bluuebunny/crossref_metadata_2025 huggingface dataset:
Snapping Biceps Femoris: clinical demonstration and operative technique
Authors: Matar HE , Farrar NG
Published: January 2018

Snapping biceps femoris syndrome has been reported in the literature in a handful of case reports but not yet with a demonstration of clinical examination and intraoperative findings. We present an educational clinical video of snapping biceps femoris with intraoperative demonstration of findings and surgical repair.
Protecting Slaves and Aborigines
Authors: Twomey Christina
Published: January 2018

The historiography on protection in the nineteenth-century British Empire often assumes that British humanitarians were the progenitors of protection schemes. In contrast, this article argues that the position of Protector or Guardian for slaves and Indigenous peoples in the British Empire drew on Spanish, Dutch, and French legal precedents. The legal protections and slave codes operative in these European colonies are compared to British colonial territories, where there was no imperial slave code and no clear status of slaves at common law. Drawing on debates in the House of Commons, Parliamentary Commissions of Inquiry, and the published work of abolitionists and anti-slavery societies, the article examines how the pressure for amelioration in the British Empire coincided with the acquisition of new colonies that offered ready-made models for slave protection. British reformers combined their calls for greater protection for slaves with their extant knowledge of European protective regimes.
The impact of environmental temperature on the diagnosis of gestational diabetes mellitus
Authors: Vasileiou Vasiliki , Kyratzoglou Eleni , Paschou Stavroula A , Kyprianou Miltiades , Anastasiou Eleni
Published: January 2018

Objective

To investigate a probable impact of seasons on the diagnosis of GDM, as well as the specific effect of the environmental temperature on the diagnosis of this clinical entity.

Patients and methods

Two observational studies, one retrospective and one prospective, were conducted in a referral center. Study A included retrospectively 7618 pregnant women who underwent a 3-h 100 g OGTT during the 3rd trimester of gestation. Study B prospectively included 768 pregnant women tested in the 3rd trimester of gestation with a 75 g OGTT. Temperature was recorded every day at 09:00 h.

Results

Retrospective Study A: GDM prevalence differed significantly by season: winter = 28.1%, summer = 39.2%, spring = 32.4% and autumn = 32.4% (P < 0.0001). The odds ratio for being diagnosed with GDM was much higher during summer 1.65 (95% CI: 1.43–1.90), with spring and autumn following with 1.23 (95% CI: 1.08–1.39) compared to winter. Glucose levels during OGTT were measured: significantly increased blood glucose values were observed at 60, 120 and 180 min in summer, which remained significant after adjustment for age, gestational age, BMI, weight gain during pregnancy and blood pressure. Prospective Study B: At temperatures above 25°C, the average glucose 60-min and 120-min levels were increased. The relative risk for abnormal glucose values at 60 min, when the environmental temperature increased over 25°C, was 2.2 (1.5–3.3).

Conclusions

GDM prevalence in Greece presents seasonal variation, with higher risk during summer due to post glucose load level variations. These variations could be attributed to differences in environmental temperature.
Coordination Compounds of Hexamethylenetetramine with Metal Salts: A Review
Authors: Kaihua Jia , Shuhong Ba
Published: January 2018

Hexamethylenetetramine (hmta) was chosen as a model ligand. Each of the four nitrogen atoms has a pair of unshared electrons and behaves like an amine base, undergoing protonation and N-alkylation and being able to form coordination compounds with many inorganic elements. The ligand can be used as an outer coordination sphere modulator of the inner coordination sphere and as a crosslinking agent in dinuclear and multinuclear coordination compounds. It can also be used as a model for bioactive molecules to form a great number of complexes with different inorganic salts containing other molecules. Studies of hmta coordination compounds with different metal salts have therefore attracted much attention. The present review summarises the synthesis, preparation, structure analysis and applications of coordination compounds of hmta with different metal salts.
Simplified shear-strength prediction models for steel-fibre-reinforced concrete beams
Authors: Islam Mohammad Shahidul
Published: January 2018

Analytical models are proposed to predict the shear strength of steel-fibre-reinforced concrete beams from existing experimental results of 222 such beams without stirrups. The beams were sorted into six different types based on ultimate strength of concrete, span–depth ratio and shape of the steel fibres (plain, crimped and hooked). A genetic-algorithm-based approach was used to predict the most feasible equation to estimate the shear strength of each group of beams accurately. A variety of statistical analyses for each suggested model was performed and compared with the results of existing studies in predicting the beams’ shear capacity. The proposed empirical models were able to assess the shear strength of beams more accurately than previously developed models.
“KEKERASAN BISA DIMAKNAI BERBEDA-BEDA”: RAGAM PEMAKNAAN ATAS KEKERASAN TERHADAP PEREMPUAN DALAM PRAKTIK GERAKAN SOSIAL ALIANSI LAKI-LAKI BARU
Authors: Ramadhan Febi Rizki
Published: January 2018

This article examines the variety of meaning towards violence against women in Aliansi Laki-laki Baru’s social movement practice as a social movement that focuses on issues regarding male engagement in ending violence against women and achieving gender equality. Using ethnographic methods, I argue that social movement, particularly Aliansi Laki-laki Baru, could not be understood as monolithic and homogeneous entity due to its participants could have various meaning on violence against women. While violence against women could be contextualized as Aliansi Laki-laki Baru’s main focus, participants in ALB could construct their own meaning on ‘violence against women’ as a sociocultural phenomenon. Furthermore, I argue that the variety of meaning towards issue on violence against women could be caused by ALB’s participants’ subjectivity and their own personal experiences.
Image of the Barbarian Nomads in the Early Byzantine Texts
Authors:   Taras Shevchenko national University of Kyiv, Zhdanovych Olesia
Published: January 2018

The article describes the image of nomads in the writings of the early medieval Roman and Byzantine authors. It focuses on the Huns and Avars, who attacked the provinces of the empire as well as the Turks, who had established diplomatic relations with the Byzantine Empire in the 5th century. The Roman reception of the alien and little-known nomadic civilization has been analyzed. It is stated that the Byzantines were almost unfamiliar with the way of life, religious beliefs and exterior appearance of the eastern barbarians. That is why most of the early data was based on the legendary sources. After the diplomatic relations had been established the information flow increased sufficiently. However the attitude to the alien cultures remained hostile. This disrespect is visible in the works of almost all the early Byzantine authors. It reflects the state of public opinion which was based on the entirely different mindset and the way of life than that of the nomadic peoples. It should be noted that the barbarians themselves actively encouraged their negative image in the Roman eyes by carrying out their marauding raids on the imperial provinces, their violation of treaties, absence of loyalty etc. In conclusion it is stated that the problem of nomadic and sedentary societies’ interaction stretches back to the ancient times. The territory of the present day Ukraine for a long period of time was the place where the cultural interaction between the nomadic and sedentary peoples took place. In this vein, this problem remains very important and relevant for our understanding of the ethnic, political and cultural history of the Eastern Europe.
Text and Performance: Director's Concepts Anatomy of the Fairy-Tale «Twelve Months»
Authors:   Sobinov Saratov State Conservatory, Zykov Alexei
Published: January 2018

The article analyses the reasons of possible director’s "invasion" into the literary text. The main thesis of this contribution focuses on the author of drama piece who initially understands the problems of its scenic embodiment. However, it is not enough: the director rearranges some parts of a piece, removes some of them, replaces the fragments with other theatrical "texts" and so on. The problem of "relationship" between the author of performance and the author of the piece is essential for the modern theater when the pieces of the past centuries are performed. The author of the article pays his attention to the reasons and limitations of the director's "invasion" into the literary text using the example of Marshak’s composition "Twelve months". Being simultaneously the director and choreographer of the performance, the author attempted to analyze the work on the performance "from within". Marshak's piece (1943) exhibits a bright fantastic plot, it has been written using succinct literary language. However, its epic narrative form makes its staging very tricky today. The analysis of the piece, including the identification of the main and accompanying plot lines, spaces of action, functioning of characters, shows that it has a big text volume, a considerable number of characters (37) and multiple scenes of action (4). At the same, the dynamics of a show, compact performance as well as its low budget are essential for the modern theater. Adaptation of the piece to the realities of our age becomes the reason of the "invasion" into the text. The invasion "frame" includes director’s rejection of using additional subject lines accompanied by the simultaneous strengthening of the main one, reduction of the fairy-tale’s "population", due to the "transfer" of functions of certain characters onto the others, concentration on the main scenes, and removal of some minor scenes. The author describes such changes in several tables, showing that the director’s "invasion" into the text of the piece neither changes its main subject lines nor distorts the main idea. This can be understood as the "invasion limits".
Problems of the Artistic Education Availability for the Late Medieval and Early Modern Women
Authors:   Taras Shevchenko national University of Kyiv, Ivanytska Lilia
Published: January 2018

The article deals with the gender discrimination in the field of artistic education during the late medieval and early modern periods. The author analyzes the historiography of the gender art history, focusing on the publications concerning the artistic education of the period mentioned above. As far as the Ukrainian scholarship is concerned, the author highlights the absence of studies dealing with the portraits of female characters and paintings by female artists of the late medieval and early modern times. There are only a few papers dealing with the subject, since as a rule, the women were almost excluded from the history and, in particular, from the history of art. Consequently, the author concludes that the artistic education for women was more like a conformance exception than a rule. The absence of great female artists among the masters of late mediaeval and early modern art may be explained as the result of social restrictions, which determined the women’s position in society, the hierarchy of arts, the lack of the artistic education availability, the prohibition to draw the academic figures, the restriction either to sign the paintings, or to sell them. It was prohibited for women artists to establish their own ateliers as well. All these facts testify to the existence of gender inequality in the artistic education in the late medieval and early modern periods.
Extratos Vegetais de Espécies de Plantas do Cerrado Sul-Matogrossense com Potencial de Bioherbicida e Bioinseticida
Authors: Da Silva Cristiano Pereira , Gomes Ricci Thiago , De Arruda Ana Lúcia , Pagliosa Frida Maciel , Rodrigues Macedo Maria Ligia
Published: January 2018

Estudos recentes têm revelado os efeitos positivos de algumas espécies de plantas do cerrado sul-matogrossense na inibição do crescimento populacional de linhagem ou espécies bacterianas. Objetivo deste trabalho foi verificar a composição química e os efeitos antimicrobianos dos extratos etanólicos de duas espécies de plantas comuns no cerrado sul-matogrossense. Os testes e análise experimental foram conduzidos nos laboratórios Multidisciplinares do Centro Universitário Anhanguera de Campo Grande, com testes de bioautografia e meios de culturas. Dentre os resultados obtidos, os testes fitoquímicos indicaram a presença de flavonoides, taninos, saponinas, terpenos e derivados cinâmicos nas espécies Synadenium carinatum e Polygonum acre. Na avaliação da atividade antimicrobiana por meio dos métodos bioautografias, as duas espécies apresentaram atividade antimicrobiana positiva, diminuindo o crescimento populacional de bactérias no meio de cultura contendo os extratos destas plantas, prospectando estudos futuros na identificação de substâncias inibidoras da divisão celular de bactérias.Palavra-chave: Plantas. Alelopatia. Inflamatórios. Naturais.AbstratRecent studies have shown the positive effects of some species from southern Mato Grosso cerrado plants in the inhibition of strain population or bacterial species growth. The objective of this study was to determine the chemical composition and the antimicrobial effects of ethanol extracts of two species fromcommon plants in Mato Grosso do Sul cerrado. The tests and experimental analysis werecarried outin the laboratory Multidisciplinary University Center Anhanguera Campo Grande, with bioauthography tests and cultures media. Among the results obtained, phytochemical tests indicated the presence of flavonoids, tannins, saponins, terpenes and cinnamic derivatives in species carinatum Synadenium and Polygonum acre. In the evaluation of antimicrobial activity using the methods bioautographies, the two species had positive antimicrobial activity, reducing the bacteria population growth in culture medium containing extracts of these plants, prospecting for future studies on the identification of substances that inhibit bacteria’s cell division.Keyword: Plant. Allelopathy. Inflammatory. Natural.
Critical appraisal of Drug Promotional Literatures (DPLs) as per World Health Organization (WHO) guidelines
Authors: Vyas Pratit P. , Bhave Amol L.
Published: January 2018

Background: The study was aimed to critically analyse Drug Promotional Literatures (DPLs) using WHO guidelines. This would help to create awareness about DPLs amongst healthcare providers thus encouraging the improvement of healthcare system.Methods: This cross sectional observational study was carried out at Department of Pharmacology, Medical College Baroda. DPLs were collected & critically analysed for consistency, accuracy, validity of the provided information as per WHO guidelines.Results: Out of total 616 DPLs collected, 371 satisfied the inclusion criteria. None of the DPL was fulfilling all criteria according to WHO guidelines. Most of DPLs were having information regarding; generic name / INN (98.39%), brand name (100%), amount of active ingredient per dosage (94.07%), approved therapeutic uses (84.91%), dosage form (91.37%) and name & address of manufacturers (91.91%). Of all the DPLs, information provided for safety parameters like; name of active ingredient known to cause problem (11.59%), dosage regimen (32.88%), side effects & drug reaction (14.56%), major drug interactions (14.02%) and precautions, contraindications and warning (14.29%) seemed to be grossly neglected. Total of 431 claims were evaluated, of which the most common type of claim was efficacy (55.45%). Relevant references to claims were present in (48.74%) DPLs. Total 203 references were evaluated from 371 DPLs, of which maximum reference were from journal article (74.38%).Conclusions: From this study, it was concluded that pharmaceutical companies didn’t follow the WHO guidelines for ethical drug promotion, thus failing to fulfil the rational promotion of drugs. Given the present findings physicians should be cautious about drawing conclusions regarding medicine based on DPLs provided by pharmaceutical companies.
Prevalence of vitamin B12 deficiency among individuals with type 2 diabetes mellitus in a South Indian rural community
Authors: D. Shailendra , Kalani Rizwan , Narayan K. M. Venkat , Prabhakaran Dorairaj , Tandon Nikhil , P. S. Reddy
Published: January 2018

Background: To estimate the prevalence of vitamin B12 deficiency in a rural south Indian community and to evaluate the association between metformin use and prevalent vitamin B12 deficiency in people with T2DM stratified by oral vitamin B12 supplementation.Methods: Using a cross sectional study design, a random sample of people with T2DM (N=438) was recruited from a rural community. Vitamin B12 deficiency was defined as serum B12 ≤200pg/ml. Data on metformin dose, duration of use, oral vitamin B12 supplementation, and diet were collected. Laboratory measurements included complete blood count, tests for hepatic, renal, and thyroid function, as well as serum vitamin B12 levels and HbA1c.Results: The prevalence of vitamin B12 deficiency in people with T2DM was 11.2% (95% Confidence Interval (CI) 8.2%-14.1%). The odds of vitamin B12 deficiency in patients receiving a metformin dose of 2 grams/day were 4 times higher compared to those receiving ≤1 gram/day, after adjusting for oral B12 supplementation (odds ratio 4.2;95% CI 1.5-11.8). The odds of vitamin B12 deficiency in those taking metformin and receiving oral vitamin B12 supplementation were lower compared to those on metformin and not receiving vitamin B12 supplementation (adjusted odds ratio 0.20; 95% CI 0.06-0.70).Conclusions: Vitamin B12 deficiency affects 1 in 10 people with T2DM, is associated with higher dose metformin use, and oral vitamin B12 supplementation mitigates B12 deficiency in this group.
Pregnancy outcome in elderly primigravidae at a Nigerian Tertiary Hospital: a five-year review
Authors: Opadiran R. O. , Isah A. D. , Adewole N. , Omonua K. I.
Published: January 2018

Background: Pregnancy though a physiologic process also comes with its complications. This has been found to be related to factors associated with the mother and fetus. Maternal age at first pregnancy is a determining factor which could affect pregnancy outcome. Objective of present study was to determine the effect of maternal age on obstetric outcome.Methods: A five-year retrospective case control study involving primigravid women aged 35years and above (elderly primigravidae) and the younger primigravidae aged below 35 years who delivered at the University of Abuja Teaching hospital (UATH) between 2012 and 2016. Data were collected from their case notes, antenatal and delivery registers. For comparative purposes, obstetric and perinatal parameters including antenatal, labour, delivery, postpartum factors were collected for both the elderly primigravidae and younger primigravidae. A total of 6,052 deliveries, of which 2,456 were primigravidae and 42 of them were ≥35years of age. Out of 42 cases, only 30 folders were found and analyzed. The matched controls were selected consecutively after each elderly primigravidae in the register without prior knowledge of their pregnancy outcome. The data was analyzed using SPSS version 20. Chi square test X2 and student T test were used for comparison of the two groups. Statistical significance was set at P values of ≤ 0.05 at 95% confidence interval.Results: The incidence of elderly primigravidae was found to be 1.2% in this study. There was increased risk of hypertensive disorders in pregnancy, caesarean delivery and low APGAR scores in the elderly primigravidae group but these were not statistically significant. No other differences in obstetrics and neonatal outcome were found between the two groups.Conclusions: Elderly primigravidae are at increased risk of hypertensive disorders in pregnancy and caesarean delivery than in younger primigravidae. On the other hand, neonatal outcome of the two groups were comparable.
Adjunctive sublingual misoprostol for secondary prevention of post-partum hemorrhage during cesarean delivery: double blind placebo randomized controlled trial
Authors: Sallam Hany F. , Shady Nahla W.
Published: January 2018

Background: Cesarean delivery is the most frequently performed major operative procedure worldwide. Objective of present study was to evaluate randomized evidence regarding efficacy and safety of sublingual misoprostol for secondary prevention of post-partum hemorrhage during and after cesarean delivery in women receiving prophylactic oxytocin as primary preventive tools and bleed around 500ml by visual analogue estimation.Methods: A prospective, randomized, double-blind, placebo-controlled trial was performed at an obstetrics and gynecology department Aswan university hospital, Egypt, between October 2015 and September 2017. Women were eligible if they were undergoing elective cesarean under spinal anesthesia and were bleed around 500ml by visual analogue estimation. All participants received 10 IU oxytocin after delivery of the newborn. Participants were randomly assigned (1:1) to receive 400 μg misoprostol or matched placebo sublingually using a computer-generated random number sequence. Participants and providers were masked to assignment. The primary outcomes were intraoperative and postoperative blood loss.Results: There was high significant reduction in intraoperative blood loss in misoprostol group (711.0±188.41) compared with placebo group (915.33±293.72) (P=0.0001). The all estimated blood loss during CS and 24 hours postoperative was significant lower in misoprostol group (890.39±194.49) than that in placebo group (1096.9±300.05) (p=0.0001).Conclusions: Misoprostol as an adjunct to oxytocin as secondary prevention of pot partum hemorrhage seemed to be more effectively reduce blood loss than did placebo with oxytocin alone.
Visceral adiposity index among young girls with PCOS and its association with phenotypes and metabolic risk
Authors: Joshi Beena , Lakhan Tejal , Mukherji Srabani , Patil Anushree , Unisa Sayeed
Published: January 2018

Background: Polycystic Ovarian Syndrome (PCOS) is a growing endocrine-metabolic disease in India. Visceral Adiposity Index (VAI) is a surrogate marker of visceral adipose dysfunction and can be used as a useful predictor of unhealthy PCOS phenotypes in low resource settings. No cut-off has been assessed among Indian population.Methods: Secondary data from 106 diagnosed girls with PCOS and 121 controls was analysed to estimate (i) VAI and BMI among different phenotypes (ii) risk of metabolic disorders using VAI among different phenotypes of PCOS and (iii) compare the overall diagnostic performance (for metabolic syndrome) of VAI, BMI and waist circumference.Results: Majority of the girls in the sample considered for analysis were lean PCOS (61%). Mean VAI among PCOS (3.02) was significantly higher than normal controls (2.81). Classic and Mild Phenotypes had high VAI. A unit increase in VAI score was found associated with 5.23 times higher risk of metabolic syndrome (AOR: 5.23, 95% CI: 2.261-12.086). A higher VAI with cut off value of 2.73 could predict risk of metabolic syndrome among PCOS cases, unlike the cutoff among Caucassian population of 1.67. The cut-off for the non- obese group was even higher i.e. 2.81.Conclusions: Given that Indians are genetically more prone to have excess visceral fat the cut-offs for measuring adiposity also needs to be re-defined. The findings of this small sample throws light on the prevalence of visceral adiposity among lean girls with PCOS emphasizing the need to also screen them for metabolic syndrome, educate them about these complications and motivate them to practice healthy lifestyles.
Obstetric near miss events and maternal deaths in a tertiary care hospital
Authors: Patil Vrinda , Kamath Vidya , Desai Rathnamala M.
Published: January 2018

Background: Maternal mortality is one of the important indicators of maternal health. Objectives of present study were to determine the frequency of maternal near miss, maternal near miss incidence ratio, maternal near miss to mortality ratio and mortality index and to study the risk factors associated with near miss events.Methods: A retrospective analysis of severe maternal morbidity from January 2015 to December 2015 was studied. Data was collected from women with pregnancy related life-threatening complications, near miss cases and maternal deaths.Results: The total number of deliveries were 5247. The numbers of maternal deaths were 12. Maternal mortality ratio was 228 per one lakh deliveries. There were 5.3 near miss events for every 1 maternal death. The nature and course of near miss cases were analysed. Severe maternal odds ratio was 14.48. Mortality index was 15.78%. Maternal near miss incidence ratio was 12.19.Conclusions: Near Miss Mortality indicator is helpful in identifying the life-threatening conditions and thus aiming to prevent maternal mortality. Hypertensive disorders and its complications are the leading causes of near miss events. Sepsis is the main cause of maternal death.
Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery
Authors: Bhatiyani Binti , . Pandeeswari , Bhasani Dolly , Dhumale Shrikant
Published: January 2018

Background: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15%. Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of the hospitalisation period. This study aims to investigate the effect of postoperative gum chewing on bowel motility after laparoscopic gynaecologic surgery.Methods: 101 women who underwent laparoscopic surgery for benign gynaecological conditions under general anaesthesia were recruited. 50 patients received sugar free chewing gum post operatively and the outcomes were compared with the control group. The study’s primary end points were the time to first regular bowel sounds and time to passage of flatus after surgery. Secondary end points were the time to first defecation, patient satisfaction, and potential side effects of postoperative gum chewing.Results: We found a significantly shorter interval between surgery and passage of flatus in the intervention group (median 10 hours compared with 13 hours p=0.0151) and a significantly higher rate of regular bowel sounds 3 hours (74% compared with 45%; p= 0.003) and 5 hours after surgery (91% compared with 78%; p=0.01). There was no significant difference in time to first defecation between groups (median 18 hours compared with 20 hours; p=0.222).Conclusions: Gum chewing seems to have beneficial effects on bowel motility when used in postoperative care after minimally invasive surgery. Gum chewing should be recommended to patients after gynaecological laparoscopic surgery
A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia
Authors: Gavit Yogita , Sharma Deepika , Dixit Pratibha V.
Published: January 2018

Background: This study was conducted to compare oral Nifedipine and intravenous Labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia. This study was observational study with 80 sample size in which 40 sample size treated with intravenous Labetalol and other 40 sample size treated with oral Nifedipine. The maternal and perinatal outcome in two groups sample size with oral Nifedipine and intravenous Labetalol compared and found that nevertheless these results do establish oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Methods: The present study was conducted in tertiary care centre Mumbai from June 2016 to October 2016. All pregnant woman diagnosed with acute hypertension in severe pre-eclampsia and eclampsia in labour room were enrolled in the study.Results: In the present study oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Conclusions: A hypertensive disorder of pregnancy is one of the life-threatening complication encountered in obstetrics and globally is major cause of maternal morbidity and mortality. Management of acute severe hypertension in pregnancy is a challenging task. Present study compares the efficacy of oral Nifedipine and IV Labetalol in reaching the therapeutic goal. From the results of this study we can well conclude that oral Nifedipine is more efficacious.
Laparoscopic resection of two peritoneal loose bodies on the rectosigmoid colon
Authors: Honda Ken-ichi , Nakagawa Tomoko , Kurihara Yasushi , Kajitani Koji , Ando Tetsuji , Tendo Masashige , Takase Aki , Hamuro Akihiro
Published: January 2018

Laparoscopic examination of a 77-year-old woman revealed two peritoneal loose bodies connected to fatty appendices on the rectosigmoid colon and resected at the stalks. The peritoneal loose bodies were found to be fat-containing masses on preoperative magnetic resonance imaging, and postoperative pathological examination revealed fat degeneration tissue with or without fibrous outer layers.
Risk factors associated with refractive error among medical students
Authors: Kumar Neelam , Jangra Babita , Jangra Mahavir Singh , Pawar Neeraj
Published: January 2018

Background: Refractive error may be defined as a state in which the optical system of the non-accommodating eye fills to bring parallel rays of light to focus on the retina. Myopia is the most common type of RE, a complex trait including both environmental and genetic factors. Refractive errors are extremely common in the young academically active population. As for any nation they are the features of hardcore human resource, it has huge economic impact. These are the major cause of mild to moderate visual impairment in young individuals; knowledge of the prevalence of refractive error would be helpful in planning of public health strategy. Methods: The present study was carried out on MBBS students studying in 2nd year to 4th year at Pt. BDS PGIMS Rohtak, Haryana. The study was a case – control type of study, in which a total of 100 cases and 100 controls were taken by simple random sampling by lottery method. Cases and controls were matched for age with a difference of ±2 years. Results: Refractive error was found statistically significant among females, students spending more reading hours, watching television, mobile use, inadequate light and family history of refractive error. Means age of refractive error was 14.46±3.4 years. Conclusions: As most of the risk factors are modifiable, so this data could help health care professionals to develop targeted refractive error control policies for the population of students in medical field & insure the policies are more rational, useful, and effective.
Healthcare service quality measurement towards successful implementation of intervention strategies in three Namibian public healthcares facilities: a deterministic framework
Authors: Shopati Abner Kukeyinge , Mitonga Kabwebwe Honore , Aipinge Lydia Penomuntu
Published: January 2018

Background: Implementation science has advanced towards improved use of theoretical tactics to provide better understanding and explanation of how and why implementation succeeds or fails. The aim of the study is to develop a deterministic framework for the successful measurement of healthcare service quality in public healthcare organisations, focusing on the staff member’s satisfaction level with 2009 - 2013 strategic decisions implementation in the three Namibian Public healthcares. Methods: The research utilized quantitative approach, a survey design and questionnaire was employed to collect data. The study used Gaskin’s CFA/SEM procedure  and applies the SPSS 23 AMOS plugins, Pattern Matrix Model Builder”(PMMB), “Master Validity”(MV), “Model fit measures”(MFM) to validate and determine the interrelationships between variables. A quantitative interpretive structural modelling (ISM) approach was used within an action implementation framework (AIF). This study employed three models that complied with the action implementation framework’s dual roles. The EIS model provided the hands on support to implementing strategy role by retrospectively focusing on the 2009-2013 MoHSS Strategic plan implementations. While, the ISF model and IFF models were used to identify the determinants for its evaluation. Results: The study found no direct link between PHOs and the public sector institutions in implementing strategic plans. However, there is 1:2 mediation effect facilitated by the MoHSS and the PHOs are responsible for implementing 33% of the mandates of the Ministry of Health and Social Services in Namibia. Conclusions: This study had demonstrated why strategic plans failed in the public sectors in Namibia in that the objectives in the plans were formulated without determining whether they had an effect or not on the implementation outcome.
Under-reporting of road traffic accidents in traffic police records- a cross sectional study from North India
Authors: Singh Preeti , Lakshmi P. V. M , Prinja Shankar , Khanduja Puneet
Published: January 2018

Background: Underreporting of deaths and injuries resulting from road traffic accidents is a major issue globally. Understanding the extent of underreporting and the causes along with the assessment of quality of data available will help in developing a better system of reporting and accurate estimation of burden and risk factors which aid in developing prevention programmes. Methods: A cross sectional study was done keeping hospital records as a baseline data to which the under reporting in the police records on traffic injuries was measured. The population under study was the total number of accidents that took place in Chandigarh in the month of June-July 2011 and had reported to the emergency department of three major government hospitals. These three hospitals have been selected purposefully as majority of the road traffic accident victims are being admitted/ treated in these hospitals. Results: A total of 537 cases and 375 cases were recorded in police and hospital records respectively for the month of June-July 2011. Only 15% cases from the police records were matched with the hospital records. Among the matched 64% were completely matched and 36% were partially matched cases. None of fatal injuries registered in both the records were among the matched cases. Most of the road traffic accident cases (79.4%) involved males aged 20-49 years. The official records of road accidents have been found to be incomplete in terms of number of accident and information on age, sex, address of the victim, type and severity of injury. Conclusions: A standardised reporting format of all RTIs should be developed and maintained by both the police and hospitals. All hospitals should mandatorily report all RTI cases reported to them to the police to ensure completeness.
An epidemiological study of burn cases admitted to a tertiary care centre of Odisha
Authors: Panda Srikanta , Mohapatra Minati , Jena Unmesh Kumar , Kar Preetam Kumar , Sarangi Anshuman , Jena Somnath , Sarangi Ashok Kumar
Published: January 2018

Background: India, has an estimated annual incidence of 6-7 million burn cases. In the state of Odisha, there are very few epidemiological studies of Burn injuries. Therefore a hospital based descriptive study among the admitted burn cases was conducted. Methods: The study was conducted among the burn cases admitted to the burn unit of Surgery Department of SCB Medical College and Hospital, Cuttack during the time period from 1st January 2014 to 31st May 2015.A total of 145 patients were included for the study. Results: Socio-demographic profile of burn cases showed 83 (57.2%) were females and rest 62 (42.8%) were males. Regarding residence, 109 (75.1%) of the burn victims were from rural area and the rest 36 (24.9%) were from urban area. Also 140 cases (96.5%) belonged to low socio-economic status and were having BPL card. Regarding the nature of burn, 108 (74.5%) cases had it accidentally while 33 (22.7%) had burn due to suicidal attempt and the rest 4 (2.8%) had homicidal burn and all these 4 cases were married females. 104 (71.7%) cases were affected by flame, 12 (8.2%) cases were due to scald while 29 (20%) were due to electric burn. Among the burn cases due to flame, kerosene was the most common cause. Conclusions: The study revealed that thermal burn was the most common type of burn and the victims were in their active productive period of life (21-40 years), married, illiterate and were from rural areas. Among the thermal burn victims, use of kerosene was the most common cause of burns in both the sexes.
Prevalence of risk factors for breast cancer in women aged 30 years and above in Mumbai
Authors: Dyavarishetty Padmavathi V. , Kowli Shobha S.
Published: January 2018

Background: Even though there is an increasing trend of breast cancer, women still do not perceive themselves at risk. Poor awareness about the disease and its risk factors and the absence of population based screening contribute to delayed diagnosis. The objective of the study was to assess the prevalence of various risk factors for breast cancer in women aged 30 years and above. Methods: The cross-sectional study using convenience sampling of all women aged 30 years and above was conducted in Mumbai. Of the 2430 women enumerated in the study area, 1158 women participated in the study. Risk factors for breast cancer assessed included age at menarche; age at first child birth; breastfeeding; use of oral contraceptive pills, age of menopause, first degree relatives with history of breast cancer, history of current and past breast cancer; history of any previous breast related abnormalities. Results: 15.5% of the women had atleast one risk factor for breast cancer. The prevalence of individual risk factors was below 6%. Conclusions: Prevalence of the risk factors for breast cancer is not very high, but never the less, the increasing trend of breast cancer in the country makes it imperative to introduce population based screening for all women with or without risk factor.
A study of work-related stress among nurses in a tertiary care hospital in Goa
Authors: Pai Vernekar Shefalee , Shah Hemangini
Published: January 2018

Background: Nursing is, by its very nature, a stressful occupation. The role of nursing is associated with multiple and conflicting demands imposed by nurse supervisors and managers, and by medical and administrative staff. Such a situation appears to lead to work overload and possible to role conflict. This seriously impairs the provision of quality care and the efficacy of health services delivery. The objectives of the study were to determine the levels of work-related stress in nurses; to identify various sources of stress among nurses; to develop suitable recommendations based on the findings of the study.Methods: A cross-sectional study was conducted among registered nurses working in wards of a tertiary care hospital, Goa wherein Expanded Nursing Stress Scale was used to assess level and sources of stress among them.Results: 59.3% of nurses experienced moderate. 36.8% severe, 2.4% experienced very severe stress. Highest mean score was in the area of death and dying subscale (2.35±0.61) and workload subscale (2.11±0.53). Nurses working in casualty and general wards were more stressed. Also, younger nurses were more stressed in dealing with death of a patient.Conclusions: Death of a patient and excessive workload were major contributors of stress. Stress reduction activities and measures to decrease workload will help in decreasing the stress at workplace.
Evaluation of implementation of persons with disabilities act 1995 in Mysuru city
Authors: A. Rashmi , B. M. Shrinivasa , M. R. Narayanamurthy
Published: January 2018

Background: The persons with disabilities act 1995, is the main legislation that deals with the rights and empowerment of person with disability. Aim of the act is to provide barrier free environment which includes access to built environment in schools, colleges, offices and public buildings, recreational areas, health centres/ hospitals etc. It is important to identify the Physical barriers that limit the disabled from accessing various facilities. Methods: A cross sectional study conducted for the period of 3 months from August to November in Mysuru city corporation area. All the institutions mentioned in the PWD act like banks, post offices, educational institutions, police stations and hospitals were included in the present study. Institutions/organizations were selected based on systematic random sampling. Consent was taken from the respective in charge of the institutions. Pre tested, semi structured questionnaire prepared based on guidelines mentioned in PWD act was filled by self-assessment only by Chief Investigator. Results: Among 50 institutions/organisations included in the current study, as many as 30 (60%) belonged to Government, 17 (34%) were Private and 3 trusts were included. Out of 50 institutions, as many as 36 (72%) had fair implementation of PWD act, 14 (28%) institutions had good implementation of the act. Implementation of the act found to be high among Private organisations compared to Government organisations. Conclusions: Creating a barrier free environment for providing equal opportunities, equity and social Justice to the person with disability is vital for their social inclusion. Hence, extent of implementation of PWD act should be improved especially in the Government organisations.
Study of domestic violence against married women in the field practice area of urban health training centre, Aurangabad, Maharashtra
Authors: Khadilkar Hrishikesh A. , Paunikar Apeksha P. , Doibale Mohan K. , Kuril Bina M. , Gaikwad Arvind V. , Andurkar Smita P. , Mundada Vinod D.
Published: January 2018

Background: Domestic violence is a global issue. It has a serious impact on woman’s health and well-being. So the present study was carried out to study domestic violence against married women in the field practice area of urban health training centre (UHTC). The objective of the study was to find out the magnitude of domestic violence in married women in last one year and to find out the type of violence to which females are subjected and factors associated with it. Methods: The present community based cross-sectional study was carried out in married women residing in catchment area of UHTC. Sample size was first estimated with help of epi info, which came out to be 275 by considering 23.6% as the prevalence of domestic violence from NFHS-4. 282 women of age 15-49 years were finally included in study who was interviewed by predesigned pretested questionnaire by female investigator. The questions were asked related to ‘do they suffer from domestic violence, type of domestic violence and from whom they suffer such type of violence.’ Results: The prevalence of married women experiencing domestic violence in last one year in the field practice area of UHTC is 21.63%, of which 57.71% and 50% experienced physical and psychological violence by partner respectively. Also the study revealed that education and occupation of couple plays an important role in domestic violence. Conclusions: Domestic violence represents the hidden iceberg in the society and hence more community awareness about domestic violence is needed.
Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city
Authors: Goyal Vidit , Kaushal Rituja
Published: January 2018

Background: Post-operative surgical site infections are deadlock for any successful surgery. This exigency triggers draining of extra resources for management of the quagmire. Methods: This prospective direct surveillance study based on incidence design was undertaken to gauge and estimate the nature of propensity of various surgical site infections in a tertiary care hospital over a period of twelve months. Results: Calculated cumulative SSI rate for the year 2016 was found to be 4.32%. Conclusions: It was concluded that a multidisciplinary approach integrating periodic training sessions on infection control, checklists based routine surveillance & following some benchmark etc. are the linchpin in controlling hospital acquired infections including surgical site infection rates in any clinical setting.
Study on the adverse effects affecting treatment outcome in smear positive tuberculosis patients under DOTS in Amritsar city
Authors: Nagpal Manisha , Devgun Priyanka , Kalra Riya Kaur , Chawla Naresh
Published: January 2018

Background: The world adopts DOTS strategy for TB control thought the national TB control programs in different countries and is making good progress. Despite the positive therapeutic effects, studies have shown that utilization of multidrug regimens can cause undesirable adverse drug reactions (ADRs) of varying degrees of severity, such as hepatotoxicity, gastrointestinal disorders, allergic reactions, arthralgia, neurological disorders and non-adherence to treatment as well. Methods: The study was conducted on new smear positive patients registered under DOTS in two Treatment Units (TUs) present in Amritsar city. The prevalence of various adverse effects like gastro-intestinal, hepato-biliary, visual disturbances, musculoskeletal, skin and appendages, peripheral nervous system, etc was recorded and their effect on the outcome was observed. Data management and analysis was done by using Microsoft excel and SPSS version 17.00. Results: Out of 250 patients, 149 (59.6%) were males and 101(40.4%) were females. Out of the total 250 cases, adverse effects were present in 44.4% cases. Most common adverse effects observed were gastrointestinal in 63.9% followed by fever and chills in 28.8% of cases. Conclusions: On statistical analysis, it was observed that the absence of adverse effects was significantly associated with the favourable outcome (p<0.001).
Infections and reactions in leprosy: a diagnostic dilemma
Authors: Kaur Jasleen , Kalsy Jyotika , Kalra Riya Kaur
Published: January 2018

Leprosy (Hansen’s disease) is a chronic infectious disease caused by Mycobacterium leprae. It continues to be a public health problem in India, which contributes about 60% to the world leprosy burden. Leprosy patients when on treatment can develop either lepra reactions or reactions due to antileprosy drugs, also they can develop other infections endemic in their areas during the course of their disease. We are presenting such two cases where in one case patient on treatment with multibacillary multidrug therapy (MBMDT) developed fever, lympadenopathy and other systemic features during the course of therapy and was mistakenly diagnosed as type 2 lepra reaction but turned out to be a case of dapsone hypersensitivity. Similarly another case developed fever and other systemic features after 6 weeks of MBMDT, thinking it to dapsone syndrome his MBMDT pack was stopped but later it turned out to be a case of dengue.