bluuebunny/crossref_metadata_2025 huggingface dataset:
A study to evaluate efficacy of Tinospora cordifolia (Guduchi) as analgesic agent using albino wistar rats as an experimental animal model
Authors: Mandal Purnendu , Das Asoke Kumar , Mandal Ananya , Biswas Tuhin Kanti
Published: January 2020

Background: Pain is a very well-known symptom of many diseases and analgesics are used to relieve pain. The main problem with these drugs remains that of side effects. Herbal medicines are better in view of their cultural acceptability, better compatibility with human body systems and lesser incidence of side effects. Extract of Tinospora cordifolia (Guduchi) plant have been traditionally used to treat pain in traditional medicine.Methods: Commercially available preparation of T. cordifolia plant has been used as test drug (aqueous extract). Healthy albino rats of either sex, weighing between 140-200 g were selected for the study, divided into 4 groups of 6 each (control, standard, 100 mg/kg, 300 mg/kg). Central analgesic activity was assessed by tail flick model (morphine as standard drug I.P). Acetic acid 1% 10 ml/kg aqueous solution I.P. was used for abdominal writhing model. Diclofenac 150 mg/kg oral as standard drug for assessment of peripheral analgesic activity. Results were analysed using SPSS version 16 and Microsoft office excel 2007.Results: T. cordifolia extract significantly increased the tail flick latency time (sec) (mean tail flick latency control, T100, T300 6.833±0.25 sec, 8.65±017 sec, 10.01±0.14 respectively) (p value control vs T100, T300 at 90 min, 120 min, 0.0573, 0.0198, 0.0198 in between group) and decreased number of abdominal writhing in comparison with the control group (p value <0.0001).Conclusions: Extract of T. cordifolia was found to possess analgesic activity and also exhibited dose and time dependant increase involving central and peripheral mechanisms. The analgesic activity of T. cordifolia found to be comparable to standard drug used.
Antibiotic sensitivity pattern of bacterial isolates from sputum samples of admitted patients with acute lower respiratory tract infections in a tertiary care teaching hospital of Tripura: a hospital record-based study
Authors: Debnath Shubhaleena , Bhaumik Debasree , Chakraborty Maitrayee , Ghosh Ranjib , Das Lakshman , Bhattacharjee Prithul
Published: January 2020

Background: Antibiotics are frequently used for various infectious diseases e.g., acute lower respiratory tract infection (ALRTI). But, injudicious use of antibiotics often leads to antibiotic resistance which is an emerging problem. The objective of this study was taken up to analyse the antimicrobial sensitivity pattern of pathogens isolated from the sputum samples of admitted patients suffering from ALRTI in a tertiary care teaching hospital.Methods: It is a hospital record-based study with a sample size of 393.Results: Klebsiella (52.16%) was the most common organism followed by Acinetobacter (13.49%) and Pseudomonas (13.23%) isolated from the sputum sample. Imipenem, piperacillin/tazobactam combination and gentamicin was sensitive against Klebsiella and Pseudomonas and the association were statistically significant. Acinetobacter was resistant to ceftriaxone.Conclusions: The commonest pathogens isolated from the sputum samples were Klebsiella followed by Acinetobacter and Pseudomonas. Imipenem, piperacillin/tazobactam combination and gentamicin was sensitive against Klebsiella and Pseudomonas.
A prospective study of metformin versus myoinositol plus d-chiroinositol combination therapy in polycystic ovarian syndrome
Authors: Jaura Sukhmani , Kaur Inderpal , Singh Jatinder , Madan Anita
Published: January 2020

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Insulin resistance and resultant hyperinsulinemia contribute to hyperandrogenism in these patients. Weight loss or pharmacologic interventions that lower insulin levels reduce androgen levels. This study was planned to evaluate efficacy of metformin versus myoinositol plus d-chiroinositol combination therapy in PCOS patients and its effects on clinical, hormonal and radio diagnostic dimensions.Methods: This was a prospective study for nine months. 50 newly diagnosed PCOS patients from the Department of Obstetrics and Gynaecology, Government Medical College (GMC), Amritsar, were randomly divided into 2 groups. One group was given metformin 500 mg twice daily and another myoinositol plus d-chiroinositol 1000 mg twice daily for 9 months. Follow up was done at 3, 6, 9 months. At each visit, ultrasonography and hormone levels were evaluated. Informed consent was taken. The approval of the Institutional Ethics Committee, GMC, Amritsar was also obtained.Results: The percentage change in free testosterone levels (22.46±6.47) and insulin levels (34.24±15.02) show statistically significant decrease in group 2 (p<0.001). There was statistically significant (p<0.05) fall in AMH levels (22.41±7.78) in group 1. There was no statistically significant difference between the 2 groups in ovarian volume on ultrasonography, random blood glucose levels, luteinizing hormone (LH), follicle-stimulating hormone (FSH) levels, estrogen and progesterone levels.Conclusions: It was observed that both treatments are equally effective in the treatment of polycystic ovarian syndrome with better tolerability in myoinositol and d-chiroinositol group.
Comparative study of patient-based versus case-based teaching in prescription writing skills of second year MBBS students
Authors: Jadav Shilpa P. , Bhansali Nishant B. , Parmar Dinesh M.
Published: January 2020

Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistical analysis of mean scores of group A (15.90) and group B (13.14) was done by Mann-Whitney U test (p<0.001). Comparison of both the groups for the individual parameters was done by Chi-square test which found significant difference in writing some important parameters like doctor’s registration no., contacts of prescriber, name of the medicine, strength of drug, dosage form, dosing instructions, total quantity of medicine and duration of medication etc. Group A students’ feedback brought out the fact that patient-based teaching is a good tool for teaching and learning.Conclusions: Patient-based teaching for prescription writing improves students’ prescription writing skills in an effective way in comparison with traditional case-based teaching.
Prescribing pattern of antibiotics among postoperative patients admitted in gynaecology and obstetrics department of tertiary care hospital in Northern India
Authors: Sawhney Neeta , Sawhney Vineeta , Khajuria Vijay
Published: January 2020

Background: The objective of the study was to study the prescribing pattern of the antibiotics in postoperative patients admitted in gynaecology and obstetrics.Methods: Current prospective observational study was conducted in the department of pharmacology, Government Medical College, Kathua in collaboration with department of gynaecology and obstetrics for a period of six months duration from 1st May 2019 to 31st October 2019. The case sheets of all post operated patients above eighteen years of age admitted were studied and analyzed.Results: Total of 1807 case sheets were analyzed and showed that 4245 antibiotics were prescribed with an average of 2.3 antibiotics prescribed. Oral cefuroxime (17.3%) was maximally prescribed in patients who delivered normal presentation with episiotomy and injection ceftriaxone along with tinidazole and gentamycin were prescribed (58.4%) where caesarean section was done. While injection ceftriaxone and sulbactum along with tinidazole and gentamycin (17.09%) was prescribed in patients who were operated for gynaecological diseases. Maximum (80%) of the antibiotics were prescribed under brand name.Conclusions: Cephalosporin’s are commonly prescribed antibiotic and in eighty percent brand names were prescribed. Results underscore that antibiotic in generic name should be encouraged.
A prospective study of antimicrobial utilization in post-operative care unit of a teaching hospital in South India
Authors: Nadeem Mohammed Naseeruddin , Maqdoom Maliha
Published: January 2020

Background: Surgical site infections, a common cause of morbidity and mortality in hospitalized patients can be prevented using an antimicrobial agent (AMA) as prophylaxis. Inappropriate use of AMA leads to antimicrobial resistance.Methods: A prospective study was conducted on 208 patients in Owaisi Hospital and Research Centre (OHRC) for a period of 6 months on post-surgical patients admitted in the postoperative care unit. Included in the study were post-operative patients aged 18 years and above, who were willing to participate in the study. Data related to demography of the patients and the AMAs used in these patients was collected and analysed.Results: Majority of the patients belonged to the age group 50 to 59 years (32%) followed by 40 to 49 age group (23%). Male patients (54%) were more than females. Common route of administration was intravenous (89%) and the most common dosing frequency was thrice a day (54%). Most AMAs were used in combinations. Metronidazole (62%) was the most commonly prescribed AMA, followed by ceftriaxone (55%).Conclusions: Cephalosporins were the preferred antimicrobials for surgical prophylaxis of aerobic infections prescribed in 74% of cases, while metronidazole was used as the primary antimicrobial agent to prevent anaerobic infections. AMA utilization needs to be continuously evaluated in post-operative units of the surgery departments in order to promote rational prescribing to decrease morbidity, cost of therapy and to contain the problem of developing AMA resistance in the region.
Study of prescribing pattern of drugs used in the treatment of bronchial asthma at tertiary care hospital of northern India
Authors: Adhaulia Garima , Singh Divya , . Suryakant , Verma Ajay , Singh Arpita , Nath Rajendra , Sachan Amod K. , Dixit Rakesh K.
Published: January 2020

Background: Asthma is a chronic inflammatory disease requiring long term treatment. For an effective control of asthma symptoms background knowledge of the prescribing pattern of anti-asthmatic drugs is a must.Methods: A prospective, observational study was conducted in the Department of Respiratory Medicine OPD, King George's Medical University, Lucknow. 114 patients of asthma were recruited for the study. A case report form was filled from patient’s prescription containing the demographic details of the patients, presenting complaints, investigations and drugs prescribed along with their dose, duration, frequency, route of administration.Results: 114 patients’ prescriptions were assessed which showed average number of drugs per prescription - 3.22. 42.8% and 50% of the drugs were prescribed in accordance with World Health Organization model list of essential medicines and National list of essential medicines. Short acting β2 agonist (salbutamol), 61.4% was the most commonly and frequently prescribed single anti asthmatic drug. Combination of inhaled corticosteroid and long acting β2 agonist, 86.8% was the most commonly prescribed fixed dose combination anti asthmatic drug. Inhalational route (75%) was the most preferred one over oral route (25%).Conclusions: Asthma being a chronic disease requires prolonged treatment which imposes economic burden on the patients. Judicious prescription of drugs not only improves the patient clinically but also removes the unnecessary burden. Data obtained from these studies can be used as a guide to make future decisions regarding standard prescription.
Prescription pattern of alpha blockers in the treatment of benign prostatic hyperplasia in India: a paper based survey
Authors: Tomar Vinay , Bhati Bhoopat Singh , Datta Biswajit , Bellamkonda Laxman , Prajapati Hiren K. , Chaturvedi Alok , Dave Nilanj , Jain Amit B.
Published: January 2020

Background: Benign prostatic hyperplasia (BPH) is the most common urological condition. The treatment of BPH depends on the severity of symptoms which aims to improve symptoms, lower the risk of progression and improve quality of life. The aim of this survey was to understand the prescription pattern of alpha blockers in the treatment of BPH among clinicians of India.Methods: A cross-sectional questionnaire-based survey was conducted between September to December 2018. Data regarding the management of BPH using α-blockers were filled by clinicians and collated for data analysis using appropriate statistical test.Results: Total of 1764 clinicians’ responses was collected and the result was analysed. According to the survey, 47.68% of clinicians felt that severity of the BPH symptoms is most common deciding factor for medical management of BPH. For the pharmacological management of BPH patients, around 58% of clinicians opted for α blockers monotherapy as a preferred option. Among α blockers, 65.14% of clinicians preferred tamsulosin as first line therapy for management of BPH patients. In this survey, 81.75% of clinicians believed that tamsulosin offers highest persistence rate among commonly prescribed α blockers. Looking at the switching to a second α-blocker, 75.45% of clinicians felt that tamsulosin shows the highest return rate following initiation of a second α-blocker. More than 90% of clinicians felt that favourable efficacy or tolerability of tamsulosin is due to its highest persistence and highest return rates.Conclusions: Tamsulosin is the most commonly preferred and prescribed α-blocker by Indian clinicians due to its favourable efficacy or tolerability.
Ciprofloxacin and levofloxacin adversely affect male infertility indicated by pharmacological, andrological and pathological evidence
Authors: Mokhimar Haitham M. , Kandiel Mohamed M. , Amin Aziza A. , Elsawah Hozaifa K. , El Mahmoudy AbuBakr M.
Published: January 2020

Background: Drug-induced reproductive organs toxicities is an important aetiology in investigation of male infertility. The aim is to study levofloxacin effect on male reproductive system in comparison to ciprofloxacin.Methods: Twenty-five male wister rats weighted 230±20 gm and aged 8 weeks were randomly divided into five groups of five. The first group received ciprofloxacin with dose 78.23 mg/kg/day in 2 doses (therapeutic dose). The second group received the double dose of the first group ciprofloxacin. The third group received levofloxacin with dose 39.11 mg/kg/day once daily (OD) (therapeutic dose). The Fourth group received the double dose of the third group levofloxacin. However, the fifth group served as a control and received normal saline with carboxymethylcellulose OD. All treatments were administered orally for 14 days. On the 15th day, blood samples and reproductive organs were obtained from all rats. Testicular tissues were prepared for genetic testing and chemical and microscopical examination.Results: Ciprofloxacin and levofloxacin negatively altered reproductive organ weights, sperm parameters and serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) level (p<0.05). Additionally, serum testosterone level was significantly deceased in ciprofloxacin-treated group (the double dose) (p<0.05) relative to control. The difference between ciprofloxacin and levofloxacin was significant in seminal vesicle weight and serum LH and FSH level (p<0.05). Testicular histopathological changes were also found with the two drugs with different degrees. Effects of levofloxacin and ciprofloxacin were dose-dependent.Conclusions: Both ciprofloxacin and levofloxacin adversely affect andrological function that should be monitored and controlled during application of these drugs.
Isolated myocysticercosis: rare presentation in quadriceps muscle
Authors: Bhardwaj Ankit , Sharma Sangeeta , Arya Amit , Kushwaha Suman , Chaturvedi Monali
Published: January 2020

Myocysticercosis is not a common disorder and in particular quadriceps muscle is rarer. We are reporting this rare case of myocysticercosis involving quadriceps muscle of right thigh with ultrasonographic demonstration of nodular scolex and associated edema with no neurological involvement.
Reasons behind late presentation of cancer patients to radiotherapy department of a tertiary Hospital in Southern Odisha: a cross sectional study
Authors: Das Bishnu Prasad , Panda Rashmi Ranjan , Patra Jitendra
Published: January 2020

Background: Prevalence of cancer is increasing worldwide. Early diagnosis with appropriate therapeutic interventions is essential for better treatment outcome. Identification and necessary modifications of factors responsible for delayed presentation might increase the life expectancy or quality of living. This study aims to identify the factors responsible for delayed presentation of cancer patients to radiotherapy department.Methods: This is a quantitative descriptive study, done with in a period from August 2018 to October 2019, among 120 cancer patients of different stages presenting to OPD of Radiotherapy department of M.K.C.G Medical College. Data were collected by using pretested semi-structured questionnaires, entered into Microsoft Excel and analyzed by using SPSS version 20.0.Results: A total of 120 cancer patients, 60 from each early and late stage had participated in the study. The mean age of presentation was 53.19 years. The number of male patients were 54 and female were 66. Maximum patients had addiction of chewing tobacco. When the time interval from appearance of symptoms to diagnosis were compared, 1 – 3 months were taken by 45% of early stage and 28.3% of late stage patients. Similarly, <1week time was taken from diagnosis to start of treatment in 25% and 13.3% in respective groups. Comparison of educational status (p=0.001), difference between primary and secondary delay (p<0.05), and socio-economic status (p=0.008) between both the groups were found to be statistically significant.Conclusions: Factors responsible for delayed presentation are related both to patient and system. Educating common people regarding early sign symptoms, emphasizing early detection at grass root level, proper referral and by upgrading existing oncology facilities, we can avoid adverse treatment outcome.
Knowledge, attitude and practice of diabetic retinopathy amongst diabetic patients in a tertiary care hospital of Jammu
Authors: Sharma Pallavi , Raina Bhavani , Bharti Anuradha
Published: January 2020

Background: Diabetes mellitus is a common metabolic disorder which is characterized by elevated blood sugar level. It is a major cause of blindness in our country, which is preventable and treatable, if healthy practice and knowledge regarding this disease is applied. The study was undertaken to assess the knowledge, attitude and practice of Diabetic Retinopathy, amongst diabetic patients attending eye OPD in GMC Jammu.Methods: 300 patients diagnosed with diabetes mellitus attending eye OPD, over a period of 10 months, in GMC Jammu, were incorporated in this study. Self administered questionnaires were used to assess knowledge, practice and attitude of diabetic retinopathy amongst the diabetic patient, after their due consent.Results: This study incorporated 300 diabetic patients out of which 168 (56%) were males and 132 (44%) were females. Most of the patients (70%) were aware of the fact that diabetes can cause eye disorders. 67.33% believed that they should go for regular eye check-ups. 79.33% agreed that timely intervention can delay the complications in diabetic eye disease.Conclusions: Diabetes can lead to serious ocular complications which can be prevented by appropriate awareness and optimistic attitude and good approach towards the disease.
Response of osteoarthritis biomarkers after a rehabilitation program: study protocol
Authors: Antonioli Eliane , Oliveira Felipe B. D. , Campedelli Rosana R. , Zorzi Alessandro R. , Specialli Danielli , Agarwal Sudha , Ferretti Mario
Published: January 2020

Background: Knee osteoarthritis is a progressive degenerative joint disease and remains a leading cause of pain, physical impairment and decline in health-related quality of life in adults.   Despite its incidence being amongst the highest in chronic diseases, effective biomarkers are not available to assist in its management. The main goal of this study is to identify mediators that serve as biomarkers and investigate if the levels of these biomarkers will be correlated to the efficacy of a rehabilitation program.

Methods: This is a prospective cohort study with 65 participants. Patients with mild-to-moderate symptomatic knee osteoarthritis will be recruited. The Rehabilitation Program will consist of three session/week during eight weeks. Assessment about functional evaluation will be performed before and after treatment, using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQOL-5D (Euro quality of life - five dimension) scales, Visual Analog Scale (VAS), and physical function tests (time up and go, isometric strength testing and kinematic gait analysis). Serum levels of classical pro-inflammatory cytokines, hyaluronan and high mobility group box 1 protein (HMGB-1) will be evaluated. The primary outcome is the change in WOMAC scale from baseline to end. Statistical analyses will be used to determine correlation of physical improvement and serum biomarkers. Adverse events will be monitored throughout the study.

Conclusions: This trial expect to study the correlation between the anti-inflammatory effects of rehabilitation program derived factors that may be involved in suppressing cytokine induction via suppressing HMGB-1.

Trial registration: Clinicaltrials.gov - NCT02964624.
Ultrasound guided hydrostatic enema reduction of acute intussusception: guidelines in therapy and review of the institutional experience
Authors: Sarma Vivek Parameswara
Published: January 2020

Background: In this review, author analyzed the cases of Acute Intussusception that underwent Ultrasound guided hydrostatic reduction during a one-year period. Author reviewed this treatment protocol and guidelines of non-operative and surgical therapy. The procedure followed and guidelines of therapy were reviewed and are detailed in the study.Methods: Retrospective analysis of the hospital data of all patients who were treated for acute Intussusception during the period of January 2017 to December 2017 was done. All records including admission data, investigations, procedure records, preoperative details and operation notes, where applicable, post procedure recovery data and incidence of recurrence were studied. Inclusion criteria included confirmed sonological diagnosis of Intussusception verified by the treating paediatric surgeon, availability of all necessary records and absence of other co-morbidities. Exclusion criteria included age more than 2 years, children who had other major systemic disease, doubtful sonological diagnosis and postoperative intussusception. The paediatric surgeon himself performed the procedure in the dedicated ultrasound suite.Results: The study was done in the mother and child wing of a medical college which is a tertiary referral centre catering to more than 200 cases of Intussusception per year. The records of 194 cases of Intussusception were available for analysis, of which only 176 could be included in the study. The age group included is 3 months to 3 years. The mean age was 11 months. The sex incidence was 94 cases in males and 82 in females.Conclusions: Ultrasound guided hydrostatic reduction is a safe, effective and convenient modality for treatment of acute Intussusception, which can be performed by the treating Paediatric surgeon himself with requisite training and exposure.
Need of the hour? does breast milk bank reduces perinatal morbidity and mortality: a retrospective observational study
Authors: E. Narayanan , Sajjid Mohd , Kumar Arun
Published: January 2020

Background: Human milk bank plays an essential role by providing human milk to infants who would otherwise not be able to receive human milk. The aims and Objectives is to study the morbidity and mortality outcome  profile of babies fed with PDHM (pasteurized donor human milk) comparing data between Pre Human Milk Breast bank (2015) and Post Human Milk Breast bank (2016, 2017 and 2018).Methods: Milk bank collect, screen, store, process, and distribute human milk. Retrospective observational study was done in Department of Neonatology, Institute of Obstetrics and Gynaecology and Women and Children Hospital, Chennai. Data obtained retrospectively comparing data Pre HMB (2015) and Post HMB (2016, 2017 and 2018).Results: In this study authors collected the data comparing Pre human milk bank (Pre HMB) and Post human milk bank (Post HMB).  After starting human milk bank, around 1799 babies were benefitted and 14.45 lakh ml milk was collected from 16000 donor mothers in last 3 years. Bacterial contamination rate of PDHM has reduced to 4.39% (2018) compared to 7.73% (2016) with P Value 0.0042 (statistically significant). CONS and Staphylococcus aureus were the most common Organisms isolated. There was reduction in morbidity profile like sepsis rate, NEC/ Feed intolerance and ROP profile. Mortality profile also reduced to (7.73-9.31%). Duration of hospital and Duration to attain full feeds were improved all GA group babies.Conclusions: In this study, after starting human milk bank there was reduction in mortality, morbidity outcome, sepsis. Duration to attain full feeds  and duration of hospital stay reduced. We concluded that establishment of breast milk bank will be more useful and beneficial for all GA group babies for better outcome.
A study on role of thrombocytopenia in retinopathy of prematurity
Authors: Benedict Aswathy , Bukelo Mario Joseph
Published: January 2020

Background: Retinopathy of Prematurity (ROP) is one of the causes of avoidable blindness in India. Globally ROP is estimated to affect more than 50,000 infants annually and in India, every year, 500 children are estimated to become blind from ROP. Many a times, lack of trained professionals and lack of timely referral are found to be setbacks in ROP diagnosis and treatment in developing nations. The aim of the study was to study if thrombocytopenia is a risk factor for retinopathy of prematurity and does supplemental oxygen with thrombocytopenia increases the risk of ROP.Methods: It was a retrospective case control study done in a tertiary care hospital. Data was collected from 177 preterm admitted to NICU over a period of 3 years from March 2015-2018.Results: A total of 177 preterm admitted to the NICU was included in this study. 77 had ROP and were taken as cases, while 100 were controls. Out of the cases, 55.6% had thrombocytopenia (OR-2.47, p value: 0.003). 89% (n =69) of cases had significant oxygen exposure (OR-8.65, p value 0.0001; 95% CI: 2.00-10.75). Oxygen exposure and thrombocytopenia coexisted in 57% of cases, with 4 times increased risk of ROP (OR-4.51, p value: 0.0001).Conclusions: Thrombocytopenia is a significant risk factor for retinopathy of prematurity in preterm. The presence of thrombocytopenia with significant oxygen exposure tends to accentuate the risk further. Future prospective studies with long term follow up are warranted to establish other risk factors.
Life style effects on hypertension and obesity in adolescents
Authors: Bhatt Sonia , Firoz Shehraz
Published: January 2020

Background: Studies based on effects of lifestyle on hypertension and obesity in adolescent age group are lacking in India. The present study was conducted to evaluate the prevalence of lifestyle associated risk factors in school going adolescents of Kendriya Vidyalaya in district Firozabad and their effects on hypertension and obesity.Methods: The study was carried out among 200 students of classes 9th and 11th in the age group of 13 to 17 years. Students were given a pre-designed questionnaire and feedback was taken about dietary practices and physical activity along with family history of hypertension and obesity. Height, weight, waist circumference, hip circumference, blood pressure was measured in all children. Effects of lifestyle associated risk factors were determined on obesity and hypertension.Results: The study documents that inappropriate dietary practices (fast food consumption, low fruit intake) and less physical activity were strongly associated with high prevalence of obesity and hypertension in the adolescents. The study also showed that adolescents with positive family history of obesity and/or hypertension are also at higher risk. There was a positive correlation between high BMI and hypertension.Conclusions: School based interventions are required to educate the adolescent children about lifestyle modifications to reduce the morbidity associated with non-communicable diseases.
Cord blood albumin as predictor of neonatal hyperbilirubinemia
Authors: V. Chandan M. , K. Praveen B.
Published: January 2020

Background: Measuring the Cord blood Albumin level and predicting neonatal hyperbilirubinemia.Methods: Prospective study was performed on 160 healthy term neonates. Relevant maternal history was collected. Cord blood was collected from the healthy term neonates at birth and cord serum albumin measured. Neonate was assessed for jaundice every day using transcutaneous bilirubinometer. Total Serum Bilirubin (TSB) was assessed if the Transcutaneous Bilirubin (TCB) values were found high and treated according to NICU protocol.Results: Study cohort was grouped as Group A, Group B and Group C based on Cord Serum Albumin (CSA) level ≤3.3 g/dl, 3.3-3.8 g/dl and ≥3.8 g/d respectively. Statistical analysis was done for correlation of CSA with Neonatal Hyperbilirubinemia (NH). It showed that cord serum albumin level ≤3.8 g/dl is critical, as it was seen in 9.1% of neonates who developed neonatal hyperbilirubinemia (p value-0.032).Conclusions: There is a correlation between cord serum albumin level and neonatal hyperbilirubinemia. Cord serum albumin level of ≤3.8 g/dl is a risk indicator in predicting the development of neonatal hyperbilirubinemia.
A prospective observational study to describe magnetic resonance imaging findings in perinatal asphyxia in terms of severity, outcome and neurological sequel in term and preterm babies
Authors: Mondal Tanushree , Gayen Gargi , Bhowmik Arijit
Published: January 2020

Background: Perinatal asphyxia is a significant cause of neonatal mortality and morbidity. MRI is useful for assessing the severity and pattern of brain injuries. There is less data of MRI findings of perinatal asphyxia from India and the subcontinents. This prospective observational study was done to describe MRI brain findings in neonates with perinatal asphyxia with respect to various determinants.Methods:  Initial MRI brain was done when babies were stable after fulfilling inclusion criteria. Immediate outcome was assessed at the end of hospital stay. They were followed up for presence of any sequel up to 1 year. Repeat MRI brain was done in few selected babies. Data was collected and statistically analyzed.Results: Total 55 babies were included in the study (term 27, preterm 28). There were 9 babies in stage 1, 17 babies in stage II and 22 babies in stage III. MRI brain findings were normal in 8 and abnormal in 47 patients. There were Deep gray matter injury (DG) in 22, Para Sagittal subcortical white matter injury (PS) in 6, Germinal matrix haemorrage (GMH), intraventricular haemorrage (IVH) and Periventricular leucomalacia (PVL) in 12 and Mixed pattern of injury in 7 babies. Findings among 9 expired babies were: 4 (44.4%) DG, 2 (22.2%) GMH+IVH and 3 (33.3%) mixed. There was neurological sequel in 13 babies (48.1%).  Babies with normal MRI initially had no sequel.Conclusion: Brain injury due to perinatal asphyxia follows several patterns according to gestational age and severity. Early and accurate recognition of these patterns with the help of MRI brain helps in managing the baby and predicting the prognosis.
Serum immunoglobulin E and absolute eosinophil count as markers of severity in childhood asthma
Authors: Trivedi Pinakin P. , Patel Ami H.
Published: January 2020

Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.
Yale observation scale for bacterial infection in febrile children
Authors: Mangla Shiwani , Jain Hemant
Published: January 2020

Background: Sepsis is one of the leading causes of mortality in children under 5 years by UNICEF statistics which is difficult to diagnose because of nonspecific initial clinical presentation and potential for rapid deterioration. In this regard use of Yale Observation Scale assists in early recognition of serious bacterial infection than other laboratory investigation as it is simple, quick, easy to apply and cost-effective bed side scale.Methods: All eligible young febrile infants and children were consecutively enrolled in the study. Axillary temperatures of the cases were documented. Yale observation scoring was done. Blood sample were sent for culture and sensitivity. Colonies were identified morphologically by Gram stain and biochemically. The collected data was analyzed using ROC curve for finding cut off scores of Yale Observation Scale for prediction of severe bacterial illness and final outcome. Statistical analysis was performed using the Statistical Packages for Social Sciences (SPSS) version 14 for MS Window.Results: Bacteremia was found in 23(15.3%) out of total 150 young febrile children enrolled in the present study. It shows that in lower YOS score blood culture was sterile and in higher YOS score blood culture was positive for bacteremia, which is statistically significant with p value (<0.05). As per ROC curve analyses the best cut off value of YOS for prediction of bacteremia was 17.5 with sensitivity 91.3%, specificity 81.9%, PPV 47.7% and NPV of 98.1%.Conclusions: YOS of  >17.5 has a good predictive ability for prediction of bacteraemia in young febrile children.
Study on ultrasound observations in children with typhoid fever in a tertiary care hospital
Authors: Md. Zubair Ahamed , Belavadi Gangadhar B.
Published: January 2020

Background: Enteric fever continues to be endemic in poor countries globally, although it has been eradicated from the developed nations due to their well-organized sanitation and protected water supply. The five Fs most concerned with spread of typhoid disease are fingers, food, fomites, flies, and feces. Enteric fever is predominantly caused by Salmonella typhi and next in frequency is Salmonella paratyphi. Very less literature is available on radiological manifestations of typhoid fever in children on the basis of age difference in India. Hence, a study was conducted to observe the radiological findings and to correlate with laboratory manifestations in typhoid fever. Objectives of the study was to observe the ultrasound abdomen changes in Typhoid fever at rural area.Methods: The current study was conducted at Department of pediatrics of Narayana Medical College Hospital, Nellore, Andhra Pradesh state in a period of one year. All patients presenting with fever having positive for Widal test were included. In total 50 patients were included and divided into 2 age groups, <5 years and >5years. The laboratory results and abdominal ultrasound were conducted in the two groups and compared.Results: Total 20 patients in <5 years age and 30 patients in >5 years were enrolled. Male to female ratio was 2:1 in both groups. Common laboratory findings showed 32 patients (64%) with Anemia, elevated liver enzymes in 40 patients (80%), and elevated ESR in 42 patients (84%). 45 patients have Splenomegaly and hepatomegaly with normal parenchymal echotexture. Gallbladder sludge and biliary sludge was seen in 6 patients. Thickened gall bladder in 34 patients (68%) was observed. Bowel wall thickening seen in 32 patients (64%). mesenteric lymphadenopathy in 36 patients (68%) observed. All were recovered by treatment.Conclusions: On ultrasound, splenomegaly, hepatomegaly, and thick-walled gallbladder were observed in most of the childrens with typhoid fever. Therefore, ultrasound can also be used as supportive diagnose along with laboratory parameters due to it is a non-invasive and economical tool of diagnosing typhoid.
Gastric residual volume as a measure of feed intolerance/necrotising enterocolitis in very low birth weight infants: an observational cohort study
Authors: Kadam Rahul M. , V. V. Lakshmi Aparna Devi
Published: January 2020

Background: To evaluate the efficacy of Gastric Residual Volume (GRV) as a measure of feed intolerance /Necrotising enterocolitis in Very Low Birth Weight (VLBW) infants.Methods: This prospective observational cohort study was done in a tertiary care hospital located in rural South India for a period of 2 years. All haemodynamically stable infants born between 30-34 weeks of gestation at birth and 1000-1500 grams of birth weight, admitted to Neonatal Intensive Care Unit (NICU) within first 24 hours of life during study period were enrolled in two groups; GRV group, where pre-feed gastric residual volume  was checked and No-GRV group, where pre-feed gastric residual volume  was not checked.Results: Both groups had similar baseline characteristics. In No-GRV group, the days to reach birth weight (12.1) and days to attain full feeds (8.0) were less when compared to GRV group. In No-GRV group, average duration of NICU stay in days (16.60) and parenteral nutrition (5.25) was less when compared to GRV group. No-GRV group does not have increased incidence of sepsis or mortality compared to GRV group. In this study there was increased incidence of NEC noted in GRV group (30%) when compared to No-GRV group (p value-0.02).Conclusions: In hemodynamically stable preterm VLBW infants, it is recommended not to check gastric residual volume routinely prior to the enteral feeding.
Takayasu arteritis presenting with massive cerebral ischemic infarction in a 15-year-old girl: a case report
Authors: S. Mohinish , K. Dhanalakshmi , Sajjan Sushma Veeranna , K. Priyanka
Published: January 2020

Takayasu arteritis is a relatively rare type of large-vessel arteritis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Depending on the different groups of blood vessels involved in the disease process, the clinical presentation of Takayasu arteritis varies. Here we report a case of a girl presenting with a debilitating massive cerebral ischemic infarct that turned out to be a relatively rare first presentation of Takayasu arteritis. Case report of 15 years old adolescent female hailing from lower socio-economic status with past history of chronic headache, no significant family history, completely immunized presented with sudden onset weakness of right upper and lower limbs, which progressed over 1day with aphasia (recovering) with deviation of angle of mouth to left side On examination left radial ,carotid artery not palpable. Her laboratory results showed an elevated C-reactive protein and erythrocyte sedimentation rate, and subsequent CT angiography demonstrated narrowing and occlusion of the major branches of her aortic arch. We report the case of a patient with Takayasu arteritis presenting with a massive cerebral ischemic infarct and review the current literature on this topic. Conclusion of takayasu arteritis is a relatively rare disease with various and sometimes devastating clinical manifestations, such as massive cerebral ischemic infarction as in our case. Currently, there are multiple diagnostic tools and treatment options available, and more under investigation. Early, appropriate diagnosis and initiation of proper therapy could avoid further progression and reduce complications of the disease.
Effect of remedial teaching on the scholastic performance of children with learning disability
Authors: Vincent Areena C. , Elenjickal Manju G. , U. Sukumaran T.
Published: January 2020

Background: To assess the effectiveness of remedial teaching in children with learning disability and to find association between IQ score and age of the child with their improvement.Methods: An interventional study using pre-post study design, took place in Child Development Centre (CDC) of tertiary care Medical College hospital. Participants includes 45 school going children of age group of 6-15 years. After initial diagnosis and IQ assessment, remedial teaching was given in CDC for 12 months. Techniques are chosen on an individual basis by formulating individualised education program (IEP) by special educators. Diagnosis and pre- post assessment were done using tool, NIMHANS SLD battery. Effectiveness was evaluated as improvement in class levels of students. Definite improvement was decided in each student if improvement was observed in 4 or more domains.  Relationship of IQ score and age with their improvement in was noted.Results: In pretest, poor results were found in attention and copying in 39 children, reading in 41, comprehension and spelling in 42, written expression in 43, and arithmetic in 44. In posttest, good results with statistical significance (p<0.05) were found in attention in 33, copying in 27, reading in 24, arithmetic in 15, and spelling in 12 children. Definite improvement was noticed for 33% of students with significant association with age and not IQ score of the child.Conclusions: This study shows that remedial teaching can bring about significant changes in academic skills namely attention, copying, reading, arithmetic, and spelling. 33% had definite improvement in 4 or more domains. The improvement in academic skills following remedial teaching was dependent on the child’s age and not on IQ score.
Characteristics of geriatric neurology patients treated at the central hospital of Sanglah Denpasar in 2019
Authors: Gunawan Stephanie Elizabeth , Laksmidewi Anak Agung Ayu Putri
Published: January 2020

Background: According to the World Health Organization (WHO), an elderly person is someone who has entered the age of 60 years and above whose percentage tends to increase along with decreasing morbidity of the elderly. Geriatric Neurology itself is the study of a group of neurological diseases in the elderly. Based on 2012 data, the proportion of elderly population in Indonesia is 7.59%. This is accompanied by an increase in the dependency ratio of the productive age population to the non-productive age population. The results of the 2013 Basic Health Research showed an increase in the prevalence of neurological disease in the elderly which was the main cause of death in 15 regencies in 2011. It is to find out the 5 most neurological diseases in the elderly, clinical characteristics and outcomes of geriatric neurology patients treated at the Central Hospital of Sanglah.Methods: It is a retrospective study using no control by looking at medical records in geriatric neurology patients aged 60 years and over who visited the Central Hospital of Sanglah in the March to May 2019 period.Results: A total of 200 patients consisted of 111 men (55.5%) and 89 women (44.5%) who were divided into 5 most geriatric neurology diseases which included 1. ischemic stroke, 2. bleeding stroke, 3. brain tumor, 4. injury head, and 5. epilepsy. The number of deaths was 16, of which 7 cases were caused by sepsis and pneumonia.Conclusions: Stroke, tumors, head injuries and epilepsy are the dominant neurological diseases found. The focus of care and supervision of elderly neurology patients is expected to be further enhanced to prevent side effects that will extend the patient’s treatment period in the hospital which will automatically increase the burden on the hospital itself.
Assessment of incidence rate and prognosis of metabolic syndrome among acute myocardial infarction: a longitudinal study
Authors: Uppin Archana M. , Badiger Raju H. , Sharma Gayatri , Soni Rishab , Parne Sowmya , Maddiri Pavan Kumar
Published: January 2020

Background: The Metabolic Syndrome (METS) is a specific clustering of cardiovascular risk factors in the same person (abdominal obesity, atherogenic dyslipidemia, elevated Blood Pressure (BP), Insulin Resistance (IR), and a proinflammatory state. A recent review of insulin resistance syndrome revealed a rapid escalation of this syndrome among Indians and the prevalence of predominant component of METS varies from region to region. Hence the present study was undertaken to assess the incidence of Metabolic Syndrome and prognosis of metabolic syndrome among acute myocardial infarction patients.Methods: A longitudinal study was carried among Acute myocardial infarction patients, who were admitted to ICCU of Shri. B. M. Patil Hospital and Research Centre, Bijapur during November 2009 to March 2011. Sample size was calculated using the formula: n=4pq/L2. Sample size required was 92. Descriptive statistics and Inferential statistics were used to analyse the results.Results: The incidence rate of METS among AMI in our study was 48.7%.  The complications were more common in METS group compared to those without METS groups. Recovery was better among those without METS group. There was a statistically significant association between complications and status of METS. The past history of DM was more common in METS. Hyperglycemia among the components of METS has strongest association with the outcome of death in patients of AMI.Conclusions: The metabolic syndrome is a highly prevalent condition among the patients with acute myocardial infarction and has detrimental impact on outcome Metabolic syndrome is also associated with a higher risk of severe heart failure and death.