RESUMEN
Armed conflicts create significant risks on almost every section of the society, as new forms of violence arise and the existing ones get exaggerated. In Kashmir, the long-standing conflict has resulted in the number of widows, orphans and enforced disappearance; however, little in-depth attention has been given in the literature on widows to the impact of this conflict. This present study examined the lived experiences of Kashmiri widows who had lost their husbands to the on-going conflict. Using the snowball sampling approach, 12 women were recruited for the face-to-face in-depth interviews. The findings of the study gained an in-depth understanding of the experiences of violence, deprivation, social stigma and psychological trauma, followed by their strategies for coping and struggle for justice. Widows are the worst hit victims of armed conflict and, therefore, inclusive interventions are needed to enhance the status of widows in a long run.
Asunto(s)
Viudez , Humanos , Femenino , Violencia/psicología , Investigación Cualitativa , Adaptación Psicológica , Conflictos ArmadosRESUMEN
The transport and deposition of atmospheric pollutants in the Himalayas have a adverse impact on the climate, cryosphere, ecosystem, and monsoon patterns. Unfortunately, there is a insufficiency of data on trace element concentrations and behaviors in the high-altitude Himalayan region, leading to limited research in this area. This study presents a comprehensive and detailed comprehension of trace element deposition, its spatial distribution, seasonal variations, and anthropogenic signals in the high-altitude Kashmir region of the Western Himalayas. Our investigation involved the analysis of 10 trace elements (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, Cd, and Pb) in glacier ice, snow pits, surface snow, and rainwater collected at various sites including Kolahoi, Thajwas, Pahalgam (Greater Himalayan ranges), and Kongdori and Shopian (Pir Panjal Ranges) during 2021. The study reveals distinct ranges of concentrations for the trace elements at different sampling sites. Our analysis of trace element concentration depth profiles in snow pits reveals seasonal fluctuations during the deposition year. The highest concentrations were found in the autumn (below 20 cm) and summer (top layer), compared to the winter concentration (10-20 cm). The high enrichment factors (EFs) suggest the severity of human-induced trace metal deposition in the western Himalayan region, relative to surrounding regions. Surprisingly, the concentrations and EFs of trace elements showed seasonal contradictions, with lower concentration values and higher EFs during the non-monsoon season and vice versa. A source apportionment analysis using the positive matrix factorization (PMF) technique identified five sources of trace element deposition in the region, including crustal sources (32.33%), coal combustion (15.62%), biomass burning (17.63%), traffic emission (18.8%), and industrial sources (15.6%). Additionally, the study incorporated backward trajectories coupled with δ18O using the NOAA HYSPLIT model to estimate moisture sources in the region, which suggests atmospheric pollutants predominately deposited from the large-scale atmospheric circulation from westerlies (75%) during non-monsoon season. These findings underscore the urgent need for enhanced monitoring and research efforts in the future.
Asunto(s)
Contaminantes Atmosféricos , Monitoreo del Ambiente , Estaciones del Año , Oligoelementos , Oligoelementos/análisis , Contaminantes Atmosféricos/análisis , Nieve/química , India , Humanos , HimalayasRESUMEN
BACKGROUND: Pancreaticoduodenectomy (PD) is the standard procedure for resecting tumors arising from the periampullary area and the pancreatic head. Nevertheless this procedure is inherently difficult and associated with high morbidity and mortality. Besides, the technique applied for exposing the portal and superior mesenteric veins is time-consuming, difficult and associated with the risk of major venous injury. Recently we have introduced a modified approach for making this part of the procedure quick, safe and bloodless, which constitutes the subject of this study. METHODS: Patients who underwent pylorus preserving pancreaticoduodenectomy (PPPD) either by superior approach technique (group 1) or by classical Whipple's technique (group 2) were retrospectively identified. Age-sex composition, body mass index (BMI), total operative time, operative blood loss, intraoperative blood transfusion requirement, morbidity, mortality and length of hospital stay were compared between the two groups. RESULTS: Between January 1997 and December 2011, 72 patients underwent PPPD by the superior approach technique (group 1) and 38 underwent PPPD by the classical Whipple's technique (group 2) at our institution. Statistically significant differences were observed in operative time (208.1+/-46.3 minutes in group 1 vs 322.0+/-33.8 minutes in group 2), operative blood loss (601.0+/-250.3 mL in group 1 vs 1371.5+/-471.8 mL in group 2), and intraoperative blood transfusion requirement [10 (13.9%) patients in group 1 and 24 (63.2%) in group 2]. Among 18 (16.4%) obese patients, significant differences in operative time, operative blood loss and intraoperative blood transfusion requirement were observed between groups 1 and 2. There was no significant inter-group difference in complication rate among obese patients, but comparing obese patients with normal weight patients revealed higher rates of complications like pancreatic fistula (27.8% vs 6.5%), delayed gastric emptying (16.7% vs 5.4%), and infective complications like wound infection and intra abdominal collection (44.4% vs 5.4%). CONCLUSIONS: On the basis of analytical data, we conclude that the superior approach technique is effective for PD compared with the classical Whipple's technique. It allows fast, safe and virtually bloodless dissection for exposure of the superior mesenteric and portal veins during early steps of PD. PD is normally a difficult and tedious procedure carrying a remote risk of major venous injury leading to substantial blood loss.
Asunto(s)
Neoplasias Pancreáticas/cirugía , Pancreaticoduodenectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica/prevención & control , Transfusión Sanguínea , Índice de Masa Corporal , Distribución de Chi-Cuadrado , Femenino , Humanos , Tiempo de Internación , Masculino , Venas Mesentéricas/cirugía , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/diagnóstico , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/patología , Pancreaticoduodenectomía/efectos adversos , Pancreaticoduodenectomía/mortalidad , Vena Porta/cirugía , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
Jammu & Kashmir and Ladakh are two union territories (UT's) famous for their beauty and cool climate. Both the UT's are familiar with their horticulture production at the national and international level. Jammu & Kashmir offers enough scope for cultivation of all types of horticulture crops covering various sub-tropical fruits like mango, guava, citrus, litchi, temperate fruits like apple, pear, peach, plum, apricot, almonds, cherry, and apricot. Horticulture has emerged as a fast-growing sector in Jammu & Kashmir and to some extent in Ladakh, offers a wide range of opportunities to farmers for crop diversification. Horticulture has proved its credibility in improving income through increased productivity, creating employment, and strengthening exports. Jammu & Kashmir comprises 20 districts and Ladakh two districts, and both having comparative advantages in some specific types of fruit cultivation due to variations in soil fertility, soil matter, topography, and variable to harsh weather. In this survey, we analyze the district wise contribution and improvement of horticulture production of fresh fruits and an increase in their growing area. The survey-based on secondary data sources collected from the Directorate of Horticulture of Jammu & Kashmir and Ladakh. The data is analytical and empirical, directly contributing to the horticulture production of India. The area and production of apple are maximum in district Baramulla, a temperate region of J&K. While, maximum area as well as the production of apricot is in district Leh, a high altitude and cold arid region of Ladakh.
RESUMEN
Metastatic breast carcinoma is rarely seen in clinical practice. It has been reported that lymphoma-leukemia, melanoma and sarcomas can metastasize to the breast. Bilateral metastases to the breast are rare and commonly have been seen to originate from ovarian carcinoma. Adenocarcinoma of rectum metastasizing to breast is an extremely rare clinico-pathological situation. We report a 28-year-old female who presented with bilateral breast metastasis 9 months after abdomino-perineal resection and total meso-rectal excision for a locally advanced mucinous adenocarcinoma of the rectum. A few case reports of a mucinous adenocarcinoma of rectum presenting with bilateral breast metastasis have been seen in the world literature and we hereby report this case who till now is the youngest patient reported.
Asunto(s)
Adenocarcinoma Mucinoso/secundario , Neoplasias de la Mama/secundario , Neoplasias del Recto/patología , Adulto , Femenino , HumanosRESUMEN
AIM: To study the clinicopathologic characteristics of chordomas from a single institution. MATERIAL AND METHODS: This study is a retrospective analysis of 18 cases of chordomas diagnosed over a period of 5-years at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, from 2006 to 2010. RESULTS: The overall mean age of the patients was 46.72 years. Males outnumbered females. Sacrum was the commonest site involved. Histopathologically, the majority of cases were conventional chordoma with four cases of chondroid variety. There was a single case of dedifferentiated chordoma that presented with bone metastasis. Most patients did well after surgery and radiotherapy. One patient had a local recurrence and one patient with dedifferentiated variant died on follow-up. CONCLUSION: Though locally aggressive, chordomas are effectively treated with resection and postoperative radiotherapy.