bluuebunny/crossref_metadata_2025 huggingface dataset:
Teratogenicity study in rats of commonly used calcium channel blockers
Authors: Jaiswal Sanjay , Bhardwaj Davinder , Brashier Dick
Published: November 2019

Background: Calcium channel blockers (CCBs) are popular medicines used to treat hypertension, tachyarrhythmia’s or angina during pregnancy. Lack of adequate safety data has however created an uncertainty in the use of CCBs in pregnancy. Nifedipine has been reportedly associated with a variety of embryotoxic and fetotoxic effects in animals. Therefore, this study was undertaken to establish whether or not the commonly used CCBs (nifedipine and amlodipine) would produce teratogenic effects in rats.Methods: Twenty pregnant rats were randomly assigned to each of the treatment and control groups. Nifedipine and amlodipine were used in three dose levels of 5, 10, 20 mg/kg and 0.5, 1, 2 mg/kg body weight respectively to test its teratogenic effects. The maximum dose of the test drugs used in our study was ten times the maximum recommended human dose. The drugs were administered to the pregnant rats using nasogastric tubes from day 6 through day 15 of pregnancy. The number of live births, stillbirths, litter sizes, crown-rump lengths, birth weights and gross abnormalities of the pups delivered were observed and recorded. Skeletal changes and soft tissue changes were also observed in the pups delivered to treated pregnant rats.Results: It was found that nifedipine and amlodipine did not produce any teratogenic effects in rats at doses 2.5 to 10 times the recommended human dose. None of the pups showed any gross morphological, skeletal or visceral defects.Conclusions: Nifedipine and amlodipine appear to be in therapeutic safe during pregnancy doses.
Evaluation of awareness about obesity among general public visiting the tertiary care hospital
Authors: Arunachalam Umamageswari , Nagesh Simhadri V. S. D. N. A. , Vivekkumar S. Priestly , V. S. Abinaya
Published: November 2019

Background: Obesity is one of the fastest growing threats of health and well-being for both developed and developing countries. The aim of the study was to evaluate the awareness about obesity among general public.Methods: After obtaining institutional ethics committee approval and written informed consent from the participants, anthropometric measures like height, weight, hip and waist circumference for computing body mass index and waist hip ratio were taken. Using portable bioelectric impedance analyzer body fat percentage was measured. A validated questionnaire including socio demographic details and questions evaluating the awareness about obesity were given to the participants.Results: Totally 100 participants were evaluated, of which majority being female. Mean height of the male and female participants was 164 and 152cm respectively. Similarly, mean weight was found to be 72 and 65 kg. Based on the body mass index only 19% participants were within normal range, remaining 81% were overweight and obese. Percent body fat and waist hip ratio was found to be increased in both sexes. Majority of the participants were aware that obesity is associated with health problems but most of them were unaware how it is measured and the dietary foods to be taken to reduce obesity. However 64% participants think that obesity can reduce the life expectancy of the individual.Conclusions: Majority of the participants were obese and overweight while awareness about preventive measures was still lacking. Hence health care personnel need to take greater effort to educate and inform people about the implications.
Maternal and fetal outcomes in pregnancy induced hypertensive patients and normotensive patients
Authors: Dev Kapil , Sood Rajeev , Sharma Anoop
Published: November 2019

Background: Hypertensive disorder of pregnancy complicates 5 to 8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality. Hypertensive disorders of pregnancy account for nearly 18% of all maternal deaths worldwide, with an estimated 62000-77000 deaths per year.Methods: This one-year prospective case control study total 200 pregnant women attending antenatal care and admitted in Eclampsia ward fulfilling the inclusion criteria were studied. Fetal and maternal outcomes data recorded and documented. Statistical analysis of data was done by student’s t-test and p-value.Results: In PIH 68% women had normal vaginal delivery (p=0.004) 10% women had instrumental delivery. In PIH group 22% women had emergency caesarian section and in normotensive group 10% women had emergency caesarian section. In PIH group 58% delivered at term and 42% had preterm delivery. In normotensive 95% delivered at term and 5% had preterm delivery (p <0.001). PIH group 29% women developed IUGR whereas in normotensive group all women had normal growth velocity (p <0.001). In PIH group 69% mothers had newborn with birth weight <2.5 kg and 31% women had newborn with birth weight >2.5 kg (p=0.0009). While In normotensive group only 9% women had newborn with birth weight <2.5 kg. In PIH group, 24% newborn babies needed NICU admission and in normotensive group only 5% newborn needed NICU admission (p=0.001). In PIH group 76% women had normal maternal outcome (p <0.001). 11% had associated abruption (p=0.0019). In the rest 13% patient develop PRES.Conclusions: We concluded that there is a significant rise of complication in mothers having PIH and also there is an increased risk of delivering low birth weight and preterm babies. The early use of antihypertensive drugs, optimum timing of delivery and strict fluid balance, anticonvulsants in cases of eclampsia will help to achieve successful outcome.
Review of 113 cases of autoimmune disorders in pregnancy
Authors: S. Maheswari , C. Poornima , Panicker Seetha
Published: November 2019

Background: Autoimmune disorders are chronic multisystem disorders affecting women of their reproductive age. Pregnancy among these women is complicated by the disease itself. Flaring up of disease, uteroplacental insufficiency due to vasculitis and drugs used for treatment are main reason for unfavourable pregnancy outcomes. The objective of this study was to analyze the pregnancy complications and outcome among 113 cases of autoimmune disorders.Methods: This study is a retrospective analysis of case records of pregnant women with autoimmune disorders. This study was conducted at PSG IMSR and Hospital, Coimbatore, and Tamil Nadu from July 2012 to June 2018. The case sheets were retrieved from medical record department and the details such as type of disease, maternal age, parity, status of disease at conception, treatment taken during pregnancy, maternal complications and fetal complications were collected and analyzed.Results: During 6-year period there were 113 pregnant women with autoimmune disorders, and they were studied of their previous and present pregnancy outcome. The disease incidence was 7.01% per 1000 deliveries. 40.7% were less than 25 years age group and 71.6% were multigravidae. We had forty-one patients (36%) who were positive for APLA syndrome which were the maximum number of patients with auto immune disorder in pregnancy and 37 patients (32.7) with SLE. We had significant numbers of maternal and fetal complications for common disorders. Most of the rare auto immune disorders were diagnosed before pregnancy and these pregnancies were managed by multi-disciplinary approach, and continued on immunomodulators throughout pregnancy, hence maternal and fetal complications were less for them.Conclusions: Adequate pre-conceptional counseling, vigilant monitoring during pregnancy and post-partum will avoid pregnancy related complications and have favorable outcomes.
Study of spectrum of cardiac disease complicating pregnancy and the maternal and foetal outcome
Authors: R. Sudha , R. Anjali
Published: November 2019

Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.
Intravenous oxytocin bolus and infusion versus infusion alone on the blood loss during caesarean section
Authors: Mathe Priyanka , Kale Suniti , Batra Aruna , Batra Achla , Aggrawal Shipra , Nagarajappa Abhishek
Published: November 2019

Background: PPH is one of the leading causes of maternal mortality in the world. In India >30% maternal mortality is because of PPH.Methods: 250 females posted for LSCS were randomised into 2 groups. Group A: 5U oxytocin bolus + 40U oxytocin infusion @125 ml/hour in 500 ml saline. Group B: 5 ml Saline bolus + 40 U oxytocin infusionPrimary outcome was to measure blood loss (objective and subjective). Secondary outcomes were time for uterine hardening, additional uterotonic agents, hemodynamic changes, side effects and need for blood transfusion within 24 hours of LSCS.Results: Blood loss was significantly less in Group A in objective as well as subjective assessment (p<0.001). Requirement for additional oxytocin bolus was significantly higher in Group B as compared Group A (p=0.025). Postoperative hematocrit of Group A was higher than that of Group B (p<0.001). Transfusion requirement was significantly higher (p=0.04) in Group B (9.6% versus 3.2%). There was no significant difference in hemodynamics between the groups in the intraoperative period (p>0.05). However, during the postoperative period increase in heart rate was noted in Group B (p<0.05). Vomiting was the only major side effect observed, which was higher in Group A (5.6% versus 3.2%).Conclusions: Combination of 5U oxytocin bolus followed by an infusion of 40 U oxytocin given over 4 hours routinely in ASA grade I and ASA grade II parturient significantly decreases the operative blood loss during LSCS without causing any hemodynamic variability. This regimen provides better uterine contractility, lesser need for additional utero-tonic agents and lesser requirement of blood transfusion.
A study of correlation of antenatal uterine scar thickness by transabdominal ultrasound with intraoperative lower uterine segment scar grading in elective repeat cesarean delivery
Authors: Vedantham Haripriya , Nee Jahagirdar Nandini Joshi , N. Ramadevi , Kamineni Vasundhara , Saranu Sarada
Published: November 2019

Background: Caesarean section (CS) is the most common obstetric surgery performed world-wide. The objective of this study was to correlate the antenatal sonographic lower uterine segment (LUS) scar thickness in women with previous one cesarean section with intra operative LUS scar grading.Methods: A Prospective observational study was conducted from December 2014 to November 2015. In a tertiary care center. 200 pregnant women from ANC clinic with previous one LSCS were recruited. Transabdominal USG done between 36-38 weeks. LUS thickness was measured from bladder wall-myometrium interphase and myometrium-chorioamniotic membrane inter phase. Intraoperative grading of LUS scar was done. Based on grading of scar participants were assigned into scar dehiscence group (grade III and IV LUS scar) and non-dehiscence group (Grade I and II LUS scar).Results: Mean LUS thickness was 3.41±0.623 mm (range: 2-7 mm). Mean LUS thickness in the scar dehiscence group and non-dehiscence group was 2.98±0.55 mm and 3.48±0.60 mm (P value < 0.05) respectively. A cut off value of 3.5 mm was derived from ROC with sensitivity, specificity, positive and negative predictive value of 92.6%, 54.3%, 24.0%, 97.8%, respectively. The present study reported 27 (13.5%) cases of scar dehiscence.Conclusions: Ultra-sonographic evaluation of LUS thickness correlated significantly with intraoperative LUS appearance. USG evaluation of LUS can be used as a screening test to predict the LUS scar integrity. Risk of dehiscence is increased in women with thin LUS i.e. sonographic LUS thickness of < 3.5 mm and needs to be further evaluated. Women with previous one LSCS with thick LUS i.e. sonographic LUS thickness of > 3.5 mm, can be counselled regarding TOLAC if not contraindicated.
Maternal and foetal outcome in women with neurological disorders
Authors: Thomas Daphne Rose , R. Beenakumari , V. Priya
Published: November 2019

Background: Wide spectrums of neurological disorders are observed in pregnancy and puerparium. These disorders can alter the course of pregnancy and pregnancy can worsen them.Methods: This was a cross sectional observational study which included 154 patients in pregnancy and postpartum up to 6 weeks with neurological disorders admitted in department of obstetrics and gynecology, Government Medical College, Kottayam over a period of one year from December 2017. All patients underwent detailed general and systemic examination and were assessed by neurologist. After delivery maternal and foetal outcome and morbidity and mortality were observed.Results: Out of total 5202 deliveries, 154 patients presented in pregnancy and puerparium with neurological disorders amounting to 2.96 %. The age of patients ranged from 18-44. The commonest neurological disorder was epilepsy (60.4%). Other disorders were eclampsia (7.8%), cerebrovascular disorders (9.1%), brain tumors (4.5%), cranial nerve palsy (3.2%) and different types of other neurological disorders (14.9%). The most common presentation was generalized tonic clonic seizures (82.8%). 76.6% of patients had normal vaginal delivery and 13% underwent caesarean section. There were 5 cases of intrauterine death (3.2%), 5 cases of foetal anomalies (3.2%) and 3 cases of neonatal deaths (1.9%). One case of maternal mortality was there due to intra-cerebral hemorhhage.Conclusions: Epilepsy was the commonest disorder with good maternal and foetal outcome. Vascular disorders and eclampsia were associated with higher maternal and foetal morbidity and mortality.
A prospective study to compare levonogestrol intrauterine system and trans-cervical resection of endometrium for treatment of abnormal uterine bleeding
Authors: Hol Kishorkumar V. , Shastri Shraddha S. , Magar Shilpa S. , Darawade Sameer P.
Published: November 2019

Background: This article is a study comparing the two most accepted forms of treatment for abnormal uterine bleeding - levonorgestrol intrauterine treatment and transcervical resection of endometrium, with regards to its acceptability, efficacy, adverse effects and user satisfaction. Aim of this study was to compare the acceptability, efficacy, adverse effects and user satisfaction of LNG-IUS and TCRE for treatment for AUB.Methods: A prospective observational study conducted in SKNMC and GH. Forty-nine women with abnormal uterine bleeding after hysteroscopic evaluation were included in this study; where 17 opted for LNG-IUS; 32 opted for TCRE with bipolar electrode. 15 patients in LNG-IUS group and 28 pts in TCRE group completed follow up. Menstrual pattern, pictorial blood loss assessment chart score, adverse effects, acceptability, satisfaction and reason for discontinuation were recorded at 6 weeks, 6 months and 12 months after the procedure. Prior to LNG-IUS insertion or endometrial ablation, endometrial and cervical pathology were excluded by D and C and cervical smear, respectively. TVUS was used to exclude possible causes of menorrhagia, including myomas and endometrial polyp as well as adnexal pathology. LNG-IUS insertion was performed as an office procedure one day after cessation of menstrual bleeding with a negative urine pregnancy test.Results: Menstrual blood loss reductions in TCRE and LNG-IUS groups were by 85.7% and 87.6% respectively after a year. Amenorrhoea was more common in TCRE group while spotting and systemic effects were more common in LNG-IUS group. Satisfaction and acceptance rates are higher in TCRE group.Conclusions: The TCRE and LNG-IUS are equally effective in reducing bleeding in AUB patients. Acceptance and satisfaction are better with TCRE, as a modality of treatment for AUB.
Measurement of serum C-reactive protein levels in early second trimester as a predictor of preterm delivery
Authors: Senthil Sujatha , Dhamayanthi S.
Published: November 2019

Background: Preterm labour is the leading cause of perinatal morbidity and mortality. Infection plays a major role in preterm labour. Elevation of CRP, an inflammatory biomarker has been associated with spontaneous preterm birth. This study was aimed at evaluating the relation of C-reactive protein in early second trimester with preterm labour and neonatal morbidity.Methods: It is a prospective cohort study, 200 pregnant women of singleton pregnancy between the gestational age of 14 to 20 weeks were enrolled. After detailed history taking, maternal serum CRP levels were estimated by ELISA method. These women were divided into two groups according to CRP levels. Incidence of preterm delivery and incidence of neonatal morbidity was compared in both groups to ascertain if measured maternal CRP levels has any association with preterm labour and neonatal morbidity.Results: In this study 42 patients (21%) had preterm delivery. Of these 30 patients had CRP > 1.5mg/dl; 12 had CRP < 1.5 mg/dl. In CRP increased group, 30 patients (57.7%) delivered preterm, 22 patients (42.3%) had term. It was found that increased levels of maternal serum CRP in early pregnancy were associated with increased incidence of preterm delivery. According to this study if the CRP value 1.5 the sensitivity will be 71.4% and specificity will be 86% to predict the preterm. Of the total 42 preterm babies, 1 from Group A (8.3%) and 12 from Group B (40%) developed sepsis. So increased CRP has association with neonatal sepsis.Conclusions: Elevated maternal serum CRP concentration in early second trimester was associated with increased incidence of preterm delivery and showed a positive correlation with neonatal sepsis.
A study on eclampsia and its maternal and perinatal outcome
Authors: Kamat Devika J. , Pednecar Guruprasad
Published: November 2019

Background: Eclampsia is one of the major causes of maternal and perinatal mortality in India. Here authors present a prospective study which was conducted in a tertiary health centre to study the cases of eclampsia, the mode of presentation and the maternal and perinatal outcomes.Methods: A total 95 women were diagnosed as eclampsia during the period of 2 years. Various parameters and their effects on maternal and perinatal morbidity and mortality were studied. Maternal outcomes were assessed based on parameters like antenatal care received, mode of delivery, complications associated with eclampsia. Perinatal outcomes were noted depending upon the period of gestation, NICU admission, stillbirths and neonatal deaths.Results: Authors found the incidence of eclampsia to be 0.9%. 52.7% women had irregular antenatal follow up at any nearby health centre. A total 76.8% women had antepartum eclampsia. 56.8% delivered by caesarean section while 7.4% required operative vaginal delivery. 61.1% women delivered within 10 hours of onset of convulsion. Authors had 02 deaths in the study group, one due to ARDS with DIC and the other attributed to pulmonary oedema. There were 51.6% preterm deliveries. 21 neonates required NICU admission with 5 neonatal deaths and 11 stillbirths.Conclusions: Due to inadequate antenatal care, most of the cases of pre-eclampsia go unnoticed increasing the referrals to tertiary care centre for intensive care. Thus, it is necessary to emphasise on timely interventions and availability of blood bank, ICU and NICU facilities at the closest referral centre for better maternal and perinatal outcome.
Study of prevalence of heart disease in antenatal mothers along with fetal and maternal outcome from a tertiary care hospital, Salem, Tamil Nadu, India
Authors: Sengodan Subha Sivagami , Selvaraj Shobhika
Published: November 2019

Background: Incidence of pregnancy in women with heart disease is increasing due to the increasing number of women with congenital heart disease. Although most cardiac conditions are well tolerated during pregnancy, there are some conditions that have adverse fetal and maternal outcome. Objective of this study is to study the prevalence of heart disease in antenatal mothers and fetal outcome with obstetric management.Methods: This is a prospective observational study carried out in the Department of Obstetrics and Gynaecology at Government Mohan Kumaramangalam Medical College and Hospital during January 2018 to March 2019 for a period of fifteen months. Authors included 149 antenatal mothers with heart disease and analysed the data using percentage analysis through excel software.Results: Incidence of heart disease in pregnancy was observed to be 1.2%. Rheumatic heart disease being 73.8%, congenital being 22.8% and complete heart block was 3.4%. Among rheumatic heart disease mitral stenosis was the most common lesion. Atrial septal defect was the most common congenital heart disease. The mean gestational age of delivery was 37 to 38 weeks. 58% delivered by vaginal route. Most common neonatal complication was prematurity. Pregnancy and neonatal outcome were favorable.Conclusions: Heart disease complicating pregnancy has increased due to late marriage, obesity, hypertension and diabetes. Early referral, regular follow-up and multi-disciplinary approach with tertiary care back-up will bring a favorable maternal and neonatal outcome in patients with heart disease.
Mucinous cystadenoma of ovary: are mammoths really extinct?
Authors: Sheregar Namrita C. , Wani Reena J.
Published: November 2019

The most common ovarian tumours are epithelial tumours. 80% of all tumours are benign, 10% borderline and 10% are malignant. Mucinous tumours represent 8-10% of the epithelial tumours; they may reach enormous size filling the entire abdominal cavity. We report here a case of a huge benign mucinous cystadenoma in a 57-year-old female. Ultrasound and MRI scan showed a large left ovarian cyst. CA-125 was 132 IU/ml. She underwent total abdominal hysterectomy and bilateral salpingo-opherectomy with appendicectomy and infracolic omentectomy. Her post-operative course was unremarkable.
Study of suicides in Mangalore region of South Karnataka, India
Authors: Kumar Jayantha , R. Rekha
Published: November 2019

Background: To evaluate the various causes of suicides and mental illness of different age groups which enables the patients to commit suicide in both sexes.Methods: The data of suicides was collected from medical records of the different Hospital in Mangalore region  of South Karnataka.Results: Total 32 cases of suicides in adults were studied at Mangalore city and district as a whole. The history of suicide was 6(18.7%) was alcoholic, 4(12.5%) were drug addicted (dependent), 5(15.6%) were HIV infected, 3(9.37%) had infertility 4(12.5%) had loss of job, 2(6.25%) had sudden loss of property, 8(25%) had failure in love affair. The clinical manifestations of suicides were (8.25%) had major depression 5(15.6%) had multiple personality disorder. 11(34.3%) were schizophrenic, 6(18.7%) had mood disorders, 2(6.25%) were epileptic.Conclusions: This study of suicides of young adults will be quite helpful to psychiatrist and medico-social workers to take preventive measures to prevents such suicides because suicide is not only social problem, but it is due to abnormal mental state too.
The study of pulmonary function tests in patients with hypothyroidism
Authors: H. Sivaranjani , R. Chaitra K.
Published: November 2019

Background: Hypothyroidism is a common disease with a prevalence rate of 11% in India. It affects all organ systems in the body. Patients with hypothyroidism frequently have symptoms of fatigue and exercise intolerance. These symptoms could arise from a reduced pulmonary reserve, cardiac reserve or decreased muscle strength or increased muscle fatigue. This study aims to study the pulmonary function test in patients with hypothyroidism.Methods: This is a cross sectional study conducted on 100 patients divided into 2 groups (a) newly detected hypothyroids (b) normal control group. Cases were matched with controls in having similar environment exposure and age group. All patients had routine symptom and clinical assessment. Laboratory investigations such as complete blood picture, pulmonary function test, chest x ray and thyroid function test were done. Data was entered and analysed.Results: In this study conducted on 100 patients, case group had symptoms of easy fatiguability (36%), breathlessness (20%), menstrual abnormality (20%), weight gain (7%) and generalised body aches (5%). Mean FEV1 levels between cases and controls were 1.34 and 1.72 (p value 0.00), mean FVC were 1.88 and 2.09 (p value 0.114), FEV1/FVC ratio of 70.56, 81.98 respectively (p value 0.00). The distribution of PFT pattern was 32% obstructive, 28% mixed pattern and 22% restrictive pattern.Conclusions: This study shows that hypothyroidism causes significant decrease in FEV1 and FEV1/FVC ratio, thereby suggesting obstructive patterns of lung involvement .Therefore PFT can be used routinely as a screening test for all hypothyroid patients to detect early respiratory dysfunction and thereby optimise treatment especially in obese patients and patients with pre-existing lung disease as hypothyroidism adds to their respiratory dysfunction.
A study of effect of low dose atorvastatin therapy on high sensitivity C-reactive protein in patients with modifiable and non-modifiable cardiovascular risk factors in central India
Authors: Verma Archana , Chandra Umesh Kumar , Verma Sandhya , Jhavar Dharmendra , Badole Shivshankar
Published: November 2019

Background: Anti-inflammatory effects of statins have generated maximum interest, as has been demonstrated in a number of studies showing rapid decrease in CRP levels in patients of acute coronary syndromes. This CRP lowering property of statins has also translated into clinical benefits as suggested by reduction in rate of recurrent angina, recurrent myocardial infarction, and mortality.Methods: This prospective, open, and controlled study was conducted on 160 indoor and outdoor patients, for total duration of two years (2005-2006), in GMC Bhopal, MP, India.Results: In all the four groups, baseline serum hs-CRP was statistically significant (p value <0.01) higher than normal hs-CRP level. Mean reduction (%) in hs-CRP after 3 months of statin therapy was 83.6% in group A and 62.4% in group C which is highly significant (p value <0.001). In group B also, 26% hs-CRP reduction was noticed which is statistically significant (p value <0.01). Baseline hs-CRP was statistically significant high (p value <0.01) in hypertensive patients. Percentages reduction in group A (87%) and group C (66%) was statistically significant (p value <0.01). Baseline hs-CRP was statistically significant higher (p value <0.01) than normal population. After 3 months of statin therapy percentage reduction in group A and group C was statistically significant (p value <0.01). Conclusions: Low dose atorvastatin can significantly reduce CRP level in patients with risk factors for cardiovascular disease. Early initiation of low dose atorvastatin can reduce this inflammatory marker in both ACS and high risk for ACS patients and can prevent major adverse cardiac events.
Is the recurrence of primary spontaneous pneumothorax predictable?
Authors: Saricam Murat
Published: November 2019

Background: Recurrence of Primary Spontaneous Pneumothorax (PSP) constitutes a serious challenge for both physicians and patients.Methods: A retrospective study was conducted in 115 patients who had chest tubes at their first onset of PSP. Considering the development of recurrence, two groups were composed and comparatively examined in terms of age, body mass index, smoking status, side and size of initial pneumothorax, presence of bulla and duration of chest tube drainage at the first episode.Results: Among 115 patients with PSP, 24 cases developed recurrence. Male gender was prominently relevant to develop recurrent PSP (p=0.034) whereas remaining inspected parameters revealed no significant relationship with a relapse. Interval between first onset and recurrence of PSP was calculated as 9.2 months. Interestingly, most of the patients developed recurrence in low-temperature months.Conclusions: Recurrence of PSP is substantially unpredictable. Therefore, close follow-up of cases in the following year of their first episode and also informing the patients about probability of a relapse and measures to consider under this circumstance is of great importance.
Thyroid profile in type 2 diabetes mellitus
Authors: Dave Mahesh , Saini Hazari Lal , Gupta Ankit , Choudhary Jitendra Singh , Burli Aniruddha
Published: November 2019

Background: Diabetes mellitus is an endocrine disorder which involves multiple organ systems and leads to significant morbidity and mortality. Diabetes mellitus has been defined as “A metabolic syndrome characterized by chronic hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiency in insulin secretion and or insulin action”. Thyroid diseases are also a common endocrinopathy seen in the adult population. Thyroid hormones are intimately involved in cellular metabolism. The present work is a modest attempt to study the prevalence of thyroid disorders in patients with type 2 diabetes mellitus.Methods: The study was carried out in total 108 diabetic patients without known thyroid disorder admitted in various Medical wards of R.N.T. Medical college and attached group of hospitals, Udaipur. It was a cross Sectional study done over a period of 10 months. Results: In the present study, 13% of patients with type 2 diabetes mellitus had abnormal thyroid profile. Out of which the most common presentation was sub clinical hypothyroidism found in 9.25% followed by1.9% had overt hypothyroidism and 1.9% had sub clinical hyperthyroidism. In persons with abnormal thyroid profile 85.7% were females and 14.3% were males which was statistically significant.Conclusions: Prevalence of thyroid dysfunction is common among T2DM patients and is higher in females than in males. There is no significant correlation between thyroid dysfunction and age, diabetes control, family history, type of treatment and HbA1c level in diabetic patients.
Is the clinic pathological profile of hypothyroidism gradually changing: a comparative study from North India
Authors: Sud Rahul , Bhagat Sagar
Published: November 2019

Background: Thyroid dysfunction has been subject of academical and therapeutically interest not only to the endocrinologist but also to the disciplines of medicine. Statistical data and studies on hypothyroidism are scanty, clinical picture is varied, investigations are usually not available at all levels and therefore to enlarge clinical profile of hypothyroidism minimal base line investigation, clinical approach and effects of replacement therapy and complications are to be studied.Methods: Observational cross-sectional study conducted among patients with hypothyroidism registered at the Air Force Central Medical Establishment (AFCME) New Delhi.Results: Among 50 patients with hypothyroidism were enrolled in this study during the study period. Idiopathic hypothyroidism was present in 98% patients while only one patient (2%) had Hashimotto’s thyroiditis. Generalized weakness was the commonest presenting symptom followed by lethargy and anorexia. Thyroid swelling was diffuse in nature with no predilection to right or left lobe enlargement. Hypertension (40%) and ischemic heart diseases (36%) were the most common comorbid condition. Mean serum TSH was elevated while serum T3 and T4 values were reduced. Antithyroid antibody titre was positive in more than seventy percentage of patients. X-ray among patients revealed cardiomegaly in ten patients (20%), pulmonary Koch’s in (4%) of patient and in rest of patients x-ray chest PA view was normal. ECG changes showed low voltage on electrocardiogram in (20%) of patients and sinus bradycardia in (24%) of patients. Most of the patients were put on replacement therapy (L. thyroxine) in dose of 1.6 - 1.7 mcg/kg/day.Conclusions: Hypothyroidism as a clinical entity is common between 4th and 6th decade of life and seen more among females. Though etiology remained unknown in majority of the patients, weakness, and lethargy were the common clinical presentation.
Evaluation of omalizumab at certain time intervals in patients with chronic spontaneous idiopathic urticaria
Authors: Kutlu Ömer , Karaarslan Engin , Karaosmanoğlu Nermin , Ekşioğlu Hatice Meral
Published: November 2019

Background: In this study, we aimed to evaluate the response of patient treated with omalizumab at certain time intervals through 6 months with pruritus visual analog scale, urticaria activity score and quality of life indexes.

Methods: The study was performed on ten patients diagnosed with chronic idiopathic spontaneous urticaria. The disease was assessed by the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and Dermatology Life Quality Index (DLQI) for every 2 weeks while was assessed by Urticaria Activity Score (UAS-7) and Pruritus Visual Analog Scale (PVAS) for once a week during the 6-month treatment period. Statistical significance was evaluated using the Mann-Whitney U test in SPSS 20.  

Results: Pre-treatment values of the DLQI, CU-Q2oL, UAS-7, and PVAS was statistically higher than post-treatment values of these indexes (p<0.05). The mean DLQI/ CU-Q2oL value of the patients before treatment was 17±6.09/ 52.87±22.07 while it was 19.4±16.36 at the end of 2nd-week post-injection per month, and was 21.85±16.56 at the end of 4nd-week post-injection per month during 6-months following. Statistically, PVAS score at the fourth week was higher than 2nd and 4th week (p<0.042, p<0.007).

Conclusions: In this study, it was detected that omalizumab had a significant effect on DLQI, CU-Q2oL, UAS-7, PVAS scores in CISU. It can be concluded that significant increase of PVAS score at 4th week compared to scores at 2nd and 3rd week may necessitate the use of omalizumab combined with antihistamines at 4th week of the treatment.
Inhibitory effects of different hand sanitizers against the resident microflora of skin
Authors: Ishma Touhida , Uddin H. M. Sayeed , Paul Anik , Feroz Farahnaaz , Acharjee Mrityunjoy
Published: November 2019

Background: Practice of hand washing is very important to eliminate the microbial contamination especially during the work in laboratories, hospital and even at home before taking food. Proper use of hand sanitizer can significantly reduce the rate of hospital acquired infection also.

Methods: The current investigation was designated to identify different bacterial species from the upper skin of hands of the laboratory managements through conventional culture methods and the efficacy of the samples (Dettol, Purell and Savlon) against the isolated bacteria through agar well diffusion method and minimum inhibitory concentration (MIC)  

Results: Different concentrations such as 25%, 50% and 100% of each of antimicrobial agents showed their antibacterial activity against Staphylococcus spp., Klebsiella spp., E. coli and Pseudomonas spp. those were isolated from the hand. 25% of Dettol exhibited 20 mm zone diameter against Klebsiellaspp. Whereas 25% of Purell and Savlon unveiled 15 mm and 22 mm zone of inhibition against E. coli and Pseudomonas spp. respectively. In case of 100% sample of Dettol, Purell and Savlon, the highest zone diameter was observed as 55 mm, 50 mm and 45 mm against Klebsiella spp., Staphylococcus spp., and E. coli consecutively. The MIC of Dettol sample was 8 µl against Staphylococcus spp., and Pseudomonas spp. In case of Purell, the MIC was 128 µl against Staphylococcus spp., Klebsiella spp. and Pseudomonas spp. were inhibited at 4 µl samples.

Conclusions: The in-vitro antibacterial activity of the hand sanitizers was so satisfactory against the isolated bacteria. This finding would be very helpful for the laboratory management in order to minimize the rate of contamination during the research and supervision of the different experiment.
Blood donation: a comparison between medical students and non-medical students
Authors: Musa Muneer M. , Shaaban Kamil M.
Published: November 2019

Background: Voluntary blood donation represents the main source of blood in Sudan. While students are a potential source of blood, this study aim to address the knowledge, attitudes, barriers and motives of both medical and non-medical students in order to recruit them for donating blood to meet the demands of the patients.

Methods: A facility based descriptive cross-sectional study was conducted at Khartoum University between January and March 2019.  Structured self-administered questionnaire was used to collect data from the participants. The Data were analyzed by the Statistical Package for Social Science software version 23.  

Results: Of the total 308 students, 75% were medical students and 25% were non-medical. Only 34 (11%) had ever donated blood. 97.1% don’t donate regularly. 79.4% of the donations were voluntary. Males were significantly more donors than females (p value=000). Students had poor knowledge about blood donation requirements but demonstrated better knowledge regarding blood borne diseases. More medical students knew their blood group than non-medical students. Not being asked to be the most reported reason for not donating blood (55.1%). Most of the donors reported that a relative or a friend needs blood was their motivation factor to donate blood (64.7%).
Conclusions:Information about blood donation services and requirements should be available to the students. In addition, campaigns and educational sessions regarding the safety and demands of blood donation is crucial to address the fears and recruit students as eligible source of blood
 
Ghee: the much maligned cooking medium, now slowly reclaiming its therapeutic reputation
Authors: Bali Sharadendu , Utaal Maneshwar Singh
Published: November 2019

Ghee or clarified butter has been gloriously extolled for its virtues in Ancient Indian Medical Systems. For thousands of years, ghee was the cooking medium of choice in North Indian homes, and was also severally used as a drug carrier for delivering phytonutrients and lipid-soluble phytochemicals from herbs. The onset of cardio-vascular diseases in the industrial era brought the focus on cholesterol and saturated fatty acids as  causative agents, and led to the sudden and dramatic decline in the use of ghee in Indian homes, beginning 1970s. The recent removal of the daily restrictions imposed on cholesterol by the FDA has reversed the derogatory narrative against cholesterol and cholesterol-rich fats like ghee. There is need to study the various properties of Ghee in a new light, including its role as a carrier for hydrophobic phyto-nutraceuticals and also as a cardio-protective agent.
The role of ISR disclosure as moderator the relationship between profitability and leverage towards corporate value
Authors: Susanti Reni , Pertiwi Imanda Firmantyas Putri
Published: November 2019

The purpose of this research is to find out the role of ISR disclosure as a moderator of the relationship between profitability and leverage on firm value in companies listed in JII for the 2014-2018 period. This research uses quantitative research using Moderated Regression Analysis (MRA). This study uses secondary data in the form of panel data on companies registered in JII for the 2014-2018 period. The populations in this study are all companies registered in JII during the 2014-2018 period. The sampling method is carried out by purposive sampling by using several criteria to obtain 15 companies used as research samples. The results of this study indicate that profitability and leverage affect the value of the company. The results of the Moderated Regression Analysis (MRA) analysis show that disclosure of the ISR is able to moderate the relationship between profitability and firm value but towards the negative. However, ISR disclosure is not able to moderate the relationship between leverage and firm value.
REFUGEE CHILDREN IN CRISIS:
Authors: Al-Sarayrah Ali Jameel Faleh , Al Masalhah Haya Ali Falah
Published: November 2019

This study aimed to identify the kinds of challenge encountered by Syrian refugee children who are living in Jordan but not in refugee camps. A sample of 120 Syrian refugee children residing in Amman provided the data for this study, which is based on a descriptive approach. The Statistical Package for the Social Sciences (SPSS) was used to analyze the data. We found that the main economic challenges faced by these children were low wages, labor exploitation, difficulties with paying back debts for their families, ongoing poverty, and the high cost of living in Jordan. Educational challenges were also largely economic and were mainly due to the high cost of education and the priority of work over school attendance. Health challenges too were economic and centered on the high cost of health care and the obstacles to obtaining medical insurance. Social challenges included lack of interpersonal bonds, an inability to form new friendships, and the absence of entertainment. This study suggests that providing financial support for Syrian refugee families consistent with the increasing cost of living in the hosting country would result in better lives for the Syrian children, as would creating job opportunities for heads of families in line with memoranda of agreement that Jordan has with international organizations. Further, public education for Syrian refugee children should be made free of charge, particularly in the elementary stages.
The search for polyprenols in dendroflora of Vietnam.
Authors: Marczewski Andrzej , Ciepichal Ewa , Canh Le Xuan , Bach Tran The , Swiezewska Ewa , Chojnacki Tadeusz
Published: November 2019

The occurrence of polyprenols in leaves of over 340 species of dendroflora in natural habitats in the regions of Hanoi and Hue in Vietnam was studied. Plant material was collected in the late autumn (October/November) during the end of a vegetation season. Leaves of about 200 plant species did not contain detectable amounts of polyprenols in contrast to few systematic families, e.g. Moraceae, Euphorbiaceae, where polyprenols were highly abundant and their pattern could be used as a chemotaxonomic criterion. Most often dominating polyprenols were prenol-11 and prenol-12. In several angiosperm species prenol-13 and detectable amounts of prenol-14 were also found. The incidence of prenol-13 and -14 was not restricted to a specific taxonomic group since species exhibiting domination of such longer chain polyprenols belonged to various systematic families. In some plants (e.g. Ceiba pentandra) alpha-cis polyprenols were accompanied by alpha-trans counterparts. This report describes several new plant species that may serve as natural sources of long chain polyprenols.
Oxytocin analogues with amide groups substituted by tetrazole groups in position 4, 5 or 9.
Authors: Manturewicz Michał , Grzonka Zbigniew , Borovicková Lenka , Slaninová Jirina
Published: November 2019

Eleven oxytocin analogues substituted in position 4, 5 or 9 by tetrazole analogues of amino acids were prepared using solid-phase peptide synthesis method and tested for rat uterotonic in vitro and pressor activities, as well as for their affinity to human oxytocin receptor. The tetrazolic group has been used as a bioisosteric substitution of carboxylic, ester or amide groups in structure-activity relationship studies of biologically active compounds. Replacement of the amide groups of Gln(4) and Asn(5) in oxytocin by tetrazole analogues of aspartic, glutamic and alpha-aminoadipic acids containing the tetrazole moiety in the side chains leads to analogues with decreased biological activities. Oxytocin analogues in which the glycine amide residue in position 9 was substituted by tetrazole analogues of glycine had diminished activities as well. The analysis of differences in rat uterotonic activity and in the affinity to human oxytocin receptors of analogues containing either an acidic 5-substituted tetrazolic group or a neutral 1,5- or 2,5-tetrazole nucleus makes it possible to draw some new conclusions concerning the role of the amide group of amino acids in positions 4, 5 and 9 of oxytocin for its activity. The data suggest that the interaction of the side chain of Gln(4) with the oxytocin receptor is influenced mainly by electronic effects and the hydrogen bonding capacity of the amide group. Steric effects of the side chain are minor. Substitution of Asn(5) by its tetrazole derivative gave an analogue of very low activity. The result suggests that in the interaction between the amide group of Asn(5) and the binding sites of oxytocic receptor hydrogen bonds are of less importance than the spatial requirements for this group.
Dermatan sulfate remodeling associated with advanced Dupuytren's contracture.
Authors: Koźma Ewa M , Głowacki Andrzej , Olczyk Krystyna , Ciecierska Magdalena
Published: November 2019

Dermatan sulfate (DS) widespread as a component of extracellular matrix proteoglycans, is characterized by great bio-reactivity and remarkable structural heterogeneity due to distinct degrees of sulfation and glucuronosyl epimerization and different polymerization degrees. However, DS metabolism under various biological conditions is poorly known. Dupuytren's contracture is a benign fibromatosis leading to complex remodeling of the palmar fascia structure and properties. However, it remains unclear whether the disease affects the structure of DS, which is the major tissue glycosaminoglycan. Thus the aim of the study was to examine the structure of the total DS in Dupuytren's fascia. DS chains were extracted from 5 samples of normal fascia and 7 specimens of Dupuytren's tissue by papain digestion followed by fractionation with cetylpyridinium chloride. Then, DS structure analysis was performed comprising the evaluation of its molecular masses and sensitivity to hyaluronidase and chondroitinase B. Dupuytren's contracture is associated with significant remodeling of DS chain structure revealed by (1) a distinct profile of chain molecular masses characterized by the appearance of long size components as well as the increase in the content of small size chains; (2) a different glucuronosyl epimerization pattern connected with the enhanced content of glucuronate disaccharide blocks; (3) chain oversulfation. These structural alterations in total DS may modify the GAG interactions especially affecting collagen fibrillogenesis and growth factor availability. Thus, Dupuytren's contracture associated DS remodeling may promote the phenomena typical for advanced disease: apoptosis and reduction in cell number as well as the appearance of dense pseudotendinous collagen matrix.