bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of fasting during Ramadan in patients with type 2 diabetes mellitus
Authors: EKŞİ HAYDARDEDEOĞLU Filiz , ŞİMŞEK BAĞIR Gülay , ÖZŞAHİN Akatlı Kürşat
Published: February 2019

Purpose: Fasting during Ramadan is a religious obligation for Muslims. Extended fasting can create undesirable acute complications of diabetes such as hypoglycemia or hyperglycemia. In this study, we aimed to evaluate the impact of fasting on glucose regulation in diabetic patients who fast during Ramadan.Materials and Methods: Patients were informed about the possible side effects of fasting for them and those who stated that they will be fasting during Ramadan were called one month after Ramadan. In this retrospective cohort study by telephone interview, the number of fasting days,  daily measurements of glucose, the number of acute complications if existed and whether the patients  have changed their treatments were asked.Results: Forty six patients were included in this study.  Mean age was 54.3±9.5 yr. The average fasting day was 25.24±2.4. They were categorized according to the risk stratifications. The number of hypoglycemic events was not higher than detected six months prior to the Ramadan. Most of the patients had hyperglycemia rather than hypoglycemia. All of the patients who had hypo-or hyperglycemia did not interrupt their fasting and did not change their medications. Conclusion: Patients who fasted during Ramadan have a tendency both hypoglycemia and hyperglycemia. To improve glycemic regulation and keep these patients in a safe and acceptable glucose range, Pre-Ramadan education is necessary.
Producción intelectual y socialización
Authors: Sánchez-Cabrera Samuel Alberto
Published: February 2019

La revista Libre Empresa es un espacio académico que permite socializar los productos de investigación y reflexiones de sus autores, como un aporte a la construcción de conocimiento en las áreas de las ciencias económicas administrativas y contables, al igual que es un aporte al proceso de enseñanza aprendizaje. De tal manera que en esta dinámica, su publicación se manifiesta como un llamado a que los lectores piensen como sujetos que piensan su área de conocimiento y sean capaces de situarse en el lugar del “otro”, en su construcción de la realidad y sus problemáticas; rescatando la dinámica primigenia de la universidad, la lectura.
Universidad Sociedad Formación Profesional
Authors: Sánchez Cabrera Samuel Alberto
Published: February 2019

La Universidad se enfrenta a plantear nuevos derroteros que propendan por una formación de la vida para la vida, desarrollando procesos dirigidos a mejorar la calidad de vida de la comunidad en resonancia con su entorno, el medio ambiente y la eco región, dirigida a permitir afrontar las realidades del contexto y las cotidianidades que surgen de las relaciones interpersonales, para dar respuesta a un estado de crisis social y política actual, que reclama persona justas y equitativas, donde las relaciones entre la personas se fundan en la otredad, sin lastimar y agredir al otro, fomentando buenas prácticas profesionales, el amor por la naturaleza y el planeta.
Factores internos que afectan la competitividad internacional del puerto de Buenaventura, Colombia
Authors: Montaño Hurtado José Luis , Nieto Gómez Libia Esperanza
Published: February 2019

La competitividad como condición, ha obligado a las organizaciones a ser no sólo más productivas, sino más consecuentes y más comprometidas con las exigencias del mercado. De hecho, en tiempos de globalización, cada economía de mercado tiene como premisa, adaptarse localmente para competir internacionalmente, y así aprovechar las oportunidades que los ámbitos de mercado ofrecen. Cada puerto marítimo en particular, debe identificar el nivel de afectación que puedan tener ciertos factores internos en su legítimo propósito de lograr los más altos niveles de competitividad; así surgen interrogantes como: ¿La infraestructura física actual es lo suficientemente moderna?, ¿Posee el puerto el personal calificado más idóneo para este tipo de negociaciones? ¿Hace un buen uso de las TICs asociadas a este tipo de comercio internacional? ¿Se encuentra alineada la academia a las necesidades laborales requeridas? En esta investigación se realizó un proceso indagatorio, precisando estos factores críticos, con el fin de advertir su impacto en la gestión comercial internacional. Se encontró que el puerto de Buenaventura tiene la posibilidad de convertirse en polo de desarrollo de gran beneficio para Colombia, el logro de la competitividad para este puerto es multifactorial, con factores que van desde lo estrictamente logístico hasta lo social.
Aprendizaje cooperativo en la formación de ingenieros
Authors: Barragan Arias Isabel C. , Arias Ortiz Constanza
Published: February 2019

Se presenta la experiencia de la estrategia metodológica del aprendizaje cooperativo en el curso del seminario de ingeniería III de la Facultad de Ingeniería de la Universidad Autónoma de Bucaramanga UNAB; su propósito es fomentar la competencia para ser ciudadano y profesional con mentalidad global, emprendedora y creativa que brinda solución a las necesidades de la sociedad. Además, despertar la creatividad para identificar oportunidades de negocio, proponer soluciones de valor y diseñar modelos de negocios viables, utilizando la metodología Canvas. El curso tiene un enfoque integral e integrador; combina estrategias de aprendizaje autónomo, cooperativo y basado en proyectos coherentes con las formas de aprender del siglo XXI. El aprendizaje cooperativo, requiere de una gestión del aprendizaje que incluya planeación, implementación, seguimiento y evaluación antes, durante y después de cada sesión de aula, con el fin de desarrollar las habilidades personales, sociales e intelectuales de los estudiantes de ingeniería. Aplicar el aprendizaje cooperativo favoreció en los estudiantes: la creatividad, flexibilidad al cambio y mente abierta para enfrentar retos; tolerancia, cooperación y productividad para lograr el objetivo común; reflexión y posición crítica para tomar decisiones frente a situaciones de su campo de acción; autoaprendizaje, definición y aplicación del pensamiento creativo, analítico y práctico; la gestión de la información de manera sistemática, la comunicación oral y escrita.
Editorial 15-1
Authors: Sánchez Cabrera Samuel Alberto
Published: February 2019

La administración Universitaria demanda de la observancia y cumplimiento de las disposiciones legales, conforme a la nalidad social del estado, en el entendido que la educación superior es un servicio público cultural, el cual permite el desarrollo de las potencialidades de los jóvenes, de tal manera que, con la apertura de nuevos escenarios se debe diseñar estrategias de gestión para permitir la coherencia y el enfoque sistémico de las acciones desarrolladas, teniendo en cuenta el enfoque estratégico de sus fases de plani cación y ejecución del ciclo administrativo, en la implementación de sus cuatro funciones clásicas relacionadas con la planeación, organización, dirección y control. Es importante en la gestión académica el diseño de estrategias integradoras que le den equilibrio a las diferentes dimensiones del desarrollo de la labor académica, que permitan enfrentar los nuevos retos de la educación superior, que plantea el diseño de procesos educativos fundamentados en principios tales como; excelencia, calidad y pertinencia.
Tecnología en Finanzas y Sistemas Contables: Objeto, Método y Pedagogía
Authors: Trujillo Peralta Enrique Omar
Published: February 2019

Este artículo tiene como propósito tratar dos problemas, uno de orden conceptual disciplinar y el otro de tipo pedagógico. Son los siguientes: ¿Cuál es el objeto y método de la Tecnología en Finanzas y Sistemas Contables? y ¿Qué obstáculos pedagógicos hay que superar en los procesos de enseñanza aprendizaje para el diseño del anteproyecto de investigación? Las dos preguntas serán analizadas de manera alterna y no secuencialmente, debido a la problemática que presenta desde un principio el problema del objeto y método de la disciplina. Al final, se obtiene como conclusión estratégica la siguiente: la orientación pedagógica del primer curso de investigación formativa y empresarial del Programa de Tecnología en Finanzas y Sistemas Contables contribuye a superar el enfoque de “Formación para la Técnica”, si su propósito se orienta a diseñar el anteproyecto para desarrollar conceptos básicos de la disciplina y movilizar principios mínimos de Tecnología Didáctica (psicología, informática, y entre otros, en un ambiente didáctico reflexivo y de autoevaluación).
Effect of Substitution of Chicken Egg with Duck Egg on Biscuit Quality
Authors: Makinde Folasade Maria , Awoyera K.D. , Oguntunji A.O.
Published: February 2019

Abstract. Eggs are characterized  with  other components such  antioxidants, folic acid and other B vitamins, and unsaturated fats which might have beneficial effects on heart disease risk that counterbalance the small adverse effect of the eggs’ cholesterol content. A specific study of the effect of chicken egg and/or duck egg in biscuit production has allowed the determination of their respective effects on baking, chemical and sensorial properties. Five sample blends of chicken and duck eggs were made respectively from the following ratios: 0, 10:90, 20:80, 30:70, 40:60 and 50:50%, respectively. Baking and nutritional properties of samples of   biscuit were determined by standard methods, while sensory evaluation was also carried out. The results on the biscuit samples revealed the following ranges: baking properties (weight 14.53-14.85g, diameter 48.4-50.04mm, thickness 9.37-9.46mm, bulk density 0.61 to 0.82g/cm3 and spread ratio 5.12-5.37;  proximate parameters (moisture 3.22-4.78%, ash 0.64-1.74%, fibre 0.49-0.51%,  protein 9.4-12.9%,  fat 15.8-19.2%,  carbohydrate 62.4-68.8% and energy 397.67-411.85kcal/g). Biscuit samples contained varying amounts of calcium, phosphorus, potassium, magnesium, zinc and iron. Baking properties showed a decrease in the weight and thickness but increase in diameter and spread ratio of the biscuits with rising levels of substitution. . The chemical analysis results revealed that biscuit samples containing different levels of duck egg had significantly higher fat, ash and protein content but lower moisture and carbohydrate than the control. Mineral concentration was significantly affected (p≤0.05) by the substitution with duck egg in the biscuit formulations. The substitution of chicken egg with duck egg at a level of up to 40% produces biscuit without any negative effect in quality attributes and reasonable acceptance. Conclusively, the substitution of chicken egg with duck egg in biscuit production is an ideal approach to utilizing uncommon food ingredients. The use of duck egg produced biscuit with different characteristics and quality, depending on level of inclusion in the formulation, offering nutritious and healthy alternative to consumers.
Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India
Authors: Raghuvanshi Shivanjali , Bhalla Shalini , Shahi Vanshika , Kumar Manoj , Qayoom Sumaira , Rawat Shalini , Srivastava Anand , Goel Madhu Mati
Published: February 2019

Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry.
Common morbidities and felt needs of salt pan workers in a coastal area of Tamil Nadu, India
Authors: Vasudevan Jyothi , Vaithiyalingam Saravanan , Anandan Velavan , Mishra Amit Kumar , Purty Anil J.
Published: February 2019

Background: The occupational hazards faced by salt pan workers during their occupation are myriad, a fact compounded by the lack of basic amenities at their workplace and lack of awareness regarding usage of personal protection equipment.Methods: This cross-sectional study was carried out among fifty-six salt pan workers in Marakkanam, Tamil Nadu to assess their common health problems and a qualitative component was added to assess their felt needs in work place and daily living. Data was collected using pre-designed data collection sheet for assessing the common morbidities. For the qualitative aspect of the study, in-depth interviews were conducted among twenty workers based on convenient sampling, using open ended questions. Data was collected after obtaining informed consent and steps were taken to ensure confidentiality at all stages.Results: The most common health problem of the workers in present study area included dental caries (41.7%), skin conditions (38.1%) musculoskeletal problems (36.7%) and anemia (35.1%) being other significant health problems. The qualitative aspect of the study revealed that the felt needs were improvement of their working conditions and more social support from the Government and the employers. There was very little awareness among the workers regarding use of PPE and none of them used any form of PPE.Conclusions: Salt pan workers had dental problems, dermatological problems and musculoskeletal problems as most common morbidities among them. Harsh working conditions, financial insecurity etc. are some of their work-related problems. Provision of housing facility and financial assistance during off- season by the government, basic amenities at the work place, paid leave in case of injuries, and insurance schemes for them by employer are their main felt needs. They also had no awareness regarding usage of personal protective equipment at the work place.
Extended reverse sural artery pedicle flap: a versatile and reproducible option for coverage of ankle and foot defects
Authors: Patil Bhushan R. , Wahegaonkar Chandrashekhar , Agarkhedkar Nikhil , Dogra Bharat Bhushan
Published: February 2019

Background: Coverage of soft tissue defects around distal third of the leg, particularly ankle and foot is a common situation faced by a plastic and reconstructive surgeon. Options available for such defects are limited due to scarcity of additional soft tissue that can be used without exposing tendons or bone. Associated conditions such as major vascular compromise, comorbidities and lack of facilities or expertise make free tissue transfer less preferred. Distally based sural artery flap has been a frequently used flap in such conditions, easy to perform and has reproducible results. We extended the reach of the flap and reproduced the results.Methods: We performed extended reverse sural artery pedicled flaps in 19 patients who presented to us between 2015 to 2017 with soft tissue defects around ankle and foot. Patients included 15 post RTA, 2 diabetic foot, 1 post resection defect and 1 post burn contracture release defect. Size of the defect ranged between 8x6cm to 14x10cm. Average follow up period was ranging from 8 months to 2.5 years.Results: All the flaps healed well without any obvious complications except one patient in whom marginal necrosis (2 cm margin of distal most flap) was observed and was secondarily treated with skin grafting.Conclusions: We observed that extended reverse sural pedicle flap is a rapid, reliable option for coverage of soft tissue defects around ankle and heel, sparing major vessel compromise and lengthy surgical procedure during free tissue transfer. This flap should be the first option for the patients with trauma and defects over weight bearing foot in whom peroneal axis vessels are preserved.
Can serum ferritin levels predict the severity of dengue early?: an observational study
Authors: Petchiappan Velammal , Hussain Thaha Mohammed , Thangavelu Saravanan
Published: February 2019

Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. We analyzed whether serum ferritin can be used to predict the severity at an earlier stage.Methods: A hospital based prospective observational study was done involving 119 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture ELISA). Serum ferritin was measured in all at the time of diagnosis. Clinical and platelet count monitoring was done daily; classified as severe and non-severe according to 2009 WHO criteria.Results: Out of 119, 5 developed severe dengue; patients with severe dengue had significantly lower median platelet count (p<0.0001); higher ferritin levels (p=0.03) and hospital stay (p<0.0001) than non-severe group. Age had a significant negative co-relation with platelet count (r= -0.427; p<0.0001); positive correlation with ferritin levels (r=0.16; p=0.08) and hospital stay (r= 0.26; p=0.004) indicating that elderly subjects are at risk of severe disease. Serum ferritin levels negatively correlated with the platelet count (r= -0.51 p<0.001). High ferritin levels in severe cases are noted from day 4 of clinical illness.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.
The impact of information and communication technologies (ICTs) on academic performance of medical students: an exploratory study
Authors: Mir Shakeel Ahmad , Shakeel Danish
Published: February 2019

Background: Information and Communication Technology (ICT) has a potential to improve teaching and learning process. There are conflicting reports on the effect of ICT on student`s outcome. Though there is an early indication of positive impact, but the technology has a potential to have a detrimental effect. The present study was taken up to explore the effects of ICT on medical student’s academic performance.Methods: All the second professional students were given the questionnaire. Only 75 students had filled up the questionnaires completely.Results: The study population consisted of 48.00% males and 52.00% females. 97.33% students had smart phones, 44.00% had a laptop too. 10.66% students got less than 50% marks in the second professional examination, 14.66% got 50-59% marks, 62.66% got 60-69% marks and 12.00% got 70% or more marks. A low negative correlation was found between academic performance and possession of a smart phone (r= -0.062), and between academic performance and possession of a laptop (r= -0.029). A moderate negative correlation was found between academic performance and the time spent on a smart phone or laptop (r = -0.309). The correlations between academic performance and gender, and academic performance and the time spent on mobile phones or laptops were found statistically significant (p=0.000 and 0.007 respectively).Conclusions: Though ICT has capabilities of improving student`s academic performance, but it has a potential to have a negative effect if not used rationally. There is a vital need to sensitize the students about the potential academic risks associated with improper use of ICT. Students should be assisted and guided on how to use it judiciously.
Echocardiographic findings in patients with chronic obstructive pulmonary disease
Authors: Patil Sarang , Patil Suresh
Published: February 2019

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition involving the airways and characterized by airflow limitation. Pulmonary hypertension (PH) is a well-known predictor of increased morbidity and mortality in COPD. The present study was done to assess the cardiac changes in patients diagnosed with COPD in this department using two-dimensional echocardiography.Methods: This observational study was conducted on fifty patients admitted with signs and symptoms suggestive of COPD in the Department of Pulmonary Medicine, Dr. DY Patil Medical College, Navi Mumbai from January 2018 to December 2018. Pulmonary function tests (PFT) were done in all and patients were graded according to the severity of COPD with guidelines given by Global initiative for Obstructive Lung Disease (GOLD). Comprehensive two-dimensional echocardiography was performed.Results: The most common age group was 60 to 69 years. There were 68% males and 32% females. Mean body mass index of the patients included in the study was 27.8±8.13 kg/m2. COPD according to the GOLD classification was mild, moderate, severe and very severe in 12%, 36%, 30% and 22% of the patients. PH was diagnosed in 56% of the patients, Cor pulmonale in 54%, right ventricular dilatation in 48%, right atrial dilatation in 38%, inter-ventricular septal wall motion abnormality in 18% and right ventricular failure in 14% of the patients.Conclusions: Echocardiography examination is a reliable method in COPD patient to assess PH and helps in early detection of cardiac complications in COPD cases giving time for early interventions.
Prevalence of urinary tract infection in febrile preschool children
Authors: Singh Swatantar , Parihar Sangeeta
Published: February 2019

Background: Children with fever is a common and comprise a substantial proportion of the practice in outpatient department and emergency department. Little attention has been focused on the identification of urinary tract infection (UTI) in febrile in infants and children in the emergency department, despite recent information that suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. The present study is undertaken to estimate the prevalence of urinary tract infection in febrile preschool children (less than 5 years of age) in febrile children.Methods: Febrile children less than 5 years attending outpatient department or admitted in Department of Paediatrics were enrolled into the study. Children below 1 month and above 5 years; any child who has received antibiotics 48 hours prior to evaluation; children with known congenital genitourinary anomalies; and were excluded from the study. Children with symptoms suggestive of UTI were interviewed using structured case record form (CRF). All symptomatic children were referred for urine routine microscopy and culture tests.Results: The prevalence of culture positive cases for UTI was 6.36%. Male infants and female infants affected equally. But females affected more in the age between 1 years to 5 years as compared to males. Apart from fever, the commonest symptoms were dysuria, abdominal pain, vomiting, chills and rigors and loss of appetite. More than two-third of the patients with CP-UTI have E. coli as causative organism for UTI. Overall most sensitive antimicrobials were Ceftriaxone.Conclusions: UTIs in preschool children are often having vague and variable symptoms, often fever is the only symptoms. An untreated UTI can lead to subsequent damage and impairment of renal structure and function, it is very important to diagnose and treat UTI in preschool children.
Finding out incidence of deafness among neonates at a tertiary care centre of western Rajasthan, India using otoacoustic emission
Authors: Gupta Ashish , Kumar Vinod
Published: February 2019

Background: Newborn hearing screening is conducted to identify suspected hearing loss and not to confirm the presence/absence of hearing loss or define features of the loss. Speech and hearing are interrelated, i.e., a problem with one could mean a problem with the other as speech and language is acquired normally through auditory system.Methods: A descriptive study conducted in the Department of Paediatrics, Dr. S. N. Medical College, Jodhpur, from June 2016 to December 2017. 5000 neonates were screened using otoacoustic emissions (OAE) in 2 stages at birth during 3rd to 7th day and 15-30 days respectively, followed by BERA at 3 months of age.Results: 1.4 infants per thousand infants had hearing loss. Presence of high-risk factors was seen to be associated be associated with hearing loss more than normal infants on screening with distortion product otoacoustic emissions (DPOAE) tests. However, on testing with BERA no such association was seen.Conclusions: 1.4 per 1000 infants had hearing loss. This study has shown that two stage distortion product otoacoustic emissions (DPOAE) hearing screening followed by british educational research association  (BERA) to confirm the hearing deficit, can be successfully implemented as new born hearing screening method in a hospital set-up, for early detection of hearing impaired, on a large scale, to achieve the high-quality standard of screening programs in a resource limited and developing nation like India.
Clinico-epidemiological profile of hepatitis A virus and hepatitis E virus co-infection in pediatric age group: a hospital based retrospective study
Authors: Handa Shikha , Wasim Sanober , Kalra B. P. , Rawat Anil , Chandar Vipan , Gupta Alpa
Published: February 2019

Background: Hepatitis-A virus (HAV) and Hepatitis E virus (HEV) are two major hepatotropic viruses of great public health importance in the developing countries like India. Both HAV and HEV are enterically transmitted and there are speculations that their co-infection might be associated with a more severe clinical course and increased rate of mortality. The objective of this study is to determine the prevalence, clinical features and biochemical parameters of Hepatitis A and Hepatitis E co-infection in hospitalized patients at a tertiary care centre in Uttarakhand.Methods: It is a retrospective study, covering a period of 4years and conducted in Himalayan Institute of Medical Sciences, SRHU Jolly Grant, Dehradun. Records of the patients with Hepatitis A and Hepatitis E co-infection were retrieved and analyzed.Results: Out of total 125 patients of acute viral hepatitis, 13 patients had HAV and HEV co-infection. 100% of the patients with co-infection presented with complaints of fever and jaundice, followed by 76.92% with vomiting, 69.23% with pruritis, 61.53% with pain in abdomen and 23.07% with altered sensorium. Mean Bilirubin, ALT, AST were 8.69±7.27 mg/dl, 2030.69±1726.93IU/L and 1880.07±1881.11IU/L respectively. Average duration of stay was 8.2 days. Encephalopathy was seen in 2 patients. However, no mortality was reported.Conclusions: Co-infection of HAV and HEV is not rare in pediatric age group. Knowledge about this will be of immense help for planning of future vaccination strategies and for better sanitation program in developing countries like India.
Mortality and morbidity of very low birth weight and extremely low birth weight babies in neonatal period
Authors: Tripathy Saroj Kumar , Chatterjee Kripasindhu , Behera Narendra
Published: February 2019

Background: Preterm birth is one of the major clinical problems in neonatology as it is commonly associated with perinatal mortality, serious neonatal morbidity and in some cases, it leads to childhood disability. The objective of this study was to find out the outcomes of VLBW and ELBW babies in the form of mortality and morbidity in neonatal period.Methods: A cross sectional study was conducted in SNCU, MKCG Medical College, Berhampur, Odisha between 2011 to 2013. All babies with birth weight less than 1500gm, admitted between days 1 to day 7 of life were enrolled in the study. Babies were broadly divided in to two groups i.e.VLBW group (weight 1000-1499gm) and ELBW group (weight<1000gm). Details of antenatal history, sociodemographic profile and birth history including significant events were noted. Outcome measures included were death, cured and with sequelae.Results: Total number of babies enrolled in this study were two hundred twelve (n=212) and following observations were made. Mortality of ELBW babies was 61.11% and that of VLBW babies was 26.41%. Death rate in babies with weight range 500-749gm, 750-999gm, 1000-1249gm and 125-1499gm was 87.50%, 53.57%, 30.76% and 20.97% respectively. It was found that morbidities such as RDS, HIE, shock and hypoglycemia are significantly higher in ELBW babies as compared to VLBW babies.Conclusions: Extremely low birth weight babies have shown high mortality and morbidity compared to very low birth weight babies and its related death multiply when associated with complications like hyaline membrane disease, hypoxic ischemic encephalopathy, and sepsis.
A study of prevalence of iron deficiency anaemia in infants and toddlers (6-24 months) by measuring serum ferritin levels
Authors: Chanpura Vaishali R. , Shah Nilesh T.
Published: February 2019

Background: Nutritional anemia is a worldwide problem with the highest prevalence in the developing countries. One of the most vulnerable groups is 6-24 months of age. NFHS-3 survey shows that the incidence of anemia in children aged 6-35 months is 79.2% with 72.7% in urban areas and 81.2% in rural areas. First stage of iron deficiency is depletion of iron stores, which is reflected by decreased serum ferritin levels and increased total iron binding capacity (TIBC) levels. The objective of this study was to detect presence of iron deficiency in children even before clinical appearance of anemia by measuring serum ferritin levels.Methods: The study was conducted from March 2017 to November 2017 in the Department of Pediatrics of Sir Sayajirao Gaekwad General Hospital, a tertiary level hospital and government medical college, Vadodara. A cross sectional study was done in which a total of 111 asymptomatic infants and toddlers in age group of 6-24 months presenting to well-baby clinic were enrolled randomly. Haemoglobin, RBC indices and serum ferritin levels were estimated. The children were classified into mild, moderate and severe anaemia according to their haemoglobin levels. Correlation with their serum ferritin levels was carried out by using statistical analysis.Results: Prevalence of anaemia (Hb <11gm/dl) was 84.14% in 6-12 months age group, 81.25% in 13-18 months age group and 84.61% in case of 19-24 months age group. Overall 83.78% of infants and toddlers were found to be anemic among 6-24 months age group. 55 infants (49.54%) among 111 infants had mild anaemia, 29 infants (26.12%) had moderate anaemia, 9 infants (8.1%) had severe anaemia. Majority of children (87 of 111 infants) had microcytic and hypochromic RBCs in their peripheral smear examination. 78 infants (72.07%)) had low serum Ferritin levels while only 31 infants had normal ferritin levels which is statistically significant (p=0.0084). Out of these, 4 infants had normal hemoglobin level.Conclusions: Anaemia is highly prevalent in the age group of 6 to 24 months even in otherwise healthy infants. Serum ferritin level is a good indicator of iron deficiency in children.
Assessment of the prevalence of G6PD deficiency in RBCs of live new-borns born at tertiary care hospital
Authors: Garg Surbhi , Joag Girish G.
Published: February 2019

Background: Glucose-6-phosphate dehydrogenase is one of many enzymes that help the body process carbohydrates and turn them into energy. The mechanism by which G6PD deficiency causes neonatal hyper bilirubin may be due to hemolysis, but other mechanisms like secondary impairment of bilirubin conjugation and clearance by the liver may play a role. Therefore, through this study authors attempt to study the need for a newborn screening program for G6PD deficiency because of high prevalence and high risk of incidence due to consanguineous marriages in India.Methods: This study was a prospective cross-sectional study conducted among 350 consecutively born live new-borns in maternity wards and NICU of Krishna Institute of Medical Sciences and Hospital and Research Centre, Karad, Maharashtra during October 2016 to October 2017.Results: The maximum numbers of newborns were in the age group of 0-10 hours (36.80%), followed by in 11-20 hours (21.80%). The mean age among newborns was 2.86±5.83 hours. Out of 350 cases females were 181 (51.71%) and males (48.29%) and female to male ratio was 1.07:1.Conclusions: G6PD deficiency is one of the major causes of neonatal jaundice within 24 hours of life in new-borns. Hence, neonatal screening for G6PD deficiency could be an alternative to the haemolytic crisis prevention strategy in order to optimize affected young child care and prevention of crisis occurrence by avoiding taking contraindicated foods and drugs.
Study of knowledge attitude practices and utilisation of existing health services by families with regard to newborn health at block level in rural India: a community based, cross sectional, observational study
Authors: Choudhary Monica , Verma Rahul , Jain Shikhar
Published: February 2019

Background: The present study was undertaken to identify KAP gaps and the objective of the study were to assessment of utilization of existing health service infrastructure at grass route level in rural community with regard to mother and neonatal care.Methods: A community based cross-sectional observational study. About 50 mother neonate pair residing in villages under study belonging to Dewas district, Madhya Pradesh.Results: Age old customs and practices of large family (80%), adolescent marriages (30%), high fertility (50%), poor housing and sanitation (48% or more) are still widely prevalent in rural India. Positive impact of NRHM with launch of JSSY and NSSK was seen in utilization of ANC services among beneficiaries with 100% ANC registrations, 98% institutional deliveries and 100% deliveries conducted by trained health professionals, prompt referral to SNCU. Birth weight was not known in 36% neonates and 18% had not received BCG vaccination. 22% were low birth weight and 22% neonate’s required SNCU care. Government emergency transport facility in form of ambulance was either absent (36%) or not utilized (26%) by majority.Conclusions: Lacunae were seen to be persisting regarding awareness and utilisation of few components of maternal and neonatal health care especially in government sector in spite of launch of third phase of NRHM. This was evidenced by, lack of awareness of Obstetric USG facility at civil hospital, non-utilisation of ambulance service for transport, not knowing neonates birth weight and no neonatal follow up care and failure to vaccinate the neonate even till 3rd or 4th week of life.
A study on the length of stay of neonates in neonatal intensive care unit in a referral hospital in India
Authors: P. Kanimozhi , K. S. Kumaravel , K. Velmurugan
Published: February 2019

Background: Estimate of length of stay is important while counseling the parents of preterm infants and also make them prepared psychologically.Methods: A retrospective study done in the Neonatal Intensive Care Unit (NICU) of Government Mohan Kumaramangalam medical college hospital, Salem, Tamil Nadu, India between December 2017 and November 2018. All the neonates admitted during the study period formed the study group.Results: There were 3902 neonates admitted in the NICU during the study period. The mean duration of stay of neonates in the NICU during the study period was 7 days. Out of 3902 neonates in the study group, 37 (0.94%) neonates stayed less than 24 hours, 2208 (56.58%) neonates stayed for 1 to 5 days, 929 (23.8%) neonates stayed for 6 to 10 days, 668 (17.11%) neonates stayed between 11 to 30 days, 41(1.05%) neonates stayed for 31 to 60 days and 7 (0.18%) neonates stayed for more than 61 days. About 45% of neonates in the birth weight category of 1001 to 1500g stayed for 11 to 30 days. A similar trend was also observed in the analysis of length of stay of 29 to 32 weeks preterm neonates.Conclusions: Every hospital should have their own data to predict the length of stay of neonates in NICU. Future directions should include strategies in reducing the length of stay in NICU thereby optimising resources for the parents and the country.
Incidence of urinary tract infection in febrile children
Authors: Ravikumar Naik R. , K. R. Venkatesha
Published: February 2019

Background: Urinary tract infection is diagnosed by the growth of many organisms of a single specimen in the urine with presence of many symptoms. bacteriuria is defined as growth with a colony of >105/ml of a single species in a midstream clean catch urine sample.Methods: A cross sectional study was undertaken in febrile children with urinary tract infection attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2017 to December 2017.Results: Out of the 200 children studied, 93 children belonged to the age group of 6 year to 12 year and 57 children belong to 1 year to 6-year age group and 50 children belongs to 12 year to 18-year age group. 97 children showed significant pyuria in centrifuged urine sample of which 49 were males and 48 were females. Majority 45 children were belonging to age group of 6 year to 12 year. Out of 97 children showed significant pyuria in centrifuged urine sample of which 46 children 5-10 cells/HPF and 27 children showed > 10 cells/HPF and 24 cases showed < 5cells / HPF. Out of 200 children, in 29 cases urine culture showed E. coli growth and 51 cases showed no growth.Conclusions: Urinary tract infections are common in childhood. Nearly all UTIs are caused by bacteria that enter the opening of the urethra and move upward to the urinary bladder and sometimes the kidneys.
Association of patent ductus arteriosus (PDA) with prematurity and low birth weight neonates
Authors: Wani Gh Rasool , Parray Nazir Ahmad , Lone Mohd Rafiq , Ganie Nisar Ahmad , Hussain Anwar , Islam Junaid Ul , Mohammad Syed Muneeb , Mohammad Syed Muneeb
Published: February 2019

Background: Patent ductus arteriosus (PDA) is a major morbidity encountered in preterm neonates, especially in babies less than 28 weeks gestation or 1000g. It may close spontaneously in preterm neonates; however, failure to close spontaneously in preterm neonates results in significant mortality and morbidity in them.Methods: This prospective study was conducted in a tertiary care hospital in north India over a period of one year. The study cohort consisted of preterm, newborn babies admitted in the hospital with gestational age less than 37weeks and birth weight <2500g.Results: In this study total number of patients admitted during the study were 2930. Out of these preterm low birth weight neonates were 432. Among preterm low birth weight neonates admitted, 132 neonates were excluded as per exclusion criteria. Patent ductus arteriosus was detected in 56 among the 300 neonates giving an overall incidence of patent ductus arteriosus 18.6%, the incidence of patent ductus arteriosus was 56.2% for neonates weighing less than 1000gm, 24.7% for neonates weighing between 1000-1499g, 11.6% for neonates weighing between 1500-1999g and 5.6% for the neonates weighing between 2000-2499g.Conclusions: Thus, incidence of patent ductus arteriosus was inversely proportional to gestational age and birth. Data also suggest that immaturity is the major determinant of the persistent patency of ductus arteriosus.
Study of risk factors for relapse in frequently versus infrequently relapsing nephrotic syndrome in 1-18 year age group: a combined prospective retrospective cohort analytical observational study
Authors: Minj Simpal Shalini , Rathi Surbhi , Kondekar Santosh , David Jane J. E.
Published: February 2019

Background: Early prediction and prevention of risk factors is the key to successful management of childhood nephrotic syndrome. This study was carried out to find the risk factors of relapse which will help in early prediction and reduce the risk of relapse in childhood nephrotic syndrome.Methods: It was a combined prospective-retrospective cohort analytical observational study of duration 18 months with sample size of 80 patients of age group 1-18 years who fulfilled the inclusion and exclusion criteria. The variables taken into account for the present study were demographic and disease related.Results: In the present study, 67.7% of patients with ≤6 year of age at first onset were frequent relapsers while 60% of patients with >6 year of age at first onset were infrequent relapsers. A 77.1% of patients belonging to lower socioeconomic strata and 60% of patients belonging to lower-middle socioeconomic strata were frequent relapsers. 100% of patients having ≥ 4 relapses within the 1st year after diagnosis were frequent relapsers while 73.2% of patients having ≤3 relapses within the same period were infrequent relapsers. In present study, out of 38 patients who had received 8 weeks of steroid therapy 92.1% were frequently relapsing while out of 42 patients who received 12 weeks of steroid therapy 64.3% were found to be infrequently relapsing.Conclusions: Younger age at first onset, higher number of relapses in first year and lower socio-economic strata is associated with frequently relapsing nephrotic syndrome. Longer duration of steroid therapy (12 weeks) lowers the chance of frequent relapses.
A study of survival of very low birth weight neonates in a tertiary care hospital
Authors: Shinde Rajendra , Haridas Kiran , Nagar Pritesh , Parakh Hemant
Published: February 2019

Background: Preterm birth is one of the major clinical problems in Obstetrics and Neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. Very low birth weight (VLBW) neonates comprise between 4-8% of live-births but about one-third of deaths during the neonatal period occur in this group of newborns. Data on the probability of survival of infant in high risk pregnancies can be of great value in guiding management. The objective is to study the survival at discharge of VLBW neonates admitted in a tertiary care hospital.Methods: Retrospective observational study of all VLBW infants admitted in Aditya Hospital NICU over 3 years between 1-7-2011 to 30-6-2014. Descriptive and inferential statistical analysis has been carried out in the present study.Results: In the present study maternal PROM was seen in 32.9% of cases, Preeclampsia in 31.7% of cases which constituted the most important antenatal risk factor for VLBW followed by multiple gestations in 25.2%. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Survival improved with increasing gestational age and weight.Conclusions: Birth weight and gestational age specifically predicts survival of preterm VLBW babies, facilitating decision making for obstetricians, neonatologists and parents. In the present study total survival rate was 86.6% with a mortality of 13.4%.
Endoscopic endonasal repair of sphenoid cerebrospinal fluid leak, review and institutional experience
Authors: Al-Jazeeri Isra , Al-Jazeeri Hassan , Al-Momen Ali
Published: February 2019

Background: Rhinogenic CSF leaks are not an uncommon presentation. Considering the possibility of drastic intracranial complications if left untreated, makes the management of such cases of outmost importance. Most of the non-traumatic CSF leaks will need a surgical repair. And since the introduction of the endoscopic nasal surgeries, these repairs are done almost always through the endoscopic endonasal approach.

Methods: Retrospective review of cases with endoscopic repair of sphenoid CSF leak, who presented to King Fahad Specialist Hospital in Dammam (KFSH-D), from November 2003 to December 2017. And the U.S. National Library of Medicine (Pubmed) database was searched for “Sphenoid CSF Leak”.  

Results: We had a total of 12 cases. The demographic data, diagnostic investigations and operative data were retrieved and reviewed.

Conclusions: We advise using high resolution CT and intra-operative fluroscein for a reliable localization. And we found no complications with use of correct concentration of fluroscein. Endoscopic endonasal approach for repair of sphenoid CSF leak was found to be both effective and safe.
Clinical study of non epidermoid malignancies of the paranasal sinuses
Authors: Prabhakar Rao Y. , Amreeta Kaur Punga
Published: February 2019

Background: Malignancy of paranasal sinuses post challenging issues not only for surgeons but also for radiologists. Patients also try to avoid and neglect the condition. Hence clinical studies are more pertinent on this issue. Objective was to study clinical picture of non epidermoid malignancies of the paranasal sinuses.

Methods: This was a retrospective hospital based study of 30 patients with non epidermoid malignancies of the paranasal sinuses from two hospitals over a period of more than four years. Clinical characteristics were studied. CT scan, diagnostic nasal endoscopy, histopathology was done for all patients. Data was analyzed using proportions.  

Results: Majority affected were males. The male to female ratio was 2:1. Maximum cases were found in the age group of 51-60 years and all of them were males. Left side was most commonly affected. The most common presenting feature was nasal obstruction in 50% of the cases. Nasal endoscopy findings has shown that there were five cases each of pinkish red polypoid mass, pinkish grey fleshy mass, pinkish red proliferative mass, pink fleshy mass, purulent discharge and fleshy pinkish red mass. Heterogeneous soft tissue density was the most common CT scan finding. Non Hodgkins lymphoma was more common. Half of the cases were managed by maxillectomy and half of the cases were managed by radiotherapy. There was no recurrence of the tumor after 6-9 months of follow up.

Conclusions: Males are more commonly affected than females. Appropriate management of cases prevents recurrence of the tumors.
Thyroid abscess: a rare condition in immunocompetent patient
Authors: Anjali P. K. , Babu Prashanth , Azeem Mohiyuddin S. M. , Maruvala Shree Harsha
Published: February 2019

Thyroid abscess is rare due to certain anatomical and physiological characteristics of the thyroid gland. Thyroid abscess can occur due to spread of flora in the upper respiratory tract to perithyroid space and thyroid gland through fistula. We are reporting case of thyroid abscess where the infecting pathogen was E. coli. USG and guided FNAC are simple and first line investigations. However there can be abscess formation following FNAC in immune compromised patients. A 50 years old man presented to us with complaints of fever and swelling over the left anterior aspect of neck of 10 days duration. It was associated with pain during swallowing. Ultrasound is investigation of choice as it does not have ionizing radiation, gives a good exposure of thyroid gland, show heterogeneous echo texture and superimposition of abscess is present. It can also show vascularity and internal haemorrhage. Patient was a case of undetected and uncontrolled   diabetes mellitus which might have predisposed him to suppurative thyroiditis. Timely detection and surgical debridement of necrosed tissue and specific antibiotic treatment with management of diabetes helped him recover from this life threatening condition.