bluuebunny/crossref_metadata_2025 huggingface dataset:
Inimputabilidad e inmadurez psicológica y su relación con Los principios generales de la responsabilidad penal del adolescente infractor en Colombia
Authors: Torres Vásquez Henry , Corrales Barona Dagoberto
Published: December 2019

The principles governing the system of adolescent criminal responsibility are found in international mechanisms for the protection of human rights which advocate for the protection of the child. They are instituted in various positive instruments both in domestic and international law. In Colombia they are in the Political Constitution, and in Law 1098 of 2006. These can be both substantive and procedural.The Criminal Responsibility System for minors in Colombia is an accusatory, adversarial, specific and differentiated system with respect to the adult system, based on a series of principles. Among these are highlighted in this article, the best interests of the minor and the age range which are essential when analyzing the imputability of the minor offender of the criminal law.
In this sense, the importance of considering the imputability based on the psychological immaturity of the minor who commits crimes based on being over 14 years old and under 18 years of age is studied. Teenagers who break the criminal law are considered attributable with special treatment, therefore respond criminally for punishable behaviors, which means that there is no impunity in their crimes.It is concluded in the article that the way to deal with juvenile delinquency, makes it necessary to conduct studies on the desirability or not of imputability based on age as the means of addressing the criminal responsibility of the child for which both the minority and coming of age from which one is criminally responsible in Colombia. In this way, it is possible to establish an adolescent penal system that responds to social expectations and prevents minors from being used for the commission of crimes by adults and that the behaviors that adolescents commit do not go unpunished.
Can vitamin D, B12, folic acid, inflammatory markers and H. pylori effective in the process of chronic spontaneous urticaria?
Authors: Gurlek Feridun , Taşdemir Eyyüp
Published: December 2019

Background: Etiopathogenesis in Chronic Spontaneous Urticaria (CSU) is not completely clear. Some vitamins, inflammatory markers and even some microorganisms have been held responsible for this process. There are limited number of publications in this field in the literature. The aim of this study is to shed light on the etiology of chronic urticaria.Methods: This study included a total of 90 patients that 45 with CSU patients and 45 healthy subjects who admitted to Allergy and Clinical Immunology and Internal Medicine outpatient clinics of University of Health Sciences, Bursa Postgraduate Research and Training Hospital between October 2018 and June 2019. They were between the ages of 18-55. Both groups were examined for CRP, Procalcitonin (PCT), Erythrocyte Sedimentation Rate (ESR), Vitamin B12, vitamin D, folic acid and Helicobacter pylori (H. pylori) antibody.Results: ESR, CRP, PCT, Vitamin B12 and Vitamin D levels were not statistically different according to the groups (p>0.05). Folic acid levels were significantly different between groups (p=0.026; p<0.05); the low folic acid ratio in the healthy group is higher than in the urticaria group. There was no statistically significant difference between the groups according to H. pylori antibody positivity (p>0.05). In urticaria group, sufficient vitamin D ratio was higher in who were H. pylori antibody negative. In healthy group; insufficient and sufficient vitamin D ratio was higher in who were H. pylori antibody positive.Conclusions: There is no direct correlation between urticaria and Vitamin B12, Vitamin D, folic acid deficiencies and inflammatory biomarkers. CRP, ESR and PCT levels may be generally normal as in patients with urticaria. However, CRP may also increase slightly in patients with severe urticaria. It may be wrong to see H. pylori as a direct cause of urticaria.
Evaluation of a novel immuno-magnetic assay technology for rapid detection of dengue NS1 antigen
Authors: Roy Partha , Gaur Ravi , Anand Ankita
Published: December 2019

Background: Serological diagnosis of dengue fever is based on the detection of NS1 antigen and further confirmed by the assay of dengue IgM and IgG. Rapid Diagnostic Tests (RDTs) are no longer recommended for use by the Government of India. However, there is a requirement of rapid results without compromising on the test quality. Accordingly, we undertook an evaluation of a novel cartridge-based system employing a unique table-top diagnostic device for dengue NS1 antigen by BluSense Diagnostics incorporating a patented Immuno-Magnetic Assay (IMA).Methods: A total of 309 samples were tested on unlinked anonymous basis. Each sample was tested using NS1 Ag ELISA (Microlisa, J. Mitra), ViroTrack and NS1 RDT (SD Alere) and results were recorded. Discordant samples were further tested by dengue NS1 AG ELISA (Panbio) and dengue IgG/IgM Maclisa (J. Mitra).Results: When compared with approved ELISA kits used globally the Virotrack test returned a sensitivity of 94.74%; specificity of 97.44%; PPV of 97.30%; NPV of 95% and accuracy of 96.10%. Hourly throughput is 5-6 samples.Conclusions: The Virotrack system is highly suitable as a POCT module in HCFs with low to moderate workload that employs novel technology, is rapid, user friendly and comparable to the ELISA in sensitivity and specificity. The equipment is user friendly and can work both on plasma/serum and whole blood. Model with multiple modules (3-4) will improve the throughput and turnaround time. Evaluation of this novel technology has been done in India for the first time.
Haematological profile of sickle cell patients attending tertiary health care centre of southern Odisha: a cross sectional study
Authors: Behera Samira K. , Kar Sonali , Kar Monali
Published: December 2019

Background: Sickle Cell Disorder (SCD) is a major health problem in India. After introduction of High-Performance Liquid Chromatography (HPLC) in MKCG Medical College, this study is first of its kind to describe haemoglobin variants of SCD. The aim of the study was to document haematological profile and pattern of haemoglobin variants in SCD patients.Methods: A Hospital based cross sectional study was conducted in Pathology department, MKCG medical college from October 2018 to May 2019. Sickle cell patients were included and patients in Sickle cell crisis or transfused with blood in last 3 months were excluded. Hematological indices were measured by Sysmex XT 2000i blood analyzer. Quantification of hemoglobin variants was done by HPLC. All data were analyzed using SPSS and Independent t-test was applied.Results: In this study 100 heterozygous and 116 homozygous cases were reported. In homozygous cases Hb were significantly low and MCV, MCH, RDW-CV were significantly high than heterozygous. Hb level was significantly lower in homozygous children. Hb F was significantly higher in children and homozygous cases. A significant positive correlation was seen between Hb and RBC in both cases.Conclusions: In homozygous cases moderate anaemia (microcytic hypochromic to normocytic hypochromic) with High Hb F and in heterozygous cases mild anaemia (microcytic hypochromic) dominated the haematological profile. Children were significantly more anaemic than adults in homozygous cases. Anisocytosis was significantly more in homozygous cases and pediatric age group. Average fetal Haemoglobin variant (Hb F) was significantly more in homozygous cases and lower in adult group in both homo and heterozygous cases.
Correlation of spirometry and six minute walk test in patients with chronic obstructive pulmonary disease from Sundargarh, Odisha, India
Authors: Dinakar Yara , Kiran Pradeep Panchadi , Mohanty Akshaya K. , Sahu Praveen Kishore , Mohanty Anita
Published: December 2019

Background: Six‑Minute Walk Test (6MWT) is a simple, objective, reproducible test which correlated well with different spirometric indices, and thus able to predict severity of Chronic Obstructive Pulmonary Disease (COPD) and can replace spirometry in resource poor set‑up. Here, author evaluated the correlation of 6 minute walk distance (6MWD) with spirometric indices in COPD patients and the potential of 6MWT as an alternative to the assessment of severity of COPD.Methods: This cross-sectional observational study included a total of 80 COPD patients, diagnosed by GOLD criteria (Post bronchodilator FEV1/ FVC ratio <0.7). Modified Medical Research Council (mMRC) grading was used (age, weight, height, body mass index- BMI and breathlessness) and all the patients underwent spirometric measurement of FEV1, FVC and FEV1/ FVC ratio and tests were repeated after bronchodilation using 200-400 μg of salbutamol. 6MWT was performed following American Thoracic Society (ATS) protocol of 6MWT and distance was measured in meters.Results: Author found significant negative correlation of 6MWT with age (r=-0.384, p=0.00) and mMRC grading of dyspnea (r=-0.559, p=0.00) and significant positive correlation with height (r=0.267, p=0.019) and weight (r=0.293, p=0.008). Significant positive correlation of 6MWD was noted with post bronchodilator FEV1(r=0.608, p=0.00), FEV1% (r=0.429, p=0.00), FVC (r=0.514 p=0.00), FVC% (r=0.313 p=0.005), FEV1/FVC % (r=0.336, p=0.001). Positive correlation was also observed between 6MWT and BMI but statistically insignificant (r=0.177, p=0.116). There was significant negative correlation between 6MWT and GOLD staging (r=-0.536, p=0.00).Conclusions: This finding concludes that 6MWT can be used for the assessment of severity of disease in COPD patients in places where spirometry is not available.
Pseudocyst of pinna: a clinical experience
Authors: Showkat Showkat Ahmad , Dar Nissar Husain , Shafi Omar Mohammed
Published: December 2019

Background: Pseudocyst of pinna is an intracartilagenous accumulation of fluid in pinna and is hardly encountered in routine ENT practice. The etiology is unclear. It is seen to affect most commonly middle-aged males. Medical treatment is ineffective. Various treatments are suggested in the literature. The aims of the paper were to study the clinical and demographic characteristic of patients with pseudocysts.Methods: Forty patients were diagnosed with pseudocyst of the auricle between July 2016 and July 2019 on the basis of clinical characteristics, colour of aspirated fluid and absence of infection. Clinical and demographic characteristics were noted.Results: Out of 40 patients only five were females. Involvement of left side was seen more than right one. None had bilateral involvement. Adults in the age group of 31-45 were commonly affected. Most common site of involvement was triangular fossa.Conclusions: Pseudocyst of the pinna is a benign condition characterized by intracartilagenous accumulation of fluid. The disease is seen commonly unilaterally in middle aged males. Many modalities of treatment have been recommended in the literature with varied recurrence and failure rates.
Vitamin D deficiency in patients with tuberculosis and its correlation with glycemic status
Authors: Karoli Ritu , Shakya Shobhit , Singh Prem Shanker
Published: December 2019

Background: Comorbidity of diabetes and tuberculosis has serious health implications. Presence of diabetes at least three times increases the risk of tuberculosis which may be mediated by an abnormal innate immune response due to hyperglycaemia or low vitamin D levels.Aim of the study- Present study was carried out to investigate whether lower serum 25(OH) D might be associated with higher prevalence of pulmonary or extra pulmonary tuberculosis which might provide an evidence for a role of vitamin D in the comorbidity of these two diseases and does it have any correlation with glycemic status.Methods: In a hospital based cross sectional study, 264 patients with newly diagnosed tuberculosis were enrolled and according to glycemic status they were divided into three groups. They were assessed for vitamin D deficiency in addition to routine laboratory and biochemical parameters.Results: The patients with diabetes had significantly lower vitamin D levels. The prevalence of severe vitamin D deficiency was highest in patients who had diabetes with tuberculosis. There was negative correlation between vitamin D levels and Hba1C and extensiveness of pulmonary tuberculosisConclusions: Serum vitamin D levels were significantly lower in tuberculosis patients with pre-diabetes and type 2 diabetes compared with those, who had normal glycemic status. We suggest that there is a need to pay more attention to vitamin D status in this country and if there is coexisting diabetes or impaired glucose intolerance, emphasis on vitamin D supplementation can be of utmost importance.
Correlation of serum androgen and gonadotropin with anti-mullerian hormone in polycystic ovarian syndrome in Eastern Indian population
Authors: Raghuvanshi Somnath Singh , Sinha Anirban , Maiti Animesh , Chakraborty Partha Pratim , Basu Asish Kumar , Ghosh Sayan , Agrawal Saurav Shishir , Agrawal Chhavi
Published: December 2019

Background: Ovarian steroidogenesis requires gonadotropin stimulation, Luteinizing Hormone (LH) is a key factor in the hyperandrogenaemia of the polycystic ovary syndrome. Progesterone is the primary regulator of Gonadotropin-Releasing Hormone (GnRH) pulse frequency; however, in the polycystic ovary syndrome, the GnRH pulse generator is relatively resistant to the negative feedback effects of progesterone.  Study aims to evaluate the association of Anti-mullerian hormone with serum androgen and gonadotropin level in adolescents and young women of Polycystic Ovary Syndrome (PCOS).Methods: This was a single centre observational Cross-sectional study carried out in the department of Endocrinology and metabolism, Medical College, Kolkata from March 2017 to January 2019. Total number of study subjects were 207 out of which 138 were cases.Results: The AMH had strong positive correlation with serum testosterone in both case and control groups (r 0.542, p<0.001 and r 0.57, p<0.001) respectively .After the adjustment of age and BMI , the AMH moderately positive  but extremely significant correlation with serum testosterone as compare to control.Conclusions: Hyperandrogenaemia and higher ratio of LH and FSH associated with higher serum AMH level is associated with the higher serum AMH in polycystic ovarian syndrome.
Evaluation of efficacy of whatsapp messenger application in medical research education
Authors: Mulkalwar Alhad A. , Dashputra Amit V. , Jaipuri Afrid T. , Sutar Pallavi V. , Mulkalwar Sarita A. , Rathod Hetal
Published: December 2019

Background: There is lack of knowledge regarding research amongst medical students as it is not included in the present curriculum of MBBS. Hence authors have selected ‘Medical Research’ as a topic to evaluate the efficacy of WhatsApp messenger application as a teaching-learning tool. There is very limited research on impact of technological modalities like WhatsApp on education. Authors undertook this study to evaluate its efficacy as a tool to supplement medical research education and assess the perception of students about e-learning via WhatsApp messenger application.Methods: A prospective analytical interventional study was conducted after obtaining ethical approval from the Institutional Ethics Committee. A self-designed comprehensive questionnaire was used to test the knowledge of medical students. A series of modules were sent and discussed on the WhatsApp study groups followed by assessment in change of the level of knowledge amongst the participants post intervention.Results: Applying the paired t-test, the scores of the study participants showed a statistically significant increase in the post- intervention evaluation (Mean=10.13, Median=10, Range=0-21) as compared to the baseline knowledge regarding medical research as reflected in the pre intervention evaluation (Mean=6.76, Median=7, Range=0-16). Conclusions: Growing availability of economical and user friendly smart phones in every generation has promoted use of WhatsApp by teachers as well as students. WhatsApp has the potential to supplement academic learning and become a natural educational modality. Necessary precautions could be taken to minimize the drawbacks expressed by the students to make it a more enjoyable and acceptable tool for teaching and learning.
Evaluation of various antibiotics used in the treatment of cellulitis at a tertiary care hospital
Authors: Mustafavi Sadiya , Siddiqui Shafia , Yousra Tanveer , Nooreen Sariya , Sultana Sabha , Sajjad Husayni Syed Mohammed , Hadi Mohammed Abdul
Published: December 2019

Background: Cellulitis is an inflammation of the skin and subcutaneous tissues, usually resulting from microbial invasion. It may occur as a result of tissue injury. The mainstay of treatment includes antibiotic therapy based on the susceptibility and severity of infection. The aim of the study is to evaluate various antibiotics used in the treatment of cellulitis at a tertiary care hospital.Methods: Participants were patients referred by Dermatologists, General surgeons with acute and complicated cellulitis. Demographic data, Clinical and biochemical data were analyzed at admission. Then the time taken for improvement of symptoms and length of stay were analyzed.Results: A total of 58 patients were included in the study of which 38(65.5%) patients were male and 20(34.4%) patients were female. Patients having comorbid conditions were found to be having higher length of stay (mean±SD-13.7±3.6 days), severity of infection and antibiotic therapy. Patients with diabetes(mean±SD-16.8±4days) have higher length of stay and slow wound healing. Patients with left leg cellulitis 32(55%) were higher than the right leg cellulitis 17(29%). The reason behind this remains undetermined, which highlights scope for future research in this region.Conclusions: Management of patients was done with mono or dual/combination antibiotic therapy or surgical treatment was done based on clinical response. According to our study patients with co-morbidities especially Diabetes have slow prognosis of cellulitis as they required longer length of stay in a hospital and prolonged treatment. Rational clinical decision on the use of various antibiotics shall be implemented based on evidence-based methods such as iv-to-po shift, regular evaluation of clinical response and stepping down to a narrow-spectrum to reduce the length of stay which can improve the paradigm and the positive clinical response for the management of cellulitis.
A comparative study of supraglottic airway devices Baska mask and ProSeal-laryngeal mask airway in short gynaecological procedures
Authors: Kachakayala Ranjith Kumar , Bhatia Parmeet , Singh Shalendra , Dwivedi Deepak
Published: December 2019

Background: Baska Mask® (BM) a newer Supraglottic Airway Device (SAD) considered to cause low incidence of Postoperative Pharyngolaryngeal Complications (POPC). This study was designed to assess efficacy, safety and early and late POPC between BM and commonly use ProSeal LMA (PMLA).Methods: Patients between 18 to 60 years of age undergoing elective short gynecological procedures were randomized into two groups, to receive ventilation with either BM (group 1, n=50) or an PMLA (group 2, n=50).Results: There was no significant difference in the ease of insertion for both the devices (p<0.24). There was no significant difference in the number of attempts for both the devices (p<0.69). When compared to PLMA, the time (in seconds) required for insertion of BM was significantly less in duration (20.9 vs. 16) (p<0.0001). Between the two groups significant hemodynamic changes noticed after removal of SGA. The blood staining of device was similar in both groups. Failure to place device, postoperative complication like laryngospasm and bronchospasm did not occur in both BM and PLMA groups.Conclusions: In conclusion, findings of this study support that BM takes significantly shorter placement time and provides a better seal as compared to PLMA but without any reduction in laryngopharyngeal complications.
Reliability and validity of the Mizo-version of neck disability index for non-specific neck pain in the rural North-East Indian population
Authors: Lalchhuanawma Andrew , Sanghi Divya
Published: December 2019

Background: The Neck Disability Index (NDI) is an important self-assessment tool used extensively worldwide, in clinical practice with implications into scientific research fields. It is used to assess the extent of pain and levels of functional disability associated with neck pain. The NDI consists of 10 items where each item was scored from a scale of 0 to 5 giving the maximum score possible to 50. Though proven to be a reliable instrument in the English-speaking population, the NDI has never been validated and culturally adapted in the Mizo language among the rural north-east Indian region where English is not spoken as means of communication. The aim is to translate and cross culturally adapt the NDI into Mizo tawng (official language of Mizoram) with the objective of establishing reliability and validity of the M-NDI in patients with non-specific neck pain.Methods: A total of 49 subjects participated voluntarily from the rural primary health care, Lunglei district, Mizoram. Subject having chronic non-specific neck pain lasting more than 3 months were included after taking a written formal consent.Results: The internal consistency determined by Cronbach alpha, and the Intraclass Correlation Coefficient (ICC) using the test-retest reliability showed a good and an excellent reliability respectively (α=0.82, ICC=0.97, 95% CI= 0.95-0.98). Construct validity was determined between the variables-Numerical Pain Rating Scale (NPRS) and NDI by Pearson’s correlation coefficient and found to have a good correlation r=0.89 and significant difference at p<0.001.Conclusions: The study results concluded the Mizo version of NDI to be easy to understand, reliable and valid instrument for measuring disability and functional limitations of daily activities in non-specific neck pain in the Mizo speaking population.
Streptococcus pseudoporcinus: a rare cause of bacteraemia in an immune-compromised patient
Authors: Swain Bichitrananda , Otta Sarita , Bhoi Priyadarshini
Published: December 2019

Streptococcus pseudoporcinus, a ß-haemolytic Streptococcus is known to cause genital infections. Author report a rare case of Streptococcus pseudoporcinus bacteremia in an immune-compromised male patient diagnosed with acute myeloid leukemia eight months back. The organism was identified as a beta hemolytic bacterium which was catalase negative, oxidase positive and bacitracin resistant. Automated methods (VITEK-2) confirmed the organism to be Streptococcus pseudoporcinus.
A case report of 29 year old male patient with breast carcinoma: diagnosed on fine needle aspiration cytology
Authors: Patel Komal , Chaudhri Pallavi , Patel Siddhi M.
Published: December 2019

Breast cancer has been considered a female dominated disease. Carcinoma of male breast is a rare disease representing 1% of all breast cancers and less than 1 % of all cancers in men. The mean age at presentation is mainly in sixties. We here present a case of male breast cancer presented at very young age of 29 years, diagnosed on fine needle aspiration which was confirmed later on histopathological examination.
Artificial intelligence and machine learning: changing paradigm in diagnostics and imaging
Authors: Badwaik Rahul
Published: December 2019

Healthcare industry is currently undergoing a digital transformation, and Artificial Intelligence (AI) is the latest buzzword in the healthcare domain. The accuracy and efficiency of AI-based decisions are already been heard across countries. Moreover, the increasing availability of electronic clinical data can be combined with big data analytics to harness the power of AI applications in healthcare. Like other countries, the Indian healthcare industry has also witnessed the growth of AI-based applications. A review of the literature for data on AI and machine learning was conducted. In this article, we discuss AI, the need for AI in healthcare, and its current status. An overview of AI in the Indian healthcare setting has also been discussed.
Increasing drug compliance to hypertension patients through android applications in Wonosobo regency province of Central Java Indonesia
Authors: . Suyoto , Agushybana Farid , Suryoputro Antono
Published: December 2019

Background: Based on data from WHO, it is estimated that 70% of the 57 million deaths that occurred in the world in 2008 were caused by non-communicable diseases. The prevalence of cases of hypertension primary in the District of Wonosobo in the year 2016 as many as 43.30%. Hypertension patients must take medication during their lifetime to prevent rising blood pressure and complications. This research aims to find out the effect of hypertension management through an android application on the practice of adherence to taking medication in hypertensive patients in Wonosobo regency.Methods: This research is a quasi-experimental with a non-randomized pre-post-test control group design. The study is conducted in patients prolanis hypertension as much as 105 respondents were divided into a treatment group 53 respondents and group control of 52 respondents.Results: Results of the study showed the significant influence of the use of android application to practice obedience to drink medicine. Results of Mann Whitney U analysis showed the treatment group experienced a rise in the mean is higher than the group of control. Likewise, the results of the test Wilcoxon which compares the level of compliance before and after treatment obtained value significantly for both groups with a mean group of treatment is higher.Conclusions: The management of hypertension through an android application has proven to be more effective in improving the practice of adherence to taking medication hypertension patients who take part in the prolanis program in Wonosobo regency.
Diabetes registry initiative in Delta State Nigeria: narrative of the kick-off experience
Authors: Igumbor Eunice O. , Agofure Otovwe , Onyimi Chukwuma , Bwititi Phillip T. , Nwose Ezekiel U.
Published: December 2019

Background: This is parallel with the piece of work on behavioral change wheel of healthcare professionals. The objective is to assess how much standard diabetes care service that is available in the community-based health facility and the barriers to patients’ participation.Methods: This was based on free diabetes clinics, which constituted the beginning of the development of diabetes register series. Observational study and surveys were conduct to determine scope service available in the hospital and factors that influence participation of patients.Results: It is observed that lack of hospital consultants is the greatest ‘health system’ barrier faced by the individuals living with diabetes.Conclusions: There is a need for individuals living with diabetes to be educated on the importance of adherence to medical check-up appointments. The healthcare professionals and providers also need professional development on the importance of diabetes register in the management of patients.
Analysis of occupation skills on all cause mortality in Pakistan
Authors: Ali Muhammad Ghafoor , Husain Saima Narjees
Published: December 2019

Background: Occupational injuries/diseases are considered as leading problems for workers, especially in less developed countries. Based on International Standard Classification of Occupation (ISCO-08) four broad skill levels are defined. Employment has been established as a fundamental determinant of health and review of occupation/all cause mortality has been carried to observe the impact of occupation skill on cause of death.Methods: A retrograde study conducted on mortality data of State Life Insurance Corporation of Pakistan. Randomly 500 death cases were collected during study period between 2006 to 2018.The death claim instrument were proposal forms and death claim register. The data about occupation and cause of death was inserted on spread sheet of excel and finally analyzed through SPSS for occupation skill and cause of death.Results: Almost equal proportion of data found in skill-1 (14%) and  skill-4 (12.6%) while maximum contribution found in skill level-2 (49.40%) followed by skill-3 (24%).The maximum percentages of mortality seen cause wise as CVS (49.39% skill-2), cancer (17.46% skill-4), road side accident (14.28% skill-1), multiple causes (6.67% skill-3), liver disorder (5.71% skill-1), CNS (3.17% skill-4), kidney disorder (5.71% skill-1), GIT (6.35% skill-4), respiration (3.17% skill-4), un-natural (2.02% skill-2), idiopathic (2.85% skill-1), endocrine (1.58% skill-4), body temperature (1.42% skill-1), poisoning (0.83% skill 3), electric shock (2.85% skill-1), sepsis (1.58% skill-4), obstetric (0.83% skill-3) and burn (1.42% skill-1) while lowest found as CVS(46.67% skill-3), cancer (7.14% skill-1), road accident (7.93% skill-4), multiple causes (2.85% skill-1), liver (1.58% skill-4), GIT (2.02% skill-2), respiration (1.61% skill-2) and idiopathic (0.40% skill-2). Many causes in skill-1 and skill-4 found no mortality.Conclusions: Mortality due to cardiovascular diseases found highest in all skills while lower frequency of death seen in other systematic disorders. Mostly highest and lowest mortality percentages found either in skill-1 or skill-4 whereas comparatively higher percentages have steadily been maintained in skill-2 and skill-3.
Breast papillary lesions: a retrospective analysis from oncology set up of Pakistan
Authors: Ahmad Waqas , Gul Palwasha , Aqeel Shahper , Tahir Eisha
Published: December 2019

Background: Papillary lesions of the breast are a heterogeneous group of breast lesions that are difficult to diagnose as benign or malignant. These lesions have varied morphologic features that carry differing prognostic implications for affected patients. Accurate diagnosis is required to ensure that effective treatment is achieved. Papillary lesions can have increased risk of carcinoma and recurrence, in these patients even for lesions yielding a benign concordant diagnosis of papilloma at percutaneous biopsy, surgical excision may be warranted. Malignant lesions are usually surgically treated. Depending on stage-adjuvant chemotherapy and/or radiation therapy is given.Methods: A retrospective study was conducted at Shaukat Khanum Memorial hospital and Research Centre Lahore Pakistan. We reviewed the electronic records of diagnostic and registered patients from January 2007 till December 2017 in women imaging section, in age range of 25 to 75 years. Total 150 diagnosed patients with benign or malignant breast papillary lesions were selected and their conventional breast imaging (mammography and ultrasound) and histopathology was retrospectively analyzed on SPSS.Results: Patients were predominantly asymptomatic or on follow-up to an abnormal mammogram. Of the 150 cases most of the patients had intra-ductal papilloma followed by invasive papillary carcinoma and intra cystic papillary carcinoma. Few patients had intra-ductal papillomatosis and invasive micro papillary carcinoma.Conclusions: Conventional breast imaging remains the first main stay and quite sensitive in detecting breast papillary lesions leading to early detection and management.
Prospects of diabetes registry in suburban community of Nigeria: experience at a private general practice
Authors: Okwelum Anthonia C. , Igumbor Eunice O. , Agofure Otovwe , Ndubueze Pleasant C. , Aninze Kenneth , Nwose Ezekiel U.
Published: December 2019

Background: As part of series of advocacy on development of diabetes register, one of the target health facilities is private general practices. In suburban Kwale community Delta State, Donak hospital was chosen to study the process of developing and implementing diabetes register program. Specific objectives include to evaluate the extent of completeness of data for patients follow-up, diabetes services within the private practice based on data collection, prevalence of high blood pressure, and patients’ compliance with medical appointments.Methods: The study followed a clinical observational method and after necessary ethical considerations, medical information was gotten from the record unit Donak Hospital, Kwale. The patients identified as potential diabetes or prediabetes were contacted for follow-up and 113 (65 females and 48 males) participants consented, all adults. Data collection were those required for a diabetes register proforma and were analyzed using Microsoft Excel Analysis Tool-pack. Results: There was no dedicated diabetes register per se except for usual medical records. The private practice has 100% record of contact details and blood pressure completeness for the participants. The scope of service offered to the patients was basically primary healthcare services. Over 50% of the participants have high blood pressure. On the patients’ compliance with medical check-up; only 23% of the participants complied with check-up appointments.Conclusions: The development of diabetes register in private practices can improve services. These services include documentation of appointments to enable follow-up strategies to encourage compliance to medical check-ups and a record diabetes education that may be provided.
Impact of sensitization programme on reproductive health awareness among adolescent girls residing in a shelter home (Snehalay) Ahmednagar
Authors: Jadhav Saili U. , Avachat Shubhada S.
Published: December 2019

Background: Adolescents comprise one-fifth of India's total population. Knowledge on reproductive health at adolescent age is essential to build their foundation of healthy reproductive practices in the future and to lower the risk of sexually transmitted diseases.Methods: An interventional study was done on 51 adolescent girls at a shelter home (Snehalaya). Informed consent was obtained from the concerned authorities. Data was collected by interview technique with the help of a structured questionnaire prepared by literature search. Response of adolescents was recorded through their answers to the questionnaires. Intervention was done in the form of sensitization lecture with the help of audio visuals and educational posters. The same questionnaire was again interviewed and the impact of intervention was assessed. Statistical analysis of data was done using percentage, proportion and appropriate tests of significance.Results: In our study we found the average age of menarche of the girls to be 12-14 years, but as several of the girls came from unhealthy backgrounds, they had several menstrual problems like dysmenorrhea, irregular menses. Three of the girls had not experienced menses after 14 years of age. After the sensitization lecture, 56% of the girls were able to write the names of the reproductive organs in the female genital tract. 85% of the girls were able to name the hazards of teenage pregnancy. All adolescents need access to quality youth-friendly services provided by clinicians trained to work with this population. Sex education programs should offer accurate, comprehensive information while building skills for negotiating sexual behaviors.Conclusions: Hence from our project we identified the unmet need of awareness regarding reproductive health amongst adolescent girls and we tried to meet those needs by providing sensitization.
Assessment of risk of developing diabetes using Indian diabetes risk score in the urban field practice area of Rajarajeswari Medical College and Hospital, Bangalore
Authors: Shaik Nazia N. , M. Jaswanth Swapna , Manjunatha Shashikala
Published: December 2019

Background: Diabetes is one of the largest global health emergencies of the 21st century. As per International Federation of Diabetes some 425 million people worldwide are estimated to have diabetes. The prevalence is higher in urban versus rural (10.2% vs 6.9%). India had 72.9 million people living with diabetes of which, 57.9% remained undiagnosed as per the 2017 data. The objectives of the present study were to identify subjects who at risk of developing Diabetes by using Indian diabetes risk score (IDRS) in the Urban field practice area of Rajarajeswari Medical College and Hospital (RRMCH).Methods: A cross sectional study was conducted using a Standard questionnaire of IDRS on 150 individuals aged ≥20 years residing in the Urban field practice area of RRMCH. The subjects with score <30, 30-50, >or =60 were categorized as having low risk, moderate risk and high risk for developing diabetes type-2 respectively.Results: Out of total 150 participants, 36 (24%) were in high-risk category (IDRS≥60), the majority of participants 61 (41%) were in the moderate-risk category (IDRS 30–50) and 53 (35%) participants were found to be at low-risk (<30) for diabetes. Statistical significant asssociation was found between IDRS and gender, literacy status, body mass index (p<0.0000l).Conclusions: It is essential to implement IDRS which is a simple tool for identifying subjects who are at risk for developing diabetes so that proper intervention can be carried out at the earliest to reduce the burden of diabetes.
Menstrual restrictions among young females in urban slums of Cochin
Authors: Chacko Maya , Retnakumar Charutha , Ramakrishnan Devraj , George Leyanna Susan , Krishnapillai Vijayakumar
Published: December 2019

Background: Menstruation is associated with taboos and socio-cultural restrictions. The social and cultural significance of menstruation interacts with the physiological process to produce culturally determined norms and practices. This study was conducted among young females aged 15-35 years from urban slums of Kochi, India. The objective was to assess prevalence, factors, and patterns of restrictions faced by young females during menstruation.Methods: A cross-sectional study was conducted among 130 young females in three urban slums of Kochi. A pre-formed pretested questionnaire was used. Data were analysed statistically by simple proportions.Results: Only 8.8% young females felt they had restrictions during menstruation but when asked in detail 88% had socio-religious restrictions. Source for restrictions was traditionally followed patterns 60.8%, patterns taught by elderly mainly mother or mother in law 11.2% and self-imposed restrictions 28%. Reasons for restriction are that 14.4% considered it was good and give rest to the body, 8% women think they are unclean and 57.6% women fear to disobey religious restrictions. 77.6% of Women felt these restrictions are necessary and 40.8% felt restrictions do not need change. Out of 22.4% who felt religious restrictions were unnecessary only 1.6% were affected by religious restrictions.Conclusions: Only a few (8.8%) felt they had restrictions and more than two-third had restrictions (88%) and felt these restrictions are necessary (77.6%). This paper explains restrictions practiced and the origin of such restrictions during menstruation. The key issues identified from the community will be an asset to combat restrictions.
Prevalence and determinants of cardiovascular disease in a rural area of Kancheepuram district, Tamil Nadu: a cross sectional study
Authors: M. Vijayakarthikeyan , V. Dhanuraja
Published: December 2019

Background: Cardio vascular disease (CVD) is the number 1 cause of death globally and an estimated 17.7 million people died from CVD in 2015, representing 31% of all global deaths. In India CVD accounts for 25% of all deaths. The objectives of the study was to estimate the prevalence of CVD among the study population and to determine the association between CVD and various risk factors.Methods: This is a cross sectional study carried out in the rural field practice area attached to SBMCH. The study group were 400 adults (20-60 years). The data was collected using a structured questionnaire containing socio-demographic particulars, details regarding CVD risk factors and physical measurements. Data was entered in MS Excel and analysed using SPSS 15 software.Results: Prevalence of CVD is 24.3% and of which hypertension (18%), coronary artery disease (6%), stroke (2.2%) and valvular heart disease (1%). The prevalence of risk factors are age >40 (63%), tobacco use (17.8%), alcohol use (22.3%), physical inactivity (52%), unhealthy diet (61.4%), obesity (19.7%), diabetes (13.6%) and positive family history (21.4%). There is a strong statistically significant association between CVD and age (p=0.008, OR-1.968), tobacco use (p<0.0001, OR-10.029), obesity (p<0.0001, OR-13.462) and positive family history (p<0.0001, OR-13.964).Conclusions: In this study prevalence of CVD is high. It is necessary to minimize the burden of growing CVD by controlling the rates of the risky behaviours by lifestyle modification and by increasing awareness regarding CVD.
Development of diabetes register in low-mid income country VII: summary of series
Authors: Nwose Ezekiel U. , Igumbor Eunice O. , Agofure Otovwe , Bwititi Phillip T. , Oshionwu Echinei J. , Odufu Alex , Okuzo John N.
Published: December 2019

Background: This is a summarizing discussion of the series. Six pieces of articles have been presented including two pilot studies and survey of the perception of healthcare professionals. The other four presented case observations from the different levels of health facilities.Methods: In this summary, a comparison between the four grades of facilities is presented with focus on completeness of patients’ contact details and clinical information regarding basic anthropometric data that can be easily collected anywhere.Results: It shows evidence that capacity and scope of diabetes services are in tandem i.e., least at the primary level and most at the tertiary facility. It also shows albeit anecdotal that the private general practices may be doing best in what they have capacity to do.Conclusions: The capacity for diabetes service in all tiers of the healthcare system. The need to advocate for diabetes register as a means to improve quality of service is highlighted.
Knowledge, attitude and practice on oral hygiene among primary school children in an urban area of Kancheepuram district, Tamil Nadu
Authors: M. K. Jasmine Sharmila , R. Umadevi , V. M. Anantha Eashwar
Published: December 2019

Background: Oral health is fundamental to general health and well-being. To organize community oriented oral health promotion programs, systematic analysis of oral health is mandatory which includes information on oral health knowledge, attitude and practice (KAP). The study was done with the aim to assess the KAP on oral hygiene among primary school children in an urban area of Kancheepuram district, Tamil Nadu.Methods: A sample of 250 primary school children in the age group of  8-10  at Anakaputhur,  an urban field practice  area of Sree Balaji Medical College and Hospital, Kancheepuram district was chosen by multi-stage sampling technique.Data on oral hygiene was collected by using a pre-tested semi-structured questionnaire by personal interview method. The data obtained was subjected to statistical analysis using SPSS version 22.Results: Among the study participants, 65.6% of children had good knowledge on oral hygiene with only 33.6% of children with positive attitude and 10.8% of children had good practice of oral hygiene. Around 96 % of the children knew that they should brush their teeth twice daily, 92% of the children knew that having sweets/fizzy drinks causes oral health problems and 96% of the children think that maintaining healthy teeth is an individual responsibility.Conclusions: Health education services at school regarding oral hygiene practices targeting the children, teachers and the parents have to be conducted at regular intervals to empower them on the benefits of the same.
A cross sectional study of the prevalence of hypertension and associated risk factors in coastal Andhra Pradesh
Authors: K. Gopalakrishna , Subrahmanya Sarma Venkata R. S. , P. Raghuram , P. S. S. Chowdary , K. Purnachandrarao , G. Somasekhar , M. Boochibabu , M. Prasad , Y. Sasidhar
Published: December 2019

Background: Hypertension (HTN) accounts for 9.4 million deaths worldwide every year. A rise in HTN is projected by the global burden of HTN 2005 study, it portrays a grim picture. Community level data for hypertension is scarce in Andhra Pradesh. A cross sectional study was conducted to know the prevalence of hypertension in Vijayawada.Methods: 1009 apparently healthy adults visiting the hospital accompanying patients in outpatient department were screened for hypertension by blood pressure recording. All measurements were obtained by automated blood pressure measuring (AOBPM) systems.Results: Of the total population screened, hypertension accounted for 42.5% (n=429). A multivariate analysis showed that hypertension is more common in age group >50 years [odds ratio (OR)=3.004, 95% confidence interval CI being=2.2707-3.9645], in diabetics (OR=2.9091, 95% CI=2.0595-4.1092), in males (odds ratio=1.3223, 95% CI=1.0214-1.7118) and in smokers (OR=1.7442, 95% CI=1.0469-2.9059). A linear positive association was found between obesity and hypertension. No significant association was found between hypertension and alcohol intake. This study also showed that awareness was present in only 44% and 37% had hypertension under control of known hypertensive subjects.Conclusions: This is the first cross sectional study done with AOBPM. Our study finds that hypertension is an important public health burden in coastal Andhra Pradesh with low awareness, treatment, and control. It implies that strategies need to be developed to improve effective primary care management of hypertension.
Communication and awareness on a new vaccine: a cross-sectional study in a tertiary care hospital of West Bengal
Authors: Chakraborty Arup , Datta Mousumi , Guchhait Debjani , Gupta Shibaji
Published: December 2019

Background: Japanese encephalitis (JE) vaccination in India started in 2006 with SA-14-14-2 live attenuated JE vaccine (JEV) following large outbreaks of JE in some districts of Eastern Uttar Pradesh and Bihar in 2005. Age groups 1-15 yrs are first vaccinated with a single dose of JEV in a campaign mode followed by integration of this vaccine in routine immunization. It is beyond doubt that added to vaccination campaigns, proper awareness on JE can play significant role in controlling the disease.Methods: An observational study with cross sectional design was conducted in Kolkata Medical College and Hospital, Kolkata during JE Vaccination campaign during January, 2018 among 85 respondents, to assess the awareness on JE, among care-givers who brought their children for vaccination at the immunization clinic.Results: It was found that only 37.6% the respondents attending the campaign knew the name of the disease; 17.6% respondents were aware about disease transmission, and 5.9% could state two or more clinical features that might be associated with Japanese Encephalitis. 69.4% had no knowledge of up to what age JE vaccines can be administered; 23.5% said it can be administered till the beneficiaries attain fifteen years of age.Conclusions: IEC activities during JE vaccination campaign was not able raise awareness on JE to the desired level. However beneficiaries were informed about service availability and could be mobilised to come for vaccination.