Dirty Research Articles

Redo surgery in Hirschsprung's disease for postoperative distension and constipation

To summarize the reason and treatment of redo surgery in Hirschsprung disease for postoperative distension and constipation. From January to December 2014, 35 patients with constipation and distention after pull-through done elsewhere were referred to our institution. The reasons procedures and outcomes of redo surgery were a retrospectively analyzed. The indication of reoperation in 21 cases was pathological problems, including residual aganglionosis, retained transition zone bowel, and in 13 cases was anatomical problems, including retained dilated segment, obstructive Soave cuff. One case had both pathological and anatomical problems. Among them, 5 cases belonged to total colonic aganglionosis. All the cases received conservative treatment for about 6 months before reoperation. Five cases had enterostomy before redo pull through surgery. Thirty cases underwent Soave surgery with or without laparoscopy or laparotomy. Twenty-six cases underwent transabdominal Soave surgery, 3 cases transanal Soave surgery, 1 case transanal Soave surgery with laparoscopy. Other surgery included Ikeda surgery, excision of diaphragm or scar, and anoplasty. Postoperative complications were found in 3 patients. One had rectovesical fistula and was cured after operation. Two cases had anastomotic leakage and then underwent diverting ileostomy. Thirty-three cases had a mean follow-up of 59 months. During the follow-up, 32 cases had no distension and constipation. Two cases presented occasional dirty pants, 2 cases frequent soiling, 1 case daily soiling. Reasons of distension and constipation in Hirschsprung's disease after surgery are pathological and anatomical problems. Operation procedure is chosen based on reasons. Transabdominal Soave surgery is safe and effective.

Classification of eggs in hatchery for production broiler

This work aimed to analyze the eggshell characteristics from 14 cores production of fertile eggs. They were monitored for three months totaling 478,680 eggs that arrived at the hatchery, through a classification known as Egg Quality Assessment. The eggs were classified as dirty, face, thin skin and crooked. To grade eggs a table was used with a lamp which allowed a better view of them. After the classified eggs that had defects were discarded. After the evaluations, we determined that most centers have not reached the ideal indices, established by the company. However, eggs classified in receipt of hatchery clenched a higher percentage compared to dirty, crooked and deformed.

Applications of CFD Techniques in the Design of Fabric Filters

Analyzing the gas flow inside a bag filter experimentally is a difficult challenge to overcome, since the complexity of the highly three-dimensional flow hinders any form of directly measuring the flow. In recent years, the increasing availability of computational resources together with the increasing accuracy of numerical methods built up techniques that describe the flow of fluids in industrial equipments through mathematical modelling and numerical simulations. Among these techniques, Computational Fluid Dynamics (CFD) is noteworthy regarding the design of new equipment, since it uses experimental data in their simulations. In this work, the CFD techniques are applied to investigate the best position for feeding the dirty gas in a filter bag, in order to support the search for a more efficient and durable equipment design. To evaluate the filter bag performance, two different inlet positions were simulated. The first, called “conventional”, with gas jet reaching the bags in the centre and the second with concentric triple feed (called “triple”), in which the same gas flow rate is fed by in three regions roughly in the top, center, and bottom of the filter medium. The aim was to determine which design has improved uniformity of mass flow distribution between the bags and lower the equipment pressure drop, in order to increase the filter lifetime. For this purpose, it was used the isothermal and incompressible single phase flow model with turbulence being treated by realizable k-e model. It was concluded that the “triple” showed a better gas distribution to be filtered among the bags system, thus representing a more advantageous layout option when compared to “conventional”.

Role of bowel management program in pediatric patients with fecal incontinence

To investigate a new bowel management program for children patients with fecal incontinence. Clinical data of 19 children with fecal incontinence undergoing bowel management program in our center between January 2012 and January 2013 were retrospectively analyzed. The main outcome measure was clinical efficacy of this program. Fifteen out of 19 cases were genuine fecal incontinence and required continuous treatment by enema. The other 4 cases were false fecal incontinence. After treatment with this program, stool dirty and constipation were improved in genuine incontinence. Two cases of false continence could control defecation independently by oral administration of antispasmodic drug. Two cases of false continence were cured and did not need medical interference. Bowel management program is an effective treatment for pediatric patients with fecal incontinence. The key of success is maintenance of perianal hygiene for 24 hours by continual adjustment of the elements and volumes of enemas.

Human Related Indifference as a Working Horse Welfare Indicator

In line with the international research tendencies, this work assessed different aspects of the welfare of working horses. The aim was to identify whether the human-related indifference is correlated with indicators of poor welfare and to discuss the possible causes of this behavioural response. Several animal-based welfare indicators were recorded in 117 working horses; data were completed by a questionnaire answered by the horse owners. The most frequent welfare problems observed were the absence of the company of other horses (88%), improper shoeing (86.3%), watering less than three times per day (83.8%), too long/too short hooves (74.4%) and housing in dirty barns (assessed by the body soiling of the horses, 64.1%). The history of at least one episode of colic in the past year was quite high (32.5%) and only 10.3% of the horses had access to daily free exercise. The most frequent behavioural response displayed was the indifference towards the observer. The strongest correlation coefficients were found between indifference and the absence of free exercise, barn dirtiness, lesions at the lip corners, harness contact points and at the hip points and also with the presence of swollen tendons/joints. In conclusion, the correlation with physical problems and poor management practices makes unlikely that the human related indifference observed in the assessed working horses reflects neutral or positive welfare such as a relaxed state or feeling of safety. Instead, it rather implies the compromised fitness of the animals or even features of learned helplessness.

The Best Proposal of Treponema Pallidum Detection for Blood Services

Objective To explore the optimal scheme of treponema pallidum (TP) detection in blood services,to reduce the TP infection caused by blood transfusion.Methods From January 2012 to December 2013,a total of 50 000 blood donors in Dongying Central Blood Station were included in this study.Two kinds of TP-enzyme-linked immunosorbent assay (ELISA) kit from different manufacturers and toluidine red unheated serum test (TRUST) kit were used to detect these donors'TP,respectively.The donors whose TP-ELISA detection results were negative,but TRUST detection results were positive,were required to be retested TP by twice ELISA test and once TRUST test,3 months after blood donation.Blood samples were confirmed as serology positive by twice ELISA detection positive or both ELISA and TRUST detection positive.In the period 2011 to 2013,the donors who donated blood more than three times,and were eliminated because of TP positive,were followed-up investigation at least 3 months.These donors were investigated whether to participate in blood donation after dirty sex.Results In 50 000 blood donors,a total of 171 cases were TP positive,including 163 cases of TP-ELISA positive,167 cases of TRUST positive,and 159 cases were both positive.In TP positive results,8 cases were negative of TP-ELISA test results,but positive of TRUST test results,accounting for 4.6％ (8/171).4 cases were TRUST negative,but TP-ELISA positive,accounting for 2.3％ (4/171).There was statistical difference in TP detection results between TP-ELISA and TRUST test (x2=134.42,P＜0.05).Only 2 cases were both TP-ELISA and TRUST positive in 8 donors who were TRUST positive.The difference of serology results was statistically significant between initial inspection and re-inspection (x2 =5.25,P＜0.05).In the follow-up of 11 cases of blood donors,five cases admitted they had unclean sexual history before the blood donation,accounting for 45.5％ (5/11).Conclusions The best scheme of TP detection should be once TP-ELISA detection and once TP nonspecific antibody detection.Twice TP-ELISA detection is questionable in most blood stations (blood center) currently.Fixed blood donors who were TP serological positive after blood donation should be tracked. Key words: Blood services; Treponema pallidum screening; Proposal

Spectrum similarities-based analysis of spatial difference of snow cover for multi-scale satellite data-a case study of MODIS and HJ-1B data

Vegetation and bare soil were collected in the areas of Miyaluo district in northwest of Sichuan province, the Qilian Mountains in Qinghai province and northern areas of Xinjiang during the years of 2007 and 2013. Then these data were converted to spectral reflectance by applying sensor response function of MODIS and HJ-1B respectively within the range of visible light, near-infrared and shortwave infrared. Comprehensive analysis was made on spectral characteristics and reflectivity similarities and differences of different sensors between old and new snowmelt, under the condition of different snow depth and different snow cover. The conclusions can be drawn That is, there exists high consistency of spectral response between new snow and dirty snow for each sensor in the visible wavelength range, also it is true for bare soil and low vegetation. However, low consistency happens to other types of snow; especially snowmelt and frozen snow. The range of NDSI is relatively stable under the condition of different snow depth for full snow cover and the trend of NDSI shows great consistency for different sensors; NDSI threshold method for monitoring snow by using MODIS and HJ-1B data showed very obvious difference in spatial scales, which is a reasonable explanation of the existence of mixed pixels.

Against the ＂Uprush of Modern Progress＂: Exploring the Dilemma and Dynamics of Modernity in George Orwell’s ＂Burmese Days＂

Published in 1934, George Orwell's first novel ”Burmese Days” was the result of his five years in Burma doing ”the dirty work of empire” and oiling the ”actual machinery of despotism” (Wigan Pier 147). This article considers the specific relationship in the novel between anti-imperialist politics and what it means to be modern in the early part of the twentieth century. How, for example, does modernity as a structure of feeling about breaking away from the past and tradition play out within the framework of a political dispensation of the imperial coupled with colonial governmentality? And what particular conception of culture and humanity might such a modernity be premised on? In ”Burmese Days”, I argue that Orwell expresses the dilemma and dynamics of modernity through his use of a self-conscious narrative voice, and the story of his main character Flory, specifically the latter's failure as a colonial, masculine subject. Orwell attempts to propose an alternative to the hegemonic version of European modernity that is based on the presence of an Other and the equation between colonialism and modernization. He explores a humanism written on and expressed through the body as part of the struggle with prejudice and bias that underlies Flory's yearning for an alternative modernity. Such an alternative proves unsustainable however and the result is cynicism, despair, and irony. Despite this, the textual search for another modernity remains ultimately of critical epistemological interest for its disclosure of the contested and far from monolithic nature of European modernity.

The Impact of Health Service of the Community Hospital Located in Thailand’s Border: migrant from Burma, LAOS, and Cambodia

The denial of difficult, dangerous and dirty work done by the Thai People has been the major cause of migrant substitution in Thailand which triggered the urgent need for proper health care. This study was aim to explain the burden and impact of providing health service to the trans-national migrant in community hospital at border area of Laos, Burma and Cambodia. Therefore survey research and data collecting was used through quantitative and qualitative methods. Results : Khemarat and Klong Yai hospital: the financial burden was high however Mae Sai hospital has strong income with less expenditure. The impact of three hospitals was 1) the only way of solving the financial burden is by using the hospital’s money. 2) No data system about trans-nation’s migrant health services has been applied so far by any hospitals here in Thailand 3) Man power of hospital is depended on the Thai people which doesn’t include the migrant which is approximately 50% 4) The language and the cultural had generated several obstacles to health service 5) Problem of prevention and control of Communicable disease such as Malaria, Dengue Hemorrhagic fever, Tuberculosis, and Elephantiasis, 6) No Referral system between Thailand and neighboring countries. Recommendations : it should be setting the strategy of AEC’s health system at nearby country, concern with the trans-national migrants, and develop the data system of health service of trans-national migrant.

Dirty Consciences and Runaway Selves:

Dirty Consciences and Runaway Selves:

Toilet is not a dirty word: close to meeting the MDGs for sanitation?

Improving access to water and sanitation facilities has been a priority on the international development agenda. Halving the number of those who do not have access to sanitation facilities is an MDG target. This study assessed the toilet conditions in an urban slum in Ghana. Many felt that the sanitary conditions were deplorable; they were unsatisfied with having to walk over half a kilometre before using a toilet. Government efforts to improve hygiene and address sanitation problems need to take into account financial, religious, and other factors that promote the supply and maintenance of appropriate toilet facilities and services in urban communities. Toilettes n'est pas un mot tabou : à deux doigts d'atteindre les OMD en matière d'assainissement ? L'amélioration de l'accès à l'eau et aux installations sanitaires a été une priorité de l'ordre du jour international en matière de développement. La réduction de moitié du nombre de personnes qui n'ont pas accès à des installations d'assainissement est un OMD. Cette étude a évalué les conditions sur le plan des toilettes dans un bidonville urbain du Ghana. De nombreuses personnes estimaient que les conditions d'assainissement y étaient déplorables; elles n'étaient pas satisfaites de devoir parcourir plus d'un demi-kilomètre pour pouvoir utiliser des toilettes. Les efforts fournis par les pouvoirs publics pour améliorer l'hygiène et résoudre les problèmes d'assainissement doivent tenir compte des facteurs financiers, religieux et autres qui favorisent la fourniture et l'entretien d'installations et de services de toilettes dans les communautés urbaines. Excusado no es una mala palabra: ¿se está próximo a cumplir con los odm en el área de saneamiento? La ampliación del acceso al agua potable y al saneamiento ha sido una prioridad del desarrollo internacional. Una de las metas de los odm es reducir a la mitad el número de personas que actualmente carecen de acceso al saneamiento. El presente artículo valora las condiciones en que se encuentran los excusados en un barrio pobre de Ghana. Muchos de quienes residen allí consideran que las condiciones de saneamiento son deplorables, manifestando su desacuerdo con tener que caminar más de medio kilómetro para hacer uso del excusado. Los esfuerzos realizados por el gobierno para mejorar la higiene y enfrentar los problemas de saneamiento, deberán tomar en cuenta tanto los factores financieros como los religiosos u otros que promuevan la oferta y el mantenimiento de excusados, así como la posibilidad de otros servicios de saneamiento en las comunidades urbanas. Banheiro não é uma palavrão: estamos prestes a cumprir os ODMs para saneamento? Melhorar o acesso a redes de abastecimento de água e saneamento tem sido uma prioridade na agenda de desenvolvimento internacional. Reduzir pela metade o número de pessoas que não têm acesso a redes de saneamento faz parte dos Objetivos de Desenvolvimento do Milênio (ODMs). Este estudo avaliou as condições de banheiros em uma favela na zona urbana de Gana. Muitos sentiam que as condições de saneamento eram deploráveis e estavam insatisfeitos em ter de caminhar mais de meio quilômetro para usar um banheiro. Esforços do governo para melhorar a higiene e abordar os problemas de saneamento precisam levar em conta fatores financeiros, religiosos, além de outros, que promovam o fornecimento e manutenção de instalações de banheiros e serviços adequados nas comunidades urbanas.

Dirty Larry and the pure youth

Dirty Larry and the pure youth

Incidence and risk factors of surgical site infection in a tertiary health institution in Kano, Northwestern Nigeria

Surgical site infection (SSI) is the most common complication following surgical procedures. The aim of this study was to determine the incidence and associated risk factors of surgical site infection in a tertiary health institution in Kano, Nigeria. The study was carried out between January 2008 and December 2010 at Aminu Kano Teaching Hospital, Kano. Data was collected in a predesigned questionnaire forms which focused on demographic details, socioeconomic background and lifestyle while the diagnosis, surgical procedure, duration of surgery, prophylactic antibiotics, postoperative antibiotics and co-morbidity were obtained from the patients hospital records. All the patients who underwent surgery in the male and female surgical wards, gyneacology and maternity wards including paediatric wards were enrolled in the study after informed consent or parents in the case of children. All patients were followed up for 30days for development of surgical site infection. Infected cases were identified using CDC, USA definition for surgical site infections. Out of 2880 patients, 585 (20.3%) were confirmed to be clinically infected. There were 1,016 (35.3%) males mean age 38.3±16.3 and 1864 females (64.9%) mean age 30.6 ± 12.3yrs. There were 65% Superficial Incisional SSI, 30% deep Incisional SSI and 5% Organ Space SSI. Incidence related to clean, clean contaminated, contaminated and dirty were 5.8%, 30.5%, 40.6%, and 64.8% wounds respectively. Age, anaemia, obesity, number in operating room and duration of surgery were all significantly associated with surgical site infection. Effective infection control measures and good regular surveillance will improve the SSI rate to an acceptable level.

Dermatofibrosarcoma: a case report

A 37-year-old female was admitted to the hospital for an itching and painful subcutaneous nodule with ulceration on the extensor aspect of her left forearm for more than 6 months.The pain was severe,continuous and localized.Systemic and local treatment with antibiotics resulted in no obvious improvement.The lesion had gradually increased in size over the past 6 months and the ulcer had enlarged for 1 month.On examination,a hard infiltrative plaque measuring about 5.5 cm × 4.0 cm with a well-defined margin was seen on the extensor aspect of her left forearm,along with ulceration and some dirty discharge on the surface.The diagnosis of fibrosarcoma,grade Ⅱ was eventually made by a biopsy of the lesion,which revealed increased pigmentation in the basal layer,and tumor tissue was tightly adherent to the epidermis.Dermis and subcutaneous fat layer were infiltrated with various sizes of spindle cells with fine collagen fiber bundles between the cells.Obvious atypia and mitotic figures were easily observed in some of the cells.Immunohistochemical analysis showed moderately positive staining for fibronectin,but negative staining for human melanoma black-45 (HMB45),S100,smooth muscle actin (SMA),Melan-a,high molecular weight cytokeratin (HCK),CD34,CD68 or cytokeratin.Some diseases should be differentiated from this case,including dermatofibrosarcoma protuberans,cutaneous spindle cell squamous carcinoma,atypical fibroxanthoma,malignant fibrous histiocytoma,and so on.

A case-control study on risk factors that associated with severe hand-foot-mouth disease in Shanghai

To explore the factors associated with severe hand-food-mouth disease (HFMD) case in Shanghai. A total of 105 severe HFMD cases diagnosed from May to July, 2011 in Shanghai were enrolled as case group while another 210 mild HFMD cases were randomly selected as control group in the same period. All subject's parents or babysitters were asked to fill in the questionnaire in which including demography, ways of babysitting, behavior and the like. All HFMD cases were diagnosed by both clinical symptom and nuclear acid testing. Data was processed by EpiData (V3.0) and analyzed by SPSS (V17.0). Factors as age, gender, Diaspora pattern, migrant, size of house, numbers of family member, numbers of children, frequency of seeing doctor, dishware that sharing with babysitter, food chewed by babysitter, dirty hand, EV71 virus type and diagnosis on HFMD in the fist visit to hospital were found associated with severe HFMD by univariate analysis. through multivariate logistic regression showed that factors including: being the only male kid, more than 3 children in the family, dirty hands, unable to be diagnosed as HFMD in the first visit to the hospital, visiting doctor during the past 6 months for 2 and 3 times etc. could be kept in the model with statistical threshold of 0.05. Adjusted ORs and confidence intervals of them were 2.431 (1.317 - 4.487), 2.661 (1.332 - 5.315), 3.403 (1.871 - 6.191), 6.607 (3.011 - 14.500), 2.431 (1.111 - 5.321), 2.628 (1.137 - 6.071) respectively. Being Infected by EV71 was also found a very important risk factor compared with CoxA16 or other enteroviruses, and its adjusted OR was 5.614 (2.409 - 13.082). It was necessary to implement molecular diagnosis for identifying the virus type of HFMD, together with improvement on the capacity of clinical diagnosis in order to diagnose the HFMD cases earlier. More attention should be paid to these HFMD cases with EV71 infection as well as prompting frequent visits to hospitals on those families with more children.

Shared fate and social comparison in the context of a stigmatized occupation

People working in mines face the challenge to construct a positive self-image as society views their occupation as dirty and dangerous. The question was how these dirty workers used different normalizing strategies when specific contexts made a range of categories salient. We used data from 32 semi-structured interviews with employees of South African gold mines, in which the participants told about the ways they dealt with taint. We found out that miners were aware of stigmas. On the one hand, there was an awareness of the group’s shared fate, in line with normalizing strategies found in other stigmatized occupations. On the other hand, we found several examples of social comparison within the group that challenged the expected strong group culture, i.e. supervisors distancing themselves from subordinates and men disparaging female miners. In contrast to previous research, the miners did not only stress the group as a unity. It seems that the opposite processes of shared fate and downward comparison can emerge both, depending on self-categorization dynamics. The nuances in these findings show the complexities of the ways people who experience work stigma deal with the taint.

Politique étrangère et guerre mondiale contre le terrorisme dans la reproduction du pouvoir algérien

Cet article revele comment l’Algerie a gere sa politique etrangere depuis la « sale guerre » desannees 1990, grâce notamment a son alliance avec les Etats-Unis de l’apres 11 septembre, pour retrouver une place dans la communaute internationale et reequiper son armee en materiel moderne. Il met en evidence les contradictions inherentes a ses relations avec les Etats-Unis, fondees sur la collusion des deux Etats dans l’invention du terrorisme et la poursuite de la guerre mondiale contre le terrorisme ou GWOT (Global War On Terror). En renforcant le systeme securitaire algerien (l’Etat securitaire) et en lui donnant la possibilite de devenir encore plus repressif, cette politique a exacerbe les problemes qui pourraient conduire a un « printemps arabe » algerien.

Fare per osservare

A reflection about the risks and the challenges that involve the aesthetics as discipline. A discipline that has a history, a specific object and that shares with philosophy the prerogative of its uselessness. A discipline that needs a new formulation (not a new foundation): a discipline that “gets his hands dirty”, that tackles the world, the perception, the emotions and the most controversial aesthetic categories.

So, What's a Dirty Colon?

A previous survey of Israeli gastroenterologists' recommendations for follow-up colonoscopy intervals based on photographs of various quality bowel preparations yielded wide-ranging responses. Now, in a similar study, 239 gastroenterologists (85% living in the U.S.) chose from a list of suggested follow-up colonoscopy intervals by assessing four photographs each of four different bowel preparations in a hypothetical average-risk, 55-year-old male undergoing screening. Photographs showed essentially no stool for the best preparation and sequentially more stool for the others. Results were as follows:

Compliance of the patients and related influential factors on the topical antifungal treatment of onychomycosis

To explore the compliance rate of patients and its influential factors on topical antifungal treatment of onychomycosis. Dermatology life quality index (DLQI) and self-administered questionnaires were employed in this study. The overall compliance rate of the topical antifungal treatment was 23.9% (92/385). The cure rates on onychomycosis in patients with good compliance was 63.04% (58/92), but only 2.05% (6/293) in those noncompliant patients, respectively. Regarding the influencing factors as age, sex, level of awareness, occupation, course of disease, personal income, inconvenience in access to the treatment, keep forgetting in taking the medicine, being impatient, lack of confidence, misunderstanding on topical as 'dirty' and the process of drug taking was troublesome, together with the quality of life were identified. There were significant differences between those compliant or noncompliant patients. For some factors as adverse effects of drug, number of affected nails, site of the disease, too busy in daily life, lack of related knowledge etc., no significant differences were found between the compliant or noncompliant patients. Our results showed that onychomycosis patients had poor compliance in topical antifungal treatment which significantly influencing the therapeutic effects. Age, sex, level of awareness on the disease, occupation, course of disease, personal income, inconvenience in receiving the treatment, forgetting to take the medicine, lack of patience, lack of confidence, different kinds of misunderstanding about the disease and quality of life etc. might affect the compliance rate of the disease.