bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study of the Relationships between Nursing Students’ Meanings of Life, Positive Beliefs, and Well-Being
Authors: Tsai Fu-Ju , Chen Cheng-Yu , Yeh Gwo-Liang , Hu Yih-Jin , Tseng Chie-Chien , Chen Si-Chi
Published: March 2019

Background: Nursing educators should train nursing students to pursue physical, psychological, spiritual, and social health promotion. The purpose of this study was to explore relationships between nursing students’ meaning of life, positive beliefs, and well-being.

Methods: A cross-sectional correlational study with a quantitative approach was adopted. Purposive sampling was used. A total of 170 nursing students voluntarily participated in this study. A 56-item questionnaire was used to examine nursing students’ meaning of life (1-25 items), positive beliefs (1-11 items), and well-being (1-20 items). The content validity index (CVI) of the study questionnaire was established as 0.95 by seven expert scholars. The reliability values for the three parts of the measure were as follows: meaning of life, Cronbach’s α 0.96; positive beliefs, Cronbach’s α 0.93; and well-being, Cronbach’s α 0.95. Percentages, frequencies, means, SDs, Kruskal-Wallis one-way analysis of variance by rank, Spearman’s rank correlation, one-way analysis of variance, Spearman’s rho correlation, and regression analysis were used for the data analysis.

Results: Nursing students had the following mean scores: meaning of life with 4.02 (SD 0.56); positive beliefs with 3.92 (SD 0.62); and well-being with 3.95 (SD 0.57). The results indicate that for all nursing students, meaning of life was positively correlated with positive beliefs, r=0.83 (P<.01); similarly, all nursing students had positive beliefs that were positively correlated with meaning of life, r=0.83 (P<.01). In the results of the study, the nursing students’ background, meaning of life and positive beliefs explained 63% of the variance in well-being (Adjusted R2 squared =0.63, F=33.41, P<.001).

Conclusions: Nursing students’ sense of meaning of life and positive beliefs may impact their well-being. Therefore, nursing educators can promote meaning of life and positive beliefs to nursing students as a way to increase their well-being for physical, psychological, spiritual, and social health promotion.
Efficacy and Safety of a Combination of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo
Authors: Kiran Dr. Mayuresh , Pawaskar Mr. Lalit
Published: March 2019

Introduction and Background: Vertigo is a medical condition where a person feels as he/ she or the objects around them are moving when they are stable and not moving. Antihistamines, Calcium antagonists, histamine analogs (eg, betahistine derivatives), diuretics, neuroleptics as well as other psychotherapeutic drugs, corticosteroids agents and hemorheologics can be used for the treatment of Vertigo. Combination of Cinnarizine which is a selective calcium-channel blocker and Dimenhydrinate which is an H 1 antihistaminic drug can be used in combination for the treatment of vertigo. This clinical study was conducted to evaluate the efficacy and safety of combination of Cinnarizine 20 mg and Dimenhydrinate 40 mg in patients of vertigo of age group 18 to 65 years.

Methodology: Out of total 216 patients, 168 completed the study. Efficacy assessment was made by analysing the reduction in vertigo symptom score (VSS). Safety assessment was made by analysing the adverse events experienced by the patient or observed by the investigator during trial.

Results: Reduction in VSS from 7.277 (baseline) to 3.975 (day 3) and 0.987 (day 5). At visit 2 and visit 3 there was reduction of 45.373 % and 86.426 % in mean VSS score.

Conclusion: A combination of Cinnarizine 20 mg and Dimenhydrinate 40 mg is safe and efficacious in the treatment of vertigo.
Relation of BMI and Body Fat Percentage with Nutritional Status of Adolescents
Authors: D. Godia Dr. Haresh , Nikam Dr. Lalit H
Published: March 2019

Aims: Relation of BMI and Body Fat Percentage with Nutritional Status of Adolescents in first year medical students.

Materials and Methods: Study was carried out in Tertiary Care Hospital and Seth G S Medical College Parel Mumbai. 100 1st year M.B.B.S. students were selected for study group contains 50 males and 50 females. Studies carried out on adolescents are very limited and it is needed to assess the nutritional status of adolescents. An attempt has therefore been made in the present study to

Conclusion: From the present study it is concluded that 72% of females and 78% of males are well nourished; 8% of females and 6% of males are over nourished and 20% of females and 16% of males are under-nourished. Considering the consequences or morbidity and mortality associated with undernourishment; corrective steps in the form of improvement in dietary pattern should be undertaken and for over-nourishment; in addition to rectification of diet, more stress should also be laid on doing physical activity. For Adolescent: BMI- Cutt off points as suggested by WHO should be followed rather than following the adult BMI values as the adult BMI value give a high estimate prevalence of malnutrition.
Tzanck Smears and Its Diagnostic Utility - An Institutional Experience
Authors: Kumar K.T Dr. Athulya Krishna , Aboobacker Dr. Kalathingal Kamarunisha , H.S Dr.Kiran , Agarwal Dr. Vishal
Published: March 2019

Aim: Tzanck smear is a simple test that gives reliable information in many varieties of skin lesions and can be used for quick, preliminary diagnosis of a number of cutaneous dermatoses. The aim of this study was to analyse the usefulness of tzanck smears in the diagnosis of cutaneous dermatoses and correlate the findings, clinically as well as histopathologically.

Materials and Methods: Retrospective analysis of all tzanck smears received during the time period of 2 years (January 2016- January 2018), was carried out. The smears were assessed with regard to its correlation to the clinical diagnosis. Corroboration of the tzanck smear findings were also evaluated with respect to the histopathological diagnosis, in cases were skin biopsy was done.

Results: A total of 70 tzanck smears were performed during our study period. Out of 29 cases of pemphigus, the tzanck smears corroborated with 22 cases. Non-specific findings were obtained in clinically suspected cases of pemphigoid. Out of 25 suspected herpetic infections, the characteristic tzanck smear findings were observed in 11 of them. Tzanck smear findings correlated with 13 out of the 19 cases of histopathologically confirmed pemphigus lesions.

Conclusion: Tzanck smear test is a rapid, inexpensive and useful tool to aid in the diagnosis of clinically suspected vesico bullous, pustular and erosive skin lesions. It also serves as a useful adjunct to histopathological evaluation of skin biopsies, especially immuno-bullous skin disorders.
Childhood Intussusception: Timely Management Leads to Decreased Surgical Risk
Authors: Dr. Arun Kumar Gupta, Dr. Vinita Chaturv Dr. Sunil Kumar Mehra, Dr. Dinesh Kumar Barolia,
Published: March 2019

Intussusception is the most common cause of intestinal obstruction in infants and children in < 1yr of age (1). Intussusception cases usually reported late therefore operative procedure was inevitable and results in significant morbidity and mortality. By this study we emphasized on timely transfer of intussusception case to a pediatric surgical center so as to decrease surgical risk. The surgical morbidity was low in those who were admitted early or directly to our center. 

Methods - We retrospectively reviewed cases of intussusception in children <15 years. Children were treated from October 2015 to December 2107 at pediatric surgery department of SMS medical college Jaipur Rajasthan. Age, sex, month of admission, symptom with duration, diagnostic methods, and treatment modalities were recorded and analyzed. 

Results - We studied 300 patients with intussusception.272 (90%) were treated surgically. We recently started ultrasonography guided pneumatic reduction and 24(85.7%) out of 28 treated successfully by it. Out of the patients requiring surgery 202 (67.34%) patients were reduced by per-operative manual reduction and in 60(22%) patients resection and anastomosis with 10(3.6%) treated with resection and ileostomy. 25.34% cases have delayed diagnosis and lately  transferred from peripheral hospitals requiring resection and diversion.

Conclusion - In conclusion, Intussusception cases usually reported late therefore high likelihood of surgical management. The patients who underwent resection have longer duration of hospital stay.
The Attitudes of Nursing Students towards Patients Who Attempt Suicide: A Study from Central India
Authors: Ghormode Deepak , Gupta Pramod , Singh S. K. , Ratnani Devendra
Published: March 2019

Background: Suicide being a global health issue, the attitudes and beliefs of the healthcare professionals towards these attempters have significant effect on the outcome of the treatment.

Objectives: Aim of the study was to assess the attitude of nursing students towards patients with suicide attempt.

Materials and Methods: The study had a cross sectional design of 284 nursing students who were randomly recruited from the two institutions. Suicide opinion Questionnaire was administered.

Results: Most were young single females, from rural locality, who were pursuing either BSc Nursing or GNM courses. Very few had previous exposure to suicide prevention training programmes. More than half of the students showed favourable attitude towards patients with suicidal attempt. Majority of students showed favourable attitudes for more than half of the attitudinal statements giving importance to the mental illness, disturbed family life, and depression and risk factors for suicide attempt. Unfavourable and uncertain attitude was noticed for a few of the statements.

Conclusions: The nursing students showed favourable attitude towards patients with suicide attempts. More educational and training programs are therefore needed in these students for improving the uncertain and unfavourable responses to a few of these attitudes for better management of these patients.
Relationship between Blood Pressure and Nutrition in Adolescents
Authors: D. Godia Dr. Haresh , Nikam Dr. Lalit H
Published: March 2019

Aims and Objectives of study: This study was confined to healthy groups. Care was taken to exclude persons suffering from obvious disease and/ or recent history of illness Aims and Objective of present study are:-

To find out BMI males and females

To find out systolic and diastolic blood pressure in males and females.

The various parameters which are studies are as follows:-

Standing height in cms

Weight in kgs.

Resting pulse rate

Resting systolic blood pressure in mm of Hg.

Resting diastolic blood pressure in mm of Hg.

Body Mass Index.

Background - The study was conducted in GSMC medical college and Tertiary care Hospital. Total 100students were selected for study, out of 50 were male students and 50 were female students.
Evaluation of Adjuvant Biomarkers in Acute Myocardial Infarction
Authors: M. V Varghese , S. B Gaikwad , M. M. Fawade , M. A. Bhattacharya
Published: March 2019

Background: Acute myocardial infarction (AMI) is one of the dreadful complications of cardiovascular disease causing increasing mortality worldwide. The alterations (increase or decrease) of intracellular and extracellular enzymes or components in developing phase of disease are called markers. Variations in biochemical markers like Cardiac Troponins - T (ctnl) creatine kinase may correlate with the extent of myocardial damage in Acute myocardial infarction (AMI). 

Aim and Objectives: This study was undertaken to evaluate serum sodium, potassium, urea and creatinine as adjunctive parameters along with cardiac markers, which probably help in better prognosis of AMI. 

Material Methods: 100 subjects were included in this study with confirmed diagnosis of recent AMI by the physicians and 100 healthy persons visiting hospital for routine checkup. Blood samples of both group were analyzed for serum urea by Diacetylmonoxime, creatinine by Jaffe's, &sodium & potassium by flamephotometry uing Bio- Lab Diagnostic Kit Methods. Whereas cardiac troponin - T was done by chemiluminescence immunoassay (CLIA) on Lumax hormone analyser and CKMB by kinetic kit method.

Results: There were statistically significant decreased levels of serum sodium (P<0.0001) potassium (p<0.0001), and elevated levels of urea (p<0.0001) and creatinine (0.0001) observed in AMI. Both established cardiac markers Trop- T and CKMB were extremely statistically significantly increased (p<0.0001) as compared to control group.

Conclusion: This study showed association of routine blood tests such as urea, creatinine, sodiumand potassium hence can be used as supplement information with regard to treatment and better prognosis of AMI patients or these could be cost effective time saving adjuvant markers in management of myocardial infarction.
Hormones in HIV- Pregnant Women
Authors: Mishra Dr. Asha , Agnihotri Dr. Madhuri A. , Ratnani Dr. Rekha
Published: March 2019

Background - HIV infected pregnant women are placed on antiretroviral drugs for treatment and to avoid maternal to child transmission of HIV. This effect of HIV infection on pregnancy hormones within 24 weeks of pregnancy compare with normal pregnant women.

Aims and Objectives - estimate testosterone, Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) and Prolactin (Prl) in HIV pregnant women compare to normal Healthy pregnant women.

Result - The level of hormones in normal pregnant women and HIV positive pregnant women. Hormone level in HIV pregnant women were significantly decreased found compare to normal pregnant women.

Conclusion: On the basis of our study we concluded that the hormone levels were significantly decreased found in HIV pregnant women due to hormones are affected by HIV / AIDs. The bidirectional interactions between hormones and the immune system contribute to both the outcome of pregnancy and female susceptibility to disease.
Ward Variant of High Expressed Emotions Discovered in a Health Worker Admitted in a Tertiary Hospital in South West Nigeria
Authors: Adekeye A, Akinshade A. Akinbote J, Elegbede A, Akanbi S, Lawal M,
Published: March 2019

High Expressed Emotion (HEE) is a collection of distinct attitudinal expressions characterized by critical, hostile and emotionally over-involved attitude towards a family member with a psychotic disorder, though more common with schizophrenia. It is however pertinent to state that, EE has also been documented between health workers and patients in the hospital and community settings. The Camberwell Family Interview (CBI) and its modified versions are objectively used to assess the expressed emotion (EE) in such situations. We report an interesting case of a young female health worker subjected to classical features of high expressed emotions in a hospital ward setting.
An Epidemiological Study of Malnutrition and Its Associated Factors in School Going Adolescents of District Ghaziabad, Uttar Pradesh
Authors: Gunjan Dr. Kumar , Arya Dr. Vimal , Arya Dr. R K
Published: March 2019

Introduction: Today, the world faces double burden of malnutrition that includes both under nutrition and overweight, especially in developing countries. Malnutrition, especially in adolescent and young women, not only effects the growth and development in this generation but also in the next. This study has been designed with the objectives to assess the nutritional status and various socio-demographic variables in the adolescent population and their association with nutritional status of the adolescents in Ghaziabad, Uttar Pradesh. 

Material and Methods: The study was carried out during November 2013 to October 2014 in higher secondary schools in urban area of district Ghaziabad by Department of Community Medicine, Santosh Medical College, Ghaziabad. Multistage sampling technique was used. 50 subjects from each school were questioned with self-administered well-designed pre-tested and close-ended questionnaire. Data was coded and transferred to a master chart and simple and association tables were prepared and analysed with appropriate statistical tests like Chi-square test with Yates correction.

Results: It was found that out of the total 550 adolescents, the majority of the adolescents (64%) were male while females added up to 36% of the total. The association between age and nutritional status of adolescents was statistically insignificant. The association between socio-economic status and nutritional status of adolescents was statistically insignificant.
Serpiginous Granuloma Annulare: A Case Report
Authors: Sharma Rajni , Manvi Sujaya
Published: March 2019

Granuloma annulare (GA) is a benign inflammatory skin condition of unknown etiology. Various clinical forms of GA including localized, generalized, subcutaneous, patch and perforating types, have been described. Although the etiology and pathogenesis of granuloma annulare are obscure, there is much evidence for an immunological mechanism. Precipitating factors are insect bites, sunburn, photochemotherapy, drugs, physical trauma, acute phlebitis and sepsis after surgery.[1] Some authors have proposed that it might be associated with a variety of underlying conditions such as thyroid disorders, diabetes mellitus and positive tuberculin skin test.[2] For definitive diagnosis, a biopsy should be performed. We report a case of generalized GA with serpiginous borders on the dorsal aspects of the hands and arms along with an association with diabetes.
Relation of Vitamins in Diabetes Melliatus
Authors: Lotake Dr. Vaibhav D. , Barsode Dr. Supriya
Published: March 2019

Introduction

Diabetes is a chronic metabolic disorder which is linked to energy metabolism, particularly carbohydrate and fat.  Obesity and physical inactivity are shown to be the major risk factors for type 2 diabetes (T2DM). Oxidative stress may also contribute to increase in blood glucose levels, thus contribute to the pathogenesis of T2DM by increasing insulin resistance or impairing insulin secretion.[1] The consequences and complications of diabetes are due to imbalance between free radical formation and their control by natural antioxidants.[2] Thus nutrients having antioxidant function are important in disease development and control also non oxidant vitamins have also shown relationship with diabetes.[3] Long-term treatment of diabetic patients with metformin may cause a higher risk of developing vitamin B-12 deficiency.[4] Vitamin A plays important role as antioxidant, thus helping to maintain the organism’s homeostasis when subjected to various forms of stress.[5] Vitamin B6 consists of a group of three compounds: Pyridoxal, pyridoxine and pyridoxamine, and their corresponding phosphorylase forms and the active form of this vitamin is pyridoxal-5’-phospate (PLP).  In new diabetic patients lower PLP concentrations were found as compared to non-diabetic persons.[6] Niacin or B3, Nicotinic acid is a component of NAD and NADH, which are essential for ATP production and energy efficiency at the cellular level and has been found to increase HDL-cholesterol, decreases TG and LDL cholesterol.[7] As T2DM is an oxidative stress disease; vitamin B12 and folic acid deficiencies in diabetic subjects have been found associated to oxidative stress so it is conceivable that vitamin B12 deficiency should be considered a risk factor for diabetic complications.[8] Plasma vitamin C concentrations have been inversely correlated to glycosylated hemoglobin and fasting and postprandial blood, Vitamin C has also been shown to reduce anxiety levels.[9] and supplementation for 3 months of vitamins C and E decreases hypertension, blood glucose while increasing superoxide dismutase and glutathione levels.[10] Vitamin D may play an important role in modifying the risk of diabetes.[11] The role of vitamin D in the function of pancreatic cells can be mediated by the union of 1,25-dihydroxyvitamin D to its receptors in the beta cell.[12]
The Prevalence of Photoconjunctivitis and Conjunctival Lesion among Fishermen in Jazan in Saudi Arabia: And the Association of Its Risk Factors
Authors: A Ahmed
Published: March 2019

Attributable to the nature of their occupation, fishermen are consistently exposed to the hazardous UV radiation which not only affects the skin but also the eye. The objective of this study is to determine the prevalence of photoconjunctivits and conjunctival lesions among fishermen in Jazan and the association with socio-demographic background and occupational history. This study employed a cross-sectional study design conducted in the Jazan region of Saudi Arabia among 511 fishermen. Data collection using a set of questionnaire was assisted by interviewer which is ensued by an eye examination. The prevalence of the photo conjunctivitis was found to be 4.3% and that of conjunctival lesions at 0.8%. An association was seen between the prevalence of photoconjunctivitis and conjunctival lesions to the exposure of sunlight.
Analgesic Effect of Zolmitriptan Nanoparticles in Experimental Animal Models
Authors: Zadeh Khezri Mr. Farshid Ali Naghi , Nargund Dr. Shachindra L. , Lakshmi Dr. C. S. R. , Nargund Dr. L. V. G. , Alisani Dr. Reza , Mohammadi Azadeh
Published: March 2019

Background: Zolmitriptan is used to treat migraine and certain other headaches. This study has been done to prepare specific Zolmitriptan Nano-nasal spray (Z-NPS) by ion gelation technique to evaluate the efficacy of analgesic activity of test drug as a nano nasal spray of Zolmitriptan (Z-NPS) and conventional preparation as a standard drug (Zolmist) against Nitro-glycerine induced migraine. The study was performed on mice by using hot plate method. Methods: In this study male Swiss albino mice weighing between 25-30 grams were taken and divided into 4 groups with 6 mice in each group. Zolmitriptan loaded chitosan nanoparticles (Z-NPS) was administered nasally (using specific inhalation mask) at a dose of 5 mg/kg and was compared with the control group which received water for injection and the standard drug Zolmitriptan (Zolmist) at a same dose in mice induced migraine using hot plate method. Reaction times were measured at 10, 20, 30 and 60 minutes after drug administration. Results: The test drug (Z-NPS) at a dose of 5 mg/kg after 10 minutes of drug administration showed an increase in the reaction time compared to the standard drug (Zolmist) at same dose of drug administration. However, Z-NPS showed significant increase in the reaction time after 10 minutes as compared to Zolmist. Conclusion: Zolmitriptan has significant analgesic properties in central-analgesic model i.e. Hot-plate method. The test drug could be used for anti-migraine activity.
A Statistical Analysis of Alleged Sexual Assaults - Its Attributes and Aftermaths
Authors: Paul Dr. Biswadeep , Haflongbar Dr. S. , Patowary Dr. A. J.
Published: March 2019

Sex related offences against females are universal phenomena and constitute the most shocking reprehensible crime against conscience and morality and attack on human dignity and subjugation of the fairer sex. Psychiatric disturbances, venereal diseases, attempted suicides, unwanted pregnancies; lust murder and interpersonal violence constitute far flung consequences of sexual offences including sexual assault and violence.  Inspite of stringent laws including POCSO, Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act and Criminal Law Amendment Act, sex crimes, rape and child abuse are on the rise. To analyse the antecedents and aftermaths, a statistical study was carried out on 93 female victims of alleged sexual offences who had consented for medical examination and study, on being brought to the Department. of Forensic Medicine, GMCH. Our study revealed that most of the victims were between 15 to18 years of age group with 30.11% of cases, 58.06% cases were Hindus, from urban areas with 52.69% cases, 48.39% were students, from lower socio-economic background with 73.12% cases and 79.57% were unmarried. Most of the sexual assaults occurred in the Month of September and 36.56% of the offenders were neighbours. A total of 60.22% cases had hymenal tears and 5.38% cases showed presence of spermatozoa in microscopic examination of vaginal, oral and anal smears. Comprehensive analysis of precipitating factors and evaluation of social, economic and psychological factors along with suggestion and remedial measures is the need of the hour for the benefit of the society in general and individuals in particular.
Instrumentation in Potts Spine: A Two Year Retrospective Study in CCM Medical College and Hospital Durg
Authors: Trivedi Dr. Adarsh
Published: March 2019

Most of the patient suffering from tuberculosis can be managed on anti-tuberculous therapy. Spinal TB patients can present with various signs and symptoms which include leg or back pain, palpable mass in the paraspinal region, kyphotic deformity and neurological compromise, out of these most important sequelae of TB spine are kyphotic deformity and neurological compromise. The spinal cord undergoes intrinsic changes due to tuberculosis and late-onset paraplegia is produced, with consequent poor chances of neural recovery even after surgery. When treatment is started the diseased segment of the spine or vertebral body is the weakest portion and it must be protected by suitable external braces. Fracture and dislocation of a diseased vertebral body may occur secondary to mechanical trauma and surgical decompression adds further instability. So indications for instrumented stabilisation can be advised. Surgical management or instrumentation in Pott’s spine helps regain motor function and ameliorates disability. Material and Methods: 38 patients were included with Thoracic and Thoracolumbar Pott's disease.  Included patients were having severe kyphosis with an active disease. Clinical evaluation of the outcome measures were evaluated at baseline, postoperatively and at 3rd, 6th and 1 year. Preoperative and postoperative X-ray, loss of kyphotic correction. Average operation time, bony fusion and implant failure were observed. Results: During study period total 1456 patients were diagnosed as TB out of which 99 were extra pulmonary cases and 58 were diagnosed as pott’s spine with thoracic and  thoracolumbar TB and 38 patients were included in the study who meet the inclusion criteria for our study. In our study of the 38 patients 18 were male and 20 were female patients. Mean age was 43.82. In Dorsal group D1 to D4, D5 to D8 and D9 to D12 involvement was seen in 4(10.53%), 10 (26.32%) and 13 (34.21%) respectively. Multi-segment involvement was observed in 3 (7.89%) patients. Dorsolumbar and lumbar involvement was seen in 5 patients. In lumber, L1 to L2, L2 to L3, L3 to L4 and L4 to L5 involvement was 1(2.63%), 0, 1(2.63%) and 2 (5.26%) respectively. Mean operation time was 290±41minutes and mean hospital stay was 16 days ranging from 8 days to 72 days. 34 patients had a successful bony fusion within a mean of 7±1.2 months, whereas 4 patients had late fusion or nonfusion because of secondary infections. Mean preoperative kyphosis was 21 degrees which was corrected to 9 degrees in final follow up after instrumentation. Conclusion: Instrumented stabilisation is safe in spinal TB. Posterior transpedicular approach is a safe surgical procedure for thoracic and thoracolumbar Pott's spine. Also Posterior transpedicular approach shows improved functional status and significantly improves neurological pain and fusion rate. However clinical trials with a larger sample size and a longer follow-up period are required.
Patents and Competitive Awards of the Innovative Elderly Products Designed by Nursing Faculty and Students in Taiwan
Authors: Ku Ya-Lie , Pan Yi-Ting , Shia Jo-Yun , Li Yi-Lun , Hsu Shu-Ting
Published: March 2019

Because of the aged society in Taiwan, the principal investigator has conducted four innovative projects to develop the four elderly innovative products with four groups of leaders. This paper introduces four innovative elderly products designed by the nursing faculty and students in Taiwan, including modified enema device, combination of turning and positioning auxiliary devices, and urine catheter fixation device for the bedridden elders. Four innovative elderly products have obtained the patents as well as awarded in 2017 International Innovation and Invention Competition by the organizations of Chinese Innovation and Invention Society and Moscow International Invention Society. Following the four innovative elderly products, the investigator would plan to conduct the evidences-based testing of the effectiveness for these products to improve the quality of care for the bedridden elders in terms of preventing or solving their clinical problems such as bedsores, constipation, and comfort.
The Use of Stimulant Augmentation of Second Generation Antipsychotics in the Management of Negative Symptoms of Schizophrenia: A Case Report
Authors: Azizi Heela , Zeng Yu Hao , Kallikkadan Jisha , Kahn Alexa , Olayinka Olaniyi , Popoola Olusegun , Khan Tasmia , Rimawi Dina , Malik Ali , Williams Shantale , Langdon Sherina , Obegolu Chidubem Matthew , Nuthalapati Deepa , Alzear Rana , Kalbouneh Hashem , Mahbub Ayesha , Ojimba Chiedozie , Oyelakin Ayotomide , Kodjo Kodjovi , Ferdous Saad Ahmed , Jegede Oluwole , Jolayemi Ayodeji
Published: March 2019

Background: Negative symptoms of schizophrenia have been demonstrated to be due to decreased dopamine in the mesocortical pathways. Stimulant medications are a class of medications that can increase dopamine activity in the mesocortical pathway. Case Presentation: We present the case of a patient whose negative symptoms improved from a Positive and Negative Syndrome (PANSS) score of 39 to 11 on the negative symptoms subscale during a three-week trial of dopamine agonist augmentation of antipsychotic therapy. The score on the positive symptoms subscale on PANSS remained low with a two-point reduction at the end of the three-week period. Conclusion: The potential benefits of using stimulant medications in treating negative symptoms of schizophrenia are discussed.
Primary Perivascular Epithelioid Cell Tumor (Pecoma) of Bladder: Case Report and Review of Literature
Authors: MD Rigvardhan , Khanna, MD Shiv Pankaj , Deb, MD Prabal
Published: March 2019

Perivascular epithelioid cell neoplasms (PEComas) represent a rare family of neoplasms. Their dichotomous phenotypic features, including both myogenic and melanocytic features can make a definitive diagnosis difficult. So far 15 cases of PEComa urinary bladder have been reported. We describe a case of PEComa bladder for its rarity along with review of literature.
Pattern and Outcome Analysis of Orthopaedic Injuries and Fractures: A Tertiary Care Hospital-Based Study
Authors: Mukherjee Dr Subhankar , Pratim Pal Dr Partha , Bhattacharya Dr Gautam , Roy Dr Sandip Kr , Roy Dr Rajiv , Mukherjee Mrs Deboti
Published: March 2019

Background: Management of a patient who has sustained multiple injuries requires specific and reliable methods of evaluation and treatment. The aim of the present study was to assess the functional outcomes of all traumatic (closed)fractures and how all the variables in our study affect the ultimate functional outcome. Materials & Methods: One hundred and thirty five patients were followed up for duration of 24 weeks at 6 weekly intervals with a proper radiograph of the involved region, with requisite number of views for the assessment of fracture union during each visit. Results: The distribution of the age of the study population was, mean 32.06 (SE 1.442) years. Injury to admission interval mean is 9.56 days (SE 0.635), and injury to definitive management interval mean is 19.43days (SE0.999). Most of the fracture sustained was in the shaft of long bones of lower limbs (22.3%) and fractures around the elbow were second most common (21.5%). Most of the patients had no complications (51.9%) but amongst others, stiffness was the most common complication (21.5%). The distribution of fractures is shaft of femur, tibia and fibula is22.3% and hind foot and proximal humerus fractures accounted for 1.5% respectively. Conclusion: Comparing the Injury to definitive management interval, Analysis of Variance (ANOVA) study showed that lesser the interval, the better the outcome and is statistically significant (P < 0.05,F stat=20.273 ).Similar comparison and ANOVA study also revealed excellent outcome in mean of 6.66(95% CI) days of admission to injury interval and poor outcome in mean14.45(95% CI) of the same.
Prevalence of Inter Arm Blood Pressure Difference among Type 2 Diabetics in Primary Care
Authors: Balushi Dr. Amal Al , Jahan Dr Firdous , Jahdhami Dr. Maiya Al , Bhargava Dr. Kamlesh
Published: March 2019

Hypertension in patients with diabetes is a common problem; it increases the risk of cardiovascular, renal and ophthalmologic complications. Appropriate measurement of blood pressure is important, as the readings are the target of all pharmacological and non-pharmacological treatment. The aim of the present study was to observe the prev-alence of significant difference in blood pressure in the arms in type 2 Diabetics and to establish if there is association between inter-arm blood pressure difference (IAD) and cardiovascular risk. A cross sectional study conducted in 5 primary care health centers. BP measurements were done by automatic Omron 7 machine; the measure-ments were done two times with interchanging the instruments between two arms. Da-ta collection included demographic data (including, age, sex, body mass index (BMI), waist circumferences, duration of Diabetes, history of HTN, and smoking status).The data collection form also included entry of last biochemical investigations done in-cluding total cholesterol, LDL, HDL, triglyceride, glycosylated hemoglobin (HbA1c) and Cardiovascular risk (CV risk ) calculated by UKPDS engine version 2.0. Data was analyzed with SPSS (version 19). A total of 155 patients were studied. Mean age of patients was 55yrs. 22 participants (14.2, 95% CI=9.1-20.7) had systolic IAD >10 mmHg, 51 (33%, 95% CI=25.6-40.9) had a diastolic IAD >5 mmHg and 9 (5.8 %, 95% CI=2.7-10.7) had a diastolic difference >10 mmHg. In addition, the results showed statistically significant correlation between systolic interarm BP difference and duration of diabetes (P=0.025).There is significant diastolic interarm blood pres-sure difference in diabetic patients. Hence it is important to measure the blood pres-sure in both arms for patients with diabetes to treat hypertension in diabetics appropri-ately.
Psychiatric Comorbidity in Patients of OCD: How Severe is Anxiety and Depression?
Authors: Kaur Dr. Navdeep , Garg Dr. P. D , Arora Dr. Rajiv
Published: March 2019

Introduction - OCD is a debilitating illness characterized by obsessions and compulsions. It affects 1-3% of population. Many psychiatric illnesses are common with it. Anxiety and depression are commonest disorders. AIM - To study severity of OCD, to study severity of anxiety and depression and other psychiatric comorbidity. Method - A cross-sectional study of 45 patients conducted in department of Psychiatry, GMC, Amritsar. Diagnosis was confirmed using ICD-10criteria.M.I.N.I, HAM-A,HAM-D,Y-BOCS were used to assess comorbidity , severity of OCD, depression and anxiety. Results - Majority of patients suffering from OCD had a chronic course with adolescent onset with male predominance and most of them had comorbid psychiatric disorder, commonest being MDD, anxiety disorders, substance abuse, BPAD etc .Relationship of YBOCS with HAM-D came out to be highly significant p-value <0.001,relationship of YBOCS with HAM-A was not significant p-value=0.202.
Comparative Study of Ondansetron Verses Palonosetron in Cisplatin Induced Nausea Vomiting
Authors: Todi Dr. Sreya
Published: March 2019

Objective: Nausea and vomiting can adversely affect the life of a patient with cancer both during and after chemotherapy. A common side effect of Cisplatin regimens is severe nausea and vomiting. Cisplatin based regimens for cancer is categorized as highly emetogenic chemotherapy. There is considerable progress in the control of nausea and vomiting from those early days but there is still paucity of data on antiemetic regimens for patients undergoing multiday Cisplatin based regimens. Palonosetron differs from first-generation 5HT3 antagonists. It has a longer half-life and a 100-times greater binding affinity to the 5HT3 receptor. This prospective study was designed to compare the efficacy of antiemetics Ondansetron and Palonosetron to prevent Chemotherapy induced nausea vomiting (CINV) in cancer patients on Cisplatin regimens. Material and Methods: A prospective randomised study was conducted at the department of Oncology at a tertiary care centre. A total of 40 chemotherapy naïve patients were enrolled in the study; 20 each in the ondansetron and palonosetron groups. All patients received Cisplatin in a dose of at least 50 mg /sq meter of body-surface area. The severity of nausea was recorded and vomiting was recorded in terms of number, frequency and time to rescue medication. Results: Of 40 patients with cancer placed on chemotherapeutic regimens containing Cisplatin 20 were placed in the Ondansetron arm and 20 were placed in the Palonosetron arm. Mean age in Ondansetron group was 54±13.84 and in Palonosetron group was56±11.93. Out of 20 patients in ondansetron group mean vomiting was 6.4 times while in Palonosetron it was 4.2. In Ondansetron group 14 (70%) showed response to Ondansetron while in Palonosetron 16 (80%) showed response. There was no response to treatment in 6 (30%) in Ondansetron and 4 (20%) in Palonosetron. Palonosetron given daily from Day 1 up to Day 5 of chemotherapy significantly reduced the incidence of nausea on. Conclusion: The overall complete response (CR) rates of Palonosetron were slightly higher than the Ondansetron. Palonosetron can reduced the incidence and severity of nausea and vomiting who are on Cisplatin therapy as compared to Ondansetron
Increasing Trend of Clinical Laboratory Testing at Gelephu Central Regional Referral Hospital, Bhutan
Authors: Chhetri Vishal , Yangchen Karma , Dawa Chenga
Published: March 2019

Bhutanese population have access to both traditional and modern medicine. The record published in Annual Health Bulletin (AHB), Ministry of Health (MoH) recorded the number of people seeking modern medicine has drastically escalated over the past few years. Gelephu based Central Regional Referral Hospital (CRRH), established in 1960’s, sees the second highest number of outpatient department OPD cases in the country. As a result the number of clinical laboratory testing has also increased over the time. The ratio of annual OPD attendance and annual laboratory test recorded at the medical record and AHB depicted at the ratio of 1:1 until 2013 and the ratio increased to 1:1.9 in 2017, significant at p<0.05. The annual total laboratory test increased from n=118567 in 2013 to n=234869 in 2017, with almost an increase by average of 2% annually. The increasing number of test order, increases the probabilities for error. Hence, laboratory quality system is of paramount importance. The introduction of automation in Biochemistry (2014) and Hematology (2015), has significantly reduced analytical errors and has generated reliable, and quality assured reports. No reports have been published until now from CRRH to indicate the increasing clinical laboratory tests. Therefore, the data analysis from this study will present the ever increasing annual laboratory testing conducted at CRRH and would also provide the national medical procurement and supply division with information critical for annual supply forecasting.
A Study of Anxiety Disorders in Terms of Severity and Prevalence in Patients of Major Depressive Disorder in a Tertiary Care Centre
Authors: Rani Dr Richa , Bala Neeru , Garg Parshotam Dass , Bansal Aashish
Published: March 2019

Background: Depression is a disorder of major public health importance. Over the last 50 years, large number of studies have been published from India addressing various aspects of depression. The objective of the current study was to study the socio-demographic characteristics and anxiety as co-morbidity in patients with major depressive disorder. Method: This was a cross sectional study conducted in tertiary care hospital in which 100 patients diagnosed with major depressive disorder, according to ICD-10 were assessed for presence of anxiety disorder as psychiatric Comorbidity using MINI and severity of anxiety was assessed using HAM-A. Results: Current study showed major depressive disorder is more common among females 59%, married 79%, housewife 50%, 61% had first episode of depression and 27% had family history of major depressive disorder. There was 48% presence of any anxiety disorder among total major depressive disorder patients. Among which 25% had generalized anxiety disorder, 9% obsessive compulsive disorder, 5% panic disorder, 4% agoraphobia, 4% post traumatic stress disorder and 1% social anxiety disorder among total patients with major depressive disorder. The maximum number of patients 43% had mild to moderate level of anxiety, 32% had mild anxiety, 19% had moderate to severe anxiety and 6% had severe anxiety. Conclusion: There is a high prevalence of anxiety disorders in major depressive disorder which is oftenly ignored because of symptom overlap between anxiety and major depression. This study is important because of increasing prevalence of psychiatric comorbidity among the patients of major depressive disorders lead to impaired functioning in patients with MDD. Therefore, monitoring of symptoms as well as functioning during the long-term management MDD could be crucial to achieve the functioning remission.
Vascular Dysfunction in Aging and Related Disease
Authors: Deshpande Dr. Pranjali , Howale Dr. Deepak S.
Published: March 2019

The process that importantly impact on their health status of elder people represents vascular aging. Aging process is one of the factors for main risk for the development of cardiovascular disease (CVD). Many studies show that 50% clinical CVD present in the elderly. Many studies epidemiologically show that risk factor for CVD is age. Actually the prevalence and incidence of coronary heart disease, hypertension, congestive heart failure and stroke steeply increase with age. Individuals in 75-84 year old as compared to 35-44 year old people increase in death rates for heart disease and cerebrovascular disease there is a ~60 fold and~80 fold respectively. The endothelium plays an active role in process of platelet adhesion and inflammation. C-reactive protein (CRP) is one of the acute phase proteins. The aim of study was screening of population with asymptomatic individuals for risk markers of hypertension and atherosclerosis leading to vascular events and also investigation of recently detected hypertension and diabetes mellitus. Materials and methods: This study was carried out in Zydus Medical College and hospital, Dahod. In this study total 200 indivuals were included. 2 control groups were include as 38 Group I healthy controls (Age range: 18-24 years) and 65 Group II controls included apparently healthy, asymptomatic individuals whose blood pressure values did not exceed 139/89 and whose fasting blood sugar (FBS) values were B110 mg% (Age range: 25-60 years). It is also grouped as group III and Group IV where in group III include recent/ newly detected hypertension whose blood pressure value range _> 140/90 without medication (age range: 25-60 years) and group IV include individuals suffered from both hypertension and diabetes mellitus (FBS level of_>110mg% with age range 25-60 years. Fasting blood sugar was done by the glucose oxidaseperoxidase method (GOD-POD method). Results: hsCRP and plasma hemoglobin are associated with endothelial dysfunction and increases both with age as well as in disease condition. Endothelial dysfunction was demonstrated in asymptomatic young adults and children with risk factors for atherosclerosis as smoking cigarette and hypercholesterolemia. Conclusion: The presence of diseases such as hypertension or diabetes alone could affect increasing lipid profile value which may be strongly affected by increasing age. Therefore this study shows hsCRP and plasma hemoglobin associated with endothelial dysfunction and increase both with age as well as in disease condition with diabetes mellitus and hypertension together.
“Hiding In Plain Sight” Chronic Kidney Disease and Potential Consequences of the Proinflammatory State: Hemodialysis Catheter-Related Masses
Authors: Rozich, M.D., Ph.D. John D. , Rozich, M.S. Jacob J. , Rozich, M.D Noah S.
Published: March 2019

Multiple observational and experimental data support that chronic kidney disease (CKD) represents a “proinflammatory” state. These findings link this disordered inflammation and immunity to increased adverse cardiovascular (CV) events present in CKD through their role in atherosclerosis, but mechanisms of activation, recruitment and propagation remain unclear. Accordingly, the present effort reviewed the common use of indwelling hemodialysis catheters as a potential inflammatory trigger and immuno-amplifying variable. Hemodialysis intravenous catheters are routinely used to provide essential functional vascular access for patients requiring emergent or urgent hemodialysis. Numerous observations report that even within hours to days after insertion, a fibrin-thrombin-cellular matrix often forms around the catheter. This catheter associated “biomass” is so common it is usually thought to be clinically silent. But intravenous masses attached, or sheared off at catheter removal or remaining even after catheter explantation are recognized to provoke embolic and direct hemodynamic-related injury. Perhaps less recognized is that their formation, size and growth may be mechanistically linked to the heightened vascular immuno-reactivity found in CKD. Thus, vascular catheter placement or the associated reactive fibrin-thrombin-cellular matrix (or both) may directly contribute to pathologic CV immune-responsiveness in hemodialysis patients.