bluuebunny/crossref_metadata_2025 huggingface dataset:
Tenapanor: new approach to counter irritable bowel syndrome with constipation
Authors: Brashier D. B. S. , Kumar Ajay , Singh Anuj , Pratap Uday
Published: June 2020

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder chronic in nature and characterized predominantly by abdominal pain or discomfort associated with altered bowel habits, diagnosis requires characteristic symptoms during the last 3 months and onset ≥6 months ago. Symptom-based approaches for functional bloating, constipation and diarrhea are best utilised to identify IBS. IBS with constipation exerts significant impairment on work productivity by hampering quality of life. Inadequate relief by existing modalities, persistent hard stools and visceral abdominal pain demanded further clinical research. Tenanapor a novel molecule acts locally on gastrointestinal sodium/hydrogen exchanger isoform 3 (NHE3), an antiporter a counter transporter and exert antinociceptive effects on visceral sensation thereby decreases the frequency of abdominal pain. Action on NHE3 receptors located on small intestine and colon’s apical surface reduces the absorption of sodium and phosphate, with minimal systemic exposure. NHE3 Inhibition induced sodium absorption results in increase in water secretion into intestinal lumen resultant an accelerated intestinal transit time and softer stool consistency. Most common adverse reactions (≥2%) are diarrhea, abdominal distension, flatulence and dizziness. The drug is metabolised mainly by CYP3A4/5 and excreted in feaces (70%) and urine (7%). Tenapanor’s minimal systemic absorption is likely to be associated with a relatively inert safety and tolerability profile. Based on positive results from the phase III T3MPO trial program, tenapanor demonstrated promising results for IBS-C management and received US Food and Drug Administration approval as IBSRELA @ Ardelyx Pharma in September 2019 and augment existing modalities for management of IBS-C.
Awareness of COVID-19 outbreak in local population of Maval taluka in Maharashtra, India
Authors: Pratinidhi Shilpa A. , Sayyed Anjum A. K. , Tilokchandani Mohak A. , Malode Sudnya V. , Bhalgat Siddhi S. , Bhujbal Chaitanya R.
Published: June 2020

Background: There is a growing fear and perceived threat about coronavirus among local population. The population, inclusive of all age groups is making use of available media such as internet, social media, newspapers and television to make themselves aware. There is no authenticity and information may be wrong. Since, corona has become major cause of concern, present study was carried out to bring the awareness and educate them about coronavirus among the local population.Methods: A cross sectional study was carried out on COVID-19 by using online Google based questionnaire in Maval area to assess the knowledge and awareness about corona virus among the 125 local participants. The questionnaire consisted of 10 validated peer reviewed questions covering various aspects of COVID-19 awareness were voluntarily filled by participants. Data was analysed in Microsoft Excel 2010.Results: Present findings revealed that 94% participants knew that COVID-19 is caused by the corona was first detected in Wuhan China and the first case of the same was reported in Kerala was known to 60% respondents. The virus remains on the surface of mobiles was known to 11% participants.76.8% participants apprised 2-14 days being the incubation period of the virus. Patients with two or more comorbidities can develop severe COVID-19 was known to 46.6% participants. Only 5% participants knew the difference between swine flu and corona virus. Nearly 89% participants knew soap is the best material for cleaning in the presence of dirt and about 51% participants knew the need of isolating persons with known COVID- 19 infection.Conclusions: Correct answers with scientific explanation were posted to the participants in the form of instantaneous feedback. Hence knowledge gained was increased by the participants. Their misconceptions were removed. More awareness can be brought & propagation of COVID-19 infection can be prevented even after lockdown period.
Novel epitope based peptides for vaccine against SARS-CoV-2 virus: immunoinformatics with docking approach
Authors: B. Jesvin Bency , P. A. Mary Helen
Published: June 2020

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative viral strain for the contagious pandemic respiratory illness in humans which is a public health emergency of international concern. There is a desperate need for vaccines and antiviral strategies to combat the rapid spread of SARS-CoV-2 infection.Methods: The present study based on computational methods has identified novel conserved cytotoxic T-lymphocyte epitopes as well as linear and discontinuous B-cell epitopes on the SARS-CoV-2 spike (S) protein. The predicted MHC class I and class II binding peptides were further checked for their antigenic scores, allergenicity, toxicity, digesting enzymes and mutation.Results: A total of fourteen linear B-cell epitopes where GQSKRVDFC displayed the highest antigenicity-score and sixteen highly antigenic 100% conserved T-cell epitopes including the most potential vaccine candidates MHC class-I peptide KIADYNYKL and MHC class-II peptide VVFLHVTYV were identified. Furthermore, the potential peptide QGFSALEPL with high antigenicity score attached to larger number of human leukocyte antigen alleles. Docking analyses of the allele HLA-B*5201 predicted to be immunogenic to several of the selected epitopes revealed that the peptides engaged in strong binding with the HLA-B*5201 allele.Conclusions: Collectively, this research provides novel candidates for epitope-based peptide vaccine design against SARS-CoV-2 infection.
Audit on results of tympanoplasty: experience at a tertiary centre
Authors: Singh Anjali , Chaudhary Ashvanee , Singh Vishwambhar
Published: June 2020

Background: Chronic otitis media can be associated with various extracranial and intracranial complications. It has led to rise in number of people living with discharging ear and reduced hearing.Methods: Authors have shared their 3 years’ experience of a single tertiary institute regarding disease burden and management and results. This is a retrospective study including 500 cases of mucosal type of chronic otitis media and underwent tympanoplasty at the study institute. Follow-up records were kept for at least 6 months.Results: Graft uptake rate after 6 months follow-up was 86.2%. Cartilage tympanoplasty was performed for revision cases and had good results. Average air-bone gap closure was 17 dB. It is a simple surgery which can be performed in day care OT without any significant intra-op or post-op complication.Conclusions: Surgical treatment is significantly useful to reduce the disease burden due to chronic otitis media.
Thyroid disorders, epidemiology and outcome among patients in South Western region: Southern Saudi Arabia
Authors: Alamri Abdulrahman M. , Alsareii Saeed A. , Ali Yagoub M. , Sultan Salem A. , Alyami Mahdi A. , Alswidan Sammah M. , Alhutaylah Mahdi A. , Almuntashiri Ahmed S. , Madkhlai Rawabi Y. , Hussain Fatmah A. Al Abu , Alkhamssan Hadi M. , Alsalaim Mohammed A. , Saihb Abdullah A. , Alfaifi Mohammed H.
Published: June 2020

Background: Thyroid gland may have a group of a medical condition that affects its main function. The thyroid gland is located at the front of the neck and produces thyroid hormones. The released hormones go through the blood to many body organs for regulating their function, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development. The study aimed to assess the epidemiology of thyroid disorders among cases in the south-western region, Saudi Arabia, and to assess the reporting quality for these cases data.Methods: A retrospective record based descriptive approach was used through reviewing medical records of all cases that were admitted and diagnosed as thyroid related disorders for different indications in the main hospital (king Khalid Hospital) during the period from January 2018 to January 2020. Data extracted throng pre-structured questionnaire including patient's bio-clinical data, preoperative radiological and laboratory investigations. Also, laryngoscope pre and post operatively was reviewed to record findings.Results: The study included 405 cases with thyroid disorders whose ages ranged from 15 to 71 years old with a mean age of 30.5±10.6 years. Females were 82.7% of the included cases, and 83.8% were Saudi. Thyroid related symptoms were recorded for 1-2 years among 58.1% of the cases and for more than 5 years among 15.8%. Thyroid enlargement was recorded for 73.1% of the cases. The multinodular enlargement was recorded for 53.5% of the cases followed with diffuse thyroid enlargement (27.3%). Regarding the type of surgery undergone, total thyroidectomy was the most recorded followed with lobectomy.Conclusions: The study revealed that the majority of the cases were females at middle age presented with benign lesions with Euthyroid status. The most important conclusion was the significant remarkable underreporting of the different clinical data for the cases with many missing items.
Prevalence of hepatitis-C viral infection among opioid dependent injectable drug users: a study conducted at regional hospital drug de-addiction and treatment centre, Solan, Himachal Pradesh, India
Authors: Verma Kushel , Kumar Sanjeev , Sharma Vaishali
Published: June 2020

Background: There are a limited number of studies regarding the prevalence of hepatitis B, hepatitis C and HIV infections among the drug addicts in Himachal Pradesh; C virus (HCV) infection in north India especially Himachal with very high rates of substance abuse. The present study was attempted to study the prevalence of hepatitis C among the injectable drug users, which is more important in a country like India where viral hepatitis is estimated to be among the top ten causes of deaths.Methods: A study was conducted in 2019-2020 (July-April). HBsAg, anti-HBs, anti-HCV and anti-HIV tests in 235 drug addicts were studied. Urine samples obtained from drug addicts were analyzed for cannabis, opiate and cocaine metabolites.Results: The subjects included were 235 IDUs who were opioid dependent. All the 235 drug users were males, and their mean age was 30.69±9.494 years; 112 (47.7%) of them were in the age group ranging 20 - 29 years (p <0.05). Of 235 drug addicts, 113 (48.1%) and 115 (48.9%) were only cannabis and opiate users, respectively. The frequencies of HBsAg, anti-HBs and anti-HCV among drug addicts were 2.6%, 38.3%, and 9.4%, respectively.Conclusions: The obtained results showed that HCV infection was an alarming problem among opiate users in this part of Himachal. It is suggested to rapidly diagnose the infected persons; thus preventive measures and appropriate control may limit further transmission of these infections.
Incidence of acute kidney injury in asphyxiated babies in university of Uyo teaching hospital, Uyo, Nigeria
Authors: Emmanuel Ikpeme Enobong , Tony Dixonumo Ofonime , Paulinus Udoh Mary , J. Udo Jacob
Published: June 2020

Background: Acute Kidney Injury (AKI) is a consequence of birth asphyxia. In resource poor countries like ours, birth asphyxia still contributes to the high rates of neonatal morbidity and mortality. A few studies have reported the incidence of AKI in birth asphyxia in Nigeria but none from Uyo, south-south region of Nigeria.Methods: A descriptive cross sectional study carried out in the Newborn Unit of the University of Uyo Teaching hospital, Uyo, Nigeria over a period of eight months. One hundred and four term neonates with provisional diagnosis of birth asphyxia using Apgar scoring were recruited. Blood sample was collected within six hours of life from each subject for serum creatinine estimation using modified Jaffe method. Urine output was assessed by application of plastic collection bag to the skin by adhesive patch. AKI was diagnosed when sCr >1.5mg/dl while oliguria was defined as urinary output <1.5ml/kg/hour.Results: Of the total of 104 asphyxiated neonates enrolled into the study, 56 (53.8%) were males while 48 (46.2%) were females giving a male/female ratio of 1.2:1. Twenty-eight (26.9%) of the subjects had severe birth asphyxia; 52 (50%) had moderate birth asphyxia while 24 (23.1%) were mildly asphyxiated. Incidence of AKI was 48 (46.1%), twelve (11.5%) had AKI based on serum creatinine criteria while 36 (34.6%) had AKI based on urinary output criteria. The mean urinary output (ml/kg/hr) for the subjects was 1.65±0.68 while the mean serum creatinine (mg/dl) was 0.88±0.46.Conclusions: The incidence of AKI among asphyxiated neonates in our locale is high at 46.1%.
Study of epidemiological aspects and hormone receptor status of meningiomas
Authors: Butta Shristi , Gupta Manoj Kumar
Published: June 2020

Background: Meningiomas account for about a third of all central nervous system tumours worldwide. Though very common, quite less is known about its epidemiology. This study aims to establish the epidemiological parameters and hormone receptor status (Progesterone Receptor-PR) involved in the development of Meningiomas.Methods: This observational study included 50 patients. Epidemiological parameters studied included age, sex, symptoms, history of hormone intake, smoking, recurrence, family history, history of other hormone related tumours and radiological assessment of tumour site. Surgical samples were grossed and typed according to the WHO standards. Immunohistochemical staining was done using PR to establish the role of hormonal receptors in the development of meningiomas.Results: The mean age was 46.84±13.54 years. The ratio of male and female (Male:Female) was 1.0:2.3. 48.5% of females had history of hormonal pill intake and 28.6% had hormone related tumours, of which fibroid was most common. Amongst the sites involved cerebral convexity was most common (56%). Chi-square (χ2) test showed that there was a significant association between histological grade and PR expression of the patients (p=0.0002).Conclusions: Positivity for hormone receptors like PR, increased intake of hormonal pills by females and association of meningioma with hormone related tumours indicates that hormonal milieu plays a significant role in the growth of meningiomasχχ. This could thus provide an insight to the pathogenesis of meningiomas. In addition, mifepristone, an anti-progestin could be a player in the medical management of meningiomas.
Quality of life of carpal tunnel syndrome with non operative treatment: cohort study
Authors: Kastilong Merlin P. , Winifred Karema , Sekeon Sekplin A. S.
Published: June 2020

Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy entrapment and it interferes with the quality of life. Treatment for CTS can be divided into operative and non-operative treatment. Our objective was to compare the quality of life and pain intensity in a patient with CTS after oral treatment and local corticosteroid injection (LCI).Methods: A prospective cohort study was conducted in 18-65 years patients with CTS. Primary outcome was to compare the quality of life post oral treatment (NSAIDs, oral steroids, gabapentin) and LCI using the Short Form-36 questionnaire. Secondary output was to compare pain intensity using Numeric Rating Scale (NRS). Mann-Whitney and independent t-test were used to assess the comparison between the treatment.Results: Sixty CTS patients were included in this study, with 32 patients (53.33%) assigned to LCI. After observation one month, statistical analysis showed that LCI improved the quality of life better than oral in physical function and bodily pain components (p = 0.036 and p = 0.047). Injection treatment decreased pain intensity more than oral not statistically significant after 14 days (p=0.087), but was significant after one month (p=0.002).Conclusions: Local corticosteroid injection improved quality of life and decreased pain intensity better than oral treatment after one month.
Lower extremity gangrene in children from traditional bone setters care: an avoidable cause of limb loss
Authors: Echem Richard C. , Eyimina Phillip D.
Published: June 2020

Background: Worldwide, lower extremity gangrene in children is rare. In orthopaedic practice in developing countries, a frequent cause of extremity gangrene is the practice of traditional bone setting. Aim of the study was to document lower extremity gangrene in children resulting from the care of traditional bone setters’ as seen in a tertiary health institution.Methods: A prospective study of children presenting with lower extremity gangrene from the care of traditional bone setters at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018. Data obtained included the patients socio-demographics and relevant information related to the diagnosis. Data was analysed with SPSS version 20.Results: Eighteen children with lower extremity gangrene were seen. Their ages ranged from 10 days to 132 months. There was a female preponderance. Their parents mostly had primary and secondary levels of education and majority were married. The most common diagnosis was tibiofibular fractures followed by congenital clubfoot. Trauma-related injuries were mostly from falls. Duration before presentation ranged from 7 to 28 days. Majority had massage, splinting and bandaging from the bone setter. Most common associated complication at presentation was sepsis. All had provisional amputation. Most common amputation was below knee. Most had stump refashioning within 15 days. One had split skin grafting. There was one mortality. Duration of hospital stay ranged from 3 to 65 days.Conclusions: Children at any age can develop lower extremity gangrene from traditional bone setters’ care. This is an avoidable and preventable sequelae of care. Parental health education is necessary to discourage their patronizing traditional bone setters.
Danger in traffic: patients with obstructive sleep apnea syndrome
Authors: Erdogdu Suleyman
Published: June 2020

Background: Author aimed to investigate the presence of a driver's license of patients with sleep apnea and obstructive sleep apnea syndrome (OSAS) and to prevent them from going into traffic until they are treated.Methods: In this study 645 hospitalized patients in the sleep lab for one night in 2017-2018 for polysomnography (PSG) test were questioned. We compared Apne Hipopne Indexes (AHI) and Body Mass Indexes (BMI). Patients who have risk for traffic accidents were identified.Results: Total 424 (66%) of 645 patients were above AHI> 15, moderate and severe Obstructive Sleep Apnea Syndrome (OSAS) was diagnosed. 221 patients (34.3%) obtained a driver's license because they have mild OSAS (The AHI <15). 162 patients with AHI 15-30 (25.1%) had severe OSAS with medium OSAS and 262 patients (40.6%) had AHI> 30. Also, 410 patients with a driver's license in 645 patients had BMI> 25 kg/m2 in 373 (91%). 340 (83%) of 645 patients with a driver's license were male; 70 (17%) of them are women. All of those with a heavy vehicle license are men and the number is 110.Conclusions: To prevent possible traffic accidents, driver patients with OSAS detected by a polysomnography test should be withdrawn from the driver's license until they receive treatment and receive an updated health report.
Role of biomarkers in predicting anastomotic leakage following colorectal surgeries
Authors: Wani Mumtaz Din , Din Ferkhand Mohi Ud , Bhat Aabid Rasool , Kumar Irshad Ahmad , Raina Ashiq Hussain , Gul Zubair
Published: June 2020

Background: Recovery after surgery for patients with colorectal disease has improved with the advent of minimal access surgery and standardized recovery protocols. Despite these advances, anastomotic leakage remains one of the most dreaded complications following colorectal surgery, with rates of 3-27 per cent depending on specific risk factors. The aim of the study was to assess sensitivity and specificity of systemic and peritoneal drain-fluid bio-markers in early prediction of anastomotic leak; and to co-relate rise in levels of biomarkers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Methods: The present study was a prospective observational study conducted on 60 patients in the Postgraduate Department of Surgery, Government Medical College, Srinagar after obtaining due ethical clearance over a period of two years.Results: The mean age was 54.87±11.901 years with 44 patients (73.3%) were males. Among systemic makers: the mean CRP level was 2.7800±0.500 mg/L, the mean total leukocyte count was 10.783±0.940 thousands and the mean serum procalcitonin level was 0.365±0.1385 ng/ml. Among peritoneal fluid drain bio-makers, the mean IL-6 level was 3551.066±1311.965 pg/ml, the mean IL-10 level was 628.533±460.358 pg/ml and the mean TNF-a level was 16.391±6.736 pg/ml. The anastomotic leak after colo-rectal surgery was noted in 16 patients (26.7%). In our study significant co-relation was noted between the rise in levels of peritoneal drain fluid biomarkers and severity of clinical symptoms but no significant co-relation was noted between the rise in levels of systemic markers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Conclusions: Systemic biomarkers are poor predictors of anastomotic leak after colorectal surgery. But sensitivity and specificity of peritoneal fluid drain biomarkers in predicting anastomotic leak was significantly high.
Comparative study of prophylactic dexamethasone versus placebo for reducing post-operative sore throat after tracheal intubation: a prospective, randomised, double blinded clinical study
Authors: George Neethu , Mathew Sumesh
Published: June 2020

Background: Tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may account for postoperative sore throat, hoarseness and cough. Dexamethasone is a very potent long acting glucocorticoid with analgesic, anti-inflammatory and antiemetic effects which helps to reduce post-operative sore throat.Methods: A prospective double blinded randomized study was conducted involving 80 patients, dividing them into 2 groups. Group D received dexamethasone 0.1 mg/kg and group S received an equivalent volume of normal saline (placebo) intravenously before induction. Intubation was performed by an experienced anesthesiologist. Anesthesia induction and maintenance dosage were standardized for all patients. The incidence and severity of sore throat, hoarseness and cough were recorded at 1, 6 and 24 hours postoperatively by using four-point scale.Results: The overall incidence of sore throat and hoarseness was significantly reduced in dexamethasone group compared to placebo (normal saline) group. Incidence and severity of sore throat and hoarseness were assessed at 1 hour, 6 hours and 24 hours interval and found out that they were reduced in dexamethasone group compared to placebo group which was statistically significant at all intervals. But incidence and severity of cough reduced significantly only in the first hour. It was comparable at 6 and 24 hours between the groups.Conclusions: Dexamethasone was effective in reducing the incidence and severity of sore throat and hoarseness at 1, 6 and 24 hours. Incidence of postoperative cough was reduced significantly at 1 hour in the dexamethasone group.
Estimation of the effects of music therapy on the anxiety and patient’s perception during an upper gastrointestinal endoscopy procedure: a randomised controlled trial
Authors: Kannan Vikram , Sundar Sumathy , Prabhu Sajeesh Manikanda , Ezhumalai G.
Published: June 2020

Background: An upper gastrointestinal (GI) endoscopy procedure is an invasive medical procedure that is used in diagnosis and treatment of various intestinal disorders. Patients posted for upper GI endoscopy procedures often experience significant levels of pre-procedural fear, anxiety and discomfort during the procedure which can negatively affect cooperation levels during the procedure with the attending doctor. A very few studies have explored the beneficial effects of music therapy in this regard and so our study was planned.Methods: A prospective randomised controlled trial was conducted with a sample of 54 patients who were enrolled for this study. They were randomly divided into two groups - group 1 consisting of 27 patients, receiving a music therapy intervention and group 2 consisting of 27 patients who served as a control group. Group 1 received a receptive music therapy intervention in the form vocal, relaxing, improvisational music with patient preferred chants for fifteen minutes before and during the endoscopy procedure. Group 2 did not receive a music therapy intervention.Results: The results indicated that the post intervention, state-anxiety levels was significantly lower in the music therapy group compared to the control group with (p=0.001). Patients’ cooperation levels during the procedure with the attending doctor was significantly higher in the music therapy group than in the control group (p=0.001).Conclusions: Repeated music therapy intervention is highly beneficial in reducing state anxiety levels and improving cooperation levels during the GI endoscopy procedure.
Indications, outcomes and complications of therapeutic endoscopic retrograde cholangiopancreatography procedures in a tertiary care centre in North East India
Authors: Choudhury Bikash Narayan , Deka Utpal Jyoti , Baruah Bhaskar Jyoti , Bhattachayya Mallika , Sarma Preeti , Debroy Porag
Published: June 2020

Background: Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is one of the most complex endoscopic procedures in the management of several pancreatobiliary diseases. There is no comprehensive data available till date about ERCP procedures from North East India. The aim of this study was to review the indications, outcomes and complications of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a tertiary care centre of North East India.Methods: We retrospectively analysed the clinical records of all patients undergoing ERCP between July 2011 and November 2019. ERCP was performed under sedation (Midazolam + Pentazocine). Patient’s demographic characters, ERCP indications, outcome and post-ERCP complications were reviewed. Potential important patient and procedure related risk factors for overall post-ERCP complications were investigated.Results: A total 1038 patients were included in the study. Cannulation of the desired duct was successful in 89.2% of ERCPs. Among them male patients were 392 and females were 646. Mean age was 45 years and the age range were 7 to 92 years. Commonest indication was choledocholithiasis followed by malignancy. Overall Success rate was 82.66% with 84.64% in CBD stone and 75.65% in stenting of malignancy. Post ERCP complications developed in 96 patients (9.2%) and pancreatitis was the most common post-ERCP complication. Sedation related complications occurred only in few cases.Conclusions: Despite its associated morbidity and risk of mortality, ERCP is an important method for managing the pancreatic-biliary diseases. Indications, outcomes, and complications of therapeutic ERCPs in our centre are comparable to those reported from other centres.
Knowledge and control practices of hypertension among diabetic attending LAUTECH teaching hospital Osogbo, Nigeria
Authors: Folami Roseline Olufunmilola , Wennie Jummai Sa'a , Folami Emmanuel Oludayo
Published: June 2020

Background: Hypertension in diabetes is an added burden and the comorbidity a faster genesis of many cardiovascular diseases that exposes the diabetics to several complications, disabilities and higher mortality rate than the non-diabetics. This study therefore asses the knowledge and control practice of hypertension among the hypertensive diabetics attending the endocrine clinic of LAUTECH Teaching hospital Osogho, Osun state.Methods: A quantitative descriptive survey design was adopted and a total enumeration method was used in recruiting 102 hypertensive diabetics. A structured questionnaire was administered and used to collect data. Descriptive statistics was used to answer the research questions.Results: The overall knowledge level of hypertension among the hypertensive diabetics was above average with overall mean score of 54.01 (65.9%). The control practice level was fair with overall mean score of 45.1%.Conclusions: Efforts to increase the knowledge and control practices of hypertension should not focus only on general health education, but individual specific knowledge needs. practical sections that show case the lifestyle practices that will explain what hypertension self-care maintenance, monitoring and management practices such as exercise sections, diet sections actually means should be incorporated in the clinic routine.
Impact of early intervention of speech and language therapy among hearing impaired child
Authors: Kumari Rina , Tiwari Sunita , Chatuvedi Arun , Kumar Sunil , Rastogi Nalini
Published: June 2020

Background: Hearing impairment is a factor that directly compromises the individual’s language which can affect emotional and academic defects by delayed development of communicative ability. This can vary according to the type and degree of hearing loss. Speech therapy intervention is important, along with the use of sound amplification devices, so that the child may have a chance to develop speech, consequently learning and re-habilitation to the society. Aims of the present study was performed to assess the effectiveness of early intervention of speech and language therapy after use of hearing aids to hearing impaired children on their syntactic and lexical development.Methods: This quasi-experimental study conducted on 100 children having different degree of hearing loss at department of Neurology and department of ENT, King George’s Medical University, Lucknow, Uttar Pradesh. After collecting socio-demographic data of subjects by observation, completion of questionnaires, and speech recording by audiologist; Speech and language therapy provide by audiologist for six month after providing hearing aids and improvement in their syntactic and lexical development recorded.Results: There is significant improvement in verbal response from 14% before therapy to 81% after therapy and non-verbal response before therapy was 86% and after therapy was 19%. Before giving speech and language therapy to subjects pointing score was 24%, sign language was 10% and words response was 0% which increases after therapy were 1%, 2% and 39% respectively. Early identified/intervened hearing-impaired children had a notable positive difference in all assessed lingual gains.Conclusions: This is study results definitely point to positive effects of intensive and continuous application of speech and language therapy to syntactic and lexical development of hearing impaired children.
Listeria monocytogenes brain abscess in an immunocompromised patient: a case report
Authors: Suri Vinit , Chatterjee S. , Handa Rohini , Jain Swapnil , Naga Mohit Kalangi Venkata , Suri Kanika
Published: June 2020

Listeria monocytogenes is a facultative intracellular gram-positive bacillus which usually infects immunocompromised patients, though it can infrequently infect immunocompetent individuals, neonates and pregnant women as well. Neurological manifestations include meningitis and cerebritis. Brain Abscess is an extremely rare presentation with approximately 80 reported cases. Authors report a patient with a brain abscess identified on an MRI scan with positive blood culture for Listeria monocytogenes. Patient was managed conservatively with intravenous followed by oral antibiotics with resolution of the abscess.
Anticoagulation in pulmonary TB induced deep vein thrombosis is it always warranted: a case report
Authors: Lodaria Binal Nitin , Muley Prasad , Sheth Dhrumika
Published: June 2020

India is a densely populated developing country and accounts for one quarter of the total tuberculosis cases reported worldwide. Deep vein thrombosis (DVT) has been associated with 1.5-3.4% cases of tuberculosis. A 14 year female presented with complaints of cough with progressive breathlessness (NYHA Grade III) since 15 days along with easy fatiguability and fever for 3 days. The patient was started on Anti-Tubercular Treatment (ATT) as per RNTCP guidelines after thorough investigations. One week after the patient was started on ATT, the patient developed edema of the right lower limb accompanied by pain. Color doppler was suggestive of thrombosis in the superficial and deep veins. Early immobilization and physiotherapy was started immediately. Over a period of 10 days, the swelling gradually decreased, and pain subsided. Tuberculosis is an independent risk factor for the development of venous thromboembolism irrespective of the presence of other risk factors. Emphasis is thus laid on high index of suspicion and early diagnosis to control and prevent further complications like pulmonary embolism. We can propose that in patients diagnosed with pulmonary tuberculosis, early immobilization and physiotherapy can prevent the development of DVT.
Interstitial granulomatous dermatitis: a rare case report of dermatological manifestation of rheumatoid arthritis
Authors: Chandrasekaran Jagadeesh , Alex Neetu Mariam
Published: June 2020

Interstitial granulomatous dermatitis (IGD), a rare dermatological disorder was first described by Ackerman et al, in the year 1993. It is characterized by a heterogeneous clinical spectrum and a specific histopathological pattern. It has been described in association with a number of auto-immune disorders, drugs, fungal infections, and malignancies. It may manifest as papules, patches, plaques, nodules, annular lesions, or less frequently, as described classically, as indurated linear subcutaneous cords. This case is being reported as interstitial granulomatous dermatitis is rare dermatological manifestation of rheumatoid arthritis and presentation as large ulcerated skin lesions is further extremely rare. In this case report we describe a 67-year-old gentleman with Seropositive Rheumatoid arthritis. He presented to our hospital with complaints of multiple well defined skin lesions with pus discharge over lower limbs, trunk and upper limbs. Biopsies from left upper limb and abdomen showed focal necrobiosis with surrounding granulomatous inflammation with rare perivascular granulomas. He was subsequently diagnosed to have interstitial granulomatous dermatitis based on histopathological examination. Interstitial granulomatous dermatitis has been described to be associated with a number of autoimmune conditions and drugs. It is very important for clinicians to have knowledge about this rare skin condition as it may be heralding presentation of a serious underlying condition like lymphoproliferative disorders or solid organ malignancies. There is no specific treatment and causative disease has to be diagnosed and targeted.
Complete androgenin sensitivity syndrome presenting with primary amenorrhoea and inguinal mass: a case report
Authors: Saranya P. , Pavani S. , . Ramalingam , Swaroopa M. Mahima , Hari Babu R.
Published: June 2020

Androgen insensitivity syndrome (AIS), also known as testicular feminization, an X-linked recessive disorder comprises a wide range of phenotypes that are caused by various types of mutations in the androgen receptor gene. AIs can be classified as complete, partial, or mild based on the phenotypic presentation. The clinical findings include a female type of external genitalia, 46-XY karyotype, absence of Mullerian structures, presence of Wolffian structures to various degree, and normal to high testosterone and gonadotropin levels. We report this case as an interesting and rare syndrome. The patient is a 15-year-old phenotypic female who presented with primary amenorrhea and normal-appearing external genitalia. Orchidectomy was done after proper counselling and proper psychological support was given to her.
Decompressive craniectomy in herpes simplex encephalitis: a case report
Authors: Suri Vinit , Jain Swapnil , Naga Mohit Kalangi Venkata , Tyagi Sudheer , Bhati Aditendraditya Singh , Suri Kanika
Published: June 2020

Herpes Simplex Encephalitis is the commonest form of sporadic encephalitis. Availability of effective antiviral therapy viz Acyclovir has significantly reduced the mortality of Herpes Simplex Encephalitis. Elevated intracranial pressure   resulting in herniation syndromes continues to be an important cause of mortality. Antiviral therapy and medical measures for managing raised intracranial pressure including osmotic diuretics, careful usage of steroids and controlled hyperventilation continue to be the cornerstones in management of these patients. Authors present a 38-year-old male patient with Cerebrospinal fluid Meningo-encephalitic panel positivity for herpes simplex virus 1 and bilateral temporal lobe lesions with secondary decline due to impending herniation syndrome despite osmotic diuretics and steroids with patient survival and complete recovery following decompressive hemicraniectomy.
Adipokines: mediators of immunity and inflammation
Authors: Kharbanda Rajat , Bansal Tarun
Published: June 2020

White adipose tissue has emerged as a highly dynamic organ that releases a plethora of immune and inflammatory mediators that are involved in obesity, metabolic syndrome and immune mediated diseases. Adipokines have complex role in various physiological and pathological processes by exerting potent modulatory actions on target tissues In this Review, In this review, we explore the effects of different adipokines, focusing primarily on leptin, adiponectin, visfatin and resistin in causing immune-mediated and/or inflammatory diseases.
Correlation between prevalence and socio-demographic, knowledge and risk factors of soil transmitted helminthiases: cross-sectional study among primary school-going children in Rarieda, Kenya
Authors: Arwa Stephen Onyango , Mogere Dominic , Musoke David
Published: June 2020

Background: Soil transmitted helminthiasis, classified as neglected tropical diseases are among the most common infections worldwide with greatest numbers occurring in Sub-Saharan Africa, Americas, China and East Asia. Globally, over two billion people are infected with school-age children bearing the greatest burdens. Transmission is through eggs present in human faeces. They are infections of public health importance as they cause among others, nutritional impairment, diarrhoea and intestinal obstruction. Prevention involves deworming, health education and sanitation.Methods: The study was carried out in Rarieda, Kenya in 2018. Study participants were primary school children of ages seven to fifteen. Cross sectional study design was used and the data was analyzed using Statistical Package for Social Sciences. All the ethical issues were adhered to as per the International standards.Results: The study established that prevalence of soil transmitted helminthiasis was high in areas where the risk factors associated with the infections were high. Pupils who were more knowledgeable on soil transmitted helminthiases were less infected. Younger pupils were more infected than older pupils. Lastly, the prevalence of these infections varied with gender of the pupils, and geographical location from where the pupils came from.Conclusions: Correlation between prevalence of soil transmitted helminthiases and risk factors, and between presence of toilets and level of hygiene practice were positive, r=0.90 and 0.93 respectively; while correlation between prevalence of soil transmitted helminthiases and knowledge was negative, r=-0.75. Values of the correlations were of statistical significance at p<0.05.
Relationship between childhood obesity and dietary behavior in selected school-going children from Dhaka city, Bangladesh
Authors: Alam Mohammad Rahanur , Habib Mohammad Asadul , Huq A. K. Obidul , Mamun Sumaiya , Reza Sompa , Zaher Abduz
Published: June 2020

Background: The prevalence of non-communicable diseases is rising in Dhaka City, Bangladesh. Obesity is one of the significant risk factors for many non-communicable diseases. This research aimed to investigate the current prevalence of overweight and obesity among children in selected schools in Dhaka City through anthropometric evaluation, as well as to assess the correlation of various environmental determinants such as physical activity, dietary behavior, lifestyle habits, are associated with increased risk of obesity in children.Methods: This school-based cross-sectional study was conducted among 106 participants (50 male and 56 female participants) aged 6-14 years selected by convenience sampling from four randomly selected primary schools of different regions of Dhaka city. A pre-tested questionnaire was used to collect data.Results: The prevalence of overweight and obesity among school-going children 24.5%, 68% respectively. Factors associated with being obese included type of game (χ2=34.036; p=0.001), total playtime (χ2=17.788; p=0.000), TV and computer watch time (χ2=27.321; p=0.007), spend money to buy fast food (χ2=26.451; p=0.002), eating days fast food in a week (χ2=24.825; p=0.003), type of tiffin (χ2=19.757; p=0.072).Conclusions: Less playtime, longer watching TV and computer, and eating more fast food are major risk factors for overweight and obesity among school-going children in Dhaka city. Interventions are needed to increase awareness of child overweight weight and obesity risk factors to decrease the prevalence of overweight and obesity.
Vaccination coverage and factors associated with incomplete childhood vaccination among children aged 12-59 months in Miagao, Iloilo, Philippines
Authors: Malecosio Serafin O. , D. Celis M. Jascha Lane , Delicana Katie B. , Deopido Anarey M. , Bacale Keanah Marie F. Kang , Labasan Van Karlo L. , Ladiao Riza Mae C. , Militante Kriza Marie D. , Paguntalan Jaypee M. , Sabusap Von Erjun P.
Published: June 2020

Background: Complete Vaccination has made a significant contribution to the prevention of infectious diseases among children. However, not all children were completely vaccinated.  This study aimed to determine the vaccination coverage, timeliness, and maternal-related factors associated with incomplete vaccination of children in Miagao, Iloilo, Philippines.Methods: A cross-sectional study of children aged 12-59 months at the time the study was conducted between April 15 and 26, 2019 in Miagao, Iloilo. A total of 515 children were selected using a two-stage random sampling design. The data were collected from the Target Client Lists records, encoded, and analyzed using SPSS v21. Binary logistic regression was used to determine the factors associated with incomplete vaccination.  Crude and adjusted odds ratio (AOR) with their confidence interval were reported.Results: The complete vaccination coverage among children was low at 28.7%. Among those completely vaccinated, 2.7% to 88.5% had untimely Vaccination.  Significant factors associated with incomplete Vaccination were children born at home (AOR=2.1; 95% CI: 1.32-3.36) and mothers who had two or less postnatal visits (AOR=3.4; 95% CI: 1.39-8.44). Age and number of antenatal visits of the mothers did not influence the outcome.Conclusions: Maternal related factors significantly associated with incomplete vaccination were the place of child delivery and the number of postnatal visits of mothers.  The study recommends educating mothers on the importance of postnatal visits and enhancing maternal health services, especially the promotion of facility-based delivery.
Indian aesthetic dance and yoga improves mental health among caregivers of children with neurodevelopmental disorders: a randomized trial
Authors: Hegde Jayashree R. , Melukote Sridhar K. , Srinivasan T. M. , Singh Deepeshwar
Published: June 2020

Background: This study aimed to assess the effects of Indian aesthetic dance (IAD) and yoga on psychological behavioral and mental health-related problems among the caregivers of children with neurodevelopmental disorders (NDDs).Methods: One hundred one caregiver participants were randomly allocated to either intervention of IAD or a structured yoga program or in a control group. The invention groups received supervised eight-weeks IAD or yoga training for 3 alternative days, 75 min each day. In total, 96 subjects completed the study with after high adherence of 95% to intervention sessions. Caregivers were assessed with self-rated primary measures including the Zarit burden scale (ZBS), depression, anxiety, and stress (DASS-21) scale; and secondary measures were revised caregiver’s appraisal scale (RCAS) and WHO Quality of Life WHOQOL (BREF) scale. The assessments were done at pre (1st day), mid (ENT of 4th week), and post (end of 8th week) of interventions.Results: Statistical analysis showed there was a significant reduction in scores of ZBS (p<0.001), DASS-21 (p<0.001), and significant improvement was found in the subscales of RCAS and WHOQOL (BREF) (p<0.001).  Conclusions: The outcome of the study suggests that IAD and Yoga can be feasible interventions for alleviating symptoms of mental health-related issues among caregivers.
Facility based retrospective infant death study in a tertiary care hospital of Tripura
Authors: Baidya Subrata , Debbarma Sanjib , Paul Debosmita , Chowdhury Purvita , Kalita Biraj Kumar , Karmakar Sanjoy
Published: June 2020

Background: Infant and neonatal mortality are important indicators of the overall physical health of a community. An increase is generally indicative of unmet human needs in healthcare, sanitation, nutrition and education. Objective: To estimate the different causes of death along with the geographic distribution of the reported death cases during the study period.Methods: Analysis of the retrospective mortality data of infant and neonates in the Pediatric Department of Agartala Government Medical College and Hospital, from 2014-2018, was conducted.Results: A total of 1525 infant deaths were recorded in the study facility, of which 878 (57.57%) were early-neonates, 120 (7.87%) late neonates and 527 (34.56%) post-neonatal infants. The most reported causes of neonatal mortality in Tripura were found to be preterm/low birth weight and perinatal asphyxia with OR of 1.45 (CI=1.137-1.857) and 1.41 (CI=1.10-1.81) respectively.Conclusions: The increasing burden of preterm births and neonatal sepsis needs attention towards ante-natal care along with holistic healthcare services. The need for intensive actions from both administration and healthcare facility to promote identification of red-flags at primary level, followed by proper referral from the periphery to tertiary care facility has been reiterated in this study.
Knowledge, attitude and practice regarding mother-to-child transmission of HIV, its prevention, and associated factors among antenatal women attending a health care facility in district Srinagar, North India: a cross sectional study
Authors: Mukhtar Mohsina , Quansar Ruqia , Bhat Suhail N. , Khan S. M. Salim
Published: June 2020

Background: HIV pandemic still remains an issue of major concern on a global scale with more than 37.9 million people estimated to be living with HIV in 2019 globally -an increase from 36.7 million in 2015. India has the third largest HIV epidemic in the world, with 2.1 million people living with HIV, with higher prevalence among men (0.25%) than women (0.19%) out of which children (15 years) accounts for 6.54%, while two fifth (40.5%) of total HIV infections are among females.Methods: A cross-sectional hospital based study was conducted over a time period of 03 months and a total of 366 pregnant women attending the health care facilities of Block Hazratbal were included in the study.Results: Among the study participants, only 15 (4.1%) women had not heard about HIV/AIDS, 314 (85.8%) were aware of sexual transmission as a mode of transmission and only half of the study subjects (50.8%) knew about MTCT, more than half of the subjects (68.3%) were aware that the transmission of HIV infection can occur during pregnancy.Conclusions: Although the study population showed adequate knowledge about HIV infection, there was a considerable lack of knowledge regarding mother-to-child transmission of HIV infection and its prevention.