bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrapartum Fever and Unexplained Seizures in Term Infants
Authors: Lieberman Ellice , Eichenwald Eric , Mathur Geeta , Richardson Douglas , Heffner Linda , Cohen Amy
Published: January 2017

Objective.

Early-onset neonatal seizures are a strong predictor of later morbidity and mortality in term infants. Although an association of noninfectious intrapartum fever with neonatal seizures in term infants has been reported, it was based on only a small number of neonates with seizures. We therefore conducted a case control study to investigate this association further.

Methods.

All term infants with neonatal seizures born at Brigham and Women's Hospital between 1989 and 1996 were identified. For this study, cases consisted of all term neonates with a confirmed diagnosis of seizure born after a trial of labor for whom no proximal cause of seizure could be identified. Infants with sepsis or meningitis were excluded. Four controls matched by parity and date of birth were identified for each case. The rate of intrapartum maternal temperature >100.4°F was compared for case infants and controls. Potential confounding was controlled in logistic regression analysis.

Results.

Cases comprised 38 term infants with unexplained seizures after a trial of labor. We identified 152 controls. Infants with seizures were more likely to be born to mothers who were febrile during labor (31.6% vs 9.2%). In almost all cases, the fever developed during labor (94.7% cases, 97.4% controls). At admission, mothers of infants with seizures were not significantly more likely to have factors associated with concern about infection such as a white blood cell count >15 000/mm3 (28.9% vs 19.1%) and premature rupture of the membranes (15.8% vs 17.8%). In a logistic regression analysis controlling for confounding factors, intrapartum fever was associated with a 3.4-fold increase in the risk of unexplained neonatal seizures (odds ratio = 3.4, 95% confidence interval = 1.03–10.9).

Conclusion.

Our data indicate that intrapartum fever, even when unlikely to be caused by infection, is associated with a fourfold increase in the risk of unexplained, early-onset seizures in term infants.
Philadelphia-negatív krónikus Myeloproliferativ Neoplasia Magyarországi Regiszter. Essentialis thrombocythaemiás betegeink adatainak elemzése
Authors: Dombi Péter , Illés Árpád , Demeter Judit , Homor Lajos , Simon Zsófia , Udvardy Miklós , Karádi Éva , Kellner Ádám , Egyed Miklós
Published: January 2017

Abstract:

Introduction: In order to establish and use a national registry, several Hungarian hematology centers collected data of myeloproliferative neoplasia patients. Aim: The recent publication is an analysis of the data of registered essential thrombocythaemic patients. Method: an online electronic registry has been established, using 2008 World Health Organization’s diagnostic criteria and thrombotic risk was evaluated according to Landolfi stratification. Results: Data of 350 essential thrombocythaemic patients from 15 Hungarian hematology centers entered up to the date of June 30, 2015 were used for analysis. Patients were followed up to (median) 6 years. The epidemiologic data (age, gender) and thrombotic events prior and after the diagnosis, were similar to the literature. The thrombotic events of anagrelide treated patient (n = 139) and the hydroxyurea + aspirin treated patients (n = 141) have been compared. The major arterial and venous events were similar between the groups, but there were fivefold less minor arterial and venous events in the anagrelide group (p<0.001). Thrombotic incidence after diagnosis were influenced only by medication and thrombotic events before the diagnosis. Conclusions: Anagrelide significantly decreased the number of patients experiencing minor arterial and minor venous thrombosis, vs hydroxyurea + aspirin. Despite of the treatment the risk of thrombotic events after diagnosis remained high, and was significantly increased in patients with thrombosis before diagnosis. Orv. Hetil., 2017, 158(3), 111–116.
A rákmorbiditás és -mortalitás jelenlegi helyzete a Nemzeti Rákregiszter tükrében
Authors: Kásler Miklós , Ottó Szabolcs , Kenessey István
Published: January 2017

Abstract:

In a previous issue of this journal the authors presented and summarized the basic objectives and tasks of the Hungarian National Cancer Registry positioned in an international environment. The recent publication is a continuation of the previous one. Based on the presentation and analysis of current statistical data, the public health background with the possible risk factors is examined. Considering changes in recent years, the mortality data are relatively stable, although slightly wavering. The trends are promising in some cancers (for example lip and oral cavity, breast, prostate cancers) however. Contrary to the barely changing nature of the total cancer deaths the number of annually reported new cases has increased significantly, which indicates a more effective role in both diagnostics and therapy. In light of the above, it is confirmed that the restructure of the national oncology care system and the European conformation is inevitable. Orv. Hetil., 2017, 158(3), 84–89.
Cardiomyopathiás és ioncsatorna-betegek regisztere: a Szegedi CardioGen Regiszter
Authors: Blazsó Péter , Kákonyi Kornél , Forster Tamás , Sepp Róbert
Published: January 2017

Abstract:

The Szeged cardiomyopathy and ion channel diseases registry aims to establish a representative disease-specific registry based on the recruitment of patients with different cardiomyopathies and ion channel diseases followed at the Cardiology Center, University of Szeged. The registry collects patient data on the main forms of primary cardiomyopathies (hypertrophic, dilated, restrictive, arrhythmogenic right ventricular, left ventricular non-compact, tako-tsubo cardiomyopathy) and ion channel diseases (long QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia). Patients with hypertrophic cardiomyopathy (388 patients) make up the largest group of patients in the registry. Patients with dilated cardiomyopathy (310 patients) and patients with the long QT syndrome (111 patients) form two other sizable groups. Analyzed data of the group of patients with hypertrophic cardiomyopathy indicate similar figures with regard to disease related mortality and morbidity and clinical parameters. Orv. Hetil., 2017, 158(3), 101–105.
A coronariarendszer komputertomográfiás vizsgálata – Országos Plakk Regiszter és Adatbázis (OPeRA)
Authors: Bagyura Zsolt , Kolossváry Márton , Merkely Béla , Maurovich-Horvat Pál
Published: January 2017

Abstract:

Introduction and aim: Coronary computer tomography angiography is a unique non-invasive imaging technique with the capability to provide information regarding plaque quantity, burden and structure. A reliable registry is required to use the data of these examinations in research projects. The difficulty is that registries need double data entry simultaneously to the hospital information system. Method: Our registry solves this problem through a structured reporting tool, which generates clinical report and stores all data simultaneously. The automatically generated report is based on international guidelines. Results: Between August 1. 2014 and September 1. 2015 we registered the data of 2866 patients. Coronary plaque was observed in 77.03% of the patients, 33.18% of the plaques were calcified. Severe stenosis was present in 13.71% of the patients. Conclusions: The structured reporting decreases reporting time, eliminates double data entry related errors. Our goal is to initiate a nationwide, unified registry, the National Plaque Registry and Database. Orv. Hetil., 2017, 158(3), 106–110.
A szívinfarktus miatt kezelt betegek ellátása Magyarországon. A Nemzeti Szívinfarktus Regiszter 2015. évi adatainak elemzése
Authors: Jánosi András , Ofner Péter , Al-Maktari Fahmi , Hajkó Erik , Hati Krisztina , Járai Zoltán , Józan-Jilling Mihály , Kiss Róbert Gábor , Lóczi Gerda , Lupkovics Géza , Ruzsa Zoltán , Schmidt Erika , Veress Gábor , Zsifkov Tibor , Merkely Béla
Published: January 2017

Abstract:

The authors summarize the most relevant data of myocardial infarction patients according to the National Myocardial Infarction Registry data base. In 2015 12,681 patients had 12,941 acute myocardial infarctions. Less than half of patients (44.4%) were treated with ST elevation myocardial infarction. National Ambulance Service was the first medical contact of more than half (51.4%) of patients with ST elevation infarction. Prehospital thrombolysis was occasionally done (0.23%), but 91.6% of the patients were treated in hospital with invasive facilities. The median of the ischaemic time (time between onset of symptoms and arrival at the invasive laboratory) was 223 minutes. Most of the patients (94%) with positive coronary arteriography were treated with percutaneous coronary intervention. The 30 day mortality of the whole group was 12.8% vs. 8.6% of patients treated with an invasive procedure. Conclusion: comparing the national and international registry data we conclude that we should analyse and decrease the prehospital delay time to improve the patient care in Hungary. Orv. Hetil., 2017, 158(3), 90–93.
VACUUM PACKAGING IS EFFICIENT TO REMOVE ASTRINGENCY AND TO MAINTAIN THE FIRMNESS OF ‘GIOMBO’ PERSIMMON
Authors: MONTEIRO MARIANA FERRAZ , AGUILA JUAN SAAVEDRA DEL , PESSOA CLEUCIONE DE OLIVEIRA , KLUGE RICARDO ALFREDO
Published: January 2017

ABSTRACT The aim of this study was to develop a simple technique to remove astringency and maintain the pulp firmness of ‘Giombo’ persimmons. Fruit were packaged in three different plastic packages: low-density polyethylene (LDPE), polypropylene (PP) and polyethylene-polyamide (PE-PA). Packages with dimensions of 30 cm x 50 cm and 20 µm thickness were sealed under vacuum. Fruit uncovered in plastic film were used as control samples. After packaging, fruits were stored at ambient conditions (22°C and 70% RH) for five days. After this period, fruits were removed from the package and kept at the same previous conditions for six days and evaluated every two days. All plastic packages showed effectiveness in removing astringency, but only PE-PA maintained pulp firmness during the six days after package removal. LDPE and PP films also caused reduction of astringency while pulp firmness was properly maintained until the fourth day. These two films did not succeed in obtaining vacuum, which was only achieved by PE-PA. PE-PA reduces astringency faster and maintains fruit firmness for a longer time at room temperature.
EVALUATION OF EMERGING METHODS ON THE POLYPHENOL CONTENT, ANTIOXIDANT CAPACITY AND QUALITATIVE PRESENCE OF ACETOGENINS IN SOURSOP PULP (Annona muricata L.)
Authors: FERNÁNDEZ ANDRÉS ELOY LEÓN , OBLEDO-VÁZQUEZ EVA NOEMÍ , VIVAR-VERA MARIA DE LOS ANGELES , AYERDI SONIA GUADALUPE SÁYAGO , MONTALVO-GONZÁLEZ EFIGENIA
Published: January 2017

ABSTRACT The aim of this study was to obtain extracts from soursop pulp that were obtained with different solvents (chloroform, methanol, ethyl acetate and water) and different extraction methods (soxhlet, sonication and microwave), and analysed their extractable polyphenol content, antioxidant capacity and qualitative presence of acetogenins. The most efficient extraction method to obtain extractable polyphenols with high values of scavenging capacity by DPPH was sonication followed by microwave when methanol was used. The acetogenins were detected only in chloroform and ethyl acetate extracts obtained by the three extraction methods. Sonication or microwave was effective to obtain acetogenins or phenolic extracts in greater quantity than reported in soursop pulp, in a short time and few solvent.
Plano estratégico para o sistema agroindustrial citrícola brasileiro
Authors: Kalaki Rafael Bordonal , Neves Marcos Fava
Published: January 2017

Resumo: A laranja é, das frutíferas, a mais cultivada, conhecida e estudada no mundo. Atualmente a citricultura brasileira conta com aproximadamente 12 mil produtores de laranja, espalhados por mais de 800 mil hectares, cultivando 165 milhões de árvores, gerando em 2009 um PIB setorial de US$ 6,5 bilhões. Apesar da superioridade brasileira na produção de suco de laranja, o setor vem passando por algumas preocupações. O estudo tem por objetivo apresentar uma proposta de plano estratégico para o sistema agroindustrial citrícola brasileiro. Para desenhar o plano foi utilizado o método de Planejamento e Gestão Estratégica de Sistemas Agroindustriais (GESis). O estudo caracteriza-se como de natureza exploratória, sendo uma pesquisa qualitativa. Foram realizadas análises de dados secundários e dados primários, coletados por meio de entrevistas em profundidade, baseadas em um roteiro semiestruturado. Como resultado, apresenta-se um plano estratégico específico para o sistema agroindustrial citrícola, no qual são propostos 8 macro-objetivos estratégicos para o sistema agroindustrial citrícola e 13 projetos que auxiliarão na busca de objetivos estratégicos e para mitigar os efeitos negativos vivenciados pelo setor, a fim de fortalecê-lo.
O impacto do tipo de hospital e tipo de parto sobre a idade gestacional ao nascer no Município de São Paulo, 2013-2014
Authors: Raspantini Priscila Ribeiro , Miranda Marina Jorge de , Silva Zilda Pereira da , Alencar Gizelton Pereira , Diniz Simone Grilo , Almeida Marcia Furquim de
Published: January 2017

RESUMO: Introdução: Foi observado que em muitos países, nos últimos anos, houve redução da proporção de nascimentos com 40 semanas e desvio à esquerda da curva de distribuição da idade gestacional (IG), quando comparada ao padrão esperado. Objetivo: Estudar o padrão de distribuição da idade gestacional nos nascimentos do Município de São Paulo (MSP) e sua relação com o tipo de hospital e tipo de parto. Métodos: Foram extraídos dados do Sistema de Informações sobre Nascidos Vivos (SINASC) de 2013 e 2014 e do Cadastro Nacional de Estabelecimentos de Saúde (CNES). Os dados são apresentados segundo nascimentos nas redes SUS e não SUS, tipo de parto e IG, com padronização segundo a idade da mãe. Resultados: Houve um desvio à esquerda da IG para o total de nascimentos e entre os nascidos na rede não SUS, e foi mais acentuado entre nascimentos por cesárea. A mediana de IG na rede SUS foi 39 semanas e na rede não SUS, 38 semanas. A proporção de nascimentos pré-termo (9,5%) é semelhante nas duas redes, porém com proporção mais elevada de nascimentos muito pré-termo (<32 semanas) na rede SUS e (34-36) pré-termo tardios na rede não SUS. Conclusão: A mudança na distribuição da idade gestacional ao nascer no MSP está relacionada ao tipo de hospital em que ocorrem os nascimentos e à alta frequência de cesáreas na rede privada.
Pathology and morphometry of Hystrichis acanthocephalicus (Nematoda) from Phimosus infuscatus (Pelecaniformes) in southern Brazil
Authors: Scheer Simone , Macedo Márcia Raquel Pegoraro , Soares Mauro Pereira , Schramm Camila Costa , Muller Gertrud
Published: January 2017

Abstract Species of Hystrichis are parasite nematodes of the digestive tract of aquatic birds in South America, Europe and Asia. In Brazil, Hystrichis acanthocephalicus has been reported in Phimosus infuscatus. There are few data on the morphometry of this species and there are no reports on pathological conditions that it causes. Therefore, the purpose of this study was to report morphometric data from H. acanthocephalicus and describe the pathological effects of this parasite on the Phimosus infuscatus proventriculus. Thirty gastrointestinal tracts of P. infuscatus were examined to search for nematodes and H. acanthocephalicus occurred in 83% of hosts. Were measured the total length and body width of males and females, and of their respective cuticular spines, esophagus, spicules and eggs, and the internal and external diameter of copulatory bursa. Histopathological examination revealed parasitic structures in the proventriculus from the lumen (anterior end) to the outer layers of the organ (intermediate and posterior parts), in which we observed inflammatory reaction with infiltration of heterophils, hemorrhage and hemosiderin. The results of this study of histopathology, morphometry and parasitological indices are the first ones reported to H. acanthocephalicus and should contribute to the identification and recognition in cases of outbreaks in the Neotropical region.
Immobilisation of apatite on Ti30Ta alloy surface by electrospinning of PCL
Authors: Souza Marisa Aparecida , Carobolante João Pedro Aquiles , Almeida Rosemeire dos Santos , d’Ávila Marcos Akira , Walker Rachael Simon , Popat Ketul C. , Claro Ana Paula Rosifini Alves
Published: January 2017

Surface modifications of titanium alloy have been extensively researched for the purpose of increasing the biocompatibility of medical implants. In this study, a Ti30Ta alloy surface was modified by functionalisation with electrospun poly(ε-caprolactone) (PCL) followed by the immobilisation of apatite (AP) to achieve a bioactive surface. Human adipose-derived stem cells were then cultured on the surfaces for up to 7 d to ensure the effects of PCL and AP treatments on cytocompatibility and cellular fate processes. PCL fibres and alloy surfaces were evaluated with scanning electron microscopy, X-ray diffraction and thermal analysis techniques. The analyses showed a uniform deposition of the electrospun PCL fibres on the entire Ti30Ta alloy surface. In addition, increases in cell growth and proliferation were seen after 7 d. Results indicated that the surface treatment of the Ti30Ta alloy with electrospun fibres and AP immobilisation may increase the bioactivity of the surface and provide a beneficial surface modification for use in biomedical applications.
Study of flow and hydraulic jump along side weirs
Authors: Jalili Ghazizadeh Mohammadreza , Attari Jalal , Farhadi Rad Samira
Published: January 2017

Side weirs are widely used for flow control and diversion. Although many studies on sub- and supercritical flows along these weirs have been conducted, only a few research studies have considered the generation of a hydraulic jump along the side weir. Spatially varied flow including a hydraulic jump along the rectangular side weir is studied in this paper. Experimental data for different weir geometries and hydraulic conditions are analysed. Based on the experimental results, new equations for estimating the jump length, the ratio of the conjugate depths and the discharge coefficient are presented. Also, the head loss due to the presence of a hydraulic jump is studied. Furthermore, a numerical model is developed for coupling the water surface profile with a hydraulic jump along the side weir. In this model the lateral outflow momentum is considered, which has been mostly ignored in previous works. The model predicts the location of the hydraulic jump. A comparison of the numerical and experimental results indicates good agreement.
Our experience in gastrointestinal perforations: a retrospective study
Authors: Kemparaj Thammegowda , Narasimhaiah Narasimhamurthy Kadirehalli , Mayigaiah Ravikiran Keragodu
Published: January 2017

Background: Peritonitis secondary to gastrointestinal perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the incidence of various types of gastrointestinal perforations, their complications and the management of patients with postoperative leaks in our surgical unit and compares our findings with those of previous studies performed between 1984 and 2014.Methods: Retrospective study analyzing the case files of all the operated cases of gastrointestinal perforations in a single unit over the last 10 years from September 2005 to August 2015 by open procedure. A total number of 381 cases were studied. All cases with perforative peritonitis, whether spontaneous, infective, traumatic or of neoplastic pathology, were included in the study.Results: Gastrointestinal perforations were common between the ages of 30-50 years; 82% were males. From July to October (rainy seasons) every year a higher number of perforations were noticed; 40% of patients had duodenal, 34% had ileal, 11% appendicular, 6% gastric, 6% jejunal and 3% had colonic perforations. Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (50%) and tachypnea (42%) were common signs; 15-20% presented late with features of shock.Conclusions: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever (typhoid) have highest morbidity and mortality. Most of the anastomotic leaks can be treated conservatively. Mortality depends on the general condition of the patient and associated pre-operative comorbidities.
A prospective study on suture ligation of internal hemorrhoids without Doppler guidance for the treatment of symptomatic hemorrhoid disease
Authors: Saxena Pradeep , Bhakuni Yogendra S.
Published: January 2017

Background: Hemorrhoids or piles are one of the most common afflictions of human being, affecting both sexes & can occur at any age. The aim of the study was to study the effectiveness of suture ligation of hemorrhoids and mucopexy as an outpatient treatment for symptomatic hemorrhoids.Methods: This prospective observational study was carried out in the department of surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India on 64 adult patients of hemorrhoids treated by suture ligation of hemorrhoid pedicle without Doppler guidance and mucopexy from July 2012 to December 2014. The patients were managed as outpatient or day care cases. The observations and follow up data were recorded and descriptive analysis was done to study the clinical presentation of hemorrhoid disease and effectiveness of hemorrhoid ligation and mucopexy in an ambulatory, outpatient or day care setting.Results: Total 64 patients of hemorrhoids who underwent suture ligation of hemorrhoids and mucopexy were studied. Most of the patients were between 31- 60 years of age (74.28%) with males predominance (64.06%). All the patients in this study had bleeding per rectum as the main symptom. All patients had hemorrhoids in primary 3, 7 or 11 ‘o clock positions and 21 patients (32.8%) had secondary hemorrhoids as well. Majority the patients had 1-3 degree hemorrhoids. However hemorrhoid ligation was also done in 7 patients with fourth degree hemorrhoid who were severely anemic and unfit for surgery due to co morbidities. Over all 82.81% patients were free from symptoms at 1 year follow up after the procedure and only 7.81% of the patients had recurrence of bleeding or prolapse.Conclusions: Hemorrhoid suture ligation with mucopexy is a simple, safe & cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.
Prevalence of iodine deficiency among multinodular goiter patients: a South Indian study
Authors: Kerakada Nishad , Manikantan Ganesh , Chisthi Meer M.
Published: January 2017

Background: Mass iodization of table salt was introduced by the Government of India to treat as well as prevent iodine deficiency problems including goitres. However, even after so many years of introduction of iodized salt, the number of patients reporting with multi nodular goiter to the hospitals in Kerala seems to be high. The coastal districts of Trivandrum and Kollam report especially high prevalence of goitres and subsequently thyroidectomies. The aim of this study was to find the prevalence of iodine deficiency among patients with multi nodular goiter in South Kerala.Methods: This was a cross sectional study of 300 patients admitted with multinodular goitre in the general surgical wards of Government Medical College Trivandrum, Kerala, India. From June 2013 to June 2014, these patients were evaluated clinically and with the investigatory facilities available at this institution. Their urine spot iodine excretion levels were measured at the laboratory of state iodine deficiency control cell, Trivandrum, Kerala, India.Results: Out of the 300 cases, 6 patients were found to have mild iodine deficiency. Mean iodine level was normal at 170 microgram per decilitre. The prevalence of iodine deficiency in multinodular goiter cases studied was found to be 2%.Conclusions: The high prevalence of multinodular goiter cases in Kerala cannot be sited per se as due to iodine deficiency as only 2% of the total number of cases studied had low urine iodine levels. This raises a question whether the salt iodization programme needs to be re-analyzed and possibly re-structured for the state of Kerala.
A study of gall stone disease from a tertiary care center of Madhya Pradesh, India
Authors: P. S. Veerabhadrappa , Tank Priyanka , Singh Abhishek , Goel Shewtank , Nathwani Parth
Published: January 2017

Background: Gall stone precipitation is multifactorial in nature. Nowadays, gallbladder disease is a frequent problem in developed countries including India, representing a major health problem. The present study was planned to study the epidemiology of gall stone disease in the region of Madhya Pradesh, India.Methods: A retrospective cohort of patients seeking surgical care for their gall stone disease during past one year at Sukhsagar Medical College, Jabalpur, Madhya Pradesh, India during formed the study population. Study tools were records of the patients such as information from MRD department and records from histopathological section.Results: Majority (26.6%) of cases was in the age group of 51-60 years followed by 21.6% cases in the age group of 41-50 years. Sex wise 63.3% were females. Most (71.7%) patients presented with the complaints of pain in the region of hypochondrial region followed by nausea in 46.6%. Jaundice was the least common presenting feature shown by 6.6% patients. As per gross morphology, majority of cases (44) had pigmented stones. As per biochemical analysis, majority of cases (33) had mixed type of stones. The gall stones size varied from 0.2 cm to 2.2 cm in diameter. The weight of gall stones ranged from 0.34 gm to 4.9 gm.Conclusions: Cholelithiasis is more common in the age group of 41- 60 years with female predominance.  Non-vegetarians are at risk for cholelithiasis compared to vegetarians. Hypochondrial pain is most common manifestation. Chronic cholecystitis was the most common histopathological diagnosis. Mixed type stones were common variety.
Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair
Authors: B. S. Madhu , Kumar H. B. Shashi , Reddy M. Naveen Kumar , Reddy Abilash V. , Kalabhairav Sangeetha
Published: January 2017

Background: Rational use of antibiotic is important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care. The efficacy of antibiotic prophylaxis in preventing surgical site infection in patients undergoing Lichtenstein tension free inguinal hernia repair still remains controversial.Methods: A randomized controlled trial was conducted in patients undergoing lichtenstein tension free inguinal hernia repair between January 2015 to June 2016, and the results were compared with the control group in whom, conventional antibiotics were given for 7 days . All patients in study group undergoing surgery were given 400 mg parenteral ciprofloxacin 30 min prior to surgery. In the control group, the patients were given 2 days parenteral ciprofloxacin 400 mg twice a day and the next 5 days the same antibiotics were given in oral route, after surgery. Total 100 patients were randomized to 50 each group. The outcome in terms of duration of surgery, surgical site infection, cost and antibiotic side effects were then compared.Results: The duration of the hospital stay, cost and side effects are significantly higher in the control group patients. Antibiotic side effects (P < 0.05) were high for control group. The infection rate was same in both the groups. There was no significant difference in terms of infection rate among two groups.Conclusions: This study concludes that prophylactic single-dose antibiotic is effective in preventing surgical site infection and is cost-effective in patients undergoing lichtenstein tension free mesh repair.
Mucocele of the appendix: a rare case report
Authors: P. B. Sudarshan , S. Reshma
Published: January 2017

Appendiceal mucocele is a rare disease. Sometimes it is discovered accidentally and sometimes it resembles acute appendicitis. Correct diagnosis before surgery is important for the selection of adequate surgical treatment to avoid intraoperative and postoperative complications. Ultrasonography, and particularly computed tomography, should be used extensively for this purpose. If mucocele is treated incorrectly, pseudomyxoma peritonei may develop. We present a case of 22 year old man who was admitted to the emergency department with the signs of acute appendicitis. Emergency open appendectomy was performed. At the time of surgery, a cystic mass was found at the tip of the inflammed appendix. No free fluid was found in the peritoneal cavity. Diagnosis of Mucocele of appendix was suspected. Appendectomy was done and specimen sent for histopathological examination. No lymphadenopathy. Histopathologic diagnosis was subacute appendicitis, mucocele of appendix with simple mucous cyst. Patient is on regular follow-up.
Fibroadenoma in an operated case of malignant phyllodes tumour: a rare case report
Authors: Shetty Iresh , Jadhav Tushar , Lad Aditya , Batra Gaurav , Rege Ishant , Thakkar Saurabh
Published: January 2017

Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of breast neoplasms. Displaying a broad range of clinical and pathological behaviour, phyllodes tumours should be regarded as a spectrum of fibroepithelial neoplasms rather than a single disease entity. We would like to present a rare presentation of fibroadenoma over site of a previously operated case of malignant phyllodes tumour. A 36 year old female came to OPD with complaints of lump in both breasts since 4 months. She gave history of previous surgery, i.e., left breast lumpectomy for which HPE report was suggestive of malignant phyllodes tumour. On examination, 3x2 cm, solitary, firm to hard, non-tender lump was felt in the junction of the upper outer and inner quadrant just below the scar of previous surgery and was not freely mobile and appeared fixed to the scar. Patient underwent excision of the lump with frozen section and final HPE report turning out to be fibroadenoma. Though diagnosis of malignant phyllodes tumour is not difficult, diagnosis of low grade phyllodes tumour and distinction from fibroadenoma on FNA is difficult due to overlapping features between the two lesions. Surgery remains the mainstay of treatment for patients with cystosarcoma phyllodes, extent of surgery been controversial, and continues to evolve. Incidence of fibroadenoma occurring at the previous operated site of malignant phyllodes tumour is very rare with no known previous documentation of such a case.
Primary angiosarcoma of the breast: a rare entity
Authors: D’Souza Dyan , Sunny Ann , Sima Rahul , Rozario Anthony P.
Published: January 2017

Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours. We report a 35-year-old woman who presented with a recurrent lump in the left breast for four months. Fine needle aspiration cytology (FNAC) was suspicious of angiosarcoma and this diagnosis was confirmed on core needle biopsy. Modified radical mastectomy was performed as sole treatment. No chemo radiotherapy was given as tumor was grade I, margins were negative and there was no lymph node involvement. She is on regular follow up and no recurrence reported since the surgery. The 5-year disease-free survival for grade I tumours can be as high as 76%, and up to 70% for grade II tumours whereas for grade III tumours it is reportedly about 15%. Primary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even after complete resection. Surgery is the mainstay of treatment with a limited role for chemotherapy and radiotherapy.
Unusual case of upper urinary tract obstruction: a case report
Authors: Singh Amarjot , Bhushan Rahul , Chadha Prerna
Published: January 2017

Ureteric endometriosis is a very rare cause of upper urinary tract obstruction. Patients presented with left ureteric colic since 1 month, two episodes severe in intensity radiating from lt loin to groin. 2x2 cm hard growth in mid ureter with dense adhesions to peritoneum, lt fallopian tube and ovary, lt internal iliac vein and serosa of sigmoid colon, left distal ureterectomy, left salpingo-oopherectomy and psoas hitch ureteric reimplantation was performed and specimen was sent for HPE. Diagnosis of left ureteric endometriosis was made on histopathological evaluation report. This diagnosis should be considered in the D/D of ureteral obstruction in a young female especially on lt side. Carefully performed surgery in the form of ureteral excision and reimplantation preserves renal function.
Pyelolithotomy of simple right sided ectopic kidney with renal stone
Authors: Meravi Sarvjeet , Mudgal M. M. , Kushwah Naveen
Published: January 2017

Ectopic kidney (renal ectopia) is a kidney that is not located in its usual position. It has an incidence of approximately 0.11% in general population and incidence of pelvic kidney is 0.0005% and ectopic kidney with a renal stone is rarer finding with very few reported cases. Mostly patient are asymptomatic and diagnosed incidentally, many a time it only presents as a lump during abdominal examination, patient may come with urinary complaints such as urine blockage, infection or urinary stone. Here we report a case of ectopic kidney with renal calculi and X Ray KUB showed the presence of stone in the pelvis which was later confirmed for it to be in the kidney by ultrasonography, CTand IVP which was managed by open pyelolithotomy with DJ stent placement using midline incision.
Protocol for an integrated phase II/III randomised controlled trial of transarterial chemotherapy and sorafenib with or without stereotactic body radiation therapy in patients with nonmetastatic unresectable hepatocellular carcinoma
Authors: Chopra Supriya , Shetty Nitin , Goel Mahesh , Engineer Reena , Rajamanickam Karthick , Kulkarni Suyash , Polnaya Ashwin , Patkar Shradha , Ostwal Vikas , Ramadwar Mukta , Swamidas Jamema , Phurailatpam Reena , Paul Siji N. , Dhandpani Epili , Joshi Kishore , Kannan Sadhana , Rangarajan Venkatesh , Mehta Shaesta , Patil Prachi , Shrivastava S. K.
Published: January 2017

Background: Vast majority of patients with hepatocellular carcinoma (HCC) present with unresectable disease. In the last decade results of randomized trials and subsequent meta-analyses established trans-arterial chemoembolization (TACE) as standard of care in patients with Barcelona clinic liver cancer (BCLC) stage B. However, there is clearly a need to investigate additional therapeutic options that would consolidate the initial response to TACE. A recent meta-analyses concluded that addition of radiation to TACE had 10-35% improvement in two-year overall survival, however as results of meta-analyses were based on small studies, the need for conducting a high quality randomized study was highlighted. The present study is designed to investigate the role of high dose stereotactic radiation as consolidation therapy after TACE in patients with non-metastatic unresectable HCC.

Methods: Patients diagnosed with non-metastatic unresectable HCC with BCLC stage B/A (medically inoperable) and Child-Pugh’s score A-B7 will be eligible. The trial will randomize patients into TACE alone arm or TACE followed by stereotactic body radiation therapy (SBRT). The primary aim is to compare in-field progression free survival (PFS) in phase II and overall survival in phase III between the control (TACE) and intervention arm (TACE+SBRT). The secondary aim is to compare cause specific survival, imaging response and quality of life in control and intervention arms.

Results: First analysis of the study has been planned when patient accrued under phase II study have completed 1 year follow up.  

Trail Registration: Clinicaltrials.gov,NCT02794337
Excellent retention, virologic and clinical outcomes after transitioning from an antiretroviral treatment clinical trial to locally-provided care and treatment in Africa
Authors: Sawe Fredrick , Hughes Michael D. , Bao Yajing , Hogg Evelyn , Shaffer Douglas , Phulusa Jacob , Kakhu Tebogo , Conradie Francesca , Kasaro Margaret , Mngqbisa Rosie , Siika Abraham , Atwiine Diana , Chipato Tsungai , McIntyre James , Currier Judith , Lockmand Shahin
Published: January 2017

Background: Little is known about outcomes among clinical trial participants following completion of study-provided care and treatment in resource limited settings. We sought to describe outcomes among HIV clinical trial participants after transitioning to local routine care in Africa.

Methods: In the OCTANE study, 741 women with CD4 <200 cells/mm3 in 7 African countries were randomized to initiate antiretroviral treatment (ART) with tenofovir/emtricitabine (TDF/FTC) plus either lopinavir/ritonavir (LPV/r) or nevirapine (NVP). When study-specified ART ended (48-191 weeks after study entry), participants transitioned to locally-provided HIV care and non-study ART. Consenting participants were interviewed and had toxicity labs, CD4 and HIV-1 RNA testing, and clinical outcomes assessed at 12 and 72 weeks after transition to local care.

Results: Five hundred thirteen (77%) of the 669 women in follow-up at completion of the interventional trial participate in the extended follow-up. 513 women, 476 (93%) had HIV-1 RNA <400 cp/mL at time of transition, and 489 (95%) completed follow-up.  Seventy-seven women (19%) had a total of 99 antiretroviral regimen changes during post-trial follow-up. 30% of the 99 regimen changes-were due to lack of local drug availability. Thirteen (3%) women had Grade ≥3 laboratory abnormalities and 3 experienced worsening of the WHO HIV stage. Two women died. Eighty-nine percent of 484 with results had HIV-1 RNA ≤400 cp/mL at 72 weeks after transition to local non-study HIV care and treatment.  

Conclusions: The vast majority of women were able to continue key components of their ART and to maintain virologic suppression through 72 weeks of locally-provided post-study care.

Trial registration: ClinicalTrials.gov NCT00089505
A systematic review of health education theories and approaches in improving the oral health behaviour among adults
Authors: Manoranjitha B. S. , K. M. Shwetha , Pushpanjali K.
Published: January 2017

Background:  Theoretical models analysing patient behaviour are necessary to understand the complex relationships underlying human behaviour. The widely accepted definition of health is according to World Health Organization (WHO) “a state of complete physical, mental and social wellbeing, not merely an absence of disease or infirmity.” To assess effectiveness of theory and approaches of oral health education in changing the oral health behaviour and improving the oral hygiene status among adults.Methods: PubMed database was searched for published studies in English language. The search dates were limited to 1990 onwards, applied to the inclusion criteria. Primary outcome was the change in oral hygiene behaviour, measured by self-reported and observed measures. Secondary outcomes were changes in plaque score, dental knowledge. Relevant titles and abstracts of studies were screened. Quality assessment was done for the studies included using checklist of items for randomized controlled trail. (CONSORT) These studies were categorised based on the type of theory used, type of intervention and outcome.Results: Out of 48 studies obtained based on the title and abstract, 15 studies were excluded based on inclusion and exclusion criteria. 13 studies fulfilled the inclusion. These studies were categorised based on the type of theory used. Studies based on 1) Operant and Classical conditioning theory 2) Social cognitive theory. 3) Self-efficacy model. 3) Transtheoritical model. 4) Motivational interviewing. 5) Self-regulatory model. 6) Health action process approach. 7) Implementation intention theory.Conclusions: Theory and approach based oral health education is effective in significantly improving the oral hygiene behaviour.
Evaluation of cold chain and logistics management practice in Durg district of Chhattisgarh: pointer from Central India
Authors: Sinha Ashish Kumar , Verma A. R. , Chandrakar Aditi , Khes Shanta P. , Panda Prem Sagar , Dixit Srishti
Published: January 2017

Background: Immunization is the effective method of preventing childhood diseases. One of the important elements for improving the immunization is cold chain and vaccine logistics management which are the left and right hands of immunization programme. Keeping this in mind, the present study was done with the objectives a) to ascertain the status of cold chain equipment and logistics management using GOI monitoring format and b) to ascertain the awareness and practice of cold chain handlers about cold chain equipment and logistics management in Durg district of Chhattisgarh, India.Methods: A cross sectional study was conducted among randomly selected 20 cold chain points (CCPs) of Durg district using standard GOI structured questionnaires.Results: Out of 20 cold chain points (CCPs), 20% CCPs, vaccine were found in frozen state. Functional thermometer was available in 75% CCPs, out of which 65% had temperature in the recommended range. Twice daily recording of temperature was found only in 95 % CCPs. Record of power failures and defrosting was noted in temperature log books in 70% CCPs. The correct placement of ice packs inside Deep freezer was observed in only one CCPs. T-series vaccine vials were placed properly in ILR in 85% CCPs. With respect to knowledge on freeze sensitive vaccine and shake test, 74 % and 53% of cold chain handlers had correct knowledge.Conclusions: The quality of immunization programme can be increased by proper maintenance of cold chain and management of vaccine logistics at every designated cold chain points. There is need to improve the knowledge level of CCHs regarding cold chain maintenances and handling practices.
Dietary intake of mother in childbearing age with BMI <18.5 kg/m2 and has heterozygous variant D327N SHBG genotype (w/v)
Authors: Parwanto ML Edy , Senjaya Hardy
Published: January 2017

Background: Body mass index (BMI) determined by genetic and environmental factors. One of the genetic factors that determine the BMI is a genetic polymorphism of sex hormone binding globulin (SHBG), whereas the intake of nutrients is one of the environmental factors. The objective: investigate to macronutrient intake of mother in childbearing age with BMI <18.5 kg/m2 and has heterozygous variant D327N SHBG genotype (W/v).Methods: Anthropometric measurement, genotyping of D327N SHBG gen exon 8, and three days repeated food recall and record was done for all subjects. BMI in the group I 16 to <17 kg/m2 and group II 17 to <18.5 kg/m2. For all subjects in both groups has heterozygous variant D327N SHBG genotype (W/v).Results: mother in chieldbearing age with BMI <18.5 kg/m2 and has heterozygous variant SHBG genotype (W/v) is undernutrition. Seventy two percent of the total subjects including type I of chronic energy deficiency (CED), and 28% as type II of CED. Protein, fat and carbohydrate intake and mid-upper arm circumference (MUAC) in the group I was lower than group II (p<0.05), while muscle mass in the group I did not different compare to group II (p>0.097).Conclusions: Mother in childbearing age with BMI <18.5 kg/m2 and has heterozygous variant D327N SHBG genotypes (W/v) shows that the lower of protein, fat and carbohydrate intake then CED status is getting low.
Combination of alfa blocker with low dose tadalafil in benign prostatic hyperplasia with erecticle dysfunction management
Authors: , Ahammad Basha Shaik S V Krishna Reddy
Published: January 2017

Objective: To study the combination therapy with daily low dose tadalafil (5mg) and alpha blockers for the treatment of BPHLUTS and Erecticle dysfunction (ED). Materials and Methods: The medical records of 168 patients who had medical management for symptomatic BPH/LUTS with or without ED from January 2010 to December 2013 were reviewed retrospectively. All patients were divided into 2 groups. Group1(n: 74) included patients received a single daily dose of tamsulosin 0.4mg or alfuzosin 10mg . Group-2 (n:75) patients with LUTS and BPH who were previously managed with alpha blockers (tamsulosin 0.4mg or alfuzosin 10mg) were included in our study by addition of 5mg phosphodiesterase type 5 inhibitor (tadalafil), which has been reported to be useful in the management of BPH/LUTS and ED. We analysed the International Prostate Symptom Score (IPSS), IIEF Score, BPH Impact Index (BII) and Quality of Life (QoL). Results: Before the inclusion of tadalafil patients exclusively on alpha blockers had a mean IPSS score of 21.51 ± 2.89). IPSS improved to a mean of 11.34 ± 1.56 ( p<0.001) after the addition of a single daily dose of 5mg tadalafil. A previous mean BPH Impact Index of 8.52 ± 1.22( p><0.001) improved to 4.38± 0.89 (p><0.001). Quality of Life index was graded with a mean of 3.76 ± 1.10 before addition of tadalafil and improved to a mean of 2.22 ± 0.76 ( p><0.001). IIEF-5 scores changed from 15.54 ± 3.68 to 7.89 ± 3.84 (p><0.001), after 12 weeks of treatment. Conclusion: We recommend tadalafil 5mg once daily dose for BPH/LUTS patients with higher IPSS score, diabetes, smaller prostate and inoperable patients.>
A Comparative Study of Refractive Errors with Age Related Cataract and Biometric Parameters
Authors: Jenisha , Sandeep Bhaskaran Muthukrishnan Vallinayagam , Rathnakumar K , Anlin
Published: January 2017

Background: The refractive errors such as myopia and hypermetropia are greatly influenced by the cataract morphology and its biometric parameters such as axial length and corneal curvature. This study aims to determine the correlation between the refractive errors, cataract and the biometric parameters of cataract like axial length and corneal curvature. Materials and methods: This cross sectional study was carried out in a tertiary care centre. Hundred patients diagnosed with cataract were recruited for this study. The corneal curvature was measured by keratometry and axial length by A-scan ultrasonography. Cataract was classified as nuclear sclerosis and cortical cataract based on slit lamp examination, and refraction was done by autorefractometer. Results: The prevalence of myopia was considerably more among the subjects than hyperopia. There was a significantly higher prevalence of myopia in nuclear cataract. Most of the subjects with nuclear cataract were associated with myopia, and a small minority with hyperopia. Majority of the patients with cortical cataract were hyperopic. There was an increase in index myopia with increasing nuclear sclerosis. Axial and curvatural myopia account for the rest of the subjects. Axial and curvatural hypermetropia were seen in less number of subjects. Conclusion: Increase in nuclear sclerosis (index myopia) accounts for the majority of myopia. Increase in axial length (axial myopia) and increase in corneal curvature (curvatural myopia) are other determinants of myopia in patients with cataract. Similarly, hyperopia was mostly index, followed by axial and curvatural varieties.