bluuebunny/crossref_metadata_2025 huggingface dataset:
A study on seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India with maternal and perinatal outcomes
Authors: M. N. Shruthi , Jois Srinivas K.
Published: May 2018

Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced.
A study to evaluate a correlation between various Gray Scale parameters and period of gestation
Authors: Chakarvarty Nancy , Srivastav Kumkum , Khanduri Sachin
Published: May 2018

Background: Accurate prediction of the gestational age (GA) is very important in the management of obstetric patients for planning a timely and uneventful outcome. Fetuses with intrauterine growth restriction (IUGR) are at high risk for poor short- and long-term outcome. The present study was conducted with the aim to evaluate a correlation between various Gray Scale parameters and period of gestation.Methods: A total of 100 clinically suspected FGR subjects were enrolled for the present study. Women with singleton pregnancies with fundal height being less than the period of gestation by 4 weeks or more and certainty of last menstrual period with previous 3 menstrual cycles were included in the present study. Ultrasound examination both by Gray Scale USG carried out serially every three weeks starting from 30 weeks till delivery. Chi-square test was used to compare the proportions while Independent Samples "t"-test was used to compare the parametric variables in two groups. Receiver-Operator curve analysis was performed to find out appropriate cut-off points for prediction of FGR.Results: Diagnostic accuracy of TCD/AC ratio as a marker of FGR was found to be 77%, of HC/AC ratio was found to be 93% and FL/AC ratio was 59%.Conclusions: Among three gray scale parameters being assessed, HC/AC ratio at 36 weeks was observed to be having 98.5% sensitivity and 82.9% specificity, thus showing the highest diagnostic accuracy (93%). However, from the point of view of early detection, TCD/AC ratio was found to be most efficient with 81.5% sensitivity and 68.6% specificity and overall diagnostic accuracy of 77%. Precision of Grayscale findings at later stage (36 weeks) are higher.
A study of maternal mortality in a tertiary care hospital
Authors: Doddamani Usha , Rampure Nirmala , . Kaveri , . Pooja
Published: May 2018

Background: Maternal mortality is a strong indicator for measuring the health care provided to the women by any society. Motherhood is an event of joy and celebrations for every family. It is tragic that deaths occur during pregnancy and childbirth and most are preventable. The aim is to study the incidence of maternal mortality, assess the epidemiological aspects, causes of maternal mortality and avoidable factors that can prevent maternal deaths.Methods: A retrospective hospital based study was conducted in the Department of OBG, Gulbarga Institute of Medical Sciences, a tertiary level health care referral centre in Kalaburgi, Karnataka, India over a period of 2 years from January, 2016 to December, 2017.Results: A total of 65 deaths were analysed. The mortality rate in study period was 364 per 1,00,000 live births. Maximum maternal deaths were reported in the age group 20-24 years. More deaths were reported in multiparous women (55.8%) as compared to primiparous women (44.2%). Most of them were unbooked cases (60%). The classic triad of haemorrhage (38.4%), hypertensive disorders (29.2%) and sepsis (12%) were the major direct causes of maternal death. Anemia was the major indirect cause of death. Other indirect causes of maternal death were jaundice, heart disease, respiratory disease and epilepsy.Conclusions: Majority of maternal deaths were preventable by proper antenatal care, early detection of high risk pregnancies and their timely referral to tertiary care centre.
Study of awareness of contraception in postnatal women
Authors: Rokade Jyoti Vikas , Hanji Vinutha R.
Published: May 2018

Background: This study was undertaken to know the awareness of contraception in postnatal women in a Government Hospital in Maharashtra.Methods: Authors conducted a prospective study in Department of Obstetrics and Gynecology at Government hospital, Miraj between January 2015 to September 2016. All postnatal patients in this hospital, willing to participate in the study were included in the study after a thorough written informed consent. Patients were given pre decided questions for answering. Answers were noted, counselling was done.Results: Out of 4860 women, 97% of the women were aware of at least 1 contraceptive method, the highest being of female sterilization (91%) 20.8% of women had ever used the contraception before and most of them used it in between pregnancies (64.4%). 79.2% had not used any contraception before and main reason for not using was found to be, they wanted to conceive (46%) followed by fear of side effects (24.7%) Regarding willingness to use the contraception after counselling, 48.5% of women said they were not sure. Among rest 51.4% women, female sterilization (32.4%) was preferred method followed by copper-T (22.8%) The most common source of information was by media and books which was 39.3%.Conclusions: There is a large lacuna between the awareness and practice of contraception. Proper education of both partners, increasing female literacy, socio economic upliftment, effective health care system is needed.
Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours
Authors: Singhal Sunita , Rajoria Lata , Mital Premlata , Batar Alka , Ainani Richa , Agarwal Monika , . Urmila , Chaudhary Kavita
Published: May 2018

Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.
Study of BMI in pregnancy and its correlation with maternal and perinatal outcome
Authors: Choudhary Jaya , Singh Swati , Tiwari Kalpana
Published: May 2018

Background: Maternal nutrition plays an important role in maternal and fetal outcome. The low maternal BMI or Obesity is associated with adverse outcome.Methods: A total 148 primigravida included. BMI was calculated on first visit and in each trimester, all booked patient was followed throughout pregnancy and delivery for any maternal and fetal complications.Results: (66.2%) of patients were with normal BMI, (17.56%) were underweight, (10.13%) were overweight and (6.08%) patients were obese. APH was seen in (11.1%) and (6.7%) cases in BMI grades ‘IV and III’ respectively. PIH was present in total 10 cases, (33.3%) cases belonged to BMI grades IV. Anemia was present in total 51 cases (53.8%) belonged to BMI grade I. Preterm delivery was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. GDM was present in 11 cases and out of them (26.7%) and (44.4%) cases belonged to BMI grade III and IV respectively. PPH was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. In BMI grade I group, (96.2%) babies had birth weight <2.5, while in BMI grade IV, (88.9%) babies had birth weight >2.5 (22.2%) cases of fetal macrosomia belonged to BMI grade IV.Conclusions: There is importance of pr-pregnancy counseling in maintaining weight of women during pregnancy to avoid pregnancy maternal and fetal outcomes.
Fetomaternal outcome in breech delivery
Authors: Airao Bhavesh B. , Sharma Vishal M. , Zala Ravi A. , Vasava Vimal
Published: May 2018

Background: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation.  Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section.Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014.Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%.Conclusions: The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.
A hydatidiform mole in a postmenopausal woman
Authors: Dhanapal Mohana , Padmapriya . , Pandian Anbarasi
Published: May 2018

Gestational trophoblastic disease occurs in less than 1 per 1200 pregnancies. The spectrum of this disease ranges from benign hydatidiform mole to trophoblastic malignancy (placental-site trophoblastic tumor and choriocarcinoma). Benign gestational trophoblastic disease generally occurs in women of reproductive age and is extremely rare in postmenopausal women. We report a case of a 54-year-old postmenopausal woman who underwent an emergency total abdominal hysterectomy due to uncontrollable vaginal bleeding associated with an increased serum β-human chorionic gonadotropin level. The resected uterus contained an endometrial, cystic, grapelike tumor. Microscopic examination demonstrated hydropic degenerated villi with a circumferential trophoblastic cell proliferation and moderate atypia, consistent with a complete hydatidiform mole. Only isolated cases of hydatiform mole in elderly women have been reported in literature. But there still remains a risk of developing gestational trophoblastic disease in the elderly and it should always be included in the differential diagnosis of postmenopausal bleed.
Rare presentation of a case of primary parasitic leiomyoma with concurrent uterine leiomyomas
Authors: B. Kalpana , Panda Soumya R.
Published: May 2018

Uterine leiomyomas are the most common pelvic benign tumours affecting women of reproductive age group. Parasitic leiomyoma is a type of leiomyoma which has been completely detached from uterus and is having independent blood supply from nearby structures, it’s attached with. Parasitic leiomyoma is regarded as a sub-type of subserosal fibroid by some authors. While others consider it as a complication of uterine procedures being performed for some type of uterine pathology. Here we are reporting a rare case of primary parasitic leiomyoma with concurrent multiple uterine leiomyomas that were managed by laparoscopic myomectomy. They create clinical dilemma due to their tendency to mimic as other pelvic tumours. So parasitic fibroids must be kept in the differential diagnosis of every case of abdominopelvic mass. Finally, it can be a rare complication of morcellation procedure performed for myoma retrieval and hence caution should exercise during such procedures.
Cervical ectopic pregnancy: a rare case report
Authors: Verma Indu , Chugh Charvi , Santpur Unmesh , Pundhir Pratibha
Published: May 2018

Cervical ectopic pregnancy is rare condition which occurs in less than 1% of all ectopic pregnancies. Early diagnosis is a key to successful management; delayed diagnosis can lead to significant morbidity and fertility loss of the mother. We present a case of woman who presented with vaginal bleeding and lower abdominal pain for 3 days following amenorrhea of 3 ½ months. Ultrasound examination done outside was suggestive of left tubal ectopic pregnancy whereas scan done at our hospital indicated either uterine rupture within intraperitoneal sac or a cervical ectopic pregnancy. She was taken up for laparotomy and hysterectomy since she was bleeding profusely, and it was lifesaving.
Primary tubal choriocarcinoma
Authors: Nandan Neetha , Prasad Kishan , Begum Mubeena , Rai Supriya
Published: May 2018

Choriocarcinoma is extremely aggressive form of gestational trophoblastic disease. It occurs due to neoplastic changes in the chorionic villi. The most common site of origin is uterus but rarely can occur in tube, cervix or ovary. Tubal choriocarcinoma may develop either by malignant transformation of a tubal pregnancy or can arise denovo without an ectopic pregnancy. The reported incidence of tubal choriocarcinoma is approximately 1.5/1,000,000 births. Here, we report a case in which salphingectomy was done thinking it was an acute ectopic pregnancy, but histopathological examination showed tubal choriocarcinoma. This tubal choriocarcinoma occurred denovo and was not secondary to an ectopic pregnancy. Patient did not need adjuvant chemotherapy as it was detected early and is being followed up by β-hcg monitoring.
Septate uterus: incidental finding in multiparous woman with breech with bad obstetric history who had an emergency caesarean
Authors: Singh Shilpi , S. R. Sheela , P. N. Sreeramulu
Published: May 2018

The most common anomalies of reproductive tract are Mullerian duct anomalies, among which septate uterus is the commonest with highest reproductive failure rate. As there are some pitfalls in diagnosis therefore the incidence is difficult to be mentioned as many remain asymptomatic. A 20 year old G5P1L0A3 with 36+4 weeks of gestation with breech presentation in active labour came to our hospital. Patient had previous history of intrauterine death at 8 months of amenorrhea and previous abortions at 5, 5 and 4 months of amenorrhoea in the year 2011, 2013, and 2014 respectively. She underwent emergency caesarean section due to breech at 36+4 weeks in active labour with the delivery of a live late preterm female baby extracted by complete breech of weight 2.28kgs with bilateral CTEV of the baby. Intraoperative findings- of septate uterus–septum extending from fundus to external os, fundal dimpling present. Though rare but uterine anomalies should be suspected in patients with recurrent pregnancy loss, preterm birth and malpresentation.
A rare case of spontaneous heterotopic pregnancy with successful pregnancy outcome following laparoscopic management of coexisting ruptured tubal pregnancy in Non-ART set up
Authors: Maiti G. D. , Jose Tony , Gupta Shilpa , Chatterjee Vibhu
Published: May 2018

Heterotopic pregnancy is a rare clinical condition where both intrauterine (IU) and extra uterine pregnancy coexists. In a non-ART set up diagnosis of tubal ectopic pregnancy becomes challenging and difficult with coexisting intrauterine viable pregnancy, even when presents with ruptured form. Author is presenting one of his challenging experience in managing successfully such type of heterotopic ruptured tubal pregnancy in first trimester where extra uterine ruptured tubal pregnancy was addressed by laparoscopic salpingectomy under spinal anaesthesia with minimal uterine manipulation to continue intrauterine pregnancy till term and thus had a successful pregnancy outcome.
Delay of early detection on cervical cancer patients advance stadium in Sanglah central hospital Denpasar
Authors: Widiastuti Ni Made Rai , Sri Witati Joce Desak Made
Published: May 2018

Background: Patients with cervical cancer late to realize that they have been infected with the disease and come treated in an advanced stage, this will increase the number of morbidity and mortality in women. The purpose of this study is to determine the factors associated with delay in cervical cancer patients do early detection.Methods: Cross-sectional analytic research design with 90 samples of cervical cancer patients who came to visit Poly Clinic of Obstetrics and Gynecology Sanglah Central Hospital Denpasar using consecutive sampling technique. Data were analyzed gradually including univariate, bivariate (chi square) and multivariate (poisson regression).Results: This study showed 61 respondents (67.8%) came to the service already in the state of advanced stage (>IIB). The variables that are significantly related to the time of self examination are education, occupation, family income, knowledge, attitude, information presentation, availability of service place, and family support. Education, knowledge, and attitude are the dominant variables.Conclusions: Efforts to increase early detection by improving the quality and quantity of education by health personnel and all supporting components.
Youth preference in generation plan (GenRe) program viewed from characteristics and access to information in Padang City
Authors: Fajria Lili , Yeni Fitra , Herman Hermalinda
Published: May 2018

Background: Future planning for teenagers is an important thing that needs to be prepared to the fullest extend. Generally, teenagers have not considered that it is not a necessary to think about that when they are still in education. Although everyone has different talents and interests, still, there are many teenagers who recklessly follow their peers and make a wrong decision in taking their field of study. The Government of Indonesia through the generation plan (GenRe) program attempts to direct teenagers regarding their future. The purpose of this study is to describe the preference of teenagers in generation plan (GenRe) program in terms of characteristics of teenagers and their access to information in Padang city. The results of this study can become an input in the implementation of the programs for teenagers.Methods: Analytical with cross-sectional approach was used as the research design. 249 respondents were 13-24 year-old teenagers who were taken with accidental sampling. Data were collected with questionnaires which contained demographic data questions (age, gender, education) and access to information about Generation Plan (GenRe) program. And the data analysis used Chi-Squre statistic.Results: There was a significant correlation between the characteristics of teenagers: age (p = 0.018) gender (p = 0.037) and education (p = 0,020) on youth preference in choosing generation plan (GenRe) program, while there was no connection to information access to the program, there were: the existing source of information (p = 0.077), the desire to find information with p value = 0.097 and information obtained with the value p = 0.075).Conclusions: Therefore, we expect that the socialization of generation plan (GenRe) program needs to be improved and socialized more through social media for further development.
Comparison of glasgow coma scale with full outline of unresponsiveness score in measuring consciousness level of endotracheal tube intubated patient in the intensive care unit
Authors: Oktarina Yosi , Simajuntak Charles A.
Published: May 2018

Background: Assessment of consciousness level is a basic ability that medical personnel, especially doctors and nurses shall master. It is due to assessment of consciousness as a basis of clinical decision making and determining the patient's prognosis. There are various types of scales to measure consciousness level of patient. One of the most famous and most widely applied is Glasgow Coma Scale (GCS). However, the use of GCS is less precise in measuring consciousness level of patients, especially in Endotracheal Tube Intubated patients (ETT). Another measure of consciousness assessment is FOUR Score. In contrast to GCS, the use of four score as a measurement tool for consciousness assessment is still not yet familiar especially in Indonesia. Four score has different component with GCS where the four score component has no assessment of verbal response but it has brainstem and respiratory pattern assessment components.Methods: This research was an observational research using prospective non-experimental approach. The sampling technique used was consecutive sampling with a sample size of 33 people. Observation of the sample was undertaken at the same time. The instruments used in this research were GCS and FOUR Score observation sheet. Data analysis was performed by measuring the sensitivity, specificity, positive predictive value, negative predictive value and ROC.Results: Four Score has sensitivity of 86.7 specificity of 83.3 predictive positive value of 81.3 and negative predictive value 88.2 and under curve area of 0.848. Meanwhile, GCS has sensitivity of 80.0, specificity of 77.8, predictive positive value of 75, and negative predictive value of 82.4 and under curve area of 0.819.Conclusions: Four scores have a better assessment in measuring the consciousness level of ETT intubated patients.
The effectiveness of lavender oil treatment using effleurage massage technique towards dysmenorrhea intensity of female students at Midwifery academy of Kartini Bali
Authors: N. W. Ari Adiputri , N. M. Darmiyanti , I. W. Candra
Published: May 2018

Background: Dysmenorrhea is a menstruation-related issue which refers to the short pain prior to or during menstruation that led to walking difficulty, low appetite, nausea, vomit and, in some cases, unconsciousness. Lavender is also used as sedative, or as medicine to ease pain and change the perception of pain.Methods: The method used in this research was pre-experimental design with time series design on the 17-25 years old-female students who experience dysmenorrhea and had never given birth prior to the research. Visual Analog Scale (VAS) was utilized to assess the scale of pain using observation method for 4 times namely, 1st observation which was conducted before the therapy, 2nd observation which is 10 minutes after the 1st observation, 3rd observation which was performed after effleurage massage therapy and goes on for 6 hours, and 4th observation which was 10 minutes after the 3rd observation.Results: From the research on 42 female students, it was found that prior to the effleurage massage therapy almost all of the samples (83.3%) had intermediate pain intensity, meanwhile after the treatment the majority (95.2%) experience low dysmenorrhea. There was an impact of effleurage massage toward the dysmenorrhea intensity with the value of P=0.00.Conclusions: The lavender oil therapy using effleurage massage technique effectively cause significant drop of dysmenorrhea intensity from 4.7 into 2.6 in the scale of pain.
Treatment compliance and retention in care among out-patient clients in a tertiary health institution in plateau state North Central Nigeria
Authors: Afolaranmi Tolulope O. , Hassan Zuwaira I. , Mbak Joy L. , Luka Davou W. , Audu Takzhir N. , Chirdan Oluwabunmi O. , Zoakah Ayuba I.
Published: May 2018

Background: Compliance with prescribed treatment and retention in care are key components in the management of chronic diseases which is vital in averting the long term complications that could arise from such conditions. Failure to comply with treatment recommendations is often associated with poor retention in care. In view of this, this study was conducted to determine the level of treatment compliance and retention in care among patients with hypertension and diabetes in Jos University Teaching Hospital.Methods: This was a cross sectional study conducted among 290 eligible respondents between September and November 2017 using quantitative method of data collection. SPSS version 20 was used for data analysis with adjusted odds ratio and 95% confidence interval used as point and interval estimates while p-value of ≤0.05 was considered statistically significant.Results: The mean age of the respondents was 54.5±13.1 years with 43.8% of the respondents found to have satisfactorily complied with prescribed treatment while 117 (40.3%) were uninterruptedly retained in care within the last 6 months' clinic appointments  prior to the study.Conclusions: This study has demonstrated the levels of compliance with treatment and retention in care bringing to bear the need to provide structured interventions targeted at attaining improvement in compliance with treatment and retention in care among individuals on long term care.
Role of pretreatment neutophil to lymphocyte ratio as an independent prognostic factor in oral squamous cell carcinoma patients: a prospective study in a tertiary care centre
Authors: Tiwari Shashwat , Nautiyal Shivani
Published: May 2018

Background: More recently, established systemic inflammation-based prognostic scores have been explored extensively, such as NLR and serum C-reactive protein (CRP). We postulated that NLR might be a readily available and inexpensive objective prognostic index that could be used in daily oncologic clinical practice and could help to stratify patients in clinical trials.Methods: In total, there were 150 patients with OSCC treated at GSVM medical college, Kanpur between October 2012 and January 2015 whose clinical information and laboratory parameters were obtained. The NLR was determined by dividing the absolute neutrophil count by the absolute lymphocyte count, and the NLR data were then dichotomized and divided into two groups as NLR-low and -high.Results: The 3-year OS rate of the NLR-high group tended to be significantly lower than that of the NLR-low group, this relationship was found to be statistically significant (p value <0.05). The 3-year DFS rate in the NLR-high group was lower than that in the NLR-low group; however, there were no significant difference between the two groups.Conclusions: Our findings reported herein demonstrated that pre-treatment NLR is a potential biomarker for predicting the overall survival in oral SCC patients. Combined with other markers, NLR may be used in decision-making and the selection of treatment modality in patients with oral SCC.
Effectiveness of a microteaching workshop designed to improve the teaching performance of post graduate medical students
Authors: Dhananjaya Shilpashree Yeliyur , Nusrath Aliya
Published: May 2018

Background: Microteaching helps in professional development in prospective professional teachers. The objectives of the present study were to know whether such a microteaching training / workshop programme conducted at our setting helped the participants to improve their teaching skills and to know what are changes that can be implemented to make such workshop more effective and useful.Methods: 54 postgraduate students participated in the workshop. It was a three-day workshop programme conducted by medical education unit. At the end of the 3rd day, feedback form was given to participants to know their perception on the effectiveness of the workshop.Results: Hundred percent of the participants felt the workshop was useful. They also felt that feedback given during the session was most useful to improve their teaching skills.Conclusions:Present study shows that postgraduates perceived the workshop to be beneficial to improve their teaching skills and to build their self-confidence. Conducting such workshops at regular interval will definitely benefit them to improve their teaching process.
Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice
Authors: Goyal Sumit , Srivastava Anshuman , Bhattacharjee Prasun , Goyal Isha , Malhotra Khushbu
Published: May 2018

Background: To study the occurrence of hypocalcaemia in neonates with physiological unconjugated hyperbilirubinemia after 48 hours of phototherapy or at the end of phototherapy, in case duration of phototherapy was less than 48 hours.Methods: This prospective study was conducted on 100 term neonates (61 males and 39 females) admitted to Neonatal intensive care unit of Teerthankar Mahaveer Medical College, Moradabad with unconjugated hyperbilirubinemia and requiring phototherapy. Total Serum bilirubin levels and serum calcium levels were checked before and after phototherapy. Neonates were assessed for clinical features of hypocalcemia i.e. jitteriness, irritability/excitability, lethargy and convulsions.Results: After phototherapy, there was hypocalcemia in 35.0% neonates. The difference between pre and post phototherapy serum calcium levels were found to be statistically significant (p <0.001). 2.86% of neonates developed jitteriness among those who had hypocalcemia. Hypocalcemia was more in subjects who received phototherapy for longer duration.Conclusions: Hypocalcaemia is a common complication of phototherapy. Therefore, calcium supplementation should be done in all neonates undergoing phototherapy.
Study of role of prognostic markers in the management of organophosphorus poisoning patients
Authors: Chaudhary Sameer , Kalmegh Rohan
Published: May 2018

Background: POP scale and serum cholinesterase levels may be effective indicators for mortality in organophosphorus poisoning. The objective of this study was to assess the POP scale score and serum cholinesterase levels at initial presentation in OP poisoning and its correlation with need for ventilator support and mortality.Methods: One hundred and fifty eligible participants were recruited, and POP scale and serum cholinesterase levels were assessed.Results: Total 32.7% patients died; of which 30 out of 75 belonged to moderate and 19 out of 22 patients belonged to severe group; as per POP scale score. 49 out of 75 in moderate poisoning and all patients in severe poisoning required ventilator support. With respect to serum cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe and moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning and all patients in severe poisoning required ventilator support.Conclusions: Assessment by POP scale and serum cholinesterase levels is useful in assessing the need for ventilator support and are indicators of mortality in OP poisoning cases.
Anxiety and health related quality of life among obese women with type 2 diabetes mellitus
Authors: Thirumalai Ranganathan , Shenoy Vaisnaavi Venkat
Published: May 2018

Background: T2DM is often accompanied by a marked reduction in QOL. Psychiatric comorbidity further worsens the QOL and is associated with poor glycaemic control and long term treatment outcomes in T2DM. Obesity may lead to anxiety disorders and is often associated with T2DM. Women in the general population are known to suffer from psychiatric problems more often than men. The health related QOL in a woman having T2DM and comorbid anxiety disorders is likely to be worse. We therefore analysed the QOL and anxiety symptomatology among obese women with T2DM.Methods: We conducted a cross-sectional study at the Government General Hospital, Chennai. We recruited 50 age and BMI matched obese women with and without T2DM. We also recruited 50 each of diabetic and non-diabetic non-obese women. We used the WHO QOL BREF to assess the QOL, HAM A to quantify anxiety and HAM D to assess depression.Results: A 71.5% of our patients experienced anxiety symptoms with scores on HAM A indicating mild to moderate levels of anxiety disorder. Obese patients irrespective of their glycaemic status had significantly higher levels of anxiety compared to our non-obese subjects. All our obese patients with T2DM scored statistically significant lowest means across all subdomains on the WHO QOL BREF scale. Obese subjects who had diabetes for >10 years were found to have severe anxiety disorder. The odds ratio that an obese woman would suffer from psychiatric comorbidity was found to be 10.211 (odds ratio = 10.211; 95% C.I. 2.963-35.185).Conclusions: Anxiety disorders are common in obese women having T2DM. They also had decreased physical health, social relation and psychological domain scores. Having diabetes mellitus for >10 years predicted anxiety symptoms among obese subjects. We suggest early diagnosis and prompt treatment of anxiety disorders in obese women with T2DM as part of their routine primary health care.
Role of yoga and meditation on serum DHEAS level in first year medical students
Authors: Kumar Kislay , Kumar Devesh , Singh Vinay , Pandey Pooja T. , . Divya
Published: May 2018

Background: Dehydroepiandrosterone sulfate (DHEAS), secreted by adrenal cortex, acts in the human body as a neurosteroid, cardio-protective, anti-diabetic, anti-obesity and immune-enhancing agent. It is also reported as a youth hormone. But due to various stimulators of stress, and also as an antagonist of cortisol, DHEAS level decreases. Yoga and meditation regulates the level of hormones and neurotransmitters that affect physiological function.Methods: This study was performed on 1st yr. medical students whose DHEAS level was low due to acute stress. 55 medical students were selected as participants through counseling and were divided into Yoga group (n= 27) and control group (n=28). Their morning serum DHEAS level was assessed and yoga group were instructed to practice Yoga (1hr/day for 12 weeks) under supervision of Yoga instructor. No such instruction was given to control group.Results: As a marker of youth and immunity, increase in DHEAS level decreases susceptibility to infections, reduces aging process as well as improves other functions. Yoga and meditation is documented to increase DHEAS level in regular practitioners. Statistical analysis has shown an increase in morning S. DHEAS level in yoga practitioners. Pre-study and post study values were 3.5±2.48 and 3.61±1.73 respectively in yoga group (overall 3.1% increase, P Value = 0.025, significant at 0.05) whereas 3.36±1.98 and 2.58±1.49 respectively in control group (23.2% decrease, P Value =0.84, not significant).Conclusions: This study concludes that practicing Yoga has significantly raised S. DHEAS level in medical students and improved their immunological status as well as enhances mood and behavior.
Knowledge and attitude of pre-conception and pre-natal diagnostic technique act (PCPNDT) in pregnant women of Indore at tertiary referral center
Authors: Gaur Naman Kumnar , Gupta Aman , Husssain Shoaib
Published: May 2018

Background: This study was conducted to know the knowledge and attitude pregnant females have about pre-conception and pre-natal diagnostic technique act.Methods: Study was conducted in Sri Aurobindo Institute of Medical Sciences, Indore, a tertiary referral centre, with a pre-structured questionnaire, consisted of 130 patients. Data collected was reviewed and statistically analysed.Results: Mean age was 27-28 years, with large number 70(53.8%) of females weren’t aware about the act but were willing to impose a strict law 124(95.4%), want to motivate others 112 (86.2%) and didn’t want sex determination 114 (87.7%).Conclusions: However, majority of females weren’t aware of the act but did show positive attitude towards the law. Further a comprehensive publicised campaign is warranted to spread the awareness.
Practices towards prevention of food borne diseases among females in rural area of Trichy, India
Authors: Hemalatha Kumarasamy , Parthiban Elavarasan , Parthipan Kathirvel , Parkavi S. , Elango S.
Published: May 2018

Background: Food borne diseases are of great importance since it leads to multiple health problems resulting in illness, malnutrition, mortality and economic loss. These diseases share a significant proportion in the occurrence of communicable diseases. Objectives was to study the knowledge about food borne diseases and food safety among women residing in rural area.Methods: This was a cross sectional study involving 150 adult females who were residing in rural field practice areas of a tertiary care teaching hospital. Practices of safe food handling were assessed using an interviewer administered questionnaire. Informed consent was obtained, and confidentiality was maintained. Appropriate descriptive statistical analysis was done.Results: Out of 150 females, 147 (98%) were aware of the importance of washing hands before cooking. Sixty four (42.7%) females had a habit of washing the vegetables with water twice before cooking. 102(68%) females consumed stored food after reheating, 48(32%)females consumed without heating. Though 70% were aware of food adulteration, none of the participants have lodged compliant against adulteration.Conclusions: Through our study we found that most of the females practiced proper hand washing before cooking and proper storage of the leftover food. The proportion of females who followed adequate cleaning of non-vegetarian food items and vegetables were found to be inadequate.
Mental health, sleep and quality of life in patients with chronic obstructive pulmonary disease: a correlational study
Authors: Akhtar Pooja M. , Yardi Sujata , Tayade B. O. , Pathak Mayuri , Saraf Bhargavi
Published: May 2018

Background: Co-morbid psychological impairments (depression and anxiety) are common in COPD and are often associated with increased disability, health care usage and morbidity. They also impair quality of life in COPD and are often not fully explored in the clinical management of COPD patients. Psychological distress may, however, contribute to sleep difficulties in all stages of disease severity. Both anxiety and depression have been shown to have a negative effect on the sleep and quality of life (QoL).Objectives: To study the correlation between depression, anxiety and sleep with quality of life in patients with COPD.Methodology: In a tertiary care hospital, this Observational study was conducted on 39 patients of age group 40-70 years, with spirometry confirmed COPD GOLD category I-IV and smokers with more than 5 years of disease who fulfilled were included  in the study. Quality of life was assessed using SGRQ-C, SF-12 and CAT. Depression, Anxiety and Sleep were assessed using PHQ-9, GAD-7 and PSQI questionnaires respectively. The correlation between quality of life scores and mental health scores were analysed using Pearson’s correlation coefficient.Results: Anxiety was significantly correlated with all the sub domains of SGRQ-C, PCS, MCS of SF-12 and the CAT score. (p value<0.001) Similarly, sleep was significantly correlated with all the three QoL Scales. (p value< 0.001) However, depression significantly correlated with all the subdomains of SGRQ-C and CAT except activity sub-domain of SGRQ-C and MCS of SF-12. (p value<0.001)Conclusion: Anxiety, Depression and Sleep moderately correlated with QoL scores in patients with COPD.
Comparative study of effectiveness of pap smear versus visual inspection with acetic acid for mass screening of lesions of cervix
Authors: Dasari Mercy Mrudula , Anem Venkatalakshmi , Gunta Sirisha , Seeram Satish Kumar , Atla Bhagyalakshmi
Published: May 2018

Background: Cervical cancer is a leading cause of morbidity and mortality among women worldwide and more over in the developing countries, so there is a need to develop screening test with high specificity and sensitivity. Aim of the study was to evaluate the effectiveness of Papanicolaou (PAP) smear versus visual inspection acetic acid (VIA) for screening cervical lesions in patients and to determine and compare their sensitivity and specificity.Methods: The present study is a hospital based prospective study for a period of two years at the department of pathology from August 2014 to July 2016 consisting of 500 patients attending gynaecology outpatient clinic. Papanicolaou (Pap) smear tests and visual inspection acetic acid were employed along with complete clinical history record. The results of VIA were correlated with that of pap smear on the basis of sensitivity, specificity and positive and negative predictive value.Results: Out of 500 cases, most common age group was 21 to 40 years of age consisting of 305 cases - 61%. VIA was positive in 156 cases-31.2%, PAP smear positive for epithelial cell abnormalities were 60 cases-12%. VIA showed higher sensitivity (52.38%) compared to Pap smear (40%) whereas Pap smear showed higher specificity (93.2%) compared to VIA (92.4%).Conclusions: Papanicolaou test is a better screening test for epithelial cell abnormality than VIA. However, in countries with low resource settings where cytology-based screening programs are not available, VIA is a promising alternative.
Lipid profile analysis of type 2 diabetic patients in Bengaluru population, India
Authors: Venkatesh Shyamala K. , M. V. Sudheer K. , T. Mohana Krishna
Published: May 2018

Background: Prevalence of Diabetes in India is 69.2 million, among which type 2 diabetes mellitus (T2DM), constitutes for 90% of all the diabetic populations. Previous studies have proved the association of T2DM, with increasing risk of cardiovascular diseases (CVDs) and the level of risk varies among males and females. The present study aims to analyze the lipid profile of T2DM patients and compare the lipid profile of T2DM males and females in Karnataka, Bengaluru population.Methods: The study included 171 T2DM patients, 59 females and 112 males aged 21 years and above. Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C) and triglycerides (TG) concentrations values were analyzed for each group. Paired students t test was applied to identify the differences in lipid profile values of males and females with T2D.Results: The mean value of TC, VLDL-C and LDL-C were higher in overall T2DM patients than the normal range and HDL-C was lower in T2DM patients. Comparison between males and females showed significantly higher LDL-C in females with T2DM than males. Other lipid parameters TC, TG and HDL-C did not show any significant differences between females and males with T2DM.Conclusions: This study demonstrated the existence of dyslipidemia in T2DM population which is major risk factor for CVD. Greater LDL-C was observed in T2DM females compared to T2DM males suggests higher risk for CVD in females compared to males.
Platelet indices evaluation in patients with dengue fever
Authors: Mukker Payal , Kiran Smitha
Published: May 2018

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.
Study of body mass index (BMI) and serum lipid profile of patients at a tertiary hospital: a cross sectional study
Authors: . Archana , Agarwal Vibhuti , Ahmad Naved , Gupta Akash
Published: May 2018

Background: Sedentary lifestyle have an impact on the prevalence and incidence of obesity related disorders and leads to the development of type 2 diabetes mellitus, dyslipidemias and metabolic disorders that aggravate the risk in the development of cardiovascular diseases (CVD).Methods: In our study, data of 220 subjects belonging to age group of 25 to 55 years were collected. Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters. Subjects were categorized into two groups (BMI <25 and BMI ≥25). Serum was separated by centrifuging blood at 3000 rpm for 10 min and analyzed for lipid profile on Erba Chem 7 semi-auto analyzer.Results: In our present hospital based study we estimated the Lipid Profile in individuals categorized into two groups. (Group 1 BMI <25) and (Group 2 BMI ≥25), We found the values of Triglycerides, LDL and VLDL in Group 1 are lower as compared to Group 2.Conclusions: Our study showed positive correlation between lipid profile and obesity. Obesity is said to predispose individuals to metabolic syndrome associated diseases.