bluuebunny/crossref_metadata_2025 huggingface dataset:
Antioxidant Protection System in the Saliva of Patients with Non-Small Cell Lung Cancer
Authors: Bel’skaya L.V. , Kosenok V.K. , Massard G.
Published: March 2019

The purpose of the study was to study parameters of the antioxidant protection system in saliva for non-small cell lung cancer. In the case-control study, included 683 volunteers, which were divided into 3 groups: primary (lung cancer patients, n = 290), comparison group (patients with nonmalignant pulmonary pathologies, n = 178) and control (conditionally healthy individuals, n = 215). Biochemical examination of saliva, histological verification of the diagnosis were carried out for all participants. The parameters of the antioxidant defense was determined spectrophotometrically. Intergroup differences were estimated by a nonparametric criterion. Saliva of lung cancer patients was characterized by imbalance in the antioxidant defense. It is shown that the activity of the enzymes of the first link of antioxidant protection (catalase, SOD) was significantly reduced (p ˂ 0.0001), whereas activity of salivary peroxidases increase (p = 0.0037). The parameters of non-enzymatic protection varied in opposite directions: the level of uric acid in lung pathologies decreases (p = 0.0399), whereas albumin concentration increased, under these conditions, it begins to exhibit prooxidant properties. Differences between adenocarcinoma and squamous cell lung cancer have been found in terms of the mode of the dynamics of antioxidant protection parameters. Probably, against the background of squamous cell lung cancer, an enzymatic link (catalase, SOD) contributes to the antioxidant protection system, whereas against adenocarcinoma - nonenzymatic (uric acid, albumin).
Prevalence of anti-sperm antibodies, risk factors associated and their impact on spermatobioscopy in infertile men
Authors: Cardeña Ignacio A. , Andrade Rodríguez Andrea C. , Ruiz Treviño Edgar O. , Araiza Navarro Junior J. , Muñoz Enrique R. , Muñoz Enrique R. , Sánchez Armando Roque , González Patricia A.
Published: March 2019

Background: The first immunological correlation with male infertility was reported in 1954 by Wilson and Rumke with the identification of anti-sperm antibodies. The prevalence of anti-sperm antibodies in infertile men varies from 9%-36%, the main cause being the loss of the blood-testicular barrier and otherwise the association with chronic inflammation. It has been shown that immune infertility is found in 15% of patients with varicocele.Methods: A transversal comparative study was carried out with 360 infertile men who were tested for anti-sperm antibodies between January 2011 and July 2018. Two groups were integrated; Group 1, infertile men with positive anti-sperm antibodies >50%, group 2, infertile men with negative anti-sperm <50%. Seminogram parameters were evaluated according to the WHO 5th edition and associated risk factors with anti-sperm antibodies.Results: 360 infertile men were evaluated during the study, 42 were excluded because they did not meet the inclusion criteria, the prevalence of anti-sperm antibodies was 14.5%. Group 1; n=46 (14.5%) and group 2, n=272 (85.5%), the clinical characteristics and the hormonal profile were compared at study admission without significant difference. There was a significant decrease in progressive motility in group 1 (38.7±23.8) vs group 2 (50.1±18.9) p=0.03. Analyzing the risk factors, varicocele was found to be significant 23.7%, OR 2.14 (1.27-3.61) p=0.004 as well as retractable testicle 26.4%, OR 2.13 (1.23-3.70) p= 0.008.Conclusions: The affectation of motility was confirmed, which leads to the suspect varicocele and retractable testicle as risk factors.
Prenatal care perception of Saudi females of childbearing age: an epidemiological study
Authors: Alqifari Saleh F. , Alharbi Fahad A. , Algeffari Abdulrahman
Published: March 2019

Background: The purpose of this study is to assess perception of Saudi women of childbearing age regarding prenatal care.Methods: Participants were invited to participate in a voluntary online survey. The brief survey consisted of 15 basic multiple choice questions administered in Arabic, and delivered as a secure link through private social media messaging services. The survey permitted only 1 attempt per user. In order to reach and capture non-respondents, 2 follow-up reminders 10 days apart were sent through the same channels of communication. The survey data was collected and analyzed using the survey software platform, Qualtrics by Qualtrics © LLC 2017.Results: Approximately 9% of participants reported previous pregnancy without use of prenatal care. Nearly 12% of respondents thought that prenatal care is only indicated for malnourished pregnant females, and 7% reported not knowing who prenatal care is specifically indicated for. Nearly 21% reported prenatal care should start after confirmation of pregnancy, 14% thought proper start is anytime within the first 3 months, 8% reported proper start should be after confirmation of healthy pregnancy and 8% reported not sure when to initiate prenatal care. Approximately 12% thought taking prenatal vitamins should be once weekly or some days of the week, while 5% do not advice women to take prenatal vitamins during pregnancy at all.Conclusions: The majority of Saudi women are well educated on prenatal care. However, women in early and late twenties are less aware of proper usage of prenatal care.
Chlorhexidine-alcohol versus Povidone-Iodine-alcohol for surgical site antisepsis in caesarean section
Authors: Kesani Vishnu Priya , Talasila Sruthi , S. R. Sheela
Published: March 2019

Background: Caesarean section is one of the most common procedures performed. Recent studies found that surgical-site infection (SSI) was the most common healthcare-associated infection. Authors hypothesized that optimization of preoperative skin antisepsis may decrease postoperative infections. The objective was to establish the efficacy of chlorhexidine-based antiseptic protocol versus povidone-iodine protocol in reducing SSI for patients undergoing caesarean deliveries.Methods: This is a randomized prospective study conducted from April 2017 to September 2017 at a tertiary care center in India. Women who underwent caesarean sections were allocated into either group. Enrolled patients were randomly assigned to have the surgical site painted with chlorhexidine-alcohol preparation or painted with a solution of 10% povidone-iodine and then with surgical spirit. The outcomes were any SSI occurring within a week or during the 30 day follow up period of the surgery including any of: superficial or deep surgical site infection, or endometritis, according to Centers for Disease Control and Prevention definitions.Results: A total of 560 subjects (273 in the chlorhexidine group and 287 in the iodine group) qualified for the study. The number of surgical-site infection was significantly lower in the chlorhexidine group than in the iodine group (6.95% vs. 14.28%; P=0.005). Chlorhexidine–alcohol was significantly more protective than iodine-alcohol against both superficial incisional infections (5.49% vs. 10.10%, P=0.03) and deep incisional infections (1.46% vs. 4.18%, P=0.04).Conclusions: This study highlighted that Chlorhexidine-alcohol provided superior skin antisepsis in comparison to povidone iodine-alcohol.
Knowledge, attitude and practice of long acting reversible hormonal contraception (LARHC) among women in urban upper Egypt
Authors: Mitwaly Abo Bakr A. , Abbas Ahmed M. , Mohammed Amal Fathy , Ismail Alaa M. , Shaamash Ayman H. , Youssef Alaa El Din A.
Published: March 2019

Background: The current study aims to assess the knowledge, attitude and practice of long acting reversible hormonal contraception (LARHC) among women in urban upper Egypt.Methods: A cross sectional study which included 902 married women, in the reproductive age, attending the outpatient clinics (Gynecology and family planning) of: 1-Assiut University Maternity Hospital, 2- Sohag University Hospital, and 3-Gehina General Hospital (MOH hospital) with current or previous use of any method of LARHC methods. A Questionnaire file was designed to assay knowledge attitude and practice of clients towards contraceptive methods. All data collected from clients reviewed separately to assess knowledge, attitude and practice of women towards contraceptive methods.Results: The most popular contraceptive method is COCs followed by IUD then DMPA. 99% of studied sample heard with good description about different types of LARHC. 54.9% of studied sample most popular/famous LARHC DMPA, most sources of information on LARHC were, Hospital, Relative/friends and health workers. 94.24% of the studied sample were in favor to use of LARHC, 94.2% of them agree to take a space between births, about 55.4% of them were health child and 61% comfortable lifestyle benefit from birth spacing, 33% of studied sample were maternal health, 68% of them were think/prefer to use implants, 64.5% of them didn’t pregnant while breastfeeding. 11% of sample women never used any contraception before and most reasons for not using contraception are fear of side effects, desire for more children, irregular sexual relationship, and husband opposition. Only 16.6 % of studied sample used LARHC before and most of them used DMPA, however 3 women who used DMPA get pregnant while using it.Conclusions: There is a good level of knowledge between upper Egypt women about LARHC methods.
An evaluation of abnormal puerperium
Authors: Jeenwal Aarti , Jharbade Hemlata , Singh Nishita
Published: March 2019

Background: Puerperium is strictly defined as the period of confinement during and just after birth. It is the period following childbirth during which body tissues specially the genital organ reverts back approximately to the pre-pregnant state both anatomically and physiologically. At some stages some of these well-orchestrated changes can go away resulting in complications which can endanger life.Methods: Retrospective c study was conducted in Department of Obstetrics and Gynecology of M.G.M. Medical College and M. Y. Hospitals, Indore. The cases were selected randomly from the patient who were admitted in M.Y. Hospital who had either a vaginal or caesarean delivery (both in our institution as well as outside institution) during the study period, irrespective of age, parity and registration status. Data was recorded in predesigned coded case report forms and statistical analysis was performed.Results: Authors found that puerperal pyrexia was the most common complication, accounting for 38.96% of total cases. The second most common complication was perineal pain affecting 28.15% of cases. The other complication was wound gaping/discharge (11.71%), mastitis and breast abscess (6.81%), secondary postpartum hemorrhage (5.33%), episiotomy gaping and infection (4%), perineal hematoma (0.59%), wound dehiscence (0.3%) and other rare causes accounted for 4.15% of the complication.Conclusions: Puerperal period is as important as antenatal period. Anaemia, suboptimal personal hygiene as well as improper sterilization can resulted in severe health hazards such as septicemia, disseminated intravascular coagulation as well as death. So, risk factor should be treated vigorously.
Spectrum of dengue morbidity in pregnancy and its impact on maternal and perinatal outcome
Authors: G. Anuradha , M. R. Sandya , George Shirley
Published: March 2019

Background: Dengue is a vector borne viral infection with seasonal outbreaks every year. The spectrum varies from just a febrile morbidity to the severe form of dengue shock syndrome (DSS). The objective of the present study was to study the influence of dengue fever on pregnancy and to analyze the maternal and perinatal outcome.Methods: Thirty-six pregnant women beyond 28weeks of gestation who tested positive for dengue infection were retrospectively analyzed during a 5year study period (Jan 2014-Dec 2018). The study was conducted in the Department of OBGYN St John’s Medical College Hospital, Bangalore. Thirty-three of these patients delivered at St John’s and there were three postpartum referral cases. The necessary data was obtained by patient record review. The data was analyzed using SPSS and the results were expressed as Mean±SD and percentages.Results: Out of 36 women analyzed the mean age was found to be 23.93±4.5 years. Majority were primigravidae (58.3%). The most common clinical manifestation was fever seen in 47.2%. Twenty five percent of patients had platelet count of <20,000 on admission. Overall 66% of the patients required transfusion. Nearly fifty three percent of the patients had vaginal delivery. There were 4 maternal mortalities (11.1%) and 2 perinatal mortalities (5.5%) both were still births in the present study.Conclusions: Dengue infection in pregnancy was associated with increased maternal and perinatal morbidity as well as mortality. The severity of the infection has direct impact on the outcome. Hence early diagnosis and prompt management in a tertiary care centre, with multidisciplinary approach improves the outcome and minimizes the complications.
Post void residue in women with pelvic organ prolapse: a prospective observational study
Authors: Saravanan Nanthini , Kekre Aruna N. , S. Mahasampath Gowri
Published: March 2019

Background: The objective of the present study was to observe the post void residual volume (PVRV) in women with pelvic organ prolapse (POP) pre and postoperatively and to correlate stage of prolapse with lower urinary tract symptoms and quality of life in women with pelvic organ prolapse.Methods: This is a prospective observational cohort study of 100 women with symptomatic pelvic organ prolapse of stage II or greater. Patients were admitted for Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in Gynaecology Department at Christian Medical College Hospital, Vellore, India over one year were recruited. This study was approved by the institutional review board and ethical committee of the hospital. Pre- and post-operative PVR were measured. The statistical analysis was done by using SPSS version 21 and P value < 0.05 was considered as statistically significant.Results: In this study 100 patients were recruited and 11% of women had pre-operative high post void residual volume of more than 100 ml. Stages of POP did not correlate with severity of LUTS and QOL. Pre-operative elevated PVR resolved post operatively in 91%, the P value <0.000 which was highly significant.Conclusions: 11% of women had preoperative high PVR. Stages of POP did not correlate with severity of lower urinary tract symptoms (LUTS) and quality of life(QOL). Pre-operative elevated PVR resolved post operatively in 91%, the P value < 0.000 which was highly significant. Majority of the patient with severe pelvic organ prolapse had elevated pre-op PVR which resolved post- operatively after surgical correction.
Unengaged head at term in primigravida: does it affect the chance of having a normal delivery?
Authors: Unnisa Sadiq , M. S. Poornima
Published: March 2019

Background: In Obstetrics it is traditional concept that fetal head engagement occurs by 38 weeks in primigravida. Unengaged head in primigravida has been considered a possible sign of cephalo pelvic disproportion. It is associated with higher risk of cervical dystocia, which has led to increased rate of caesarean section with its financial implication and future restriction of family size. Labour is prolonged, the duration of both latent and active phase increases, due to improper fitting high fetal head.Methods: The prospective descriptive study was conducted at the Yenepoya Medical College hospital OBG Department.  Study population included were 75 primi gravidas with unengaged head at term. Details of labour were noted down.  Augmentation was done with oxytocin and dose of oxytocin was titrated . CTG was used to monitor fetal heart.  Emergency LSCS was performed in patients with fetal distress or non-progress of labour.  In case of vagina delivery, duration of 1st and 2nd stage, APGAR score at 1 and 5 minutes, and birth weights were recorded.Results: Of the 75 primigravida 66.66% were in the age group of 21-25yrs.  Majority of the women were of 39-40 weeks (42.66%) of gestation. Common causes of unengaged head was deflexed head in 15 (20%) CPD in 11 (14.66%), loops of cord around neck in 8 (10.66%), polyhydramnios in 2(2.66%), placenta previa type-I and II  : anterior in 5 (6.66%) 8 patients were with occipito posterior position.  No cause could be identified in 27 cases (36%). Vaginal delivery occurred in 68% and LSCS in 32%.Conclusions: Unengaged head in primi gravida with spontaneous onset of labour is not an indication for LSCS. The attitude of watchful expectancy and timely intervention especially in those cases in which no significant etiological factor is found, the chances of vaginal birth increase there by reducing maternal land foetal morbidity.
Multidrug resistant tuberculous meningitis in pregnancy: a rare case report
Authors: Nagashree U. , . Charumathi , Meenakshisundaram U.
Published: March 2019

The prevalence of tuberculosis, especially extrapulmonary tuberculosis is increasing worldwide. TB meningitis is one of severe manifestations of extra pulmonary TB. Prognosis of cases of multidrug resistance tuberculosis meningitis is worse and even more challenging in pregnant women. It’s mostly associated with increased frequency of maternal disability, hospitalisation during pregnancy, foetal growth retardation, prematurity, low-birth weight and increased perinatal mortality. As information on outcome of pregnancy among women with extra pulmonary TB is limited; various medical and surgical options for timely management has been discussed. Authors bring out a case report of a primigravida at 26 weeks gestation with severe multidrug resistant TB meningitis who was successfully managed at our hospital with a healthy infant.
Prevalence of gestational diabetes mellitus and its relationship with various risk factors in a tertiary care hospital in West Bengal with special reference to tribal population, India
Authors: Sharma Narenrda Kumar , Mahto Subodh Kumar , Sharma Rahul , Sheoran Ankita , Suman Sumit Kumar , Gupta Pulin Kumar , Sarkar Bishwanath Sharma , Dey Ramprasad
Published: March 2019

Background: Gestational diabetes mellitus (GDM) is the most common medical complication and metabolic disorder of pregnancy. The aim and objective of this study was to determine the prevalence of GDM and its relationship with various risk factors with special reference to tribal population.Methods: The study was done in 200 patients between 24 and 28 weeks of gestation, attending antenatal outdoor in a tertiary care hospital of West Bengal.  These patients were given 75gm oral glucose irrespective of the last meal and their plasma glucose was estimated at 2hours. Patients with plasma glucose values ≥140 mg/dl were labelled as GDM. Patients who were diabetic before pregnancy or whose pre pregnancy body mass index was not known or was in labour or had chronic disease, were not included in the study.Results: Prevalence of GDM was 11% in whole population while it was 14.63% and 10.06% in tribal and non-tribal population respectively.  Prevalence of GDM and its correlation with most of risk factors in previous pregnancies was found to be significant in both non-tribal and tribal population. Family history of diabetes mellitus was the most prevalent risk factor in both non-tribal (9.4%) and tribal population (14.63%). There was no single most common risk factor among GDM patients found as there were multiple risk factors present with same frequency in both tribal and non-tribal population.Conclusions: The prevalence of GDM is 14.63% in the tribal population and 10.06% in non-tribal population which is not statically significant (P<0.407). The relation between the prevalence of GDM and risk factors was found to be significant for most of the risk factors.
Study of association between the serum lipid profile and age-related macular degeneration in a tertiary care centre of Central UP
Authors: Husain Ahmad , Singh Brijesh , Ranjan Ravi , Jawad Kalbe , Sami Ifsa , Verma Vivek Kumar
Published: March 2019

Background: Age-related macular degeneration (ARMD) is the major challenge in the new millennium in the developing countries as the size of elderly population continues to rise due to betterment of medical facilities and increased life expectancy. Lipids are implicated in the pathogenesis of ARMD. The relationship between systemic lipids and ARMD has not been well characterized, especially in rural population. The objective was to investigate the relationship between serum lipids and ARMD in older adults.Methods: In this case-control study, 300 adults, aged ≥50 years, 150 each among cases and controls were included in the study. Mean lipids values between cases and controls were compared.Results: Mean age of cases was 62.45±8.472 years and mean age of controls was 61.89±8.51 years. Among 150 cases, 124 (82.66%) cases were of dry ARMD while 26 (17.33%) cases were Wet ARMD. Author found that 38 cases among total cases (25.33%) and 15 individuals (10%) among controls had altered lipid profile. All mean lipid values were higher among cases compare to controls (p>0.05), while the mean of VLDL, TG and TG/HDL were significantly raised showing positive association (p<0.05).Conclusions: Present study showed that high levels of serum lipid values especially VLDL, TG and TG/HDL positive association with an increased risk for development of ARMD, implying that strategies reducing serum lipid levels may be useful to prevent the development of the disease.
Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study
Authors: Ghosh Anasuya , Chaudhury Subhramoy , Datta Atin
Published: March 2019

Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.
Impact of distractors in item analysis of multiple choice questions
Authors: Burud Ismail , Nagandla Kavitha , Agarwal Puneet
Published: March 2019

Background: Item analysis is a quality assurance of examining the performance of the individual test items that measures the validity and reliability of exams. This study was performed to evaluate the quality of the test items with respect to their performance on difficulty index (DFI), Discriminatory index (DI) and assessment of functional and non-functional distractors (FD and NFD).Methods: This study was performed on the summative examination undertaken by 113 students. The analyses include 120 one best answers (OBAs) and 360 distractors.Results: Out of the 360 distractors, 85 distractors were chosen by less than 5% with the distractor efficiency of 23.6%. About 47 (13%) items had no NFDs while 51 (14%), 30 (8.3%), and 4 (1.1%) items contained 1, 2, and 3 NFDs respectively. Majority of the items showed excellent difficulty index (50.4%, n=42) and fair discrimination (37%, n=33). The questions with excellent difficulty index and discriminatory index showed statistical significance with 1NFD and 2 NFD (p=0.03).Conclusions: The post evaluation of item performance in any exam in one of the quality assurance method of identifying the best performing item for quality question bank. The distractor efficiency gives information on the overall quality of item.
Comparative study of Bacillus clausii and multistrain probiotics in the management of acute diarrhoea in children
Authors: Hamid Farzana , Quaium Syed Moosa M. A. , Rahman Azizur
Published: March 2019

Background: Diarrhoea is the second most common cause of under-five mortality especially in developing world. Many studies have been conducted so far using different probiotic strains with variable outcome. So, the aim of the present study was to compare the clinical efficacy of Bacillus clausii and multi strain probiotic formulation as adjunct treatment of acute diarrhoea.Methods: This prospective single blind randomized controlled clinical trial included 300 infants and children between 6 months to 6 years of age admitted in a tertiary care hospital Sylhet, Bangladesh with acute watery diarrhoea having varied dehydration status ranging from no to severe dehydration excluding shocked state. Cases were randomly assigned to three groups which were group I (n=100) comprised of children who were treated with standard treatment (according to WHO guideline) only as control group, group II (n=100) who received standard treatment plus Bacillus clausii and group III (n=100) who received standard treatment plus multi strain probiotic formulation (Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacterium breve, Bifidobacterium infantis, Streptococcus thermophilus). Primary outcome variables were duration, frequency of diarrhoea and consistency of stool. Secondary outcome variable was duration of hospital stay.Results: Mean duration of diarrhoea was significantly shorter (p=0.001) in group III (2.62 days) compared to group I (3.26 days) and group II (3.22 days). Frequency of diarrhoea was significantly lower on day 3 of probiotic administration in group III (p <0.05) and on day 5 of treatment in group II (p <0.05). Stool consistency significantly improved on day 3 in group III (p <0.05) while it was on day 4 in group II. The duration of diarrhoea, hospital stay, stool consistency and frequency of stool on day 3 were not statistically significant (p >0.05) in group II in comparison to group I and group III.Conclusions: Multistrain probiotic formulation is effective in reducing the duration, frequency of diarrhoea and duration of hospital stay.
Candida tropicalis: insight into the characteristics and outcome of adult patients admitted in medical and surgical intensive care units
Authors: Sandhu Raminder , Aggarwal Ramnika , Kumar Surinder , Budhani Diksha
Published: March 2019

Background: Non albicans species are emerging increasingly as significant ICU pathogens.  The increasing incidence of C. tropicalis infections is a significant problem because of its ability to develop rapid resistance to fluconazole.Methods: The study was designed to isolate, evaluate the risk factors and outcome of C. tropicalis infection from intensive care units. Identification was done by the biochemical methods. A total of 89 patients culture positive for C. tropicalis were selected for retrospective analysis over a period of one year. We collected various data about risk factors and outcome from the medical records.Results: A total of 89 patients culture positive for Candida tropicalis were analysed. Majority of these culture isolates were obtained from their blood (59.55%) followed by urine samples (31.46%). The indwelling devices (93.2%) remained a highest risk followed by prolonged administration of antibiotic therapy (92.1%) and admission in ICU for more than a week (88.8%). Overall mortality rate was 31.5%. Mortality was higher in patients with longer total length of stay in hospital (89.3%; p 1.000), indwelling devices (85.7%; p 0.5663) and in whom the antimicrobial therapy was administered for prolonged duration (82.1%; p 0.7581), although these factors remained statistically insignificant. 92.1% of isolates were sensitive to amphotericin B and showed 52.8%; 9.0% sensitivity to itraconazole and fluconazole respectively.Conclusions: C. tropicalis is now classified as the third or fourth NAC species being commonly isolated from clinical samples and associated with persistent systemic infections leading to a longer stay in the hospital. Several virulence factors seem to be responsible for high dissemination and mortality.
Association between C-reactive protein and age-related macular degeneration
Authors: Borooah Mitali , Ekka Jayant
Published: March 2019

Background: Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment among the elderly, worldwide affecting 30-50 million individuals. Inflammation is now increasingly thought to be a key risk factor for AMD. The association of CRP with AMD has been reported in only a few studies, with somewhat inconsistent results. The present study was undertaken to determine the association between AMD and serum CRP levels.Methods: A total of 53 patients diagnosed of any form of AMD fulfilling inclusion and exclusion criteria were included. A 5 mL sample of venous blood (non-fasting) was collected to determine serum high-sensitivity CRP levels (hsCRP). Different stages of AMD and serum hs CRP level were compared using one-way ANOVA test and calculated p value <0.05 was considered as statistically significant. Comparison between the two groups, one with risk factor and one without risk factor was performed using student-t test and calculated p value <0.05 was considered statistically significant.Results: Out of 53 patients 21 were having early AMD, 21 were having intermediate AMD and 11 were having advanced AMD. The mean serum hs CRP level was 0.14±0.05 mg/dL, 0.20±0.09 mg/dL and 0.28±0.08 mg/dL in early, intermediate and advanced AMD respectively. When statistically analysed the difference of mean serum hs CRP level among the three groups was found to be statistically significant.Conclusions: Type of AMD influence the baseline hsCRP level. Smoking and diabetes are associated with higher baseline serum hsCRP in all stages of AMD.
Study on absolute eosinophil count correlation with severity of bronchial asthma
Authors: Lalrinpuia Benjamin , P. Naveen
Published: March 2019

Background: Bronchial asthma is defined as chronic inflammatory disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli. Eosinophil infiltration is a characteristic feature of asthmatic airways. It presents as an obstructive type of ventilator defect usually diagnosed from a reduced FEV1% (Forced Expiratory Volume) or from a reduced peak expiratory flow (PEF) associated with reduced airway caliber during expiration. Allergen inhalation results in a marked increase in activated eosinophils in the airways. Correlation between the degree of bronchial hyperresponsiveness (a cardinal feature of asthma) and peripheral blood eosinophilia has been observed in patients with dual response following allergen challenge.Methods: The study comprises a total number of 50 bronchial asthma patients of both sexes (male and female) between the age groups of 13-65 years. Based on severity, asthma patients were classified into mild, moderate and severe asthmatics, assessed by FEV1% computerized Spirometry Helios model number 701, recorders and medicare system. Peripheral blood sample was collected from each patient for absolute eosinophil count, the count was done on the same day.Results: The mean±SD absolute eosinophil count of 50 patients is 330±88.64 which is slightly above normal (300 cells/mm3). Author found that the mean±SD absolute eosinophil count of 405±83.16 in severe asthma patients is quite high, corresponding with a steep decline in the FEV1% 45.3±12.6.Conclusions: Absolute eosinophil count and FEV1% are important indicators of bronchial asthma severity and can even be used to predict disease progression.
Imaging spectrum and prevalence of variant branching pattern of aortic arch
Authors: K. V. Vipin Krishnan , Narayan Varun , Ibrahim Niyaz , Mathew John , James Sheen Maria
Published: March 2019

Background: Variant branching patterns of the aortic arch are not infrequent but are commonly under reported. This study was conducted to determine the spectrum of Variant branching pattern of aortic arch and their prevalence using contrast enhanced computed tomography (CECT) images of the cases from a tertiary care centre.Methods:  Contrast enhanced computed tomography (CECT) images of aortic arch region from 1116(629 male and 487 female) cases from 18 to 85 years of age were examined retrospectively. The images were reviewed for normal and variant anatomy of aortic arch and the results were analyzed statistically.Results: Of 1116 patients, 878 (78.6%) cases showed normal and 238 (21.3%) cases had variant branching pattern of the aortic arch. The most common variation was the common origin of brachiocephalic trunk (BCT) and the left common carotid artery (LCCA) which was observed in 160 (14.3%) cases. In 8 (0.7%) cases, BCT and LCCA took origin from a single common trunk arising from the aortic arch. In 60(5.4%) cases, the left vertebral artery (LVA) originated directly from the aortic arch between the origin of the LCCA and left subclavian artery (SCA). 8 (0.7%) cases had aberrant right subclavian artery. Two (0.2%) cases showed right aortic arch.Conclusions: Interventional radiologists and surgeons should be well aware of variant anatomy of aortic arch. Contrast CT is a highly reliable imaging method for demonstrating anatomical features and variations of the arch.
Analytical and morphometric study of nutrient foramina of femur and its clinical implications
Authors: Dervisevic Lejla , Dervisevic Amela , Ajanovic Zurifa , Hasanbegovic Ilvana
Published: March 2019

Background: The femur is supplied princially by the diaphyseal nutrient artery which enters the bone throught the nutrient foramen. This supply is essential during the growing period, the early phases of ossification, and in different surgical procedures. The aim of present study was to examine the morphology and topography of the femur nutrient foramen to provide detalied data on such features.Methods: This was a cross-sectional-descriptive study in which we observed 50 femurs. We analysed the number and location of nutrient foramina, the length of the bone, the position of the nutrient foramen regarding to values of FI, correlation between number of nutrient foramen and length of femur, correlation between position of nutrient foramen and side of extremity to which femur belongs.Results: The double foramina were common in right (57.1%) and left (42.1%) femur, mostly located in medial lip of aspera line in right (64.3%) and on the lateral lip in left femur (68.4%), with statistically significant correlation, χ = 4.85; p = 0.03, p <0.05.  The foramina in left (89.5%) and right (96.4%) femur were commonly observed at their middle third, with no statistically significant correlation between position of foramen accordingly to Foraminal Index value and side of extremity on which femur belongs (p=0.56; p>0.05). There is positive correlation between length of right and left femur and number of foramina.Conclusions: The study provides data of the nutrient foramina on femur, which is helpful for clinicians to help preserve bone vascularization during surgery.
Motor nerve conduction study parameters in healthy individuals: effect of limb dominance
Authors: Shakya Binnam , Thakur Dilip , Paudel Bishnu H. , Khadka Rita , Pokhrel Suman
Published: March 2019

Background: Nerve conduction study (NCS) is useful for evaluation of nerve, muscle, and/or neuromuscular function. Neurophysiologist interprets NCS with consideration of various anthropometric and technical parameters viz. age, gender, height, temperature etc. apart from the underlying pathology. Fewer studies have reported the effect of limb dominance on NCS. Moreover, the findings are controversial. Therefore, author aimed to investigate the effect of limb dominance on motor nerve conduction study parameters.Methods: This cross-sectional comparative study included sixty healthy individuals (44 right and 16 left handed) of either sex with age 18 to 30 years. The NCS parameters of median and ulnar nerves were assessed by stimulating it and recording from the muscle and skin overlying the nerve respectively using Digital Nihon Kohden machine. The obtained data were analyzed using independent sample t-test.Results: Right ulnar nerve onset latency was significantly longer in left-handed individuals (1.85±0.508 ms vs 1.62±0.195 ms, p=0.012). The left ulnar nerve F wave minimum latency (25.88±0.74 ms vs 24.46±2.64 ms, p=0.002) was significantly longer in left-handed individuals. Likewise, right ulnar nerve distal latency (2.45±0.76 ms vs 2.14±0.39 ms, p=0.044), and right ulnar nerve F wave minimum (25.9±1.21 ms vs 24.85 ms±1.74, p=0.030) were significantly high in left-handed individuals.Conclusions: NCS parameters in terms of latencies were longer in left-handed individuals. Therefore, limb dominance seems to be an important factor one should pay attention during bilateral comparison of obtained data in neurophysiological reporting of referred cases.
Ground sections of teeth: histopathological study modality
Authors: Yadav Suresh Motilal , Wakode Rupali , Kumar Sourab , Jadhav Abhishek
Published: March 2019

Ground sections of teeth or bone are considered best solutions for the study of any hard tissues in the study of histopathology. Various studies have been performed like progression of dental caries, enamel studies, dentin studies, cementum annulation studies, bone morphologies, age determinaton studies, etc. It is important study part in any forensic studies where mass disasters occurring as natural phenomenon of cyclonic events, earth quakes, floods and volcanic explosions and airplane accidents, industrial accidents and terror related acts. Forensic dentistry has played a vital role and many medico-legal cases are solved by studying the teeth. Ground sections study is important in any part of research. For a dentist this phenomenon is less understood, and this article brings in limelight various methods and study pattern of ground sections of teeth. With this knowledge an understanding and performing ground sections of teeth becomes a well start for dental graduates. Various other modalities in histopathology are decalcification studies, histopathological staining procedures, special stains procedures, immunohistochemistry. All the histopathological modalities have their own importance and are used appropriately in the study of oral pathology.
Acute mild gallstone pancreatitis: timing of cholecystectomy
Authors: A. A. Mageed Samir , Helmy Mena Z. , Redwan Alaa A.
Published: March 2019

Background: Cholecystectomy is essential to prevent recurrent attacks of mild acute gallstone pancreatitis, but the precise timing of cholecystectomy remains a subject of ongoing debate. The aim of this study is to address the optimal timing of cholecystectomy in patients with mild acute gallstone pancreatitis.Methods: From September 2013 to September 2018, patients with mild acute gallstone pancreatitis were prospectively randomized to either an early laparoscopic cholecystectomy (ELC) versus a delayed laparoscopic cholecystectomy (DLC) group. Recurrent biliary complications, success and failure rate, difficulty of cholecystectomy, operative time, cholecystectomy related complications, length of admission between the two groups were evaluated.Results: A total of 80 patients were randomized to the ELC (41 patients) and to the DLC group (39 patients). There were a statistically significant differences in the total length of hospital stay and recurrent biliary events (4.5±1.1 vs. 7.4±2.6 days, p<0.01 and 4.9% vs. 41%, p<0.001; respectively). There were no differences regarding success and failure rate, difficulty of cholecystectomy, operative time, cholecystectomy related complications, and length of index admission between both groups.Conclusions: In mild gallstone pancreatitis, ELC results in a shorter overall hospital stay with a significant reduction in the recurrent biliary events with no apparent impact on the safety and technical difficulty of the procedure or perioperative complication rate.
Assessment of wound healing in relation to nutritional status of the patients in common surgical condition in tertiary care centre
Authors: Singh Rahul , Tripathi Shashank Shekhar , Tripathi Ankur , Pandey Himansha
Published: March 2019

Background: Wound healing depends upon a balance between general factors which include nutritional status of the patient and local factors. Assessment of wound healing in relation to nutritional status of the patients in common surgical conditions.Methods: 46 surgical patients admitted in S.R.N. Hospital, Motilal Nehru Medical College, Allahabad during the period from July 2017 to July 2018, were included. Clinical, anthropometric examination, assessment of wound healing and factors affecting wound healing was done.Results: The mean age of the males patients were 38 years and that of female 33 years. Out of 46 patients included in our study 71.74% were male and 28.26% were females, and among these 15.15% of male and 38.46% female were malnourished. Percentage of wound contraction was 11.38% among the healthy and 2.30% in malnourished group, while the percentage of infection was 14% and 13% among healthy males and female and 20% each for malnourished males and females. Loss of weight was 9.4% and 10.1% among healthy male and female and 6.54% and 7.5% for malnourished male and females. The percentage of wound disruption in our study was 9% among malnourished group.Conclusions: Wound infection and disruption collectively increased the mortality and morbidity significantly in patients of malnourished group. Socio economic status has indirect correlation with wound healing. Malnourishment has a definite effect on wound healing.
Stapled haemorrhoidopexy vs. open haemorrhoidectomy: a comparative study
Authors: Aggarwal Naman , Agrawal Saurabh , Ray Jitendra P.
Published: March 2019

Background: Haemorrhoidal disease is one of the most common anorectal disorders. The grading of haemorrhoids depend on their severity and tendency to prolapse. Surgery is essential for grade 3 and 4 haemorrhoids. This study aims to compare the outcomes of the stapled haemorrhoidopexy and open haemorrhoidectomy in terms of intra and postoperative complications in terms of pain, return to activity of daily living (ADL) i.e. return to functional activity.Methods: A single-centred observational follow-up study on patients undergoing surgery for haemorrhoids between 2016-2017. Total number of patients operated were 106. Total cases included in the study are 95, out of which 59 were in open haemorrhoidectomy group and 36 in stapled haemorrhoidopexy group. Data was collected and the various parameters compared between the two groups.Results: The most common symptom found in the study was bleeding per rectum (91%). Intraoperative bleeding was more in open group compared to the stapled group (p<0.005). The pain experienced in the immediate postoperative period was higher for the open group (p<0.005). Noticeable difference in the hospital stay between the two groups was observed, with stapled group being discharged earlier (p<0.005). The immediate postoperative complications were not significantly different in the two groups. The need for postoperative analgesia was seen to be lesser in the stapled group compared to the open group (p<0.005).Conclusions: Our study confirms that stapled haemorrhoidopexy is better than open haemorrhoidectomy in terms of intra operative duration and pain experienced by the patient with an early return to activities of daily living.
An analysis of discrepancies in consent form for laparoscopic cholecystectomy in a tertiary care hospital: “FILTER” model
Authors: Mukherjee Ramanuj , Mohanta Arup , Samanta Sudipta
Published: March 2019

Background: Informed consent is needed to be full-proof but many discrepancies arise as it is subjected to individualization for each patient depending on their IQ, personality etc. Considering all aspect, the study aims to identify the issues and seek for potential remedies through “FILTER” model.Methods: This is a retrospective, Institution-based, observational study conducted in R.G. Kar Medical College over 3 years on 500 patients who underwent laparoscopic cholecystectomy.Results: Most of the consents (79%) were taken by consultant surgeons and rest was by junior residents. Junior residents wrote the consent form on behalf of patients in most cases (67%). 78% of the forms were signed by the patient party, 23% by patient himself and 19% by the surgeons. 67% of the total consent forms were printed and rest were hand-written. 65% of the total consent forms were signed after the patient or the patient party was informed and rest were signed without informing them. CBD injury (72%), bleeding (55%), bile leak (46%) and post-op collection (37%) were the frequency of complications encountered by the patients not informed beforehand. As the patients were informed beforehand, the need for conversion to open operation (62%), retained stone (89%), cardio-respiratory (98% and 93% respectively) complications were common. Need for an open operation, cardio-respiratory complications were most commonly informed. Bleeding (10%), CBD injury (2%) and bile leak (12%) was less informed.Conclusions: Proper and more standardized procedures and protocols should be followed for obtaining consent irrespective of the intervention required.
Early removal of nasogastric tube with early feeding versus conventional removal of nasogastric tube with delayed feeding after bowel anastomosis: a prospective randomized controlled trial
Authors: Negi Anil , Kumar Dhiraj , Rajput Neeraj Singh , Pandey Avinash , Gawer Divyansh , Ansari Afzal Ahmad
Published: March 2019

Background: Nasogastric (NG) decompression and delayed oral feeding after bowel anastomosis is conventional and years old practice. The aim of the present study was to evaluate the advantages and disadvantages of early removal of naso gastric tube (<24 hrs) and delayed feeding, compared with delayed removal and delayed enteral feeding in patients undergoing bowel anastomosis.Methods: It is a single blind, prospective randomized study involving patients with bowel anastomosis from December 2016- November 2018 at a tertiary care hospital. In study group naso gastric tube was removed within 24 hours. After 12 hours of surgery patients were allowed sips of water, then free liquids followed by semisolid and normal diet in calculated way. In control group naso gastric tube was retained till passage of flatus and orally allowed only after passage of stool.Results: A total of 241 patients were enrolled. In study group bowel sound returned after 30.57±31.19 hours of surgery and in control group 46.90±48.65 hours and this difference was significant (p<0.002). In study group first free liquid was allowed on 38.14±38.50 hours in post operative period, as compared to the control group where free liquids were allowed after 50.09±51.80 hours this difference was significant (p<0.04). Total hospital stay in the study group was significant (p<0.02).Conclusions: Early removal of naso gastric tube and early feeding is better than the conventional practice.