bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural-functional peculiarities of left atrium remodeling in patients with different body mass, suffering from chronic obstructive lung disease
Authors: Kostareva R. A. , Khovaeva Ya. B. , Podyanova A. I.
Published: July 2018

Aim. To study the left atrium (LA) remodeling in patients with different body mass, suffering from chronic obstructive lung disease (COLD).

Materials and methods. Seventy two patients with COLD, who were divided into 3 groups, underwent echocardiography: group 1– patients with normal body mass (n = 31), group 2 – patients with excessive weight (n = 21), group 3 – patients with degree I obesity (n = 20).

Results. Among patients with COLD, belonging to group 3, indexed parameters of minimum (15.43 ± 1.62 ml/м2, р = 0.004) and presystolic (20.52 ± 1.88 ml/м², р = 0.03) volumes of LA increased; these patients also demonstrated growth of maximum upper-lower size of LA with elevation of its linear maximum and minimum sizes, when compared with patients of group 1. Patients with different body mass, suffering from COLD, have similar volumes of passive and active depletion and their corresponding fractions. COLD patients with excessive body mass and obesity showed moderate pulmonary hypertension.

Conclusions. Patients with obesity, suffering from COLD, have significantly elevated indexed parameters of presystolic and minimum LA volumes, which can be considered as early markers of impaired function of LA. Increased minimum LA volume can be one of the factors of gas exchange impairment.
Contribution of academician Ye. A. Vagner into development of national surgery, medicine and public health (on the occasion of 100th birthday anniversary)
Authors: Koryukina I. P. , Zarivchatsky M. F. , Podluzhnaya M. Ya.
Published: July 2018

The materials, reflecting the course of life and creative work of Ye.A. Vagner, are presented in the paper. His work as a talented surgeon, great scientist, first Academician of the Academy of Medical Sciences of the USSR in the Ural, State prize winner, founder of scientific surgical school, remarkable pedagogue and tutor, experienced head of higher medical school is shown. During 25 years he was the head of Perm State Medical Higher School, named now after him. The contribution of Ye.A. Vagner into development of not only national, but also world surgery, medicine, public health is invaluable.
Analysis of The Nucleotide Sequence Diversity of the Lassa Virus and Augmenting its Phylogenetic Tree
Authors: Oddoye Sean
Published: July 2018

Lassa Virus (LASV) is the etiological catalyst for Lassa fever, an acute hemorrhagic disease with a mortality rate of 15%. Many aspects of the Lassa virus are not understood, like the causation of deafness in ⅓ of surviving patients or why symptoms are benign for 80% of those infected with the virus. Ambiguities like these suggest that there might exist some genomic heterogeneity among infecting viruses and demonstrate a need to quantify and analyze polymorphisms within LASV. Patterns that emerge from phylogenetic trees can be used to assess the structure of a population while also providing insights to the genetic makeup. The purpose of this investigation was to develop a more streamlined means of calculating nucleotide diversity within a subpopulation of Lassa virus strains and to augment a phylogenetic tree of the Lassa Virus glycoprotein precursor (GPC) segment. A total of 25 partial and complete data sequences of LASV strains were obtained from the Genbank Archives. During phase one of this investigation, the sequence data was inputted into MEGA analytical software and the sequence diversity was derived on a nucleotide level. Data from the individual strand sequences was used to augment a phylogenetic tree using Treeview X software. In phase two of this investigation, an algorithm was created using RStudio, with BSGenome and BioStrings extensions. The sequence diversity derived from the statistical analyses on MEGA was compared to that of the algorithm created. A p-value of 0.08 was found, which deviates from the accepted range of non-medical p-value of 0.00 to 0.05. It is suggested that future research focuses on creating a refurbished version of the algorithm to calculate a nucleotide diversity within a percent error of 5%.
ETİK LİDERLİK, İŞGÖREN SESSİZLİĞİ VE ÖZNEL İYİ OLUŞ ARASINDAKİ İLİŞKİNİN İNCELENMESİ
Authors: ÖZDEMİR Kutay , GÜNAY Ahmet , ÇETİNCELİ Koray
Published: July 2018

Bu
çalışma, etik liderliğin işgören sessizliğine ve işgörenlerin öznel iyi oluşuna
etkisini tespit etmek amacıyla yapılmıştır. Bu amaç doğrultusunda, Süleyman
Demirel Üniversitesi'nde çalışan akademik personele toplamda 36 ifadeden oluşan
etik liderlik, işgören sessizliği ve öznel iyi oluş ölçeklerinin bulunduğu bir
anket uygulanmış ve 321 akademisyene ulaşılmıştır. Yapılan anket sonucunda elde
edilen veriler IBM SPSS 22 ve LISREL istatistiksel veri analizi programları
aracılığıyla analiz edilmiştir. Veriler, LISREL programında tek bir havuzda
faktör analizine tabi tutulmuş ve soruların ait oldukları boyutlar altında
toplandığı tespit edilmiştir. Hipotezlere uygun olacak şekilde yapılan modelleme
yine LISREL programı vasıtasıyla incelenmiş ve etik liderliğin hem öznel iyi
oluşu hem de işgören sessizliğini kayda değer oranda etkilediğini ortaya
koymuştur. Elde edilen sonuçlar bu alanda yapılan çalışmaları doğrular
nitelikte olup, etik liderlik ile işgören sessizliği arasında negatif bir
ilişki olduğunu, etik liderlik ile öznel iyi oluş arasında ise pozitif bir
ilişki olduğunu kanıtlamaktadır.
MALİ MÜŞAVİR OLABİLME HAKKINA SAHİP OLAN ÖĞRENCİLERİN MUHASEBE MESLEK ALGISI ÜZERİNE BİR ARAŞTIRMA
Authors: GÜNER Oğuzhan , ÇARIKÇI Oğuzhan
Published: July 2018

Küreselleşme
kavramının ortaya çıkmasıyla her alanda değişimleri beraberinde getirmiştir. Bu
etki ile dünyada sınırlar ortadan kalkmıştır. Sınırların ortadan kalkmasıyla
işletmelerin değişimlere uyum sağlaması ve günümüz şartlarına uygun şekilde
organizasyon yapılarını belirlemek zorunluluğu ortaya çıkmıştır.
Küreselleşmenin muhasebe alanına etkisi ise işletmelerin teknolojik değişimleri
takip etmesini ve muhasebe mesleği kavramına etkisini inceleyerek organizasyon
yapılarını buna göre düzenlemesi olmuştur.Muhasebe mesleğinin ortaya çıkması
işletmelerin faaliyetlerine uygun muhasebe meslek mensuplarını temin etmesi
gerekliliğini ortaya çıkarmıştır. İşletmelerin hedef ve stratejilerine uygun
meslek mensubu temin edebilmesi için meslek eğitimi kavramının önem kazanmasına
neden olmuştur. Bu bağlamda çalışmada muhasebe kavramı incelenerek, muhasebe
eğitimi hakkında bilgi verilmiştir. Batı Akdeniz bölgesinde ki mali müşavir
olabilme hakkına sahip olan öğrencilere anket yapılmış ve öğrencilerin
demografik özelliklerine göre mali müşavirlik mesleğini tercih etme durumları
ve mesleki algıları hakkında bilgi verilmiştir.
ENERJİ TÜKETİMİ İLE FİNANSAL AÇIKLIK, TİCARİ AÇIKLIK VE FİNANSAL GELİŞME ARASINDAKİ İLİŞKİNİN KARŞILAŞTIRMALI ANALİZİ: TÜRKİYE VE İTALYA ÖRNEĞİ
Authors: KORKMAZ Özge
Published: July 2018

Bu çalışmanın amacı, Türkiye’de ve İtalya’da 1970-2016 dönemi için enerji
tüketimi ile finansal açıklık, ticari açıklık ve finansal gelişme arasındaki
ilişkiyi ortaya koymaktır. Bu kapsamda, bağımlı değişken olarak kişi başına
düşen enerji tüketimi, bağımsız değişken olarak da kişi başına düşen özel
sektöre sağlanan yurtiçi krediler, ticari açıklık oranı ve finansal açıklık oranı
kullanılmıştır. Çalışmada enerji tüketimiyle söz konusu makroekonomik
değişkenler arasında eşbütünleşme ilişkisinin varlığı ARDL Sınır testi
yaklaşımı ile incelenmiş, her iki ülke için de değişkenler arasında uzun
dönemli ilişkinin var olduğu tespit edilmiştir. Uzun dönemli ilişkinin varlığı
nedeniyle, analize hata düzeltme modeliyle devam edilmiştir. Hata düzeltme
modeli sonucuna göre, Türkiye için ticari açıklık oranının, İtalya için ise
finansal açıklık oranının enerji tüketimi üzerinde pozitif ve anlamlı bir
etkisi olduğu saptanmıştır. Çalışmada her iki ülke için de finansal gelişme
oranının enerji tüketimi üzerinde pozitif ve anlamlı bir etkisi olduğu sonucuna
ulaşılmıştır.
Clomiphene citrate: the changing landscape
Authors: Gupta Mahesh C. , Khanna Jyoti
Published: July 2018

Ovulatory dysfunction is one of the leading causes of female infertility. Clomiphene citrate has emerged as a boon in the induction of ovulation in the human female. Clomiphene results in many adverse effects some of which are documented, and some reported spontaneously. Clomiphene citrate is a non-racemic mixture of two isomers, zuclomiphene and enclomiphene, having individual and opposite biological actions. It is accepted that cis isomer (zuclomiphene) is estrogenic and trans isomer (enclomiphene) is anti-estrogenic. Zuclomiphene does not have any ovulation-induction propertybut gets accumulated for a longer time in the human body and it has more agonistic activity than enclomiphene. Thus, Zuclomiphene may be responsible for the adverse effects by clomiphene citrate. Enclomiphene is being explored for its potential use in male as well as female infertility. Trails are underway to explore its effectiveness and safety in various disorders. This article highlights the pharmacology of Clomiphene with respect to its isomers and the potential uses of enclomiphene based on evidences available.
Utility of apremilast in the treatment of psoriasis
Authors: Snehalatha K. , Ravindranathan Roshni , Sriram D. K. , George Melvin
Published: July 2018

Psoriasis is an autoimmune disease that affects more than one bodily system with predominantly skin and also joint manifestations affecting almost 2% of the world population that occurs primarily due to immune dysregulation. Apremilast is an oral, selective inhibitor of phosphodiesterase-4 (PDE4) enzymes. Inhibition of PDE-4 results in specific elevation of cAMP, an innately occurring intracellular secondary messenger that functions as a modulator of inflammatory responses. The drug is taken orally in strengths of 10, 20 and 30 mg. The drug may be a suitable alternative to different systemic therapies. Apremilast is a much-needed molecule for the treatment of psoriasis that is resistant to first line therapy and also useful in combination therapies.
Comparison of Levetiracetam and sodium Valproate in the prevention of migraine: a randomized clinical trial study
Authors: Abbasi Vahid , Atalu Abolfazl , Seddighnia Perham
Published: July 2018

Background: Sodium valproate is an anti-seizure drug used for prophylactic use of migraine headaches. Despite the efficacy of this drug due to complications that cause some patients to not tolerate the drug. The purpose of this study was to Comparison of levotiracetam and Sodium valproate in migraine prophylaxis.Methods: This is a clinical trials study. 100 migraineurs who referred to the Alavi neurology clinic and indicated the onset of prophylaxis of migraine were studied in two groups of 50, one of which was a group of levetiracetam and another group of sodium valproate Received. Patients received daily 500mg of drug for 3 months and the effect of the drug on the number of attacks, severity of attacks, and MIDAS score was measured. Collected data analyzed by statistical methods in SPSS version 19. P<0.05 was considered as significant.Results: In both cases, significant improvement was observed in the number of attacks, severity and MIDAS score. In all of the criteria, levetiracetam and sodium valproate were almost identical, except for reducing the number of headache attacks that had a significantly in levothyramine group less than sodium valporoste group (P = 0.0001).Conclusions: This study showed that levothyramineacetamin can be used as a good alternative in those who do not tolerate sodium valproate.
A comparative study of effects of nebivolol and atenolol on blood pressure and lipid profile in patients of mild to moderate hypertension
Authors: Vakharia Monali P. , Zad Vijay R. , Mankar Nishikant N. , Wadivkar Pratik P.
Published: July 2018

Background: Beta blockers have been used in the treatment of hypertension, since last four decades and are widely accepted as the first-line treatment for hypertension. Nebivolol, a third generation β-blocker has highest β1 selectivity and is devoid of intrinsic sympathomimetic activity. Along with peripheral vasodilatation and nitric oxide (NO)-induced benefits such as antioxidant activity and reversal of endothelial dysfunction, nebivolol promotes better protection from cardiovascular events. The objective of the study was to compare the effects of atenolol and nebivolol on both blood pressure and lipid profile in patients of mild to moderate hypertension.Methods: This was a prospective, randomized, parallel, open labelled study. Patients were recruited from the medicine out-patient department (OPD) and cardiology OPD. A total of 100 patients were enrolled in the study. 50 patients were allocated to atenolol group and 50 patients to nebivolol group. BP and baseline investigations such as lipid profile were performed. Tests to determine lipid profile were performed on the first visit (Week 0) and at 24 weeks. Continuous variables between the two treatment groups were analyzed by unpaired t-test. Efficacy endpoints within the group were analyzed by using paired t-test.Results: All the lipid levels except HDL-C were increased with atenolol therapy. At 24 weeks, atenolol therapy led to increase in LDL-C, VLDL-C, TC and TG which was highly significant (p<0.0001). HDL levels were decreased at 24 weeks which was also statistically highly significant (p<0.0001). The mean values of lipids in nebivolol group at baseline and at 24 weeks. At 24 weeks, nebivolol therapy led to changes in LDL-C, VLDL-C, HDL-C, TC and TG which was not statistically significant (p>0.05).Conclusions: From study it can be concluded that atenolol and nebivolol are equally effective in reducing BP but atenolol worsens lipid profile as compared to nebivolol.
Drug utilization pattern of antiepileptic agents among pediatric epilepsy at tertiary care teaching hospital of Gujarat: a cross sectional study
Authors: Dave Hirenkumar H. , Trivedi Niyati A.
Published: July 2018

Background: Epilepsy is one of the most common neurological disorders characterized by recurrent episodic paroxysmal involuntary clinical events associated with abnormal electrical activity from the neurons. Without the knowledge of how drugs are being prescribed and used, it is difficult to initiate discussion on rationale drug use and to suggest measures to change prescribing habits for the better management. Present study was performed with an aim to study the utilization pattern of anti-epileptic drugs (AEDs) for the paediatric patients suffering from various forms of epileptic seizures.Methods: The present cross-sectional study was conducted at the epilepsy clinic of Department of Paediatrics, Tertiary Care Teaching Hospital of Gujarat, on patients diagnosed to have epilepsy July 2014 to October 2014. Hundred Paediatric patients of either gender diagnosed to had epilepsy and taking treatment from pediatric epilepsy clinic OPD, S.S.G. Hospital, and Baroda. Patient’s detailed medical history, demographic details and other required information was recorded on a prestructured data entry form.Results: Out of 100. GTCS was found to be the most common (55%) form of epilepsy among pediatric patients and Carbamazepine was the most commonly prescribed (41%) AED followed by sodium valproate (38%). 71% patients were prescribed monotherapy. Carbamazepine +Clobazam was the most commonly (7%) used combination.Conclusions: Use of appropriate AEDs in the majority of patients as per WHO guidelines, has decreased number of ADRs in this study.
Dermatological adverse drug reactions in tertiary care hospital: an analysis of causality and severity
Authors: Bharani Kalpana R. , Chandel Nitibhushansingh R. , Goyal Chhaya A.
Published: July 2018

Background: Dermatological adverse drug reactions (ADRs) are easily detected by patients and that precludes further usage of drugs. So, decided to study the pattern, causative drugs, severity of adverse drug reactions and their causality in tertiary care hospital.Methods: It was prospective non inventional cross sectional study. Patients attending OPD or admitted to IPD of all age group and both gender with suspected dermatological ADRs following drug intake were included and the ADRS were recorded on CDSCO’s Pharmacovigilance form. Collected data was analyzed for assessment of causality using WHO-UMC scale, for severity by using Modified Hartwig and Siegel. Morphological pattern, drug groups, gender and age distribution was analyzed.Results: 231 dermatological ADRs were recorded and analyzed. Maximum cases were found in 21-30 years age group (74 cases). Dermatological ADRs were found in 143 females and in 88 males. Three major classes of drugs found responsible for causing dermatological ADRs were -oral Antimicrobials-41 (17.75%) and Injectable Antimicrobials-40 (17.32%), NSAID's-40 (17.32%.) and Topical Betnovate-36 (15.58%.). Regarding the type, 95 cases were of maculopapular rashes (41.12%), steroid damaged face in 42 (18.18%) andacute urticaria in 20 (8.65%). In terms of Severity assessment, authors found 23 cases (9.95%) as Mild, 176 cases (76.19%) of moderate severity and 32 cases (13.85%) of Severe category. In terms of causality assessment: 3 cases as Certain, 68 cases as Probable and 160 cases as Possible.Conclusions: From this study, it was found maximum Dermatological ADRs of moderate severity and few cases of causality category as “Certain”.
Comparison of early postoperative outcome of laparoscopic and open inguinal hernia mesh repair
Authors: Garg Pulkit , Pai Sreekar Agumbe , Vijaykumar Hosamath
Published: July 2018

Background: Laparoscopic hernia has all the benefits of a tension free repair. The aim of this study was to compare the early postoperative outcome of laparoscopic and open inguinal hernia mesh repair.Methods: This is a prospective study conducted at Ramaiah hospital Bangalore from June 2016 to July 2017. 70 cases of inguinal were included in the study hernia diagnosed clinically and radiologically who fulfilled the inclusion & the exclusion criteria. The principal operative techniques were laparoscopic hernioplasty (LH) and open inguinal mesh hernioplasty (OH).Results: 35 patients each were allotted to two group (LH and OH). The mean age was 50.53. LH group had significantly less postoperative pain than the OH group on 12, 24 and 72 hrs (P <0.05). Although the vas pain scores of LH group were also comparatively lower on postoperative day 14, these differences were not statistically significant. Than mean operative time was significantly higher for LH group (131.86 vs 80.29 min) although in bilateral cases the difference was considerably less but was still significant (138 vs 107 min). The mean hospital stay after surgery was less for LH group (2.68 vs 3.25 days) but was not statistically significant. (p = 0.073). Chronic pain persisted for 2 patients (5.7%) in OH group whereas none had chronic pain in LH group.Conclusions: Laparoscopic hernioplasty is equivalent to open repair in the treatment of inguinal hernia, with less post-operative pain, lower risk of wound infection, shorter duration of hospital stay, and less incidence of chronic pain however requires a long learning curve and is more expensive.
Prevalence and clinical predictors of silent myocardial ischemia in asymptomatic type 2 Diabetes Mellitus patients at Puducherry, India
Authors: Hussain K. Shaik Anwar
Published: July 2018

Background: Silent MI is common among diabetics due to autonomic dysfunction and loss of pain alert mechanism. There are various risk factors associated with silent MI in diabetes which needs screening earlier to prevent unanticipated cardiovascular mortality. The objective of the present investigation was to study the prevalence and clinical factors associated with silent myocardial ischemia as diagnosed by TMT among type 2 diabetics who had no previous history or symptoms of cardio-vascular disease.Methods: A total of 200 type 2 diabetes affected subjects with duration of diabetes for at least 6 months, above 18 years of age, attending to the diabetology OPD, during the time period June 2017 to May 2018 were included in the study. Blood investigations and TMT were done for all the participants and documented in a proforma.Results: Silent MI was documented by using TMT in 36.5% (n=73) of patients with type 2 diabetes mellitus. The factors like age (59.1±16.3 years), duration of diabetes (8.2±2.6 years), obesity (BMI=29.6±4.7 kg/m2), Glycated haemoglobin (9.7±2.8 %), lipid levels and post-prandial blood sugar levels (236±11.8 mg/dl) associated well with silent MI as predicted by TMT. Fasting blood sugar did not show significant association with Silent MI.Conclusions: The prevalence of silent MI was higher among the type 2 diabetic individuals compared to non-diabetics. Age, duration of diabetes, HbA1c levels, BMI, dyslipidemia and post prandial blood glucose levels were associated significantly with incidence of silent MI in patients with type 2 diabetes.
A study on prevalence of cardiac valvular calcification and its correlation with serum phosphate levels in chronic kidney disease
Authors: Hariprasad S. , Senthilnathan P. , Malathy A. R.
Published: July 2018

Background: Higher cardiovascular morbidity found to be more in early stages of chronic kidney disease patients. Present study was done to study the prevalence of cardiac valvular calcification correlated with serum phosphate levels in chronic kidney disease.Methods: A total of 153 (78 chronic kidney disease patients, 75 controls with age and sex matched) coming to ESIC Hospital, Chennai were utilized to conduct the present study. Patients of stages 3 to 5 with matched controls of age and sex were considered for this study. Cases were classified in to different stages of chronic kidney disease based on estimated Glomerular Filtration Rate which was calculated using Cockcroft-Gault equation using age, body weight, and serum creatinine. The blood samples of patients belonging to both the groups were tested for serum creatinine and serum phosphate. The Echocardiogram was done for the patient with chronic kidney disease to assess cardiac valvular calcification.Results: 51% of the subjects in the study group were detected as having chronic kidney disease in ultrasonogram. 20% of the patients in the study group were having coronary artery disease compared to 4% in the control group. Mean serum phosphate levels between subjects with Valvular calcification in chronic kidney disease and without calcification was statistically significant among the study group was noted in the present study.Conclusions: Elevated levels of serum phosphate correlated with cardiac valvular calcification showed significant role in chronic kidney disease.
Comparison between the efficacy of double blockade and single blockade of RAAS in diabetic kidney disease
Authors: Gupta Arvind , Narain Upma
Published: July 2018

Background: Diabetic kidney disease is associated with high morbidity and cardiovascular mortality. A number of guidelines and recommendations have been issued over the years recommending the use of renin angiotensin aldosterone system blockade in the management of diabetic kidney disease.Methods: A prospective observational study was done on 750 diabetic chronic kidney disease patients during July 2012 to August 2014 to compare the efficacy of double blockade and single blocked of renin angiotensin aldosterone system in diabetic kidney disease.Results: At the end of 24 months urinary protein excretion rate of group I and group III were compared by using student t-test and p value (0.0268) was found significant. Similarly, on comparing group II and group III, p value (0.0278) was again significant. Mean arterial blood pressure of group I and group III were statistically significant (0.0496) while comparing group II and group III, p value (0.0419) was again significant.Conclusions: The study concludes that the use of double renin angiotensin aldosterone system blockade therapy is more effective than mono-therapy at reducing albuminuria and proteinuiria, and in decreasing blood pressure at the same time not causing significant deterioration in glomerular filtration rate in diabetic kidney disease patients. Novel potassium-lowering therapies are shown to effective compensate the hyperkalemia risk associated with renin angiotensin aldosterone system blockade use in people with diabetic kidney disease, offering promise for more adequate therapy and greater renal and cardiovascular risk protection in the future.
Role of serum interleukin-6 in heart failure
Authors: Deokar Smita Amol , Dandekar Sucheta P. , Shinde Ganesh A. , Prabhu Surekha S. , Patawardhan Mugdha
Published: July 2018

Background: A growing body of evidence suggests that inflammation plays the key role in different cardiovascular diseases. But very study has been done so far in relation to serum interleukin-6 in heart failure patients.  The aim of the study was to measure serum interleukin-6 in heart failure patients.Methods: Total 22 heart failure patients and 22 age and sex matched controls were included in this study from August 2015 to June 2016 for serum analysis of interleukin-6.Results: serum interleukin-6 was significantly [median(IQR) 14.3(26.2) pg/mL] increased in heart failure patients compared to age and sex matched controls [median(IQR) 0(2.4) pg/mL].Conclusions: Even though little is known about function of interleukin-6 in heart failure patients, this study shows that increased level of IL-6 in heart failure patients plays an important role as a pro-inflammatory marker in development of cardiovascular disease i.e. heart failure.
Comparison of the efficacy of triple blockade, double blockade and single blockade of RAAS in non diabetic chronic kidney disease
Authors: Gupta Arvind , Narain Upma , Sachan Aditya
Published: July 2018

Background: Although dual blockade of the renin-angiotensin-aldosterone system with the combination of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker is generally well established as a treatment for nephropathy, this treatment is not fully effective in some patients.Methods: A prospective observational study was done on 600 chronic kidney disease patients during July 2012 to August 2014 to compare the efficacy of triple blockade, double blockade and single blockade of renin-angiotensin-aldosterone system in non diabetic chronic kidney disease.Results: At the end of the study, 24 hours urinary protein excretion rate of group I and group III were compared by using student t-test and p value (0.0268) was found significant. Similarly, on comparing group II and group III, p value (0.0160) was again found significant.Conclusions: Triple blockade of the renin-angiotensin-aldosterone system was effective for the treatment of proteinuria in patients with non-diabetic nephropathy whose increased urinary protein had not responded sufficiently to a dual blockade.
Paronychia: incidence during Magh Mela
Authors: Narain Upma , Kant Arun , Bajaj Ashok Kumar
Published: July 2018

Background: Paronychia is one of the most common infections of the fingers and toes. Clinically, paronychia present as an acute or a chronic condition.Methods: The retrospective study was carried out from January 2018 to February 2018 at Allahabad. Gram stain, ZN stain, KOH examination and culture were carried out in 230 cases and species identification was done by Vitek-2 system.Results: Out of these 230 cases 142 (61.73%) presented acute paronychia, 58 (25.21%) cases of chronic paronychia and the remaining 30 cases (13.06%) did not show any growth. In the cases of acute paronychia, authors identified 53.52% Staphylococcus aures, 15.49% Staphylococcus saprophyticus, 2.82% Micrococci and 6.34% Citrobacter among aerobes while among anaerobes authors isolated 5.63% Peptococcus, 8.45% Peptostreptococcus, 3.52% Bacteroides and 4.23% Fusobacterium. Among chronic paronychia authors recorded 48.28% pure bacterial growth, 18.97% pure fungal growth, 20.69% mixed bacterial infections and 12.07% mixed bacterial and fungal infections.Conclusions: From this study authors conclude that cold weather and humidity were the predominant and predisposing factors of the high incidence of acute paronychia. Due to very short span single pathogen was isolated from the lesions. In cases of chronic paronychia 37.76% mixed infection were also recorded which may be due to super aided infections with primary pathogen.
Effect of Carica papaya leaf extract (CPLE) on thrombocytopenia among dengue patients of tertiary care hospital, Chitradurga, India
Authors: S. B. Vijeth , Kauser Mohamed Murtuza , Mangasuli Vijayalaxmi , S. R. Vagesh Kumar , Sree Suba , Varghese Sona Ann
Published: July 2018

Background: Dengue is a global public health problem and thrombocytopenia associated with it is a serious complication for which there is no specific treatment available. This study was done to assess the effect of Carica papaya Leaf Extract (CPLE) on thrombocytopenia associated with Dengue and to study other clinical parameters of dengue.Methods: A longitudinal study conducted in Department of General Medicine, BMCH, Chitradurga, from September 2017 to March 2018. All the participants were randomized into two groups by simple randomization by lot method. Study group was given Carica papaya Leaf Extract (CPLE) and routine supportive treatment for other group. The patients were followed from the day of admission till their discharge from hospital. The platelet counts and other baseline hematological investigations, duration of hospital stay in both the groups were compared statistically by unpaired t-test.Results: There were total 127 males and 73 females. Age groups were comparable in both the groups. Most common presenting complaints were fever (100%) followed by headache (85%), myalgia (81.4%), fatigue (75%), arthralgia (65%). On admission baseline investigations were done and mean levels of both groups were compared. It was found that there was only significant difference of mean RBC levels (p=0.045). When followed up with daily platelet counts of both the groups, it was seen that there was increase in platelet counts in study group compared to placebo group and on third day there was significant difference between both (p=0.002). It was also found that discharge rate is earlier in study group than placebo group.Conclusions: Carica papaya leaf extract accelerates the increase in platelet count and reduces the hospital stay. So, it can be used as supplementary drug to reduce complications.
A study on serum cholinesterase level in organophosphorus poisoning and its correlation with severity of organophosphorus poisoning
Authors: Honnakatti Vilas , Nimbal Naren , Doddapattar Prakash
Published: July 2018

Background: There has been a steady increase in the use of organophosphates (OPs) as pesticides in most of the developing countries including India for more than 50 years. OPs tend to be the commonest cause of poisoning worldwide and are persistently and deliberately used in suicides in Agrarian areas. As stated by WHO, 3 million cases of pesticide poisoning occur every year, of these about 1 million are accidental and 2 million are suicidal poisonings, resulting in more than 0.25 million deaths per year. As there is limited availability of facilities and resources in developing countries, all OP poisoning patients are not managed in intensive care units. Hence it is important to understand the clinical features and other factors that indicate severity of poisoning which should be identified in the initial examination.Methods: It was a hospital based prospective study of 100 OP poisoning patients that were attending to casualty of BIMS Hospital and Medical College Belagavi, India. Over a period, patients fulfilling inclusion criteria were included and patients were categorized according to Peradeniya Organophosphorus Poisoning (POP) scale. Serum cholinesterase level measured at the time of admission.Results: The patients were in the age group of 18 to 70 years. Majority of the patients were in the age group of 21-30 years (51%). Sixty nine percent of the patients were from rural areas and 38% of them were farmers. Sixty nine percent of patients were from low socioeconomic stratum. Major route of intake of poison was ingestion. Eighty four percent of patients consumed poison with a suicidal intent. In this study, authors observed that there is a significant correlation between the severity of poisoning categorized by the POP scale and the serum cholinesterase at the time of initial presentation of the patients (P<0.001).Conclusions: Present study concluded that significant correlation between the degree of derangement in serum cholinesterase level and severity of poisoning at the initial presentation. Higher the score on the POP scale, the greater was the degree of derangement in the serum cholinesterase level.
The prevalence of pulp stones in a Hazaribagh population: a radiographic survey
Authors: Sandhu Harpreet , Bhargava Ankur , Rehan Danish Ahmad , Saigal Sonal
Published: July 2018

Background: The goal of this retrospective study was to determine the prevalence of pulp stones in a Hazaribagh population. Any possible associations between pulp stones tooth type and dental arch were also evaluated.Methods: A total of 4625 teeth of 500 patients were examined in our department who came for diagnostic radiograph of posterior teeth. The presence or absences of pulp stones were recorded.Results: Pulp stones were found in 834 (18.03%) of 4625 teeth detected. The occurrence of pulp stones was most significant in among the age groups of 31-50 years of age.  The pulp stones were significantly higher in permanent maxillary first and second molars.Conclusions: Pulp stones are not only incidental radiographic findings of the pulp tissue but may also be an indicator of some serious underlying disease. On the other hand, they may provide useful information to predict about the susceptibility of patients for other dystrophic soft tissue calcifications such as urinary calculi and calcified atheromas.
A hospital based follow up study on predictors of mortality in patients with Intra cranial hemorrhage
Authors: Kishan U. , B. Rajiv Kumar , N. Arun Kumar
Published: July 2018

Background: Intra-cerebral hemorrhages account for approximately 10-15 percent of all stroke cases and are associated with the highest mortality rate (30-40%). Study of predictors can modify the mortality rates. The objective of the present study the predictors of mortality in patients with intra cranial hemorrhage.Methods: Hospital based cross sectional study was carried out. Forty patients with CT scan evidence of intra cranial hemorrhage admitted to our hospital were randomly selected. All investigations were done. Patient characteristics were noted down.Results: In the present study among 40 patients, 16 patients died. The mortality was 40%. As the age increased, the mortality rate increased. But there was no difference between the mortality among males and females. Mortality was more than twice among those with SBP more than 180 mmHg i.e. 58.8% compared to only 26.1% among those with SBP less than 180 mmHg. Similar findings were noted for DBP and MAP. As the severity of motor weakness increased, the mortality increased. Patients with presence of bilateral plantar extensor response were found to be more at risk of death with a death rate of 66.7% compared to only 18.2% among those without presence of bilateral plantar extensor response. As the Glasgow coma scale increased, the mortality decreased from 100% in patients with a score of 3-4 to only 31.2% in patients with a score of 9-13. Intra-ventricular extension of haemorrhage, presence of hydrocephalus, volume of hematoma >30 ml, decreased consciousness level was important predictors.Conclusions: Bad prognosis i.e. death can be expected if the patient is older, low GCS, hematoma size > 30 ml, gaze palsy, severe motor neuron weakness, abnormal pupils, ataxic respiration etc. hence intensive care should be given to such patients to bring down the mortality.
Risk factor analysis among patients with stroke: a cross sectional study at a tertiary care hospital
Authors: B. Rajiv Kumar , Kishan U. , Kumar N. Arun
Published: July 2018

Background: Study of risk factors of stroke is very important in different settings to confirm their existence and to take necessary steps to prevent them especially in elderly so that incidence of stroke can be brought down. The objective of the present study is to perform the risk factor analysis among patients with stroke.Methods: A hospital based cross sectional study was carried out at a tertiary care hospital from June 2015 to March 2016. A total of 40 patients diagnosed with stroke were included in the present study. Detailed information and all necessary investigations were carried out. Risk factor analysis was done, and categorization was done for certain risk factors.Results: The predominant age group was 6-60 years. The age ranged from 1 month to 67 years. The Male: Female ratio was 14:9. The common etiologies were congenital, post infective and intracranial bleed in 26.1% (n=6) each. Favourable outcome was seen in 82.6% of cases. The failure rate was 17.4%. Most no of cases with favourable outcome was seen in 6-60 years age group, whereas >60 years age group had the most no of cases with poor outcome. The overall mortality rate was 21.6% (n=5). Wound related complication was seen in 1 patient (4.3%).  Two (8.7%) patients required VP shunt post ETV. The cause of mortality was aspiration pneumonitis in 3 cases, CSF metastasis and wound infection in 1 cases each.Conclusions: The leading cause as well as risk factor for stroke was found to be hypertension followed by alcohol and smoking.
Eosinophilic gastroenteritis in an immunosuppressed patient: a case report
Authors: Dhas Clement J. , A. Murali , C. Yoganathan
Published: July 2018

Eosinophilic gastroenteritis is a rare disease that is characterized by Eosinophil infiltration in one or multiple segments of the gastrointestinal tract. The etiology of this condition remains unknown. Eosinophilic gastroenteritis has heterogeneous clinical manifestations that depend upon the location and depth of infiltration in the gastrointestinal tract, and eosinophilia may or may not be present. This article reports a case of Eosinophilic Gastroenteritis in a 57 years old retroviral male patient, who presented with chronic diarrhea, bilateral pedal edema and eosinophilia. Ultimately, the diagnosis of eosinophilic gastroenteritis was clinched.  The rare character of eosinophilic gastroenteritis and its varied clinical presentations often lead to delayed diagnosis and complications. Case reports may help to disseminate knowledge about the disease, thereby increasing the likelihood of early diagnosis and intervention to prevent complications.
Parental perception of girl-child early marriage amongst the Urhobos in Nigeria
Authors: Agege Emmanuel A. , Nwose Ezekiel U. , Odjimogho Stella
Published: July 2018

Background: This study was on the parental perception of early marriage amongst the Urhobos in the Central District of Delta State. World Health Organization (2013) defined early marriage, or child marriage, as the marriage or union between two people in which one or both parties are younger than 18 years of age. The aims of this research were to assess the parents on four themes including concept of early marriage as well as perceptions on causes, consequences and strategies to mitigate the problems.Methods: A descriptive cross-sectional survey adopted questionnaire that comprised 4-themes and a critical review. A total 360 out of 384 samples were drawn from 8-communities within the local governments in the Central senatorial district of Delta State. The percentages of responses from the respondents categorized on the Likert scale groups were determined.Results: The analysis shows disagreements among respondents’ perception. 60% are yet to acknowledge gender discrimination in the underlying practice of early marriage. 77% admitted that ignorance is a factor. There is also some strong agreement that early marriage was due to unexpected pregnancy. A total of 62.5% of respondents admitted that their daughter married the boys who impregnated them, and all the girls were forced into it by their parents.Conclusions: The observation lies credence that unexpected pregnancy is the highest cause of early marriage. It is hereby inferred that there appear to be ignorance leading parents to force their girls into early marriage because of premarital pregnancy.
Knowledge and practice of the universal precaution among nursing students of Eras’s Lucknow Medical College and Hospital, Lucknow
Authors: Hussain Firdous , Khatoon Ruby , Sachan Beena , Srivastava J. P.
Published: July 2018

Background: Health care workers (HCWs) are at risk of various occupational hazards in the hospital, including exposure to bloodborne infections such as HIV and hepatitis B and C virus (HBV and HCV) infection from sharps injuries and contact with body fluids. All health care workers should routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure during contact with any patient's blood or body fluids that require universal precautions. The objective of the study was to evaluate both the knowledge and the practice of standard precautions by nursing   students in the teaching hospital.Methods: It is a cross sectional study conducted in Era’s Lucknow Medical College and Hospital over a period of two months from November 2014 to December 2014 on nursing students. 100 nursing students were included in this study. All the nurses had been professionally active for 1 year or more in direct patient care and hospital hygiene.Results: Most of the nursing students were aware of the concept of universal precaution. 97% of nursing students used to wash their hands before and after patient care. In reasons for use of universal precaution it was found that100% of nursing student said use of universal precaution is to protect health care worker. While 100% said it protects HCW while handling infectious waste. Nursing students knowledge regarding indications of hand hygiene was found 97.Conclusions: The findings of this study highlight the need to implement a programme to improve knowledge on standard precautions.
Study of knowledge, behaviour and practice of biomedical waste among health personnel
Authors: Chowdhary Anjuman
Published: July 2018

Background: Healthcare wastes are of great importance due to its hazardous nature. As World Health Organization (WHO) indicated, some of healthcare wastes are considered the most hazardous and potentially dangerous to human health and pollute the environment. With this background this study was undertaken to assess awareness, behavior and practices healthcare personnel about biomedical waste, its hazards and management.Methods: This one cross-sectional study was conducted at S.V.B.P. hospital associated with L.L.R.M. medical college, Meerut. A total of 291 healthcare personnel who consented for interview were interviewed biomedical waste management rules and observed for biomedical waste management practices by using redesigned and a pretested questionnaire. The data was analysed by using SPSS software.Results: Awareness regarding bio-medical waste management rules was 67% in doctors, 60% in nurses, 57% among lab technicians, but the sanitary staff was not aware about this. Awareness about category of BMW, number, colour coding, disposed content, labelling and cover of waste containers and segregation of waste were more among nurses and lab technicians in comparison to doctors but minimum among sanitary staff. All the respondents (100%) doctors, nurses and lab technicians knew that HIV and Hepatitis B transmitted through Bio medical waste but their awareness regarding Hepatitis C and other diseases was very low. 74% of sanitary Staff did not know that these diseases could be transmitted through bio medical waste.Conclusions: Healthcare facilities should get their healthcare personnel trained from accredited training centers.
Knowledge, practices and restrictions related to menstruation in young girls: a study from North India
Authors: Sharma Pallavi , Singh Nilanchali , Tempe Anjali , Sharma Shalini
Published: July 2018

Background: The aim of the study was to study the awareness, myths and menstrual practices in young girls in a tertiary care center.Methods: Predesigned structured questionnaire based study was done in 180 girls between the age group 13 to17 years, in the outpatient department of a tertiary care hospital in New Delhi. Informed consent was taken before filling up the questionnaire.Results: The participants were ignorant about the importance of proper hygiene and faced a lot restrictions related to daily life during their periods. 68% participants lacked adequate knowledge about the physiology of menstruation. 45% girls were informed regarding menstruation by mothers, sisters and friends whereas teachers played a limited role. 30% girls were using sanitary pads, while most were still using homemade cloths. Pads were being reused in every cycle and they were dried in damp places, preferably during night. Lack of awareness and appropriate care for menstrual morbidities was seen in these girls, which affects their educational attainment. Age old myths and practices still have a lot of impact on the Indian household.Conclusions: Ignorance and myths regarding menstruation still prevail in our society. The need of the hour is starting educational campaigns and schools based initiatives which can educate the girls. Thought should be given in manufacturing low cost sanitary pads as a national program. People especially in the rural set up should be encouraged to improve women’s social and reproductive health situation and counselling should be provided in relation to sanitation and disposal.
Psychosocial problems, chronic illness and welfare service utilization among elderly population in urban areas of Vijayapur, Karnataka
Authors: Patil Vidya V. , Udgiri Rekha
Published: July 2018

Background: Aging is a universal process. In India, the elderly account for 7.7% of the total population and the United Nations defines a country as “ageing” where the proportion of people over 60 years reaches 7.7%. Morbidity among elderly has an important influence on their physical functioning and psychological well-being. The objectives of the study were to assess the psychosocial problems associated with the elderly and to describe the chronic illness and utilization of welfare services among elderly.Methods: A cross sectional study was conducted in the urban field practice area of Shri B M Patil Medical College, Vijayapur. House to house survey was conducted for a period of 3 months from September to November 2014.Results: Total of 372 elders were interviewed, 54.5% were males, 45.4% were females. Majority were Hindus 78.8%. 46% were illiterate. Majority 79% were financially dependent. 53% were working. Around 32% were feeling lonely Most common chronic illness is joint pain (66.66%), visual problem (50%), dental and chewing problem (48%).Conclusions: Financial dependence was high among the participants and majorities were suffering from one or the other chronic illness which needs attention and knowledge about geriatric welfare services should be given.