bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and clinical correlates of psychiatric morbidity among caregivers of patients attending a psychiatric hospital in North India
Authors: Rather Yasir Hassan , Dar Mansoor Ahmad , Bhat Fazle Roub , Shah Majid Shafi , Wani Rayees Ahmad
Published: August 2020

Background: Consequent to the high prevalence of psychiatric disorders in present day world, their caregivers form an important group in the public health. Research on the physical and psychological well-being of caregivers is being carried worldwide with varied results. Psychological health of these caregivers is usually ignored both by these persons themselves and the health-care providers. The objective of the study was to screen for psychiatric morbidity among caregivers of patients attending a psychiatric hospital in North India, and to study the clinical correlates of the same.Methods: A total of 205 patients and their caregivers were consecutively recruited over a one month period. Sociodemographic and clinical information of patients was obtained either from the hospital records or from the caregiver. Scoring of the patient’s global assessment of functioning (GAF) was done by clinicians. The caregivers were administered a sociodemographic questionnaire, general health questionnaire (GHQ-12) and Zarit Burden interview. The presence of psychiatric morbidity was confirmed by a consultant psychiatrist.Results: Among the caregivers, 32.2% had GHQ scores of 3 and above. Majority of caregivers in this study were females (59.0%) while as majority of the patients were males (61.9%). Factors associated with psychiatric morbidity among caregivers include the high level of subjective burden of care, low level of functioning, and comorbid medical and psychiatric conditions.Conclusions: The study reveals a high level of psychiatric morbidity among the caregivers of patients with mental health problems.
Determination of nitrofurantoin and fosfomycin susceptibility among urinary Escherichia coli isolates
Authors: Kanaujia Rachana , Kumar Amit , Bajpai Malay
Published: August 2020

Background: Urinary tract infections (UTIs) are one of the most common infections. For treatment of UTIs, there are limited antibiotics due to increased resistance among uropathogens. Two older antibiotics; Nitrofurantoin and Fosfomycin have become novel oral therapeutic options against uropathogens. Aim of the study was to identify UTI causing micro-organisms and evaluate in-vitro activity of nitrofurantoin and fosfomycin against most common isolated organism (E. coli).Methods: Results of urine samples culture and susceptibility testing over a period of 1 year were analysed and included in this study.Results: Micro-organisms were isolated from 568 urine samples. Most commonly isolated organism was Escherichia coli (40.50%), followed by Klebsiella spp. (20.07%) and Staphylococcus spp. (17.07%). Susceptibility of E. coli to nitrofurantoin and fosfomycin was 91.74% and 65.65% respectively. Conclusion: Good activity of nitrofurantoin and fosfomycin against E. coli indicates that these two drugs are potential therapeutic alternatives for urinary tract infections.
Factors influencing motivation in alcohol dependence syndrome patients in a tertiary care hospital of Assam
Authors: Ghosh Prosenjit , Barman Prakash , Bhattacharjee Ankur
Published: August 2020

Background: The aim of this study is to study the change in motivation in patients with alcohol dependence syndrome (ADS).Design: 50 consecutive patients admitted for the treatment of ADS in a tertiary care hospital were evaluated. It was a cross sectional observational study.Methods: The study was done in a tertiary care hospital in the in-patient department of psychiatry. Structured performa for sociodemographic details. Psychiatric morbidity was assessed by structured clinical interview according to ICD10. SAD-Q (severity of alcohol dependence questionnaire) to assess severity of alcohol dependence. The assessment of motivation was done using the University of Rhode Island change assessment scale at baseline and after 10 days of admission. Data was evaluated keeping the aims and objectives in mind with appropriate statistical method using Statistical package social software (SPSS) version 21 and descriptive statistics was used. Chi square and Fisher exact test were used to assess the significance.Results:  A total 64% were in pre-contemplation, 30% in contemplation and 6% were in action stage of motivation at baseline assessment. A significant change was seen in the levels of motivation towards contemplation and action stage after a brief hospital stay of 10 days. Motivation to change had a significant association with education and severity of alcohol dependence.Conclusions: Pharmacological and non-pharmacological treatment during a short hospital stay results in improvement in readiness for change in patients of alcohol dependence syndrome.
Patching with video gaming versus patching with mobile phone use in treatment of adult amblyopia: an experimental study
Authors: Johnson Steffy
Published: August 2020

Background: Adults with amblyopia are currently offered no treatment in clinical practice Recently, it has been demonstrated that patching one eye of a binocularly normal subject with a diffuser strengthens that eye's contribution to the binocular percept when the diffuser is removed. So, this study assesses effectiveness and difference of occlusion therapy while using mobile phones and while playing video games in adult patients with amblyopia.Methods: Subjects with refractive, anisometropic, sensory and strabismic amblyopia in 18 to 40 age year old included in the study. It’s a 6 months’ observational study with 2 follow-up after first visit. 66 patients were observed. The first group (n=29) give occlusion therapy while using mobile phone and second group (n=37) done occlusion therapy while playing video games. Student t-test is used to analyse vision and contrast sensitivity and analysed using statistical software SPSS (version 20.0).Results: Out of 29 patients in first group, 18 (62%) were females, and 11 (38%) were males. Out of 37 patients in second group, 20 (54.1%) were females, and 17 (45.9%) were males. First group (patching with reading in mobile phone) had more improvement than second group (patching with video gaming) in vision and contrast.Conclusion: Males are more adult amblyopes comparing to females (in both the groups). In case of comparing the improvement of visual acuity and contrast sensitivity. Better improvement is obtained more in contrast sensitivity during follow-up.
Comparative study of fentanyl versus tramadol as adjuvant with low dose local anaesthetic ropivacaine (0.1%) for epidural labour analgesia
Authors: Choudhary Aman , Maheshwari Sakshi , Paliwal Naveen , Ujwal Shobha , Singariya Geeta
Published: August 2020

Background: Toxonomy committee of International Association defined pain as an unpleasant emotional and sensory experience associated with potential tissue damage. The present study was conducted to evaluate the effect of a combination of low dose ropivacaine with fentanyl and tramadol in epidural labour analgesia.Methods: This prospective randomized double blinded clinical study was conducted in 100 patients in labour after ethical committee approval. Inclusion criteria was patients who had ASA I and ASA II (American society of anesthesiologists physical status classification system), age above 18 years, height more than 150 cm, weight less than 110 kg, either primigravidae or gravid 2. Patients were allocated into two groups Group F (ropivacaine with fentanyl) and group T (ropivacaine with tramadol) by computer generated randomisation technique.Results: In the present study, mean age in group F (ropivacaine with fentanyl) was 22.54±2.5, mean age in group T (ropivacaine with tramadol) was 22.86±2.17, and weight in group F was 56.68±2.75 and group T was 56.58±2.58. Duration of labour in group F was 3.39±1.01 hrs and in group T was 3.42±0.70 hrs. There was no significant difference between the two groups at any time points for mean VAS score. There was no significant difference in the mean heart rate and arterial blood pressure among both the groups statistically (P>0.05). More side effects were seen in group F.Conclusions: Both fentanyl and tramadol in combination with ropivacaine provide similar analgesia with minimal motor block. Both have no adverse effects on cardiotocographic parameters. However side effects were relatively more common in fentanyl group. Thus tramadol is a safer alternative to fentanyl as an adjunct to epidural labour analgesia.
Increased tumor marker ca-125 in multiple myeloma: a case report
Authors: . Dwiwahyonokusuma , Wiratnaya I. Gede Eka , Yudha Gede Agung Krisna , Putra I. Gede Mahardika
Published: August 2020

Multiple myeloma (MM) is a malignant B-cell lymphoproliferative disorder of the marrow, with plasma cells predominating. It is unlikely to encounter rising level of any tumor marker in MM patient. We present a case of 46-year-old female came to the orthopaedic clinic with chief complains of pain on her right arm, left shoulder and right hip after 5 months. The results of the bone survey of these patients showed multiple lytic lesions with a punched-out appearance in calvaria. The expansive lytic mass was seen with cortical destruction in one third proximal metaphysis to diaphysis of humerus with periosteal reaction and surrounding soft tissue mass. The basic metabolic panel (BMP) result of these patient is hipocellular with decrease of erythroid, myeloid, and megakaryocytes activity and there are 30% plasma cells with positive myeloma cells. Therefore, the patient was diagnosed with MM. The laboratory result of these patient also showed elevation of carbohydrate antigen 125 (CA-125) marker to 56 and 92 (normal range is <35). The patient reported herein showed clear signs and symptoms of MM accompanied by elevated level of CA-125 and CA-15.3 tumor markers. Elevated CA-125 values most often are associated with epithelial ovarian cancer, although levels also can be increased in other malignancies such as endometrial, fallopian tube, breast, lung, esophageal, gastric, hepatic, and pancreatic. However, there were no clear mechanism of how a malignant B-cell lymphoproliferative disorder of the marrow stimulates the production of tumor marker such as CA-125.
Snake bite induced delayed hypopituitarism: a rare case report
Authors: Bhowmick Niladri , Mukhopadhyay Jotideb , Kar Soumyadip , Das Amrita
Published: August 2020

Hypopituitarism following snake bite induced AKI and dialysis is an uncommon complication. Often the presentation is delayed and Can present with a myriad of features. We present a case of a 27 year old male patient, with past history of snake bite and acute kidney injury (AKI) requiring dialysis and which subsequently resolved, presenting to us with fatigability and weakness, absence of secondary sexual character and poor academic performance. On examination, the patient had pale white and coarse skin. Hoarseness of voice was present. There was proximal upper and lower limb muscle weakness present with pseudo myotonia on examination. There was loss of axillary and pubic hair with low testicular volume. Routine reports suggested mildly elevated creatinine with severely elevated Triglyceride levels. Creatine phosphokinase (CPK) was raised. Hormonal profile revealed low free thyroxine (FT4) and serum 8 a.m. Cortisol but an inadequate increase in thyroid stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH) levels were suggestive of central hypopituitarism. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), Insulin-like growth factor 1 (IGF-1) levels were reduced. Neuroimaging revealed empty sella suggestive of pituitary apoplexy. The above were suggestive of delayed hypopituitarism following post snake bite dialysis mediated pituitary apoplexy. In all cases of snake bite, a common occurrence in our country the possibility of hypopituitarism should be kept in mind and the hormonal profile followed up closely along with the renal parameters.
Belching on exertion - coronary artery disease
Authors: Rao Bhavana Venkata Nagabhushana , Mahesh Garikapati
Published: August 2020

Belching is a ubiquitous symptom in clinical practice. It could be due to gastrointestinal disease or behavioral, functional and physiological causes. It’s association with acute myocardial infarction, more frequently, with inferior myocardial infarction, has been well established. But exertional belching as a cardinal symptom of coronary artery disease is not well documented and its presence is not mentioned in any standard textbooks. It is rarely reported in the literature. Here we present a female diabetic, who presented with exertional belching as a lone complaint. She was confirmed to have significant coronary artery disease necessitating an intervention. So it may be prudent if clinicians are aware of the fact that exertional belching could be of cardiac origin and needs further evaluation and intervention.
Coronavirus 2019: a review of virology, clinical features, diagnosis, and treatment
Authors: Younus Shifa , Maqsood Hamza , Gulraiz Azouba
Published: August 2020

Coronavirus 2019 (COVID-19) is an enveloped ribonucleic acid (RNA) virus that is diversely found in humans and wildlife. A total of six species have been identified to cause disease in humans. The most recent outbreak initially presented as pneumonia of unknown etiology in a cluster of patients in Wuhan, China. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and is a declared global pandemic. This review will introduce a general overview of virology and describe the clinical features, diagnostic testing, and management of COVID-19 patients. There are multiple drug trials going on with some positive results. However, since no vaccine is available, the best way to combat the virus is by preventive methods. Our review will also provide a means to raise awareness among primary and secondary healthcare providers during the current pandemic.
Study the universal critical congenital heart disease screening in a peripheral area of Uttarakhand, India
Authors: Sahota Ravi , Kaur Navpreet , Singh Gurpal , Joshi Veena , Gahtori Bharti , Mehrotra Divya , Upadhyay Nisha
Published: August 2020

Background: Congenital heart disease (CHD) is the most frequently occurring congenital disorder, responsible for 28% of all congenital birth defects. The birth prevalence of CHD is reported to be 8-12/1000 live births. Considering a rate of 9/1000, about 1.35 million babies are born with CHD each year globally. Objective of research work to study the prevalence of CHD among newborn and its types.Methods: This cross-sectional study was carried among 34 cases of CHD/5126 newborn screened at 4 birthing places in Kashipur a small town in Uttrakhand at pediatrics department of Sahota Super-specialty hospital, Kashipur, Uttarakhand. Screening program between 22 August 2014, and March 30, 2019. All newborns, including preterm babies, delivered in these facilities were eligible for inclusion in this study.Results: Present study found the prevalence of CHD was 0.7 per 1000 children (34/5126). Around 26.5% participants have cyanotic CHD and 73.5% have acynotic CHD. Almost 44%, 28%, 20%, 4% and 4% participants of acynotic congenital heart diseases have VSD, ASD, PDA, AVSD and valvular PS respectively and 55.6%, 22.2%, 11.1% and 11.1% participants of cynotic congenital heart diseases have TOF, DORV/VSD, dTGA/VSD and tricuspid atresia respectively.Conclusions: Screening for congenital heart disease should be included as a part of newborn assessment as it is a common congenital problem. Early identification influences outcome. Barriers in implementation of the screening programmes in resource limited setting is a challenging feature. This study can provide observed data that can help in policy making in the health sector.
Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age
Authors: Thakur Bhagat Ram , Kumar Pancham
Published: August 2020

Background: Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age.Methods: Children aged 2 to 60 months admitted for the first time were included in the study and divided into two groups i.e. with and without clinical signs of rickets. Disease profile was studied in both groups. Incidence of lower respiratory tract infection was compared between two groups.  Children with clinicoradiological signs of rickets were also investigated for biochemical abnormalities.Results: During the one year study period a total of 393 children were admitted, 65 were found to have rickets constituted as study group and 328 were without rickets were included the controls. Rickets incidence was 16.5% of which majority (74.6%) were males and most rachitic children (64.6%) were below six months of age. Acute lower respiratory tract infection (64.6%) was commonest in study group and acute gastroenteritis (24.4%) in the controls. The rate of ALRTI was nearly three times in study group.  Frontal bossing (67.7%) was most common sign of rickets and increased alkaline phosphatase (93.8%) was the commonest biochemical abnormality.Conclusions: Nutritional rickets, a multifactorial disease, is easily preventable. The present study has revealed the high incidence of rickets i. e., 16.5% and also show the strong statistically significant association of nutritional rickets with acute lower respiratory tract infections.
Detection of fetal malnutrition and its associated maternal factors in a rural setting
Authors: Janardhan Alok M. , Alok Sandhya , Janardhan Leelavathi
Published: August 2020

Background: The objectives of study were to analyse and compare the methods for detection of fetal malnutrition and to study the maternal factors associated with fetal malnutrition in babies born in rural hospitals.Methods: Periodic prospective cross-sectional case-control questionnaire-based study. Nursing home and Hospital based in rural population from January 2017-March 2018. There were 350 term newborns born in Shrinivasa Nursing Home, and Crawford General Hospital, Sakleshpur, were selected consecutively. Inclusion criteria: live, singleton term neonates. Exclusion criteria: Preterms, post-terms, those with congenital malformation, multiple gestations, cephalhematoma, subgaleal bleed. Anthropometry, fetal malnutrition assessed using clinical assessment of nutrition (CAN) score, Ponderal and Kanawati indices between 24–48 hours of birth. Newborns with fetal malnutrition (cases), and well-nourished babies (controls) assessed for maternal risk factors using standardised questionnaire from mothers.Results: CAN score identified 185 (52.9%) as malnourished and 165 (47.1%) as normal; Ponderal index classified 170(48.6%) as malnourished and 180 (51.4%) normal. Kanawati index grouped 151 (43.1%) as malnourished. Maternal factors:  age (91.7% among <20 yr mothers-malnourished, 25% among >35 yrs), socioeconomic status (status 3, 4 had 57.2%, 66.7% malnourishment), improper antenatal care(80.7% irregulars; 38.5% among regulars), primiparity (60%;against  38.3% among multipara), pre-eclampsia (78.7%; 41.3% in normotensives), anemia (55.4%), weight gain (83.2% in <10 kg; 33.33% in >10 kg), stature (73.5% in <145 cm; 39.7% in >145 cm), medical illness (55.81%).Conclusions: CAN score is simple, systematic, clinical method of identifying malnutrition; statistically superior as screening tool. Maternal factors: improper antenatal checkups, primiparity, pre-eclampsia, medical illness, inadequate weight gain, short stature had significant association with fetal malnutrition. Maternal age, socioeconomic status, anemia not statistically significant.
Profile of sever acute malnutrition children admitted at nutritional rehabilitation centre at tertiary care treatment centre of Gujarat
Authors: Prajapati Nisha , Shah Seema
Published: August 2020

Background: Sever acute malnutrition (SAM) may be major obstacle for India to achieve targeted Infant Mortality Rate and under five mortality rate. Malnutrition and infection form vicious cycle and contributes towards mortality. So, malnutrition prevention is major objective of government. Study of malnourished children helps to know aetiology and their response to treatment. The objective of study is to understand clinic-demographic profile of SAM children.Methods: It is retrospective secondary data analysis study. For the purpose of this analysis, we retrieved the data of all children with SAM admitted from 1 January, 2018 to 31 December, 2018 to NRC. At the NRC, a physician conducted a clinical examination in children to detect the presence/absence of medical complications during their admission and these data were available in case sheet.Results: A total of 162 children, aged 6-59 months were referred to the NRC. Around fourty seven percentage of children were in age group 6–12 months Majority of children were in age group of 7 months to one year of age. Majority of children were admitted based on weight of height criteria (Z score < 3SD). Mean admission weight is lower in female compare to male children.Conclusions: Faulty weaning practises and delay in weaning in some cases predisposes later half of infancy period to undernutrition. So, proper health education and good IYCF practices prevent children from undernutrition.
Demographic profile and outcome analysis in paediatric intensive care unit at tertiary care hospital in the sub-Himalayan region
Authors: Bagchi Nilay Ranjan , Das Goutam , Guha Aritra
Published: August 2020

Background: Care of critically ill children continues to be one of the most challenging aspects of the field of paediatrics. Our study therefore, was done to see the demographic and morbidity pattern of the disease at a tertiary care hospital in the Sub Himalayan region and also the modifications that can lead to better outcomes.Methods: This was a retrospective record-based study which reviewed the admissions in to the PICU of tertiary care centre in the Sub Himalayan region of North Bengal for a period of 2 years (April 2018 to April 2020) with age group more than one month to twelve years of age from both medical and surgical sub-specialties. Data collected in pre-designed pro forma. Descriptive study analysis was done.Results: Out of the total 776 cases analysed 59% were male. LRTI comprised of maximum percentage of cases 27.8%, followed by sepsis (21.6%) and meningo encephalitis (16.7%). A maximum of 39% stayed for 3-7days in PICU, and 29.9% expired. Out of the total deaths, meningo encephalitis was responsible for maximum (27.6%).Conclusions: Our study is the first of its kind depicting the the demographic and morbidity patterns of the disease at a PICU in a tertiary care hospital in the Sub Himalayan region. Outcome analysis showed that PICU mortality rate was higher than in relevant recent studies.
Fungal endocarditis in neonate
Authors: Verma Manoj Kumar , Bharti Abnish Kumar , Jaiswal Rahul , Gupta Amit , Gupta Anuj
Published: August 2020

Neonatal endocarditis is a rare but usually fatal disease. Fungal endocarditis is an uncommon complication of invasive fungal infections and is associated with a high burden of morbidity and mortality. It frequently occurs in premature infants. The majority of these infections are caused by Candida (60-70%) and Aspergillus species (20-25%). The diagnosis is difficult because the criteria that have suggested and used in adults are not readily applicable for neonates. The incidence of fungal endocarditis in a neonate is on the rise, reported in the last decade secondary to use of central venous lines, frequent use of broad-spectrum antibiotics and neonatal surgical interventions.
Chronic urticaria in a two year old child: a diagnostic dilemma
Authors: Suresh Jayasurya , R. Nidheesh Chandran
Published: August 2020

A 2 year old child presented with history of recurrent urticaria for 2 months. The cause was initially idiopathic. On close questioning about diet and observation it was found that mother started using a coriander based masala powder 2 months back and it was found that the child was allergic to coriander. Chronic urticaria should be dealt with extreme caution and careful elicitation of history for the offending agent should be taken in a case of urticaria which poses as a diagnostic dilemma.
Rare presentation of mycoplasma pneumonia: a case report
Authors: Vaishnavi Bhimana , Janakiraman Lalitha , Dhanalakshmi K.
Published: August 2020

Mycoplasma is a frequent cause of community acquired pneumonia in children accounting for 20 percent of the cases. Though CNS complications are the most common extra pulmonary manifestations of M. pneumoniae stroke is a rare entity. Here we report a case of 7 years old male child with macrolide resistant M. pneumoniae complicated pneumonia that developed right hemiparesis and dysphasia. Brain magnetic resonance imaging and angiography showed left fronto parietal infarct and left carotid artery stenosis. He responed to non-macrolide antimicrobial regimen. This potential yet rare complication should be considered and closely monitored for in children presenting with complicated pneumonia.
Child with community acquired staphylococcal pneumonia complicated by bilateral pneumothorax
Authors: Kumar Magesh , Jain Chirag
Published: August 2020

Community acquired Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia usually present in children with some comorbidity and may have fulminant course in these children. In this case report authors have described a healthy child with MRSA pneumonia complicated by bilateral pneumothorax.
Neurofibromatosis type-1 with seizures and cerebrovascular malformation: a case study
Authors: Gopaal Nishant , Sharma Jagdish N. , Mathur Priyanshu , Agarwal Vijay , Jadoun Laxman
Published: August 2020

Neurofibromatosis type 1 (NF1) is the most common autosomal dominant neurocutaneous among humans. Epilepsy is more prevalent in NF1 patients than in the general population. NF1 vasculopathy is also a significant but underrecognized complication of the disease, affecting both arterial and venous blood vessels. Herein, we report a 2 year old female child with seizures and multiple cafe-au-lait spots on the body. The patient was diagnosed with NF1 based on clinical findings and family history. MRI Brain revealed middle cerebral artery dysplasia. Here we discuss diagnostic and treatment challenges and briefly reviews the existing literature.
A cross-sectional observational study assessing the clinical profile of patients with iron deficiency anaemia
Authors: Shah Nauka S. , Pathak Jaya M. , Shah Purva C.
Published: August 2020

Background: Our objective in this research was to study the clinical profile of patients having iron deficiency anaemia.Methods: This was an observational cross sectional study conducted in Medicine out-patient and in-patient departments of Baroda Medical College and SSG Hospital, Vadodara from February, 2018 to November, 2018 and included all patients (N=50) above eighteen years of age who were diagnosed on admission with microcytic hypochromic or normocytic normochromic anaemia. Following detailed history, general examination and basic haematological investigations like complete blood count, haemoglobin, mean corpuscular volume, etc., statistical analysis of the data was performed.Results: In the present study, it was found that maximum number of patients belonged to a younger age group (mean=36.82 years) with a majority being females (74%). Most common presenting complaint was weakness seen in 96% cases while the commonest clinical finding was pallor present in 100% cases followed by koilonychia in 32%. The most common cause of iron deficiency anaemia was nutritional seen in 60% patients.Conclusions: Generalised weakness, breathlessness, and pedal edema were the commonest presenting complaints in our study while pallor, koilonychia, and pedal edema were the most common clinical findings. Maximum number of patients had IDA due to a nutritional cause. Chronic gastrointestinal bleeding, inflammatory bowel disease, and menorrhagia are other causes of IDA. Amongst addicted, alcohol addiction seen in most cases.
Hemoglobin E: a potential interferent in measurement of glycated hemoglobin
Authors: Goel Shobhit , Tripathi Preeti , Sen Arijit , Sampath Sangeetha
Published: August 2020

Glycosylated hemoglobin (HbA1C) is a routinely measured parameter to monitor long term glycemic control in patients with diabetes mellitus. There are many potential interferents which can affect measurement of HbA1C by high performance liquid chromatography (HPLC). Variant hemoglobins, especially, are a common source of confusion and errors in HbA1C measurement. Authors present an interesting case of Hb E variant (undiagnosed hitherto) which came to attention when the machine repeatedly failed to give Hb A1C levels. Hb E is the commonest Hb variant in North East India. In the presence of Hb E, HbA1C may not be detected by ion exchange chromatography as both hemoglobin’s co- elute together, thereby causing errors. In such cases, the clinician may resort to subcutaneous sugar monitoring as an alternate or if required, Hb A1C measurement may be done by other techniques like immunoassay technique or boronated affinity chromatography. The laboratory staff and clinicians, both, should be aware of this limitation of HbA1C estimation in patients with HbE and other Hb variants.
An overview on seborrheic dermatitis and its treatment (allopathy and homeopathy)
Authors: Nagateja Ch. , Padmasree G. , Madhuri B. Jaya , Sailaja K.
Published: August 2020

Seborrheic dermatitis is a common, chronic inflammation of the skin, characterized by the appearance of red, flaking, greasy areas of skin, most commonly on the scalp, nasolabial folds, ears, eyebrows and chest. The incidence of the disease has two peaks: one in newborn infants up to three months of age, and the other in adults of around 30-60years of age. The exact causes of seborrheic dermatitis are not completely understood, multiple factors appears to be involved in the pathophysiology of the disease. The principle three factors involved are: sebum secreted from sebaceous gland, presence of Malassezia yeast, and the immune response of the host. Currently allopathic treatment and prophylaxis regimens usually include antifungal agents, most often azoles, mild topical steroids, immunomodulatory activity of topical calcineurin inhibitors such as tacrolimus and pimecrolimus and other agents such as selenium sulfide, sulfur, metronidazole and coal tar. Homeopathy offers an excellent treatment for seborrheic dermatitis during all stages. Various homeopathic medicine used to treat seborrheic dermatitis are kali sulphuricum, thuja occidentalis, natrum muriaticum and more. The objective of this review is to discuss and provide information about seborrheic dermatitis and its epidemiology, etiology, pathogenesis, symptoms, diagnosis and its treatment in allopathy and homeopathy.
Association between serum vitamin D3 status and essential hypertension: a review
Authors: Patil Divya V. , Dutta Tarun Kumar
Published: August 2020

The fat-soluble vitamin D is synthesized when the ultraviolet rays strike the surface of skin. The relationship between cardiovascular disease mainly arterial hypertension with low vitamin D levels is supported by literature. It has been observed that arterial hypertension has been associated with low levels of vitamin D. Obesity and reduced sunlight exposure are factors associated with lower serum vitamin D levels. Isolated systolic hypertension has been associated with vitamin D deficiency and insufficiency. Protective mechanism implicated in lowering the blood pressure is the suppression of renin angiotensin aldosterone pathway with optimal vitamin D levels. But randomised controlled trials are necessary to clarify whether vitamin D supplementation is beneficial in the control of blood pressure; as the results of many studies do not consistently favor the association of low vitamin D levels with hypertension.
Ear, nose and throat foreign bodies and their spectrum in rural South India
Authors: Rai S. Juthika , Chandre Gowda B. V. , Kamath Rakshita R.
Published: August 2020

Background: Ear, nose and throat foreign bodies are among the most common emergencies presenting to Otorhinolaryngologists world over and when dealt with poorly can cause high morbidity and mortality. Our study aimed at analysis of age, gender, types of foreign bodies and various aspects of their management in rural population.
 Methods: An observational prospective study was conducted in MVJ Medical College and Research hospital, Hoskote which is a tertiary care teaching hospital in rural Karnataka. 224 patients complaining of foreign body in ear, nose and throat between June 2018 to December 2019 were analyzed.

Results: Among 224 patients, majority were >10 years of age (57%). Most common site was ear (63.8%) followed by nose and throat. Single site foreign bodies were vast with cotton being most common object. About 67% foreign bodies were organic objects with 28%living and 72% non-living. 4% of the cases needed anesthetic augmentation for removal of which only 8 cases required general anesthesia. 60% cases were previously attempted removal cases with 2.7% cases developing sequela at follow up.

Conclusions: Early presentation, timely intervention and skilled removal by otorhinolaryngologists can help prevent adverse outcomes of foreign body Ear Nose and throat.
Glossopharyngeal neuralgia due to exposed glossopharyngeal nerve post tonsillectomy and transoral styloidectomy
Authors: Mahalingappa Ajith Keragodi , Gupta Richa , Ramakrishnan Sathi
Published: August 2020

Glossopharyngeal neuralgia (GN) is a rare facial pain syndrome, characterized by paroxysm of excruciating radiating pain in the sensory distribution of the auricular and pharyngeal branches of glossopharyngeal and vagus nerves. In relation to the tonsil, the glossopharyngeal nerve passes deep to the styloid process and related muscles attaching to styloid process. The lingual branch of the glossopharyngeal nerve provides sensation to the posterior tongue and enters the tongue base by traveling through the constrictor muscles in the area of the lingulotonsillar sulcus. Post tonsillectomy fossa with exposed nerve causing intractable pain is a rare entity. We report a case of 64 year male patient, post tonsillectomy and transoral styloidectomy, with complaint of severe throat pain on left side for 2 years, radiating upwards to the ipsilateral ear, face and eye. Glossopharyngeal nerve and its branches were found exposed in the posterior and inferior aspect of tonsillar bed. Surgical resection of exposed glossopharyngeal nerve and its branches was carried out in view of failure to respond to oral carbamazepine. Patient was symptom free during 10 months of follow up visit. GN is a rare condition following tonsillectomy and styloidectomy. Radical dissection of tonsillar bed during tonsillectomy and not suturing tonsillar bed properly after styloidectomy can lead to exposure of glossopharyngeal nerve and its branches, resulting in intractable GN.
Granulomatosis polyangitis: an otorhinolaryngological perspective
Authors: Hedge Jyotirmay Shyamsundar , Dechamma Shruthi
Published: August 2020

Granulomatosis with polyangitis or Wegeners granulomatosis is a rare entity, however is known to have specific otorhinolaryngological manifestations. Initial clinical manifestations could be subtle but deteriorate rapidly with an underlying active autoimmune process which can be life threatening in severe subglottic stenosis. We report a case of Granulomatosis with polyangitis in an adolescent girl initially presented with otitis media refractory to treatment and epistaxis and rhinitis and eventually with the progression of disease presented with subglottic stenosis. Diagnosis was made by anti-neutrophil cytoplasmic antibody proteinase 3 (ANCA-PR3) positive status and histological confirmation by nasal biopsy, elevated C-reactive protein (CRP) levels and renal involvement with evidence of microalbuminuria. She underwent dilatation of the subglottic stenosis twice, with resection of the stenotic mass by coblation. The diagnostic and therapeutic challenges faced are emphasized in this report.
Treatment of supra condylar fractures of humerus in children, a SKIMS medical college study
Authors: Bhat Jawed Ahmed , Wani Arshad H. , Din Abid , Dar Reyaz , Mir Naseer Ah
Published: August 2020

Background: Supracondylar fractures of the humerus account for sixty percent of all fractures around the elbow in children. Delayed presentation of these fractures is very common even in developed countries. The aim of the present study was to evaluate the clinical, radiological and functional results following closed reduction (C/R) and percutaneous pinning of widely displaced supracondylar fractures of humerus. An objective of this study was to study supracondylar fractures of humerus in children in Skims medical College.

Methods: A total 86 patients with displaced extension type supracondylar fractures (gartland type III) of humerus were managed by closed reduction and percutaneous fixation at Skims medical college after achieving optimal and satisfactory reduction. There were 52 boys and 28 girls. Average age was 6.69 years (range 2-12).

Results: A total 86 patients were successfully treated with C/R and cross pinning. 6 patients were lost to follow-up. 80 patients with a minimum follow-up period of 12 months formed the basis of this study.

Conclusions: C/R and pinning is effective method despite delayed presentation. Strict anatomical reduction and stable fixation minimises the risk of developing cubitus varus deformity.
Salter-Harris type II fracture of the middle phalanx with concomitant central slip injury in an 11 years old: a case report
Authors: Higginbotham Devan O. , Tsai Andrew G.
Published: August 2020

An 11-year-old male sustained an irreducible, completely displaced epiphyseal fracture of the proximal interphalangeal joint (PIPJ) of the middle finger with an associated central slip injury. Central slip injuries occurring in conjunction with Salter-Harris type II middle phalanx fracture are rare entities, with no previously documented case. Our patient underwent open reduction, internal fixation through crossed-pins to achieve reduction and fixation. He was then splinted in extension for six weeks to allow healing of the central slip injury. At 1-year follow-up, the patient had full range-of-motion with no clinical indication of physeal disruption or growth arrest of the repaired digit. We demonstrate a case in which ephiphyseal fractures of the proximal interphalangeal joint with a concomitant central slip injury can safely be treated with open reduction internal fixation combined with a period of immobilization. We characterize a surgical method of reduction and fixation with splinted immobilization and describe lessons learned from this previously unreported case.
A review on drug induced skin disorders: pathophysiology and therapeutics
Authors: N. Priyanka , Srinivasan R.
Published: August 2020

Drugs are the central part of treatment of various disorders. The consequence of drug use may be either positive outcomes (clinical effect of the drug) or negative outcomes (adverse drug events). That is, it contains both risk and benefit. In recent years multiple disorders treated with many drugs by monotherapy or by fixed-dose therapy existing in the market which leads to increased drug-related problems one among that is drug-induced disorders. Morbidity and mortality have increased due to drug-induced disorders. This study was aimed to describe the various drugs induces skin disorders, its pathophysiology, diagnosis and treatment approach. We completed a review of the current evidence for various drug-induced skin disorders its causative drugs and therapeutic intervention of drug-induced skin disorders. A review through Medline, Embase, Pubmed, Wiley online library and selected studies related to drug-induced skin disorders. This is the comprehensive review of drug- induced skin disorders, designed to address prospectively its etiopathogenesis and clinical management. Penicillin, sulfa, phenyl-butazone, Tetracycline are the most common drug induces various skin disorders. There is not much significant differences in the clinical, histopathological or immuno-pathological features between various skin disorders and drug induced skin disorders. Hence knowing the etiopathology, and differential diagnosis is important to a proper treatment approach.
HUMANIZAÇÃO DA ASSISTÊNCIA DE ENFERMAGEM EM UNIDADE DE TERAPIA INTENSIVA NEONATAL
Authors: Leite Pamela Iasmine Amorim Garcia , Pereira Fabricio da Gama , Demarchi Rafael Fernandes , Hattori Thalise Yuri , Nascimento Vagner Ferreira do , Terças-Trettel Ana Claudia Pereira
Published: August 2020

Objetivo: compreender a humanização da assistência de enfermagem em Unidade de Terapia Intensiva Neonatal (UTIN) de hospital privado mato-grossense. Métodos:estudo de caráter descritivo, exploratório e qualitativo. A coleta de dados realizada em 2016 com Enfermeiros que atuam na UTIN, com análise de conteúdo. Resultados:Os profissionais demonstram conhecimento sobre a humanização, compreendendo a mesma como um processo vivencial, que é adquirido por intermédio da experiência da prática clínica sob um viés afetivo e da própria ciência da enfermagem. Destacou-se a importância da prática na prestação do cuidado de enfermagem ao neonato, devendo a atenção humanizada ser estendida à família, buscando fortalecer os vínculos do binômio mãe-filho. Conclusão:Percebeu-se uma preocupação dos profissionais, em relação a importância do envolvimento familiar no processo de humanização, que perpassa pela confiança mútua até o processo de empoderamento gerado nos pais pela equipe, devido ao estímulo da participação nos cuidados com o recém nascido.
RELIGIOSIDADE/ESPIRITUALIDADE, INDICADORES DE SAÚDE MENTAL E PARÂMETROS HEMATOLÓGICOS DE PROFISSIONAIS DE ENFERMAGEM
Authors: Carneiro Élida Mara , Arantes Josiane De Pádua , Da Silva Djalma Alexandre Alves , Catarino Jonatas Da Silva , Rodrigues Junior Virmondes , Borges Maria de Fátima
Published: August 2020

Objetivo: analisar a relação entre Religiosidade e Espiritualidade, indicadores de saúde mental, parâmetros hematológicos e percepção de saúde de profissionais de enfermeiros. Método: estudo transversal com 53 funcionários. Utilizou-se Medida Multidimensional Breve de Religiosidade e Espiritualidade, Inventário Stress Lipp, Ansiedade e Depressão de Beck, Bem-Estar Subjetivo, questionário de classificação de saúde, hemograma e imunoglobulina A. Resultados: Dimensões Experiências Espirituais Diárias e Autoavaliação Global são os fatores com maior força de relação com os índices de estresse, depressão e Bem-Estar em profissionais. Participação religiosa foi o fator que influenciou maiores valores de leucócitos, neutrófilos e imunoglobulina. Conclusão: os resultados identificaram relação entre Religiosidade e Espiritualidade, indicadores de saúde mental e parâmetros hematológicos. Profissionais de enfermagem mais religiosos e espiritualistas apresentam melhor saúde mental e maior imunidade, além de melhor percepção de saúde.
MULHER E A DESCOBERTA DO CÂNCER DE MAMA: TRILHANDO CAMINHOS NO SISTEMA ÚNICO DE SAÚDE
Authors: Manorov Maraisa , Souza Jeane Barros de , Geremia Daniela Savi , Martins Emanuelly Luize , Conceição Vander Monteiro da
Published: August 2020

Objetivo: compreender como mulheres detectaram o câncer de mama, desvelando o tempo entre o diagnóstico e início do tratamento. Método: estudo do tipo exploratório, descritivo, com abordagem qualitativa, com dez mulheres mastectomizadas. A coleta de dados realizou-se por meio de entrevistas com roteiro, contendo questões semiestruturadas. Para análise dos dados utilizou-se a análise de conteúdo. Resultados: sete participantes detectaram alterações na mama por meio do autoexame, levando-as a investigação diagnóstica. Quatro entrevistadas iniciaram o tratamento em até 60 dias e as outras seis extrapolaram o tempo preconizado, portanto, o tempo entre diagnóstico e início do tratamento variou de dois a oito meses. Conclusão: salienta-se a necessidade de maiores investimentos no setor saúde, fortalecendo ações para rastreamento, detecção precoce do câncer de mama e início do tratamento no prazo de 60 dias, contribuindo para reduzir a mortalidade e os riscos de morbidade ocasionados pelos tratamentos, interferindo também no emocional das mulheres.
Growth regulator and microfertilizers on Sage (Salvia officinalis L.) and Greater Burdock (Arctium lappa L.): effectiveness of complex application
Authors: Kovalev N. I. , Pushkina G. P.
Published: August 2020

Relevance.Meeting the needs of the pharmaceutical industry with domestic medicinal raw materials is relevant.

Methods.The aim of the study is to determine the effectiveness application by growth regulator, organomineral and microfertilizers on Sage (Salvia officinalis L.) and Greater Burdock (Arctium lappa L.) in conditions of Non-chernozem zone of the Russian Federation. The experimental part of the work was performed in Institute of Medicinal and Aromatic Plants in 2010-2011 and 2016-2017 by field experiments. On burdock we tested fertilizer Siliplant (0.5 l / ha): the first treatment was in the rosette phase, the second - after 20 days. On sage studied binary mixture of organomineral fertilizer EcoFys (1 l / ha) with fertilizer Zitovit (0.5 l / ha; applied in phase regrowth of plants) with following foliar application by complex microfertilizers Siliplant (0.5 l / ha) and growth regulator Zircon (40 ml / ha). The solution consumption is 300 l / ha.

Results. The effectiveness of chelated form micro-fertilizers and organomineral fertilizers applied on various medicinal plants was shown. It has been established, that complex application by EcoFys+Zitovit (I treatment) and microfertilizer Siliplant with growth regulator Zircon (II treatment) can increase the productivity of Sage:  yield of grass raised by 23%, roots by 40%. Similar results were obtained on the Greater Burdock culture – treatment of plants with microfertilizer Siliplant allowed to increase the yield of roots by 28%, leaves-by 24%.