bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of rapid test as an aid in rapid diagnosis of malaria at bed side in an endemic region in comparison to conventional microscopy
Authors: Reddy A. Bhaskar , K. N. Deepthi , Eluzai Zion
Published: June 2018

Background: The routine and commonly used test for malaria diagnosis is obtaining thick and thin smears and examining it under microscope. This test required skilled laboratory and skilled staff. Hence rapid diagnostic kits have been developed. Present study attempts to study the efficacy of this optical test in the diagnosis of malaria among children. Objectives of present study was to study efficacy of rapid test in rapid diagnosis of malaria at bed side in an endemic region.Methods: Hospital based cross sectional diagnostic evaluation study was carried out at SVS Medical College, Mahabubnagar, Telangana, India from September 2015 to September 2016. 100 in-patients with fever from pediatric ward belonging to 1-14 years of age were included in the present study after applying the inclusion and exclusion criteria.Results: Maximum children belonged to 1-5 years of age. All patients presented with fever. Splenomegaly, convulsions and pallor was seen in most of the children. Diagnostic accuracy of rapid test was near 100% as it missed only one case of P. falciparum. For vivax malaria there was 100% sensitivity and specificity of the rapid test. For falciparum malaria, it was 97.8% and 100% respectively. Statistically this was significant.Conclusions: Rapid test can be considered as diagnostic test in areas where laboratory facilities are not available. It is cost effective. It takes little time. It can be done anywhere.
Study of urinary uric acid to creatinine ratio as a biochemical marker of perinatal asphyxia and its correlation with Apgar Score
Authors: Sreekrishna Yathiraj , Eregowda Adarsh , H. L. Aarti Sharma
Published: June 2018

Background: Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. Every hour, 104 children die as a result of asphyxia. In India; between 250,000 to 350,000 infants die each year secondary to birth asphyxia and mostly within the first three days of life. The present study was performed to determine the Urinary Uric Acid to Creatinine Ratio in perinatal asphyxia and its correlation between APGAR score and urinary uric acid to creatinine ratio in perinatal asphyxia.Methods: A randomized case control hospital-based study was conducted on 50 asphyxiated and 50 normal newborn. Urinary uric acid and creatinine were estimated in spot urine within 24 hours after birth in both cases and controls. A ratio between the concentrations of uric acid to creatinine was estimated and comparison done between cases and controls.Results: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.Conclusions: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.
Correlation of maternal lipid profile with newborn’s lipid profile
Authors: Gora Anamika , Dev Deveshwar , Gupta Palak , Gupta M. L.
Published: June 2018

Background: Atherosclerotic cardiovascular disease (CVD) is a major cause for morbidity and mortality in the adult population. Altered lipid levels are the recognized factors. This process is considered to begin in early life and progress silently over decades. Maternal lipid concentrations may exert an in-utero influence on infant’s lipid profile. The objective of the study was to find out the correlation of maternal lipid profile with newborn’s lipid profile.Methods: This is a hospital based, cross sectional study. After applying inclusion and exclusion criteria, a total of 220 parturients and their respective newborns were enrolled. Out of 220 newborns, 110 were <2.5 kg (group A) and 110 were ≥2.5kg (group B) babies. 2.5 ml of Cord blood sample from each of enrolled newborns was collected from the placental end of the cord just after the delivery. Blood samples from the parturients were collected right after delivery. The concentrations of total cholesterol, triglycerides and HDL-c were determined by an enzymatic colorimetric method and LDL-c was calculated by the Friedewald formula.Results: In present study there was a statistically significant but poor negative correlation between maternal TG and babies’ TG level among low birth weight (˂2.5kg) babies and no other significant correlation was observed between maternal lipid profile and newborn’s lipid profile.Conclusions: Change in maternal lipid profile is not significantly associated with the mean concentrations of total cholesterol, LDL-c, HDL-c and triglycerides in newborns. Hence it shows that neonatal lipogenesis may be independent of maternal lipogenesis.
Perinatal variables influencing cord blood thyroid stimulating hormone
Authors: Garg Manasi D. , Kumar Poornima , Abirami Sakthi , M. Manikandan , Krishnan Lalitha
Published: June 2018

Background: Newborn screening using cord blood Thyroid Stimulating Hormone (TSH) is an effective and an easy way to screen babies for congenital hypothyroidism. Congenital hypothyroidism is a common preventable and treatable cause of mental retardation. Early diagnosis with the help of newborn screening aids in timely management and decreased morbidity. Various maternal and neonatal variables can affect cord blood TSH level thereby affecting the accurate diagnosis of congenital hypothyroidism. This study aims at studying the perinatal variables affecting cord blood TSH.Methods: In a retrospective cross-sectional study conducted in a tertiary care hospital, the hospital case records of 1465 newborn and their mother were studied for variables including cord blood TSH, maternal age, mode of delivery, parity, gender of baby, gestational age and growth of baby. The effect of these perinatal variables on cord blood TSH was analysed statistically. P value below 0.05 was considered as statistically significant. The statistical analysis was done used the SPSS software version 18.0.Results: The median cord blood TSH was 8 microIU/ml (IQR= 6-12) with 8.1% newborns having values more than 20 microIU/ml. Cord blood TSH was significantly raised in male babies (p <0.01) and in neonates born by assisted vaginal delivery (p <0.01).  Significant increase in cord blood TSH (p <0.02) was observed in neonates born to primiparous mothers. Maternal age, gestational age of the newborn and growth of the newborn did not have significant effect on cord blood TSH values.Conclusions: The mode of delivery, parity and gender of the baby were found to be significant variables affecting cord blood TSH values. Hence, cord blood TSH values should be interpreted in the light of these perinatal variables.
Micronutrient deficiency status in children below 2 year of age with delayed milestones
Authors: Kumar Naresh , Poswal Lakhan , Goyal Suresh , Chaudhary Chakshu , Rattan Ananta , Koli Harimohan
Published: June 2018

Background: Micronutrient deficiency have strong association with delayed achievement of milestones. Objective of present study was to know the micronutrient deficiency status in children below 2 years of age with delayed milestones.Methods: Study was carried out among 50 children below 2year of age with delayed milestones without any known cause for it. These children were evaluated for hematopoietic micronutrient deficiency and they were compared with controls.Results: A total of 50 children (22 male and 28 female) of delayed milestone were enrolled. Maximum number of children were in age group 7-12 months. Majority of children (62%) were from BPL families. Majority of children had Wt/ Ht -1 to -2 SD. Breastfeeding was initiated late (2-6 hr) in 38%. Sixty four percent children were exclusively breast fed up to six month of age, in the rest top milk feeding was also given along with BF. No complimentary feeding was started in 51.1% children after 6 months of age. In 73% of those in whom complimentary feeding was started the amount was inadequate. Maximum children were given complimentary feeding at the age of 9-12 month. In this study significant number of patients (p = <0.001) had low levels of serum vit. B12 (78% v/s 10% in control), iron deficiency (66% v/s 6% in control) and deficient folic acid level (16% v/s nil in control).Conclusions: Association was found between hematopoietic micronutrient deficiency and delayed milestone in children below 2 years age without any other risk factors.
Clinical profile and outcome in children with dengue fever
Authors: Nayak N. Prasad , Ahamed Zaheer , Maben Roshan
Published: June 2018

Background: Dengue fever (DF) has emerged as a serious health threat not only in India but worldwide. Mangalore, a coastal city of Karnataka has seen an alarming rise in dengue fever (DF) over the last decade. So, it is of utmost importance to study the clinical profile and treatment outcome in children suffering from dengue fever.Methods: A retrospective study was conducted to analyze the clinical profiles and treatment outcome.  The case files of 52 children admitted with dengue fever over last 5 years (2009-2014) in Pediatric department in a tertiary care centre located in Mangalore, Karnataka were included in this study. The data was collected from the Medical Records department. Statistical analysis was done by using SPSS 16.0.Results: Children aged 4-12 years are more affected (59.6%). Fever was present in all the cases. 63.5% of the cases had petechiae and other bleeding manifestations were seen in 9.6% of the cases. Poor intake was seen in all the cases. Abdominal pain, maculopapular rash, respiratory distress, retro-orbital pain, convulsions were present in 96.2%,50%,15.4%,78.8% and 1.9% respectively. Hypotension in 86.5%, hepatomegaly in 65.4% and vomiting was seen in 100% of cases. ICU admission was done for 41 patients (78.8%). However, there was no mortality seen.Conclusions: Early diagnosis and prompt management will help in preventing serious morbidity and mortality in pediatric age group.
Prevalence of enteric fever in the patients admitted to paediatric ward in a rural tertiary care teaching hospital: a retrospective study
Authors: Kumar K. Santosh , Sasireka B. I. , Kannan I.
Published: June 2018

Background: Enteric fever or typhoid is one of the major cause of morbidity among the human population in many regions of the world. The current knowledge on epidemiological aspects comes from studies in adult populations. However, there are conflicting opinion about the prevalence rate in paediatric age groups. Hence, in the present study an attempt has been made to find the prevalence of the enteric fever among paediatric age group in a teaching hospital of rural area.Methods: The retrospective study was carried out in Tagore Medical College and Hospital, Rathinamangalam village, Tamil Nadu, a rural teaching hospital in India over a period of 1st January 2015 to 31st December 2017. Data regarding admitted children below 12 years of age with signs and symptoms suggestive of enteric fever were recorded.Results: Total of 224 cases of enteric fever case were admitted during the study period. There were 115 (51%) males and 109 (49%) females. Most of the patients were above the age of 4 years. The leading clinical feature were fever (100%), headache (92.85%), followed by coated tongue (88.4%), anorexia (85.71%) and hepatomegaly (79.02%).Conclusions: It is imperative to include Enteric fever in the differential diagnosis of febrile paediatric patients with abdominal symptoms. Even though blood culture is the confirmatory test, Widal test plays supportive role in diagnosis of enteric fever, especially when patients come after a course of antibiotics. In the present study, ciprofloxacin is still a good drug for the treatment of enteric fever.
Prospective study to find out the role of gastric aspirate examination by Ziehl-Neelsen staining (ZN staining) and cartridge based nucleic acid amplification test (CB-NAAT) as a diagnostic method in childhood tuberculosis
Authors: Arora Akansha , Jain Anil , Karnawat B. S. , Kumawat Rakesh
Published: June 2018

Background: Tuberculosis in children has been relatively neglected mainly because clinical diagnosis has low specificity, radiological interpretation is subject to inter-observer variability and the tuberculin skin test is a marker of exposure, not disease. The recent introduction of Cartridge based nucleic acid amplification test has significantly transformed the diagnostics of tuberculosis in adults but its application for Paediatric Tuberculosis is under evaluation. Therefore, authors conducted a study on role of gastric aspirate examination by ZN stain and Cartridge based nucleic acid amplification test in the diagnosis of childhood Tuberculosis.Methods: Authors did a prospective hospital-based study from Nov 2016 to Nov 2017 consisting of 100 randomly selected patients suspected of tuberculosis who had their gastric aspirate tested for CBNAAT and ZN stain for acid fast bacilli (AFB) along with Mantoux test and other routine investigations. Chi square test was used.Results: Culture positive tuberculosis was found in 21 out of 100 children. The sensitivity, specificity, positive predictive value and negative predictive value for CBNAAT were 76.1%, 98.7%, 94.1% and 93.9% and for ZN stain were 47.6%, 98.7%, 90.9% and 87.6% respectively. Positive history of contact (p value 0.0217), reactive Mantoux test (p value < 0.001) and low socioeconomic status were independently associated with a positive CBNAAT result.Conclusions: Analysis of gastric aspirate samples with CBNAAT is a sensitive and specific method for rapid diagnosis of pulmonary tuberculosis in children who cannot produce sputum. Compared with microscopy, CBNAAT offers better sensitivity and its scale up will improve access to tuberculosis diagnostics in children.
Weight gain in preterm low birth weight infants with multisensory intervention
Authors: Modi Krupal , Khandare Shilpa , Palekar Tushar J. , Gazbare Preeti , Shah Vidhi , Mehta Tanpreet Kaur
Published: June 2018

Background: Birth weight is a significant determinant of newborn survival. In neonatal deaths, LBW is the underlying cause in 60-80% cases. This study was aimed to assess whether preterm infants receiving Multisensory intervention had more rapid weight gain compared to control group infants during NICU stay.Methods: Subjects for the study were preterm infants between 32 to 37 weeks of gestation age with birth weight between 1500 g to 2500 g and staying in NICU. Participants meeting inclusion criteria were randomly divided into either experimental group (n=15) or control group (n=15). The experimental group received Multisensory stimulation such as Auditory, Tactile, Visual and Vestibular stimulation for 10 consecutive days (15 min. /day) in NICU. Control group received routine NICU care. Weight was measured using an electronic weighing scale at day-1, day-5 and day-10 of intervention in both the groups and collected data was analysed.Results: The preterm infants of the experimental group had shown better growth than those in the control group with statistically significant differences (p<0.05) between the study and the control group at end of 10 days of intervention.Conclusions: From Analysed data, it is concluded that 5-day of Multisensory intervention could not elicit statistically significant improvement in weight gain, but 10 days intervention could elicit significant improvement. The result supports the use of multisensory intervention as a cost-effective therapy to promote growth.
Clinical profile of cerebral palsy: a study from multidisciplinary clinic at tertiary care centre
Authors: Kumar Raj , Gupta Anand Kumar , Runu Ritesh , Pandey Sanjay Kumar , Kumar Manish
Published: June 2018

Background: Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain. The aim of this study is to Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain.Methods: Retro prospective cross-sectional study done in super speciality tertiary care centre of East India. Total 70 Children enrolled in multidisciplinary CP clinic in Physical medicine and Rehabilitation (PMR) OPD between September 2017- March 2018.Results: 78.57%male and 21.42% female, all had hospital delivery with 78.5% had normal and 21.5% caesarean section. 70% had history of birth asphyxia and 61.5% required NICU admission. 61.4% had birth wt. less than 2 kg and 10% had birth wt. less than 1kg. One fourth cases had microcephaly and one third had history of seizures. Visual abnormalities, Hearing impairment and history of jaundice were found in about one sixth children. Spastic CP was the most common (76% cases) followed by Dyskinetic 10%, Hyponic and Ataxic (1%). In spastic CP Diplegia was most common (55%), followed by Quadriplegia 24%, Hemiplegia 19% and Monoplegia 2%. GMFCS score 5 was seen in 29% (mostly quadriplegic), followed by GMFCS level 1, 21.27% (mostly hemiplegic), others mostly diplegic in level 3(19%), level 2 and 4 (14%).Conclusions: Male CP are more reaching tertiary care centre in Bihar. Perinatal factors (asphyxia) were main etiological risk factor, and Spastic Diplegia is the most common type of CP. Disability need to be detected at the earliest to facilitate a timely and appropriate intervention like early rehabilitation, special education and psycho-social support.
Resilience level among adolescent children: a school-based study in Kolkata, India
Authors: Banerjee Rajarshi , Dasgupta Aparajita , Burman Jayeeta , Paul Bobby , Bandyopadhyay Leena , Suman Sweta
Published: June 2018

Background: The rat race of modern life is affecting each and every strata of our society and adolescents are not exempted from this underlying stress. Lack of resilience in adolescents may lead to psychosocial maladaptation and psychopathology in adulthood. This study was undertaken to determine the resilience level and its possible predictors among adolescents of a Kolkata based school.Methods: This was an institution-based, observational cross-sectional study done from June-August’17 among 151 students of 7th-9th standards in a school of Kolkata. A pre-designed, pretested, structured, self-administered questionnaire along with CYRM-12 (‘Child and Youth Resilience Measure-12’) questionnaire was used. The scoring of each question was from 1-3 (higher score indicates more resilience) in CYRM-12 and in this study median attained score of 31 was taken as cut off for determining resilience level. Ethical issues were addressed. SPSS (v.16.0) was used for data analysis.Results: Among 151 students of 12-14 years, 57(37.7%) students were resilient and factors like ‘class’ [OR=4.01(1.85-8.67)]; ‘family type’ [OR=7.73(3.66-16.30)]; ‘time spent with father’ [OR=8.64(4.07-18.37)]; ‘time spent with mother’ [OR=5.97 (2.87-12.42); ‘physical activities’ [OR=9.11 (4.07-20.37) and self-rated school performance [OR=3.12(1.39-6.96)] were associated with high resilience during univariate logistic regression analysis. In the final model of multivariable logistic regression analysis by LR forward method factors like ‘family type’ [AOR=4.45(1.73-11.45)]; ‘time spent with father’ [AOR=5.27(2.04-13.6)]; ‘time spent with mother’ [AOR=4.83(1.80-12.90)] and ‘physical activities’ [AOR=8.14(2.95-22.47)] retained its significance.Conclusions: Quality parental time for children and engagement in physical activity will help to increase resilience level and build up the coping capacity.
Role of gene Xpert test in clinical TB suspect in children
Authors: Gupta Sheenu , Kotrashetti Veerana , Ahmed Rizwan
Published: June 2018

Background: Tuberculosis (TB) is a major global health problem. Childhood tuberculosis (TB) is common in our community but it is relatively neglected, due to greater challenges in diagnosis. Clinical manifestations of childhood TB differ from adults. The diagnosis in most cases is based on clinical evidence but chest X-ray, Mantoux test, history of Kochs contact, malnutrition and sputum/gastric sample microscopy are important supporting investigations. WHO recommended use of newer diagnostic tests like Gene Xpert in pediatric cases where TB is mostly paucibacillary and identification of TB bacilli is difficult for confirmation of diagnosis.Methods: This prospective study was conducted among admitted and OPD patients in the department of Pediatrics over a period of 1and half year. Clinically suspected cases of TB in the age group 0-12 years who met the diagnostic criteria made the study group. Refusal of consent by parent and children already on TB treatment were excluded from this study. Investigations like chest X-ray, Mantoux test, sputum/gastric aspirate microscopy and Gene Expert were done to confirm the clinical diagnosis.Results: Pulmonary tuberculosis was more common (28%), TB lymphadenitis 22%, TB meningitis 14%, Tubercular Pleural effusion 12 %. and rest were no TB. BCG scar was present in 90%. History of contact was present in 76% and Mantoux test was positive in 76%. Gene Expert was positive only in one case in our study rest 49 cases were negative. The most common symptoms were fever (72%), cough (52%) and weight loss (40%).Conclusions: This study supports that detailed history, clinical evaluation and active investigative workup in addition to newer diagnostic tests like Gene Xpert has a major role in diagnosing childhood tuberculosis.
Gastric aspirate cytology as a screening tool for neonatal sepsis: a prospective study from a tertiary care centre
Authors: Kumar Ranjith , Reddy Bhaskar , Soren Chapay , Reddy Venkataramana , . Raheemunisa
Published: June 2018

Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first 28 days of life. It is responsible for 30-50% of the total neonatal deaths each year in developing countries. Gastric aspirate cytology has been used for neonatal infection. The presence of more than five polymorphs per high power field co-relate with neonatal infection. The objective of the present study was to evaluate the utility of gastric aspirate cytology as a screening tool for neonatal sepsis and to determine the polymorphonuclear leukocytes count in smear of gastric aspirate and correlating it with culture proven sepsis.Methods: This prospective observational study was conducted from February 2017 to January 2018 at level III Neonatal intensive care Unit of Sri Venkata Sai Medical College and Hospital, Mahabubnagar, Telangana. A total of 108 neonates with risk factor and / or clinical features of sepsis were included in the study.Results: Out of 108 neonates, 40 were blood culture positive   and 68 were culture negative. Gastric aspirate smear showed ≥5 polymorphs in 30 and <5 polymorphs in 10 neonates with positive blood culture. Among blood culture negative cases, 20 had ≥5 polymorphs and 48 had <5 polymorphs in gastric aspirate smear. Gastric aspirate culture was positive in 48 neonates and negative in 60 neonates. Of the 48 gastric aspirate positive neonates, 45 had ≥5 polymorphs and 3 had <5 polymorphs in gastric aspirate smear. Similarly, among 60 gastric aspirate culture negative neonates, 55 had ≥5 polymorphs and 3 had <5 polymorphs in gastric aspirate smear. This was statistically significant (P<0.000001). Of 48 neonates with positive gastric aspirate culture, 30 had positive blood culture and 18 had negative blood culture.Conclusions: Gastric aspirate cytology is a good screening tool for neonatal sepsis added to a detailed perinatal history and clinical examination but does not completely substitute the present day available screening parameters.
Risk scoring and prediction of early onset septicaemia in neonates through study of perinatal factors
Authors: Sharma Deepika , Batham Ashish
Published: June 2018

Background: Diagnosis of early onset septicaemia is often difficult due to lack of specificity of clinical manifestations. Being a common but neglected problem, the present study was undertaken to develop a scoring system which can predict early neonatal septicemia.Methods: 300 newborns born out of consecutive deliveries were assessed for the total score as combination of physical factors and neuromuscular factors. Information for perinatal factors was collected on a prepared pro forma by questionnaire method. Data was tabulated and subjected to statistical analysis.Results: Incidence of neonatal infection was higher in the presence of birth asphyxia, unclean vaginal examination, presence of foul smelling vaginal discharge, or when duration of labour exceeded 24 hours as compared to prolonged rupture of membranes. Incidence of infections among babies born before 37 weeks gestation or having a birth weight of 2 kg or less was nearly the same as in the cases of premature rupture of membranes (PROM). 224 cases got score 0-3 and only 0.6% got infected, whereas out of 62 cases with score 4-5, 51.6% were infected and 14 out of 14 having score of 6 or more had infection. The sensitivity of scoring system was 96%, specificity 90%, positive predictive value of 88% and negative predictive value of 60.5%.Conclusions: Besides PROM there are many other perinatal factors which are of significance in relation to early onset infections. This led to the formulation of the presenting scoring system. Validation of this scoring system through further studies can help in early diagnosis, administration of proper antibiotics and inhibition of the irrational use of antibiotics.
Gaucher disease: masquerading as chronic malaria
Authors: Rai Seema , Sethi Gurmeet Kaur , Kumari Rama , Kaul Varun
Published: June 2018

Gaucher disorder s rare lysosomal disorder characterized by glycolipid laden lysosomes leading to hepatosplenomegaly, bone marrow involvement. Three types of Gaucher disease have been described based on the clinical features, ethnicity and the natural history of the disease. Gaucher disease Type 1 (GD1) occurs mainly in infancy to adulthood and is the commonest lysosomal storage disorder. Gaucher Disease Type II (GD2) and Gaucher disease type III (GD3) patients have onset at less than 1 year, and 2-20 years, respectively.1 GD1 patients do not have neurological involvement. GD2 is the acute neuronopathic and GD3 is the chronic neuronopathic type.
A rare case report of unusual presentation of Edward’s syndrome (trisomy 18)
Authors: Kushwah Meenakshi S. , Gaur Ajay
Published: June 2018

Edwards syndrome, a rare genetic disorder is characterized by the extra copy of chromosome 18. About 50% babies with this syndrome do not survive one week of age and approx. 95% do not survive past the first year of life. The syndrome is usually characterized by dysmorphic facies, microcephaly, flexion finger deformity and rocker- bottom feet. There is involvement of cardiacvascular and renal system with intellectual disability. Authors report a case of Edwards syndrome presenting with failure to thrive and developmental delay in the absence of usual clinical features of Edwards syndrome.
Suicide tree poisoning
Authors: A. Shivaraja , Appaji Shruti , V. R. Sudha Reddy
Published: June 2018

Poisoning accounts to 0.33-7.6% paediatric emergency admissions, which are accidental or unintentional. Yellow oleander, an ornamental plant with a scientific name “Thevetia peruviana”. All the parts of the tree are poisonous hence, known as “Suicide Tree”. Trees are easily accessible and swallowing of seeds which are the most toxic, is the preferred mode of intentional poisoning in South India. Ingestion of one seed is equivalent to 100 digoxin tablets. The phytotoxins of the plant can cause local gastric irritation and severe cardiotoxic manifested as arrhythmias, conduction defects which if left untreated is fatal. Management includes gastric decontamination, specific antidotes anti-digoxin Fab and Fructose 1,6 diphosphate administration, cardioversion and cardiovascular supportive care. Here, authors report an adolescent female presenting with sinus bradycardia following intentional consumption of the yellow oleander seeds.
An intracranial space occupying lesion in a 4-year-old child: a case report
Authors: E. S. Akshara , Nadkarni Jayashree
Published: June 2018

Primary central nervous system tumours are a heterogenous group of diseases that are collectively, the second most common malignancy in childhood and adolescence. The overall mortality among this group approaches 30%. Despite of high mortality rates, outcomes of these malignancies has improved with neurosurgery, radiation therapy, and chemotherapy as a therapeutic modality. Here authors have reported a 4-year female child who was diagnosed with brainstem glioma in present institute. The child presented with the typical clinical presentations of brainstem glioma.
Study of anemia among adolescent school girls and young adults
Authors: Kumar Anil , Goyal Akhilesh , Verma Niket , Mahesh Ashwin
Published: June 2018

Background: The world’s adolescent population (age 10–19 years) is estimated to stand at more than 1 Billion, yet adolescents remain largely neglected, difficult-to-measure, and hard-to-reach. Population in which the needs of adolescent girls, in particular, are often ignored. Anemia during adolescence limits growth and delays the onset of menarche, which in turn may later lead to cephalopelvic disproportion. In armed forces young serving soldiers make the backbone of forces, anemia in this group affects man hour badly. So, study was planned to assess prevalence of anemia in these two groups.Methods: A prospective study was carried out with 340 girls and 500 serving adults and prevalence of anemia was carried out with respect to different prevailing factors.Results: The prevalence of severe, moderate and mild anemia in girls was 0.5%, 10.6% and 27.9% respectively and in serving soldiers prevalence of anemia was 1.8%, 2.8% and 3.4 % respectively.Conclusions: In the present study, the prevalence of anemia was found to be 39% in adolescent girls and 8% in serving soldiers. Strongest predictor to anemia in adolescent girls was history of excessive menstrual bleeding and vegetarian diet. Age group, age at menarche and BMI did not affect anemia prevalence. Strongest predictor to anemia in soldiers was age.
Caesarean section: an epidemic
Authors: Uppadhaya Sandeep Kumar , Verma Manoj
Published: June 2018

Worldwide steady increase in caesarean section (CS) rate during the last decades has been the cause of alarm and needs an in depth study. Caesarean section is major surgery and increases the likelihood of many short and longer-term adverse effects in mothers and babies. The caesarean epidemic is a reason for immediate concern and deserves serious international attention. There are to be needs to make policy on caesarean section for reversing this trend that can be truly called as "Caesarean section: an epidemic”.
Prevalence of urinary tract infection and associated risk factors among women in Sindhupalchowk district, Nepal
Authors: Paudel Leela , Manandhar Naresh , Sah Saroj , Khadka Sudesha , Neupane Samikshya , Joshi Sunil Kumar
Published: June 2018

Background: Urinary tract infection (UTI) occurs in all age groups, more common in women due to short urethra and its close proximity to anus and vagina. UTI is defined as “microscopic finding of >10 pus cells/high power field (40x) in urine”. The purpose of the study is to find the prevalence of UTI and its association with various risk factors.Methods: An analytical cross-sectional study on prevalence of UTI was done among 260 women aged 15 years and above. Convenient sampling technique was used. Semi-structured questionnaire was designed to collect the data and urine sample was collected for routine and microscopic examination at the time of interview. Collected urine was sent, within 3 hours of collection.Results: The mean age of the respondents was 36.43±16.17 years. The prevalence of UTI among women aged 15 years and above was 36.9%.The most common symptom was frequency of micturition (35%) followed by lower abdominal pain (38.46%). There was significant association between frequency of micturition, burning micturition and lower abdominal pain with occurrence of urinary tract infection. On urinalysis, 96 samples were positive for pus cell; one sample showed blood, 16 samples showed ca-oxalate and 57 samples showed protein which determines the type of UTI. Smoking [COR-2.15, C.I-(1.12, 4.09)] and unavailability of toilet facility [COR-0.27, C.I-(0.08, 0.93)] were the significant risk factors for occurrence of UTI.Conclusions: There was high prevalence of UTI among women aged 15 years and above and association between smoking and unavailability of toilet facility and UTI was significant.
Dietary assessment of the ‘sweet enough program’ for primary school students in Chiang Mai, Thailand
Authors: Noochpoung Rakchanok , Sriram Shyamkumar
Published: June 2018

Background: Since 2007, Chiang Mai Public Health Office has conducted a campaign called “Chiang Mai On Wan” to decrease sugar consumption. The aim of this study was to evaluate the dietary patterns of students in schools participating in the program.Methods: The cross-sectional data were obtained from primary school children during November 2010 to February 2011. A total of 240 children were selected from Prathom 5 students (US Grade 5) in 12 schools. Sweet Enough Program (SEP) schools are those which implement public nutrition policies and supportive environments according to the Ottawa Charter, including no candy, no high-risk decay food or drink, and campaigns to reduce sugar consumption. Dietary patterns were collected using 7-day meal books in which each student recorded individual consumption.Results: Students in the SEP were found to have a much lower sugar intake than those in non-SEP schools. All students consumed candy, jelly and sweet snacks but the percentages of candy, jelly, and sweet snacks for SEP students were 1.7%, 3.4%, and 11.8%, respectively, while non-SEP students’ percentages were 26.4%, 11.6%, and 37.2%, respectively. There were significant differences between program school students and non-program school students with regards to candy (p<0.001), jelly (p=0.043), sweet crackers (p<0.001), biscuit (p<0.001), and chips (p<0.001).Conclusions: The success of this program is highlighted by the nutritional changes among the students. This was achieved by creating public health policies and supportive environments, as set out in the Ottawa Charter strategy.
Prediction of risk of type 2 diabetes mellitus using Indian diabetes risk score: a cross sectional study in urban field practice area of a medical college, Bagalkot
Authors: Mannapur Basavaraj S. , Sidenur Bhagyalaxmi S. , Dorle Ashok S.
Published: June 2018

Background: Diabetes is considered as a global emergency where a person dies from diabetes every 6 seconds and diabetes is seen on 1 in 11 adults. Identification of individuals who are at risk is very much necessary to prevent diabetes in India. IDRS could also help to detect people at risk of having prediabetes. The objective of the study were to estimate the prevalence of diabetes mellitus in the age group of >20 years in urban field practice area of S.N. Medical college, Bagalkot and to identify high risk subjects using Indian diabetes risk score (IDRS).Methods: A cross sectional study was done in urban field practice area of S.N. Medical College among adults >20 years of age with sample size of 207. Systematic random sampling was used to select the subjects. Data was collected using standardised questionnaire which included socio-demographic profile, standard glucometer was used to measure random blood glucose for all participants. IDRS was used to ascertain the risk of developing diabetes. Data was analysed using Pearson’s Chi square test and Fischer exact.Results: The overall prevalence of diabetes was 14.1%. Among 206 subjects, 4.8% were in low risk category. 39.6% and 55.1% were in moderate and high risk category respectively. Total of 11 subjects were newly diagnosed in our study. Among them 10 subjects were in the high risk category and 1 was in the low risk category. Sensitivity of IDRS was 90%, specificity 50%, positive predictive value 43.8% and negative predictive value 96.74%..Conclusions: This study estimates the usefulness of simplified Indian diabetes risk score for identifying high risk diabetic subjects in the community. It can be used routinely in commu­nity-based screening to find out high risk people for diabetes so that proper intervention can be done to reduce the burden of the disease.
A study on knowledge attitudes and practices on mal aria among tribal communities of East Godavari district, Andhra Pradesh
Authors: Sowmyasudha K. , Krishnababu G. , Sujatha P. , Satyanarayana K.
Published: June 2018

Background: Malaria is one of the world’s important parasitic diseases ever known to mankind. The global toll of malaria in 2010 there were an estimated 216 million cases of malaria worldwide. India is predominantly characterized by unstable malaria transmission. In Andhra Pradesh among five endemic districts East Godavari is one. We made an attempt to report knowledge and practices on malaria regarding its causation, transmission, symptoms, diagnosis, treatment and prevention.Methods: Using a systematic random method a total of 1136 participants were interviewed in four tribal P.H.C areas of East Godavari district. P.H.C‘s was identified by using a multistage random method. A semi-structured questionnaire which consists questions on malaria causation, transmission, symptoms, diagnosis, treatment and prevention were used as a tool to interview them. Data were entered into excel sheets and analysed by giving scorings and its categorization as good, average and poor.Results: Knowledge among study participants on Cause, diagnosis and treatment of malaria 41.67%, man mosquito contact among study participants- 22.53%. Attitude among study participants regarding cause, diagnosis and treatment of malaria 56.22%, mosquito breeding places 45.77%, prevention of man mosquito contact 46.71%. Practices among study participants on preventive practices on cause, diagnosis and treatment 49.56%, prevention of mosquito breeding places and man mosquito contact- 42.54%.Conclusions: In our study we found more knowledge regarding cause, diagnosis and treatment of malaria. Attitudes for prevention of mosquito breeding places are quite high. Less than half of the preventive practices were reported.
Treatment outcome in tuberculosis patients under DOTS treatment, tuberculosis unit, Nahan, Himachal Pradesh, 2013-2015: a record based descriptive study
Authors: Kashyap Rashmi , Singh Kamaljit
Published: June 2018

Background: Tuberculosis (TB) has existed for millennia and remains a major global health problem. There has been significant progress in cure rates achieved in revised national tuberculosis programme (RNTCP), however concerns regarding effectiveness of RNTCP regimens, still exist. These concerns could be addressed through an assessment of treatment outcome. The present study was conducted to ascertain the treatment outcome in tuberculosis patients under DOTS treatment.Methods: A record based descriptive study was conducted in patients enrolled under directly observed treatment strategy (DOTS). The data included the summary of case findings as new smear positive, new smear negative, new extrapulmonary, new others, relapse, failure, treatment after default, category II. Treatment outcome was assessed as cured, treatment completed, died, loss to follow up, failure and transferred out. Different variables were represented as frequency distribution and percentages. Chi square test was used to observe the association of different variables with the outcome of the disease.Results: A total of 899 patients were enrolled under DOTs treatment for tuberculosis. Sputum positivity was present in 481 (72.8%) patients. Outcome showed 384 (79.8%) patients as cured, treatment completed in 414 (81.8%) patients and treatment success rate of 798 (89.7%). Treatment failure was observed 9 (1.9%) patients.Conclusions: Treatment success rate of TB patients in this study was encouraging for TB control through DOTS strategy. However, to reduce poor treatment outcome, patients should be strictly followed by health workers or ASHAs.
A study to assess the efficacy of medical nutritional therapy in reducing blood sugar level in type 2 diabetic patients
Authors: Arshad Shoaib , Khan Amreen , Melwani Veena , Sethia Soumitra , Priya Angelin , Melwani Satish
Published: June 2018

Background: Physicians in India have less time for Diet consultation, despite the fact that diet planning plays an important role in management of diabetes mellitus type II. Medical nutritional therapy is defined as Nutritional diagnostic therapy, and counseling services for the purpose of disease management. The objective of the study was to study the efficacy of medical nutrition therapy in type 2 diabetics.Methods: A study was done on residents of Fatehgarh and Shaheed Nagar area of Bhopal. 44 patients with known history of diabetes with age 45 years or above were selected by house to house visit using purposive sampling. Subjects were divided in 2 groups. 1. Intervention group- known cases of diabetes mellitus type 2 with medical nutritional therapy. 2. Non Intervention group- known cases of diabetes mellitus type 2 without medical nutritional therapy. Diet plan according to the calorie requirement on the basis of the desired body weight was prepared and prescribed to the subjects of group 1. Monthly home visits for blood glucose monitoring was done.Results: The mean RBS of group 1 was 200mg and of group 2 was 194. The mean RBS of group 1 decreased by 6.5% in second reading and 8.2% in third reading.Conclusions: Only 19 out of 22 Diabetics belonging to intervention group adhered to the prescribed medical nutrition therapy. The reason being poor patient compliance because of casual attitude towards health. Better results could be obtained if the study duration was longer and HbA1c was considered.
Knowledge and practice of polio vaccination among mothers of infants attending community health centre of northern Kerala
Authors: Kaithery Nivya Noonhiyil , Kumaran Jayasree Anandabhavan
Published: June 2018

Background: Poliomyelitis is a highly infectious disease caused by polio virus which invades the nervous system causing irreversible total paralysis.The aim of the study is to assess the knowledge and practice of mothers regarding polio vaccination.Methods: It’s a descriptive type of study conducted in mothers of Infants who had attended Community health centre of Kannur district during a study period of 2 weeks (June 1 to June 14, 2017). Written consent was obtained from the mothers. Data was collected using a semi structured questionnaire with 3 sections -demographic details, knowledge and practice. Data was analyzed and the results are expressed in terms of frequency and percentage.Results: A total of 220 women were studied. Out of 220 mothers, 93.6% had satisfactory knowledge and 90.45% mothers had their child immunized up to age according to National Immunization Schedule. All of them were taking their children to government hospital for vaccination and their main source of knowledge were health workers.Conclusions: In the present study, majority of the mothers had attended immunization class and had satisfactory knowledge. In order to achieve 100% vaccination coverage, we have to emphasize more on awareness campaigns.
Prevalence of hearing impairment in Aligarh: a community based study
Authors: Khan Mohammad Asif , Khalique Najam , Khan Zulfia , Hasan Abrar
Published: June 2018

Background: Hearing impairment is avery complex phenomenon, which has many and serious consequencesfor people and involves many factors and issues that should becarefully examined. The objective of the study were to estimate the prevalence of hearing impairment in the study population.Methods: Study design was a community based cross sectional study. Setting was on field practice areas of the urban and rural health training centers, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh. No. of Participants was 422 study subjects age 18 and above 18 years; Systematic random sampling and proportionate to population size method (PPS). Statistical analysis was carried out using SPSS version 13; Chi-square.Results: Overall prevalence in present study population was found to be 23.1%. The prevalence in the rural areas (24.8%) was found to be higher than that of the urban areas (20.5%). The age specific prevalence showed that the maximum prevalence was in the age group of more than 70 years (66.6%). In the rural areas the prevalence was highest in the >70 year age group(75%) while in the urban areas it was maximum in the 61-70 year age group(61.5%). The prevalence was least in the 31-40 year age group in both urban (5.4%) as well as rural areas (14.5%). The association of hearing loss with age was found to be highly significant.Conclusions:A high prevalence of hearing impairment was found in the study. Increasing prevalence of hearing impairment was observed with advancing age.
Depression and anxiety among people living with HIV in a coastal city of Karnataka
Authors: R. Kavya , Badiger Sanjeev
Published: June 2018

Background: Living with HIV/AIDS not only hampers physical health but also mental and social well-being. The aim of this study was to assess the proportion of depression and anxiety among people living with HIV in the coastal city of Karnataka.Methods: A cross sectional study was conducted in a community based organization in Mangaluru. It involved 169 study participants selected by simple random sampling technique. After the informed consent, the data was collected by interviewer’s method using Beck’s depression scale and Hamilton’s anxiety scale. The data was analysed using SPSS software version 22.Results: Of the 169 participants, the most prevalent age at diagnosis of HIV infection was found to be 26-34yrs (40.8%) and 57.9% belonged to rural community. 22% of them had borderline clinical depression and 12% had mild to moderate anxiety. Depression and age at diagnosis (χ2=35.199, p=0.00); relationship status (χ2=6.241, p=0.00) showed a significant association.Conclusions: Though counselling is a part of ART services but still there is lack of follow up of cases and assessing the need of psychiatric support.