bluuebunny/crossref_metadata_2025 huggingface dataset:
As mulheres do império: uma leitura de Ana de Amsterdam / Women’s Empire: A Reading of Ana de Amsterdam
Authors: Nascimento Naira Almeida
Published: August 2019

Resumo: Enquadrado no bojo da produção identificada como “literatura dos retornados”, o interesse principal de Ana de Amsterdam (2016a), de Ana Cássia Rebelo, não recai nas imagens traumáticas do retorno ou na violência praticada entre colonizadores e colonizados, como é recorrente no gênero. De forma até sintomática, as lembranças de África são esporádicas na menina de cinco anos que deixou Moçambique junto à família. Em seu lugar, a exuberância de uma Índia portuguesa sonhada e projetada por ela ocupam as lacunas de um presente insatisfatório, dividido entre a criação dos três filhos de um casamento em crise e o emprego burocrático desempenhado numa Lisboa pouco atrativa. Em ambos, tanto na Goa portuguesa como no trajeto para o trabalho, despontam narrativas de mulheres que constituem a síntese entre o diário íntimo de Ana e a escrita testemunhal da diáspora. Numa primeira parte do estudo, recupera-se a gênese do romance no formato do blog assinado pela autora, evidenciando a “escrita do eu”, nos moldes dos estudos de autobiografias, diários e afins. O segundo momento volta-se para a escrita testemunhal no lastro da narrativa pós-colonial e também da pós-memória. Em comum, os dois planos tratam da perspectiva feminina, seja na batalha contemporânea da cosmopolita Lisboa, seja nos desdobramentos silenciados do pós-colonialismo, em meio às histórias duplicadas de outras tantas Anas.Palavras-chave: Ana de Amsterdam; Ana Cássia Rebelo; diário íntimo; literatura de testemunho; blogs.Abstract: Framed in the center of the production identified as “literature of the returnees”, the main focus of Ana de Amsterdam (2016a) by Ana Cássia Rebelo, does not lie in the traumatic images of the return or in the violence practiced between colonizers and colonized, as it is usually the case in this genre. Somehow, even symptomatically, African memories are sporadic in the five-year-old girl who left Mozambique with her family. Instead, the exuberance of a Portuguese India, dreamed and projected by her, occupies the gaps of an unsatisfactory present, dividing herself to raise three children of a marriage in crisis and work in the bureaucratic employment situated in an unattractive Lisbon. In both, Portuguese Goa and on the way to work, narratives of women emerge and represent the synthesis between Ana’s private diary and the testimonial writing of the diaspora. In a first part of the study, the genesis of the novel is recovered in the form of a blog signed by the author, emphasizing the “writing of the self”, in the molds of autobiographies, journals and etc. The second moment turns to the testimonial writing in the basis of the postcolonial narrative and also of the post-memory. In common, the two plans deal with the feminine perspective, whether in the contemporary battle of cosmopolitan Lisbon or in the silenced developments of postcolonialism, in the middle of the duplicate stories of so many Anas.Keywords: Ana de Amsterdam; Ana Cássia Rebelo; diary; testimonial literature; blogs.
Escritas literárias de uma deslocação histórica: o “retorno” / Literary Writings of a Historical Displacement: The “Return”
Authors: Leal Maria Luísa
Published: August 2019

Resumo: Como é que três escritoras oriundas de Angola e Moçambique representam, em três romances escritos em 2009 e 2011, o movimento de retorno forçado a Portugal em 1975? Como se articulam memórias individuais e história? Quais as implicações da focalização narrativa? Estas e outras questões decorrem do quadro histórico e teórico representado nos romances: o do Portugal colonial e pós-colonial. O conceito de “retorno” permite aprofundar a questão da identidade individual e nacional e avançar algumas reflexões sobre um tema que ganha se cruzarmos diferentes ferramentas teóricas: estudos pós-coloniais, imagologia, estudos de género e narratologia.Palavras-chave: retornados; identidade; subjetividade; colonialismo; pós-colonialismo.Abstract: How do three women writers from Angola and Mozambique represent, in novels written in 2009 and 2011, the historic movement of forced return to Portugal in 1975? How are individual memoirs and history articulated, and what are the implications of narrative focus? These and other questions are the result of the historical and theoretical framework represented in the novels: that of colonial and post-colonial Portugal. The concept of “return” allows us to deal with individual and national identity issues, and suggest some reflections on a theme that gains ground if we cross different theoretical tools: Post-Colonial Studies, Imagology, Gender Studies and Narratology. Keywords: returnees; identity; subjectivity; colonialism; post-colonialism.
Intracervical PGE2 gel application for cervical ripening and induction of labour: a clinical study
Authors: Modi Shilpa , Mahur Jayalaxmi , S. Shashank V.
Published: August 2019

Background: PGE2 gel (cerviprime) not only helps in cervical ripening but also sensitizes the uterine musculature to physiological PGE2 for generation and maintenance of uterine contractions. In the present study the efficacy of PGE2 intracerival gel for ripening and induction of labour has been reported.Methods: This is a randomized prospective study of 80 cases admitted to the labour room during period of 2 years i.e. March 2017 to March 2019 in Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka. All patients had clear indications for termination of pregnancy. The initial bishop score determined prior to induction by pelvic examination. Under aseptic precautions PGE2 endocervical gel was instilled. The results analyzed for successful ripening, induction delivery interval, results in primigravida and multigravida with single instillation or reinstallation if required, mode of delivery and maternal and perinatal complications.Results: The present study of 80 cases showed that a single application of intracervical PGE2 gel caused favorable changes in cervix by increasing Bishop score and shortened induction delivery interval with minimal side effects. Successful ripening with single application was achieved in 92.5% of cases (primi 42.5% and multi 50%). Only 6.25% of primi's and 1.25% of multi’s required reinstallation of PGE2 gel. Successful induction was achieved in 47.5% primi's and 50% multi’s i.e. 97.5% cases.Conclusions: The study concludes that single low dose intracervical PGE2 (cerviprime) gel proved to a safe, reliable and effective method for cervical ripening and induction of labour.
Comparative evaluation of menstrual patterns and hormonal profiles in normal and abnormal perimenopause
Authors: Kaur Harshiba , Goel Neerja
Published: August 2019

Background: Currently there is only one marker to objectively establish perimenopause ie menstrual irregularities. Due to the wide variation in hormones like LH, FSH, estradiol, they become unreliable in predicting approaching menopause. This study was conducted to study and compare the patterns of LH, FSH and Estradiol in normal and abnormal perimenopause using the Stages of Reproductive Ageing Workshop (STRAW) criteria.Methods: A comparative evaluation was done after enrolling 200 patients out of which 100 women were in normal perimenopause (early-25 and late perimenopause-75, depending upon menstrual characteristics as defined by STRAW criteria) and 100 having AUB. Sociodemographic data, presence of menopausal symptoms were recorded. S. LH, S.FSH and S. estradiol we determined by adapted solid phase direct sandwich ELISA.Results: FSH was in menopausal ranges (>20IU/L) in early and late perimenopause. LH and FSH in women with AUB ranged from pre to post menopausal ranges. There was significant difference in LH and FSH between normal perimenopause and abnormal uterine bleeding. Estradiol levels showed a significant difference between late perimenopause and AUB p=0.015.Conclusions: This study shows that there is a progressive incremental trend in FSH and LH and decremental trend in Estradiol from early to late perimenopause due to decrease in ovarian follicular reserve, although the difference is not significant. Clinical symptoms present in 50% of late perimenopausal women showed that besides menstrual characteristics we can correlate these menopausal symptoms with raised FSH and low Estradiol. These women can be picked up and preventive therapy may be provided.
Analysis of still births in a tertiary care system and changed scenario over six year period
Authors: Mittal Rita , Mittal Shivika , Chandel Anubala , Samyal Poonam
Published: August 2019

Background: In India, the maternal and infant mortality rates have been steadily decreasing in recent years, but there has been no corresponding decrease in the perinatal mortality. Hence, there is need to evaluate the factors leading to this unfortunate event. The objective of this study was to find out various factors (especially preventable) responsible for perinatal stillbirths.Methods: An analytical comparative study in a tertiary care hospital comparing fresh and macerated still births over a period of one year in 2011 and 2017 and responsible factors were analysed.Results: Amazingly, despite improvement in the antenatal services, more institutional deliveries, there is no change in the incidence of still birth rate. However, there was decrease in the rate of still births due to extreme prematurity and congenital malformations. There was no change in incidence of PIH/ Eclampsia, IUGR and placental causes but there was substantial increase in the incidence of GDM.Conclusions: Perinatal mortality can definitely be reduced by strengthening and improving quality of antenatal services, early identification of high risk pregnancies, timely referral and appropriate intervention.
Health seeking behaviour of women with unwanted pregnancies: a tertiary care centre based study of eastern Uttar Pradesh, India
Authors: Gupta Sudhir Kumar , Tiwari Harish Chandra , Srivastav Reena
Published: August 2019

Background: Termination of an unwanted pregnancy is legal in India. Many women in this region are still not aware about safe abortion services and its consequences. Especially young, economically deprived and those without a supportive male partner are at higher risk of unsafe abortion. There is no clear and established evidence on this issue in our region. In the study, the aim was to explore the health seeking behaviour of women with unwanted pregnancies.Methods: Present cross-sectional study was conducted among 303 patients visiting to obstetrics and gynecology ward of BRD Medical College, Gorakhpur from April 2018 to September 2018. Their socio demographic profile, reasons for current termination of pregnancy and health seeking behaviour was explored.Results: Most common reason given for terminating the current pregnancy was completed family size 65.3%. Unmarried girls with pregnancy were 5.6 % who wanted termination of pregnancy. Majority (67.0%) took medication for termination of pregnancy from nearby medical store without an expert consultation 15.8% of women consulted to a local quack or local dai for termination of pregnancy. 12.9% of women tried a method as advised by family/friends for termination of pregnancy. About 4% of women 1st tried traditional and herbal medicines, drinking tea or juice for termination of pregnancy. Majority of women (84.5%) visited to medical college for management of complications of earlier tried method of termination of pregnancy.Conclusions: Completed family size was found most common reason for termination of pregnancy. Self medication without consultation of authorised doctor was found most common practice of abortion leading to complications.
Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus
Authors: Kaur Navjot , Goel Poonam , Mehra Reeti , Kaur Jasbinder
Published: August 2019

Background: Estimation of HbA1c in gestational diabetes mellitus patients is not being recommended by any societies/guidelines as studies regarding the role of HbA1c for monitoring of euglycemic control and predicting the maternal and perinatal outcomes in GDM patients (unlike overt diabetes) are conflicting and sparse.Methods: This was a prospective study with an aim to evaluate the role of HbA1c estimation in late pregnancy (early and late third trimester) for prediction of pregnancy outcomes in GDM patients. 53 patients with GDM (diagnosed before third trimester) were recruited for the study. HbA1c levels were estimated in late pregnancy (at 28-32 weeks and again repeated at 37 - 39 weeks or at the time of delivery). Correlation of HbA1c levels in third trimester with maternal and perinatal outcome was studied in patients with gestational diabetes mellitus and cut off taken was 5.8%.Results: Of the total 53 patients 54.7% had HbA1c levels <5.8% and 45.3% had HbA1c ≥5.8% done at 28-32 weeks. Also when HbA1c levels done at 37-39 weeks POG/ at the time of delivery, 52.8% patients had <5.8% and 47.2% had HbA1c ≥5.8%. Approximately one-fourth of the patients had HbA1c ≥ 5.8% even with normal blood sugar levels (euglycemic) control. There was statistically significant increased incidence of polyhydramnios, LGA (large for gestational age babies) and increased mean birth weight in patients with HbA1c ≥ 5.8%, done in late pregnancy. However there was no statistically significant difference in the incidence of preterm labour, gestational hypertension or preeclampsia, urinary tract infections, vulvovaginal infections, caesarean deliveries and postpartum haemorrhage in patients with HbA1c ≥5.8% compared to patients with HbA1c <5.8%.Conclusions: The study revealed that in patients of GDM with HbA1c levels ≥5.8% done in third trimester was statistically significantly associated with increased incidence of polyhydramnios, large for gestational age babies and increased mean birth weight when compared to patients with HbA1c <5.8%.
Study of adolescent clinic: holistic approach for women health with dual client methodology
Authors: Shetty Vishma H.
Published: August 2019

Background: The study is done to understand the gynaecological problems in adolescent girls. Do counseling, imparting knowledge for the girl and her mother, hence creating a holistic approach towards the women health in the family by dual client approach.Methods: 400 adolescent girls attending the clinic were studied (prospective observational study). Hb%, S.TSH was done for all the girls. Ultrasonography abdomen and pelvis was done on patient basis. Treatment was given. Mothers were counseled regarding their gynecological issues and screening tests (pap smear, self breast examination) was done after taking consent.Results: 70% girls had menstrual disturbances, 20% had complains of vaginal discharge. 44% had anemia (4% had severe anemia). Subclinical hypothyroidism was detected in 8% of cases. Ultrasonography was done in 52% of cases in which 81 patients had features suggestive of polycystic ovaries. 85.5% of the adolescent girls were accompanied by their mothers. 12% girls took HPV vaccination and 52% mothers underwent pap smear.Conclusions: Teenage problems need to be dealt very sensitively. Counseling is an integral component of treatment strategies. At present, adolescent gynaecology remains an area to which increased awareness and greater attention should be given to promote the health of teenagers and incult healthy lifestyle practices. In the same set up even the mothers of girls can be given counseling and address their gynaecological issues as majority of times mothers are the accompanying person creating the dual client approach in one setting. Hence adolescent clinic should aim for holistic, dual client approach for improvement of overall women health in the family.
A study of comparison of efficacy and side effects of intravenous paracetamol and intravenous diclofenac as a postoperative analgesic
Authors: Agrawal Sharda A. , Nikhate Surendra D. , Thakur Manasi M. , Bal Himadri
Published: August 2019

BBackground: A postoperative patient suffers from pain the best relief of which is a clinician’s duty. Till date very few studies have been conducted for comparison of paracetamol and diclofenac as analgesics. As a result a comparative study between Paracetamol and Diclofenac was carried out. The aim of the study was to compare the efficacy and side effects of intravenous Paracetamol and intravenous Diclofenac in patients undergoing major abdominal open surgeries in obstetrics and gynaecology. The study was conducted to assess the postoperative visual analogue pain scores (VAS) and total analgesic requirement in the first 24 hours and also to study the total requirement of additional analgesics despite administration of either Paracetamol or Diclofenac in postoperative period.Methods: 100 patients satisfying the inclusion/exclusion criteria were recruited for the study. They were divided into two groups of 50 each. Group A was given IV Paracetamol 6 hourly for 48 hours starting 2 hours after surgery. Group B was given IV Diclofenac 8 hourly for 48 hours starting 2 hours after surgery. Patients were assessed for pain relief by visual analogue scale (VAS) of zero to ten after 6 hours, 12 hours, 24 hours and 48 hours of surgery by asking the patient to point the position on the 100 mm scale.Results: The results revealed that when we compared the VAS scores between the 2 Groups at different time intervals, it showed that at 24 hours and 48 hours VAS score in the Diclofenac Group was significantly less than the Paracetamol Group. The main side effects were nausea and vomiting in both the groups. There was more nausea and vomiting in Diclofenac group compared to Paracetamol group.Conclusions: It was concluded that at 24 hour and 48 hour pain reduction was more in the Diclofenac group as compared to Paracetamol group, but the side effects were more in the Diclofenac group compared to Paracetamol group.
A study on clinico social impact of teenage pregnancy in a tertiary care hospital
Authors: Konduru Anuradha , Bathula Anil Kumar , Rao R. Nageswara , Prabhavathi N.
Published: August 2019

Background: In India, teenage pregnancy is an important public-health problem, although the national policy of the Government of India advocates the minimum legal age of marriage for girls to be 18 years. Data of the National Family Health Survey (NFHS)-3 revealed that 16% of women, aged 15-19 years, have already started childbearing. Teenage pregnancies represent a high-risk group in reproductive terms because of the double burden of reproduction and growth. Complications of pregnancy and childbirth are the leading cause of mortality among girls aged 15-19 years in developing countries. Aim and objective of the study was to study the prevalence of teenage pregnancies and to study the clinic social impact of teenage pregnancies.Methods: The observational cross-sectional study was conducted in Government General Hospital, Guntur in the department of Obstetrics and Gynaecology over three Months from August to October 2018. All pregnant women coming to either OPD or directly to the labour room were included in the study group. History was taken and examination was done.Results: Among the 709 deliveries in the institute, 138 are teenage pregnancies contributing to 19.4%. Prevalence of anaemia in teenage mothers is as high as 63.7%, pregnancy induced hypertension contributing to 26.8% and abortions 9.4%. The neonatal outcome is poor in teenage mothers, low birth weight 20.2% contributing to the main morbidity.Conclusions: Teenage pregnancy is associated with an increased incidence of preeclampsia, eclampsia, preterm delivery, increased incidence of instrumental deliveries and lower segment caesarean sections due to cephalopelvic disproportion, neonatal complications, increased neonatal morbidity and mortality mainly due to low birth weight was noted in babies delivered to teenage mothers.
Assessment of quality of care provided at a tertiary hospital of Sikkim by patient's degree of responsiveness
Authors: Rahman Hafizur , Khalda Ezzat
Published: August 2019

Background: Quality of care is concerned with the interface between provider and patients, between health services and community. The aim of the current study was to evaluate the quality of provided health care and patient experiences at a tertiary hospital based on the concept of responsiveness.Methods: This was a cross-sectional survey among reproductive women of Central Referral Hospital over a period of 5 months from August 2016 to December 2016. A pre-designed, pretested, self-administered response questionnaire on rate of service utilization using the WHO health system responsiveness modulewas used.Results: A total of 450 women were approached and requested to participate during the study period of which 374 women completed the survey. According to the evaluation of in-patient care (Table 2), "able to change doctor if wanted" showed the lowest degree of responsiveness (52.7%). A significant proportion of patients experienced discrimination for different reasons: 9.6% reported feeling they had been treated worse than others because of lack of money, while a similar proportion reported they had been discriminated for the language they speak or because they were having insurance from a company.Conclusions: Health care access in terms of prolong waiting  time in the reception and before being attended by doctor, difficulty to change doctor when wanted and discriminatory experiences were identified as priority areas for actions to improve responsiveness and patient satisfaction.
Correlation of serum magnesium levels in eclampsia with pritchard and single dose magnesium sulphate regimen
Authors: S. Shreya M. , H. Nayana D.
Published: August 2019

Background: Magnesium sulphate is anticonvulsant of choice for eclampsia. Single dose magnesium sulphate therapy was tried for the management of Eclampsia and Imminent Eclampsia considering the low body mass index of Indian population.Methods: A prospective interventional study comprising of total 80 patients having either eclampsia or imminent eclampsia, to whom the Pritchard or a single dose MgSO4 was given alternatively in a tertiary hospital   from October 2014 to October 2017. Serum magnesium levels, maternal and perinatal outcome and recurrence of convulsions were evaluated using Student- t test and chi square test.Results: Mean Serum Magnesium levels in eclampsia and imminent eclampsia group at 0 min, 30 min, 4 hours in Pritchard regimen were 1.96mg/dl, 5.85mg/dl, 4.68mg/dl while in single dose regimen it was 1.78mg/dl, 462mg/dl, 3.63mg/dl respectively. Those who received Pritchard regimen showed higher level of Serum magnesium levels at 30 minutes and 4 hours than those receiving single dose. By applying T-test it was found that there is a significant difference in serum magnesium levels range in both group but no statistical difference in the control of convulsions in both groups.Conclusions: With increased and almost widespread use of magnesium sulfate in obstetrics there has been concerns regarding its safety. In the study, although P-values are not significant because of small sample size, there is considerable difference in serum magnesium levels 30 min and 4 hours, recurrence of convulsions and maternal morbidity between Pritchard regimen and single dose regimen. The goal which was achieved with Pritchard regimen previously, now can be achieved with single dose regimen in Indian women. Single dose magnesium sulphate is safe and effective in controlling convulsions with improved maternal and perinatal outcome.
Expression and cellular distribution of insulin-like growth factor 1 receptor during window of implantation in infertile women with intramural fibroids
Authors: Makker Annu , Goel Madhu Mati , Nigam Dipti , Pandey Amita
Published: August 2019

Background: The “window of implantation” (WOI) is a transient but well defined period during which the hostile endometrial lining is transformed to a surface receptive to accept the embryo. Recently, data are beginning to accumulate suggesting negative influence of non-cavity distorting intramural uterine fibroids (NCD-IMF) on endometrial receptivity that may have implications for implantation failure. However, molecular mechanisms underlying infertility associated with NCD-IMF remain unclear. The aim of present study was to examine the expression and cellular distribution of insulin-like growth factor 1 receptor (IGF1R) during WOI in infertile women with NCD-IMF and fertile controls. While, reports are available that support role of IGF1R in mediating adhesive interaction with the implanting blastocyst, the effect of NCD-IMF on IGF1R expression during the WOI is not defined.Methods: Quantitative real-time polymerase chain reaction and immunohistochemistry were used to evaluate messenger RNA (mRNA) and protein expression of IGF1R in midsecretory endometrial biopsies obtained from infertile women with NCD-IMF (n=20) and healthy fertile controls (n=10).Results: As compared to fertile controls, significantly higher IGF1R: i) mRNA levels (1.59 fold up regulation; p=0.044) and ii) immunoscore in the luminal epithelium (8.94±3.13 versus 6.31±1.49; p=0.009) were observed in infertile women with NCD-IMF.Conclusions: Over expression of IGF1R in infertile women with NCD-IMF, during the window of receptivity, may result in altered ability of uterine epithelial cells for blastocyst adhesion and subsequent implantation, which might lead to poor reproductive outcome in these women.
Relationship of umbilical coiling index and cord twist direction with adverse perinatal outcomes
Authors: Sarkate Pratibha S. , Hiwale Sujitkumar
Published: August 2019

Background: The main objectives of this study were to examine - (1) relationship of pregnancy-related factors (maternal age, gestational diabetes mellitus, pregnancy-induced hypertension, oligohydramnios, small for gestational age (GA), and fetal gender) and postnatally measured umbilical coiling index (UCI); (2) association of UCI and cord twist directions with the following adverse perinatal outcomes, meconium staining of amniotic fluid, non-reassuring FHR on CTG, low Apgar score (<7) at one and five minutes, low birth weight, and NICU admission.Methods: The inclusion criteria were singleton live-birth pregnancy with GA > 34 weeks. The cases were categorized in hypocoiled (UCI <10th percentile), hypercoiled (UCI >90th percentile) and normocoiled groups. To study relationship of pregnancy-related factors and UCI, multivariate logistic regression was used; whereas bivariate analysis was used to study impact of UCI on various adverse perinatal outcomes. UCI was measured by a single observer.Results: In total, 100 subjects were enrolled. The mean UCI was 0.268 (SD = 0.13; 10th percentile = 0.139; 90th percentile = 0.410) coils/cm. Pregnancy-related factors had non-significant relationship with UCI. For adverse perinatal outcomes, only the non-reassuring/abnormal FHR patterns were significantly associated with hypercoiled groups (OR = 4.5; CI =1.15 - 17.58). Both cord directions had almost equal distribution without any significant difference in outcomes; however, anticlockwise twisted cords were found to have significantly high UCI.Conclusions: No significant relationship was observed with pregnancy-related factors and UCI. However, it was observed that hypercoiled cords had significant association with non-reassuring/abnormal FHR patterns on CTG.
Correlation of wrist circumference with waist circumference and body mass index in adults with early-onset type 2 diabetes mellitus
Authors: V. Ajithkumar P. , L. Manju , M. Deepa
Published: August 2019

Background: Recent studies have shown that wrist circumference is correlated with insulin resistance, obesity and new onset diabetes. Being easy to measure, it may be useful in identifying individuals at risk for cardio- metabolic disorders.Methods: 112 consecutive subjects with new onset type 2 diabetes in the age group 18-44 years were included in the study. Socio demographic characteristics, anthropometric and biochemical measurements were carried out using standard techniques. Pearson product movement Correlation Coefficient was used to find out correlation with other measures of obesity and ROC curve to determine its cut off values.Results: Wrist circumference showed moderate positive correlation with BMI (r+0.389) and waist circumference (r+0.443). The cut off value of wrist circumference when compared with BMI in defining obesity was 16.5cm in male and 15.7 cm in female. The cut off value of wrist circumference with waist circumference in male was 16.2cm.Conclusions: Measurement of wrist circumference may supplement in assessing obesity especially when other measures of obesity like BMI or Waist circumference measurements are difficult or not feasible.
Next generation sequencing in early diagnosis of pneumocystis jirovecii pneumonia after chemotherapy: a case report
Authors: Zheng Donghua , Chen Kai , Xiao Fang , Liu Na
Published: August 2019

The incidence of Pneumocystis pneumonia is increasing in immunosuppressive patients. How to diagnose and treat Pneumocystis pneumonia in the early stage has become an important issue for clinicians. The development of Next-generation Sequencing (NGS) provides technical support for the diagnosis of Pneumocystis pneumonia. Case report: A 14-year-old male patient was diagnosed with T lymphoblastoma and treated with chemotherapy. After chemotherapy, the patient developed bone marrow suppression and was complicated with severe pneumonia. He was given endotracheal intubation and ventilator assisted respiration. Samples of patients' alveolar lavage fluid were obtained, and Next-generation Sequencing (NGS) was used for diagnosis, confirming the pathogen as Pneumocystis jiroveci, which was treated by TMP/SMX. The patient's condition gradually improved, and was finally removed from ventilator and endotracheal tube. Pneumocystis jiroveci is a common opportunistic pathogen in immunosuppressive patients, and Next-generation Sequencing (NGS) can be used for rapid diagnosis of Pneumocystis pneumonia, thus improving the clinical therapeutic effect.
Case report of Anotia with ipsilateral facial nerve palsy
Authors: Buhaibeh Qasem , Madad Sulaiman , Dhaiban Tawfik
Published: August 2019

Anotia is the severe form of microtia anomalies that involve pinna and external auditory canal  present at birth is rare to be associated with congenital facial nerve palsy. The author reports a man with Right side Anotia and ipsilateral facial nerve palsy. This is rare report of such an association in adult patient had right Anotia and ipsilateral right facial palsy.
Scrub typhus: as it stands today
Authors: Sharma Raman , Gupta Mayank , Mahavar Sunil K. , Agarwal Madhulata
Published: August 2019

Scrub typhus is one of the three most common causes of prolonged fever in Southeast Asia and Pacific affecting almost 1 million people annually worldwide out of 1 billion exposed. Scrub typhus is a rickettsial infection caused by Orientia Tsutsugamushi transmitted through bite of Chiggers (larval stage of trombiculid mite). It is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure and death. Deaths are attributable to late presentation, delayed diagnosis, and drug resistance. Scrub typhus, though endemic in India; yet is under reported. It should be considered as an important differential diagnosis in a febrile patient with thrombocytopenia, deranged liver or renal functions, and B/L chest opacities. Relapse is not uncommon. Presumptive treatment with Doxycycline can be a suitable option in febrile patients from Typhus pockets. Alert physician should keep an eye on deviation from usual presentation to changing spectrum of the disease. Early diagnosis and appropriate treatment is rewarding and prevents morbidity and mortality.
Analysis of serum level of 25-hydroxycholecalciferol, calcium and lipid profile in carcinoma breast
Authors: Saha Sanjeev , Singh Bipin Kumar , Singh Kirti , Khanna Rahul , Meena Ram Niwas
Published: August 2019

Background: Breast cancer (BC) is one of the major surgical problems in India, particularly in younger females. There are conflicting reports regarding the association between the serum lipid profiles, vitamin D, calcium and BC. The objective of the study was to measure the serum vitamin D, calcium and lipid profile levels in BC, benign breast diseases (BBD) and healthy control (HC), and compared these variables with clinico-pathological parameters in BC patients.Methods: Forty histologically confirmed invasive BC, 20 BBD patients and 20 healthy individuals taken as controls were enrolled for estimation of serum lipid profile, calcium and vitamin D. The study variables were compared with all three groups. In BC group, the levels were also compared with clinico-pathological parameters.Results: The mean age of subjects in BC, BBD and HC group was 48.88±11.33, 31.10±3.93 and 36.30±5.97 years respectively. The levels of serum cholesterol, triglyceride, HDL, LDL, VLDL and calcium was significantly increased and vitamin D was significantly decreased in BC patients as compared with BBD and HC group (p<0.001). On comparing lipid profile, calcium and vitamin D in receptor positive BC patients and triple negative BC patients, only serum HDL and serum calcium was significantly high in receptor positive BC patients (p=0.047 and p=0.041).Conclusions: Our findings suggest that lower vitamin D level and higher calcium and lipid profile level could be an important etiopathological factor in the causation of BC. Correction of these factors could be used as a prophylactic and preventive strategy in the population against BC.
A clinical study of gastrointestinal obstruction among children in a tertiary referral centre of North India
Authors: Singh J. K. , Singh Mayank
Published: August 2019

Background: Children are a unique lot in that, since, in contrast to adults, in which post op adhesive obstruction and inflammatory causes predominate, in children congenital causes also make a significant part.Methods: This study was a retrospective analysis of the clinico pathological data of patients (between 1 month and 12 years of age) who presented to the department of surgery, MLNMC, Prayagraj with clinical diagnosis of intestinal obstruction. The study included patients who were admitted to the department between April 2013 and April 2019.Results: A total of 130 patients were admitted in pediatric unit of general surgery department during the study period. Of these 83 were males and 47 were females. In the end, 116 fulfilled the inclusion or exclusion criteria. 21 patients were successfully managed conservatively. 95 were operated.Conclusions: Intussusception is the most common cause. Kochs abdomen is the most common cause in children >5years with a vast majority being females. Majority of the patients whose clinical diagnosis is Koch’s abdomen, post-operative adhesive obstruction or worm infestation can be conservatively managed.  Obstructed inguinal hernia still remains a potential preventable cause of intestinal obstruction.
Thyroid gossypiboma: a rare diagnosis with common presentation
Authors: Lohani Kush Raj , Kataria Kamal , Ranjan Piyush , Khadka Sarada , Jayaram Jnaneshwari
Published: August 2019

Gossypiboma is a surgical negligence and is commonly reported in major abdominal surgeries. It has rarely been reported after thyroid surgeries. We present gossypibomas found in two post-hemithyroidectomy patients who presented differently and at varied time interval after primary surgery. First patient is a middle-aged lady who presented with persistent discharging sinus from neck for the past 4 years. She underwent hemithyroidectomy in the past. Another patient is an elderly lady who presented with lump in the neck for the past 3 months. She also had history of thyroid surgery about 36 years back. With the working diagnosis of thyroid abscess and malignancy in the respective cases, extensive work up was done including imaging and needle aspiration. However, definitive diagnosis could only be made intra-operatively, where gauze piece was found embedded in the prior surgical site. Gossypibomas can present in a varied fashion that can be easily missed from clinical judgement and imaging. High clinical suspicion in patients with prior history of surgery presenting with chronic discharging sinus or lump is key to diagnosing gossypibomas. Safer working environment with safety checkpoints are warranted to avoiding such incidences.
Broken chest tube: a rare complication treated by video-assisted thoracic surgery
Authors: Bakhshi Girish D. , Rahul Kushagra , Gangawane Shraddha S. , Borade Ashwini S. , Pawar Dinesh S. , Parikh Atish K.
Published: August 2019

Intercostal chest drain (ICD) or chest tube is a simple device used very frequently in medical, surgical and critical care specialties to drain air, blood or pus from the pleural cavity. Fracture of ICD and displacement of fractured segment within the pleural cavity is a rare complication. Minimal invasive approaches via video-assisted thoracic surgery (VATS) have been demonstrated predominantly in traumatic thoracic foreign body removal cases in a primary surgical setting. Here we present a case of a broken chest tube in the pleural cavity removed using VATS. A brief case report, review of literature and prevention of this complication is described.
Retrocaval ureter: a rare cause of urinary tract obstruction
Authors: Kulkarni Narsinha Vamanrao , Sarda Vikram R. , Gupta Kartik Chandrakant
Published: August 2019

Retrocaval ureter is an uncommon cause of ureteric obstruction due to a rare congenital anomaly of inferior vena cava. We report a case of 23 year old male who presented with right flank pain and was diagnosed with ultrasound and intravenous urography. He underwent open retroperitoneal ureteroureterostomy.
Histopathological spectrum of spindle cell tumours of gastro-intestinal tract
Authors: Rasool Zubaida , Feroz Imza , Wani Abdul Haseeb , Nazir Mir Wajahat un
Published: August 2019

Background: Spindle cell lesions of gastro-intestinal tract (GIT) are relatively uncommon tumours compared to epithelial tumours. The anatomic location of spindle cell tumour is important, whether the tumour is located in mucosa, submucosa or muscularis propria.Methods: Authors endeavoured to study the histopathological spectrum of spindle cell lesions for a period of one year from January 2018 to December 2018 in our hospital.Results: This was a prospective study of 1 year starting from January 2018 to December 2018. A total of 30 cases of spindle cell lesions of gastrointestinal tract were seen. Out of 30 cases 23 were gastrointestinal stromal tumours (GIST), 2 cases were schwannomas, 2 cases were of leiomyomas, 1 case was fibromatosis, 1 case was inflammatory fibroid polyp, and one case was inflammatory myofibroblast tumour.Conclusion: GISTs are the commonest spindle cell tumours of GIT. Besides GIST, there are other spindle cell tumours which range from benign to malignant, and need to be differentiated from GIST for proper management.
Association between age at onset of multiple sclerosis and vitamin D level in Saudi population
Authors: Younis Hossam H. , Alzahrani Abdulrahman H. , Alomar Abdulmageed S.
Published: August 2019

Background: Several studies have shown an association between 25-hydroxyvitamin D (Vitamin D) levels and multiple sclerosis (MS). This study aimed to evaluate association between age at onset of Multiple Sclerosis and vitamin D level in Saudi population.Methods: This cross-sectional study was performed in the Neurology Department king Fahd Military Hospital Jeddah in the Kingdom of Saudi Arabia (KSA) included 75 patients with MS and 99 healthy controls group matched for gender and age. Comparing vitamin D measurement in multiple sclerosis patients at the time of diagnosis with healthy controls group.Results: We found no significant association between age at onset of multiple sclerosis and vitamin D level in Saudi population p value (0.723). However we also found that 74.66% of the sample Members who had MS and has a deficient of vitamin D and 83.83% people of the sample members didn’t have MS, but vitamin D was deficient with them.Conclusions: Study has revealed a high rate of vitamin D deficiency in patients with MS and in the controls group, as well Therese no clear relation to MS, Thus Therese no significant association between age at onset of multiple sclerosis and vitamin D level in Saudi population.
The prevalence of anemia in pregnant women in the 10 priority villages for stunting control in Sumedang district, West Java: a community-based survey
Authors: Nainggolan Sudung , Siagian Forman E.
Published: August 2019

Background: Anemia in pregnant women possessed potential harm to mother and child. There were 48.9% of pregnant women suffering from anemia and 40% of women of childbearing age also suffer from anemia. Incidence of anemia among pregnant women is prominent health problems especially in developing countries such as Indonesia. The aim of the present study is to determine the prevalence of anemia among pregnant women in relation to infection of Soil-Transmitted Helminthes (STH) and Serum Iron deficiency in 10 priority villages for stunting control set by the government in Sumedang district, West Java.Methods: This is a community-based survey. Hemoglobin concentration was obtained from finger prick blood test. Containers for stool specimens and anal swabs were given to each woman at the time of hemoglobin fingerpick blood test showed positive results for anemia. Data were analyzed using SPSS software.Results: Out of 209 pregnant women examined we found 39 pregnant women (18.7%) suffering from anemia. Followed by serum iron analysis we found 23.3% of the total number of pregnant women with iron deficiency. On microscopic examination of fecal specimens and anal swabs we found no worm eggs or larvae in the specimens examined.Conclusions: Hemoglobin examination found that there were 18.7% pregnant women with anemia and 23.3% suffering iron deficiency. Microscopic examination of fecal samples and anal swabs in pregnant women with anemia showed neither STH eggs nor larvae.
Strengthening opportunistic screening for hypertension: report from a tertiary care institution in a district of West Bengal, India
Authors: Ghosh Ritu , Maulik Sanghamitra , De Saikat , Tikader Tanmoy , Jha Sankar Nath , Mondal Sayantan , Mallik Sarmila , Banerjee Manju
Published: August 2019

Background: Hypertension is a major public health problem in India and considered as a silent killer disease. The national program for prevention and control of cancer, diabetes, CVD and stroke (NPCDCS) recommended opportunistic screening for hypertension at all levels health facility. The present study was conducted with the objectives to estimate the magnitude of hypertension among the General OPD attendees aged 18 years and above in tertiary care hospital in a district of West Bengal and to find out the factors influencing hypertension among them.Methods: The study was a hospital based observational, descriptive study with cross sectional design and conducted among 244 study participants in 2018. Study variables included socio demographic factors and both modifiable and non-modifiable risk factors for hypertension.Results: In this study 40.2% subjects had normal blood pressure, 18.4% were known hypertensive and 101 (41.3%) people were newly diagnosed as having high blood pressure. Among known hypertensive, 75% had poor control of hypertension. Age, religion, family history of hypertension, body mass index (BMI) and central obesity had significant association with hypertension.Conclusions: The study recommended strengthening of opportunistic screening of all patients for hypertension at all levels of health care, especially through the village health nutrition day platform and providing treatment free of cost. Awareness generation and counselling for lifestyle modification should also be strengthened.
Pathoradiological association between depth of invasion and neck node metastasis in oral cavity tumours
Authors: Venugopalan Shruti , Mistry Sejal N. , Lavana Yash D. , Mehta Manish R. , Khavdu Paresh J.
Published: August 2019

Background: The aims of the study were to know whether the increase in the depth of invasion in oral cavity carcinoma assessed histopathologically and radiologically co-relates with neck node metastasis and to accurately co-relate the radiological thickness at which neck dissection is required.

Methods: A retrospective study has been conducted over thirty patients with oral cavity carcinoma (buccal mucosa and tongue) in the time period of April 2018 to December 2018 who were operated in our tertiary care hospital.  

Results: Depth of invasion is relatable histopathologically and radiologically, is directly proportional to neck node metastasis. Pre-operative radiology is a reliable modality to rule out the need of neck node dissection.

Conclusions: Depth of invasion is directly proportional to the incidence of neck node metastasis and pre-operative radiology has been reliable to rule out the need of neck dissection and reduce its morbidity.
Pediatric neck masses: a clinicopathological study
Authors: Rao Seepana Soma Shekara , Ramesh Seepana , Ramesh Hanumanthu , Pradep Kusuma Jeevan , Bakshi Satvinder Singh , Das Soumyajit
Published: August 2019

Background: Pediatric neck masses are one of the most commonly presenting problems in ENT practice. Based on the etiology they are classified as infectious, congenital or neoplastic. A detailed history and physical examination are essential to establish the diagnosis and treat them. The study was undertaken to assess the clinicopathological profile of the pediatric neck masses.

Methods: The present study was conducted for a period of 24 months between March 2015 to February 2017 in the Department of ENT, Government General Hospital Srikakulam in a tertiary care hospital in costal Andhra Pradesh.

Results: A total of 226 patients were enrolled into the study. Of them 132 were males and 94 female. Inflammatory swelling was most common etiology (76.1%) followed by congenital (16.3%) and neoplastic (7.5%).

Conclusions: In most cases of pediatrics neck masses diagnosis is made based on a detailed history and the findings of the physical examination. If radiological examination is required, US should be the first choice. Infectious and inflammatory diseases are the leading causes of neck masses in the pediatric age group.
Facial nerve paralysis: a clinical study
Authors: Sudhakaran Shilpa K. , Madayambath Sagesh
Published: August 2019

Background: A facial paralysis is one of the most emotionally traumatic deficits a person can experience. It is essential to understand the cause and nature of nerve injury and undertake proper measures for restoration and rehabilitation of facial symmetry. The present study was conducted to evaluate the various aetiologies of lower motor neuron facial paralysis that presented to our department. The aim of the present study is to investigate into the demographic data and etiology associated with peripheral facial nerve paralysis and to assess the site of lesion, severity grade and treatment outcome of peripheral facial nerve paralysis.

Methods: A prospective longitudinal study conducted in a tertiary care hospital, over a time period of one and a half years from November 2014 to April 2016. All the patients were assessed regarding the time of onset of symptoms, rapidity of progression, duration and completeness of paralysis. Topo diagnostic tests were done to assess the site of lesion and response to treatment monitored.  

Results: The most common cause for LMN facial nerve paralysis was external trauma and Bell’s palsy. The mean age group was 37.5 years with a male preponderance. Majority of the lesions were suprageniculate and had a House Brackmann grade IV severity score.

Conclusions: Peripheral facial paralysis showed a good response to treatment and timely intervention would result in a full or partial recovery at the end of a follow up.

 