bluuebunny/crossref_metadata_2025 huggingface dataset:
Socioeconomic status on pregnancy outcomes in Indian scenario
Authors: Patel Santosh , Jain Swati , Babu G. Chitti , Kumar Masuram Bharath
Published: December 2020

Background: Socioeconomic status (SES) is one of the main components related with clinical outcomes. At the point when SES is low, clinical consideration is lacking and this has been credited to unfriendly results include anemia and pregnancy-induced hypertension.Methods: The study was conducted in the Department of obstetrics and gynecology and the Department of Community Medicine of a private Hospital, for one year. Data was collected using a questionnaire by interview. Study variables included monthly income (i.e. Rs. 12000) lifestyle, eating habits and type and amount of food consumed, a pattern of health care utilization, chronic illness, history of illicit and employment status of husband and women.Results: In the current study, the majority of 83 (67.4%) participants were between 18 and 19 years of age, with their mean age being 18.1±2.3 years, and 108 (87.8%) were Hindus by religion. As many as 113 (91.8%) teens were housewives and 42 (34.1%) of their husbands were factory workers. Most 59 (47.9%) of the teens belonged to class IV socioeconomic status as per modified BG Prasad classification and 93 (75.6%) were living in a joint family.Conclusions: The mean age of participants was 18.1 years, and that of marriage was 17 years and this occurrence of pregnancy in teenagers leads to adverse outcomes. Thus, periodic information, education and communication activities have to be held, and the child marriage act has to be strictly enforced to improve their health.
The level of residue of pesticides in vegetables by GC-MS, health risk and the negligence in implementation of policies, India
Authors: Khan Azra , Srivastava J. P. , Bose Dipak Kumar
Published: December 2020

Background: Over the past years there has been an increase in the use of pesticides in vegetable farming developing countries. This study describes over spraying pesticide use among small-scale farmers in Jasra block of Allahabad district of Uttar Pradesh.Methods: The purpose of this study was proposed to determine the pesticide residual level in 120 vegetable samples like brinjal, lady finger, tomato, chili, cabbage analysed by (GC-MS) gas chromatography mass spectrophotometry technique. Assessing the health risk due to the daily consumption of contaminated vegetables Jasra block of Allahabad district.Results: Samples were contaminated with organophosphorus group namely chlorpyriphos in bringal 1.215 mg/kg, and less carbamate (carbaryl) from 0.025 mg/kg, ladyfinger with the concentration of  chlorpyriphos 0.418 mg/kg carbaryl 0.092 with very less residue of dichlorvos 0.005, green chilli with the concentration of chloropyriphos 1.507 mg/kg. Carbaryl 0.033 mg/kg, tomato with the concentration of chlorpyriphos 1.631mg/kg followed by less carbaryl 0.026 mg/kg, malathione, 1.890 mg/kg followed by cabbage with the concentration of chlorphyriphos 1.907 mg/kg. And less carbaryl concentration was recorded 0.064 mg/kg.Conclusions: Five vegetable with pesticides residues, exceeding the maximum residue level (MRL) recommended by FSSAI, FAO/WHO. Farmers over spraying methods leads to acute diseases like respiratory tract infection, extreme weakness, and longer use  pesticides exposure leads to chronic diseases like asthma, anxiety, depression, cancer, leukemia, allergies, nausea, vomiting, headache, blur vision, skin itching etc.to minimize the risk of diseases policy making and farmer protection standard and proper handling techniques, trained professionals to improve health safety.
Interpreting Kaplan Meier’s survival curve in COVID-19 patients: a systematic review
Authors: Tapnikar Lata Ajay , Patil Sneha , Nyse Jaydeep
Published: December 2020

Covid 19 is the causative agent of coronavirus disease in 2019-2020; was declared a pandemic by the World Health Organization on 11th March 2020. The article aims to interpret the functionality of Kaplan Meier’s survival curve used in various study designs. The search strategy and selection of published works in the MEDLINE database from the National Library of Medicine (NLM) was used to identify original journal articles published in English from March 1, 2020 to September 11, 2020. The search strings in title/abstract were ‘COVID-19’ or ‘coronavirus’ or and ‘Kaplan Meier curve’ that yielded 225 articles. Finally only 28 articles were reviewed. These were clinical trials (N=1), and retrospective (N=10) and prospective (N=1) observational studies (N=2), case control study (N=1) retrospective cohort study (N=6), medical record based study (N=3), observational studies (N=2), not specified (N=1), diagnostic test (N=1). 88% of articles were from China. Kaplan Meier’s curve was depicted in all the studies and 17 were found to be highly significant for KM curve, 2 were found significant as 6 were found to be non significant and in 3 no mention of significance of p value was given. It was concluded that it is the first systematic review to date related to interpreting Kaplan Meier’s survival curve in patients with COVID-19. The  graph has been used singularly, in multiples and cumulatively, thus giving visual assessment which enhances the interpretation of results for survival analysis, failure to time and time to event plots. It is not only used in RCT study designs but a range of observational and retrospective studies.
Pharmacologic agents for the management of COVID-19: a review
Authors: Hassan Syeda Maria , Sohail Hamza , Iftikhar Abeer , Rathore Rabia , Fatima Qandeel
Published: December 2020

Coronavirus, in December 2019, caused a SARS-2 pandemic. Primarily targeting the human respiratory system, the major symptoms of this disease are high grade fever, dry cough, shortness of breath, sore throat, and fatigue while symptoms involving other organ systems such as diarrhea, headache, conjunctivitis, and rash also develops. Like a SARS-CoV-1 outbreak in 2002, SARS-CoV-2 is difficult to treat as minimal data is available regarding its treatment strategies and potential cure of the disease. A thorough literature review was done to identify different potential treatments for SARS-CoV-2 and a perspective of a developing country, Pakistan, on managing and treating this infection was provided. We found that use of off-label drugs including including chloroquine, hydroxychloroquine, remdesivir, azithromycin, interferon, ribavirin, lopinavir-ritonavir, increased exponentially to treat COVID-19 patients around the world and studies suggested their efficacy against SARS-CoV-2. Use of adjunctive therapies including convalescent plasma, interferons, and corticosteroids also showed positive results in slowing down the progression of the disease. Different clinical trials are being conducted around the world to identify drugs and develop vaccine against infection caused by this deadly virus. Use of these off-label drugs and adjunctive therapies was also seen in a developing Country like Pakistan, which need desperate measures to overcome COVID-19 disease burden on the country’s people and the economy. Coronavirus is infecting thousands of people daily, worldwide. Major action including upgrading medical facilities, investing in health care sector, developing effective drugs, must be taken in both developed and developing countries like Pakistan to fight, contain and prevent future pandemics.
Overview on Cigarettes and Other Tobacco Products Act and its implementation: current update
Authors: Thakore Dhwanit , Chavda Mahesh , Parmar Girish , Sheth Tejal
Published: December 2020

Tobacco use- a major public health issue in India has an enormous effect on the lower SES population. . There is an evident link between tobacco use or consumption and poverty. The widespread use of almost all forms of tobacco among the Indian population can be attributed to the social and cultural acceptance in the country. Cigarette and Other Tobacco Products Act, 2003 (COTPA) is the legislation that regulates tobacco in India. The prime objective of this review is to compile the literature with information about the laws regulating tobacco use and the status of implementation of tobacco control provisions covered under COTPA. Since effective tobacco control measures involve multi-stakeholders i.e public health, law, trade and commerce, industry, consumer, human rights and child development, coordinated efforts are required to successful enforcement. The outcome of the current literature is bridging the gaps to make the tobacco control a very important public health goal and thereby protect the population from the consequent morbidity and mortality due to tobacco use.
Cricoid pressure controversies
Authors: Kaur Harpreet , Pareek Ravi , Harsh Harsh Kumar , Shukla Veena , Tulsyan Nitin
Published: December 2020

Rapid sequence induction (RSI) is a common technique used in clinical anaesthesia to prevent pulmonary aspiration of gastric contents. Sellick introduced this in 1961. However, scientific validation to show the advantage of this technique in preventing aspiration is limited in literature. Numerous researches have shown that cricoid pressure (CP) application might have no benefit in preventing aspiration. Additionally this could lead to problems in securing the airway. Proper teaching and regular training sessions of this technique are mandatory in routine anaesthesia practice.
Promotion of mental health and well-being in Indian prisons
Authors: Mishra Arjyalopa , Shreya Amartya , Shukla Anuj
Published: December 2020

Decades of study on prison sociology have sought answers to questions pertaining to the social organization of the prison community. Various researchers expressed their opinion, stating that incarceration has a negative psychological impact. Indian Prisons framework it is seen that the penitentiaries are exceptionally stuffed, this in a situation where the crime percentage has expanded alarmingly which further extends the overburdened detainment facilities. This study is aims to review the documentation of committee reports which were attempts to observe the changes in the Indian Prison Structure. It also makes an attempt to explore the behavior, cognitions and emotional adjustments as different variables in understanding the adaptation process in the Prison set up. Overall, it also attempts to highlight the state of wellbeing and promotion of mental health in the Indian Correctional Systems as major reforms to be incorporated.
Economic impact of COVID-19 on the Indian healthcare sector: an overview
Authors: Shukla Divyanshu , Pradhan Arvind , Malik Parul
Published: December 2020

A fearsome health calamity- the novel coronavirus of 2019 struck the world and created havoc with its rapid spread. Various countries got affected in terms of economic and other losses and the extent of impact depended on the pre-existing financial arrangement of the country and various other factors. Due to this outbreak, healthcare sector was one of the worst affected. Also, it needed most investment and had to respond quickly and effectively to manage this crisis. Among the countries affected, India- a financial centre with significant worldwide connectivity was impacted directly, leading to an imminent breakdown of economical markets. This paper tries to understand the different aspects of economic challenges faced by the Indian healthcare system and devise the possible measures to overcome the effect of COVID-19 pandemic in India. It analyses the short term and possible long-term impact of this pandemic on the health care sector of India in terms of efficiency and equity. The Indian Government had acted rapidly to allocate funds, resources and manpower. It announced relief packages for the marginalized communities and covered costs. Specific research centres in the country need to work to quickly mitigate any further damage.
Advancement of existing healthcare setting through tele-medicine: the challenges faced in India
Authors: B. Swarna Priya , Srinath Kalepu , Jammalamadaka Anagha , Hindodi Anurita
Published: December 2020

Telemedicine is the mixed structure of tele-communication technologies and quality health care making it feasible for general populace to obtain superlative healthcare. Starting from video chat for medical services in 2000 to e-Sanjeevani OPD 2020, Indian healthcare reform has come a long way in achieving sustainable healthcare in which, the setting up of the National Telemedicine Taskforce by the Health Ministry of India, in 2005, played a huge role for various projects like the ICMR-AROGYASREE, NeHA and VRCs. Despite the lack of awareness among common public on Tele-medicine, it has a lot of benefits on existing health care settings which makes it to thrive and progress within a decade. Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. This article in brief discusses on the changes and advancement of traditional healthcare system, realizing the pace of timeline in bringing Tele-medicine into practice. As, international telemedicine initiatives are attaining quality healthcare, this article also describes the challenges of telemedicine in Indian healthcare settings.
Mechanical System Evolution and Reasonable Structural Design Parameters of Long-Span Deck-Type Beam-Arch Composite Rigid Frame Bridge
Authors: Ding Yanchao , Xiang Zhongfu , Li Yayong , Zhang Xuesong , Zhou Yin
Published: December 2020

Long-span deck-type beam-arch composite rigid frame (BACRF) bridge fully integrates the merits of arch bridges and beam bridges, and overcomes the cracking and deflection problems of continuous rigid frame bridges. As a perfect combination of beam bridges and arch bridges, the long-span deck-type BACRF bridge boasts a light structure, a strong bearing capacity, and a powerful spanning capability. From the perspective of mechanical system evolution, this paper theoretically analyzes the structural mechanics of the beam-arch composite system, establishes a half-bridge model for BACRF bridge, and derives the expressions of the internal force and displacement of the beam-arch composite system. Next, finite-element analysis was conducted to analyze how the variation of a single parameter, e.g., rise-span ratio, open web ratio, and side-to-middle span ratio, affects midspan displacement, arch-beam junction displacement, main beam bending moment, and main arch axial force. Finally, the calculation formula for deflection-span ratio of BACRF bridge was proposed based on the maximum hyperplane method. The research results provide a reference for the structural design of similar bridges.
Bio-pellets Manufacture from Palm Fruit Skin as Renewable Alternative Fuels in Updraft Type Gasification Furnaces
Authors: Abdurrahman Ridwan , Syafitri Radja Masyita Aulya , Ridwan Abrar , Utami Lega Putri
Published: December 2020

Biomass is a suitable alternative to be used as fuel, but the use of biomass without prior processing can cause respiratory disease. In Indragiri Hilir Regency, the utilization of palm fruit skin waste is still minimal. Bio-pellet is a fuel derived from biomass waste that has gone through a densification process. The process of making bio-pellets is carried out by refining the raw materials, mixing the adhesives, printing the raw materials that are pressed under high pressure, and drying. The results of the research on the bio-pellet characteristic test of Nipah fruit peel waste according to its parameters obtained an average value of 1.28% water content, 0.51% ash content, 21.3% flying substance content, 76.88% bound carbon content and weight. type 1.41 gr / cm3. For the combustion test in the updraft type gasification furnace with the addition of 0.5kg, 0.3kg and 0.2kg of fuel, the results obtained from the rate of fuel consumption are 0.041kg / minute, 0.033kg / minute and 0.033kg respectively. /minute. In the results of combustion efficiency, the value according to SNI 7926: 2013 is the addition of 0.5kg of fuel at the beginning of ignition and 0.2 kg at the end of ignition, which is 0.04.
Does the Crisis Change the Nature of Agglomeration Economies in Indonesia?
Authors: Khoirunurrofik
Published: December 2020

By examining their source and magnitude, this paper looked at the changes in the nature of Indonesia’s agglomeration economies over three distinct, successive periods: the pre-crisis boom (1990–1996), the deep crisis (1997–2000), and the post-crisis recovery (2001-2010). We found that economies of localisation and urbanisation are both present during the observation periods, with the former generating a stronger effect than the latter. Furthermore, types of agglomeration externalities have significant relationship with variations in size of plants and industrial sectors. These factors shed some light on the nature of agglomeration economies and how the agglomeration sources changed across the crisis periods in favour of localisation economies. The results also demonstrate the industry life cycle at work, as evidenced by changing industry structure during the recovery period.
A Descriptive Study on Levels of Serum Bilirubin and GammaGlutamyl-Transferase (GGT) in Patients of Acute Coronary Syndrome Visiting a Tertiary Care Hospital of Southern Bihar
Authors: Gupta Nitin Kumar , Singh Abhilasha , Goyal Rajan , Kamendu Abhishek
Published: December 2020

BACKGROUND Most cases of ACS (Acute Coronary Syndrome) are caused by rupture of an atherosclerotic plaque in a coronary artery, resulting in the formation of a thrombus. Atherosclerosis results from an over balance between radical generating, compared with radical scavenging systems, a condition called oxidative stress. Bilirubin had some role in mechanism of ACS. We wanted to evaluate the association between raised total bilirubin level and GGT levels with different subsets of acute coronary syndrome. METHODS The present descriptive cross-sectional study was conducted at Narayan Medical College and Hospital from July 2019 to April 2020. Total serum bilirubin was measured in the laboratory by spectrophotometry method. Gamma glutamyl transferase levels were measured in all the patients using a standardized photometric method. RESULTS In our study the mean value of triglyceride is 159.86 ± 42.36 with range 60 - 246. Total bilirubin 2.23 ± 0.827, with range 1 - 4. The value of gamma glutaraldehyde was 56.67 ± 26.48 with range 22 - 104. On studying the correlation of serum bilirubin and serum triglyceride in our study subjects, we found very mild correlation with an R square of 0.028. On finding correlation of GGT and serum triglyceride in our study subjects. We found almost no correlation with R square 0. When we do multivariate analysis of effect of serum bilirubin, GGT on total cholesterol level we found that there is very mild correlation with R square 0.031. CONCLUSIONS In our study there was very mild correlation between serum bilirubin and gamma glutamyl transferase with marker of acute coronary syndrome such as serum triglyceride level and total cholesterol level but the association was significant. KEYWORDS Acute Coronary Syndrome, Triglyceride, Bilirubin, Gamma Glutaraldehyde
A Clinical Comparative Study between Epidurally Administered Ropivacaine 0.2 % and Ropivacaine 0.2 % with Clonidine for Post-Operative Analgesia in Lower Limb and Abdominal Surgeries
Authors: V.M Vishwanath , R.B Ravishankar
Published: December 2020

BACKGROUND There are many modalities to give postoperative analgesia. Out of them epidural analgesia offers good reliable pain relief. Addition of alpha agonist enhances the onset of analgesia and duration of analgesia is prolonged. This study was done to compare the analgesic efficacy, and the hemodynamic parameters of ropivacaine compared with ropivacaine in combination with clonidine for post-operative epidural analgesia. METHODS 30 patients of age 18 - 70 years with ASA grade of I & II, undergoing elective lower limb and abdominal surgeries were randomly taken into each of the 2 groups. Group R received 0.2 % ropivacaine and group RC received 0.2 % ropivacaine + clonidine (1 mcg / Kg) epidurally.1,2 Patients were monitored for onset, duration, quality of analgesia, cardiorespiratory stability and side effects. RESULTS The onset of analgesia and quality of analgesia were better in the RC group compared to the R group. The duration of analgesia in group RC (9.43 + - 1.17 hours) was found to be significantly prolonged than group R (4.90 + - 1.03 hours) with p < 0.001. Blood pressure was more stable in group RC compared to group R. CONCLUSIONS In this study we found that ropivacaine with clonidine as epidural postoperative analgesia provided superior and more effective analgesia when compared to ropivacaine. The duration of analgesia was significantly longer in group ropivacaine with clonidine. KEYWORDS Ropivacaine, Clonidine, Post-operative Analgesia, Epidural
Effect of Pre-Anaesthetic Evaluation on Complication Free Outcome among Day-Care ENT Surgeries in a Tertiary Care Hospital
Authors: C.G Jayachandran , James Naiji S. , P.R Ushakumari
Published: December 2020

BACKGROUND Day-care surgery in all the surgical specialities has become an accepted and popular method among the health care personnel and patients. Lesser demand for in-patient beds and lower cost of hospital stay are making this therapeutic modality more acceptable. Current concepts in anaesthesia, availability of newer anaesthetic drugs and surgical methods have helped in achieving progress of daycare surgeries. Pre-anaesthetic evaluation of patients determine their fitness for day-care anaesthesia and surgery, and at times guide the anaesthesiologist in formulating appropriate plans and strategies. We wanted to observe the demography of patients undergoing day-care surgery and estimate the proportion of complication free outcome among day-care ENT procedures following preanaesthetic evaluation. METHODS 96 patients aged between 18 and 60 years undergoing day-care ENT surgeries for which pre-anaesthetic evaluation was done were included. Demographic data was obtained, thorough pre-anaesthetic evaluation and detailed clinical ENT examination were done. Nature of anaesthesia given, duration of the surgery and severity of the postoperative pain were recorded. Analgesic protocol undertaken during recovery period and associated symptoms were recorded. RESULTS Out of 96 patients 55 (57.29) were males and 41 (42.70 %) were females with a male to female ratio of 1.4:1. The mean age was 31.50 ± 4.15 years. 32 / 96 (33.33 %) ear surgeries, 26 / 96 (27.08 %) nose surgeries, 22 / 96 (22.91 %) throat surgeries and 16 / 96 (16.66 %) head and neck surgeries were performed. The smallest mean duration of surgery was 13.30 ± 02.5 minutes for removal of foreign body in the ear and the largest mean duration of surgery was for cortical mastoidectomy, 91.65 ± 6.20 minutes. Postoperative pain was present in 93 / 96 (96.87 %) of the patients varying from class I to class V of Verbal Pain Intensity Score (VPIS). CONCLUSIONS To manage patients undergoing day-care surgeries, efficient pre-anaesthetic evaluation is essential. It should include proper selection of patients, assessing the nature of surgery, analysis of comorbid conditions, counselling patients regarding type of anaesthesia and postoperative pain management. The postoperative pain and associated symptoms should be assessed and monitored periodically and should be managed by trained health care personnel to avoid unplanned overnight stays. KEYWORDS ENT, Anaesthesia, Day-Care Surgery, Complications, Pre-Anaesthetic Medication and Post-Operative Outcome
Histopathological Changes in Helicobacter pylori Associated Gastritis and Scope of Special Stain and Immunohistochemistry as Diagnostic Aids
Authors: Elias Ruby Elizabeth , Gisuthan Bindiya , A.S Sreeganesh
Published: December 2020

BACKGROUND Helicobacter pylori associated chronic gastritis plays a vital role in the development of majority of gastric adenocarcinomas and most gastric MALT (Mucosa Associated Lymphoid Tissue) lymphomas. Many diagnostic methods are available for the identification of this organism. However, in gastroenterology practice, histopathological examination of biopsy samples provides visual identification of the pathogen and the associated mucosal changes with special stains like Giemsa. The aim of this study was to evaluate the efficacy of three stains H & E- (Haematoxylin and Eosin), Giemsa and IHC (Immunohistochemistry) in the identification of H. pylori. Associated histologic changes were noted and the relationship between the degree of colonisation and the activity and chronicity of gastritis were analysed. METHODS 585 gastric biopsies taken from dyspeptic patients were evaluated for gastritis, based on updated Sydney System. In 250 randomly selected cases, three staining methods were used. RESULTS Out of 585 cases, 413 (70.60 %) had features of chronic gastritis. Mild chronic gastritis was the commonest finding and is seen in most cases of mild H. pylori colonisation. When activity was monitored, mild activity was the most frequent finding [225 (38.46 %)]. Majority of the severe activity cases showed severe H. pylori colonisation. 13.16 %, 4.79 % and 7.35 % showed intestinal metaplasia, atrophy and dysplastic changes respectively. Out of 250 cases, H & E and Giemsa stains showed 45.6 % and 57.2 % positivity while IHC demonstrated maximum number of positivity (156 cases - 62.4 %). Sensitivity and specificity of H & E was found to be 77.90 % and 98.95 %, positive predictive value was 99.13 % and negative predictive value was 69.18 %. For Giemsa stain, sensitivity was 91.67 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 87.85 %. DISCUSSION H. pylori gastritis was a frequent finding in dyspeptic patients in southern part of India. When chi-square test was done, a significant statistical relationship between the severity of H. pylori colonisation, activity and chronicity of gastritis was noted. P value was < 0.001. With the use of special stain, Giemsa and ancillary techniques like IHC, the detection rate of H. pylori was enhanced considerably. CONCLUSIONS With increasing number of H. pylori in the mucosa, there was increase in the chronicity and activity of gastritis. Although immunohistochemistry revealed more cases of H. pylori, Giemsa can be a cost-effective substitute, because of its high specificity and positive predictive value. KEYWORDS H. pylori Gastritis, Giemsa, Haematoxylin and Eosin Stain, Immunohistochemistry
A Study of Allergic Rhinitis with Special Reference to Use of Intranasal Corticosteroid in Its Treatment in a Tertiary Care Hospital
Authors: Mukherjee Diptanshu , De Maumita , Bandyopadhyay Saumendra Nath
Published: December 2020

BACKGROUND Allergic rhinitis is a fairly common condition. A large number of patients of allergic rhinitis are usually found in daily ENT practice. Symptoms of allergic rhinitis are still a major problem, which can affect day to day activities of an individual. Intranasal corticosteroid has potent anti-inflammatory actions and is believed to exert its beneficial effects by inhibiting several types of cells and chemicals involved in immune and inflammatory responses. Present study determines the efficacy of intra nasal corticosteroid over placebo in patients of allergic rhinitis. METHODS A single blinded non-randomised trial was conducted among patients attending allergy clinic of ENT out-patient department of a Tertiary Medical College & Hospital of West Bengal, India from March 2008 to May 2008. Two groups of patients were selected from the total sample size of 100 patients by alternate sampling technique. One group (Gr-F) was treated by intranasal corticosteroid (fluticasone nasal spray) and the other group (Gr-P) by placebo (normal saline aqueous spray) for 6 consecutive weeks. Patients were asked about their subjective feeling of symptoms and relevant examinations & investigations were carried out. Improvements following treatment were judged by total nasal symptoms scoring. Collected data were analysed using SPSS version 20. McNemar’s test was carried out on paired nominal data and p value of < 0.05 was considered to be statistically significant. RESULTS The present study revealed that 69 % male and 31 % female were suffering from allergic rhinitis. Most common symptom was nasal discharge followed by sneezing and nasal obstruction. 41 % had family history of allergic rhinitis. It was seen that inflamed nasal mucosa reverts back to normal in 35 % in fluticasone group after 6 weeks of treatment. Study also showed the decrease of blood eosinophil count in 60 % of patients in fluticasone group. 92 % of patients in the fluticasone group revealed that they improved after taking the drug, whereas 88 % of patients in placebo group did not improve after taking spray. CONCLUSIONS It can be concluded from the present study that intra nasal corticosteroid spray is more effective than placebo for treatment of allergic rhinitis. KEYWORDS Allergic Rhinitis, Intranasal, Fluticasone, Corticosteroid, Normal Saline, Efficacy
A Comparison of Wilson Risk Sum Score and Combination of Modified Mallampati Classification, Hyomental Distance Ratio, Ratio of Height to Sternomental and Thyromental Distances for Predicting Difficult Laryngoscopy in Indian Population
Authors: Kumar Deepak , Bhargava Saurabh , Sisodiya Ravindra Singh , Tiwari Deepak
Published: December 2020

BACKGROUND A few patients of apparently normal appearance unexpectedly present with great difficulties during intubation which may lead to potentially serious consequences. Thus, we worked on this area with the aim to determine the ability to predict difficult visualisation of larynx using the following preoperative airway predictors: MMC (Modified Mallampati Classification), RHSMD (Ratio of Height to Sternomental Distance), RHTMD (Ratio of Height to Thyromental) and HMDR (Hyomental Distance Ratio) and comparison of these with WRSS (Wilson Risk Sum Score), in isolation and in combination. METHODS A double-blind, prospective study was carried out on 300, ASA grade I or II patients posted for elective surgery in supine position under general anaesthesia. Different parameters were recorded in pre-op period and Cormack-Lehane grading and difficulty of intubation was recorded at the time of intubation. Chi Square test and receiver operating curve were used to assess the association of all the airway tests and various combinations with CL grading. Cohen’s kappa was calculated to determine the strength of agreement between laryngoscopy grade and various tests in isolation and combinations. RESULTS In our study, highest strength of agreement was found with WRSS of 0.925 (0.873 - 0.976) and only a fair agreement was seen with HMDR (κ = 0.319). RHSMD and combination of RHSMD + MMC showed good strength with kappa of 0.638 and 0.634 respectively. CONCLUSIONS No single test or group of tests was able to predict all cases of difficult laryngoscopy at the preoperative airway assessment. Wilson Risk Sum Score was found to be the best predictor of difficult laryngoscopy when compared to MMC, RHTMD, RHSMD and HMDR in isolation and any possible combination. KEYWORDS Difficult Laryngoscopy, Difficult Intubation, Wilson Risk Sum Score, Airway, RHSMD, RHTMD
A Clinical Study on Peripheral Ulcerative Keratitis of Non-Infective Aetiology
Authors: Arumugam Sudarvizhi , Vadivelu Sharmila Devi , Senthilkumar Niranjan Karthik , Babu Meenakshi , Mohan Sivakami
Published: December 2020

BACKGROUND Peripheral ulcerative keratitis (PUK) is a destructive inflammatory disease of the juxta-limbal corneal stroma that is caused by various infectious and non-infectious ocular and systemic diseases. Certain morphologic and immunologic characteristics of peripheral cornea make it more vulnerable to inflammatory reactions and necrosis. Early diagnosis and prompt treatment prevent blindness due to this devastating inflammatory condition. We wanted to study the aetiology, clinical features and outcome of various treatment modalities of peripheral ulcerative keratitis of non-infective aetiology. METHODS 54 eyes of 40 patients with peripheral ulcerative keratitis of non-infective aetiology were evaluated and treated with either medical or surgical therapy or both in a tertiary care centre and were followed up. The total study duration was 12 months. RESULTS 60 percent of cases were males (24 / 40). The most common age group affected was 60 - 70 years (32.5 %) and the mean age in our study group was 57.7 ± 18.33 years. 65 % were unilateral (26 / 40). In our study 15 eyes (27.77 %) had meibomitis. 13 % of eyes had mild involvement, 40.8 % eyes had moderate involvement, 46.2 % eyes had severe involvement. Severe involvement was the most common presentation. The incidence of perforated PUK in the study group was 20.37 % (11 / 54 eyes). 45 % were found to have unknown aetiology. Of the remaining, the most common aetiology was Mooren's ulcer (32.5 %) followed by rheumatoid arthritis (20 %) and Systemic Lupus Erythematosus (2.5 %). Among 54 eyes, the resolution of signs of active PUK was seen in 50 eyes (92.59 %) after treatment. Visual acuity improvement noted on comparison of mean of pretreatment visual acuity 0.90 with standard deviation 0.39 and the mean of post treatment visual acuity 0.62 with standard deviation 0.37 logarithm of minimum angle of resolution units with P value is < 0.001 which is significant. For perforated peripheral ulcerative keratitis eyes, patch graft was found to be successful in 87.5 %. Peritomy was successful in 100 % and peritomy with amniotic membrane graft was successful in 70 %. CONCLUSIONS In our study, male patients were more than female and the commonest presentation was unilateral. Most common aetiology was idiopathic followed by Mooren's ulcer, rheumatoid arthritis and systemic lupus erythematosus. Mild to moderate cases respond well to medical management. Severe cases need immunosuppressants. Perforated cases needs surgical intervention especially patch graft which is better in achieving good anatomical integrity and enhanced visual acuity. Early referral of patients with peripheral ulcerative keratitis to a tertiary care centre helps in early treatment which is beneficial in avoiding blindness. KEYWORDS Peripheral Ulcerative Keratitis, Non Infective, Immunosuppressants, Patch Graft
A Study of Histopathological Profile of Liver in Paediatric Choledochal Cysts
Authors: G.J. Vani Padmaja , Krishna Othuluru Radhika , Siddiqa Seereen , Reddy Mandakini Kotaiah Srinivas , Reddy Kota Ramesh
Published: December 2020

BACKGROUND Choledochal cysts are rare congenital dilatations of the biliary tract with an incidence of approximately 1 in 1000 live births. Most cases present with jaundice or other obstructive symptoms and are treated by surgical resection of the cyst and re-anastomosis. A liver biopsy at the time of surgery is mandatory to study the histological changes including fibrosis and to grade these changes to determine prognosis. We wanted to study the histology of liver biopsies received along with choledochal cysts, grade the hepatocellular damage and fibrosis, and correlate these findings with clinical presentation of the patients. METHODS 40 liver biopsies received along with choledochal cysts in paediatric patients were assessed for histological changes using 7 parameters including liver fibrosis and scored semi-quantitatively according to established scoring systems. These scores were correlated with the clinical data, age at surgery, sex of the patient, type of choledochal cyst, clinical features, and the results were analysed for their role in predicting patient prognosis. RESULTS We found that all the cases showed histological variations in the liver biopsy. Age of children showed an inverse relationship with histological scoring. Infants showed higher scores in comparison to older children. Fibrosis of the liver was also higher in Infants. Most of the cases presented with clinical jaundice. Patients with jaundice, pain abdomen, fever and acholic stools showed higher scores. We found that the sex of the patient and type of choledochal cysts were independent of the scores. CONCLUSIONS Younger age and more severe clinical presentation warrant an urgent surgical intervention in paediatric choledochal cyst. Histological assessment of the liver is mandatory to grade the hepatocellular changes including fibrosis and suggest prognosis and follow up of patients. KEYWORDS Liver Histology, Grading, Paediatric Choledochal Cyst
The Use of Population Attributable Risk to Estimate The Impact of Preventive Interventions of Smoking Cessation in Chronic Obstructive Pulmonary Disease(COPD)
Authors: Namayandeh Seyedeh Mahdieh , Jafarabadi Zahra , Azadi Sanaz
Published: December 2020

This article is a Letter to Editor and does not include an Abstract.
An Evaluation of Internet Addiction and Its Related Factors among the Students of Yazd University of Medical Science
Authors: Namiranian Nasim , Mansouri Seied Saman , Shafiee Mohammad
Published: December 2020

Introduction: Considering the increase in Internet addiction rate, we tried to investigate the rate of internet addiction among medical students of Shahid Sadoughi University of Medical Sciences in Yazd in 2016.
Methods: This analytic-cross-sectional study was performed on 350 students of Shahid Sadoughi University of Medical Sciences in Yazd. The data collection tool was a demographic questionnaire, and Yang's Internet addiction inventory. The questionnaire contains 20 questions, according to which the person is placed in one of four classes: normal, mild, moderate, and severe. After collecting the data, the data were entered into SPSS 16 software and analyzed using Chi-square and independent t-tests. The significance level was considered less than 0.05.
Results: According to Internet addiction, students were 65% normal, 33.3% border lip and 1.7% were addicted to the Internet. The results also showed that there was a significant statistical relationship between the prevalence of internet addiction among students and sex, smoking, and registration in cyberspace (p<0.05), and there was no significant statistical relationship between the prevalence of internet addiction and marital status, place of residence and birthplace (p>0.05).
Conclusion: According to the results of the study, it can be concluded that by increasing the awareness of medical students, the rate of Internet addiction in them can be minimized
Investigating the Relation between Religious Orientation and Locus of Control with Tendency toward Substance Abuse, Case study: Addicts and Non-Addicts Men, Isfahan, 2018
Authors: Zareei Mahmood Abadi Hassan , Heydari Sooreshjani Razieh , Rajaei Rizi Fatemeh , Akrami Leila
Published: December 2020

Introduction: Drug addiction, is one of the major challenges in human societies. This study aimed to investigate religious orientation, locus of control, and the tendency toward substance abuse in addicts and non-addicts in Isfahan, 2018.
Methods: A case-control method was used, and the study population was 200 men who participated in Isfahan. Cases were selected from drug-dependent using cluster sampling method. Allport’s Religious Orientation Scale, Rotter’s Locus of Control Scale, and Scale of Tendency toward Substance Abuse were used for data collection. The mean ± SD age of addicts was 34.8 (±4.35) years. Most addicts were illiterate 33% (33), and about 30% (30) had academic degrees. Finally, data analysis was done by SPSS version 16 and confidence Level was 95%.
Results: The groups were homogeneous in terms of income, number of children and residential area. The mean ± SD of religious orientation was in normal group 60.39 ± 3.26, addicted group 40.25 ± 7.8 and locus of control was in normal group 59.13 ± 3.17, and addicted group 45.45 ± 1.33 that findings of t-test showed that there was a significant difference in religious orientation (t= 5.40, p<0.003), and locus of control (t= 4.37, p<0.001) between addicts and normal individuals. There was a significant relationship between religious orientation (r=-0.328, p<0.04) and locus of control (r= -0.365, p<0.01) in addicts with a tendency toward substance abuse. confidence Level was 95%.
Conclusion: Poor religious orientation and lack of internal locus of control are important causes of the tendency toward substance abuse, which demands measures to be urgently taken.
Relationship between Self-efficacy and Mental Health with Health Literacy in Patients with Diabetes in Kazerun City, Fars, Iran
Authors: Sohrabi Renani Mohammad Taghi , Nourafkan Fahimeh , Fathimard Fariba , Sadegheyan khashoei Kaveh , Mazarei Roghayeh
Published: December 2020

Introduction: Since diabetes is a complex network of psychological and healthcare factors, this paper aims to investigate the relation between type 2 diabetes and mental health
Method: This study was analytical cross-sectional research on 60 diabetic patients referring to Kazerun health care centers, southwest of Iran, in 2018. The samples were selected by convenience sampling method. The data were collected using the Demographic Profile Questionnaire, General Self-Efficacy Scale  (GSES), Health Literacy Questionnaire  (HELA), and Mental Health Continuum (MHC-SF). Data analysis was performed in APSS v21 and from descriptive statistics including mean and standard deviation and using the statistical tests of Spearman correlation coefficient and multiple regression analysis (P <0.01).
Results:   Mental health has a significant positive relationship with health literacy (p <0.001). Thus, individuals with better mental health evaluate their level of health literacy better. However, no relationship was found between self-efficacy and health literacy(r= -0/19, p >0.001). Besides, regression results indicated that mental health can predict a 54% variance of health literacy (R2= 0.54, p <0.001).
Conclusion: The findings of this study shows that boosting an individual’s mental health leads to an increase in health awareness in patients afflicted with diabetes which after all, can cause a better coping capability in these people.
Social Support or Organizational Support: Which One Is More Predictive of Job Burnout in workers?
Authors: Servat Farokhlegha , Mazloomy Mahmoodabad Seyed Saeed , Abbasi-Shavazi Masoumeh , Dehghani Ali
Published: December 2020

Introduction: Social and organizational supports are effective factors closely related to job burnout and Due to the limited studies in this area on Iranian workers, this study aims to determine the predictability of social support and organizational support in  job burnout for workers in Yazd.
Methods: This cross-sectional study was carried out among 200 textile workers in Yazd through stratified random sampling. The data were collected by the tools including demographic characteristics, questionnaires of social support, organizational support, and Maslach's job burnout. The data were analyzed by SPSS using the Pearson correlation coefficient and the multiple linear regression. The Significance level of tests was considered as p <0.05. 
Results: There was a significant strong positive relationship between job burnout and emotional exhaustion (r = 0.88) .There was found a significant negative correlation between job burnout  and social support (r =- 0.390), friend support (-0.401), family supoert (-0.218), important others support (- 0.283) (p <0.001 (. Multiple linear egression analysis showed that friends, the family, explained 17.8% of job burnout changes, and important people  (R2=0.178,  p<0.001) whereas support from friends was the strongest effective factor for job burnout (β= - 0.338, p <0.001). 35.9% of the changes in job burnout were explained by social and organizational support (R2= 0.359, p<0.001) with organizational support being the strongest effective factor on job burnout (β= - 0.472, p<0.001).
Conclusion: Given that organizational support was the most significant predictor of job burnout in workers, developing organizational intervention to  increase support in workplace can be regarded as strategies to reduce or slow down job burnout among workers.
The Effect of Eight Weeks of Aerobic Exercise on Balance Function and Physiological Cost Index in Multiple Sclerosis Patients
Authors: Sadeh Mohammad Reza , Sharifatpour Reza
Published: December 2020

Introduction:   Muscle weakness and balance problems are limiting factors in Multiple sclerosis patients that can be improved due to physical activity. The purpose of this study was to investigate the effect of 8 weeks of aerobic exercise on balance function and Physiological Cost Index in patients with MS in Yazd city in 1394.
Methods: This quasi-experimental study was conducted in two stages: pretest and post-test. The subjects were selected by targeted and available sampling and randomly divided into training and control groups that included 30 patients (15 in the experimental group and 15 in the control group). The subjects were randomly divided into two groups of experimental and control. Subjects in the experimental group participated in an aerobic exercise program for eight weeks, three days a week, each session of 60-90 minutes with an intensity of  50-70% of maximum heart rate. For statistical analysis we used descriptive statistics such as mean, standard deviation, and the Shapiro-Wilk test used to measure the normality of the data, independent t-test and the covariance (ANCOVA). The significance level of the tests was p < 0.05 by using the SPSS-25 software.
Results:   ANCOVA results revealed that the selected aerobic training significantly increased both static balance (p = 0.007) and dynamic balance (p = 0.001). Moreover, aerobic training positively influenced the physiological cost index (P = 0.001.
 Conclusion: aerobic exercise can improve both static and dynamic balance and increase the Physiological Cost Index in M.S patients. Therefore, these exercises are recommended for patients with MS.
Determinants of the Public Environmental Issues and Concerns: A Case Study in Rafsanjan, Iran
Authors: Eslami Hadi , Khodadadi Hassan , Safari Arezoo , Rajabi Samaneh , Akhondi Mahdiyeh
Published: December 2020

Introduction: This study aimed to evaluate the most important public environmental issues and concerns, the public knowledge about these issues, as well as the quality of environmental issues in Rafsanjan, Iran.
Materials and Methods: In this descriptive-analytical study, 384 people were randomly selected from Rafsanjan City and their public environmental issues and concerns were evaluated. The data were collected using a researcher-made questionnaire, with confirmed validity and reliability. The data were analyzed by Mann-Whitney and Kruskal-Wallis statistical tests using SPSS-18 software.
Results: The findings showed that the most important environmental concerns in Rafsanjan included water quality and quantity, pesticidesin agriculture, and air pollution, respectively.However, the quality of drinking water and water resources were not appropriate from the public’s view point.The mean score of environmental knowledge and environmental issues’ quality level were 5.91 ± 2.53 and 36.07 ± 7.21, respectively. Knowledge level and environmental quality level had a statistically significant relationship with education, occupation, and level of using public transportation (P <0.05).
Conclusion: It can be concluded that improving the quality of drinking water, promoting the farmer’s knowledge and behavior about application of pesticides, as well as monitoring and controlling air pollution were among the most important needs and demands of Rafsanjan citizens. So, authorities should consider these issues attentively.