bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensive Corneal Neovascularisation Treatment by Ultraviolet Corneal Collagen Crosslinking
Authors: Shehadeh Mohammad M ,   Faculty of Medicine and Health Sciences, An-Najah National University Hospital, An-Najah National University, Nablus, Palestine,   Vardinoyannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece, Akkawi Mohammad T ,   Faculty of Medicine and Health Sciences, An-Najah National University Hospital, An-Najah National University, Nablus, Palestine, Diakonis Vasilios F ,   Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, US,   Vardinoyannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece, Aghbar Ammar A ,   Faculty of Medicine and Health Sciences, An-Najah National University Hospital, An-Najah National University, Nablus, Palestine, Shanab Abdelraheem Abu ,   Faculty of Medicine and Health Sciences, An-Najah National University Hospital, An-Najah National University, Nablus, Palestine
Published: August 2017

The purpose of this article is to report a case of extensive corneal neovascularisation that was treated by ultraviolet corneal collagen crosslinking (CXL). The case report is about a 24-year-old man who was referred to the cornea clinic with a case of keratitis. He was treated with topical antibiotics. After full resolution of keratitis, his condition was complicated by extensive corneal neovascularisation. A trial of photochemical corneal collagen CXL with riboflavin/ultraviolet A resulted in a dramatic improvement and resolution of the corneal neovascularisation. Thus, we can conclude that corneal collagen CXL could be a promising procedure to treat certain cases of extensive corneal neovascularisation.
The E-cigarette – a New Tool to Aid Smoking Cessation
Authors: Bartsch Pierre ,   Department of Chest Diseases, University of Liège, Belgium
Published: August 2017

This editorial shows that, despite controversies in the public health community and among professionals regarding the role of e-cigarettes as an aid to stopping smoking, and although the potential health risks of long-term use of nicotine are unknown, modern devices should be regarded more as a solution than a problem. Clinicians, owing to the high morbidity and mortality of smoking should include e-cigarettes as efficient tools to help smokers to quit smoking or at least as a substitute for cigarettes. Effort is needed to improve knowledge about this tool.
Sleep in Children with Chronic Lung Disease
Authors: Ersu Refika ,   Marmara University, Istanbul, Turkey
Published: August 2017

Sleep is a vulnerable period for the respiratory system. Patients with chronic lung disease (CLD) may be at risk for hypoxemia during sleep; they have reduced baseline arterial oxygen pressure that develops with advancing lung disease. Nocturnal hypercapnia may be present in CLD without nocturnal hypoxemia or daytime gas-exchange abnormalities. Increased upper airway resistance, including nasal obstruction, is a risk factor for obstructive sleep apnoea in children with cystic fibrosis and primary ciliary dyskinesia. Sleep problems are usually underestimated in these patients. Non-invasive ventilation and supplemental oxygen may be helpful in mitigating the adverse effects of nocturnal hypercapnia and hypoxemia. Sleep should be evaluated in children with CLD to improve the care of these patients.
Inhaler Characteristics in Asthma
Authors: Biddiscombe Martyn Francis ,   Airway Disease Section, National Heart and Lung Institute, Imperial College London, and Royal Brompton Hospital, London, UK
Published: August 2017

The history of inhaled therapy goes back a surprisingly long way. More than 4,000 years ago, in India, the vapour of plants from the nightshade family placed on hot bricks was inhaled to alleviate breathing difficulties. The bronchodilators, derived from these plants, and compounds related to them, have played a significant part in therapeutic aerosol delivery over the years and remain important in the treatment of lung diseases today. The development of inhaled therapy has accelerated over the past 60 years with the arrival of the first truly portable inhaler in 1956 to relieve the symptoms of asthma. Initially, only bronchodilators were delivered from these devices, but as the true nature of asthma was revealed, inhaled corticosteroids were introduced to treat the underlying inflammation that is a major component of asthma. Further advances have led to long-acting bronchodilators becoming available, and combination therapies containing both longacting bronchodilators and corticosteroids in one inhaler. Asthma therapy has come a long way in a comparatively short time with over 230 device and drug combinations available for treating the disease. However, despite enormous investment asthma remains a huge healthcare problem. The number of people with asthma continues to grow with over 300 million people affected worldwide and 250,000 annual deaths attributed to the disease. It affects people of all ages and has a varying degree of severity. In this article, we look at the ideal characteristics for asthma inhalers and highlight some of the most important reasons for the failure of current asthma treatments.
Soothsaying song thrushes and life-giving snails : motifs in A.S. Byatt's "Babel Tower" and "A whistling woman"
Authors: Johnson Jennifer Anne
Published: August 2017

Thrushes and snails are scattered throughout the pages of A .S. Byatt’s Babel Tower and A Whistling Woman, functioning as motifs that link the main narrative with its intertexts, thematically and symbolically. Although the thrush appears to be a predatory creature, it links a line of soothsayers and helpers created by Byatt herself as well as others in the works of Robert Browning, J.R.R. Tolkien and Thomas Hardy. The snail is a complex figure, associated with myths of life and death as well as with scientific research into neuroscience, environmental studies and DNA, the basis for all life. As a result it serves to bridge the two cultures of the literary and scientific worlds in the second half of Byatt’s tetralogy.
Contesting identities : Representing British South Asians in Damien O'Donnell's "East is East"
Authors: Zapata Sarah
Published: August 2017

The presence of Asian in Great Britain has added a new perspective to debates about notions such as ‘identity’, ‘multiculturalism’ and ‘Englishness’. East is East (Damien O’Donnell, 1999) explores the culture clash that occurs in the context of a half Pakistani and half British family living in early 1970’s Salford. Through its representation of an atypical family the film’s emphasis lies most conspicuously on its portrayal of the beginnings of contemporary multi-ethnic and multicultural British society. This way, the film highlights issues of cultural diversity, difference and hybridity while also raising questions about identity, belonging and the concept of Englishness. The aim of this essay will therefore be to examine how Daniel O’Donnell’s film East is East explores the paradoxical nature of “identities” inevitably swaying in between two cultures by looking at the diverse discourses on identity and how they have been constructed.
A Spanish portrait : Spain and its connections with the thematic and structural dimensions of "For whom the bell tolls"
Authors: Marín Ruiz Ricardo
Published: August 2017

After having visited several countries in Europe and Africa, Hemingway found in Spain a land which would play a key role in his later literary career. His first stay in our country in the early twenties would mean the outset of a closed and long relationship with Spain that took almost forty years. During his different travels to Spain, Hemingway had the chance of discovering in the Spanish people a set of values and traits for which he felt a special attraction, such as violence, rebelliousness and, above all, a fatalistic vision of existence where death was inherent to life itself. In his most renowned novel, For Whom the Bell Tolls (1940), Hemingway offers a wider and deeper vision of those characteristics which made the Spanish soul so particular from his point of view. We identify some of them by analyzing the main structural and thematic elements of this novel set in the Spanish Civil War.
Mary Reilly as Jekyll or Hyde : Neo-Victorian (re)creations of Feminity and Feminism
Authors: Miquel Baldellou Marta
Published: August 2017

In his article “What is Neo-Victorian Studies?” (2008), Mark Lewellyn argues that the term neo-Victorian fiction refers to works that are consciously set in the Victorian period, but introduce representations of marginalised voices, new histories of sexuality, post-colonial viewpoints and other generally ‘different’ versions of the Victorian era. Valerie Martin’s gothic-romance Mary Reilly drew on Stevenson’s novella to introduce a woman’s perspective on the puzzle of Jekyll and Hyde. Almost twenty-years after the publication of Martin’s novel, the newly established field of research in Neo-Victorian fiction has questioned the extent to which Neo-Victorian recreations of the Victorian past respond to postmodern contemporary reflections and ideas about the period. This article aims to examine the ways in which this Neo-Victorian gothic text addresses both the issues of Victorian femininity and feminist principles now in the light of later Neo-Victorian precepts, taking into consideration that Martin’s novel introduces a woman’s perspective as a feminist response to Stevenson’s text but also includes many allusions to the cult of domesticity as a legacy of the Victorian gothic romance.
Some reflections on the origins of cognitive linguistics
Authors: Bernárdez Sanchís Enrique
Published: August 2017

The purpose of these notes is to contribute to the understanding of the intellectual and scientific origins of Cognitive Linguistics (CL); it is not, therefore, a history, even partial and incomplete, of CL; neither does it offer any exhaustive consideration of all the factors, influences, linguistic and psychological models, or of all the linguists that have contributed to the birth and development of the discipiline, an enterprise that is probably premature.
The R files : applying relevance model to conspiracy theory fallacies
Authors: Martínez Sánchez Roser , Figueras Solanilla Carolina , Casacuberta Sevilla David
Published: August 2017

The general aim of this article is to test how the relevance model can be of use to model argumentation. More specifically, to check if the theory developed by Sperber and Wilson (1986) is able to explain some specific fallacies, the so called "conspiracy theory fallacy". This paper contains: a short introduction both to fallacies and to relevance theory; a summary of two real conspiracy theories taken from the book "The 60 greatest conspiracies of all times", and a detailed analysis of these two conspiracies by means of the relevance model.
When consequences are causes : Texts as guided paths
Authors: Inchaurralde Besga Carlos
Published: August 2017

Causation is a very important structuring principle of our perception of reality, but causation is, very often, imposed, and it basically depends on the observer and his or her perspective. It will be illustrated here how causation can be manipulated, as well as the relevance of this fact for language and communication. In scientific texts, the reader is guided through an evaluative process whose main goal is persuasion, but in this kind of message there is little room for manipulation concerning the ordering of causes and consequences. Logical fallacies, which may appear in ordinary conversation but also in more specialized varieties of linguistic usage (e.g. political language) illustrate it better. However, where this manipulative resource excels is in messages constructed around big metaphorical mappings. This is exemplified with the case of the treatment of the Gulf War in the mass media, as Lakoff (1992) very clearly explains. Moreover, we have that mass media exchanges between two different sides normally try to assign causes and consequences in a manipulative manner too, and there is a last example presenting this fact. Finally, our conclusion shows how all these possibilities share some configurational properties.
A cognitive view on bilingualism and "bilingual" teaching and learning
Authors: Niemeier Susanne
Published: August 2017

Foreign language teaching and learning may profit substantially when discussed from a cognitive point of view. The paper deals with the situation of a new direction of foreign language teaching and learning in Germany, where in the last years so-called "bilingual" approaches have been implemented. This means that subjects such as history or biology are taught in English instead of in the mother tongue, thus exposing the learners to the foreign language to a degree that can not be offered by traditional English lessons. Furthermore, in those content subjects, the foreign language is used in a much more authentic and holistic way. So far, the results have been very promising. Combining some reflections on this new kind of teaching with insights from cognitive linguistics seems to be a way of introducing the learners not only to more exposure to the language, but also offers a way to provide the learners with insights into the way language works as well as with insights into the conceptual world behind the foreign language, and it tries to prevent the students from generating an indiscriminate mixture between their home culture and the foreign culture
Subsidiarity relationships between image-schemas : an approach to the force schema
Authors: Peña Cervel María Sandra
Published: August 2017

In this paper, we investigate the nature of the FORCE image-schema as subsidiary to the PATH schema. On the basis that not all image-schemas can be ranked on a par (see Pauwels and Simon-Vandenbergen 1993 and Peña 1998) we establish three different types of subsidiarity relationships between image-schemas. We further observe that the FORCE image-schema plays a prominent role in the conceptualization of metaphors for emotions in English. Additionally, the seemingly chaotic and abstract domain of emotions will be shown to be endowed with coherence and structure.
The role of cognitive mechanism in making inferences
Authors: Ruiz de Mendoza Ibáñez Francisco José
Published: August 2017

Discovering the nature and role of inferential mechanisms in language understanding is a distinctly common concern in work carried out both within Cognitive Linguistics and Relevance Theory. Cognitive linguists increasingly tend to see language-related inferences as a matter of the activation of relevant conceptual structures. This is generally accepted by relevance theorists; however, they tend to play down the importance of such structures in favour of pragmatic principles. This is evident in their treatment of phenomena like metaphor and metonymy, which are explained by them as a question of deriving strong and weak implicatures. In this paper we revise this treatment and argue in favour of dealing with metaphor and metonymy as cognitive mechanisms which provide us with explicit meaning or, as relevance theorists would put it, with sets of "explicatures". This allows us to reformulate the implicature/explicature distinction and to reconsider the way it works in relation to other phenomena which are also of concern to relevance theorists, like disambiguation in conjoined utterances.
Semantic structure, realtional networks, and domains of reference
Authors: Santibáñez Sáenz Francisco
Published: August 2017

In this paper we make use of some of the conceptual tools provided by Cognitive Linguistics in order to discuss the issue of knowledge organization. We start off from the account provided by Ruiz de Mendoza (1996), who fleshes out the key ideas of the network organization model postulated by Langacker (1987). In Ruiz de Mendoza's account a semantic characterization consists of what he terms a general definer, which is a kind of semantic invariant, plus a number of prototypical instantiations of the definer. The instantiations are accessed relationally. Our own account tries to improve on Ruiz de Mendoza's initial insights by making his proposal compatible with Langacker's notions of base and profile, and by organizing the resulting description in the form of sets of converging cognitive models, a proposal made by Lakoff (1987) which is fully compatible with the network characterization. To illustrate our view we offer an analysis of the concept of 'mother', which has been variously studied by a number of linguists working within the cognitive paradigm. Our analysis is mainly based on Lakoff's account, but we further structure each converging model in terms of the domains on which it is potentially profiled. This has the advantage of providing a much richer characterization which facilitates the instantiation process.
Grounding politeness
Authors: Pérez Hernández Lorena
Published: August 2017

Traditional theories of politeness, like Brown and Levinson’s (1987 [1978]) and Leech’s (1983), claim a universal status which can be questioned on the basis of the evidence provided by studies on the politeness mechanisms of the most diverse cultures. In the present paper, we attempt to prove that one of the reasons which prevents those theories from reaching the desired pancultural validity is no other than their use of conceptual metaphors (i.e. a culture-specific construct) in their explanation of politeness. In addition, we would like to establish a firmer ground for a crossculturally valid theory of politeness by considering the workings of some universal cognitive tools (i.e. image-schemas) in the conceptualization of this subject matter.
Prognostic significance of micro RNA 150 marker in BCR-ABL positive chronic myeloid leukaemia patients on imatinib mesylate
Authors: Ezeanosike Obumneme B. , Afonne Onyenmechi J.
Published: August 2017

Background: Micro-RNAs control gene expression by destabilizing targeted transcripts and inhibiting their translation. In chronic myeloid leukaemia (CML), abnormal expressions of miRNAs have been described. The current treatment for newly diagnosed cases of CML is imatinib mesylate which produces rapid haematological responses. It is currently impossible to predict whether a patient will develop resistance to imatinib mesylate. This makes identification of predictors of resistance to imatinib an important goal in management of patients with CML. MicroRNA expression patterns can be used to predict outcome which can be remission or relapse. This study therefore, was set to assess the possible use of microRNA 150 for prognostication.Methods: Fifty peripheral blood samples previously collected from CML patients who were being treated with imatinib mesylate and stored in the refrigerator at +4°C were analyzed for the expression of microRNAs 150. Total RNA was extracted from guanidium isothiocynate (GITC) lysate of the blood samples using RNeasy mini spin column. The total RNA was converted to complimentary DNA by random hexamer priming using Murine Moloney Leukaemia Virus Reverse Transcriptase. Real time Multiplex PCR was used for detecting Breakpoint Cluster Region-Abelson Murine Leukaemia (BCR-ABL) transcript type.Results: The patients’ samples showed an expression of miRNA-150. Correlation of BCR-ABL ratio with miRNA-150 was done and the Spearman correlation coefficient (Rho) between BCR-ABL1 and miRNA-150 was 0.442 (p = 0.001; CI = 0.18-0.65) showing that there was a positive correlation between BCR-ABL1 and miRNA-150. The coefficient of determination was 20% (CI = 3-42%), which implies that about 20% of BCR-ABL1 ratio could be accounted for by the miRNA-150 values.Conclusions: Therefore, once patients who are on imatinib achieve molecular remission of the CML, the miRNA-150 can be useful in predicting outcome which could be relapse or complete molecular remission but is weak at diagnosis in predicting such outcome.
Clinical profile of fever in newborn and predictors of outcome
Authors: Janakiraman Deepa , Muthumani Karthikeyan , Thirumalaikumaraswamy Sivaraman
Published: August 2017

Background: Hyperpyrexia, in neonates is considered as a medical emergency. The aim of the present study was to evaluate complete clinical profile and relevant laboratory investigations in arriving at various etiologies of fever in neonates and to arrive at predictors of mortality among newborns presenting with fever symptoms.Methods: This prospective study conducted in the Neonatology Department of Institute of Child Health and Hospital for Children during the period January 2015 to September 2015. A total of 100 neonates from Day 1 to Day 28 of life regardless of gestational age with fever were included in the study. Complete blood cell counts and blood cultures were obtained on all of the patients.Results: Out of 100 neonates 87% were term new born. Lethargy was the major presenting complaint (48%) associated with fever. Respiratory distress was the most common clinical sign observed in febrile neonates (21%). 63 had a positive septic screening. 16 among those with positive septic screen had an organism grown in the culture. Staphylococcus aureus was the most common organism isolated in febrile neonates. Mortality was seen only in 6% of the neonates who had fever.Conclusion: Children with fever are at higher risk of bacterial infections. They need immediate medical supervision for identification of exact etiology.
Clinical study of lower respiratory tract infections in children attending a tertiary care hospital
Authors: Munagala Venkata Krishna , Uma Mahesh Ramisetty M. , Kandati Jithendra , Ponugoti Munilakshmi
Published: August 2017

Background: WHO estimated burden of respiratory tract infections in 2010, estimates four and half million deaths due to respiratory tract infections among children every year. In India, 1.2 million deaths have been reported among children due to RTI among 5.9 million deaths globally. Lower respiratory tract infections are most common causes of death than upper respiratory tract infections. Pneumonia and Bronchiolitis are most common types of LRTI in children. Pneumonia accounts for most of the deaths in children < 5 years of age. The present study was undertaken with an objective to know the various types of lower respiratory tract infections in children less than 12 years of age. The study also aims to know the various bacterial agents causing respiratory tract infections with their antibiotic susceptibility.Methods: Hospital based, prospective cross-sectional study was conducted for a period of one year and 375 children were enrolled. Demographic, clinical history and examination was done and signs and symptoms noted. All necessary investigations were performed and followed regularly for management and outcome.Results: Incidence of LRTI in the study was 9.76% with male preponderance (65.33%) and most common among children in 1-4 years age group. Ratio of males to females was 1.9:1. 73.6% of cases were in low socio-economic group, 35.2% were found with PEM-I grade and 18.13% had no immunization coverage. Cough and breathlessness were the major symptoms and respiratory distress and clubbing were major signs in the study. Bronchopneumonia was the commonest cause (38.7%) followed by bronchiolitis and Allergic bronchitis. 18.45 of cases had anemia and Leucocytosis was also present. Pulmonary infiltration was the major finding in the X-ray of chest. Streptococcus pneumoniae and Klebsiella pneumoniae were the common bacterial pathogens isolated.Conclusions: To conclude, our study clearly highlighted the various types of clinical presentations, risk factors and different types of LRTI in children <12 years of age. Understanding a clear knowledge of the etiology and bacterial pathogens clearly provides guidance for the physician in management and clinical outcome.
Assessment of missed opportunities of immunization in children visiting health facility
Authors: Verma Suresh Kumar , Mourya Harish Kumar , Yadav Anita , Mourya Saroj , Dabi D. R.
Published: August 2017

Background: A missed opportunity of immunization is one of the important contributing factors for poor immunization status of western desert part of India. The present study is aimed to know the prevalence of MOI in children visiting the Health facility.Methods: Immunization status was assessed via interview method using standard protocols recommended by the WHO, in a total of 600 children aged less than two years (200 indoor and 400 outdoor patients) enrolled randomly. The children who had missed an immunization opportunity were compared with those who had not, for socio-demographic variables and reasons for same were determined.Results: 45.64% of children had missed an opportunity for immunization in health care visit Illiteracy, higher birth order, rural residence; poor socioeconomic status emerged as the risk factors. Failure to assess Immunization during health visit was found in 82.39%, lack of knowledge of the parents regarding immunization schedule in 79.40% and false contraindications (mild acute illness in 21%, current antimicrobial therapy in 8.22%, convalescent phase of illness in 7.86%, recent exposure to infectious disease in 5.24%, fever precipitating seizures in 1.12%, pre-maturity 0.74% in that order) were the main causes.Conclusions: Immunization is an important but yet neglected part of child health visits. Each child’s immunization status should be assessed at every health care visit to avoid missed opportunities.
Practicing pediatrician’s perspective on the immunization schedules: a short survey
Authors: S. Jagannathan , K. S. Kumaravel , B. Rameshbabu
Published: August 2017

Background: The practicing pediatrician is left in a dilemma regarding the need for the newer vaccines and conflicting scientific data from vaccine manufacturers. This study is aimed at evaluating the pediatrician’s perspective regarding the immunization schedule.Methods: A brief questionnaire was framed to bring out the most common issues faced by the pediatrician in immunization schedules.Results: About 77 percent of respondents felt that our National Immunization is inadequate. About 37 percent and 28 percent of respondents felt that the next vaccine that is to be introduced in the National Immunization Schedule is Pneumococcal vaccine and Rotavirus vaccine respectively. Nearly half of the respondents trusted IAP as the single most important influencing factor in choosing a newer vaccine. About 76 percent of respondents felt that the immunization schedules are influenced by vaccine makersConclusions: The practicing pediatrician who had always looked at IAP Immunization schedule as his bible in office practice is now beginning to doubt its authenticity. The threat of not having a consensus on Immunization is detrimental. It is the duty of IAP to clear the air regarding the controversies it had faced in the immunization schedule.
Growth and neurodevelopmental outcome of high risk premature neonates at 1 year in a tertiary level NICU of central India
Authors: U. Sudhir , Ghanghoriya Pawan , Barman Mangilal , Joshi Trusha
Published: August 2017

Background: To study the outcome of growth and development till one year of age of very preterm neonates and moderate to late preterm admitted and discharged from a tertiary level NICU in central India.Methods: 120 preterm babies admitted and discharged from NICU were enrolled consecutively. Out of them 82 were followed up for a period of 1 year. Physical parameter like weight, length and head circumference were recorded on admission and at 1, 3, 6 and 12 months of corrected gestational age. Developmental assessment was done at 12 months of corrected gestational age by DASII (developmental assessment scale for Indian infants).Results: Among the 82 enrolled subjects 28 were very preterm (28-<32 weeks) and 54 were moderate to late preterm (32-<37 weeks). Overall growth (all the anthropometric parameters) was higher in the moderate to late preterm group. In very preterm babies weight gain was better from 6-12 months of postnatal age and was statistically significant (p<0.005). Length gain was higher in very premature babies group but not statistically significant and head growth was significantly higher in very preterm babies from 1 month to 1 year compared to moderate to late preterm babies (p<0.05). Neurodevelopmental delay was seen in 28% (n=23) of the study group at 1 year, 65.2% (n=15) were very preterm babies. Associated risk factors were RDS, hypoglycemia, NEC and sepsis. Developmental quotient was lower in very preterm (66.45) compared to moderate preterm babies (79.86).Conclusions: Prematurity and its associated complications are linked to adverse physical and neurodevelopmental outcomes. Improved perinatal care, early assessment of development by appropriate tools and early intervention is a must to improve the outcome of these babies.
Assessment of non-ketotic hypoglycaemia in new born attending in Malda Medical College and Hospital
Authors: Dawn Indranil , Jeauddin Sk. , Biswas Gauranga , Jana Jadab Kumar
Published: August 2017

Background: Blood glucose level of <40/dl irrespective of period of gestation is known as hypoglycaemia. Nonketotic hypoglycaemia is associated with disorders of fructose or galactose metabolism, hyperinsulinism, fatty acid oxidation and GH deficiency. Aim of our study to detect the new born having clinical manifestations of hypoglycaemia, measure the capillary blood glucose and urinary ketone bodies in neonates with sign and symptoms of hypoglycaemia and to perform detail work up of neonates having non ketotic hypoglycaemia.Methods: It is hospital based cross-sectional study carried out for one calendar year extending from 01.01.2015 to 31.12.2015.Results: Thirty-five patients were identified as hypoglycemic Nine patients were diagnosed with non ketotic hypoglycemia for a prevalence of 8.5/100, 00. Two patients had the low growth hormone (GH) levels (0.4 ng/ml and 0.5 ng/ml). Three patients had increased Asparate Aminotransferase (AST) and Alanine Aminotransferase (ALT) level. Three patients increased urinary acetyl-carnitine level.Conclusions: Patient suffering from different congenital disorder and an extensive and overzealous workup for endocrinopathy or inborn error of metabolism is necessary.
Etiological evaluation of convulsions in children between 1 month to 5 years of age
Authors: Mamillapalli Bharathi , A. Penchalaiah
Published: August 2017

Background: Convulsions are the most common pediatric neurological disorder worldwide. The incidence is highest in children younger than 3 years of age with a decreasing frequency in older children. The different causes of seizures are febrile convulsions, CNS infections, neurologic or developmental, metabolic, traumatic or vascular, idiopathic or epilepsy, oncologic. The objective of our study is to find out the various etiologies of convulsions in children between 1 month to 5 years of age.Methods: 200 consecutive cases admitted to the hospital with convulsions in this particular age group were studied by detailed history, thorough examination and stepwise investigations including blood counts, CSF analysis, EEG and neuroimaging studies.Results: The most common cause for seizures in our study was febrile seizures (34.5%). Hypocalcemic seizures were the predominant cause (13%) between 1 month to 1 year of age. Other causes included viral encephalitis (20%), pyogenic meningitis (11%), TB meningitis (8.5%), epilepsy (8%), hypoglycemia (2%), neurocysticercosis (1%), head injury (1%) late HDN (0.5%). Cerebral palsy, mental retardation syndromes with developmental delay and epilepsy constituted 5.5% of the cases.Conclusions: Convulsions in children can be due to various underlying pathology. A detailed history, thorough examination and certain investigations helps to recognize the cause for the convulsions and can be treated accordingly.
Study of hematological indices in neonates admitted with non-obstructive jaundice and its outcome in a tertiary care hospital
Authors: R. Vikram , Balachandran C. S.
Published: August 2017

Background: To study non-obstructive causes and laboratory profile of neonatal hyperbilirubinemia. Design: prospective study.Methods: Selection of cases were done from routine cases reporting to newborn unit in the department of paediatrics, with clinical evidence of jaundice in neonates. Blood group of the mother and baby, Serum bilirubin estimation, Complete blood count with peripheral smear examination, Reticulocyte count, Direct coomb’s test and C-reactive protein of the baby were done.Results: Study includes 89 cases of newborn admitted in our tertiary care institute. Out of 89 neonates, 52 (58.42%) were male while 37 (41.57%) were females. Total number of Pre-term babies was 35 (39.32%). Neonates having low birth weight were 30 (33.7%) and very low birth were 10 (11.23%). Physiological jaundice constituted majority cases. Septicemia was the commonest cause of pathological jaundice and ABO incompatibility is second commonest cause of pathological jaundice. Pre-term and low birth weight babies were having higher levels of serum total bilirubin but the difference was not significant (P >0.05). The rise in serum bilirubin level was found to be more in pathological jaundice as compare to physiological jaundice. Difference was significant statistically with p value of <0.05.Conclusions: Most of the cases were having physiological jaundice although septicemia and ABO-Rh incompatibility were not exceptional. Peak serum bilirubin levels were found to be more among the pathological jaundice. Also, prematurity and low birth weight were having higher levels of serum bilirubin. Special care must be given to them in order to avoid future complications of hyperbilirubinemia.
Clinical profile of Candidiasis in neonates
Authors: S. Latha G. , V. Veeresh Babu D. , K. Thejraj H.
Published: August 2017

Background: Opportunistic infections are increasing in Neonatal Intensive Care Unit (NICU). Neonates often have compromised skin integrity, gastrointestinal tract disease, chronic malnutrition, central venous catheters, long term endotracheal intubation and other factors that lead to increased risk of acquiring such infections. Infections with fungi (candida) and with coagulase-negative staphylococci (CoNS) are especially prevalent. The need of study is to know the clinical profile of candidiasis in neonates in our setup and to determine associated risk factors of candidiasis.Methods: The present study was undertaken by Dept of paediatrics, SSIMS and RC Davangere among 296 neonates of which 96 babies admitted in NICU and 200 were in PNC ward to study clinical profile of candidiasis in neonates and risk factors associated with them. Parents of 296 babies were interviewed using preformed study proforma. Clinical examination was done and investigations included KOH examination of oral swab, Gram stain of the swab and blood culture of suspected sepsis babies. There are several factors associated with development of neonatal candidiosis. Of them, prematurity, LBW, perinatal birth asphyxia, long term antibiotics, central venous catheters, mechanical ventilation, septicemia, played a major role in development of candidosis.Results: In the present study, incidence of candidiasis in neonates revealed 13.8% of babies admitted in NICU. Male babies out numbered the female babies in incidence of candidiasis in neonates. Males formed 69% and females 31% of positive cases. Most of neonates admitted in NICU (96) were of low birth weight between 1.5kg to 2.5 kg. Out of which most of cases positive for candidiasis/candidemia were belonged to 1.0-1.5 kg. In present study, 13 babies were positive for candidiasis, of which 5 babies (38.3%) were of birth weight between 1-1.5kg. Birth asphyxia alone or with mechanical ventilation played an important risk factor in development of candidiasis in neonates. In present study, birth asphyxia and mechanical ventilation per se had played a significant role in development of candidiasis in neonates admitted in NICU.Conclusions: The present study revealed the clinical profile of candidiasis in neonates associated with various risk factors. Study shows that low birth weight, birth asphyxia and mechanical ventilation were significant risk factors for candidiasis in neonates. Blood cultures were positive in babies without mucosal lesions suggesting the importance of diagnosing fungal sepsis.
Maternal hypovitaminosis D: a cause of neonatal hypocalcemic seizures
Authors: Deepika G. , Raghoji Chaitali R. , R. C. Ashwini , Guruprasad G.
Published: August 2017

Neonatal late onset hypocalcemia is the one which occurs after 72 hours of life. 1,25 (OH)2- vitamin D and Parathormone (PTH) play crucial role in regulation of calcium and phosphorus homeostasis in the body. Vitamin D helps in the absorption of calcium and phosphorus from the gut. PTH promotes absorption of calcium from thick ascending loop of henle and distal tubule whereas it increases excretion of phosphorus. During hypocalcemia, parathormone level shoot up in the body to maintain normal calcium levels. In a patient with poor resources of vitamin D, there is disturbance of Calcium, phosphorus homeostasis leading on to clinical manifestations. Exclusively breast-fed infants without vitamin D supplementation and infants born to mothers with Vitamin D deficiency are at risk to develop Hypovitaminosis D and manifest symptoms of hypocalcemia.
Assessment of awareness and practice of foot care and physical activity among people with type 2 diabetes attending a tertiary care teaching hospital
Authors: L. N. Deepa , Murty Pallavi , Reddy Madhavi , C. Muninarayan , Shetty Soumya
Published: August 2017

Background: Diabetes Mellitus is one of the leading non communicable diseases in India. Associated complications are also on rise. Knowing about self-care becomes important to prevent these complications in them. This study was done to determine the level of awareness and practice of foot care among type 2 diabetes patients attending a tertiary care center.Methods: A cross sectional descriptive study done by interviewing 106 diabetic patients attending a teaching hospital in Kolar, using pretested questionnaire.Results: In the present study the mean (SD) of awareness and practice of foot care were 5.33 (3.09) and 6.54 (2.94) respectively. Low mean scores were significantly associated (p<0.05) with lack of formal education and not receiving advice on foot care by doctors. Only 51.9% of them were educated regarding foot care while 77% of the subjects were advised to do physical activity. Only 8.5% of them had good knowledge, 35.8% had satisfactory level and more than 50% of them had poor or very poor knowledge regarding foot care. On the other hand about 15.1% of the study participants’ foot care practice was good, 36.8% were satisfactory and 48.1% were poor or very poor in foot care practice. A strong positive correlation (r=0.85) was observed between level of awareness and practice of foot care which was statistically significant (p<0.001).Conclusions: Low mean scores of awareness and practice suggests that there is a need for focused educational intervention on foot care to all diabetic patients in order to prevent foot complications in them.
A study on multi drug resistant tuberculosis at Sree Mookambika Institute of Medical Sciences
Authors: Solanke Prashant V. , Pawde Preeti , M. Ajin R.
Published: August 2017

Background: Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. Resistance to antitubercular drugs has been noted since the drugs were first introduced, and occasionally outbreaks of drug-resistant tuberculosis have been reported worldwide. WHO emphasizes that good TB control prevents the emergence of drug resistance in the first place and that the proper treatment of multi-drug resistant tuberculosis prevents the emergence of XDR-TB. The objectives of the study were to examine the sputum samples regarding MDR-TB, to study the grading regarding sputum positive and to study the multi-drug resistance tuberculosis in Sree Mookambika Institute of Medical sciences.Methods: Study design was cross-sectional, Study duration was January 2016-March 2017. Study place was Sree Mookambika Institute of Medical Sciences Hospital, Kulasekharam. Sample size was 400. Data entered in MS-Office Word- 2016. Institutional ethical committee clearance was obtained. Results: In present study 54.86% patient had sputum AFB positive, 45.13% had sputum AFB negative smears. 75% of the sputum AFB positive pulmonary TB came under the age group between 20-60 and 25% above 60 yrs. 78.24% males, 21.75% females had sputum AFB smear positive pulmonary tuberculosis and 43.73% patients had positive sputum culture, 56.26% patients had negative sputum culture and the most common strain found was Mycobacterium tuberculosis. Conclusions: So from our study we found that Mycobacterium tuberculosis is the major strain isolated from sputum samples. The resistance is more to Isoniazid and Rifampicin and is more in the rural parts of India. Early screening and drug susceptibility test of culture positive and MTB cases will help in initiating treatment of MDR-TB.
To assess the prevalence of STI/RTI using syndromic case management in the urban health centre area of greater Visakhapatnam municipal corporation, Andhra Pradesh
Authors: Ganta Srinivas Rao , Prasad K. K. L. , Srinivas P. J.
Published: August 2017

Background: Sexually transmitted diseases remain a major public health problem in many parts of the world. 340 million new cases of curable STIS occur every year. 75 to 85% are seen in developing countries and rank second as the cause of healthy life lost among women of reproductive age group, after maternal morbidity and mortality. Methods: The study was conducted at Rama Murthy Pantulu Peta in the field area of urban health centre of greater Visakhapatnam Municipal Corporation, Visakhapatnam during September 2015 to October 2016. The study design was a community based descriptive study. Based on the prevalence of STI as stated by National AIDS Control Organization, a sample of 1541 is calculated.Results: The overall prevalence of RTI/STI in our study is 18.88%. The prevalence of symptoms suggestive of STI/RTI among female respondents is found to be 27.97%. Majority of females complained of vaginal discharge (26.68%),vulvas itching (10%), lower abdominal pain (6.34%) followed by abnormal vaginal bleeding (5.91%).The prevalence of symptoms suggestive of RTI/STI is found to be 9.75% among male respondents and majority complained of Urethral Discharge (8.4%) followed by inguinal/scrotal swelling (5.2%). Conclusions: The prevalence of Reproductive tract infections is more in females when compared to males in our study. Health education regarding the sexual and personal hygiene should be targeted to both males and females so as to decrease the prevalence of Sexual transmitted diseases in the urban health centre areas of Visakhapatnam.
Prevalence of risk factors for obesity, hypertension, coronary artery disease and diabetes among under-graduate medical college students of Tamil Nadu
Authors: Ibrahim Razeek Mohammed , Palaniyappan Priyadarsini Sengoda Gounder , Nayeem Rahim Abdul , Somasundaram Vellomgattupalayam Muthusamy , Shankar R.
Published: August 2017

Background: The present scenario indicates that NCD-related diseases are on the rise among young people. Once the behavioural patterns of an individual are established, it often persists throughout life and is hard to change. Research has documented that adolescence is the appropriate time period for appropriate intervention. The aim of the study was toassess the prevalence of various risk factors of hypertension, coronary artery disease and diabetes among the medical students.Methods: A cross-sectional observational study was conducted among the medical college students of Annapoorna Medical College Hospital for a period of one year. A total of 406 students had participated in the study. A semi-structured and pilot tested questionnaire was used to collect the personal and demographic details of the students. Measurements such as BMI and blood pressure were recorded. Biochemical measurements such as fasting blood sugar and lipid parameters were measured. Results: A total of 38 (17.9%) male students and 6 (3%) female students are at risk of developing diabetes, hypertension or CAD at a very early age as per their clinical and biochemical reports. Conclusions: Promotion of supportive environment for strengthening student-based approaches and strategic delivery of health education is essential to target the risk behaviours among our future doctors.
Status of birth preparedness and complication readiness among recently delivered women: a community based study in a slum of Kolkata, West Bengal
Authors: Ghosh Ayon , Dasgupta Aparajita , Paul Bobby , Bandyopadhyay Lina , Sembiah Sembagamuthu , Mallik Nazrul
Published: August 2017

Background: Birth preparedness and complication readiness (BPACR) is a strategy that promotes timely use of skilled care and deal with emergencies especially during childbirth, by encouraging pregnant mothers and their families to make effective plan for child birth. The objective of the study was to assess the awareness and practices of BPACR among women who had delivered in last 24 month and identify the predictors of favourable BPACR.Methods: A cross sectional, community based study was conducted in a slum of Chetla, Kolkata, among 98 women who delivered during the previous 2 years. Data were collected with a structured, interview schedule after obtaining informed consent from them. Results: Out of 98 women only 43 (43.9%) were well prepared for birth and its complication in their last pregnancy. 32.7% women were knowledgeable about danger sign of pregnancy. 100% of study participants identified the place of delivery and made a birth plan with discuss with family members. Bivariate logistic regression shows education status of study subject OR (CI) 4.34 (1.4712.8), education status of their spouse OR (CI) 2.92 (1.187.24) and per capita income OR (CI) 7.18 (2.6619.34) have significant association with birth preparedness. However in multivariable logistic regression after adjustment with different confounding variable only income remained significant AOR (CI) 5.82 (2.0816.29). Conclusions: The poor status of BPACR as observed in this study calls for increased emphasis on counselling of pregnant women and their families regarding the different components of birth preparedness.
Prevalence of open air defecation and awareness and practices of sanitary latrine usage in a rural village of Raipur district
Authors: Panda Prem S. , Chandrakar Aditi , Soni Gopal P.
Published: August 2017

Background: The practice of open defecation is rampant in India and our country is home to the world’s largest population of people who defecate in the open. Insanitary disposal of human excreta, along with unsafe drinking water and poor hygiene conditions, is a leading cause of morbidity and mortality in low-income countries. The study was conducted with objective to find sanitary latrine usage, prevalence of open air defecation and awareness related to diseases caused by open air defecation in the rural population of a village in Raipur district.Methods: A total of 155 households were selected for the study using simple random sampling technique by lottery method. One member from each household, preferably the head of the family (if not available, any elder person in the family), was interviewed personally. A structured questionnaire was used to collect information regarding the background characteristics, awareness and practices about sanitary latrine usage. Results: Majority of the study participants 109 (70.3%) had sanitary latrines in their houses. The prevalence of open air defecation in the study area was found to be 23.2%. Around 2/3rd (65.2%) of study subjects were not aware about spread of disease due to open air defecation. Conclusions: Awareness regarding spread of diseases due to open air defecation is poor. Effective political commitment and administrative support will be the key points of success of the Swachha Bharat Abhiyaan program.