bluuebunny/crossref_metadata_2025 huggingface dataset:
Possible use of the growing liver biological set for hepatic recovery after toxic damage (an experimental study)
Authors: Gal`perin E.I. , Ataullakhanov R.I. , Dyuzheva T.G. , Platonova L.V. , Melnikova T.M. , Monakov M.Yu. , Dudchenko A.M. , Lyundup A.V. , Klabukov I.D.
Published: October 2017

The lack of acceptable pharmacological approaches for restoration of the injured liver is associated with complex of mechanisms involved in hepatic regeneration and with difficulty of the target selection. The aim of this research was to study the hepatoprotective function of the extract from both the growing and regenerating liver containing a natural set of factors crucial for the hepatic restoration. Extracts from both regenerating liver of rats after 70% hepatic resection and the growing liver of neonatal pigs were obtained using own original technique. The set of resultant extracts was named as the hepatic regeneration set (HRS). HRS fractionation was carried out using the Toyopearl HW-50S sorbent. The efficiency of HRS and its fractions was estimated using a model of the mouse liver thioacetamide injury and monitoring hepatic enzyme activity in blood serum. The activities of AST and ALT in intact animals were 50 U/l and 80 U/l, respectively; after thioacetamide administration they increased to 2059±212 U/l and 4280±440 E/l, respectively (p<0.05). Treatment of injured animals with HRS from the rat regenerating liver resulted in a significant decrease of transaminase activities to 924±148 U/l (AST; p<0.05) and 1633±308 U/l (ALT; p<0.05). A similar effect was observed after treatment with HRS from the neonatal pig liver: the AST decreased to 937±138 U/l (p<0.05), while ALT activity decreased to 1710±237 U/l (p<0.05). HRs fractionation resulted in identification two active fractions characterized by much higher (8-29) hepatotropic effect that that of the whole extract. These fractions contained peptide/protein components with the range of molecular mass of 3-60 kDa (fraction 1) and 3-25 kDa (fraction 2a). Fraction 1 also contained some polynucleotides in fraction 1. Subsequent studies of these fractions exceeding the hepatotropic effect of original HRS is clearly needed to identify their individual components by immunochromatography methods, ELISA, MRM mass spectrometry and quantitative PCR.
Colorectal cancer: a review
Authors: Granados-Romero Juan José , Valderrama-Treviño Alan Isaac , Contreras-Flores Ericka Hazzel , Barrera-Mera Baltazar , Herrera Enríquez Miguel , Uriarte-Ruíz Karen , Ceballos-Villalba Jesús Carlos , Estrada-Mata Aranza Guadalupe , Alvarado Rodríguez Cristopher , Arauz-Peña Gerardo
Published: October 2017

Colorectal cancer (CCR) is the third most common cancer worldwide in men and women, the second largest cause of death related to cancer, and the main cause of death in gastrointestinal cancer. The risk of developing this cancer is related to bad alimentary habits, smoking, intestinal inflammatory disease, polyps, genetic factors, and aging. Of the patients that are diagnosed with colorectal cancer 90% are older than 50, with a median age of 64 years; however, the disease is more aggressive in patients that are diagnosed at younger ages. According to the American Cancer Association, it was accounted for more than 49,700 deaths in 2015. The goal is to reduce the mortality rate with early diagnosis and treatment. Currently, the survival rate is used to predict a patient’s prognosis. The patient is considered to have a positive familial history if a first-degree relative has been diagnosed with colorectal cancer or colonic polyps before the age of 60, or also if two or more first-degree relatives have been diagnosed with cancer or polyps at any age. There are several methods for detecting colorectal cancer, such as the guaiac test, immunochemical test of stool, DNA stool test, sigmoidoscopy, colonoscopy, and barium enema. The stage in which the cancer is detected determines the prognosis, survival, and treatment of the patient. Provide a review about generalities, genetic basis, risk factors, protective factors, clinical course, diagnostic methods, therapy and survival in colorectal cancer. Conducted research from different databases such as PubMed, Medline, MedScape, on the definition, genetic factors, classification, risk factors, protective factors, diagnostic methods, epidemiology, survival and treatment of colorectal cancer. Articles from 2000 to 2017 were included using the following keywords.
Pharmacotherapeutic options for attention deficit hyperactivity disorder (ADHD)
Authors: Singh Jarnail
Published: October 2017

Attention deficit hyperactivity disorder (ADHD), the most common behavioral disorder in children, may disable the patient throughout life. Diagnosis of ADHD is based on DSM-IV-revised criteria. ADHD is a costly health problem and various drugs including stimulants, tricyclic antidepressants (TCAs), bupropion, pemoline, clonidine and atomoxetine have been used to treat it. Atomoxetine and stimulants are the most commonly prescribed drugs for pediatric ADHD with similar efficacy, but serious adverse events with atomoxetine have been reported.
Clinical profile and prognostic factors of leptospirosis: a study of 50 cases from North Kerala, India
Authors: Kannan Rijit , George Alex Anoop , George Alex Anoop
Published: October 2017

Background: Leptospirosis is the most common zoonosis in the world. In humans it is caused by leptospira interrogans group of organism. It is an emerging disease in various part of the Kerala since 1980 and frequent epidemic with high mortality is being reported. Severe leptospirosis is characterized by jaundice, renal dysfunction, and hemorrhagic manifestation and with high mortality. Studies on assessing the prognostic factors in leptospirosis is only few from this area. This study was conducted to assess the clinical profile and prognostic factors of icteric leptospirosis.Methods: This is a prospective study conducted at academy of medical sciences Pariyaram involving 50 cases from the medical intensive care unit and wards with clinical features of leptospirosis and confirmed by the ELISA. All the patients were investigated and assessed for the complications and out come.Results: 50 cases of clinically and serologically confirmed cases of leptospirosis were included in this study of which 39 (78%) were males and 11(22)% were females. Among males maximum cases were reported in 40 to 44 age group and that females 30-34 age group. Of the 50 cases 7 patients expired and most common cause of mortality among this were acute respiratory distress syndrome (90%). Five patients had residual renal failure at the time of discharge.Conclusions: Leptospirosis was a common cause of hepatorenal failure in this area and important cause of mortality among agriculture workers during monsoon and post monsoon period. Acute respiratorydistress syndrome, and renal failure was the most common cause of mortality. Out of the 50 patients studied, 36 patient got cured and severn patient died and and five patients got discharged with residual renal and hepatic dysfunction. The mortality rate was 14% higher than noticed in other studies. patient who had early dialysis, plasma transfusion had a better prognosis.
Perceptions and practices of various maternal and child health services: a study among women of reproductive age group in a costal block of Ganjam District, Odisha
Authors: Chandra Pal Prafulla , Panda Manasee , Panda Manasee , Karmee Nivedita , Karmee Nivedita , Kumar Sahoo Sanjaya , Kumar Sahoo Sanjaya
Published: October 2017

Background: “Healthy mothers - Healthy children” and “children’s health - tomorrows health”. Any intervention which should be planned towards the upliftment of health status of this group must start with gathering information about their present status especially in the underprivileged section. This study was conducted with an objective to assess perceptions and practices of various Maternal and Health services in the study group.Methods: An observational, cross-sectional study was conducted among women in reproductive age group residing in villages of a coastal block with a predesigned and pretested questionnaire.Results: Among the study population 54.7% women were in the 25-34 years age group, majority (46.7%) were illiterate and one-fourth of the study population age at marriage was below 18 years. Though 90.7% of study population were aware of the ongoing contraceptive practises only 37.4% of the respondents accepted some or other contraceptive methods. Fear of side effects (35.4%) found to be the chief reasons for unwillingness for adopting contraception. Majority (90.2%) responded that pregnant women need to go for ANC but only 51.9% knew correctly about minimum number of ANC. Women having adequate knowledge on ANC was found to be significantly associated with their educational status and age at marriage. Among PNC mothers 57.6% had completed the requisite no. of ANC and only 30% of respondents had completed the course of iron and folic acid tablet during their last pregnancy.Conclusions: The literacy status of the study population has to be improved which will lead to demand generation and utilization of the health and other services provided by the Government.
Effect of medical nutrition therapy on vitamin C and malondialdehyde in HIV positive malnourished children
Authors: Dias Bina F. , Nimkar Aparna Dilip
Published: October 2017

Background: The objective is to assess the effect of medical nutrition therapy on biochemical parameters like Vitamin C and Malondialdehyde by estimating oxidative stress in HIV positive malnourished childrens’ sample. Any alteration in the antioxidant markers can help to assess the effectiveness of MNT as a therapeutic agent. There is limited data on the use of Ready to Use Therapeutic Food (RUTF) in India. Therefore, the study was conducted to determine the effect of prepared Ready to Use Therapeutic Food (RUTF) also termed as Medical Nutrition Therapy (MNT) in HIV positive malnourished children.Methods: In this prospective comparative study, pre MNT and post MNT sample as well as the parameters-Malondialdehyde and Vitamin C were analyzed in 19 HIV positive malnourished children in the age group of 6-12 years at L.T.M.M. College. HIV positive malnourished children showed adverse effects on nutrition as well as immune system. Thus, to supply adequate micronutrients and macronutrients, the subjects were treated with Medical Nutrition Therapy (MNT).Results: The post MNT HIV positive malnourished childrens’ samples revealed significant results than pre MNT HIV positive malnourished childrens’ samples.Conclusions: The level of antioxidant marker (vitamin C) increased and peroxidation marker (MDA) decreased post medical nutrition therapy. The increased post levels of vitamin C activity helped in the eradication of excess free radicals, thereby reducing oxidative stress and hence the oxidative damage to cells as well as inhibiting lipid peroxidation (which is indicated by decreased post level MDA).
Prescription to practice in hypertension: a community experience in central Kerala
Authors: Mathew Elsheba , Aiyappan Rajalakshmy , M. Mili , N. Navaneetha , Shibu Priyanka , Aravindakshan Rajeev
Published: October 2017

Background: Control of blood pressure is a global challenge and non-adherence to hypertension medications is a public health concern. Patient, medication and system related factors can contribute to non-adherence. The study was to determine adherence to hypertension medications and to understand the barriers to adherence in an adult group in Pathanamthitta District of Central Kerala.Methods: A cross sectional study was conducted in a community setting in 2016, among 139 adults aged 30 years and above on treatment for hypertension for at least six months. Those with gestational hypertension, those having serious comorbid conditions and those unwilling to participate were excluded. The data sheet included basic demographic information and history related to hypertension. A content validated eight item questionnaire was used to assess reported adherence and scores classified level of adherence as good (8), moderate (6-<8) and poor (<6). The data was analyzed using SPSS. Chi square test of significance and multivariate regression analysis were done. P<0.05 was considered statistically significant.Results: The participants were in the age group 34-91 years, 50.4% belonging to 50-69 years, and 75.5% were females. Adherence to hypertension medications was good in 49.6%, moderate in 31.7% and poor in 18.7%. The most common factors reported to contribute to non-adherence were forgetfulness (70.5%), high cost of medications (51.8%), and symptom-free state (27.3%).Conclusions: Adherence was good in less than half the study participants and poor in almost one-fifth. Forgetfulness and high medication costs were the most commonly reported barriers. These findings highlight the importance of individuals, families and health service, joining hands to tackle the public health problem of non-adherence to hypertension medications.
Assessment of wash practices among women in urban slums of Berhampur, Odisha: a cross sectional study
Authors: Tripathy Radha Madhab , Acharya Geeta Chand , Karmee Nivedita
Published: October 2017

Background: Access to Water, Sanitation and Hygiene (WASH) is a pre- condition for people to acquire good health, well-being and benefit from economic development. WASH constitutes both provision of water and sanitation facilities and hygiene promotion. The study objective is to assess the practices and existing perceptions of water, sanitation and hygiene among women in urban slums of Berhampur.Methods: A cross sectional study was conducted among 400 women (households) residing in urban slums of Berhampur from August2016-January 2017 by simple random sampling. Data was collected using a predesigned pretested questionnaire.Results: Out of the total, 62.3% respondents depended on public tap as major source of drinking water , 31.5% purified water before drinking , 68.5% allowed water to stand for a day before use , 86.5% practiced hand wash before meal , 33.2% practiced open defecation, 7% and74% used soap and water for handwashing before meal and after defecation respectively, 68.3% threw liquid wastes haphazardly, 59.8% threw solid wastes haphazardly into drains, 78.5% respondents children had a history of diarrhoea in the past 6 months and 86.8% had flies menace in their houses.Conclusions: Components such as purification of water (31.5%), open defecation (33.2%), hand washing with soap and water before meal (7%), indiscriminate disposal of waste suggest a long way to go to achieve the targets of SDG -6. Adequate IEC activities are needed for effective WASH Strategy implementation.
A double blind, randomized, placebo controlled, phase IV, proof-of-concept, comparative study to evaluate the efficacy and safety of Swasawin asthaloc tablets when given as add-on therapy in patients suffering from mild to moderate persistent bronchial asthma
Authors: Karande Shilpa P. , Munshi Renuka P. , Kumbhar Dipti A.
Published: October 2017

Background: Asthma, known as “Tamaka Shwasa” in Ayurveda, as a chronic inflammatory disorder of the airways associated with increased airway hyper-responsiveness, recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night/early morning. The key component to improving control and preventing attacks is the avoidance of triggers. Swasawin Asthaloc tablet, a polyherbal proprietary medication, is claimed to be effective in asthma. The Objective of the study was to evaluate the safety and efficacy of Swasawin Asthaloc tablets when given as add-on therapy to patients suffering from mild to moderate persistent bronchial asthma.Methods: The study was initiated after receiving Institutional Ethics Committee approval. Patients suffering from mild-to-moderate persistent bronchial asthma were randomized to 2 study groups after written informed consent process for 6 months. Group I received the study medication Swasawin Asthaloc tablet (1 tablet twice daily) in addition to regular anti-asthmatic medications (inhaler ± oral medications). Group II received Placebo tablets in a similar dose as add-on therapy. The study efficacy parameters included spirometry, breath holding time (BHT), Asthma symptom score and Ayurvedic Asthma symptom score.Results: 60 patients were enrolled in the study, of which 50 patients completed the study. In case of spirometry, both FEV1 and PEFR values showed statistically significant improvement at the end of 6 months therapy. Significant improvement in the Breath Holding Time (BHT), Ayurvedic Asthma symptom score and Asthma symptom score was observed in the active group as compared to the baseline (p <0.001).Conclusions: Add-on therapy with Swasawin Asthaloc tablets helped in reducing bronchial inflammation and improving asthmatic symptoms by virtue of its anti-inflammatory, bronchodilatory and antihistaminic properties. Hence it can be used as add-on therapy in patients with mild-to-moderate persistent bronchial asthma and may decrease the need for rescue medications especially steroids.
A study on knowledge regarding eye donation among first year nursing students of a nursing school and college of Berhampur, Odisha
Authors: Jena Parsuram , Jena Dhaneswari , Kar Monali , Jena Pravati , Nayak Ranjeeta
Published: October 2017

Background: In India bilateral corneal blindness constitute one percent of total blindness, With huge addition of cases of corneal blindness annually. Corneal transplantation offers the potential for sight restoration. The patients for corneal transplantation are growing due to insufficient number of eye donations in India. The gap between demand and supply is due to low awareness. Especially there is a need to study the knowledge of first line health counsellor in health facility where potential donors are available.Methods: A cross-sectional study was conducted on May 2016 with 140 first year Nursing students to assess their perception towards eye donation. Data were expressed as proportions and percentages using SPSS 16.Results: All participants knew about eye donation and 95.7% said these can be done irrespective of age and sex of the deceased. 55% students told HIV is a contraindication, 10% said that request for eye donations can be made by person himself alive or relatives after death. 15% knew that eye can be donated within six hours of death but none were aware regarding storage of donated eyes before transplantation. Only 2.1% of them heard about Hospital Corneal Retrieval Programme. Television (100%) was the main source of information. All of them personally supported eye donation.Conclusions: The present study revealed that nursing students had heard about eye donation but knew less about the details of the procedure. They can contribute to awareness and motivating people for eye donation during their postings in various department in hospital.
Clinico-etiological profile of acute kidney injury in children admitted to paediatric intensive care unit of a tertiary care centre
Authors: V. Jakanattane , M. Mathivanan
Published: October 2017

Background: Acute Kidney Injury (AKI) refers to a reversible accumulation of urea, creatinine and nitrogenous waste products and disturbances in maintenance of fluid and electrolyte homeostasis. The incidence of AKI continues to increase in the Paediatric age group particularly in critically ill children with the etiology shifting from primary renal disorders to multifactorial cause. The objective of the study to determine the incidence, clinical profile and outcome of AKI in critically ill children using p-RIFLE criteria.Methods: A prospective observational study was done with 342 children aged between 1-12 years, admitted in Paediatric Intensive Care Unit (PICU) of Institute of Child Health and Research Centre, Madurai Medical College, Madurai during July 2015 to June 2016.Results: The overall incidence of AKI among critically ill children was 30.1%. The mortality rate was 43.7% and 20.7% patients with AKI had partial renal recovery at the time of discharge. 27.2% patients required renal replacement therapy (RRT). Infectious causes 57.3% (Sepsis, Meningoencephalitis, Bronchopneumonia) dominated the etiological profile.Conclusions: Incidence of AKI is high in critically-ill children. AKI continues to be associated with adverse outcomes, including high mortality and partial renal recovery.
A study on morphometry of coracoid process of scapula in north Indian population
Authors: Verma Usha , Singroha Ritu , Malik Preeti , Rathee Suresh Kanta
Published: October 2017

Background: Coracoid process is a part of scapula and plays an important role in shoulder function. It arises from the antero-lateral aspect of the scapula. The aim of our study is to record the various morphometric parameters of the coracoid process.Methods: The study was performed on 50 pairs of human scapula of known sex in Department of Anatomy at PGIMS Rohtak. The parameters recorded were length, breadth, thickness, height and types of coraco-glenoid space by using vernier calipers. These parameters were compared in both sexes on both the sides.Results: Type I (round bracket) coraco-glenoid space was found to be predominant. Statistically significant difference was noted in all four parameters between males and females except in thickness on right side. Though all the four parameters have higher values on right side in comparison to left side but the difference was statistically insignificant.Conclusions: The study provides valuable information regarding the role of these parameters in etiology of subcoracoid impingement syndrome which will be helpful in its management to the surgeons.
Social factors influencing diabetes mellitus in adults attending a tertiary care hospital in Nagpur: a cross sectional study
Authors: Patil Sneha D. , Deshmukh Jyotsna S. , Patil Chaitanya R.
Published: October 2017

Background: Social determinants of the health are the conditions in which individuals are born, grow, live and age. Increasingly, these are being recognized for their relationship to the soaring incidence of diabetes mellitus. So, we conducted a study to find the social factors of diabetes mellitus.Methods: A cross sectional study was conducted in adults having type 2 diabetes in outpatient department of tertiary care institute in Nagpur from July to September 2015. Socio demographic factors, health care access factors, stress related factors and self-care behavior of these patients were studied. Data was analyzed using Epi Info 7.1 software.Results: Out of 140 diabetic patients studied females were predominant (55.71%). Most of them were married (92.85%), were Muslim by religion (47.14%), were from nuclear families, (53.57%) and lower middle class (40%). 50% said that they have health care facilities nearby their house and 50.71% do not get drugs regularly in that health care facility. and only (27.14%) were insured. 64.28% of study subjects said that they were accompanied by relatives to hospital. The financial stress (73.57%) and family stress (72.85%) was more in the patients than work stress (49.28 %). 75.72% and 71.42 % checked their blood sugar levels every 6 monthly and blood pressure every monthly and very less patients kept follow up for complications.Conclusions: Our study showed that in spite of having health care facility nearby, the irregularity of drugs was a major concern. Very less study subjects were insured for their health, this implicates higher stress related factors. They had less compliance towards follow-up of complications of diabetes mellitus.
Hematological changes in patients of chronic renal failure and the effect of hemodialysis on these parameters
Authors: Habib Anwar , Ahmad Razi , Rehman Sana
Published: October 2017

Background: Chronic kidney disease (CRD) is a global public health problem, where slowly progressive deterioration in kidney function lead to numerous hematological and biochemical dysfunction which further make the patients vulnerable to cardiovascular morbidity and mortality if appropriate measures is not taken for their control. The aim of present study was to find out the common hematological dysfunction that may occur in the patients of chronic renal failure (CRF) and in the process of dialysis and suggest appropriate measures for their management.Methods: Forty-two patient with CRF and on regular maintenance dialysis and 40 healthy adults were recruited into the study. Hemoglobin concentration, total red cell count, total white blood cell count and platelet count and ESR were assessed for the subjects and controls. Results were analyzed using SPSS 21.0 version.Results: showed that the RBC count, hemoglobin levels and platelets counts are significantly reduced in the patients of chronic renal failure and the process of hemodialysis further decreases the level of all the above mentioned hematological parameters whereas there is slight increase in total leucocyte count but significant increase in ESR was detected.Conclusions: Chronic renal failure is associated with different degrees of abnormality in hematological parameters that needs careful evaluation and management.
Structured teaching programme on knowledge about polycystic ovarian syndrome among adolescent girls
Authors: Rawat Sonia , B. Gomathi , Kumar Laxmi , V. Mahalingam
Published: October 2017

Background: Polycystic ovarian syndrome is a common female endocrine disorder affecting 4 – 18% of women in their reproductive age. It is common in adolescent girls. Polycystic Ovarian Syndrome affects throughout the life and produce gynaecological and metabolic health problems. The aim of this study to create the awareness about the polycystic ovarian syndrome to the adolescent girls.Methods: A Quantitative approach with pre- experimental design was used to study the effectiveness of STP on Poly Cystic Ovarian Syndrome. Ninety-four adolescent girls aged between 15 – 18 years were conveniently selected. Data was collected by using Structured Knowledge questionnaire.Results: The mean post-test knowledge score (22.55± 3.57) was higher than that of mean pre-test mean knowledge score (11.13± 3.32) and the mean difference was11.42. The ‘t’ calculated value was 23.45 which is higher than the tabulated value of 1.98 (df 93 at p< 0.05). Therefore, research hypothesis was accepted. So, it can be interpreting that structured teaching programme is effective in improving the knowledge of adolescent girls.Conclusions: The findings of the study revealed that STP was effective in enhancing the knowledge of adolescent girls on PCOS. Hence the study concluded that structured teaching programme had a great potentiality to increase the awareness on PCOS.
Evaluation of nasal mucociliary clearance in rheumatoid arthritis: a comparative analysis using saccharin test
Authors: Deswal Shelja , Yadav Jyoti , Deswal Mohit , Singh Harpreet
Published: October 2017

Background: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown etiology characterized by persistent inflammatory synovitis, usually involving peripheral joints in a symmetric distribution. RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations the mucociliary clearance system protects the lower respiratory system by trapping and removing inhaled pathogenic viruses and bacteria, in addition to nontoxic and toxic particulates (e.g., pollen, ash, mineral dust, mold spores, and organic particles), from the lungs. Effective clearance requires both ciliary activity and the appropriate balance of periciliary fluid and mucus.Methods: This was a case control study conducted in the Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak in 50 females of age group 30-50 years. Control group comprised of 25 healthy volunteer females while study group comprised of 25 rheumatoid arthritis female patients with disease duration of more than five years. Proven cases of RA (as per 1987 ACR criteria) were taken with disease duration of more than five years from Rheumatology clinic of Pt. B.D. Sharma PGIMS, Rohtak. Nasal mucociliary clearance time was evaluated by saccharin method.Results: The results of our study showed abnormal mucociliary clearance in rheumatoid arthritis patients.Conclusions: The study shows an abnormal mucociliary clearance in rheumatoid arthritis patients. Impairment of mucociliary clearance seems to be the result of qualitative and quantitative alterations in respiratory secretions.
A cross-sectional study on morbidity pattern of elderly population residing in a rural area of Tripura
Authors: Karmakar Nabarun , Nag Kaushik , Datta Anjan , Sekhar Datta Shib , Bhattacharjee Partha
Published: October 2017

Background: The elderly is one of the most vulnerable and high-risk groups in terms of health and their health seeking behaviour is crucial in any society. A major component of the burden of illness for the elderly derives from prevalent chronic disease. The objective of study aims to find out morbidity pattern of elderly population aged 60 years and above.Methods: A community based cross-sectional study was done in rural areas of Madhupur, Sepahijala district, Tripura from August 2015-January 2016. A total of 260 (elderly aged 60 years and above) study participants were selected by simple random sampling.Results: Majority (52.7%) were between 60-70 years of age, least (1.5%) was in 90-100 years age group. Most of the study population (84.6%) were Hindu and female were more than male (51.9 % vs 48.1%). Majority (38.8%) of them were suffering from two (2) morbidities and 8.1% of study population had 4 and more morbidities. Non-specific generalized weakness was the most common (62.7%) morbidity, followed by gastrointestinal problems (56%) found in geriatric population. Musculoskeletal problems (low back pain, joint pain, osteoarthritis) were 45% followed by anaemia (42%) and impaired vision (36%). Increasing age group and non-smoke tobacco habit among the elderly population was associated with number of morbidities (≥ 3 morbidities/ person) per person (p <0.05).Conclusions: The study showed high prevalence of morbidities among elderly population. Non-specific generalized weakness was one of the most important problems in this age group. We have to find out the underlying cause of this non-specific generalized weakness by further clinical examination and laboratory investigations in future research.
Comparison of haematological parameters between alcoholics and non-alcoholics
Authors: . Elanchezhian , T. Yoganandh , Mayilsamy S. , Radhakrishnan Shankar
Published: October 2017

Background: Alcohol being one of the most commonly used drug, whose consequences include changes of CBC. The main causes leading to changes of CBC (complete blood count) are: myelosuppression that is accompanying with slight reduction in all blood cells, blood loss from gastrointestinal tract, malnutrition etc. Alcoholics may suffer from moderate anemia, characterized by enlarged, structurally abnormal RBC’s; mildly reduced numbers of WBC’s, especially of neutrophils; and moderately to severely reduced numbers of platelets. The objective of the study was to study the haematological manifestation among alcoholics based on the quantity and duration of alcohol intake and compare them with non-alcoholics.Methods: A cross-sectional study was conducted for a period of one year in our medical college hospital in medicine OPD with the collaboration of department of pathology and bio-chemistry. The study was started after getting the approval from the institutional ethical committee. A total of 150 study subjects were included in the study in which 50 were non-alcoholics, 50 were moderate alcoholics (less than or equal to two drinks per day for men and less than or equal to one drink per day for women) and the remaining 50 were severe alcoholics (more than 7 drinks a week in women and more than 14 drinks in a week in men). Blood investigations such as CBC, prothrombin time, liver function test, renal function test, folic acid levels and vitamin B12 levels were measured and the levels were compared between alcoholics and non-alcoholics.Results: Mean RBC count, mean MCH, MCHC were normal among the non-alcoholic group and it started decreasing among moderate alcoholics and more so with severe alcoholics and a similar type of result was also seen with total count and platelet count and the difference was found to be statistically significant. LFT, RFT, prothrombin time and vitamin B12 levels were found to be high and folate levels were decreased among alcoholics group when compared to non-alcoholics and the difference was statistically significant.Conclusions: Detection of hematological changes in chronic alcoholics and giving psychiatric counseling and treatment for alcohol dependence will decrease the future complications like cirrhosis liver, cardiac and renal disease, cerebellar degeneration, neuropathy, pancreatitis, etc. and reduce the morbidity and mortality in alcoholics.
A case of SLE with pancreatitis
Authors: Jain Karan , Palange Amit A. , Gokhale Vijayashree S. , Kakrani Arjun Lal
Published: October 2017

Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by the presence of autoantibodies, immune complex formation, and multiple organ system involvement. Gastrointestinal manifestations are common in SLE patients, but acute pancreatitis is rare. Here we present a case of a 23 yrs. old male who came to the medicine OPD with the chief complaints of pain in abdomen, swelling all over the body since, 8 days and multiple joint pain for 1 and half months. On examination he was febrile pallor present with anasarca, periorbital edema with heliotrope around both eyes. Dry and xerotic ski over the face, butterfly rash present. Blood investigations, USG and CECT suggestive of acute panceatitis. Patient was treated in ICU for pancreatitis. Patient was found to be hypothyroid and treated with thyroid supplements. ANA BLOT was suggestive of SLE. Renal biopsy showed diffuse proliferative lupus nephritis. Hence our patient had pancreatitis possibly due to SLE induced hypertriglyceridemia.
Schwannoma in oropharynx: a rare site posing diagnostic challenge
Authors: Rana Deepshikha , Raychaudhuri Sujata , Sharma Nimisha
Published: October 2017

Schwannomas are benign nerve sheath tumors. These arise from Schwann cells of the neural sheath. Intra oral region is a relatively uncommon site of these tumors. They are solitary, slow growing, smooth surfaced, usually asymptomatic, and encapsulated tumors, about 25% of all schwannomas are located in the head and neck, but only 1% show intraoral origin. A 22-year-old female came with dysphagia since, 3 years. FNAC was not feasible and so excision biopsy of the lesion was performed. Histopathology revealed schwannoma like picture and it was confirmed with diffuse S-100 positivity on immunohistochemistry. Hence, finally confirming schwannoma of the oropharyngeal region. Schwannomas can be found anywhere in the body but a quarter of all occur in the head and neck region. Intraorally its percentage is only 1% with tongue being the commonest. Pharyngeal presentations of schwannoma are rare. Schwannomas are benign tumors having excellent prognosis. Basically, this case report is important as these very rarely occur in the oropharyngeal region and it’s a must to consider them in the differential diagnosis of lesions at this site.
Spindle cell sarcoma of sphenoid bone
Authors: Nimmagadda Moorthy N. L. , Rao Vithaleswar M. , S. Padmaja , Reddy Harshini
Published: October 2017

Primary bone tumors involving skull are extremely rare and they constitute 0.8% of all bone tumors. The common tumors that are seen in skull base include fibrous dysplasia, giant cell tumor, chordoma, ossifying fibroma, angiosarcoma. We report a rare case of spindle cell sarcoma arising from right sphenoid bone in a 70-year-old male which presented as unilateral defective vision with mild proptosis.
Mucinous adenocarcinoma of gall bladder: a case report
Authors: Tangde Ashwini Radhakishan , Rathod Santosh Govind , Joshi Anil R. , Bindu Rajan S.
Published: October 2017

Gall bladder carcinoma is the fifth most common malignancy of gastrointestinal tract. Mucinous carcinoma of gall bladder is very rare variant of gall bladder carcinoma. Only 20 cases of mucinous carcinoma reported till now. We report one such case of 55yr old female patient presented to our hospital with complaining of pain in right hypochondriac region and vomiting since, one month. Radiological examination revealed neoplastic thickening of gall bladder neck with cholelithiasis. Cholecystectomy was performed and specimen showed glistening grey white infiltrative firm solid mass at the neck of gall bladder. On microscopic examination showed mucinous adenocarcinoma. Tumour comprised of cystically dilated mucin filled glands. Tumour was seen infiltrating into muscle layer.
Renal cell carcinoma presenting as pulmonary embolism
Authors: Jaish Shaikh Saud Abdul , Kashyap Prashant , Chandrekar Santwana , Shetty Varun
Published: October 2017

We report a case of massive pulmonary embolus demonstrated on CT in an adult male presenting with dyspnea, with no known risk factors for embolism. Abdominal CT on further investigation showed a renal tumor invading the left renal vein and the inferior vena cava as the cause of the pulmonary embolus. In a patient presenting with pulmonary artery embolism without venous thrombosis, the differential diagnosis should include an occult tumor as the cause of the embolus.
Comparative study between excision with primary closure versus Limberg flap for treatment of primary sacrococcygeal pilonidal sinus
Authors: Abdelraheem Omar , Khalil Magdy
Published: October 2017

Background: Surgical treatment of sacrococcygeal pilonidal sinus is associated with significant recurrence rate. However; recent study suggested the use of rhomboid excision and Limberg flap repair as feasible procedure for treatment of pilonidal sinus disease. Our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with Limberg flap by comparing this procedure with the traditional excision and primary closure.Methods: This prospective study included 60 patients with sacrococcygeal pilonidal sinus. The patients were randomly divided into 2 equal groups. Rhomboid excision of the sinus with limberg flap was performed in 30 patients (group A), and excision of the sinus with primary closure was done to the other 30 cases (group B). Demographic data and surgical outcome were compared between both groups.Results: Group A showed significant early retained to work and significant less postoperative pain than group B (P=0.04 and P=0.02 respectively). Incidence of wound dehiscence, postoperative hematoma and seroma was less among group A but without significant difference. The incidence of postoperative infection and recurrence rate was significantly less in group A than group B (P=0.04 and P= 0.035 respectively).Conclusions: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple excision with primary closure in treatment of sacrococcygeal disease. In addition, it is safe and easily procedure; it may be an ideal treatment option in management of pilonidal sinus.
Use of gatekeeper in obese patients with fecal incontinence before bariatric surgery, is it improving the results?
Authors: Ibrahim Ahmed Abdel Monem
Published: October 2017

Background: Fecal incontinence or bowel incontinence is a lack of defecation control with loss of bowel continent for gas, liquid, or solid content. Causes of incontinence are so different and might occur as apart of diarrhea or constipation. After following up patients with gastric bypass surgery for bariatric purpose we observe that most of them develop incontinence by different grades after bariatric surgery. Also, some of them complaining from soiling by different degrees before any operative procedure. Gatekeeper is a bulking agent recently introduced for treatment of fecal incontinence, implants of polyacrylonitrile (4-6) implants are inserted in inter-sphincteric space (Gatekeeper, THD) is used as a bulking agent to increase the volume in the inter-sphincteric space in cases of fecal incontinence follow-up was at 2, 4, 8 months. Aim is to evaluate efficacy of gatekeeper application in obese patient with fecal incontinence after bypass bariatric surgery.Methods: Thirty obese patients (19 females) and (11 males) undergoing bariatric surgery at Alsalama Hospital Abu Dhabi from the period between July 2015 to July 2017, are classified into two groups (group I) 15 patients (9 females and 6 males) are subjected to gatekeeper before gastric bypass surgeries and (group II) 15 patients (10 females and 5 males) not subjected to the use of gatekeeper and both groups were followed at 2, 4 and 8 months postoperative.Results: This randomized controlled study was conducted on 30 patients between July 2015 to July 2017 at Alsalama hospital Abu Dhabi. The use of gatekeeper in obese patients undergo bypass surgery is un effective technique to improve liquid stool incontinence.Conclusions: The use of gatekeeper in obese patients with fecal incontinence before gastric bypass surgery has improved the incontinence postoperative signs and symptoms.
A comparative study between fistulotomy and fistulectomy in management of low anal fistulae
Authors: R. Ganesan , K. Karunakaran , Anandan Heber
Published: October 2017

Background: Fistula in ano is a silent menace in human beings, the treatment is a challenging one even for experienced surgeons, fistula in ano forms a good majority of treatable benign lesions of rectum and anal canal. Aim was to study the efficacy of fistulotomy and fistulectomy in the treatment of low anal fistulae.Methods: A randomized control study was conducted to compare fistulotomy with fistulectomy in patients with low anal fistulae.Results: The operating time in fistulotomy group was 12.13minutes±2.11minutes and in fistulectomy group was 22.23±3.36minutes. The post-surgery hospital stays in Group I was 1.80±0.66days and in Group II was 2.60±0.563 days. The wound healing time in Group I was 24.20±2.95 days which was considerably less when compared to patients in Group II where it was 31.50±4.34 days.Conclusions: Fistulotomy has a slight edge over fistulectomy in the treatment of low anal fistulas since it has shorter operating time, less post-operative pain, less complications, quicker wound healing time, less incontinence and a comparable recurrence rate.
Evaluation paraumbilical flap for coverage of forearm and hand defects
Authors: Chikte Baliram , Goud I. Raja Kiran Kumar
Published: October 2017

Background: To find out the reliability and dimensions of the pedicled paraumbilical perforator flaps to cover the compound defects of the forearm and hand.Methods: Twelve (12) patients with defects of hand, wrist, forearm and elbow are included in this study. The study period extends from August 2012 to February 2015. Patients were aged between 12-45 years. The detailed systemic examination of the patient and the local examination of the wound was carried out in all the patients. For the patients with burns, hemodynamic stabilization was done with appropriate fluid management and blood transfusions. The routine laboratory investigations were done.Results: It was a prospective study of twelve (12) cases was carried out in this study. Six men (50%) aged between 25-45 years were the commonly affected group, followed by three women (25%) aged between 35 - 40 years and three children (25%), two males and one female aged between 12-17 years. Most common cause of the defect was electrical burns in seven cases (58.33%) due to accidental contact with high tension live electrical wire while at work in adults. In children it was due to accidental contact with live electric wire while they were playing. Most common site of injury was found on forearm in seven cases (58.33%), out of which left forearm was injured in five cases (41.66%) and right forearm in two cases (16.66%), followed by wrist in 2 cases (16.66%), dorsum of hand in one case (8.33%) and elbow in two cases (16.66%). All the defects were compound in nature with exposure of the tendons and bones and they were devoid of paratenon and periosteum.Conclusions: This study conclude that the paraumbilical flap is useful flap for coverage of the upper limb defects involving the hand, wrist, forearm and elbow. A fairly large flap with dimensions as large as 18 x 13 cm can be harvested. The flap is reliable with flap survival rate of 91.66%, (11 cases). There is no need to isolate the vascular pedicle, and the dissection is quick and easy. The flap and the limb remain in an elevated position and there is minimal edema and congestion postoperatively. Although the donor site scar is not concealed, as in groin flap, majority of the patients accepted the donor scar as it got concealed under the traditional dress. Thus, this flap can become workhorse for the defects of hand, wrist, proximal forearm and defects around the elbow.
A comparative study of laparoscopic versus mini laparotomy cholecystectomy
Authors: Naik Suresh , Alam Firoz , Yadav Nagendra , Khandarpa Akhil
Published: October 2017

Background: Gallstones are common in Indian population and its treatment has shown a decisive shift from open to minimally invasive route. There is no doubt that laparoscopy require longer and steeper learning curve and higher cost, especially in the absence of health insurance to majority of suburban and rural Indian population. However, preferences of patients are changing rapidly due to better level of awareness and availability of healthcare facility. Aims was to study safety and efficacy of laparoscopic cholecystectomy in patients of cholelithiasis by comparing withresults of mini laparotomy cholecystectomy by comparing use of post-operative analgesia, operative Time, post-operative hospital stay, morbidity and mortality.Methods: It is a prospective randomized study of 100 Patients of cholelithiasis aged between 25 years to 65 years operated during 2016-2017 at Dr. D Y Patil medical college Pune. They were divided into mini laparotomy and laparoscopic cholecystectomy group by draw a lot method. Patient’s written valid informed consent for the particular procedure was taken and the pros and cons of both the procedure were explained in detail to the patient. This study was done after due clearance of ethical committee.Results: The median (range) operation time for laparoscopic cholecystectomy was 50-175 min (mean=103.98 min) and 35-95 min (mean=70 min) for mini laparotomy cholecystectomy (p<0.001). During the study period operation time for laparoscopic cholecystectomy showed a tendency to become shorter. The use of Injectable analgesics in case of laparoscopic cholecystectomy (Mean no. of days=1.5) is considerably less than mini laparotomy cholecystectomy (Mean no. of days=3.36). Conversion rate in literature in laparoscopic cholecystectomy ranges from 3% to 15% in well trained hands. In our series it is 6% in spite of being a teaching and training institution.Conclusions: Minimally invasive surgery is better than mini laparotomy cholecystectomy in terms of post-operative pain, analgesic requirement and early return to work. However, mini laparotomy cholecystectomy is preferred method for Surgeons in the beginning of their career and in case of difficult cholecystectomy.