bluuebunny/crossref_metadata_2025 huggingface dataset:
“Eu quero muito trabalhar um tema”: estratégias argumentativas no programa televisivo Conexões Urbanas
Authors: Bentes Anna Christina , Mariano Rafaela Defendi , Accetturi Ana Cecília Almeida
Published: February 2017

Neste artigo, buscamos analisar a natureza argumentativa do programa de reportagens televisivo Conexões Urbanas, exibido pelo canal fechado Multishow de 2008 a 2015, procurando investigar (i) a correlação entre os tipos de atores sociais que são convidados a participar do programa e os tipos de argumentos mobilizados por eles em suas falas e (ii) o papel das temáticas do programa na configuração do tipo de acordo estabelecido para a configuração do auditório. Nossas análises apontam para o fato de que ocorre uma predominância de certos tipos de argumentos na fala de certos tipos de atores sociais, o que revela que a estruturação argumentativa do programa é correlacionável ao status social de seus participantes. Por fim, verificamos que as temáticas e as estratégias argumentativas dos/nos episódios analisados configuram para cada um deles um perfil específico de auditório.
Apresentação
Authors: Molina Jorge Alberto , Lebler Cristiane Dall'Cortivo , Lima Helcira Maria Rodrigues de , Vitale Maria Alejandra
Published: February 2017

É com satisfação que apresentamos aos leitores da Signo o primeiro número de 2017, dedicado aos estudos que relacionam linguagem e argumentação. A chamada, lançada em meados do ano de 2016, contou com mais de duzentas submissões de artigos por autores do Brasil e do exterior. Tal número de trabalhos expressa não só a relevância da Revista Signo, especialmente no ano em que o Programa de Pós-graduação em Letras da Unisc tem o seu curso de Doutorado em Letras aprovado pela CAPES, mas também o lugar que ocupa na divulgação da pesquisa de ponta produzida tanto no cenário nacional quanto internacional.
Exploring the relationship between the relative age effect and youth development among male house league ice hockey players
Authors: Chittle Laura , Horton Sean , Weir Patti , Dixon Jess Charles
Published: February 2017

The current study examined if relative age influences the youth developmental experiences of male house league ice hockey players. Participants completed an on-line survey that solicited their date of birth and responses to the Youth Experience Survey for Sport (YES-S). Our analysis revealed no relative age effect among the house league hockey players. The MANOVA results revealed no significant multivariate differences between quartile of birth and the five YES-S dimensions (p = .493). It is reassuring that the experiences of the house league ice hockey players in our sample do not differ in their developmental experiences as a consequence of when they were born throughout the selection year.
A POLÍTICA DE EDUCAÇÃO ESPECIAL NA PERSPECTIVA DA INCLUSÃO: AMBIGUIDADES CONCEITUAIS E SUAS CONSEQUÊNCIAS PARA A EFETIVAÇÃO DE UMA ESCOLA INCLUSIVA
Authors: Mattos Nicoleta Mendes de
Published: February 2017

Esse artigo analisa as mudanças ocorridas na política educacional brasileira a partir de 1996, quando é instituído um único modelo de educação no qual a educação especial passa a ser compreendida como uma modalidade de ensino, bem como as várias alterações da terminologia relacionada ao público-alvo da educação especial. Problematiza criticamente a implantação do modelo educacional inclusivo a partir da mudança terminológica e conceitual, empreendendo um estudo teórico que realiza uma síntese da literatura e indica avanços e desafios nas políticas de inclusão brasileira. O modelo de educação inclusiva brasileiro implicou num redimensionamento da educação especial e do seu alunado, que foi se delineando nas políticas publicas de educação, gerando imprecisões conceituais que se refletem nas ações e práticas educacionais vigentes. Conclui-se que as imprecisões apontadas evidenciam uma ambiguidade conceitual que concorre para a manutenção de políticas excludentes na educação escolar brasileira, contribuindo para manter a proposta de inclusão como uma mera modalidade educacional, dificultando a efetivação de uma política orientada para o respeito e valorização das diferenças, que proponha ações a curto, médio e longo prazo.
Soneto de Castillejo
Authors: Busch Wernicke Jorge R. , Cedeño Salazar José Gregorio
Published: February 2017

Discutimos la autoría del soneto con primer verso «Si las penas que dais son verdaderas», por siglos atribuido sin dudas a Cristóbal de Castillejo pero publicado recientemente por varios autores como escrito por Juan Boscán. Pensamos que esta última atribución es errónea, quizás motivada por el título «Soneto de Boscán» que Velasco, editor en 1573 de la obra de Castillejo, le puso a este soneto. La comparación de dos versiones de la obra de Castillejo que incluyen este soneto nos permite apreciar cuán fino poeta era el autor, y cuán escrupuloso en sus revisiones.
La Lij en la publicidad: Un ejemplo de intertextualidad y lecturas multimodales en el Grado en Educación Primaria
Authors: García-Manso Angélica
Published: February 2017

Nuestro estudio describe y analiza el Seminario dedicado a “LIJ y Publicidad” en el marco de las Lecturas Multimodales de la asignatura Didáctica de la Literatura Infantil del tercer curso del Grado en Educación Primaria. En concreto, se estudian cinco anuncios de marcas de automóviles cuyo intertexto está representado por un relato infantil. La noción de Mendoza Fillola de “competencia lectora” o “intertexto lector” se amplía pues a la de “competencia multimedial”, dado que los anuncios resaltan iconográficamente elementos secundarios de los cuentos y se convierten de esta forma en centrales. Del análisis se desprende la metamorfosis que experimentan en el marketing publicitario los textos de Cenicienta, La Cigarra y la Hormiga, Blancanieves y La Liebre y la Tortuga, además del personaje de Gulliver.
Reseña del libro: Literatura y música del hampa en los Siglos de Oro
Authors: Pérez Fernández Julián Jesús
Published: February 2017

Reseña del libro: Literatura y música del hampa en los Siglos de Oro
Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre
Authors: Koppad Bhavana , Prakash Kulkarni Poornima
Published: February 2017

Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.
Solid malignant pediatric tumors: a histopathological study
Authors: Gupta Neelu , Choudhary Monika , Pachar Sandeep , Dhaka Jai Prakash , Verma Roshan
Published: February 2017

Background: In general, the features of malignancies in children differ biologically and histologically from those of adults with respect to incidence, type of tumor, underlying familial or genetic aberration and tendency to regress spontaneously or cytodifferentiation. In recent years, identification of specific genes, oncogenes, tumor markers and other biological and pathological factors have played an important role in staging and classifying risk categorization of specific tumors as low, intermediate and high-risk lesions.Methods: This study is under taken to evaluate the incidence and morphological features of solid malignant tumors in children of fifteen years and below. The material for present study is obtained from S. P. Medical College, Bikaner and referred cases. The histopathology slides and paraffin blocks are reviewed.Results: The sections 3-5 μ thick, are cut and stained by haematoxylin and eosin in all cases and special stains like PAS, MTS, RS done where ever feasible. An analysis of 60 cases of solid malignant tumors of childhood over a period of 5years are made. The early onset and the embryonal nature of the major pediatric tumors, suggest a prenatal origin and role of genetic factors. Infections, exposure to drugs and chemicals during pregnancy are other contributory factors.Conclusions: Accurate incidence of data is important in the planning and evaluation of clinical trials. Documentation of cases, advanced diagnostic methods like IHC, cytogenetic studies and treatment modalities with close follow up is needed to achieve better statistical evaluation of the problem.
Correlation of C-reactive protein and neutrophil counts as early indicators of severe dengue in children
Authors: Atukuri Sandhya Rani , Nayak Praveen
Published: February 2017

Background: Dengue has broad clinical presentation with unpredictable clinical evolution and outcome while most patients recover following a self-limiting non-severe clinical course, a small proportion progress to severe disease. As early diagnosis of dengue infection remains a challenge around the world in areas of limited resources, laboratory parameters like CRP, Neutrophil counts may serve as predictive markers to promote early diagnosis. The objectives of this study were to stratify the levels of C-reactive protein and Neutrophil counts in children with dengue fever and to determine the correlation of C-reactive protein and Neutrophil counts with the severity of dengueMethods: This was an Observational chart based descriptive study done in all pediatric dengue children (aged 1-15 years) admitted at Father Muller medical college hospital, Mangalore during the period of June 2014 to 2016. Total sample size was 100. Data collection was done by using purposive sampling based on inclusion and exclusion criteria from case records. Controls (n = 20), children with diagnosis of viral fever were considered in the study.Results: Out of the 100 children studied, 16% were <5 years ,33% between 6-10 years and 51% above 10 years of age. Mean CRP levels in NS1, IgM and both are 6.2, 6.9, 6.3. CRP values >5 were considered as positive. Mean CRP values in dengue fever with warning signs (DF1), without warning signs (DF2) and Severe Dengue (DF3) were 6.3, 6.2, 11.4 respectively. Absolute Neutropenia was observed in 52% of the study population of dengue (DF1) of which severe neutropenia was observed in 19% and 15% OF DF2 (with no warning signs) also showed neutropenia. CRP values are significant in the study when compared to controls and absolute neutropenia was observed in 52% of dengue with warning signs. Hence CRP and neutropenia may be helpful as early predictors of severe dengue.Conclusions: Our study was an attempt to correlate CRP and neutropenia for early prediction of severe dengue. Mean CRP values in the population were significant statically but not as markedly elevated in other bacterial illness as the study population have no enrolled cases of severe dengue. But neutropenia (<1,500/cmm) and positive CRP (>5) may serve as predictive markers in a resource limited setting.
Clinical profile, outcome and clinical indicators for poor prognosis in full term babies born with severe birth asphyxia: study from tertiary care hospital from western India
Authors: Thakkar Pareshkumar A. , Valia Paresh , Parmar Niyati , Javadekar Bakul , Thakkar Ukti P.
Published: February 2017

Background: The World Health Organization describes birth asphyxia as failure to initiate and sustain default breathing at birth. The aim of the study was to study the clinical profile and outcome at 3 months of age of full term babies born with severe birth asphyxia and to analyze risk factors associated with adverse outcome.Methods: This was a prospective observational study carried out over period of 12 months in year 2015-16. All full term babies born with severe birth asphyxia (n = 45) during four months period were enrolled and were followed up for 3 months. Severe birth asphyxia was defined as APGAR score 3 or less at 1 minute. Baseline characteristics, clinical profile and outcome were noted. HIE was graded as per Sarnat and Sarnat staging. Neurological Assessment at 7th day and on discharge was done and were assessed by Amiel Tison Scale at 3 months. Multivariate analysis by linear regression was done to find risk factors associated with adverse outcome. Results: Of total 45 babies with SBA, 35 developed HIE, of which 13 (28.8%) were in HIE grade II and 13 (28.8%) were in HIE III. Mortality found was 20% while 28.5% of survivors had abnormal neurological outcome at 3 months. Multivariate analysis of risk factors shows that abnormal neurological finding on 7th day of life, APGAR ≤ 6 at 10 minute and HIE grade II or more where associated with abnormal outcome(p = 0.01). The risk factors associated with mortality were multiorgan dysfunction, difficult to control seizures, APGAR ≤4 at 10 minute (p = 007).Conclusions: Full term neonates with severe birth asphyxia has significant mortality and significant number of survivors has abnormal neurological outcome at 3 months of age. Presence of certain clinical indicators is associated with increased risk of adverse outcome.
Cord blood albumin as a predictor of neonatal hyperbilirubinemia in healthy neonates
Authors: K. C. Gaurav Aiyappa , Shriyan Ashvij , Raj Bharath
Published: February 2017

Background: Neonatal jaundice or icterus neonatrum has been observed in newborn babies for many centuries. The objective of this study was to determine the correlation between cord albumin levels and development of hyperbilirubinemia in term healthy neonates.Methods: A prospective study was conducted on 165 term healthy neonates. Gender, gestational age, anthropometric measurements were taken into consideration. It was ascertained that there was no other risk factor for hyperbilirubinemia amongst the neonates. The neonates were divided into two groups A and B based on the cord albumin levels of <2.8 gm/dl and >2.8 gm/dl.Results: Of the 165 babies included in the study, 126 babies were under Group 1 and 39 under Group 2. 44 babies (34%) in group 1 and 28 babies (71.7%) in group 2 (p<0.0005) developed clinical icterus of which 16 in group 1 and 19 in group 2 required phototherapy (p<0.05). 1 baby in group required exchange transfusion. The sensitivity and specificity of cord albumin in detecting neonatal hyperbilirubinemia in this study was determined to be 71.8% and 65.1% respectively.Conclusions: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So, routine determination of cord albumin can be advocated to keep a track on at risk neonates.
Cord C-reactive protein as a marker for early onset neonatal sepsis children
Authors: Patrick Reeba , Rajan Aswathy , Shriyan Ashvij
Published: February 2017

Background: Of the 2.8 million neonatal deaths, worldwide, 0.43 million is contributed by sepsis alone. The objective of this study was to determine the levels of umbilical cord C-reactive protein and assess the suitability of this test in diagnosing early onset sepsis in newborns born to mothers with no risk factors for intrapartum infection. To determine the influence of other factors such as parity, birth weight and mode of delivery on the levels of cord CRP.Methods: CRP levels in cord blood were estimated for 103 consecutive newborns delivered at a tertiary care teaching hospital. These babies were monitored for signs of sepsis for 72 hours and were later followed up with serum CRP and blood cultures.Results: A prospective cohort study of 103 consecutive newborns were taken of which 53.4% were male babies. Comparison of cord CRP levels of baseline characteristics revealed significant elevation in babies born to multipara mothers (p = 0.0028) and in low birth weight babies (p = 0.05), while there were no significant changes in different modes of delivery. The mean cord CRP of the study group was 0.694±0.2979. Out of 104 babies, 16 had elevated cord CRP (above 1.1mg/l) of these, 12 babies were later confirmed to have sepsis. The mean cord CRP level in babies with EOS was 1.3±0.255 (p = 0.001). A sensitivity of 100%, specificity of 90.9%, positive predictive value of 75% and negative predictive value of 100% was determined.Conclusions: This study confirms that cord CRP is an effective marker to predict EONS. An optimal concentration of cord CRP > 1.1 mg/L has maximal sensitivity and specificity to predict EONS.
Immunization status of 24-35 months old children in urban slums of Ahmedabad, Gujarat, India: a cross sectional study
Authors: Chaudhari Chintu C. , Gunjana Geet , Modi Khushboo Kiritbhai , Patel Manali Prashantkumar , Thakker Nisarg Rajivbhai , Thakor Nilesh
Published: February 2017

Background: Immunization is one of the most cost effective methods of preventing childhood diseases and needs to be sustained with higher coverage for desired benefits. Objective of the study was to assess immunization coverage in children of 24-35 months of age group in urban slums of Ahmedabad city, India.Methods: Using the purposive sampling method, a cross sectional community based study was conducted in urban slum area (Vadaj area) of Ahmedabad city during July-November 2014. All 214 children of 24-35 months age group of the area were included after taking verbal informed consent of their parents or guardians. Vaccination status of the children was verified using the Immunization card. In conditions where the Immunization card was not available, the mother/parents were asked about the site of vaccinations to confirm the vaccines being given. Analysis of study was done by using appropriate statistical software. Results: Total 936 households were surveyed. There were 214 children in the 24-35 months age group. Mamta card or immunization record was available with 145 (73.6%) mothers of 24-35 months age group of children. Vaccination coverage in the age group of 24-35 months old children was maximum for BCG and OPV first dose (96.7%) followed by Pentavalent first dose (95.8%) and OPV second dose (95.3%). Overall, 75.7% of the children in the 24-35 months age group were completely immunized while only 6 children were unimmunized. Dropout rate percentage for Pentavalent 1st dose to pentavalent 3rd dose was 3.44% while for BCG to second dose of measles was 19.75%.Conclusions: Complete immunization coverage was 75.7% which was better than the national surveys still the causes for no/ partial vaccinations need to be addressed.
Prevalence of urinary tract infection among preschool febrile children attending the pediatric OPD
Authors: Shetty Pradeep N. , S. Prashanth , Jagadeeshwara Sowmya
Published: February 2017

Background: Urinary tract infection (UTI) is one of the most common bacterial illness among febrile infants and preschool children with a reported prevalence between 4.1% and 7.5%. The objective of this study was to know the prevalence of urinary tract infection in preschool febrile children.Methods: Cross sectional study conducted in pediatric OPD of a Government teaching hospital with 500 febrile preschool children aged 3 to 6 years. Results: Prevalence of UTI in febrile preschool children aged 3-6 years was 2.9% in males and 5.5% in females with overall prevalence of 4%. 15% had temperature > 39.3 oC. 45% had dysuria, 35% had vomiting. 25% and 20% had increased frequency and burning micturition respectively. 70% patients with UTI and 30% cases without UTI had proteinuria. 95% patients had pus cells > 5 per HPF. 60% patients had bacteria in their urine where as in culture negative cases only 1.04% had bacteria. E coli was the common organism isolated (80%), followed by Klebsiella. Majority were resistant to Ampicillin (55%). 75% of microorganisms were sensitive to ceftriaxone. 70% were sensitive to gentamycin, norfloxacin and cephalexin. 5% UTI cases had RFT. KUB X-ray was normal in all the cases. 20% of cases showed features suggestive of acute pyelonephritis on Ultrasonography. 1 out of 4 Patients who underwent Intravenous pyelography showed hydronephrosis. 2 out of 4 cases showed VUR in MCU.Conclusions: UTI is a potential cause of fever in children below 6 years of age. Urine culture is the gold standard for diagnosis of UTI in children. Parents should be educated about the importance of UTI and its long-term complications.
Clinical, etiological, biochemical, microbiological and neurosonogram factors in related with neonatal seizures in Visakhapatnam, India
Authors: Rao Marpi Suryaprasada , Rao Gavara Chinna , Sultana Ayesha , Karthik Putrevu Jagannadha
Published: February 2017

Background: Neonatal seizure is a common neurological problem in the neonatal period. Detection of seizure, its etiology, and clinical types is important for guiding therapy. A varied number of conditions are capable of causing seizures in the neonatal period. The aim was to study biochemical, microbiological and, nurosonogram factors related with neonatal seizures in Visakhapatanam, India.Methods: The study was carried out in the Department of Paediatrics, Andhra medical college, King George Hospital, Visakhapatnam, Andhra Pradesh. The study was done to assess the biochemical changes, nurosonogram factors and microbilogical organisms implicated in neonatal seizures.Results: The present study is descriptive in nature where clinical spectrum of neonatal seizures in neonates was studied. 1500 neonates were admitted in NICU during the study period, among them 200 (13.3%) developed neonatal seizures. Etiology in majority of the cases of neonatal seizures was hypoxic ischemic encephalopathy (45%) followed in frequency by intracranial haemorrhage (14%), meningitis (12%), hypoglycaemia (11%), hypocalcaemia (4%) and others (14%). The most common organism implicated in neonatal seizures was Escherichia coli (36%), followed by Klebsiella (30%), staphylococcus aureus (19%), Streptococci agalactiae (7%) and unknown (8%). Meningitis accounted for 12% of neonatal seizures. Most common biochemical abnormalities noted were hypoglycemia, hypocalcaemia and hyponatremia.Conclusions: Biochemical abnormalities may significantly contribute to seizure activity and possibly correction of these abnormalities may play a significant role in seizure control. A biochemical work up is necessary for all cases of neonatal seizures. Appropriate treatment with antibiotics is essential. Examination of cerebrospinal fluid is essential work up in cases of neonatal seizures. Neurosonogram had good potential in predicting neurological outcome in neonates with perinatal asphyxia. Neurosonogram should be incorporated in the routine evaluation of seizures.
Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India
Authors: Vasundhara Arigela , Sahoo Manas Ranjan , Chowdary Sai Silpa
Published: February 2017

Background: Shock is a state of impaired tissue perfusion resulting in an imbalance between oxygen demand and supply. This widespread reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients, the end result of which is an altered cellular and sub cellular function leading to anaerobic metabolism and accumulation of lactic acid, and consequently cellular damage, multiple organ dysfunction and finally cardiovascular collapse.Methods: The present study was conducted in the department of Pediatrics at Alluri Sitarama Raju Academy of Medical Sciences hospital, Eluru, between December 2014 and June 2016. It is a prospective study. Children aged 1 month to 12 years with a clinical diagnosis of shock were included after written consent from parents.Results: Out of 75 children admitted with shock, 69.33% had septic shock, 25.33% had hypovolemic shock, 2.66% had distributive shock, 2.66% cardiogenic shock. Most common age group admitted with shock was 1 month-1 year 38.666%. Among 75 children with shock, 74.66% children survived and 25.33% children died. Mortality rate in cardiogenic shock was 100%, in septic shock 28.84%, in hypovolemic shock 10.52%.Conclusions: Septic shock was the most common type of shock. Most common cause for septic shock was pneumonia. Septic shock has got highest mortality in the present study.Need for inotropes and mechanical ventilaton indicates poor prognosis in shock.
Adenosine deaminase activity in cerebrospinal fluid: diagnostic investigation in central nervous system disorders in children
Authors: Rahaman Sk Rafikul , Panda Anshuman , Mandal Pradyut K. , Chatterjee Kripasindhu , Borgaonkar R. V.
Published: February 2017

Background: Tubercular meningitis (TBM) is an endemic disease in developing countries. Adenosine deaminase activity (ADA) has been of great importance for many years in TBM diagnosis. The objective of this study was to determine the CSF-ADA levels in different CNS disorders, to compare the CSF-ADA activity in different types of meningitis, to find out the sensitivity and specificity of CSF-ADA in the diagnosis of TBM and to establish the prognostic value of CSF-ADA in TBM in comparison to Control group.Methods: For control group CSF was collected from the patients of simple febrile convulsions and idiopathic epilepsy.Results: The present study was carried out in the 112 cases of different CNS disorders, age ranging from 4 months to 12 years with a mean age of 4.12 years and 38 cases (27+11) of control group (simple febrile convulsion and idiopathic epilepsy). In the present study CSF-ADA level was statistically significantly increased in all types of meningitis (p<0.05). In case of TBM, the mean CSF-ADA level increased statistically significantly with increase in CSF protein level (p<0.05). In case of TBM, there was no significant difference in the mean ADA value according to CSF sugar level (p<0.10). In case of TBM, the mean CSF-ADA level increased significantly with increase in CSF cell count (p< 0.01) mainly lymphocytes.Conclusions: Thus it can be concluded from our study that CSF-ADA estimation is relatively simple and inexpensive procedure in the early diagnosis of tuberculous meningitis with high sensitivity (100%) and specificity (97.5%) at a cut-off level of 5IU/L and can be used in differentiating TBM from other types of meningitis. Along with diagnostic utility of CSF-ADA, it has also prognostic value in the follow-up case of tuberculous meningitis.
Influence of maternal HbA1C on fetal insulin levels
Authors: H. T. Yashoda , B. Swetha , G. Manasa
Published: February 2017

Background: Gestational diabetes is the most common medical complication during pregnancy. The objective of this study was to study the effect of maternal HbA1C levels on fetal insulin levels.Methods: Study was conducted at KIMS. 57 babies born to eligible diabetic pregnant women aged between19 to 40 years with gestational age between 35 and 42 weeks were recruited. Multiple births, gestational age <34 weeks, steroids given within 24 hours before birth, delay of >20 minutes in cord blood collection, delay of >60 minutes before freezing of plasma were excluded. Maternal investigations (HbA1C) were collected from maternal records. Umbilical cord blood was collected immediately after delivery and insulin levels were measured.Results: In this study, mean cord blood insulin levels were 7.83±3.53 μU/ml, mother’s mean HbA1C levels were 6.47±1.26. Statistically significant association was found between maternal HbA1C levels and fetal insulin levels. (r 0.37; P 0.004).Conclusions: Increased cord blood insulin levels were found in infants of diabetic mothers at birth, more so in large for gestation age babies, suggesting inutero fetal programming and hence strict control of maternal diabetes is recommended to decrease long-term fetal effects.
Vitamin D status in children with cerebral palsy
Authors: Manohar Sowjan , Gangadaran Rajakumar Ponnandai
Published: February 2017

Background: The aim of the study was to find the prevalence of vitamin D status - vitamin D deficiency and insufficiency in children with cerebral palsy and to compare them with normal children. To identify the risk factors associated with vitamin D deficiency in these children.Methods: A prospective case control study was done in 200 children in Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur, Tamil Nadu, India over a period of one year from December 2014 to December 2015 after obtaining approval from institutional ethical committee. Study group contained 100 children with cerebral palsy. 100 Age and sex matched children were taken as controls. Children included in the study were between 1 to 12 years. All children were subjected to the following investigations: serum calcium-total, serum phosphorus, serum alkaline phosphatase (SAP) levels. These were determined by an automated analyzer. The 25OH vitamin D levels were estimated by CLIA (chemi luminescence immunoassay) method. Results: Vitamin D deficiency was observed in 32 (32%) and insufficiency in 61 (61%) of children with cerebral palsy in case group. Similarly, vitamin D status studied in control children was found that majority of them 49 (49%) was normal. While 38 (38%) were vitamin D insufficient, 13 (13%) showed deficient levels (p <0.0000001).Conclusions: The presence of feeding difficulties, poor sunlight exposure, poor nutritional status, and the use of antiepileptic drugs, type of CP and the functional grade of CP had statistically significant association with Vitamin D deficiency in these children.
Common breast feeding problems in mothers in early postnatal period
Authors: R. Yogendra Prasad , P. Chandrakala , G. Manasa
Published: February 2017

Background: Breast feeding is the optimal method of feeding in infants and provides improved short and long term health outcomes. The objective of this study was to identify common breast feeding problems in mothers in early postnatal period.Methods: Four hundred and ninety-four mothers in early postnatal period admitted in Kempegowda Institute of Medical Sciences and Research Centre were enrolled in this study during the period from March 2016 to June 20016.All the mothers were questioned regarding about their knowledge of breast feeding, health education received during Antenatal visits, the problems during breast feeding and were also observed for any mistakes of mothers during breast feeding.Results: In this study, the age of the mothers was in the range between 18-38 years. Out of them most were house wives (87.5%) and from urban area (78.4%). This study showed lacking antenatal education of mothers about breast feeding. Among the study group only about 13% had the knowledge about breast feeding, which reflects real breast feeding problems especially in the postnatal period which is critical period in starting and continuation of breast feeding. Among the problems encountered, majority of the mothers had no experience how to hold the baby in right position for breast feeding (16.5%), mothers believed that milk was not sufficient (13%) and the refusal of the baby to suckle (8.7%).Conclusions: This study clearly shows that there is lack of knowledge regarding importance of breast feeding and its benefits to the baby by mothers, during antenatal visits which leads to all problems during breast feeding and hence has to be tackled earlier during pregnancy by educating them about breast feeding.
Tuberous sclerosis with cardiac rhabdomyoma: a case report
Authors: Arora Sunita , Brar Harnoorjit Kaur , Dhillon Prabhjot Kaur
Published: February 2017

Tuberous sclerosis or tuberous sclerosis complex (TSC) is a genetic disorder, caused by mutations on either of two genes TSC1 and TSC2. Clinical manifestations are caused by growth of benign tumours in different parts of the body. Ten months old female child with four major criteria of tuberous sclerosis complex and asymptomatic cardiac rhabdomyoma is presented. A case of TSC warrants cardiac evaluation for the presence of cardiac rhabdomyoma and if a cardiac rhabdomyoma is detected on antenatal ultrasound or postnatal echocardiography, one should have high index of suspicion for the diagnosis of TSC. Continued research on this disease has unfolded many realities regarding its etiology as well as treatment.
Defecation practices in residents of urban slums and rural areas of hubballi, Dharwad: a cross sectional study
Authors: Bathija Geeta V. , Sarvar Rana
Published: February 2017

Background: The unsafe disposal of excreta is a principal cause in the transmission of pathogens within the environment and improvements in excreta management provide significant reductions in diarrhoeal diseases. Objectives of present study are to understand the factors impacting on defecation practices and to study the prevailing defecation practices in adults and children and to assess the knowledge and attitudes with regard to sanitation practices in rural areas and urban slums of Hubballi, Dharwad, Karnataka.Methods: A community based cross sectional study was conducted in 3 areas of Hubballi and Rural Areas of Noolvi. A total of 120 households were visited; 55 of urban and 65 rural. The adult member of the household was interviewed about the sanitary practices followed and their knowledge and attitude towards Safe Sanitation and Open Air Defecation was assessed.Results: 64.18% of the households had an independent toilet in their house (87% in urban and 44.6% in rural). Among these, in only 85% households the toilet was used by all members. While in 11 houses some individuals preferred open air defecation. The practice of open air defecation was found in 44.16% of study sample (21% in urban slums and 63% in rural areas). In children, usage of toilets was only 46.5%. 54% children practiced open air defecation (28.8% in urban slums, 80% in rural areas). The usual sites for open air defecation were open fields (77%), alongside gutter (3%) and streets (20%).Conclusions: According to World Health Organisation, open defecation is the “riskiest sanitation practice of all.” Effort from individuals, communities and government is essential to achieve the goal of open defection free India.
Spectacle compliance amongst school children of Rohtak, Haryana, India
Authors: Bhatt Nikunj K. , Rathi Manisha , Dhull C. S. , Sachdeva Sumit , Phogat Jitender
Published: February 2017

Background: Refractive errors are the commonest cause of visual impairment in school children worldwide. They can be easily corrected by a pair of spectacles, only when they are used regularly. The purpose of present study is to document the actual rate of spectacle wear at the time of examination, assess principle determinants of spectacle wear and reasons for non-compliance among different demographic groups.Methods: 200 school children in the age group of 6-15 years with refractive errors were selected. The schools were visited without prior intimation to the students 3 months after the initial examination. Reasons for spectacle wear non-compliance were enquired.Results: 78 (39.0%) children out of 200 were compliant to spectacle wear, while 122 (61.0%) were non-compliant to spectacle wear. Main reason for not wearing spectacles was ‘teased about the appearance with spectacles’.Conclusions: School teachers should explain the risk of non-wearing of spectacles and benefits of spectacle wearing to both children and their parents. Most of the children were not compliant because they were teased about, did not like, or were not comfortable in their spectacles- all societal issues that could and should be addressed.
A Statistical study to estimate the effects of smoking and cotton dust exposure on lung function of cotton workers of Varanasi district, Uttar Pradesh, India
Authors: Pandey Shubham , Singh Ankit , Singh T. B.
Published: February 2017

Background: Occupational health has been included in National Health Policy, with a mission of providing safe healthy environment for the cotton textile workers by Government of India. With large population being agriculture dependent, the cotton textiles sector is the second largest provider of employment in India. Workers of these cotton and related industries are exposed to cotton dust in mills during carding, blowing, spinning and weaving of cotton fibers. Smoking is another causative factor for aggravating these respiratory symptoms in workers as most of them are habitual to smoking due to work load. Following studies was initiated with an objective to evaluate the interaction between cotton dust exposure and smoking on the lung function of these subjectsMethods: Five hundred (500) male weavers, from Varanasi, the state of Uttar Pradesh, North India working in various spinning outlets, were approached for this study with work duration of 10-15years. These subjects selected were in the age group of 28-41 years with no chronic medical history and lung ailments. Some of the workers had smoking history varying from 5-18 years. After segregating them in various groups (G1-G4), lung functions were monitored by evaluating the peak expiratory flow rate (PEFR) in workers of all the groups in lit/min.Results: As lung functions were evaluated in terms of PEFR as main parameter. The results of the present study indicate significantly low values of PEFR (lit/min) in cotton spinning workers (G-3) as compared to normal healthy individuals (G-1), which got further impaired due to prevalence of smoking in subjects of cotton spinners (G-4). The level of significance (p<0.05) for altered lung functions in smoking workers was much higher than those in nonsmoking workers suggesting involvement of larger airways.Conclusions: Present results of this study; indicate that smoking potentiates the effects of cotton dust exposure on the respiratory functions of spinners by indicating the prevalence of enhanced lung symptoms as well as byssinosis.
Levels and determinants of maternal morbidity in Sangli, Maharashtra, India: a community based study
Authors: Quraishi Sanjay R. , Gaydhanker Anuradha P. , Dhumale Girish B.
Published: February 2017

Background: In developing countries, the leading cause of disability in women aged 15-44 years is pregnancy and childbirth related complications. Many women do not die of causes related to pregnancy but suffer severe morbidities due to pregnancy related physiological stress.Methods: It is a Community based cross sectional study, conducted at randomly selected villages, towns and households in Sangli, Maharashtra, India. Sampling was done by simple random sampling, with a computed sample size of 3200. Study tool was a pre-tested questionnaire. Statistical analysis was done using percentages and Chi-square test. Microsoft Excel and SPSS 22 were used for analysis.Results: The study revealed a high prevalence of maternal morbidity in Sangli, Maharashtra, India. 52.65% women in urban area and 96.53% in rural area suffered from at least one morbidity. In rural area of Sangli, Maharashtra, India maximum of the women surveyed i.e., 30% have primary school education as compared to urban area of Sangli, Maharashtra, India which constitute 34%. A majority of the women in both the districts were suffering from mild complications but the percentage of serious complications is very high in the rural area (15%) than in the urban area (6%).Conclusions: In spite of low levels of perception about maternal morbidities, relatively higher utilization of health services during antepartum period should be taken as an advantage for initiating complete antenatal services, i.e. beyond the coverage of women by TT injection and supply of IFA tablets. The governmental initiation of supplying protein-rich food to pregnant and lactating mothers through ICDS programme has significantly lowered the morbidity levels probably by lessening the levels of anaemia.
Factors associated with therapeutic non-compliance among type 2 diabetes mellitus patients in Chidambaram, Tamilnadu, India
Authors: M. Manobharathi , P. Kalyani , Felix A. John William , A. Arulmani
Published: February 2017

Background: Diabetes mellitus is one of the most common non-communicable diseases causing many serious complications worldwide. Therapeutic non-compliance leads to treatment failure thus making diabetes a serious problem to both the individuals and the health care providers. There are many factors which influence patient’s compliance. The aim of this study is to assess the frequency of therapeutic compliance and factors associated with therapeutic non-compliance.Methods: A descriptive cross-sectional study was conducted among type 2 diabetes mellitus patients attending the urban health centre, Chidambaram.  Compliance and factors associated with non-compliance were assessed using Morisky Medication adherence questionnaire.Results: 108 diabetic patients were enrolled. The overall compliance rate was found to be 39.8%. A statistically significant association was found between non-compliance and associated chronic diseases (p=0.007), financial problems to buy the medicines (p=0.001), reporting side effects with the prescribed medicines (p=0.049), missed at least one dose in last one week(p=0.01).Conclusions: Majority of the patients were non-compliant. This emphasizes the need of strengthening health system and improving patients knowledge through teaching programs.
Pattern of mortality in sudden death: an autopsy study
Authors: Shah Pinkal A. , Gamit Bhavna , Dalal Chintan , Shah Pinal
Published: February 2017

Background: Sudden death has plagued mankind from time Immemorial. Clinical presentations include wide spectrum from symptom complex to completely asymptomatic. Sudden cardiac death in many cases, ‘first and only symptom. The high incidence, sudden, unexpected nature, combining with the low successful rate of resuscitation, make sudden cardiac deaths a major unsolved problem. Therefore, this study was conducted to illustrate etiolopathology, risk factors and triggers of sudden death with the expectation to provide new insight in epidemiological aspects of sudden death, which will help in care of patients, and prevention of premature cardiac deaths.Methods: A study of 50 cases of sudden death was conducted at tertiary care hospital. After evaluating detailed history from the family members, autopsy has been performed to find out cause of sudden death.Results: Principal culprit of sudden death is cardiovascular disease. Highest numbers of sudden death are in middle age group and having male preponderance might be due to presence of multiple risk factors, which have added or multiplicative effect. There are few autopsy negative cases, which are unexplained sudden death.Conclusions: Sudden and unexpected deaths in young population frequently become the subject of pathologic investigation to determine the cause of death.
A comparative study of prevalence of mental abnormalities among high school children in tribal, rural and urban Mysuru district, Karnataka, India
Authors: Satyanarayana Pradeep Tarikere , B. Prakash , Kulkarni Praveen , M. Kishor , M. Renuka
Published: February 2017

Background: Adolescence is defined by WHO as period in human growth and development that occurs after childhood and before adulthood from ages 10 to 19 years. According to WHO, half of all mental health disorders in adulthood start by age 14 years, but most cases are undetected and untreated.Methods: The present study was community based cross sectional comparative study was conducted on study participants were high school children aged 14 years to 16 years in tribal, rural and urban areas of Mysuru from November 2014 to May 2016, i.e., one and a half years (eighteen months). Around 9 tribal high schools, 8 rural high schools and 13 urban high schools were selected and sampling was done according to probability proportionate to size. Institutional Ethics Committee clearance was obtained before start of the study. The study methodology was discussed with and permission obtained from all Principals and Headmasters of respective High Schools. Written informed assent was obtained from each study participant. Data thus Obtained were coded and entered into Microsoft excel Work sheet .This was analyzed using SPSS 22 version. Descriptive statistics like percentage, mean and standard deviation were applied. Inferential statistical tests like chi square test were applied to find out association. The difference, association were expressed statistically significant at p-value less than 0.05.Results: Among the study participants, in tribal area, 88 (47.3%) belonged to age group of 15 years, in rural area, 103 (51.5%) belonged to age group of 15 years and in urban area 116 (59.8%) belonged to age group of 14 years. Anxiety disorders were seen more in urban participants 26.3% and least in rural, major depressive disorders were seen more in urban participants (4.1%) and suicidality was seen more in rural participants (6.5%).Conclusions: Anxiety disorders were seen more in urban participants 26.3%, Major depressive disorders were seen more in urban participants (4.1%) and suicidality was seen more in rural participants (6.5%). The present study stresses importance of School-based specific diagnostic screenings such as for anxiety disorders, depression, ADHD should be implemented.
A study on caffeine consumption and its association with stress and appetite among call centre employees in Mumbai city, India
Authors: Kale Lakshmi B. , Reddy Kejal Joshi
Published: February 2017

Background: Caffeine is a widely consumed chemical having controversial effects. Caffeine may interact with the satiety and may be associated with stress levels. The prevalence of caffeine consumption among call centre employees is known to be high. The aim of the study was to assess the caffeine intake, appetite levels, stress levels and correlate these parameters among call centre employees aged between 25-35 yearsMethods: A cross sectional study with purposive sampling was carried out among a call centre at Mumbai, India. Anthropometric measurements and structured questionnaires were used for data collection.  Results: The average caffeine intake was 200mg/day through coffee and 150mg/day through tea among the habitual consumers. As per the scoring categories of modified appetite questionnaire (CNAQ), 54.7% (n=64) of the participants were at risk to abnormally low appetite. The stress questionnaire results showed that 84.6% (n=99) of the participants were at high risk to stress. Significant negative association was found between coffee intake and appetite score (r- 0.55, p<0.001), indicating that with more coffee consumption the appetite score was lower, similarly significant negative association was seen between tea consumption and appetite score (r- 0.300, p<0.05). Habitual smoking along with daily coffee intake had a significant negative association with appetite score (r- 0.476, p<0.05). Significant difference (p<0.01) was observed between the mean appetite score of habitual smokers and non-smokers; mean appetite score of non-smokers was greater.Conclusions: Caffeine had a negative impact on the appetite levels. Smoking was observed to worsen the effect of caffeine on appetite.