bluuebunny/crossref_metadata_2025 huggingface dataset:
To evaluate the efficacy and safety of intravenous ferrous carboxymaltose compared with Iron sucrose in treating iron deficiency anemia in postpartum period
Authors: Akriti Gupta  , Ashkrit Gupta  , Uttara Gupta  , Anand Gupta
Published: December 2022

Background: Iron deficiency anemia continues to be a serious problem in developing countries resulting in spectrum of adverse events in pregnant women. The first choice for prophylaxis and treatment of mild IDA in pregnancy is oral iron therapy. However, in patients with moderate and severe anemia, oral therapy takes very long time and compliance could be a big issue in our country. Thus, pregnant women with moderate anemia should be better treated with parenteral iron therapy. Postpartum women were eligible for the study with hemoglobin level <10 g/dl, while those with sickle cell anemia, aplastic anemia, megaloblastic anemia, etc., or having allergy to parental iron were considered not eligible for this study. The eligible women were randomly categorized to receive intravenous iron sucrose and intravenous ferrous carboxymaltose.
Aims and Objectives: (1) To Compare ferrous carboxymaltose with iron sucrose in treating iron deficiency anemia in postpartum period (2) To assess the adverse effects and patient compliance.
Materials and Methods: A comparative, prospective, and randomized distributed in 50 patients within the Department of Obstetrics and Gynecology, MGM Medical College and Hospital, Navi Mumbai. The subjects were randomized into two group, first group receiving iron sucrose, whereas second group receiving ferrous carboxymaltose.
Results: Study, 25 women received iron sucrose and 25 women received ferrous carboxymaltose. There was significant higher increase in hemoglobin levels at 6 weeks in ferric carboxymaltose (FCM) group as compared iron sucrose group hemoglobin levels. There was significant higher increase in ferritin levels at 2 and 6 weeks in FCM group as compared iron sucrose group hemoglobin levels. There was significant higher increase in reticulocyte count at 6 week in FCM group as compared iron sucrose group reticulocyte count.
Conclusion: Ferric carboxymaltose is safe and efficient in treatment of iron deficiency anemia in postpartum women as compared to iron sucrose with lesser adverse effect and better patient compliance.
Traumatic brain injury in pediatric patients –Clinical manifestations and outcome
Authors: Arijit Ghosh  , Aniruddha Chattopadhyay  , Jayanta Ghosal  , Sumanta Sarkar
Published: December 2022

Background: Pediatric traumatic brain injury (TBI) is a global public health concern and is preventable, but there are no approved therapies to treat it definitely until date. Falls are the most frequent mode of injuries followed by road traffic accidents (RTA). Most of the TBIs have favorable outcome, though this is influenced by geographical, environmental, societal, and ethnic differences.
Aims and Objectives: The aims of this study were to determine the several modes of injury, severity of injury, outcomes, and complications in the Eastern Indian population.
Materials and Methods: Children-aged <18 years suffering from TBI who were attended to in Bangur Institute of Neurosciences, Institute of Post-Graduate Medical Education and Research, Kolkata, were prospectively studied for 1 year. Detailed history, clinical examinations, assessment of pupillary status, and Glasgow Coma Scale (GCS) score was recorded. Severity of TBI was done based on GCS score for each case. Computed tomography (CT) scan of head without contrast was the initial mode of neuro imaging and findings were recorded diligently. Patients were treated conservatively and surgically as required. Outcome was assessed in relation to age group, gender, initial GCS score, pupillary status, CT findings, intervention, and associated injuries. Simple statistical analysis was done.
Results: Among the total 150 patients aged 1–18 years, most common mode of injury was fall in 56.66% followed by RTA in 23.33%, assault in 6.66%, and other modes such as sports, hit by object on head, and firearm injury in 13.33%. RTAs had a poor outcome in 14.29% and fall had a poor outcome in 14.12%. Poor outcome was associated with the highest (68%) being midline shift (MLS)>3 mm and it was 12.77% with MLS of <3 mm and it was 10.26% in patients with no MLS. It was noticed that chest, spinal, and multiple injuries were associated with poor outcome.
Conclusion: The most important prognostic factors regarding pediatric TBI are GCS at presentation, pupillary status, associated injuries, and CT scan findings.
Effect of pre-emptive intravenous paracetamol, magnesium sulfate, and lignocaine on hemodynamic variables during perioperative period in pre-eclampsia patients scheduled for lower segment cesarean section under general anesthesia: A prospective randomized study
Authors: Dilip Kothari  , Anjali Bansal  , Seethal Ann Sunny
Published: December 2022

Background: Hemodynamic alterations during general anesthesia with endotracheal intubation are due to stimulation of the sympathetic nervous system and catecholamine release. Therefore, it is important to attenuate these responses in pre-eclampsia patients who are already under stress.
Aims and Objectives: The present study aimed to evaluate the combined efficacy of paracetamol, magnesium sulfate, and lignocaine in attenuating hemodynamic responses during intubation and perioperative period.
Materials and Methods: Eighty ASA II pre-eclampsia patients were randomly divided into two groups. Group PLM received intravenous infusion of paracetamol (1 g) and magnesium sulfate (30 mg/kg) in 100 ml normal saline and IV bolus Inj. lignocaine (1.5 mg/kg) 15 min before induction. Group C received only IV infusion of 100 ml normal saline. Pulse rate (PR), blood pressure (BP), and oxygen saturation were measured at various time intervals up to 40 min of delivery of baby and in up to 240 min in post-operative period. Post-operative visual analog score (VAS) and the time for first rescue analgesia (TRA I) were recorded.
Results: Demographic and baseline hemodynamic parameters were comparable in both groups (P>0.05). Changes in PR and BP during laryngoscopy, intubation, and perioperative period were significantly lesser in Group PLM as compared to Group C (P<0.05). The post-operative VAS score was significantly lower whereas TRA I was significantly longer in Group PLM than in Group C at all measuring times (P<0.05).
Conclusion: Combination of paracetamol, magnesium sulfate, and lignocaine attenuates hemodynamic responses during laryngoscopy, intubation, and perioperative period along with prolonged post-operative analgesia in cesarean section under general anesthesia in pre-eclampsia patients.
A comparative study showing effect of local insulin injection on wound vascularization seen in color Doppler imaging in patients with diabetic foot ulcer disease before and after therapy
Authors: Mayurika Singh  , Singh Saurabh , Singh Sanjay , Uttam Sarthak
Published: December 2022

Background: Diabetic foot ulcer disease is one of the most common complications of diabetes, especially in developing nations like India. Management and successful treatment of diabetic ulcers have been under rigorous research and interventions for the past few decades now. This study is an attempt to analyze the effects of a relatively newer treatment modality for diabetic foot ulcers.
Aims and Objectives: The primary objective of this study was to determine results after treating patients of diabetic foot ulcers with local insulin injection therapy and compare with the placebo group after 1 week of treatment.
Materials and Methods: In this study, 50 patients with diabetic foot ulcer disease were enrolled, of which 25 patients were randomly selected for the intervention group and the rest were kept in a control group. In the intervention group, patients were treated by injecting insulin preparation at the ulcer site whereas in control group, normal saline was used. Wound assessment was done by measuring the ulcer size and by determining the ankle peak systolic velocity (APSV) using color Doppler technique before and after the treatment in both intervention and control groups.
Results: Mean ulcer size before the treatment (7.19 cm2) was higher than post-treatment size (3.48 cm2) and the difference was statistically highly significant (P=0.00) while there was no significant difference in ulcer size post-treatment by insulin or non-insulin (normal saline) group (P=0.274). Mean APSV before the treatment (30.75 cm/s) was lower than post-treatment velocity (43.50 cm/s) and the difference was statistically highly significant (P=0.00) while there was no significant difference in APSV post-treatment by insulin or non-insulin (normal saline) group (P=0.061).
Conclusion: It meant that insulin and normal saline were equally effective in reducing ulcer size and improving APSV without being superior to one another.
Study of computer vision syndrome among medical undergraduates of Kumaon region, Uttarakhand
Authors: Maroof Mohd , Mohd Masjood  , Preeti  , Mohd Najmul Aqib Khan  , Sadhana Awasthi  , Shanti Pandey
Published: December 2022

Background: Activity on digital screen has increased so much during the COVID era that there is surge in persons complaining of symptoms of computer vision syndrome (CVS).
Aims and Objectives: The aim of the study was to determine the prevalence of CVS among the medical students and its associated factors during COVID period and to compare it with pre-COVID period.
Materials and Methods: A cross-sectional study was conducted among 337 undergraduate medical students at Government Medical College, Haldwani, Uttarakhand using pretested structured questionnaire which was filled through Google form for which link was circulated in class WhatsApp group. Data were analyzed using SPSS version 16. Frequency, percentage, binary logistic regression, and McNemar test was applied. P<0.05 was considered significant.
Results: The prevalence of CVS was significantly higher during COVID period, 54.9% (95% CI=49.7–60.1) that was significantly higher than non-COVID period. Eye strain (16.6%) was the most common CVS symptom during both pre-COVID and COVID period. The prevalence of CVS was significantly associated with use of preventive measures. During COVID period, average hours spent in digital screen was significantly higher as compared to non-COVID period.
Conclusion: This study showed that there was increase in CVS among the study participants during COVID era as there was increase in spending hours on digital screen and not or reduction in adopting preventive measures. It is important to increase awareness regarding the symptoms and precautions related to CVS.
Neonatal versus postneonatal presentation of intestinal malrotation: A retrospective cross-sectional study in a tertiary care hospital at Hyderabad, India
Authors: Srinivas Srirampur  , Kavimozhy Ilakkiya Poyyamozhy  , Thanneeru Suresh Kumar , Nagarjuna Kumbha
Published: December 2022

Background: Malrotation commonly presents in neonates with bilious vomiting. It may also present in post neonatal age group with vague symptoms such as chronic abdominal pain, vomiting, and failure to thrive. These indistinct symptoms also result in delay of diagnosis.
Aims and Objectives: This study is done with an objective to know whether age of presentation in malrotation determines morbidity and mortality.
Materials and Methods: This is a retrospective study conducted in Gandhi medical college and Hospital, Hyderabad, from 2017 to 2020, based on the records of 50 patients who were diagnosed to have malrotation. The differences in clinical presentations, diagnosis, management, and outcomes were analyzed with respect to age.
Results: Children who presented in neonatal period had classical symptoms (P<0.00001) and early diagnosis (P<0.0239). Children who presented later (>1 month of age) had higher incidence of atypical symptoms (P<0.00001) and delay in diagnosis (P<0.0239) compared to neonatal age group. Plain X-ray abdomen is readily diagnostic in neonatal age group (P<0.0004) and diagnosis was confirmed by contrast study, whereas in older children, plain abdomen X-ray findings were not always distinct and most of them needed contrast series to reach definitive diagnosis. The incidence of bowel gangrene and mortality was not statistically significant (P value of 1) between neonatal and post neonatal groups.
Conclusion: In post neonatal age group, lack of classical presentation may lead to difficulty in diagnosing malrotation, but may not have significant difference in terms of morbidity and mortality. Considering malrotation early in differential diagnosis leads to timely intervention even in older age group children.
A study to assess the prevalence of anemia among patients attending an urban health training center in Bihar: One year experience of anemia Mukt Bharat test and treat campaign
Authors: Neha Chaudhary  , Purushottam Kumar  , Haripriya Hari  , Rubina Saha  , Shamshad Ahmad  , Pragya Kumar  , Asiff Nathi Aneef
Published: December 2022

Background: Anemia is a major and serious public health problem. Its prevalence is disproportionately high in developing countries due to its low socio-economic status and poor access to health services. Consequently, this study was conducted to sought the prevalence of anemia as well as its association with the sociodemographic characteristics among the beneficiaries of Anemia Mukt Bharat test and treat campaign in an Urban Health Training Centre in Bihar.
Aims and Objectives: The aim of the study was to assess the prevalence of anemia among patients attending an Urban health training center in Bihar.
Materials and Methods: It was a retrospective record based study conducted at Urban Health Training Centre running under Department of Community and Family Medicine of a Tertiary care teaching hospital. The registered cases from September 2018 to August 2019 were taken up and case records were retrieved. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21 software.
Results: Screening of total 2042 was done over the study period of 1 year. The overall prevalence of anemia among the beneficiaries was 64.3% (95% CI: 62.3–66.5%) in the study. Significantly higher prevalence of anemia was noted among the adolescent girls (62.5%), pregnant women (62.4%), and reproductive age female (71.1%). Whereas, only 32.3% male were found to be anemic. Furthermore, illiteracy (73.5%), non-consumption of non-vegetarian diet (69.3%), and IFA tablet (84.6%) were found to be associated with anemia.
Conclusion: The association of anemia with few socio demographic and dietary factors has been highlighted through the study findings. Screening programs for anemia, awareness campaigns, deworming program, fortification of food and salt with iron and folic acid, and non-pharmacological interventions such as cooking in iron utensils are some of the measures that can be implemented.
Incidence of renal artery stenosis and its hemodynamic significance in patients subjected to angiography for suspected coronary artery disease
Authors: Deepak Arun Khore  , Sushilkumar Dharamraj Navsare
Published: December 2022

Background: Renal artery stenosis (RAS) may occur alone (isolated anatomical RAS) or in combination with hypertension (renovascular or essential hypertension), renal insufficiency (ischemic nephropathy), or both. Renal artery stenting can be performed safely with nearly uniform technical success without exposing them to significant incremental risk.
Aims and Objectives: The objectives of the study are as follows: (A) To study the incidence of RAS in suspected coronary artery disease patients. (B) To study the hemodynamic significance of RAS in patients diagnosed having RAS. (C) Should patients undergoing coronary angiography be subjected to routine renal angiography during the procedure?
Materials and Methods: We prospectively did renal angiography of consecutive 100 patients, who underwent coronary angiography for their suspected coronary artery disease. Data regarding risk factors were recorded for every patient.
Results: Out of 12 patients with RAS, 10 had significant stenosis (>50%) out of which seven patients showed hemodynamically significant RAS on captopril renogram. These were the patients having stenosis of 70% or more on renal angiography. Three patients having RAS 50–70% on renal angiography were not having hemodynamically significant lesion on captopril renograms.
Conclusion: Renal angiography should be performed in patients undergoing coronary angiography. Femoral artery should be the preferred access site for coronary angiography to approach renal arteries. The patients with RAS should undergo captopril renography to evaluate the hemodynamic significance of the stenosis.
Chlorhexidine (2.5%)–alcohol versus povidone-iodine (10%) alcohol for surgical site antisepsis in cesarean section in a tertiary care hospital – A prospective observational and analytical study
Authors: Dasgupta Shyamal , Das Pallabi , Pan Avijit , Ghosh Chiranjit , Roy Poulami , Mukherjee Srijita , Barua Medha , Patel Hetal , Biswas Avijit
Published: December 2022

Background: Rising trends of cesarean section globally demand identification of most suitable pre-operative antiseptic agent to minimize surgical site infections (SSI) and its consequences.
Aims and Objectives: The aims of this study were to determine, compare, and analyze SSI developing following the use of chlorhexidine (2.5%)–alcohol and povidone-iodine (10%) alcohol as pre-operative antiseptic agents in cesarean section.
Materials and Methods: A prospective, observational, and analytical study was conducted in a tertiary care center for 1 year, where 300 women receiving pre-cesarean surgical site antisepsis with chlorhexidine (2.5%)–alcohol were compared with another 300 receiving povidone-iodine (10%) alcohol.
Results: The two study groups were compared in terms of various sociodemographic and clinical parameters which might act as confounding factors and were found to be similar. As compared to women receiving povidone-iodine (10%) alcohol, women receiving chlorhexidine (2.5%)–alcohol had significantly lesser incidence of overall (P<0.001), superficial (P<0.001), and deep (P<0.05) SSI, infections developing at 48 h–5 days (P<0.001) and at 5 days–30 days (P<0.05). There was no significant difference among the two groups with respect to wound swab culture reports and post-SSI inflammatory markers. As compared to the povidone-iodine group, in the chlorhexidine group, a significantly (P<0.05) greater percentage healed with meager dressing and a significantly (P<0.05) lesser percentage required secondary suturing and readmissions and had a significantly (P<0.05) lesser mean duration of hospital stay.
Conclusion: Chlorhexidine (2.5%)–alcohol appears to be a better pre-operative surgical site anti-septic agent than povidone-iodine (10%) alcohol in cesarean section.
Variations in the branching pattern of renal artery
Authors: Aishwarya Thanigai Arasu  , Muniappan Veerappan  , Sundarapandian Subramanian  , Ananthi Varadharajan
Published: December 2022

Background: In terms of living kidney transplantation programs worldwide, India is only second to the United States of America. Every year, over 7500 renal transplants are done in India, with 90% of the transplants coming from living donors and the rest from deceased donors.
Aims and Objectives: The aim of the study is to examine and describe differences in human renal arteries, compare past studies with the present study, and report the occurrence of major categories of variation.
Materials and Methods: This observational study was carried out on 25 well-embalmed adult cadavers in the Department of Anatomy, Rajah Muthiah Medical College, Annamalai Nagar, Chidambaram from December 2016 to October 2018. In all the 25 specimens, the renal artery took its origin from the lateral side of the abdominal aorta.
Results: We observed that there is a 92% correlation between L1 and L2, 8% between L3 and L1, and zero between L1 and L2. Accessory renal artery (ARA) was discovered in 18 specimens (36%), with 10 on the right side and eight on the left. Superior polar arteries – 4 (8%), inferior polar arteries – 1 (2%), and hilar arteries – 5% on the right side (10%). Superior polar arteries – 6%, inferior polar arteries – 0%, and hilar arteries – 5% on the left side (10%).
Conclusion: Living donor grafts have become a primary source for preserving the donor pool as the need for kidney transplantation rises, and a successful allograft with numerous arteries has become a must. All major vascular channels have not entirely regressed if there are polar or numerous renal arteries to a regularly positioned kidney.
Screening of aqueous extract of fenugreek seeds for its anti-inflammatory potential in albino rats
Authors: Brahadeesh Mayathevar
Published: December 2022

Background: Inflammation is a common defense mechanism that involves a complicated network of cell-cell, cell-mediator, and tissue interaction. Fenugreek (Trigonella foenumgraecum L.) seeds are used for the treatment of many inflammatory conditions.
Aims and Objectives: The aim of the study was to analyze the anti-inflammatory properties of aqueous extracts of fenugreek seeds in albino rats and compare it to control and standard anti-inflammatory treatments in animal models of acute and chronic inflammation.
Materials and Methods: The methods employed to study the anti-inflammatory activity are carrageenan-induced rat paw edema and turpentine induced arthritis model in rats for acute inflammatory model and cotton wool pellet granuloma in rats for chronic inflammatory modelfollowing acquisition of the Institutional Ethics Committee approval. The control group was given 1% gum acacia, standard group was given 10 mg/kg Indomethacin dissolved in distilled water and test group was given 200 mg/kg of aqueous extract of fenugreek seeds suspended in 1% gum acacia orally.
Results: The test group displayed almost equal increase in paw volume edema as that of the standard group under experimental conditions. In Carrageenan-induced rat paw edema model and turpentine induced arthritis model, aqueous extract of fenugreek seeds and indomethacin had comparable anti-inflammatory effect. The anti-granuloma effect of aqueous extract of fenugreek seeds was of moderate degree compared to the standard under the present experimental conditions.
Conclusion: When compared to standard indomethacin, the aqueous extract of fenugreek seeds demonstrated significant anti-inflammatory activity in acute models of inflammation and moderate activity in chronic models of inflammation.
Post-injection syndrome and olanzapine long-acting injection in patients with schizophrenia: A case series
Authors: Saheli Dey  , Khasnobis Madhurima
Published: December 2022

Pamoate salt of atypical antipsychotic Olanzapine in long-acting injection depot formulation (OLAI) is often used in patients with schizophrenia having poor compliance. This depots formulation having a cluster of adverse events characterized by post-injection delirium/sedation syndrome (PDSS). Here, we present three cases of different age group, different gender suffering from Schizophrenia of varied duration of illness who developed PDSS after receiving OLAI, how they were identified and promptly managed with early intervention. PDSS noted in approximately 0.07% of the injections, in 1.3% of patients. Symptoms such as sedation, delirium, extrapyramidal symptoms, ataxia, autonomic dysfunction, aggression, and speech impairment were reported, onset was immediate to 3–5 h post-injection, patients recovered within 2–72 h. No such risk factors could be identified in any of the cases. PDSS following OLAI occurs when there is accidental intravascular release of high dose of olanzapine. The importance of post-injection syndrome in the above cases lies in the fact that following administration of OLAI a 3–4-h observation period in a health-care facility in the presence of an appropriate qualified personnel is of utmost importance. Furthermore, one should rule out other causes of acute sedation in such patients before establishing the diagnosis of PDSS. There is no specific antidote for olanzapine and almost all such patients improve with conservative and supportive treatment.
Vitamin D status of children with lower respiratory tract infections and its correlation with severity of pneumonia: A comparative study
Authors: Mohammed Mujtaba Qureshi  , Saifuddin Mohammed
Published: December 2022

Background: Acute lower respiratory tract infections (LRTI) is responsible for considerable morbidity and mortality among pediatric age group and remains one of the common causes for pediatric intensive care unit admissions. Vitamin D deficiency is one of the important risk factors not only for the occurrence but also for the increased severity of LRTI. We undertook this study to analyze vitamin D status of children admitted for LRTI and to find out its correlation with severity of LRTI.
Aims and Objectives: The aims of this study were as follows: (1) To find out vitamin D status of children presenting with LRTI and (2) to find out correlation of vitamin D levels with severity of LRTI.
Materials and Methods: This was a hospital-based comparative study, in which 60 children below age of 5 years and admitted for acute LRTI were included on the basis of a predefined inclusion and exclusion criteria (Group A). Sixty other children admitted for non-respiratory causes were included as control group (Group B). Vitamin D status of children in both the groups was determined. The severity of LRTI and its correlation with vitamin D status was determined. P<0.05 was taken as statistically significant.
Results: There was a male predominance in both the groups. The mean age of patients in Group A and Group B was found to be 17.70±7.80 months and 18.41±7.11 months, respectively (P>0.005). In Group A, 42 (70%) patients were having bronchiolitis, whereas bronchopneumonia was seen in 16 (26.67%) patients and two patients (3.33%) were found to have lobar pneumonia. Forty-eight (80%) children were having pneumonia and remaining 12 (20%) children were found to have severe pneumonia. Higher number of children were either vitamin D inefficient or deficient in Group A as compared to Group B and the difference was found to be statistically highly significant (P<0.0001). The mean 25 (OH) D levels were found to be low in patients with severe pneumonia as compared to pneumonia and the difference was found to be statistically highly significant (P<0.0001).
Conclusion: Lower levels of vitamin D were found to be a risk factor not only for the development but also for severity of LRTI. Determination and management of vitamin D deficiency status is one of the important parts of management of children with LRTI.
Chronic prostatic inflammation as a prognostic marker for post-operative improvement in clinical parameters after transurethral resection of prostate
Authors: Venkatesh Velivela  , Ifrah Ahmad Qazi  , Tappa Mahammad Mustaqrasool  , Vedamurthy Reddy Pogula  , Reddy Sandeep Kumar
Published: December 2022

Background: Medical therapy of prostatic symptoms and reduce study on benign prostatic hyperplasia (BPH) recently demonstrated a link between histological prostatic inflammation and prostate enlargement or symptoms scores.
Aims and Objectives: Prognostication of symptoms of lower urinary tract based on pathological diagnosis following transurethral resection of prostate (TURP).
Materials and Methods: This was a prospective observational study. A total of 60 BPH patients who underwent TURP were studied; 30 patients in each group, BPH without inflammation (Group I), and BPH with inflammation (Group II). Pre-operative and post-operative international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and uroflowmetry were compared in both groups. Chronic prostatic inflammation was assessed by the grade (lymphocyte density), extent (lymphocyte distribution), and location of inflammation.
Results: The prostate volume was significantly higher in Group II as compared to Group I (53.2±1.29 vs. 50.87±1.48). The improvement in IPSS and OABSS in each group, before and after surgery, was significant but the between-group difference was not significant. The post-operative voided volume (in ml) in Group I was 273.27±52.34 and in Group II, it was 289.47±34.25 (P=0.03). The post-operative post-void residual volume (in ml) was 21.97±2.55 in Group I and 13.28±2.11 in Group II (P=0.017). The post-operative Qmax (ml/s) in Group I was 15.41±2.1 and in Group II it was 19.28±2.11. (P=0.041).
Conclusion: Surgical resection of the prostate helps in a higher degree of improvement in post-operative clinical parameters in BPH patients with inflammation.
Evaluation of various options for resurfacing of soft-tissue defects of dorsum of hand and their outcome assessment
Authors: Sasanka Nath  , Subhashis Karmakar  , Dipankar Mukherjee  , Amitesh Kumar Jha
Published: December 2022

Background: Soft tissue defect of dorsum of hand is a difficult problem to deal with in reconstructive surgery. Various factors have to be considered for planning of the reconstruction.
Aims and Objectives: To assess the overall incidence of soft tissue defect on dorsum of hand, evaluation of different options for coverage of soft tissue defect on dorsum of hand, assessment of outcome and complications (both primary and donor sites) of reconstructive procedures and coverage of defect with like for like tissue.
Materials and Methods: We present our experience of resurfacing soft-tissue defects of dorsum of hand in 27 patients by split thickness skin grafting, local flaps, distant pedicled flaps, and free flaps.
Results: Among total 27 patients, in whom resurfacing was done, distant pedicled flaps such as groin/abdominal flap were performed in 13 patients, regional flaps like posterior interosseous artery flap were done in seven patients, free flap like anterolateral thigh flap was the method in three patients, and skin grafting was used in two patients. Complications such as partial or complete flap necrosis were noted in one patient each of free and regional flap and none in distant pedicled flap. The operating time was relatively less in distant pedicled flaps.
Conclusion: Skin grafting had limited use when underlying vital structures were exposed. Distant pedicled flaps such groin and abdominal flaps were very useful for resurfacing the defect especially in emergency situations. Regional and free flaps had limited indications.
Comparison of conventional awake extubation with endotracheal tube – laryngeal mask airway exchange extubation for evaluation of respiratory and hemodynamic parameters during emergence in neurosurgical patients
Authors: Vyas Amit , Singh Baghel Kamalraj , Nandurkar Pawan , Tripathi Sonali
Published: December 2022

Background: Emergence from general anesthesia and tracheal extubation may be associated with tremendous physiological and metabolic stress in patients which could be major concern for the anesthesiologist in patients especially with neurosurgical patients.
Aims and Objectives: The study was designed to find a novel method to achieving a smooth extubation in neurosurgery by compare the respiratory complications and hemodynamic stress response between conventional awake extubation of an endotracheal tube (ETT) and that following exchange extubation of ETT using a laryngeal mask airway (LMA) in craniotomy surgeries.
Materials and Methods: A total of 60 patients of American Society of Anesthesiologists physical status I and II between ages 18 and 60 years undergoing neurosurgery were evaluated for respiratory events such as bucking, coughing, desaturation, and hemodynamic changes due to sympathetic stimulation such as tachycardia, hypertension, and any other complications that have occurred in any of the two extubation methods.
Results: In Group A, 86.67% patients have shown significant events of bucking and coughing while desaturation events were comparable between two groups. Manipulation events, that is, chin lift and jaw thrust had to perform in 66.67% and 21.67%, respectively, in patients of Group A compared to only 03.33% patients in Group L. (P<0.05). In Group A, 97.33% patients shown tachycardia compared to 30% in Group L where only 30%. Similarly, mean arterial pressure after extubation found to be significantly high in 63.33% of the patients in Group A with 63.33% as compared to13.33% of patients in Group L (P<0.05).
Conclusion: ETT/LMA exchange is the most effective technique for achieving the clinical endpoints of the study, that is, prevention of emergence hypertension and respiratory complications compared to awake extubation methods. The exchange of ETT with LMA in deeper plane of anesthesia significantly reduces emergence related the hemodynamic and respiratory unwonted events.
A comparative study of liver function test between normal neonates and neonates with different stages of hypoxic ischemic encephalopathy in a district medical college of Eastern India
Authors: Kanai Lal Barik  , Barnika Purkayastha  , Nilanjan Ghosh  , Laha Sumanta , Amit Adhikary  , Sayan Bera
Published: December 2022

Background: Hepatic dysfunction is a known complication in neonates with hypoxic ischemic encephalopathy (HIE).
Aims and Objectives: We conducted this study to compare hepatic function between normal and asphyxiated newborn and whether the changes in liver function vary with the grade of HIE.
Materials and Methods: This observational analytical cross-sectional study was done in a rural medical college of eastern India for 1 year with 51 HIE (17 each in HIE I, II, and III group) and 51 healthy neonates as control. Biochemical parameters of liver function such as alanine transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), total serum bilirubin (TSB), serum albumin, and prothrombin time (PT) were measured in both groups between 48 and 72 h of birth.
Results: We found that TSB, liver enzymes, and PT ware significantly elevated and serum albumin reduced in HIE group in comparison to control group. However, TSB, PT, and serum albumin does not differ much among three stages of HIE. By contrast, liver enzymes increases significantly among three stages of HIE, and also, there is significant difference in ALT, AST, and ALP between survivor and non-survivor of HIE babies.
Conclusion: Hence, liver function test may serve as an useful early marker of perinatal asphyxia when the history of birth asphyxia is lacking and it can also be used as a prognostic indicator as there is more rise of liver enzymes from low to high grade of HIE and from survived to expired HIE babies.
Chylolymphatic Cyst - Presenting as Acute Intestinal Obstruction – A Case Report
Authors: Arora Sunita , Kaur Taranjeet , Singh Rana Harwinder
Published: December 2022

Chylolymphatic cyst is one of the rare variants of mesenteric cysts. These cysts are present within mesentery and contain chylous or lymphatic fluid. Chylolymphatic cysts are rare in paediatric age group. We present a case of a four years old boy who presented with features of acute intestinal obstruction. CECT abdomen revealed a hypodense cystic mass in the peritoneal cavity. Exploratory laparotomy of the abdomen revealed a solitary cyst measuring 10.7 cm x 9.4 cm x 10.5 cm which was adherent to the loops of small intestine and right kidney. Complete excision of cyst along with resection of the adjacent gut and end to end anastomosis was done. Histopathology of the excised cyst was suggestive of chylolymphatic cyst. It has been highlighted that chylolymphatic cyst can be a rare cause of intestinal obstruction in children.
Isolated Pleural Effusion- An Interesting Case Report of Foreign Body Aspiration-A Case Report
Authors: Gupta Ashish , Shreyas Deepa , Nayak Ramya
Published: December 2022

Foreign body (FB) aspiration is a serious medical problem that can mimic other respiratory conditions. Isolated pleural effusion is a rare presentation of FB aspiration. We report herein a six years old boy presenting with fever and cough without history of choking and respiratory distress and X-ray chest suggestive of pleural effusion. Although, the child was initially misdiagnosed as pneumonia with sympneumonic effusion, the diagnosis was established only once he coughed out a piece of foreign body. The present case highlights that FB aspiration, even though rare, should be considered as one of the differential diagnosis of pleural effusion.
Determinants of Mortality in Preterm Newborns Admitted in a Neonatal Intensive Care Unit: Findings from a Tertiary Level Maternity Hospital in Nepa
Authors: Karmacharya Shailendra Bir , Upadhyaya Subedi Kalpana , Agrawal Sumit , Pradhan Noora , Barnwal Ritesh , Paudel Prajwal
Published: December 2022

Introduction: Prematurity is a major cause of admission in the NICU in most hospitals. Premature babies are likely to face complications. Understanding the factors contributing to preterm mortality is needed to identify interventions required to reduce neonatal mortality rate. This study aims to determine the causes of mortality in preterm babies.
Methods: A retrospective study was carried out in Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal. All the preterm babies admitted in the sick newborn units were included. Descriptive statistics were performed using frequency and percentage. The bivariate and multivariate analyses were performed to determine the causes of mortality in preterm.
Results: Total 205 (71.4%) admitted preterm babies had complications at the time of admission. LBW babies were three times more likely to have mortality among preterm admission (p – value < 0.0001). Co-morbidities such as sepsis (p - value < 0.05) and perinatal asphyxia (p – value < 0.0001) were significantly associated with preterm mortality. The duration of stay among preterm babies was higher compared to term babies. The mortality rate was higher among preterm admission compared to term admission (60% vs 40%).
Conclusions: Preterm babies with LBW, neonatal sepsis and perinatal asphyxia are at greater risk of mortality. Improved antenatal and perinatal care, quality newborn care and appropriate infection prevention measures can help reduce preterm birth, prematurity related complications and mortality among these vulnerable group of newborns.
Empyema Thoracis in children: A Five-Year Analysis from a Tertiary Care Center in Eastern Nepal
Authors: Kafle Shyam Prasad , Koirala Namu , Ahmad Eqtedar , Rauniyar Lalan Prasad , Bhatta Mukesh
Published: December 2022

Introduction: Complicated community-acquired pneumonia resulting in empyema thoracis remains the largest single cause of morbidity and mortality worldwide in children. This study was carried out to evaluate the clinical profile, associated complications and outcome of empyema thoracis in children.
Methods: A retrospective study was conducted in the Department of Paediatrics at a tertiary care center in Eastern Nepal. A total of 106 children were managed with the diagnosis of complicated pneumonia with effusion or empyema thoracis from March 2017 to February 2021 (Five years). Only those patients who had clinico-radiological evidence of pleural effusion or empyema thoracis and received treatment with or without intercostal chest tube drainage (ICD) as the initial procedure were enrolled in the study. Besides supportive treatments and antibiotics; streptokinase was instilled intrapleurally in all the patients for three days. Patients who did not respond underwent VATS / decortication.
Results: Majority of the children (60.19%) were below five years of age and were males (73.58%). Majority (55.67%) had a right-sided pleural effusion and fever was the predominant symptom (55.66%) at presentation. The pleural fluid culture was sterile in more than half (55.66%) of the patients with Staphylococcus aureus grown in 33.96%. The three most common complications were subcutaneous emphysema, thickened pleura, and pyo-pneumothorax. The success rate of medical management was 83.96% and the mortality was low (2.84%).
Conclusions: The success rate of conservative management with antimicrobial therapy, intercostal drainage and fibrinolytics in this study was high (83.96%) with no major adverse effects of fibrinolytic therapy in empyema thoracis.
Extrauterine Growth Restriction among Very Low Birth Weight Neonate using Intergrowth 21st in a Neonatal Intensive Care Unit: A Retrospective Study
Authors: Panda Santosh Kumar , Meher Bijay Kumar , Jena Pravati , Pradhan Deepti Damayanty , Priyadarshini Subhadra
Published: December 2022

Introduction: Extrauterine growth restriction (EUGR) is a universal problem but its prevalence using recent reference growth charts and morbidities associated with it are lacking. The study aims at estimating EUGR prevalence in very low birth weight (VLBW) neonates and its associated morbidities.
Methods: All VLBW neonates admitted to NICU between Jan 2018 to June 2019 were analysed. Neonatal anthropometries were recorded on Intergrowth 21st gender based postnatal growth chart. EUGR was defined by weight below 10th percentile at discharge. Demographic profile and neonatal morbidities were compared between EUGR and non-EUGR by using unpaired t test and Chi-square test. Regression was used for identification of the risk factors.
Results: Out of 148 VLBW neonates, 92 (62.1%) were male, 26 (17.56%) were below 1000 gm, 102 (68%) were EUGR at discharge. Mean (SD) birth weight and gestational age were 1202 (221) gms and 30.89 (2.77) wks respectively. Caesarean delivery, higher gestational age, lower birth weight, SGA at birth and prolonged duration to achieve full enteral feeding were significantly associated with EUGR (P < 0.05). Sepsis was significantly associated with EUGR (36.28% vs. 17.4%; P 0.022). EUGR babies needed longer hospital duration (24.56% vs. 16.78%; P 0.005) with a higher mean PMA at discharge (38.07 wks vs. 35.11 wks; P < 0.001). In regression model SGA at birth and delay in achieving full feeding were independent predictor of EUGR.
Conclusions: In VLBW neonate, prevalence of EUGR at discharge was 68%. Sepsis was significantly associated with EUGR. SGA and delay in achieving full feeding were independent predictors of EUGR.
Hyperbaric Oxygen Therapy : A new Evolving Future Perspective for Management of Mucormycosis and COVID 19 in Children in Developing Countries
Authors: Lakra Mahaveer , Taksande Amar , Lakhkar Bhavana , Damke Sachin , Lakra Ashwini
Published: December 2022

The SARS COVID-19 virus has arisen as a major hazard to mankind, posing harm to the whole world population. During the second COVID wave, mucormycosis has emerged as one of the deadliest and most devastating illnesses. Mucormycosis is strongly associated with diabetes, prolonged use of steroids, prolonged hospitalisation and immunocompromised states. Children have also been affected by this badly. Hyperbaric oxygen therapy is a non-invasive, cost-effective and painless therapy where 100% oxygen is given to patients under high atmospheric pressure in small tents or chambers. It helps in tissue regeneration and angiogenesis. Hyperbaric oxygen has proved to be effective in the treatment of oculo-rhino-cerebral mucormycosis. Various studies have proved its role in the management of mucormycosis and acute respiratory distress syndrome associated with COVID-19 infection. The advantages of hyperbaric oxygen are same in children as in adults with minimum side effects. Hyperbaric oxygen therapy can be one of the good adjunctive therapies in the management of mucormycosis. It is found to be safe in the treatment of COVID-19 infection, but data is still limited on its use and further studies are needed. This article is all about its use, its efficacy, and future perspectives in the management of mucormycosis and COVID-19 in view of the arrival of the third COVID wave in developing countries like India.
FEATURES OF FORMING THE COST OF AGRICULTURAL PRODUCTS IN MODERN CONDITIONS OF DEVELOPMENT OF SMALL FORMS OF AGRICULTURAL FORMATIONS
Authors: Tatarinova Maria , Feskova Marina , Dyachenko Elena
Published: December 2022

Introduction. The growth of state support for crop and livestock areas of agricultural production requires agricultural economic entities to solve problems of improving the efficiency of the accounting process in terms of accounting for production costs and costing. One of the areas of state support is the development of fruit and berry and vegetable industries, where a special place is given to small forms of agribusiness. The issues of cost accounting and calculation methods in this case require additional research in order to clarify and adapt them to the specifics of the activity and the size of the economic entity. Methods. Studying the directions of state support for agriculture as well as the features of the accounting process of agricultural organizations was based on methods: analysis, synthesis, generalization and systematization. Results. In the course of the study, the directions of state support in agriculture were analyzed. The production of fruit, berry and vegetable products is defined as a promising direction of development for small forms of agribusiness, the features of cost accounting and costing of fruit, berry and vegetable products are studied, an algorithm for forming the cost in priority areas for small forms of agro-formations is presented, examples of calculating the cost of vegetable growing products are given. Conclusion. State support for agriculture, the growing role of small businesses in agribusiness, the specifics of their functioning impose special requirements on the quality of accounting support for the activities of economic entities, in particular, on cost accounting and calculation of production costs. The organization of the accounting process in this area determines the accuracy and reliability of the calculation of economic indicators necessary for making managerial decisions to find ways to reduce costs while maintaining a given level of product quality, identifying reserves, and determining promising directions for the development of the economy.
Motor activity of children of middle school aget
Authors: Bondar I. , Huk G. , Ryhal V. , Pasternikov V.
Published: December 2022

Determine the level of physical activity of middle school students. Research organization. The contingent of subjects was made up of 5th-7th grade students of secondary schools of Lviv № 20, 50, 62. At the time of testing, they were 10-12 years old. A total of 86 schoolchildren took part in the study, including 46 boys and 40 girls. The results. According to the results of pedometry, we observe that the number of steps per day is higher for boys than for girls aged 12 years. According to the results of motor activity, 92.3% of boys and 85% of girls are rated as elementary. Conclusion. Most schoolchildren show low motor activity in everyday life and prefer a passive way of rest. The average values of physical activity of boys and girls aged 10-12 years (from 2542±691 to 4038±1838 steps/day) is at an extremely low level. More than a third (33.3-40.7%) of middle school-age children have initial levels of physical activity. At the same time, according to the results of self-assessment regarding the number of days per week, when students believe that they are engaged in intensive physical exercises for more than 60 minutes per day, the majority of respondents indicated an exaggerated number of days per week; because the number of their steps every day does not correspond at all to their answers in the questionnaire (real volumes of motor activity are lower than declared). This indicates that children mistakenly consider their motor activity sufficient. We see a significant reserve in increasing the competence of schoolchildren in physical education in the participation of schoolchildren in various forms of motor activity.