bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of grey zone sample testing of transfusion transmissible infectious diseases on safety of blood-experience of a tertiary care referral teaching hospital blood bank from South India
Authors: M. Anitha , V. Sreedhar Babu K. , D. Praveen M. , T. V. N. Sriranjitha
Published: July 2017

Background: Grey zone samples with optical density (OD) lying between cut-off OD and 10% below the cut-off OD (cut-off OD × 0.9) were identified during routine transfusion transmissible infectious disease (TTIs) screening. Enzyme-linked immunosorbent assay (ELISA) used for this purpose can sometimes fail to detect blood donors who are recently infected or possessing the low viremia. Estimation of a grey zone in ELISA testing and repeat testing of grey zone samples can further help in reducing the risks of TTI in countries where nucleic acid amplification testing for TTIs is not feasible.Methods: On performing repeat ELISA testing on grey zone samples in duplicate, the samples showing both OD values below grey zone were marked nonreactive, and samples showing one or both OD value in the grey zone were marked indeterminate. The samples on repeat testing showing one or both OD above cut-off value were labelled reactive.Results: Of the 21,908 blood donors screened during the study period, a total of 144 blood donors were found to be in grey zone. On repeat testing of these grey zone samples, 35 (24.30%) were found to be reactive for TTIs.Conclusions: Estimation of grey zone samples with repeat testing can further enhance the safety of blood transfusion in resource poor developing nations where more sophisticated and sensitive methods such as nucleic acid amplification test (NAT) is not available in all the blood banks.
Evaluation of Integrated Childhood Development Services (ICDS) program implementation in an urban slum of Delhi, India
Authors: Meena Jitendra Kumar , Verma Anjana , Kumar Rajesh
Published: July 2017

Background: The Integrated Childhood Development Services (ICDS) scheme is India’s foremost program imparting comprehensive and cost-effective services to meet the multi-dimensional needs of children. Following a populist approach, the program has now increased its umbrella coverage to reproductive age, pregnant and lactating women. The impact of such development and existing program performance remain debatable due to the paucity of evaluation research.Methods: A mix-methods descriptive case study was done using adapted ICDS monitoring tool in a pre-identified slum. The slum was purposely chosen for its intensive habitation of the poor and marginalized population. Primary data were collected through personalized interviews with program staff, health functionaries, and community representatives. Secondary data were collected from records available at Anganwadi centre (AWC). The data were triangulated and analyzed with results being expressed in narrative, simple proportions and percentages.Results: The mean coverage of ICDS services was 58.3%. Maximum coverage recorded for Supplementary Nutrition (SN) and minimal for Nutrition and Health Education (NHE). SN, immunization, Pre-school education (PSE) and growth monitoring (0-3 years) were regularly held. Maternal and child health services were unsatisfactory. Poor community perception reported for AWC and ICDS services with exception of SN.Conclusions: Present case study unveils poor infrastructure, coverage and community participation for ICDS services. Immunisation and referral networking is often dysfunctional reflecting the need for enhanced intersectoral cooperation. Adapted tools could serve as an effective strategy for evaluating and facilitating need-based improvements.
Perceptions about malaria among the Bedia tribal people in Uttar-Dinajpur district of West Bengal, India
Authors: Paul Uttam Kumar , Bhattacharyya Pramukh , Bhattacharyya Rituparna , Bandyopadhyay Arup
Published: July 2017

Background: In a tropical country like India, malaria is a major vector borne disease ranging from highly urbanised to deep rural areas. Though lots of health activities are going on against it in urban areas it is difficult to penetrate the deep rural areas particularly the tribal based interior villages because of lack of initiative, huge illiteracy, gross poverty and language problems. Therefore, a study was ventured in a rural community in North Dinajpur district of West Bengal, India occupied by members of scheduled tribe called 'Bedia' whose mother tongue is a tribal language called 'Nagori'- to understand their knowledge and perceptions about malaria so that future actions can be taken to uplift their health status and awareness particularly in relation to malaria.Methods: Present study have conducted three focus group discussions (FGDs), one with male participants, one with females and the third one involving both the sexes. There were 9-11 participants per FGD and total of 28 participants were included in the study.Results: The transcripts were at first coded and then categories were framed. Total six categories, which are: perceived causes of malaria, perceived features of malaria, mode of spread, treatment, difficulties and modes of prevention. After the content analysis of the transcripts conclusion was drawn.Conclusions: Through our field work and the focus group discussions on the Bedia tribes we understood several misconceptions and lack of awareness of the tribal community about malaria. However, it was possible to create awareness and confidence among them that they could take all preventive measures and positive approaches towards malaria.
Thrombocytopenia during pregnancy: an institutional based prospective study of one year
Authors: Pandey Anubha , Singh Roma
Published: July 2017

Background: Platelets are non-nucleated cellular fragments of megakaryocytes, they play a critical role in haemostasis. Thrombocytopenia, defined as blood platelet count below 150.000/μL is the second leading cause of blood disorders in pregnancy after anemia. It complicates 7 to 10% of all pregnancies. Gestational thrombocytopenia explains 70-80% of all cases of thrombocytopenia in pregnancy. Hypertensive disorders account for approximately 20% and immune thrombocytopenic purpura for about 3-4%. Other etiologies are considered rare in pregnancy.Methods: The study was conducted in the tertiary institute over a period of one year, from January 2016 to December 2016. The samples of blood were collected from the Antenatal out-patient department and from indoor patients of the department of gynecology and obstetrics of the J.K. Hospital, Bhopal, Madhya Pradesh India.Results: Maximum number of patients had moderate degree of anemia around 58%. Most of the cases presented during 30-34 weeks of gestation. The most common etiology was gestational thrombocytopenia.Conclusions: Thrombocytopenia in pregnancy may occur secondary to a variety of causes. Most of these cases occur during specific periods of gestation. Management of pregnant women with platelet disorders requires a multidisciplinary approach and close collaboration between obstetric and hepatologist.
Pattern of head injury in central India population
Authors: Pate Rajeshwar S. , Hire Rohan C. , Rojekar Mohit V.
Published: July 2017

Background: In India, the developing economy and growing population simultaneously made a strong impact on increase in motor vehicle population. This increase in motorization has some adverse effects such as increase in road accidents with economic and functional loss. Head injury is the most common cause of mortality in road traffic accidents. The aim of this study was to know the incidence, pattern, mechanism, mode of head injury along with its distribution in relation to site of vault fracture and intracranial hemorrhage.Methods: Total 391 post-mortem cases of head injury were enrolled during study period. The information regarding age, sex, residence, marital status, date and time of time of accident and of death was gathered from police inquest report, relatives, dead body challan and clinical details from hospital records. During autopsy, detailed examination was carried out and data regarding both external and internal injuries were carefully recorded and analyzed.Results: The peak incidence of head injury was observed in the age group of 21-30 years. Most of deceased were from early age group and the male deceased were more than females. Majority victims of head injury were from road Traffic Accidents followed by fall from height, railway accidents and assault. Fissured fracture of vault was found in almost half cases. Subdural and subarachnoid hemorrhage were the most common one we encountered.Conclusions: Head injury due to RTA is well known public health problem causing death and disability. It is required from concerned government authority to take appropriate and immediate measures for reducing the incidence of head injury.
Comparative evaluation of FESS and septoplasty with FESS in cases of DNS with chronic maxillary sinusitis
Authors: Thakur Kuldeep , Gupta Vikas Deep , Surya Mukesh , Ahluwalia Ajay
Published: July 2017

Background: Present study compares basic FESS and septoplasty with FESS alone in DNS with maxillary sinusitis.Methods: Sixty patients of DNS with chronic maxillary sinusitis were divided into two groups alternatively. After pre-operative symptoms score and computerized tomography (CT scan), twenty patients underwent FESS with septoplasty (group A) and other 20 underwent FESS alone (group B) under local anaesthesia and topical 4% lignocaine with 1:1000 adrenaline. At 6 weeks, post-operative symptom score and CT scan findings were documented and compared statistically by using unpaired student t-test.Results: Ninety six percent of patients in group A and 87.6% in group B have shown complete improvement in facial pain/pressure. Ninety three percent of patients in group A and 83.3% in group B have shown complete improvement in headache. Ninety percent patients in group A and 63.3% in group B has shown complete improvement in nasal obstruction. Seventy six percent of patients in group A and 63.3% of patients in group B have shown complete improvement in nasal discharge. Eighty six percent and 63.3% of patients in group A and group B respectively were satisfied from the surgery. Ninety three percent of patients in group A and 70% in group B were found to have normal maxillary sinus mucosa on HRCT nose and PNS after 6 weeks following surgical treatment. Hundred percent patients in group A and 96.7% of patients in group B were found to have normal OMC on HRCT nose and PNS 6 weeks after surgery.Conclusions: It was observed that FESS with septoplasty is effective for the treatment of chronic rhinosinusitis with deviated nasal septum on VAS as well as radiologically (the Lund and Mackay staging system: radiologic staging) than FESS alone.
Effect of cissus quadrangularis linn and zingiber officinale rosc in osteoarthritis patients
Authors: Viswanath J. , Cheekavolu Chakrapani , Sankaraiah S. , Dixit Renu
Published: July 2017

Background: To evaluate the efficacy of Cissus quadrangularis Linn. or Zingiber officinalis Rosc. or in combination treatment of osteoarthritis which reduces joint pain, joint swelling and tenderness without risk of side effects.Methods: Total 60 patients were selected and divided into 3 groups (each group consist of 20 patients); data were collected before and after treatment of following groups: Group A-Cissus quadrangularis linn-5gm; Group B- Zingiber officinale rosc-5gm; Group C-Treatment of Cissus quadrangularis linn combined with Zingiber officinale rosc-5 gm/dose twice a day with luke warm water.Results: 60 % cases of joint pain were relieved at the end of the treatment in group B & C, in group A 50%, reduction in joint pain extremely significant in all groups A, B, C (p<0.0001). ‘C’ 80%, ‘A’ 15% and ‘B’5% reduction in symptom of Joint swelling and which is very significant in group A, and group B (p<0.001) and extremely significant in group C (p<0.0001). Symptom of tenderness ‘C’ 90%, ‘A’ 85%, and ‘B’ 10% cases were relived from the complaint. The difference in tenderness is statistically extremely significant when compared between groups (p<0.0001).Conclusions: Present study reveals that, significant reduction of joint pain, joint swelling and tenderness after treatment of Cissus quadrangularis Linn. or Zingiber officinalis Rosc. and extremely significant reduction of joint swelling and tenderness in combination therapy.
Diagnostic yield of video capsule endoscopy in obscure occult gastrointestinal bleed
Authors: Gaikwad Nitin R. , Gupta Sudhir J. , Sankalecha Tushar H. , Kothari Harit G.
Published: July 2017

Background: Gastrointestinal blood loss is the leading cause of iron deficiency anemia in developing world. Many patients had normal findings on initial upper and lower gastrointestinal endoscopy. When such patients present with stool occult blood positivity, it’s an indication to evaluate small bowel by video capsule endoscopy for detecting possible source of bleeding. Aim was to know the diagnostic yield of video capsule endoscopy in anaemic patients with occult gastrointestinal bleed.Methods: In this retrospective study, we evaluated all the data of video capsule endoscopy which were done in patients with obscure occult gastrointestinal bleed.Results: Total sample size was 21 patients. M:F ratio was 1.6:1 Average age of patients was 51.52±6.3 years. Youngest patient was of 16 years and Oldest patient was of 78 years. Video capsule endoscopy was normal in 8/21(38.09%), and had positive findings in 13/21(61.90%). Most common finding was aphthous ulcer in jejunum and ileum in 19.04%. Followed by Telangiectasia in 14.28%, NSAID enteropathy in 4.76%, Jejunal diverticulosis in 9.52%, celiac disease, xanthelasma, enteroliths in ileum, ileal nodularity in 4.76% each. Complication occurred in one patient (4.76%) in the form of retention of the capsule, which was retrieved by double balloon Enteroscopy.Conclusions: Video capsule endoscopy has a good diagnostic yield of around 61.90% in patients with obscure occult gastrointestinal bleed. It is best performed during ongoing bleed or immediately thereafter. Careful patient selection and repeating the upper and lower GI Scopy before video capsule endoscopy can be a reliable option before video capsule endoscopy to prevent complication.
Efficacy of sublingual nitroglycerine spray in attenuation of hemodynamics to tracheal extubation
Authors: Tagalpallewar Ameya Arun , Ambare Bhushan M. , Agrawal J. N. , Masare Monika S.
Published: July 2017

Background: The present study was undertaken to evaluate efficacy of nitroglycerine (NTG) spray for attenuating haemodynamic response to tracheal extubation in normotensive and hypertensive patients.Methods: The study enrolling total 120 ASA I and II patients, (60 normotensive and 60 hypertensive) who had undergone elective surgery under general endotracheal anaesthesia. Both these types of patients were randomly subdivided into two groups of 30 patients each -50% receiving NTG spray and 50% not receiving NTG spray.Results: There was significant increase in heart rate in all four groups after NTG spray. During extubation this increased in heart rate was not statistically significant in group A (Normotensive with NTG) but was significant in group C (hypertensive with NTG) when compared with control groups. Similarly, during extubation there was significant rise in systolic, diastolic and mean arterial blood pressure were noted in all four groups and with use of NTG spray the increase could be significantly attenuated in NTG groups. Increase in heart rate along with reduction in blood pressure seen after NTG spray did not produce significant increase in RPP as compared to hypertensive and normotensive patients who did not receive the NTG spray.Conclusions: Sublingually administered nitroglycerin spray in a dose of 0.8 mg prior to extubation is an effective, practical, easy and relatively safe method in attenuate haemodynamic response to tracheal extubation.
Modified hematological sepsis score in early diagnosis of neonatal sepsis
Authors: Krishnamurthy Vani , Thandaveshwar Deepti , Doreswamy Srinivasa Murthy
Published: July 2017

Background: Diagnosis of neonatal sepsis at an early stage substantially reduces the mortality. The clinician often relies on laboratory parameters to support the clinical suspicion. As blood culture takes time and yield is low, hematological and biochemical parameters often guide to the diagnosis and management. Rodwell’s Hematological sepsis score (HSS) has a reasonable sensitivity but low specificity. Some of the parameters included in that scoring system are repetitive of same pathogenic mechanism. A modified HSS was developed by the authors by removing the repetitive parameters, increasing the weightage for low neutrophil count and adding a new parameter - nucleated RBC. Objective of the study was to compare the diagnostic ability of the modified hematological sepsis score with Rodwell’s hematological sepsis score.Methods: Prospective analytical study conducted in a tertiary level hospital. Neonates admitted to NICU and had complete blood count done were included. Babies with clinical signs of systemic inflammatory response syndrome and evidence of organ dysfunction were considered septic. They were classified as proven sepsis if the blood culture was positive. All the samples were scored for both HSS and modified HSS. The sensitivity, specificity and other diagnostic ability tests were compared between the two scoring systems.Results: Total of 75 neonates were enrolled. 25 of them had sepsis and three had blood culture positive. At a score of 3, the sensitivity and specificity of HSS was 80 and 70% and that of Modified HSS was 84 and 82% respectively.Conclusions: Modified hematological score improves the specificity and likelihood ratios without decreasing the sensitivity in early diagnosis of neonatal sepsis.
Awareness study of Pharmacovigilance among the health care professionals (nursing staff) at tertiary care hospital, Solapur, Maharashtra, India
Authors: Patil Amruta Pasgonda , Shirure Prashant A. , Khobragade Rasika S.
Published: July 2017

Background: Early detection of adverse drug reaction is one step towards the prevention of ADRs. Foundation of Pharmacovigilance is spontaneous reporting which is minimal in India. Among the all health care professionals, nurses are caregivers at bedside. Improvement in knowledge and practice of adverse drug reaction reporting among nurses will definitely increases spontaneous reporting. In this study, knowledge, attitude and practice of nursing staff about pharmacovigilance was evaluated.Methods: It was prospective, cross-sectional, observational, questionnaire-based study among the nurses of the tertiary care hospital Solapur. A questionnaire evaluating knowledge, attitude and practice was distributed among nursing staff and filled questionnaire were collected back and analyzed by microsoft excel 2013.Results: Response rate of our study was 44.88%.  38.61% doctors were knowing meaning of pharmacovigilance while 61.38% participants knew that all drugs available in market are not safe. Taking proper medication history before prescribing drugs was considered important by 92.57% participants. 79.70% participants were aware about Pharmacovigilance program of India. 64.35% doctors answered correctly to elements which are mandatory to record. Only 24.75% participants were knowing the basis that pharmcovigilance provides for.Conclusions: Nursing staff of tertiary care hospital, Solapur had very appreciable and positive attitude towards pharmacovigilance but there is a need for improvement in knowledge and practice of ADR reporting.
Age at menarche and the menstrual pattern of secondary school adolescents in central India
Authors: Ambade Rakhee , Sagdeo Mohan
Published: July 2017

Background: Population studies on characteristics of menstrual cycles are scarce. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.Methods: A cross sectional study was conducted and 622 school girls were selected randomly. A pretested questionnaire was used to gather data.Results: Mean age of participants was 16.9 ± 1 years. About 92.2% had attained menarche. Probit analysis of the status-quo data yielded median age at menarche of 14.8 (13.9-15.3) years and by recall method to be 15.8 ± 1 years. The mean age at menarche was, significantly, 0.3 years younger for urban females compared with rural ones. Cycle length between 21-35 days was observed in 70.3% of the girls. Mean duration of flow was 4 ± 1.3 days. Menstrual cycles were irregular in 42.8% of the subjects. Overall prevalence of dysmenorrhoea was 72%. and of PMS was 75.4%.Conclusions: Age of menarche was found to be significantly delayed. Considerable number of students complained of dysmenorrhoea and premenstrual symptoms.
Comparative evaluation of different culture media for the isolation and identification of common urinary pathogens
Authors: Chaturvedi Aarti , Garg Ritu , Singh Varsha A.
Published: July 2017

Background: Urinary tracts infections (UTIs) are one of the most common infections encountered in hospital as well as community settings. There is continuous increase in incidence of this infection leading to more consumption of antimicrobial drugs. Urine cultures occupy most of the workload of routine microbiology laboratories in developing country like India. Accurate and rapid identification of pathogens is the primary responsibility of a clinical microbiology laboratory.Methods: Mid-stream urine and catheterized samples were collected. Cultures were plated on blood agar, MacConkey agar and cysteine lactose electrolyte deficient media and incubated overnight at 35°C-37°C in ambient air. Colonies on the MacConkey agar, CLED agar and blood agar were also identified. The final identification of the isolates was done using standard identification protocol.  Antimicrobial susceptibility was performed by Kirby- Bauer disc diffusion test according to the CLSI guidelines.Results: Out of 500 urine samples processed, 211 samples showed significant growth, 24 samples showed polymicrobial growth and 265 samples were reported sterile.  Out of these 211, 199 showed pure growth and 12 showed mixed growths. Out of 199 pure growths, 126 were gram negative bacilli, 56 were gram positive cocci and 17 were yeast. All the gram-negative bacilli grown on all the media but most of the gram-positive cocci and yeast were unable to grow on Mac-Conkey agar and blood agar but grew successfully on CLED agar.Conclusions: So, in resource constrain laboratories, CLED agar can be used as media of choice for isolation of common uropathogens because it is user friendly, cost effective and decreases work load of the laboratories.
Serum zinc and copper levels: a marker of disease activity in senile cataract patients
Authors: Rai Pooja S. K. , Deokar Smita A. , Yadav Ravi R. , Shelke Sudarshan , Sundharan Shimi
Published: July 2017

Background: The present study was aimed to study alterations in levels of zinc and copper in senile cataract patients.Methods: 25 senile cataract patients in age group of 50 to 80 years and 25 control group were included in the study. Serum zinc and copper levels were determined by colorimetric method.Results: Significantly increased levels of serum zinc in cataract patients (199.8±24.32 µg/dl) were found as compared to controls (85.80±3.6 µg/dl) (p<0.0001). Serum copper concentration in cataract patients (249.5±34.59 µg/dl) were significantly (<0.0001) increased when compared to controls (125.7±4.66 µg/dl).Conclusions: Copper and zinc are involved in the pathogenesis of cataracts by different mechanisms such as damaging lipid membranes and lens capsule, crosslinking and in solubilization of lens proteins, leakage of beta and gamma crystalline into the aqueous humour through the production of hydroxyl radicals and peroxyl radicals. So, abnormal elevation of serum copper and zinc can be used as a marker in the opacification of the lens cortex in age-related human cataract.
Are health professionals serious about breast self-examination? a study from a medical college and tertiary level hospital of Central India
Authors: Kawalkar Aishwarya Narendra , Koparkar Anil Ramesh
Published: July 2017

Background: Breast cancer is increasing in prevalence all over the world and health professionals are having main responsibility to counter this rapid increase by early diagnosis and prompt treatment. Breast self-examination is cheapest, easy and most cost-effective way of screening of breast cancer. If health professionals themselves know, understand and practice BSE, then only they are expected to be oriented towards taking this tool seriously and include in their practice. Therefore, to study breast self-examination (BSE) among Health professionals in tertiary hospital this study was conducted.Methods: This cross-sectional study was conducted at a medical college and tertiary level hospital in Nagpur, from August 2016 to October 2016. All female Interns, female Post-graduate students, all female teaching staff in all clinical, para-clinical and non-clinical departments and nurses were included in the study. Total 400 Health professionals had participated in this study. Data entry and analysis was done using EPI-Info.Results: In this study, 93.75% of participants were having knowledge regarding BSE but only 86.36% practically knew how to do BSE. Moreover only 74.75% were practicing BSE (at least once in a month). Common reasons for not practicing BSE were ‘not having time’, ‘don’t feel it’s necessary’ and ‘feels awkward’.Conclusions: This study revealed that there is strong need of intervention in health professionals in making them aware of BSE, to improve knowledge and making BSE a universal practice them.
Diagnostic yield of TBNA and bronchial biopsy in lung cancer
Authors: Kumari Anita , Gupta Madhu , Abhesheik .
Published: July 2017

Background: Lung cancer has been the most common cancer worldwide since 1985, both in terms of incidence and mortality.  In India, approximately 63,000 new lung cancer cases are reported each year. The study was undertaken to detect diagnostic yield of bronchial biopsy and transbronchial needle aspiration in suspected cases of bronchogenic carcinoma.Methods: This was a prospective study including 57 patients having clinical and radiological features of malignancy. Endobronchial forceps biopsy (FB) and transbronchial needle aspiration cytology (TBNA) has been employed during fiber-optic bronchoscopy. The statistical analysis was done using chi-square test.Results: Out of total 57 patients, 43 were found malignant on FB plus TBNA. The majority of patients (59.45%) were found to have squamous cell carcinoma on biopsy followed by Adenocarcinoma (16.21%), Small cell carcinoma (13.51%) and untypable cases (10.81%). On TBNA majority of patients (41.93%) could not be typed into any of the specific subtype. Out of rest typable carcinoma majority were squamous cell carcinoma (35.48%). Sensitivity of TBNA in diagnosing lung malignancy was 67.6%. The yield of TBNA, FB and TBNA plus FB was 54.38%, 64.91% and 75.43% respectively. Additional yield of TBNA over FB was 10.52%.Conclusions: TBNA is a beneficial, safe and minimally invasive bronchoscopic technique and may be considered routinely during Fiberoptic Bronchoscopy procedure to increase the yield with insignificant side effects in the diagnosis of bronchogenic carcinoma.
USG and CT scan evaluation of patients of acute and chronic pancreatitis- a cross-sectional, comparative study
Authors: Bhatt Aastha , Tiparse Awdhut , Patel Arpita , Gandhi Birwa
Published: July 2017

Background: Pancreatitis is a condition of inflammation of pancreas with high rate of morbidity and mortality. USG provides the initial radiological assessment of the organ, clue of the extent of involvement and an opportunity to evaluate other abdominal organs. CT scan provides a cross-sectional anatomy of the organ, its internal structure, focal or diffuse involvement and involvement of adjacent structures. This study is done to evaluate the role of USG and CT scan in patients of pancreatitis admitted to Sir Takhtsinhji hospital, government medical college, Bhavnagar, Gujarat, India. Aim was to understand the role of CT and USG in determination of diagnosis of pancreatitis and to highlight and evaluate the cases in which USG failed to diagnose the cases which were helped through by CT.Methods: This study was done in department of radio diagnosis at Sir Takhtsinhji hospital, government medical college, Bhavnagar, Gujarat, India, over a period of one year from June 2015 to June 2016. Each patient was studied taking into consideration relevant clinical and laboratory factors. USG of patients was done using My Lab 40 or My Lab 20 plus machine. CT scan was done using GE 16 Slice CT scan machine.Results: Ultrasound by non-invasiveness, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However, USG fails imaging in conditions with excess of bowel gas or fatty patient. It lacks in detailed characterization of the inflammatory process and does not delineate extent of necrosis of the gland. CT is superior to ultrasound for precise detection of size, parenchyma, MPD, calcification, pseudocyst, ascites, pleural effusion, necrosis and peri pancreatic region and hence helps to determine exact extent of inflammation of the organ, multi-system involvement and prognosis.Conclusions: Ultrasound by non-invasiveness, easy availability, cost parameters, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However, ultrasonography lacks in detailed characterization of the extent of involvement of the organ and adjacent structures. CT is superior to ultrasound for precise detection and extension of the pancreatitis and it has better sensitivity and specificity than ultrasonography.
Primary sternal osteomyelitis mimicking a neoplastic growth
Authors: Vinod Nagadarshini Ramagiri , Tahir Hassan , Ahmed Arslan
Published: July 2017

Chronic osteomyelitis usually present as bony growth but it can rarely present as a soft tissue growth mimicking neoplasm and is usually diagnosed by the combination of radiology and microbiology. This is a case report of an adult male who had chronic osteomyelitis mimicking a neoplastic growth of soft tissue. CT scan showed soft tissue mass mimicking a soft tissue tumor but microbiology test and MRI confirmed the diagnosis of chronic osteomyelitis.
Hypersplenism in a young girl: managed non-surgically
Authors: Batra Tanvi , Gulati Shipra , Gokhale Vijayashree S. , Kakrani Arjun Lal
Published: July 2017

A 16-years-old female, non-alcoholic, presented with pain in left hypochondrium and distention of abdomen. Her USG Abdomen, portal vein doppler and CT abdomen revealed chronic thrombosis of intrahepatic portion of portal vein with multiple collaterals and gross splenomegaly suggestive of portal hypertension. Trans jugular liver biopsy showed no regeneration or fibrosis of liver. Endoscopy showed grade III oesophageal and gastric varices. Splenic artery embolisation was done for hypersplenism. Post procedure CT abdomen revealed large areas of splenic infarction-sequelae of splenic artery embolization.
Case of acute pulmonary embolism in post pneumonectomy-a rare clinical presentation and management
Authors: B. V. Manjunath , Sahoo Bhabani , Thakre Gaurav , Gudage Nitin
Published: July 2017

With a history of right pneumonectomy, pulmonary embolism affecting bilateral pulmonary artery is rare and needs to be meticulously managed to prevent pulmonary infarction of the normal lung with a clinical decision regarding thrombolysis. A 64 years male diabetic and hypertensive with a history of right pneumonectomy 10 years back, presented to ER with dyspnea and 2 episodes of syncope with right leg pain and swelling for 3 days. BP was 140/90mmHg and pulse rate of 100/min. SPO2 in room air was 95%. ECG suggested S1Q3T3 with sinus tachycardia. Echocardiogram revealed features of pulmonary embolism. Venous doppler of right leg showed DVT and CT Pulmonary angiogram was suggestive of pulmonary embolism. High-sensitive troponin I and NT-pro BNP were negative. Diagnosis of submassive pulmonary embolism was made. Protecting the normal lung from infarction was of paramount importance. There was no indication for thrombolysis. Treatment with LMWH was initiated and overlapped with the novel oral anticoagulant (NOAC) dabigatran. Symptomatically patient improved along with a reduction in pulmonary arterial hypertension and improved RV function. Post pneumonectomy of one lung, protecting the normal lung from infarction is utmost important in a setting of pulmonary embolism. It is a rare case scenario. Clinical decision regarding thrombolysis should be taken carefully. In this case thrombolysis was not indicated as per guidelines. LMWH, oral anticoagulation and broad-spectrum antibiotic to prevent secondary lung infection are the mainstay in the treatment of submassive pulmonary embolism where thrombolysis is not indicated.
Hepatocellular carcinoma in a case of hepatitis C
Authors: Suthar Pokhraj P. , Parmar Gaurav R. , Trivedi Chinmay , Vithlani Hemen I.
Published: July 2017

Hepatocellular carcinoma has incidence of 90% of all liver cancers. HCC is the second most common hepatic malignancy in children after the hepatoblastomas. Patients with hepatocellular carcinoma presents with symptoms like pruritus, splenomegaly, bleeding oesophageal varices etc. Computed Tomography of the liver can look for local spread and thorax can look for metastases. Our case was a 49-year- old hepatitis C positive female came with vague right upper quadrant abdominal discomfort with weight loss of 7 lbs in last 2 months. Mild icterus was present on examination. CT scan revealed a well-defined iso-dense lesion in the segment V of right lobe of the liver, which shows enhancement in the hepatic arterial phase and rapid washout in the portal venous phase. Laboratory investigations showed abnormal liver function test. The HCV RNA levels were 1.45×105 IU/ml by real time PCR. Histopathology examination of biopsy specimen shows characteristic morphological features of steatohepatitic variant of hepatocellular carcinoma. Then the patient was referred to the higher center for the further management.
γδ T-cell lymphoma: a rare entity mimicking hemophagocytic syndrome-report of two cases
Authors: Maheshwari Ujwala , Mahore Kalyani , Pereira Evith , Dhar Reeta
Published: July 2017

γδ T-cell lymphoma is a rare extranodal and systemic neoplasm which accounts for less than 1% of all NHL having peak incidence in adolescents and young adults with a male predominance. Study report two cases, 29 and 25 years male presented with fever, abdominal pain and pancytopenia; one had hepatosplenomegaly while other had marked splenomegaly respectively and both showing feature of hemophagocytosis. Both underwent splenectomy. On gross examination, the spleen was markedly enlarged and shows a deep brown cut-surface. Histologically the normal structure of the spleen is totally effaced by a monotonous lymphoid population consisting of medium-large sized lymphoid cells with vesicular chromatin and small eosinophilic nucleolus with tumor cells showing moderate amount of eosinophilic cytoplasm. Liver biopsy showed regenerative changes in parenchyma and sinusoidal involvement by tumour cells. Peripheral smear revealed atypical lymphocytes with pancytopenia. Bone marrow aspiration showed moderate neoplastic infiltrate by lymphoid cells. Immunophenotypic study showed tumour cells expressing CD3, CD56, CD 2 (dim), TIA-1, TCR-gamma. The tumour cells were immunonegative for CD20, CD5, CD4, CD8, granzyme B, CD7, CD10 and CD 23. Immunophenotypic study is must for diagnosis of   γδ T-cell lymphoma which can mimic hemophagocytic syndrome.
Triple threat: pregnancy, SLE, EBV as potential triggers in secondary hemophagocytic lymphohistiocytosis
Authors: Rajendran Aiswarya , Sherif Akil Adrian , Divakar Arun , Surendran Sandeep , Visalakshy Jyothi , Pillai Madhavan Pillai Gopalakrishna
Published: July 2017

We present a case of hemophagocytic lymphocytosis (HLH) that occurred secondary to a combination of Epstein Barr virus (EBV) infection and systemic lupus erythematosus (SLE) in early pregnancy. A 29-years-old lady presented with complaints of fever, vomiting and loose stools. She underwent successful in-vitro fertilization (IVF) and embryo transfer 20 days prior to the onset of these symptoms. Her blood investigations revealed anemia, neutropenia, hyperferritinemia and hypertriglyceridemia, eventually resulting in a diagnosis of HLH further substantiated by bone marrow examination. Additional investigations revealed positive anti-dsDNA and EBV IgM antibodies amongst other findings, adding SLE and EBV to the diagnoses. They were considered potential triggers for HLH. However, the occurrence of these events following IVF poses the question of whether pregnancy played a role in the development of HLH. Our patient responded well to pulse steroid therapy and has had an uneventful course till date.
Knowledge, practice and experiences of parents with a thalassemic child
Authors: Saxena Amit , Sharif Mumtaz , Siddiqui Sadaf , Singh Swati
Published: July 2017

Background: Thalassaemia is a chronic disorder requiring lifelong transfusions and medications causing emotional and financial burden to the family. This study was done to assess the knowledge and awareness of parents having a thalassemic child and to ameliorate their experiences in the upbringing of their child.Methods:A cross sectional, descriptive study was conducted in Pediatric Ward of a Tertiary care Hospital in Navi Mumbai from May-August 2016 in which parents of 40 beta Thalassemia major children between age group of 6 months to 15 years were enrolled. Parents were interviewed through a questionnaire to assess their knowledge, awareness, the practices they follow in regard to the transfusion, treatment, vaccination and prevention of thalassemia. The study also focuses on the emotional suffering of the parents.Results: 47.5% of parents were aware of thalassemia being a genetic disorder.62.5% were aware of regular blood transfusion. 23 parents were aware of the regular medications taken by their children. 42.5% parents had adequate knowledge of the optional vaccines to be taken. 90% parents followed a good practice of getting their child for regular blood transfusion and 92.5% gave them regular medicines.31 parents would periodically get their child investigated but 65% of parents lacked in giving optional vaccines to the child.60% agreed to undergo MTP while only 45% knew about the antenatal detection.Conclusions:Majority of parents followed good practice and had a positive attitude, though the knowledge and awareness about the disease was inadequate.
Финтех – через трансформацию к новой экономике
Authors: Катрич Алексей Сергеевич
Published: July 2017

В статье рассматривается модель цифровой трансформации экономики, анализируются исторические предпосылки указанной трансформации и текущие возможности ФИНТЕХ. Проведен анализ стратегий цифровой трансформации применительно к банковской системе и даны рекомендации по выстраиванию банковской технологической инфраструктуры.
Ценные бумаги высокотехнологичных компаний как инструмент долгосрочных инвестиций
Authors: Барская Полина Владимировна , Синицына Дарья Дмитриевна , Чернышова Марина Витальевна
Published: July 2017

Работа посвящена инвестированию в ценные бумаги высокотехнологичных компаний, ставших основой развития современной экономики и предопределенных текущим технологическим прогрессом. На основе российского законодательства, выделены долговые и долевые ценные бумаги как ключевой критерий классификации. Были определены основные риски инвестирования в данные ценные бумаги, по каждому из которых проведено исследование оценки их значимости для инвесторов.
Los derechos de los contribuyentes en los acuerdos de intercambio de información suscritos por Colombia
Authors: González Henao Tatiana
Published: July 2017

En la última década se han logrado avances significativos en materia de intercambio internacional de información tributaria, comenzando con las modificaciones introducidas al artículo 26 del modelo de convenio de la OCDE, continuando con la amplia red de acuerdos bilaterales de intercambio de información tributaria suscritos por los diferentes Estados para llegar, finalmente, a un acuerdo multilateral basado en el estándar internacional para la transparencia fiscal. Por su parte, Colombia ha adoptado una función activa en el intercambio internacional de información tributaria, pero desafortunadamente las garantías constitucionales de los contribuyentes en el marco de acuerdos de información tributaria no han tenido la misma prevalencia en la agenda política del Gobierno. La presente investigación se centró en analizar si los acuerdos suscritos por Colombia habían sido celebrados en cumplimiento de los principios constitucionales o si, por otra parte, se podían identificar algunas violaciones de normas constitucionales para efectos de mostrar la necesidad de incorporar mecanismos efectivos de protección de los derechos de los contribuyentes y la regulación del secreto tributario.
Potential Beneficial Effects of Exogenous Nitric Oxide (NO) Application in Plants under Heavy Metal-Induced Stress
Authors: Corpas Francisco J.
Published: July 2017

Nitric oxide (NO) has become in a key molecule in higher plants because this molecule, direct or indirectly, is involved in a plethora of physiological and (a)biotic stresses. Plants are exposed to many adverse environmental conditions, among them heavy metal contamination has caused unfortunately collateral damage associated with the development of our contemporary lifestyle. Although plants have developed different strategies to palliate the negative effects of these metals, usually there is associated a nitro-oxidative stress. During the last decade, the application of exogenous NO seems to offer some advantages which allows to plants to face the cellular damages induced for heavy metals. Consequently, this update will focus on the potential benefits of the use of NO-donors to counteract the heavy metal harmful effects on plant metabolism.
Environmental Susceptibility: Soil Contamination of Heavy Metals in the Territory of E-Waste Recycling Area
Authors: Gangwar Charu , Singh Aprajita , Pal Raina , Kumar Atul , Sharma Saloni , Tripathi Anamika
Published: July 2017

E-waste is a popular name given to those electronic products nearing the end of their useful life which has become a major source of heavy metal contamination in soil and hence, became the global concern. Various samples of soil were collected from different sites and were determined for heavy metal analysis by the ICP-AAS after the digestion process. The main source of contamination is illegal e-waste recycling activities such as burning of PCB's acid baths etc. Different soil indices like contamination factor, I-geo, pollution load index, were calculated to determine the quality of the soil. Results indicate that e-waste recycling and industrial area are strongly contaminated by the heavy metals. Physiological analysis of soil revealed that e-waste processing and industrial activities decrease the soil pH and organic matter while enhancing the electrical conductivity of soil. The exceedance of metal contamination imposed negative impact to the soil environment and human health.
Genus Oscillatoria Vaucher (Cyanoprokaryota) in Maldah District, West Bengal, India
Authors: Gupta Pratibha
Published: July 2017

Genus Oscillatoria Vaucher is the ubiquitous Cyanoprokaryote, growing in almost all habitats in fresh-water ecosystem like bils, dighis, lakes, ponds, wetlands, and marine water system like - salt marshes and pans, estuaries, brackish waters and ocean. It also occurs on inter-tidal rocks, snow and even in cold lakes underneath 5 m of ice pack as well as in thermal springs. During systematic investigations recorded altogether 25 species, 4 variety and 2 forms from Maldah District viz. Oscillatoria acuta Bürhl and Biswas, Oscillatoria agardhii Gomont, Oscillatoria amoena (Kütz.) Gomont, Oscillatoria amphibia C.Agardh ex Gomont, Oscillatoria amphigranulata Goor, Oscillatoria angusta Koppe, Oscillatoria chalybea G.Mertens ex Gomont, Oscillatoria formosa Bory ex Gomont, Oscillatoria formosa f. loktakensis Brühl and Biswas, Oscillatoria geitleriana Elenkin, Oscillatoria geminata Menegh. ex. Gomont, Oscillatoria limnetica Lemmerm., Oscillatoria limosa C.Agardh ex Gomont, Oscillatoria minnesotensis Tilden, Oscillatoria okenii C.Agardh ex Gomont, Oscillatoria ornata var. crassa C.B.Rao, Oscillatoria perornata f. attenuata Skuja, Oscillatoria princeps Vaucher ex Gomont, Oscillatoria prolifica Gomont, Oscillatoria proteus Skuja, Oscillatoria pseudogeminata var. unigranulata Biswas, Oscillatoria quadripunctulata Brühl and Biswas, Oscillatoria raoi DeToni, Oscillatoria redekei Goor, Oscillatoria rubescens DC. ex Gomont, Oscillatoria splendida Grev. ex Gomont, Oscillatoria subbrevis Schmidle, Oscillatoria tenuis C.Agardh ex Gomont, Oscillatoria tenuis var. natans Gomont, Oscillatoria tenuis var. tergestina Rabenh. ex Gomont and Oscillatoria willei N.L.Gardner. However, Oscillatoria subbrevis Schmidle, Oscillatoria tenuis C.Agardh ex Gomont are the most common species followed by Oscillatoria amphigranulata Goor, Oscillatoria acuta Bürhl and Biswas, Oscillatoria amphibia C.Agardh ex Gomont, Oscillatoria amphigranulata Goor in water bodies of Malda District. Oscillatoria redekei Goor is reported new from India.