were evaluated. The FI was classified into periodontal, periapical, perforated and mixed types.@* Results@#Among the 164 FIs of endodontically treated mandibular first permanent molars, the periapical type was the most common (41.5%), followed by the mixed type (26.2%), perforated type (18.3%), and periodontal type (14.0%). Among the 68 periapical-type FIs of endodontically treated mandibular first permanent molars, 48.5% were proper root canal filling, 44.1% were insufficient filling and 7.4% were overfilling. Among the 43 mixed-type FIs, the periodontal mixed periapical type was the most common (72.1%).@*Conclusion @#Detailed evaluation and classification of furcation involvement could be performed using CBCT images; therefore, the study has guiding significance for clinical treatment.

Effect of contracted endodontic access cavity and root canal preparation by One Curve on danger zone of mesial root canal in mandibular first molars / 口腔疾病防治

Objective @#To explore the influence of a contracted endodontic access cavity on the risk of canal transportation in the danger zone of the mesial root canal of mandibular first molars (MFMs) using a one-curve preparation system, and to provide an experimental basis for the clinical selection of a better pulp approach.@*Methods@#Twenty MFMs extracted for severe periodontal disease that met the inclusion criteria, including intact coronal roots, mesial roots with two separate root canals, mesiobuccal canal (MB) and mesiolingual canal (ML), and a curvature of 0° to 20°, were selected. Subsequently, these MFMs were randomly divided into two groups based on the endodontic access design, including the traditional endodontic access cavity (TEC) group and the contracted endodontic access cavity (CEC) group. In the TEC group, the pulp chamber roof of the tooth was completely removed, while in the CEC group, the pulp chamber roof and peri-cervical dentin were preserved as much as possible. Then, the One Curve single file was adopted to conduct root canal preparation. Next, cone beam computed tomography (CBCT) was performed on extracted teeth before and after preparation, and the measurement sections were located at 0-7.0 mm below the root bifurcation of the mesial root canal at 1 mm intervals. The minimum wall thickness on the mesial and distal aspect of the root canal was measured in each section.@* Results @# ① Prepreparation CT measurements of 20 MFMs showed that the danger zone in the range 0-4 mm under root bifurcation, a mean thickness of 1.18 mm on the mesial aspect of the MB root canal and 1.08 mm on the distal aspect. The mean thickness of the ML root canal was 1.28 mm on the mesial aspect and 1.07 mm on the distal aspect. ② Compared with that of the traditional endodontic access cavity, no significant difference in the decrease of wall thickness was observed in the danger zone of mesial root canal of MFMs in the contracted endodontic access cavity (t = 1.319，P = 0.19). ③ In the mesiobuccal canal, compared with the apical transportation of the traditional endodontic access cavity, which tends to be more mesial side, the apical transportation of contracted endodontic access cavity tends to the distal side. In the mesiolingual canal, both apical transportation groups tended to be on the distal side. @*Conclusion @# When using the One Curve file, compared with traditional endodontic access, the contracted endodontic access cavity based on the minimally invasive concept does not increase the risk that the mesial root canal of mandibular first molars is transported.

Knowledge of Accredited Social Health Activist (ASHA) Workers Regarding Maternal Health Services: A Comparative Study between Rural and Urban Areas of a Block of Haryana

Introduction: All people, everywhere, deserve the right care, right in their community. In any community, maternal mortality ratio strongly reflects the overall effectiveness of health systems. To increase utilization of existing health services, Accredited Social Health Activist (ASHA) is the key component of the National Rural Health Mission. o assess compare the level of knowledgeO : bjective T any of ASHA workers regarding maternal health services in between rural and urban areas of a block of Haryana. Method: The present cross-sectional, community-based study was conducted in block Barwala, district Hisar of Haryana. The assessment of knowledge of ASHA workers was done on the basis of scoring. Appropriate statistical tests like percentages and chi-square (?2) test were applied. RegardingResult :s maternal health services majority of ASHA workers had good knowledge, assessed by score gained by them and none of them was having poor knowledge about maternal health services. However in rural area score, gained was better than urban area & the observed difference was found to be statistically significant. Knowledge of identification & treatment of anaemia and identification of danger signs during pregnancy were inadequate among ASHA workers of both areas. Knowledge of ASHA workers wasConclusion: inadequate as far as anaemia and danger signs during pregnancy were concerned. Frequent and regular refresher training should be organized in their working area.

Level of Birth Preparedness and Complication Readiness among Pregnant Women Residing In Urban Slums of Shivamogga City, India

Background: Safe motherhood is about informing and educating woman about danger signs in pregnancy, how to identify and seek advice from health personnel and prepare for safe confinement. In public health system, in India it is the responsibility of ASHA to motivate the pregnant woman in her area for safe institutional delivery. BPACR is a tool which assesses, how well the pregnant women are prepared for the challenges in pregnancy. Aim& Objective: To ascertain the level of awareness of Birth Preparedness and Complication Readiness (BPACR) among antenatal mothers residing in urban slums . Methodology: A community based cross-sectional study was conducted among pregnant women residing in urban slums of Shivamogga, Karnataka. Data was collected using pre-designed questionnaire, 揗onitoring BP/CR?tools and indicators for maternal and new born health� of the 揓HPIEGO�. Data was analysed and results were tabulated. Results: In this study, only 42% of pregnant women knew about the term 態irth preparedness� while the rest 58% pregnant women did not know it. Education status and complication experienced during present or previous pregnancy were found to have significant association with BPACR. Identification of blood donor and skilled birth provider were less among study group. Conclusions: Awareness of danger signs and complication readiness was found to be good in our study.

Una mirada a la concepción de riesgo desde la enfermería / A Nursing Approach to the Concept of Risk

Introducción: El término riesgo, aunque se enuncia con frecuencia en el contexto de salud, aun necesita de análisis actualizado y documentado. El profesional de enfermería está expuesto al riesgo de forma continua, por lo que este concepto debe abordarse en los fundamentos de la disciplina y profesión. Los riesgos biológicos se han abordado de manera implícita por teorías de enfermería, lo que demuestra la necesidad de análisis en su contexto. Objetivo: Sistematizar el término de riesgo en el contexto de la enfermería. Métodos: Revisión sistemática realizada durante mayo-agosto del 2020. Para un análisis crítico reflexivo de contenidos de documentos publicados en español desde 2001 a 2020 con una clara metodología y referencial teórico seleccionado. Se utilizaron las palabras clave identificadas en DeCS: "riesgo", "peligro", "vulnerabilidad", "enfermería" y "cuidados de enfermería" y los operadores booleanos AND y OR. La búsqueda fue realizada en las bases de datos SciELO, Dialnet, Google Scholar, Index. Se utilizó el diagrama de flujo (PRISMA) para la formulación de la estrategia de búsqueda. Se realizó evaluación crítica de los 13 estudios incluidos de los 69 encontrados, se les realizó análisis de contenido. Conclusiones: La sistematización y análisis del término riesgo en el contexto de la enfermería implica cuán relevante resulta la distinción entre riesgo y peligro dentro del contexto de la salud y el cuidado. Durante la sistematización se establecieron nexos conceptuales entre el riesgo y el devenir histórico de la enfermería, lo que condujo a la definición del riesgo para el profesional de enfermería(AU)

Introduction: The term risk, although frequently mentioned in the health context, still needs an updated and documented analysis. The nursing professional is continuously exposed to risk, a reason why this concept must be addressed among the fundamentals of the discipline and the profession. Biological risks have been implicitly addressed by nursing theories, demonstrating the need for analysis in its context. Objective: To systematize the term risk in the nursing context. Methods: Systematic review carried out during May-August 2020, in view of a critical-reflective analysis of the contents of documents published in Spanish from 2001 to 2020, with a clear methodology and selected theoretical framework. The following keywords identified in DeCS were used: riesgo [risk], peligro [danger], vulnerabilidad [vulnerability], enfermería[nursing] and cuidados de enfermería [nursing cares], as well as the Boolean operators AND and OR. The search was carried out in the databases SciELO, Dialnet, Google Scholar and Index. The flow chart (PRISMA) was used to formulate the search strategy. Critical evaluation of the thirteen studies included, from the 69 studies found, was carried out, together with content analysis. Conclusions: The systematization and analysis of the term risk in the nursing context implies how relevant the distinction between risk and danger is within the context of health and care. During the systematization, conceptual links were established between risk and the historical evolution of nursing, which led to the definition of risk for the nursing professional(AU)

A inter-relação do acidente de consumo e assistência à saúde: revisão integrativa / The interrelation of consumer accidents and health assistance: integrative review / La interrelación de los accidentes del consumidor y la asistencia a la salud: revisión integradora

Objetivo: Analisar a produção científica acerca da inter-relação entre consumidor, produto e assistência à saúde. Método: Trata-se de uma Revisão Integrativa da Literatura realizada nas bibliotecas e bases de dados: BVS, PubMed, Scielo e Portal de Periódicos CAPES. Foram arrolados dez estudos após a aplicação dos descritores não controlados: "consumidor/ consumer", "acidente / acident" combinados pelo operador booleano "AND" e dos respectivos critérios de inclusão e exclusão. Resultados: A análise dos estudos selecionados possibilitou que três categorias emergissem: Principais fatores que levam a ocorrência de acidentes de consumo; Métodos de prevenção dos acidentes de consumo; e, O papel da equipe de saúde na prevenção dos acidentes de consumo. Conclusão: Nesse viés, compreende-se a importância da articulação para estratégias de prevenção de acidentes de consumo, sobretudo, no que se refere ao promissor papel da equipe de saúde neste âmbito, no que tange à educação para prevenção e avaliações para aperfeiçoamento dos produtos.

Objective: to analyze the scientific production on the interrelationship between consumer, product and health. Method: this is an Integrative Literature Review carried out in the libraries and databases: VHL, PubMed, Scielo and Portal do Jornal CAPES. Two studies were found after application of two uncontrolled descriptors: "consumidor/ consumer", "acidente/acident" combined with the recommended Boolean operator "AND" and two respective inclusion and exclusion criteria. Results: When analyzing two selected studies, it is possible that three categories may arise: Main factors that lead to the occurrence of consumption accidents, Methods for the prevention of two consumption accidents, Or the role of the health team in the prevention of two consumption accidents. Conclusion: In this regard, it is understood the importance of articulation for consumer accident prevention strategies, especially not referring to the promising role of the health team in this area, not involving prevention education and evaluations for the improvement of two products

Objetivo: Analizar la producción científica sobre la interrelación entre consumidor, producto y cuidado a la salud. Método: Se trata de una Revisión Integrativa de Literatura realizada en las bibliotecas y bases de datos: BVS, PubMed, Scielo y Portal de Periódicos CAPES. Fueron registrados diez estudios tras la aplicación de los descriptores no controlados: "consumidor/ consumer", "acidente / acident", combinados por el operador booleano recomendado "AND" y los respectivos criterios de inclusión y exclusión. Resultados: El análisis de los estudios seleccionados permitió emerger tres categorías: Principales factores que conducen a la ocurrencia de accidentes de consumo, Métodos de prevención de accidentes de consumo, El papel del equipo de salud en la prevención de accidentes de consumo. Conclusión: En este contexto, se comprende la importancia de la articulación para las estrategias de prevención de accidentes del consumo, especialmente en lo que respecta al rol prometedor del equipo de salud en esta área, en lo que corresponda a la educación para la prevención y las evaluaciones para mejorar los productos.

Measurement of the Radial Nerve Danger Zone in Filipino Adults: A Cadaveric Study

@#Introduction: The radial nerve danger zone (RNDZ) is an important anatomic consideration to anticipate or prevent injury in trauma assessment or surgical fixation. No published estimate currently exists for Filipinos. In this study, we sought to provide a local estimate and explore potential predictors of this anatomic region in Filipino adult cadavers. Materials and methods: Posterior dissection to expose and measure the radial nerve, from the lateral epicondyle to the lateral intermuscular septum, was performed in 60 upper limbs from 30 formalin-preserved cadavers in the laboratory of the Department of Anatomy, College of Medicine, University of the Philippines Manila. Univariate and multivariate linear regression modelling was performed with RNDZ as the dependent variable and age, sex, height and humeral length as potential independent variables individually and in combinations. Results: The mean radial nerve length from the lateral epicondyle to the lateral intermuscular septum was estimated at 10.6 cm (95% confidence interval: 10.3 cm, 10.9cm). Height and humeral length were statistically significant univariate predictors in female cadavers, while only height was significant in male cadavers. In addition, all multivariate regression models were statistically significant and accounted for more than 57% of the variability in female RNDZ estimates. In comparison, only models that included height and age were statistically significant predictors of RNDZ and accounted for at most 22% of the variability of the estimate in males. Conclusion: The estimated length of the radial nerve danger zone generated in this study should be strongly considered over other published estimates in surgical fixation procedures performed in adult Filipinos.

Study on knowledge, attitude and practice of ante-natal care among pregnant women attending antenatal tertiary care institution

Background: The primary aim of antenatal care is to achieve a healthy mother and baby. Antenatal care helps to identify the complications and to remove anxiety and dread associated with delivery. Current study designed to assess knowledge, attitude and ante natal care practice among pregnant women attending to antenatal tertiary care hospital.Methods: A cross-sectional study was conducted on 500 pregnant women attending antenatal care centre at department of obstetrics and genecology, Narayana Medical College and Hospital, Nellore during June 2017 to June 2019 under Narayana Mathru Seva Pathakam. Face to face interview was conducted to assess their knowledge, attitude and practice using a structured questionnaire.Results: A total 86% belongs to 20-29 years age group and 71.4% belongs to multiverdia. 20.6% women responded that they had completed 3 antenatal visits, 26.6% are those who thought that at least more than 5 ANC checkup should be done during pregnancy. 96.1% pregnant responded that registration for antennal care and visits is essential. 87.2% responds to take iron and folate during pregnancy and 11% responds does not taken the same. 92% pregnant responded that tetanus toxoid (TT) should be given during pregnancy but 3.2% told don’t know. When they asked about resting period, 24.2% responded 5-6 hours, 35.4% responded 7-8 hours, 35.6% responded > 8 hours per day to rest they are taking. 55.8% pregnant responded that they had taken decision to give birth the baby in the hospital. 71.2% pregnant females reported that they knew about the danger signs during pregnancy. The reasons for not attending antenatal check-up were financial reasons, illiterate (15.4%), transport and unaware about ANC.Conclusions: Information, education and communication activities should be increased on ANC through community campaign and mass media to motivate women to utilize maternal care services.

Awareness of Mother’s Regarding Under Five Danger Signs in a Selected Rural Community of West Bengal, India

@#Introduction: The first five years of life constitute the foundations of the child's physical, mental growth and development. Mortality and morbidity are high during this age group. Early detection of danger signs is very crucial to prevent this. The objectives were to assess the knowledge of mothers regarding under-five danger signs and explore the association between the effects of knowledge with selected factors. Method: A descriptivestudy was conducted in a rural community of West Bengal from Jan’2018 to Sept’2018. Total study sample was 110 mothers having under five children. Door to door data collection was done through interview and data was analyzed both manually and by computer feeding. Results: Out of total study sample, majority (60%) belongs to age group 18-25 years followed by 31% among 26-33 age group, then 16% were more than 33 years. Out of total mothers, majority (40%) belongs to higher educated group, (37%) secondary group, followed by 10% with primary education and 13%were illiterate. Knowledge score was more than 50% among higher educated group (64%). Out of total respondents 61 (55.5%) mothers were not able to identify any danger signs whereas, 35.5 % mothers identified 1-2 danger signs and 9% mothers were able to identify 3-4 danger signs. Knowledge score about danger signs was more who visited antenatal clinic more than 4 times (61%). Conclusion: Awareness regarding under five danger signs are more among higher educated mothers. Number of antenatal visits also influences knowledge score.

Knowledge about obstetric danger signs among pregnant women attending antenatal clinic in a tertiary care hospital of Delhi: a cross sectional study

Background: According to UNICEF, globally 800 million women die due to preventable causes related to pregnancy and childbirth; 20% of which occur in India. It is therefore imperative to understand the level of knowledge about danger signs among pregnant women to augment timely redressal of preventive obstetric causes of mortality.Methods: A hospital based, cross sectional study was conducted at the ANC Clinic in Safdarjung Hospital, New Delhi from 2nd July to 27th July 2018. Convenient sampling was used to identify and interview 354 pregnant women, using a semi structured questionnaire. Data was entered and analysed with SPSSv21. Results were presented as frequencies and proportions. Chi square was used to test for association between qualitative variables, and p-value less than 0.05 was considered significant.Results: 48.3%, 35.6%, and 40.1% of pregnant women had knowledge about danger signs during pregnancy, labour and postpartum respectively. Majority of the women had knowledge about abdominal pain (58.4%) and severe fatigue (80.7%) as danger signs of pregnancy, while bleeding (82.5%) was the most common response as danger sign of labour. More than half had knowledge about heavy bleeding (59.9%) as danger sign of postpartum. The women lacked awareness about Convulsions (92.9%) as danger signs of pregnancy and labour, as well as smelly vaginal discharge (79.6%) in postpartum.Conclusions: Knowledge of obstetric danger signs among pregnant women is still lower. It needs further awareness as it can help in early diagnosis and referral of patients thus reducing maternal mortality and morbidity.

Birth preparedness and complication readiness among women attending Immuno-Prophylaxis Centre, Dr. S. C. Government Medical College, Nanded

Background: As signatory to United Nation’s Sustainable Development Goals, India is striving hard to achieve these goals by end of 2030, especially for goal number 3 with targets related to maternal and child health. Birth-preparedness and complication-readiness (BPCR) is a tool to promote maternal and neonatal survival. This study was conducted to assess the perception and practices of recently delivered women on BPCR with its correlates.Methods: Hospital-based cross-sectional study was conducted at Immuno-prophylaxis centre of Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. Women attending IPC along with their baby within two to four months of delivery for immunization of their babies during the month of March 2014 constituted study subject of this study. After obtaining informed consent, data was obtained on socio-demographic characters like age, caste, religion, education, parity, ANC registration and questions regarding birth preparedness and complications readiness in their last pregnancy.Results: Total 117 women found to be eligible as study subject. Overall BPCR index of the study population was 67.28. Proportion of women who received first antenatal check-up within first trimester, four or more antenatal checkups, saved money for childbirth and had institutional delivery were 87.18%, 86.32%, 51.28% and 100% respectively. Around 23.08% women had knowledge of at least 3 key danger signs of pregnancy while only 19.65% identified blood donor. Awareness regarding danger signs of pregnancy and arrangement for blood donor was found poor in comparison to other indicators in study subject.Conclusion: There is need of increasing awareness regarding BPCR so that perception and practices in the community increased.

Birth preparedness and complication readiness among pregnant and recently delivered women in villages of a block of Ganjam, Odisha, India: a community based cross-sectional study

Background: Globally approximately 830 women die from pregnancy and child birth every day. Most of deaths can be prevented by proper planning like birth preparedness and complication readiness (BPCR). The aim of study was to assess awareness and practice regarding BPCR among pregnant women and recently delivered women and to identify socio-demographic factors affecting it.Methods: A community based cross sectional study was conducted from September to December 2018 in villages of Chhatrapur block of Ganjam District among pregnant women (completed 24 weeks) and recently delivered women (12 months) regardless of newborn outcome. Sample size was calculated to be 96. Multi stage random sampling was adopted and PPS (Probability proportional to size) method was used. A questionnaire was used which contained socio-demographic information and set of 11 indicators to determine BPCR index. All data were analysed in SPSS.Results: BPCR index was 44.6% and it was higher (61%) in recently delivered women. 26% can be said to be well prepared and 45.8%, 27%, 32.3%, 37.5% knew at least one key danger sign in pregnancy, delivery, post partum and about new born respectively. A significant association was found between maternal education, age and pregnancy with awareness regarding BPCR.Conclusions: BPCR index in study area was low and a low proportion of participants were well prepared. Awareness about danger signs was quite low. So health workers at grassroots level should be encouraged to explain BPCR components to women and educational activities should be carried out to promote women to make plan a priori.

Assessment of awareness regarding obstetric and newborn danger signs among pregnant women and recently delivered mothers in urban slums of Raipur city, Chhattisgarh

Background: Knowledge regarding danger signs has been found helpful to reduce delays in seeking, reaching and obtaining care during obstetric emergencies. Aims & Objectives: To assess the awareness regarding obstetric and newborn danger signs among pregnant and recently delivered mothers residing in urban slums of Raipur city. Material & Methods: Observational study was conducted among 160 pregnant and 70 recently delivered women residing in urban slums. The assessment of awareness regarding danger signs was done by adding the marks obtained in various phases. Appropriate statistical tests were applied for any association between knowledge score and socio-demographic variables. Results: Subjects knowing at least one key danger sign during pregnancy, labour, postpartum and newborn period was 54.3%, 51.9%, 7.4%, and 11.3 % respectively. Those with age more than 20 years (p value 0.000), joint family (p value 0.000), educated more than 5 years (p value 0.009), and having married and getting first time pregnant after 20 years (p values 0.001 and 0.022 respectively) were found to have significantly more knowledge about danger signs. Conclusions: Knowledge regarding danger signs should be given at the time of every ANC visit and also at follow up visit after delivery.

Danger signs of acute respiratory tract infections in under-five children: awareness among mothers in the urban slums of Hyderabad, its relation to treatment seeking behaviour

Background: Sustainable development goals (SDGs) proposes to all countries an aim to reduce under-five mortality to 25 per 1000 live births by 2030. Acute respiratory tract infections including pneumonia are the leading cause of death among the children less than five years in India. Identification of severe respiratory infections from non-severe forms necessitates that care-givers, especially mothers are aware of danger signs. An attempt is made to study the awareness of danger signs among the Mothers and see its relation to treatment seeking behaviour.Methods: Community based cross-sectional survey was conducted involving 344 mothers of under-five children living in the urban slums of Hyderabad.Results: The awareness of mothers about the danger signs of ARI is poor. Very few knew that fast breathing (11 percent), wheezing (4.7 percent), convulsions (1 percent), lethargy (1 percent) are major danger signs of ARI requiring urgent medical attention. A majority of mothers took the child with ARI to private hospital (42 percent) while few approached Govt. Hospital or dispensary (4.7 percent). Many mothers (77 percent) were aware that vaccination against diseases might protect the children against ARIs. The prevalence of acute respiratory infections among the children in the current study (59.3 percent) is much higher that previous studies elsewhere.Conclusions: A very high proportion (44 percent) of the mothers were ignorant of any danger sign of ARI. The significant association between awareness and positive health care seeking behaviours, like consulting allopathic doctor or govt. hospital or private hospital establishes the evidence that awareness levels are the prerequisite for the positive health care behaviour.

La Tuberculosis a través de la Historia: un enemigo de la humanidad / Tuberculosis through history: an enemy of mankind

Introducción: La tuberculosis es una enfermedad infectocontagiosa causada por el Mycobacterium tuberculosis, la cual representa un serio problema de salud. Se evidencia, a través de la Historia, la lucha del hombre en su afán de contrarrestarla y los estragos que la enfermedad ha causado y provocado innumerables muertes sin importar razas, edad, clases sociales, aunque si afectando en mayor medida a los más desposeídos. Objetivo: Describir algunos aspectos generales que caracterizan la historia de la tuberculosis y su efecto negativo sobre la salud del hombre, precisar la lucha de las instituciones de salud a nivel mundial contra esta enfermedad y aspectos del programa de prevención y control utilizado en Cuba. Material y Métodos: Se realizó una revisión bibliográfica en el período comprendido entre mayo y junio de 2015. Se evaluaron revistas de impacto de Web of Sciencies (43 revistas) y revistas cubanas. Se consultaron las bases de datos de sistemas referativos, como MEDLINE, PubMed y Scielo con la utilización de descriptores como tuberculosis pulmonar tuberculosis Infection. Se incluyeron artículos en idioma inglés y español, y publicaciones de los últimos 5 años. Se obtuvieron 55 artículos, y se circunscribió el estudio a 27 que enfocaron estas temáticas de manera más integral. Conclusiones: La tuberculosis es una enfermedad muy antigua y a pesar del avance científico y social alcanzado, continúa siendo un inminente peligro para la salud. Constituye un compromiso político de todas las naciones mejorar y desarrollar programas y servicios de salud para el mejor desempeño en la lucha contra esta enfermedad(AU)

Introduction: Tuberculosis is an infectious-contagious disease caused by Mycobacterium tuberculosis, which represents a serious health problem. The man´s fight against this disease has been evidenced through history. He has demonstrated his desire to control it and the damage it has caused such as uncountable deaths regardless race, age, and social classes; mainly affecting the dispossessed. Objective: To describe some general aspects that characterize the history of tuberculosis and its negative effect on man´s health, specify the fight of health care centers worldwide against this disease, and present prevention and control measures used in Cuba. Material and methods: A bibliographic review was carried out during the period between May and June, 2015. Impact factor journals from the Web of Sciences (43 journals), and Cuban journals were evaluated. Reference databases such as MEDLINE, PubMed, and SciELO were consulted using some descriptors such as pulmonary tuberculosis, and tuberculosis infection. Articles in English and Spanish languages were included, as well as publications of the last 5 years. A total of 55 articles were obtained, and the study was limited to 27 ones that focused these topics in a more comprehensive way. Conclusions: Tuberculosis is a very old disease and, despite the scientific and social progress achieved, it continues being an imminent danger to health. The development of programs and health services for best actions in the fight against this disease is a political commitment of all nations(AU)

Percepción del riesgo en la cotidianidad de los adolescentes / Perception of the risk of adolescent's everyday events / Percepção do risco na cotidianidade dos adolescentes

Resumen Objetivo: Describir los significados que el adolescente y sus padres atribuyen al riesgo en la adolescencia. Metodología: Se realizó una investigación cualitativa con enfoque fenomenológico hermenéutico de tipo narrativo. Se realizaron siete entrevistas con adolescentes y siete con padres. Resultados: El riesgo es visto por padres y adolescentes desde cuatro dimensiones: peligros, excesos, estética y moral e histórica. Conclusión: El riesgo es visto como peligro proveniente de acontecimientos externos (amenazas) y elecciones propias (toma de decisiones)

Abstract Objective: Describe the significance adolescents and their parents attribute to risks during adolescence. Methodology: Qualitative research with a narrative type hermeneutical phenomenological approach. Seven interviews were conducted with adolescents, and 7 independent interviews with parents. Results: Risk is seen by parents and adolescents from four dimensions: Dangers, excesses, aesthetics and morality and history. Conclusion: Risk turned into a narration shows the different shades in which dangers originating from threats (external events) come in and decision-making (personal choices).

Resumo Objetivo: Descrever os significados que o adolescente e os seus pais lhe atribuem ao risco na adolescência. Metodologia: Investigação qualitativa com enfoque fenomenológico hermenêutico de tipo narrativo. Se realizaram sete entrevistas com adolescentes e sete com os pais. Resultados: O risco é visto por pais e adolescentes desde quatro dimensões: perigos, excessos, estética e moral e histórica. Conclusão: O risco feito relato mostra diversas tonalidades entre as que se encontram os perigos provenientes das ameaças (acontecimentos externos) e da tomada de decisões (eleições próprias).

Miedo a volar: Componentes y formas de afrontamiento de un grupo de patagones que viven en aislamiento relativo / Fear of flying: Components and forms of coping with a group of Patagonians living in relative isolation

Resumen El presente estudio trata del temor a volar, las expectativas de peligro y las estrategias de afrontamiento que las personas dicen utilizar al momento de volar en avión. Un total de 287 participantes, habitantes de una zona aislada geográficamente, que utilizan habitualmente el avión, fueron medidos en las variables ya señaladas. El muestreo fue no probabilístico accidental y el diseño utilizado fue no experimental transversal correlacional. Los principales resultados indican que las personas dicen temer principalmente a situaciones que provocan en ellos la pérdida del control emocional aunque sus estrategias de afrontamiento más comunes suelen estar orientadas a la resolución de problemas. Estas estrategias, orientadas a recuperar simbólicamente el control psicológico, no apuntan al afrontamiento de las emociones. También se describen algunas diferencias en el uso de estas estrategias según género. Se discuten estos resultados en términos de su sincronía con los estudios previos y sus potenciales implicancias para los actuales programas terapéuticos de intervención de dicho problema.

Abstract This study is about the fear of flight, the danger expectations and the coping strategies that people say to use when flying on an airplane. A total of 287 participants, people from a graphically isolated zone that usually use planes, were measured according to the already mentioned variables. The sampling was not accidental probabilistic and the designed used was not experimental transversal correlational. The principal results indicate that people say to be afraid principally of situations that cause in them the loss of the emotional control, although, their most common coping strategies use to be oriented to affront anxiety. This strategy, aimed to regain the psychological control symbolically, does not point to the emotions coping. Also, some differences in the use of these strategies according to gender are described. These results are discussed regarding its timing with previous studies and their potential implications for current therapeutic intervention programs for this problem.

Autoimmune Responses in Severe Asthma

Asthma and autoimmune diseases both result from a dysregulated immune system, and have been conventionally considered to have mutually exclusive pathogenesis. Autoimmunity is believed to be an exaggerated Th1 response, while asthma with a Th2 underpinning is congruent with the well-accepted Th1/Th2 paradigm. The hypothesis of autoimmune involvement in asthma has received much recent interest, particularly in the adult late-onset non-atopic patients (the “intrinsic asthma”). Over the past decades, circulating autoantibodies against diverse self-targets (beta-2-adrenergic receptors, epithelial antigens, nuclear antigens, etc.) have been reported and subsequently dismissed to be epiphenomena resulting from a chronic inflammatory condition, primarily due to lack of evidence of causality/pathomechanism. Recent evidence of ‘granulomas’ in the lung biopsies of severe asthmatics, detection of pathogenic sputum autoantibodies against autologous eosinophil proteins (e.g., eosinophil peroxidase) and inadequate response to monoclonal antibody therapies (e.g., subcutaneous mepolizumab) in patients with evidence of airway autoantibodies suggest that the role of autoimmune mechanisms be revisited. In this review, we have gathered available reports of autoimmune responses in the lungs, reviewed the evidence in the context of immunogenic tissue-response and danger-associated molecular patterns, and constructed the possibility of an autoimmune-associated pathomechanism that may contribute to the severity of asthma.

The Application of Annular Suture in the Treatment of Postpartum Hemorrhage Caused by Dangerous Placenta Previa / 昆明医科大学学报

Objective To study the effect of pre-operative internal iliac artery capsule combined with the lower segment of the uterus with annular suture on the treatment of postpartum hemorrhage caused by dangerous placenta previa and the long-term effect of the operation. Methods from January 1, 2015 to March 31, 2017, the second people's Hospital of Yunnan province for Cesarean danger in placenta of patients using preset internal iliac artery balloon combined with lower uterine segment ring-shaped suture in the treatment of 22 cases of patients as research group, Lower uterine segment multiple is not used in loop suture for treatment, but has a preset internal iliac artery balloon 18 cases of dangerous patients with placenta previa, as retrospective analysis clinical data of the comparison group. Results Mean blood loss in 22 patients 1329.54±290 ml. Does not occur in all patients around organ damage and other complications. 1 examples of hysterectomy. 5.23 days postoperative average hospital stay. After 3 months of follow-up ultrasound, uterus shape well. In 18 patients in the control group average blood loss 1451.11 ±311 ml of blood loss were significantly higher in the study group, there was a statistically significant difference ( <0.05) . 2 examples of hysterectomy in the control group. Uterine reservations there was statistically significant ( <0.05) . Conclusion Combined preset internal iliac artery balloon uterus circular suturing for the dangerous result of placenta previa with placenta accreta intraoperative uterine bleeding for better effect.