bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualidade Microbiológica de Polpas de Açai Comercializadas no Município de Ji – Paraná, Rondônia
Authors: Barcelos Izabel Bárbara , Barcelos Valiatti Tiago , Virgolino de Almeida Fernanda Karen , Ferreira Lima dos Prazeres Priscila , Moura Costa Silva Wilker , De Oliveira Solla Sobral Fabiana , Faria Romão Natália , Melo Calegari Gabrielle
Published: January 2018

O açaizeiro é uma fruteira típica da região norte do Brasil, sendo a polpa de seus frutos utilizada na produção de diversas bebidas e produtos alimentares, contudo sua perecibilidade, proveniente da alta carga microbiana, tem sinalizado uma preocupação com relação à qualidade e segurança dos produtos fornecidos aos consumidores. Objetivou-se por meio do presente estudo avaliar a qualidade microbiológica de polpas de açaí comercializadas no município de Ji-Paraná, Rondônia. Para tanto foram analisadas 16 amostras, realizando a quantificação de Coliformes totais e mesófilos e pesquisa da presença ou ausência de Listeria monocytogenes. Constatou-se a presença de coliformes totais em todas as amostras, sendo que 68,75% apresentaram índice de contaminação na ordem de 102. Quanto à análise de mesófilos verificou-se que 100% das mesmas apresentaram positividade, em que que a ordem 106 foi a mais frequente com 25%. A presença de Listeria monocytogenes não foi detectada em nenhuma das amostras analisadas. Diante do exposto é importante que sejam tomadas medidas no sentido de implantarum controle de qualidade, visando garantir um produto seguro e de qualidade ao consumidor, tendo em vista que as amostras se mostraram contaminadas por Coliformes totais e Mesófilos.Palavras-chave: Região Norte. Contaminação. Segurança Alimentar.AbstractThe aça tree í is a typical fruit tree in the northern region of Brazil, with the pulp fruit used in the production of various drinks and food, but their perishability, from the high microbial load, has signaled a concern about the products’ quality and security supplied to consumers. The objective through the present study was to evaluate the açaí pulp’s microbiological quality sold in the city of Ji –Paraná, Rondônia. Therefore, we analyzed 16 samples, performing the quantification of total coliforms and mesophilic and tests for the presence or absence of Listeria monocytogenes. It was found the presence of coliforms in all samples, and showed 68.75% infection rate in the order of 102. Whereas the mesophilic analysis, it was found that 100% of them were positive, where the order 106 was the most common with 25%. The presence of Listeria monocytogenes was not detected in any of the samples. Given the above it is important that measures be taken to implement a quality control, to ensure a safe and quality product to the consumer, given that the samples were found contaminated with Coliform and Mesophiles.Keywords: North Region. Contamination. Food Security.
Estudo de Caso: Avaliação de Impactos Ambientais no Horto Florestal – Tote Garcia em Cuiabá – Mato Grosso
Authors: Ferreira Tafnys Hadassa da Cunha , Chig Léo Adriano , Favaro Emerson Giuliano Palacio , Andrade José Maria de , Oliveira Suize Silva
Published: January 2018

O Estudo de Impacto Ambiental busca maneiras e estabelece normas para o uso sustentável da utilização de recursos naturais. A pesquisa teve como objetivo avaliar os principais impactos ambientais no interior de uma unidade de conservação, visando indicar métodos que minimizem esses impactos. Foi realizada a identificação e caracterização dos impactos com dados qualitativos baseados na frequência, duração, extensão, reversibilidade, origem, sentido e grau que os impactos se manifesta sobre o meio dispostos em uma matriz de Leopold. Na avaliação se verificaram ações antrópicas que impactam, negativamente, o meio ambiente, como por exemplo: alargamento das trilhas, erosão, pisoteamento e supressão da vegetação, ausência de placas indicativas e acessibilidade, animais domésticos, resíduos sólidos e sedimentação ao longo do rio Coxipó. Um novo plano de manejo e de manutenção se faz necessário ao considerar que o objetivo da Unidade de Conservação é a preservação ambiental, existe muitos pontos a serem melhorados, como a reestruturação física, administrativa e planejamento.Palavras-chave: Áreas Protegidas. Reflorestamento. Preservação Ambiental.AbstractThe Environmental Impact Study seeks ways and standards for the sustainable use of natural resource use. This study aimed was to evaluate the main environmental impacts within a protected area, in order to indicate methods that minimize these impacts. The identification and characterization of impacts with qualitative data were performed based on the frequency, duration, extent, reversible origin, direction and extent that the impact on the environment manifests arranged in a Leopold matrix. In the evaluation human actions were verified that negatively impact the environment, such as: enlargement of the trails, erosion, trampling and removal of vegetation, lack of signposts and accessibility, domestic animals, solid waste and sedimentation along the Coxipó river. A new management and maintenance plan is necessary to consider that the purpose of the conservation area is environmental preservation, there are many points to be improved, such as physicaland administrative restructuring and planning.Keywords: Protected Areas. Reforestation. Environmental Conservation.
Assessment of undergraduates’ preferences and opinions on teaching of Pharmacology
Authors: Bukar B. B. , Falang K. D. , Gyang S. S.
Published: January 2018

Background: The preference and opinion of undergraduate students on teaching of pharmacology was assessed using structured-based questionnaires. The objective was to determine the best way to teach pharmacology and the areas the students prefer most.Methods: The questionnaires were administered to students during academic sessions in any of their pharmacology lectures by the help of technical assistants. It was also ensured that the identity of the students was not made known except for the gender. A total of 8 questions with options ranging from 2-4 were used. Each respondent was to select only one option as the most preferred. A total of 405 students participated during the study period and it was ensured that no student participated more than once. The students recruited were 4th and 5th year medical and pharmacy students of the University of Jos, Jos, Nigeria for the 2014/2015 and 2015/2016 academic sessions.Results: The results showed that the students have high preference for latest technology teaching aids such as power point presentation and use of software for lecture notes.Conclusions: Knowledge of pharmacodynamics, clinical pharmacology and laboratory experiment were preferred and significant differences exist between observed and expected results and also between males and females in preferences among some of the options. Students need to be informed at the beginning of their lectures that pharmacology is a subject that must be regarded as a whole with no areas of preference.
An assessment of pattern of adverse drug reactions of cardiovascular drugs in a tertiary care institute
Authors: Wankhede Smita Y. , Pardeshi Milind L. , Ghorpade Vishal V. , Ghongane Balasaheb B.
Published: January 2018

Background: Cardiovascular disease is very prevalent in India. So, use of cardiovascular drugs is also more. So, it is very important to keep watch on adverse drug reactions. Aim of this study was to assess the pattern of adverse drug reactions (ADRs) reported with cardiovascular drugs in a tertiary care institute.Methods: The study was carried out in medicine department of a tertiary care hospital over a period of one year. Each ADR was analysed for demographic data, causality, relationship between frequency of ADRs and the number of drugs used etc. In statistical analysis Microsoft excel 2013, SPSS software was used.Results: A total of 136 patients, 58 (43%) men and 78 (57%) women, using cardiovascular medications reported ADRs during the entire study period. Total 168 ADRs were reported out of which, Amlodipine (causing headache and edema feet) was the most common drug with 51 (30.3%) ADR’s followed by Enalapril, Aspirin and Isosorbide Dinitrate with 37 (22%), 24 (14.2%), 23 (13.6%) ADRs respectively. Most common ADR was headache (due to amlodipine and Isosorbide di nitrate) affecting 38 (22.62%) cases followed by dry cough 37 (22.02%) cases, edema feet 36 (21.43%), gastritis 24 (14.29%) and 10 (5.95%) of nausea.Conclusions: Monitoring ADRs in patients using cardiovascular drugs is a matter of importance since this class of medicines are mostly used as multidrug therapy and always prone for ADRs.
A study on management of oral cancer in a tertiary care hospital
Authors: Srinivas Mangala , Volabailu Ravichandra , K. Jayarama Shetty , Sharma Sangeeta Nath
Published: January 2018

Background: Oral cancers form nearly 30% of the cancers. The most effective way of combating oral cancer is by early diagnosis followed by concurrent chemo-radiotherapy which is the most popular approach in current practice. The adverse effects seen in oral cancer patient’s due to their treatment are nausea & vomiting, mucositis, constipation, diarrhoea, fatigue & radiation dermatitis. Polypharmacy is due to variety of treatment options in oral cancer patients, which needs to be addressed.Methods: Over a period of 18 months, the in-patient records of 79 patients with oral cancers, admitted to oncology ward of Justice K. S. Hegde Charitable Hospital, Mangalore, were scrutinized and the data collected in a specially designed proforma. Descriptive analysis of the data was done.Results: Required data was collected from 79 patients, out of which 55.7% of the patients underwent surgery and later received chemotherapy and radiotherapy. Most commonly seen adverse effects due to treatment were weight loss (75.9%), reduced appetite (67.1%), fatigue (75.9%), pain (79.7%) and skin discoloration (50.6%), etc. Various classes of adjuvant drugs were used for complications caused due to the treatment of oral cancers. Drugs like topical applicant /mouth washes constituted the bulk of the prescriptions (22%) followed by nutritional supplements (15.34%), NSAID/opioids (12.76%) hematinic (12.59 %) and other groups of drugs were also used.Conclusions: Present study helped us to plan evidence based strategies to reduce or prevent post treatment complications. Most of the adverse effects were treated accordingly to keep the patient comfortable.
A prospective pharmacovigilance study to evaluate adverse effect profile of first line anti-tubercular drugs in newly diagnosed sputum positive patients
Authors: Agrawal Akhil , Bhosale Uma A.
Published: January 2018

Background: Tuberculosis (TB) continues to remain one of the most pressing health problems in India with highest TB burden country in the world. Anti-tubercular therapy (ATT) induced organ toxicities are potentially serious ADRs of first line ATT regimen. The underlying mechanism of ATT-induced ADRs especially hepatotoxicity and the factors predisposing to its incidence which is significantly high in Indians are not clearly understood. It's vital to emphasize on ATT induced ADRs as it has direct influence on therapeutic outcome; result in high dropout rate and potential to develop MDR/XDR cases. ADR monitoring help us to revise the treatment protocol thereby improve treatment adherence and therapeutic outcome. Objective of this study is therefore designed to explore and monitor ADRs of first line anti-TB drugs.Methods: In this prospective observational study 60 TB patients (18-70 yrs) of either sex, newly sputum positive with normal parameters were included. Patients were followed up for six months aiming primarily to assess rate of ADRs and to identify preventable and potentially serious ADRs of anti-TB drugs. The ADRs of ATT on various organ systems (heart, kidney and liver), biochemical and haematological parameters were assessed and compared after 2 and 6 months; gender and age specific adverse events were also studied. Data obtained was analysed using student’s t-test of OpenEpi statistical software.Results: Study clearly revealed that ATT exhibit significant increase in toxicity markers viz. liver enzymes (p<0.01), urea and creatinine (p<0.01), ESR (p<0.05) and PTINR (p<0.01), wherein decrease in Hb% (p<0.01) when compared to baseline.Conclusions: ATT related ADRs is the major cause of dropouts and development of MDR/XDR cases. It's crucial to develop strategies to ameliorate ADRs both to improve the quality of patient care and to control TB safely. The data obtained from present study may be helpful in developing these effective strategies.
Drug utilization study in ophthalmology in OPD patients at a tertiary care teaching hospital
Authors: Bhatt Jigar H. , Verma Shashwat , Bagde Srushti , Sane Rohit M. , Shahani Savita
Published: January 2018

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs.
Epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar (Senegal)
Authors: Gassama Omar , Mbaye Magatte , Niass Aminata , Boye Diodio , Biaye Babacar , Mbodj Assatou , Diallo Astou Niassy Colly , Dieme Marie Edouard Faye
Published: January 2018

Background: Twin pregnancy is the simultaneous development of two embryos and then two fetuses in the uterine cavity. Objective of present study was to assess the epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar.Methods: A descriptive and analytical retrospective bi-centric study of all cases of twin deliveries recorded in two referral center in Dakar was conducted during the period January 1st, 2005-December 31st, 2015, i.e. an 11-year period. It concerned 619 pregnant women who gave birth to twins in these two referral medical structures. The epidemiological parameters, clinical, prognostic and therapeutic aspects of twin childbirth were studied. The data were entered and analysed using Epi info version 3.5.3.Results: The twinning prevalence was 1.11%. The majority of our parturient women (506 or 81.7% of the cases) came from the Dakar suburbs. The average age of the parturient women was 28 years and the gestity age 3.1. Pregnancy was well monitored for 98.5% of the parturient women with an average number of prenatal consultations of 3.6. The first prenatal consultation was performed in 52% of cases in the first quarter. In more than one third of cases (234 or 37.8%), the diagnosis was made in the third quarter of pregnancy. 113 cases (18.2%) of premature rupture of membranes, 10 cases (1.61%) of threat of premature delivery and 7 cases (11.13%) of placenta previa were registered. During labour, the diagnosis was made by clinical examination in 32.2% of cases. Bichorial biamniotic twin pregnancy was the most frequent anatomical type (62.6%). On admission, the first twin (T1) was in cephalic presentation in 56.7%, in breech presentation in 15.2%; The second twin (T2) was in breech presentation in 21.1% of the cases. Caesarean section was related to the first twin in 50.6% and the second twin in 53.8% of the cases. Caesarean section was performed in 50.6% for the first twin and in 53.8% for the second twin. The mean time interval between the delivery of T1 and that of T2 was 17.4 min. Low birth weight was more frequent for the second twin (54.3%). The stillbirth rate was 48.26 per thousand. Maternal complications were dominated by renal-vascular syndromes (4.2%), haemorrhagic causes (1.86%), perineal lesions (1.6%) and uterine rupture (0.97%). Postpartum haemorrhage was observed in 8 cases (1.29%). Maternal mortality was nilConclusions: Twin delivery poses varying difficulties due to the complexity of obstetrical mechanics and the frequency of dystocic presentations. Despite improved maternal prognosis, in recent years, perinatal mortality and morbidity, still high, remain a constant concern.
Use of glycosylated HbA1c and random blood sugar as a screening tool for gestational diabetes mellitus in first trimester
Authors: Amreen Shaiesta , Suneel Anjali , Shetty Ananya , Vasudeva Akhila , Kumar Pratap
Published: January 2018

Background: GDM cases go unidentified with inadequate screening methods in first trimester which in turn increases the maternal and neonatal morbidity which is preventable. The purpose of the study was to find out a cut off level for HbA1c and RBS at first trimester for screening Gestational diabetes mellitus (GDM).Methods: Observational study on pregnant women in a tertiary care teaching institution. Early screening with HbA1c and RBS at booking visit and followed up to second trimester GTT at 24-28 weeks. Pregnant women were divided into 2 groups based on GTT results. Pregnant women with overt diabetes and multiple pregnancy were not included in the study.Results: Out of the 151 subjects, 76 cases were diagnosed with GDM while the other 75 were found to be non-GDM by following the 75g GTT approved by IADPSG. According to our study optimal cut-off for HbA1C was found to be 5.496±0.48 %, as it gives a sensitivity of 80% and specificity of 55.3%. Optimal cut-off for RBS was found to be 112±0.77 mg/dl, as it gives a sensitivity of 35.55 and specificity of 94.7%.Conclusions: Glyco Hb A1c and RBS can be used as screening tool for the diagnosis of GDM.  The likelihood of having GDM at a cutoff of Glyco HbA1c 5.5% is 1.8 times and RBS level 112mg/dl is 7 times in pregnant women.
Hysterectomy: still a treatment of choice for pelvic pathologies in rural India
Authors: Khunte Vimal , Armo Meena , Gahne Renuka , Sisodiya Aditya , Verma Shradha
Published: January 2018

Background: Hysterectomy has always been a subject of controversy in India and increasing rate of unnecessary hysterectomies in young, premenopausal women is cause for concern regarding women’s health and rights. The aim of this study is to review and analyse cases of hysterectomy in a rural population and to correlate with underlying factors behind seeking hysterectomy as a treatment of choice for pelvic pathologies.Methods: This was an ambidirectional observational descriptive study in which 352 women were included who underwent hysterectomy between January 2016 to July 2017 in the Department of Obstetrics and Gynecology, Government Medical College Rajnandgaon and a tertiary care referral hospital of central Chhattisgarh, India.Results: Majority were between 31-50 years of age group, grandmultipara, uneducated, insured by National health insurance scheme.76.1% patients had attended medical college hospital to avail free services. 60.5% took prior treatment from unqualified/ unregistered/registered general practitioners. Erratic use /use of suboptimal dosage of hormones to stop abnormal uterine bleeding, nonspecific antibiotics to treat infection, incomplete treatment and poor compliance were possible reasons behind failure of previous treatments. Abnormal menstruation was the commonest presenting complaint observed in 75.2%. 72.4% patients refused to come for follow up and reasons were unavailability of transport facility, fear of losing job, loss of daily wages and financial constraints. Commonest indication for hysterectomy was symptomatic fibroid in 32.0%. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was the most common procedure done in 59.0%. The rate of hysterectomy came out to be 57.6% which is quite higher than that reported in other studies. Fever was the most common complication encountered in 0.80%.Conclusions: Despite the remarkable improvement in conservative management and media coverage, hysterectomy still remains the most preferred modality of treatment with excellent satisfaction for pelvic pathologies in rural India.
Role of transvaginal ultrasound in predicting preterm labor in singleton pregnancies
Authors: Beigh Mehbooba , Mir Mohammed Farooq , Amin Rifat , Shafi Simrath
Published: January 2018

Background: Preterm delivery (PTD) is a major cause of perinatal morbidity and mortality. Objective of present study was to identify the women at risk of preterm delivery with the help of trans-vaginal ultrasound by assessing cervical length changes, funneling of lower uterine segment, cervical dilatation.Methods: A prospective study was carried out over a period of 2 years on 50 patients with 24-36 weeks of gestation who clinically presented with signs of threatened preterm labor and were subjected to transvaginal sonographic measurement of cervical length.Results: Prediction of spontaneous preterm birth at <37 weeks of gestation with cervical length to be 2.75 cm has sensitivity of 95%, specificity of 96.5%, positive predictive value of 86.36% and negative predictive value of 98.7%.Conclusions: Transvaginal ultrasonography is the reliable, reproducible and objective method to assess cervix and to predict the risk of preterm delivery.
Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation
Authors: Hymavathi Kaliki , Gottipati Malini Devi , . Prasuna , V. Sudha
Published: January 2018

Background: Dysfunctional Uterine bleeding (DUB) is the most common cause of abnormal uterine bleeding (AUB). Medical therapy being the first line of management, an ideal drug should be able to block the estrogenic effects on the Endometrium without interfering with its beneficial effects on other tissues. Both Ormeloxifene - a selective estrogen receptor modulator (SERM) and Tranexamic acid-an anti fibrinolytic inhibitor is important in the treatment of DUB. The aim of this study is to assess the efficacy and safety of Ormeloxifene v/s Tranexamic acid in the treatment of DUB.Methods: This is a prospective double blind study conducted for 2 years in 200 women presenting with DUB attending to the Gynaecology outpatient department (OPD) of Narayana Medical College and Hospital, Nellore, AP, India. Two hundred women presenting with DUB were recruited into this study (after fulfilling inclusion and exclusion criteria) with informed consent and randomly divided into two equal groups (Group-A and Group-B) after obtaining college ethical committee approval.Results: The reduction in the mean pictorial blood loss assessment chart (PBAC) score with Ormeloxifene (from 278 to 97.6) was significantly more than that of Tranexamic acid (from 261 to 134.5) at six months (p <0.0001). The rise in Hemoglobin concentration (8.4g% to 11.15g% vs. 8.5 to 9.7gm%; p <0.008) and reduction in Endometrial thickness (from 10.57mm to 6.5mm v/s 9.96mm to 7.24mm p <0.0001) were also significantly more with Ormeloxifene than with Tranexamic acid. Relief from dysmenorrhoea and subjective improvement were also found to be considerable with Ormeloxifene.Conclusions: Both Ormeloxifene and Tranexamic acid can be considered for DUB treatment but Ormeloxifene is found to be superior to Tranexamic acid in various aspects.
Study on Meconium stained fluid-perinatal outcome
Authors: Harikumar Soumya , Rajesh Aparna
Published: January 2018

Background: The objective of this study is to find a correlation between the presence of MSAF in mothers with co- morbidities like PIH and GDM and to study the fetal heart variability in cases with MSAF and the significance of an admission test. This study also throws a light on the perinatal outcomes associated with MSAF.Methods: 100 women in labor with Meconium stained amniotic fluid were taken in this study. An admission test was done for all patients, along with continuous fetal heart monitoring was done in the presence of MSAF. Effect of thin and thick meconium on fetus was studied. The cases with maternal co-morbidities were closely monitored along with the mode of delivery, Apgar score, birth weight, resuscitation of baby was studied. All the newborns born through meconium stained liquor were followed up to one week of neonatal life.Results: Out of a total of 100 cases there was 60 cases with thick meconium with a non-reactive NST seen in 65% cases with thick MSAF and 32.5% cases with thin MSAF. 79% of cases with MSAF underwent emergency LSCS. The neonatal complications were more with thick meconium stained liquor accounting to 28.3% incidence of MAS, 23.3% of sepsis, 3.3%of pneumonitis and 21.7% of birth asphyxia.Conclusions: This study ascertained the need for an admission test and continuous CTG monitoring in cases detected to have meconium stained amniotic fluid. Co-morbidities like GDM did have a small role to play though the incidence was not very high. The neonatal complications were more common among cases with thick meconium stained liquor and probably the use of procedures like amnioinfusion can bring down the incidence of perinatal morbidity along with the rate of caesarean sections.
The effects of food habits on pregnancy outcome
Authors: Pitale Devdatt Laxman
Published: January 2018

Background: Nutrition during pregnancy plays an important role for an optimum outcome of pregnancy. Maternal undernutrition can lead to poor intrauterine growth and low weight of the baby at birth. Moreover, the leading causes for maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. The aim of this study was to study the effects of food habits on pregnancy outcome.Methods: 350 women from the antenatal clinic, who satisfied the criteria were admitted to the study.Results: The majority of pregnant women belonged to the age group of 21-25 years (47%) followed by the 26-30 years age group (40%) and 83% belonged to the low socioeconomic class. Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kg. There was a significant association (p value <0.05) between the socioeconomic status of the mother, parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status, the birth weight of the baby and the need for NICU admission (p value <0.05).Conclusions: Maternal food habits have significant effects on the pregnancy outcome.
Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy
Authors: L. Rashmi , Bhattacharjee Ashish
Published: January 2018

Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome.
Isolated oligohydramnios: effects on obstetric and perinatal outcome
Authors: L. Ashwini Vishalakshi , P. Reddi Rani
Published: January 2018

Background: Outcome of oligohydramnios has been studied at a large. Varying results have been projected in each study. This study has been done to establish the obstetric and perinatal outcome in pregnancy associated with oligohydramnios as compared to women with normal liquor.Methods: This was a prospective case controlled study done which included 100 women with oligohydramnios who were compared with 100 women with normal liquor. Maternal and perinatal outcome was compared between the two groups.Results: There was a significant difference in the obstetric and perinatal outcomes among the study and control groups. Significant variation was seen in the obstetric outcome with regards to the incidence of induction of labor and mode of delivery (by caesarean section). Both were increased among the study group as compared to the control group. CTG changes, meconium stained liquor, neonatal admissions and observations were more among the study group as compared to control group.Conclusions: Athough there is an increased rate of caesarean section, NICU admission and observation, thick meconium stained liquor and NST changes there is no significant increase in the perinatal morbidity and mortality.
Should the appendix always be removed during surgery for mucinous ovarian tumors?
Authors: Patel Bijal M. , Desai Ava D. , Patel Shilpa M. , Mankad Meeta H. , Dave Pariseema S. , Parekh Chetana D. , Gami Amisha J.
Published: January 2018

Background: Appendectomy is performed in all mucinous ovarian tumors (MOT) identified intraoperatively to ensure microscopic metastases from appendix are not missed. Several recent studies suggested that appendectomy should only be performed in cases with a grossly abnormal appendix or with evidence of pseudomyxoma peritonei. Our study aimed to determine the frequency of malignancy in a grossly normal appendix in women undergoing surgery for borderline or malignant MOT.Methods: In a single institution retrospective study, women undergoing surgery for MOT from January 1, 2008 to June 30, 2016 were included. Women with benign MOT, those with a history of either prior appendicectomy or prior gastrointestinal (GI) malignancy were excluded.Results: Of 266 women identified with MOT, 153 with borderline and malignant MOT were included in the study after application of inclusion criteria. The study population comprised of 29 (18.95%) borderline and 124 (81.05%) malignant MOT. Among the borderline MOT, 13/29 had undergone appendectomy. Five (38.46%) had grossly abnormal appendices of whom 1 had mucinous cystadenoma, 3 had borderline mucinous tumor and 1 had mucinous cystadenocarcinoma of the appendix. Histology was normal in all 8 (61.54%) grossly normal appendices. Among the malignant MOT, 80/124 (64.52%) underwent appendicectomy. Nineteen (23.46%) had grossly abnormal appendices and histology was suggestive of adenocarcinoma of appendix. Histology was normal in all 62 (76.54%) macroscopically normal appendices.Conclusions: Present results suggest that appendectomy be performed only for those appendices that are grossly abnormal or associated with pseudomyxoma peritonei at surgery for MOT
Pregnancy outcome in women treated for subclinical hypothyroidism detected in early gestation
Authors: C. Raja Rajeswari , Paul Suman , Nayak Madhusmita
Published: January 2018

Background: Thyroid disorders are among the most common endocrine disorders in pregnancy. Objective of present study were to investigate the outcome of pregnancy in those women detected to have subclinical hypothyroidism in early gestation and to evaluate whether treatment of subclinical hypothyroidism reduces the adverse pregnancy outcome.Methods: Pregnant women detected to have Subclinical hypothyroidism (TSH >2.5- 6 mU/L and N Free T4) in the 1st trimester were selected and randomly divided into 2 groups. One group received treatment with Thyroxine. They were followed up till delivery and outcome noted.Results: The mean maternal age of both the group was 26 yrs. The gestational age at delivery and the newborn birth weight did not show any statistically significant difference. Antenatal complications like Gestational Diabetes, hypertension, small for gestation, and preterm were almost the same in both groups. There was significant increase in the primary caesarean rate in the treated group. No significant difference in the number of term vaginal delivery in both groups.Conclusions: Treatment of women with SCH (TSH <6 mU/L) does not reduce the risk of adverse pregnancy outcome. Benefits of treatment need to be weighed against any potential risks.
Labour with low dose epidural analgesia: maternal perception and fetal outcome
Authors: Sawant Vasudha , Kumbhar Archana
Published: January 2018

Background: Experiencing labour pains and giving birth to infant is normal physiological process. Though it is a natural phenomenon, it produces severe pain which requires analgesia to relieve pain during labour. The objective of this study was to compare effects of low dose epidural analgesia verses no analgesia during labour on mother and fetus.Methods: Here in this study we have assessed effect of epidural analgesia on mother and fetus. Total we have taken 60 women in age group of 20-26 years with full term pregnancy (37-42 weeks). Those who have entered spontaneous labour with vertex presentation, without any previous uterine surgery, clinically adequate pelvis. We had divided these women in 2 groups, 30 were given epidural analgesia and 30 without any analgesia. Variables recorded were pain score during labour using VAS, duration of labour during each stage, mode of delivery, Apgar score of newborn at 1 minute and 5 minutes.Results: Present study shows that duration of first stage of labour in epidural and non-analgesia group are same. Second stage of labour is prolonged in epidural group than non-analgesia group. Both groups had normal APGAR score. Epidural analgesia is not associated with any change in mode of delivery. Visual analogue scale is good with epidural analgesia.Conclusions: There was no significant difference in first stage of labour in both group. Second stage of labour was slightly prolonged in EA group than control, but it was less than two hours. No harmful neonatal outcome in epidural analgesia.
A two-year retrospective study of infants with Erb-Duchenne's palsy at a tertiary centre in Rajasthan, India
Authors: Hasabe Rakesh Appasaheb , Diwane Dnyaneshwar S. , Chandawar Sushant S.
Published: January 2018

Background: Brachial plexus injury (BPI) has prevalence of between 0.5 and 4.4/1000 live births. It is commonly believed to be attributed to extensive lateral traction during difficult neck delivery. This paper aims to look at one aspect of birth injuries, Erb-Duchenne palsy, its incidence and contributing factors.Methods: All infants sustaining Erb-Duchenne palsy during birth were identified at Department of OBGY, NIMS Hospital, Jaipur. The notes of the infants and mothers were reviewed. Special attention was given to the known risk factors for birth trauma such as ethnicity, parity, antenatal care, history of diabetes etc.Results: During the two-year period 2013 to 2015, there were 6 infants diagnosed with Erb-Duchenne palsy, giving an incidence of 0.79 in 1000 live births. Out of six, four were primigravidae. All pregnancies were singleton, cephalic/vertex undergoing vaginal deliveries; none required forceps or ventouse deliveries. The mean infant birthweight was 4.378 kg with a median value of 4.48 kg (range 3.51-4.78). Four infants were classified as macrosomic i.e. birthweights greater than 4 kg, four infants had birthweights of 4 kg to 5 kg; none weighed over 5 kg. Three of the deliveries were documented as difficult shoulder delivery/shoulder dystocia. Five of the infants had APGAR scores that were less than seven.Conclusions: This study suggested that Erb-Duchenne palsy is strongly associated with fetal macrosomia and shoulder dystocia. Diabetes was not significant in causing macrosomia as only single mother was found diabetic. Fetal macrosomia contributed to shoulder dystocia in the majority of cases.
A clinical study of skin disorders in pregnancy
Authors: Meena Manju , Gehlot Hanslata
Published: January 2018

Background: Various physiological adaptation of pregnancy related, immunological, metabolic, endocrine and vascular changes occurs during pregnancy which make the pregnant women susceptible to changes of skin and appendages to study the various cutaneous changes of pregnancy.Methods: This study was an observational cross-sectional study conducted in Obstetrics and Gynaecology Department at Umaid Hospital and Skin Department at MDM Hospital, Jodhpur. Total number of 200 pregnant females were included in this study after informed consent and ethical committee clearance in duration of 6 months. Detailed medical and obstetric history of patients were obtained, and physical and dermatological examination were performed. Relevant systemic examination and appropriate investigations were done to confirm diagnosis if required.Results: Most of patients show cutaneous changes, among them physiological changes were most common 196 (98%). The most common physiological change was hyperpigmentation, which was seen in 189 (94.49%) cases followed by striae distensae (76.5%), glandular changes (11.5%) and vascular (9%). Tinea cruris was noted in 04 cases (2%) while scabies was present in 10 females (5%). 15 (7.5%) cases of contact dermatitis were noticed, and psoriasis was found in 3 (1.5%) pregnant females. Herpes genitalis was seen in 1 case (0.5%). The most common Specific dermatoses was pruritic urticarial papules and plaques of pregnancy 10, (5%) followed by pruritic folliculitis 4 (2%), eczema 4 (2%) and intrahepatic cholestsis of pregnancy 2 (1%).Conclusions: Pregnant women are prone to various cutaneous manifestation during pregnancy. A detailed history and awareness of clinical presentation is helpful for confirmation of diagnosis and most appropriate laboratory evaluation is helpful to diminish the maternal and foetal morbidity.
Fetomaternal outcomes in premature rupture of membranes at term: a case control study
Authors: Shetty Suprajna , Shetty Harish
Published: January 2018

Background: Premature rupture of membranes is defined as spontaneous rupture of fetal membranes beyond 28weeks of pregnancy but before the onset of uterine contractions. It occurs in approximately 10% of all pregnancies and in 70% it occurs at term. If PROM occurs before 37 completed weeks, it is referred as preterm premature rupture of membranes(PPROM). PROM is associated with adverse outcomes in both, hence its management becomes crucial. It complicates 8% of pregnancies. Objective of present study was to investigate the labour, maternal and perinatal outcomes.Methods: 75 patients who entered labour room at term with PROM were taken as cases and those with intact membranes as controls. Investigations are sent, and prophylactic antibiotics were given. Progress of labour, PROM delivery interval, method of induction, mode of delivery along with maternal and fetal outcomes, total duration of hospital stay was noted and compared with controls.Results: Rate of caesarean is higher in study group (14.7%) and failure to progress was the common indication. Intrapartum morbidity was higher in the study group (16%) and perinatal morbidity was 20%. NICU admission and the need for antibiotics were higher in study group and hence longer duration of hospital stay.Conclusions: PROM is associated with increased incidence of neonatal sepsis and subsequently antibiotics given were higher in cases. There is a higher incidence of caesarean rates and hospital stay. Proper screening of high risk cases and appropriate management is suggested to reduce perinatal morbidity.
Oral cancer: general awareness, in-depth knowledge and associated biosocial factors
Authors: Kumar Vikas , Patra Somdatta , Agrawal Kamal
Published: January 2018

Background: Oral cancer accounts for approximately 200,000 deaths annually worldwide and 46,000 deaths occurring in India. Oral cancer is largely preventable by avoiding known risk factors. Delayed presentation of oral cancer is mainly due to lack of awareness of the public about oral cancer and its associated risk factors. The knowledge and understanding of oral cancer influences individuals in prevention and treatment seeking behavior. Methods: A cross-sectional community based survey was conducted in North-east Delhi and 775 families were covered. The eldest member from each family, were interviewed about oral cancer by using pre tested study schedule. Data were analyzed and appropriate tests of significance were applied. Results: Majority of the study subjects were females (63.5%) and were belonging to socioeconomic class V and IV (68.1%). Although 80.9% of the study participants were aware and have heard about oral cancer, and this awareness was directly proportional to literacy status (p=0.001). “Chewing tobacco” was most commonly recognized risk factor (77.7%). Less than half of them knew that oral cancer is preventable (45%). The most common media through which this study population heard about oral cancer was electronic media (90.3%). Conclusions: Although the majority of the study population had heard about oral cancer, but in-depth knowledge of its risk factors and sign and symptoms was poor that affects the practices regarding prevention and early detection negatively. For increasing awareness oral health education programs should be carried out.
Implementing success factors for effective strategic plans implementation in public health facilities, in Namibia
Authors: Shopati Abner Kukeyinge , Mitonga Kabwebwe Honore , Aipinge Lydia Penomuntu
Published: January 2018

Background: Public healthcare organizations are implementing strategic plans modelling with the supposition that the outcome will be enhancing organizational effectiveness, efficiency and delivered superior healthcare services to its clientele. However, in Practices, a good strategy shall be a call for both actions and blueprint for success in responsive to the need it was formulated to address. The aim of this research is to develop implementation success factors model (ISF) for effective strategic plan implementation in public healthcare organization in developing countries.Methods: The research utilized quantitative approach, a survey design and questionnaire was employed to collect data. The study used Gaskin’s CFA/SEM procedure and applies the SPSS 23 AMOS plugins, pattern matrix model builder (PMMB), master validity (MV), model fit measures (MFM) to validate and determine the interrelationships between variables.Results: Reviewing the literature, 20 variables were identified and implementing success factor (ISF) model with two major factors was developed, CSFs for strategic plan formulation and CSFs for strategic plan implementation. This model, in the order of effect, identified CSFs for strategic plan formulation: structural dimension (0.95), content dimension (0.75), operational dimension (0.34) and context dimension (0.23), CSFs for strategic plan implementation: operational dimension (0.70), structural dimension (0.47), contextual dimension (0.46), content (0.37).Conclusions: The research shows that developing implementation success factors model for effective strategic plan implementation in public healthcare organization in developing countries, it will be plausible to consider CSFs for strategic plan formulation and CSFs for strategic plan implementation. Structural equation modelling/CFA has been run to prove the validity of basic CSFs in this research.
The effect of omega 3 polyunsaturated fatty acids in serum CK-MB and troponin I as markers of myocardial injury after PCI
Authors: Avesta Leili , Habibzadeh Shahram , Shahbazzadegan Bita , Doostkami Hosein , Shahalinia Hamoon , Shahbazi Ali
Published: January 2018

Background: The mortality rate of patients with this disease is approximately 30%. Re-opening of blocked coronary artery is important because of decreasing mortality and improves quality of life in patients with acute myocardial infarction. Now there are various methods for opening coronary artery, including the use of thrombolytic drugs and PCI. Due to the fact that PCI is a critical treatment for cardiovascular patients yet it has dangerous complications during and after it too. Some of these complications include vascular dissection, and thrombosis and ischemic sudden blockage. By reducing the side effects of this treatment, it can be safe and reliable construction. To determine the effect of Omega 3 in the prevention of myocardial injury induced by coronary interventional procedures by reducing levels of CK-MB and Troponin I is our objective. Methods: Among those who were randomly going for elective PCI, we selected 100 patients and divided into 2 groups of 50 persons. In Group A, 12 hours before PCI, approximately 3 grams of omega-3, with routine medications before PCI include Aspirin and Plavix were given. In Group B, 12 hours before PCI placebo in combination with routine medication before were given and PCI was performed, then the CK-MB and Troponin I in the 2 groups was measured and compared to each other and against the values before performing PCI were measured. Results: The results that were obtained, show that levels of CK-MB and Troponin I raise after PCI in Group A lower than Group B. Conclusions: Results confirmed the effect of omega 3 in the prevention of myocardial damage caused by PCI, so we can use omega 3 for reducing PCI complications.