bluuebunny/crossref_metadata_2025 huggingface dataset:
Indonesian Short Story Perspective Environmental Psychology: Alternative Research of Psychology Literature
Authors: Ahmadi Anas
Published: March 2020

In this study, Indonesian short story is explained from the environmental psychology perspective. The core of environmental psychology is human interaction with the environment, from the side of restoration or degradation. This research uses data source from Cerpen Pilihan Kompas 2015 [2016]. From this environmental psychology perspective, it is found that Indonesian short stories shows environmental conditions from the unhealthy side, for example the short story of “Anak ini Mau Mengencingi Jakarta?” by Ahmad Tohari. As for the environmental restoration side, it appears in the short story of “Liang Liu” by Utari. Short story of “Batu Lumut Kapas” by Gus TF Sakai tells about the environment and natural stone.
A Few Sketches on Environments Imprinted on the Novels of Ajneya
Authors: Das Beauti
Published: March 2020

It is a well-known fact that the very environment which surrounds us bears a great impact on our body, mind and soul.  Anybody can understand what will be the feelings of a person when he is surrounded by cold and heavy air in a situation that he comes in contact. In the same way the feelings of a person in a desert are well understood by anyone without having any question to the person concerned. This is why the environment portrayed by a novelist for the plotline of a novel is so important that it must suit to the characters in question, it must help the smooth progress of the plotline as well as it must pierce in to the heart of a reader, so that the reader can visualize the very movement of the protagonist at every moment of time. To air out our thoughts in this regard it might be the best way to cite the example of the environment that had been created by the great novelist Ernest Hemingway in his novel The Old Man and The Sea. He had allowed the old man to go to the sea again and again for a long period but he never allowed the old man to have success at his hand. In fact he had portrayed an environment of pessimism for the readers by not allowing the old man to have a success at his hand despite of his all efforts. In order to add more pessimism in the mind of a common reader he had given a nick name to the old man by Shalao. The very environment created by the author made every reader believe that the old man will never be successful at any cost, whatever the intensity of his effort may be. This is how one can imagine the influence of the environment on the mindset and belief of a common reader.
Open and Distance Learning in Rural Communities of Zimbabwe: Exploring Challenges Faced by Zimbabwe Open University Students in Kadoma District, Zimbabwe
Authors: Mutanana Ngonidzashe
Published: March 2020

This study sought to explore challenges faced by Open and Distance Learning (ODL) students in rural communities using Kadoma District as a case study. The specific objectives of this study were to (i) identify challenges faced by ODL students in rural communities in achieving their educational goals and (ii) establish effects of these challenges in accomplishing/finalizing their programmes. The research employed a mixed research approach to triangulate the results. The study used a case study research design to solicit information. The target population was undergraduate students who were currently pursuing the following programmes; Commerce, Education, Applied Sciences, and Agriculture. A sample of 30 postgraduate students and five key informants were used to collect data. The sampling techniques employed were convenience and purposive samplings respectively. Findings revealed that students in rural communities are facing some challenges during their academic career. These challenges include inadequate access to tutor support and physical resources, inflexible practices and access to ICT, poor or no electricity to operate ICT appliances, financial, cultural, community and employment responsibilities. These challenges have some effects which include but not limited to late submission of assignments, poor quality results and university dropouts. Basing on these conclusions, the study recommends the university to recruit more tutors who should be available for students at district offices. The university should ensure technological development at the district centers, and within the student’s locations. The study also recommends the university to provide students in the rural communities with study skills, time management skills, as well as guidance and counseling required to manage their studies. The study finally recommends further studies on strategies to encounter challenges faced by ODL students in rural communities.
Analysing the Methods of Agrarian-Economic Terminology Lexicon Enrichment in French
Authors: Dvorakova Milena
Published: March 2020

The paper deals with one of the principles of term formation in the economic terminology of the French language. When analyzing ways of enriching the French agrarian-economic terminology, a word-formation process of terminologization is discussed in more detail. To determine the degree of agrarian-economic terminologization in the French text, a statistical survey was carried out, based on four types of document - a scientific publication, university textbooks, popular professional publication and scientific paper. It would be necessary to use the results of the statistical analysis in the teaching of i.e., languages because the knowledge of the principle of the term formation is one of the prerequisites for mastering the terminology.
The Most Celebrated Chinese Writer of the Twentieth Century: An Introduction to Lu Xun
Authors: Wong Leei
Published: March 2020

Over the years, many renowned scholars have done several researches about the great writer, Lu Xun and his works. Much interest is centred on him even today. We will examine here, briefly the reasons that is unique in him that he is hailed “the most celebrated Chinese writer of the twentieth century”, through the historical background at that time and his writings.
Description of Subjugated Woman in ZoraNaele Hurston’s “Their Eyes were Watching God”: A Feminist Analysis
Authors: Ghauri Qasim Javed , Ehsan Muhammad , Shafique Quratul Ain , Khalil Muhammad Zohaib , Mustafa Atta-ul
Published: March 2020

This study aims to explore the subjugated woman in male dominant society in ZoraNaele Hurston’s novel “Their Eyes Were Watching God”. “Their Eyes Were Watching God” has become the most widely read and highly acclaimed novel in the canon of African-American Literature. One of the most important and enduring books of the twentieth century, “Their Eyes Were Watching God” brings to life a Southern love story with the wit and pathos found only in the writing of ZoraNeale Hurston. The novel follows the fortunes of Janie Crawford, a woman living in the black town of Eaton, Florida. This study spotlights how women live under social restrained destiny; where they suffer letdown, thwarting, dismay and mocking. Subjugation against women which transcends all natural, ethnic and class boundaries. Women are mistreated by patriarchy financially, politically, socially and mentally. Where there is patriarchy, the woman is the other. She's objectified and marginalized, characterized just by her distinction from “ale standard”. All women’s activist movement specifically advances social change and women’ equality. A woman is not considered an equal, but rather the other, and thus inferior to a man. All these problems and incidents are dangerous for women’s identity. The research deals with major aspects of hegemonic masculinity, and violence against women. This research will study the threats to female identity in the light of Lois Tyson’s feministic views.
Impact of Afghan Conflicts as Reflected in Khaled Hosseini’s The Kite Runner
Authors: Matta Rakib Farooq
Published: March 2020

The Kite Runner is a novel by Khaled Hosseini and one of the literary works that presents the social life of Afghan people in each political era of Afghanistan. The aim of this paper is to discuss the impact of the Afghan conflict since the end of 1970’s until the 2000’s, the author describes the impact of the conflict of Afghanistan since the time of Daoud Khan’s coup, the Soviet Invasion, the Civil War Afghanistan, and the Taliban regime. This study used a mimetic approach that compares the actual occurrence with what is found in the novel. In analyzing this novel, the author uses sociological theory of literature by Alan Swingewood, first perspective regard literature as historical documentation and the time of the literary works made. Then the author uses qualitative methods, where the research described in a descriptive form of words or experts from novel and other sources related to the Afghan conflict. This paper focuses on the condition of Afghan society’s life during the Afghan conflicts and the impact of Afghan conflicts as reflected in the novel, The Kite Runner.
Nature of Crime Victims in Bangladesh
Authors: Yesmen Nelufer
Published: March 2020

The study focused on realizing the condition of crime victim and it is a tearing problem in Bangladesh. Police are the principal delegates of the criminal justice system local jurisdictions across the country face significant challenges in criminal justice. The particular sorts of crime and criminal justice problems that local governments face change extensively the nation over. To observe the nature of crime victimization in Bangladesh and try to find out the factors and their legal appreciations is the objectives of this study. In addition, secondary method and data is used for fulfillment of the study. There are some factors increase the visibility of victims i.e. role of media, the higher public profile etc. The victim is weak in relation to the offender – the ‘ideal victim’ is likely to be a female, sick, very old or very young and victim is blameless for what happened. Victims suffer from trauma resulted from the crime. Legal appreciation of victims’ right is, the Code of Criminal Procedure 1898, Section 545 (1 & 2) and section 546 recognized the right of compensation, but the opportunity was hardly available.
A Translation into English of Khalil I. Al-Fuzai’s1 “Reaching the End”2
Authors: Dohal Gassim H.
Published: March 2020

A youth cannot marry his cousin because her father refuses for economic reasons.  This story shows how the Saudi Arabian society connects marriage with wealth, even when it comes to relatives who are obligated culturally to take care of one another.  A father is ready to sacrifice his daughter for a rich person, hoping that marriage bargain will improve his economic status.  The customs of the society validate that a father can do to his daughter what he sees as good. Also, the norms of the society require a younger relative to obey an older one, even working for him; a person cannot fight back or challenge an elder.  Accordingly, the relation between relatives is a relation of traditional and cultural power recognized and imposed by the society.

In this story, the protagonist is colonized physically and mentally: in addition to having been exploited for fifteen years, he believes that his life is secured with his uncle.  And hence, “he almost lost his personal independence,” as the story states.  He can lose anything as long as his future is granted, for he believes that he is the only heir of his uncle.  But after his uncle’s refusal of his proposal, he becomes aware of being marginalized and colonized.  He has to struggle and search for his identity after being considered as “a nobody in the world of the living.”  Like the protagonist who kills his father in the previous story, the youth of this story “deludes himself that he is brave and that he has to prove it.”

Yet as an oppressed and marginalized person, the main character is neither supposed nor expected to practice oppression.  But he thinks of violating his uncle’s daughter’s honor—for no fault except that she is his uncle’s daughter.  In a culture that valorizes masculine values, the wretched girl becomes the victim of both her father, who wants to sell her as a commodity for the one who pays more, and of her cousin, who wants to exploit her in order to achieve his goals. Finally, in my translation, some well-known words are kept with their original pronunciation and written in italics to keep the reader aware of the Arabic text.3
Acquiring Scientific and Technological Proficiency: State of Science Education in Bangladesh
Authors: Yeasmin Sabina , Mahmud Md. Dulal
Published: March 2020

Developing scientific values in students’ mind is the goal of science teaching. Bangladesh, of late, has adopted various strategies to educate the people and mainly the children. There are still many challenges for the country to attain an acceptable standard of education. Science education here in Bangladesh is in a state of crisis. The enrolment for science studies in the country shows a sharp decline over the past few years. This discipline, what once used to be the most sought after subject at secondary, higher secondary and tertiary levels in the country, is losing its appeal in an alarming shift of choice. Indeed it is important know what the obstacles are and how they are removed within a stipulated short period. This paper aims to present the current situation of Bangladesh in terms of science and technological development in the education sector. There is no alternative of a scientifically and technologically literate workforce as the future economy will also be science i.e. ICT based.
The safety and efficacy of oral Arborium plus, a herbal liquid formulation in the treatment of diabetic foot syndrome: an open label study
Authors: Chalivendra Pallavi , Shaik Nurul Hameed , Balapalli Hari Prasad , Parasaram Murali Krishna , Bommadi Bhavya , Ravanam Sai Anjani , Attili Subha
Published: March 2020

Background: Diabetic foot ulcers are the most universal cause of non-traumatic amputations of the foot in developing countries. One of the treatment modalities is to improve the peripheral blood supply to the area of ulcer. To this purpose the study was done to evaluate the safety and efficacy of oral Arborium plus (herbal liquid formulation) in the wound closure of diabetic foot patients.Methods: 50 patients were randomly assigned to either of the groups (each group 25 patients) to receive either the test drug (Arborium plus) at tertiary care teaching hospital, it was an open label prospective and interventional parallel group study to evaluate the efficacy and safety of Arborium plus in diabetic foot syndrome. The study participants were randomized into control and intervention groups. Base line measurements of vascular flow was ankle- brachial pressure index (ABPI) and wound size measurement.Results: The baseline characteristics of the patients age in years test and control group 68±12.3 and 67±13.4 respectively. Male/female in both groups was 21/4 and 22/3 respectively. Duration of diabetes in years 8.65±8.3 and 8.5±7.6 respectively. BMI was 25.11±4.15 and 24.75±0.85, duration of smoking (years) 17.3±9.5 and 19.5±10.5 respectively in both groups. Among the test group who received the proprietary formulation of Arborium plus, there was a significant reduction in the wound size.Conclusions: Wound healing and ABPI improvements were observed with usage of Arborium plus suggest an improvement in peripheral vascular flow in diabetic foot subjects.
Bio-equivalence study of two tilmicosin phosphate formulations (Micotil 300® and Cozina 300®) in broiler chickens
Authors: Elkomy Ashraf , Aboubakr Mohamed
Published: March 2020

Background: The present study was designed to assess the comparative bio-equivalence of Micotil 300® and Cozina 300® in healthy broiler chickens after oral administration of both products in a dose of 15 mg tilmicosin base/kg body wt.Methods: Twenty four broiler chickens were divided equally into two groups (12 chickens for each group). The first group was designed to study the pharmacokinetics of Micotil 300®, while the 2nd group was designed to study the pharmacokinetics of Cozina 300®. Each broiler chicken in both groups was orally administered with 15 mg tilmicosin/kg body wt. Blood samples were obtained from the wing vein and collected immediately before and at 0.08, 0.16, 0.25, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours after a single oral administration.Results: The disposition kinetics of Micotil 300® and Cozina 300® following oral administration of 15 mg tilmicosin/kg body wt revealed that the maximum blood concentration [Cmax] were 1.73 and 1.67 μg/ml and attained at [tmax] of 2.01 and 2.04 hours, respectively.Conclusions: Cozina 300® is bioequivalent to Micotil 300® since the ratios of Cmax, AUC0-24 andAUC0-∞ (T/R) were 0.96, 0.93 and 0.91 respectively. These are within the bio-equivalence acceptance range. Micotil 300® and Cozina 300® are therefore bioequivalent and interchangeable.
A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion
Authors: Kumar Avdhesh , Kumar Brijesh , Verma Sanjay Kumar , Kumar Anand , Mathur R. K. , Chaudhry Sudhir , Kant Surya
Published: March 2020

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females.  The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.
Study the association between platelets count and grades of oesophageal varies in patients of cirrhosis of liver with portal hypertension
Authors: Priyadarshi B. P. , Khan Imran Kamal , Kumar Vinay , Verma Ashok Kumar , Midha Tanu , . Madhuri , Singh Mahendra
Published: March 2020

Background: cirrhosis of liver is a diffuse process of fibrosis that converts the liver architecture into structurally abnormal nodules Portal hypertension leads to dilatation of portal vein, splenomegaly, and formation of portal systemic collaterals at different sites. Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy.Methods: Statistically 100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were selected for the study. Ultrasonography was performed in all cases to note the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was done to detect presence of varices with grades. Statistical Analysis: Statistical analysis was done using Statistical Package for Social Survey (SPSS) for Windows version 17.0. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient, p value <0.05 was considered significant.Results: Among 100 patients studied ,90% patients were found to have esophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 esophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of platelet count with grades of esophageal varices it was evident that 44 patients had their platelet count less than 1 lac out of which 24 patients had grade 2 varices followed by 14 patients with grade 3 varices, p value <0.001 and was highly significant.Conclusions: The study depicts that with decrease in platelets count the chances of formation of higher grades of oesophageal varices increases and also a positive association exists.
Evaluation of severity of chronic obstructive pulmonary disease using bronchial obstruction, dyspnea, exercise index and global initiative for chronic obstructive lung disease classification and it’s correlation with physical quality of life measured by St. George’s respiratory disease questionnaire score
Authors: Daga Snehal , Khadke Vrushali , Phalgune Deepak , Chopadawala Abbas
Published: March 2020

Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) criteria classified chronic obstructive pulmonary disease (COPD) by severity into four stages. Recently, Body mass index (BMI), Bronchial Obstruction, Dyspnea, Exercise (BODE) index, was proposed to provide useful prognostic information of COPD patients. Health-related quality of life (HRQOL) is measured by St. George’s Respiratory disease Questionnaire (SGRQ). Study was undertaken to assess correlations between BODE index and GOLD classification with SGRQ score.Methods: Fifty five COPD patients were included. Spirometry was performed in all patients. Modified Medical Research Council (mMRC) scale was used to label severity of dyspnea. Six-minute walking distance (6 MWD) was performed. BODE index was calculated by giving points to BMI, forced expiratory volume in one minute (FEV1), 6 MWD, and mMRC. SGRQ was used to determine HRQOL. Correlation analysis was done using Pearson’s method.Results: Mean symptoms, mean activity, mean impacts and mean total SGRQ score were significantly higher in patients having mMRC scale 0-1, patients who could walk ≤149 meters, and in patients who had GOLD III and IV class. Lesser the FEV1, higher the mMRC grade, and lesser the 6 MWD, worse was the quality of life. BODE index (r = 0.72) and GOLD classification (r =0.59) were significantly and positively correlated with symptoms score, activity score, impacts score and total SGRQ score.Conclusions: BODE index correlated better than the Gold classification with SGRQ score implying that apart from the airflow limitation, functional impairment measured by the 6MWT and mMRC also affect HRQOL.
Study of etiological spectrum and clinical profile of patients admitted in tertiary care hospital of South Gujarat, India
Authors: Patel Mohnish M. , Bhatt K. N. , Jariwala Khyati T.
Published: March 2020

Background: Pancytopenia is defined as reduction of all three formed elements of blood below normal reference range. The symptoms are fatigue, fever, dizziness and weight loss. Evaluation was done using complete hemogram and peripheral smear. The presenting marrow biopsy is most useful and accurate in evaluation of pancytopenia.Methods: Two ml of anticoagulated blood was collected for complete hemogram. The peripheral blood smear was stained with Leishman's stain and studied. Bone marrow biopsy and aspiration was done in all the patients to identify etiology.Results: Predominance was seen in the age group of 31-60 years. Most common cause of pancytopenia was megaloblastic anaemia in this study compared to other studies all over the world where most common cause was aplastic anaemia. This reflects higher prevalence of megaloblastic anaemia in the Indian subjects.Conclusions: A comprehensive clinical, haematological land bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause.
Study on haematological abnormalities in various stages of chronic kidney disease: stage 3-5
Authors: Swarnalatha Pattu , Vinotha T.
Published: March 2020

Background: Chronic kidney disease is one of the major health problems worldwide and a major cause of morbidity and mortality. CKD is diagnosed on the basis of the presence of markers of kidney damage and kidney function. Aim of the study to assess the prevalence of hematological abnormalities in CKD (stage 3-5) and to assess their correlation among various etiologies of CKD (diabetes, chronic glomerulonephritis, hypertension.Methods: The study was done in 150 cases diagnosed as CKD in the Department of Nephrology, IMCU, and in the medical ward at Tirunelveli Medical College Hospital. The diagnosis was based on an estimated GFR level <60ml/mt/1.73M2. Total count, differential count, Hb, MCV, MCH, MCHC, WBC count, platelet count, and peripheral smear examination, coagulation profile were done on all the patients and results were compared and correlated with each other.Results: In 150 patients, 90 males and 60 females were included. Among 90 males 43 were in stage 3 CKD, 11 in stage 4, 36 in stage 5. Among 60 females 7 were in stage 3, 39 in stage four, 14 were in stage 5. 63 patients had both hypertension and diabetes, 30 patients had only diabetes. There was a decrease in RBC, Total count platelet value with respect to increase in stages of CKD. There was a prolongation in BT, CT, PT, APTT and INR value in respect to increase in stages of CKD.Conclusions: Chronic kidney disease patients have lower haematological indices and the degree of changes depends on the severity of kidney disease.
A prospective study of correlation between smoking and serum calcium in newly diagnosed essential hypertension
Authors: S. Chandra Babu , Chepuri Venkata Ravi Kumar , Ella Sireesha
Published: March 2020

Background: Smoking significantly reduces the vitamin D and serum parathyroid hormone levels. But no significant difference was observed in serum calcium levels in previous studies. Some studies showed significantly low serum calcium levels in essential hypertension. There are limited international and local studies about the effect of cigarette smoking on the levels of serum calcium in relation to hypertension. Our study aims to find correlation between smoking and serum calcium in newly diagnosed essential hypertensive patients.Methods: Total 70 cases of newly diagnosed essential hypertension who attended the outpatient department at the government general hospital were included in this study based on inclusion criteria. Base line data including age, gender, risk factors were obtained. Blood biochemistry including serum calcium levels were obtained at the time of diagnosis and results were analysed.Results: Among 70 cases of essential hypertension there were 24 smokers and 46 nonsmokers. Serum calcium was found low in 37 cases of essential hypertension. Out of 37, 12 were smokers and 25 were nonsmokers, p value is 0.6981 and it is not significant.Conclusions: Smoking is a major health hazard, with detrimental effects on many organs. In our study serum calcium was significantly less among Hypertensives and correlated inversely with blood pressure. But there was no significant difference in serum calcium among smokers and nonsmokers. Measuring the level of parathyroid hormone in cigarette smokers, may help to clarify the finding in present study.
A comparative prospective open label randomized controlled 8 week study in patients of depression treated with vilazodone and sertraline
Authors: Arya Nirmal , Nischal Anuradha , Nischal Anil , Agarwal Manu
Published: March 2020

Background: Depression is a mood disorder treated with various antidepressant such as SSRIs due to lesser toxicity and improved safety profile.Methods: This was an eight week randomised active controlled parallel group study. 54 patients were allocated in two group. Group A received vilazodone while group B received sertraline. Assessment done at baseline, 2, 4 and 8 weeks on the basis of clinical efficacy, sexual dysfunction, side effects and weight gain using Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Arizona Sexual Experience Scale (ASEX) and UKU Side Effect Rating Scale.Results: HAM-D score of group A was 18.78±1.78 and 7.67±1.66 while in group B was 19.04±2.12 and 8.15±1.77 at baseline and 8 weeks respectively. HAM-A score of group A was 15.44±1.50 and 6.63±1.39 while in group B was 15.26±1.83 and 7.07±1.14 at baseline and 8 weeks. ASEX total score of group A was 15.63±1.28 and 14.63±1.33 while group B was 15.52±1.37 and 16.41±1.12 at baseline and 8 weeks. ASEX desire score of group A was 9.63±0.93 and 8.67±0.88 while of group B was 9.59±0.93 and 10.07±0.92 at baseline and 8 weeks. UKU side effect rating at 2 and 8 weeks of group A was 0.22±0.42, 1.04±0.76 while in group B was 0.37±0.49, 1.89±0.85.Conclusions: Vilazodone and Sertraline are equally efficacious in treatment of depression and associated anxiety. When side effect profile were compared Vilazodone is found superior to Sertraline
Prognostic significance of serum cortisol and serum albumin in patients of ischemic stroke
Authors: Fatima Saman , Khan Ruhi
Published: March 2020

Background: Stroke is the second most common cause of mortality worldwide and a major contributor to morbidity and chronic adult disability. To study the prognostic significance of serum cortisol and serum albumin in patients of ischemic stroke was the objective.Methods: This hospital based observational cohort prospective study was undertaken in the Department of Medicine in collaboration with the Departments of Radio diagnosis and Pathology, Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh from January 2017 to November 2018. By convenience method for sampling, 102 patients who were admitted with the diagnosis of acute ischemic stroke to IPD of JNMCH, Aligarh, on clinical as well as radiological grounds were taken into study.Results: Mean cortisol was 450.84±190.35 nmol/L. The (mean±SD) of serum cortisol was 258.10±77.91 ng/ml in patients with good outcome and 585.77±113.34ng/ml in patients with poor outcome. (p<0.05, r= 0.812). Mean serum albumin was 2.83±0.76 gm/dl. The (mean±SD) of serum albumin was 3.47±0.64mg/dl in patients with good outcome and it was comparatively lower in patients with poor outcome (2.38±0.45mg/dl).  (p <0.01, r=-0.659).Conclusions: Serum albumin, serum cortisol are prognostic indicators of functional outcome at 3 months in patients of ischemic stroke.
High sensitivity C-reactive protein level in cerebrovascular accident
Authors: Rajesh Kumar Sonal , Vidya T. A.
Published: March 2020

Background: Stroke is the second leading cause of death worldwide according to WHO. High sensitivity C-Reactive Protein (hs-CRP) is an acute phase reactant which is being studied extensively to delineate its role in development of stroke as well as in prognostication.  This study was done to assess correlation of hs-CRP with risk factors of stroke and its association with types of stroke and prognosis.Methods: A prospective case control study of 100 patients with acute stroke along with 100 controls was conducted with informed consent.  At baseline, hs-CRP levels were measured and Modified Rankin Scale (MRS) was assessed. On day 90 the Modified Rankin Scale was assessed again. Patients were divided into groups based on hs-CRP levels and MRS and the results were analysed.Results: Prevalence of stroke was more in men than women (p=0.0002).  Statistically significant difference was found between mean hs-CRP levels in men (4.722±0.8982 mg/L) and women (4.133±0.9446 mg/L) (p=0.005) and between cases and controls (p=0.0003). There was no significant association with type of stroke (p=0.456).  Mean total cholesterol levels between cases and controls showed statistically significant difference (p=0.0005). High MRS was significantly associated with high hs-CRP levels (p=0.003).  Higher hs-CRP on day 1 correlated with higher MRS on day 90.Conclusions: hs-CRP level is increased in stroke and shows significant association with severity of stroke and prognosis.
An observational study of the evaluation of fatty liver in non-alcoholics with metabolic syndrome using fatty liver index and its correlation with USG elastography
Authors: Danasekaran Vaishnavi , Narayanan M.
Published: March 2020

Background: NAFLD (Non Alcoholic Fatty Liver Disease) is being considered the hepatic component of metabolic syndrome. It is now the most common cause of chronic liver disease worldwide and needs to be addressed urgently as it is asymptomatic and widely prevalent and can progress to cirrhosis and hepatocellular carcinoma. There is a need for simpler methods to diagnose the condition in modern day practice which will help in identifying vulnerable subjects and in bringing  about awareness and lifestyle modifications focused on reversal of the condition. Aim of this study was to check the applicability of the fatty liver index in modern day out patient practice using formula based FLI calculator.Methods: It was a cross sectional study on patients with metabolic syndrome in a tertiary care hospital. 60 patients with metabolic syndrome, both male and female above the age of 30 years and who were non-alcoholics were enrolled in the study. BMI, waist circumference, lipid profile and GGT were obtained and FLI calculated. It was compared with the ultrasound and Elastography reports. Chi square test, Independent t test and ANOVA test were used for comparing parameters. A p value of <0.05 was considered statistically significant.Results: Among 60 patients all had fatty liver which emphasizes that fatty liver is the hepatic component of metabolic syndrome. There is a significant correlation between BMI (Body Mass Index) and waist circumference in predicting fatty liver and to some extent its grade. Patients with higher BMI had a greater grade of fatty liver.Conclusions: The fatty liver index is a reliable predictor of fatty liver in people with metabolic syndrome. The grade of fatty liver increases with increase in waist circumference and increased BMI. Ultrasound and Elastography are reliable non invasive methods of detecting fatty liver. BMI and Waist circumference are strong predictive factors for fatty liver.
Seroprevalence of hepatitis C virus among patients at a tertiary health care centre in Rajasthan, India
Authors: Mathur Ajay , Goyal Laxmi Kant , Sharma Manoj Kumar , Gupta Arvind Kumar , Hooja Nupur , Yadav R. N.
Published: March 2020

Background: To ascertain the prevalence of Hepatitis C infection among patients visiting a tertiary care center in Jaipur, Rajasthan.Methods: An observation analytic study was done at a tertiary care center affiliated to Medical College with retrospective analysis of the hospital data of two calendar years. During this period HCV infection screening (anti-HCV) was offered to every suspected patient admitted in hospital and every pregnant women visiting antenatal care clinic.Results: The study prevalence of HCV infection was 0.05% (13/25311). The prevalence was more in female (0.03%) than male (0.02%). The study prevalence of anti-HCV among pregnant female was 0.02% (3/16224). Maximum positive cases (4/13, 30.77% positive cases) were in the age group of 21-30 years (sexually active group) and >50 years age group while minimum positivity was found in children (00 case, 0-20 years age).Conclusions: In this study, prevalence of HCV infection was 0.05%. The study prevalence of HCV among pregnant females was 0.02%. Maximum positive cases (4/13, 30.77% positive cases) were in the age group of >50 years and 21-30 years. This study aids in view to strengthen proper screening for HCV infection to reduce HCV related morbidity and mortality
A cross sectional study of lipid profile in stroke patients
Authors: C. Nirmala A. , S. Hrishikesh
Published: March 2020

Background: Atherosclerosis affects multiple vascular beds, accounting for nearly all of coronary heart disease and some proportion of ischemic strokes. Serum lipid levels have an effect on the short-term mortality due to strokes. But in some studies, there was no dyslipidemia in patients who presented with acute stroke. It is important to evaluate the serum lipid levels in both the types of strokes to guide lipid lowering therapy which can reduce incidence of stroke and related mortality. This study is undertaken to evaluate the role of serum lipids in patients of stroke in our centre.Methods: It is a cross sectional study, conducted on 176 patients of stroke, who were assessed by NIHSS stroke scale clinically. Serum lipid profile was measured in all patients. Data was entered in Microsoft Excel and analysed by descriptive statistics. Chi Square test was used for association of qualitative variables. A p value<0.05 was considered statistically significant.Results: In this study conducted on 176 patients, LDL values were deranged more in CVA-bleed group compared to CVA-infarct group. BMI was the best anthropometric measure that correlated with LDL. LDL was also the most common parameter that was deranged in nonsmokers (61.8%) whereas in smokers, total cholesterol (66.3%) was most commonly deranged. Triglyceride and VLDL values were deranged more commonly in diabetic group than in non-diabetic group.  A total of 123 out of 145patinets with CVA- infarct, had deranged lipid profile and among patients with CVA- bleed 24 out of 32 had deranged lipid profile.Conclusions: Results of this study shows significant derangement in lipid profile especially in LDL cholesterol levels in both infarct and bleed group, therefore starting statin therapy would prove to be beneficial in preventing recurrence of stroke.
Study of the prevalence of isolated vitamin B12 deficiency related dementia in patients presenting to a tertiary care hospital
Authors: Reddy Patirla Devendra , Seela Pranavendra Nath , Rao Maske Pravin Gulab
Published: March 2020

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.
Synovial cell sarcoma of the pleura: an uncommon cause of a haemorrhagic pleural effusion
Authors: Choudhary C. R. , Desai Govind , Verma Lokesh , Yogi Suresh Kumar
Published: March 2020

Soft tissue tumors account for a small percentage of malignancies and synovial sarcomas account for 10% of soft tissue tumors in our body, among them are the synovial sarcomas (SS).These arise from various sites and are of mesenchymal origin, Primary pleural synovial sarcomas are very rare tumours and account for not more than 0.5% of lung malignancies, they are being diagnosed mainly by the immunohistochemistry and classical cytogentic translocation t(x;18). This tumor has no sex preference and is commonly seen in the age group of 30-45.Our case is of a elderly male with massive pleural effusion who was diagnosed as having biphasic variant of synovial sarcoma of pleura by the help of immunohistochemistry. Treatment is mainly surgical resection and chemotherapy with ifosfamide/ adriamycin or radiotherapy. It must be considered as differential for biopsy proven malignant mesothelioma and hence immunohistochemistry should be must for all biopsy proven mesotheliomas.
Digital infarct and mononeuritis in a middle aged female: always suspect Antineutrophil cytoplasmic antibodies associated vasculitis
Authors: Majumdar Avirup , Atam Virendra , Pandey Saurabh , Singh Prashant , Chauhan Himanshu
Published: March 2020

Vasculitis is a process caused by inflammation of blood vessel walls and results in a variety of disorders.  Small-vessel vasculitis (vasculitis involving arteries, venules and capillaries) should be suspected in any patient who presents with a multisystem disease that is not caused by an infectious or malignant process. Testing for Antineutrophil cytoplasmic antibody (ANCA) is the basis of classification of small vessel vasculitis into ANCA associated and non - ANCA associated vasculitis. Apart from cutaneous manifestations like palpable purpura and vasculitic urticaria, digital gangrene in a patient with evidence of mononeuritis multiplex is highly suggestive of ANCA associated vasculitis (AAV). Clinically most of these vasculitides have overlapping clinical presentations and similar treatment. Early diagnosis and rapid initiation of treatment of AAV is recommended rather than ordering for definitive tests (e.g. histopathology or angiograms) since delay in treatment can result in serious end organ damage (pulmonary or renal).
A review of role of uric acid in acute ischemic stroke: changing trends
Authors: Balasubramani Soorya Narayanan , Kuppuswamy Jeyapalan
Published: March 2020

Uric acid, a powerful and potent antioxidant. Effect of uric acid in acute stroke was a controversy. Chronic hyperuricemia is atherogenic. But in recent days various articles were published about the antioxidant and the beneficial effects of uric acid due to cerebral antioxidant effect. In this article, we had reviewed various articles which discuss the major beneficial and deleterious effect of uric acid in neurological diseases to conclude the effect of uric acid in the scenario of acute ischemic stroke. This review was conducted through an Internet search on a public access website like PubMed, Google Scholar, Cochrane library, ProQuest and Medline databases until 2019. Keywords utilized included uric acid (UA), Acute ischemic stroke, neuroprotection, stroke therapy, and vasculoprotection. Total of 10 article from literature was reviewed, the major exclusion criteria were the studies that included patients which coronary artery disease, chronic kidney disease, Metabolic syndrome and patients who are taking drugs that influencing the uric acid levels. Chronic hyperuricemia is atherogenic and it had a negative impact on outcome in stroke, but in acute setting resent days various papers had been published about the beneficial effect of uric acid due to its antioxidants property. This was further supported by the co administration of Intravenous uric acid along with thrombolysis for acute ischemic stroke. Hence, we had concluded that, uric acid had a beneficial effect in a setting of acute ischemic stroke.
A review of relationship between platelet indices and microvascular complications in type 2 diabetic patients
Authors: Subramanian Subashini , Green Siva Ranganathan
Published: March 2020

Diabetes is a common metabolic disorder affecting the world population which accounts for major amount of morbidity and mortality mainly due to its micro vascular and macro vascular complications. This is a comparative study which analyses the correlation between the Platelet indices like Mean platelet volume, platelet distribution width, plateletcrit and total platelet count in diabetic patients with micro vascular complications and without complications. This review of the literature was conducted through an Internet search on a public access website like PubMed Google scholar, Medline databases until 2019. Keywords utilized included Diabetes mellitus, Microvascular complications, platelet indices. The major exclusion criteria was studies which included the patients with macrovascular complications and patients taking drugs which alters the platelet indices. All these articles were analysed. Platelet indices like Mean platelet volume and platelet distribution width was significantly higher in individuals with microvascular complications, predominantly Diabetic Nephropathy and Diabetic Retinopathy when compared to those without microvascular complications. Change in platelet indices were found to be statistically associated with diabetic microvascular complications. Hence these parameters can be used to monitor and to predict the risk of microvascular complications.
A study to determine the incidence of otitic barotrauma during hyperbaric oxygen therapy
Authors: R. Karthik Madesh , Naga Rahul , A. P. Arjun , Pyadala Nagababu
Published: March 2020

Background: Hyperbaric oxygen therapy (HBOT) is approved as a treatment modality for large number of indications and Middle ear barotrauma is one of its most common side effects.

Methods: A prospective study was done on 100 patients involving 1216 HBOT sessions for a period of 2 years on all those undergoing HBOT in our hospital.  

Results: 19 patients which was 1.56 per 100 treatment sessions developed otitic barotrauma with severity from grades I to III, maximum in II and none in IV to V. All resolved with temporary break in HBOT and treatment conservatively. The incidence of barotrauma was significantly less, probably due to the proper counselling, pressure equalization techniques and precautions.

Conclusions: HBOT can be used as a safe treatment modality and the incidence of otitic barotrauma can be minimized with pressure equalization techniques and precautions during the therapy sessions.
Role of topical phenytoin in treatment of chronic venous ulcers
Authors: Singh Santosh Kumar , Lata Sneh , Gupta Anil Kumar , . Rajkumar
Published: March 2020

Background: Venous leg ulcers are a common cause of significant morbidity leading to compromised quality of life and a huge financial burden on patients. Apart from the systemic therapy, many topical agents are available to accelerate healing in these ulcers. Topical phenytoin is one such agent which has been studied for promotion of wound healing. The aim of the study was to study the efficacy of topical phenytoin in healing of chronic venous ulcers.

Methods: 56 patients of chronic venous ulcer were randomly divided in two groups of 28 each. First group was given daily dressing of phenytoin in normal saline (group A) and second group was given only normal saline dressing (group B) for a period of 8 weeks. After 8 weeks the reduction in size of ulcer was measured, on the basis of which results were calculated.

Results: The mean age of the patients was 50.29±13.37 years. The mean duration of ulcer was 10.13±4.66 weeks. Compared to the conventional normal saline dressing, patients given phenytoin and normal saline dressing showed far greater tendency to heal (p=0.02). 35.7% patients in phenytoin group showed excellent response out of which 21.42% achieved complete healing, while in normal saline group only 14.28% patients showed excellent response and none of patient showed complete healing. No significant adverse effects were observed in either of the group.

Conclusions: Topical phenytoin appears to be a safe, easy, effective and inexpensive option to promote wound healing and can be used as an adjuvant for treatment of chronic venous ulcers. Further studies with larger population are merited.