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.

Introducción: La regulación de la temperatura es vital para la supervivencia y estabilidad del recien nacido (RN), su cuidado y control por parte del personal de enfermería permite tener control del ambiente, del traslado y de las intervenciones de enfermería, por ello, se ha creado el código Romeo- Noviembre en la Secretaría Armada de México. Objetivo general: Identificar las intervenciones de enfermería en el RN Sano durante el código Romeo - Noviembre, en el mantenimiento de la termorregulación e identificar factores de riesgo que favorezcan la aparición de complicaciones. Metodología: Estudio cuantitativo, descriptivo, aplicado que se enfoca en identificar las intervenciones de enfermería en el RN Sano durante el código Romeo – Noviembre del Centro Médico Naval durante los meses de octubre y noviembre del 2020, se seleccionó personal de enfermería que se encuentra en el servicio de alojamiento conjunto y tococirugía, el muestreo fue no probabilístico, por conveniencia. Resultados: Se analizaron 47 RN por parte del personal de enfermería para el mantenimiento de la termorregulación, el 55.3% fueron del sexo masculino, 44.7% femenino, nacieron por parto el 23.4%, 76.6% cesárea, por Capurro tuvieron 38+2 semanas de gestación, la temperatura ambiental en la recepción de tococirugía fue de 20+1.8ºC, en alojamiento conjunto de 23+2.1ºC, en la recepción de tococirugía el RN tenía 37+0.2ºC, durante el traslado 36+0.7ºC y en alojamiento conjunto de 36.9+0.2ºC. El personal de enfermería realizaba calentamiento previo de la incubadora, con monitorización cada 30 min y una hora. Conclusiones: Se concluye que el personal de enfermería está capacitado para la atención del RN, aunado a los ajustes que se hacen en las instalaciones y equipos de pediatría, para que se tenga la menor pérdida de calor, además, el código Romeo – Noviembre del Centro Médico Naval es ideal para la atención del RN.

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.

Introducción: La falta de seguridad en las intervenciones quirúrgicas es un problema mundial de salud pública que afecta a los países de todo el mundo, sin importar su nivel de desarrollo. Debido a esta problemática, la Organización Mundial de Salud (OMS) creó de la Alianza Mundial para la Seguridad del Paciente, de esta Alianza emanó la Lista de Verificación de la Seguridad de la Cirugía (LVSC). Objetivo: Determinar la percepción del paciente postoperado con respecto de la seguridad de su cirugía realizada en el Centro Médico Naval (CEMENAV) entre octubre y noviembre de 2020. Métodos: estudio observacional / no experimental, cuantitativo, descriptivo, prospectivo, de cohorte transversal. La población se conformó por 105 pacientes intervenidos quirúrgicamente en el CEMENAV en el periodo comprendido del 20 octubre al 10 de noviembre de 2020, la muestra estuvo constituida por 65 pacientes, a quienes se les aplico un cuestionario basado en los ítems de la LVSC susceptibles de ser identificados por los mismos, dividido en tres momentos: antes de la anestesia, después de la cirugía y la opinión sobre la seguridad y satisfacción, con lo que se permitió medir la percepción de seguridad de la Cirugía desde la perspectiva del paciente. Resultados: Solo el 40.0% de los casos el (la) enfermero(a) preguntó al paciente en qué parte del cuerpo sería su cirugía, En el 64.6% de los casos el (la) enfermero(a) preguntó y verificó que el paciente hubiera firmado el consentimiento informado. En el 71.4% casos el (la) cirujano(a) no efectuó el marcaje quirúrgico, en el 10.8% de los casos el (la) anestesiólogo(a) no preguntó al paciente si tenía algún tipo de alergia. El anestesiólogo dio recomendaciones para la recuperación del paciente en el 58.5% de los casos, el cirujano lo hizo en el 55.4 % de los casos, y personal de enfermería en un 43.1% de los casos. El 3.1% de los pacientes sintió inseguridad de su cirugía, todos afirmaron hallarse satisfechos con la atención recibida y todos recomendaron el CEMENAV para operarse. Conclusiones: existe incumplimiento en la confirmación de los ítems de la ”LVSC” por parte del el equipo quirúrgico del CEMENAV. La percepción del paciente postoperado con respecto de la seguridad de su cirugía es inadecuada.