bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of single submucosal fibroid in unmarried females with uterine artery embolization
Authors: Juneja Sunil Kumar , Kaur Gagandeep , Chaudhary Muskan
Published: January 2020

Background: Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis. The location of fibroids, whether submucosal, subserosal, pedunculated subserosal, intramural, or endocavitary, is important because signs and symptoms may be determined by location. Uterine artery embolization (UAE) for many patients is an effective alternative treatment to surgical therapy for fibroid tumors. It is a minimally invasive procedure, which allows for rapid recovery and return to normal activities. Objective of this study was to know the efficacy of minimally invasive technique UAE for reducing symptoms in sub-mucous uterine leiomyoma in unmarried females.Methods: This retrospective analysis was performed on 9 unmarried females with symptomatic single submucosal fibroid diagnosed on MRI with size range of 3.5 cms to 6.5 cms. They presented at Dayanand Medical College and Hospital, Ludhiana, Punjab in a period of 3 years from January 2016-December 2019. Inclusion criteria were unmarried females, single submucosal fibroid diagnosed on USG/MRI. Exclusion criteria was active infection, more than one fibroid in uterus, prior GnRH analogues treatment during the previous 3 months.Results: All patients presented with heavy menstrual bleeding (HMB) and dysmenorrhea, lower abdomen pain was encountered in 3 patients and 2 patients had inter-menstrual bleeding. Recurrent, UTI was there in 1 patient and 1 patient had vaginal discharge. All fibroids belonged to stage 1 FIGO classification. UAE was done and patients were followed for 6 months. Symptomatic success was seen in 100% patients and 77.77% patients expelled the fibroid per vaginally.Conclusions: UAE is alternative method of treatment for submucosal fibroids in unmarried females who do not want to undergo surgery. Proper case selection can give us good results and symptomatic relief.
Factors associated with breast cancer occurrence before the age of 40 in Yaoundé
Authors: Essiben Felix , Meka Esther JN Um , Ayissi Gregory , Essome Henri , Atenguena Etienne , Foumane Pascal
Published: January 2020

Background: In Cameroon, one third of breast cancers concern women less than 40 of age and young age appeared to be an independent predictor of adverse outcome. This study aimed to determine factors associated with the development of breast cancer before the age of 40 in Yaoundé.Methods: A case-control study was conducted for 7 months, from November 1st, 2016 to May 31st, 2017 at the General Hospital and the gyneco-obstetric and Paediatric Hospital of Yaoundé. Study compared the socio-demographic, clinical and lifestyle data of 50 women less than 40 of age with breast cancer (cases) with those of 200 women below 40 of age without breast cancer (controls). Descriptive statistics, bivariate and multivariate logistic regressions were performed to assess the socio-demographic, clinical and lifestyle data. Data were computed using the SPSS version 23.0 software. The significance threshold value was set at 0.05.Results: After multivariate analysis, the factors independently associated with the occurrence of breast cancer before the age of 40 were: age ≥ 30 (aOR = 2.05); family history of breast cancer (aOR = 8.65); parity ≥ 1 (aOR = 2.46); breastfeeding (aOR = 3.39); waist circumference ≥ 88 centimeters (cm) (aOR = 4.38); breast density ≥ 90                      (aOR = 2.89); physical activity ≤ 3 hours/week (aOR = 4.78). Conclusions: Breast cancer in women under 40 is associated with family history, reproductive life and women's lifestyles.  Breastfeeding more than 12 months, having a balanced diet, supplementary screening tests in women with dense breasts and practicing physical activity; would be  effective ways to prevent it in young women.
Diagnosis and management of benign ovarian tumors at the Ignace Deen Maternity Hospital of Conakry University Hospital in Guinea
Authors: Diallo Abdourahamane , Bah Ibrahima Koussy , Magassouba Aboubacar Sidiki , Diallo Mamadou Cellou , Y. Telly S.
Published: January 2020

Background: Benign ovarian tumors are a common reason for consultation and intervention in gynecology. The objective of this was to describe the clinical, ultrasonographic, histological and therapeutic aspects of benign ovarian tumors in the department.Methods: This is a retrospective and descriptive study of three years and six months from January 1, 2016, to June 30, 2019, which focused on the records of women-operated during this period of benign ovarian tumors.Results: The incidence of benign ovarian tumors was 12.58%. The circumstances of discovery were dominated by disorders of the menstrual cycle (35.05%) followed by infertility (20.78%), the sensation of a pelvic mass (19.48%), and pelvic pain. (15.58%). The ultrasound report was in favor of a serous cyst in 74% of cases, a mucoid cyst in 14% of cases, a 9% dermoid cyst, and a 3% endometriotic cyst. Histology revealed serous cystadenoma in 54% of cases, mucinous cystadenoma in 13% of cases, mature poly tissue teratoma in 7% of cases, and endometrial cyst in 3% of cases. Cystectomy was the most performed surgical procedure (71%).Conclusions: Benign ovarian tumors are common in our practice. The most common histological forms were serous and mucinous cystadenomas. Conservative treatment has been practiced in the majority of cases.
Etiological factors of abnormal uterine bleeding according to PALM- COEIN classification in perimenopausal women in a tertiary care centre
Authors: Mitra Nishi , Patil Pooja , Sethia Ayushi
Published: January 2020

Background: Perimenopause is described as years prior to menopause that encompasses the change from normal ovulatory cycle to cessation of menses, ending 12 months after the last menses. International federation of gynaecology and obstetrics (FIGO) developed a new classification PALM-COEIN in order to standardize the factors associated with AUB. It classifies AUB as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia (PALM) - structural abnormalities Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified (COEIN) - unrelated to structural abnormalities. Objectives of this study were to categorise the causes of AUB in perimenopausal women in context to PALM COEIN classification system. Correlation of co-morbities (diabetes, hypertension and thyroid disorders) with AUB in perimenopausal age group.Methods: This is a retrospective study from the month of May 2019 to October 2019, considering 100 patients of perimenopausal age group (40 to 55 years of age group) in J. K. Hospital Bhopal, Madhya Pradesh with complaints of abnormal uterine bleeding, admitted in gynae ward.Results: Most of the patients in the current study were between 45-50 years of age i.e. 44%. Menorrhagia was the commonest menstrual disorder encountered in 52% of patients. As per FIGO; AUB-L constituted 42% AUB-O constituted 12%, AUB-P constituted 11%, AUB-A 10%, AUB-M constituted 8% AUB-E constituted 8%, not yet classified constituted 4% of total cases.Conclusions: AUB (PALM-COEIN) for causes of abnormal uterine bleeding classification was very useful in categorizing cases of AUB. It suggests that etiology of AUB and also gives place for presence of multiple factors as a cause of AUB in a particular case.
Can we have many C-sections
Authors: Ghazal Kariman , Hajjar Charlote , Yared Georges , Chahine Rabih
Published: January 2020

The rate of cesarean section is increasing worldwide. It decreases maternal and fetal mortality when complications happen. However, it is a major surgery that could be associated with maternal and fetal risks especially after repeat cesarean deliveries. We report a case of a woman who had her 9th C-section.
An unusual case of ruptured noncommunicating rudimentary horn pregnancy at 10 weeks
Authors: Pande Kiran , Yadav Angela
Published: January 2020

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 10 weeks 3 days in a woman. She had a routine USG before pregnancy in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So, a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality.
Near death 18 weeks preeclampsia in molar pregnancy
Authors: Es Saad O. , Tanouti Saloua , Bkiyar H. , Mimouni A. , Housni B.
Published: January 2020

Authors present a case of a molar pregnancy of 18 weeks with preeclampsia complicated with acute pulmonary oedema. A condition carrying a significant risk to mother, therefore, raising an important issue on preeclampsia symptoms on pregnancies before 20 weeks. A 31-year-old woman gravida 2, parity 1 presented with dyspnea at 18 weeks' gestation. Blood pressure was very high (180/110 mmHg) and there was markedly proteinuria (+4). She had severe dyspnea and her oxygen saturation level was 75%. Her chest X-ray graph showed massive acute pulmonary oedema. Ultrasonography shows endometrial cavity containing multiple small cystic spaces, creating a characteristic “snowstorm” and “cluster of grapes” appearance. Markedly elevated quantitative human chorionic gonadotropin (250.000 mIU/mL). The acute pulmonary oedema has been managed by diuretics (Furosemide) and oxygen. There was no cardiac abnormalities in the tranthoracic echocardiogram. Authors administered antihypertensive therapy (intravenous nicardipine and lmethyldopa in per os), and magnesium sulfate in prevention of eclamptic seizures. The pregnancy was terminated by uterine evacuation under oxytocin infusion by manual ultrasound aspiration. She was followed up intensive care unit for two days. Causes of secondary high blood pressure had been eliminated. The patient's blood pressure rapidly normalized two days after delivery. Dyspnea disappeared one day later. Pathologic and cytogenetic analyses revealed a complete hydatiform mole. Two days after delivery; the serum β-hCG level was 99000 mlU/ml. A control ultrasonography shows an empty uterus. Hydatidiform mole is classified into 2 different subtypes, complete hydatidiform mole and partial or incomplete hydatidiform mole development of preeclampsia prior to 20 weeks of gestation should prompt a clinical evaluation to exclude the possibility of an underlying hydatidiform molar pregnancy. Ultrasonography and level of serum BHCG are the initial investigation of choice for the detection of hydatidiform mole. Aspiration is the treatment of reference.
Letrozole: an emerging array of hope for infertile women
Authors: Maladkar Manish , Tekchandani Chitra , Karchodi Akshata
Published: January 2020

Ovulation induction has been a major breakthrough in the management of female infertility since many decades. Letrozole, an aromatase inhibitor has been used as a potential therapy for ovulation induction. A large number of clinical evidences have been emerging which cite the beneficial role of Letrozole in conditions like anovulatory infertility, polycystic ovary syndrome (PCOS), unexplained infertility and an incipient role in endometriosis- related infertility with regards to higher live-birth rates. Letrozole is a superior alternative to Clomiphene citrate (CC) which has been used conventionally as ovulation inducer. Clomiphene citrate has certain well-defined disadvantages, whereas Letrozole overcomes these limitations to a reasonable extent. The peripheral anti-estrogenic effect of CC leads to prolonged depletion of estrogens receptors, adversely affecting endometrial growth and development as well as quantity and quality of cervical mucus. Persistent blockade of estrogen receptor leads to CC resistance and is associated with reduced ovulation and pregnancy rates. Available evidences suggest Letrozole is superior to CC owing to the lack of persistent anti-estrogenic action due to its short half- life and lack of action on estrogen receptors. This typically leads to monofollicular growth and also higher live birth rates. The current evidences suggest that Letrozole can be placed as first line therapy for the management of infertility due to PCOS and unexplained infertility.
Prevalence and professional implication of updated versus previous hypertension classification
Authors: Nsanzabera Charles , Sagwe Daniel Nyamongo , Ndengo Marcel
Published: January 2020

Background: Hypertension remains the global challenge and the leading causes of worse cardiovascular event with 7.5 million toll deaths. The 2010 WHO estimate was 1.3 billion representing 31.1% of all adults with an astounding increase in low and middle-income countries including Sab-Saharan Africa.Methods: This cross-sectional study was undertaken in two beverage industrial workplaces with a sample of 440 employees and their spouses during the period of 2016 to 2018. WHO stepwise questionnaire was used to collect data and biomedical samples were taken for predicting the 10-year cardiovascular risk by Cox regression model and multivariate logistic regression was run to determine the key factors associated with both Hypertension (HTN) classifiers. The data were coded and analyzed by SPSS 16.0 version.Results: Overall HTN prevalence was 32.27%, male with 37.8% and female with 25.2% by previous HTN classifier. Whereas the updated classifier showed an overall prevalence of 61.81%, male with 67.1% and female with 55%. The findings showed a huge difference of 29.54% with p<0.001 between the two prevalence of previous and updated blood pressure classification. Employees had a relatively high HTN prevalence of 35.92% to 65.18%, compared to the spouses with 26.47% to 56.47%, p<0.001 by previous and updated classification, respectively.Conclusions: The relatively rise prevalence of the HTN revealed by this study suggests new and combining health promotion tactics, cultural theories to fight this rampant silent killer.
A multi-institutional, cross-sectional study on disclosure of HIV status to sexual partner(s) and associated factors among people living with HIV/AIDS attending selected hospitals in Kigali, Rwanda
Authors: Mashora Moreblessing Chipo , Dzinamarira Tafadzwa , Ngomi Nicholas Njau
Published: January 2020

Background: In Sub-Saharan Africa, human immunodeficiency virus (HIV) remains a public health problem. There is need for evidence-based interventions to curb new infections. HIV status disclosure, especially to sexual partner(s) remains a critical step towards reducing viral transmission across sexual partners.Methods: A hospital-based cross-sectional study, conducted at HIV clinics of three selected hospitals. Systematic random sampling was employed to sample 384 people living with HIV/AIDS (PLWH). A pre-tested self-administered questionnaire was used to collect data.Results: Of the participants, 66% of the participants reported HIV positive status disclosure, with only 46% of these having disclosed to their sexual partner. Logistic regression analysis identified age (p value 0.035; AOR 0.94), being satisfied with counselling (p value 0.017; AOR 0.24), gender (p value 0.030; AOR 5.51) and education (p value 0.041; AOR 2.14) as factors associated with having disclosed HIV status. Being younger, satisfaction with counselling, being female and having attained at least secondary education were all associated with higher odds of HIV status disclosure.Conclusions: Based on the findings of the current study, it can be concluded that there is need to improve rates of HIV status disclosure among PLWH in Kigali, Rwanda. The current study findings have provided baseline information for the local health authorities, health care providers, policy makers and other scholars working in HIV epidemic control. The local health authorities can use this as a guide to develop a programme aimed to address the issue of non-disclosure of HIV status in Kigali City and hence help control the incessant spread of HIV infection.
Communication skills and its related factors in Ardabil Alavi Hospital nurses and staff
Authors: Zeynizadeh Somayeh , Pirzadeh Akbar , Tabrizian Shervin
Published: January 2020

Background: Communication skills (CS) is an important topic which help the nurses and staff to maintain effective relationships and have professional standards in all legal, ethical and clinical areas. So low level of CS between nurses could be led to more medical mistakes and reduce the patient’s quality of care. The aim of this study was to determine the level of CS among Ardabil teaching hospitals nurses and staff and its related factors.Methods: This descriptive-analytical study was conducted on 145 Ardabil Alavi hospitals’ nurses and staff from May 2019 to November 2019. The data collection tool was communication skills questionnaire of Burton G (1990) which included demographic data and interpersonal communication skills test (18 items) with a range of 18-90. Data analyzed in SPSS version 21 by using descriptive and analytical statistics tests such as; Spearman, Mann-Whitney U, and Kruskal Wallis at significant level of p<0.05.Results: Of all students, 72.4% were women and the rest were men. The average age of participants, was 36.9±8.4 years. The mean score of total communication skills was calculated 59.2±7.3. The mean score of verbal skill, listening skill, and feedback skill were calculated in order to 20.8±3.43, 17.6±4, and 20.7±3.2, respectively. Total Communication skills was significantly related with past work experience but other demographic variables hadn’t significant relation with CS.Conclusions: The results indicated that the CS of Ardabil hospital nurses and staff were in moderate levels. So, providing training programs for raising their CS in future is essential.
Analysis of statistic health care as indicators of efficiency service in Semen Padang Hospital through Barber Johnson graph
Authors: Nasution Nurhasanah
Published: January 2020

Background: The efficiency of service delivery is very important for hospitals. One measurement of service indicators that can be used is the Barber Johnson graph (GBJ). GBJ is needed to see and measure the level of service efficiency in hospitals. The indicators used are bed occupancy rate (BOR), bed turnover rate (BTR), turnover interval (TI), and length of stay (LOS). This graph can also be used to compare or view hospital developments at different times, and to increase the likelihood of changes in one variable by changing other variables. This research was conducted at Semen Padang Hospital (SPH), Padang, West Sumatera, Indonesia.Methods: The purpose of this study was to determine the statistical value of hospital and hospital service efficiency levels by using the Barber Johnson graphic. This research method is descriptive by direct observation of the medical record file of inpatients since the January to December 2017 period.Results: Statistical data obtained from SPH in 2018 showed the value of service days 30132, and the Number of beds 144 units. From the data processing results obtained a total bed occupancy rate 60.83%, bed turnover rate 6.86 times, turnover interval 2 days and average length of stay 3 days.Conclusions: Statistical data obtained from SPH in 2018 shows the value of BOR, TI is in an efficient, while BTR and LOS are inefficient.
Vulnerability to infectious and contagious diseases in daycare center teachers: an observational study
Authors: De Sousa Cicero V. L. , Gehrke Flavia de S. , Alves Beatriz da C. A. , Veiga Glaucia R. L. , Azzalis Ligia A. , Adami Fernando , Fonseca Fernando L. A.
Published: January 2020

Background: The risks caused by infectious and contagious diseases in the school environment are of importance to the conduct of early childhood education in the contemporary world. In this work authors aimed to analyze vulnerability to infectious and contagious diseases in daycare center teachers who work in public institutions in the Municipality of Fortaleza-CE, Brazil.Methods: This was aquanti-qualitative study approach of the descriptive, cross-sectional type, of an exploratory nature. This study was carried out with 30 daycare center teachers from the Municipality of Fortaleza from October to November 2016.   Results: The main infectious and contagious diseases that affect children in the daycare center were high rates of two or three comorbidities per child. Regarding the workplace risk to the teachers’ health, 58.6% of the teachers consider that the working in the daycare center does not bring greater risks of illness and 41.4% believe it does.Conclusions: Stress due to the presence of students with viral infections who need to remain in the daycare center, lack of hygiene, rest and inadequate nutrition contribute to the vulnerability to illnesses in the teachers.
Prevalence of non-cancer chronic morbidity in tobacco users among adults in Kolar district: community-based study
Authors: S. Harish , Prasad K. N.
Published: January 2020

Background: Tobacco contains many chemicals which causes cancer and chronic morbidities as evidenced from number of studies. Information regarding the chronic morbidities resulting from tobacco use was lacking in Indian setting. This study was conducted with the objective to find the prevalence of chronic morbidities other than cancer and oral conditions in tobacco users among adults in Kolar district.Methods: This is a community based, cross sectional study conducted in Kolar district among selected sample size of 1534 from six taluks during December 2018 to March 2019. The structured questionnaire was used to collect information at different geographical and social meeting places to represent the sample. The questionnaire contained information about sociodemographic, tobacco use and self-declared morbidity conditions.Results: Study subjects were aged between 18 to 80 years and the mean age was 53.7±18.2 years.  The prevalence of chronic morbidity was 14.4% in 1534 subjects and 24.2% in 521 tobacco users. Diabetes mellitus and cardiovascular diseases accounted for 80 percent of morbidities followed by respiratory and other systems. The odd ratio (OR) was 3.4 for tobacco users and chronic morbidities, OR for diabetes mellitus and cardiovascular diseases was 5-19 and 5-22 respectively.Conclusions: The prevalence of diabetes mellitus, cardiovascular diseases and other conditions are high among any form of tobacco use or consumption, illiterates, aged above 51 years and agriculture related workers compared to no tobacco users. There is a need of awareness about early detection of chronic morbidities to reduce the premature deaths and economic loss to the community.
Prevalence of iodine deficiency disorders and its determinants among school children aged 6 to 12 years in rural areas of Koppal district, Karnataka
Authors: Mane Vijaykumar P. , Yenkanaik Yuvaraj Banot , Nimbannavar Smita M. , L. Anilkumar , Holyachi Sharankumar , K. V. Chetana
Published: January 2020

Background: Iodine deficiency disorders are recognized as major public health problem in India and the simplest, most effective and inexpensive preventive method is the consumption of Iodized salt. The objective of this study is to estimate the prevalence of goitre among children aged 6 to 12 years in rural areas of Koppal district, to determine various factors associated with goiter among children, to estimate the level of urinary iodine excretion among urine samples collected from children and to estimate the level of iodine content among salt samples collected in the study setting.Methods: A cross sectional study was conducted for a duration of 6 months from June 2018 to November 2018 in rural areas of Koppal district among 3047 school children aged 6 to 12 years selected by cluster sampling technique. Goiter was detected and graded using standard techniques and the collected salt and urine samples were sent to MRHRU, Sirwar, Raichur for analysis. Data was collected using pretested and semistructured questionnaire and was analyzed using WHO Epi info software version 3.5.4.Results: The prevalence of goitre among school children in Koppal district was 442 (14.5%) and it was found to be significantly associated with age and source of drinking water. Majority i.e., 65.96% of urine samples had iodine content less than 100 µg/l and majority i.e., 79.15% of salt samples had iodine content less than 15 PPM.Conclusions: Goiter is mild public health problem in Koppal district with majority of urine samples excreting iodine below optimum levels and majority of salt samples being inadequately iodized.
Doctor-patient interactions with respect to type of practice
Authors: Hullur Himaad M. , Dandekar Ashlesha A. , Raje Swati S.
Published: January 2020

Background: The doctor-patient relationship is the core foundation for healing, care, establishment of trust and an essential part of modern-day medical ethics. The last few decades have seen an exponential growth in the scientific component of the medical field which has led to a strain on doctor-patient relationship. With the growing trend of patients wanting more information from their doctor in order to have a more active role in their health-care, active communication from the physician’s end is needed. Present study aims to find out what doctors over various fields expect out of this relationship.Methods: A cross sectional prospective study was conducted among a total of 49 urban and rural doctors of various specialities in an urban area of Maharashtra using a pre-structured questionnaire. The statistical tools used to analyse the data was by using Microsoft excel software.Results: It was also noted that time spent with patients was less by the specialists as compared with other doctors for all aspects of consultation. On evaluating experience with the duration of consultation, we noted that doctors having more than 30 years of experience gave lesser time for all aspects of consultation as compared to those with lesser experience. A close range, between 45%-57% of all physicians, admitted to answering phone calls during consultations.Conclusions:It is imperative to study doctor-patient interactions since a better relationship results in a more satisfied patient with better treatment outcome.
Attitude of researchers towards ethics committee at a medical research institute in Coimbatore: a cross sectional study
Authors: Ganesan Subhashini , Rajaragupathy Sujatha , Subramanian Kavitha , Karthikeyan Jayagowri
Published: January 2020

Background: The role of ethics committees has been well defined, but many researchers regard ethical review as a road block to research.Methods: To assess the attitude of the researchers towards the ethics committee, a cross sectional study was conducted among 80 researchers, which includes both faculty and undergraduate students at a medical research institute.Results: Our study shows that though most of the researchers agreed that ethics committee is mandatory, they felt that ethics committee review delays research projects, undermined the role of non-medical members in the committee, felt annoyed about the documentation and answering the full board queries and presentations.Conclusions: Study concludes that though the researchers have understood the critical role of ethics committee, they lack a positive attitude when it comes to the ethics committee functioning. Therefore, training should be conducted for researchers, which addresses these issues, so that the misunderstandings and conflicts are minimized.
Adverse drug reactions in patients taking anti tuberculosis therapy from directly observed treatment short course centre at Mandya Institute of Medical Sciences, Mandya: a cross sectional study
Authors: Kambale Shambhulinga , Subhas Babu P. , Goud B. Nagaraja , B. R. Harish
Published: January 2020

Background: Ending the tuberculosis (TB) epidemic by 2030 is among the health targets of the sustainable development goals. Side effects to anti-TB drugs are common and may lead to reduced compliance to treatment. These adverse effects must be recognized early to reduce associated morbidity and mortality. Objective of this study was to determine the adverse drug reactions (ADR) to anti-tubercular therapy among patients visiting directly observed treatment, short-course (DOTS) centre MIMS, Mandya.Methods: A cross sectional study was conducted at DOTS Centre MIMS, Mandya. TB patients registered at DOTS Centre during the year 2018 were selected for the study. Verbal informed consent was taken from the TB patients and interviewed using pretested semi-structured questionnaire. Data analysis was done using descriptive statistics and chi square test.Results: Among the study population (n=90), 67 (74.4%) experienced ADR among which 47.7% took treatment for ADR and the remaining 52.3% patients were given reassurance. In this study, gastrointestinal manifestations (42.3%) were the most common adverse drug reaction (ADR). Of the TB patients who experienced ADR, 9.0% of them had interrupted ATT, however they completed full course of ATT.Conclusions: A considerable number of TB patients taking ATT experience ADRs and some of them may have to interrupt treatment. However, they need to be counselled or supervised with caution to complete their course of treatment to reduce the chances of treatment default and also reduce the occurrence of drug resistance.
Influence of health warnings present on cigarette packets, on motivation to quit smoking, among smokers in a slum of Kolkata
Authors: Dalal Rajesh Kumar , Sarkar Dipanwita , Tiwary Narendra Kumar
Published: January 2020

Background: The Government of India by National Health Policy 2017 has set the target of relative reduction in prevalence of current tobacco use by 15% and 30% by 2020 and 2025 respectively. The Union health ministry had notified to mandatory display new health warnings to be covering 85% of the principal display area on all tobacco products (1 April 2016).Methods: This was an observational descriptive study with cross sectional in design carried out at Baghbazar slum in Kolkata with objective to study the smoking pattern, knowledge about health warning symbols (HWS) on tobacco products among the study population and to assess their motivation to quit and influence of HWS on their motivation. A total 66 smokers were interviewed using predesigned and pre tested questionnaire and analysis done using SPSS version 1.Results: About 83.3% study subjects were presently smoking and they were smoking daily, about 10 cigarette and bidi was smoked daily (median) and median duration without smoking was 1 month. About 63.6% study subjects were highly motivated to quit smoking. Health warning was definitely motivating them to quit smoking (p=0.01) but it was not resulting in actual quitting smoking (p=1.000). The main reason for motivation for quitting smoking was self-health related factor (84.6%).Conclusions: Health warning on cigarette packets increased the awareness about ill effects of smoking and motivated the smokers to quit smoking but not compelling them to quit smoking. Mostly those who were motivated to quit smoking were actually thinking about quitting due to other reasons.
Outcome of community based planned intervention targeting perceptions, attitudes and health seeking behaviour regarding cancers in New Delhi, India
Authors: Kotwal Atul , Seth Tulika , Thakur Rakesh , Rath G. K. , Sharma D. N. , Nagpal Jitendra
Published: January 2020

Background: Cancer prevention and control needs to be based on effective implementation of all approaches. Community as well as individual level interventions to increase knowledge and early reporting have shown effectiveness. A community-based intervention trial was conducted to design, implement and test short-term outcomes of evidence based preventive strategies.Methods: A mixed methods, three phased study was conducted in three districts of Delhi, which were selected by a random process. Two randomly selected districts out of these three were intervention districts while third was the control. A total sample of 500 in each district was studied in quantitative pre and post -intervention phases. Multistage, stratified, cluster sampling was utilized. Pre-tested and validated tools were used.Results: Post intervention, statistically significant higher scores were observed in all domains in intervention districts as compared to control (p<0.01). Though comparison of slum versus non-slum showed significant increment in knowledge and practice scores, with higher scores for non-slum respondents, the attitudes were very similar (p>0.05). The increment score changes between males and females was similar in all classes of society versus control district. Comparison within the intervention and control groups revealed increased scores in intervention districts and decreased scores in control district, in all domains (p<0.05).Conclusions: Our study has helped in understanding the determinants of perceptions, attitude and practices regarding cancer in the community, This, helped in formulating the need-based intervention strategies. Testing the short-term outcome of intervention showed it to be effective.
Children commute to schools in Bangalore urban and rural districts: travel pattern, behaviour and perceptions
Authors: . Manjunatha , Uthkarsh Pallavi Sarji , . Gangaboraiah
Published: January 2020

Background: Children form vulnerable road users during their regular school commute. School children safety is not taken into consideration before construction of road network. The total number of persons injured in India during 2015 near schools or colleges or educational institutions due to road traffic accidents are 13,270 in urban areas according to National Crime Records Bureau which is quite alarming. Current study is the first attempt in both rural and urban Karnataka towards understanding travel pattern, behaviour and perceptions among school children during commute to schools. The objectives of the present study were to assess travel pattern, behaviour and perception of school children in Bangalore urban and rural districts and to assess factors associated with travel pattern.Methods: A cross sectional study was conducted using a representative sample of schools selected by simple random sampling. Data was collected using a pre-tested, semi-structured questionnaire which was analysed using SPSS version 20.Results: Nearly 86% of school children travelled less than 5 kms to reach their schools. Nearly 39% of school children travelled alone to school. Most common mode of travel to school was by walk. Nearly 27.4% did not cross the main roads safely. Adherence to road safety behaviour was insufficient. Vehicular traffic was perceived as a major apprehension by children during school commute.Conclusions: Commute of children to schools in both urban and rural part of Bangalore was unsafe with least adherence to safety measures, which might increase their vulnerability to road traffic injuries.
Efficacy of vision therapy in impaired stereoscopic depth with intermittent exotropia (true divergence excess) with unilateral amblyopia: a case report
Authors: Gupta Reena , Jangra Richa , Dubey Gaurav , Hooda Ramesh , Parmar Nirmal
Published: January 2020

Divergence excess (DE) can be described clinically as exotropia at far greater than the near deviation by at least 10 prism dioptres (PD). We are reporting a rare case of 25-year-old female visited in the eye department for a routine eye check-up with a history of decreased vision in one eye. On examination, it was detected as a case of unilateral amblyopia with intermittent exotropia of true divergence excess with high accommodative-convergence over accommodation (AC/A) ratio. The patient was asymptomatic from exo-deviation due to the presence of binocular vision and good fusional reserve. The patient was started on active conventional vision therapy along with occlusion therapy. Post 16 weeks of constant therapy, a vision assessment with complete squint assessment along with binocular vision tests were performed. The result interprets to support the use of active conventional vision therapy as an integral part of the clinical treatment of amblyopia and intermittent exotropia. The rate of recovery of several monocular functions monitored during the vision therapy period provides the evidence of neural plasticity at multiple sites in the visual pathway in this adult amblyope. Therefore, if an ordered plan is being followed for the management of the patient of unilateral amblyopia and divergence excess, it can yield long-lasting improvement in visual acuity and binocular functions of any age.
Fatal dengue encephalitis in a recruit: lessons learnt
Authors: Pardal Maninder Pal Singh , Singh M. V. , Rath T. K. , Mustafa M. S.
Published: January 2020

Dengue infections may present within a widely variable spectrum of clinical manifestations. However, neurologic complications in general are rare and unusual. A 19 yrs old healthy male army recruit was brought to a service hospital in South India in a state of unresponsiveness, following 12 km route march. Despite aggressive and prompt management, his condition progressively deteriorated and he finally passed away about 10 hrs after reporting to the hospital. The final cause of death was acute dengue encephalitis with raised intracranial pressure. Epidemio-clinico-pathological correlation in this case led to the conclusion that vigorous exertion with a hyper-metabolic state of fever in a setting of encephalitis led to metabolic injury, multi-organ failure, cerebral edema and intracranial hemorrhage. Encephalitis following dengue virus (DENV) infection is a rare phenomenon with the incidence ranging from 0.5% to 6.2%. Neurological features associated with DENV were first reported by Sanguansermsri et al in 1976. The rare neurologic presentations reported with DENV infection are transverse myelitis, acute encephalomyelitis, myositis, and gullain barre syndrome. As encephalitis caused by DENV mimics that caused by other pathogens it should always be kept in mind while managing encephalitis of unknown origin. Medical officers should maintain a high index of suspicion of DENV encephalitis. Training of medical officers; therefore, needs to be undertaken with regular refresher cadres, besides equipping of all peripheral facilities with rapid diagnostic kits for dengue. The same will ensure prompt detection of cases and timely referral to higher medical centres in chain. The instant case reflects an important, potentially fatal, complication of dengue. Pathophysiology of DENV encephalitis needs to be elucidated on priority through research involving all stakeholders.
Elementy konstruktywistyczne w twórczości Iannisa Xenakisa (1922-2001)
Authors: Krzymowska-Szacoń Kinga
Published: January 2020

Iannis Xenakis (1922-2001) był kompozytorem nietuzinkowym. Zamiast studiów w konserwatorium muzycznym wybrał Politechnikę Narodową w Atenach. Zamiast przepisywać fugi J.S. Bacha, kreślił na papierze milimetrowym innowacyjne szkice architektoniczne. Milan Kundera nazwał go prorokiem bezuczuciowości, zaś Artur Honegger odmówił jego próbom kompozytorskim miana muzyki. W środowisku drugiej awangardy Xenakis zyskał sobie jednak niekwestionowaną, wiodącą pozycję za sprawą innowacyjnych technik kompozytorskich, opartych zarówno na regułach matematycznych (probabilistyka, teoria zbiorów i in.), jak i na kształtującej się wówczas technologii informacyjnej. Prezentowany artykuł ukazuje twórczość artysty w odniesieniu do założeń rosyjskiego konstruktywizmu – nurtu, który, choć rozwinął się w innym środowisku, okazał się jednak zaskakująco zbieżny z stylem Xenakisa, ukazując pewne uniwersalne tendencje w XX-wiecznej sztuce awangardowej.
Rozwój formuł melodycznych w staroruskiej monodii cerkiewnej na przykładzie dogmatyka tonu drugiego na podstawie wybranych zachodnioruskich irmologionów XVI-XVIII w.
Authors: Sawicki Daniel
Published: January 2020

W artykule autor dokonał analizy formuł melodycznych zastosowanych w dogmatyku tonu drugiego. W tym celu posłużył się wybranymi Irmologionami, zarówno tymi najstarszymi, pochodzącymi z terytoriów dzisiejszej Białorusi i Ukrainy, jak również śpiewnikami pochodzącymi z cerkwi unickich Południowego Podlasia, w szczególności Rokitna i Witoroża. Autor wskazuje na istotną rolę prawosławnych monasterów, a po zawarciu Unii brzeskiej (1596 r.) także parafii w rozwoju staroruskiego śpiewu cerkiewnego. W toku prowadzonych badań autor wykazał, iż pomiędzy melodyką dogmatyka tonu drugiego a tekstem zachodzi ścisły związek. Ponadto prowadzone badania ukazały, iż struktura melodii dogmatyka tonu drugiego oraz dobór formuł melodycznych, mimo upływu lat, nie uległy istotniejszym zmianom.
O języku i stylu w Vademecum biskupa Wilhelma Pluty
Authors: Rutkowska Joanna
Published: January 2020

Celem autorów tekstów z zakresu komunikacji języka religijnego jest przede wszystkim oddziaływanie na postawy i poglądy odbiorców. Język analizowanych rozporządzeń, mimo że jest prosty, zrozumiały, przystępny dla konkretnego odbiorcy, którym tu jest duszpasterz – formator grupy, odpiera tezę stawianą przez współczesnych językoznawców. Styl, w którym dominują przede wszystkim terminy z zakresu szeroko rozumianej teologii i komunikacji religijnej, wzmacnia funkcję nakłaniającą, zachowując jednocześnie gatunkowo-stylistyczne wyznaczniki tekstu religijnego. Wielość i różnorodność stosowanych środków językowych wzbogaca język i styl oraz składa się na modalność o złożonym charakterze. Funkcja perswazyjna pełni zatem rolę nadrzędną, zaś jej elementem składowym jest szereg środków językowo--stylistycznych, charakterystycznych dla wypowiedzi z zakresu języka religijnego.
Kierunki badań w homiletyce niemieckojęzycznej XXI wieku (cz. 1)
Authors: Szewczyk Leszek
Published: January 2020

Celem niniejszej publikacji jest przybliżenie najnowszych kierunków badań w homiletyce niemieckiego obszaru językowego. Ze względu na mnogość publikacji opracowanie podzielono na dwie części. W pierwszej omówiona została działalność Zrzeszenia Homiletów Niemieckich (AGH), seria wydawnicza Ökumenische Studien zur Predigt oraz podręczniki do teologii homiletycznej. W drugiej części zaprezentowano – na podstawie kilkudziesięciu opublikowanych w latach 2000-2018 monografii – kierunki badań w homiletyce niemieckojęzycznej.
İKİ ADAM BİR KURAM: HAAS ve SCHMITTER İLE NEOFONKSİYONALİZMİN KARAYİPLER TOPLULUĞU’NA YANSIMASI
Authors: KÖKSOY Fulya
Published: January 2020

Supranasyonel ve hükümetlerlerarası özellikleri içinde taşıyarak nev-i şahsına münhasır bir yapı olan Avrupa Birliği’nin, topluluktan birliğe evirilirken geçirdiği dönüşüm sürecinin analizi geçmişten günümüze önem arz etmektedir. Bu noktada, kökeni çok eskiye dayansa da II. Dünya Savaşı sonrasındaki konjontür doğrultusunda somut olarak 1950’lerde Avrupa bütünleşmesine yönelik başlayan sürecin teorik bir zeminde incelenmesi, topluluktan birliğe dönüşen ve içinde birbiriyle etkileşim içinde olan farklı niteliklere sahip bir yapının geçirdiği değişim sürecinin gözler önüne serilmesine yol açmaktadır. Ekonomik bütünleşmeden, siyasi bütünleşmeye evirilme hedefiyle yola çıkan, son dönemde tüm Avrupa’yı etkileyen çeşitli problemler yaşayan, henüz siyasi bütünleşme hedefine ulaşamayan ve yakın gelecekte bu hedefi gerçekleştirme olasılığı bulunmayan Birliğin kuruluşunda ve derinleşme döneminin ortaları (1950 ve 1960’lar) boyunca neofonksiyonalizm kuramının etkin olduğu bilinen bir realitedir. Bu minvalden hareketle çalışmada Avrupa bütünleşmesinde önem arz eden neofonksiyonalizm kuramı, kuramın iki önemli teorisyeninin varsayımları ekseninde analiz edilip, akabinde kuramın Avrupa dışındaki bir bölgede bulunan Karayipler Topluluğu (Caricom) üzerindeki işlerliği test edilecektir.
Türkiye-ABD-Rusya İlişkilerinde Karadeniz, 2000-2010
Authors: BAŞARAN Ali
Published: January 2020

Makalenin amacı Türkiye-ABD-Rusya İlişkilerinde Karadeniz’in yeri ve önemini 2000-2010 yılları için ortaya çıkarmaktır. Türkiye-SSCB-ABD ilişkileri Karadeniz kıyılarında II. Dünya Savaşından sonra dostça değil, düşmancaydı. Yöneticiler Karadeniz ve kıyı ülkeleri haritasına genelde savunma ve saldırı planları açısından bakmak zorunda kalmışlardı. SSCB’nin dağıtılması sonrası RF ve Türkiye yöneticileri Karadeniz ve kıyı ülkeleri haritasına barış ve refahı planlamak için baktılar. Ancak onların şüpheleri süregitti. Makalenin hipotezleri Putin (Medvedev) yönetimi döneminde Karadeniz ve çevre ülkelerinde ABD-RF sert rekabeti yaşanmıştır. RF rekabette öne geçmiş, RF’nun siyasi ve askeri yönden etkisi artmıştır. Türkiye, Yeltsin döneminde ABD’nin belirlediği politikalara yakındı. Türkiye, Putin döneminde daha ziyade kendi politikalarını belirleyip izlemiştir. Türkiye’nin kendi politikaları RF’nun Karadeniz politikaları ile daha uyumlu idi. Bu hipotezleri doğrulayan ya da yanlışlayan veriler toplanmıştır. Araştırmada odaklanan döneme ait gizli resmî belgeler meri mevzuata göre en erken 2030-2040 yılları arasında açılacaktır. Bu şartlar altında hipotezin sınanması açık kaynaklardan elde edilen bulgulara dayalıdır.
Interaction of higher plant ribosomal 5S RNAs with Xenopus laevis transcriptional factor IIIA.
Authors: Barciszewska M Z
Published: January 2020

In this paper transcriptional factor IIIA (TFIIIA) has been used as a probe for identity of three-dimensional-structure of eukaryotic 5S rRNAs. I was interested in finding a common motif in plant and Xenopus 5S rRNAs for TFIIIA recognition. I found that the two eukaryotic 5S rRNAs (from wheat germ and lupin seeds) are recognized by X. laevis TFIIIA and the data clearly suggest that these 5S rRNAs have very similar if not identical three-dimensional structures. Also effects of various conditions on stability of these complexes have been studied.
The dependence of electrophoretic and spectroscopic properties of the pyruvate dehydrogenase complex on mono- and divalent ions.
Authors: Pawełczyk T , Easom R A , Olson M S
Published: January 2020

The effects of various mono- and divalent ions on the pyruvate dehydrogenase complex (PDC) were investigated. To determine the radius of PDC under various conditions a two-dimensional agarose gel electrophoresis technique was used. The radius of PDC cross-linked with glutaraldehyde at ionic strength 0.04 M was calculated to be 22.0 +/- 0.1 nm. The presence of K+, Na+ or HPO4(2-) prevented changes in electromobility and of the calculated radius of PDC induced by alteration in ionic strength. The fluorescence emission spectra of PDC depended on the ionic strength and monovalent cations. The fluorescence intensity of PDC increased in the presence of 80 mM K+, and decreased in the presence of 80 mM Na+ with no shift in the emission maximum wavelength. Changes in the ionic strength to which PDC was exposed resulted in alteration of the UV absorption spectra in the 230 nm region. These alterations were prevented by HPO4(2-), whereas Na+ or K+ ions had no effect on the UV absorption spectrum of PDC.
A rare arrhythmia in the newborn: posterior fascicular ventricular tachycardia
Authors: YILMAZ Fatma Hilal , OFLAZ Mehmet Burhan , TARAKÇI Nuriye , GÜLTEKİN Nazlı Dilay , ALTUNHAN Hüseyin
Published: January 2020

Arrhythmias are most frequently seen in the neonatal period. Left posterior fascicular ventricular tachycardia is quite rarely seen in children and infants. In this case report, we present a newborn patient and management of left posterior fascicular ventricular tachycardia.