bluuebunny/crossref_metadata_2025 huggingface dataset:
Cervical spine fracture in geriatric blunt trauma: are the NEXUS criteria sensitive enough?
Authors: Young Katelyn A. , Buonpane Christie L. , Walker Charles W. , Dove James T. , Widom Kenneth A. , Torres Denise M. , Wild Jeffrey L.
Published: August 2019

Background: The NEXUS criteria lack an age consideration. This study characterizes NEXUS sensitivity for significant cervical fracture (CF) in non-geriatric (18-64 years) and geriatric (≥65 years) patients.Methods: This was a single-institution, retrospective review of blunt trauma patients (admitted between January 1, 2011 and December 31, 2016). Significant CF was an acute injury requiring surgery/orthosis. Propensity matching was used.Results: Overall, 353 patients had significant CF and notably 101 (28.6%) denied neck pain and tenderness at presentation. There were 162 geriatric patients with 17 patients who failed to meet any NEXUS criterion (sensitivity: 89.5%). The remaining 191 patients were non-geriatric, only six failed to meet any NEXUS criterion (sensitivity: 96.8%). NEXUS sensitivity was reduced among geriatric patients (89.5% vs. 96.8%, p=0.01), even after propensity matching (n=73/group; 86.3% vs. 97.3%, p=0.02).Conclusions: Alarmingly, 28.6% of patients with significant CF denied pain and tenderness. NEXUS demonstrated reduced sensitivity in the geriatric cohort, even after propensity matching. Liberal imaging is recommended for geriatric patients.
A study of interventions and their outcome in the management of acute pancreatitis
Authors: Viswanath Muppa , R. Rakesh , Kunnuru Supreeth Kumar Reddy , Perubhotla Raghu Sri Charan , Gurjar Mayank Kumar , Varty Gurudutt P. , Desu Bharath Kumar , Salavakam Muni Krishna , S. Thirunavukkarasu
Published: August 2019

Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. The suddenness of its onset, the illimitable agony which accompanies it, and the mortality attendant upon it, all render it the most formidable of catastrophes. Aim of the study is to evaluate the treatment outcome in acute pancreatitis.Methods: All the patients who underwent surgery for chronic pancreatitis were included in the study. initial APACHE II score at admission and CT severity index was evaluated.Results: Edematous pancreatitis accounts for 80–90% of acute pancreatitis and remission can be achieved in most of the patients without receiving any special treatment. Necrotizing pancreatitis occupies 10–20% of acute pancreatitis and the mortality rate is reported to be 14-25%. Alcohol (45.8%) was the most common causes of acute severe pancreatitis in this study. Males were predominately affected (Male: Female = 29:5). Complication rate or morbidity is 50%. The initial APACHE II score at admission and CT severity index in the first scan were high in patients who underwent necrosectomy and the patients who died. The overall mortality in this study was 30.6%.Conclusions: In conclusion, one reason attributed to high mortality was due to the subgroup of patients who underwent PCD alone and failed to show any change in the recovery nor deterioration and lead to gross nutritional depletion and death, secondly those patients who underwent step up approach and ultimately needed surgery have more aggressive disease evidenced by high APACHE II score, CT severity index and % of necrosis.
Outcome of fat injection in treatment of retracted scars
Authors: Varghese Fobin , Kochunarayanan Ajayakumar , Joseph Aneesh , Sadasivan Kalesh
Published: August 2019

Background: Fat grafting was developed in recent years with refinement mainly based on Coleman technique. The method consists of taking fat removed by liposuction under low pressure, fat processing and then placement of fat on the treated area.Methods: Patients who presented with depressed or retracted scars were considered. 12 patients were selected for the study as one year. Patients were given fat injection by Coleman’s technique and were evaluated at 1, 3 and 6 months. Patient and observer scar assessment score (POSAS) was used for evaluation.Results: The present study infers that there is a significant decrease in POSAS score on both the patient and observer side after fat injection for retracted scars. The overall patient score decreased from 5.75 (±0.866 SD) pre-operatively to 3.17 (±1.115 SD) post-operatively with a p value of less than 0.005. The difference between the scores is 2.58 which are comparable to other studies. The overall observer score decreased from 4.25 (±1.422 SD) pre-operatively to 2.58 (±0.996) post-operatively with a p value of less than 0.005. The difference between the scores is 1.67 which is comparable to other studies.Conclusions: Autologous fat grafting seems to be a promising and effective therapeutic approach for scars with different origins such as trauma, burns, post-surgery. In general, we can affirm that treated areas regain characteristics similar to normal skin, which are clinically perceptible, leading not only to aesthetic but also functional results.
A study of variables in gastrointestinal stromal tumor: surgical experience at a single institute
Authors: Shah Udit Jaydeep , Akruwala Sushil D. , Sharma Vidhyasagar M. , Pipalia Manubhai V.
Published: August 2019

Background: Gastrointestinal stromal tumors (GIST) have been recognized as a biologically distinctive tumor type, different from the smooth muscle and neural tumors of the gastrointestinal tract. They constitute majority of the gastrointestinal mesenchymal tumors of the gastrointestinal tract and are considered to be refractory to conventional chemotherapy or radiation. Surgery remains the mainstay of primary tumor management of GIST.Methods: This was a cross sectional study of the diagnosis, management and clinical outcome of cases diagnosed with GIST of the gastrointestinal tract from a teaching institute in a single year and a comparison of findings with previously published cases.­­ Study included patients newly diagnosed with GIST and managed in department of general surgery from 10 April 2018 to 31 March 2019.Results: Most patients were of age group 60-69 years with an almost equal incidence among males and females. Stomach and small bowel were found to be the commonest sites with an equal distribution of 45.45% with an average tumor size of 5 cms.Conclusions: Surgical treatment remains the main stay of management for the GIST, depending on the location, staging and metastasis. Staging laparoscopy may be done to assess respectability as peritoneal deposits can be missed by CT scan. Immunohistochemistry is mandatory in defining GIST.
Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study
Authors: C. Balaji , Neogi Sushanto , Ramasamy Sadasivam , Vats Manu
Published: August 2019

Background: A major surgical complication after emergency midline laparotomy is abdominal fascial dehiscence. Dehiscence is associated with increased morbidity and mortality rates up to 30%, prolonged hospital stay, and a long-term risk of developing incisional hernia. The risk factors of Wound dehiscence can surgeon factors or patient factors. This study was aimed at comparing effectiveness of interrupted-X technique versus conventional continuous closure of rectus sheath in midline laparotomy in emergency setting.Methods: This study was conducted in a total of 100 patients underwent midline laparotomy for perforation peritonitis in emergency setting. Out of which 50 patients underwent rectus sheath closure by interrupted-X technique (group A) and 50 patients by conventional continuous closure (group B) using non-absorbable, monofilament, no.1 polypropylene suture. Necessary preoperative patient data, wound length, the time taken for rectus closure, length of the suture material used, post-operative complications like wound dehiscence, surgical site infection, period of hospital stay were recorded for analysis.Results: Preoperative patient data among both the groups were comparable. Group A was found to have less wound dehiscence (p=0.001 for partial and p=0.008 for complete) and less period of hospital stay (p=0.054), which were statistically significant. Surgical site infections were similar in both groups. Group B was found to have less time taken for closure (p=0.003) and less length of suture material used (p=0.003), which were statistically significant.Conclusions: Interrupted-X technique of rectus sheath closure reduces the rate of wound dehiscence and period of hospital stay, although it consumes more length of suture material and more time for suturing as compared to conventional continuous closure.
Post-operative morbidity and mortality following D2 gastrectomy in a state funded tertiary care centre in South India
Authors: Jayaraman Chandrabose Ambedkar Maravadi , Chidambaram Kalyanasundarabharathi , Chinnusamy Kolandasamy , Shanmugasundaram Rajendran , Obla Naganathbabu Lakshmanamurthy
Published: August 2019

Background: Radical gastrectomy with D2 lymphadenectomy is a surgery with significant post-operative morbidity. Pre-operative malnutrition portends a poor post-operative outcome following any gastrointestinal surgery in general. This study aims at finding out whether it is feasible to perform D2 lymphadenectomy in patients presenting with significant malnutrition.Methods: In this single centre study, we retrospectively analysed the post-operative morbidity and mortality data of 46 patients who underwent D2 gastrectomy for operable gastric cancer between October 2016 to April 2019. Almost all the patients who were analysed fulfilled at least one criterion for malnutrition.Results: The morbidity rate was 39.1% and the mortality rate was 6.5% which were a little high when compared to results from other Indian centres but not prohibitive, considering the nutritional status of these patients. Almost 50% of these patients were able to complete adjuvant chemotherapy.Conclusions: D2 gastrectomy can be performed in patients with poor pre-operative nutritional status. If perioperative nutritional requirements are taken care of promptly, the post-operative outcomes can be better.
Association of metabolic syndrome with intravesical prostatic protrusion and international prostatic severity symptoms score in patients with benign prostatic enlargement
Authors: Sarma Debanga , P. Rajeev T. , Ghanghoria Ashish , Baruah Saumar Jyoti , Barua Sasanka Kumar , Bagchi Puskal Kumar , Phukan Mandeep , Pratihar Sarbartha Kumar
Published: August 2019

Background: Intravesical prostatic protrusion (IPP), a morphological change resulting from enlarged lateral and median lobe of prostate. It could be for assessment of BOO (Bladder outlet obstruction). MetS is one of the causative factors for the development of Benign Prostatic Enlargement (BPE) and associated LUTS. The aim of this study is to assess the association of components of MetS and MetS with IPP, TPV and International Prostatic Severity Symptoms Score (IPSS).Methods: This is a single centre cross-sectional study in Department of Urology, GMCH, Guwahati, Assam, India between March 2016 and May 2018, 114 consecutive men aged >50 years presenting with LUTS suggestive of BPE (PSA 0-4ng/ml). MetS was defined according to International Diabetes Federation criteria. We have analysed IPSS and IPP of these patients. Patients were classified into 3 groups each for IPSS and IPP (IPSS: group I - 0-7, II -8-19, III ->20 and IPP: Group I- <5 mm, II- 5-10 mm, III- >10 mm).Results: We have correlated these groups with each component of MetS and MetS. IPSS group III had significant correlation with hyperglycaemia (HG), hypertriglyceridemia (HTG), hypertension (HTN) and HDL cholesterol (HDL), group II had significant correlation with HG, HTN and HDL and group I had significant correlation with HTN (p<0.001). Similarly, IPP group III had significant correlation with HG, HTG, HTN, obesity and HDL, group II had significant correlation with HG, HTN and obesity and group I had significant correlation with HTN only (p<0.001).Conclusions: We found that patients with higher IPSS and IPP had significant correlation with MetS components.
Comparative study of wound sequlae in layer closure and retention closure of midline laparotomy
Authors: D. Euvalingam , Nathan Sendhil
Published: August 2019

Background: Layered closure of the abdomen has been considered to be ideal until recently however single layer mass (retention) closure technique, in which all the layers of the abdominal wall are closed in single layer is being increasingly used by surgeons. We conducted this study to analyze outcome measures in patients in whom wound closure was done by retention closure and layered closure.Methods: This was a prospective comparative study in which 60 patients undergoing elective or emergency laparotomy were included on the basis of a predefined inclusion and exclusion criteria. In 30 cases (50%) layer closure was done whereas in remaining 30 (50%) patients retention closure technique was used. Major outcome measures studied were time required for wound closure and post-operative complications.Results: Out of 60 studied cases there were 42 (70%) males and 18 (30%) females with M: F ratio of 1: 0.42.The time required for closure in layered suture group (group A) was 26.76±3.36 whereas in case of retention closure suturing it was 19.36±4.35. The difference was found to be statistically highly significant (p<0.0001). The complications rates were found to be statistically significantly higher in layer suturing (Group A) as compared to retention suture group (Group B).Conclusions: We conclude that retention suturing is preferable as compared to layered suturing in patients undergoing midline laparotomy in terms of time required for closure of wound and post-operative complication rates.
Incidence of malignancy in gastric/antral perforation
Authors: Bhaskar Sumit , Kumari Priyanka , . Sweta , Sinha Dipendra K.
Published: August 2019

Background: Gastrointestinal perforation is one of the most commonly encountered cases in emergency department. Acute perforation of the stomach and duodenum causes significant morbidity and mortality. These perforations occur more commonly as a complication of peptic ulcer disease but in a few cases gastric cancer also present as gastric/antral perforation. Previously it was reported that approximately 10-16% of all gastric are caused by malignancy/gastric cancer. To study the incidence of malignancy in gastric perforation in present time, a study was carried out at our institute including all cases of gastric/antral perforations that presented to emergency department over a period of two years.Methods: Cases of gastric/antral perforation that presented to our emergency were included in study. Biopsy from the margin of perforation was taken and sent for histopathological examination. Results obtained were further analysed with respect to total no. of cases, age, sex, personal habits and histopathological type.Results: Out of total 60 cases that were included in study, biopsy report of 5 cases came to positive of malignancy.Conclusions: The incidence of malignancy in gastric/antral perforation was found to be 8% in our study which shows a decline in this region as compared to incidence in the world.
Primary retroperitoneal mucinous cystadenoma in a male patient: a case report
Authors: Yau Joachim Wen Kien , Tan Cher Heng , Chau Cora Yuk Ping , Wong Kar Yong
Published: August 2019

Primary retroperitoneal mucinous cystic neoplasms are very rare, especially in men. To our knowledge, only 13 cases of such neoplasms have been reported in men to date. The most common type is the primary retroperitoneal mucinous cystadenoma, which almost invariably affects females. Most patients present with non-specific symptoms. In this case report, we will describe a case of a 53 year old male patient who presented with raised CEA tumour marker and vague right sided abdominal discomfort. A computed tomography (CT) scan was performed, which revealed a 4.9 × 4.7 × 7.5 cm lobulated retroperitoneal cystic lesion abutting the posterior wall of the mid ascending colon. A laparoscopic excision was eventually performed with complete removal of the retroperitoneal cystic lesion. Subsequent histological assessment confirmed the diagnosis of a primary retroperitoneal mucinous cystadenoma with borderline malignancy. On comparison with a prior CT scan performed about seven and a half years earlier, we managed to derive a doubling rate of about 626 days, which is the first reported case in English literature to document the growth rate of such a tumour. The patient has since been discharged well, with no evidence of tumour recurrence on an interval CT scan.
Laparoscopic management of acute cholecystitis with hepatic choristoma of the gall bladder wall: case reportand review of the literature
Authors: Espitia Francisco Terrazas , Davila David Molina , De Alba Carlos Armando Diaz
Published: August 2019

Choristoma is a term which refers to the presence of histologically normal tissue in a heterotopic location; hepatic choristoma is a condition in which hepatic tissue can be found in abnormal locations above or below the diaphragm, the gallbladder wall being the most frequent heterotopic site for implantation, this disease is usually asymptomatic and is rarely detected preoperatively with imaging studies due to a general lack of knowledge of this entity. We present the case of a 37 year old male patient who presented with acute abdominal pain in the right upper quadrant, colicky in nature, accompanied by nausea and vomiting; a HIDA 99 mTc scan revealed gallbladder diskynesia as well as a radiolucent bilobulated image. Upon laparoscopy, we encountered two masses on the superoanterior gallbladder wall and Hartmann´s pouch, which upon histopathological specimen examination revealed the presence of hepatic choristoma. This entity should be considered whenever a soft tissue mass is reported on the anterior gallbladder wall on imaging studies; It has been reported that hepatic choristoma is at higher risk for development of hepatocellular carcinoma and should be removed en bloc with the gallbladder.
Intraoperative decision preventing orchidectomy
Authors: Tonape Trupti , Athavale Virendra , Balasubramanian Sree Kumar , Khandalkar Shivamurti , Ghatnekar Aditya , Koduru Srilikhitha
Published: August 2019

Adenomatoid tumors are regarded as distinctive benign mesothelial neoplasms of the paratesticular region, most commonly occurring at the tail of the epididymidis. Because of its rarity, the clinical and histopathological aspects are discussed. We present the case of 40 years old male patient came to our OPD with complaints of left hemiscrotal swelling since 6 months duration. A clinical diagnosis of testicular neoplasm was made, but the final diagnosis of adenomatoid tumor was made after excision. Due to its low incidence in intrascrotal pathology, we believe it is important for the physician to be aware of this interesting entity in order to make a differential diagnosis from other inflammatory processes and to adopt the proper surgical approach.
Fibroadenoma of ectopic breast tissue in chest wall: a rare case report and review of the literature
Authors: Balmiki Pradeep , Mourya Kamlesh
Published: August 2019

Fibroadenoma of ectopic breast tissue is a rare disease. Ectopuc breast tissues are found along milk line. Malignancy is more common than fibroadenoma in ectopic breast tissue. Ectopic breast tissue can be present with nipple or without nipple areola complex. Here we report a case of 20 years old patient having fibroadenoma of ectopic breast tissue in anterior chest wall without nipple areola complex. Patient underwent excision and biopsy. Histopathology confirmed it as fibroadenoma of the ectopic breast tissue. This case has been reported for its rarity and to reemphasise the importance of screening of EBT for any pathology during routine screening of breast.
Telemedicine: an ICT based healthcare approach to ensure health service for all
Authors: Akhtar Rasheda , Alam Sazzadul , Siddiquee Noor Kutubul Alam
Published: August 2019

Background: Despite enormous efforts, healthcare service is still a daunting challenge area of Bangladesh healthcare systems. Bangladesh suffers from both a shortage of and geographic mal-distribution of human resource for health, as well as inadequate resources. Considering the challenges, telemedicine can be a blessing especially to the people living in hard-to-reach and rural areas. The current study was conducted on to measure the outcomes of providing telemedicine service at the field level.Methods: The study was conducted in Nagarkanda Upazilla of Faridpur district. Mixed method approaches including user experience and perception survey, case study and in-depth interview were adopted in order to bring a comprehensive scenario.Results: Around 50% of the users used to visit telemedicine center frequently. For quality of service provided from telemedicine service point, there were few benchmarks like service provider’s behavior, waiting time, accessibility, distance, cost of treatment, willingness to pay and referral mechanism. Telemedicine service centers were found situated within the reach of people (within 1-2 km of 83.30% km). 97% participants rated service provider’s behavior as good. Cost of treatment including diagnosis, prescription and medication was found within 501-3000 BDT for 60% of participants.Conclusions: Although the studied telemedicine service was not comprehensive in nature, it still helped to save time, reduce cost and most of all increased access to healthcare services.
Prevalence of overweight and obesity in Medical and Allied Science students of Karnataka, India
Authors: Parajuli Keshab , Lamichhane Rajendra , Lama Nishant , Marasine Nirmal Raj , Narasannavar Ashwini , M. S. Shivaswamy
Published: August 2019

Background: Overweight and obesity is the underlying cause of death for about 3 million people each year. More than 100 million individuals are obese in India. Few studies have been carried out among Indian undergraduate students where irregular dietary pattern, stress and anxiety are more prevalent due to academic pressure. The objective of this study was to estimate the prevalence of over-weight and obesity in Medical and Allied Science students.Methods: The cross-sectional study was conducted in 2017 among 922 medical and allied science undergraduate students of Jawaharlal Nehru Medical College, Karnataka, after obtaining the institutional ethical approval and written informed consent. Information was obtained with the help of pre-designed, pretested semi-structured questionnaire by self-administered method and anthropometric measurement.Results: Overall prevalence of overweight and obesity among students was 23.6% and 5.2% respectively. Prevalence of overweight among male students was 28.7% and 18.6 % in female. Obese male students were 5.5% and 5 % were obese in female.Conclusions: About one fourth of the students were overweight and more than one in twenty students were obese. Overweight and obesity was more in male than female.
The effect of spirituality assistance on improving life quality in cancer children
Authors: Pratiwi Etik , Adi Giri Susilo
Published: August 2019

Background: Cancer is a disease with a high mortality rate.1 States that the death rate from cancer can reach 45% in 2007. Emotional and spiritual dysfunction in children and adolescents can lead to symptoms of depression and is one of the risk factors for suicide.6Methods: This research is a type of mixed research (mix method), with a sequential explanatory strategy. This strategy is a method of approach by conducting quantitative data collection as the main method then followed by qualitative data collection.Results: There were 30 children who were used as respondents in this study, the majority of whom were male and aged over 13 years. The majority of children experience leukemia. The results of data analysis showed the influence of spirituality assistance on quality of life. The value of the total quality of life of the total respondents conducted by spirituality assistance increased in value by 8,962, from an average value of 75,055 to 84,017. The p value for total quality of life is 0,000.Conclusions: There is an influence of spirituality accompaniment on the quality of life for children with cancer. Children can be invited to worship together with parents, this is an effective coping to motivate them to survive in carrying out their lives and activities everyday even in conditions of illness.
A study to assess the assess the food safety knowledge and hygienic practices among food handlers
Authors: Kushwah Sudarshan , Gour Devendra , Nair Akhil R. , Bagri Sucheta , Patel Varshika , Priyabrat Prince , Chandak Ankit
Published: August 2019

Background: Improper food production, handling, and preparation techniques have direct influence on health. A food borne disease is a disease usually either infectious or toxic in nature, caused by agents that enter the body through ingestion of food. The objective of the present study was to assess the food safety knowledge and hygienic practices among food handlers and to assess the improvement in knowledge and hygienic practices after educational intervention.Methods: This was a longitudinal educational interventional study, carried out during October to December 2017 among 50 randomly selected food handlers in and around Gandhi Medical College campus, where the study subjects were interviewed by using a questionnaire in local language regarding their knowledge and practices of food handling, and were then later educated on proper food handling practices by lecture and demonstration method followed by a post intervention interview after a gap of 2 weeks.Results: Out of 50 food handlers, 62% had knowledge of the food borne diseases and it raises up to 100% post intervention. During pre-intervention, only 78% of the participants used to wash their hands before preparing meal and after intervention 92% were washing their hands before preparing meal.Conclusions: Food safety knowledge and hygienic practices among food handlers improved by 73% after the educational intervention. Maximum improvement was seen in the use of gloves, caps and hand washing practices.
Basic life support skills and health emergency preparedness among school teachers in India: a questionnaire-based study in an urban population
Authors: Srinivasan Ranjiini , Krishnan Surya G. , Bhojaraja Shashank , Srinivasan Mithuna
Published: August 2019

Background: The purpose of this study was to assess basic life support (BLS) knowledge and attitudes among school teachers in India, and to elicit school preparedness in handling medical emergencies.Methods: Using a two stage sampling technique, 198 teachers from 10 schools in a metropolitan city participated in the study. A pre-validated questionnaire was administered to assess school teacher knowledge of BLS, and the principals of the schools provided information regarding the facilities available to manage health emergencies.Results: Although more than half of the surveyed teachers were aware of the term BLS, only 7 percent were trained in resuscitation. Thirteen percent of teachers had encountered emergencies in the classroom. Most of the schools maintained a basic first aid kit but lacked other equipment necessary to manage more serious health emergencies.Conclusions: Our study suggests that although teachers may be aware of BLS, they lack formal training and schools may be poorly equipped to tackle medical emergencies. It is therefore necessary to regularly train teachers in BLS and ensure that schools are provided with resuscitation equipment to enable them to handle health emergencies in children.
Body mass index profile among school children: an anthropometric study
Authors: Mahalakshmi S. , Abirami M. J.
Published: August 2019

Background: The study aimed to analyse the trends in the growth pattern of the children in the age group of 3-21 years of both boys and girls using body mass index (BMI). The study also compared the BMI of the sample with the WHO norms and the group average.Methods: A study was conducted in India covering 1728 children 849 boys and 879 girls from LKG grade to +2 grades in the age group of 3-21 years. BMI grades were computed as per WHO 2006 standards (underweight- <18.50, normal- 18.50-24.99, overweight- >25.00 and obese- >30.00). Results were analyzed using percentage and ANOVA.Results: The data shows that 88.9% of children in the age group of 3-8 years are underweight and in 15-21 years of age children are relatively healthy, but are inclined to move to overweight (17.66%) and obesity (7.21%). More of boys (31%) tend to be underweight than girls. Age and gender were found to be significantly related to BMI. The average BMI of the sample group is above the national standards of WHO (World Health Organization) in all the three age groups. Boys are found to be on par with WHO norms while girls exceed the same. Majority of the sample were below the average denoting underweight.Conclusions: Age and gender was significantly related with BMI. Average BMI of the sample was on par with national standard of WHO. BMI was thus found to be an effective tool for predicting the well-being of school children.
A study on prevalence of hypertension and its relationship with overweight and obesity in adolescents and young adults, Nizamabad city
Authors: Raj G. Chethan , Junapudi Syam Sundar
Published: August 2019

Background: The overall imbalance between unhealthy diet intake and physical activity leads to obesity which contributes to high blood pressure and high cholesterol. It is multi factorial disease and changes in the levels of blood pressure and blood lipids differ by age sex and race and are influenced by body fat and dietary patterns. These risk factors need to be monitored and evaluated in childhood and adolescents. So identifying and modifying the risk factors in early age reduces the incidence in adolescents and adult. Prevalence of hypertension varies across countries and states. The prevalence of hypertension in India is reported as ranging from 10 to 30.9%. The objective of the present study is to observe the prevalence hypertension among study population and to study contributing factors for hypertension among study population.Methods: A cross sectional study done on 100 adolescents and young adults of both sexes in the age group 17 to 25 years from 2 degree colleges randomly selected in Nizamabad city, Telangana, India.Results: In the present study population 52 were males and 48 were females, 22 students belongs to rural area and 78 belongs to urban area, pre-hypertension and hypertension was found 8% in both age groups. Overweight and obesity (>25) was found 7% in 17-19 age group and 9% in 20-25 age group. Pre-hypertension and hypertension was found among 10% of alcoholics.Conclusions: The result of our study concluded that there is increasing prevalence of hypertension with increase in age and is associated with overweight and obesity.
Perception of parents of private school students on measles and rubella vaccination campaign in Sambalpur town
Authors: Mishra Sanjeeb Kumar , Lakra Kulwant , Satapathy Durga Madhab , Panda Sadhucharan , Pradhan Subrat Kumar
Published: August 2019

Background: In order to eliminate measles and rubella (congenital rubella syndrome) WHO has emphasized on measles and rubella (MR) vaccination campaign and India launched the ambitious MR Campaign with the help of WHO and GAVI. In Odisha the MR campaign was launched on January 29 with a target to cover nearly 1.13 crore children. The objective of the present study is to assess the knowledge of parents regarding measles and rubella infection and to identify the source of information regarding MR campaign.  Methods: A cross-sectional study was conducted in Sambalpur City across 10 private schools during February 10 to March 12. Total 440 parents of children aged 5-15 years were given a questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards MR Campaign. The data were collected subsequently in the next 10 days. Out of 440 parents 408 returned filled up questionnaire. Data were entered into and analyzed by using Microsoft Excel.Results: Out of the 408 respondents 362 (88.7%) parents had knowledge about MR campaign. 156 respondents was aware about importance of rubella vaccine. Parent teacher meeting (PTM) was the leading source of information for these. 388 (95%) respondent’s children had received the vaccine during campaign.Conclusions: Parent-teacher's meeting was the main source of information. However social mobilisation such as street play, miking, rallies by school children and NGOs etc., needs to be taken up for such campaigns in future.
Assessment of physical activity level among patients with type 2 diabetes mellitus attending rural health centre, Marappadi
Authors: Bruce M. S. Praythiesh , Mallika M. C. Vasantha
Published: August 2019

Background: Insufficient physical activity is one of the ten leading risk factors for death among patients with Non- Communicable Diseases (NCDs) such as cardiovascular diseases, cancer, and diabetes mellitus worldwide. Globally, one in four adults is not physically active. More than 80% of the world's adolescent population is insufficiently physically active. Physical inactivity is very common in India with a prevalence of 54.4%. Lack of knowledge regarding physical activity leads to non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, and diabetes which in turn can lead to death and disability.Methods: The cross sectional study was conducted on patients diagnosed to be diabetic visiting the Out Patient Department of Rural Health Centre Marappadi. Convenient sampling was used and the study was conducted from January 2017 to June 2018 using a pre-tested, semi-structured questionnaire.Results: The mean age of the patients was 57.00±8.747 years. Patients aged 60 years and above had a lower physical activity level. In the older age group, low physical activity was associated with obesity. Adequate motivation was found to be reason for high physical activity level in patients (60.0%).Conclusions: The physical activity levels of the diabetic patients were unsatisfactory especially in the elderly. Low physical activity was associated with poor glycaemic control in the older age group. There is a need to encourage diabetic patients to undertake regular physical activity in order to achieve good health and well-being, optimal glycaemic control and to prevent diabetic complications.
Socio-cultural practices related to mother and child health in Mewat, Haryana, India
Authors: Akshay Pooja , Anand Sarita
Published: August 2019

Background: Mothers and young children bear the burden of high morbidity and high mortality due to various socio-economic and cultural reasons complicated by illiteracy, unawareness, ignorance, and lack of access to health care services. Objective of this study was to discuss the perspectives of women from villages of Mewat, Haryana in India on mother and child health in the context of their socio-cultural norms, practices and assess their information needs related to pregnancy, child birth and child care.Methods: The study design was qualitative and descriptive in nature. FGDs were conducted in four villages in Mewat district of Haryana with approximately 100 community women who were either pregnant or mothers of at least one child in 0-2 years. Through these FGDs, their responses were documented on prevalent socio-cultural norms and practices about antenatal care, institutional delivery, diet during pregnancy and post-partum, breastfeeding, immunization, family planning etc.Results: Majority of women were unaware of the healthy behaviours and desired practices for optimal pregnancy outcomes due to their limited exposure and unavailability of authentic sources of information. They seemed to be unable to follow the right practices because of poor socio-economic status, patriarchal structure with resultant gender dynamics and religious norms, overwork and pre-conceived socio-cultural norms which impede their health seeking behaviour.Conclusions: Knowledge on healthy practices during pregnancy, child birth and child care can promote health seeking behaviour amongst women along with optimal pregnancy outcomes. However, majority of women were unaware about such healthy practices. Hence, it is important to raise awareness amongst women to ensure mother and child health.
Effect of stress on hypertension among professional groups at Bareilly: a cross sectional study
Authors: Gupta Shailesh , Gupta Shruti
Published: August 2019

Background: The objective of the present study was to study the effect of stress on hypertension in various professional groups.Methods: A cross sectional study was done from 1st August 2015 to 30th August 2017 in district Bareilly. A predesigned and pretested questionnaire was used comprising of demographic data and stress. Three types of professionals were included in this study: doctors, managerial staff and school teachers from the teaching institutions.Results: This study showed association of hypertension with stress level and found that 24.62% doctors, 72.31% school teachers and 27.69% managerial staff were hypertensive with mild stress level. Among all study subjects 41.54% were hypertensive with mild stress level. 15.38% doctors, 10.77% school teachers and 46.92% managerial staff were hypertensive with moderate stress level. Among all study subjects 24.36% were hypertensive with moderate stress level. 46.15% doctors, 0.76% school teachers and 8.46% managerial staff were hypertensive with severe stress level. Among all study subjects 18.46% were hypertensive with severe stress level. Chi-square test for association was applied and p-value was found significant for doctors, managerial staff and insignificant in school teachers. Among all study subjects p value 0.016 was found significant.Conclusions: The present study showed highly significant association for hypertension with stress level among doctors and managerial staff with p value (0.005) and (0.001).
A study to assess the prevalence of iodine deficiency disorders in Betul district, Madhya Pradesh, India
Authors: Kushwah Sudarshan , Nair Akhil R. , Meena Jeevan Singh , Verma Shipra , Sawlani Harshima , Chandak Ankit
Published: August 2019

Background: Iodine deficiency disorders (IDD) constitute the single largest cause of preventable neurological damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. The study was conducted to assess the prevalence of goiter in school children aged 6-12 years, to estimate the urinary iodine excretion and to assess the level of iodine concentration in salt samples obtained from households of selected school children.Methods: Population proportionate to size sampling. Sample size was 90 primary school-going children of age 6-12 years in each selected village, total 2700 from 30 villages/wards in Betul district, Madhya Pradesh, India.Results: The prevalence of goiter among the 6-12 years children was found to be 32.06%. Females had higher prevalence compared to males. Of the 540 salt samples, 370 (68.4%) had iodine concentration ≥15 ppm at household level.Conclusions: IDD is a mild public health problem in Betul district.
Nutritional status and dietary intake among unmarried adolescent girls in rural area of Chittoor district: a community based survey
Authors: Reddy S. Uday Kumar , Chaudhuri Sirshendu , Amrin Syeda Fathima , Rabeka Gunasekaran
Published: August 2019

Background: Nutritional status and dietary intake during adolescent period play a crucial role in their mental and physical development. Objectives of the present study were to estimate the prevalence of undernutrition, as defined by the World Health Organization (WHO), among unmarried adolescent girls in rural area of Chittoor district; to estimate the average daily intake of different macro and micro-nutrients, i.e., calorie, protein and iron, by the same group by 24-hour dietary recall method; and to identify individual and family level determinants for undernutrition and decreased intake of nutrients.Methods: In this cross-sectional community-based survey anthropometric measurements were done, and dietary intake of unmarried adolescent girls was assessed by 24-hour recall method.Results: Majority is suffering from poor nutrient intake. This is more prominent for calcium [25.1-40.9% of the recommended daily allowance (RDA)] and energy intake (68.6-88.9% of RDA). Only 55% of the adolescents get iron supplementation; rests consume minimal iron (8.5gm) on average. Prevalence of thinness and stunting was 29.4% (95% CI: 20.4%, 38.4%) and 21.4% (95% CI: 13.3, 29.5%) respectively. Economic and housing conditions were associated with low dietary intake and poor nutritional status. Considerable cluster-wise variation exists for both the conditions.Conclusions: High prevalence of stunting and thinness together with substantial macro and micro-nutrient deficiency exist among adolescent girls. Existing national programs for this age group needs adequate supervision. Awareness development regarding locally available low-cost nutritious food together with periodic anthropometric measurements is required.
Morbidity profile and nutritional status of tribal under five children attending the phulwaris in rural Chhattisgarh
Authors: Dishani Madonne Rufina , Kannan Radhika , Philip Reni , Ramesh Naveen , Jain Yogesh , Mohite Anjali
Published: August 2019

Background: According to UNICEF report, 19.8% children under-five years in India are wasted, 48% are stunted and 42.8% are underweight. Multisectoral initiatives by the national and state governments are yet to reduce the burden of malnutrition. Jan Swasthya Sahyog (JSS) Health Centre in Chhattisgarh, plays a vital role in improving nutritional status of tribal under- three children attending the phulwaris (or creches). Objectives of this study were to assess the nutritional status of under-five children attending the phulwaris located under Bamhni sub center and to identify the common morbidities among these children.Methods: The researchers conducted health check-up for 357 children in the 19 phulwaris of Bamhni sub center spread over 16 villages.Results: Mean age of children attending the phulwaris was found to be 29±12.5 months. Among the 357 children, 128 (35.9%) were underweight; 53 (14.8%) were severely underweight; 35 (9.8%) were wasted; 18 (5%) were severely wasted; 58 (16.2%) stunted and 16 (4.5%) severely stunted according to WHO growth charts for weight for age, weight for height and height for age respectively. Point prevalence of morbidity was 142 (39.7%), which included respiratory tract infection (24.6%); scabies (8.4%); otitis media (3.1%); pyoderma (2.2%); developmental delay (2.2%); worm infestation (2.2%); sickle cell anemia (0.6%) and (0.3%) had epilepsy.Conclusions: Under nutrition was still prevalent among the children attending the phulwaris and upper respiratory tract infection was the most common morbidity.
Treatment times in locally advanced oropharyngeal cancer: evolution from 2011 to 2016 in a Portuguese Head and Neck Oncology Centre
Authors: Gomes Patrícia S. , Breda Eduardo , Monteiro Eurico
Published: August 2019

Background: Delays in cancer diagnosis and treatment are usually associated with patient anxiety, tumour progression and lower survival. This study aims to analyse the potential impact of rescheduling adjuvant treatments on survival outcome of patients with locally advanced oropharyngeal squamous cell cancer (OPSCC).

Methods: A retrospective review of medical records comprising all patients with advanced oropharyngeal cancer who underwent primary surgery and postoperative radiotherapy (PORT) in a Tertiary Oncologic Centre from 2011 to 2016 was performed.

Results: 63 patients with a male/female ratio of 8:1 and mean age of 57.5±9.6 years were enrolled. Patients waited a mean of 47.2±18.2 days from diagnosis to surgery and a median of 61 days from surgery to radiotherapy. Median radiotherapy duration was 43 days and the mean package time was 104.5±21.0 days. Analysis of these parameters has shown decreasing intervals from 2011 to 2016, although this was only significant for duration of PORT (p=0.022). Longer time span from surgery to PORT and PORT duration were predictive of superior package times (p<0.001). Five-year overall survival and disease-free survival was 63.8% and 64.8% respectively with no statistically significant impact of waiting times on clinical outcome.

Conclusions: Despite presenting favourable long-term outcomes, patients with locally advanced OPSCC have experienced longer waiting times than recommended. Waiting times were not prognostic factors in this condition, although efforts to reduce it might provide superior quality of care. Future studies assessing the factors involved in treatment delays might provide means to offer timely treatments.  

 

 
Prevalence of sensorineural hearing loss in type 2 diabetes mellitus
Authors: Chavadaki Jyothi Anand , Malli Mohammed Nadeem Afroze
Published: August 2019

Background: The association of sensorineural hearing loss (SNHL) in diabetes mellitus patients is known since decades, yet there is no clear consensus among previous studies, with respect to the prevalence of SNHL in type 2 diabetes patients and the effect of duration and control of diabetes on hearing acuity. Hence the objectives of this study are to find the prevalence of SNHL in type 2 diabetes patients and to find the effect of duration and control of diabetes on hearing loss.

Methods: The present study was conducted on 86 type 2 diabetes patients attending Navodaya Medical College Hospital, Raichur and age and gender matched 86 non- diabetic controls in the age group of 30-65 years, selected based on inclusion and exclusion criteria. After detailed history taking and clinical examination, all subjects underwent FBS, PPBS estimation and HbA1c evaluation was done for diabetic patients. All underwent pure tone audiometry and the findings were recorded and analyzed.  

Results: Diabetes patients had insidious onset, gradually progressive, bilaterally symmetrical SNHL. SNHL is prevalent in 67.44% of type 2 diabetes patients compared to 23.26% of controls. It is aggravated with the increasing age and duration of diabetes. Poor control of diabetes showed increased prevalence of SNHL compared to good control of diabetes.

Conclusions: There is increased prevalence of SNHL in type 2 diabetes patients and it is more evident in patients with long duration of diabetes and more pronounced in patients with poor diabetic control.
A retrospective study on middle ear risk indices in analysing the postoperative outcome following tympanoplasty
Authors: Vignadutt P. , Shaik Ali
Published: August 2019

Background: Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem worldwide especially in developing countries where large percentage of the population lack specialized medical care. A normally functioning eustachian tube is an equally essential physiologic requirement for a healthy middle ear and normal hearing. In this study we have used the middle ear risk index (MERI) developed by Kartush which generates a numeric indicator of the severity of the middle ear disease to stratify patient groups according to the severity of the disease and to evaluate the efficiency of MERI score in predicting the outcome of tympanoplasty.

Methods: Patients who came and got operated for tympanoplasty to the ENT Department in Konaseema Institute of Medical Sciences and RF, Amalapuram during the study period of February 2017 to February 2018.  

Results: In this study graft was accepted in 22 patients (88%) and rejected in 3 (12%) patients. In patients in the mild MERI risk group n=22, graft was accepted in 21 (95%) patients and rejected in 1 patient (5%). Patient had a residual perforation. In patients in the moderate MERI risk group n=2, graft was accepted in 1 (50%) patients and rejected in 1 patient (50%).In severe risk group none of the grafts were accepted (100%).

Conclusions: MERI index is in fact a very useful and honest predictor of the graft uptake and audiological gain in patients undergoing tympanoplasty surgeries for CSOM. Lower the MERI index better the outcome. Positive Belluci criteria were also found to be inversely associated with the graft uptake.