bluuebunny/crossref_metadata_2025 huggingface dataset:
Attention to Multiple Objects Facilitates Their Integration in Prefrontal and Parietal Cortex
Authors: Kim Yee-Joon , Tsai Jeffrey J. , Ojemann Jeffrey , Verghese Preeti
Published: April 2017

Selective attention is known to interact with perceptual organization. In visual scenes, individual objects that are distinct and discriminable may occur on their own, or in groups such as a stack of books. The main objective of this study is to probe the neural interaction that occurs between individual objects when attention is directed toward one or more objects. Here we record steady-state visual evoked potentials via electrocorticography to directly assess the responses to individual stimuli and to their interaction. When human participants attend to two adjacent stimuli, prefrontal and parietal cortex shows a selective enhancement of only the neural interaction between stimuli, but not the responses to individual stimuli. When only one stimulus is attended, the neural response to that stimulus is selectively enhanced in prefrontal and parietal cortex. In contrast, early visual areas generally manifest responses to individual stimuli and to their interaction regardless of attentional task, although a subset of the responses is modulated similarly to prefrontal and parietal cortex. Thus, the neural representation of the visual scene as one progresses up the cortical hierarchy becomes more highly task-specific and represents either individual stimuli or their interaction, depending on the behavioral goal. Attention to multiple objects facilitates an integration of objects akin to perceptual grouping.

SIGNIFICANCE STATEMENTIndividual objects in a visual scene are seen as distinct entities or as parts of a whole. Here we examine how attention to multiple objects affects their neural representation. Previous studies measured single-cell or fMRI responses and obtained only aggregate measures that combined the activity to individual stimuli as well as their potential interaction. Here, we directly measure electrocorticographic steady-state responses corresponding to individual objects and to their interaction using a frequency-tagging technique. Attention to two stimuli increases the interaction component that is a hallmark for perceptual integration of stimuli. Furthermore, this stimulus-specific interaction is represented in prefrontal and parietal cortex in a task-dependent manner.
Neural Correlates of Semantic Prediction and Resolution in Sentence Processing
Authors: Grisoni Luigi , Miller Tally McCormick , Pulvermüller Friedemann
Published: April 2017

Most brain-imaging studies of language comprehension focus on activity following meaningful stimuli. Testing adult human participants with high-density EEG, we show that, already before the presentation of a critical word, context-induced semantic predictions are reflected by a neurophysiological index, which we therefore call the semantic readiness potential (SRP). The SRP precedes critical words if a previous sentence context constrains the upcoming semantic content (high-constraint contexts), but not in unpredictable (low-constraint) contexts. Specific semantic predictions were indexed by SRP sources within the motor system—in dorsolateral hand motor areas for expected hand-related words (e.g., “write”), but in ventral motor cortex for face-related words (“talk”). Compared with affirmative sentences, negated ones led to medial prefrontal and more widespread motor source activation, the latter being consistent with predictive semantic computation of alternatives to the negated expected concept. Predictive processing of semantic alternatives in negated sentences is further supported by a negative-going event-related potential at ∼400 ms (N400), which showed the typical enhancement to semantically incongruent sentence endings only in high-constraint affirmative contexts, but not to high-constraint negated ones. These brain dynamics reveal the interplay between semantic prediction and resolution (match vs error) processing in sentence understanding.

SIGNIFICANCE STATEMENTMost neuroscientists agree on the eminent importance of predictive mechanisms for understanding basic as well as higher brain functions. This contrasts with a sparseness of brain measures that directly reflects specific aspects of prediction, as they are relevant in the processing of language and thought. Here we show that when critical words are strongly expected in their sentence context, a predictive brain response reflects meaning features of these anticipated symbols already before they appear. The granularity of the semantic predictions was so fine grained that the cortical sources in sensorimotor and medial prefrontal cortex even distinguished between predicted face- or hand-related action words (e.g., the words “lick” or “pick”) and between affirmative and negated sentence meanings.
Novel Regulatory Mechanisms for the SoxC Transcriptional Network Required for Visual Pathway Development
Authors: Chang Kun-Che , Hertz Jonathan , Zhang Xiong , Jin Xiao-Lu , Shaw Peter , Derosa Brooke A. , Li Janet Y. , Venugopalan Praseeda , Valenzuela Daniel A. , Patel Roshni D. , Russano Kristina R. , Alshamekh Shomoukh A. , Sun Catalina , Tenerelli Kevin , Li Chenyi , Velmeshev Dmitri , Cheng Yuyan , Boyce Timothy M. , Dreyfuss Alexandra , Uddin Mohammed S. , Muller Kenneth J. , Dykxhoorn Derek M. , Goldberg Jeffrey L.
Published: April 2017

What pathways specify retinal ganglion cell (RGC) fate in the developing retina? Here we report on mechanisms by which a molecular pathway involving Sox4/Sox11 is required for RGC differentiation and for optic nerve formation in micein vivo, and is sufficient to differentiate human induced pluripotent stem cells into electrophysiologically active RGCs. These data place Sox4 downstream of RE1 silencing transcription factor in regulating RGC fate, and further describe a newly identified, Sox4-regulated site for post-translational modification with small ubiquitin-related modifier (SUMOylation) in Sox11, which suppresses Sox11's nuclear localization and its ability to promote RGC differentiation, providing a mechanism for the SoxC familial compensation observed here and elsewhere in the nervous system. These data define novel regulatory mechanisms for this SoxC molecular network, and suggest pro-RGC molecular approaches for cell replacement-based therapies for glaucoma and other optic neuropathies.

SIGNIFICANCE STATEMENTGlaucoma is the most common cause of blindness worldwide and, along with other optic neuropathies, is characterized by loss of retinal ganglion cells (RGCs). Unfortunately, vision and RGC loss are irreversible, and lead to bilateral blindness in ∼14% of all diagnosed patients. Differentiated and transplanted RGC-like cells derived from stem cells have the potential to replace neurons that have already been lost and thereby to restore visual function. These data uncover new mechanisms of retinal progenitor cell (RPC)-to-RGC and human stem cell-to-RGC fate specification, and take a significant step toward understanding neuronal and retinal development and ultimately cell-transplant therapy.
Low-Frequency Cortical Oscillations Entrain to Subthreshold Rhythmic Auditory Stimuli
Authors: ten Oever Sanne , Schroeder Charles E. , Poeppel David , van Atteveldt Nienke , Mehta Ashesh D. , Mégevand Pierre , Groppe David M. , Zion-Golumbic Elana
Published: April 2017

Many environmental stimuli contain temporal regularities, a feature that can help predict forthcoming input. Phase locking (entrainment) of ongoing low-frequency neuronal oscillations to rhythmic stimuli is proposed as a potential mechanism for enhancing neuronal responses and perceptual sensitivity, by aligning high-excitability phases to events within a stimulus stream. Previous experiments show that rhythmic structure has a behavioral benefit even when the rhythm itself is below perceptual detection thresholds (ten Oever et al., 2014). It is not known whether this “inaudible” rhythmic sound stream also induces entrainment. Here we tested this hypothesis using magnetoencephalography and electrocorticography in humans to record changes in neuronal activity as subthreshold rhythmic stimuli gradually became audible. We found that significant phase locking to the rhythmic sounds preceded participants' detection of them. Moreover, no significant auditory-evoked responses accompanied this prethreshold entrainment. These auditory-evoked responses, distinguished by robust, broad-band increases in intertrial coherence, only appeared after sounds were reported as audible. Taken together with the reduced perceptual thresholds observed for rhythmic sequences, these findings support the proposition that entrainment of low-frequency oscillations serves a mechanistic role in enhancing perceptual sensitivity for temporally predictive sounds. This framework has broad implications for understanding the neural mechanisms involved in generating temporal predictions and their relevance for perception, attention, and awareness.

SIGNIFICANCE STATEMENTThe environment is full of rhythmically structured signals that the nervous system can exploit for information processing. Thus, it is important to understand how the brain processes such temporally structured, regular features of external stimuli. Here we report the alignment of slowly fluctuating oscillatory brain activity to external rhythmic structure before its behavioral detection. These results indicate that phase alignment is a general mechanism of the brain to process rhythmic structure and can occur without the perceptual detection of this temporal structure.
Posterior Orbitofrontal and Anterior Cingulate Pathways to the Amygdala Target Inhibitory and Excitatory Systems with Opposite Functions
Authors: Zikopoulos Basilis , Höistad Malin , John Yohan , Barbas Helen
Published: April 2017

The bidirectional dialogue of the primate posterior orbitofrontal cortex (pOFC) with the amygdala is essential in cognitive–emotional functions. The pOFC also sends a uniquely one-way excitatory pathway to the amygdalar inhibitory intercalated masses (IM), which inhibit the medial part of the central amygdalar nucleus (CeM). Inhibition of IM has the opposite effect, allowing amygdalar activation of autonomic structures and emotional arousal. Using multiple labeling approaches to identify pathways and their postsynaptic sites in the amygdala in rhesus monkeys, we found that the anterior cingulate cortex innervated mostly the basolateral and CeM amygdalar nuclei, poised to activate CeM for autonomic arousal. By contrast, a pathway from pOFC to IM exceeded all other pathways to the amygdala by density and size and proportion of large and efficient terminals. Moreover, whereas pOFC terminals in IM innervated each of the three distinct classes of inhibitory neurons, most targeted neurons expressing dopamine- and cAMP-regulated phosphoprotein (DARPP-32+), known to be modulated by dopamine. The predominant pOFC innervation of DARPP-32+ neurons suggests activation of IM and inhibition of CeM, resulting in modulated autonomic function. By contrast, inhibition of DARPP-32 neurons in IM by high dopamine levels disinhibits CeM and triggers autonomic arousal. The findings provide a mechanism to help explain how a strong pOFC pathway, which is poised to moderate activity of CeM, through IM, can be undermined by the high level of dopamine during stress, resulting in collapse of potent inhibitory mechanisms in the amygdala and heightened autonomic drive, as seen in chronic anxiety disorders.

SIGNIFICANCE STATEMENTThe dialogue between prefrontal cortex and amygdala allows thoughts and emotions to influence actions. The posterior orbitofrontal cortex sends a powerful pathway that targets a special class of amygdalar intercalated mass (IM) inhibitory neurons, whose wiring may help modulate autonomic function. By contrast, the anterior cingulate cortex innervates other amygdalar parts, activating circuits to help avoid danger. Most IM neurons in primates label for the protein DARPP-32, known to be activated or inhibited based on the level of dopamine. Stress markedly increases dopamine release and inhibits IM neurons, compromises prefrontal control of the amygdala, and sets off a general alarm system as seen in affective disorders, such as chronic anxiety and post-traumatic stress disorder.
An Under-Body Blanket is More Effective than an Over-Body Blanket in Reducing Intraoperative Hypothermia in Patients Undergoing Robot-Assisted Laparoscopic Prostatectomy: A Retrospective Study
Authors: Furuichi Yuko , Sakamoto Atsuhiro
Published: April 2017

Purpose: The study aimed to investigate whether an under-body blanket is more effective than an over-body blanket in preventing intraoperative hypothermia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). Methods: This was a retrospective observational study. We analyzed the medical records of patients who underwent RALP between January 2014 and December 2015 at Nippon Medical School Hospital. The patients were divided into the following groups: under-body blanket group (n=89) and over-body blanket group (n=43). Results: The number of patients using the under-body blanket and the over-body blanket was 89 and 43, respectively. Intraoperative temperatures (at 3 h, 4 h, 5 h, and 6 h after induction of anesthesia, and at the end of the operation) and the postoperative temperature (on arrival in the ward and at 1 h, 2 h, 3 h, and 4 h after arrival in the ward) were significantly higher in the under-body than the over-body blanket group. The maximum and minimum temperatures of the patients and the serum creatinine levels were significantly higher in the under-body blanket group than in the over-body blanket group just after the operation, on postoperative day 1, and just before discharge. The postoperative course was not significantly different between the two groups. Conclusion: The under-body blanket was observed to be more effective in preventing intraoperative hypothermia in patients undergoing RALP than the over-body blanket.
SELEKSI JENIS ANTIOKSIDAN DAN PENENTUAN KONSENTRASI OPTIMUMNYA PADA PEMURNIAN MINYAK IKAN LEMURU
Authors: Irianto Hari Eko , Fawzya Yusro Nuri , Peranginangin Rosmawaty
Published: April 2017

Minyak ikan mengandung asam lemak tak jenuh cukup tinggi, sehingga menyebabkan mudah rusak akibat oksidasi. Penelitian ini ditujukan untuk mendapatkan metoda peningkatan stabititas minyak ikan selama permunian dengan menggunakan antioksidan. Jenis antioksidan yang diteliti efektivitasnya pada penelitian pendahuluanadalah BHA, BHT, propil galat, TBHQ dan tokoferor.
Facial Alveolar Bone Width at the First and Second Maxillary Premolars in Healthy Patients: A Cone Beam Computed Tomography Study
Authors: Rojo-Sanchis Julio , Viña-Almunia Jose , Peñarrocha-Oltra David , Peñarrocha-Diago Miguel
Published: April 2017

The purpose of this study was to analyze the thickness of the facial alveolar bone at the first and second maxillary premolars and determinate the percentage of premolars that reached 2 mm in width. A retrospective study was performed, analyzing cone beam computed tomography scans from the database of the Oral Surgery Unit of the University of Valencia. Patients with periodontal disease, orthodontic treatment, absence among the first maxillary molars, premolars with endodontic treatment, or prosthetic restorations were excluded. The facial alveolar bone width was measured at 1, 2, 3, and 5 mm apical to the vestibular bone peak. A total of 44 patients were included in the study, with 72 first premolars and 72 second premolars analyzed. A descriptive analysis was performed and the normal means were assessed using the Kolmogorov-Smirnov test. The average width of the facial alveolar bone at first and second maxillary premolars was respectively: 1.41 ± 0.50 and 1.72 ± 0.56 at 1 mm, 1.68 ± 0.72 and 2.23 ± 0.66 at 2 mm, 1.71 ± 0.89 and 2.43 ± 0.82 at 3 mm, 1.44 ± 1.00 and 2.31 ± 1.06 at 5 mm from the vestibular bone peak. The facial alveolar bone width at the second maxillary premolars was greater than at the first maxillary premolars at all points measured. This information should be taken in account when planning immediate implants. Further studies are needed to analyze bone resorption at maxillary premolars to better understand facial alveolar bone width influence in implant treatment.
The Effect of the Federal Reserve’s Securities Holdings on Longer-Term Interest Rates
Authors: Bonis Brian , Ihrig Jane , Wei Min
Published: April 2017

In an effort to promote more accommodative financial conditions following the financial crisis of 2008 and the ensuing recession, and at a time when the conventional monetary policy tool--the federal funds rate--was at its effective lower bound, the Federal Reserve conducted large-scale asset purchases (LSAPs) and a maturity extension program (MEP). This note outlines a way to estimate by how much Federal Reserve securities holdings resulting from these purchase programs reduce longer-term interest rates. In this note, we focus on another channel through which LSAPs may affect the economy: the portfolio balance channel.
Antiangiogenic activity of zinc and zinc-sorafenib combination using the chick chorioallantoic membrane assay: a descriptive study
Authors: Kumar Manu , Meshram Girish Gulab , Rastogi Tripti , Sharma Sonal , Gupta Rachna , Jain Seema , Prasad Anisha , Galav Vikas , Bhattacharya S. K.
Published: April 2017

Background: Zinc, a trace element, is known for downregulating several proangiogenic growth factors and cytokines. However, its antiangiogenic activity is not adequately studied. The present study was aimed to evaluate the possible antiangiogenic activity of zinc via the chick chorioallantoic membrane (CAM) assay. Also, the antiangiogenic activity of the combination therapy of zinc with various doses of sorafenib, a tyrosine kinase inhibitor, was evaluated.Methods: A pilot study was initially conducted so as to select suitable doses of zinc and sorafenib. The antiangiogenic activity after combining zinc 2.5 μg/embryo with sorafenib 1, and 2 μg/embryo was also evaluated. The antiangiogenic activity was quantified in terms of total length of blood vessels, number of junctions, number of branching points, and mean length of the blood vessels.Results: Zinc 2.5 μg/embryo showed significant (p <0.05) antiangiogenic activity, as compared to the control group. However, its effect was not comparable to that of sorafenib 2 μg/embryo. The combination of zinc 2.5 μg/embryo with sorafenib 2 μg/embryo did not show an additive/synergistic effect. The combination of zinc 2.5 μg/embryo with sorafenib 1 μg/embryo produced an antiangiogenic activity which was comparable (p >0.05) to that of sorafenib 2 μg/embryo.Conclusions: Zinc caused significant antiangiogenic activity in the CAM assay. The lack of addition/synergism in the zinc-sorafenib combination could have been due to the variability in the dose/ratio selection. Addition of zinc to sorafenib therapy could improve treatment tolerability, reduce cost of therapy, and reduce the emergence of drug resistance. Future mechanistic studies could identify the exact pharmacodynamics of zinc as an angiogenesis inhibitor.
Placenta praevia in Najran University hospital: incidence and risk factors
Authors: Mustafa Sana B. , Elbashir Abdulhadi M. , Waddad Adil Y. , Ibrahim Abdelrahman M. A.
Published: April 2017

Background: Placenta praevia is a source of drastic pregnancy, fetal and neonatal complications. There was variable incidence in the literature in different parts of the world and within the same country regions. We carried out this study to find the impact in our area and the possible risk factors for this serious obstetric problem.Methods: This study is a cross-sectional descriptive, one-year retrospective one-year prospective study, carried out from April 2014 to April 2016. All pregnant women attended the antenatal care clinic in Najran University Hospital during the study period, were included.Results: The incidence of placenta praevia was found to be 2.7%. AMONG the study group, the most affected age group was between 20-29 years. Previous placenta praevia and previous caesarean  section were the significant risk factors P=0.00 and 0,017 repectively.Conclusions: The incidence of placenta praevia in Najran KSA in this study was high, compared to other regions in Saudi Arabia and the majority of the international figures. Caesarean section and previous placenta praevia were the significant risk factors for placenta praevia in this study.
Effect of sildenafil on IUGR
Authors: Singh Abha , Daharwal Abha , Kujur Avinashi , Awasthi Pragati
Published: April 2017

Background: IUGR is one of the major culprit of perinatal mortality and morbidity in India, with reported incidence of 21-28%. Objective of present study is to investigate the effect of sildenafil on pregnancies complicated with IUGR and to see its effect on fetal outcome.Methods: This was a case control study conducted after clearance of Ethical Committee of the Institute from July 2014 to July 2016 in Department of Obstetrics and Gynecology of Dr. B.R.A.M. Hospital, Raipur [C.G.]. All women with pregnancies complicated with IUGR were identified and included in study. According to treatment with Sildenafil women were divided in two groups. Both groups were followed up till delivery and their outcome including birth weight, AC and complications related to IUGR were compared.Results: IUGR was found to be more prevalent in primi gravidas and women of lower socioeconomic and educational status with low BMI.  We found Hypertension in pregnancy as significant causative factor precipitating the IUGR [68%]. In sildenafil treated group significant 63% mothers had baby with birth weight >10 percentile whereas in sildenafil non treated group only 20% had > 10 percentile birth weight. The mean birth weight of Sildenafil treated group was 2594gm whereas in non-treated group it was 2200gm.  In our study, we observed improved AC in 70% whereas in control group improvement was only in 34% which was significant.Conclusions: Sildenafil was found to improves birth weight, abdominal circumference, and reduce the complications related to IUGR.
A randomised clinical trial comparing myoinositol and metformin in PCOS
Authors: Chirania Kishan , Misra Sujata , Behera Sandhya
Published: April 2017

Background: The medical management of PCOS is fast changing from the combination hormonal pills/progesterone for cycle regularisation, cosmetological treatment of acne and hirsutism to management of obesity and insulin resistance. This study evaluates the effects of the insulin sensitisers in improving the clinical and hormonal alterations in cases of PCOS and improving the reproductive outcomes.Methods: This 3-arm prospective randomized comparative study was done from August 2015 to July 2016 in the Department of Obstetrics and Gynaecology at SCB MCH, Cuttack wherein patients of PCOS were studied based on treatment with metformin, myoinositol or both.Results: Myoinositol helped in the resumption of spontaneous menstrual cycles in 66.66% of women with PCOS with menstrual complaints, whereas the same effect in patients who took metformin was only in 15.78%, which was not significant. Use of myoinositol in Infertile women with PCOS resulted in a pregnancy in 57.14% of women, without the need of any ovulation inducing agent while use of metformin gave a pregnancy in all the 9 patients, thought 5 out of them required clomiphene citrate for ovulation induction. With myoinositol there was a reduction in weight, BMI, LH/FSH ratio, acne and hirsutism. Metformin has resulted in a decrement of body weight, BMI and acne only.Conclusions: This study conclusively proves that myoinositol has a definitive role in decreasing the ovarian dysfunction of PCOS. There has been a significant improvement in the symptom profile, weight loss and a significant change in the hormonal parameters.
Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study
Authors: Dutta Amit , Sahu Ramesh Kumar , Chatterjee Kripasindhu , Kothari Sanjay , Rahaman S. K. Rafikul , Sen Shipra
Published: April 2017

Background: The development of mild hypertension or preeclampsia at or near term is associated with minimal maternal and neonatal morbidities. Obstetric ultrasound provides a cornerstone to other modalities used for assessing hypertensive disorders of pregnancy. Placental architecture is modified in PE and eclampsia. This study was designed to detect the placental changes in hypertensive disorders of pregnancy and correlation with ultrasonic and histopathological changes.Methods: The study group comprised of 42 patients with pregnancy complicated with hypertension with period of gestation above 20 weeks and B.P. more than 140/90 mm of Hg measured on two occasions 6 hours or more apart. The control group consists of 42 normotensive patients matched with age and parity. One ultrasonic examination was performed between 28 weeks and 34 weeks and another after 34 weeks till term. Apart from routine parameters i.e. BPD, AC, FL, Amniotic fluid index, EBW and gestational age routine placental grading were performed according to the classification proposed by Grannum and associates. To evaluate perinatal outcome following measurement were studied birth weight immediately after delivery, mode of delivery, perinatal morbidity and mortality, APGAR score, presence of fetal distress.Results: In 97.62% cases (41 out of 42) of control group showed Grade–II changes as opposed to 57.14% of cases (24 out of 42) in study group before 34 weeks. All 21 cases in study group showing Grade ‘III’ changes before 34 weeks had infarction, calcification, increased syncytial knots, fibrinoid necrosis from 95.23 to 100% of these cases showed all these changes. Only 2 cases (9.52%) showed perivascular hemorrhage having Grade ‘III’ before 34 weeks.Conclusions: Accelerated maturation of placenta in pregnancy complicated with hypertension are more common in the hypertensive group. Increased histopathological degenerative changes e.g. calcification, fibrinoid necrosis etc., are more marked even before 34 weeks of gestation in hypertensive group.
The role of cystatin c in the prediction of outcome in hypertensive disorders of pregnancy
Authors: Saldanha Cimona Lyn , Ara Shabnum , Parvez Tabassum
Published: April 2017

Background: Hypertensive disorders of pregnancy greatly influence the maternal and foetal outcome in terms of morbidity and mortality. Complications include involvement of the kidney and progression of the disease which leads to deterioration of renal parameters and function. If left unattended, oliguria and renal shutdown are serious sequelae. Hence the importance of monitoring serum concentrations of cystatin C, creatinine and uric acid. The present study was designed to understand the variations of these markers in pregnant women in this part of India.Methods: Serum levels were therefore determined in samples from 75 healthy women at term as well as in 38 samples of patients with Gestational hypertension and in 30 patients with pre-eclampsia (PE). The values were analysed after tabulation and results subjected to statistical analysis using SPSS software programme.Results: The levels of all three components were significantly higher in pre-eclamptic patients when compared to healthy controls with the mean±SD being 1.86±0.82 vs. 1.08±0.33 for cystatin C, 0.93±0.18 vs. 0.62±0.07 for creatinine and 7.02±1.92 vs. 4.04±1.06 for uric acid respectively. In gestational hypertension, cystatin C was significantly higher, 1.42±1.1 unlike creatinine, 0.84±0.16 and uric acid, 5.26±1.40.Conclusions: In view of significant increase in serum cystatin C, creatinine and uric acid in hypertensive disorders of pregnancy compared to those of healthy pregnant women, in our study, we conclude that these parameters are of significant value if used as markers to predict the onset of GH/PE. This can be established after further and larger clinical trials.
Incision length: an emerging risk factors for surgical‐site infection following cesarean section
Authors: Nagaria Tripti , Kujur Avinashi , Thakur Neha
Published: April 2017

Background: Since late nineteenth century, the caesarean section first done there is a tremendous improvement in the surgical and anaesthetic skills. It has emerged as a safe mode of delivery but now, in the present era there is a continuous rising trend of caserean section. Objective of present study is to evaluate the effect of some specific gestational factors and other known variables associated with poor wound healing in women who delivered by cesarean section.Methods: A total of 1215 women delivered by cesarean section at Pt. JNM Medical college, Raipur, Chhattisgarh, India from May 2014 to April 2015 were included in this study. The BMI was measured at gestational age when she got operated, grade of surgeons was noted. Subcutaneous tissue depth was intra-operatively measured from the fascia to the skin surface, while the incision length was measured after skin closure.Results: Out of 1215 women operated 251 cases developed SSI with incidence of 20.5%. Incision length (OR 2.40, 95% CI 2.11-2.73; p<0.0001), Body mass index (BMI) at term (OR 2.9, 95% CI 1.82-4.44; <0.0001), previous caesarean section scar (OR 0.72, 95% CI 0.54-0.96; p=0.02), Grade of surgeon (OR 5.5, 95% CI 3.3-9.3; p<0.0001), subcutaneous tissue thickness (OR 1.88, 95% CI 1.60-2.23, p<0.0001) were found to be correlated with wound complications. The receiver operating characteristics curve analysis suggested a cut-off of 28.7 for the BMI at term with AUC 0.8 (0.79-0.84, p<0.0001) and 147 mm for the wound length with an AUC 0.8 (95% CI 0.78-0.82; p <0.0001). The multivariate logistic regression model, applied to these variables showed an independent correlation of incision length with SSI   incision length >14.7; OR 2.40, 95% CI 2.11-2.73, p<0.0001.Conclusions: Incision length by itself was found to be an independent risk factor for development of surgical site infection.
Antibiotics in children with bronchial asthma
Authors: Muhammed Safal , Joshi Deepak
Published: April 2017

Background: This study was conducted to determine if oral antibiotics started at presentation reduce the duration of acute exacerbations of bronchial asthma by comparing the durations of mild to moderate exacerbations of asthma managed with or without antibiotics in children below 12 years.Methods:In this systematic trial, we allocated the eligible children to antibiotic group (who also received standard of care and control (the standard of care) group (n=40 in each group) and compared the duration of acute asthma exacerbation between the two groups.Results: The mean difference of duration of mild and moderate exacerbations between the antibiotic and control group was 4.76 hours (95% Confidence Interval (CI) of -36.76 to 28.84) which was found not to be statistically significant (p value- 0.482).Conclusions:There was no significant reduction in the duration of mild to moderate exacerbations of asthma in children below 12 years by the administration of empirical antibiotics.
Unmet need for contraception among urban women: a cross sectional study in Puducherry
Authors: V. Sudha , H. N. Vrushabhendra , S. Srikanth , E. Suganya
Published: April 2017

Background: Providing universal family planning services is an important strategy to reduce maternal morbidity and to control population growth. Worldwide, when contraception is used properly and effectively to avoid unwanted pregnancy it can reduce 25–35% of maternal deaths. The present study aimed at measuring the proportion of married women with unmet need for family planning in an urban area of Puducherry.Methods: A cross sectional study was conducted among 235 married women in the urban field practice area of Sri Venkateshwara Medical College Hospital & Research Centre, Puducherry. Participants were selected based on predetermined eligibility criteria using systematic random sampling method. SPSS version 23.0 was used for statistical analysis. Proportion, Mean, Standard deviation and Logistic regression were applied to interpret the results.Results: Mean age of the participants was 33.3 ±6 years, Nearly 77 %( 181) of the participants reported having used any method of contraceptive at least once and 34.5 %( 81) were found to have unmet need for family planning. The most common reason for unmet need for contraception was fear of side effects (39.5%) and others were infrequent sex (12.3%),insisted by family members (12.3%) and religious reasons (12.3%).Conclusions: Unmet need for family planning was found to be fairly high in our study population. Health care personnel, preferably field staff should be trained to give an informed choice of contraception to the eligible couples to reduce the unmet need for contraception.
Pulmonary function of automobile repair workers in the informal sector of Raichur urban
Authors: M. K. Krishna Kumar , George Leyanna Susan
Published: April 2017

Background: Automobile repair workers of the informal sector are exposed to dusts, toxic fumes and aerosols. Long term occupational exposure may lead to pulmonary function impairment. Hence, the objectives were to study the occurrence of obstructive and restrictive pulmonary impairment among the automobile repair workers by using pulmonary function test and the factors associated with it.Methods: A cross sectional study was carried out in automobile repair workers who work in informal sector in the urban area of Raichur in Karnataka. The pulmonary function tests viz. Forced Expiratory volume in one second, Forced vital capacity, Peak Expiratory Flow Rate per liter and FEV1/FVC ratio in percentage were measured for each worker in sitting posture using a digital spirometer. Data collected were analyzed in SPSS 16.0 software. Chi-square test and t test was used.Results: Out of the 97 automobile repair workers, 42 (43.3%) had normal pulmonary function. Among the abnormal PFT, 20 (20.6%) had obstructive lung function, 25 (25.8%) had restrictive lung function and 10 (10.3%) had mixed obstructive and restrictive lung function. The workers with abnormal PFT consisted of body repair workers (25.0%), mechanical workers (38.1%), spray painters (75.0%), battery repair workers (100.0%) and tyre retreading workers (88.9%).Conclusions: In this study, 56.7% of workers had some form of pulmonary function impairment. Smoking, increase in duration of work hours and years of work showed significant pulmonary impairment. The study highlights the need for creating awareness and encouraging the use of protective gears such as masks, early screening, diagnosis and treatment of respiratory diseases among the garage workers.
Analysis of post implantation speech recognition abilities of children with hearing impairment using cochlear implants
Authors: Kant Anjali R. , Banik Arun A.
Published: April 2017

Background: As per census’2011, in India, there are 15, 94,249 children with hearing impairment below 18 years of age. A current method in treating children with hearing impairment is cochlear implantation. The use of cochlear implants aids in improving auditory detection, discrimination, identification and speech recognition. Although, speech recognition is a primary outcome measure in cochlear implantees, there is a paucity of word lists or tests to assess speech recognition abilities, both in local languages in general and Hindi in particular.

Methods: In order to construct word lists comprising of monosyllabic and multisyllabic, easy and hard words, language samples from children (3 - 5 years of age, n = 120) were collected in order to create a database to select stimuli from. The frequency of occurrence and neighborhood density for the words selected from this database was then computed and word lists were constructed.  These newly constructed Hindi word lists were administered to 45 cochlear implantees (4.1 to 9 years of age); one year post implantation. Subjects were instructed to listen to the words and repeat them. Responses were scored as number of words correctly repeated.  

Results: Cochlear implantees were able to show lexical effects of difficulty, i.e. they achieved higher scores for easy words than those for hard words. However, they were not able to show the same effect for word type.

Conclusions: The newly constructed Hindi word lists appear to be valid lists in assessment of speech recognition abilities of children with hearing impairment using cochlear implants.
A study of clinical and functional outcome of primary total knee arthroplasty using posterior cruciate substitute design
Authors: A. M. Radhakrishna , S. Shivananda , S. Girish
Published: April 2017

Background: To study the clinical and functional outcome in a consecutive series of Total Knee Arthroplasty using Posterior cruciate substituting (PS) design using the Knee Society Score(KSS). The objectives of the study was 1) To assess the improvement in pain relief post-operatively, stability, mobility of the joint and to assess the correction of deformities. 2) To compare the knee clinical score (KCS) pre-operatively and post-operatively. 3) To compare the knee functional score (KFS) pre-operatively and post-operatively. 4) To assess the radiological outcome of total knee arthroplasty. 5) To study the association between the KCS and the KFS.

Methods: The study was conducted on patients who have undergone Primary total knee replacement, in Department of Orthopaedics, KIMS hospital from June 2014 to February 2017. The patient was assessed clinically, functionally using the Knee Society Score and a radiographic evaluation was done. These evaluations were performed at 6weeks, 12 weeks, 24 weeks and 1year follow up visits.

Results: At 1 year follow up of 60 knees, the average pre-op knee clinical score and functional score of 24.7 and 41.2 improved to an average post-op score of 89.9 and 87.8 respectively. Knee clinical and functional score grade of excellent to good was seen in 96.7% (58 knees of 60). Significant association was seen between KCS and KFS. 5 patients had delayed wound healing and one patient had deep infection. Alignment of prosthesis was found satisfactory in all patients. Flexion deformity, valgus and varus correction achieved in all the patients.

Conclusions: Total knee arthroplasty using posterior cruciate substituting designs resulted in excellent relief of pain, range of motion, restoration of function, low prevalence of patellofemoral complications and continues to function well during the follow-up period. Improvement in clinical score correlated significantly with improvement in functional score. Knee society scoring system effective in evaluating clinical, functional and radiological outcomes.

 
Comparison of study of a dynamic condylar screw surgery and distal femoral locking compression plate technique in distal femoral fractures
Authors: Reddy G. Ramachandra , Prasad P. N.
Published: April 2017

Background: An extensive soft tissue damage, intra articular extension, severe comminution and injury to the quadriceps mechanism make the management of the distal fractures of the femur a significant challenge. The advent of techniques such as dynamic condylar screw surgery and distal femoral locking compression plate technique have improved the, management of these fractures compared to the conventional methods. We in the present study have attempted to compare the outcomes of Dynamic condylar screw surgery and distal femoral locking compression plate technique.

Methods: 72 patients over the age of 20 years who sustained simple or compound factures of the lower 1/3rd of femur and admitted into our hospital were included into the study. The patients were divided into 2 groups, one group who underwent Dynamic condylar screw surgery and the other groups were managed by distal femoral locking compression plate technique.

Results: The most common cause of fracture was road traffic accidents, involving both two wheelers as well as four wheelers (51.4%). 19.4% of the patients had a fall from height and 13.9% had a fall from standing height. The mean operative time in DCS was about 121 minutes in comparison to 118 minutes in the LCP. The average hospital stay and the no of RBCs used were comparable in both the cases. Although the mean number of days for full weight bearing as well as the average time of union of the fracture was marginally lower in LCP than in DCS, it was not significant.

Conclusions: It is therefore observed that both condylar screw and the locking plate are very similar in their performance and satisfaction to the patients, although distal femoral locking plate is better in comminuted distal fracture compared to the dynamic condylar screw fracture management.
Efficacy of bipolar hemiarthroplasty in the elderly people: a study in a tertiary care centre
Authors: Ramachandra Reddy G. , Prasad P. N.
Published: April 2017

Background: Intertrochanteric fractures are associated with severe displacement and comminution are very common among the elderly patients especially women. Hemiarthroplasty is a procedure, where the head of the femur is replaced with a prosthetic implant. This study was performed to evaluate the efficacy of the bipolar hemiarthroplasty among the elderly patients with intra capsular fractures.

Methods: Bipolar hemiarthroplasty with or without cement was performed on 77 patients above the age of 60 years with femoral neck fractures.

Results: Out of the 77 patients, 79.2% were females and 20.8% were males. The mean age of all the patients was 68.4 years. Type IV was found to be most common among the elderly. The outcome of the surgery was excellent in more than 75% of the cases. Only one patient had a poor outcome. The most common complication of the surgery was limb shortening in 5.2% patients followed by superficial infections in 2.6%.

Conclusions: Bipolar hemiarthroplasty for the unstable hip fractures in the elderly has good results with early mobilizations and minimal complications. This ultimately affects the general health of the patients and reduces morbidity and mortality.
Treatment of open tibial shaft fractures using intra medullary interlocking
Authors: Reddy G. Ramachandra , Prasad P. N.
Published: April 2017

Background: It has been estimated that annual incidence of open fractures of long bones is 11.5 per 100 000 personswith 40% occurring in the lower limb and commonest site is the tibial diaphysis. This study was performed to evaluate clinical outcome of patients with open fracture of shaft of tibia.

Methods: It was a hospital based observational prospective study was performed on a total of 30 study participants were enrolled and out of them 2 were lost to follow up. After discharge follow up was done every four weeks for clinical, radiological progress of bony union and soft tissue healing.

Results: Majority of the study participants were in the age group of 31-40 years (37%). Males were the main study participant (63.3%). The process of healing took for about 13-16 weeks in 57.1% of the study participants were as in 18% of them it healed within 12 weeks. In 25% of the study participants the healing was completed in more than 16 weeks.

Conclusions: It has been observed from the study that interlocked intramedullary nailing is a very effective and safe and technique for the management of open tibial fractures.
A study to assess epidemiological, clinical profile and outcome of Monteggia fracture dislocation in adults: a retrospective study
Authors: Reddy G. Ramachandra , Prasad P. N.
Published: April 2017

Background: Among all the forearm fractures Monteggia fractures account for approximately 1-2%. Early recognition with anatomical reduction and stable internal fixation is most important in the management of Monteggia fractures. This study was performed to evaluate clinical profile and functional outcome of Monteggia fracture dislocation.

Methods: This retrospective study was done on 381 forearm fractures, out of which 31 were Monteggia fracture dislocation. All adults patients who were >20 years were included in the study.

Results: During the study period, of 381 cases 31 (8.1%) were having Monteggia fracture dislocation. Most of the study participants were males in (61.2%) compared to females (39%). The cause of the fracture in most of the cases was road traffic accidents accounted by 45%. In most of the cases, the outcome of the operation was excellent (61.3%).

Conclusions: If the injury is properly classified and if stable anatomical reduction is achieved at the proper time then the results will always be excellent. In present study all the patients achieved excellent results after surgery.
Role of footwear allergens in juvenile plantar dermatosis
Authors: Perumbil Shyni , Muhammed Kunnummal , Sasidharan Pillai Sarita
Published: April 2017

Background: Juvenile plantar dermatosis (JPD) is characterized by shiny dry fissured dermatitis of the plantar surface of the foot, affecting children aged 3-14years. The most accepted theory is that JPD is a frictional contact dermatitis of the forefoot in which atopics are more prone to develop. Allergic contact dermatitis remains a close differential diagnosis; it can aggravate the predisposing JPD. In this background we carried out a study among children aged fourteen years and below with clinically diagnosed JPD to know the age and sex profile, aggravating factors and clinical features in this part of the country.

Methods: All children aged 14 years and below with JPD attending our outpatient department from November 2006 to November 2007 were included in this study. Using a preset proforma, data regarding age and sex, information on any relation to footwear, past history of allergic disorders in person or family members was collected. All the 40 patients were patch tested using the footwear allergen series in petrolatum base. Patch test unit was removed after 48hours and the results were interpreted using criteria laid down by International Contact Dermatitis Group (ICDRG). The data was analyzed and made an attempt to understand the role of footwear allergy in JPD.

Results: 22 girls and 18 boys attended our OPD with JPD between the age group of 4-14 years. 52.5% were using footwear made of plastic; 25%used leather; 12.5% rubber footwear. Patients presented with erythema and glazed appearance of foot along with fissuring. The areas of involvement were distal soles and toes in 70%, distal sole alone in 7.5% and distal sole and dorsum of toes in 22.5% of patients. Personal history of atopy was documented in 15% of patients and family history of atopy was present in 20% of cases. 20% of patients complained of exacerbation with footwear. Of the 40 patients who underwent patch testing, 10% only showed positive patch test reaction mainly to potassium dichromate (5%).

Conclusions: JPD is not an uncommon disease and it predominantly affects school going children. Seasonal variation was associated with aggravation of disease. Specific footwear was identified to cause flare ups in a significant percentage of study population (20%) and this was proven by patch test results in half of them. Though nearly one fifth of the affected had an atopic diathesis in person or family, the present data suggests that JPD is not exclusive to atopics. A large sized study is required to evaluate the role of footwear in JPD.