January 2021

The concept of inclusion has emerged from the ideas of providing equal opportunities to ‘all’ children. Providing equal opportunities does not mean providing ‘similar’ things to all children. It means providing equal opportunities keeping in mind the diverse nature of their individual needs. A teacher in the classroom needs to be responsive to diverse needs of ‘all’ children. But socially and academically meaningful inclusion of children with disabilities and special needs is a challenge before our teachers in particular and govt. in general. There has been a wide spread belief that the children with disabilities and special needs can be trained and educated properly in special schools and by special educators only. But slowly and gradually, this notion changed as it has been realized that segregated education cannot develop personality of such children in a wholesome way.. Meaningful inclusion of such children in regular schools therefore depends to a large extent upon the attitude of general education teachers. But researches have shown that teachers have negative attitude towards inclusion of children with disabilities into regular classroom which can be attributed to their lack of requite skills, training and professional preparedness. The Director General of UNESCO, Matsuurra (2008)), has articulated his vision of Inclusive education in the following words: “Inclusive education is an approach that looks into how to transform educational systems and enhance educational quality at all levels and in all settings in order to respond to the diversity of learners and promote successful learning” (UNESCO, 2008). It completely dispels the commonly held notion that inclusive education concerns itself exclusively with the inclusion of children with disabilities into the general education system. In fact, it involves a process of reform and restructuring of the school as a whole in terms of curriculum, assessment, pedagogy and grouping of pupils. Although there is widespread support for inclusion at a philosophical level, there are some concerns and barriers that are not supporting the policy of full inclusion and these are - professional preparedness, attitude of general education teachers and ineffective instructional strategies. Inclusion requires teachers to accept the responsibility for creating schools in which all children can learn irrespective of any differences in their abilities. In this task, teachers are crucial because of the central role they play in promoting participation and reducing underachievement particularly among children who might be perceived as having difficulties in learning. Meaningful inclusion of such children in regular schools therefore depends to a large extent upon the professional preparedness, effective teaching strategies and supportive attitude of general education teachers. But researches have shown that teachers have negative attitude towards inclusion of children with disabilities into regular classroom which can be attributed to their lack of requite skills, training and professional preparedness. Teachers overwhelmingly believed that inclusive education is impossible unless their needs for specialist resources are addressed. The present paper reviews some of the barriers to successful inclusion and suggests the ways of overcoming them by reconsidering the roles & responsibilities of teachers. It also provides some suggestions regarding effective instructional strategies for teachers to manage inclusive classrooms effectively including requisite skills, knowledge, attitudes and beliefs so that they can support and manage the inclusive classrooms effectively.

Background: Root canal treatment is a procedure that allows to preserve the dental organs, even when they have presented infectious processes due to the direct or indirect presence of microorganisms in the oral environment. For this reason, multiple technologies have been developed that allow endodontists to establish diagnoses and develop treatments with better results. Foramen locators are equipment that allows the identification of the location of the file introduced to the root canal, in relation to the anatomical structures of the apex such as: the constriction and the apical foramen (the apical constriction corresponds to the place where it must be instrumented for shaping the apical stop). Multiple studies have been carried out to identify the effectiveness of these devices, with a predominance in “ex vivo” studies, which leads to the question: What is the effectiveness of the iPex II NSK® foramen locator in patients who attend the endodontic consultation of the CEMENAV in the period: July - December 2019 with diagnoses of symptomatic irreversible pulpitis and asymptomatic apical periodontitis in the distal root of the lower first molar? Objective: To determine the effectiveness of the iPex II NSK® foramen locator in patients with diagnoses of symptomatic irreversible pulpitis and asymptomatic apical periodontitis in the distal root of the lower first molar. Material and methods: Measurements of the distal root of the first lower molars of patients who came with a diagnosis of symptomatic irreversible pulpitis and acute apical periodontitis were performed. Subsequently, radiographic taking was carried out with the Morita® Root ZX II foramen locator (gold standard) and subsequently the measurement with the iPex II NSK® foramen locator. Results: After six months of measurements (68 cases), it was possible to identify an effectiveness of 85.29% in the measurements, due to obtaining 58 coincidences and 10 discrepancies that correspond to: 34 measurements with 100% effectiveness in the cases with a diagnosis of Symptomatic irreversible pulpitis and 34 measurements with 70.58% effectiveness (only 24 coincidences), in cases with asymptomatic apical periodontitis. Conclusions: Due to the results obtained and the methodological sequencing used, it is possible to identify the effectiveness of the iPex II NSK® foramen locator in patients with diagnoses of symptomatic irreversible pulpitis and not in patients with asymptomatic apical periodontitis in the measurements made in the distal root of the former. lower molars that were part of the study.

We report a case of peripheral facial nerve palsy with uncontrolled hypertension. There are few case reports in literature which shows association between facial nerve palsy and malignant hypertension especially in adults.

Background: The safety of surgery is a widely recognized problem throughout the world. Comprehensive patient safety in the surgical area is a key component of the quality of nursing care. The development of information tools such as the WHO Surgical Safety Checklist can promote the early identification of the most frequent problems in nursing care. Nevertheless, previous studies indicate that, despite the many benefits of the systematic implementation and use of checklists in operating rooms, achieving full adherence to it by the medical and nursing professionals is not an easy task, as their performance is not usually as constant or consistent as it should be. Objective: To determine the level of application of preventive measures for the safety of the surgical patient in the Navy Medical Center in the period between August and December 2019. Methods: An observational, exploratory and retrospective study was carried out using a sample of 307 cases obtained based on a selective-intentional, non-probabilistic, incidental sampling by consecutive cases and by quotas. The data collection instrument consisted of a checklist that grouped for each clinical record the evaluable data on the parameters established in the clinical practice guide Preventive interventions for safety in surgical patients, as well as the corresponding to the WHO Surgical Safety Checklist, the nursing sheet, the anesthesia sheet, informed consent for surgery, and pre-anesthetic assessment. The working hypothesis was that the level of application of preventive interventions for the safety of the surgical patient would be less than 80%.Descriptive statistical analysis was performed using SPSS v.20.0 software. Results: The percentage of fulfillment of certain preventive security measures was very variable. The data obtained reveals that there is still a long way to go in order to achieve 100% compliance with the safety measures in surgery. Only in the cases of taking informed consent and confirming the risk of bleeding, full compliance was observed. Meanwhile, in the rest of the measures contained in the safety checklist, percentage of non-compliance ranges between 3% and 8%. Conclusions: Compliance with most of the preventive interventions for the safety of the surgical patient occurred in more than 80% of the cases. Only presurgical soap bath obtained less than 80% of the compliance frequency, which may be due to a bias in the records.

Introduction: Intussusception is not commonly seen in adults. There are various causes of Intussusception in adults. Commonly these are due to malignant tumours. Some benign tumours are also encountered. Aim of the study: To study the cause of intestinal obstruction in this case. Materials and Methods: This study was conducted in a tertiary care hospital in Kolkata.Result: This is a case study of an elderly man with intestinal obstruction who was admitted to the hospital with pain abdomen and mass in the abdomen. USG revealed a mass containing fat. Postoperative histopathological examination confirmed submucosal lipoma. Conclusion: Lipoma is one of the causes of Intestinal obstruction. It can be confirmed by histopathological examination after surgery.

Introduction: Temperature regulation is vital for the survival and stability of the newborn (RN), its care and control by the nursing staff allows control of the environment, transfer and nursing interventions, therefore, the Romeo-November code has been created in the Mexican Navy. General objective: Identify nursing interventions in the Healthy RN during the Romeo - November code, in maintaining thermoregulation and identifying risk factors that favor the appearance of complications. Methodology: Quantitative, descriptive, applied study that focuses on identifying nursing interventions in the Healthy RN during the Romeo - November code at the Naval Medical Center during the months of October and November 2020, nursing staff who are in the joint accommodation and toco-surgery service were selected, the sampling was non-probabilistic, for convenience. Results: 47 RN were analyzed by the nursing staff for maintenance of thermoregulation, 55.3% were male, 44.7% female, 23.4% were born by delivery, 76.6% by cesarean section, by Capurro they had 38 + 2 weeks of gestation, the environmental temperature in the toco-surgery reception was 20 + 1.8ºC, in joint rooming 23 + 2.1ºC, in the toco-surgery reception the RN had 37 + 0.2ºC, during the transfer 36 + 0.7ºC and in joint rooming 36.9 + 0.2ºC. The nursing staff performed pre-heating of the incubator, with monitoring every 30 min and one hour. Conclusions: It is concluded that the nursing staff is trained to care for newborns, in addition to the adjustments made to the pediatric facilities and equipment, to ensure minimal heat loss. In addition, the Romeo - November code of the Naval Medical Center is ideal for caring for newborns.

Background: This research goes on the line of studies focused on the evaluation of the effect of the use of virtual reality on the state of anxiety in patients; specifically, during the preoperative care. Anxiety is a problem that patients manifest before entering a surgical procedure, either due to the risk of the surgery to which they will be subjected, due to lack of information, or due to the predisposition of their character to anxiety (trait anxiety).A state of high anxiety can put surgery at risk, affecting the patient's vital signs, leading the anesthesiologist to increase the dose of anesthesia or, in extreme cases, forcing to reschedule the procedure. Evaluating preoperative anxiety is one of the functions of the surgical nursing staff, as well as proposing and evaluating alternatives in order to reduce the state anxiety of patients. Objective: To evaluate the effect of virtual reality on state anxiety in patients during preoperative care. Method: A descriptive, cross-sectional and prospective research was carried out on a sample of 19 patients scheduled for different types of surgeries. In order to measure the level of anxiety before and after the use of virtual reality lenses, an instrument was applied during preoperative care. Vital signs, state anxiety and self-perception anxiety were assessed. For measuring the state anxiety level, a modified version of the Spielberger’ State-Trait Anxiety Inventory was used. Statistical analysis was performed with parametric and non-parametric hypothesis tests for related samples, as appropriate. Results: Occurrence of statistically significant changes in vital signs, state anxiety and self-perception of anxiety before and after the use of virtual reality was corroborated (p <0.05).This suggests the reduction of general anxiety on patients during preoperative care while using virtual reality lenses. Results obtained are compatible with most part of the antecedent literature on the subject, which states that virtual reality is a technique has shown favorable results for the treatment of anxiety in different surgical or clinical contexts. Conclusions: The use of virtual reality lenses favorably affected the reduction of state anxiety in the patients analyzed during the perioperative care. This suggests that virtual reality technique has great clinical potential.

Introduction: The lack of safety in surgical interventions is a global public health problem that affects countries around the world, regardless of their level of development. Due to this problem, the World Health Organization (WHO) created the Global Alliance for Patient Safety, from this Alliance emerged the Surgical Safety Checklist (LVSC). Objective: To determine the perception of the postoperative patient regarding the safety of their surgery performed at the Naval Medical Center (CEMENAV) between October and November 2020. Methods: observational / non-experimental, quantitative, descriptive, prospective, cross-sectional cohort study. The population consisted of 105 patients who underwent surgery at CEMENAV in the period from October 20 to November 10, 2020. The sample consisted of 65 patients, to whom a questionnaire based on the LVSC items that could be identified by them was applied, divided into three moments: before anesthesia, after surgery and the opinion on safety and satisfaction, which allowed to measure the perception of safety of Surgery from the patient's perspective. Results: Only in 40.0% of the cases did the nurse ask the patient which part of the body their surgery would be on. In 64.6% of the cases, the nurse asked and verified that the patient had signed the informed consent. In 71.4% of cases the surgeon did not perform surgical markings, in 10.8% of cases the anesthesiologist did not ask the patient if he/she had any type of allergy. The anesthesiologist gave recommendations for the patient's recovery in 58.5% of cases, the surgeon did so in 55.4% of cases, and the nursing staff did so in 43.1% of cases. 3.1% of patients felt insecure about their surgery, all stated that they were satisfied with the care received and all recommended CEMENAV for surgery. Conclusions: there is noncompliance in the confirmation of the items of the "LVSC" by the CEMENAV surgical team. The perception of the postoperative patient regarding the safety of his/her surgery is inadequate.