bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge and practice of menstrual hygiene among adolescent school girls in Umunna, Imo State, Southeast Nigeria: implications for parents, healthcare providers and policy makers
Authors: Duru Chika O. , Ikeanyi Eugene M. , Merenu Irene
Published: January 2021

Background: Menstrual hygiene management is critical in the life of the woman. For optimal attendance and participation in school activities, future reproductive and sexual health; quality menstrual hygiene practice is crucial. The objective of this study was designed to assess the knowledge, practice and challenges of menstrual hygiene management among the adolescentsMethods: A cross-sectional study was conducted on a community secondary school girls from 1st May to 30th June 2016.  Data was collected with a semi-structured pre-tested questionnaire and analyzed with statistical software as appropriate.Results: A total of 416 (97.4%) of the respondents were analyzed. Their mean chronological age and age at menarche were 15±2.1 years and 12.9±0.7 years respectively. Most (77.9%) of the respondents had premenarchal menstrual hygiene knowledge and mothers (68.8%) were the main source of information. Sanitary pad (56.3%) and cloth (31.2%) were the most commonly used absorbents.  Sanitary pad use was higher in respondents whose mothers had higher level education (RR=6.3, p<0.001). Most of the respondents changed absorbent twice or less daily (77.4%), bathed at least twice (77.4%), washed vulvoperineal region with soap and water (50.2%) and wiped perineum front to back (72.8%).  Burning (51.9%) and refuse dump (26.0%) were the main disposal methods and 48.1% washed hands before and after changing menstrual absorbent materials. Main menstrual disturbances were abdominal pain (37.7%) and malaise (18.5%) and main intervention was medication from patent medicine store (47.2%). Menstruation-related school absenteeism was 30.8%.Conclusions: There was poor premenarchal menstrual awareness and inappropriate menstrual hygiene practices among adolescent schoolgirls.
A study to assess the gynecological problems among adolescent girls attending gynecology out patient department in secondary care hospital in North East India
Authors: Joshi Reetika , Duomai Veino Kuveio
Published: January 2021

Background: Adolescence is a period of transition between childhood and adulthood. It is marked by enormous biological, physical and psychological changes. The young girls are embarrassed to discuss their gynecolgical problems and are hesitant to seek medical help, however their problems need to be identified and addressed. This study identifies the major health problems faced by adolescent girls.Methods: This research study was conducted at Baptist Christian hospital, Assam from Oct 2019 to Mar 2020. A total of 61 adolescent girls in the age group of 10 to 19 years attending gynecology out patient department of Baptist Christian hospital, Assam were included in this study.Results: Most of the girls who attended the OPD were between 17 to 19 years of age (54%). Maximum number (75%) of girls attain menarche at the mean age of 12.6 years. 55.7% of girls presented with menstrual disorders and the most common menstrual disorder was found to be menorrhagia (32%), followed by oligomenorrhea (29%).Conclusions: This study gives out that young girls must be taught to take care of their body and they must be made aware of their bodily changes during growing up years. Health education regarding menstrual hygiene, menstrual problems and reproductive health should be imparted to them.
Clinico-pathological study of ovarian tumors at tertiary care hospital, Udaipur
Authors: Jain Runjhun , Patel Pooja , Goyal Sharda
Published: January 2021

Background: Diagnosis of malignancy in ovarian tumour is always questionable clinically as well as by investigation. Ovarian tumour arise in any age group and any type of body tissue present in tumour like epithelial tissues, germ cells, embryonic cells due to varied histology of ovary and metastatic non ovarian tumours. Aim and objective of the study was to study the correlation ovarian masses regarding their clinical presentation investigation and histo-pathological report.Methods: All the women who presented with lump and/or pain or menstrual problem attending Gynecology, Surgery and oncology OPD of GMCH, Udaipur. Our study design is prospective hospital based study. The statistical analysis was performed using IBM statistical for social sciences (SPSS).Results: In our study, 85.43% were benign tumour and 12.67% were malignant tumour. Among this, 70.87% were cystic, 14.56% were solid and 14.56% were mixed tumours. Mostly they were epithelial tumours (85.43%). Main surgery was total hysterectomy with bilateral salpingoopherectomy. In malignant tumours 61.53% also had Chemotherapy and 0.97 % had debulking.Conclusions: There is strong correlation of ultrasonography finding with histopathology report. Though clinically it was 55 % only. Specificity of the Ultrasonography was 73.33% but sensitivity was 100%. Positive predictive value was 95.65% and negative predictive value was 100%.
Fetomaternal outcome in pregnancy with oligohydramnios: a prospective study
Authors: Talesara Heena , Shah Vidhi C. C. , Modi Dipti A. , Modi Rahi S.
Published: January 2021

Background: Oligohydramnios is defined as amniotic fluid index <5th percentile or 2 standard deviation below the normal amniotic fluid volume. It affects 4% of all the pregnancy. The aim of this study is to evaluate the etiological risk factor of oligohydramnios and to assess their clinical significance and mode of delivery and maternal and perinatal outcome.Methods: This study was conducted at a tertiary health care centre, SSG Hospital, Baroda, from 1st September 2019 to 30th August 2020. It is a prospective study of 200 cases of oligohydramnios with gestational age > 30 weeks.Results: The most common risk factor associated with oligohydramnios was hypertensive disorder of pregnancy (35%) followed by intra uterine growth restriction (31%), preterm rupture of membranes (17%), post-datism (5%) and about 12% were due to idiopathic causes. Among cases majority were primigravida (43%). Lower segment caesarean section was done in 86 cases (43%), and main indication was fetal distress. There was no maternal mortality in the study. NICU admission for low birth weight (26%), pre-maturity (20%), meconium aspiration syndrome (8%), congenital anomalies (8%). Among congenital anomalies, posterior urethral valve had highest incidence (50%) followed by renal agenesis (25%). The neonatal mortality was 5%.Conclusions: Oligohydramnios adversely affects the perinatal outcome. Therefore, it requires meticulous assessment, prompt detection, timely management and treating underlying condition. However, a favourable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care.
Study of various intrauterine pathologies by hysteroscopy leading to various gynaecological problems
Authors: Agarwal Vandana , Mehani Rekha
Published: January 2021

Background: This study was to diagnose different types of intrauterine pathologies, their locations and relations with clinical presentations (like abnormal uterine bleeding (AUB), recurrent abortions, unexplained infertility and secondary dysmenorrhoea) by hysteroscopy. To know the prevalence and identification of the demographic relations of different intrauterine pathologies and clinical symptoms were observed. This study also aimed in selecting OPD or indoor operative procedure.Methods: Data collection of 144 cases was done with suspicion of intrauterine pathology on the basis of history and clinical examination. They were screened by per abdomen, per speculum, pelvic examination. USG and HSG in cases of infertility were used. Further intrauterine pathologies were explored by hysteroscopyResults: On hysteroscopy no abnormality was detected in 80/144 (55.6%) cases which was the maximum finding observed. AUB 96 (66.7%) was the most common presenting complaint followed by infertility 39 (27.1%). In 96 cases there was no organic pathology. Thickened endometrium was the commonest 17/144 (11.8%) pathology observed by hysteroscopy followed by endometrial polyp 14/144 (9.7%).Conclusions: With increasing demands for one-stop clinics where diagnosis and treatment are offered in same sitting. Diagnostic hysteroscopy by virtue of its diagnostic and therapeutic capabilities can become the procedure of first choice in evaluation of gynaecological problems.
Prevalence and complications of hypothyroidism during pregnancy in western Uttar Pradesh
Authors: Chaudhary Karishma , Mani Poonam , Yadav Lalita , Tyagi Mamta
Published: January 2021

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Uttar Pradesh and its potential complications. A prospective and comparative clinical study to know prevalence of thyroid disorder in pregnancy and pregnancy outcome was done.Methods: Eight Hundred eighty seven pregnant cases from Department of Obstetrics and Gynaecology, Chattrapati Shivaji Subharti Hospital, Meerut were enrolled in the study from the year 2018 to 2020. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4, TSH and Anti-TPO) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Thirty seven patients dropped out from the study.Results: In this study, prevalence of thyroid disorder was 27.28% which was high when compared to other regions in India and in other parts of Asia. Subclinical hypothyroidism and Overt hypothyroidism was 16.57% and 10.71% respectively. Subclinical hypothyroidism was more prevalent and hidden, leading to the poor obstetrical outcome and fetal complications. Rate of miscarriage was high in overt hypothyroid patients.Conclusions: Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder.
Maternal and perinatal outcome in obstetric cholestasis- a prospective observational study
Authors: Anand Ruma S. , Khan Naghma , Malik Najma , Aditya Vani , Singh Reeta
Published: January 2021

Background: The objective of this study was to study the maternal and perinatal outcome of pregnancy complicated by obstetric cholestasis.Methods: This prospective observational study included 80 cases, diagnosed as obstetric cholestasis on the basis of symptoms of persistent pruritus (generalized or localized), biochemical evidence of altered liver function test and excluding other liver and skin disorder. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcome were studied.Results: Incidence of obstetric cholestasis was 1.9%. Majority of women (55%) were primigravida and recurrence rate was 61.1% among multiparous women. Pruritus (generalized) was the cardinal symptoms in 90% patients and mostly (88.7%) presented and diagnosed after 28 weeks i.e. in third trimester. A total of 43.7%women had caesarean section (CS) which was quite high incidence. Most common pregnancy complications included preterm labor (25%), post-partum haemorrhage (13.75%) and preterm premature rupture of membrane (11.25%). Perinatal outcome revealed meconium aspiration (20%), preterm birth (30%), low birth weight (35%), fetal distress (18.75%) and intrauterine fetal death (2.5%). 43.75% neonates required NICU (Neonatal intensive care unit) admission. Serum transaminase levels tended to be higher in patients with poor perinatal outcome such as still birth, fetal distress and meconium stained amniotic fluid. LFT (liver function test) returned to normal in 95% of women and 100% women became symptom free after 6 weeks postpartum.Conclusions: Obstetric cholestasis has an adverse effect on the fetal outcome and hence early diagnosis with careful clinical examination and biochemical testing is essential. Serum abnormality in liver function test (transaminases) tended to be higher in women with poor perinatal outcome.
Adjunctive misoprostol for prevention of post-partum haemorrhage: a pragmatic strategy of selective sequential administration
Authors: Mishra Nalini , Nekkanti Lalitha Priya , Barma Poulami , Mishra Ishan , Mishra Ishan
Published: January 2021

Background: To evaluate the effect of adjunctive misoprostol in preventing postpartum haemorrhage (PPH) by selective administration above threshold bleeding in order to reduce its side effects in comparison with primary prevention with oxytocin alone.Methods: It was a prospective observational cohort study conducted at Government medical College of central India. Population included 500 low risk women delivering vaginally. After having received oxytocin as primary prevention, women were monitored for bleeding by quantitative assessment of blood loss (QBL) using an innovative drape (kept prepared at the point of care) and once bleeding crossed 350 ml mark, alternate women were given 800 µg misoprostol sublingually as an adjuvant (study group) and compared with those who did not receive adjuvant misoprostol (control group). Main outcome measure: Comparing the incidence of PPH and side effects between study and control group.Results: 150 women had blood loss >350 ml which constituted 76 women in study and control group each. Incidence of PPH was significantly less in the study group (10.52 versus 22.36%, p<0.05, RR 0.470 95% CI= 0.216-1.024). Though side effects were more (38.15%) in study group but these were mild in nature and when the number was extrapolated to all recruited women, the incidence came down to 11.6%.Conclusions: Sequential adjuvant misoprostol at 350 ml blood loss after primary prevention with oxytocin is an effective and pragmatic strategy for preventing PPH when compared to oxytocin alone but with reduced overall side effects owing to less number of women receiving misoprostol.
Perinatal and maternal outcome in advanced maternal age, more than or equal to 35 years: a prospective observational study
Authors: Prasad Deepti Nagendra , Madhavth Beena
Published: January 2021

Background: As there is increasing trend with pregnancy being delayed due to various reasons, this topic was studied so as to help patient and health care provider know the effect of advanced age on pregnancy and its outcome both related to mother and fetus. The objective of the study was to evaluate maternal and perinatal outcome in advanced maternal age in terms of fetal outcome, maternal outcome and labour outcome.Methods: 102 pregnant patients of age 35 years and more over 1 year from November 2015 to October 2016 in Holy family hospital, Bandra, Mumbai.Results: Incidence of hypertensive disorders, malpresentation, rate of conception on treatment and caesarean section is more in advanced maternal age.Conclusions: A proper pre-conceptional consultation and intensive antenatal care assessment can reduce the risks in advanced maternal age pregnancy.
A comparative analysis of the cycle fecundity rates associated with ovarian hyperstimulation along with IUI versus medical management in the treatment of mild to moderate oligozoospermia in males
Authors: Acharyya Tanaya , Choudhury Arun Paul
Published: January 2021

Background: To compare the pregnancy rate in infertile couples with mild to moderate oligozoospermia receiving ovarian hyperstimulation and IUI, with that of medical management with CC.Methods: A total 120 couples with males having sperm concentration between 5 to 20 million/ml, normal serum gonadotropins and testosterone, and a presumptively fertile partner were enrolled in this prospective clinical study, during the study period of 19 months, 31st January 2019 till 1st September 2020. 120 couples were divided randomly into two groups A (n=60) and B (n=60). In group A, 60 couples were subdivided equally into 3 groups, each having 20 couples. Ovarian hyperstimulation protocols with IUI were used in different subgroups in group A.  A total of 216 IUI cycles done for 60 couples. While in group B, 60 males with oligozoospermia were prescribed CC treatment 25mg/day on alternate days for 3 months.Results: Out of 60 patients in group A, 24 achieved pregnancy with a cycle fecundity rate of 4% in CC+IUI, 9.87% in HMG+CC+IUI and 21.67% in HMG+IUI. 5 out of 60 patients in group B achieved pregnancy with cycle fecundity rate of 2.78%.Conclusions: These data suggest that acceptable pregnancy rates can be achieved with IUI combined with ovarian hyperstimulation in males with oligozoospermia. The role of CC treatment in males with oligozoospermia in improving the pregnancy outcome is extremely mearge. Thus, owing to the cost effectiveness and non-invasive modality, IUI is preferred prior to other more invasive and potentially costly reproductive technologies in the treatment of male factor subfertility.
Acute abdomen in pregnancy: a case series on clinical presentation and diagnostic dilemma
Authors: Abhirami G. R. , Sathyavani Chennaiahgari , Patil Ravi N.
Published: January 2021

Acute abdomen in pregnancy remains one of the most challenging situation in regard with the diagnosis and management. Pregnancy is a unique state in which the female body undergoes both anatomical and physiological changes which can pose a challenge in diagnosis. This may result in delay in management and increase in maternal and fetal morbidity and mortality. This study was to identify the spectrum of causes, the clinical presentation and diagnostic dilemma of acute abdomen in pregnancy. It was an observational study was done over a period of 3 years which included all the pregnant women who presented with acute abdomen. In this study, eighteen pregnant women presented with acute abdomen. Among the study group, 5.5%, 50% and 44.5% presented in first, second and third trimester respectively. The diagnosis included acute appendicitis in 11.1%, acute cholecystitis in 16.6%, acute pancreatitis in 16.6%, malrotation in 11.1%, uterine rupture 11.1%, rudimentary horn rupture in 22.4% and ovarian cyst torsion in 11.1%. The clinical presentation included pain abdomen (16.6%), pain abdomen and vomiting (44.4%), pain abdomen in shock (39%) and abdominal tenderness (33.3%). The diagnosis was confirmed with ultrasonography in 55.6%, 11.1% women required higher imaging like magnetic resonance imaging (MRI) and 33.3% women were diagnosed on table. Majority of them had good outcome, but there was one maternal mortality (6%). Diagnosis and treatment of acute abdomen in pregnancy should be individualized. Good clinical acumen is essential for ordering early diagnostic test in acute abdomen in pregnancy. Appropriate intervention should be undertaken at the earliest to reduce the maternal and fetal complications.
Choriocarcinoma presenting following a molar pregnancy and preterm vaginal delivery: rarest of rare case
Authors: N. R. Sindhu , Shetty Shraddha
Published: January 2021

Choriocarcinoma is the aggressive histologic type of GTN and is characterized by vascular invasion and metastases of widespread. Choriocarcinoma metastasizes hematogenously. Suction and evacuation were done on admission. Beta-hCG was 67900 mIU/ml and 144523 mIU/ml on day 1 and day 3 respectively and histopathology showed Choriocarcinoma. This is very unusual case of reviewing sequential events. It was difficult to detect is it new pregnancy or choriocarcinoma. Investigators were biased with high beta-hCG values indicating malignancy. So there was differential diagnosis as choriocarcinoma based on history of molar pregnancy and increasing beta-hCG value and also dictum of 'non molar pregnancy following live birth is always choriocarcinoma. However histopathology report suggested choriocarcinoma and was diagnostic.
Appendicular endometriosis: a case report
Authors: Bagdi Priyanka , S. Niranjani
Published: January 2021

Endometriosis is an estrogen-dependent inflammatory disease that affects 8 to 10% of women at reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity. In our case we are presenting a case report of a reproductive age group woman with appendicular endometriosis, because of the presence of pelvic endometriosis combined with an enlarged appendix, the choice was appendectomy, with complete suppression of abdominal symptoms after the surgery, a fact also reported by other authors. We concluded that endometriosis of the appendix is rare and almost never diagnosed before the surgery, with the definitive diagnosis obtained through microscopic examination. However, it should always be taken into account for the diagnosis of chronic pelvic pain, especially in young women complaining of recurrent pain, history of infertility and pelvic endometriosis.
Effectiveness of directly acting oral antivirals in treatment of chronic HCV infection in children - experience from a tertiary care institute in southern India
Authors: Ramalingam Senthil Kumar , Thomas Winston , Dheivamani Nirmala , Elumalai Sathish Kumar
Published: January 2021

Background: Worldwide, an estimated 71 million people are chronically infected with HCV, of which an estimated 2.1- 5.0 million are children aged ≤15 years. Children with chronic HCV infection have fewer treatment options than adults. Very few reports are available on HCV infection, treatment strategies and its outcome particularly in pediatric population. In this background, we evaluated the effectiveness and safety of Sofosbuvir/Ledipasvir in treating HCV infection in children.Methods: In this retrospective study, a total of 33 children with HCV positive status, 12 cases (children above 12 years of age) were selected for treatment. HCV-RNA quantitative assay, genotyping was carried out. Children above 12 years with HCV genotype 1 were treated with tablet ledipasvir-sofosbuvir (90/400 mg) orally once a day as morning dose for 12 weeks. Children with genotype 3 were treated with sofosbuvir 400 mg and weight based ribavirin for 24 weeks. Viral load was repeated after 12 weeks of completion of treatment with antivirals for sustained virological response (SVR 12).Results: Out of the 12 patients 11 patients had genotype 1 (5/11 had subtype-1a and 6/11 had subtype-1b) infection and only 1 patient has genotype 3 (subtype-3a). All of them attained SVR at the end of 12 weeks. The regimen was well tolerated and there were no side effects noted by the children and their caretakers. Drug compliance and the palatability of the drugs were good.Conclusions: Ledipasvir-sofosbuvir combination was highly effective at treating children with chronic HCV genotype 1 infection. The availability of an all oral, direct-acting antiviral regimen for paediatric population with chronic HCV would improve care for patients who currently have limited treatment options.
A study of mean platelet volume in acute ischemic stroke
Authors: Kamat Vivekanand , Kinagi Satish , Patil Anilkumar
Published: January 2021

Background: A stroke is defined by the abrupt onset of neurological deficit that is attributable to a focal vascular cause. Because of the growth in the number of ageing population, the burden of stroke is likely to increase automatically in the coming future. Mean platelet volume (MPV), a marker of platelet function is a physiological variable of hemostatic importance. Changes in MPV play a more important role in hemostasis than platelet count. Very few studies has looked at the association between mean platelet volume and ischemic stroke. So, the objectives were to study mean platelet volume in acute ischemic stroke, the role of mean platelet volume as an independent risk factor in acute ischemic stroke and to study the association between MPV and outcome in patients with acute ischemic stroke.Methods: A cross sectional analytical study was conducted on 60 patients with ischemic stroke identified based on clinical features and MRI of Brain admitted in Mahadevappa Rampure Medical College, Kalaburgi. Mean platelet volume (MPV) on admission was documented and severity of stroke at the presentation and at discharge was assessed using Modified Rankins scale (MRS).Results: Among 60 patients, 40% of the study patients were aged between 60-80 years and 60% of study population were male and 40% female. The co-morbid conditions present were hypertension in 50%, diabetes mellitus in 41% .The MPV was raised (>12.5fl) in 64 %of the patients. The clinical severity of stroke at presentation as determined by the Modified Rankin‘s scale (MRS) were moderate (20%), moderately severe (35%) and severe disability in 36.7% of cases. In our study MPV showed statistically significant correlation with Ischemic stroke severity. Clinical outcome as assessed by comparing MRS at admission and discharge with presentation MPV showed 25% moderately, 30% moderately severe and 23% were severely disabled. However, no statistical significance was seen.Conclusions: We conclude that MPV is raised in acute ischemic stroke and is an independent predictor of the risk of stroke. Higher MPV are associated with more severe stroke and tend to have poorer outcome. Mean platelet volume an indicator of platelet reactivity is a simple and easy test available in panel of hemogram and can serve as a valuable predictor of severity and outcome in acute ischemic stroke patients.
Admission leukocytosis and its implications on intra cerebral haemorrhage
Authors: Velayudham Rajendran , Dasarathan Ramesh , S. Nirumal Khumar , S. Senthil Kumar
Published: January 2021

Background: Intracerebral haemorrhage is one amongst the most common subtype of stroke. It is a catastrophic disease with significant rate of mortality and may lead to severe disabilities. Immediate and effective treatment is a prime requisite of ICH, as rapid mortality occurs within first 24 hours. Definitive diagnosis of ICH is difficult as its symptoms are similar to ischemic stroke. Aim of current investigation was to establish a relationship between intra-cerebral haemorrhage and leukocytosis and to use it as an early tool for detecting haematoma expansion for prognostication and developing newer drugs using a suitable therapeutic target.  Methods: Current investigation was an observational study carried out on 100 patients with intra-cerebral haemorrhage. Differential counts were studied with respect to influence of particular subtypes on hematoma expansion. Follow up NCCT was done after 48 hours of the event.  Results: Results of present investigation revealed that mean age of the patients was 56 years, 82% were males and all the patients were hypertensive. It was observed that majority of patients with neutrophilic leukocytosis, did not show hematoma expansion and neutrophilic leukocytosis was preferentially present in patients with higher initial bleed volumes. Significant association was observed between monocytosis and haematoma expansion and association between lymphocytosis and volume expansion was observed to be non-significant.  Conclusions: Current study findings can aid in early risk stratification and prognostication of ICH patients and can also provide a tool for identification of new therapeutic targets for controlling haematoma expansion.
A study of clinical profile of pneumonia in Shivamogga institute of medical science attached hospital with special reference to curb scoring
Authors: P. Eshwarappa , R. A. Naveen Kumar , M. Ranganatha , G. K. Ranjith Kumar
Published: January 2021

Background: Our study was done to study in detail the clinical profile of cases admitted with pneumonia to Mc Ganna hospital, SIMS, Shivamogga. Aim of the study were to study in detail the clinical profile of pneumonia and to know the morbidity and mortality associated with pneumonia by comparing with CURB score.Methods: Ours is a clinical, prospective, observational and open study. The study subjects were pneumonia patients admitted to Shivamogga institute of medical sciences attached McGann hospital, Shivamogga with signs and symptoms suggestive of pneumonia. After obtaining a detailed history and clinical examination the patients were subjected to relevant investigations. The complete data was collected in specially designed case recording form and transferred into a master chart which is then subjected to statistical analysis.Results: We studied 100 cases of pneumonia, out of which 12 patients presented with confusion, 30 patients presented with raised blood urea nitrogen, 28 patients with raised respiratory rate, and 30 patients with hypotension. CURB score of 0 was observed in 54 patients, score 1 in 16 patients, score 2 in 8 patients and score 3 in 22 patients. Prognosis was good in patients aged less than 50 years and those without any comorbidities. Fever was the most common symptom of presentation.Conclusions: Our study had highlighted the fact that CURB scoring is helpful in triaging pneumonia patients but it is not a good predictor of mortality in pneumonia patients.
Diabetic mastopathy
Authors: Dhanju Avtar S. , Batra Pranjali , Gupta Namit , Manekar Praneet , Khubber Manisha , Singla Deepshikha , Thiyagu K. , Ohri Poonam
Published: January 2021

Diabetic mastopathy is used to describe the breast related complications of diabetes mellitus. It is a benign breast disease. Its accurate diagnosis in appropriate clinical and radiological setting shall avoid unnecessary surgical excision. Authors report a case of 25 years old female, a known case of Type 1 diabetes mellitus who presented with a rare finding of diabetic mastopathy.
Monocytic leukeima masquerading as a cutaneous lesion
Authors: Singh Abhishek , Farheen Shifa , Tripathi Preeti , Sen Arijit , Kashyap Akriti
Published: January 2021

Cutaneous lesions preceding a leukaemia are extremely rare and are referred to as ‘aleukaemic leukaemia cutis’. We present a case of acute monocytic leukaemia where skin infiltration of leukemic cells preceded any blood or bone marrow evidence of leukaemia.  A 67-year-old woman presented with multiple cutaneous nodules all over the body of 3 months duration. Cutaneous examination showed multiple erythematous papules and plaques which were present over the face, trunk, extremities and back. Patient was evaluated at a nearby facility and was found to have normal blood parameters (TLC- 7130/cmm, N-57% L-34% M-09%). A skin biopsy done revealed infiltration of the dermis by atypical cells suggestive of a hematolymphoid malignancy. The patient was then shifted to our institution for tertiary care management. The blood counts over a period of one month showed gradually increasing TLC from an initial normal blood count to one showing absolute monocytosis (TLC-25500/cmm, AMC-3825/cmm) and finally abnormally high TLC (TLC-154050/cmm) with 79% monoblasts and promonocytes suggestive of acute leukaemia. A repeat skin biopsy again showed infiltration of atypical cells in the dermis. IHC done showed the atypical cells to be positive for monocytic markers (CD14, CD64). The patient had now started exhibiting systemic findings corroborating with the cutaneous lesions and skin biopsy. Bone marrow aspirate was hypercellular and showed replacement by monoblasts (82%). Cellular morphology was suggestive of AML-M5. Bone marrow biopsy showed a diffuse replacement of marrow by immature cells/blasts. Flow cytometry reports were also positive for monocytic markers. The patient was hence diagnosed as AML M5 with cutaneous metastasis/leukemia cutis and was immediately started on chemotherapy (3+7). Post induction phase, the patient was in remission and her skin lesions subsided. She was subsequently discharged and advised regular OPD follow up for maintenance therapy. This case is reported for its rarity.
Self-medication practice and associated socio-demographic variables among adult in Morang district of Miklajung rural municipality
Authors: Poudyal Aassmi , Nepal Susmita
Published: January 2021

Background: Self-medication is the selection and use of medicine to treat self-recognized illness. The study’s main purpose was to evaluate the self-medication practice and its associated socio-demographic factors.Methods: A cross-sectional study design was conducted in the Miklajung rural municipality of Morang district. A total of 408 households were selected by systematic random sampling. Participants from age 19-59 years old who had self-medicated for acute diseases in the last three months were included in the study. A semi-structured questionnaire was used as a tool to collect information regarding self-medication. All data extracted from questionnaires were entered and analyzed using SPSS version 20, for the association chi-square test was done.Results: The overall prevalence of self-medication practice in last three months was 61.5%. The most common acute disease for self-medication was common cold 70.5%. More than 50 % of participants had used painkillers as medicine which was brought from the pharmacy, and the source of information on medicine was obtained from pharmacists. The main reason for self-medication practice was due to respondents perceiving illness as minor and cost of health services. The self-medication practice was found associated with occupation, marital status and wealth quintile with p value 0.01, 0.04 and 0.02 respectively.Conclusions: The study revealed a high prevalence of self-medication practice among the adult. There was an association between self-medication practice and socio-demographic factors. People should be educated about the risk and benefit of self-medication practice.
Improvement of paragraph writing skills through direct object techniques for level 1 students D3 study program nutrition science Poltekkes Kemenkes Paxdang
Authors: Wahyuni Sinta , Ningsih Ayu Gustia , Retti Sufia , Wahyuni Neneng
Published: January 2021

Background: Learning to write did not attract the attention of students. This is due to several factors, including: (1) the lack of variation in methods or techniques taught in learning to write, (2) the low value of writing student descriptions. Based on these facts, renewal and refresher in writing learning is needed to arouse students' enthusiasm in writing, especially in improving the ability to write descriptions. The purpose of this study was to prove whether the writing skills of the D3 Nutrition Study Program students at the Poltekkes of the Ministry of Health in Padang could be improved through direct object techniques in learning or not.Methods: The implementation of classroom action research proposed by many experts consists of (1) planning, (2) implementation, (3) observation, and (4) reflection. Students' descriptive paragraph writing skills can be improved through direct object techniques.Results: In the initial test, the average score of students' writing skills was 75.9. After being given action and stabilization in the learning process in two cycles, the average skill of writing descriptive paragraphs of students increased to 80.15 and continued to increase in cycle II, namely 85.83.Conclusions: Thus, it can be concluded that the use of direct object techniques in learning to write descriptive paragraphs can improve students' writing skills, especially in describing objects being observed. The significance can be seen from the unfavorable initial test result data, after giving the action, the test results in cycle I increased and so on also increased in cycle II.
Demographic profile of subjects currently undergoing frontal sinusotomy for frontal sinusitis, in a tertiary health care facility of Punjab
Authors: Munjal Manish , Puri Sanjeev , Chaudhary Anurag , Sharma Sarit , Munjal Shubham , Arora Madhurima , Gupta Dhruv
Published: January 2021

Background: The demographic profile of patients with frontal sinusitis undergoing surgical intervention in the state of Punjab was analysed. The emphasis was on the age, gender and clinical presentation in this prospective study.Methods: In this prospective study 85 patients of clinically diagnosed frontal sinusitis were randomly selected from the Rhinology clinics of Oto-rhino-laryngology services, Dayanand Medical College and Hospital Ludhiana; in a period of one and a half years (June 2008 to December 2009). All patients were taken up for functional endoscopic sinus surgery with frontal sinusotomy.Results: 3 (3.53%) subjects, with frontal sinusitis were in the pediatric age group, 65 (76.47%) were males 20 (23.53%) females. Males outnumbered females by a ratio of 3.25:1. The age range varied from a minimum of 8 to a maximum of 86 years. 16 (18.8%) had a discharge in the right middle meatus and 21 (24.7%) over the Eustachian tube orifice. Right sided deviation of the nasal septum was in 13 (14.1%) patients, septal spur in 4 (4.7%) and hypertrophy of the inferior turbinate in 7 (8.2%).Conclusions: Frontal sinusitis was seen in all ages with a male predominance. Nasal blockage on the right side rather than frank frontal headache was the primary complaint. Purulent discharge in the middle meatus and over the Eustachian type were the common findings. Pathology on histopathology encountered was mucosal hypertrophy followed by polyp in the sinus. There was no correlation of frontal sinusitis with the weight and height of the patients
Effectiveness of structured teaching programme regarding reproductive health on knowledge among adolescent girls in selected school of rural area
Authors: Singh Sarita , Kumar Rohitash , Singh S. K.
Published: January 2021

Background: Reproductive health is a crucial part of general health and central features of human development. WHO reported that nearly one-third of all healthy life lost among adolescent girls because of reproductive health problems. 250 million new cases of STD occur worldwide each year with a high rate in 16-19 years age group.Methods: A quantitative study was carried out in 80 adolescent girls and the non-probability purposive sampling technique was used for the selection of the subjects and the school. The data was collected through of using a structured knowledge questionnaire. A structured teaching program was developed and administered to the adolescent group (13-19 years).Results: The data were analyzed by using descriptive and inferential statistics. The result revealed that after the intervention the mean and standard deviation of the post-test knowledge was 18.41±3.40 being compared to mean and standard deviation of pre-test knowledge 14.06±2.46. The enhancement of knowledge score is the mean difference 4.35. It indicates that there was a significant improvement in the level of knowledge of participants. The calculated t-value (7.39) on analysis of the data was found to be significant at p value 0.05.Conclusions: The study concluded that a structured teaching programme was significant effective to improving the level of knowledge of reproductive health.
A comparative study to assess knowledge regarding tobacco use and its ill effects among school children of district Sirmour Himachal Pradesh
Authors: Verma Kavita , Sharma Anjali , K. Anupama
Published: January 2021

Background: Drug addiction is one of the major problems across the globe. It is seen in various forms like marijuana, tobacco, hashish, cannabis and heroine etc. especially tobacco being the most common. The objective of the study was to assess the knowledge regarding tobacco use and its ill effects among school children of district Sirmour Himachal Pradesh. The objective of this study was to assess the knowledge regarding use of tobacco and ill effects among school children.Methods: The school going (9th-12th standard) boys and girls were taken as study sample. The convenient sampling technique was used.Results: The study findings showed that the pre-test score of girls and boys are different i.e. 49% of girls had excellent pretest score while 56% boys are had excellent pretest knowledge and 51% of girls and 39% of boys had good knowledge where as 5% of boys had average knowledge score. The post-test score findings shows that 43.1% of girls had excellent knowledge, 27.5% of girls had good knowledge and 4.6% of girls had average knowledge while the post-test score of 53.2% of boys had excellent, 16.5% of boys had good and 5.5% of boys had average level of knowledge. The t value 4.264 was found to be highly significant among adolescent boys.Conclusions: This study provides insight into the factors to consider while planning adolescent anti-smoking programs in this and similar settings.
We burn or bury….! why not donate? A comparative study on barriers of organ donation among medical and non-medical students in Puducherry
Authors: J. Barathalakshmi , J. Jayasheela , R. Arulprasad , S. Sriram
Published: January 2021

Background: Organ transplantation is an effective medical care for end- stage organ failure. Health professionals play an important role in raising awareness, motivating, and subsequently increasing the organ donation rates In India, "The Transplantation of Human Organs Act" was legalized in 1994. Yet, organ donation rate in India is very poor (0.34 per million) compared to developed countries. This study was done with the aim to identify the barriers of the organ donation among Medical and Non-Medical students and to compare the Knowledge, awareness and attitude towards donation among Medical and Non-Medical students.Methods: This is a cross sectional study carried out in two months duration, by the Department of Community Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry.Results: Among the 400 participants, 76 percent of students were aware of organ donation, out of which highest awareness (100%) among medical students and lowest (54%) were among arts and science students. Among the four streams, nursing and allied health science students reported better knowledge score of (11.09±2.18), whereas arts and science students reported a lower score of (8.94±2.73), p- value <0.05.Conclusions: The attitude and practice towards organ donation were similar among all streams of students. But the students related to medical field had a better awareness and knowledge compared to non-medical students.
A study on immunization practices amongst private medical practitioners of Bhopal city in central India
Authors: Mahra G. D. , Pandey Vikaas , Saxena D. M. , Kaushal Rituja
Published: January 2021

Background: WHO advocates and highly recommend that National Immunization Programmes (NIPs) should increase collaboration and communication with private providers delivering vaccination services to ameliorate the purpose immunizing beneficiaries efficiently.Methods: It is a cross sectional observational study. It is done to assess immunization practices and other rel-evant aspects amongst private paediatrics practitioners of Bhopal city.Results: After doing appropriate statistical analysis, results revealed that most of the cold chain practices, vaccine administration practices, record keeping and reporting mechanisms were not up to the mark (i.e. p values < 0.05 at 95% confidence interval). However, training and level of experience contributed to improve in certain practice outcomes.Conclusions: Quality of immunization services in private sector could be enhanced by providing training and support to private immunization service providers.
The prevalence of anemia among the tribal children from the western districts of West Bengal, India
Authors: Dolai Tuphan Kanti , Mondal Somnath , Jain Manisha , Mandal Prakas Kumar
Published: January 2021

Background: Tribal population in West Bengal constitutes a significant proportion (5.1%) and the vulnerable group because of lower socio-economic status, poor literacy rate and malnutrition. The present study was conducted to evaluate hemoglobin level and prevalence of anemia among the tribal children from the western districts of West Bengal, India.Methods: A cross-sectional study was conducted on school going (class I to class VIII) tribal children (≥5 to <13years) during March 2019 to February 2020. A complete blood count was done by automated blood cell counter and anemia was classified as per WHO criteria.  They were also tested for markers of common nutritional anemias (serum ferritin, serum vitamin B12 and serum folate). Data entry and analysis was done on SPSS version 15. A p-value of <0.05 was considered statistically significant.Results: Total 1, 010 tribal children were included with male:female=1:1.35. Among these, 46.34% (n=468) children had anemia. Among all anemic children 47.65% (n=223), 51.93% (n=243/468) and 0.42% (n=2) respectively had mild, moderate and severe anemia. There was a high prevalence (81.68%) of microcytic red blood cells in the total cohort; among anemic children, 53.94% have microcytosis while no macrocytosis was revealed. Among all grade anemias, iron, folate and vitamin B12 deficiency were found in 44.65% (n=209/468), 13.24% (n=62/468) and 25% (n=117/468) respectively.Conclusions: The prevalence of anemia among tribal children of West Bengal is a matter of concern. The high prevalence of microcytic indices in non-anemic population highlights the dire need for screening for the causes of anemia in this population.
A knowledge and attitude of school teachers towards learning disabilities in Bishnupur district, Manipur: a cross sectional study
Authors: Asok Anaswara S. , Akoijam Pooja , Gupta Avantika , Akoijam Brogen Singh
Published: January 2021

Background: Learning problems significantly interfere with academic activities that require reading, mathematical or writing skills. In India 10-14% of children have specific learning disability. The teacher with adequate knowledge of learning disabilities and skills or competencies can do better justice to the children than teacher with general pedagogy backgrounds. The study aimed to assess the teacher’s knowledge and attitude towards learning disabilities and to determine the association between knowledge and attitude with their background characteristics.Methods: A cross sectional study was conducted among 181 teachers of both government and private schools of Bishnupur. Data collected using self-administered questionnaires assessing the knowledge and attitude. Data entered in IBM SPSS 21. Data was expressed using descriptive statistics like frequencies and percentages. Chi-square test   was used to check significance between proportions.Results: Data was collected from 181 teachers. Mean age of participants was 42.7±1 and 59.1% of them worked in govt. schools and 40.9% in private. 48.1% of them had adequate knowledge on learning disabilities. Majority (93.9%) had favourable attitude. Association between type of school the teachers taught and knowledge was found to be significant (p<0.05). There was no significant association between attitude with any of the socio-demographic variables.Conclusions: More than half of the teachers had inadequate knowledge on learning disabilities while majority of them had favourable attitude. Teachers belonging to govt. schools had better knowledge on learning disabilities.
Biostatistics: road less travelled
Authors: Dharaiya Darshankumar K.
Published: January 2021

Initially developed as a branch of mathematics, biostatistics has evolved to take important position in the field biomedical research including medicine. Currently biostatistics has been used in almost all areas of biomedical research as well as treatment and planning for heath related programmes and resource distribution. Despite being of paramount importance, biostatistics is the field which is mostly neglected by students and professionals due to various reason which can have long-term impact on education, research, treatment and health programs and policy making as well. Very few institutes are providing training in the field of biostatics and less and less scholars are taking interest in that training. Researchers have come up with newer approaches to teach the subject and they have shown encouraging results, but still its long way to statistical literacy in the medical field.