bluuebunny/crossref_metadata_2025 huggingface dataset:
Scope of Western Surgical Techniques to Correct Cleft Lip and Palate Prior to the 18th Century
Authors: Romero Martín , Saez José Miguel
Published: October 2013

Objectives

To present the state of knowledge and surgical practice concerning cleft lip and palate leading to the modern era.

Design

Bibliographical review.

Setting

Analysis of the scientific medical, surgical, and odontological literature from the 16th to 18th centuries.

Results

Texts and art confirm the existence of cleft lip and palate from antiquity in all cultures; however, the first certain references in Western scientific literature did not appear until the works of Celsus (ca. 25 BC to AD 50) and Galen (AD 129 to 200). Indications for cleft lip surgery appear in the Middle Ages with Albucasis (936 to 1013) and Yperman (1260 to 1332). From the Renaissance period onward, and with the invention of the printing press, numerous authors described their own surgical methods.

Conclusions

Given the limitations imposed by pain and infection, the authors of the Modern Age focus on correcting the functional and esthetic defect of the lip with techniques that do not differ greatly from those described in the Middle Ages. The treatment for cleft palate was limited to the creation of “obturators” and surgery for cleft palate was not possible until the 19th century.
The Plagiarist's Craft: Fugitivity and Theatricality inRunning a Thousand Miles for Freedom
Authors: Sanborn Geoffrey
Published: October 2013

After showing that nine percent of William Craft'sRunning a Thousand Miles for Freedomis plagiarized in ways that strongly resemble the ways in which William Wells Brown typically plagiarized, I argue that Brown wrote the narrative in tandem with Craft. Recognizing that possibility encourages us to pay closer attention to the formal aspects ofRunning, whose abrupt tonal shifts and frequent comic digressions make it one of the most peculiar of the major African American slave narratives. Just asRunningprolongs, to an extraordinary degree, the intermediate condition of its fugitive protagonists, so does it hold open, by means of its highly theatrical interludes, the prospect of another future, another stage on which black and white Americans might encounter one another.
Mistranslation, Unsettlement, La Navidad
Authors: Brickhouse Anna
Published: October 2013

On 14 october 1492, on the island that he had just named San Salvador, Christopher Columbus Seized Seven TaÍno indians to serve as translators. The abduction was clearly an act of significant forethought, registering Columbus's intention that these interpreters “inquire and inform … about things in these parts” (Columbus, “Tetter” 118)—a first step toward the subjugation of all the inhabitants of San Salvador, who might one day be “taken to Castile or held captive” on the island (Columbus, Diario 75). The taking of these indigenous translators has been no less momentous for contemporary scholarship, perhaps especially in early modern English and American literary studies: in the year of the Columbian quincentenary, Stephen Greenblatt memorably called it “the primal crime in the New World … committed in the interest of language” (24); Eric Cheyfitz concurs that “translation was, and still is, the central act of European colonization and imperialism in the Americas” (104). Yet the concept of translation as a wholly imperial instrument, as commonplace in Columbus's day as in our own, has limited our thinking in important ways (Adorno, “Polemics” 20). As ethnohistorians and literary critics alike have suggested, the interpretive sway of the “linguistic colonialism” model can obscure as much about its Native objects as it reveals about the purported discursive complexity of its European subjects.
Newly developed TiO2-2-HABT functional material for water treatment
Authors: Rahangdale Pralhad K.
Published: October 2013

In the present investigation, initially, 2-hydroxyacetophenone–biuret–trioxane (2-HABT) terpolymer was successfully synthesized, purified and characterized in the laboratory. Then, titanium oxide photocatalyst was anchored on 2-HABT terpolymer using molecular adsorption–deposition method. The titanium oxide particles, deposited on the 2-HABT terpolymeric molecules, formed a coating of about 100 nm in thickness. This newly modified functional photocatalytic material was characterized by means of infrared spectroscopy, X-ray diffraction and scanning electron studies. An anatase-type titanium oxide was uniquely developed. This new TiO2-2-HABT photocatalyst exhibited an excellent photocatalytic activity in the photodegradation of quite concentrated dyes. The dye molecules in bulk solution was supposed to be condensed around titanium oxide particles because of the adsorption phenomenon on 2-HABT polymer molecules, and, therefore, the photocatalytic process was enhanced due to the combined effect of adsorption by 2-HABT terpolymer macromolecules and photocatalytic activity on anatase-type titanium oxide. It was observed that the decolorization of contaminated water occurred within a short-time interval. Thus, it can be concluded that the functional photocatalytic material, reported in article, can be successfully used for water and wastewater treatments.
Exercise Therapy in Individuals With Chronic Kidney Disease: A Systematic Review and Synthesis of the Research Evidence
Authors: Koufaki Pelagia , Greenwood Sharlene A. , Macdougall Iain C. , Mercer Thomas H.
Published: September 2013

Chronic kidney disease (CKD) is becoming a serious health problem throughout the world and is one of the most potent known risk factors for cardiovascular disease (CVD) which is considered the leading cause of morbidity and mortality in this cohort of patients. Additional independent risk factors for poor health outcomes among many include diabetes, physical inactivity and physical dysfunction. Physical inactivity partly contributes to the accelerated deterioration of physical function in people in all stages of CKD, to levels that significantly impact on clinically and patient important outcomes such as morbidity, employment, quality of life (QoL) and ultimately survival. Ongoing research aims to determine the effectiveness and impact of exercise rehabilitation on reducing/managing the risk of CVD, alleviating physical function limitations, preventing disability and enhancing QoL. Current research also aims to elucidate the mechanisms via which exercise therapy may contribute to clinically relevant benefits.
ROS and RNS Signaling in Skeletal Muscle: Critical Signals and Therapeutic Targets
Authors: Michaelson Luke P. , Iler Colleen , Ward Christopher W.
Published: September 2013

The health of skeletal muscle is promoted by optimal nutrition and activity/exercise through the activation of molecular signaling pathways. Reactive oxygen species (ROS) or reactive nitrogen species (RNS) have been shown to modulate numerous biochemical processes including glucose uptake, gene expression, calcium signaling, and contractility. In pathological conditions, ROS/RNS signaling excess or dysfunction contributes to contractile dysfunction and myopathy in skeletal muscle. Here we provide a brief review of ROS/RNS chemistry and discuss concepts of ROS/RNS signaling and its role in physiological and pathophysiological processes within striated muscle.
Physical Activity Intervention Studies and Their Relationship to Body Composition in Healthy Women
Authors: Weber Buchholz Susan , Wilbur JoEllen , Halloway Shannon , McDevitt Judith H. , Schoeny Michael E.
Published: September 2013

Engaging in regular physical activity is a key component for maintaining a healthy weight and preventing overweight and obesity. Obesity continues to be a concern globally, especially for women, and women are less physically active than men. This systematic review examined current research on physical activity interventions designed for healthy community dwelling women and assessed the effects of those interventions on physical activity and body composition. Three author-developed data collection tools were used to extract and examine study variables. For studies with suitable data, effect sizes were obtained. The initial search identified 1,406 titles published between 2000 and 2012, of which 40 randomized clinical trials met inclusion criteria. Of these 40 studies, 16 had a physical activity intervention that did not have a diet component and 24 had a physical activity intervention along with a diet component. The overall weighted mean effect was
A Smad Signaling Network Regulates Islet Cell Proliferation
Authors: El-Gohary Yousef , Tulachan Sidhartha , Wiersch John , Guo Ping , Welsh Carey , Prasadan Krishna , Paredes Jose , Shiota Chiyo , Xiao Xiangwei , Wada Yoko , Diaz Marilyn , Gittes George
Published: October 2013

Pancreatic β-cell loss and dysfunction are critical components of all types of diabetes. Human and rodent β-cells are able to proliferate, and this proliferation is an important defense against the evolution and progression of diabetes. Transforming growth factor-β (TGF-β) signaling has been shown to affect β-cell development, proliferation, and function, but β-cell proliferation is thought to be the only source of new β-cells in the adult. Recently, β-cell dedifferentiation has been shown to be an important contributory mechanism to β-cell failure. In this study, we tie together these two pathways by showing that a network of intracellular TGF-β regulators, smads 7, 2, and 3, control β-cell proliferation after β-cell loss, and specifically, smad7 is necessary for that β-cell proliferation. Importantly, this smad7-mediated proliferation appears to entail passing through a transient, nonpathologic dedifferentiation of β-cells to a pancreatic polypeptide–fold hormone-positive state. TGF-β receptor II appears to be a receptor important for controlling the status of the smad network in β-cells. These studies should help our understanding of properly regulated β-cell replication.
Contribution of Endogenous Glucagon-Like Peptide 1 to Glucose Metabolism After Roux-en-Y Gastric Bypass
Authors: Shah Meera , Law Jennie H. , Micheletto Francesco , Sathananthan Matheni , Dalla Man Chiara , Cobelli Claudio , Rizza Robert A. , Camilleri Michael , Zinsmeister Alan R. , Vella Adrian
Published: October 2013

The contribution of elevated glucagon-like peptide 1 (GLP-1) to postprandial glucose metabolism after Roux-en-Y gastric bypass (RYGB) has been the subject of uncertainty. We used exendin-9,39, a competitive antagonist of GLP-1, to examine glucose metabolism, islet hormone secretion, and gastrointestinal transit in subjects after RYGB and in matched control subjects. Subjects were studied in the presence or absence of exendin-9,39 infused at 300 pmol/kg/min. Exendin-9,39 resulted in an increase in integrated postprandial glucose concentrations post-RYGB (3.6 ± 0.5 vs. 2.0 ± 0.4 mol/6 h, P = 0.001). Exendin-9,39 decreased insulin concentrations (12.3 ± 2.2 vs. 18.1 ± 3.1 nmol/6 h, P = 0.002) and the β-cell response to glucose (ϕTotal, 13 ± 1 vs. 11 ± 1 × 10−9 min−1, P = 0.01) but did not alter the disposition index (DI). In control subjects, exendin-9,39 also increased glucose (2.2 ± 0.4 vs. 1.7 ± 0.3 mol/6 h, P = 0.03) without accompanying changes in insulin concentrations, resulting in an impaired DI. Post-RYGB, acceleration of stomach emptying during the first 30 min by exendin-9,39 did not alter meal appearance, and similarly, suppression of glucose production and stimulation of glucose disappearance were unaltered in RYGB subjects. These data indicate that endogenous GLP-1 has effects on glucose metabolism and on gastrointestinal motility years after RYGB. However, it remains uncertain whether this explains all of the changes after RYGB.
Short Leg Length, a Marker of Early Childhood Deprivation, Is Associated With Metabolic Disorders Underlying Type 2 Diabetes
Authors: Johnston Luke W. , Harris Stewart B. , Retnakaran Ravi , Gerstein Hertzel C. , Zinman Bernard , Hamilton Jill , Hanley Anthony J.
Published: October 2013

OBJECTIVE

Short leg length, a marker of early childhood deprivation, has been used in studies of the association of early life conditions with adult chronic disease risk. The objective of this study was to determine the cross-sectional associations of leg length with measures of insulin sensitivity and β-cell function.

RESEARCH DESIGN AND METHODS

Subjects (n = 462) at risk for type 2 diabetes were recruited into the PROspective Metabolism and ISlet cell Evaluation (PROMISE) longitudinal cohort. Leg length was calculated from sitting and standing height at the 3-year clinical examination. Glucose tolerance status was determined using an oral glucose tolerance test. Insulin sensitivity was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda insulin sensitivity index (ISI), while the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion sensitivity index 2 (ISSI-2) determined β-cell function. Multiple linear regression analysis was conducted, adjusting for covariates including age, sex, ethnicity, family history of diabetes, waist, and weight.

RESULTS

Leg length and leg-to-height ratio were significantly associated with HOMA-IR (β = −0.037, β = −10.49, respectively; P < 0.0001), ISI (β = 0.035, β = 8.83, respectively; P < 0.0001), IGI/IR (β = 0.021, P < 0.05; β = 7.60, P < 0.01, respectively), and ISSI-2 (β = 0.01, P < 0.03; β = 3.34, P < 0.01, respectively) after adjustment for covariates. The association of shorter leg length with lower insulin sensitivity was most evident for those with high waist circumferences.

CONCLUSIONS

Shorter legs were independently associated with lower insulin sensitivity and β-cell function, suggesting that early childhood deprivation may increase the risk of developing diabetes.
Association Between Hyperglycemia at Admission During Hospitalization for Acute Myocardial Infarction and Subsequent Diabetes: Insights From the Veterans Administration Cardiac Care Follow-up Clinical Study
Authors: Shore Supriya , Borgerding Joleen A. , Gylys-Colwell Ina , McDermott Kelly , Ho P. Michael , Tillquist Maggie N. , Lowy Elliott , McGuire Darren K. , Stolker Joshua M. , Arnold Suzanne V. , Kosiborod Mikhail , Maddox Thomas M.
Published: October 2013

OBJECTIVE

Among patients with acute myocardial infarction (AMI) without known diabetes, hyperglycemia at admission is common and associated with worse outcomes. It may represent developing diabetes, but this association is unclear. Therefore, we examined the association between hyperglycemia (≥140 mg/dL) at admission and evidence of diabetes among patients with AMI without known diabetes within 6 months of their hospitalization.

RESEARCH DESIGN AND METHODS

We studied a national cohort of consecutive patients with AMI without known diabetes presenting at 127 Veterans Affairs hospitals between October 2005 and March 2011. Evidence of diabetes either at discharge or in the following 6 months was ascertained using diagnostic codes, medication prescriptions, and/or elevated hemoglobin A1c. Association between hyperglycemia at admission and evidence of diabetes was evaluated using regression modeling.

RESULTS

Among 10,499 patients with AMI without known diabetes, 98% were men and 1,761 (16.8%) had hyperglycemia at admission. Within 6 months following their index hospitalization, 208 patients (11.8%) with hyperglycemia at admission had evidence of diabetes compared with 443 patients (5.1%) without hyperglycemia at admission (P < 0.001). After multivariable adjustment, hyperglycemia at admission was significantly associated with subsequent diabetes odds ratio 2.56 (95% CI 2.15–3.06). Among those with new evidence of diabetes, 41% patients (267 of 651) had a hemoglobin A1c ≥6.5% without accompanying diagnostic codes or medication prescriptions, suggesting they had unrecognized diabetes.

CONCLUSIONS

Hyperglycemia at admission occurred in one of six patients with AMI without known diabetes and was significantly associated with new evidence of diabetes in the 6 months following hospitalization. In addition, two of five patients with evidence of diabetes were potentially unrecognized. Accordingly, diabetes-screening programs for hyperglycemic patients with AMI may be an important component of optimal care.
Microstructural Brain Tissue Damage in Metabolic Syndrome
Authors: Sala Michiel , de Roos Albert , van den Berg Annette , Altmann-Schneider Irmhild , Slagboom P. Eline , Westendorp Rudi G. , van Buchem Mark A. , de Craen Anton J.M. , van der Grond Jeroen
Published: October 2013

OBJECTIVE

We investigated the association between metabolic syndrome risk factors and brain tissue integrity, as assessed by magnetic resonance imaging.

RESEARCH DESIGN AND METHODS

From the Leiden Longevity Study, which is a community-based study of long-lived subjects, their offspring, and partners thereof, 130 subjects (61 men; mean age 66 years) were included. A metabolic syndrome score was computed by summing the individual number of components according to the Adult Treatment Panel III criteria. We performed linear and logistic regression analysis and used standardized β-values to assess the association between metabolic syndrome and brain macrostructure (brain volume and white matter lesion load, lacunar infarcts, and cerebral microbleeds) and microstructure (mean magnetization transfer ratio [MTR], MTR histogram peak height, fractional anisotropy, and mean diffusivity [MD]). Linear and stepwise regression analysis was performed to identify the individual contribution of one metabolic syndrome parameter adjusting for the four other parameters. Models were adjusted for age, sex, and relation to long-lived family.

RESULTS

Brain macrostructure was not associated with metabolic syndrome. In contrast, metabolic syndrome was associated with decreased gray (β = −0.3 P = 0.001) and white matter peak height (β = −0.3, P = 0.002) and increased gray matter MD (β = 0.2, P = 0.01, P = 0.01). Serum HDL cholesterol (β = 0.22, P = 0.012), triglycerides (β =−0.25, P = 0.002), BMI (β =−0.2, P = 0.014), and diastolic blood pressure (β = −0.17, P = 0.047, and β = −0.23, P = 0.009, for gray and white matter, respectively) were independent factors in these changes in brain microstructure.

CONCLUSIONS

In early manifest metabolic syndrome, brain tissue decline can be detected. Serum HDL cholesterol, triglycerides, BMI, and diastolic blood pressure were independent factors in brain tissue integrity.
Geography studies in Poland after 1989 — selected issues
Authors: Tracz Mariola , Hibszer Adam
Published: October 2013

Changes in the position of geography as a field of education are examined in the context of the socio-political transition in Poland after 1989 and in relation to the changes in higher education. The influences of changes in higher education on the number of geography students in the years 1990–2009, the regional differentiation of interest in geography studies, and developments in staff and the organization of schools with geography programmes are analysed. In the years 1989/90–2008/09 the number of higher education schools offering geography programmes increased by one third. The range of programmes offered was widened with new specialisations
Modelling the influence of oil content on optical properties of seawater in the Baltic Sea
Authors: Rudź K. , Darecki M. , Toczek H.
Published: September 2013

The accuracy and correct interpretation of optical parameters of seawater depend on the complete information osn the interactions between seawater components and the light field. Among components influencing the radiative transfer, the droplets of oil can cause over- or underestimation of modelled and measured optical quantities, especially in closed seas and coastal zones. Oil content in the Baltic Sea varies from several ppb in the open sea to several ppm in estuaries or ship routes. Oil droplets become additional absorbents and attenuators in seawater causing changes in apparent optical properties. These changes can potentially enable remote optical detection of oil-in-water emulsion in visible bands. To demonstrate potential possibilities of such optical remote sensing, a study of inherent optical properties of two types of crude oil emulsion was conducted, i.e. high absorptive and strongly scattering Romashkino, and low absorptive and weakly scattering Petrobaltic. First, the calculations of spectral absorption and scattering coefficients as well as scattering phase functions for oil emulsions were performed on the basis of Lorentz-Mie theory for two different oil droplets size distributions corresponding to a fresh and 14-days aged emulsions. Next, radiative transfer theory was applied to evaluate the contribution of oil emulsion to remote sensing reflectance Rrs(λ). Presented system for radiative transfer simulation is based on Monte Carlo code and it involves optical tracing of virtual photons. The model was validated by comparison of Rrs(λ) simulated for natural seawater to Rrs(λ) from in situ measurements in Baltic Sea. The deviation did not exceed 10% for central visible wavelengths and stayed within 5% for short and long wavelengths. The light Petrobaltic crude oil in concentration of 1 ppm causes typically a 10-30% increase of Rrs while the heavy Romashkino reduces Rrs for 30-50%.
Intensity noise in ultra-high frequency modulated semiconductor laser with strong feedback and its influence on noise figure of RoF links
Authors: Ahmed M. , Bakry A. , Altuwirqi R. , Alghamdi M. S. , Koyama F.
Published: September 2013

We characterize the intensity noise associated with the ultra-high frequency direct modulation of semiconductor lasers under strong optical feedback over a millimeter-wave frequency passband between 54.5 and 56.5 GHz. Enhancement of the modulation response over this millimeter wave band due to optical feedback is clearly shown by time-delay rate equation analysis fully involving the strong optical feedback effect. The contribution of the relative intensity noise of the laser to the noise figure of an ultra-high speed radio over fiber link is evaluated. We show that subjecting the laser diode to strong feedback improves the noise figure of a 55.8-GHz radio over fiber link nearly by 20 dB in the regime of small-signal modulation and 10 dB under large-signal modulation.
Fabrication of adhesive lenses using free surface shaping
Authors: Hoheisel D. , Kelb C. , Wall M. , Roth B. , Rissing L.
Published: September 2013

Two approaches for fabricating polymer lenses are presented in this paper. Both are based on filling circular holes with UV curing adhesives. Initially, the viscous adhesive material creates a liquid and spherical free surface due to its own surface tension. This shape is then preserved by curing with UV-hardening light. For the first approach, the holes are generated in a 4 inch Si-wafer by deep reactive ion etching (DRIE) and for the second, a polydimethylsiloxane (PDMS) mould is manufactured. Three types of UV-curing adhesives are investigated (NOA 61, NOA 88 and NEA 121 by Norland Products). Preliminary to the determination of the lens curvature, a contact angle goniometer is used for taking side view images of the lenses. The radius of curvature is then extracted via image processing with the software MATLAB®. Furthermore, the surface roughness of the PDMS mould and the generated lenses is measured with a white light interferometer to characterize the casting process. The resolution power of the generated lenses is evaluated by measurement of their point spread functions (psf) and modulation transfer functions (mtf), respectively.
High coupling efficiency to a low dispersion slow light-supporting photonic crystal waveguide
Authors: Moghaddam M. Khatibi , Attari A. R. , Mirsalehi M. M.
Published: September 2013

In this paper, we design a waveguide on photonic crystal slab for propagation of low-dispersion slow light. By shifting the air holes adjacent to the waveguide, we obtain a photonic crystal waveguide with a group index of 25 in 25 nm bandwidth which results in a group index bandwidth product of 0.366. To take the advantages of low dispersion slow light generated in this engineered waveguide, we next focus on low coupling efficiency limitation. A low group index coupler is proposed to increase the transmission of the light to the slow mode in the low dispersion bandwidth. By using the proposed coupler and adjusting the structural parameters, the coupling efficiency to low dispersion slow light is improved 11 dB compared to the transmission without the coupler.
Avian Influenza
Authors: Chaudhary S , Pahwa VK
Published: September 2013

DOI: http://dx.doi.org/10.3126/jucms.v1i3.8750 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 1-3
Effect of Antituberculosis Treatment on Serum Zinc Level in Tuberculosis
Authors: Bhandari S , Neupane Y , Badade ZG , Potdar P
Published: September 2013

INTRODUCTION: Tuberculosis is a major public health problem worldwide. One third population of world is infected with M. tuberculosis. Zinc is micro-mineral essential for human growth, development and immune function. Deficiency of this micronutrient impairs overall immune function and resistance to infection. Present study was conducted to evaluate the level of serum zinc in patients with tuberculosis at various period of treatment.   METHODS: Total 92 subjects included were evaluated from OPD, IPD and DOTS centre of MGM group of Hospitals, Navi Mumbai, India. Among them there were 50 patients with Tuberculosis and 42 normal healthy controls. In all the subject estimation of Zinc was carried out. Out of 50 tuberculosis patients, 31 patients were assessed for zinc after two months and six months (i.e. completion) of DOTS therapy. The assessment was done according to the cut off values of serum zinc i.e. 60- 120 µgm/dl.   RESULTS: Serum zinc levels were significantly low (p<0.001) in study group as compared to the healthy control. Serum zinc concentration of the patients increased gradually after anti-tuberculous therapy and reached normal levels after completion of therapy.   CONCLUSION: In the present study serum zinc levels of patients with pulmonary tuberculosis was found low as compared to healthy control subjects. Supplement of zinc during the treatment can be important for the betterment of the treatment of this disease. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8751   Journal of Universal College of Medical Sciences Vol.1(3) 2013: 15-17
Skin and Soft Tissue Infections: Bacteriological Profile and Antibiotic Resistance Pattern of Isolates
Authors: Sah P , Khanal R , Upadhaya S
Published: September 2013

INTRODUCTION: Emergence and spread of antibiotic resistance in organisms causing skin and soft tissue infections (SSTIs) is posing a great therapeutic challenge. This study aimed to determine bacteriology of SSTIs and study antibiotic resistance among the isolates. MATERIAL AND METHODS: A retrospective analysis of 149 consecutive pus specimens received at microbiology laboratory of Universal College of Medical Sciences & Teaching Hospital, Bhairahawa over a period of 8 months from July 2012 to February 2013 was done. The bacterial isolates were identified by standard microbiological techniques and antibiotic susceptibility testing was done by Modified Kirby-Bauer method. RESULTS: Growth was seen in 92 (62%) specimens out of which 88 specimens yielded single isolate and 4 specimens yielded 2 isolates. Hence a total of 96 isolates were isolated. The commonest isolates were Staphylococcus aureus (n=39) followed by E. coli (n=11), Pseudomonas spp (n=11), Coagulase negative staphylococci (n=9), Klebsiella spp (n=6), Proteus spp (n=5), Streptococcus spp (n=4), Acinetobacter spp (n=1), and unidentified gram negative bacilli (n=10). Among gram positive cocci susceptibility to Amikacin was highest followed by vancomycin and gentamycin. Among gram negative bacilli aminoglycosides and ciprofloxacin susceptibility was high, however all E. coli isolates were ciprofloxacin resistant. Majority of isolates were resistant to amoxicillin, ceftriaxone and cotrimoxazole. CONCLUSION: In conclusion this study reports the commonest organism in SSTIs is S. aureus followed by E.coli and Pseudomonas spp. Continued monitoring of susceptibility pattern need to be carried out to detect the true burden of antibiotic resistance in organisms and prevent their further emergence by judicious use of drugs. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8759 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 18-21
The Application of Cope Inventory in Obsessive-Compulsive Disorder
Authors: Thapa DK , Shyangwa PM , Shakya R , Sapkota N
Published: September 2013

INTRODUCTION: Epidemiological Catchment Area study has recognized obsessive compulsive disorder (OCD) as the fourth commonest psychiatric condition and OCD is ranked 20th in the Global Burden of Disease Studies. Although there are extensive researches on the pathways to professional care, much less is known about other actions that people take to cope with symptoms. OBJECTIVE: To assess the coping mechanisms in subjects with OCD by application of COPE Inventory (developed by Carver C S, Scheider M F and Jagdish Kumari Weintrau- 1989) METHODS: It was a descriptive, analytical, cross-sectional, hospital based study of one year duration. All 30 consecutive cases meeting the inclusion and exclusion criteria were included. The coping mechanisms used by those subjects with OCD were assessed by application of COPE Inventory. RESULTS: The age of the patients ranged from 14- 45 years with the mean of 29.5 ± 8.87 years. Of the 30 subjects, 17 (56.7%) were male and 13 (43.3%) were females and greater number of the subjects were married i.e. 17 (56.7%) and 13 (43.3%) were single. Based on COPE Inventory, the five most common coping strategies adopted by OCD subjects were; Active coping, Planning, Suppression of competing activities, Focus on and venting of emotions and Positive reinterpretation and growth. The least used were humor and substance use. CONCLUSION: Determining the type of coping used by the subjects and encouraging the use of problem- solving coping style may lead to a better outcome. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8760   Journal of Universal College of Medical Sciences Vol.1(3) 2013: 22-27
Colonoscopy: A Two Year Experience from Western Nepal
Authors: Chaudhary S , Chaudhary P , Jaiswal N , Chaurasia RK
Published: September 2013

INTRODUCTION: Colonoscopy remains the gold standard in diagnosing lower gastrointestinal pathologies. Colonoscopy is also helpful in preventing colorectal carcinoma by removing adenomatous polyp, however, colonoscopy is a difficult skill to master. Though Upper GI Endoscopy is widely available, colonoscopy facilities are relatively rare in developing world. In this field, the vast majority of reported data come from developed countries, and data from a developing country like Nepal is relatively scarce. With this background, present study was aimed to see clinical profile of patients presented for colonoscopy at a colonoscopy centre from western Nepal. MATERIAL AND METHODS: It was a cross sectional study which was carried out in Endoscopy Centre, Edmond City Hospital, Butwal, Nepal from 1 October 2010 to 31 September 2012. Study was approved by the hospital authorities. All the patients for colonoscopy at our centre were evaluated as per predesigned Pro-forma. Colonoscopy was done in all the patients under intravenous sedation after bowel preparation. Colonoscopic abnormalities were noted and biopsied if indicated and sent for histopathological examination. RESULTS: Sixty patients underwent colonoscopy in our centre during study period, among them 33 (55%) were male and 27 (45%) were female. The mean age was 45.23 ± 15.30 years (range 1678 years). Procedure was completed in 54 (90%) patients. Altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Significant lesions were seen in 35 (56.67%) patients. Among the patients with significant lesions anal canal or rectum or sigmoid colon were involved in 34 (97.14%) patients. The most common finding in colonoscopy was nonspecific colitis involving rectum and sigmoid, seen in 8 (13.33%) cases. Other findings include ulcerative colitis 6 (10%), anal fissure 6 (10%), haemorrhoids 5 (8.33%), ca colon 4 (6.67%), colonic polyp 4 (6.67%), ca rectum 1 (1.67%) and solitary rectal ulcer 1 (1.67%) patients.CONCLUSION: In present study altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Anal canal, rectum, sigmoid colon involvement were seen 97.14% patients. There is an urgent need to strengthen Lower GI Endoscopy facilities in resource poor setting. Flexible sigmoidoscopy may be a cheaper and easier initial screening tool for evaluating colorectal diseases.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8761Journal of Universal College of Medical Sciences Vol.1(3) 2013: 28-32
Correlation between Endoscopic and Histopathological Findings in Gastric Lesions
Authors: Poudel A , Regmi S , Poudel S , Joshi P
Published: September 2013

INTRODUCTION: Stomach is an important site for wide variety of lesions which include congenital, inflammatory and neoplastic conditions. Helicobacter pylori(H. pylori) has been implicated in varied range of gastric lesions including Gastritis, Peptic Ulcer (PU), Gastric Adenocarcinoma and Gastric Lymphoma. MATERIAL AND METHODS: A total of 43 gastric biopsies were studied retrospectively over a period of 5 months from March to July 2013 at Department of Pathology, Universal College of Medical Sciences Teaching Hospital, Bhairahawa.RESULTS: Out of these 43 cases, 29 (67.4%) were male and 14 (32.6%) were female with a male to female ratio of 2.07:1. According to the endoscopic findings, out of 43 cases, 25 (58.1%) cases had Gastritis, 5 (11.63%) had Peptic Ulcer, 4 (9.30%) had gastric Carcinoma, 4 (9.30%) had Chronic Gastritis (CG) with Atrophy, 3 (6.97%) had Erosive Gastritis and 2 (4.7%) had normal mucosa. The correlation of endoscopic and histopathological diagnosis of these gastric lesions was 34.88%. CONCLUSION: It was observed that endoscopic diagnoses of gastric lesions poorly correlated with those of histopathological diagnoses. H. pylori has a high prevalence in our region and is mostly associated with Intestinal Metaplasia (IM), CG and Atrophic Gastritis (AG).DOI: http://dx.doi.org/10.3126/jucms.v1i3.8763 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 37-41
A Clinical Trial of Melatonin in Elderly Patients with Insomnia
Authors: Doshi NR , Das CR , Sah D
Published: September 2013

BACKGROUND: The quality of life in the fast ageing population in the twentieth century is of great importance. Insomnia and melatonin levels in the geriatric population greatly affect sleep quality thereby also affecting blood pressure, mood changes and immune functions in this large segment of population. AIM: To study the effect of melatonin in elderly persons with insomnia  whether it restores sleep quality and sleep duration. METHODS: Insomnia is defined as inadequate sleep. Thirty subjects participated in the study, 20 females and 10 males. The study was conducted on subjects attending the OPD at the Nepalgunj Medical College & Teaching Hospital at Kohalpur between December 2008 and March 2010. Age group of the subjects ranged from 36 years to 80 years. All subjects were administered melatonin 3 mgm tablets before going to bed for 10-20 days. All data obtained were subjective relying on patient's recall and compliance. RESULTS: In 26 patients the quality of sleep was good and they felt relaxed and cheerful. In 15 patients melatonin was combined with alprazolam 0.25 mgm. Adverse effects were reported by a few subjects (like tachycardia, headache & depression). One case reported hypothermia. CONCLUSION: Melatonin has a beneficial effect in elderly subjects with insomnia. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8764  Journal of Universal College of Medical Sciences Vol.1(3) 2013: 42-45
A Comparative Study on Effect of Oral Administration of Turmeric and Nutmeg on Memory Boosting and Regaining in Wistar Albino Rats
Authors: Kumar SS , Jissa G , Setty PV , Mukkadan JK
Published: September 2013

BACKGROUND AND OBJECTIVES: Although a few drugs are available today for the management of Alzheimer's disease (AD) and many plants and their extracts are extensively employed in animal studies and AD patients, yet no substantial drug or plant extract is able to reverse the AD symptoms adequately. It is tangible that there has been augmenting need for such therapeutic intervention. The present study was undertaken with an objective to compare the memory boosting and regaining effects of oral administration of nutmeg and turmeric which are used commonly as spice in various dishes, as components of teas and soft drinks. MATERIAL AND METHODS: A total of 24 male and female wistar albino rats were used for this study. They were randomly assigned into three groups with 8 rats in each group. The influence of oral intake of nutmeg and turmeric extract on behavioral task performance was studied by using T-maze and radial arm maze and physiological measures relative to a milk control group was investigated. RESULTS: We have observed significant memory boosting and memory regaining effects of nutmeg when administered orally when compared with control group..However, nutmeg is having strong memory regaining effect than turmeric. CONCLUSION: We conclude that nutmeg is having strong memory regaining effect than turmeric. However further pharmacological and biochemical investigations will clearly elucidate the mechanism of action and helpful in projecting these plant extracts as a therapeutic target in diabetes research. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8765   Journal of Universal College of Medical Sciences Vol.1(3) 2013: 46-52
Severe Left Ventricular Dysfunction in Falciparum Malaria: A Case Report and Review of Literature on Cardiac Involvement in Malaria
Authors: Chaudhary N , Verma N , Bhatia BD , Gupta BK , Kabiraj N , Lodha R
Published: September 2013

Malaria is an important cause of death in both children and adults, especially in tropical countries like India1. Nearly one third cases of malaria are reported from South Asia where majority (65%) of them are from India alone 1,2. If undiagnosed and untreated promptly, falciparum malaria can be an important cause for high case fatality rate. Cerebral malaria is one of the commonest causes of death in children1. Although involvement of myocardium and cardiac failure is rare, few cases have been reported in literature. We report a 10-year old male child diagnosed as falciparum malaria with severe left ventricular dysfunction. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8766 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 53-55
Meckel's Diverticulum Series at UCMS, Bhairahawa, Nepal
Authors: Joshi P
Published: September 2013

Meckel's Diverticulum is the most common congenital malformation of the Gastrointestinal tract. It represent the patent intestinal end of the vitellointestinal duct. It occurs in 2 % of of population in autospy series and usually lie 60 cm from the Ileocaecal junction. It possesses all the three coats of intestinal wall. It has the same microscopic structure as the adjacent small bowel and it has a separate blood supply from the adjacent small bowel mesentery (the omphalomesenteric artery).1   In 20% of the cases, the mucosa contains heterotopic epithelium, namely gastric, colonic and sometimes pancreatic tissue. Although Meckel's diverticulum occurs with equal frequency in both sexes, symptoms usually resulting   from   the epithelium contained in the diverticulum predominantly occur in males.2Complications develop in only 4% of patients with this malformation, with most cases presenting in childhood3. Complications of Meckel's diverticulum include hemorrhage, bowel obstruction, inflammation, and perforation. All of these complications can be challenging to diagnose because patients may present with non-specific symptoms, which produce a clinical  picture that  can  mimic  other  more  common  gastrointestinal  disorders.4 Most  of  the  cases  are  diagnosed intraoperatively. Here, we present a case series of 5 patients in a year 2012 at Universal College of Medical College & Teaching Hospital, Bhairahawa, Nepal.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8767  Journal of Universal College of Medical Sciences Vol.1(3) 2013: 56-57
Interdisciplinary Approach in Treatment of Endodontic- Periodontal Lesion : A Case Report
Authors: Somanath G , George G , Sinha JN , Gautam V
Published: September 2013

Endodontic periodontal combined lesion is a clinical dilemma because making a clinical diagnosis and deciding a prognosis are difficult. The treatment of endodontic periodontal lesion combined requires both endodontic therapy and periodontal regenerative procedures. This case report evaluates the prognosis of endo- perio lesion which was first treated with conventional endodontic therapy and then followed by periodontal therapy. At a three month post operative evaluation there was gain of clinical attachment level and reduction in probing depth with radiographic evidence of substantial alveolar bone gain.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8768Journal of Universal College of Medical Sciences Vol.1(3) 2013: 58-61
Minimally Invasive Cardiac Surgery
Authors: Dhaliwal RS
Published: September 2013

Conventional open heart surgery on cardiopulmonary bypass although safe and effective, but is associated with definite morbidity and mortality due to deleterious effects on body systems like haematological, renal, hepatic, respiratory and nervous system. In the last two decades minimally invasive cardiac surgery is rapidly emerging as a safe and cost effective alternative therapeutic modality. The aims of minimally invasive cardiac  surgery are to  achieve an  early extubation, less blood loss, rapid recovery, shorter  hospital stay, less patient morbidity, faster return to  routine activity, increased patient comfort and low cost without compromising on the results. Various strategies have been developed to avoid cardio-pulmonary bypass, global myocardial ischemia and hypothermia. Minimally invasive cardiac surgery is especially beneficial in patients who are at high risk due to left ventricular dysfunction, calcified aorta, carotid artery occlusion, bleeding diathesis and impaired renal dysfunctionDOI: http://dx.doi.org/10.3126/jucms.v1i3.8769Journal of Universal College of Medical Sciences Vol.1(3) 2013: 62-66
Unnecessary & Unsafe Injections Replace Disposable by Auto-Disable Syringes
Authors: Srivastav SL
Published: September 2013

Injections are a skin procedure performed with a syringe and needle to introduce a substance for prophylactic, curative, or recreational purpose. Injections can be given intevenously, intramuscularly, intradermally, or subcutaneously. Injections are among the most frequently used medical procedures, with an estimated 12 billion injections administered worldwide.  A large majority (more than 90%) of these injections are administered for curative purpose (for every vaccination, 20 curative injections are administered). Injections have been used effectively for many years in preventive and curative healthcare. In preventive healthcare, injections have been used to administer vaccinations that have had major impact in reducing childhood mortality due to measles and other vaccine preventable diseases. While injections are still necessary today to administer most vaccination, the number of vaccination injections could be reduced through the use of combination vaccines. In curative healthcare, injections have been used to administer such antibiotics as Penicillin, Streptomycin, as well as many other life saving medications. Today, safe and effective alternatives to injected medications are available and most medications used in primary care can be administered orally. Injections are predominantly needed for treatment of severe diseases, mostly in hospital settings. Nevertheless, injections are overused to administer medications in many countries because of an ingrained preference for injections among health workers and patients. A safe injection does no harm to the recipient, does not expose the healthcare worker to any risk, and does not result in waste that is dangerous for the community. To achieve this, an injection needs to be prepared with clean hands in a clean area, using a syringe and a sterile needle. After administration, sharp equipments such as needle need to be discarded in a puncture proof container for appropriate disposal. When these rules are not followed, injections are unsafe and may expose recipients, healthcare workers, or the community to infections. Among unsafe practices, syringe or needle reuse between patients without sterilization is associated with a high risk of blood-borne pathogen transmission. Unsafe injections occur in many parts of the world and more particularly in developing countries where up to 50% of injections are administered with reused syringes and needles. To reduce the overuse of injections, and to assure safe injection practice, multidisciplinary strategies comprising of various elements have been discussed in this article. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8770 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 67-70
Patients Rights
Authors: Srivastava CP
Published: September 2013

Gone are the days when a treating doctor was treated as next to god! The education and literacy is rising day by day and so is the awareness among people of every walk of life. Human rights propagated by the United Nations is already in existence. Our children, students and people of the world today are conscious of their rights. Thus patients also are aware of their rights. This is a healthy modern trend for the medical world today.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8771   Journal of Universal College of Medical Sciences Vol.1(3) 2013: 71-72
Pattern of Tibial Shaft Fractures in Universal College of Medical Sciences, Bhairahawa: A Review of Sixty Cases
Authors: Baral R , Khan JA , Singh GP
Published: September 2013

BACKGROUND: Tibia is one of the commonest long bone fracture seen in emergency. Road traffic accidents are the major causes of fracture shaft of tibia. However, studies on these fracture have not been conducted in this part of the world so we conducted this study to identify epidemiological characteristics (age, sex, mechanism of injury, season, source of injury, type of fracture. any associated injury, location, method of treatment and complication) in patients with fracture shaft of tibia admitted in the emergency of Medical College hospital, Bhairahawa. METHODS: This is hospital based prospective observational study conducted at Universal College of Medical Science Teaching Hospital, Bhairahawa (Lumbini zone) among 60 tibial shaft fracture patients in hospital emergency. The study period was from December 2010 to November 2011. RESULTS: All total of 60 tibial shaft fracture in 60 patients with a mean age of 28.35 yrs(3-75yrs) were reviewed. The cause of injury were mostly road traffic accident of which Bike (26.6%,), Bus (6.7%), Car (6.7%), Cycle (10%), Rickshaw (6%), Tractor (6.7%), Truck (1.7%), and Vehicle collision (3.3%) were more prevalent. Other injuries were Bomb blast (1.7%), Fall injury (16.7%), Logroll (3.3%), Sports/football (5.5%) and Stone injury (1.7%) . Distal one third of tibial shaft (49.2%) was the commonest site of fracture. Most of the patients presented between 1st  hour to even 10 days of injury. Sixty five percent of the fracture were closed and 35% were open. Most were managed operatively (51.7%). Mean time for union of close type of fracture was 13.78(SD ±2.99) weeks and for open was 16.2 weeks (SD±3.34). Complication included infection in one patient and delayed union in two patients. CONCLUSION: In our present study, most tibial shaft fracture were due to road traffic accident. So, efforts should be made by concerned authorities for improving the roadways system of Nepal as well as provision of standard but affordable health care for victims of road traffic crashes.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8773 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 11-14