bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia: A Randomized Crossover Study
Authors: Ranjan Ajenthen , Schmidt Signe , Damm-Frydenberg Camilla , Steineck Isabelle , Clausen Trine Ryberg , Holst Jens Juul , Madsbad Sten , Nørgaard Kirsten
Published: October 2016

OBJECTIVE

This study compared the ability of glucagon to restore plasma glucose (PG) after mild hypoglycemia in patients with type 1 diabetes on an isocaloric high-carbohydrate diet (HCD) versus a low-carbohydrate diet (LCD).

RESEARCH DESIGN AND METHODS

Ten patients with insulin pump–treated type 1 diabetes randomly completed 1 week of the HCD (≥250 g/day) and 1 week of the LCD (≤50 g/day). After each week, mild hypoglycemia was induced by a subcutaneous insulin bolus in the fasting state. When PG reached 3.9 mmol/L, 100 µg glucagon was given subcutaneously, followed by 500 µg glucagon 2 h later.

RESULTS

Compared with the HCD, the LCD resulted in lower incremental rises in PG after the first (mean ± SEM: 1.3 ± 0.3 vs. 2.7 ± 0.4 mmol/L, P = 0.002) and second glucagon bolus (4.1 ± 0.2 vs. 5.6 ± 0.5 mmol/L, P = 0.002). No differences were observed between the diets regarding concentrations of insulin, glucagon, and triglycerides.

CONCLUSIONS

The LCD reduces the treatment effect of glucagon on mild hypoglycemia. Carbohydrate intake should be considered when low-dose glucagon is used to correct hypoglycemia.
Greater Engagement Among Members of Gay-Straight Alliances
Authors: Poteat V. Paul , Heck Nicholas C. , Yoshikawa Hirokazu , Calzo Jerel P.
Published: October 2016

Using youth program models to frame the study of Gay-Straight Alliances (GSAs), we identified individual and structural predictors of greater engagement in these settings with a cross-sectional sample of 295 youth in 33 GSAs from the 2014 Massachusetts GSA Network Survey (69% LGBQ, 68% cisgender female, 68% White, Mage =16.07). Multilevel modeling results indicated that members who perceived more support/socializing from their GSA, had more LGB friends, were longer serving members, and were in GSAs with more open and respectful climates reported greater engagement. Further, there was a curvilinear association between organizational structure in the GSA and engagement: Perceptions of more structure were associated with greater engagement to a point, after which greater structure was related to less engagement.
Association of Haemophilia with Down Syndrome
Authors: Narang Gursharan Singh , Singh Tarsem , Sharma Anubha , Malik Supriya , Kaur Amandeep
Published: October 2016

Hemophilia B is a hereditary bleeding disorder caused by a lack of blood clotting factor IX. Without enough factor IX, the blood cannot clot properly to control bleeding. Hemophilia B presenting in association with Down’s syndrome is quite rare. We report a case of a one month old child who presented to us with continuous unexplained bleeding.J Nepal Paediatr Soc 2016;36(1):75-77.
Glycogen Storage Disease 1b: Diagnosis and Workup of a Novel Mutation
Authors: Sanjeev Rama Krishna , Shetty Swathi , Harith Arun , Nair Bindu T , Surendran Sajith
Published: October 2016

Glycogen Storage diseases (Glycogenoses) are a diverse group of disorders, numbering more than 12, resulting from deficiencies of various enzymes & transport proteins in the pathways of glycogen metabolism. GSD 1 is caused by absence or deficiency of glucose-6-phosphatase activity in the liver, kidney or intestinal mucosa. In GSD 1(b), the enzyme which transports Glucose-6-Phosphate across the microsomal membrane is defective, thereby resulting in accumulation of Glycogen. The clinical features of 1a & 1b are similar with fasting hypoglycaemia, hepatomegaly, growth retardation and metabolic abnormalities except for the presence of neutropenia with recurrent gingivitis in GSD 1b. A genetic diagnosis solves this conundrum with the added benefit of antenatal diagnosis of future pregnancies & identification of carrier state in patients. We report the work up of an infant with suspected GSD where a novel mutation with heterozygous carrier state in the parents was diagnosed by genetic testing.J Nepal Paediatr Soc 2016;36(1):85-87.
Recurrent Afebrile Episodes of Spontaneous Pneumothorax in a Child with Well Controlled Systemic Lupus Erythematosus Disease
Authors: Mehta Sudhir
Published: October 2016

Systemic Lupus Erythematosus is an autoimmune disorder with multiple system involvement. Despite its pleuro-pulmonary involvement, recurrent spontaneous pneumothoraces are rare complication of childhood SLE. We report a 12 year old girl having SLE with nephritis, who developed recurrent episodes of spontaneous pneumothoraces. Surgical management with prolonged evacuation and aggressive immunosuppressive therapy improves the outcome for these patients. J Nepal Paediatr Soc 2016;36(1):94-96.
Culture and Sensitivity Pattern of Sepsis in Ventilated Newborns
Authors: Sur Somen , Pallavi Dr , Mondal Sanjib , Gupta Atul Kumar
Published: October 2016

Introduction: Neonatal sepsis is a major cause of mortality and morbidity in modern neonatal intensive care units (NICU). Increasing trend of antibiotic resistance makes this problem more difficult to tackle, at present. Haemodynamically compromised neonates, particularly those requiring ventilator support, often suffer from multidrug resistant sepsis. The objectives of this study were to determine micro-organisms causing sepsis in those neonates requiring ventilator support and the sensitivity patterns of those micro-organisms.Material and Method: During 18 months of study period, 48 neonates, who had fulfilled the chosen inclusion criteria were included in this study. They were investigated with blood culture, urine culture, CSF culture, and endotracheal tube tip culture (taken within 48 hours of starting ventilation), as per relevance. Those who were found positive to any micro-organism, were also explored. They were studied further for antimicrobial sensitivity pattern. Data obtained from this study were analysed using SPSS-20.0.Results: 15(31.3%) neonates were found to be culture positive. Klebsiella sp. was most common (33.3%) organism isolated, followed by Pseudomonas aeruginosa (20%). Most common antibiotic found to be sensitive was Meropenem (86.67%), followed by Colistin and Tigecycline (80% each).Conclusion: Nowadays, all NICUs throughout the world face a common problem of multidrug resistant sepsis. There is always a doubt regarding choice of second line antibiotics, when one considers for upgradation. As per this study, authors considered Meropenem as second line antibiotic of choice, as other sensitive antibiotics like Colistin, Tigecycline wield more adverse effects on neonates.J Nepal Paediatr Soc 2016;36(1):34-37
Rare Presentation of Congenital Cystic Adenomatoid Malformation of the Lung
Authors: Sharma Anubha , Pannu MS , Lata Neeraj , Dhillon SPS , Singh Narinder , Sareen Ashwini
Published: October 2016

Congenital cystic adenomatoid malformation is a rare entity presenting with respiratory difficulty in newborns and even later in infancy. Various cases have been reported but recurrent spontaneous pneumothorax in an infant with failure to thrive and pectus carinatum since birth(with uneventful antenatal history and asymptomatic course in the first seven months of life) is an extremely rare presentation of this congenital lung condition.J Nepal Paediatr Soc 2016;36(1):91-93.
Changes in the Disease Spectrum of Hospitalized Children in a County Hospital of China
Authors: Liu Yonglin , Liu Juan , Shamsi Bilal Haider , Hao Xiao Xia
Published: October 2016

Introduction: Considering the present situation of disease spectrum changes, it is very important to understand the changes of disease in primary settings, to find out the feature of disease area, to direct the decision making so as to allocate the medical resources accordingly. The objectives of this study were to understand the changing trends in disease spectrum and mortality rate of children hospitalised in the department of paediatrics in Shenmu hospital, and to provide scientific basis for the future medical care and prevention of childhood diseases.Material and Methods: A retrospective statistical analysis was done using the data regarding hospitalization of children in Shenmu County. The study lasted fifteen years, from January 1998 to December, 2012.Results: A total of 23,448 children were hospitalized below the age of 14. Majority of the patients were younger than three years old constituting 78.8% (which included age 1 month~1 year 57.2%). The average number of days of hospitalization was 6~8 days, with a median time of six days. The leading cause of hospitalization was respiratory disease. Other major illnesses causing hospitalization included: infectious diseases, digestive tract diseases, neonatal diseases and nervous system diseases. A total of 144 children died during this period. The top three causes of death were: asphyxia, premature birth and neonatal respiratory distress syndrome.Conclusion: The changing trends in paediatric disease hospitalisations and mortality rate over the 15 years are significant for clinicians so as to prevent and minimise such diseases by appropriate preventive and therapeutic options to contain them.J Nepal Paediatr Soc 2016;36(1):19-23
Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in an Infant
Authors: Paul Subhasish , Guha Suparna , Basu Sumita , Mukherjee Dilip Kumar , Banerjee Raja
Published: October 2016

Haemophagocytic syndrome caused by CMV infection in a one month old infant is rare. Cytomegalovirus can cause congenital or perinatal infection in an infant. We report a case in a baby who had secondary haemophagocytic syndrome. The baby had progressive pancytopenia, hepatosplenomegaly and diagnosed to be infected with CMV. Inspite of aggressive management the baby succumbed to death. CMV infection in a neonate may predispose to haemophagocytic syndrome.J Nepal Paediatr Soc 2016;36(1):88-90.
Additional Use of Alarm Systems in Wakefulness in the Treatment of Mono-Symptomatic Nocturnal Enuresis
Authors: Kosilov Kirill Vladimirovich , Loparev Sergey Alexandrovich , Kuzina Irina Gennadyevna , Shakirova Olga Victorovna , Zhuravskaya Natalia Serveevna , Lobodenko Alexandra
Published: October 2016

Introduction: There are many factors associated with nocturnal enuresis in children and can be very challenging as regards its management. Consequently, misunderstanding could arise explaining the state when a child for years urinates in bed. The aim of this study was to investigate possibilities of increase of efficiency of alarm systems and decrease of time of result achievement in case of usage of such modernized therapy algorithm.Materials and methods: 452 children (307 boys and 145 girls) took part in the study. All patients were randomly divided into two groups prior to alarm systems therapy. Group А patients (206) were offered to use alarm system (Wet Stop/ BYE-WET by PALCO LABS, Inc (USA) in normal mode. Group В patients (246) were using alarm system in wakefulness – urinated on device catching sensor. Alarm intervention was carried out within 12 weeks, total period of observation over the patients– 5 months.Results: We found out that number of patients with urination in sleep after 3 months of therapy was reliably less in this group than in control (23.5 against 40.3 percent, p < 0.05).Conclusion: Usage of alarm systems in patient’s wakefulness in addition to standard treatment regimen was improved the efficiency of Alarm-therapy up to 76.5 percent. Day training with the usage of alarm systems reliably increased the number of dry nights and self-wakening in case of desire to urinate. Usage of alarm systems in wakefulness was safe and did not result in additional refusal from treatment.J Nepal Paediatr Soc 2016;36(1):8-13
Knowledge, Attitude and Socio-cultural Beliefs of Adolescent Girls towards Menstruation
Authors: Kapoor Anju , Khari Smriti
Published: October 2016

Introduction: Knowledge regarding physiology of menstruation and hygienic practices are poor in adolescent girls. Deep rooted social beliefs make their attitude more negative.Material and Methods: In a hospital based cross sectional study, one hundred adolescent girls who have attained menarche were interviewed with a pre-validated semi-structured questionnaire to assess their knowledge, experiences, effect of mother’s education on menstrual hygienic practices and factors affecting their positive and negative attitude.Results: Mean age of menarche was 13.28 (SD ± 1.42) years. Mothers were the first informant to 56% girls. Only 11% girls knew that menstruation is a normal biological phenomenon and 28% girls were mentally prepared before menarche. Readymade pads were being used by 46% girls. Most girls were forced to follow various restrictions during menstruation. Maternal education was significantly associated with use of readymade pads (p-value 0.031). Significant positive correlation was seen between premenarchal preparedness to pleasantness (r = 0.3215; p = 0.001) while negative correlation was found between preparedness to secrecy (r = -0.1549; p = 0.124), annoyance (r = -0.1421; p = 0.158) and worrying thoughts (r = - 0.2074; p = 0.038). Negative correlation was also seen between years of experience with menses to secrecy and worrying thought (r = -0.0162; p = 0.872 and r = -0.1033; p = 0.864 respectively).Conclusion: There is significant lack of knowledge, poor hygienic practices and negative attitude among adolescent girls that needs to be addressed by educating them and their mothers.J Nepal Paediatr Soc 2016;36(1):42-49
Prevalence of Under-Nutrition Measured by Composite Index of Anthropometric Failure (CIAF) Among the Bhumij Children of Northern Odisha, India
Authors: Goswami Monali
Published: October 2016

Introduction: Under-nutrition continues to be a serious health problem among the children in India. In view of the paucity of recent attempts to classify under-nourished children satisfactorily the Composite Index of Anthropometric Failure (CIAF) has been implemented to measure the seriousness and severity of overall under-nutrition in a population. However, there exists scanty information of the prevalence of under-nutrition among the tribal children of Odisha and India. Therefore the objective of the present study is to evaluate the overall prevalence of under-nutrition among the Bhumij children of Northern Odisha, India.Materials and Methods: A total of 136 Bhumij children aged 1 to 6 years (69 boys and 67 girls) were measured. Children were considered as underweight, stunting and wasting if their weight-for-age, height-for-age and weight-for-height Z-scores below -2.0 SD of the National Center for Health Statistics (NCHS) reference data. Severe under-nutrition was assessed as Z-score below -3.0 SD.Results: The overall age and sex combined prevalence of stunting, underweight and wasting recorded was 32.4%, 42.6% and 25% respectively, and these rates were considered as high (30-39%), very high (≥30%) and also very high (≥15%), respectively. CIAF showed a higher prevalence of undernutrition (54.4%) i.e., children suffering from anthropometric failure, in comparison to other three conventional indicators (stunting, underweight and wasting).Conclusions: Therefore various nutritional intervention programs can be formulated to improve the nutritional status of the children. It was established herein that CIAF is a better indicator of nutritional status than traditional measures of stunting, underweight and wasting because it differentiates overall and total anthropometric failure.  J Nepal Paediatr Soc 2016;36(1):61-67
Incidence and Severity of Intra-Ventricular Hemorrhage (IVH) in Preterm Infants, Northeast of Iran
Authors: Fouladinejad Mahnaz , Khorsand zak Hadi , Nematollahi Nematollah , Alaee Ehsan
Published: October 2016

Introduction: The incidence rate of Intra-Ventricular Haemorrhage (IVH) varies from 20% to 25% among preterm infants with a very low birth weight. IVH could compose critical disabilities which are directly associated to its grade. The aim of this study was to evaluate the incidence and severity of IVH in preterm infants referred to the academic Hospital of Gorgan, Northeast of Iran.Materials and Methods: In this cross-sectional study, we examined all preterm infants who had been referred to the academic Hospital of Gorgan, Northeast of Iran between Augusts 2014 and February 2015. Seventy one preterm infants (≤34 weeks of gestation, ≤1500g birth weight) have been included. Cranial ultrasound was done within 3-5 days of birth for all subjects and subsequent ultrasounds were performed based on their birth weight by portable ultrasound device.Results: The overall incidence of IVH was 64.8% in the present study. There was a significant relationship between IVH incidence and the gestational age (p=0.010). Also the lower birth weight was associated to the higher rate of IVH complications reported in sequential ultrasounds (p<0.05).Conclusion: Gestational age and birth weight seem to have key roles in the occurrence and severity of IVH, respectively.J Nepal Paediatr Soc 2016;36(1):38-41
Pattern of Growth Retardation and Sexual Maturation in Children having Beta Thalassaemia
Authors: Chhabra Gurpreet Singh , Sodhi Manmeet Kaur
Published: October 2016

Introduction: Thalassaemia is a group of genetic disorders of blood, characterized by decreased synthesis of one of two types of poly peptide chain (α or ß) that form a normal adult human haemoglobin molecule (Hb A- α2 ß2). This results in decreased filling of red cell with haemoglobin and anaemia. Retardation of growth and delayed sexual maturation can occur as a complication of thalassaemia. The objectives of this study were to study the pattern of growth failure and sexual maturity rate (SMR) in children with β-thalassaemia major, and to compare it with controls.Material and Methods: In this case-control study conducted simultaneously at two centres at Bebe Nanki Mother And Child Care Centre, Amritsar and Sri Guru Ram Das Charitable hospital, Amritsar, the growth parameters (height,weight and sexual maturation ) and serum ferritin levels of a total of 114 patients aged 8-16 years (64 males and 50 females) with β-thalassaemia major were compared with those of 100 healthy controls of the same age and gender.Results: Underweight was observed in 89(78.1%) of patient group and 9(9%) of control group. Short stature was observed in 64(56.1%) patients and 7(7%) of the control group. The mean age of menarche for female thalassaemia patients was 12.11±2.1 years and for control females was 11.42±1.11years, The SMR were delayed in 108(95%) of patients and in 6 (6%) of controls. The level of serum ferritin was found to be significantly associated with delayed SMR in thalassaemia patients.Conclusion: Growth failure and delayed SMR significantly occur in thalassaemia patients, when compared to the controls. Adequate chelation therapy can help in controlling serum ferritin levels and thereby facilitating normal physical growth and sexual development in chronically transfused thalassaemia patients.J Nepal Paediatr Soc 2016;36(1):56-60
Cutaneous Polyarteritis Nodosa Presenting with Digital Gangrene
Authors: Kumar K Jagadish , Ramaswamy Subramanian , Saldana Karen
Published: October 2016

Cutaneous polyarteritis nodosa is a vasculitis with characteristic manifestations like tender subcutaneous nodules, livedo reticularis, cutaneous ulcers and necrosis. Diagnosis requires histopathologic evidence of necrotizing inflammation of the medium and small arteries. We report a six year old girl with cutaneous PAN with gangenous changes of the fingertips which responded to methylprednisolone.  J Nepal Paediatr Soc 2016;36(1):82-84.
Upper Gastrointestinal Bleeding due to Hemobilia
Authors: Lamichhane Ritu , Joshi Binita G. , Wadhwa Nishant , Gupta Arun
Published: October 2016

Haemobilia is one rare but potentially life threatening complication of delayed haemorrhage following liver trauma which occurs as a result of pathological communication between bile ducts and intra or extrahepatic vessels. We describe here a case of two year old child who presented with upper gastrointestinal bleeding and developed haemobilia in one month duration after blunt abdominal trauma. CT angiography revealed a right hepatic artery pseudo aneurysm as the cause of haemobilia and was successfully treated with right hepatic artery embolisation.J Nepal Paediatr Soc 2016;36(1):100-102.
A Case of Hodgkin Lymphoma Presenting as Nephrotic Syndrome
Authors: Dakhane Yogesh Rambhau , Singh Rajesh Kumar , Thapar Rajeev Kumar
Published: October 2016

Nephrotic changes as part of the paraneoplastic syndrome are rare in lymphoid malignancies. One percent of cases of Hodgkin's Lymphoma cases may present with nephritic syndrome. We are reporting a case which initially presented as nephritic syndrome and later was diagnosed to have of Hodgkin's Lymphoma and managed accordingly.J Nepal Paediatr Soc 2016;36(1):72-74.
Culture and Sensitivity Pattern of Urinary Tract Infection in Hospitalized Children in Patan Hospital
Authors: Amatya Puja , Joshi Suchita , Shrestha Shrijana
Published: October 2016

Introduction: Urinary tract infection is one of the most common infections in children. Antibiotics are usually given empirically before urine culture reports are available. The primary aim of this study was to see the causative organisms and culture and sensitivity pattern of urinary tract infection in hospitalized children.Material and Methods: All children aged 0-15 years with culture positive urinary tract infections who were admitted to children’s ward from 14th April 2013 to 14th April 2014 were included. The causative organisms for urinary tract infection along with its antibiotic sensitivity pattern were retrospectively reviewed and analyzed.Results: 48 cases of culture positive urinary tract infection were enrolled in this study in a period of 12 months. The most common causative organism was Escherichia coli (67%), followed by Klebsiella pneumoniae (21%), Non-hemolytics streptococcus (4%), Enterobacter (2%), Acinetobacter (2%), Proteus (2%) and Coagulase negative staphylococcus (2%). Most cases of the culture positive urinary tract infection occurred between 2 months to 1 year of age. Out of 48 cases, 90% were sensitive to Amikacin and 85% were resistant to Ofloxacin.Conclusion: Escherichia coli is the most common organism causing urinary tract infection in children. As resistant to first line antibiotic is increasing, antibiotic stewardship programme should be strengthened.J Nepal Paediatr Soc 2016;36(1):28-33
Central Retinal Artery Occlusion Associated with Varicella dermatitis
Authors: Agarwal Lalit , Agrawal Nisha , Labh Rajan Kumar , Choubey Rahul , Agrawal Bimal
Published: October 2016

A 12 year girl presented with left eye (LE) loss of vision for four days. Fundus examination and fluorescence angiography revealed LE central retinal artery occlusion (CRAO). She had multiple rashes all over the body. IgM-Varicella antibody assay corresponded with varicella infection and she was diagnosed with CRAO associated with varicella dermatitis.J Nepal Paediatr Soc 2016;36(1):78-81.
Surgical Outcome of Traumatic Cataract Following Corneal Perforation in Children in a Tertiary Eye Care Centre in Nepal
Authors: Shrestha Ujjowala Devi , Adhikari Srijana
Published: October 2016

Introduction: Traumatic paediatric cataract is challenging and its management is difficult. It is associated with other distortion of ocular anatomy and subsequent post- operative complication poses more problems. It is mostly unilateral. The purpose of this study is to assess the outcome of traumatic cataract following corneal perforation in Nepalese children in a tertiary eye hospital in Nepal.Material and Methods: It was a retrospective review of medical records of children who developed cataract following perforating corneal injuries. The study included 69 cases diagnosed as unilateral traumatic cataract over a period of 70 months (January 2010 till October 2015) at Tilganga Institute of Ophthalmology (TIO). Traumatic cataracts caused by other than the perforating corneal injuries were excluded from the study.Results: Children between 6 to 10 years of age had highest percentage of ocular trauma. Boys were more commonly affected than girls. Forty two percentages of children had visual outcome of better than or equal to 6/18.Poor visual outcome was mainly due to anterior segment pathology- corneal scar (14.49%).Posterior segment pathology like macular scar, vitreous haemorrhage and retinal detachment contributed to 7.34% of the cause.Conclusion: Outcome of the traumatic cataract surgery varied. Visual outcome of post traumatic cataract after corneal perforation was dependent on multiple factors like co- existence of the anterior and posterior segment trauma, per –operative and post-operative challenges. Prompt and good management of traumatic cataract can result in good visual outcome.J Nepal Paediatr Soc 2016;36(1):50-55
Single nucleotide polymorphisms in the FOXP3 gene are associated with increased risk of relapsing-remitting multiple sclerosis
Authors: Eftekharian Mohammad Mahdi , Sayad Arezou , Omrani Mir Davood , Ghannad Masoud Sabouri , Noroozi Rezvan , Mazdeh Mehrdokht , Mirfakhraie Reza , Movafagh Abolfazl , Roshanaei Ghodratollah , Azimi Tahereh , Inoko Hidetoshi , Taheri Mohammad
Published: October 2016

BACKGROUND:

Although Multiple Sclerosis (MS) is an autoimmune multifactorial disease with unknown etiology, various genetic and environmental factors are known to contribute to the pathogenesis of the disease.

OBJECTIVE:

Recent studies have confirmed that the suppressive function of regulatory T cells (T (reg)) is impaired in MS patients and that the FOXP3 gene is a crucial transcription factor in the regulation of CD4+CD25+FOXP3+ Treg cells. Polymorphisms in the promoter region of the FOXP3 gene may alter the gene expression level and, therefore, contribute to the disease susceptibility.

METHODS:

The present study aimed to investigate the possible association between single nucleotide polymorphisms (SNPs) rs3761548 and rs2232365 in the FOXP3 gene and predisposition to MS. We conducted a case-control study on 410 patients with sporadic MS and 446 healthy controls. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).

RESULTS:

Significant differences in distribution of both rs3761548 and rs2232365 A allele were found in MS patients in comparison to controls. Haplotype frequencies were also different among the studied groups. The A-A and C-G haplotype blocks showed a significant difference between case and controls.

CONCLUSION:

we have provided further evidence for the association between genetic variations and haplotypes in FOXP3 and MS in Iranian population.
Measurement and relationships of proprioceptive isokinetic repositioning, postural control, and a self-reported questionnaire in patients with chronic ankle instability
Authors: Saavedra-Miranda Melissa , Mendez-Rebolledo Guillermo
Published: October 2016

BACKGROUND:

In subjects with chronic ankle instability (CAI), balance and functionality have been evaluated to determine the stability of the ankle, but there is limited evidence about relationships between these variables with active (AJR) and passive (PJR) isokinetic joint repositioning.

OBJECTIVE:

To determine the correlation between isokinetic joint repositioning, static balance, dynamic balance and a self-reported questionnaire in CAI participants.

METHODS:

Twenty subjects with unilateral CAI participated. AJR, PJR, average velocity (AV), average radius (AR), Modified Star Excursion Balance Test (SEBT) and Identification of Functional Ankle Instability were measured.

RESULTS:

The principal correlations were between the AJR of the affected ankle and the bilateral static balance [AV (r = -0.74, R2= 0.55, p = 0.005) and AR (r = -0.73, R2 = 0.53, p = 0.006)]. A correlation between the PJR of the non-affected ankle with the SEBT of non-affected ankle in a posterolateral direction (r = -0.67, R2= 0.45, p = 0.017) was observed.

CONCLUSIONS:

Strong relationships were seen between the AJR of the affected ankle and the bilateral static balance. In standing position, the non-affected ankle could mask the altered proprioception and balance.
Computation of eddy currents in highly conductive particles dispersed in a moderately conductive matrix
Authors: Rognin Etienne , Rossa Guillaume Barba , Brun Patrice , Sauvage Emilien , Lacombe Jacques
Published: October 2016

In this article, we report 3D numerical simulations of highly conductive non-magnetic particles dispersed in a moderately conductive matrix, subject to an AC magnetic field in a range of several hundred kHz. We address the issue of the scaling of current loops and heating power with respect to the volume fraction of the dispersed phase. Simulations are performed in two steps. First, a static electric potential gradient is imposed between two opposite faces of the simulation domain and an effective conductivity is computed in good agreement with percolation models. Second, the particles are constrained in a spherical sub-region and an AC magnetic field is imposed at the boundary of the domain. For small volume fractions, the induced Joule power is in good agreement with an analytical model of dilute dispersions. As the volume fraction increases, wider current loops form, until the percolation threshold is reached. Then the induced power in the spherical aggregate is well described by the power induced in an equivalent sphere with a volume-fraction-dependent conductivity.
Numerical modelling of silicon melt purification in induction directional solidification system
Authors: Djambazov G. , Bojarevics V. , Pericleous K. , Forzan M.
Published: October 2016

Solar grade silicon production is an energy intensive and harmful to the environment process. Yet 40% of this valuable product material is lost into sawdust (kerf loss) during wafering. The kerf waste from Fixed Abrasive Sawing of PV silicon wafers is pelletized and then remelted in an induction furnace. The furnace has a square cross-section quartz crucible, surrounded by graphite susceptors and heated by an induction coil that enables directional solidification of the new ingot. Top and bottom `pancake' coils provide additional temperature control. Once melted, silicon becomes electrically conductive and subject to stirring by induction. To recycle the silicon, particulate impurities (due to the sawing, condensed silicon oxides or carbides) need to be removed. Flow control and the electromagnetic Leenov-Kolin force are used to expel particulates, through a novel dual frequency induction scheme. Three-dimensional, multi-physics numerical modelling captures the electromagnetic, fluid-flow and heat-transfer effects in this process. The presented results show it is possible to retain the impurity particles on the sides of the solidified ingot where they can be sliced off and removed.
Effectiveness of Levofloxacin in Community Acquired Pneumonia in Adult Bangladeshi Population
Authors: Rokonuzzaman SM , Ali Mohammad Hyder , Parvin Soheli , Prasad Deb , Hossain Md Enayet , Haque Rashimul
Published: October 2016

Community- acquired pneumonia (CAP) is a common condition with a significant mortality. Levofloxacin is recommended for the empiric management of CAP in inpatienst and outpatients. The present study conducted to find out the effectiveness of Levofloxacin in CAP among Bangladeshi Population. Total 50 Patients aged more than 18 years, diagnosed pneumonia based upon clinical features of respiratory tract infection and rediological changes, were included in this study. The study consists of four visits: first one for screening and enrollment. Second visit on day 2-4 during which patient on therapy, third visit 5-7 day after the last dose of the drug and fourth visit 28days after the last dose of the drug. The mean # SD of age of the respondents was 34.3# 19.1 years with a range of 18-100 years. Among the respondents 62.0% were male and 38.0% were female. Most of the respondents presented with fever (98.0%) and cough (100.0%) and chest pain was present in 66.0% cases. Ninety six percent respondents presented with productive cough and only 4.0% respondents with dry cough. Consolidation in left lower zone was the most common findings (32.0%) followed by consolidation in right mild zone (30.0%). Among the respondents 32.0% were treated with oral form and 68.0% were treated with injectable form of levofloxacin. About 92.0% were improved with the treatment. Levofloxacin monotherapy is well tolerated, cost-effective treatment for patients with CAP. Further large scale multi- centered study will help to strengthen this outcomeMedicine Today 2015 Vol.27(2): 9-13
Demographic Profile of NSTEMI (Non ST Elevation Myocardial Infarction) Patients & Association of ST-Segment Depression and Level of Troponin I with NSTEMI Patient's In-Hospital Outcome
Authors: Zahid Md Abu , Khan HI Lutfur Rahman , Chowdhury Abdul Wadud , Sabah Khandker Md Nurush , Kabir SM Eftar Zahan , Rahman Md Hasanur , Hossain Mofazzal , Khan Tunaggina Afrin
Published: October 2016

Acute coronary syndrome (ACS) remains the leading cause of death in the developed world and second leading cause of death in developing countries. Elevated troponin levels and extent of ST-segment depressions are clinically important because they may act as an effective prognostic marker .This cross-sectional study has been designed to see the correlation of ST-segment depression and level of troponin I with in-hospital outcome of NSTEMI patients. The study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011- March, 2012. A total of 90 patients were selected by purposive sampling. In this study,the mean ±SD age of the patients was 55.9±9.1 years with a range of 36-80 years with a male -female ratio of 2:1.Over all dyslipidaemia was the most common risk factor present in 55(61.10%) patients followed by smoking in 48(53.3%) patients then obesity in 32(35.60%) then hypertension in 31(34.4%) patients. Troponin I level was significantly high in patients who developed acute LVF (10.36±7.4 vs 7.0124±6.8, p=.027), and cardiogenic shock (13.72±11.37 vs 8.64±7.35, p=.033). Troponin I was significantly high in patients who developed complication (10.72±8.84 vs 6.24±5.41, p=.005) than the patients who were discharged without complication. ST segment depression was significantly more in patients who developed acute LVF(1.07±1.63 vs.55±.74, p=.048). Logistic regression analysis of acute LVF with Troponin I and ST-segment depression showed that ST-segment depression and level of Troponin I were important correlates of acute LVF .Medicine Today 2015 Vol.27(2): 14-19
Efficacy of the Canalith Repositioning Procedure in Benign Paroxysmal
Authors: Karim Abul Mansur Md Rezaul , Hasanuzzaman Md , Chowdhury Mohammed Abu Yusuf , Tayeb Md Abu
Published: October 2016

Benign paroxysmal positional vertigo (BPPV) is paroxysms of vertigo occurring with certain head movements, typically looking up or turning over in bed comprising about 20% of Dizziness cases. This study was carried out to evaluate the Efficacy of canalith repositioning procedure(CRP) in BPPV. A randomized clinical trial including 80 patients with BPPV was performed Medicine & Neurology Outpatient Department, Chittagong Medical College Hospital. The patients were randomly divided into two groups. Group A treated by anti-vertigo drug and CRP, Group B treated by anti-vertigo drug alone. All patients were followed up in hospital at one week after & 4 weeks. The rates of effectiveness of CRP treatment and the control treatment for were 86.8% and 59.4%, respectively. There was a significant difference (27.4%) in the outcomes of the CRP & control groups (P <.05). Mean total drug use for the group A was 10 ± 1, whereas it was 30 ± 1.5 for group B, mean difference = 20 (P < .001, highly Significant). At 4 Weeks, subjective improvement and symptom free occurred in 94.7% patients in group A and 73% patients in group B (difference21.7%). Complications in the CRP group were observed in 10.6% of the patients. This study demonstrated that canalith repositioning procedure (CRP) was effective in the treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery & low drug dependence. Complications of CRP were limited to 10.6% of patients.Medicine Today 2015 Vol.27(2): 23-27
Value of Widal Test in the Diagnosis of Typhoid Fever
Authors: Chowdhury Mohammed Abu Yusuf , Haque Md Gofranul , Karim Abul Mansur Md Rezaul
Published: October 2016

Typhoid Fever occurs worldwide primarily in developing nations where sanitary conditions are poor. The absence of specific symptoms and signs makes the clinical diagnosis difficult. Definitive diagnosis requires the isolation of S. typhi from blood or other body fluid. But in developing countries culture facilities often not available & diagnosis rely upon clinical features and the detection of antibodies by the Widal test. Numerous studies however have cast serious doubts on the value of the test. The aim of the study was to reassess the utility of a single Widal test in the diagnosis of typhoid fever. The descriptive study was carried out on 100 adult patients with suspected cases of typhoid fever, in the Department of Medicine, Chittagong Medical College Hospital for a period of one year from January to December 2009. Blood samples were collected to perform culture and Widal test. TO titre ?1:160 were considered as significant. AO or BO?1:160 was also considered as significant. The results showed 24 among 100 clinically suspected typhoid fever cases yielded growth of S. typhi. Widal test was found significant in 20(83.33%) out of 24 cultured confirmed cases. Results revealed significant difference in Widal test results between culture positive and negative cases, X2 value 5.601, P value 0.018(<0.05).The study concluded that use of Widal test may be justified in second week of illness as a suggestive test for clinical diagnosis or in patients who have clinical typhoid fever but are culture negative.Medicine Today 2015 Vol.27(2): 28-32
Changes in the Contraceptive Practice among the Women of Reproductive Age in a Selected Hospital of Dhaka City
Authors: Begum Kazi Shahnaz , Alam Shah , Tamanna Tahmina
Published: October 2016

Family planning is an essential tool for reducing fertility rate. An increase in contraceptive prevalence rate results in reduction of population growth, which in turn contributes significantly to the improvement of people's health. This is a cross-sectional, descriptive type of study carried out among the married women attending in the gynaeout patient department of MARKS Medical College and Hospital. This study was conducted from 1st June 2013 to 31st May 2014. Sample size was 250 which were selected purposively.Reproductive history was used as research instrument for data collection. Data was collected by face to face interview using structured questionnaire. Among 250 married women 156(62%) women practicing contraceptives. Majority 45.6% of the respondents were in the age group of 25-29 yrs. Among the respondents housewives 36%, service holder 64% and 38.4% were educated. About 42.8% respondents had 2 child followed by 3 children 36% & only 1.6% had 4 children. 100% respondents had knowledge about oral pill and barrier method. Among the contraceptive users 35.8% respondents accepted OCP followed by barrier method 33.3%, IUCD users were 16.7%, 7.7% respondents used injectables, 6.4% were natural method user and only 1.2% used emergency pills. Maximum 59% respondents were using contraceptives for less than one year, only 4.5% were using contraceptive of different methods for 10 years. Fertility rate, menstruation regulation is lower among servicing women. Education, empowerment and social position of women help to reduce fertility.Medicine Today 2015 Vol.27(2): 33-36
Tension Pneumatocele a Rare Presentation
Authors: Aftabuddin Md , Rahman Md Mokhlesur , Khan Omar Sadeque , Adhikary Asit Baran
Published: October 2016

A 10 months old female baby admitted with diagnosis of tension pneumatocele in right side of hemithorax with collapse right lung. The baby was first managed conservatively, but the condition did not improve. Surgical management was done after one month of admission in hospital, with improvement of baby's symptoms and general conditions. One month later the baby was well and her lung was found expanded completely.Medicine Today 2015 Vol.27(2): 37-39
Pulmonary Alveolar Microlithiasis(PAM)
Authors: Sarkar Devendra Nath , Hossain Md Ismail , Haque Md Mahmudul , Zahin AKM , Miah Md Shahin , Ohab MA , Hossain Altaf , Saha Beauty
Published: October 2016

PAM is a rare parenchymal Lung disease. Very few case report are available about PAM in Bangladesh. It is diagnosed incidentally during chest radiograph. It is a autosomal recessive disease and is associated with sporadic or familial mutation of SLC 34A2 gene. Many patients are asymptomatic and have either normal or restrictive pulmonary function. Some patients remain static and others progress into pulmonary dysfunction, respiratory failure and corpulmonale. The disease is usually discovered up to 40 years and there is no definitive treatment of this disease. Chest radiograph, HRCT used lung biopsy (transbronchial or open) are the main investigations. This patient come with chest pain and dyspnoea on exertion and nonproductive cough and diagnosed as PAM incidentally during chest radiograph. On the basis of clinical features and laboratory finding, we diagnosed him a case of PAM a very rare condition. As there is no definitive treatment, we treat himsymptomatically.Medicine Today 2015 Vol.27(2): 40-43
Noël Coward, Rebecca West, and the Modernist Scene
Authors: Hammill Faye
Published: October 2016

Noël Coward and Rebecca West shared a long friendship, and often met each other at theatrical openings, on transatlantic liners, and at parties hosted by the ‘international set’. Their wary negotiation with one another's celebrity and cultural value played out not only at these social events but also in print, through reviews, gossip columns, and memoirs. Using the relationship between Coward and West as a case study, this essay explores the social scene of modernism, paying particular attention to the suggestion of theatricality in the word ‘scene’. It takes up the notion of the ‘modernist party’ as, on the one hand, a kind of stage on which celebrities from different spheres performed together, and, on the other, a happening which, through reports in print, contributed to the forming of literary reputations and to the public fascination with modern style.
Emploi et chômage
Authors: Erhel Christine , Gautié Jérôme
Published: October 2016

Les problèmes d’emploi et de chômage sont revenus au cœur des préoccupations depuis la crise qui a débuté en 2008 (la « Grande Récession »), y compris dans les pays où le taux de chômage apparent est revenu à un niveau relativement bas. L’objectif de ce dossier est de faire un point théorique et empirique à partir de trois thématiques transversales : la question de la mesure des performances du marché du travail et des indicateurs, pour souligner la nécessité d’une approche allant au-delà du seul taux de chômage ; le besoin de confronter les théories économiques à l’épreuve d’une crise particulièrement importante dont les conséquences sont encore sensibles ; l’importance d’une réflexion prospective sur l’emploi dans un contexte de changement technologique intense.
Au-delà des chiffres de l’emploi et du chômage
Authors: Gautié Jérôme
Published: October 2016

Les « chiffres » de l’emploi, et surtout ceux du chômage, occupent une place importante dans le débat public. Ceci conduit à s’interroger sur les contours de ces catégories et les modalités d’usage des indicateurs qui les quantifient. Les catégories statistiques, et les concepts qui les sous-tendent, sont toujours l’objet d’une construction liée à un contexte socio-historique donné. La catégorie de chômage a connu son âge d’or durant la période de l’après-guerre. L’entrée dans l’ère post-fordiste amène à reposer les questions de l’accès à l’emploi et de la précarité en dépassant le « chômage », ou du moins en le complétant par d’autres catégories et indicateurs.
La qualité de l’emploi
Authors: Erhel Christine , Guergoat-Larivière Mathilde
Published: October 2016

La qualité de l’emploi est devenue, au cours des deux dernières décennies, un objectif de politique économique pour la plupart des grandes organisations internationales. Après avoir rappelé les fondements théoriques sur lesquels s’appuient les définitions de la qualité de l’emploi, cet article présente les différentes approches adoptées par les institutions internationales et les principaux résultats empiriques issus des travaux sur ce sujet : quels sont les différents « modèles » de qualité de l’emploi en Europe ? Comment a évolué la qualité de l’emploi au cours des dernières décennies et en particulier pendant l’épisode de crise ? Quels sont les facteurs macro et microéconomiques susceptibles d’influencer la qualité de l’emploi des travailleurs ?
Les raisons du chômage en France
Authors: Heyer Éric
Published: October 2016

Les raisons d’un chômage de masse en France étant multiples et de nature diverse, les pistes permettant de le résorber le sont également. Au niveau macroéconomique, il est nécessaire de modifier la gouvernance en zone euro en proposant des politiques macroéconomiques plus coopératives, mieux adaptées à la conjoncture et prenant en compte les contraintes environnementales. Au niveau microéconomique, il convient d’investir dans la qualité : celle de l’emploi, sans discrimination selon le sexe ou l’origine ; celle de l’éducation et de la formation de nos citoyens ; celle du logement ; celle des produits, de manière à substituer une stratégie de compétitivité hors prix à celle de compétitivité-prix qui mène l’économie européenne sur le chemin dangereux de la déflation ; celle, enfin, de notre cohésion sociale, déterminant des performances économiques de notre pays et de la compétitivité de notre tissu productif.
Cartographier les jungles
Authors: Lobbé Quentin
Published: October 2016

Sortir les jungles de l’invisible de manière à les graver dans la mémoire collective : tel est le projet de deux équipes bénévoles qui ont mené deux campagnes de cartographie sur les jungles de Grande-Synthe et de Calais. En impliquant les habitants des jungles dans la construction même des cartes, les auteurs ont voulu donner à ceux que l’on veut exclure les moyens de créer leurs propres archives, leur propre mémoire.
Les e-préfectures restent inaccessibles
Authors: Faron Lise
Published: October 2016

Constituant un réel progrès pour la majorité de la population, la dématérialisation des démarches administratives est une source d’exclusion pour les populations les plus fragiles. La généralisation de l’usage d’internet a, en particulier, pour effet d’écarter du service public les étrangers en situation précaire. Loin de simplifier leurs démarches, le passage obligé par internet représente un obstacle insurmontable. Pour les préfectures, cette inaccessibilité est une mise à distance des indésirables.
Les réfugiés piégés par la frontière numérique
Authors: Le Verger Mélanie
Published: October 2016

La préfecture de Bretagne expérimente une nouvelle borne d’enregistrement des empreintes digitales des étrangères et étrangers ayant demandé un visa biométrique pour entrer en Europe. Ce nouveau dispositif, qui s’ajoute à la borne Eurodac et qui devrait être étendu à l’ensemble du territoire, risque de devenir un obstacle majeur au dépôt des demandes d’asile en France et, à terme, dans tous les États membres.
L’asile par visioconférence
Authors: Licoppe Christian
Published: October 2016

Depuis quelques années, à Cayenne, aux Antilles, à Mayotte, le traitement en appel des demandes d’asile par la Cour nationale du droit d’asile se fait par visioconférence. Les conséquences de cette mutation sur l’issue des procédures, si elles sont jugées mineures par les participants, restent à observer et analyser du point de vue du principal intéressé, le demandeur d’asile « traité à distance ».