bluuebunny/crossref_metadata_2025 huggingface dataset:
Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile
Authors: Udonquak Mbuotidem M. , Kalu Queeneth N. , Eshiet Atim I.
Published: May 2017

Background: Bupivacaine is commonly used as a sole agent for spinal anaesthesia unlike Pethidine. This study compares the immediate postoperative complications and recovery profile following spinal anaesthesia with pethidine and bupivacaine.Methods: Fifty-two patients who required short duration surgical procedures below the umbilicus were randomized to receive spinal anaesthesia with pethidine 1mg/Kg and 2.5 mL 0.5% bupivacaine. Time to recovery of pin prick sensation at S2, plantar flexion, proprioception of the big toe, and full motor recovery were compared for the two agents. Complications of pain, sedation, nausea and vomiting, pruritus and urinary retention in the immediate postoperative period were also compared.Results: Comparing Pethidine and Bupivacaine, time to return of pinprick sensation at S2 was 94.62±20.25 and 205.96±31.05 minutes respectively; return of plantar flexion was 92.88±12.01 and 193.85±39.56 minutes respectively; recovery of proprioception of the big toe was 31.15±9.41 and 172.50±42.70 minutes respectively; complete motor recovery was 47.89±14.08 and 221.73±44.72 minutes respectively. All the differences in recovery times were statistically significant (p<0.0001). There was no statistically significant difference in the incidence of pain and sedation. Only 4 (15.38%) patients in the Bupivacaine group experienced mild pain. There was no incident of nausea and vomiting. However, pethidine group experienced pruritus (19.22%) and bupivacaine group none. Bupivacaine group also had urinary retention (11.54%), while pethidine group had none. These differences were statistically significant (p=0.01).Conclusions: Pethidine exhibited a shorter recovery profile than Bupivacaine and also caused no significant complication in the immediate postoperative period.
Hypokalemia in hospitalized patients in tertiary care teaching hospital Belagavi, Karnataka, India: a retrospective study
Authors: Lokapur Anand , Badiger Raju , Somannavar Manjunath
Published: May 2017

Background: Hypokalemia is well known condition in which serum potassium levels falls less than the normal level (normal range 3.5 to 5.1mmol/L). It has adverse effect on cardiac rhythm, blood pressure.1 The objective of the study was to look for causes and associated factors of hypokalemia.Methods: Patients age, sex, potassium value and primary diagnosis of hypokalemia patients collected from tertiary care teaching hospital retrospectively. Hypokalemia patients are classified based on the severity of hypokalemia, age, sex and primary diagnosis. Results: Study reveals that both males and females are equally affected by hypokalemia, individuals with age between 40 to 60 are most affected and less than 20 are least affected by hypokalemia.Conclusions: Hypokalemia is significantly associated with gastrointestinal and genitourinary disorders when compared with other disorders.
Thrombocytosis as a predictor of thromboembolic complications in patients with malignant diseases
Authors: Maksimović Siniša , Maksimović Siniša , Jakovljević Aleksandar , Jović Darko , Latinović Ljiljana , Ćulum Jovan , Trkulja Nebojša , Sibinčić Sanja , Spahic Amir
Published: May 2017

Background: To prove the frequency of thrombocytosis in patients with cancer, and the importance of anticoagulant therapy. Thrombocytosis represents an elevated platelet count of more than 350,000/mm3 which is one of the risk factors for venous thromboembolism.Methods: This study has analyzed 146 patients who were hospitalized at the Oncology Clinic of the University Clinical Centre, Banja Luka and the Day Oncology Hospital “S.tetik”, Banja Luka in the period between 2009 and 2014. These were patients with breast tumor, gastrointestinal or gynecological malignancies. Thrombocytosis was detected in 38 patients in the moment of diagnosing. All examinees were analyzed by sex, age, primary site of tumor, presence of comorbidity, relevant laboratory analyses, clinical stage of the disease (metastatic or localized disease).Results: In the observed sample of 146 patients, thrombocytosis was detected in 38 patients in the moment of diagnosing the disease (26%). Through the follow-up, DVT (deep venous thrombosis) was found in 13 patients (34.2%) and anticoagulant therapy was administered. Out of patients who were not on anticoagulant therapy because they had no thrombotic manifestations (25 patients, 65.8%), 2 ended up experiencing the development of a clinical presentation of massive pulmonary embolism with fatal outcome.Conclusions: The occurrence of thromboembolism significantly increases morbidity and mortality, as well as the total cost of treating cancer patients. Regardless of the fact that cancer patients are at a high risk of thromboembolic events, thromboembolic prophylaxis has not been adopted as a standard therapeutic modality because of potential bleeding.
Effect of physical training on lung function and respiratory muscles strength in policewomen trainees
Authors: Awad Kamal M. , Magzoub Aamir , Elbedri Omer , Musa Omer
Published: May 2017

Background: Measurement of respiratory muscles strength has not been widely investigated in the context of physical training.Methods: This cross-sectional study has assessed pulmonary function and strength of respiratory muscles in two women groups: group I includes healthy policewomen (n=28) exposed to physical training 3 hours daily for at least 2 years and group II is a matched control group (n=31) of untrained apparently healthy second year medical students. Lung function tests including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEF) were performed using a digital spirometer and maximum inspiratory and expiratory pressures (MIP and MEP) as indicators for respiratory muscle strength were measured using a digital respiratory pressure meter.Results: The mean FVC (L), FEV1 (L), PEF (L/min) values were significantly higher in the police-trained group (p=0.000, 0.000 and 0.003 respectively). Similarly, the mean MIP and MEP (cm/H2O) values were significantly higher among trained group (p=0.000 and 0.003 respectively).Conclusions: Long-term regular physical exercise improves lung function as well as respiratory muscle power and may delay the age-related decline in lung function.
Etioclinical profile and outcome of acute bacterial meningitis in post neo natal U-5 children: a study from tertiary care center of coastal Odisha, India
Authors: Mohanty Niranjan , Biswas Tapan Kumar , Satapathy Smita , Meher Shantanu Kumar , Patro Debasis
Published: May 2017

Background: Acute bacterial meningitis (ABM) continues to remain an important cause of morbidity, mortality and handicap in children despite availability of wide range of antimicrobials. The microorganisms vary according to age, socio economic condition and geographical area along with other factors.Methods: A prospective study was conducted over 2.5 years from October 2012 to April 2015 in the department of pediatrics, SVP Institute of Pediatrics, SCB Medical College, Cuttak, Odisha, India. Total 104 subjects were included after taking meticulous inclusion criteria.Results: Out of 104 cases, majority (70.2%) were infants. 60.6% were male with M:F ratio 1.5:1. Fever was the commonest symptom in 69.2% followed by convulsion 61.5%, vomiting 36.5%, altered sensorium 33.7%. On examination 69.2% children were febrile, having bulging fontanelle in 34.6%, pneumonia 31.7%, positive meningeal sign 29.8%, cranial nerve palsies 14.4%, papilledema 12.5% and hemiplegia 11.5% cases. GCS were poor (<7) in 26.9% cases. 33.6% had high CSF cell count (>100/cumm). In 82 cases (78.8%) etiological agents were identified consisting of H. influenzae in 46.4%, S. pneumoniae in 36.6%, E. coli in 8.6% and others in 8.4%. CT scan of brain revealed brain edema in 29.4% followed by subdural effusion 19.6%, hydrocephalus 17.6% and infarction in 5.9%. 63.5% children were recovered completely. Mortality was 16.3% with sequelae in 20.2% cases.Conclusions: Hib and Pneumococci were two most common organisms causing ABM in U-5 children with high mortality and sequelae which can be prevented by early diagnosis, optimum lab diagnostic facility and mass vaccination. There is urgent need to include Pneumococcal vaccine in NIP for substantial reduction of infant mortality.
A study evaluating the awareness among general population towards common medical emergencies
Authors: Naqash Mohd Mubarik , Salati Sajad Ahmad , Bhat Arif Nabi , Akram Waseem , Gulzar Ishfaq
Published: May 2017

Background: Basic life support has been found to be lifesaving in common medical emergencies. The level of awareness about emergency care in general population and the approach of the common people with regards to common medical emergencies is an important determinant of positive outcome.Methods: This study was conducted in 445 participants randomly selected from visitors of our outpatient department, to study the awareness in general public about the medical emergencies and basic life support skills.Results:  This study was conducted in 445 participants randomly selected from visitors of our outpatient department, to study the awareness in general public about the medical emergencies and basic life support skills.Conclusions: Awareness about common medical emergencies is low in general public and there is a need to devise strategies to improve this awareness.
A comparative study of dermatoglyphic markers in schizophrenia patients and normal controls
Authors: Latiff Ashma A. , S. Sundarapandian , R. Arul Saravanan
Published: May 2017

Background: Schizophrenia is a complex mental illness with multiple etiological factors. Prenatal insult to the developing foetus has been implicated as a major risk factor for the genesis of schizophrenia, according to the neuro-developmental model. As the brain and skin are ectodermal derivatives, insult to developing brain is reflected in several dermatoglyphic markers.Methods: Total finger ridge count (TFRC), Total A-B ridge count (TABRC) and ATD Angle of 100 patients diagnosed with schizophrenia were compared with 100 age and sex matched healthy controls.Results: Statistically significant differences were observed in the values recorded and compared between healthy controls and schizophrenia patients.Conclusions: This study shows the correlation between abnormalities in dermatoglyphic patterns and development of schizophrenia.
Role of rhubarb and α-keto analogues of essential amino acids supplementation in halting progression of chronic kidney disease
Authors: Khan Irfan Ahmad , Nasiruddin Mohammad , Haque Shahzad F. , Khan Rahat A.
Published: May 2017

Background: Chronic kidney disease (CKD) is an emerging chronic disease due to rapidly increasing incidence of diabetes and hypertension worldwide. Newer drugs are being searched which can stop nephron damage and are cost effective. This study was undertaken to compare the efficacy and safety profile of rhubarb and α-keto analogues of essential amino acids supplementation in patients of chronic kidney disease.Methods: A prospective comparative study was conducted in patients of chronic kidney disease attending Renal Clinic of a tertiary care centre. Randomization of patients was done into three interventional groups: conservative management along with placebo was given in first group (Control); conservative management along with Rhubarb capsule (350 mg, thrice daily) was given in second group (Rhubarb) and conservative management along with α-keto analogues of essential amino acids (600 mg, thrice daily) was given in third group (KAA). The treatment was given for 12 weeks. Clinical and biochemical parameters were assessed at 0, 4, 8 and 12 weeks of treatment.Results: Patients of all three groups showed gradual improvement in clinical features and biochemical parameters as compared to their pre-treated values which was more marked in KAA supplemented group. There was reduction in: fasting blood glucose (12.51%, 19.15% and 20.78%), PPBG (14.80%, 19.00% and 20.89%), serum creatinine (25.00%, 30.54% and 39.52%), blood urea (25.55%, 33.64% and 38.09%), and 24-hour total urine protein (TUP) (19.80%, 30.18% and 38.34%) in Group I, II and III respectively. There was increase in: haemoglobin level (12.64%, 14.99% and 19.77%), 24-hour total urine volume (TUV) (19.41%, 28.82% and 33.32%) and GFR (22.6%, 46.5% and 49.2%) in Group I, II and III respectively. Rhubarb and KAA supplementations were safe and well-tolerated.Conclusions: KAA is more effective than Rhubarb as add on therapy with conservative management in patients of chronic kidney disease.
Prescribing trends in respiratory tract infections in a tertiary care teaching hospital
Authors: Beg Mirza A. , Dutta Shakti B. , Bawa Shalu , Kaur Amanjot , Vishal Subhash , Kumar Upendra
Published: May 2017

Background: Respiratory tract infections are a major cause of morbidity and mortality in developing countries. Polypharmacy and irrational prescribing in respiratory diseases are common practice worldwide. Keeping in consideration this scenario, present study was undertaken to analyze the drug utilization pattern of respiratory tract infections.Methods: This drug utilization study was conducted by Pharmacology department at SGRRIM & HS to analyze drug utilization pattern of respiratory infections. A total of 585 prescriptions were collected from hospital and randomly evaluated for prescribing pattern using WHO drug indicators.Results: A total of 585 prescriptions were analyzed. Male:Female ratio was 1:0.77. Age wise distribution was done; 81(13.84%) 0-15 years, 54(9.23%) 16-30 years, 198(33.84%) 31-45 years, 75(12.82%) 46-60 years and 177(30.25%) patients belongs to >60 years of age group respectively. A total of 4869 drugs were prescribed, 2754(56.56%) antibiotics, 675(13.8%) bronchodilators, 630(12.93%) corticosteroids, 303(6.22%) antacids, 507(10.41%) in miscellaneous category respectively. 2562(52.61%) oral, 1491(30.62%) injectable and 816(16.75%) inhalational drugs were prescribed. Numbers of Fixed dose combinations were 645(13.24%). 8.32 drugs were prescribed per prescription. 2409(49.47%) drugs were prescribed from national essential medicine list 2015. 4320(88.72%) drugs were prescribed by their brand names.Conclusions: Irrational prescribing and polypharmacy was observed. The drug utilization studies are important tool to sensitize and increases awareness among physicians, which ultimately improves rational prescribing and patient care.
Clinical and biochemical profile of liver abscess patients
Authors: Jain Vineet , Manjavkar Smita , Kapur Prem , Durfishan . , Rajput Divya , Mir Tanveer
Published: May 2017

Background: Liver comprises 48% of all the visceral abscesses. It is common in India with 2nd highest incidence due to poor sanitation, overcrowding and inadequate nutrition. Worldwide, approximately 40-50 million people are infected annually with amoebic abscesses. This study aims to observe the clinical and biochemical profile of liver abscess patients so that a prompt diagnosis can be made and early treatment can be given.Methods: The study was conducted over a period of 1 year on 50 patients of liver abscess. History and physical examination was done. All patients were subjected to complete hemogram, liver function test, coagulation profile (PT/INR) and USG abdomen. Serology for Entamoeba histolytica and HIV was done.Results: The mean age of the patients was 41.8 years with male preponderance. Amoebic liver abscess (86%) was predominant over pyogenic liver abscess (14%). Alcoholism (52%) and diabetes mellitus (20%) are main predisposing factors in case of liver abscess. Hepatomegaly was found in 80% cases. Elevated ALP, low albumin, increased PT INR points to the diagnosis of liver abscess. The abscesses were predominantly in right lobe (76%) and solitary (66%). Complications seen were ascites (12%) and pleural effusion (6%).Conclusions: Liver abscess should be suspected in patients presenting with prolonged fever and pain upper abdomen specially if patient is alcoholic or has diabetes mellitus. Ultrasonography is an easy and cost effective investigation to diagnose liver abscess. Early and aggressive treatment is the mainstay to prevent complications, morbidity and mortality.
Comparison of peribulbar anesthesia and topical anesthesia on outcome of phacoemulsification
Authors: Mehta Rishi , Punjabi Sharda , Bedi Nutan , Nagar Chandra Kant
Published: May 2017

Background: Due to advancement in phacoemulsification techniques, there has been growing shift from peribulbar anesthesia (PA) to topical anesthesia (TA). But dilemma exists regarding the supremacy of one over the other as both types have certain advantages and disadvantages.Methods: A prospective study was conducted. Patients were divided into two groups. Group-1 underwent PA while group-2 underwent TA. Satisfaction score of patients and surgeons and incidence of complications were noted. The data was analyzed.Results: Lowest patients’ satisfaction score among group-1 vs. group-2 was 160 (87.9%) vs.82 (45.81%). Highest surgeons satisfaction score among group-1 and group-2 was 74(40.65%) vs. 2(1.1%). Intraoperative complications among the group-1 and group-2 were 35 (19.2%) vs. 86(48.0%).Conclusions: While TA provides initial painless phase of surgical procedure, PA results in lesser intraoperative complications resulting in better visual outcome.
Ultrasonography awareness among pregnant women attending medical college hospital in Kolhapur District of Maharashtra, India
Authors: Yadav Jeevankumar U. , Yadav Deepmala J.
Published: May 2017

Background: Globally there has been increased medicalization of pregnancy due to advances in technology. Ultrasonography examination during pregnancy has become an integral part of antenatal care throughout the world with advanced health care services.Methods: The cross-sectional study was conducted in pregnant women attending the ANC clinic of Obstetric department of D. Y. Patil Medical College Hospital, Kolhapur, Maharashtra, India for routine check up to know the awareness about ultrasonography among them. The study included 290 pregnant women. All were explained the purpose of study and assured confidentiality. Data has been collected from willing participants using pre-tested questionnaire in June-August 2015.Results: The study shows literacy was 87.6%, pregnancy above 20 years age 98.97% and most of them unskilled (83.4%), majority of middle social class (89%). Many (72.41%) pregnant women considered USG use to detect fetal anomalies while 27.93% considered for sex detection. Majority (93.1%) done USG in this pregnancy, of that more (43.45 %) in second trimester and mainly advised by doctors (91.03%). Nearly half of them (50.69%) considered its expensive procedure, 69.31% spent 200/- to 500/- rupees per USG, in spite 94.83% of them would recommend other pregnant women to undergo USG in pregnancy. 50.69%% of them opined it should be done twice in pregnancy. Almost 94.83% considered USG as safe and beneficial.Conclusions: Awareness regarding the uses of Ultrasonography during pregnancy and attitude towards it was found to be average. There is need to create more awareness in community about PCPNT act and its provisions. Also there is need of counselling about the safety, utility and frequency of USG during pregnancy to avoid misuse.
Phacolytic glaucoma: visual outcome
Authors: Peram Venkataratnam , Atti Srihari , Mahendra Superna
Published: May 2017

Background: This study was conducted to evaluate the visual outcome of phacolytic glaucoma, a common cause of ocular morbidity.Methods: Participants were 30 patients in a tertiary care hospital for both urban and rural population. 30 eyes of patients clinically diagnosed as phacolytic glaucoma were treated. Demographic data and duration of the symptoms of the patients before presenting to the hospital were noted. Intraocular pressure (IOP) and visual acuity were recorded preoperatively and postoperatively. Small Incision cataract surgery with posterior chamber intraocular lens implantation (IOL) was done after the control of intraocular pressure and inflammation. Postoperative complications were noted. The data was analyzed by simple statistical methods.Results: Age group distribution was 19 (63.3%) in >50-60 yrs, 9 (30.0%) in >60-70 yrs and 2(6.4%) in >70 yrs. Sex distribution was 21 (70.0%) of males and 9 (30.0%) of females. Mean age of the all the patients was 60.7 yrs (males 59.95 yrs and females 62.6 yrs). Laterality was RE in 16 (70.9%) and LE in 9 (30.0%). Duration of the presenting symptoms before reporting to the hospital was <1 week in 17 (56.6% and >1 week in 13 (43.3%). Mean IOP was 45.8 mmHg preoperatively. Visual Acuity was PL doubtful in 2 (6.6%), PL +ve in 15 (50.0%) and HM<3/60 in 13 (43.4%) preoperatively. Postoperative visual acuity at 6-8 weeks was <6/60 in 8 (26.7%) and >6/60 in 22 (73.3%). Postoperative complications were bullous keratopathy in 5 (16.6%), anterior uveitis with membrane on IOL in 7 (23.3%), posterior capsular tear in 3 (10.0%) and Zonular dialysis in 2 (6.6%). Fellow eye showed pseudophakia in 22 (73.4%), immature cataract in 6 (20.0%) and Aphakia in 2 (6.6%).Conclusions: This study concludes that a better Visual outcome in phacolytic glaucoma depends on the effective Preoperative control of intraocular pressure and inflammation.
Clinical pathological and epidemiological study of triple negative breast cancer
Authors: Ajay Arun , Radhakrishnan Priya
Published: May 2017

Background: Worldwide breast cancer is the most frequently diagnosed life threatening cancer in women and a leading cause of cancer death among women. In Kerala, India around 30% of cancer-affected women have carcinoma breast. Breast carcinomas which do not express estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER-2/neu) receptors are known as triple negative breast carcinomas (TNBC). They are extremely aggressive with poor prognosis. Here the authors described the clinical pathological and epidemiological characters of triple negative breast carcinomas in a tertiary care hospital in Kerala, India and compare with non-TNBC.Methods: It was a cross sectional comparative study. Clinical, pathological and epidemiological characteristics of 75 cases of TNBC were compared with that of 225 cases of non-TNBC presented in Department of General Surgery, Government medical college, Kozhikode, Kerala, India between a period from March 2014 to October 2015 (20 months). Patients were recruited after obtaining an informed consent. ER, PR, HER-2/neu status were determined by immunohistochemical staining. Data obtained were statistically analyzed using SPSS software.Results: Triple negative breast carcinoma was significantly associated with a younger age (mean age 43.67 years), early age of menarche. Commonly seen in premenopausal age group (78.7%). Patients with the triple-negative carcinoma had relatively large tumors (mean size 4.45cm compared to 3.14cm) and a high rate of node positivity (86.67%). More advanced stage at diagnosis with high grade tumor characteristics. Most common histopathology was invasive ductal carcinoma (98.7%) but no statistical difference was noted with non-TNBC.Conclusions: No significant difference was noted between TNBC and non TNBC on comparing family history, parity, age at 1st child birth, OCP use. The outcome of the disease following treatment was unable to study due to short time frame of the study.
The seroprevalence of HIV, hepatitis B, hepatitis C and venereal disease research laboratory test seropositivity in blood donors: a 5-year retrospective comparative study at tertiary care hospital in Mumbai, Maharashtra, India
Authors: Parveen Khaneta , Khan Abdul Faheem , Khan Abdul Salim
Published: May 2017

Background: The high seroprevalence of transfusion-transmitted infectious (TTI) diseases such as HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in India affects the safety of blood for recipients. This study was undertaken with the aim to screen the blood donor’s demographic profile and to estimate seroprevalence of HIV, HBV, HCV and VDRL transmissible by blood transfusion in voluntary and replacement male and female blood donors during the last 5 year period.Methods: The present study was conducted over a period of 5 years (2001-2005) and involved 1,53,020 blood donors including both (voluntary, replacement males and females) who were thoroughly screened and selected for blood donation in blood bank at Departments of Pathology, Seth GS Medical College and KEM hospital, Mumbai, Maharashtra, India.Results: Total five years seropositivity for all four disease marker in all blood donors was 9150 (5.97%). The incidence of HIV seropositivity was 1995 (1.30%), the seroprevalence of HBV in total blood donor was 4673 (3.05%), HCV consist of 1599 (1.04%), and VDRL seropositivity was least, i.e. 883 (0.57%). Out of total 9150 (5.97%) seropositive blood donors, 24 (0.26%) blood donors showed concomitant seropositivity for more than one of the blood transmissible diseases.Conclusions: Seroprevalence rate of all the four blood transmissible diseases was higher in replacement donors, and lower in voluntary group of donors. Therefore, it has been evaluated that the voluntary blood donation is safer and promoted for safe blood donation in comparison to replacement blood donation.
Doppler interrogation of fetoplacental circulation in hypertensive disorder of pregnancy and their perinatal outcomes
Authors: Devi Jyoti , Kumar Devender , Shukla Mala , Jain3 P. K.
Published: May 2017

Background: Hypertensive disorders of pregnancy are one of the major causes of maternal morbidity-mortality leading to 10-15% of maternal deaths especially in developing areas of the world. The Doppler examination makes it possible by providing a unique, non-invasive and safe method of studying blood flow characteristics in both the fetoplacental and uteroplacental circulations that is being used in clinical evaluation of high risk pregnancies. The aim was to study early detection of fetoplacental compromise in hypertensive disorder of pregnancy with Doppler indices and to know its role in predicting perinatal outcomes and interventional strategies in these patients.Methods: This prospective study was conducted on 100 subjects, 50 patients in study group with hypertensive disorders and 50 patients in control group with normotensive pregnancy. Doppler studies of umbilical and middle cerebral artery done and parameters recorded were systolic/diastolic ratio, pulsatility index and resistance index at 28-37 weeks of gestation. Perinatal outcomes of both groups compared, analyzed statistically. Multiple pregnancy, chronic hypertension, fetal congenital anomalies, systemic disease and those lost to follow up till delivery were excluded from study.Results: Statistically significant difference in the incidence of induction of labour (p=0.012) and caesarean delivery (p=0.049), preterm delivery (p=0.004), low birth weight (p=0.003), low apgar score (p=0.045) and NICU admission in the patients with abnormal umbilical artery doppler of hypertensive group were seen .66.66% and 100% perinatal mortality seen in absent end diastolic flow and reverse end diastolic flow of umbilical artery in hypertensive group respectively.Conclusions: Abnormal umbilical artery had highest sensitivity 76% and positive predictive value 84% in predicting adverse perinatal outcome and MCA Doppler having highest specificity 96% to exclude the false positive results of abnormal UA. The sequential study of both vessels useful in predicting interventional strategies and improving perinatal outcomes.
Efficacy and tolerability of eperisone versus tizanidine in patients suffering from low back pain with muscle spasm
Authors: Khan Abdul F. , Parveen Khaneta , Khan Abdul S.
Published: May 2017

Background: Low back pain (LBP), a high prevalent condition, is usually associated with 'muscle spasm' that is responsible for giving rise to pain. Eperisone hydrochloride is widely used for treatment associated muscle stiffness and pain. The aim of the study was to compare the efficacy and safety of eperisone tablets 50 mg three times daily versus tizanidine 2 mg tablets thrice daily for the treatment of low back pain with muscle spasm.Methods: The study was carried in 50 patients from a private hospital at Mumbai. Only patients satisfying the inclusion criteria were enrolled into the study. Subjects suffering from low back pain with spasm were divided in two groups. The patients were then followed up on Day-14.Results: Patients receiving eperisone showed a mean value of 16.48±1.15 in the Roland Morris low back pain and disability questionnaire both groups on day 1 and was reduced to 7.92±1.15 (51.94%) on day 7 and 2.56±1.53 (84.46%) on day 14. Similarly, the patients in tizanidine group had mean value of 15.96±1.62 on day 1, which was reduced to 6.76±1.66 (57.64%) on day 7, and 2.88±1.92 (81.95%) on day 14, as similar to eperisone group. There was no statistical significant difference between the two groups, (p>0.05) for pain at rest, pain at night, restriction of movement, changes in stiffness, changes in numbness and changes in tenderness. There was statistical significant difference between the two groups, (p<0.05) for pain on movement and kinesalgia.Conclusions: Eperisone was found to be comparable to Tizanidine in improving the signs and symptoms of changes in pain Self-assessment by the patient on different applied parameters.
The study of the humerus and femur length as combined predictors of the gestational age of human fetuses using ultrasonography
Authors: B. R. Chaithra Rao , Sreepadma Sunkeswari
Published: May 2017

Background: Ultrasound dating of pregnancy is the most effective and easiest method presently used to assess the gestational age of fetus. The study evaluates the diaphyseal lengths of humerus and femur as combined parameters to estimate the gestational age of the fetus at the time of examination.Methods: The study was done on 152 pregnant women of gestational age from 15 to 40 weeks attending antenatal clinic of a certain medical college hospital. Subjects with maternal disease known to affect normal fetal growth, history of recurrent miscarriages and of chronic medications, multiple gestations or other complications and major fetal abnormalities were excluded. The diaphyseal lengths of humerus and femur were measured in a standardized manner. The relationship of the humerus and femur length in centimeters is compared with the gestational age in weeks. The multiple correlation equation of humerus and femur length with the gestational age was deduced.Results: It was observed that the diaphyseal length of humerus and femur gradually increased from 15 weeks to 40 weeks of gestation and by applying multiple correlation, a formula was derived to calculate the gestational age.Conclusions: The measurement of the humerus and femur length (in cm) can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses belonging to that geographical area using the derived formula.
The effect of waist hip ratio on the various stress types in I year Indian medical students
Authors: A. K. Sunitha Priya , Panchu Pallavi , Babu Rose , Bahuleyan Biju
Published: May 2017

Background: A medical student faces tremendous academic and non-academic stress owing to the vast curriculum and inadequate time. The impact of stress results in detrimental mental and physical health which is assessed here using stress questionnaires and anthropometric parameters. Stress need not be only academic.  Hence it becomes vital to identify and target the specific and common non-academic stressors to enable the students to have a stress-free learning environment. The objective of this study was to find the inter relationship between waist hip ratio (WHR) and various stressors the student is exposed to.Methods: 97 I year medical students participated in this cross-sectional study and were administered the medical student stress questionnaire (MSSQ), a validated tool and the anthropometric measurements (waist and hip circumference, waist hip ratio, body mass index) were taken. The data was analyzed using SPSS version 22.Results: The study showed a negative correlation of WHR with all the stress parameters of which inter personal relationship stress (IRS) and teaching learning related stress (TLRS) were significant.Conclusions: Increasing the duration of I year MBBS course and helping learners acclimatize to the new study environment may help in reducing stress. Stress relaxation techniques, psychological counselling and strengthening the mentor- mentee programs along with exercise regimen may aid in the stress reduction process and facilitate physical health.
Upper airway resistance syndrome: evaluation of patients with excessive day time sleepiness non-invasively
Authors: Ingle Vaibhav Kumar
Published: May 2017

Background: Upper airway resistance syndrome (UARS) is a recent concept introduced among sleep disordered breathing (chronic snoring and Obstructive sleep apnea) disorders. UARS also presents with excessive daytime sleepiness (EDS), which is associated with impaired social functioning, work performance and driving ability. However, UARS is not merely a continuum between chronic snoring and obstructive sleep apnea (OSA). Not only UARS patients have equal gender distribution and thin body habitus but they also do not fulfil Polysomnographic criteria of OSA. UARS diagnosis requires oesophageal manometry for diagnosing increased respiratory efforts against increased upper airway resistance (without complete cessation of airflow or hypoxia) and correlating it with EEG arousals to mark an event. Oesophageal manometry is invasive and uncomfortable, therefore, non-invasive means are desirable for evaluation of UARS. The aim of the study is to evaluate the patients with EDS for UARS non-invasively.Methods: 25 consecutive patients with EDS (Epworth Sleepiness Score >9) visiting sleep clinic at a tertiary level hospital in North India were enrolled after informed consent. It was a non-blinded, interventional trial. All enrolled patients underwent nocturnal polysomnography using VIASYS healthcare sleep screen apnea screen cardio polysomnography machine. After PSG, those patients satisfying criteria for OSA were not analysed further. In remaining patients, greater than 10 alpha EEG arousals/h (Spontaneous Arousals) along with flattening or plateau of inspiratory flow contour (by nasal cannula) was employed to diagnose UARS non-invasively. Epi-info software was used in statistical analysis.Results: Out of 25 patients with EDS, 60% (15) were diagnosed as OSA based on Apnea-Hypopnea Index (AHI) > 10/hr. Among 15 OSA patients,10 patients had severe (AHI >30); 2 had moderate (AHI 15-30) and 3 had mild OSAS (AHI 10-15). Only one patient was provisionally diagnosed as UARS based on nasal air flow graph and spontaneous arousals/hr >10.Conclusions: Upper airway resistance syndrome (UARS) is a distinct sleep disorder from obstructive sleep apnea syndrome (OSAS) with unique pathophysiology and it need be evaluated in all patients with unexplained arousals.
Intrathecal baclofen in management of a patient with very severe tetanus
Authors: Jaju Madhusudan R. , Goverdhan M. , Reddy N. Pavan Kumar , Muttavarapu Sirisha Rao , Sekhar V. Chandra , Bandla Siddharth , Rammohan Srikanth , Srivastav Shashank Kumar
Published: May 2017

Tetanus is uncommon in developed countries. The majority of tetanus cases occur in third world countries and 50% of these cases occur in neonates. There are more than 800,000 deaths due to tetanus each year in the world. We present a case of 40-year-old male patient diagnosed to have very severe tetanus - Grade IV as per Ablett classification of severity, managed in our hospital with aggressive treatment for 27-days and use of intrathecal baclofen he showed drastic improvement in this status.  He was discharged in neurological intact conditions with hemodynamic stability.
Skin pigmentation, a window to diagnose Alkaptonuria: a very rare entity
Authors: Chauhan Sandhya , Garg Ashok , Tegta G. R. , Thakur Kuldeep
Published: May 2017

Alkaptonuria (AKU) or endogenous ochronosis is a very rare inborn error of tyrosine metabolism inherited by autosomal recessive mode. There is complete absence of homogentisic acid oxidase enzyme which results in accumulation of homogentisic acid in cartilaginous connective tissue thus produces ochronotic clinical manifestations. Here we reported a 36 year old woman with bluish pigmentation of pinnae, index fingers (lateral aspect), nails, teeth and sclera. Detailed clinical and investigative workup was done to diagnose patient. Skin biopsy showed changes of ochronosis and urine examination revealed detectable level of homogentisic acid. Classical ocular findings, ochronosis on clinical and HPE and positive urinary tests for homogentisic acid confirmed the diagnosis of alkaptonuria. The highlight of our case is that an asymptomatic patient was detected early by ochronosis prior to development of musculoskeletal or cardiac complications.
Nephrotic syndrome in a case of Rubinstein Taybi syndrome: a rare case report
Authors: Patro Debasis , Agarwalla Sunil Kumar , Ali Nasreen , Sahoo Manaswinee
Published: May 2017

Rubinstein Taybi syndrome (RSTS) also known as Broad Thumb Hallux Syndrome characterized by distinct facial features with beaked or straight nose, short stature, moderate to severe intellectual disability, broad thumb and big toe. We report an interesting case of female child with history and examination suggestive of RSTS with Nephrotic syndrome. Investigation revealed presence of albumin in urine with hypercholesterolemia and hypoalbuminemia. Purpose of this case report is to highlight the distinctive presentation of this syndrome and to update the current state of knowledge.
Scalp shagreen patch: an unusual cutaneous manifestation of tuberous sclerosis complex: a case report
Authors: Abualiat Abdullah , Elobeid Wifag , Edris Hala
Published: May 2017

Tuberous sclerosis complex (TSC) is an inherited neurocutaneous disorder with multisystem involvement and highly variable expression of the disease. Common cutaneous manifestations include angiofibromas, periungual fibroma, ash-leaf-shaped macules and shagreen patch which is slightly elevated soft skin-coloured plaque usually found in lumbosacral region.  We report a case of TSC in a 21- year- old Saudi man with a 13 years history of asymptomatic skin lesions and generalized tonic-clonic seizures. Dermatological examination revealed facial angiofibromas, ash leaf macules, pedunculated fibromas on trunk, and shagreen patch on the back. Scalp swelling was found and confirmed to be shagreen patch by the histopathology findings. In conclusion, scalp shagreen patch is an unusual presentation of TSC. It should be considered in clinical examination of suspected cases of TSC with relevant histopathology to confirm the lesion.
Tubulo- lobular carcinoma: a rare mixed invasive carcinoma of
Authors: Priya V. Sri Lakshmi , Prasaad Priavadhana Rajan
Published: May 2017

Tubulo-lobular carcinoma is a rare variant of invasive carcinoma of breast, exhibiting the features of both tubular and lobular component. It accounts for about 1% of mammary carcinomas. Study report a case of 39-year-old female with lump in the left breast for 6 months. Histopathologically it was diagnosed as tubulo-lobular carcinoma of breast. Hence histopathology plays an important role in diagnosis and treatment of mammary carcinomas.
A safe method for the retrieval of a dislocated trial head in total hip arthroplasty
Authors: Janipireddy Satish B. , Sinha Sanjay , Sinha Sanjay , Ferguson David W. , Ferguson David W. , Atkinson Henry D. , Atkinson Henry D.
Published: May 2017

Total hip arthroplasty is a life changing procedure providing a significant improvement in the quality of life for those receiving treatment. An 81-year-old male with severe right sided hip osteoarthritis underwent uncemented total hiparthroplasty. Intraoperatively the 32mm trial head dislodged from the trial stem over the anterior rim of the acetabulum relocating to within the pelvic cavity. Time efficient retrieval was performed during primary surgery through a mini-incision at the iliac crest.
Unilateral absence of musculocutaneus nerve and its clinical significance
Authors: Rohilla Aarti , Rohilla Jyoti , Singh Kamal , Rathee Suresh Kanta
Published: May 2017

Musculocutaneous nerve arises from lateral cord and supplies the muscles of front of arm and then continues as lateral cutaneous nerve of forearm. Musculocutaneous nerve has frequent variations. Nerve may be doubled or even absent. There is unilateral absence of musculocutaneous nerve in this case. Musculocutaneous nerve arises from lateral cord and supplies the muscles of front of arm and then continues as lateral cutaneous nerve of forearm. Musculocutaneous nerve has frequent variations. Nerve may be doubled or even absent. There is unilateral absence of musculocutaneous nerve in this case. Musculocutaneous nerve was seen to be absent in one case on right side. Branches arise either from lateral cord or median nerve to supply the flexor muscles of arm. Total absent musculocutaneous nerve is quiet uncommon. Hence knowledge of this variation can help clinicians in understanding the cause of weakness or paralysis of flexor muscles of arm due to median nerve injury which is unusual.
A peculiar case of dural venous sinuses with resulting atypical bony markings in posterior cranial fossa
Authors: Khorwal Gitanjali , Kalra Sunita
Published: May 2017

A paramedian or midline suboccipital approach for craniotomies and craniectomies is commonly employed for decompression or tumour resections from posterior cranial fossa. The reference for midline is taken as the line joining the nasion and inion on the surface of the skull which is the estimated position of superior sagittal sinus. In the interior, the internal occipital protuberance is the site of confluence of sinuses which presents a spectrum of variations. An unusual pattern of drainage of dural venous sinuses was observed at the site of customary confluence during routine dissection of head region for undergraduate medical students in a sixty-year-old female cadaver. The superior sagittal sinus continued as right transverse sinus as usual but it was connected to the left transverse sinus through a venous channel. There was no appreciable confluence of sinuses at this site. A prominent and atypical cerebellar process emerged from right hemisphere of cerebellum and projected between right transverse sinus and the venous channel connecting right and left transverse sinuses. In the posterior cranial fossa, the internal occipital crest was present on the left of midline separated from internal occipital protuberance. Another small ridge was present to the right of midline. A triangular fossa thus formed on the right side of internal occipital crest was occupied by the unusual prominent process emerging from the right hemisphere of cerebellum.Pre-operative assessment of dural venous sinuses is imperative before any surgical intervention especially around the confluence of the sinuses.
Prevalence of overweight and obesity amongst adolescents and identification of risk factors
Authors: Choudhary Kirti , Mathur Priyanshu , Garg Manisha , Gupta P. P.
Published: May 2017

Background: Childhood overweight and obesity are global nutritional concerns that are on the rise. These are among the most prevalent nutritional problems in the developed and developing countries and are associated with increased consumption of processed and fast foods, dependence on television and computers for leisure and less physically active lifestyle.Methods: The study has been conducted in the Department of Pediatric of Mahatma Gandhi Medical College of Mahatma Gandhi University of Medical Sciences and Technology, Jaipur. The study was a cross sectional analytical study conducted in schools of Jaipur. This study was done from August 2011 to November 2011 and 180 patients of aged between 10 to 18 years of age were enrolled.Results: In this study, we found the prevalence of overweight to be 32.65 percent in males and 34.15 percent in females. It was seen that 33.67 percent males and 32.93 percent females belonged to the obese category. It was seen that majority of overweight (65 percent) and obese (73.33 percent) adolescents lead a physically inactive lifestyle. None of the overweight and obese adolescents were involved in physical activity for more than an hour. The observation was significant (p=0.000). Most of the overweight and obese adolescents had appropriate diet. However, 11 of the overweight and 27 among adolescents consumed calories more than the requirement. This observation was found to be significant (p=0.000). Out of 149 adolescents consuming fast food, 59 were overweight and 51 were obese. This observation was found to be significant (P=0.015).Conclusions: The prevalence of overweight was 32 percent in boys and 34 percent in girls and the prevalence obesity was 33 percent in boys and 32 percent in the girls. There was no significant difference in overweight and obesity between boys and girls. Hours of physical activity, diet, consumption of fast food had a significant association with B.M.I. It was, therefore, concluded that reduced physical activity for less than 1 hour for less than 3 days a week, increased caloric intake and increased consumption of fast food have a significant association with BMI.
Nutritional status and prevalence of anemia in rural adolescents
Authors: Ramalingam Ezhilarasu , Thirumalaikumarasamy Sivaraman , Nadesan Balakrishnan , Mooorthi Mani Madhavan Sachithanantha
Published: May 2017

Background: In developing countries like India, the adolescents constituting one fourth of population are not given the due importance in terms of resource allocation on health care or research. Thus, painting a lopsided picture of adolescent’s health and nutritional status is not truly reflective of ground realities. The objective of this study was to assess the nutritional status of the adolescent community residing in rural block and the prevalence of anemia among these adolescents.Methods: The study was a community based cross sectional survey among adolescents of 10 to 19 years of both sexes, from October 2004 to March 2006. Nutritional status, hemoglobin and prevalence of anemia were observed.Results: Under nutrition was found to be a significant problem in both sexes of rural adolescents. Anemia was more common in female than in male in both school going and non-school going.Conclusions: The significant number of anemic is in the middle adolescent age group, could be explained by the fact that menarche is attained around 12 years and the first few cycles are irregular with increased blood loss. So, any policy towards low birth weight and neonatal mortality needs the policy makers to make a note of this alarming trend of anemia among adolescent girls.