EKADHIKEN PURVEN-BEAUTY OF VEDIC MATHS

It has been proven in many medical research that Vedic Maths keep both sides of brain ?t. In cut throat competition of today's world, where the only constraint is time, the need is to train the students in such a way that they can do long calculations in a very short time. Vedic Maths does the same. Though there are many controversies about the origin of Vedic Maths Sutras, but it is not important. The only thing that is important is that these Sutras are very handy in saving precious time. In this paper we are discussing the one very important and interesting Sutras of Vedic Maths that is Ekadhiken Purven and some of its applications in various mathematical problems and their algorithms in detail.

Policondritis recidivante: manifestaciones clínicas y tratamiento / Recurrent polychondritis. Clinical, diagnosis and treatment

La policondritis recidivante es una enfermedad rara caracterizada por la inflamación recurrente del cartílago y otros tejidos en todo el cuerpo. La afectación del oído es la característica más común, pero puede afectar otras áreas del cuerpo, incluidos el cartílago costal, los ojos, la nariz, las vías respiratorias, el corazón, el sistema vascular, la piel, las articulaciones, los riñones y el sistema nervioso. Los signos y síntomas varían de persona a persona según las partes del cuerpo afectadas. La causa subyacente exacta de la policondritis recidivante se desconoce, aunque los científicos sospechan que se trata de una enfermedad autoinmune. Las complicaciones respiratorias (colapso de la tráquea e infecciones) son la causa más común de muerte, seguidas de la afectación cardiovascular. Los objetivos principales del tratamiento son aliviar los síntomas actuales y preservar la estructura del cartílago afectado. Gracias a las mejoras en el tratamiento, en los últimos años las tasas de supervivencia han aumentado, incluso después de 10 años(AU)

Recurrent polychondritis is a rare condition characterized by recurrent inflammation of cartilage and other tissues throughout the body. Ear involvement is the most common feature, but a variety of other areas of the body may be compromised, including costal cartilage, eyes, nose, airways, heart, vascular system, skin, joints, kidneys and nervous system. The signs and symptoms vary from person to person depending on the body parts affected. The exact underlying cause of recurrent polychondritis is unknown; however, scientists suspect it is an autoimmune condition. The main goals of treatment for people with recurrent polychondritis are to alleviate current symptoms and preserve the structure of the affected cartilage(AU)

Reconstrucción con bloque óseo tricortical cadavérico en luxación glenohumeral anterior recurrente con pérdida ósea glenoidea: técnica modificada de Eden Hybinette / Reconstruction with cadaveric tricortical bone block in recurrent anterior glenohumeral dislocation with glenoid bone loss: modified Eden Hybinette technique

Resumen: La luxación glenohumeral recurrente suele asociarse a pérdida ósea de la porción glenoidea, siendo la localización anteroinferior la más afectada. El entendimiento de las estructuras relacionadas así como el uso de estudios de imagen actuales tales como la tomografía axial computarizada y la resonancia magnética han permitido avanzar respecto a la comprensión de la patología, asimismo el desarrollo de materiales quirúrgicos y herramientas de mínima invasión nos permiten continuar innovando respecto a los tratamientos previamente descritos, siendo posible intervenir en detalles técnicos con la intención de mejorar los resultados. Es por eso que hemos realizado lo descrito por Eden-Hybinette utilizando injerto tricortical cadavérico con tornillos canulados como método de fijación, limitando las comorbilidades asociadas a la toma de autoinjerto, dando como resultado un amplio beneficio para el paciente durante el procedimiento quirúrgico y en el período de recuperación.

Abstract: Recurrent glenohumeral dislocation is usually associated with bone loss of the glenoid portion, with the anteroinferior location being the most affected. The understanding of the related structures, as well as the use of current imaging studies such as computed axial tomography and magnetic resonance imaging, have made progress in understanding the pathology, as well as the development of surgical materials and minimally invasive tools, they allow us to continue innovating with respect to the previously described treatments, being possible to intervene in technical details with the intention of improving the results. That is why we have done what described by Eden-Hybinette, using tricortical cadaveric graft and as fixation method, limiting the comorbidities associated with the autograft taking, resulting a wide benefit for the patient, during the surgical procedure and in the recovery period.

Comparative Evaluation of Golden Proportion, Recurring Esthetic Dental Proportion and Golden Percentage in Himachal Demographic

Aim:The purpose of this study was to comparatively evaluate the validity of Golden Proportion, Recurring Esthetic Dental (RED) proportion and Golden Percentage in maxillary anterior teeth in population of Himachal Pradesh.Methods and Materials:Dentulous stone casts of maxillary arch were made of the subjects who met the inclusion criteria. Conditions for inclusion criteria included that the individuals:1) should be of Himachaliorigin with agreeable smiles 2) have well aligned anterior dentition 3) should be between age group of 20-40 years Total of 200 students representing Himachal Pradesh population were included. Measurements were done for the spaces in the grids using the digital caliper. Results:1)The Golden Proportion ratio of 1.3 and 1.4 were more commonly observed in 27.5% and 40% respectively than 1.618 which was observed in 5.5% under study of the population. 2)A Paired sample t-test showed there was no significant gender based difference in Lateral/Central incisor Red Proportion.(P-value>0.05) except for the Canine/Lateral Red Proportion. (P-value<0.05). 3)The Golden Percentage for males in central and lateral incisors and canine was 22.48%, 15.96% and 11.08% respectively. The mean value for females in central and lateral incisors and canine was 22.72%, 16.25% and 10.97% respectively. Conclusions:Golden percentage could be used for aesthetic correction and was found to be more applicable in the population included in this study. Golden percentage could be used for aesthetic correction and are more applicable to natural dentition in the population of Himachal Pradesh.

Reparación de fístula urogenital con interposición de injerto biológico de submucosa intestinal / Urogenital fistula repair with intestinal submucosa biological graft interposition

Resumen ANTECEDENTE: el tratamiento de una fístula genitourinaria compleja es un reto por las múltiples dificultades para conseguir un resultado exitoso; el injerto biológico de intestino porcino puede ser una opción en estos casos. OBJETIVO: describir el diagnóstico de las fístulas genito-urinarias y su reparación con una innovadora interposición de injerto biológico de intestino delgado porcino. MATERIALES Y MÉTODOS: estudio prospectivo de serie de casos con diagnóstico de fístula vésico-vaginal y uretro-vaginal de pacientes atendidas en el Instituto Nacional de Perinatología entre los años 2012 a 2014. Descripción de los datos demográficos de cada paciente, proceso diagnóstico-clínico y estudios de gabinete y laboratorio; características de la fístula, técnica quirúrgica y seguimiento. RESULTADOS: se estudiaron 5 pacientes con fístulas tipo III o vésico-vaginales localizadas en el trígono, 3 de ellas relacionadas con cirugía ginecológica y 2 con un evento obstétrico, y una tipo I o uretrovaginal en la uretra proximal, relacionada con parto instrumentado. En el cierre del segundo plano, para la colocación del injerto biológico, se aplicó la técnica de reparación de Latzko modificada. Una paciente tuvo 4 reparaciones previas, otra una reparación previa y el resto ninguna. El tamaño varió de 0.5 cm a 3 cm. El seguimiento posoperatorio no evidenció recurrencia; una paciente tuvo incontinencia urinaria de esfuerzo un año después. El seguimiento mínimo fue de 1 y el máximo de 2 años. No se registraron complicaciones posoperatorias. CONCLUSIÓN: el injerto de mucosa de intestino delgado porcino para la reparación de fístulas urogenitales complejas y recurrentes fue efectivo en todas las pacientes.

Abstract BACKGROUND: treatment of a complex genitourinary fistula is a challenge given the multiple difficulties to achieve a successful result, the biological grafting of porcine intestine can be an option in these cases. OBJECTIVE: to describe the diagnosis of genitourinary fistulas and their repair with an innovative interposition of small intestine porcine biological graft. MATERIALS AND METHODS: a prospective trial of a series of cases with a diagnosis of vesicovaginal and urethrovaginal fistula in patients of the Instituto Nacional de Perinatología between 2012 to 2014. Description of patient demographics, diagnostic and clinical process, imaging and lab tests; characteristics of the fistula, surgical technique and follow up. RESULTS: 5 patients with type III or vesicovaginal fistulas located in the trigone were studied, 3 of the fistulas are related to gynecological surgery and 2 with an obstetric event and one type 1 or urethrovaginal in the proximal urethra caused by an instrumented delivery. In the closure of the second layer for placement of the biological graft, we applied the modified Latzko repair technique. One patient had 4 previous repairs, another one had one previous repair and the rest had none. The size varied from 0.5 cm to 3 cm. The postoperative follow-up period did not show recurrence; one patient had stress urinary incontinence one year later. The minimum follow-up was 1 year and the maximum 2 years. No postoperative complications were reported. CONCLUSION: the porcine small intestinal submucosa graft for the repair of complex and recurrent urogenital fistulas was effective in all patients.

Patología del trasplante hepático, aspectos más relevantes del período postrasplante tardío / Most Relevant Pathology Issues in the Late Post Liver Transplant Period

La sobrevida de los pacientes postrasplante hepático supera el 90% al año y el 75% a los 5 años. Entender las causas de pérdida del injerto, o inclusive la muerte del paciente, es esencial para mejorar aún más los resultados a largo plazo. La evaluación de las biopsias hepáticas tiene un papel importante en la explicación y manejo de la disfunción del injerto de hígado, que ocurre después del primer año del trasplante. La interpretación de estas biopsias puede ser muy difícil, en especial por la alta incidencia de enfermedades recurrentes que pueden mostrar un cuadro clínico y unas características histopatológicas que semejan varias condiciones, especialmente cuando el rechazo agudo o crónico pueden sobreponerse a una patología ya existente o presentarse de manera simultánea y contribuir a la disfunción tardía del injerto, por lo que el análisis de la biopsia puede ayudar a determinar el componente principal de la lesión. Es indispensable la correlación clínico patológica, teniendo en cuenta la enfermedad original, el tipo de inmunosupresión, las pruebas de función hepática, las serologías virales, los autoanticuerpos y los hallazgos radiológicos. En este artículo comentaré las patologías más frecuentes y las que causan más problemas en su diagnóstico durante el período postrasplante tardío

One year survival rates of liver transplant patients exceed 90% while five year survival rates exceed 75%. Understanding the causes of graft losses and patient deaths is essential for further improvement of long-term results. Evaluation of liver biopsies has an important role in explaining liver graft dysfunction that occurs more than one year after transplantation, and thus is key for post-transplant patient management. The interpretation of these biopsies can be very difficult especially because of the high incidence of recurrent diseases that sometimes have clinical and histopathological features that resemble various other conditions. This is especially true for acute and chronic rejection which can overwhelm an existing condition and which can develop simultaneously with other conditions that contribute to late graft dysfunction. Analysis of the biopsy can help determine the main component of a lesion. Clinical findings must be correlated to pathological findings, and the correlation must take into account the original disease, the type of immunosuppression, liver function tests, viral serology, autoantibodies and radiological findings. In this article I will discuss the most common diseases and those that cause the most problems for diagnosis during the late post-transplant period

Comparative photographic evaluation of various geometric and mathematical proportions of maxillary anterior teeth: A clinical study.

Aim: This study aimed to investigate the existence of the golden proportion, recurring esthetic dental (RED) proportion and golden percentage between the frontal view widths of the maxillary anterior natural dentition among students of Indian origin by the aid of digital photography. Materials and Methods: This study was conducted with 80 dental students (41 female and 39 male), with ages ranging from 20 to 23 years. Students whose natural smile did not develop any visual tension with regard to the study’s and their own criteria were selected as having an esthetic smile. Photographs were taken, and the mesiodistal widths of six maxillary anterior teeth were measured digitally using software. Once the measurements were recorded three different theories of proportion were applied and statistical analysis was done. Results: The golden proportion, i.e., 62% RED proportion and golden percentage were not observed in the subjects. According to the subjects evaluated, the average width of the maxillary lateral incisor was 72% of the frontal view width of the central incisor. The average width of the canine was 84% of the frontal view width of the lateral incisor. Conclusion: The golden proportion and RED proportion were not observed in the natural smiles of subjects who were deemed to have an esthetic smile. The values proposed for the golden percentage theory were not observed in subjects with an esthetic smile. Average frontal view percentage widths of the maxillary anterior dentition exist and can be useful in predicting naturally occurring widths in smiles deemed to be esthetic in a specific population.

Disseminated bronchiectasis in an adult with common variable immunodeficiency / Bronquiectasias diseminada en un adulto con inmunodeficiencia común variable

Primary immunodeficiencies (PID) are traditionally considered childhood diseases; however, adults account for 35% of all patients with PID. Antibody deficiencies, especially Common Variable Immunodeficiency (CVID), which have their peak incidence in adulthood, require a high suspicion index. Even though the estimated frequency of CVID is not high (1:25,000), high rates of under diagnosis and under reporting are very likely. The delay in diagnosis increases the morbidity and mortality; therefore, adult physicians should be able to suspect, identify and initiate management of individuals with PID. Here we report the case of a 37 year-old man presenting to the emergency room with dyspnea, fever and cough; he developed respiratory failure requiring mechanical ventilation. He complained of recurring pneumonia associated with widespread bronchiectasis since he was 18 years old. Serum immunoglobulins quantification showed severe hypogammaglobulinemia (total IgG <140 mg/dL; total IgA, 2.9 mg/dL; and total IgM <5 mg/dL). Treatment with Human Intravenous Immunoglobulin (IVIG) 10% was started, and with antibiotic treatment for severe pneumonia (during 14 days) was also prescribed. His clinical evolution has been favorable after one year follow-up. Common Variable Immunodeficiency (CVID) diagnosis was made.

Las inmunodeficiencias primarias (IDP) son patologías que tradicionalmente se consideran de la niñez sin embargo los adultos representan el 35% del total de pacientes con IDP. Las deficiencias de anticuerpos, en especial la Inmunodeficiencia Común Variable (IDCV) tienen su pico de incidencia en la edad adulta, requiere un alto índice de sospecha y si bien su frecuencia estimada no es alta (1:25,000), es muy posible que el subregistro y subdiagnóstico si lo sean. El retraso en el diagnóstico aumenta la morbi-mortalidad razón por la cual los médicos de adultos deben estar en capacidad de sospechar, identificar e iniciar el manejo de las personas con IPD. Presentamos el caso de un hombre de 37 años de edad atendido en la sala de urgencias con disnea, fiebre y tos, desarrolla falla respiratoria requiriendo ventilación mecánica. Refería neumonías a repetición desde los 18 años de edad asociadas con bronquiectasias generalizadas. La cuantificación de inmunoglobulinas séricas evidenció hipogammaglobulinemia severa (IgG total <140 mg/dL, IgA total 2.9 mg/dL, IgM total <5 mg/dL), se inició inmunoglobulina humana endovenosa (IGIV) al 10%, y recibió tratamiento antibiótico por 14 dias para neumonía severa, su evolución clínica ha sido favorable hasta ahora (un año de seguimiento), se estableció el diagnostico de Inmunodeficiencia Común Variable (IDCV).

A educação física, o docente e a escola: concepções e práticas pedagógicas / Physical education, the teacher and the school: conceptions and pedagogical practices

Este artigo baseia-se em um estudo que investigou de que maneira as mudanças ocorridas na área da educação física vêm marcando a concepção do professor e a sua prática pedagógica. Trata-se de pesquisa qualitativa, investigando quatro professores de educação física, selecionados segundo os seguintes critérios: atuar no ensino público em escolas diferentes, ter tempo de formado e de docência diferentes entre eles. Os dados foram coletados através de entrevistas recorrentes. Este procedimento baseia-se em algumas etapas de entrevistas seguida de categorização dos dados após cada uma delas. Os sujeitos participam ativamente completando, alterando e esclarecendo informações, interagindo com o pesquisador. Os resultados possibilitaram identificar que as mudanças ocorridas na área da educação física, na visão dos docentes investigados, influenciam desde os aspectos relacionados à formação inicial, passando pelas condições de trabalho na escola e a forma de organizar a prática pedagógica, influenciando na valorização da área, bem como do docente...

This article is based on a study which investigated how the changes that took place in the Physical Education area have been marking the teacher's conception and pedagogical practice. It is a qualitative research which investigates four Physical Education teachers who were selected based on the following criteria: working with public education in different schools, and having different under-graduation and teaching time from each other. Data were collected by recurrent interviews. This procedure is based on some interview steps followed by data categorization after each interview. The subjects have an active participation by completing, changing and clearing some information and due to interacting with the researcher. The results enable us to identify that changes which took place in the Physical Education area, from the investigated teachers' point of view, have influenced aspects related to initial formation, the schools' working conditions and also how the pedagogical practice is organized, increasing the value for both the area and the teacher...

Devic’s neuromyelitis optica: a critical review

Devic's neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating and necrotizing disease characterized by predominant involvement of the optic nerves and spinal cord. In Asian countries relapsing NMO has been known as opticospinal multiple sclerosis. It has long been debated if NMO is a variant of multiple sclerosis (MS) or a distinct disease. Recent studies have shown that NMO has more frequently a relapsing course, and results from attack to aquaporin-4 which is the dominant water channel in the central nervous system, located in foot processes of the astrocytes. Distinctive pathological features of NMO include perivascular deposition of IgG and complement in the perivascular space, granulocyte and eosinophil infiltrates and hyalinization of the vascular walls. These features distinguish NMO from other demyelinating diseases such as MS and acute demyelinating encephalomyelopathy. An IgG-antibody that binds to aquaporin-4, named NMO-IgG has high sensitivity and specificity. Magnetic resonance imaging (MRI) studies have revealed that more frequently there is a long spinal cord lesion that extends through three or more vertebral segments in length. Brain MRI lesions atypical for MS are found in the majority of cases. Treatment in the acute phase includes intravenous steroids and plasma exchange therapy. Immunosupressive agents are recommended for prophylaxis of relapses.

Neuromielite óptica ou doença de Devic (NMO) é uma doença inflamatória com desmielinização e necrose envolvendo preferencialmente os nervos ópticos e a medula espinal. Desde sua descrição inicial tem havido controvérsia se a NMO é uma variante da esclerose múltipla (EM) ou se é uma entidade independente. Na Ásia a doença é conhecida como esclerose múltipla óptico-espinal. Recentes avanços tem demonstrado que na maioria dos casos a NMO é recorrente e resulta de alterações inflamatórias por ataque à aquaporina-4, uma proteína localizada nos pés dos astrócitos na barreira hemato-encefálica. Patologicamente a NMO difere da EM pela presença de necrose e cavitação no centro da medula, deposição perivascular de IgG e complemento, infiltração de neutrófilos e eosinófilos, assim como por hiperplasia e hialinização dos vasos. O anticorpo contra a aquaporina-4 (IgG-NMO), detectado no soro dos pacientes, tem alta sensibilidade e especificidade. Imagem por ressonância magnética demonstra lesão medular que se estende três ou mais segmentos vertebrais. Na maioria dos casos há lesões cerebrais atípicas para EM. Corticosteróide venoso em altas doses e plasmaférese são usados no tratamento das fases agudas, enquanto os imunossupressores devem ser usados na profilaxia das recorrências.

Recurring Candida albicans esophagitis in a HIV-infected patient undergoing long-Term antiretroviral therapy, and with absent-negligible immunodeficiency

A patient with HIV infection developed the first episode of AIDS-defining opportunism (severe Candida albicans esophagitis) with an underlying CD4+ lymphocyte count of 1,025 cells/µL. After treatment with a highly active antiretroviral therapy (HAART), taken with insufficient compliance and leaving a residual viral load, our patient suffered from two relapses of esophageal candidiasis, which occurred three months and seven years later, when his CD4+ lymphocyte count was 930 and 439 cells/µL, respectively, and a viral load slightly above 10(4) copies/mL was still present. Also in the HAART era, Candida esophagitis remains one of the most common AIDS-defining diseases, but a presentation with a concurrent CD4+ count above 1,000 cells/µL remains a rare exception, as well as the two isolated, subsequent relapses, occurred with a CD4+ count ranging from 439 to 930 cells/µL, and a residual HIV viremia due to insufficient adherence to the prescribed HAART regimens. Our case report represents the opportunity to revisit the epidemiology and, especially, the pathogenesis of this opportunistic fungal complication in HIV-infected patients and in other subjects at risk, on the ground of an extensive literature review, and to explore possible alternative supporting factors other than the crude absolute CD4+ lymphocyte count, with emphasis on the possible role of a persisting HIV viremia, and other potential contributing factors. Clinicians engaged with immunocompromised patients and subjects with HIV disease, should be aware that a Candida esophagitis may occur and relapse also when the cell-mediated immunity, as measured by a simple CD4+ cell count, do not show relevant abnormalities.

A study on treatment of recurring nephritic syndrome with integration of Chinese and Western medicine / 中国实用内科杂志

Objective To study the efficacy of the integration of Chinese and Western medicine in treating recurring NS. Methods Patients were deivided into tow groups,control group was treated with western medicine,experimental group was treated with integration of Chinese and Western medicine.We could understand that which curative effect would be better by contrast.Results The complete remission rate and the total remission rate in experimental group were 53.2% and 95% respectively,it was significantly higher than that in control group.In control group,The complete remission rate and the total remission rate were 30.0% and 70% respectively.The remission rate was significantly diffence com- pared with two groups(P

O sonho da maternidade: representação social de mulheres que vivenciaram abortamentos recorrentes / The dream of maternity: social implications for women that experience recurring miscarriages

Este estudo teve como objetivos caracterizar o perfil sócio-demográfico e a história reprodutiva das mulheres que sofreram abortamentos recorrentes, inscritas no Ambulatório de Esterilidade de um centro de referência para a saúde da mulher do município de São Paulo, com base nas informações contidas em seus prontuários, e com base em depoimentos buscou-se identificar as representações sociais dessas mulheres acerca do abortamento, da maternidade, da saúde, da assistência à saúde e de sua inserção no serviço. A análise dos dados de 211 prontuários permitiu traçar o perfil dessas mulheres em uma análise quantitativa. Verificou-se que (48,8%) encontram-se na faixa etária de 30 a 39 anos; (65,0%) são de cor branca ou parda, (45,5%) professam a religião católica, (52,6%) são casadas ou vivem em união estável, (24,2%) completaram o primeiro grau e que (41,7%) procuraram o serviço por iniciativa própria. Quanto à história reprodutiva, observou-se que, para (78,7%) das mulheres, a menarca ocorreu entre 10 a 15 anos, (68,7%) nunca pariram e que (76,3%) relatam dois ou três abortamentos. As alterações anatômicas responderam por (14,7%) dos casos de abortamentos e (52,1%) não necessitaram de curetagem pós-abortamento. Dentre as 52 pacientes que informaram duas gestações, a totalidade resultou em abortamentos. Dentre aquelas com 3 gestações, a maioria, 51(63,8%), sofreram três abortamentos e 25 (30,9%) dois. Entrevistas semi-diretivas realizadas com quinze dessas mulheres, em tratamento ou não na ocasião, evidenciaram que as representações sociais atribuídas ao abortamento apresentam-no como uma ruptura abrupta do sonho de ser mãe e de dar um filho ao companheiro, acompanhada de frustração, sensação de culpa, vazio e medo de uma nova perda, sentimentos potencializados pela má qualidade da assistência recebida. A maternidade é representada pelas entrevistadas como a realização plena, um desejo acalentado desde a infância, ) a transição para a maturidade, para a plena assunção das responsabilidades que advêm da vida conjugal, cujo objetivo é "constituir família". Os sentimentos em relação aos abortamentos são agravados pela pressão do grupo social, em que a maternidade aparece como um valor, como parte da função social da mulher. O percurso pelos serviços de saúde revelou-se tortuoso, uma vez que não há hierarquização ou referência entre os serviços, cabendo às mulheres empreender tentativas individuais para ter acesso aos serviços especializados. Verificou-se que, além das perdas, essas mulheres experienciam um longo e árduo percurso em busca da realização de seu desejo da maternidade - papel socialmente construído e definidor da identidade feminina e que aparece como direito garantido pela Constituição Brasil. Considera-se que compreensão das representações sociais das entrevistadas pode acrescentar conhecimentos aos profissionais da saúde de modo a subsidiar transformações na assistência à saúde dispensada às mulheres em situações semelhantes.

The objective of this study is to describe the socio-demographic characteristics and the reproductive history of women that have had recurring miscarriages and to identify the social implications for these women regarding miscarriages, maternity, health, health care and their opinion of the service, based on their statements. All of the women are enrolled in a well-known women's Sterility Out Patient Center in São Paulo and our study is based on the information contained in the medical histories of these patients. The quantitative analysis of data from 211 medical histories allowed us to create a profile. The data show that 103 (48.8%) are between 30 and 39 years of age, 138 (65.0%) are white or of mixed race, 96 (45.5%) are Catholic, 111 (52.6%) are married or in a stable union, 51 (24.2%) have a primary education or less and 88 (41.7%) sought out the service of their own accord. As for their reproductive history, it is observed that for 166 (78.7%) of the women, their menarche occurred between 10 and 15 years of age, 145 (68.7%) have never given birth and 161 (76.3%) report two or three miscarriages. Anatomical alterations are responsible for 31 (14.7%) of the miscarriage cases and 110 (52.1%) needed no post miscarriage curettage. Of the 52 patients that reported two pregnancies, all resulted in miscarriages. Among those with 3 pregnancies, the majority, 51(63.8%), had three miscarriages and 25 (30.9%) two. Semi-directed interviews carried out with fifteen of these women, undergoing treatment or not at the time, demonstrated that the social implications attributed to miscarriages destroy the dream of being a mother and giving a child to their companion. This is accompanied by frustration, guilt, feelings of emptiness and fear of a new loss. Feelings exacerbated by the poor quality of care received. Maternity is defined by the patients interviewed as complete fulfillment; a desire they have nurtured from infancy. It is seen as the transition to maturity. A time when they will fully assume the responsibilities that result from conjugal life, whose objective is "to have a family." The feelings regarding miscarriages are aggravated by social group pressure where maternity is prized as part of the social function of a woman. The path through the health services is tortuous. Since there is no hierarchy or reference among the services, it is up to the initiative of the women to gain access to specialized services. It has been noted that in addition to their losses, these women experience a long arduous road in an effort to fulfill their desire for maternity - a social role that defines the feminine identity and appears as a right guaranteed by the Brazilian Constitution. It is considered that the understanding of these social implications of the patients interviewed can increase the knowledge for health professionals in a way that would aid in the transformation of health care administered to women in similar situations

The study of short-term curative effect for recurring NPC with the treatment of intracavitary brachytherapy after interventional chemotherapy / 介入放射学杂志

Objective To evaluate the clinical curative effect and methods for recurring NPC with treatment of intracavitary radiotherapy after interventional chemotherapy. Methods 32 cases of recurring NPC were divided into two groups, each of which consisted of 16 cases. Group one was treated with intracavitary chemotherapy plus intracavitary radiotherapy. On the third day after interventional chemotherapy, the first intracavitary radiotherapy was performed (5 Gy) and the second treatment was done next day. Group two was only performed with intracavitary radiotherapy. The dose and interval were the same. The time of re examination was two weeks later. Results In the first group, clinical symptoms were improved, local swelling lymph nodes were shrunk, secretion on the nasopharyngeal surface was hardly left or disappeared. Tumours were shrunk and atrophy. On the intracavitary radiotherapy group, clinical symptoms changed a little, except the secretion on the mass surface was reduced. The white blood counts of the two groups showed no difference and there were no functional changes of liver, kidney and digestive system in the interventional group. Conclusions It is a new and effective therapy to treat recurring NPC with interventional chemotherapy plus intracavitary radiotherapy.