bluuebunny/crossref_metadata_2025 huggingface dataset:
Awareness of human papilloma virus vaccine among medical interns in tertiary health centre
Authors: Ashrita C. , N. Prasad Nayak , Saldanha Prakash
Published: October 2019

Background: Human Papilloma virus [HPV] infection is one of the most common sexually transmitted disease[STD] in the entire world. In India, HPV infections stands as one of the first few major cause of STD among both male and female adolescents and adults. However studies done in major centers reveals that awareness about this disease among the general population is poor. Aim of this study was the awareness of HPV and its preventive measures among medical interns who have recently completed their graduation and doing medical internship in a tertiary care centre.Methods: Total 100 participants were subjected to questionnaire study which has questions on basic knowledge about HPV and its preventive measures. The data were analyzed using Microsoft excel software.Results: Statically 98% of the study population was aware of HPV, whereas 78% were having knowledge about the vaccine availability for prevention of HPV and only 55% of them knew that the vaccine is available for use in India.Conclusions: Although majority of participants are having knowledge about HPV, the awareness on vaccine and its potentials are very poor. It is very important to put more emphasis on educating medical, nursing, para medical students and interns of various discipline on HPV infection and its preventive measures.
Survey of obesity among school children in rural Kerala, India
Authors: Abraham Robin Joseph , Pillai Priyadarsini C.
Published: October 2019

Background: Childhood obesity is a risk factor for subsequent development of diabetes mellitus, hypertension etc. Rural children show lower levels of obesity and higher rates of malnutrion. Objectives: Study seeks to access the prevalence of obesity and overweight among higher secondary students in rural Kerala).Methods: 1577 students were selected from schools picked randomly in and around vadavukode block in Ernakulam district, Kerala, of which 761 from private and 816 from government and aided school. Their height, weight and BMI was recorded and plotted in WHO growth charts to assess stunting, wasting, overweight and obesity.Results: No difference was found among the government and private schools. The finding from the data tally with the results from other parts of rural India with overweight and obese children (around 10%). The study found 44% children were found to be undernourished. Malnutrition was noted in both private and public schools possible highlighting knowledge deficit on Nutrition may be the cause of malnutrition. Only 47% students were in the normal range.Conclusions: Rural Kerala is afflicted with a serious problem of undernutrition and lower levels of obesity. There was striking prelidiction for obesity was noted among stunted children in the study highlighting the complex nature of the nutrition problem in India where malnutrition and obesity coexist and cause double burden of diseases. The solution is to encourage the message of healthy living, equally to the over nourished and the undernourished, where balanced diet and exercise as a way of life is encouraged.
A study on clinical profile and etiological agents of empyema in hospitalised children in Jaipur, India
Authors: Meena Poonam , Jain Pankaj Kumar , Sharma Abhishek , Sharma B. S.
Published: October 2019

Background: Objective is to study the clinical profile and etiological agents of empyema in hospitalised children in Jaipur.Methods: This hospital based prospective study was carried out in the Department of Pediatrics, SMS Medical College, Jaipur between April 2016 to March 2017. Children between 1 month to 18 year of age having empyema thoracis (pleural tap showing pus cells under microscopy or on gross examination purulent exudates) were included in the study. Children with Empyema secondary to post-surgical or post-traumatic cause and with tubercular effusion were excluded from the study. Relevant history, clinical examination and investigation were done. Pleural fluid studies were done for cytology, biochemical analysis , culture and antibiotic sensitivity pattern.Results: Total 100 patients were included in study. Out of total 100 patients 62 (62%) were between 1 month to 5 years. Most common symptoms were fever (94%), breathlessness (87%) and cough (85%). 27% patients were severely malnourished as per IAP classification of PEM. Pleural fluid culture was positive in 29 (29%) patients. Most common organism isolated was Staphylococcus aureus (27%), 87.5% isolates of Staphylococcus aureus had sensitivity to vancomycin and linezolid.Conclusions: Empyema thoracis is frequently encountered complication of bacterial pneumonia. Fever, cough, and respiratory distress were the most common presenting complaints and severe acute malnutrition was an important risk factor. Staphylococcus aureus was found to be the most common organism for childhood empyema.
Study of the prevalence of urinary tract infection in febrile children attending paediatric OPD in Government medical college and general hospital, Srikakulam, Andhra Pradesh, India
Authors: Kumar Pondugala Sunil , Ketireddi Dinendraram
Published: October 2019

Background: Children with fever comprise a major proportion of our practice in outpatient department of Paediatric. Among the fever cases Urinary tract infection is the third most common cause of febrile illness in children. The emphasis on identification of urinary tract infections in febrile children is minimal. Very often, children receive antibiotics empirically, without any adequate evaluation for urinary tract infection. The objective of our study is to determine the prevalence of urinary tract infection in all febrile children from 1months to 5 years of age.Methods: A prospective study was undertaken in the department of Pediatrics, Government medical college, Srikakulam. Urine was collected from enrolled febrile patients and sent for routine microscopic examination as well as for culture and sensitivity.Results: The study included 500 children. Females were 256(51.2%) and males were 244(48.8%). The total prevalence of UTI cases were 6%. The incidence in <1 year was 7.05%, 1-2 years was 5.97 % and >2 years was 5.35%. The prevalence of UTI was higher among females (7.68%) than males (4.68%). Apart from fever, the commonest symptoms were dysuria, abdominal pain, vomiting, chills and rigors and loss of appetite. Urine culture shows E. coli followed by Klebsiella were found to contribute the maximum number of cases.Conclusions: Possibility of Urinary Tract Infection must be considered in all febrile children and urine culture specimen must be collected as a part of diagnostic evaluation.
Clinico-epidemiological study of neonatal seizures from a tertiary care hospital of Western Rajasthan, India
Authors: Verma Suresh Kumar , Dabi Jagdish Chand , Rawat Sandeep , Dabi Basanti
Published: October 2019

Background: Neonatal Seizures are frequent may be either symptoms of an underlying disorder and malfunction of the developing CNS or due to a primary epileptic condition. Their varied clinical presentations, delay in recognition and treatment results in poor neurological outcome. This study attempts to find out the clinical and etiologic profile of neonatal seizures and associated biochemical abnormalities in this geographical part of India.Methods: A hospital based prospective observational study undertaken in a tertiary care pediatric hospital of Medical College Jodhpur India, on 202 consecutive neonates who presented with seizures during period of one year. A detailed antenatal history and baseline characteristics of convulsing neonate at admission and clinical details of each seizure episode reported by the mother and subsequently observed by doctors on duty were recorded. Venous blood sample was analyzed as soon as possible for blood glucose, total serum calcium levels and electrolytes, before instituting any treatment. Data were managed on Microsoft Excel spreadsheet, and analysis was performed using SPSS version.Results: The overall frequency of neonatal seizures in our set up was recorded as 4.08%. Perinatal asphyxia with subsequent HIE was the most common (40.09%) cause of neonatal seizures while hypoglycemia was the most common metabolic cause (11.38%) observed specially in VLBW babies. Subtle seizures were the most common type (34.65%) and tonic seizures were the second most common (33.66%) type of seizures encountered. Hypocalcemia was the second commonest biochemical abnormality found in primary metabolic seizures. HIE, ICH and Hypoglycemia were the common seizure etiology in preterm neonates.Conclusions: Perinatal asphyxia and subsequent HIE was the commonest etiology with subtle, tonic and multifocal seizures being the commonest clinical types encountered. Hypoglycemia and hypocalcemia were the most frequent biochemical abnormality found.
Comparison of hematological parameters among newborns with meconium stained amniotic fluid and clear amniotic fluid
Authors: Garg Preeti , Saxena Shruti
Published: October 2019

Background: Meconium stained amniotic fluid is an indirect marker of fetal hypoxia. Fetal hypoxia affects bone marrow and affects production of cell lines. Indirect marker of erythropoietin activity is nucleated red blood cells count. Aim of the study is to compare hematological parameter in newborn born with meconium stained liquor and clear amniotic fluid. Also, to determine cut off levels of nucleated RBC as marker of fetal hypoxia in meconium stained amniotic fluid(MSAF).Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo medical college and hospital, Indore. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Cord blood samples were collected and hematological parameters were compared.Results: Hemoglobin % and WBC counts were seen in study group in comparison to control group, which is statistically significant (P<0.05). The reported NRBC/100 WBC between the two groups was statistically analyzed. The mean NRBC count in study group were 8.09±6.09 which was statistically higher than the corresponding values in control group 2.07±2.25 (P<0.05).Conclusions: Study concluded that the hemoglobin levels , WBC and NRBC counts in babies with meconium stained amniotic fluid is higher than those babies delivered with clear amniotic fluid and NRBC can be taken as a surrogate marker of hypoxia in a resource limited setting.
Volume guarantee ventilation in premature neonates with respiratory distress: a comparative study
Authors: A. Sudheer K. , B. Sunil , Rajiv P. K. , Kripail Mathew , Nithya E.
Published: October 2019

Background: Respiratory distress syndrome (RDS) occurs in about 50% of preterm infants born at less than 30 weeks of gestational age. Surfactant therapy and mechanical ventilation have been the standard of care in the management of RDS. Objective of this study to compare the time required to achieve successful extubation criteria in Volume guarantee mode of ventilation to that with Time cycled pressure-limited mode of ventilation and the duration of mechanical ventilation between them in preterm neonates ventilated for respiratory distress syndrome.Method: The study was done at Neonatal intensive care unit, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala over a period of 2 years. Total of 37 inborn preterm neonates between 26 weeks to 32weeks with RDS requiring mechanical ventilation were included in 2-year study period with 18 babies in 1st year study period ventilated with SIPPV mode and 19 babies in 2nd year study period on SIPPV–VG mode of ventilation. Analysis was done using SPSS v. 16 software.Results: In the present study the neonates receiving SIPPV-VG ventilation had stable and equivalent gas exchange at significantly lower MAP and PIP compared to neonates receiving SIPPV -TCPL. Also, neonates receiving SIPPV-VG had achieved significantly faster extubation criteria than SIPPV-TCPL and hence lesser duration of ventilation.Conclusion: Our study concludes that Volume Guarantee ventilation achieves near stable tidal volume delivery by auto-weaning peak inspiratory pressures thereby promoting early extubation and hence reducing volutrauma and barotrauma in contrast to TCPL mode.
Study on risk factors of respiratory distress syndrome in term neonates: a retrospective case-control study
Authors: B. Sunil , Nithya E. , N. Girish
Published: October 2019

Background: Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. It is more common in preterm neonates but also been found in term and late preterm neonates. This study aims at studying the risk  factors for developing RDS in term neonates. Objectives was to study the maternal and perinatal risk factors for RDS in term neonates.Methods: This is a retrospective case control study conducted in neonatal intensive care unit of tertiary care centre. A total of 100 term neonates with RDS were taken as cases and 150 normal term neonates were taken as control. Data were collected from the hospital NICU records, maternal and neonatal history was taken. The χ2 tests or Fisher’s exact text were used for one-way risk factor analysis. The effects of multiple factors on term neonatal RDS were analyzed using logistic regression analysis.Results: In our study RDS in term neonates  was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. Among the significant risk factors severe birth asphyxia, maternal-fetal infection, PROM, MSAF were showing positive association with RDS in full-term neonates.Conclusions: Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS. Hence these could provide a significant reference for the diagnosis and treatment of term neonatal RDS.
A study of bacteriological profile and outcome of babies born to mother with Premature rupture of membrane and its correlation with blood and gastric culture
Authors: Kamble Milind B. , Nagargoje Ramchandra , Chopde Sagar G.
Published: October 2019

Background: PROM, a condition that occurs when fetal membranes are ruptured at least one hour before onset of labor. While PROM is observed in 10% of all pregnancies, 60-80% of PROM is observed in term and 20-40% in pregnancies less than 37th gestational week. PROM is the most significant reason for preterm labor. The three causes of neonatal death associated with PROM are prematurity, sepsis and pulmonary hypoplasia. Infants born with sepsis have a mortality rate four times higher than those without sepsis. Objective of the study was correlation of blood and gastric culture positive sepsis in PROM newborns. It helps to find out the incidence of PROM in our locality.Methods: This retrospective study enrolled 90 neonates born to healthy mothers with history of PROM more than 18 hours duration, admitted in SNCU/ward at a tertiary care hospital for six months duration from 1st January 2017 to 30 June 2017. Clinical profile of these Newborn with history of PROM was noted such as birth weight, gender, gestation, duration of membrane rupture, history of maternal fever. For all newborns with PROM, sepsis screen had been sent. The neonatal outcome was also recorded, and the data was collected and analyzed by using frequency and percentages.Results: Gram negative bacilli were the commonest cause of neonatal sepsis and male neonates were more prone to infection. PROM and low birth weight especially, ELBW and VLBW are the common high-risk factors for early onset sepsis. Most common organisms isolated in blood and gastric culture were Klebsiella and Staphylococcus aureus respectively.Conclusions: PROM is a high-risk obstetric condition. Active management is needed to enable delivery within 24 hours of PROM as it offers better neonatal outcome. Morbidity and mortality increase as the duration of PROM increases. This can be reduced by early diagnosis, specific treatment and strict infection control practices in neonatal units.
Childhood pneumonia: read the smear and clinch the diagnosis
Authors: K. Nandhini , S. Kaveri , S. Elayaraja , P. Umapathy , Ravichandran Latha
Published: October 2019

Childhood pneumonia has a myriad of disease causing organisms. Identifying the etiology often helps us predict the natural course of the illness. We would like to share an interesting child with pneumonia by the hematological manifestation of the disease. Case report of this study is a 8 year old boy who presented with high grade fever for eleven days associated with cough. History of skin rashes which worsened following therapy with penicillin. On Examination child had maculopapular rashes predominantly over the trunk with decreased air entry in the left hemithorax. Chest x-ray done showed left lower lobe consolidation hence treated with cephalosporins and macrolide. Counts revealed falling trend in haemoglobin with high MCV count. Peripheral smear done showed agglutinated RBC’S and occasional nucleated RBC’s. Direct Coombs test was positive. With these haematological manifestations child was diagnosed to have Mycoplasma pneumonia which was proven by positive antibodies against Mycoplasma. Child recovered completely and haematological manifestations became passive after four weeks. Cold agglutinin disease is poorly understood affecting 15% of patients with Autoimmune hemolytic anemia. Respiratory tract involvement and extrapulmonary complications manifest in 3-10% and 25% respectively. Antibodies (IgM) against the I antigen on human erythrocyte membranes appear during the course of M. pneumoniae infection and produce a cold agglutinin response. AIHA typically occurs during 2-3rd week after febrile illness with sudden onset of hemolysis which is self-remitting within 4-6 weeks. The conclusion of this study is extra-pulmonary manifestations in a child with pneumonia help in diagnosing the etiology. This in turn helps us like provide rationale management and Predict the natural course of the illness.
Unusual umbilical cord finding in a neonate
Authors: Raja Antonieo Jude , K. Sriambika
Published: October 2019

Umbilical cord cyst refers to any cystic lesion that are associated with the umbilical cord. They are classified as true cysts or pseudocysts. True cysts are small remnants of the allantois, whereas false cysts originate from liquefaction of Wharton Jelly. In present case, cyst was diagnosed at birth without any associated congenital anomalies and resolved spontaneously within a few days requiring nil surgical intervention. Umbilical cord cysts deserve special attention since 20% of them, regardless of type, are associated with structural or chromosomal anomalies. Because of this, fetal karyotyping and amniocentesis should be considered when cysts persist beyond the first trimester.
Severe thermal injury of larynx in a child following accidental ingestion of hot tea
Authors: Jamir Bendangienla , S. P. Senthil Kumar , Azam Md Nawed , Kumar Arun , Patnayak Pupun
Published: October 2019

Thermal injury to the upper respiratory tract caused by aspiration of hot liquids resulting in laryngeal edema and subsequent obstruction of the airway is commonly not seen in the pediatric population. Unlike adults, children are more prone for subglottic injury, swelling and resulting obstruction of the airway due to the smaller size of the trachea and relatively large epiglottis. Examination of the airway with laryngoscopy hence should be recommended in all patients with inhalational and aspiration burn injury as it will help in guiding airway management and preventing development of complications. Authors report a case of a 3-year-old male child with accidental ingestion of just made hot tea. Upon presentation there was severe stridor and signs of respiratory distress requiring emergency intubation. Direct laryngoscopy revealed glottic edema and ulcer. Upper GI endoscopy showed erythematous arytenoids, esophagus and stomach showing few erythematous flat lesions. Chest radiographic examination showed bilateral para cardiac and perihilar inhomogeneous opacities suggestive of aspiration pneumonitis. The child was gradually weaned and extubated on day three of admission. Ingestion of hot liquids can cause airway and esophageal thermal burns. Rapid diagnosis and treatment are essential in management of inhalational and aspiration burn injury to reduce the morbidity, mortality and long-term sequelae in these patients. Children are more prone for burn accidents due to their curious and exploratory behavior and their inability to perceive the hazards. Since most of the pediatric burn accidents happen at home, parents should be offered education about prevention of burn and advised on how to manage and treat minor burn injuries and to watch for any warning signs in which case to rush to the nearest hospital.
Comparative assessment of psoriasis area and severity index and fasting blood sugar levels in psoriatic patients with diabetes mellitus
Authors: Parmar Devendra , Salvi Dhairya
Published: October 2019

Background: Present study was done with objectives to study the co-relation between PASI and Fasting blood sugar (FBS) levels in psoriatic patients with diabetes mellitus and to study the association between duration of topical steroid therapy and Fasting blood sugar (FBS) levels.

Methods: Present study was conducted in the 26 patients at the Department of Dermatology at a tertiary care centre in Bhuj, Gujarat. A detailed history on the type of psoriasis, duration, associated co-morbid conditions and details of topical steroid therapy was obtained from all patients. They were examined in detail and assigned a PASI score to assess the severity of psoriasis. Patients with nail involvement were scored using N NAIL tool. Fasting blood sugar levels were noted in patients with Diabetes.

Results: Age of patients ranged from 15 years to 72 years. The different types of psoriasis observed were palmoplantar psoriasis-14 (50%), and chronic plaque psoriasis - 11. The joint was involved in 7 patients while 19 did not have joint involvement. The Pearson co-relation coefficient between PASI and FBS was 0.60 and p value was 0.001. The Pearson co-relation coefficient between duration of topical steroid therapy and FBS was 0.15, and p value was 0.50.

Conclusions: A statistically significant positive correlation between PASI and FBS was noted in this study. The duration of topical steroid therapy was not associated with significant changes in FBS in psoriatic patients with diabetes mellitus. 
A study on thyroid dysfunction in acne vulgaris
Authors: Srinivasan Shreya , Thomas Jayakar
Published: October 2019

Background: This study was done to evaluate the role of thyroid function i.e., free T3, free T4 and thyroid stimulating hormone (TSH) in relation to the occurrence of acne vulgaris.

Methods: A total of 50 patients clinically diagnosed with acne vulgaris were subjected to a thyroid function test and results were evaluated.

Results: While all the 50 patients had normal free T3 and free T4 levels, 9 (18%) of the 50 patients displayed an elevated TSH level. Gender distribution among the patients with elevated TSH learned more towards the male population with 6 patients while there were only 3 female patients with elevated TSH.

Conclusions: There have been few studies regarding the role of thyroid function in acne vulgaris in relation to free T3, free T4 and TSH, though the presence of thyroid antibodies have been highlighted in quite a few studies. This study has shown the insignificance of thyroid function in acne vulgaris thus accentuating the negative.
A cross-sectional observational study on child sexual abuse
Authors: Perumal Saradha Kandasamy , Sudhakar Sarankumar , Sampathkumar Mithra
Published: October 2019

Background: A child sexual abuse (CSA) incident never comes into limelight unless it is a rape, probably because it could be an asymptomatic event causing only an emotional trauma or due to fear of revealing. It has been observed that sexually transmitted infections (STI) are in increasing trend among adolescents due to early sexual maturity, increased promiscuity and sexual offenses.

Methods: An observational cross-sectional study was carried out for a group of 774 school children between the age group of 14-17 years using a structured questionnaire to estimate the level of unreported child sexual abuse and sexual awareness. Descriptive statistical analysis was carried out in this study (SPSS 21.0).

Results: It was observed that 5.5% of children had been abused among which 37.3 % and 62.7% were males and females respectively. 11.1% and 6.25% were abused in penetrative, 59.25% and 43.75% in non-penetrative forms among female and male victims respectively. Abusers were mainly family and friends (25.5%) followed by strangers (23.2%). 25.3% of unaffected and 27.9% of affected was aware of POSCO law. 88.3% of affected and 62.3% of unaffected rated good and above for the questionnaire.

Conclusions: Unreported and silent victims have to be identified and addressed to prevent crimes and provide a safer environment for children. Implementation of POCSO law at the root level with sex education must be strengthened. Our study concluded that CSA is an extensive problem and even the lowest prevalence includes a huge number of victims who still need to be considered.
A comparative study of effectiveness of autologus serum therapy with oral antihistamines versus oral methotrexate and oral antihistamines in chronic urticaria patients
Authors: Pandey Amit Kumar , Ojha Suryakant , Mohan Aayushi , Prajapati Sunil
Published: October 2019

Background: Chronic urticaria (CU) is a worrisome problem and patients of CU suffer from the morbidity that arises from irritable itch thus they are subjected to a huge antihistamine pill burden. The symptoms are more prominent in autoreactive urticaria (AU) where auto-antibodies in blood causing recurrent flares. Therefore a need of adjunctive drug to reduce the pill burden is felt need.

Methods: A randomized, controlled study was done. 50 patients were given AST and 50 patients were given oral pulse methotrexate (10-15 mg once weekly) along with levocetrizine in an on-demand basis in both groups. AST was given weekly for nine weeks and followed-up for a total period of 24 weeks. Urticaria total severity score (UTSS) was used to evaluate the effectiveness of treatment. Safety parameters assessed were the spontaneously reported adverse events and laboratory parameters.

Results: UTSS showed significant improvement from baseline, 7th week and 8th week onwards in AST group and methotrexate group respectively. Group comparison showed significant improvement 4th week onwards.

Conclusions: Autologous serum therapy as well as methotrexate both proved effective in chronic urticaria patients. On follow-up improvement is sustained for at least 3-4 months after the last injection in case of AST. 
Study of cutaneous manifestations in chronic kidney disease patients on maintenance hemodialysis at a tertiary care centre
Authors: Vudayana Kirankanth , Korla Vidyasagar , Chintada Dilipchandra , Shree Jami Vijaya
Published: October 2019

Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages, presents with various cutaneous manifestations regardless of its aetiology. Patients of CKD disease on hemodialysis treatment which prolong the life expectancy and can also produce skin lesions. Skin changes described in patients with chronic renal disease are also found in patients with renal failure undergoing treatment with either peritoneal dialysis or hemodialysis. High percentage of patients receiving dialysis complains of pruritus that may be severe, in some instances the pruritus worsens with dialysis. The aims of the present study were to study the pattern of cutaneous lesions in patients with chronic kidney disease and to determine the incidence of skin manifestations specific to and associated with CKD.

Methods: Hundred patients of CKD on MHD with cutaneous manifestations attending skin outpatient department, nephrology out-patient department, dialysis center and patients admitted in medical wards were included in the study.

Results: The common cutaneous manifestations were xerosis 91%, pallor 78% and pruritus 69%. Nail manifestations include onycholysis 37% and half and half nails 33%. Hair manifestations in 24% patients.

Conclusions: Most common cutaneous manifestation was xerosis, followed by pallor. Most common nail manifestation was onyholysis.
Topical olive oil and narrow band ultraviolet-B trial for segmental vitiligo among adult Sudanese patients in Khartoum state, Sudan 2018
Authors: Ali Loai Gaffer Ahmed , A. Fadul Al Taieb Mohammed , M. Taha Mohammed Abdullah
Published: October 2019

Background: Adult segmental vitiligo treated by narrow band ultraviolet B (NB-UVB) showed delayed repigmentation. This study is being undertaken to determine the efficacy of topical olive oil addition before (NB-UVB) sessions for vitiligo patients (pts).

Methods: Randomized controlled trial (RCT) enrolled ten volunteers suffering segmental vitiligo on both upper limbs, all patients left limb was tested by topical olive oil before each NB-UVB session and twice daily in session free days for a total of 20 sessions (46 days), the right upper limb was the control (only NB-UVB), each site response was assessed based on time of appearance of erythema and repigmentation. Statistical analysis was done by the Chi-square test.

Results: All patients were ten, seven were female (70%), three males (30%) of middle age group, university graduates live in Khartoum state. Their left upper limbs showed erythema in <3 sessions in five pts (50%) and three-five sessions in (50%), repigmentation started in <3 sessions in one patient (10%) and three-four sessions in five pt. (50%) and >5 sessions for four pts (40%), pattern of repigmentation was marginal in eight pts (80%), mixed in two pts (20%). Their right upper limbs showed erythema in three-four sessions in two pts (20%) and eight pts (80%) needed five sessions, repigmentation started after five sessions in all patients (100%), pattern of repigmentation was follicular in one pts (10%), marginal in five pts (50%), mixed in four pts (40%).

Conclusions: Addition of topical olive oil to NB-UVB for segmental vitiligo patients showed earlier occurrence of repigmentation and better pigmentation pattern.
Clinical spectrum of childhood dermatoses during peak summer in a tertiary care centre
Authors: Subramaniam Jayanthi Nagappan , Pichaachari Saraswathy , Balakrishnan Prithivirajan
Published: October 2019

Background: Paediatric dermatoses are very common and may reflect the health and hygiene status of children. The incidence of these skin lesions is widely influenced by seasonal factors. The aim of the study was to study the spectrum of various dermatoses in summer months in children in a tertiary health care centre in north Chennai.

Methods: The study included all paediatric cases up to 12 years of age attending the skin OPD of our hospital during the month of May 2018. Total numbers of patients were 975. The patients were divided into 4 categories -infants (< 1 year), toddlers (1-3 years), pre-school children (3-5 years), school going children (5-12 years) as A, B, C and D respectively.

Results: Number of children seen in different groups included infants (8.20%), toddlers (23.59%), pre-school children (22.67%), school going children (45.54%) in groups A, B, C and D respectively. The most common skin disease observed comprised of pyoderma (44.18%), followed by miliaria rubra, scabies, dermatophytosis, insect bite allergy, HFMD and others with less than 1% prevalence.

Conclusions: The study shows that infections were more common in the paediatric age group in summer, which can provide a suitable environment for the organisms to survive and the infections can be controlled easily by providing proper health care facilities. In order to plan better health care for children, it is mandatory to have a good idea about the existing ailments in the region.
Evaluation of adapalene alone versus combination therapy of adapalene with benzoyl peroxide and adapalene with clindamycin in treatment of acne vulgaris: a prospective, observational study
Authors: Parikh Nehal R. , Sood Shikha V. , Rana Devang , Chaudhary Raju , Malhotra Supriya D.
Published: October 2019

Background: Acne vulgaris is majorly affecting adolescent population with profound negative impact on the quality of life (QOL). The objectives of the present study was to evaluate adapalene 0.1% alone vs combination therapy of adapalene 0.1% with benzoyl peroxide (BPO) 2.5% and adapalene 0.1% with clindamycin 1% in the treatment of acne vulgaris and to analyse health related QOL using the cardiff acne disability index (CADI).

Methods: This prospective, observational study of 12 months duration involved patients who were being treated with adapalene alone and adapalene combined with either clindamycin or benzoyl peroxide in the normal course of treatment. Efficacy of treatment and QOL was assessed by the comprehensive acne severity system (CASS) and CADI respectively.

Results: A total of 180 patients were enrolled (n=60 in each group). Male: female ratio was 1: 2.52. 76.7% patients were of adolescent age with the Mean age of 21.17±3.28 years. Average age of onset was 18.03±2.80 years. Most patients had moderate grade of acne (51%) followed by mild grade (46%) and almost clear (3%). Face was the common site, followed by back and chest. There was a statistically significant improvement in both number of lesions and also QOL in all the three treatment groups (p<0.0001).

Conclusions: Topical adapalene 0.1% is efficacious in the treatment of acne vulgaris both alone as well as in combination with topical benzoyl peroxide 2.5% and topical clindamycin 1%. Adapalene also has positive influence on the QOL alone as well as in combination but no superiority of one group over the other was observed with regard to efficacy as well as QOL.

 
Clinical study of herpes zoster in 109 patients in central referral hospital, Gangtok
Authors: Sharma Rukma L. , Sharma Rekha
Published: October 2019

Background: Herpes zoster results from the reactivation of varicella-zoster virus lying dormant in the dorsal root ganglia following an earlier primary infection (chickenpox), usually in childhood. The reactivation occurs due to multifactorial causes leading to decreased immunity.

Methods: This study was conducted on 109 cases of herpes zoster. Patient’s particulars were noted. A detailed history was recorded; morphology, the site and side of skin lesions were recorded. Any other associated diseases were noted.

Results: Out of 109 patients 66 were male and 43 were female. The total of 53 (48.6%) patients were under the age of 40 years and 56 (51.4%) patients above 40 years. Bhutias were affected in highest number (18.4%) followed by Sharma community (15.6%). The ophthalmic division of trigeminal nerve was the most commonly affected single nerve with 13.8% followed by T10 and T7 dermatome at 9.17% and 7.3% respectively. Thoracic nerves the most commonly involved thoracic nerves with 44 cases. Single dermatomal eruptions were found in 55 patients. The dissemination of herpes zoster was although very rare but was present in three patients. Type 2 diabetes mellitus was the common associated systemic illness with 10.09% of patients.

Conclusions: From this study it was revealed that both young adults and older age group people were affected almost equally. The male: female ratio was 1.5:1 with Bhutia community being mostly affected. Thoracic dermatome was the most common dermatome involved and in half the patients some form of associated disease noted.
Peeling skin syndrome: an investigational dilemma
Authors: Saini Shefali , Kharkar Vidya
Published: October 2019

Peeling skin syndrome  is a rare autosomal recessive disorder of cornification that starts either at birth or later in childhood, characterized by widespread painless peeling of the skin in superficial sheets. We report the case of a 13-year-old boy who presented with asymptomatic peeling of skin since birth. Sheets of skin were peeling from the neck, trunk and extremities following mild friction or rubbing, with sparing of palms and soles. The case is being reported due to its rarity.
“Marseille-Provence: European Capital of Culture in 2013”, the double socio-economic face of a cultural labeling policy
Authors: Grondeau Alexandre , Vignau Mathilde
Published: October 2019

Este artigo tem como foco o processo de rotulação territorial que ocorreu em 2013 no território de Marselha-Provença (MP13). Com efeito, este caso é particularmente representante das políticas de desenvolvimento na área cultural e questões decorrentes. Como Glasgow no passado, Marselha tem sido seriamente impactada por inúmeras crises contra a qual tem lutado, a partir da cultura e criatividade. Para os políticos e planejadores urbanos, a distinção de “Capital Europeia da Cultura” representa um grande passo no sentido social, econômico e de renovação urbana. Assim, é relevante mostrar como Marselha foi capaz de obter este título específico (especialmente pela valorização de suas próprias fraquezas territoriais). Mostramos aqui, em que medida esta distinção está relacionada às grandes transformações urbanas e quais são suas conexões com o neoliberalismo. No entanto, para além daqueles elementos que contribuem para resultados econômicos e turísticos positivos, o evento MP13 enfrentou alguns inconvenientes, pois, na verdade, não foi possível integrar as pessoas mais pobres e bairros que não foram capazes de valorizar os artistas locais, que muitas vezes defendem outras vias de expressão cultural.
Do império do cobre ao turismo cultural no sul do Brasil
Authors: Gevehr Daniel Luciano , Schwab Patricia Ines , Bonho Fabiana Tramontin
Published: October 2019

O artigo objetiva descrever a transformação espacial e econômica, ocorrida na Mina do Camaquã, desde a extração dos primeiros minérios de cobre, até a atualidade, onde oferecem, aos seus visitantes, experiências de ecoturismo e turismo de aventura. O turismo, campo de práticas históricas, sociais, culturais e de lazer, é um meio de promoção do desenvolvimento e defesa do patrimônio, relação esta necessária e possível. Nessa perspectiva, em âmbito local, o desenvolvimento deve promover a melhoria da qualidade de vida da população, assimilando as novas realidades produtivas, aliadas a identidade da cultura local. A pesquisa evidenciou o uso, para finalidade turística, do espaço pós-industrial e produtivo da Mina do Camaquã, enquanto potencial de desenvolvimento local. A Vila Mina do Camaquã, oferece uma infraestrutura completa para o recebimento de turistas e, conta com o empreendimento Mina Outdoor Sports, que apresenta um portfólio amplo de modalidades de turismo de aventura. Conclui-se, com a pesquisa, que há a necessidade de reconhecimento – de fato – do potencial e da valorização do patrimônio histórico-cultural e natural, tendo em vista a consolidação das Minas do Camaquã, como um atrativo turístico permanente do Rio Grande do Sul.
تصورات المعلمين وأولياء الأمور والطلبة حول السمنة في مرحلة الطفولة في رأس الخيمة
Authors: ستوت كيلي
Published: October 2019

ورقة العمل هذه سوف تبحث عن معنى البدانة وزيادة الوزن عند الاطفال، وستناقش كيف تؤثر هذه المشكلة على دولة الإمارات العربية المتحدة تحديدا. باستخدام حالة إمارة رأس الخيمة، وهي الإمارة التي تقع في اقصى شمال البلاد، ورقة العمل هذه ايضا ستتناول بعض التحديات التي يواجهها الأطفال فيما يتعلق بالانشطة البدنية واللياقة البدنية وتناول الوجبات الصحية. ثم ستختتم برفع عدد من التوصيات لمساعدة صانعي السياسات على التصدي لهذه الظاهرة بهدف الحد من مشكلة البدانة وزيادة الوزن وتعزيز انماط حياة صحية في إمارة رأس الخيمة ودولة الإمارات العربية المتحدة عموما.
الطاقة البديلة في دولة الإمارات العربية المتحدة: إمكانيات إنتاج الوقود الحيوي المستمد من أشجار المانغروف في إمارة رأس الخيمة	مكسيم مرعب، رشايل مطر، ميلاد سليماني، جون مارتن، كامل أبو يوسف، رواد حديفي، نوشين شفيق
Authors: مرعب مكسيم , مطر رشايل , سليماني ميلاد , مارتن جون , أبو يوسف كامل , حديفي رواد , شفيق نوشين
Published: October 2019

من خلال تحليل الكائنات الحية الدقيقة الوفيرة التي تعيش في بيئة أشجار المانغروف الطبيعية بإمارة رأس الخيمة في دولة الإمارات العربية المتحدة، تناقش ورقة السياسة هذه جدوى مستقبل تستثمر فيه دولة الإمارات في أنواع الوقود الحيوي المستمدة من أشجار المانغروف بدلاً من استخدام طرق الوقود التقليدية لإنتاج واستخدام الطاقة، التي يمكن أن يكون لها آثار سلبية على البيئة والاقتصاد. وتستكشف النجاحات والتحديات خلال كل مرحلة من مراحل ابتكار تكنولوجيا الوقود الحيوي، للسماح لصّناع القرار من الاستفادة من التجارب والأخطاء السابقة، لأن ذلك سيمكنهم من إجراء تقييم نقدي للإمكانات المتاحة نتيجة استخدام الوقود الحيوي في التكنولوجيا الحالية وكذلك في المشاريع المستقبلية. وجدت هذه الورقة انه من الممكن حالًيا استخدام أشجار المانغروف الموجودة كمصدر للفطريات لإنتاج الوقود الحيوي، ولكن هناك حاجة إلى المزيد من الاستثمار لدعم الإنتاج على المستوى الصناعي. وتختتم الورقة برفع توصيات السياسة لدعم البحوث المستقبلية، وتنفيذ حلول الطاقة طويلة الأجل التي تخاطب المخاوف البيئية والاقتصادية لدولة الإمارات العربية المتحدة، وتشجع قادة المستقبل والمبدعين على التفكيرمحلياً من أجل إيجاد حلول للمشاكل العالمية.
Modern Wound Dressings and their Application
Authors: Yaghoobi Maliheh , Nasrollahzadeh Masoumeh , Asjadi Fatemeh
Published: October 2019

Introdution: Wound healing is a complex and dynamic process, which requires to be prepared a suitable environment to promote healing process. Wound dressing is one of the most important external factors affecting the wound healing process. With the advancement in technology, more than 1000 types of modern wound dressings have been developed. Wound dressings are either based on natural materials or on the basis of synthetic and chemical materials. In addition to the protective and covering role, which modern wound dressings play, they have a chemical and physical interaction with wound bed addition. They carry antibiotics, drugs and nanoparticles and play an important role in maintaining moisture or hydration the wound; all of these factors can facilitate the wound healing process. In this study, the wound healing process and the properties of wound dressings were presented first and then the types of wound dressings and their applications were investigated. This study, with comprehensive information on the types of modern wound dressings and their advantages and drawbacks, will help a physician in the proper selection of an appropriate wound dressing.
Effect of Eight Weeks Resistance Training On Gene Expression of TNF-Α and IL10 in the Heart of Type II Diabetic Male Rats
Authors: Soltanian Zahra , Vanaky Behnaz , Ramezani Nasrin , Shakeri Nader , Shams Zahra , Fakhari Rad Fatimah
Published: October 2019

Introduction: Type 2 diabetes has many complications, including cardiovascular disease, which is associated with an increase in inflammatory biomarkers. Research has shown that physical activity can reduce inflammatory factors and improve cardiovascular disease. The purpose of this study was to investigate the effect of resistance exercise on some of the inflammatory and anti-inflammatory factors in the heart tissue of type 2 diabetic rats.
Methods: In this study, 18 male rats were selected. Rats were diabetic with nicotinamide and streptozotocin (stz) and then randomly divided into 2 groups of control (n=9) and training (n=9). The training group performed a resistance training program for 8 weeks, 5 days a week. Measurement of TNF-α and IL10 expression in the heart tissue was determined using the one step SYBR TAKARA single-step kit. To compare the difference between the mean of variables between exercise and control groups, independent t-test and t-test were used also to determine the effect of diabetes induction on variables. To determine the relationship between variables, Pearson correlation coefficient and separation correlation coefficient were used. Data were analyzed by SPSS software version 22.
Results: The results showed that the insulin resistance index decreased significantly in the training group compared to the control group. On the other hand, the expression of TNF-α gene decreased and IL10 showed a significant increase (α≤0.05).
Conclusion: The results indicate that resistance training may be effective in modulating the inflammatory factors of TNF-α and IL10 in the heart tissue of type 2 diabetic rats.
Type 2 diabetes, Heart, Resistance training, Inflammatory factors.
Change in the Expression of BAK، FAS، BAX، TNF-A، BCL-2 and Survivin Apoptosis Genes of the Human Breast Adenocarcinoma Cells (MCF-7) by Staphylococcal Enterotoxin B
Authors: Afzali Sara , Doosti Abbas , Heidari Mansour , Babaei Nahid , Keshavarz Parvaneh
Published: October 2019

Introduction: Breast cancer is one of the most prevalent malignancies among women. Patients whose suffering from this condition, as a result of the use of conventional therapies often have a poor response to treatment and the relapse among them is frequent. In this study, the effects of staphylococcal enterotoxin type B on BAK، FAS، BAX، TNF-a، BCL-2 و Survivin genes expression in human breast adenocarcinoma cells (MCF-7) was examined. Staphylococcal enterotoxin B is a powerful member of the Staphylococcus aureus toxins family, which is known as an anticancer agent with potential for killing cancer cells.
Methods: The experimental study was carried out at the Biotechnology Research Center of Islamic Azad University, Shahrekord Branch. By using Lipofectamine 2000 reagent, MCF-7  cells transfected with the pcDNA3.1(+)-seb (recombinant) and  pcDNA3.1(+) (non-recombinant)  plasmids and were selected by culturing in a selective medium of RPMI- 1640 containing 600 μg / mL antibiotic G418. Then, the expression of BAK, FAS, BAX, TNF-a, BCL-2, and Survivin genes in transfected cells were analyzed by real time PCR. Student's t-test, SPSS Inc., Chicago, IL; Version 16 and also Excel program for statistical analysis were used.
Results: The results of this study indicated that staphylococcal enterotoxin type B (SEB) remarkably changes the expression of apoptotic related genes in MCF-7 cell line. It was observed a significant increase in the expression of BAK, FAS, BAX, and TNF-a genes, the expression of BCL-2 and Survivin genes significantly decreased compared to the control group (P=0/032).
Conclusion: Staphylococcal enterotoxin type B has an inhibitory effect on the growth, proliferation and invasion of breast adenocarcinoma cells through altering the expression of the genes involved in the apoptosis process. Therefore, it seems that there is a good research field for the use of this toxin in the control and treatment of human breast adenocarcinoma.